200902-biz-cover01.jpgCompanies make big investments in their leaders. Knowing what high stress can do to their decision-makers — and their bottom lines — some progressive businesses are putting top-level employees through an extensive program called Executive Health Physicals.

Following a growing trend among many top medical institutions that offer executive health care programs tailored to busy professionals, Lafayette General Medical Center started offering these executive physicals in March 2008, dedicating an entire floor to this program at Burden Riehl across the street from the hospital and tapping Dr. Benjamin Doga, a family practitioner, to run it.

During the process of taking the exam, patients have no waiting time and get individualized attention from a physician and technologists, with test results available to patients immediately. The entire evaluation lasts between four to five hours. “We are marketing the program to executives, but you don’t have to be in a big company,” explains Leslie Davis, LGMC communications specialist. “We have had executives come through with smaller companies. It’s for anyone who wants an extreme, thorough physical, where the doctor will sit down with you and take the time to go through all of the results in depth.”

Acadiana Business recently followed 37-year-old Courtney Juneau, vice president of safety for Safety Management Systems, a division of Acadian Ambulance, through his examination. Acadian Ambulance offers this fitness evaluation to its more than 20 vice presidents — all of whom are grateful for the perk. “The other VPs [who did the exam] were impressed and encouraged me to do it,” says Juneau. “A key to being healthy, I think, is preventive medicine. Nobody likes to go to a doctor, especially when you’re not sick. But with Acadian Ambulance affording me this opportunity, I just felt like I needed to take advantage of it.”

The standard package for testing is being offered at an introductory price of $1,695, a competitive rate when compared with $2,000 to $2,500 at some facilities out of state — not to mention the cost of travel and time out of the office. When the introductory offer expires, companies sending multiple patients for physicals will receive discount pricing.

Before the exam, Juneau filled out an intensive medical form, covering everything from his exercise and diet habits to his family background. When he arrived, he was escorted to a private lobby, complete with a cushy couch, drinks and snacks, and a television. Doga joined him, explaining the examination process in detail. Afterwards, Juneau had a blood draw, then went through a comprehensive battery of tests, including a vision exam, hearing screening and pulmonary function test. The tests check cholesterol levels and essential minerals like iron, sodium, potassium, chloride and calcium. There’s a thyroid, PSA, testosterone and a complete blood count test. Doga then conducted a general physical examination before Juneau underwent an exercise stress test on the treadmill.  

After a short recovery time in the lobby, Juneau walked down the hall to radiology. He had complained of lower back problems, so Doga ordered an MRI. After 20 minutes on the machine, Juneau walked down the hall for a cardiac CT for calcium scoring. The five-minute test involves looking at the heart and coronary arteries for any calcium deposits, which indicate plaque or blockage.

Juneau and Doga then sat down with a radiologist, Dr. Joseph Prejean, who reviewed the films in detail. Finally, Doga met privately with Juneau in a wrap-up session to go over the blood work, lung function test, CT scan, MRI, lab work and physical. “If there are some abnormalities, then hopefully, we have caught them very early, which is the whole point of this — early detection and intervention,” Doga says.

 200902-biz-cover02.jpg
 Acadian Ambulance's Courtney Juneau and LGMC's Casey Babb
 photo by Robin May
 

Based on the evaluation, Doga might recommend lifestyle changes, such as diet or supplements, or possible treatment plans. The patient can then ask any questions of the doctor, including general health, lifestyle changes, exercise, medication and/or supplements. “We have as much time as the patient needs,” says Doga, who stays with the patient throughout the process.

If there is a problem, say a CT angiogram that shows potential blockage, Doga can immediately get the patient to a cardiologist and into the cath lab.

Juneau is 5-foot 9-inches and weighs 190 pounds; he does cardio and weight training three times a week. “I went into it not knowing what to expect, because it had been a long time since I had a physical,” he says. “What I was impressed with was the number of things they tested for with this single blood test. Then the doc went through and explained all of the levels. The testing is just about head to toe, and I came out of it better than I thought I would.”

You don’t have to be an executive, however, to get a detailed, preventative examination. With cardiovascular disease the No. 1 cause of death in the U.S., local cardiologists saw a need to prevent or reduce the mortality risk. Just opened in the River Ranch’s Carriage House is a more focused type of facility for early detection of heart problems, Coeur Health Cardiovascular Risk Reduction Center. Operated by Drs. David Baker, Kevin Courville, Christopher Mallavarapu, and Vernon Valentino, all of the Heart Hospital of Lafayette, Coeur Health is available to patients through direct appointment or physical referral.

