New Orleans Magazine | Dining, Entertainment, Homes, Lifestyle and all things NOLA (2024)

November 1, 2013

Tiffany & Co. will open at The Shops at Canal Place the week of Thanksgiving. The timing of the move to New Orleans seems particularly appropriate as the retailer recently launched a new collection of jewelry it calls “Jazz Age Glamour.” The company’s website touts that this jewelry line “casts a romantic spell unique to an era that remains fresh in the minds of movie makers, artists and designers.” “We look forward to joining the New Orleans community,” says Diane Brown, Vice President of Tiffany & Co. “The city is steeped in history and there is no better place for Tiffany, with its own great heritage, to call home.” Beyond the diamonds, the company also emphasizes a social issue: Many diamond buyers are concerned about purchasing “conflict diamonds” and contributing to human rights violations.

Tiffany & Co. works with its ethical subsidiary, Laurelton Diamonds, to only purchase diamonds from countries that participate in the Kimberley Process, left, an initiative that aims to curb the use of diamonds by rebel movements to finance wars. Further, the company uses only subcontractors that participate in the Tiffany & Co. Social Accountability Program. Through these efforts, Tiffany & Co. upholds its standards for quality, environmental and social responsibility.

November 1, 2013

Remember Karen, the tropical system that flirted with us early last month? While it never amounted to much, it certainly stirred up one minor tempest. It all began the Friday night of the weekend that the depression was going to do whatever it was supposed to do. Toward the end of WYES, Ch. 12’s “Informed Sources” program, reporters go around the table and mention an upcoming news item to be aware of. (After years of trying to think of a better name, the segment is still called, “the thing at the end.”) One of the journalists, investigative reporter Gordon Russell of The New Orleans Advocate, predicted confidently that Karen was going to be a “shoo-shoo.” I, who was also there, knew exactly what Russell meant and was glad to hear it, but to my surprise, another reporter asked, “What is a shoo-shoo?” Suddenly a show during which the previous half-hour had been dedicated to discussing crime, politics and scandal, became lively in its last few minutes with debate over the origin and public familiarity of a phrase, which given the sudden interest was anything but a shoo-shoo.

Russell said he thought it might be a Cajun term. I mentioned it means roughly something that fizzle outs, but no one was sure exactly where the phrase came from. I was aghast though; I thought everyone knew shoo-shoo.

This story might have ended there except the next afternoon I got an email from a friend who was amused at a headline on Nola.com that proclaimed “Tropical Storm Karen becoming a shoo-shoo, judging from 4 p.m. update.” The friend, who had not seen “Informed Sources” the night before, was amused by the phrase and had even consulted the Urban Dictionary, where there were several definitions, the most pertinent being “to kill time talking about nothing.” That is about as good of a definition as there is.

Not that I relied on Google for my own personal research, but had I done so I would have discovered that within some cultures the term is also a polite substitution for a negative word that also begins with “sh”. More commonly, half the phrase, the singular “shoo,” means get away, as in “shoo, fly.”

Sometimes I have to remind myself that not everyone knows our colloquialisms. Many years ago I was in Chicago at a diner where I ordered a hamburger and asked for it “dressed.” The counter guy didn’t know what I was talking about. “Lettuce and tomato, and a little mayo,” I explained as though he was raised on the wrong side of the neutral ground.

As for Karen, let it be recorded that we along the Gulf never did have to wish for it to “shoo,” because ultimately it was, in fact, a shoo-shoo.

• Things To Do

November 1, 2013

And they’re off!

For generations of New Orleans horse racing fans, November is the time to get their wagers ready. The city’s track, now called Fair Grounds Race Course & Slots, traditionally kicks off its season on Thanksgiving Day. This year, because the holiday falls so late in the month, racing begins a few days before Thanksgiving so the track can hold its required 84 days of action before the New Orleans Jazz & Heritage Festival moves in.

The racecourse’s 142nd thoroughbred racing season opens on Nov. 22 with Starlight Racing. Fair Grounds spokesman Mark Conner says the night meet, with a 5 p.m. post time, will be a lively affair with the Chee Weez in the Clubhouse and DJ San-D in a trackside tent. Other attractions include food vendor carts and a beer garden. It is one way the racecourse tries to attract a younger crowd, including those who may never have been to the track, he says.

Starlight races are also scheduled for Dec. 20 (with the Bucktown All-Stars and DJ Crush); Jan. 17 (with Groovy 7 and DJ Digital); Feb. 7 (with The TopCats and DJ San-D) and March 14 (with The Mixed Nuts and DJ Kemistry). In all, the upcoming season will feature 58 races with purses totaling $7.51 million.

Other highlights of Nov. 22’s opening night schedule include exotic animal racing featuring camels and ostriches (slated for early in the evening to accommodate families) and a Mascot Race, pitting the track’s “Gentilly Billy” against other New Orleans area mascots. The exotic races are especially popular, Conner says. Last year more than 10,000 people came out for them.

Of course, lots of horseflesh lovers will make Nov. 28, Thanksgiving Day, their kickoff to the racing season. Families from all over the area like to combine their turkey dinners with the excitement of top-shelf racing. “I’m sure we’ll fill up quickly,” says Tim Bryant, who has been president of the Fair Grounds since 2010. Bryant, who came to the track from Harrah’s New Orleans Casino, says he sees lots of familiar faces each Thanksgiving and even has gotten to know some diehards who come in every live race day.

The Fair Grounds is the country’s third-oldest racetrack. Bought by Churchill Downs Inc. in 2004, the track also operates more than 620 slot machines and 11 off-track betting parlors in southeast Louisiana. Revenue from the slots helps beef up racing purses, Conner says. The slot machines are open year round.

In addition to thoroughbred racing, the Fair Grounds holds an annual Summer Quarter Horse Meet.

The racecourse’s clientele is a real “gumbo,” Conner says. Admission to the ground level and grandstand spots is usually free, while on the Clubhouse level patrons pay an admission fee and can enjoy fine dining. Businesses can reserve space for meetings; families hold debutante luncheons there and everybody enjoys the famed corned beef sandwiches that have sustained generations of bettors. On Thanksgiving and Derby Day the atmosphere is party-like and women enjoy wearing their most fashionable hats.

Depending on your cable provider, you might be able to catch Fair Grounds races at home on channel HRTV, Conner says. The action is also shown in 1,000 simulcast spots across the country.

Derby Day. This year the racetrack will hold the 101st running of the Louisiana Derby on March 29, with seven stakes worth $2.51 million. The meet will be the richest afternoon of racing in Louisiana history, Conner says. For the second consecutive year, Louisiana Derby Day will include an infield festival with live music and food and beverage stands. Post time will be 2 p.m.

Those who follow racing often consider the Louisiana Derby a prep for the Kentucky Derby, Bryant says, with Louisiana Derby Day jockeys going on to make strong finishes in the Kentucky Derby.

Attendance has been good at track events, Conner says. “We have fared very well in recent years on the track and the handle,” he says – and the turf looks good for the coming season.

The Black Gold 5 Prize will also be making a return. The winning bettor must be the only person who correctly selected the winners in the five final races of the day. If there is no winner, half the pool carries over and the other half is distributed as consolation prizes to the tickets with the most correct picks.

The only additions to the stakes schedule for the new season are two minor stakes restricted to Alabama-breds: the $50,000 Magic City Classic for older horses and the $25,000 Kudzu juvenile for 2-year-olds.
The season’s final Louisiana-bred event for older horses has been renamed the Star Guitar Stakes. Star Guitar became the all-time Louisiana-bred earning leader last year by winning the race that will now carry his name.

