SOUTHEAST TEXAS

ITAL SIGNS
SUMMER 2016

ALSO INSIDE:
SURPRISE MEDICAL BILLING
ESCAPING VIOLENT ENCOUNTERS
WINNER
FIRST TEXAS WOMEN NERVOUSLY AWAIT ZIKA
PLACE
2016 ANSON JONES AWARD AN EXAMINER CORPORATION PUBLICATION
CALENDAR Julie Rogers Gift of Life Program
5K Ribbon Run Color Rush

OF EVENTS
Tuesday, Aug. 30
AUGUST Medical Center of Southeast Texas
Fertility 101: Everything You Wanted to
Monday, Aug. 1 Friday, Aug. 5
Know but Were Afraid to Ask
The Arc of Greater Beaumont
with Dr. Josh Skorupski of Houston
Summer Day Camp for children with
Fertility Institute
special needs
The Medical Center of Southeast Texas
The Arc of Greater Beaumont Multi-
Victory Campus, Beaumont
Purpose Facility, Beaumont Saturday, Sept. 24
6 p.m.
9 a.m. 3 p.m. American Red Cross
(877) 765-WELL
(409) 838-9012 Tee it Up Red Golf Tournament
Woodland Hills Golf Club, Nacogdoches
SEPTEMBER 8 a.m.
Saturday, Aug. 6
Altus Emergency Centers (409) 782-9121
Thursday, Sept. 8
Tools 4 School Third annual Back to Southeast Texas Food Bank
School Festival 25th Anniversary Celebration Honoring OCTOBER Southeast Texas
Altus Emergency Center, Lumberton Hunger Heroes (Beaumont) Walk to
9 a.m. noon Saturday, Oct. 1 End Alzheimers
MCM Elegant Hotel, Beaumont
(409) 227-0537 Julie Rogers Gift of Life Program
6 p.m. Dauphin Athletics Complex, Beaumont
5K Ribbon Run Color Rush
(409) 839-8777 7:30 a.m.
Saturday, Aug. 6 Downtown Beaumont
Friday, Sept. 9 8 a.m. (409) 924-0576
Anayat Medical Hospitality House
Southeast Texas Food Bank (409) 833-3663
Zummo Big Cup Golf Challenge The Arc of Greater Beaumont
Beaumont Country Club Fifth annual Will Golf for Food Beaumont Buddy Walk
Tournament Saturday, Oct. 8
9 a.m. shotgun start Event Centre, Beaumont
Bayou Din Golf Club, Beaumont Childrens Miracle Network and Christus
(409) 898-7011 Walk Begins at 10 a.m.
8 a.m. 1 p.m. Health Foundation Southeast Texas
(409) 838-9012
(409) 839-8777 Shootin For a Miracle
Sunday, Aug. 7
1 in One Hundred Gun Club, Lumberton Harbor Foundation
The Arc of Greater Beaumont
Saturday, Sept. 17 8:30 a.m. and 11:30 a.m. Dinner for Life 2016
Back to School Basics Resources for Alzheimers Association (409) 899-7555 Event Centre, Beaumont
parents of children with special needs Southeast Texas (Beaumont) Walk to End 7-11 p.m.
The Arc of Greater Beaumont Multi- Alzheimers Saturday, Oct. 15
(409) 981-1888
Purpose Facility, Beaumont West Brook High School, Beaumont National Multiple Sclerosis Society
4-6 p.m. 8 a.m. MuckFest MS 2016 Every Tuesday through Feb. 7
(409) 838-9012 (409) 833-1613 Royal Purple Raceway, Houston Beaumont chapter of Sahaja Yoga
9 a.m. Meditation
Friday, Aug. 12 Wednesday, Sept. 21 (713) 526-8967 Free Sahaja Yoga Meditation - Chakra
Ubi Caritas Ubi Caritas Date Auction Course
Third annual Blow Dry Bar Friday, Oct. 21 Elmo Willard Library, Beaumont
Madisons, Beaumont
The Loft Hair Studio, Beaumont Childrens Miracle Network and Christus 6:30-7:30 p.m.
6 p.m.
4-8 p.m. Health Foundation Southeast Texas (409) 201-9918
(409) 832-1924 ext. 104
Swinging For a Miracle
(409) 554-4002 First and third Saturday
Bayou Din Golf Course, Beaumont
Thursday, Sept. 22 of each month
7:30 a.m. and 1:30 p.m.
Saturday, Aug. 13 Baptist Hospitals of Southeast Texas The Medical Center of Southeast Texas
(409) 899-7555
American Red Cross Foundation Childbirth Classes
Swing Red Golf Tournament Soiree Volunteer Kick Off Party Saturday, Oct. 22 The Medical Center of Southeast Texas,
Sunset Grove Country Club, Orange Beaumont American Cancer Society Classroom 4, Port Arthur
8 a.m. 6 p.m. Making Strides Against Breast Cancer 5K 9 a.m. 4 p.m.
(409) 782-9121 Call (409) 212-6113 to volunteer. Walk RSVP: (877) 765-WELL

4 Vital Signs Summer 2016

Vital Signs Summer 2016 5

tric patients
Robot helps relieve pedia
xi et y d ur in g un co m fo rtable procedures
an
A
trip to the physician or emergency room can be a
painful ordeal for a young child. Blood work, shots,
IVs and other nasty tests can make a visit to the doctor
unnerving for children and parents, as well as care providers.
Jennifer Trachtenber, MD, a nationally recognized parent-
ing expert, says in her book, The Smart Parents Guide: Get-
ting Your Kids Through Checkups, Illnesses, and Accidents,
that during doctors office and hospital visits, 6-12 year-olds
worry about pain, especially when it comes to shots. But kids
arent the only ones who get stressed out.
Pediatric emergency doctors often get two patients at
once the child and the parent, Trachtenber says. Most
parents are usually fine until you have to insert an IV, do a
spinal tap, intubate their baby, or put their frantic child in soft
6 Vital Signs Summer 2016
Joseph Boutte admires
CHAMP, Christus Southeast
Texas St. Elizabeths new
pediatric robot. CHAMP is
used to provide comfort
to children during medical
procedures at the hospital.
Photos by David Block
restraints in order to do stitches or other delicate procedures.
In my experience, even the coolest cats tend to freak out over
these four common necessities.
Thursday, June 16, Christus Southeast Texas St. Elizabeth
unveiled what may be a solution for hospital-visit anxiety for
both pedis and parents alike the hospitals newest associate,
CHAMP (Christus Health Associate Medibot Pal).
CHAMP is a MEDi RxRobot and is the first medical robot
of its kind to be offered at a Texas hospital, according to Ivy
Pate, executive director of the Christus Health Foundation
Southeast Texas. The robot helps reduce fear and anxiety in
children surrounding medical procedures by interacting with
them.
It means so much to know that we have a new avenue for
CHAMP, Christus Southeast Texas St. Elizabeth hospitals new MEDi robot can be used during medical examinations and procedures to keep childrens
mood calm.
children to relieve their fears, Pate said. The
robot, which retails for $15,000, was donated
by Natalie and S.L. Greenberg of Beaumont,
she said. Children will trust CHAMP
because they are so used to interacting with
electronics and animation. We really appreci-
ate the Greenbergs generous donation.
Aldebaran Robotics invented the robot
NAO in 2006, and it evolved into the
MEDi robot Christus Southeast Texas St.
Elizabeth is using today with the help of Dr.
Tanya Beran, a tenured professor at the Uni-
versity of Calgary in the Cumming School
of Medicine in Calgary, Alberta, Canada.
As an educational-psychologist with a
focus on child health-related issues, Dr.
Beran has published over 1,000 papers in
peer reviewed scientific journals and books
and began researching childrens interac-
tions with robots in 2010. She commer-
cialized the MEDi robot in 2014 and has
sold the robot to 14 hospitals and dental
offices across Canada and the U.S. to pro-
vide comfort to children during medical
and dental procedures.
The idea for MEDi stems from a robotic
arm RxRobots built in 2009 to display at
the Telus World of Science in Calgary.
Eight years ago I started research to see
how kids would react to a robot, Dr. Beran
told Vital Signs. We didnt have a robot as
fancy as the NAO robot available. I con-
tacted a fellow professor at the University of
Calgary, and we built a robot arm.
Beran programmed the robot to stack
blocks, and to accidentally drop the last
block. They observed children trying to
help the robot arm by talking to it and
even yelling at it to try again. Beran was
especially surprised to discover that the
majority of children thought it had the
ability to think, feel and act in ways that
clearly it couldnt.
Beran published the results and real-
ized that a robot could be a useful tool in a
medical environment.
I thought to myself if kids responded
to this robot arm as if it were alive, then
maybe kids in hospitals who are facing
medical challenges, health problems,
and may have to go through some pain-
ful medical procedures maybe a robot
could help them face these kinds of chal-
lenges, she said.
Beran purchased a NAO robot from
Aldebaran and started research at a local
hospital in Calgary. She founded RxRobots
Inc. and became product developer for the
company, launching MEDi for the specific
purpose of pain and distress management
during medical procedures for pediatric
patients in 2014.
I program the robot with cognitive
behavioral interventions the behaviors
and speech that I know as a psychologist
are appropriate in helping children manage
pain, she said. One easy way to reduce
our anxiety is to take long, deep breaths.
But when we teach strategies like breathing
to kids, they tend to forget to use them be-
cause they are just too afraid of the needle
to think about using them. When we try to
SEE PAIN PAL PAGE 8
Vital Signs Summer 2016 7
Christus Southeast Texas
St. Elizabeth Certified Child Life
Specialist Ashley Bares shows Joseph
Boutte how she controls CHAMP.

PAIN PAL FROM PAGE 7

get their parents to remind their kids to breathe, sometimes par-

ents may end up exacerbating their childrens anxiety. But when
MEDi role models, demonstrates, practices and in a playful way
gets the kids to breathe, then the intervention is delivered properly
every single time.
Kids enter into playful imagination with the robot, thinking
the robot is expressing real feelings and showing real behavior, Photo by Kevin King
Beran said. One example she gives is an application that can be
utilized during blood tests.
The MEDi robot is capable
You can download sound files into the robot. He turns his
of running 80 different
head around and plays the sound of a buzzing mosquito, she said.
applications and speaks 19
He moves his head from side to side quickly as if hes looking for
different languages. There
the bug and says, Did you hear that? He stops and then blinks
are applications available
his eyes he has lights in his eyes that when they turn on and
for many different medical
off makes it looks like his eyes are blinking and says, Ouch! It
situations such as calming
landed in my eye. Can you please blow to get it out of my eye. or distracting children during an
Beran said kids will then spontaneously blow to help get the IV start or blood test, as well as
bug out of the robots eye. normative play applications.
What they are doing is relaxing their muscles, she said.
Theyre more cooperative for the lab technician or the nurse who
is trying to roll up their sleeve, hold their arm in place, or put on
a tourniquet because the kids are more focused on the robot and they are helping the robot, the
theyre less focused on the needle. Its a form of distraction, but its parents are thinking the kids are
also getting the kids to use an intervention of something that we having fun, and we know the
know works the breathing and the blowing then the proce- robot is being very deliberate
dure gets done more quickly. in helping cope with pain and
Whats delightful about the whole thing is the kids think anxiety.
8 Vital Signs Summer 2016