Patients at Coeur Health undergo a thorough history-taking with a nurse practitioner. The NP also counsels the patient on diet, exercise and lifestyle. Afterwards, the patient moves to the room next door for a blood draw, which tests for total cholesterol, HDL and LDL cholesterol and triglyceride levels.

Following are four non-invasive, specialized tests in private rooms. One is for arterial elasticity analysis, measuring stiffness of the large and small arteries. This elasticity decreases with age and is an early indicator of blood vessel abnormalities placing individuals at risk for heart attacks and strokes.

Another test involves a treadmill, which at first glance appears to be a standardized procedure. The difference is that this stress test focuses on a patient’s recovery time. The increase of rise in blood pressure during exercise might be an indication of early stiffening of the arteries. Through this test, doctors measure the patient’s blood pressure response to three minutes of moderate exercise while walking on the treadmill.

Patients are often surprised to find out what their eyes can foretell about their health risks. The eye retina photo analysis allows the technician to visualize small arteries that can place individuals at risk for heart attacks and strokes when they become thicker and smaller. “We don’t have to dilate your eyes like the ophthalmologist does,” Baker explains. “The camera takes a picture, blows it up, and then we measure the ratio between the arteries and the veins at a certain distance from the optic nerve. By determining what that ratio is, we can determine whether there is any early vascular compromise, be it from high blood pressure or high cholesterol, or whatever.”

During the ultrasound screening, doctors measure the heart mass. “There are a lot of people running around who have an increased heart mass because of intermittent high blood pressure, and we can pick that up very early,” Baker says. At the same time, the clinic performs a carotid intimal thickness test, which measures the thickness of the lining of the artery. “So, if there is any early thickening or early deposition of plaque, we can see that.”

Administration of these state-of-the-art tests takes, along with the interview, about two hours. Afterwards, the cardiologist comes up with a score. “Based on that score, we can determine what one’s risk is,” Baker explains. “Right now, our data goes out as far as seven years. So, we can tell you what your risk is over the next seven years of having an event.”

According to Baker, Coeur Health is the only facility in Louisiana using the risk score. If a patient has a score in the low range, the risk for a cardiac event over the next seven years is very remote. However, if the score indicates a risk is in the moderate range, then the patient needs to undergo intensive therapy, “because your risk starts at about 48 months,” Baker says.

The program is geared toward patients of any age but is particularly targeting people who are younger and have concerns about their heart, according to Baker. “Because, heart disease doesn’t spare any population, any race, any gender. So, we are trying to impact people very early.”

 

 


 

Just Do It
It’s real easy for today’s executives to come up with excuses for not getting and staying in shape, but for this group of decision-makers, climbing the ladder of success means a few miles on the Stairmaster.

Sharon Moss, dealer/president, Moss Motors
I started Zumba, and I love it. I do Zumba on Monday and Wednesday at Red’s, and that’s an hour class. I go to the gym afterwards for about 10 minutes and do some upper body arm work. Then, on Tuesday and Thursday, I do Pilates at Wise Body Pilates. It’s awesome — it’s sort of like weights, because you have machines, but it’s like resistance stuff. You work your center core a lot. I saw the difference after the first year, when I went to put on my bathing suit, and it was like, “Wow!” It firms you and tightens you, and it lengthens you. And then, if I’m being real good, I will go into Red’s and do the ball class or spinning. Now that I kind of tamed the “wild of the dealership” and I have so many great managers, including my son Coury, I have got it down where I am able to plan most of my meetings and to do my paperwork from noon on, so I work out in the morning.

I think it relieves a lot of stress. It can kind of take you away, take your mind off things. Especially Pilates. Pilates involves breathing along with going on machines. I get stressed — I’m not one of these laid-back people. I like to get stuff done, and I want it done now. So, I think exercise definitely de-stresses you, calms you down.

I used to play tennis. In high school, I was sort of a “jockette.” I used to go to the basketball gym and shoot hoops with the guys. I think like a guy sometimes. You kind of have to when you are in a man’s world. I’m blessed. I’m fortunate to have my mornings to work out. It wasn’t always that way.

