H+W, Dec. 2011

HW +

BE STRONGER. LIVE LONGER.

GAM BIT’S HEALTH & WELLNESS > DECEM BER 2011 > VOLUME 2 > NUM BER 12

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

HEALTHY TEETH =

HEALTHY HEART?

7

A FESTIVE SEAFOODSTUFFED ORANGE RECIPE

9

A YOUNG ENTREPRENEUR

SHAPES UP

10

Dr. Tod Engelhardt

HealtH & Wellness > bestofneworleans.com > december 06 > 2011

Cardiovascular Thoracic Surgeon

02

When faced with a patient suffering from what had been diagnosed as a fatal pulmonary embolism, Dr. Tod Engelhardt responded by pioneering a new procedure that today is becoming the standard of care for those with pulmonary embolism.

Dr. Engelhardt is a cardiovascular thoracic surgeon at East Jefferson General Hospital. His EKOS procedure allows him to treat PE’s directly and effectively.

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C

ntEnts D ECE M B E R 2011

go thE DistanCE Marathon training tips

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HealtH & Wellness > bestofneworleans.com > december 06 > 2011

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HealtH & Wellness > bestofneworleans.com > december 06 > 2011

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BasicTraining

By Russ L ane

Want to complete a marathon by next spring? Here’s how.

P

eople looking for a challenge or who want to take their workouts to the next level might consider running a marathon. If runners start training now, even novices have a shot at completing a marathon next spring, like the Rock ’n’ Roll Marathon on March 4.

“I recommend starting training now (for the Rock ’n’ Roll Marathon),” says Rebecca King, a health fitness instructor at East Jefferson General Hospital who has completed more than 15 marathons, two Ironman races and four ultra-marathons ranging in length from 32 to 52 miles. “If you’re a newbie, I’d consider the half-marathon, because marathon training is pretty challenging. But there’s still time for the full marathon — it’s just a matter of how much time you put into training. If anybody comes up to me and asks, ‘Do you think I could do a marathon?’ I say, ‘Yes. Are you ready to train for one?’”

King follows online running programs designed to help people prepare for marathons. She says the program is simple — “There’s nothing rocket science about it” — but sticking with it takes time and discipline. “Training for a marathon is like a second job,” she says. Here are a few guidelines.

>

JOIN A RUNNING GROUP

>

GET THE RIGHT GEAR

After runners have a solid support system and training schedule in place, it’s time to think about gear. Proper shoes are the most important equipment, but a quick jaunt through a running store reveals products ranging from anti-chafing products to superhero-esque hydration belts. The array can prove overwhelming. However, Patrick Gavin, who co-owns Louisiana Running Company, says these items are not essential for beginners. Until runners regularly log eight miles, they can hold off on loading up on gear.

“The bare essentials are the right shoes,” Gavin says. “If you’re just starting with running, I think that’s the most important thing.”

King echoes these sentiments and recommends anyone embarking on marathon training visit a running store to get specially fitted for shoes. Running style, arch height and the way a runner’s feet flare out or point inward all must be considered when buying shoes. “Shoes can make you or break you,” King says. “I was running with the wrong shoes, and I got shin

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splints. I pound a lot of weight on my feet, so I need a thicker cushion. I would go someplace that has devices that can measure your running. There are places that study your feet and your mechanics — they’ll do a little run test with you and fit you for a shoe. There’s a shoe for everybody.”

LEARN PROPER FORM AND INJURY PREVENTION TACTICS >

Even a motion as natural as running has a form and structure that best prevents injury.

Most professionals discuss running in terms of striking, or where the foot lands on the ground: toe striking, mid-foot striking or heel striking. “Some people are more pronators or supinators; some hit the heels, some hit the toes,” King says. Radecker recommends striking from the middle of the feet to best

page 6

HealtH & Wellness > bestofneworleans.com > december 06 > 2011

There are benefits to making the commitment to run a marathon. Elena Perez finds training for races provides structure, a goal and a way to turn exercise into an experience.

