2010 v1 Take Care

Wellness news for Better Living from Terrebonne General Medical Center Spring 2010

Cancer Care Gets Personalmeet the doctors at mary bird perkins at tGmc

TGMC Links EKG With Acadian Ambulance

the latest on mammoGraphyfrom dr. raul doria

Diagnosis and Treatment of IBSs i l e n t c a u s e s o fk i d n e y d i s e a s e

Healthy EatingFor Diabetics

TGMCone of four hospitals in state to receive carf accreditation for stroke proGram

TERR_9466_TakeCare_13_V5.indd 2 5/20/10 4:52:59 PM

Dear Friends,At Terrebonne General Medical

Center (TGMC), your health and satisfaction are on the top of our list as we work together to provide a health care experience that is truly beyond compare.

In this issue of Take Care, we provide you with the information you need to live a healthier life, including ways to decrease your chances of developing kidney disease and hypertension. Because hypertension and diabetes are a leading cause of kidney disease, our leading nephrologists will give you insight into lowering your chances of developing these problems. We also bring awareness about irritable bowel syndrome and how to prevent its associated problems.

I’m proud to announce that TGMC recently became the only hospital in the Tri-Parish area to receive accreditation for its stroke specialty program by the Commission for Accreditation of rehabilitation Facilities (CArF). Another exciting development is that our hospital is now linked with Acadian Ambulance, which feeds EKG results to our doctors and the Cath Lab before you arrive. This lowers your wait time and expedites treatment.

We’d also like you to meet our cancer center doctors on a personal level. Dr. Doria, Dr. McGaw, Dr. Gamble and Dr. Long will discuss why they are passionate about their profession, what motivates them and their interests outside of work.

TGMC is proud to announce its presence in social media. Follow us on Twitter (@tgmcforlife) and become our fan on Facebook. We’d love to hearfrom you.

Finally, as we sort through health care reform, TGMC will continue to provide the highest level of care possible to our community. As always, thank you for your support.

Sincerely, Phyllis PeoplesPresident and Chief Executive Officer

2 Spring 2010

WWhen Shedrick Williams suffered a stroke last year, he had some paraly-sis and weakness from his stroke. “I couldn’t even go to the bathroom by myself,” he said. Williams said the doctors and the staff at Terrebonne General Medical Center’s Rehabilita-tion Center were an integral part of his recovery process.

“When I gave up, they said ‘nope, we’re not a giving-up center,’” Wil-liams explained. “When I said ‘not today,’ they said ‘we’ll come back.’ Ev-ery morning at 7 a.m., they were ready, even if I wasn’t. They are determined to make you better. Everyone around me reached out a hand and picked me up. ‘We’re not going anywhere; we’re going to see you through’ and they really did. They touched my heart. Without them I’d be confined to a wheelchair or bed.” TGMC’s rehabilitation department recently received an accreditation for its stroke specialty program by the Commission for Accreditation of Rehabilitation Facilities (CARF), making it the only hospital in the

Tri-Parish area with this designation and only one of four such facilities in the entire state. Medical

Director Dr. Hector Linares explained that

the certification tells the public, patients, other doctors and insurance companies that TGMC offers the same level of stroke rehabilitation care as state-of-the-art medical facilities, only closer to home. “We have all the ele-ments that larger facilities can offer,” he said. “The Mayo Clinic, whatever you compare it to, we have it.” The rehab facility has received CARF’s general accreditation since 1997. The stroke specialty accreditation signifies the hospital’s compliance in areas including leadership, risk management, health, safety and performance. It also focuses on interventions such as preventing, recognizing, assessing and treating a stroke, as well as identifying and reducing risk factors for recurrent stroke. The program includes func-tional independence, social skills, quality of life, and support services for the patient and family. The patient and family additionally receive educa-tion regarding home modifications, safety and health risks. The accreditation addresses the prevention of cardiovascular complica-tions, deficiencies, infections, mood swings and pain. It requires that the rehab program include health assess-ments such as communication disor-ders, cognitive functions, motor skills, visual problems, activities of daily living (dressing, grooming, toileting,

cooking), functional mobil-ity and depression. Health promotion and screenings, as well as preventative care and health care delivery, are also integral elements of the rehabilitation department.

