FALL | 2017
Breast Cancer Doesn’t Discriminate Living life to the fullest in spite of cancer.
Cancer Care Close to Home Is It An Emergency? ER vs. Urgent Care Mako: Robotic-Arm Assisted Surgery
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Milk Depot: Donating to Make a Difference
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Urgent Care | Is It An Emergency?
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Cancer Care Close to Home
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Cover Story
Breast Cancer Survivor Claire Bohn
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Mako™ Robotic-Arm Assisted Surgery
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Dr. Hamilton | How Doctors & Parents Talk
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Neuroimaging Certification Kevin R. Hargrave, M.D.
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LGH Events
NEWS & ANNOUNCEMENTS
Lafayette General Southwest Receives the 2017 Women’s Choice Award® LGSW, a campus of Lafayette General Medical Center, has been named one of America’s Best Hospitals for Emergency Care by Women’s Choice Award®, America’s trusted referral source for the best in healthcare. Emergency Room waiting times are one of the key measurements for the award.
Lafayette General Medical Center Moves into D4 Phase of Becoming a Baby-Friendly Hospital Baby-Friendly USA, Inc., announced Lafayette General Medical Center (LGMC) has achieved D4 – Designation status, in the Baby-Friendly Hospital Initiative. Becoming a Baby-Friendly Hospital is a comprehensive, detailed and thorough journey towards excellence in providing evidence-based maternity
Health In General
care with the goal of achieving optimal infant feeding
is produced by the Lafayette General Health Community Relations Department
201 Audubon Blvd. Ste.102 Lafayette, LA 70503 (337)289-8600
LGH SYSTEM DIRECTOR OF COMMUNICATIONS
COMMUNITY RELATIONS STAFF
Daryl Cetnar
Meghan Connell Alexandra Donaldson Brent Pelloquin
outcomes and mother/baby bonding.
UHC opens Urgent Care Clinic to Accept Medicaid and SMH opens new Medicaid Clinic University Hospital & Clinics (UHC) opened a new Urgent Care Clinic to serve Medicaid patients across Acadiana. The clinic sees patients on
ON THE COVER:
a walk-in basis with no appointment
Claire Bohn
needed. Patients are seen on a “first come first serve” basis COVER PHOTO BY:
with minimal wait time. UHC Urgent Care Clinic is open
Glen Clark
Monday through Friday from 5 p.m. to 9 p.m., and Saturday through Sunday from 7 a.m. to 3 p.m.
St. Martin Hospital opened a new Medicaid Clinic located
in St. Martin Hospital Specialty Center. Appointments are available, but not necessary. The clinic currently accepts all Shopping at SMILE.AMAZON.COM, after selecting Lafayette General Foundation as your charity, ensures a donation is made directly to the Foundation, at no cost to you!
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Medicaid payers except United Healthcare. The clinic is open Monday through Friday from 7:30 a.m. to 4 p.m.
Donating to Make a Difference. Did you know pasteurized donor human breast milk can save a baby’s life?
Research shows premature babies who
are fed human milk avoid serious medical complications. One in eight babies are born premature, yet half of the mothers of preemies are not able to provide their baby breast milk. A mother’s milk has Omega 3 fatty acids which are powerful for brain growth and development.
Last year Lafayette General Medical
Center (LGMC) opened the first milk bank depot in Southwest Louisiana. Since its opening, 24 donors have donated over 23,702 ounces of donor breast milk.
Jamie Vead, of Maurice, has donated
8,082 ounces to the milk depot at LGMC.
“I’m a big proponent of
breastfeeding,” said Jamie Vead. “I’m very fortunate to produce so much that it got to a point where my freezer was full. So, I found out about the milk depot. LGMC had a need and I had a need, so it was a perfect fit.”
The demand for human
donor breast milk in hospital
“I was very fortunate that when my
sons were born, they were both born healthy without any complications,” said
Collection sites like LGMC are called
‘depots’ because they function as a user-friendly and safe satellite storage
Jamie. “I asked myself, ‘If I would have
facility. The milk is kept frozen before
been a mom whose child was sick or
it is shipped to MMBA for pasteurization.
did have complications, would I want
someone to step in and help my child if
a registered donor, visit
I wasn’t able to?’ It’s kind of like paying
LafayetteGeneral.com/MilkDepot
If you would like to become
it forward to help others.”