“I started (with) a running group so I had goals,” says Perez, who ran competitively in high school. “I enjoyed (running) when I was younger, and I kind of let it go by the wayside.”

Perez joined a running group that meets Monday and Wednesday evenings at Louisiana Running Company, and there are other groups that meet at Southern Runner and Phidippedes.

Louisiana Running Company co-owner, personal trainer and experienced marathoner Jennifer Radecker helps Perez train, and Perez also benefits from the support and expertise of a diverse group of runners. King recommends running groups for everybody from beginners to experienced athletes.

“I used to train on my own, and now I run with groups, and my running has gone to a different level,” says King, who points out that running groups can offer advice on training programs, nutrition, hydration and avoiding injuries. “Just hearing the trials and errors of other people really helps. They offer motivation to keep going,

and it’s social. Those long runs get boring. Sometimes being with other runners helps out.”

05

page 5

distribute weight and keep injuries to a minimum.

Other tips include keeping the upper body loose and ensuring you have a strong core. “You’re always going to run better just from that,” Radecker says.

King stresses the importance of proper warm-ups and cooldowns to prevent injuries like pulled muscles.

“Use the start of your run as a warm-up, and at the end, make sure you cool down with five minutes of slower running.” She also recommends cross-training with low-impact exercises like biking, swimming or exercising on an elliptical machine. Radecker leads runners in a series of warm-up exercises: running in place while keeping knees high and abdominal muscles tight, running backward and stepping side to side.

Chad Rice, a veteran of six marathons and numerous half-marathons, advises new runners to choose varied running paths. “Too much road running, people pounding the pavement, just causes a lot of repetitive motion injuries,” Rice says. Avoid running exclusively on the road, and get out in uneven ground that isn’t covered in asphalt. More experienced running group members often impart advice on running paths, and websites like USA Track and Fields Route Database (www.usatf.org/routes) help determine mileage.

Many area parks offer pathways for running and biking. >

STICK TO THE SCHEDULE

HealtH & Wellness > bestofneworleans.com > december 06 > 2011

A running schedule provides structure and support. Radecker says the time necessary to train for a marathon can vary based on a runner’s experience.

Generally, marathon training consists of alternating between shorter and longer distances and gradually

building up to 26-mile treks.

“I recommend four to five days of running a week, with at least one day set aside for long-distance running, and a day of rest after that,” King says. “You’ll probably work up to 12 to 15 hours a week of training.

It’s pretty challenging, but it’s doable.”

During the time leading up to a marathon, shorter races are a way for runners to get experience and enjoy the energy boost of running with a group and seeing a cheering crowd. Perez plans to tackle a 3K and 5K prior to a marathon. “I’m doing baby steps,” she says. >

BE MENTALLY TOUGH

King currently is training for an ultra-marathon with her brother: Over the course of three days, they’ll log 126.2 miles, running day and night and stopping only for 15-minute naps. “You get a little delusional from all the impact and lack of sleep, but I’ve heard good things about it, as long as you’re training properly,” King says.

King stresses that mental toughness is essential to long-distance running, whether you’re completing an ultra event or your first half-marathon. “The body goes out first, and the mind tells the body, ‘You can’t quit,’” she says. “The mind and the heart keep the muscle part of the body going.” >

ENJOY THE PROCESS

Somewhere along the journey to complete a marathon, training becomes about more than a race; it’s about belonging to a community of positive thinkers who love running and don’t think a large goal is impossible.

How do we measure 35 years of success?

In pounds and inches.

Rebecca King and heR bRotheR gabRiel King have Run moRe than 15 maRathons and aRe tRaining foR a 126.2mile ultRa-maRathon.

“I’ve heard, ‘You’re crazy, you’re insane,’ but (my brother and I) purely love ultra sports. For us, it’s just about the satisfaction of what we love to do,” King says. “You can train the human body to do whatever you want it to do, to an extent, and I feel like I’m made to do these events and show it can be done with motivation, perseverance and support.”