TGMC BECOMES OnLy HOSPITAL In THE

TrI-PArISH ArEA TO SPECIALIzE In

Stroke Care


dear tGmc: i am writing this letter with sincere gratitude and appreciation and to inform the people of our community about the wonderful, competent and caring health care providers working at our community hospital, terrebonne General medical center (tGmc). one year ago, at the age of 46, i was stricken by a stroke that left me paralyzed from the neck down. the prognosis was grim and i was sad-dened to think of my future. however, after a lot of tender, loving care and the expertise of the doctors, nurses and the staff at tGmc, i have hope because i have regained movement and am able to be more independent. i can’t help but want everyone in our community to know how much i appreciate tGmc for being in our com-munity and for everything they have done for me and my family. i would like to extend my appreciation to the emergency department physicians and staff. also, i would like to acknowl-edge the rehabilitation department staff for the time and patience that they had with me. i had to re-learn how to care for myself which included basics such as learning how to walk, talk, eat and write. starting from scratch, they worked with me day in and day out until i was strong enough to do things by myself. i would also like to thank my cardiology doctors, dr. richard abben and dr. eric engeron, for saving my life. prior to the stroke, i had several operations and now live with a pace-maker and defibrillator. in addition, i would like to thank my neurologist, dr. christopher Wright, for working with me to identify the neurological condition that i have as a result of my stroke. i would also like to thank my family doctor, dr. patrick Walker, and his staff for maintaining my care currently. most of all i have to thank God. Without him there are no health care providers to take care of patients like myself. for his hands are on their hands as they care for the sick so that they can provide hope to so many people. last but not least, i would like to thank my wife, sheryl Williams, and family for standing by me.

sincerely,shedrick Williams, patienttGmc stroke specialty program

3Terrebonne General Medical Center

Stroke Care

“Many of our rehab patients are stroke patients, and at our facility we have the experience and knowledge to work with all levels of stroke patients from prevention to recovery,” said Nancy Dupre, director of rehabilita-tion. “This accreditation focused not only on our basic knowledge of stroke, but further education. Many of our staff members are certified in neuro-development techniques and VitalStim treatment, therefore their treatment techniques are designed to improve deficits associated with stroke.” The new stroke specialty ac-

creditation validates the overall high level of rehabilitation care that TGMC provides. “Our standards are high,” said Dupre. “Patients can ex-pect quality care if they come to our rehab facility. We have the additional knowledge and the expertise to treat all stroke patients.” Dr. Linares, a CARF surveyor himself, is constantly aware of new standards. He knows firsthand the dedication and commitment it takes for a program to become CARF accred-ited. In visiting hospitals across the country and around the world, he can

TGMC’s rehabilitation department recently received an accreditation for its stroke specialty program by the Commission for Accreditation of Rehabilitation Facilities (CARF), making it the only hospital in the Tri-Parish area with this designation and one of only four such facilities in the entire state.


4

see other programs in action, observe what works best and bring new ideas back to TGMC.

TGMC’s rehab staff consists of nurses, social workers, speech thera-pists, occupational therapists, physical therapists, recreational therapists, a full-time medical director, certified nursing assistants and rehab techni-cians. Together the staff provides a multi-disciplinary approach for each patient’s individualized care. On aver-age, there are nine patients requiring varying levels of care in inpatient rehab at any given time.

“We work as a team because our patients’ deficits are quite complex,” explained Dr. Linares. “The treatment that is provided is a result of a combi-nation of efforts. A stroke happens in seconds. Recovery, however, may take a year to reach maximum potential, depending upon the severity of the patient’s stroke.”

THE TGMCrEHABILITATIOn TEAMIndividualized treatment begins with therapists assessing each patient and determining strengths and deficits, said Dupre. The rehab team then meets and decides what goals and challenges are specific to the patient, including input from the patient and the patient’s family. “They work as a team to make sure that all goals and needs are met for each patient,” explained Dr. Linares. “No one person is the same as another, even though there are some commonali-ties. The overall goal is to get the pa-

tient as independent as possible within his or her deficits.” Dupre said the rehabilitation program tries to emulate a ‘typical’ day. This includes getting dressed in the morning, attending breakfast, lunch and dinner in the dining room, and attending therapy throughout the day to address activities of daily living such as walking, transferring to the commode and tub, walking up and down stairs, toileting, and cooking. Recreational and leisure activities, as well as com-municating with others and solving routine problems, round out an average day in rehab. “The rehabilitation process can be rewarding for many patients as they chart their progress,” said Dr. Linares. “The majority of patients that come to our unit receive great benefits.” The av-erage rehab stay is 14 days, after which the patient receives outpatient therapy or home health services. As part of the stroke specialty ac-creditation process, CARF assessed the department’s performance. According to 2009 Functional Independent Measure (FIM) data, TGMC exceeded regional and national averages for improving patient functional gains. “Exceeding gains in FIM means our center was able to improve our stroke patients’ ability to perform daily activities and return to community tasks at a higher level than that of the national and regional average,” said Dupre. “We are very proud of our ac-creditation, but our reward is always our patient’s healing and recovery.”

