WHJ_March2010

the

Health Journal March 2010

TM

Williamsburg Edition

Vol. 5 No. 10

Seeking Second Opinions

When Studies Collide

Making Sense of Cancer Screening Guidelines

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March Contents [ Features ]

2010

7 A Fresh Idea

Farm Fresh launches “nutrition iQ” food labeling system.

9 Cast Your Vote!

Take The Health Journal’s 2010 Readers’ Choice Survey.

12 So, You Want to Be a Vegetarian?

Cut the meat from your diet without sacrificing good nutrition.

28 Healing Haiti

Two emergency room docs reflect on their recent search-and-rescue mission.

42 A Little Piece of History

Gym proprietor Julie Jackson sets up shop in a century-old building.

[

In Every Issue

4 Editor’s Note 5 Inbox

16 Fitness

21 Skin & Beauty 34 Snapshots

35 Health Directory 40 Calendar 42 Profile

]

22

When Studies Collide What you should know about cancer screening guidelines.

28

the

Health Journal

TM

The Health Journal is a free, monthly consumer health magazine distributed throughout Hampton Roads. Three editions are currently available: Williamsburg, Peninsula and Southside, with a combined circulation of over 78,000 copies.

Publisher Brian M. Freer

Executive Director Rita L. Kikoen Editor Page Bishop-Freer

Associate Editor Beth Shamaiengar

Medical Editor Ravi V. Shamaiengar, MD

Administrative assistant Danielle Di Salvo Sales Executives David C. Kikoen

GRAPHIC DESIGNERs Natalie Monteith Jean Pokorny PhotographY Danielle Di Salvo Brian M. Freer Page Bishop-Freer Dawn Griffith

Contributing Writers Sharon Miller Cindrich Gregory Epps Joseph Han, MD Alison Johnson Amy Johnson Gayle Pinn, CPT Keith Schumann, MD Joy Vann

The Health Journal—Williamsburg Edition is directmailed to homes and businesses in Williamsburg, James City County and Northern York County.

Newsstand, rack and countertop distribution supplement our hand-delivery program.

Subscriptions are available for $24/year. Please send a check or money order, payable to RIAN Enterprises, LLC, to the address below. Include current mailing address and other contact information. Notify us of any change in address.

The editorial content of The Health Journal is produced with the highest standards of journalistic accuracy.

However, readers should not substitute information in the magazine for professional health care.

Editorial contributions are welcome. All submissions become the property of the publisher. We reserve the right to edit for style, clarity and space requirements.

For Advertising and editorial Information, call or write: The Health Journal 4808 Courthouse Street, Suite 204 Williamsburg, VA 23188 (757) 645-4475 • Fax (757) 645-4473 info@thehealthjournals.com www.thehealthjournals.com

4 THE HEALTH JOURNAL

Editor’s

Note

Nearly six months ago, when our daughter Cami was ready to start sampling solid foods, I made it my personal mission to ensure that, before her first birthday, she tasted her way through all the edible plant groups, more than 20 in all. So, here we are, 11 months of age and counting, and I can look proudly at that list and say with confidence that my little pea-pod really has tasted the full rainbow of fruits and vegetables (along with some legumes, spices and the entire contents of her toy box).

Cami’s expressions ranged from delight (hummus) to disgust (peas) as each new food was introduced. Taking recipe cues from store-bought baby food, I made my own concoctions to freeze and serve later, relying on canned baby food (organic, of course) when in a pinch. My mission had a clear purpose: I’d see to it that, no matter what life may bring for our first child (and admitted center of our universe), she would get a successful start with food. I’d help her to appreciate nutrient-dense foods over processed ones, to prefer the taste of fresh fruit over fruit snacks.

Brian likes to joke that my culinary talents were limited to blue-box macaroni and cheese when we first met, but the past few years have proved to be a learning period for me as far as cooking abilities go. Planning healthy, tasty dinners has become a top priority; I guess you could say I have become our family’s official unofficial nutritionist. Making smart selections isn’t always easy, though. Food labels can be confusing or misleading, and convenience foods always seem “conveniently” placed on the grocery’s center shelves.