Last season, 10 of the Fair Grounds stakes were graded – five Grade II (the Risen Star Stakes and Louisiana Derby for 3-year-olds, the Fair Grounds Oaks for 3-year-old fillies, the New Orleans Handicap for older horses and the Mervin H. Muniz Memorial Handicap for older turn horses) and five Grade III (the Lecomte Stakes for 3-year-olds, the Rachel Alexandra Stakes for 3-year-old fillies, the Mineshaft Handicap for older horses and both the Fair Grounds Handicap and the Colonel E.R. Bradley Handicap for older turn horses).

When the North American Graded stakes committee meets to determine grades for 2014, Fair Grounds officials hope the Louisiana Derby will receive a Grade I status in light of the fact that it’s a proven prep for the Triple Crown. “We traditionally have one of the strongest jockey colonies in the industry,” Conner says.

Leading the pack. Fair Grounds favorites led the lists of winning jockeys, trainers and owners at the end of last season, and bettors can look forward to seeing these leaders come on strong when the new season gets going.

Tom Amoss and Steve Asmussen tied for top trainer with 42 wins apiece. Asmussen, with 12 leading trainer titles, recently became the second-leading trainer in history, beating Jack Van Berg’s record. Amoss has 10 leading trainer titles.

Either Amoss or Asmussen has been the leading trainer annually at the Fair Grounds since the 1998-’99 meet, when Al Stall Jr. tied with Amoss.

With 125 wins, Rosie Napravnik nailed top jockey status for the third straight season. Second was James Graham, with 82 wins.

Meanwhile Maggi Moss, an Iowa-based attorney, earned her third straight leading owner title with 19 wins.

But statistics aren’t the only things bettors consider when they put their money down, Conner says. “Customers like certain jockeys for certain reasons,” he says. And, he adds, superstitions also play a role.

Nov. 22’s opening night schedule includes exotic animal racing featuring camels and ostriches – slated for early in the evening to accommodate families.

On Thanksgiving and Derby Day the atmosphere is party-like and women enjoy wearing their most fashionable hats.

Starlight races with live music, food vendor carts and a beer garden help attract a younger crowd, including those who may never have been to the track.

• Music + Festivals

November 1, 2013

MARDI GRAS In his new book, Mardi Gras: Chronicles of the New Orleans Carnival, Mardi Gras expert Errol Laborde – who is also the editor-in-chief of the magazine you’re reading right now – shares an in-depth look at the history and culture of New Orleans’ most famous celebration. The stories and photos that flow throughout the book give readers a comprehensive look at how New Orleans’ Carnival celebration has evolved.

KATRINA Sheri Fink’s Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital has received a lot of national attention, thanks to Fink’s interviews on “The Daily Show,” NPR and more, but the Hurricane Katrina book is worth the hype. The book recounts what happened at Memorial Medical Center in New Orleans before, during and after Hurricane Katrina. The book is incredibly well researched and provides extensive background about the hospital and the moral and ethical dilemmas the doctors faced during the time of crisis.

BOOKS No matter how well you know New Orleans, all booklovers will learn something new in Susan Larson’s The Booklover’s Guide to New Orleans: Second Edition. As a former book editor for The Times-Picayune, the host of “The Reading Life” radio interview show on WWNO and a board member for the Tennessee Williams/New Orleans Literary Festival, Larson is a true literary New Orleans expert. Her knowledge shows in her recent guide, which is full of places, shops and stories of interest to New Orleans bookworms, and also includes interesting facts, such as where John Dos Passos lived on Esplanade Avenue.

ROCK/BLUES New Orleans isn’t synonymous with rock music, but accomplished musicians such as Anders Osborne are examples that New Orleans has a lot of variety to offer in addition to jazz. With his latest album Peace, the Swedish native offers 11 tracks that showcase his famous guitar skills, those of which American Songwriter compared to the iconic Jimi Hendrix.

November 1, 2013

What I’m thankful for: The levees didn’t break. I don’t have to paint my toenails again until hot weather. Same thing with shaving my legs. There is still a month to buy Christmas presents.My mother-in-law says she’ll cook Thanksgiving dinner, and I just have to bring the pie. Rouses’ pies ain’t bad.

But especially: I don’t have Skeets this year.

But don’t get no ideas. Skeets ain’t no stomach problem or sexual transmission disease or nothing like that. I am talking about a dog. This dog belongs to the mother-in-law of my sister-in-law, Gloriosa.I am also talking about my son Gargoyle’s ex-girlfriend – I’ll explain about her in a minute.

Even though the dog has an official name, Lady Skeeter MacReeter, being as she’s a registered pedigreed, she don’t know how important she is. She is a nice little thing who follows you around and smiles with her tongue lolling out like dogs do.

Gloriosa’s mother and father-in-law are taking a 10-day cruise to somewhere, and they entrust little Skeets to Gloriosa. There ain’t no love lost between Gloriosa and her mother-in-law, so Gloriosa thinks this is her chance to smooth things over. And then her husband surprises her with a five-day Thanksgiving trip to Sweden. (Gloriosa and her husband are the rich branch of the family.)

The five days are in the middle of the in-laws’ 10-day trip, so Gloriosa asks my high-school daughter, Gladiola, to come over and dog-sit for $20 a day and unlimited use of her TV, which is the size of a billboard.

Gladiola is delighted. Until the second day. Then she calls me, hysterical. Skeets had a digestive upset and did her business all over the Oriental rug in the living room. I go over and we clean it up and powder it down with baking soda – and call the vet. The vet says evidently her dog food isn’t agreeing with her, so Gladiola should cook chicken and rice for her until her owners gets back.

The next night, to protect the rug, Gladiola coops her up in the kitchen. But Skeets gets lonesome. And she cries. And whines. And howls. So Gladiola calls me. And she cries. And whines. And howls.

Finally me and my gentleman friend, Lust,offer to bring an air mattress over there so Gladiola can sleep in the kitchen with the dog.

While they’re waiting for us, Gladiola and Skeets curl up and watch The Exorcist on the big TV. Bad idea. By the time we get there Gladiola is too terrified to let us leave. She and me wind up sleeping together upstairs and Lust sleeps on the air mattress in the kitchen with the dog. Lust sleeps fine, but Skeets don’t. She has another digestive upset and the next morning we got to clean up the kitchen floor. I ask Gladiola how she cooked Skeets’ chicken and rice, and she tells me she bought it at Popeyes. Extra spicy.

I decide Skeets needs to come home with me. I can cook bland chicken and rice; I got no Oriental rugs, and Lust says he ain’t about to sleep on nobody’s kitchen floor again.

It works. Skeets is cured – although Lust is still kind of grouchy.

Problem is, this dog gets very upset if she’s alone, and the next day is Thanksgiving. We got dinner at my mother-in-law, Ms. Larda’s. I call and ask if I can bring Skeets along and Ms. Larda says sure.

Before we go, I make sure to give Skeets her chicken and rice and take her to relieve herself. But I’m still nervous that somebody will feed her something else and we’ll have a disaster on Ms. Larda’s rug.

Which isn’t Oriental, but still.

So I’m a little distracted when my son Gargoyle arrives from LSU and introduces his new girlfriend. She was the Crab Queen of her hometown on the bayou, he says, and that strikes me funny and I try not to snicker. I guess I don’t pay attention to what else he says.

I should have, because her name is Skeets.

Now who would name a girl Skeets? Bad enough for a dog. And just like the dog, she got an official name, Sara Kit Estes. But she goes by Skeets.