For Williams, part of his rehabilita-tion consisted of speech therapy for his limited, slurred speech. “I can stand in front of anybody and speak now,” he said. “It’s a blessing.” He places his current overall stroke recovery at the halfway mark. “I still have a long way to go. It’s slow healing, but I’m closer to 100 percent than I once was.” Before Williams started rehab he could walk 15 feet, but when he left, he was able to walk 150 feet. And for that, he thanks the staff at TGMC’s rehabilitation department. “If it wouldn’t have been for them, God and my wife, I wouldn’t be able to talk, walk, eat and write,” he said. “It was a miracle that I’m still here and able to do everything I once did. They never gave up on me. I thank God for them being there. Terrebonne General is one of my blessings.”

Spring 2010

Dr. Hector Linares, Medical Director of

TGMC’s Rehabilitation Center, knows firsthand

the dedication and commitment it takes

for a program to become CARF

accredited.


TTT


LIFENET System IMPrOvES HEArT PAT IEnT CArE AT TGMC

The AHA and the ACOC both recommend that a patient get from the door of the hospital to the cath lab within 90 minutes. Since adding this technology, TGMC has exceeded this recommendation every time.

Time is critical when health matters of the heart are involved. The American Heart Association and the American College of Cardiology both recom-mend that a patient get from the door of the hospital to the cath lab within 90 minutes. The cath lab is where interventional cardiologists evaluate the coronary arteries and can open a blocked or clogged area with a balloon. This procedure is called a balloon angioplasty.

Terrebonne General Medical Center (TGMC) and Acadian Ambu-lance are shaving critical minutes off the diagnostic process with the help of LIFENET STEMI Management Solutions. The system uses portable electrocardiogram (EkG) machines with satellite technology. EMS person-nel can hook up a patient to the EkG machine in an ambulance and transmit the results to TGMC automatically. The cath lab team can be preparing the lab before a patient even arrives. In fact, TGMC has beaten the 90-minute recommendation in every case since adding this technology.

“When a coronary artery is oc-cluded, blood is not getting to the heart,” explained Nancy Yzaguirre, the emergency department nurse director for TGMC, “so the heart is basically dying.” Doctors call this a myocardial infarction, or MI. Most people know it as a heart attack.

If a patient is having chest pains in the middle of the night or a weekend, the early warning can make a big dif-ference. “If the staff is on call, but not on-site, it can take up to 20 minutes to get the cath lab set up and get staff in place to perform a balloon angioplasty,” explained Yzaguirre. With notification prior to the patient’s arrival, the staff can be on the way and getting set up

while the ambulance is en route. On the flip side, the results can prevent having to call in the staff for a false alarm. The system can even help when the lab is up and running. If someone who needs an immediate procedure is on the way, the staff can coordinate rooms in the cath lab to promptly accommodate the emergent patient. Most patients are not aware of the 90-minute goal for acute MI, or heart at-tack. To the community, this technology means if they do need intervention, they will have a better, faster recovery and will be able to have a more productive, normal life. Not everyone who is having heart attack symptoms will need an angio-plasty. The procedure is for patients who are having an acute myocardial infarction, better known as a STEMI. This is one kind of heart attack caused when a blood clot is cutting off blood supply to the heart. A STEMI is considered a severe heart attack because large sections of muscle can die until the artery can be reopened. The LIFENET system helps TGMC prepare for each patient appropriately. Heart attacks are not the only things an EkG can help diagnose. “It helps when patients come in with abnormal heart rhythms. The EkG can help the staff prepare for whatever may be coming its way,” said Yzagguire. The system sounds an alert when an EkG is received in theemergency department. The results then automatically print for a doctor to review. The pictures, according to Yzaguirre, are clear and easy to inter-pret. It has been in place since November and gets plenty of use. Some days as many as 20 EkG tests pass through the machine.