On page 6, you’ll get the scoop on Farm Fresh’s new product labeling system “nutritioniQ.” The goal of the program is to help health-conscious consumers make better food choices, especially in the center of the store, where it’s so tempting to buy empty-calorie items like cookies, chips and soda. (You’ve probably heard the mantra, “Shop the perimeter of the store,” because that’s where you’ll find the healthiest, most nutritious items.)

In fact, in looking over this issue from front to back, I realized that in so many ways it reflects our core mission here at The Health Journal—to, first and foremost, provide you with tools you can use to make more informed decisions about your health, and secondly, to do it at no cost to our readers (thanks to our advertisers), and finally, to present the information in an attractive, readable format that readers will enjoy.

From Joy Vann’s piece on nutritioniQ, to Gregory Epps’ insightful look at why it’s important to get a second opinion (page 19), this issue is filled with articles intended to help you become a wiser health consumer, whether you’re shopping for a family doctor or your family’s groceries. And be sure to read our cover story, “When Studies Collide: Making Sense of Cancer Screening Guidelines” (page 22), in which local cancer experts weigh in on some of the recent recommendations relating to breast, prostate and cervical cancer screening—a subject that’s had U.S. doctors up in arms since last fall.

Will Cami come to appreciate the taste of peas, brussell sprouts, lima beans and all the other “delicious” dishes she’ll never remember eating? I can only hope. But, at the very least, we’ve had fun at the kitchen table. And, for me, those memories will last forever.

HJ Readers’ Poll: What’s the best health advice your mother ever gave you, and did you follow it? E-mail your reply to page@thehealthjournals.com.

Page Bishop-Freer, Editor page@thehealthjournals.com

page’s picks

MarchFavorites Trader Joe’s Sea Gummies With these tasty treats, you’ll never forget to take your fish oil supplement again! Plus, no fishy aftertaste means you won’t be mistaken for the Gorton’s Fisherman. ($7.99 at Trader Joe’s)

inbox

Re: February Issue “Thanks for including the article on the Shaws in the February issue [“Partners in Practice,” page 9]. The coverage for all of the couples turned out nicely.

—Bill G., Williamsburg “I just sat down to look over The Health Journal as a couple of headlines caught my eye (Fitness Trends, Age Spots? NO PROBLEM). After that I was captivated by every article written and especially treasured the “Remembering Josephine” story. What a lovely tribute to her and her family’s undying love. I so appreciate the wonderful list of physicians, too. Plus, the stories are informative and inspiring at the same time. Thank you so much for doing your job so well. God Bless.”

—Sharon D., Virginia Beach

“Thank you for printing the story on Baby Josephine. I know that was very difficult for Ed and Claire Lampitt, but what could be more inspiring than their faith and love? My heart and prayers go out to them. My five-year-old was diagnosed with a rare, acute, stage-four brain cancer at just 13 months of age.

What a joy they had with Josephine. I pray that as medicine progresses, more cures will be found. God bless you all.”

—Elizabeth L., city unknown

Kashi GoLean Toasted Berry Crumble I’ve always been a fan of the proteinpacked GoLean line of cereals, but this is the best-tasting one yet. With 190 calories per serving and 9 grams of protein, one bowl will keep you satisfied all morning.

“Awesome February issue.

I love the Journal.”

—Lynn H., Naperville, Ill.

The “Measure Up Bowl” The Health Journal Administrative Assistant Danielle DiSalvo discovered these handy bowls, invented by mother-of-two Heather Harvey (at left is the “Classic Bowl,” $19.99 at shopmeasureupbowl.com). Measure Up Bowls eliminate the need for measuring cups—a major time-saver if you’re watching portion sizes (plus, you’ll have fewer dishes to wash since you don’t need a measuring cup).

Foam Roller Ladies and gentlemen, foam rollers are great for alleviating tight muscles and sciatica pain (featured at left is Fitness Gear’s 36-inch black roller, $39.99 at www.dickssportinggoods.com). You can pick up a roller pretty much anywhere that sporting goods are sold, including Target and Wal-Mart. As a general rule, rollers with good length and density offer the greatest relief because they allow you to roll large areas and provide the most compression.