Which, like I said, I don’t hear. Ms. Larda is already announcing it’s time to eat.

Now, when the entire Gunch family eats together we don’t have enough table room, so we spill over into the living room and wherever we can find chairs and eat out of our laps. After everybody has their plate and we say the grace, I stand up and announce, “Don’t nobody give nothing extra to Skeets. She got a stomach problem.”

Skeets, the girl – who don’t have a stomach problem, even if she’s on the roundish side – is sitting right behind me. I guess her eyes bug out a little, but I don’t see this. After a while I notice Skeets, the dog, going from person to person with big sad eyes, and I say real loud, “Skeets! No more for you. You ate enough!” Unfortunately Skeets, the girl, happens to be getting seconds at the time.

She and Gargoyle left out the back door right after I yelled at the dog that I was going to put her out in the yard if she kept bothering people.

Evidently that ended Gargoyle’s romance with Skeets, the girl. He said later – after a lot of explaining from both sides – that it was probably for the best, so I guess his heart ain’t broken.

Now I got to mention two more things I’m thankful for: Gloriosa and them will be home this year, so they’ll have Thanksgiving dinner with us.

And nobody named Skeets will be there.

November 1, 2013

I have been struggling with gratitude lately. I don’t really know why, except maybe that it was my birthday on Monday, and I still kind of act like a spoiled brat on my birthday. Also, Georgia has been sick with Hand, Foot and Mouth disease, and between her misery and my lack of sleep, I’ve just been in a mood.

I think it started when I read something a fellow mommy blogger had written about how her living room was a mess and her kids were screaming but how she wouldn’t want to be anywhere else in the world. I get that sentiment; I really do. I feel that way myself most of the time. But not that night. “Ugh,” I thought, looking at my own messy living room and listening to my own screaming kids. “I can think of 100 places I would rather be than right here right now: the beach, the bookstore, a quiet room, taking a solitary drive in the country – anywhere but here on my stained sofa with a teething, sick toddler and a feisty, sassy 6-year-old who doesn’t want to do her math homework, with ketchup smeared on my pajama pants and ranch dressing smeared on the ottoman and snot (not my own) smeared on my T-shirt and the TV blaring the same episode of ‘Yo Gabba Gabba’ I’ve seen 87 times this week alone.”

Then a friend of mine emailed me the day after my birthday, partially to wish me a happy birthday and partially to ask if I liked the timing of my birthday because she and her husband were contemplating starting a family and September was “the only month that would work” for them. That kind of mindset makes me a little bit angry and a little bit jealous and a little bit smug and a little bit sad and really a little bit of everything. My very first due date was actually my own birthday, but that pregnancy ended 14 weeks along, and I had Ruby four days before Christmas, something I never would’ve planned.

The idea that someone could be so … naïve? hopeful? delusional? … as to think that having a baby is really just as easy as picking the date that works best for you, counting back nine months and having sex – I don’t know. I think it was more my crummy mood than anything, but I didn’t feel gratitude for the two little miracles that I brought into the world with the help of almost 1,000 injections of blood thinner so much as I felt an urge to write back, “If you’re that much of a control freak, just don’t have kids.” I think I’ll write a kinder, gentler version of that soon – her question was meant in a good way and she’s a good person, but giving up any sense of control is really a crucial step in both pregnancy and parenting – but I was just cranky. Definitely cranky.

I knew I needed an attitude adjustment when Georgia woke burning up and crying hysterically at 3 a.m., and my first emotion was a stab of envy as I thought of the Catholic priest I was set to interview the following day. I am not all that religious, honestly, but when you’re struggling to administer a rapidly melting Tylenol suppository to a screaming, miserable infant in the middle of the night, a quiet child-free life of contemplation starts to seem at least a little bit appealing.

I tried, repeatedly, to tell myself I was being a jerk for not being more grateful for the wonderful things in my life: my beautiful, charming daughters; my sweet, funny stepson; my brilliant husband who cooks and cleans and rocks the baby to sleep and makes me laugh a lot; my dad who is 75 and robustly healthy and volunteers as a notary at the public library; my awesome mom who watches my kids all the time and fields my frantic phone calls and works with at-risk youth; my in-laws who are generous with their time and affection; my home in a safe neighborhood; a grocery budget that allows for fresh fruit and veggies and organic milk. I am extremely fortunate. I know this. Somehow, though, knowing you should be grateful doesn’t always translate into gratitude. When I was pregnant, for example, I knew how lucky I was and how much I wanted my babies. But gratitude was hard to come by when a Red Lobster commercial made me puke into my lap or bruises from the blood thinner made my entire stomach a gross purply-blue. The overall gratitude for what I had was there; it was just buried under the unpleasant but very real details.

In the midst of my bad attitude last night, though, Ruby mysteriously disappeared for about 10 minutes, and when she came back into the (messy) living room, the front of her shirt was soaking wet.
“I know you’re tired because the baby isn’t sleeping, Mom, so I did the dishes for you,” she said.

I went in to the kitchen to find the floor covered in soapsuds, the waterlogged sponge dripping off the counter and dried pasta still clinging to the bottom of the “clean” pot. But Ruby flung her damp self at me, so proud of her attempted good deed, and then feverish Georgia toddled over and held out her arms and said, “Up? Up, Mama? Hug?”

And suddenly, there was no place I would rather be.

November 1, 2013

New Orleans streetcars are an integral part of New Orleanians’ experience, and children’s streetcar memories usually begin in family company. Paulette Perrien notes that when her children were young “we would get on the streetcar on Carrollton Avenue, and get off on Canal at Carondelet Street, and go to D. H. Holmes for lunch. That was fun, riding with young children. You’d hold one and sit one by the window.”

Ken Kolb remembers taking the streetcar downtown to the orthodontist. “I used to like to stand in front by the conductor and watch him move the lever to control the speed. Sometimes, the front window would be open and you would get the wind in your face.” Pherabe Kolb relates how her younger brother Kenneth lost his hat out of the streetcar window and Cora Lee Larks got them off the car so they could walk back to get it.

Cherie Schneider recalls that when she was a student at Newcomb College she could take the streetcar down St. Charles Avenue to her grandmother’s tea room – later Corinne Dunbar’s restaurant.

Many New Orleanians still take the streetcar for their daily commute to work. In the past, when you tired of reading the over-the-seats ad for Speed Writing Shorthand (“u cn gt a gd jb w mo pa”), you could browse the “Riders’ Digest.” Back when New Orleans Public Service, Inc., ran the transit system, each car had a holder for a stack of these small newsletters.

NOPSI operated public transportation from 1922 to ’83, and published “Riders’ Digest” from the ’40s until ’83. “Riders’ Digest” contained both corporate and general news items and announcements (the company ran the electric and gas utilities as well as city transit), jokes, (“How do you get to Carnegie Hall? Practice, practice.”) sports news and a popular local history column titled “Did You Know?” Thomas Ewing Dabney of The Times-Picayune was credited with writing some of those columns, as was author Charles “Pie” Dufour. The New Orleans Public Library has a collection of “Riders’ Digest” issues, and an online list of the history column topics, with the date each ran, can be found at NewOrleansPublicLibrary.org.

Sometimes current fashion didn’t mix well with streetcars. As Karen Brown recalls of her 1970s era commute, “in those days, my skirt wasn’t that long – it didn’t come down to my fingertips. Getting on the streetcar with that little bitty skirt and my platform shoes, you had to turn sideways to get up the step – and I could do it!”