Jed Darby, general manager, Giles Automotive
I am the “Cajun Man.” I actually won that (triathlon) race eight times. I had a 17-year absence — some tough breaks from a lot of training. I took off and I went fishing. My wife, Debbie, started doing some spinning classes last September, and we entered a UL triathlon. That was her first triathlon, and she finished second overall. In 2008 I won the master division, and was fourth overall.

I train before and after work. In the car business, it’s tough — you work a lot of hours. I get up at 5 in the morning and do my running. And after work, we do a lot of riding out in Youngsville. We do long rides on Saturday and Sundays. I am running about 25 miles a week. I also race for the Precision Cycling team owned by Mark Miller. My wife will come do training with us — about 25 guys. A lot of times, there will be three or four of us left, and she will hang with us.

In 2009 I have a couple of goals. One is to work up to Olympic distance, depending on my health, because I am injury-prone. I’ve actually been injured five times in the past year. A half-iron man is a 1.2 mile swim, a 56-mile bike, and 13.1-mile run. My wife and I are planning to go to one in Arkansas and one in Austin. I think she is going because of the success she’s had. It’s been phenomenal.

It has always helped me mentally as well as physically. Because, people in our position, we want to be challenged. I like to win. And, this keeps me really sharp. It’s just in you — you just have to do it.

Bob Giles, president/CEO, Giles Automotive
In a typical week, I normally will do the elliptical trainer four or five days a week for 30 minutes. I will do three different days of weights for an hour. And, I will typically ride my road bike two or three times a week, for 25 to 65 miles a ride.

I do the elliptical trainer every morning when I am at home, unless I am riding my bike. I typically ride the bike on weekends. This weekend, I did 30 miles on Saturday morning, and 40 miles Sunday morning. And, I worked out both afternoons at the City Club for weights. When we have daylight savings time, there are some groups that leave during the week on Tuesdays and Thursdays from Youngsville, like at 5:30 or 6. We’ll ride until it gets dark, a couple of hours. When it gets dark early, I’ll probably ride just on the weekends and cut out one day during the week and will replace that with cardio at my home at about 6:30 in the morning.

I do something almost every day, unless I’m traveling and I can’t. It’s not hard to fit in.

The benefit is, I get to eat more. Clay Allen and I have a couple of business deals, and we often work out together. We use the gym as an opportunity to hash out ideas while we are working out, so we kind of can mix business with exercise. That works out great. A two-hour bike ride or a four-hour bike ride is an incredible stress reliever. In addition to having the opportunity to enjoy the outdoors, it gives you an opportunity to think, particularly if you have some business issue that you are trying to work out. And, for me, I seem to think clearer during and after working out than when I am sitting at my desk all day.

 

Chuck Rush, attorney, Rush, Rush & Calogero
I used to do the triathlon thing, the iron-man distance and marathons. And then, because my knees were falling apart and everything else, what I’m doing right now is going to the gym three to five days a week. I was there at 4:45 this morning. I do weights and cardio stuff — treadmill, Stairmaster, bike — for an hour. Because of my knees, I’m not doing the obsessive-compulsive training. When I was doing triathlons, I was working out twice a day, Monday through Friday. I’d be out early in the morning, and I was running, biking and swimming.

I stopped doing that about two years ago, when I had two stents put in. When I was training for another season, I found that I was having a hard time getting going. And then, I started getting what I thought was reflux. I kept running, but I was getting bent over on the street from chest pains. So, I went to see a doctor, and it turns out I had 99 percent blockage in one artery and over 50 in another. I was a walking heart attack. So, after that, I started to pull back some, stopped doing the racing and that sort of stuff, because you have to push yourself so hard.

My son, Tyler, does triathlons. He is 17 years old. The others are 10, 9 and 6 — they are not into it yet, but Tyler is serious. In fact, at the sports banquet for the Ascension football team, he was presented awards for defensive player and also most valuable player. He is also a really big rock climber ­— that is what he really focuses on. He is ranked regionally in rock climbing.