The milk bank depot at LGMC gives
lactating mothers a convenient drop-off location for their donation. The depot is serviced by Mother’s Milk Bank at Austin
For more information or to make a donation, call Darlene Leblanc, RN, Lactation Consultant at (337) 289-7785.
(MMBA). Nonprofit milk banks like MMBA ensure donor human breast milk is safe and available to the infants who need it most.
“When you have a three year old and
an infant, it isn’t exactly easy to tote them around plus an ice chest of milk,” said Jamie. “Darlene Leblanc, [Certified Lactation Consultant at LGMC] made dropping of my donations so simple. I called when I was 10 minutes away, and when I pulled up at the hospital and she was right there at the door waiting for me. I didn’t even have to get out of the car.”
neonatal intensive care units (NICUs) continues to rise across the country.
Meghan Allen Breast Milk Donor
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Is It An Emergency? ER VS. URGENT CARE
It never fails that an illness or injury pops up when you least expect it. You may wake up in the middle of the night with a severe cough or stomach pain. You might fall after work and can no longer apply weight on your swollen foot. Or, your child’s fever spikes on the weekend when the pediatrician’s office is closed.
What if you become sick or injured when your doctor’s office is closed, or you can’t
Lafayette General has three Urgent Care Centers located in River Ranch, Sugar Mill Pond and Carencro.
University Hospital & Clinics recently
opened an Urgent Care Clinic at 2390 W. Congress St. to serve Medicaid patients across Acadiana.
get an appointment?
Deciding whether your illness or injury is a true emergency can be hard when you
feel sick or are in pain. The answer is not always simple, but knowing your options could save you a lot of time and money.
When you experience a sudden illness or injury going to the Emergency Room (ER)
is not always your best option. While all Lafayette General Health (LGH) Emergency Rooms are prepared for every kind of medical emergency, our urgent care clinics are a faster alternative available for non-life-threatening injuries and illnesses.
“We know medical issues don’t just pop up during normal business hours,” said
Melissa Bergeron, Lafayette General Urgent Care Center Manager. “Our clinics also have evening and weekend hours too.”
For times when your primary care physician’s office is closed, urgent care provides
easy access for medical needs that can’t wait for an appointment. Urgent care sees patients on a walk-in basis with no appointment needed, and minimal wait time. A common misconception is the ER treats patients on a “first come first serve” basis.
WHEN TO GO TO URGENT CARE Any Cough or Cold That Does Not Get Better in several days, or a cough that gets worse and is accompanied by a fever Migraines Low-Grade Fevers Rash, especially if there is a fever Minor Broken Bones and Sprains Cuts That Might Need Stitches Minor Burns Severe or Constant Vomiting or Diarrhea Animal and Insect Bites Allergies / Sinus Headache / Stomachache Earache Pink Eye Painful Urination
However, the ER actually follows a triage system and treats patients in order of the severity of their condition. Patients facing life-threatening conditions are seen before those with non-life-threatening conditions, therefore, increasing wait time for many.
A trip to the hospital is not needed for most medical conditions. However, if you have
a common illness or minor injury, you should not wait too long to get medical treatment.
A true emergency is when you believe a severe injury or illness is life-threatening.
If you or an unborn baby could die or be permanently disabled then you need to seek emergency medical treatment in the ER or call 911 immediately.
Lafayette General Urgent Care Centers also offer immunizations, such as the flu
shot, x-rays, lab draws, annual check-ups and sport physicals on a walk-in basis.
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To learn more about urgent care services and locations, visit LafayetteGeneral.com/UrgentCare
Cancer Care Close to Home Raven Green, of Port Arthur, TX, was relaxing on her week off when she started to have trouble breathing. Less than a few days later, Raven’s journey began.
hospital everyday,” said Raven. “I didn’t
Raven began to research other cancer
really want to stay in Houston. I really
treatment facilities that could continue her
wanted to go home. They said if I found a
care if needed.
doctor that would accept me in Port Arthur
or nearby then I could go there instead.”
of Acadiana,” said Raven. “I didn’t want to
She started her treatment plan at an
prolong my treatments. I didn’t want to take
outpatient clinic in Port Arthur right away.
any chances, so I was like ‘Can we just go?’”
“As the days went on during the week it
at Lafayette General and resumed her
so I went to the hospital,” said Raven.
treatments the Friday before Harvey made
“They did my labs and everything. Then
landfall.
they said I needed a blood transfusion
because I didn’t have any plasma.”