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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

D

r. Pooja Maney, diplomate of the American Board of Periodontology and assistant professor of periodontics at the LSU Health Sciences Center, estimates periodontitis (gum disease) affects 15 to 20 percent of the population. It also is linked to cardiovascular disease, stroke, diabetes and low birth weight in babies whose mothers have periodontitis. Dr. Maney explains the role of dental health in total wellness and how to maintain healthy teeth and gums.

Can you explain the connection between periodontitis and cardiovascular disease?

One is bacteria gets directly into the bloodstream and starts colonizing along the blood vessels.

They contribute to forming plaques that produce atherosclerosis of the blood vessels. The other way is all these inflammatory mediators like the c-reactive proteins actually go through the blood vessels and increase inflammation along the blood vessels, which makes them more prone to forming the plaques.

What is the link between periodontitis and other diseases?

How often should you see a dentist to maintain healthy teeth and gums?

Visit the dentist for a cleaning every six months and brush teeth for at least two minutes twice daily. Flossing every day is very important. Gum disease starts between the teeth. Periodontitis doesn’t hurt, so people neglect it until it is too late. We see patients come in with a lot of bone loss and gum inflammation and bleeding gums. The process happens over a lot of

years, so they can save money if they come in for checkups every six months.

Is there any advantage to using an ultrasonic toothbrush instead of a manual toothbrush?

There is no difference overall. A few studies indicate ultrasonic toothbrushes can be better for people who aren’t doing a good job with a manual toothbrush. With a manuel toothbrush, the technique matters, so the advantage (of an ultrasonic toothbrush) is you don’t have to use a technique — you just hold the brush where your tooth and gum meet.

Is there anything else you want people to be aware of regarding oral health?

People need to look at oral hygiene as part of their overall health and not just dental health. And of course, dental health is really important, because if you don’t have your teeth, you won’t be able to chew, which leads to problems like malnutrition, not to mention low confidence. There is definitely a connection to oral and systemic health.

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HealtH & Wellness > bestofneworleans.com > december 06 > 2011

Periodontitis is an inflammatory condition, so when oral hygiene is poor, the plaque buildup in the gums and teeth leads to inflammation of the gums, and that produces a lot of proinflammatory factors known as cytokines. They are released into the bloodstream and actually trigger the liver to release c-reactive proteins, which are inflammatory proteins. So it predisposes the body to different systemic conditions, and there are direct and indirect mechanisms as to how periodontitis can affect the cardiovascular system.

What are these mechanisms?

Periodontitis, cardiovascular disease and stroke go hand in hand.

For diabetes, most of the evidence points toward the fact that people with uncontrolled diabetes develop a severe type of periodontitis, because diabetes affects the immune system. So the relationship is more toward diabetes producing periodontitis, and it is a significant risk factor for periodontitis. The other thing is low-birth weight babies being born to women who have periodontitis.

Inflammatory mediators enter the fetal placenta and the maternal blood stream, and they can induce labor early, so there are pre-term babies as well as low birth weight babies being born.

07

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HealtH & Wellness > bestofneworleans.com > december 06 > 2011

Amerigroup is a culturally diverse company. We welcome all eligible individuals into our health care programs, regardless of health status. If you have questions or concerns, please call 1-800-600-4441 (TTY 1-800-855-2880) and ask for extension 34925. Or visit www.myamerigroup.com.

08

by ruSS lane

e at to li ve

what

SeaFooD-StUFFeD oRaNGeS with MiSo

&

how

Inspired by a dish served at Cafe Minh.

Recipe by Russ Lane.

12 laRGe oRaNGeS 2 1/2 poUNDS SeaFooD (aNy coMbiNatioN oF ShRiMp, ScUNGilli, ScallopS, lobSteR, whiteFiSh choppeD to ShRiMp Size) 1/4 cUp ShiRo (white) MiSo 3 cUpS DaShi (JapaNeSe SoUp Stock) oR 1 cUp chickeN bRoth aND 1 cUp wateR 1/4 cUp MiRiN (cookiNG Rice wiNe) 1 tableSpooN Rice wiNe viNeGaR 2 cloveS RoaSteD GaRlic 1 teaSpooN GRateD FReSh GiNGeR (aboUt 1/2 iNch Stalk) 2 eGG yolkS

garnished with lobster tail and drizzled with miso sauce, this cafe minh appetizer inspired a similar recipe that is healthful yet festive.