Red Lerille, owner, Red Lerille’s Health and Racquet Club
I wake up every day at a quarter before 3 a.m. I pedal my bike to Red’s. I work out with weights for about 1.5 hours with my training partner. And then, I ride a bicycle for about 40 minutes. That’s my basic workout. I do half the body one day — like I’ll work out on Monday, and I’ll do the chest, shoulders and triceps, and do a little gut work, and on Tuesday, I’ll do back, biceps and legs, and then I do a little gut work. And Wednesdays, I’ll only ride a bike, and I’ll do Monday’s workout on Thursday and Tuesday’s workout on Friday. On Saturday, I’ll only ride a bicycle. Sunday, I don’t do anything.

Recently, I had foot surgery, and I did all my working out except for riding a bicycle. Surprisingly, I did pretty well. I couldn’t put any weight-bearing exercises on the foot for about the first five weeks or so, but I did thigh extensions, leg curls — whatever I could do. And then, I would work the one leg by itself.

I was very careful about maintaining the weight. One of my little hints is to get on the scale every day. It’s a lot easier to lose a pound or two in a day than it is to lose 20 pounds in a month. My biggest tip is to watch your weight every day, and then stick to good foods — a lot of fresh fruits and vegetables, and a little meat, cheese, eggs, chicken and fish, and whole grains, like oatmeal and good quality bread. Eat three good, quality meals a day.

Dr. Barry Bohn, ophthalmologist
Monday, I work out from roughly 7 to 8 a.m., give or take. Usually, I do an elliptical trainer, rowing machine or bike in the gym, anywhere from a half-hour to 40 minutes. I do the same thing on Tuesday, Wednesday and Thursday mornings, and usually Friday afternoon and Saturday sometime. I also do intervals on those machines.

I had an evaluation of my oxygen capacity done and found out what heart levels to get for the maximum heart rate without getting into the anaerobic zone. So, I stay in the aerobic zone most of the time. But, that varies, depending on how I’m feeling. I do intense exercise for 20 or 30 seconds a minute, and then back to the normal heart rate zone. So, I’m trying constantly to increase the capacity.

Thursday afternoon, I do an hour of Reformer Pilates, where you are doing core work, a lot of abdominal and twisting and turning exercises, as well as the large muscle groups of the arms and legs. Once or twice a week, I’ll do a session of weights. Sometimes, I’ll do light weights with lots of repetitions, and sometimes I’ll do heavier weights with lower reps. A lot of times, that’s 30 to 60 minutes, and I may substitute that with an aerobic session sometimes. The weights are also intervals of various exercises. I have an interval of four days or so between weights to recuperate from that, especially if it is a heavy session. I try to do 30 minutes of some sort of machine every day, except Sunday, when I don’t do anything.    

Usually, I change my routine around every three to six months, and do different exercises. I think the interval training gives you better cardiovascular effects, and is long-term much better. I have lowered my resting pulse rate from about 70 down to about 55 over the past four or five years by doing that. I have a heart monitor, so I monitor my heart rate when I’m doing that.

Flexibility is a problem, and I kind of use Pilates for some of that.

I find that exercise is a tremendous stress relief, especially with busy schedules, medical decision-making and all of the problems involved in trying to decide what to do with patients day in and day out. It helps your cardiovascular system, your longevity, it keeps your weight down, helps with your mental attitude, with your sleep — all of those things.

Mike Guidroz, Lafayette president, Business First Bank
Ever since I was a boy and was ushered out of the house by my mom’s thickly accented phrase, “Get out from under my feet and go outside,” exercise has been about playing. I grew up in a big family in a neighborhood full of kids and spent my youth playing games at every spare minute. I still approach exercise the same way. While in high school, I got a job at Red’s and felt like I hit the jackpot. It was the greatest job ever. Working for Red and being around the athletes that frequent the club reinforced my passion for working out. It made such an impression on me that I once celebrated my birthday by spending 17 straight hours at Red’s to prove that a person could be there all day without duplicating any activity.       