Acute MI–a heart attack occurs when the blood supply to part of the heart muscle itself, the myocardium, is severely reduced or stopped. the reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle is blocked. this is usu-ally caused by the buildup of plaque, a process called atherosclerosis. the plaque can eventually burst, tear or rupture, creating a “snag” where a blood clot forms and blocks the artery. this leads to a heart attack. (definition courtesy of the American Heart Association)

STEMI–this heart attack, or mi, is caused by a prolonged period of blocked blood supply. it affects a large area of the heart muscle and causes changes on the ekG as well as in blood levels of key chemi-cal markers. (definition courtesy of the Cleveland Clinic)

EKG–an electrocardiogram, abbreviated as ekG or ecG, is a test that measures the electrical activity of the heartbeat. With each beat, an electrical impulse or “wave” travels through the heart. this wave causes the muscle to squeeze and pump blood from the heart. (definition courtesy of the American Heart Association)


6 Spring 2010

Dr. Raul Doriaoncologyyears of experience: 24

Education: Dr. Doria graduated from medical school at Asunción Paraguay in 1986. He completed his residency at Jackson Memorial Hospital in Miami. He also completed a fellowship in hematology/oncology at Yale University in 1995.

Even as a child, Dr. Raul Doria always wanted to be a doctor but could never decide on a specialty. Once he was accepted into medical school, he learned his mother was diagnosed with lung cancer after already losing his father to gastric cancer at age 11. “My mother passed away when I finished medical school. The experience gives me the strength and courage to try to beat cancer every day,” he said. “It takes a special person to be in this field. You can be cold or you can be compassionate. I choose the latter.”

Dr. Doria spends much of his time in the great outdoors. “Ever since I came to Houma, I’ve been introduced to the outdoors,” he said. “I enjoy hunting pheasant, quail and duck. I also like to play golf and soccer.”

Dr. Robert Gamblehematology/oncologyyears of experience: 29

Education: Dr. Gamble graduated from medical school at Universidad Nordestana in 1981. In 1987, he completed his residency and part of his fellowship at St. Luke’s - Roosevelt Hospital in New York City, as well as additional years of his fellowship in New Jersey at St. Michael’s Medical Center. Since the completion of his fellowship, he has been working in hematology and oncology at Terrebonne General Medical Center.

If you ask Dr. Robert Gamble what keeps him motivated in a profession like oncology, he will tell you it’s patients’ smiles. “That’s what keeps you going most of the time,” said Dr. Gamble. “When you see patients smile, you know that not only have you alleviated the pain and made them comfortable, but also that you have upheld their hope.”

“knowing how precious life is, you realize time with family cannot be replaced by anything. So I spend time with them whenever possible,” said Dr. Gamble. “You work to try and make a difference in people’s lives and then go home to your family.”

Dr. Gamble cycles up to 10 to 15 miles a week. “When you work in a field like oncology, you need stress relief,” stated Dr. Gamble. “With cycling, I’ve been able to meet and have fun with people outside of work.”

MEET THE MAry BIrD PErKInS CAnCEr SPECIALISTS AT TGMC

Fighting Cancer is Personal

W WHILE THESE DOCTORS

SPEND MOST OF THEIR DAYS

TREATING AND CARING FOR

THEIR CANCER PATIENTS, THEY

ALSO HAVE A WIDE VARIETY OF

INTERESTS AND PASSIONS. ONE

GROWS A VEGETABLE GARDEN

AND IS A CERTIFIED BLACkSMITH,

ONE HAS RECENTLY WRITTEN A

NEW YORk TiMES BESTSELLING

BOOk, ONE BIkES 10 TO 15 MILES A

WEEk, AND ONE ENJOYS PLAYING

SOCCER AND GOLF TO RELIEVE

STRESS. WHILE THESE AREN’T

THE FIRST THINGS YOU WOULD

THINk OF WHEN YOU THINk

ABOUT CANCER SPECIALISTS,

IT’S IMPORTANT FOR US TO

INTRODUCE YOU TO THESE

CARING PHYSICIANS, FIND OUT

WHAT MOTIVATES THEM AND HOW

THEY SPEND THEIR DAYS WHEN

THEY ARE NOT FIGHTING CANCER.


Dr. Jeffrey Longradiation oncologyyears of experience: 28

Education: Dr. Long graduated from the University of Iowa College of Medicine in 1981. He completed his residency in radiation oncology at University of Iowa Hospital in Iowa City. Because radiation oncology patients are treated between two to eight weeks, it’s important for Dr. Jeffrey Long to interact personally with his patient when treating them for cancer. “It gives me time to get to know my patients so I can practice medicine in a highly professional manner while still having that personal connection that I enjoy,” he said. Dr. Long’s mother fought cancer four different times so he knows firsthand what it is like to watch a loved one battle the disease. “She’s doing fine today,” he said. “But going through something like that makes fighting cancer close and personal. It strengthens my resolve to do the best for every patient every day.” Dr. Long enjoys community outreach through the Rotary Club, photography, and is the founder and webmaster of the Radiation Oncology Online Journal, www.rooj.com. Perhaps his most remarkable accomplishment has been to write the recent New York Times bestseller “Evidence of the Afterlife: The Science of Near-Death Experiences.” He also appeared on NBC’s