Once the water boils, add seafood and cook for one minute. Immediately spoon seafood out of the boiling water and into cold water.

Once the seafood is completely cooled, remove it from the water and drain on paper towels.

PHOTO BY MISSY WILKINSON

Stuffed to the Gills Seafood-Stuffed orangeS blend delicate flavorS of citruS, white miSo and ShellfiSh.

i

f you’re celebrating the Feast of Seven Fishes or simply want to add flair to your holiday spread, take inspiration from dishes at Vietnamese, French or Creole restaurants. Though much of the fare can be starchy and heavy on sodium and fat, there are often creative twists on mainstays like salads or appetizers. So don’t just eat at restaurants; mine them for ideas — especially the restaurants you assume are off-limits for healthconscious diners.

Seafood-stuffed oranges are inspired by an appetizer that makes the occasional appearance on Cafe Minh’s (4139 Canal St., 482-6266) menu for

special events like New Year’s Eve dinners. Dramatic and elegant, the shellfish is combined with a delicate miso sauce and baked in an orange.

“Seafood is so delicate, you don’t want to kill it,” says Cafe Minh chef Cynthia Tran. “Then you bake it and it’s magical.”

Seafood-stuffed oranges serve as an excellent addition to a holiday spread. The seafood and sauce can be prepared and chilled in advance, and the recipe provides enough oranges for ambrosia. Also, any leftover seafood and sauce creates ample leftover fodder — mix with whole wheat udon noodles or drain the liquid and add

Add dashi, miso, mirin, vinegar, garlic and ginger to a pot and warm over medium heat, stirring to combine. Adjust the flavor, consistency or intensity by adding miso, stock or vinegar. Do not let the mixture boil. In a small bowl, mix egg yolks and 1 tablespoon of the liquid.

Once combined, add yolk mixture to the pot and stir to combine and thicken. Remove from heat. Combine seafood and sauce and ladle into oranges. Bake for 15 minutes, until tops appear golden.

low-fat mayonnaise to create an Asian seafood salad. The remaining liquid can be used for a marinade or salad dressing. Because orange sizes vary widely, this dish requires some experimentation.

For cooks devoted to interesting health food, the recipe bestows several year-round lessons: • Many international dishes with sweet traditions can be given a savory twist. For example, oranges provide housing for a classic Sicilian dessert with almonds, Grand Marnier and whipped cream. This seafoodstuffed orange recipe uses notes

of orange and delicate white miso to lend sweetness without resorting to sugar.

• Miso is a wonder food. Consisting of fermented soybeans combined with barley or rice, miso paste stays good for years when refrigerated and can stand in for salty bouillon cubes. People monitoring their sodium intakes should be wary, but miso offers substantial flavor and nutrition that table salt does not: protein, fiber and vitamins B-12 and zinc, all with minimal calories.

HealtH & Wellness > bestofneworleans.com > december 06 > 2011

Preheat oven to 350 F. Bring a pot of hot water to a boil, and prepare a bowl of ice water. While waiting for the water to boil, remove the tops of each orange and scoop out flesh with a spoon. Reserve 1-2 tablespoons of juice and save the fruit for another use, such as ambrosia.

Place oranges in a pan or baking sheet.

09

C

S ALE DOWN

F R O M W W L -T V ’S W E I G HT LO S S W E D N E S DAYS

BY MEG FARRIS

WITH MEG FARRIS

The Business of Health A YOUNG ENTREPRENEUR DEVOTES HIMSELF TO A NEW VENTURE: PERSONAL FITNESS

HealtH & Wellness > bestofneworleans.com > december 06 > 2011

DARRIN COOK LOST 175 POUNDS BY STICKING TO A HEALTHY DIET AND EXERCISE PROGRAM.