Carolyn Brown (no relation to Karen Brown) still commutes by streetcar. In the past, she regularly read “Riders’ Digest,” but today, “I have my MP3 player in my ear.” Tourists are frequent fellow passengers, and she’s happy to identify landmarks for them. Plus, there are many regular riders on her route: “you may not know them by name but you recognize them.”

The worst day for a streetcar ride? “It’s the day before Mardi Gras. The police have to go in front of the car with a bull horn to get the people off the tracks.”

She admits that sometimes she likes to sit in what was once the conductor’s seat (when it’s unoccupied at the rear of the car.) “I can see the world going backwards.” Usually, she sits in the regular seats. “I leave the front seats (the sideways ones, formerly called the ‘beauty seats’) for tourists and senior citizens.”

The St. Charles Streetcar has been named a National Historic Landmark; there are lines now on Canal Street, Loyola Avenue and the Riverfront, and others are planned, but streetcars once ran on many different city streets.

Everyone rode. Walter Carroll remembers hearing that on the old Prytania Street car line (closed in 1932), a Mrs. Bruns would go from her home on Prytania Street to shop for groceries at Solari’s in the French Quarter, and when she arrived back home, the conductor would stop the car and carry in her bags for her.

Dr. Michael Mizell-Nelson is now on the faculty of the University of New Orleans, but he did his doctoral dissertation at Tulane University on the subject of streetcars: “Challenging and Reinforcing White Control of Public Space: Race Relations on New Orleans Streetcars, 1861-1965.” Mizell was also one of those responsible for a television documentary, Streetcar Stories, on WYES-TV (for more information visit StreetcarStories.org).

Mizell was born in New Orleans, and he used a transit pass to take the streetcar to Benjamin Franklin High School when it was located on Carrollton Avenue. His son will be using a pass for the first time this year.

Don Hubbard, who lives on St. Charles Avenue today in the bed and breakfast he and his wife own, also used a transit pass when he was a student at Walter L. Cohen High School. In those days, as Mizell’s dissertation records, there were signs in streetcars and buses that marked the racial distinction line: blacks were relegated to the rear. In 1958, the signs were removed and transit was integrated.

As Hubbard recalls, “they integrated the year I graduated from high school.” Hubbard and his school friends decided to mark the midnight integration, and boarded a bus on Freret Street about 11:45 p.m. “By midnight we were at Washington Avenue, and I got off for my stop. I just took that sign with me.” The sign today can be seen at the Hubbard Mansion, 3535 St. Charles Ave.

That is right on the car line.

Tracking the Internet
It is possible to experience streetcars online. The website NewOrleansHistorical.org, (with a free downloadable app for your smartphone) holds a wealth of stories about everything New Orleans, along with videos and photographs to help you find out about old car lines, the women who were hired for streetcar work in World War II, streetcar unions and strikes. The website is a project of the History Department of the University of New Orleans and the Communication Department of Tulane University. If you have stories to add to the site, contact Dr. Michael Mizell-Nelson at mmizelln@uno.edu or Dr. Vicki Mayer at vmayer@tulane.edu.

• Food + Drink
• Recipes

November 1, 2013

I recently went to a gathering of old college buddies. Reunions often turn out to be curious in the unexpected and unpredictable ways many of us have changed over the years. But in this case, my puzzlement was caused by the wording of the invitation itself. The cash bar was no surprise; after all, unless a hedge fund manager was underwriting the event, it would be foolhardy to offer free drinks to this crowd. What threw me was the phrase “Heavy Hors D’Oeuvres.” As opposed to what? Light hors d’oeuvres? Were we talking about the weight of the food or the amount and variety? I had no idea.

It turned out that there were a lot of hot and cold hors d’oeuvres, enough to constitute a light meal, although some food was on the heavy side. It was good to have a variety of snacks to go along with the drinks.

Americans have reputations for being snackers, and often that carries negative connotations of obesity and poor nutrition. At the same time, we’re criticized because we frequently drink alcoholic beverages in the absence of food. Both of those observations are valid, though they do seem contradictory. In many societies, it is customary to nibble on something while drinking. Think of tapas in Spain or mezedes in Greece. The practice of accompanying alcohol with food is a sensible one in terms of both enjoyment and sobriety.

Who doesn’t enjoy eating a variety of foods, either as a prelude to a meal or as the meal itself? This has given rise to restaurants that feature “small plates,” appetizer-size portions that can be combined to make a meal. In truth, the appetizer section of restaurant menus is often more interesting than the entree section. I don’t know why, but it sometimes prompts me to make a meal entirely of appetizers. And count me among those who love dim sum at Chinese restaurants. Tasting menus are an extension of the same desire for variety. Instead of having an appetizer and a main course, diners are offered a succession of very small portions of signature items.

When I lived in Chicago there was a holdover law dating back to the temperance movement that prohibited bars from offering free food. To get around this absurdity, savvy tavern owners would charge a pittance for something to eat as long as you bought a drink. One place offered fried chicken on Sundays for a nickel. A bar near the office laid out a sumptuous array of foods, a literal smorgasbord, for which patrons paid a quarter. I don’t know if such places still exist, but if they don’t, they should.

Where I live now, in Acadiana, many bars have a tradition of serving a free supper one night a week. It might be a rabbit spaghetti, fried fish, chili, gumbo, jambalaya or even something more elaborate. (I once walked into a country bar where the owner was putting out trays of fried soft-shell crabs. Talk about lagniappe!) For someone who is so inclined and can keep his days straight, it’s possible to get a free meal at a different bar almost every night of the week.

With all the parties this time of year, we’ll have plenty of opportunities to enjoy something to eat with our drinks. The following recipes are a few possibilities that don’t require a great deal of time or effort to prepare.

Mushrooms Stuffed with Boudin

Boudin is a versatile sausage that can be enjoyed on its own or incorporated into a variety of preparations.

• 1 pound small white mushrooms
• 1 tablespoon olive oil
• 1/2 teaspoon coarse salt
• 1/2 pound boudin

Preheat broiler and grease a baking sheet.
Wash mushrooms and dry thoroughly. Remove stems and reserve for another use.
In a large bowl, toss mushroom caps with olive oil and salt.
Remove boudin from casing and stuff mushroom caps.
Place stuffed mushrooms on baking sheet and broil until nicely browned, about 5-6 minutes.
Makes about 3 dozen stuffed mushrooms.

Gorgonzola and Roasted Walnut Spread

This is an all-purpose spread that can be served on small slices of pumpernickel, croutons or crackers. It is also wonderful melted over a grilled steak.

• 1/2 cup walnuts
• 3/4 cup gorgonzola
• 4 tablespoons butter

Preheat oven to 350 degrees.
Place walnuts on baking sheet and roast in preheated oven, tossing occasionally, until lightly toasted, about 8-10 minutes.
Rub walnuts between your fingers to flake off walnut skins.
Transfer walnuts to bowl or food processor and pulse until finely chopped.
Add gorgonzola and butter and process until smooth.
Makes about 1 cup.

Crab Salad

Nothing could be simpler, more delicious or more elegant than crab salad.

• 1 pound lump crabmeat
• 2 tablespoons lemon juice
• 1/4 cup mayonnaise
• 1 tablespoon chopped parsley
• Cayenne pepper to taste
• Salt and freshly ground black pepper to taste
• Croutons or crackers

In a medium bowl, combine crab, lemon juice, mayonnaise and parsley.
Toss gently to combine and season with cayenne, salt and pepper.
Serve with croutons or crackers.
Makes about 2 cups.

Bagna Cauda

This assertive sauce from the Piedmont region of Italy is a welcome departure from the mayonnaise and sour cream dips often served with raw vegetables. It is also delicious spooned over steamed vegetables.