Dr. Tanya Beran launched MEDi for the specific purpose of pain and distress management during
medical procedures for pediatric patients in 2014.
In a 2013 study of 57 children receiv-
ing their annual flu vaccination, Beran and
fellow researchers Alex Ramirez-Serranoa,
Otto Vanderkooib and Susan Kuhnb
found that when introducing a humanoid
robot to interact with children during their
vaccination, childrens pain was lower on
the Faces Pain Scale, a common metric
Photo courtesy of RxRobots
in pediatric pain measurement showing a
series of faces ranging from a happy face at
0 to a crying face at 10. Eighty-five percent
of children said they would like the robot
used at future vaccinations. According to
the study, kids who interact with MEDi
reportedly experience 50 percent less pain
during medical procedures.
Beran said the MEDi robot is capable
of running 80 different applications and
speaks 19 different languages.
Locally, CHAMP is controlled by
Christus Southeast Texas St. Elizabeths
Certified Child Life Specialist Ashley
Bares, whom the hospital recently hired.
In addition to the mosquito application
Beran described, Bares said the robot also
reads stories, dances and plays games with
children such as rock, paper, scissors and
hide and go seek.
MEDi applications can be used to pro-
vide normative play for patients in the hos-
pital who may not be getting a procedure
but just need a little extra boost in their
energy or mood, Bares said. Whereas, if
somebody is getting an IV start or getting
their blood taken, Rx applications are good
for that. But really they go hand-in-hand.
Although she received training from
RxRobots, Bares said she is still learning
how to use CHAMP, and teaching nurses
how to operate him, as well. The process
has been intriguing.
Its been interesting to figure him out
and see how different patients react to
him, she said.
Kevin King

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Vital Signs Summer 2016 9


Surprise!
As insurers and providers blame each other, Texas lawmakers
seek legislative fix for unexpected medical bills
T
exas patients sometimes feel the
pain from unexpected out-of-pock-
et costs not covered by their health
insurance, known as surprise billing or
balance billing, which occurs when a
health insurance company pays less than
what a doctor charges, leaving the patient
to pay the balance of the bill.
The Texas Medical Association (TMA)
says it is taking aim at the problem.
TMA, the largest state medical soci-
ety in the nation, assembled a group of
physician leaders, the Balance Billing Task
Force, to study the issue.
Among the causes TMA research found
for why patients are increasingly weighed
down with unexpected out-of-pocket costs
are insurance companies selling plans with
limited networks and high deductibles and
10 Vital Signs Summer 2016
notoriously inaccurate network directories.
Often the surprise in this billing is due
partly to the health insurance companies
failure to help their customers understand
how their coverage works, TMA explains.
Several things are happening due to
this lack of understanding. Patients might
incorrectly assume the care they are receiv-
ing is covered by their policy; the insured
patient might not yet have met his or her
deductible, meaning he or she must pay
more out of pocket before insurance ben-
efits kick in; and the physician or health
care provider treating the patient might
not be in the network list for that patients
health plan, a release by the organization
SEE INSURANCE PAGE 12
Texas patients sometimes feel
the pain from unexpected
out-of-pocket costs not
covered by their health
insurance, known as surprise
billing, when a health
insurance company pays less
than what a doctor charges.
This leaves the patient to pay
the balance of the bill.
What you have in Texas is an
emergency care problem. Most
emergency care physicians are
out-of-network providers working
in in-network hospitals. Because
they dont have a contract with
the health insurance company,
there is no limit to what that
provider can bill that consumer.
Jamie Dudensing, CEO of Texas
Association of Health Plans
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INSURANCE FROM PAGE 10
states. In that situation, when
patients receive care from a
doctor not listed in their insur-
ance plans network, the health
insurance company can refuse
to pay for some or all of that
out-of-network medical care.
As a result, the out-of-network
physician may charge the in-
sured patient for the remaining
balance of the bill.
Some states are seeking to
stop surprise bills by limit-
ing physicians ability to bill
patients for the balance owed
in those situations, but TMA
physician leaders say lawmakers
must hold health insurers ac-
countable for the larger prob-
lems of inadequate networks,
policy limits and other business
practices.
Nobody wants surprise bills.
But the real problem is not bal-
ance billing. The real problem is
narrow networks, said Denton
obstetrician-gynecologist Joseph
Valenti, MD, and Balance Bill-
ing Task Force member. Pa-
tients are in the middle of this
because its not made clear to
them what they are purchasing.
According to TMA, health
plan providers want to cut costs
and increase profits.
One way to accomplish
this is to pay less for care, and
one way to accomplish that is
to have fewer doctors in the
plans provider network, forcing
more patients to receive out-
of-network care, the organiza-
tion says in a release. Then the
patient is responsible for paying
more of his or her medical bills,
while the insurer pays less.
The narrower (insurers)
make these networks, the more
they shift costs onto patients
and doctors, and if regulators
dont look at this, we are all in
big trouble, Dr. Valenti said.
While TMA places the blame
on insurance companies seek-
ing to increase profits, Jamie
Dudensing, CEO of Texas
Association of Health Plans
(TAHP), the statewide trade
association representing health
12 Vital Signs Summer 2016
insurers, says a bulk of the
problem occurs when emer-
gency care providers are not
in-network. Physicians need to
be transparent about whether
they are in-network or not in-
network, she said.
Balance billing most often
occurs when a consumer goes to
a doctor that is not within their
insurance providers network,
Dudensing argues, and out-of-
network physicians are taking
advantage of these situations.
When you are in an emer-
gency or a car accident and an
ambulance picks you up and
takes you to a hospital, you
dont really have a lot of time
to investigate the network
status of every physician in
that hospital, Dudensing told
Vital Signs. Because they dont
have a contract with the health
insurance company, there is no
limit to what that provider can
bill that consumer in addition
to what the health insurance
company already paid them.
What you have in Texas is
an emergency care problem.
Most emergency care physicians
are out-of-network providers
working in in-network hospi-
tals. It will be a large emergency
care physician group who has
an exclusive arrangement with
that hospital who has the only
contract with that hospital and
will not be in-network with the
insurance companies that that
hospital is in-network for.
A report from the Center for
Public Policy Priorities (CPPP),
an Austin-based, nonpartisan,
nonprofit organization that uses
data and analysis to advocate
for public policies to better the
economic and social conditions
of low- and moderate-income
Texans, seems to substantiate
Dudensings claim.
The report Surprise Medical
Bills Take Advantage of Texans
analyzes data from Texas three
most popular insurers: Blue
Cross Blue Shield, Humana and
United Healthcare.
According to the report, it is
common for Texans who receive
care in an in-network emer-
gency room to receive treatment
from an out-of-network doctor.
Of the states three largest
insurers, Humana and its net-
work hospitals top the list with
56 percent of network hospitals
having no in-network emergen-
cy room physicians. Even with
Blue Cross Blue Shield, the best
performing of the three in this
category, one in five network
hospitals have no in-network
emergency physicians.
Disturbingly, 8 percent of
hospitals (23 of 276 hospitals)
that contract with all three
insurers have no in-network
emergency room physicians
with any of the three insurers
meaning emergency room
physicians at these hospitals
(none of which are in South-
east Texas) are not in the PPO
networks of any of Texas three
largest insurers (see Table 2).
As a result, a large percent-
age of insured patients who
use these hospitals emergency
rooms get doctor bills substan-
tially higher than the emergency
room co-payments they would
expect under the terms of their
insurance plan.
But according to TMA lead-
ers, physicians often try to join a
network and are refused.
For 61 percent of doctors
who tried to join a plans net-
work, the insurer essentially said
no, TMA statistics show.
TMA and Texas physician
surveys show that 32 percent of
those physicians received an un-
acceptable offer from the insurer,
while 29 percent received no
response at all.
We try hard to be in net-
work, said Keith A. Bourgeois,
MD, chair of TMAs Balance
Billing Task Force. The big
dilemma is that sometimes
being out of network is not a
choice of the practice. He said,
in those cases, the insurance
company makes that choice;
doctors receive low-ball, take-
it-or-leave-it offers from health
insurers.
According to TMA research,
only two insurers offer broad
PPO networks, three-fourths
containing ample physicians for
patients to see in Texas 2016
Affordable Care Act insurance
marketplace, and both sell only
regional coverage. In the 2015
health insurance marketplace,
four health plans offered hun-
dreds of PPO plans across Texas.
CPPP says Texas has a good
surprise-bill mediation system,
but loopholes keep it from
fully protecting consumers in
emergencies. The Austin-based
nonprofit suggests building on
the current system to better
protect consumers by:
 Lawmakers want physicians to be
a part of the solution. And we want
the same things our patients want,
which is transparency, not just
from physicians but from all health
plans and all health care providers,
because our patients dont deserve
to get a surprise bill.

Dr. Ray Callas, Beaumont anesthesiologist, task force

member and chair of TMAs Council on Legislation

Stopping surprise bills from emergencies.

Preventing consumers from being on the hook for extra
charges from out-of-network providers they did not choose; they
should be responsible for their deductibles, copays and coinsur-
ance, but not balance bills.
Ensuring providers and insurers can directly utilize Texas me-
diation system to reach fair payment amounts in out-of-network
billing disputes.
Ensuring consumers are informed about payment disputes
and their right to participate in mediation, if desired.
TMA says it will support legislation to preserve physicians
rights to bill for care they provide, while at the same time arming
patients with more information to lessen the likelihood of receiv-
ing a surprise bill.
Lawmakers want physicians to be a part of the solution. And free local delivery service

KINGS
we want the same things our patients want, which is transparency,
not just from physicians but from all health plans and all health
care providers, because our patients dont deserve to get a surprise
bill, said Beaumont anesthesiologist Ray Callas, MD, task force

SEE INSURANCE PAGE 16

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Nightingale
Experience
High school students get insight
into nursing field Photos by Kevin King
F
orty-five area high school stu-
dents visited the Lamar University
JoAnne Gay Dishman Department
of Nursing to learn about the nurs-
ing profession during the 14th annual
Nightingale Experience from June 10-
11.
The two-day event for high school
students who are interested in nurs-
ing careers provides an opportunity
to practice skills in simulated hospital
settings with Lamar nursing students,
faculty, and those already in the profes-
sion. High school participants spend
the night at Cardinal Village Dormitory
on the Lamar campus with supervision
provided by nursing faculty and current
nursing students. The free event is spon-
sored by Christus Southeast Texas.
High schools participating in the
14 Vital Signs Summer 2016
Lumberton High School
student Makenna Thurman
(left) preps a needle to
practice an injection.
event this included Anahuac, Bridge
City, Central, Hamshire-Fannett, Hull-
Daisetta, Kountze, Legacy Christian,
Little Cypress Mauriceville, Lumber-
ton, Monsignor Kelly, Nederland, Port
Neches-Groves, Vidor, Warren, West
Hardin and Woodville.
Every year we have a counselor
luncheon, and we invite all the school
counselors in Region 5, and some from
outside of Region 5. We also invite
counselors from the private schools,
said Gina Hale, director of recruitment
and retention at the Lamar University
Dishman Department of Nursing. This
luncheon is an opportunity to update
high school counselors on how they can
best advise high school students who Kountze High School junior Carli Swor
are interested in nursing as a career and performs chest compressions during a mock
also update them on whats going on at code session.