Raven. “There are other ways around it. I’m receiving the same treatments I was at MD
APL is a subtype of the cancer Acute
Anderson and Port Arthur and now here,
Myeloid Leukemia (AML). With APL, the
it’s still the same medicines and everything.
bone marrow produces too many cells
Really the only difference is the location.”
called promyelocytes. When too many
promyelocytes gather in the marrow, they
renowned hospitals to Acadiana, so
not enough healthy blood cells to do their
patients can be treated closer to home.
job, patients are at high risk for infection or
In addition to Lafayette, CCA provides
bleeding. me from Port Arthur to MD Anderson that I was really sick,” explained Raven.
Raven met with doctors at MD Anderson
to develop her treatment plan. “They were telling me I would have to stay there in Houston and go back and forth to the
The objective of CCA is to bring the
same cancer treatments used in world-
crowd out healthy blood cells. If there are
“It didn’t register until they transferred
“You don’t have to up and leave your
life because of the sickness,” explained
On April 28, 2017, Raven was diagnosed
with Acute Promyelocytic Leukemia (APL).
Raven brought her prescribed treatment
plan to Cancer Center of Acadiana (CCA)
started to get harder and harder to breathe,
“I was glad when I found Cancer Center
treatment centers in Abbeville, Crowley, Raven has been in remission since June,
New Iberia and Opelousas.
however she still had eight months of treatments remaining.
Then the unexpected happened in
August. Hurricane Harvey made landfall along the Texas coast as a Category 4
To learn more about Cancer Center of Acadiana, go to LafayetteGeneral.com/Cancer
hurricane. With the uncertainty of the storm
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Breast Cancer Doesn’t Discriminate Claire Bohn | Breast Cancer Survivor
Right after her 50th birthday, Claire Bohn visited her doctor for a routine mammogram when the unexpected occurred. The doctor found a small lump in her breast. “At that time my doctor said we will check it again in six months,” said Claire. “I never thought about it again, because that’s just not my personality. Then the phone rang seven months later and it was Bonnie, the nurse from my doctor’s office. She said we need to schedule you for an exam. I made my appointment and that’s when they found breast cancer.”
According to Susan G. Komen, one
in every eight women in the U.S. will be diagnosed with breast cancer in
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her lifetime. When Claire received her
diagnosis, she knew she needed to
mammograms, Claire went in for her
take action because her journey was
annual exam. Twenty years after
just beginning.
her first diagnosis, she was told once
again that her mammogram showed
“April 1994, I had a lumpectomy,”
A true believer in routine
said Claire. “It was so small and so early
an abnormality.
that I didn’t have to receive chemo,
which was a wonderful blessing. I had
24 hours later and said it was the same
“They did a biopsy and came back
34 radiation treatments, and that was it.
breast but a different type of breast
Bye, bye cancer!
cancer,” explained Claire. Michael
“I’m here after two cancers because mammograms saved my life.” Claire Bohn Breast Cancer Survivor
Cain, M.D., Medical Oncologist at
Cancer Center of Acadiana (CCA)
at Lafayette General recommended
a double mastectomy.
“The call back was very hard,”
explained Claire. “When they did the
biopsy and it was cancer, I just didn’t
want to think about that. Maybe that’s denial or maybe that’s survival, I don’t
“Five, 10, 15, 20 years went by, and
know what you could call it, we’re all different.”
I sure had a good time,” explained
Claire. “I traveled, ate, danced, raised
and that of those around her as the
my children and everything. We had so
key to her survival.
much fun!”
It is many different types of diseases,
For women 50+, skipping an annual
Claire credits her positive attitude
Breast cancer isn’t just one disease.
mammogram every other year can miss
with varying molecular structures,
up to 30 percent of cancers.
behaviors and side effects, but all
“Lafayette General is such a wonderful place, I think it’s because the people really care about their patients here.” Claire Bohn
developing in one area of the body:
of breast cancer. Still today, when
on the eighth floor I got to see all of
the breast. Cancer does not
she talks about her experience, the
the fireworks across the city. You have
discriminate based on who you are,
impression that was left isn’t the fight
to look at something wonderful. You
where you live or how much money
of cancer. It’s the positive people who
have to have humor, and never give up
you have, it can happen to anyone,
she surrounded herself with and who
hope. There is always hope.”