• 4 tablespoons butter
• 4 garlic cloves, minced
• 1 (2 ounces) can anchovy filets, drained
• 3/4 cup extra virgin olive oil
• Coarse salt and freshly ground black pepper
• Bread sticks
• Assorted vegetables, such as carrots, celery, bell peppers, fennel, zucchini, broccoli, cauliflower, cut as for crudities

Combine butter, garlic and anchovies in saucepan over low heat.
Using a large spoon, mash anchovies and simmer until garlic is softened.
Add olive oil and season with salt and pepper.
Serve hot with vegetables and bread sticks for dipping.
Makes about 1 cup sauce.

Chicken Wings Tom Yum

Tom yum paste is a hot and sour chili paste seasoned with lemon grass, lime, shallot, garlic and other ingredients.
It is used to make soup in Thailand and Laos, but it can also flavor other dishes, such as these chicken wings.
The paste iseasy to find in Asian markets, but purchasing chicken wings in the supermarket is another matter.
Shoppers now have the option of choosing whole wings or what are sometimes labeled “party wings,” which are the second and third joints of the wing that have been separated and are sold without the wing tips.
There are also packages labeled “drumettes” and “wingettes.” Take your choice.
Using lime juice in the recipe intensifies the piquancy of the dish, while mango nectar tones it down.

• 12 chicken wings
• 1/4 cup tom yum paste
• 1/4 cup lime juice or mango nectar

If using whole wings, separate the three sections with a knife.
Reserve wing tips (first joint) for making stock.
Combine tom yum paste with lime juice or mango nectar in a bowl.
Add wing sections and coat thoroughly. Cover and marinate for an hour or longer.
Preheat oven to 400 degrees.
Place a rack on a heavy baking sheet.
Place wings on rack and roast for 15 minutes in preheated oven.
Turn wings over and roast until nicely browned and cooked through, about 10 minutes.
Drain on paper towels.
Makes 24 “wings.”

November 1, 2013

‘Tis the season, and Louisiana streets and buildings are once again donning those tinsel-time colors of red and green. For New Orleans and especially the French Quarter, however, red is the dominant hue by a wide margin, thanks to a fleet of big London-style tour buses introduced this year by the local Valentino family of hoteliers. You’ll spot the fire-engine red double-deckers immediately, cruising the streets of the Quarter (and beyond) as they circle past historic landmarks, entertainment locations and famous restaurants, each bus loaded with riders pointing and snap-shooting from the lower-level windows and open-air top-deck seating.

While these so-called Hop On-Hop Offs are the most recently arrived mode of guided-tour transport in town, they’re but one of a long list of choices that range from traditional to ultra-modern, all vying for the pleasure of telling you the stories and showing you the sights of the city.

When it comes to the traditional conveyances, everyone thinks first of French Quarter carriage rides (some now offering jazz- and ghost-themed tours as well as the standard historic fare, some even straying beyond the Quarter into other landmark-filled neighborhoods). An occasional buggy tour is a beloved tradition among locals and high on the agendas of most visitors, providing something of a feel for life in the Vieux Carré before it got so vieux (especially when passing a group of costumed Dickensonian Christmas characters who roam the sidewalks this time of year).

You don’t see white mules every day (said to be wellsprings of good fortune, or maybe it’s harbingers of doom – can’t remember), but you’ll see several of them among the line of dray mules patiently waiting for you with their carriages and drivers along Decatur Street at Jackson Square. Pick a buggy and hop on for a pleasant and informative ride, and, if you haven’t ridden in a while, prepare yourself for a difference: The days of wildly inaccurate spiels by the guides are long gone by. That means the loss of some humor value, perhaps, but it’s nice to know visitors are no longer going back to Oshkosh with the notion, for instance, that Napoleon lived in the Napoleon House.

Other sightseeing experiences long ranked as de rigueur are steamboat port tours aboard the Natchez IX or Creole Queen and, of course, the walking tours offered by Friends of the Cabildo (a State Museum support group), National Park rangers (whose passing tour groups always make me feel like Yogi Bear), cemetery preservation groups and countless commercial guide services. The walking tour tradition is about as old as walking itself, but the list of themes is still growing. Naturally the architecture/history tours of the Quarter were the first, and they’ve now spread as far as the Garden District, Arts District and Irish Channel. Cemetery tours came next, born of visitors’ desire to see the tombs of Marie Laveau and Jean Laffite’s half-brother Dominique You in St. Louis Cemetery No. 1, since spread to St. Louis No. 2 and, in the Garden District, to wonderful old Lafayette No. 1.

The list of themes has at least quadrupled in recent years, and now you can find guides offering haunted-places tours, “Witches Brew” tours (the coven crowd and other scaries), vampire tours (blame Anne Rice), Voodoo tours (inspired by Marie Laveau and Dr. John – the name borrowed by the famous and funky singer Mac Rebennack), “underworld” tours (Mafia and more), “True Crime” tours, Scandal Tours (featuring “murder, mayhem, corruption, prostitution, assassination conspiracy”), the “Romantic Tour” (exclusive offering of Good Old Days Tours, (504) 523-0804), music history tours, live music venues, co*cktail tours and guided dine-arounds.

Keeping right up with the lengthening list of themes has been the growing number of modern transportation types, some making it possible to cover vast expanses of the city in a single tour, while other modern varieties cling to the shorter radius but bring new elements of thrills to the traditional routes. Segways, for instance –those two-wheeled, vertical, one-man rigs usually seen in weaving convoys following at the heels (wheels, that is) of a tour guide – are agile enough to maneuver through the heavy foot traffic of pedestrian tour groups, and when it comes to wider-ranging excursions, needless to say it’s helicopter-hopping that holds that record as measured in square-miles per hour.

The gentlemen of Jesuit Bend Helicopters, for instance, with two-day and sometimes even one-day notice ((504) 912-5300 or NOLAheli.com), can meet you at the Mercedes-Benz Superdome Heliport and in a single tour take you “flightseeing” above all the most popular sights: Jackson Square and the Moonwalk, cruise ships and the towering International Trade Mart along the river, the great old Whitney Tower and modern skyscrapers of the Central Business District, Lee Circle, universities, sprawling above-ground cemeteries, and even the sailboats and shrimpboat docks of surrounding lakes and wetlands. (On Dec. 7-8, incidentally, you can find the Jesuit Bend whirlybirders downriver at the Plaquemines Parish Orange Festival, offering short-hop aerial views of the river, old star-shaped Ft. Jackson and the ruins of Ft. St. Philip.)
Back on the ground and back in town, two other new tour-types offer a chance to see the sights while working off the calories from last night’s cream-based sauces: guided bicycle tours and (no foolin’) jogging tours! Bike rentals are plentiful, but Bicycle Tours and Rentals at (866) 293-4037 offers licensed guides to lead their Creole and Crescent bike tour of the Quarter or Garden District Tour of other early neighborhoods. New Orleans Jogging Tours ((504) 858-9988) provides a jogging buddy (also licensed) who’ll lead and narrate a 90- or 120-minute tour (with ample breaks along the way) of French Quarter and Garden District landmarks and celebrity homes. “Anyone can do this tour,” they say, and I for one will take their word for it.

Excursions get longer and longer as you graduate from mule power and leg power to “horsepower.” The big modern motor-coaches of BUS-VISION circle constantly around the major attractions of the city, with free optional walking tours along the way, and the van-tour service called Movie Tours ((504) 383-8668) has combined the concept of big-radius routes with the new tradition of specialty themes to create a tour of local film locations (each matched with video clips of that location’s scenes), ranging from vintage and recent movies to actual live film sets.