Caleb DeBarge, a Hull-Daisetta High School junior, attending the Nightingale Experience on Friday,
June 10, works side-by-side with Lamar nursing student Cale Rich during the birth simulation.
Nederland High School junior Christian Martinez is hoisted from a hospital bed by fellow Nightingale
Experience participants during a lesson on how to use the Hoyer lift under Lamar nursing student
Cara Ortizs (third from left) supervision.
Lamar in the nursing department.
Counselors will then nominate students
from their respective schools to attend
the Nightingale Experience, where cur-
rent nursing students, nursing faculty and
hospital staff introduce the participants to
the nursing profession through a variety
of fun and educational, hands-on nursing
experiences.
One of the benefits of being a nurse
is the opportunity to work with differ-
ent types of patient populations such as
intensive care, emergency care, labor and
delivery and surgery. The Nightingale
Experience provides students with an over-
view of the many types of nursing posi-
tions there are in a hospital setting. With
this in mind, the Nightingale Experience
includes learning activities such as wound
care, blood pressure, injections, Hoyer lift,
nasogastric tube insertion, intravenous
catheter, tracheostomy care, birth simula-
tion, and mock code scenarios.
This gives them the exposure to some
of the things that nurses do, Hale said.
They get excited about the hands-on skills
that theyre learning.
Students also visited Christus Southeast
Texas St. Elizabeth Hospital to see real-life
nurses in action and to experience the busy
environment they work in on a daily basis.
Christus has been a consistent partner
in this since we started it in 2004, Hale
said. When participants go to the hospital,
they get to see the different clinical areas
that nurses can work in. The good thing
about nursing is once you get a degree and
pass a licensing exam, there are a count-
less number of specialty areas that you can
choose to work in. The hospital will take
them through these different specialty areas,
so they can get a glimpse of what goes on in
that particular nursing specialty.
Attending the Nightingale Experience
often leads to high school students becom-
ing part of the Lamar nursing program.
Naelyn Mills is a Bachelor of Science in
Nursing (BSN) student at Lamar Univer-
sity as well as an extern at St. Elizabeth
Hospital, where she works in Labor and
Delivery. Mills went through the Night-
ingale Experience as a Lumberton High
School student, she said.
It was really great to see the facilities
before I went, Mills said. A lot of colleges
wont take you through the nursing facili-
ties. Theyll just tell you about it or show
you pictures, but with this program, you
get to see everything and talk to students
and faculty before you commit.
Now on the other end of the experience,
Mills helps guide high school students
through the learning activities and is able
to offer them insight on what it is like to
be a Lamar nursing student.
This experience is what made me want
to be a nurse, Mills said. This is what
solidified it for me.
Caleb DeBarge, a Hull-Daisetta High
School junior attending the Nightingale
Experience on Friday, June 10, said the
hands-on experience is invaluable.
I knew most of the basics, but getting
the hands on experience is really different,
said DeBarge, who wants to be an RN or
nurse practitioner. Ive learned how to
do an IV start, a nasal tube, and also how
to clean a laceration. I would definitely
recommend this program.
For more information about the Night-
ingale Experience, contact Gina Hale at
(409) 880-8835 or gina.hale@lamar.edu.
Kevin King
Vital Signs Summer 2016 15
 TAN opens Orange clinic
Triangle Area Network (TAN) announces the Grand Opening of the TAN-Orange Clinic on Tuesday, June 28, with a ribbon cutting ceremony held by the Greater Orange
Area Chamber of Commerce. The new clinic, located at 3737 N. 16th St., is now open and accepting new patients. TAN provides full clinic services, administering compre-
hensive and primary care for all individuals in Southeast Texas. The clinic accepts Medicare, Medicaid, private insurance, and offers sliding scale payments for uninsured
clients. For more information, call (409) 920-4223.
INSURANCE FROM PAGE 13
member and chair of TMAs Council on
Legislation.
Dr. Callas recently presented TMAs
new legislative recommendations to protect
and inform patients to the Senate Com-
mittee on Business and Commerce, and
the House Committee on Insurance.
TMA suggests:
Mandatory increase in state agency
oversight of the adequacy of insurer net-
works, especially for insurers often brought
to mediation by patients.
Expanding the current mediation
process to include all out-of-network phy-
sicians, other health care professionals and
vendors providing services at a facility.
Expansion of the current mediation
process to apply to any out-of-network
hospital, outpatient hospital, ambulatory
surgical center, free-standing emergency
medical facility or department, and ground
ambulance services.
Requiring that, prior to any preautho-
rized elective services, the insurer inform
the patient about the network status of the
facility-based physicians and others who
may bill for services.
Use of a standard form by physicians
and providers to tell patients which physi-
cians and providers might be involved in
their care and how to contact them. Physi-
cians and providers also should advise pa-
tients that its possible that another doctor
or provider might treat the patient when
unforeseen scheduling or staffing changes
16 Vital Signs Summer 2016
at the facility occur.
Requiring insurers selling PPOs to
include a clear and conspicuous notice
regarding the implications of using or
receiving services from an out-of-network
physician and the potential for balance
billing on their websites, policy docu-
ments and directories.
Requiring that insurance brokers and
agents educate consumers about the inher-
ent limitations of the plans they buy, espe-
cially their out-of-pocket responsibilities for
care provided both in and out of network.
Texas House District 21 Rep. Dade I understand that insurers
Phelan said he expects legislation that are out to make a profit and
changes the way balance billing is handled
to be introduced to the Texas Legislature in physicians have to make a living.
January, but hashing out all the details may The solution is not going to be
be a grueling process.
I understand that insurers are out to
easy. There are powerful forces
make a profit and physicians have to make on both sides of this. Anytime
a living, said Phelan, who said his family you talk about more oversight of
was actually a victim of surprise billing last
year when his wife had a baby. It took him the insurance networks, there is
and his wife six months to resolve the bill. going to be pushback.
Phelan said, The solution is not going
to be easy. There are powerful forces on
both sides of this. Anytime you talk about Texas House District 21
more oversight of the insurance networks, Rep. Dade Phelan
there is going to be pushback.
When asked what side of the debate he a market-informed approach that works for
would support, Phelan merely stated he Texas families. Ultimately, people on every
would do what is best for the consumer. side of the health care triangle (doctors, fa-
District 4 Sen. Brandon Creighton, vice- cilities and insurers) must come to the table
chair of the Senate Committee on Business ready to work together on effective, conser-
& Commerce, added, As we prepare for vative solutions that emphasize freedom and
the upcoming legislative session, we are limit the role of government.
working with all stakeholders in pursuit of Kevin King
 COMFORTABLE AFFORDABLE SOCIABLE
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 Dear Diary,
I have cancer
Rebecca Windham, music instructor and director of the Cardinal Jazz Singers at Lamar University, didnt let her chemotherapy prevent her from
participating in the Lamarissimo! Concert Series, an accomplishment of which she is most proud.
A
breast cancer diagnosis can be
devastating. While treatment has
drastically improved over the years
with technological advancement, the pain
not only physical but emotional pain
of chemotherapy treatments should not be
understated.
However, Baptist Hospital in Beaumont
believes it has the answer for dealing with
the emotional distress of receiving a cancer
diagnosis and the physical and mental
anguish that comes with a strict regimen of
chemotherapy treatments, and it may not
be what youd expect.
Since April, the hospital is now includ-
ing a patient journal with the standard
information kit that comes with a cancer
diagnosis.
Our patients are encouraged to jour-
nal in order to chronicle their experiences
along their journey to being a cancer survi-
vor, said Todd Senters, service line admin-
istrator for Baptist Hospital in Beaumont.
When you face a health crisis, it is truly a
life-changing experience; you begin to view
things from a different perspective. Journal-
ing allows you to capture these thoughts.
It may be a poem or a short story, or a
conversation you had with someone who is
sharing the same journey.
The hospital partnered with Lamar
University to share their patients journal
entries with students who take Professor
Melissa Hudlers Medical Humanities class.
Patients personal information is withheld,
and with their permission, only their jour-
nal entries are shared with students.
18 Vital Signs Summer 2016
Photo by Brandon Gouthier Photography
Academically, I was interested in seeing
if there were any kind of thematic threads,
common themes that were brought up or
images, metaphors or rhetorical patterns
that seemed to emerge in their writing,
said Hudler, who holds an MA in English
and a Ph.D. in English Literature, special-
izing in Renaissance Studies.
In addition to using patients journals as
a teaching tool for her Medical Humanities
classes, Hudler hopes to meet with patients
and help them interpret the feelings ex-
pressed in their journals and reflect on their
cancer experience.
Hudler says there is extensive research
that finds journaling can actually speed up
the healing process.
Theres over 20 years worth of research Rebecca Windham reads from her patient journal
on expressive writing and the value of ex- in which she wrote poetry to help her cope with
pressive writing to physical and emotional 33 days of radiation therapy for breast cancer.
health, she said. Its fascinating. One of Photos by Kevin King
the reasons I wanted to do this is to show
people the value of expressive writing, writ-
ing about how they are feeling about things
Day 12 Friday, May 23, 2014
and whatever comes to mind, not just to Radiate, radiate, how much more to tolerate?
have a record of what youre going through, My life is swelling in and out of all my control.
but to help and to speed up the healing Like a pendulum it swings,
process and cope better with it. Unlike opium it stings.
James Pennebaker, a cognitive psycholo- For better or for worse this thing is taking its toll.
I need to be real
gist at the University of Texas, has under-
About how I feel.
taken a series of investigations into the I dont need permission to experience my grief.
benefits of writing, including its ability to Its part of the process,
promote physical healing. You cant make it cost less.
According to Pennebaker, 20-minute Working my way through, I have hope for relief.
Rebecca Windham
SEE DEAR DIARY PAGE 24
 n teers
Volu
F I T T I P S
spirit of volunteerism

S
KNOW YOUR NUMBERS. outheast Texas is
Keep track of your basic health blessed to have many
statistics. Know what your average
strong and caring
blood pressure, heart rate and
weight are, so you have an individuals that believe
early heads up if and when what H. Jackson Brown Jr.
one of your numbers is outside wrote: Remember that the
of its usual parameters. The same happiest people are not
concept goes for blood work and checkups. Stay aware and those getting more, but
ahead of the game whenever it comes to your health. those giving more. This
group of people contribute Medical Center of Southeast Texas volunteers are (front
FIND AN ACTIVE HOBBY. thousands of service hours, row) Jeri Tingle and Shirley Rhoden, (back row) Yolanda
Guess what? Walking the neighborhood, playing racquet-
often take money from their Gorman, Asha Sahadeo and Billy Young
ball, riding your bike, or gardening they are all exercise!
Any activity that increases your heart rate and own pockets to help, and generously share their lives and talents with those they serve.
gets your blood pumping counts In this issue of Vital Signs, we visited with the caring volunteers at Medical Center
toward your physical activity of Southeast Texas and Harbor Hospice, and found again what Paula ONeal, executive
goals. We tend to thrive director of Some Other Place in Beaumont, said more than a decade ago: You will never
doing things we enjoy, find any place on earth that has a bigger or better group of caring volunteers than you
so why not enjoy your will here in Southeast Texas.
exercise?
All volunteer profiles and photos by Brenda Cannon Henley

Now offering Bio-Identical Hormone Replacement

Therapy and innovative approaches to help you
quit smoking such as Nicotine Lollipops.
All Healthcare Plans Accepted Including Medicare Plan D

Jasper (J.J.) Lovoi, r.ph.