“The Today Show” in January 2010 to discuss his book and the unique topic. “I originally learned about near-death experiences in the Journal of the American Medical Association when I was in radiation oncology training,” said Dr. Long. “Two years later, a friend was describing her near-death experience during which she was clinically dead, but had a highly organized and visual experience.” Dr. Long created a website to collect near-death experiences from all over the world. After nearly a decade of gathering more than 1,300 stories, Dr. Long conducted the largest study of near-death experiences ever reported. He used the information to deduce nine lines of evidence strongly suggesting that near-death experiences are medically inexplicable. “Sometimes when I’m at the Rotary Club, someone will walk up to me and say, ‘Gosh, I’ve never met a New York Times bestselling author,’” said Dr. Long. “And I think to myself, ‘I haven’t either.’ It’s all been so sudden.”

Dr. Harry McGawoncologyyears of experience: 36

Education: Dr. McGaw graduated from medical school at Louisiana State University in 1974. He completed his residency with Louisiana State University in New Orleans at Ochsner Hospital where he also completed his fellowship in oncology.

For Dr. Harry McGaw, treating patients is all about being personal. “When I meet a patient, I try to make personal contact by listening and empathizing with them,” he said. “As I get older, I have begun to understand the importance of those things more.” A few years ago, the tables were turned when Dr. McGaw was diagnosed with osteomyelitis, an infection of the bone, in his arm. He remembers spending months on antibiotics and treatment. “During that time, I remember receiving a get well card, and it was amazing how well it made me feel to know someone had taken the time to send it,” recalled Dr. McGaw. “I learned a lot about contact with a doctor during that time. Apart from the intellectual part, the human contact and emotion is important.” On his 70-acre property, Dr. McGaw does everything from cultivating his half-acre garden that can feed up to six families to storing his collection of 26 anvils to tending his beehives. “I have plenty of hobbies,” said Dr. McGaw. “With doctors, there is always a thirst for learning, which is why we are usually on the go.” Dr. McGaw’s thirst for knowledge is seemingly unquenchable. He has also attended blacksmithing school and is currently learning French and Spanish.

In addition to oncologists Drs. Doria, Gamble and McGraw, Dr. James Schweitzer is also on active staff at TGMC. Radiation oncologist Dr. Long is joined by Drs. Johnson, King and Sanders on active staff at TGMC.


Dr. Robert Gamble Dr. Harry McGaw

the mary bird perkins cancer center at tGmc recently received a three-year accreditation in radiation oncology from the american college of radiology (acr) – american society for radiation oncology accreditation program.

“you know everyone shares a commitment to excellence when you meet the high standards of the acr,” said dr. Jeffrey long, radiation oncologist at tGmc. “so you can look at your patients every time and say here at tGmc, you get the very best.” in addition to the acr accreditation in radiation oncology, mary bird perkins cancer center at tGmc is nationally accredited with commendation for excellence in cancer care by the american college of surgeons (acos) commission on cancer (coc)—the gold standard for community-based cancer care.

TGMC Receives Accreditation in Radiation Oncology

Dr. Raul Doria Dr. Jeffrey Long


8 Spring 2010

AAccording to the International Foundation for Functional Gastrointestinal Disor-ders (IFFGD), there are between 2.4 and 3.5 million physician visits per year for Irritable Bowel Syndrome (IBS). Yet it is estimated that these figures represent less than half of the American adults who actually suffer from the disease. And, according to Mayo Clinic statistics, as many as one in five U.S. adults may have signs and symptoms of IBS.

TGMC gastroenterologists, David C. Pellegrin, M.D. and khalid Moussa, M.D., are dedicated to helping and treating patients with digestive diseases and disor-ders, specifically IBS, and have worked to raise awareness for many people who suffer in silence with this confining syndrome.

According to Dr. Pellegrin, IBS is a “chronic gastrointestinal disorder that has no obvious organic cause.” Dr. Moussa added that the disorder is extremely common in the U.S. and Western Europe, and generally affects about twice as many females as males, although the reason for this is uncertain.

“IBS greatly interrupts a person’s routine, job, family and social life; an extremely important and unfortunate factor of IBS,” explains Moussa. Accord-ing to the University of North Carolina’s Center for Functional GI and Motility Disorders, IBS is one of the most common reasons for work or school absenteeism, second only to the common cold. People with IBS miss 3–4 times as many work-days annually as the national average.