Happy to say, the guided tour services of New Orleans, of every theme and mode, are all busy as Santa’s elves this season, but it’s the newest of the new – the exciting look and novelty of those London-inspired double-decker “Hop On-Hop Offs” – that are turning all the heads. They just look like fun on wheels, and that explains their spread around the world including about 100 cities in the U.S., operated locally by City Sightseeing New Orleans under the purview of Hotel Management of New Orleans. That enterprise, headed by owner-manager Michael Valentino, owns five major Valentino family hotel properties in the city as well as Basin Street Station, a 105-year-old Southern Railroad Station recently restored to serve as a New Orleans information center (travel counselors, maps and literature, hotel reservations, arts/crafts/music exhibits, elaborate antique coffee bar and special event facilities) at 501 Basin St.

Located at the historic “hub of cultures” adjacent to the Quarter, Mid-City and Iberville districts (and accessible effortlessly via the Exit 235-A of I-10 East), the old station also serves as terminal of the Hop Ons. As such it provides free parking and ticket sales ($29 per day or $39 per week), but riders can also board and buy passes at any of the dozen stops strewn along Loyola Avenue (Hyatt Regency), Canal Street (Harrah’s and the Marriott), St. Charles, Magazine Street, Tchoupitoulas (Mardi Gras World), Julia Street (Arts District) and Decatur (Jackson Square and the French Market). You can Hop Off wherever you please, stay as long as you like and just Hop On the next half-hourly bus (9:30 a.m. to 5:30 p.m. daily) when you’re ready to move along.

BEST BETS

Going solo: If you’re a curmudgeon and just don’t like group tours, remember that with your vehicle, or with all those bike rentals, Segway rentals and Hop Ons, it’s no great challenge for a visitor to get around New Orleans unassisted. And thanks to the many very portable sources of directions and information on local landmarks and attractions, provided by guidebooks (from souvenir shops, bookstores and the gift shops at hotels and attractions) and digitally (courtesy of your App Store, iPhone, i-This and i-That), your solo sightseeing can be quite successful.

Still too public? The massive privately endowed archive called the Historic New Orleans Collection can help. Visit hnoc.org/vcs to “tour” their Digital Survey of every street, every block, every structure in the French Quarter – compiled as the Vieux Carré Survey by decades of researchers and housed at the HNOC, but not digitalized and accessible online (complete with the modern and vintage maps, engravings and paintings) till 2012.

History in the Round: As of 2013, the great marble and granite Louisiana State Exhibit Museum (née Louisiana State Exhibit Building), one of the “goods” blown Louisiana’s way by the ill wind of the Depression, has stood adjacent to the State Fairgrounds in Shreveport for 75 years. It was the work of architects Edward F. Neild and D.A. Somdal and product of FDR’s Works Projects Administration, tasked to create jobs in the bleak 1930s by funding worthwhile projects in categories like construction, reforestation and the arts.

Beyond Conrad Albrezio’s immense exterior fresco at the entrance, the great central gallery (encircling a lush doughnut-hole courtyard) and flanking side galleries present exhibits that celebrate the entire state, not only by now-historic artworks but by such unusual media as a giant topographic Louisiana map by sculptor Duncan Ferguson; 22 wax-figure dioramas of Louisiana agriculture, industry and life; natural history collections and important artifact collections representing our greatest prehistoric (Poverty Point) and historic (Caddo Nation) Native American cultures.

Visit the website of museum “Friends” today (flsem.mmcchosting.com), and visit this great Smithsonian-affiliate museum (9 a.m. to 4 p.m. weekdays, free) at your first opportunity.

November 1, 2013

Brothers Kevin and Stephen Mixon have been off of work for an hour, but their mobile phones buzz with text messages every few minutes. The two men are nurse practitioners, but the messages aren’t about medicine; they’re about bees.

For the past five or six years, the brothers have kept honey bees as hobbyists, though this is much more than your average weekend pastime or every-now-and-then project. Stephen keeps about 30 hives, while Kevin tends 80 to 100. The hives are scattered on farms and friends’ land on the north shore of Lake Pontchartrain. It seems whenever they’re not working their day jobs, they’re maintaining their hives or fielding phone calls and texts from less experienced hobbyists who have questions or need help.

“I do something with bees every day,” Kevin says. “Either put together a frame, put together boxes. It just keeps getting larger and larger.”
“The limiting factor is time,” Stephen adds.

The Mixons first started keeping bees with their father, who retired and acquired some hives from a friend.

“We ended up with four hives stuck on the edge of the property, and we didn’t really mess with them,” Stephen says. “The bees were doing their thing, and after six months it was time to go get some honey. There was honey everywhere.”

“That first year I turned those hives into either 13 or 14 by the next winter. It just hasn’t stopped since,” says Kevin, who also sells honey at the Covington Farmers Market.

busy bees

It’s tough to pin down the number of amateur beekeepers in Louisiana, but there are eight local clubs registered with the larger Louisiana Beekeepers Association. At the Southeast Louisiana Beekeepers branch, where Kevin is president, there are 125 dues-paying members. But the brothers think there are more hobbyists not participating in clubs than there are in them. And there are professional beekeepers throughout the state, too.

Small-scale beekeeping requires little more than a backyard and a watchful eye. Hobbyists must examine their frames, looking for signs of healthy activity and productivity. They can learn to recognize the signs of disease and predators and to safely extract honey when it’s time. There can be a bit of a learning curve, which is why the Mixons’ expertise is in such high demand.

The beehive itself is a humming community of queens, workers and drones. Each hive has lone queen, whose job is to mate with the drones and create more bees. The worker bees shoulder the burden of gathering pollen and nectar to bring back to the hive. They also clean and build the hexagonal cells that make up the hive, nurture growing larva, control the hive’s temperature and protect it from invaders.

Honey bees – the Louisiana state insect – have complex communication methods. When foraging bees locate a food source, they return to the hive to tell the other bees. They do so by performing dances that relay to other bees where the food is; each dance move communicates the location and direction of the pollen source.

These creatures are capturing the attention of a growing populace, as the Mixons have attested. More and more aspiring hobbyists are showing up at association meetings, and more small-scale farmers and enthusiasts are offering land for apiaries. But all the while, there are growing challenges to keeping healthy bees – on any scale.

the birds and the bees

Honey bees are not native to the United States, though we’ve come to rely on them heavily – and for more than just honey. Europeans brought Apis mellifera to North America in the 17th century. Now, we use them to pollinate some $15 billion in crops annually, including okra, onion, cashew, celery, cabbage, chestnut, lemon, lime, cotton, apple and almond. Though there are other pollinators out there, including a long list of native species, it is the honey bee who does most of the work for these major crops. They are such efficient pollinators that industrial agriculture has become dependent on the insect.

Professional beekeepers transport their colonies from farm to farm, unleashing their bees. They buzz from flower to flower to collect nectar and pollen, but inadvertently drop some pollen – the male sex cells of a flower – onto the stigma – the female receptive organ. Without this delicate process, plants cannot set the fruits and vegetables and tree nuts we eat. One in every three bites of food consumed in this country is directly or indirectly pollinated by honey bees.

Honey bees have captured the nation’s attention in recent years because they face threats from the environment.

Viruses, parasites and big farms’ chemical fertilizers and fungicides have contributed to alarming numbers of bee die-offs in the past few years. In the winter of 2012-‘13, nearly one-third of commercial honey bee colonies in the United States died or disappeared. At that level, much of the country’s food supply is at risk. In fact, in March of this year, there were so few bees that the almond crop in California almost collapsed entirely.