owner & pharmacist in charge

Visit us online at
www.lovoiandsons.com

3480 Fannin St. Beaumont, TX 409-833-7538

Vital Signs Summer 2016 19
BE A MAN.
GET CHECKED.
Gift of Life provides free prostate cancer
screenings for Southeast Texas men Dr. Apryl Mensah, radiation oncology medical director at Baptist Hospitals of
Southeast Texas (center), with Gift of Life clients Courtesy photo

T
he Gift of Life and its medical
partners provided prostate cancer
screenings and a full panel of ad-
ditional medical tests, including choles-
terol and glucose, blood pressure, and
HIV and Hepatitis C screenings, for
more than 500 medically underserved
Southeast Texas men at sites in Beau-
mont, Port Arthur and Orange during
June, National Mens Health Month.
Educational health awareness informa-
tion was also distributed to hundreds of
families that attended the sites.
Men tend not to go to physicians,
tend not to get themselves checked,
said Commissioner Everette Bo
Alfred, honorary chair of Gift of Life
Mens Health Month. The free services
provided by the Gift of Life benefit the Photo by Kevin King
whole community. Your health is your
wealth, and we are a wealthy com- Gift of Life volunteer Mary Perry, a student in the LSCPA LVN to ADN Nursing Program, does a
munity from the industry standpoint. blood sugar and cholesterol test on a Gift of Life client at the Carl Parker Center in Port Arthur.
We want to make sure our people are job of helping people help themselves. ized health education and immediate
healthy, too. A lot of the commis-
More than 200 volunteers from treatment navigation for any clients who
sioners courts and city councils around
Baptist Hospitals of Southeast Texas, presented adverse test results. This cus-
this state would love to have (the Gift of
Diagnostic Pathology Associates, Gulf tomized care ensured that each patient
Life). We do, and we cherish it.
Coast Health Center, Lamar University received a positive medical experience.
Clients expressed appreciation for
faculty and students, Legacy Commu- We are humbled by the support of
having access to a full continuum of
nity Health Services, Spindletop Center, our friends in the medical community,
care, including consultations with physi-
Triangle Area Network, UTMB, as well said Gift of Life Program Services Man-
cians.
as other medical groups, have dedicated ager Christina Morris, BSN, RN. We
My father was diagnosed with
hundreds of hours to support this life- could not extend these services without
prostate cancer at 74 years old, said one
saving mission. In addition, volunteer their participation. Southeast Texans
Port Arthur screening client. He fought
physicians Maria Blahey, MD; Bodo are fortunate to have such compassion-
the cancer and is still with us today. Un-
Brauer, MD; John Fowler, MD; Ashok ate, skilled medical professionals who
fortunately, my uncle was also diagnosed
Malani, MD; Wayne Margolis, MD; are willing to go the extra mile for their
with prostate cancer, but he did nothing
patients.
about it and it took his life. Its better to Apryl Mensah, MD; Mustafa Musa,
know if you have a health issue so it can MD; and Moses Wilcox, MD have been SEE GET CHECKED PAGE 21
be treated. The Gift of Life does a great available for consultations, personal-

20 Vital Signs Summer 2016

 GET CHECKED FROM PAGE 20

Studies suggest that despite the momentum of medical technol-

ogy, on average, American men will die five years earlier than their
female counterparts. In 2016, prostate cancer will be diagnosed
in 180,890 men. Although the survival rate is nearly 100 percent
when diagnosed early, an estimated 26,120 men will die from the
disease this year.
As part of the Gift of Lifes continuum of care, the programs
Prostate Cancer Support Group, Men Against Cancer, offers
assistance for men with prostate cancer, their families and caregiv-
ers. Meetings are hosted the second Tuesday of each month at St.
Marks Episcopal Church and allow men an opportunity to meet
others, share their experiences and gain information from featured
speakers to strengthen recovery and have one-on-one support.
The Gift of Lifes annual Mens Health Month screenings are
funded in part by support of the programs annual fundraiser
Champagne & Ribs, including the South Texas Ford Dealers title
sponsorship and major gifts from Shelley and Joe Tortorice, Linda
and Joe Penland, Robin Dauphin, Mrs. William C. Sallye Keith,
Sheila and Walter Umphrey, and Colleen Sherlock, as well as other
generous donors.
Since 2000, the Gift of Life has made available more than
8,400 free prostate cancer screenings and helped extend the lives
of 69 men who have been diagnosed with prostate cancer and
whose diagnostic and cancer treatment costs were entirely under-
written by the Gift of Life.
The Gift of Life screens men who are at least 45 years of age
(40 if African American or younger if there is a family history of
prostate cancer) who have not had prostate cancer, have limited
income and are medically underinsured.
For additional information, contact the Gift of Life at (409)
833-3663 or visit giftoflifebmt.org.

F I T T I P S
SLEEP TIGHT.
Your sleep cycle is your bodys recovery period, and it can often
come back to haunt us if we neglect this aspect of our health. Every-
one has their own sleep sweet spot, but generally speaking, adults
need 7-9 hours of restful sleep each night. If you find yourself waking
up in the middle of the night, look for ways to address what is waking
you. Track your average sleep patterns, and note the mornings when
you wake up feeling the most refreshed. Sometimes sleeping an extra
30 minutes can give you an extra groggy morning. Who knew waking
up earlier could help you to feel more refreshed?

Vital Signs Summer 2016 21

Healthcare where
 The Acorn & the Oak
T
he acorn produces the oak; written out, the information contained in the acorn fills a
library. The information needed to provide excellent healthcare fills multiple libraries.
To bring that knowledge to bear on your health needs, SETMA has an acorn in every
examination room. We call it a computer.

The knowledge and information required to secure your future health is beyond anyones capacity
to memorize, or physically to carry from place to place. Therefore, in every examination room, in
every emergency room, on every floor of every hospital and in every providers home and in every
nursing home, SETMA has an acorn - a computer which places at the providers fingertips the
data needed to guide your healthcare decisions.

With disease management tools for hypertension, congestive heart failure, headaches, diabetes,
weight management, metabolic syndrome, cholesterol, exercise, asthma, hydration, kidney disease,
diabetic education, depression, heart disease and many more, and with health and wellness
algorithms, SETMA can bring the acorns capacity to bear upon every visit.

SETMAs multi-specialty, multi-sited, multi-faceted diagnostic clinic - SETMAs healthcare oak -

is a unique Southeast Texas healthcare resource. Come see what the future of healthcare looks
like today.

Come see what your health

can be tomorrow.

your health is the only care

 DEAR DIARY FROM PAGE 18
writing assignments, where participants
write about their deepest emotions and
thoughts about the upheaval that is affect-
ing their lives, have led them to report feel-
ing happier and less negative than prior to
their writing experience, and having fewer
symptoms of depression and anxiety. In his
studies, Pennebaker reported improvement
in immune system functioning in patients,
among other positive outcomes.
As the number of studies increased, it
became clear that writing was a far more
powerful tool for healing than anyone had
ever imagined, Pennebaker writes in his
book Writing to Heal.
Rebecca Windham, a 53-year-old music
instructor and director of the Cardinal Jazz
Singers at Lamar University, was diagnosed
with breast cancer in December 2013.
Windham, who is originally from Atlanta,
Georgia, had just moved to Beaumont, was
51 at the time, and was settling into a new
job at the university when she received the
disturbing news.
I was at home when I got the call
that I had been waiting very anxiously for
from my doctor, which said the results
were positive for stage one breast cancer,
Windham said.
Her oncologist ordered radiation
therapy.
I rebelled against radiation. I was very
upset, Windham said. There was some-
thing very invasive about it. I found it very
difficult.
Jaylene Carr, manager of the Dauphin
Cancer Screening and Prevention Center
in Beaumont, saw that Windham needed
an outlet to vent.
Im a creative person. Thats my profes-
sion. Im a musician, songwriter, composer
and a teacher, Windham said. Jaylene said
I could come to the Dauphin Center after
my radiation. That saved me. I got a journal
Day 29 Thursday, June 19, 2014
Radiate, radiate, the concept of incinerate
Comes to mind when lying on the table flashing
heat
Today starts electrons
Weve passed through the photons
What a joy to know about the particles I meet!
Keeping it simple
On the skin not a pimple
Just a big red tan that beams, Weve got the cancer
BEAT!
Rebecca Windham
24 Vital Signs Summer 2016
Vicki Suire used her journal
to document her cancer
treatments and keep up with
her routine.
and wrote poetry for every day I had radia-
tion. I had my coffee. I ended up counseling
some women who were in there who had
their mammograms, and it was a godsend.
Windham experienced 33 total days of
radiation therapy, and despite the painful
experience, she said she looked forward to
her journaling.
I had a pattern of starting every days
poetry with the words radiate, radiate, as
that was my recurrent theme, she said.
Looking back, I think this was a sarcastic
and humorous manifestation stemming
from my attitude of resentment, loathing
and rebellion, which sort of protected me
from complete denial, and also ended up
being a very effective coping mechanism to
help me stay on course, and not choose to
bolt and abandon my treatment.
She didnt let her chemotherapy prevent
her from participating in the Lamarissimo!
Concert Series, an accomplishment that
Windham is most proud of. It has been
two years since Windham finished her
radiation treatment, and she expects to be
cancer free when tested again.
While Windham chose to write poetry
to express her emotions, other patients ap-
proach journaling in a different manner.
They are for use by the patient however
they see fit, Carr said. They can write in
them, they can do poetry, they can draw,
just keep notes for documentation to help
them remember things. I think its a way
for patients to feel like they have control
over the situation.
Vicki Suire, 62, of Nederland said she
used her journal to document her treat-
ments and just keep up with her everyday
routine.
Suire had surgery for her breast can-
cer a lumpectomy, in which 13 lymph
nodes were removed, two of which were
positive for cancer, and Suire still needed
chemotherapy following her surgery at St.
Day 30 Friday, June 20, 2014
Radiate, Radiate, how to differentiate?
So many complex thoughts and feelings rushing
through my mind.
One day its great; the coast has cleared!
The next day fate has interfered!
What can I do to stop this massive rollercoaster
grind?
Dear Lord, give me peace and strength
Guide me toward ease, and not the brink...
Move me to be bold enough to seek so I shall
find
Peace of Mind with Human Kind.
Rebecca Windham
Joseph Hospital in Houston treatments
that were horrific, according to Suire.
Suire underwent 52 weeks of chemo,
and in the midst of her cancer nightmare
had a second tragedy, when she lost her
mother to ALS.
Unlike Windham, who took a creative
approach, Suire journaled to keep up with
her treatments, medical tests and care.
I documented it all, she said. I could
go back and see what they did because
when I got home, I couldnt remember.
Suire is currently cancer free. She said
when reflecting on her journal, she cannot
believe she had the strength to endure what
she did.
I think it empowers patients to write
their emotions down, Carr said. They go
back and read it and realize how strong they
really were to get through what they did and
still be a mom, a wife, a grandma, a friend
and keep going in life and just survive.
Once enough journals have been used,
Hudler said she plans to take excerpts from
the journals and compile a publication
that will be distributed to doctors, nurses,
patients and their families.
Kevin King
 n tee rs
Volu Ray of sunshine
Quiet dignity
Jeri Tingle, volunteer, Medical Center of Southeast Texas

J
eri Tingle of Nederland is the Medical Center of Southeast Texas Gift Shop
Asha Sahadeo, volunteer, Medical Center of Southeast Texas chairman and arranges for the volunteers to be on duty there, helps to
select the merchandise