WHAT TO LOOK FOrIrritable Bowel Syndrome is a life-influ-encing disorder, and difficult to ignore due to the abnormal influences on the intestines. The most common symptoms for this disorder include abdominal bloating, cramping, distention and pain, gas, and altered bowel habits such as constipation, diarrhea, a combination of the two, and/or mucus in the stool.

WHAT ArE THE CAuSES?Although the specific cause of IBS is unknown, our doctors outlined three major factors that can combine to affect or trigger the symptoms of IBS. Those factors include dietary influences, psychological issues and stress.

“Some people have more sensitive systems, which causes them to have allergies to and difficulties with dairy products, gas-producing foods like vegetables, beans and/or wheat products,” explained Pellegrin. “Oftentimes, IBS can be associated with lactose intolerance and Celiac Disease, which is an allergic reaction one gets from eating gluten that is found in most wheat products.”

Moussa stressed that anxiety or stress can definitely play a major role in contributing to the problems associated with IBS. “Although IBS does not threaten people’s lives, it does threaten their quality of life.”

TrEATMEnTBecause IBS is a syndrome, there are many things that can be done to rectify the problems associated with its occur-rence. “Medications that prevent spasms in the intestines can be prescribed, as well as antidepressants and over-the-counter medicine,” Pellegrin said. “Biofeedback, psychotherapy and even hypnosis have been used in the past for extreme cases, and have also worked.”

According to Moussa, “Patients’systems and daily bowel habits must be monitored, along with other factors including diet and lifestyle. Stress reduction is very important as well as learning relaxation techniques. While IBS is not a life-threatening disorder, a person experiencing these symptoms should not hesitate to consult with a doctor. Cases of IBS can also develop into a severe gastro infection.” In severe circumstances where conditions may be ignored, people oftentimes self-diagnose as having IBS, when it is really something far more serious. With serious symptoms, doctors may want to test patients to confirm it is not related to other problems such as Celiac Disease, colitis or even colon cancer, explained Moussa. In summary, Dr. Pellegrin expressed the importance of patients first finding a doctor they have confidence in and opening up the lines of communication and consulting with them about their symp-toms. “A lot of people are embarrassed to bring it up, and do not want to talk to their doctors about this disorder. The most important thing is for patients to make their doctor aware of all symptoms in order to receive accurate treatment. Having a good relationship between the patient and doctor is imperative.” For more information on Irritable Bowel Syndrome, visit www.tgmc.com or call 1-888-543-TGMC (8462).

IBS DOES nOT HAvE TO MEAn A LIFETIME OF COnFInEMEnT.

Dr. David C. PellegrinDr. Khalid Moussa


DDiabetes and hypertension, or high blood pressure, are the leading causes of kidney disease, and both can be virtually undetectable. For this reason, they are considered the silent causes of kidney disease.

The American Heart Association (AHA) reports nearly one third of people who have hypertension don’t even know it. So how do you catch these silent problems? Prevention and early man-agement are key. At-risk patients must control the factors that can contribute to kidney disease.

COnTrOLLInG DIABETESIn both Type I and II diabetes, maintain-ing blood sugar levels within the target range may prevent the development of kidney disease.

According to Dr. Herminio Suazo, a kidney specialist at Terrebonne General Medical Center (TGMC), “Although the onset of Type I diabetes is often estab-lished because of its unusually explosive symptoms, Type II diabetes has a much slower course. Individuals with Type II diabetes may have the disease for many years without knowing.” “Once diagnosed with diabetes, as part of their regular care, patients should have their urine tested for microalbu-min,” explained Dr. Suazo. “The test checks for the presence of a protein called albumin. The presence of this protein in urine is the reflection of damage to kidneys.” This simple period-ic testing can ensure that kidney disease may be treated as early as possible. “People do not automatically think kidney disease when they begin feeling tired, experience loss of appetite, and swelling of feet and ankles, but these are common symptoms of kidney disease,” said Dr. Gregory C. Maidoh, another kidney specialist at TGMC.

rECOGnIzInG HyPErTEnSIOn, Or HIGH BLOOD PrESSurEHigh blood pressure can affect many parts of the body because of the damage it causes to blood vessels. Because kidneys remove waste in the blood, damaged vessels flowing into and out of the kidney may result in progressive kidney damage. “Appropriate control of high blood pressure may be the most powerful way of slowing down this progression,” said Dr. Suazo.