10

W

hen entrepreneur Darrin Cook decided he was tired of being obese, he used the same skills and determination to lose weight as he did to build a successful business. Today, at 225 pounds, Cook is 175 pounds lighter and well on his way to his target weight of 185 pounds.

“It felt like I was carrying another person,” says Cook, whose weight climbed to nearly 400 pounds when he was a teenager. “I’d see my friends who were much smaller than me and … here I was with all this weight. It really killed my self-esteem.”

Now 21 years old, Cook had what he calls a “life-changing moment” during a family vacation five years ago.

“We went to swim with the dolphins, and I had this life vest that was about ... (size) 5X. Even though it was this large, it was still skintight. I was like, ‘Darrin, this is enough. You know, no more lying to yourself,’” Cook says.

He was tired of being “just friends” with girls and feared for his future health.

“When I was that size, I was on the verge of having diabetes,” Cook says. “I didn’t want to have to deal with having diabetes, hypertension, dialysis and getting limbs amputated. You know, that was a nightmare for me and what encouraged me to keep going on.”

A graduate of NOCCA and St. Augustine High School, Cook started his first Internet company at age 14 and owns a growing business, My Mogul Media (www.mymogulmedia.com), which offers consultations on logos, branding, websites, graphics and marketing to 65 clients nationwide. Cook channeled that same drive for success when he began searching the Web for nutritional help.

“I … cut out the fast food, the fried foods, the soft drinks, the sweets, the cookies, the snowballs, everything,” he says. “I was determined — no more wearing size 56-waist pants.”

Cook says he had an addiction to food, which East Jefferson General Hospital fitness expert Mackie Shilstone believes is even harder to overcome than addiction to drugs and alcohol, because no one can live without food.

“Would you run your health the same way you run your business?” Shilstone asks. “Could you afford to run your business like you are managing your health?

If most people who own a business ran their business like they take care of their health, they’d be bankrupt.”

“I did have the cravings and still do to this day,” Cook says. “I basically had an addiction to food, and a food addiction is no different than someone who’s addicted to alcohol or drugs. It’s a constant, day-to-day battle.”

Cook found support in his trainer, Joshua Casimier, who has become a friend and reminds Cook of his goal when he wants to skip a session. According to a 2005 study published in the Journal of American Academy of Physician Assistants, if you have an encouraging person around, you are more likely to value the workout and stick to the behavior change.

“A lot of people need motivation from an outside source, and there’s nothing wrong with that,” says Dr. Kim Edward LeBlanc, head of the Family Medicine Department at LSU Health Sciences Center. “It’s just getting a consultation for something else you need.”

When Cook started working with his trainer, he was determined to walk once around the block. Now he is able to run

three miles, and he regularly lifts weights, boxes, runs, bicycles and does floor exercises.

Last spring, Cook received a degree in finance from Xavier University. He divides his time between Atlanta and New Orleans, where he recently bought his first rental property. He plans ahead to schedule exercise time during frequent business trips to New York and Los Angeles.

“I come up with small things to be creative and still get my workout in,” says Cook, who will be featured on CNN.com’s health section later this month. “I try to fit my running shoes in a suitcase and find a hotel with a gym.

In the airports, I’ll walk the terminal instead of riding a train.”

Even with all his accomplishments, Cook says weight loss is the achievement people notice most. He has yet to drink a soft drink, and he now wears size 34 pants.

“I feel like I’m alive now,” Cook says.

“I really enjoy spreading the message to young people and letting them know they can do anything if they put their mind to it: You can lose 100, 200 pounds, start your own business. ... Go out there, take risks and don’t be afraid to fail.”

Look for Meg Farris’ Medical Watch reports weeknights on WWL-TV Channel 4 and anytime on wwltv.com.

DARRIN COOK WEIGHED 400 POUNDS AT AGE 16 (LEFT). HE NOW WEIGHS 225 POUNDS AND RUNS A SUCCESSFUL MARKETING BUSINESS.