A
sha Sahadeo, a 17-year-old Nederland offered, and handles the counter
High School student, proves that and register.
many of our young people today have She has been doing these
the determination and will to succeed and are chores since 1999 and loves what
willing to work for what they want. Asha volun- she does.
teers in the Neonatal ICU at the Medical Center I like to deal with people, meet
of Southeast Texas, working with babies. She new ones, and I have formed close
has served as a volunteer for two years while friendships among my peers, says
carrying a full load of classes and remaining on
Jeri, who has 9,951 volunteer hours
the A-B honor roll at her school.
logged to her credit.
Asha was inspired to begin volunteering by a friend of hers in Florida who
also works at her local hospital. Jeri is originally from
I was rather overwhelmed at first when I saw the babies, understood Cheneyville, Louisiana, a town of
their issues, and began to meet their parents and family members, she says. about 1,000 on a busy day, she
I knew I wanted to help and to do a good job for them, so I listened and I says. She graduated high school
learned. in 1953, married in 1954, had her
Asha has now helped to recruit six other teens to serve as volunteers, and daughter in 1955, and her son followed in 1956.
she works five days a week, amazing when you consider her full schedule. She jokingly says, I did it all in four years and needed more to do, so here I am.
I do it because I love to help people, and I want to major in the care of Jeri enjoys playing cards with friends, traveling to the various casinos in the
infants when I graduate, she says. When I feel that I have helped someone, area, and volunteering at St. Elizabeth Catholic Church. She brings a quiet dignity
and I see a smile spread across their sometimes very weary face, it gives me to her position, but has a spark of humor and a twinkle in her eye that attracts
hope and an affirmation that I have made a difference for them. folks of all ages to her side.

Vital Signs Summer 2016 25

Medical Center
expands sleep
services to
Beaumont campus
T
he Medical Center of Southeast
Texas has expanded its sleep study
services with the opening of a diag-
nostic sleep center at the hospitals Victory
Campus.
Located on the first floor of the Beau-
mont hospital, the new sleep center
includes rooms equipped with queen-sized
beds, flat screen TVs, private bathrooms
and massaging recliners in an environment
designed to promote a peaceful nights
sleep.
The reading room boasts state-of-the-
art patient equipment to monitor each
patients sleeping patterns.
The center is an expansion of the ser-
vices provided at The Medical Center of
Southeast Texass existing Diagnostic Sleep
Center in Nederland, which opened in
November 2012.
By expanding our sleep services into
Beaumont and surrounding areas, we are
further exemplifying our commitment to
fulfill our mission of making healthcare ac-
cessible throughout our community, said
Richard Gonzalez, Chief Executive Officer
of The Medical Center of Southeast Texas.
Not getting a good nights sleep can
26 Vital Signs Summer 2016
Jennifer Walker, a certified respiratory therapist (CRT) with more than nine years experience and
clinical coordinator at the Medical Center of Southeast Texas Victory Campus, reads data from a sleep
study. Polysomnography records brain waves, oxygen level in the blood, heart rate and breathing, as
well as eye and leg movements. Photos by Kevin King
cause much more than frustration and problems cardiac problems, chronic ob-
drowsiness during the day. Recent studies structive pulmonary disease, and if there is
show a growing correlation between sleep a prevalence of stroke in their near future.
disorders and a variety of serious health is- You can find a lot of other ailments just by
sues such as high blood pressure, increased doing a sleep study.
risk of heart attack and stroke, respiratory Medical Director for the Sleep Center
failure, obesity, depression and much more. Dr. Sujatha Goli is triple board-certified
It is estimated that over 70 million people in pulmonary medicine, internal medi-
suffer from sleep problems, and over 40 cine and sleep medicine, Sonnier said,
percent of children ages 8 to 10 years old and technicians at the Sleep Center are
experience some type of sleep disturbance. double board-certified meaning they are
The main thing we test for is obstruc- registered respiratory therapists as well as
tive sleep apnea, said Sleep Center Direc- registered polysomnographic technologists.
tor at the Medical Center of Southeast Sleep services have previously been
Texas Rick Sonnier, who added that the limited for children in Southeast Texas
clinic tests for narcolepsy as well. With suffering from sleep disorders, causing
our tests, we find restless leg syndrome many parents to seek assistance outside of
(RLS), periodic leg movement (PLM), and the area. With this expansion, The Medical
we also find a lot of other underlying Center of Southeast Texas Diagnostic Sleep

Dr. Jeremy Roebuck
Center now has the advanced equipment
and capabilities to care for children ages 7
and up.
We are reducing the need for our
smallest patients and their families to travel
outside of our area for testing and treat-
ment, Gonzalez said.
Dr. Jeremy Roebuck, a native of Beau-
mont and board-certified otolaryngologist
at Southeast Texas Ear, Nose & Throat, will
treat pediatric patients at the sleep center.
Each room is equipped with queen-sized
beds, flat screen TVs, private bathrooms
and massaging recliners in an environment
designed to promote a peaceful nights sleep.
One of the No. 1 reasons to take out
tonsils and adenoids in children is sleep
apnea, Dr. Roebuck said. In 99 percent
of kids, it fixes it completely. In adults,
usually a (continuous positive airway pres-
sure) CPAP is given.
In adults, sleep apnea is only consid-
ered significant if the respiratory distur-
bance index (RDI) is more than 20, he
said. The RDI is a formula used in report-
ing sleep study findings. It is the average
number of episodes of apnea, hypopnea
and respiratory event-related arousal per
hour of sleep.
In kids, if it is over 1, thats signifi-
cant, Dr. Roebuck said. Any amount of
obstruction in a kid is considered signifi-
cant, whereas in an adult it is 20 or more
per hour.
Kids will be able to bring their favorite
stuffed animal, blanket or toy to the sleep
lab, Roebuck said. If necessary, a parent
will also be able to stay overnight with
their child, added Sonnier.
Were going to do whatever the child
would normally do at home to be able
to go to sleep, Roebuck said. Weve got
nurses and people that work in the lab and
the hospital that work with kids all the
time, so they are good at making them feel
comfortable.
Unlike adults, who usually spend the
whole night because they might receive a
sleep test and get fitted for a CPAP in one
night, pediatric patients usually dont have
to spend the whole night to have a success-
ful sleep test, according to Roebuck.
If we get a good couple of hours of
data from that child, normally that is
enough that we know what to do, he said.
Bed wetting, especially in older children,
is a sign of sleep apnea, Roebuck said.
And for adults, leaving sleep apnea
untreated can be deadly, Dr. Roebuck
warned.
Youll see this happen all the time
especially somebody who may be taking
anything to help them sleep or for pain
or may drink too much alcohol one night
they can stop breathing. They can pass
away. Thats the worst thing, he said.
Other things that can happen regularly
over an extended period are high blood
pressure, heart attack and stroke.
For more information on the Sleep
Center at Medical Center of Southeast
Texas, call (409) 727-3612 or visit www.
medicalcentersetexas.com/services/rehabili-
tation/sleep-center.
Kevin King
Vital Signs Summer 2016 27
A warm effort
Seniors knit caps to welcome Beaumonts newest residents

S
ome of Beaumonts most seasoned residents have been busy making
sure its newest residents receive a warm welcome to the city.
Since 2002, residents at Calder Woods senior living community
have been meeting to knit caps, which are donated to newborn babies at
Christus Southeast Texas St. Elizabeth Hospital and Baptist Hospital. About
30 caps are donated monthly and prepared by two women who are part of a
knitting group that meets each Wednesday at 1 p.m. at the senior living com-
munity to work on their knitting projects, build the bonds of friendship, enjoy
conversation and create something that serves a greater purpose.
The two women who donate their caps, Agnes Northrup, 96, and Ethlyn
Johnson, 89, were recently honored for their giving spirit by being named
Calder Woods 2016 Volunteers of the Year.
At a time when not many people make anything by hand, it is
impressive to see these women volunteer their time to create
these welcome gifts to the babies of Beaumont, said Ben
Mazzara, executive director of Calder Woods. The knit-
ters are a huge asset to our community and contribute so
much to others through the creation of these caps. They
are special to everyone who receives them, and creating
them brings such purpose to the residents lives.
Both women began knitting at a young age, Northrup in
her 20s after she was married, and Johnson as a young wom-
an when World War II was beginning. In Johnsons hometown
of Ada, Oklahoma, the American Red Cross requested vol-
unteers knit sweaters for men entering the Navy. They
continued knitting into adulthood, creating
garments and gifts for their husbands
and children.
After retirement, the
women began knitting
more regularly, and
Johnson taught
her husband
to knit.

28 Vital Signs Summer 2016

Ethlyn Johnson, 89, and Agnes Northrup, 96, both Calder Woods residents,
knit caps for newborn babies. The caps are donated to Baptist and Christus
Southeast Texas St. Elizabeth hospitals in Beaumont. Photo courtesy of
Calder Woods

The couple started to knit baby caps for Baptist Hospital in Hous-
ton, where they lived at the time. The pair logged more than 2,500
volunteer hours knitting in Houston, and they continued with their
tradition when they moved to Calder Woods. Northrup also previ-
ously donated her knitting projects to Navy men and women in need
through the Navy Relief Society in San Diego, California, where she
logged more than 4,100 hours of volunteer time.
I enjoy doing something that serves a greater purpose and
allows me to give back to the community, said Johnson. It also
helps me pass the time in my apartment when I watch television,
and it keeps my mind engaged and active. Caring for the small-
est members of our community is such a blessing to the staff and
physicians at Baptist Hospitals of Southeast Texas. To be able to
add kindness, compassion, and the true sense of caring from our
Calder Woods partners is priceless for not only the new babies but
for the new moms, said Mary Poole, public information officer,
Baptist Hospitals of Southeast Texas.
Each week, without fail, a handful of women gather to con-
tinue the various projects theyre working on, some to donate and
some as gifts for others. Over the years, the group has even taught
some residents and other visitors the art of knitting. An estimated
4,000 caps or more have been delivered to Beaumont hospitals,
thanks to the efforts of Johnson and Northrup.
Agnes and Ethlyn give from their hearts, and their handmade
caps truly warm everyone, said Christus Southeast Texas St.
Elizabeth Neonatal Coordinator Kelli Huebel, BSN, RNC. The
babies, literally, and the moms and dads, the nursing team and
physicians because it shows how much our community cares.
Technology and medical care have made big advances in 40 years,
but the heart of our community, and the hearts of Agnes and
Ethlyn, remain steadfast.
In addition to the donation to the hospitals, they also enjoy
creating baby caps to congratulate staff members at Calder Woods
who are expecting children or grandchildren.
I learned to knit through a class at my local department store which
also sold yarn, said Northrup. After I got married, knitting kept me
active when I stayed at home with my kids. It is something I continue
to enjoy in my retirement. Its a very constructive activity and allows
others to benefit, which I love. Knitting isnt done very much today, so
to be able to deliver a handmade item to a baby in our area is a joy.
Vital Signs Summer 2016 29
I CAN SEE
CLEARLY NOW
D
an Wilkes, a 75-year-old retiree of the not need them, and I am certain
National Petroleum Institute, headquar- your vision might improve only
tered in Washington, D.C., could surely by about 4 percent or less.
sing the lyrics of the very successful I Can See Wilkes was shocked and
Clearly Now, written and recorded by Johnny asked, What do you mean,
Nash in 1972. Wilkes, a resident of Kemah, joined Doctor?
the ranks of the more than three and a half mil- You have good vision in both
lion patients in America who opt to have cataracts eyes, and especially for someone of
removed each year. Cataract surgery is not only one your age, but what you do have are
of the most common surgical procedures in the cataracts in both eyes, his doctor re-
United States, but also one of the most successful. plied. Your left eye has some coverage,
A cataract is not a type of film that forms but your right eye is almost completely
over the surface of the eye. In reality, a cataract is covered with a large cataract. No wonder
the result of a natural change occurring inside the you are having trouble seeing well.
eye, a gradual clouding that can make vision less After a second doctor confirmed the
sharp over time. The eye works much like a camera, diagnosis and suggested immediate surgery,
and like a camera, depends on a clear lens to help Wilkes agreed and chose Dr. Edward C.
properly focus images. A healthy transparent lens Wade, M.D., F.A.C.S., who is known in
absorbs light and accurately focuses it onto the Southeast Texas for performing state-of-the-
retina (the back of the eye), providing a crisp, clear art cataract surgery without needles, sutures or
image. As people age, proteins in the lens begin to patches. Wade has performed more than 65,000
clump together, forming opaque or cloudy clusters. successful cataract procedures and is one of
Over time, these protein clumps will eventually the first surgeons in the United States to
cloud the lens, allowing significantly less light to perform laser cataract surgery with the
pass through. These clusters will also change the FDA-approved Len5X Laser.
coloration of the normally clear lens, often tinting Once it is determined that a cataract
it a brownish shade that may alter color perception. has formed, the only way to restore
Never wearing glasses or contact lenses, Wilkes vision is to surgically remove
valued his good vision while others his age strug- the cloudy lens.
gled with glasses, headaches, and an inability to see Wilkes met
well as they aged. One night as he was viewing the with a
local news, he noticed that he was having difficulty
reading the alerts running along the bottom
of the television screen. He checked his
TV for flaws or scratches to be sure
it wasnt playing tricks on him,
and when he determined
that the screen was
indeed clear, he im-
mediately called his
optometrist for an
appointment.
After a lengthy
and comprehen-
sive examination,
the doctor spoke
with Wilkes
and said, I can
prescribe glasses
for you, but
you really do