Therefore, it is very important to know who is at risk and how to maintain healthy blood pressure levels. While there are no hard and fast rules to why people suffer from hypertension, certain risk factors may contribute to the problem.

Lifestyle changes can help you maintain a healthy blood pressure. Both Dr. Maidoh and Dr. Suazo cite dietary re-strictions such as decreasing sodium and alcohol intake, smoking cessation, and general weight loss as immediate recom-mendations to decreasing hypertension.

Some uncontrollable factors in hy-pertensive patients are family history and race. According to the AHA, 40 percent of African-American adults are affected by high blood pressure.

“Sometimes hypertension does not have to do with what you do,” said Dr. Maidoh. “Many times it is genetic, espe-cially in minority populations.” There are medications that can treat hypertension. Your doctor will determine and prescribe the medication that will best treat your high blood pressure. Maintaining a healthier lifestyle, as mentioned previ-ously, should still accompany treatment.

A HEALTHy rELATIOnSHIPWhen it comes to the development or progression of kidney disease caused by hypertension or diabetes, the most important thing a patient can do is maintain a long-standing relationship with his or her physician.

“An annual physical is like having your car checked every few thousand miles. You do not wait for the engine or brakes to fail. You want to catch problems before the major damage occurs,” said Dr. Maidoh. “By having an annual physi-cal, a physician may be able to prevent disease before symptoms even occur.”

By keeping track of important numbers like blood pressure or blood sugar level, patients can catch issues before major damage occurs.

Drs. Maidoh and Suazo (pictured) and Drs. Vander and Madisette are nephrologists on active staff at TGMC.

kidney Disease


CATCHInG THE “SILEnT CAuSES” OF

Dr. Herminio SuazoDr. Gregory C. Maidoh


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10 Spring 2010

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TGMC, along with the Louisiana Organ Procurement Agency and the Louisiana Hospital Association, are part of the Louisiana Hospital Campaign, a hospital donor registration drive initiative in the nation. To sign up on the donor registry or for more information, go to www.donatelifela.org.

In March 2010, The Mary Bird Perkins Cancer Center at TGMC held its 4th Annual Ladies Night Out gala. The proceeds from the gala, in conjunction with grant funds se-cured by TGMC, will benefit a Women’s Boutique in the Mary Bird Perkins Cancer Center at TGMC that will provide specialty services, products and fittings for women undergoing treat-ment and recovering from cancer. Keynote speaker Peggy Kline gave a humorous, uplifting message to the 700 women in attendance.

Keep the Beat, a free bystander CPR train-ing course, was held in March 2010 at the H-T Civic Center. Team Terrebonne volunteers assisted with CPR instruction as well as assisted with various other aspects of the event.

The AHA annual Over and Under Tunnel Run was held in March 2010 at the Municipal Auditorium. TGMC raised over $2,000 for the AHA as well as provided Team Terrebonne volun-teers to assist with registration and serve food.

Give the Gift of Life.

Ladies Night Out Super CooperHeart Run

keep the Beat

Tunnel Run

The 4th Annual Super Cooper Heart run was held in March and had the largest turnout in event history with 500 partici-pants and volunteers on-site at the Workout Co. in Houma. The event proceeds will be do-nated to TGMC’s nICu to help provide medical and social care to the infants and families of infants admitted.



Dear Friends,

It’s important for our readers to stay informed about the recent recom-mendations regarding mammograms and to not jeopardize their health by delaying breast cancer screenings. Recently, the United States Preventive Services Task Force released new breast cancer screening guidelines recommending that women wait until age 50 to start getting mammograms every two years. The rationale offered is that too many women are getting unnecessary biopsies, or are getting unnecessary treatment for something that may never turn cancerous. Furthermore, the Task Force also stated that breast self-exams do not save lives. Mary Bird Perkins Cancer Center at TGMC strongly disagrees with these recommendations and will continue to follow the American Cancer Society (ACS) screening guidelines for breast cancer that recommend annu-al mammograms beginning at age 40. In addition, the ACS advises women to consult with their physician if there is a strong family history of cancer as to whether or not they should begin screenings earlier than age 40. We wholeheartedly agree with the screening guidelines put forth by the ACS and will continue to promote the message that early detection can and does save lives, as well as the concurrent importance of breast self-examination. Breast cancer is the most common cancer and the second leading cause of cancer deaths in American women. Mary Bird Perkins Cancer Center at TGMC and its partners conduct free breast cancer screenings annually. Since 2007, more than 6,000 women have been screened with approximately 12 percent having an abnormal finding that required addi-tional testing. These screenings have resulted in the diagnosis of 53 breast cancers throughout our 18-parish service area—47 percent of them found in women were under the age of 50, the youngest being 27 years old. Too many women die because their cancer is detected too late, at a point when treatment can no longer help. Women should continue to do regular breast self-examinations and get annual mammograms starting at age 40. Early detection is a person’s best defense in the fight against cancer.