even twice.
took care of her.
remain active, and keep her life as
“Lafayette General is such a
wonderful place, I think it’s because
“It takes a whole hospital to get you
Along Claire’s journey she tried to
well,” said Claire. “It takes everybody
normal as possible in her situation.
the people really care about their
from the doctors to the sweet lady who
patients here.”
changes your sheets. Even the happy
she explained. “I think it helps towards
“I try to do yoga four times a week,”
To help patients, CCA provides a
person who comes in with the mop,
surviving. When I finish the class I
patient navigator who meets with the
dancing and showing me some kind
feel like, ‘Hey I did it, and I’m ok, and
patient as they first arrive. They provide
of a jig.”
this was fun.’ Some of the aerobics
crisis counseling for patients and
classes got tougher over time, but
their families, and referrals to needed
point to find something good and
with yoga you feel relaxed, at peace
services, from emotional to financial
positive in everything along her
and happiness.”
support.
journey.
is October, but mammograms are
It’s been three and a half years since
Claire is free from her second round
Claire explained that she made a
“I was in the hospital on New Year’s
Eve,” explained Claire. “From my room
Breast Cancer Awareness month
performed all year long.
“Have your mammogram,” says
Claire. “Please don’t let anybody tell you, ‘It puts radiation in your body!’
One
IN EVERY
Eight
women in the U.S. will be diagnosed with breast cancer in her lifetime.
I’m here after two cancers because mammograms saved my life.”
To learn more about services offered through Cancer Center of Acadiana, visit LafayetteGeneral.com/Cancer
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Choose the Surgery Doctors Choose for Themselves. According to the Centers for Disease Control, 332,000 Americans need Hip Replacement Surgery annually. Sometimes doctors are amongst those in need of surgery.
Steve Rees, M.D., was experiencing
increased problems in his hip for more a long time. He developed a limp and began losing range of motion. Simple everyday tasks such as putting on a sock were becoming increasingly difficult.
“The worst thing was trying to sleep
at night,” says Dr. Rees. “About every 20 minutes I was changing positions. My wife went so far as to take our king-sized bed and turn it into two twin mattresses so she wouldn’t feel me flopping around like a fish all night.”
As a physical medicine and
rehabilitation specialist, Dr. Rees works
to see a trend,” says Rees. “The therapists
potential for impingement, wear
were seeing a trend too. Patients who
and dislocation. It also allows for more
had the Mako robotic-arm assisted
accurate leg length restoration, within
surgery seemed to recover much quicker,
3mm reducing the potential for discomfort
and seemed to have less pain from the
and walking complications.
beginning.”
on the same day as my surgery, the
Dr. Rees underwent a right total hip
replacement on May 30, 2017. “When it was time for me to decide how I was going
mobility through therapy. He’s worked with many patients in the Lafayette area who’ve undergone various different types of orthopedic surgeries.
“In my experience in seeing how the
patients were responding, I was starting
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“At about two o’clock in the afternoon
physical therapist came in,” says Rees. “I got up and walked with a walker about
to have my hip replaced, it was a fairly
400ft without anybody giving me any
easy decision. I decided to go with Mako
assistance at all. I ended up leaving the
robotic-arm assisted surgery,” says Dr. Rees.
next morning.”
Mako eliminates much of the guesswork
For many patients, joint pain becomes
involved with manual knee and hip
part of their life and they don’t always
replacement. The results are more accurate,
realize how much discomfort they are
maximizing the opportunity for patient
actually experiencing.
satisfaction, and may increase the lifespan
of the implant.
the pain I had been dealing with for about
seven years was gone,” says Dr. Rees.
Mako hip replacement enables the
pelvic cup alignment to be within five
“The moment I woke up from surgery,
“I can sleep again. I can get into a position
degrees of the center of rotation and within
and go to sleep and I will wake up much
2mm of the surgical plan. This reduces the
more refreshed than before.”
very closely with patients after surgery to help them regain their strength and
Steve Rees, M.D. Mako Patient
“Patients who had the Mako robotic-arm assisted surgery seemed to recover much quicker, and seemed to have less pain from the beginning.”