The major attention-getting bee problem of late is called colony collapse disorder (CCD), a phenomenon first reported in 2006. With CCD, honey bees inexplicably vanish from the hive, never to return. CCD is actually on the decline, but the bees are still dying. Heavy pesticide use on big farms, malnutrition, parasitic infections and perhaps even the stress of being overworked, spread thin among so many farms that demand their services, the bees face many threats. And farmers lose money when their bees die; if there’s no profit, there are no beekeepers.

If bees are dying, other pollinators, like butterflies, moths, bumblebees and hummingbirds are certainly suffering similar fates. Honey bee die-offs are just more apparent because apiaries are huge colonies with high visibility. We have to work harder to see the effects on other species.
“The bees are the canary in the coal mine,” Stephen says. “The bees themselves are a barometer to environmental health.”

the hobbyists’ challenge

Louisiana hobbyists, who operate on a much smaller scale than their industrial counterparts, have their own, similar challenges.
For the Mixons, mosquito spraying is a big problem. Trucks and planes unleash the pesticide Resmethrin for mosquitoes, but the broad-spectrum pesticide kills bees, too. Last spring, more than half a million of the Mixons’ honey bees died in a single location after a Resmethrin spraying in Tangipahoa Parish.
But the bees are only the most visible victim, the canary in the coal mine.

“It’s killing everything. Every dragon fly, lighting bug, every type of insect, it’s killing it. If it’s a winged insect it’s dead. It’s my biggest soapbox,” says Kevin.
The brothers say colony collapse is no great mystery.

“Sure, there are mites, hive beetles, all these pests. There are diseases. But the colonies that collapse, they’re weakened by pesticides,” Kevin says.
“It’s pesticides,” Stephen echoes. “If you disrupt the hive, they will eventually just leave. If you mess with them enough, they’ll just fly away.”
There are other challenges, too, even for the expert. The Mixons will see hives fail on occasion, though not because of CCD. Sometimes, bees just get sick; other times, the beekeeper is at fault.

“The hives that I have that ‘fail’ are from manipulation error, pests or weak/old queens. If the hives have food – pollen and honey – and enough bees to efficiently operate, collect food and water, clean and guard thehive, they normally do not fail,” Stephen says. If he takes too much honey from the hive, the bees may run out of food. He can accidentally kill a queen while inspecting his apiary. Even if a beekeeper does everything right, there are still external problems like sick or aging queens, mite and hive beetle infestations, and robbing of pollen and honey by stronger hives.

Challenges aside, the Mixons have noticed a growing – and more diverse – populace at their bee club meetings.
“It’s a nice cross-section of inquisitive minds,” Stephen says. “People are just fascinated.”

The brothers say that anyone can learn to be a good beekeeper, as long as they’re observant and persistent. They recommend buying a book on beekeeping and joining a local bee club as the best ways to get started. And, of course, having a mentor like a Mixon certainly can’t hurt.

• Wellness

November 1, 2013

edical care is a constantly evolving field. New technologies and new surgeries become available to patients on a regular basis. Residents in all five regions of Louisiana can look forward to top-notch medical innovations in their area.

BATON ROUGE

Chronic heartburn (aka GERD – gastro esophageal reflux disease) isn’t fatal, but it can cause chest pain, difficulty swallowing and trouble breathing. Previously, patients had to take proton pump inhibitors daily to eliminate symptoms. Now, the transoral incisionless fundoplication (TIF) procedure is showing promising results.

While previous surgical interventions were reserved for only the most severe cases, the TIF procedure makes surgery a more viable option for moderate GERD sufferers by largely eliminating the side effects (bloating and difficulty swallowing) of older procedures. Instead of taking a pill daily for decades and risking side effects (such as bone-density loss) from long-term usage, patients can have a safe, effective procedure instead.
According to data the TIF US Registry released this year, 81 percent of patients who underwent the TIF procedure experienced either total elimination or noticeable improvements in their GERD.

“The TIF procedure is a viable option due to the dramatic shift in the risk-reward profile associated with correcting the underlying anatomical failure, and it allows a majority of patients to stop taking daily medication for reflux,” says Dr. Aldo Russo of Ochsner Medical Center – Baton Rouge.

CENTRAL LOUISIANA

With trauma patients, the “golden hour” is everything. For the best chance of survival, a patient should go from trauma to surgery in less than an hour. Until recently, trauma patients in central Louisiana needed to be flown into New Orleans. But now, Rapides Regional Medical Center in Alexandria has a Level 2 trauma center.

The center is the first in an initiative to develop a statewide series of trauma centers (outside of New Orleans) that will ensure that all Louisianians will be no more than 50 miles from trauma care. Louisiana is currently one of seven states without a statewide trauma system and features the ninth-highest mortality rates for trauma patients.

Donna Lemoine, trauma center director at Rapides Regional Medical Center, said central Louisiana sees a lot of ATV, horseback riding and industrial accidents requiring urgent trauma care. Rapides has a full staff of surgeons available to treat any traumatic injury. When patients are 10 minutes away from the hospital, doctors are notified so they can be waiting for the patient when he or she arrives, instead of the patient waiting on the doctor. The hospital sees patients from as far away as Natchez, Miss.

LAFAYETTE/ACADIANA

Increasing numbers of people are telecommuting to work every day. Now, it’s possible for some Louisiana residents to telecommute to the doctor.
For employees of Stuller, a large jewelry manufacturer and one of Acadiana’s biggest employers, leaving work for a doctor’s appointment was a tremendous hassle. Because employees handle highly valuable jewelry, security is high entering and leaving the facility.

Lafayette General Medical Center has introduced a telemedicine center within the Stuller premises. A nurse is on-site from 10 a.m.-2 p.m., Monday through Friday, and doctors see patients through video conferencing. A bluetooth otoscope and stethoscope transmit information from the patient to the doctor as if he were in the room with the patient. Video screens show both the patient and the doctor what the otoscope sees.
Geoff Daily, executive director of the Lafayette General Foundation, estimates that the telemedicine clinic can do 75 percent of the services of a walk-up clinic (anything that doesn’t require a hands-on examination). Now, patients who put off going to the doctor because it was so time consuming can see one quickly and conveniently.

“We took a process that used to take two or three hours and turned it into a half-hour process,” Daily says.

NEW ORLEANS

Each year, 1 out of 1000 American babies is affected by myelomeningocele (MMC), one of the most serious forms of spina bifida. Because of an opening in the spine, the spinal cord is exposed, leaving nerves vulnerable to injury from amniotic fluid. The children can suffer a lifetime of neurological disabilities, difficulty moving lower limbs, sensation impairment and bladder/bowel issues.

Even though MMC is detectable when the fetus is 12-14 weeks old, the defect was traditionally repaired after birth. But, recent studies indicated babies who received a prenatal operation were twice as likely to walk independently at age 2, have better motor function, and were less likely to need a ventricular shunt (a plastic pressure-releasing tube inside the brain). At Ochsner Medical Center, doctors are now able to perform spina bifida repair in utero.

“To be able to intervene early enough so that a child will be able to walk, that’s huge,” said Dr. Chong Bui, pediatric neurosurgeon with the fetal surgery team at Ochsner Medical Center. “To save a child from a lifelong dependency on a shunt is remarkable. It doesn’t only impact the baby, but it impacts the entire family.”

NORTHWESTERN LOUISIANA

Cancer treatment in northwestern Louisiana will take a big step forward with the installation of revolutionary proton therapy equipment at Shreveport’s Willis-Knighton Cancer Center.