30
30 Vital
Vital Signs
Signs Summer
Summer 2016
2016 Stock photo
 Dan Wilkes is prepped for surgery.
Photos by Brenda Cannon Henley
Clinical Nurse Manager Aaron Thibodeaux for the University of Houston College of Optometry
Surgery Center walks attending students through the surgical procedure for Dan Wilkes cataract
removal.
trained counselor at the Eye Center of Tex-
as to discuss the various options available
to him and to determine where and when
his cataract surgeries would take place. He
chose the University of Houston College
of Optometry Surgery Center on the main
campus of the school. Everyone connected
to his case agreed that the badly damaged
right eye should be done first, with the left
eye following in three weeks.
Wilkes chose the new laser removal
rather than the basic surgery, which also
produces excellent results. A femtosecond
laser would be used to initially break up
the cataract and then remove it from his
eye. It is completely bladeless and com-
puter-controlled. This method automates
some of the most challenging steps of
refractive cataract surgery, Dr. Wade said.
One of the nurses on duty suggested Wil-
tion to help them prepare for the surgery,
kes think of it as a GPS for the surgeon.
Another plus for cataract surgery
patients is that today, a tiny lens called
an Intraocular Lens, or IOL, with the
custom corrective power required by the
individual eye itself, is placed in the eye as
soon as the offending cataract is removed.
Vision is usually restored in a matter of
days. Drops are prescribed for the patient,
and they generally begin three days prior
to the surgery. The majority of patients are
prescribed an antibiotic, a non-steroidal
anti-inflammatory medication, and a ste-
roid medication, which also treats inflam-
mation. It is essential to the success of the
surgery that all medications be taken as
prescribed.
The actual procedure took only about
15 minutes, and Wilkes walked out of the
surgical suite under his own power. It is
Wilkes returned to the Eye Center of Texas after
each surgery for evaluation.
required that any patient having cataract
surgery have someone to drive them there
and back to avoid accidents. He was also
pleased that he was allowed to wear his
own clothing and even his shoes and
socks. The patients are given a medica-
but in Wilkes case, he was not asleep
during the procedure. Very strict instruc-
tions were shared before the patient was
dismissed that included not bending his
head forward, picking up any weight, and
calling the office if any discomfort was
noted.
Wilkes reported to the Eye Center of
Texas for a complete checkup on the day
following the surgery on both eyes and
reported that he thought it had been very
successful.
After a few days had passed after each
surgery, Wilkes said, I had no idea that
my vision had been getting dimmer and
duller by the day, but once the cataracts
were removed, I can see so much more
clearly, and the color is absolutely amaz-
ing.
Brenda Cannon Henley
(Editors note: The author was able to observe the en-
tire surgical procedure for the purpose of this article.)
Vital Signs Summer 2016 31
32 Vital Signs Summer 2016
 n tee r FIT TIPS
Volu mr. involvement
Billy Young, volunteer, Medical Center of Southeast Texas

B SURROUND YOURSELF WITH

illy Young of Port Arthur is a human dynamo de-
voted to serving others. Billy is active in the Port
Arthur chapter of the American Red Cross, Port
POSITIVE INFLUENCES.
Cities Rescue Mission, Hospitality Center, and is a cub Recruit a buddy to jump on the healthy bandwagon or find
master for Boy Scouts of America, as well as vice presi- a few friends who enjoy hitting a trail after work, rather than
dent in charge of new membership and orientation for happy hour. While your social circle may get a slight makeover,
the volunteers of the Medical Center of Southeast Texas. so will you! Date nights can turn into bike rides, and family fun
Along with recruiting and training new volunteers, he can be found at the farmers market. Dont be shy about meet-
is the preferred golf cart driver, taking patients and ing new people who will encourage you to be healthy.
family members to and from their vehicles, and making
them laugh along the way.
Billy is a retiree from Southwestern Bell and holds an accounting degree from Lamar
University. When he was promoted within the large company, he was one of the first
African-Americans to hold such a position and was responsible for traveling to 78 different
Texas cities. Billy has 10 children, with eight of them holding a degree and one managing
her own business. He has 16 grandchildren and says his life revolves around them, along
with his volunteer work. One of Billys granddaughters is a rising track star and is listed as
a second in the nation in the 100 yard dash, and she is only 9 years old. She trains each day
under the watchful eye of her mom, who is also her coach.
Billy attributes his work ethic and life philosophy to his step-grandfather, who was
blind. He built his own chicken coop, cut his own grass, did gardening and even ran an
electric line to the coop without any outside help, he says.

Southeast Texas Cardiology Associates,

Vein Clinic and Vascular Center
Comprehensive Peripheral Arterial & Venous Disease Evaluations & Treatments

Meeting all of your cardiovascular needs including non-healing wounds

or ulcers, caused by poor circulation and/or venous insufficiency

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Best Cardiology 2016

Paris P. Bransford, MD and Rodolfo P. Sotolongo, MD, FACC

Board Certified Cardiologists and Vascular Specialists

www.setxcardiology.com 2693 North St.

409.832.8862 www.setxveinclinic.com Beaumont, TX 77702
Vital Signs Summer 2016 33
 Stock photo

surviving violence
LIT to offer courses on escaping violent encounters for EMS workers, medical professionals

L
amar Institute of Technologys Department of Public Ser-
vice and Safety EMS Program participated in a week-long
training course on Escaping Violent Encounters from June
20-24. The class was taught by DT4EMS Defensive Tactics
4 Escaping Mitigating Surviving, a company from Cartersville,
Georgia and was held at the LIT Multi-Purpose Center Confer-
ence Room.
The course is DT4EMS EVE (Escaping Violent Encounters)
for Instructors. The first two days (16 hours) are the provider
classes followed by three days (24 hours) of instructor classes. LIT
is planning on making these courses available to healthcare pro-
viders, educational professionals, pre-hospital providers, womens
organizations, industries and anyone wanting to take advantage of
this educational opportunity, according to a release by the college.
The Provider Course covers the basic skills required by any
responder or provider when facing possible or imminent assault or
use of force.
The Instructor Course is both physically and mentally demand-
ing. This part of the course focuses on how to teach violent en-
counter escape. After successful completion, the participant could
coordinate and train EMS/Fire and health care providers on how
to escape violent encounters they face in the medical field all
while maintaining a professional image.
Many EMS and fire personnel remember being attacked by
a violent patient, an angry bystander or upset family member.
The frequency of assault on fire and EMS providers is alarming, DT4EMS Instructor-Trainer Brett Peine works with LIT EMS students and
and while most attacks are not life threatening, the risk of serious instructors at the LIT Multi-Purpose Center Conference Room. The course
injury is real. is designed to help EMS workers defend themselves from assault while on
Most acts of violence against EMS providers are not deadly. the job. Photos courtesy of LIT
34 Vital Signs Summer 2016

DT4EMS Instructor-Trainer Brett Peine shows students how to escape when pinned to the floor.
However, according to the article, Oc-
cupational fatalities in emergency medical
services: a hidden crisis, the relative risk
of non-fatal assault for EMS workers is
roughly 30 times higher than the national
average. The article goes on to say that
over a five-year period during which 91
line-of-duty fatalities were identified, 10
(9 percent) were violence-related, putting
the relative risk of fatal assaults for EMS
workers about three times higher than the
national average.
The National Association of Emergen-
cy Medical Technicians found four in five
medics have experienced some form of
injury as a result of the job. The majority,
52 percent, claimed to have been injured
by assault. More than 20 percent ranked
personal safety as a primary concern.
With these statistics in mind, LIT will
offer escaping violent encounters through
LITs Workforce Training and Continuing
Education Department in the near future
and will include the following: Escaping
Violent Encounters for Fire & EMS, Es-
caping Violent Encounters for Healthcare
Providers, Escaping Violent Encounters for
Women, and Escaping Violent Encounters
for Educational Professionals, said Allen
Welch, Emergency Medical Technology
Program Director at LIT.
For more information, contact LITs
Workforce Training and Continuing Edu-
cation Department at (409) 880-8114 or
e-mail workforcetaining@lit.edu.

Photo by Brandon
Gouthier Photography A publication of The Examiner Corporation

Publisher: Don J. Dodd

Editor: Kevin King

Creative Director: Adam Balla

Copy Editor: Joshua Cobb
Advertising Director: Kristi Dodd
Contributors: Jennifer Jackson, Brenda Cannon Henley,
David Block, Brandon Gouthier, Amber Norris, Madeline Conway,
Dr. Mark Bruyn
Cover Photo: David Block

Any erroneous reflection upon the character, standing or reputation of

Vital Signs repeats TMA Award win
Vital Signs editor Kevin King receives the first-place Texas Medical Association
Anson Jones, MD Award from Dr. Garrett Peel, president of the Jefferson County
Medical Society. King won the award for his article Never Give Up, which ap-
peared in the fall 2015 issue of Vital Signs. This marked the second straight year
Vital Signs won the first-place Anson Jones award in the Small Circulation Print
category. The award is given annually for excellence in health communication.
any person, firm, or corporation which may occur in Vital Signs will be
gladly corrected upon being brought to the attention of the editor.
Published three times per year. Vital Signs is a publication of
The Examiner Corporation, 795 Willow Beaumont, TX 77701
409-832-1400.
Copyright 2016. All rights reserved.