How Doctors, and Parents,Talk
Many doctors, including me, go
“harumph” when parents bring their
“In my clinical practice, I’ve seen a shorter
recovery time for Mako robotic-arm assisted surgical patients,” says Scott Yerger, M.D. “ A faster recovery means a more rapid return
However, doctors are often pressed
for time, particularly in ERs, and feel they
child to the Emergency Room (ER) with
can’t take lots of time to listen. Here’s the
non-emergencies, like rashes or insect
data – a patient or parent, given about
bites. Non-emergencies are what doctors’
90-120 seconds, will tell the doctor most
offices are for. However, often when I
everything they need to know to make
talk to the parents, they relay a hidden
the correct diagnosis. Not a real time
fear that they feel couldn’t wait for their
sink! However, data also shows that most
doctor. “My father-in-law had flesh-eating
doctors interrupt the patient’s story after
bacteria and almost died,” they’ll say.
about 15 seconds, start asking yes-or-no
“Does my child have it too?”
questions, and shut down the patient’s
to the joint feeling like the patient’s joint.
Which, results in a faster return to their
communication between doctors and
activities and daily living, their lifestyle, their
parents. When doctors go into exam
ER doctors, that may not listen to a
work and the fun things they like to do.”
rooms with bad attitudes, glance at the
patient’s whole story. Since they have
With conventional hip replacement
This illustrates the importance of good
narrative. Specialists are another group besides
rash, grumble about parents wasting their
patients referred to them from other
surgery, patients can experience significant
time, and zip out, they don’t get a chance
doctors, some feel the patient’s story has
restrictions in range of motion for six to nine
to hear why the family is there and allay
already been told, is in the record and
months following surgery. A major concern
their fears.
doesn’t need repeating. However, the
is the possibility of displacement.
best specialists take their own histories
“Dr. Yerger told me that while I was in
Doctors make about 85% of diagnoses
by the history of the patient’s illness
from the beginning. Who knows what
surgery he moved my hip around in all
alone. This is also why communication
new clue the patient will reveal in the
different directions and that it is stable,”
is important – doctors need to be good
retelling, that may make the diagnosis
says Rees. “I can tell you, I can even feel the
listeners to make accurate and helpful
the referring doctor missed?
stability. It is much more stable than it was
diagnoses. Taking histories is a special
prior to surgery. One month after surgery my
skill doctors learn in medical school,
range of motion is already improved. I’m able
polish in residency, and hone throughout
to do much more than I was doing before.”
their careers. I’m sure I take better
histories now than I did, say, 10 years ago.
Lafayette General is the only hospital
Please visit ParentsDontFret.net to read the rest of this article.
in Acadiana offering Mako surgery. With more experience than anyone in the region, Acadiana Orthopedic Center is your choice.
If you are living with joint pain and discomfort, then the answer may be Mako robotic-arm assisted surgery. Visit LafayetteGeneral.com/Mako, for more information. To schedule a consultation at Acadiana Orthopedic Center, call (337) 706-1300.
Scott Hamilton, M.D. , is a board-certified pediatrician by the American Board of Pediatricians and medical advisor in Lafayette General Medical Center’s dedicated pediatric treatment area within the Emergency Department. Dr. Hamilton is a Pediatric Advanced Life Support course instructor. His blog is available at ParentsDontFret.net and through a link at LafayetteGeneral.com, where it is accessible to parents anytime, anywhere there is an Internet connection. ParentsDontFret.net
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Local Neurologist One of Few In Louisiana With Certification Kevin R. Hargrave, M.D., Medical Director of Neuroscience Center of Acadiana at Lafayette General and Co-Medical Director of Sleep Center of Acadiana at Lafayette General, recently received the United Council of Neurologic Subspecialties (UCNS) Neuroimaging Certification.
Neuroimaging is a subspecialty of
disorders, including sleep apnea, restless
neurology, which involves interpreting
leg syndrome, insomnia, narcolepsy, and
CT and MRI scans of brain and spine.
other sleep conditions.