Considered the most advanced cancer treatment, proton therapy accelerates protons to two-thirds the speed of light to kill cancer cells. While chemotherapy kills healthy and cancerous cells alike, proton therapy deposits the majority of radiation within the tumor, sparing healthy tissue from damage. The new treatment is advantageous in treating cancers where options are limited and conventional radiation is risky (eye, brain, pancreas and prostate cancers, among others).

The 11 existing proton therapy centers are in facilities approximately the size of a football field and cost $120-200 million. Willis-Knighton’s center will feature the first compact proton therapy system, costing only $40 million. The equipment will be installed and tested in 2013, with treatments to begin in late 2014.

“We cannot wait to see proton therapy become an available option for our patients,” says Dr. Lane Rosen, medical director of radiation oncology at the Willis-Knighton Cancer Center. “The addition of proton therapy allows our patients to continue to receive the world’s best treatment without the need to travel out of the region.”

• Wellness

November 1, 2013

It’s difficult to pick the top health ailments in Louisiana. The ways to construct such a list of both syndromes and specific diseases are abundant.
But by far the most common complaints coughed up to primary care physicians are related to the upper airways. Common colds are just that – common. But the symptoms of a common cold rarely linger over a week or two. Yet I see at least a couple of patients a week in my office with persistent symptoms lasting weeks to months: “I need an antibiotic for this cold that won’t go away.”

Most minor respiratory symptoms resolve with tincture of time. Current treatment guidelines, usually written by so-called experts not in the trenches of providing primary care, stress the importance of not prescribing antibiotics for persons with simple nasal congestion, bronchitis, coughs, lingering colds and the like. This is where medicine the art supersedes medicine the science. I am quick to prescribe doxycycline, a cheap and relatively safe broad-spectrum antibiotic that also packs an anti-inflammatory punch, for these questionable situations. I usually avoid Z-Paks, Levaquin and newer antimicrobials because they have more adverse effects, fuel resistance problems and cost more than the average office visit.

Seasonal and even year-round respiratory allergies are the bane of living in our hot, humid climate. Everything – from dust mites to co*ckroach parts – is suspect. Various expectorants and prescription inhalers can work magic. Cough is a natural reflex to “bring it up” but a cough suppressant is occasionally indicated. Antihistamines can help, especially if taken before contact with the allergen or maybe shortly after symptoms start.

Hypertension is the most common chronic disease bringing folks to see general internists on a recurring basis. Untreated chronic hypertension over time increases the likelihood of strokes, heart attacks, hardening of the arteries and congestive heart failure. Diet, weight loss and so-called lifestyle changes are important, but the root cause for most folks lies in their genetic makeup. Early treatment of hypertension is optimal. Antecedent fluctuating blood pressures are common before sustained hypertension. Forget about “white coat hypertension.” Folks with up and down elevated values (labile hypertension) should not postpone definitive treatment.

If I had to pick a single disease that has taken our state by storm in the last 50 years it would be obesity. The hair on my neck bristles every time I hear someone blame Louisiana food for our obesity epidemic. Our blend of Creole and Cajun foods served us well for centuries before our collective waistlines started expanding eight to 10 inches some 40 to 50 years ago. For proof, look at old newspaper pictures with an eye for what I call the obesity index. Occasionally a newspaper or magazine will publish a 1967 picture of Saints fans in the old Tulane stadium. Contrast the number of obviously obese fans then to now. This same expanding epidemic of tummy fat is also easily visible in then-and-now pictures of shoppers from Canal Street in New Orleans to Ryan Street in Lake Charles.

No doubt a more sedentary lifestyle plays a role. But in my opinion, the leading villain causing our expanding abdomens is the fast-food epidemic fueled by sugar and sugar substitutes sending coded messages to the brain to consume more calories. As a population, we are consuming more calories than we did 50 years ago. And, as we eat fewer meals prepared and cooked at home, we are eating less healthy food. The culprit is not our traditional and famous food; the culprit is the invasion of fast and takeout food that has consumed us like kudzu-covered Mississippi.

Obesity and hypertension are two of the three components of the metabolic syndrome, a condition unknown to most, even though it affects more than a third of our state’s adult population. Most folks know that onion, celery and bell pepper are our culinary holy trinity. A lesser-known unholy trinity is the elevated blood pressure, abdominal obesity and a slightly abnormal glucose or lipid level comprising the metabolic syndrome. People with clusters of these separate risk-factors are at a much higher than normal risk for developing diabetes, heart attacks, strokes and an increasing number of other recognized complications from psoriasis to erectile dysfunction.

Obesity is also a risk factor for snoring and other common sleep disorders. The inability to fall to sleep quickly or stay asleep is the driving force for most patients who request sleeping pills. Often times the real diagnosis is obstructive sleep apnea. Sleeping pills and metabolic syndrome are best friends. Hypnotics rarely promote normal sleep patterns. Disordered deep sleep in particular can cause or fuel weight gain, fatigue, hypertension, depression, excessive daytime drowsiness, attention deficit disorders, fibromyalgia and troublesome anxiety.

We almost hit a trifecta with sexually transmitted diseases, thanks to blundering cuts to our state’s public health funding. The syphilis rate in Louisiana is the highest of all states, and the first runner-up isn’t even close. We are also No. 1 in gonorrhea, with Mississippi as a close second. For AIDS in the country’s 100 largest cities, at least we don’t lead the pack. Miami is No.1, followed by New Orleans and Baton Rouge in second and third places, ranked by the number of cases per 100,000 population.

Cancer is a mixed bag of diseases that deserves its own top 10 list. According to one research consortium, about 160 Louisianians a week die of cancer-related causes. Even so, our true incidence of serious cancers is not all that out of line with other states. We just have higher death rates. The reasons are certainly multifactorial. Two contenders are delayed diagnoses and lessthan-optimal treatment with more, rather than less, often being the culprit. A prime example is the now-closed bone marrow transplant center for women with breast cancer in an Uptown New Orleans hospital. The costly treatments were associated with more complications than benefits.

Any list of top medical problems in our state would be incomplete if it did not include substance abuse. Our citizens are more likely to be long-term tobacco users than our neighbors in the North and West, fueling chronic obstructive pulmonary diseases. It is hard to walk through a casino without seeing a person on portable oxygen at the slots. I am not sure how our problems with gambling, alcohol and illegal drug abuse compare with the other 49 states, but I have not heard Gov. Jindal bragging about reduction of these rates as he scouts his prospects for an out-of-state gig. At least Jindal does not have to take blame for our high skin cancer rates, a problem caused by our positioning on the planet and the sun. We do need to pay more attention to sun protection and sunscreens.

How is metabolic syndrome diagnosed?

Three or more of these components usually define metabolic syndrome:
• Central or abdominal obesity (measured by waist circumference):
• Men – Greater than 40 inches
• Women – Greater than 35 inches
• Fasting blood triglycerides greater than or equal to 150 mg/dL
• Blood HDL cholesterol: Men less than 40 and women less than 50 mg/dL
• Blood pressure greater than or equal to 130/85 millimeters of mercury
• Fasting glucose greater than or equal to 100 mg/dL

People with metabolic syndrome are at increased risk for atherosclerosis, peripheral vascular disease, coronary heart disease and heart attack, stroke and Type 2 diabetes. Check out My Life Check for a scoring tool and checklist to improve your cardiovascular health and reduce individual risk factors whether you have metabolic syndrome or not.
Source: American Hearth Association with an important action plan on the web at mylifecheck.heart.org