Sincerely,

Raul Doria, M.D.Medical Director, Cancer Program of Mary Bird Perkins Cancer Center at TGMC

MammographyTHE LATEST On

Dr. Raul Doria speaks about mammography to the women of Terrebonne Parish


Healthier Meat Loaf1 lb. uncooked lean ground beef¾ c. uncooked oatmeal½ c. ketchup1 egg1 c. onion, chopped1 tsp. garlic, minced1 tsp. salt¼ tsp. black pepper1 tsp. dried basil1 tsp. dried parsley

Mix all ingredients. Form into loaf pan. Cook in 350 degree oven for 1 hour or until meat internal temperature is 160 degrees.

Serves 8. Calories 163, Fat 4g, Sodium 504mg, Carbohydrate 10g, Fiber 1g, Protein 19g.

Pineapple Chicken Stir-Fry¼ c. lite soy sauce2 tbsp. sugar1 tbsp. cider vinegar1 tbsp. ketchup

Pineapple Chicken Stir-Fry (cont’d)½ tsp. ground ginger1 tsp. minced garlic1 lb. boneless skinless chicken breast, cut in strips2 tbsp. vegetable oil1 pkg. frozen stir-fry vegetables1 (16 oz.) can unsweetened pineapple chunks, drained

In a small bowl, combine the first 6 ingredients; set aside. In a large skillet or wok, stir-fry chicken in oil for 5–6 minutes until juices run clear. Add vegetables and stir-fry 3–4 minutes until crisp-tender. Stir in pineapple and soy sauce mix. Heat through.

Serves 6. Calories 232, Fat 1g, Sodium 877mg, Carbohydrate 44g, Protein 21g.

Easy Baked Tilapia4 (4 oz.) fillets tilapia2 tsp. butter¼ tsp. Old Bay seasoning or to taste½ tsp. garlic powder or to taste1 lemon, sliced1 (16 oz.) pkg. frozen cauliflower with broccoli

Preheat oven to 375 degrees. Grease 9x13-inch baking dish. Place tilapia fillets in the bottom of the baking dish and dot with butter. Season with Old Bay and garlic. Top each one with a slice or two of lemon. Arrange frozen mixed vegetables around the fish and season lightly with salt and pepper. Cover the dish and bake for 25 to 30 minutes in preheated oven until vegetables are tender and fish flakes easily with a fork.

Serves 4. Calories 172, Fat 3g, Sodium 354mg, Carbohydrate 7g, Fiber 3g, Protein 25g.

Terrebonne General Medical Center8166 Main StreetHouma, Louisiana 70360

P R E S O R T E D

S T A N D A R D

U . S . P O S T A G E

P A I D

M O B I L E , A L

PERMIT NO. 435

Take Care is a publication of Terrebonne General Medical Center.President and CEO Phyllis Peoples Editor Ann Dupre

This newsletter is produced as a community service to the residents of Southeast Louisiana.Entire publication ©Terrebonne General Medical Center 2010. All rights reserved.

For information: Marketing & Planning Department, Terrebonne General Medical Center, PO Box 6037, Houma, LA 70361-6037; call us at 985-873-4616; or visit us on the Web at www.tgmc.com.

For people living with diabetes, healthy eating is a key ingredient

to managing the disease and minimizing complications. The

staff and resources of the Diabetes Management Center at TGMC

provide information, education and support services for many diabetes

patients living in SE Louisiana. Two areas our team focuses on

are nutrition and meal planning and we are pleased to offer a Louisiana

cuisine cookbook. The cookbook is a collection of delicious recipes from

family and friends, capturing some of our Louisiana favorites. A nutritional

analysis is displayed for all recipes, making it easy to determine healthy

food choices. We’ve assembled a sampling of recipes here to tempt

your palate and jazz up your regular meal fare. For more information

on how the Diabetes Management Center can help you or someone you know manage their disease, contact

us at 985-850-6200. Cookbooks are available at the TGMC

retail shops, OutReach Center and Diabetes Management Center

and cost $12 each.

B E T T E r L I v I n G T H r O u G H H E A L T H y A D v I C E

DoubleTAkES

Healthy Eating For Diabetics


2010 v1 Take Care

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