Vital Signs Summer 2016 35


Organ Engineering
N
ASA, in partnership with the non-
profit Methuselah Foundations
New Organ Alliance, is seeking
ways to advance the field of bioengineering
through a new prize competition.
The Vascular Tissue Challenge offers a
$500,000 prize to be divided among the
first three teams that successfully create
thick, metabolically-functional human
vascularized organ tissue in a controlled
laboratory environment.
The humans who will be our deep
space pioneers are our most important
resource on the Journey to Mars and
beyond, said Steve Jurczyk, associate ad-
ministrator for NASAs Space Technology
Mission Directorate in Washington. The
outcome of this challenge has the potential
to revolutionize healthcare on Earth, and
could become part of an important set of
tools used to minimize the negative effects
of deep space on our future explorers.
Related cells that are joined together are
36 Vital Signs Summer 2016
NASA Challenge aims
to grow human tissue
collectively referred to as tissue, and these
cells work together as organs to accomplish
specific functions in the human body. Blood
vessels around the cells vascularize, provid-
ing nutrients to the tissue to keep it healthy.
The vascularized, thick-tissue models
resulting from this challenge will function as
organ analogs, or models, that can be used
to study deep space environmental effects,
such as radiation, and to develop strategies
to minimize the damage to healthy cells.
Studying these effects will help create
ways to mitigate negative effects of space
travel on humans during long duration,
deep space missions. On Earth, the vascular-
ized tissue could be used in pharmaceutical
testing or disease modeling. The challenge
also could accelerate new research and de-
velopment in the field of organ transplants.
When the Wright Brothers discovered
how to control aircraft during flight for
aviation in the early 1900s, there was an
explosion of progress after this key bar-
The Vascular Tissue Challenge offers
a $500,000 prize to be divided
among the first three teams that
can successfully create thick,
metabolically-functional human
vascularized organ tissue in a
controlled laboratory environment.
rier was removed, said Dave Gobel, chief
executive officer of the Methuselah Foun-
dation. In the same way, once the vas-
cularization limit is solved, via the NASA
Vascular Tissue Challenge, there inevitably
will be an historic advance in progress and
commercialization of tissue engineering ap-
plications to everyones benefit.
Competitors must produce vascular-
ized tissue that is more than .39 inches (1
centimeter) in thickness and maintains
more than 85 percent survival of the
required cells throughout a 30-day trial
period. Teams must demonstrate three
successful trials with at least a 75 percent
success rate to win an award. In addition
to the laboratory trials, teams also must
submit a proposal that details how they
would further advance some aspect of their
research through a microgravity experi-
ment that could be conducted in the U.S.
National Laboratory on the International
Space Station.

Astronaut Butch Wilmore sets up Rodent Reseach-1 hardware in the Microgravity Science Glovebox.
The new challenge was announced as
part of White House Organ Summit, which
highlighted efforts to improve outcomes for
individuals waiting for organ transplants
and support for living donors. In a related
initiative, the Center for the Advancement
of Science in Space (CASIS), which manag-
es the International Space Station U.S. Na-
Photos courtesy of NASA
tional Laboratory, announced a follow-up
prize competition in partnership with the
New Organ Alliance and the Methuselah
Foundation that will provide researchers the
opportunity to conduct research in micro-
gravity conditions. CASIS will provide one
team up to $200,000 in flight integration
support costs, along with transportation to
the ISS National Laboratory, support on sta-
tion and return of experimental samples to
Earth. CASIS also announced the winners
of the $1 million 3-D Microphysiological
Systems for Organs-On-Chips Grand Chal-
lenge, Ricky Tuan, University of Pittsburgh
and Siobhan Malany, Micro-gRx
The Vascular Tissue Challenge prize purse
is provided by NASAs Centennial Challenges
Program, part of NASAs Space Technol-
ogy Mission Directorate. Centennial Chal-
lenges, managed by the agencys Marshall
Space Flight Center in Huntsville, Alabama,
is NASAs citizen inventor prize program
that invites the nation to help advance the
technologies that will enable us to go to Mars
and beyond, as well as improve life on Earth.
The New Organ Alliance, which is adminis-
tering the competition on behalf of NASA, is
a nonprofit focused on regenerative medicine
research and development to benefit disease
research and tissue engineering.
For information about the Methuselah
Foundations New Organ Alliance, official
challenge documents, rules and schedule of
events, visit neworgan.org/vtc-prize.php.
For more information about the Vascu-
lar Tissue Challenge, visit www.nasa.gov/
vtchallenge.

FIT TIPS
EAT WELL.
Sounds simple, but there are so many options.
How do you know what is healthy and what isnt?
Start with the obvious: Fast food is not healthy.
Period. The more of it you can cut out of your
diet, the better. Keep your food as close to its
natural state as possible. Shop the outer edges
of the grocery store. Aim for single ingredient
items (think chicken, orange, carrot, etc.). If you
are purchasing a packaged food, try to keep your
ingredients pronounceable and limited to five or fewer.
Seek out a community class if you need more help there are
options galore!
SMILE.
Simply put, the more often you
keep a smile on your face, the less
stressed you will feel. You can actu-
ally trick your mind into feeling happy
by smiling. The feeling of relief that
you get whenever you finish a
project can also be achieved by
letting go of stress and smiling.
n tee r
Volu steady leadership Shirley Rhoden, volunteer, Medical Center of Southeast Texas
S
hirley Rhoden of Nederland serves in
several positions at the hospital. She is
now 78 and has served as a volunteer for
13 years. You might find Shirley in the gift shop, at
the information desk, in registration, or handling
her duties as president of the Medical Center
volunteers, a position she has held for five years.
I started volunteering after I retired from
work, Shirley says. It simply feels good to be
helpful in somewhat stressful times for people,
and the patients appreciate our help and guid-
ance.
Shirley is normally scheduled for three days a
week, but can sometimes be found at work all week long.
She is here five days a week, and sometimes seven, said her friend, Billy Young. There
is always something more to be done, and Shirley is doing it.
Proof of Billys words can be seen in the fact that Shirley has 14,000 volunteer hours to
her credit.
Rhoden hails from Springdale, Arkansas, and lived in Oklahoma before settling in
Southeast Texas when her husband came to work for DuPont. She has been a widow for 30
years and has three children, five grandchildren, and nine great-grandchildren. Rhoden is
a member of First Methodist Church in Nederland and loves to babysit her grandchildren,
read, crochet and travel.
Vital Signs Summer 2016 37
REBUILDING
NOT-SO-GOLDEN
ARCHES
I
f you experience moderate to severe
arch pain, heel pain or muscle cramps
within your foot, the problem could
be a collapsed arch commonly known
as flatfoot. Though not all flat feet are
problematic, some can really slow you
down.
38 Vital Signs Summer 2016
Beaumont podiatric surgeon Mark
Bruyn, DPM, said he has performed
almost a thousand flatfoot reconstruction
surgeries in his 32-years of practice.
In general, patients come to me be-
cause they have pain with activity such Before
as walking or running difficulty fit-
ting shoes, or swelling, Dr. Bruyn said.
The pain may be deep and focused, or a
widespread, achy feeling. If the discom-
fort doesnt go away after all non-surgical
options are exhausted, then in most cases,
flatfoot reconstruction can relieve the pain
and restore the function of the foot.
Dr. Bruyn said he has developed a
unique approach to the surgery, which
takes about two hours to perform. It is
routinely done on an outpatient basis, he
said, and involves lengthening the Achilles
tendon and bone grafting in combination
with implantation of an endoprosthesis.
According to Dr. Bruyn, this approach
allows him to achieve extraordinary cor-
rection without the need of joint fusion,
which limits motion and decreases the After
functionality of the foot later in life.
I had a special reason for develop- surgical residents nationwide to perform
ing this procedure, said Dr. Bruyn. his technique, and lectured at state and
My father suffered from a painful national seminars.
and disabling flatfoot deformity While many would assume a surgery
for almost his entire life. He had like this might require a drive to Houston,
been told by other doctors that he Bruyns surgery is available through the
would just have to live with it. Medical Center of Southeast Texas Victory
After I performed the surgery, Campus in Beaumont.
he was able to play both tennis Some of my patients traveled to a well-
and golf, pain free. I know known orthopedic hospital in Houston for
first-hand what a difference it flatfoot surgery and did not get the results
made in his life. they expected, Dr. Bruyn said. Ive redone
Dr. Bruyns combination their surgeries with positive outcomes. My
procedure has been published main goal is to help patients of any age re-
in the Journal of Foot and solve their issues with pain and mobility. It
Ankle Surgery and in McGlamrys is gratifying to improve their quality of life.
textbook, Foot and Ankle Surgery. For more information on flatfoot recon-
These are reference sources for most po- struction and other procedures, visit www.
diatric foot and ankle surgeons, Dr. Bruyn beaumontfootspecialists.com or call (409)
said. In addition, he has trained podiatric 833-7465.
Beaumont podiatric surgeon Mark Bruyn, DPM, has developed a unique approach to foot
surgery that involves lengthening the Achilles tendon and bone grafting in combination with
implantation of an endoprosthesis.
 n tee rs I P S
Volu Mr. congeniality Sonny Smith, volunteer, Harbor Hospice
F I T T
PUT YOURSELF ON THE LIST.

S
onny Smith loves what he Dont forget that YOU are important! It is easy to get
does as a volunteer for Harbor caught up in the hustle and bustle of the day and
Hospice. taking care of others, but dont forget about
Its my job to bring a live flower your own needs. Give yourself permission to
arrangement or bouquet to every spend an hour each day on you. It could be
hospice patient in our in-house
a relaxing soak in the tub, time with a good
facility once a week, Sonny says.
I also offer to pray with them book, or an evening stroll. Whatever it is
can offer communion if desired, and that rejuvenates your body and mind, take
minister to the needs of the family the time to unwind and step away from the
or friends visiting their loved one. stresses of the day.
Sonny has volunteered for 14
years in various endeavors, but prior DONT GIVE UP.
to his retirement, he was a project manager in the oil and gas industry. Ever. You will find hurdles along the way,
Sonny and his wife Fran live in Mauriceville and enjoy helping others. and you might become discouraged during your
Our lives have been blessed and we want to share those blessings with journey to becoming and maintaining a healthier
others, he says. you. But like a loyal friend, your healthy choices
Sonny, whose mom was a patient at Harbor Hospice, says his heart was are always waiting for you with open arms. No
pricked when he noticed that not every patient had someone to come in and matter how long it has been since your last step
visit, sit with them, help do errands, speak to doctors, and in general, care. class or green smoothie, it isnt too late for your
That made me sad, and so I decided to do what I could to change that, he next one.
says, adding, I only bring beautiful, colorful, live flowers. The flowers are
first class because these folks deserve first class.
Sonny says that some of the floral arrangements are donated; others he
purchases from his own funds, and some he grows and arranges.
It thrills my heart and makes me know it is a valuable contribution when
I see tired, hurting eyes open, a smile spread across a face, sometimes a tear
trickle down a weathered cheek, and to know I have made a difference for
someone for that moment.