E

W LL spring top Docs

Vitals.com, a website that provides information about more than 720,000 physicians nationwide and allows patients to submit reviews of doctors, recently released a list of the top 10 patient-rated diabetes specialists in Louisiana. They are Drs. Rajat Bhushan, Alan Bowers, Karen Dantin, Justin Fontenot, Jolene Johnson, Laura Kimball-Ravari, Hanna Lubbos, Victor Pouw, Ghyass Rizk and Alan Yager.

According to the Centers for Disease Control and Prevention, Louisiana has one of the nation’s highest diabetes rates, with 9 percent of adults diagnosed with the disease.

grants for thE Louisiana tumor rEgistry

By Missy Wilkinson kids deal with stress by teaching them coping strategies. The book is available at www.amazon.com and www.friesenpress.com.

suiciDE intErvEntion

Suicide and attempted suicide calls in St. Tammany Parish are on the rise: As of Oct. 31, 2011, the fire department had responded to 65 calls, compared to 68 calls in all of 2010. St. Tammany Parish has the highest suicide rate in Louisiana, according to St. Tammany Fire District deputy chief Stephen Krentel. The fire department urges people considering suicide to dial 211, a free, 24-hour hotline offering crisis intervention and counseling.

accoLaDEs for ochsnEr’s LivEr transpLants

Ochsner Clinic Foundation’s liver transplant program was ranked among the top in the nation by HealthGrades, an independent ratings organization.

Ochsner is one of seven hospitals to receive the HealthGrades Liver Transplant Excellence Award. Since performing Louisiana’s first liver transplant in 1974, The Ochsner Multi-Organ Transplant Institute has performed more than 3,500 liver, kidney, heart, lung and pancreas transplants.

hELp for vEtErans

A recent study by LSU Health Sciences Center shows hyperbaric oxygen treatments improved symptoms of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) in US veterans injured in Iraq. After 30 days of low-dose hyperbaric oxygen therapy, the veterans demonstrated improvements in shortterm memory problems, headaches, sleep disruption, cognitive deficits and depression. According to a 2008 RAND study, 546,000 military service members deployed to Iraq and Afghanistan have PTSD, TBI or post-concussion syndrome (PCS).

Mandeville psychologist dr. shari taylor recently published a children’s book, Outsmart YOur WOrries (Friesenpress), that helps kids cope with stress.

thE KiDs arE strEssED out

According to the Anxiety Disorders Association of America, one in eight children has an anxiety disorder. Dr. Shari Taylor, a board-certified nurse practitioner and a faculty member at Southeastern Louisiana University, recently published a children’s book, Outsmart Your Worries (FriesenPress), that helps

Drug stuDy rEcruiting participants

Pennington Biomedical Research Center is recruiting men and women over age 50 with existing cardiovascular disease to participate in a clinical trial.

The study will determine whether an investigational medicine can increase “good” cholesterol and decrease “bad” cholesterol. Participants receive free cholesterol medication and a stipend of up to $390. Call (225)763-3000, visit wwwpbrc.edu/clinical-trials or email clinicaltrials@pbrc.edu for eligibility information.

2520 Harvard Ave. Suite 2B Metairie, LA 70001 • 504-454-3004

HealtH & Wellness > bestofneworleans.com > december 06 > 2011

The Centers for Disease Control and Prevention recently gave the Louisiana Tumor Registry a three-year, $794,000 grant. It will allow the registry at LSU Health Sciences Center to develop a system that efficiently reports children’s cancers by linking pathology laboratories, state pediatric organizations, doctors, hospitals and birth records. According to LSU, this brings total federal grant money awarded to the tumor registry to $3.5 million a year.

h E a Lt h n E Ws b r i E f s

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2700 Napoleon Avenue ochsner.org/baptist

*There can be critical situations that occur which may delay wait times beyond our guarantee.

If this happens, patients will receive two complimentary passes to the Entergy IMAX® Theatre. ©2011 Ochsner Health System (ochsner.org) is a non-profit, academic, multi-specialty, healthcare delivery system dedicated to patient care, research and education.

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10/26/11 10:42 AM