“One of the parts of my job I enjoy the
The Sleep Center offers clinical
most is having the opportunity to look
evaluation, testing and treatment in one
at my patients images and be able to
convenient location. The center has six
comfortably validate their imaging reports,”
beds for comprehensive sleep studies,
said Dr. Hargrave. “We are fortunate in
EEG’s, Multiple Sleep Latency Tests
Acadiana to have many great radiologists,
(MSLT) and Maintenance of Wakefulness
but occasionally clinician review adds
Tests (MWT).
additional insight to a patient’s imaging
interpretation and changes medical
at Lafayette General is the only
management.”
comprehensive sleep medicine facility
The Sleep Center of Acadiana
Dr. Hargrave passed the exam,
demonstrating expertise in brain and spine
“One of the parts of my job I enjoy the most is having the opportunity to look at my patients images and be able to comfortably validate their imaging reports”
and neurovascular imaging modalities. He now holds the distinction of being the only neurologist in Acadiana, and one of six in the entire state, to be a UCNS neuroimaging diplomate. To obtain
Kevin R. Hargrave, M.D.
certification, a multistep process and substantial amount of preparation, in addition to support letters from colleagues is required. He has greater than 15 years of
Dr. Hargrave is board certified by
in Lafayette with two neurologists board
private practice experience in neurology
the American Board of Psychiatry and
certified in sleep medicine. If you are
and sleep medicine.
Neurology and by the American Board of
snoring, or have trouble sleeping, and
Sleep Medicine and now is proud to hold
would like to make an appointment, call (337) 289-8282.
“We are very proud of all the
neurologists at Neuroscience Center
this certificate in neuroimaging.
of Acadiana,” said Al Patin, Chief
Administrative Officer for Lafayette
M.D., are co-directors of the Sleep Center
General Medical Doctors. “Dr. Hargrave’s
of Acadiana at Lafayette General. Both
accomplishment is no small feat and is
physicians have years of experience in
a great honor for any physician.”
Dr. Hargrave and Adam Foreman,
helping teenage and adult patients with a vast range of neurological and sleep
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For more information on Dr. Hargrave and Sleep Center of Acadiana visit LafayetteGeneral.com/SleepMedicine.
EVENTS
The James M. Cox Foundation announced a $250,000 grant to Lafayette General Foundation (LGF) that will be used to further expand telemedicine in St. Martin Parish public schools. Through Project Health, Education and Technology (HEAT), a partnership between Lafayette General Health, St. Martin Parish Schools and Cox Communications, as many as 8,000 students in the parish will have access to healthcare by harnessing the technologies of telecommunications, high-definition cameras and viewing monitors, enterprise health records and cloud-based software.
University Hospital & Clinics hosted a White Coat Ceremony welcoming three new fellows! Two of the fellows will begin UHC’s new Sports Medicine Fellowship program, working with the orthopedic and family medicine clinics, and the third fellow will join the geriatric medicine program. The fellows working in orthopedics will be working with the Ragin’ Cajuns athletic department and its student-athletes.
On August 11th, four LGMC Emergency Department and Trauma nurses received the 2017 Emergency Nurses Association Award! The awards were presented by The Louisiana Council of the Emergency Nurses Association and are given to the best emergency and trauma nurses in the state. Awards are based upon excellence in practice, leadership and education through provided service.
The Foundation received a grant from Project LAUNCH. This is the third year in a row LGF was awarded this grant. The grant goes toward the pediatric clinic at University Hospital & Clinics and provides counseling services for his pediatric patients.
LGF and the LSUE Foundation announced the Lafayette General Medical Center Endowed Professorships on August 1. LGF raised funds for a new scholarship through its Heart of Nursing event. This gift has the potential to create a $20,000 scholarship endowment for LSU Eunice students. Selected as the 2017-18 LGMC Endowed Professors are Maria Papillion, Instructor of Nursing and Kerri Trumps, Clinical Coordinator in Diagnostic Medical Sonography.
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Your Health Your Health RISK FACTORS
DETECTING HEART DISEASE
SYMPTOMS
Smoking Family History of
Heart Disease
Obesity
Chest Pain or Uncomfortable Pressure
(lasting more than a few minutes and/or stopping and starting)
Pain in the Upper Back, Shoulders, Arms, Neck or Jaw
High Cholesterol
Throat Discomfort
Indigestion or Heartburn
High Blood Pressure
Cold Sweat/Dizziness
Nausea and Vomiting
Diabetes
Shortness of Breath
Extreme Fatigue
Inactivity
A lack of symptoms does not mean an absence of problems, which is why checking with a cardiologist is so important.
To make an appointment with a cardiologist
Call (337) 289-8429.
-PR H ENAOLN TH I NO FGIETN, ECROAML M |U NFIATLYL- O2W 0 1N7E D H E A L T H S Y S T E M 12 A