I’ve always been a proponent of weight lifting. From the days of doing chin ups on the clothes line and working out with my 110 pound weight set from Sears, strength training has been at the core of all fitness for me. Today, I usually get three to four workouts in during a typical week. Sometimes they’re really abbreviated or varied, but it’s the consistency that’s important. I started running after college and really enjoyed it. Racing and structured training became a way of life for a number of years. While I haven’t been as structured or as committed to running over the past few years, I believe it to be the best form of cardio work, and I still get in three or four runs a week. My wife is a runner, and it’s a big part of our life. I also feel like running in groups offers the highest level of camaraderie among participants like no other form of exercise. There’s something about running with other people that builds a great bond, and I still count my running friends as some of the best folks I’ve ever known. Conversely, there are days when running by yourself is the best thing you can do for “your own self.” On those days that you’re overwhelmed, stressed, lazy or just mad at the world, a solitary run can put it all right again. Finally, I haven’t lost that bug to play, and I throw in any form of sport whenever a game breaks out. I coach a middle school soccer team at Fatima every year and help with the lacrosse team at STM, so I jump in on the drills and get to run around with the kids every now and then. I’m not even close to being able to keep up anymore, but it’s still fun to play.

Jim Gibson, attorney, Allen & Gooch
I used to run a lot, and I’ve done a few marathons. I started having injuries a few years ago, so I switched to a bike — Mark Miller at Precision guided me as to what kind of bike to get and got me into it. I ride a bike five or seven days a week, about an hour to two hours a day. I also do weights three or four times a week, just to keep some level of strength involved.

The other thing that helps me is that I am a horrible insomniac. So, I’m usually on my bike between 3 and 4 o’clock in the morning. It really works well for having the time to do that. If you can’t sleep, you might as well do something. It’s either that or work for me. So, I do a little bit of work, and I get on the bike every morning early, and I’ve got everybody making fun of me when they see me. But, at least, so far, I haven’t been hit by a car.

On the weekends, I generally ride with groups. I pick one of the groups really depending on how I feel. If I feel like I am in a little bit better shape, I will ride with the triathletes. They are an incredible group of guys and women. Then, I have a couple of what I consider my “old band” group — one out of St. Martinville and another one in Lafayette. So, I bounce around among all of those. But during the week I do it all by myself, which frankly, works out better for me. Because I probably do as much thinking about my law practice in that hour or two — strategy on cases, or if I have to do oral arguments on that particular day before a judge or jury, I pretty much have practiced it on the bike a bit before I ever show up in court. I don’t know if it helps me with winning anything, but at least I have an idea of what I am going to say before I show up.

For me, mostly, it’s mental, because I’ve been a runner since college. And that has been always my stress relief — running. About five years ago is when I started having all of these weird injuries, and decided that I was going to have to try something else. I tried swimming, but I hated it. A lot of folks can do the classes, but I just can’t do those — I just have a mental block when it comes to doing classes and machines and all. So, I’ve got to go outside and do something. If it’s pouring down rain, I don’t go out. If it’s a light rain, I still go out. If it’s cold, I just layer up. I’m out there when it’s 29 degrees, riding my bike. I hate to be cold. But for me the definition of bad weather is it’s got to be really cold. At that point, I just go to Red’s and work out with weights.

Chuck Lein, retired president and COO, Stuller Inc.
A long time ago, I ran marathons, 10-Ks and 5-Ks. People said that I was going to pay the price later. For a long time, I was running 70 miles a week and 40 races a year. I was so skinny that I had to run around the shower to get wet. I don’t have that problem anymore.

Now, I find that it takes too darned long to go and change clothes, get sweaty, dress and leave. I spend most of my time in the cardio room. And then, on weekends, I’ll get a blend of cardio, as well as weights and physical therapy exercises. I have arthritis in my right shoulder and right knee, so there are so PT things that I need to do. Typically, I’ll do never less than 40 or more than 60 minutes of cardio and get a blend of the elliptical machine and a straight up-and-down stationary bike. On days when I am able to take to the time, typically on weekends, I’ll do the cardio, then do a blend of weights and exercises for 40 minutes.

The full routine, with weights and cardio, is never than less twice a week or more than three or four times a week. I just can’t work out every day. But, I keep track of it. I started doing that more than 30 years ago when I started running. I keep a little scorecard in the closet area and if I see very many Xs in a row, then I know I am in trouble.

Usually, I work out late at night, and that’s the down side. I [retired] at the end of January, and I’m going to work out regularly, but it’s not going to be too late. Too often, it’s a 7:30 p.m. to 9 p.m. thing, and you are muddling through your soup at 9:30 at night. But, I subscribe to the theory that 40 minutes is better than nothing. When I retire, I’m going to take a look at some of the classes at the City Club, instead of dashing in there and dashing out, and being the last one out of the door at night as they are turning off the lights.

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