Ms. Kindness
Jean Barrett, volunteer, Harbor Hospice

J
ean Barrett of Port Neches is kind in her
demeanor and in her volunteer efforts. She has
served for six years and says that while her hus-
band was a patient at Harbor Hospice, she realized
that she would like to help others facing loss.
The volunteers would come into our room with
a big smile and a pitcher of fresh water and ice,
she says. One month after my husband died, I attended a training class and
was assigned my first duties, which were to call patients in their homes. I most
often talked with caregivers, and having been a caregiver, I understood and
had suggestions to offer.
Jean says she knew that the caregivers needed encouragement and that it
was her pleasure to offer it to them.
She and her husband, Milford, were married for 39 years and she retired
from Ford Credit Company in 1999. She is a member of Central Baptist Church,
where she is president of the Baptist Women. She also visits patients in nurs-
ing homes and care centers.
I have truly enjoyed volunteering with Harbor, Jean says. It has given me
a sound way in which to give back to the community a small portion of what it
has given me.

Vital Signs Summer 2016 39

M
imi Garcia recalls reading a
string of news stories about the
Zika virus, the mosquito-borne
illness linked to birth defects spreading
in Latin America, in late February and
early March, around the time she learned
she was pregnant with her second child.
Garcia, 35, lives in Austin, where
no known cases of the virus have been
transmitted by mosquitoes. While she
considers her risk of coming down with
Zika to be fairly low, she is still taking
precautions, including avoiding travel for
work to South Texas, where mosquitoes
could circulate the disease this summer.
Garcia is not the only Texas woman continental United States, where there Baylor College of Medicine in Houston,
concerned about coming down with Zika is not yet evidence that mosquitoes are the virus comes up in conversations with
while pregnant. The uncertainty over spreading it. patients and colleagues there all the
where and when the virus might spread The more than 200 pregnant women time.
has left Texas women and doctors with in the United States with the virus The perception is that it will come,
questions about how best to prepare for contracted it while traveling abroad or she said. And thats certainly terrifying.
an outbreak questions as personal as from a partner (the disease also can be Some women are asking their doctors
whether women should delay pregnancy transmitted sexually). Fewer than 50 if they should delay pregnancy out of
as they wait to learn more. cases of people with Zika have been fear that the disease could come to Texas
The World Health Organization reported in Texas, according to the state while they are expecting and put them
recently recommended that people living health services department. and their unborn babies at risk. Eppes
in areas where mosquitoes are known to While there are not yet any recorded called that conversation common, and
be transmitting Zika be informed and cases carried by mosquitoes within Texas, complicated, given all the factors that go
oriented to consider delaying pregnancy, experts say Zika will likely come to the into deciding when to have children a
given that infected women in Brazil and Gulf Coast soon, since the mosquito that patients age and access to medical care
elsewhere have given birth to babies with carries it, Aedes aegypti, is native to the and contraception, among others. That
microcephaly, a condition characterized area and could soon bite people infected the virus could defy expectations makes
by an underdeveloped brain. That from travel and spread it. According to those discussions still more difficult.
advice applies to Puerto Rico, where the Catherine Squire Eppes, an assistant
SEE ZIKA PAGE 41
virus is actively circulating, but not the professor in obstetrics and gynecology at
40 Vital Signs Summer 2016
 n te e r
Volu
ms. humor
Yolanda Gorman, volunteer, Medical Center of Southeast Texas

Y
olanda Gorman has volun-
teered at the Medical Center
of Southeast Texas for over
four years and loves what she does.
She credits her mother and aunts for
instilling in her a need to give back.
They were all strong women, and
they reared a strong woman, she says.
Yolanda retired after a 34-year
career as a secretary for DuPont.
I loved my job, and now, I love
that I can give my time volunteering
to help others, she says.
Yolanda seems to be on a mission
to make everyone she meets feel
good and smile. Yolanda recently ex-
perienced a health problem that was
no laughing matter, however, a heart
attack that almost took her life.
She said she had been at her lake-
side home all weekend, enjoyed the
outing, and returned home to Groves
when her chest literally begin to feel
as though an elephant was sitting on
it and her arm began to tingle.
Knowing the symptoms of a
heart attack because her sister had
suffered one, she asked her husband
to take her to the Medical Center of
Southeast Texas .
People began quickly to work
with me, and I knew it was serious
from their expressions, she says.
She looked up to see her doctor
and said, Dont worry, Doc, I am
not going to die.
He said, How do you know that?
And she answered, Because I
am not going to let them get
my inheritance.
She was out of commission for
three months on doctors orders.
Yolanda recently returned to
work at the hospital, where she has
2,263 volunteer hours.

were planning on becoming pregnant? I state to declare a public health emergency

ZIKA FROM PAGE 40
Its hard to tell you how long you
would need to delay pregnancy. Theres
no known endpoint, Eppes said. We can
hypothesize that it will come to the Gulf
Coast in the summer, but it might be later
on. Its really hard to think of delaying
pregnancy with no known endpoint, and
that doesnt work for every family.
William Schaffner, the chairman of
the preventive medicine department at
Vanderbilt University Medical Center, said
he expects that a Zika outbreak in the United
States would be limited compared to some
Central and South American countries
where it is already circulating. Still, he
said even women in Tennessee have asked
him about it, and experts agree that health
providers are in uncharted territory.
I think theres a lot of hand-wringing
going on trying to figure out what the
best thing to do is, said Peter Hotez, the
dean of the National School of Tropical
Medicine at Baylor.
Hotez, who supports the WHOs
decision to advise women in areas with
Zika about delaying pregnancy, said Zika-
like illnesses have historically come to
Texas at about this time of the year. And
when Zika is introduced to a region, it
spreads quickly. That fact, Hotez said, is
an argument for delaying pregnancy now.
He raised a hypothetical: What would
I advise my two adult daughters if they
would probably advise them to hold off
until we see how this is going to unfold.
Not forever, but hold off for this very
scary time when were waiting to see if
Zika emerges on the Gulf Coast because if
its going to happen, its going to happen
during the summer months.
A lack of information about the virus
adds to the uncertainty, Hotez said.
Its still unclear how likely it is that a
baby born to a mother infected with Zika
will have microcephaly the Centers for
Disease Control and Prevention estimates
that between 1 and 13 percent of fetuses
infected over the first trimester are at risk,
a range Hotez called a big difference.
It also remains to be seen if babies born
without the condition develop other
problems.
A lot of us are kind of going by the
seat of our pants a little bit because so
little is published about this epidemic,
Hotez said. We dont have a lot of really
hard scientific information to base sound
public health decisions on.
As public health officials await
evidence of Zika transmission in the
United States, Eppes is advising patients
not to travel to areas with Zika and to
avoid mosquito bites even in Texas, given
the possibility of a risk. Texas has started
a campaign telling people to protect
themselves from bites, and Houston
Mayor Sylvester Turner has called on the
to fight the virus. Andrea Morrow, a
spokeswoman for the Texas Commission
on Environmental Quality, said in an
e-mail that the commission has no plans
to issue a statement.
Officials may not know that Zika is
endemic here until patients come down
with the disease, experts said, or babies
are born with microcephaly a condition
Hotez called every parents worst
nightmare.
When we catch it, it would already
be too late, Eppes said. So I think
focusing on avoiding mosquito bites now
is important.
Garcia, in Austin, plans to continue
avoiding travel to South Texas ahead of
her December due date. As a pregnant
woman, she said, Zika is now one of many
possible concerns.
In a way, we dont actually know for
sure that it hasnt been transmitted within
Texas because a lot of people could be
asymptomatic, Garcia said. To get
through your day as a pregnant lady in
Texas in the summer, theres a lot of stuff
to be concerned about.
Madeline Conway
The Texas Tribune is a nonpartisan, nonprofit
media organization that informs Texans and
engages with them about public policy, politics,
government and statewide issues.
Vital Signs Summer 2016 41
Raw doughs
a raw deal
E
ating raw dough or batter
whether its for bread, cookies,
pizza or tortillas could make
you and your kids sick, according to
an investigation by the Food and Drug
Administration.
According to Jenny Scott, a senior
advisor in the FDAs Center for Food
Safety and Applied Nutrition, the bot-
tom line for you and your kids is dont
eat raw dough. And even though there
are websites devoted to flour crafts,
dont give your kids raw dough or baking
mixes that contain flour to play with.
Why? Flour, regardless of the brand,
can contain bacteria that cause disease.
The U.S. Food and Drug Administration
(FDA), along with the Centers for Dis-
ease Control and Prevention (CDC) and
state and local officials, is investigating an
outbreak of infections that illustrates the
dangers of eating raw dough. Dozens of
people across the country have been sick-
ened by a strain of bacteria called Shiga
toxin-producing E. coli.
The investigation
found that raw
dough eaten or
handled by some
of the patients
was made with
General Mills
flour produced
in a Kansas City,
Missouri, facility. Sub-
42 Vital Signs Summer 2016
sequent tests by the FDA linked bacteria
in a flour sample to bacteria from people
who had become ill.
General Mills conducted a voluntary
recall of 10 million pounds of flour
sold under three brand names: Gold
Medal, Signature Kitchens and Gold
Medal Wondra. The varieties include
unbleached, all-purpose and self-rising
flours. Flour has a long shelf life, and
many people store bags of flour for
a long time. If you have any of these
recalled items in your home, you should
throw them away.
Some of the recalled flours had been
sold to restaurants that allow children
to play with dough made from the raw
flour while waiting for their meals. CDC
is advising restaurants not to give cus-
tomers raw dough.
People often understand the dangers
of eating raw dough due to the presence
of raw eggs and the associated risk with
salmonella. However, consumers should
be aware that there are additional risks
associated with the consumption
of raw dough, such as particu-
larly harmful strains of E.
coli in a product like
flour.
Flour is derived
from a grain that comes
directly from the field
and typically is not
treated to kill bacteria,
says Leslie Smoot, Ph.D., a senior advisor
in the FDAs Office of Food Safety and
a specialist in the microbiological safety
of processed foods. So if an animal heeds
the call of nature in the field, bacteria
from the animal waste could contaminate
the grain, which is then harvested and
milled into flour.
Common kill steps applied during
food preparation and/or processing (so-
called because they kill bacteria that cause
infections) include boiling, baking, roast-
ing, microwaving and frying. But with
raw dough, no kill step has been used.
And dont make homemade cookie
dough ice cream either. If thats your
favorite flavor, buy commercially made
products. Manufacturers should use
ingredients that include treated flour and
pasteurized eggs.
Symptoms and who gets sick
Common symptoms for Shiga toxin-
producing E. coli are diarrhea (often
bloody) and abdominal cramps, although
most people recover within a week. But
some illnesses last longer and can be
more severe, resulting in a type of kidney
failure called hemolytic uremic syndrome
(HUS). HUS can occur in people of
any age, but is most common in young
children under 5, older adults and people
with weakened immune systems.
For more information, visit www.fda.
gov.
southeast texas medical associates

MISSIon STATEMEnT
To build a multi-specialty clinic in southeast texas which is worthy of the

tRust of every patient who seeks our help with their health, and to
promote excellence in healthcare delivery by example.

SETMA I SETMA Ii setma west SETMA lumberton

2929 Calder ave. 3570 college st. 2010 dowlen rd. 137 B lhs dr.
suite 100 suite 200

SETMA nederland SETMA port arthur SETMA orange

2400 highway 365 2501 jimmy johnson blvd 610 strickland dr.
suite 201 suite 401 suite 140

( 409 ) 833-9797 | www.SETMA.c o m