“Excellent! Excellent! Excellent! Your Feb. 2010 edition is outstanding. Keep up the great work. The article written by Joy Vann, “Partners in Practice,” is of the highest caliber. “Remembering Josephine,” painstakingly written by grieving father Ed Lampitt, provided a personal look into a family that has gone through so much. My prayer is that Ed and Claire hold onto the peace that passes understanding as they welcome their son into the world. Thank you for allowing them to speak both life and hope into a personal and painful situation.”

—Martha J., Yorktown

Subscriptions

“I would like to get The Health Journal delivered to my home. How can I subscribe?”

—Vanessa O., Hampton

Ed.: Subscriptions are $24 a year. Please send your name, address, and a check, payable to RIAN Enterprises, to: 4808 Courthouse St., Williamsburg, VA 23188.

THE HEALTH JOURNAL

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A Smarter Way to Shop Farm Fresh launches ‘nutrition iQ’ labeling system to help curb customer confusion Written by Joy Vann

I

Farm Fresh t’s well known that the perimeter of the grocery store is the corporate dietitian place to find the healthiest foods including fresh produce, meat Jennifer Shea and dairy items. But when shoppers venture into the “center of the store” for staples such as cereal, canned items, pasta and frozen products, they can stumble into processed foods that often carry misleading or overstated health claims.

As many a mom can tell you, that “healthy” trail bar packed in a child’s lunchbox isn’t so healthy when the nutrition panel on the package reveals that it contains as much sugar as a candy bar and as much sodium as a bag of chips.

To help customers avoid “center-aisle confusion,” Farm Fresh, which operates 45 stores in Hampton Roads, Richmond and Elizabeth City, N.C., recently launched the first phase of a new food-labeling program designed to highlight products in the center of the store with the most health benefits. Though a roll-out date for the second phase has not been set, it will spotlight items on the perimeter of the store including produce, meats and dairy products.

Named “nutrition iQ,” this program is being billed as “The BetterFor-You Food Finder.” It was developed in collaboration with an independent panel of dietitians from Joslin Clinic, part of an academic medical center affiliated with Harvard Medical School.

“Since the launch of nutrition iQ, we have received numerous requests from our community partners for additional information on how they can incorporate niQ into their programs by partnerBecause manufacturers’ ing with Farm Fresh,” says Susan Mayo, vice president of consumer products are often packaged affairs and public relations for the chain. “Our community partners to “scream out” health inforand health professionals view this program as a credible source for mation, Shea says consumeducating their clients about making smarter, better-for-you choices ers should look for natural at the grocery store.” products, such as oatmeal, Jennifer Shea, corporate dietitian for SUPERVALU, the Minneapthat won’t necessarily olis-based parent company of Farm Fresh and other grocery store feature dubious nutritional chains throughout the country, introduced the program to area dieticlaims, i.e., something that’s cians as well as hospital and health organization experts at Farm touted as “low-fat” but is Fresh’s Virginia Beach corporate headquarters in January. high in sodium. Here are To explain the need for a program such as nutrition iQ, Shea cites some other tips: scary-yet-familiar statistics about the health of Americans, notably • Shop with a list. that approximately one in four Virginians is obese.

• Don’t shop on an empty The goal of nutrition iQ, Shea says, is simply to make it easier for stomach. customers to make smarter food choices at the point of purchase.

“Customers have difficulty making sense of nutrition guidelines • Use spices for flavor in and say that they need practical tips to guide them,” Shea says. “With place of salt or butter. more than 60,000 products, it can be difficult to maneuver through • Stick to basics found on the supermarket. And, many say that they do not have time to read the perimeter of stores labels, so we started where consumers have the most confusion—the such as eggs or egg subcenter of the store—[and encourage them to make] smarter choices.” stitutes, fat-free or lowFarm Fresh’s nutrition iQ program uses bright, color-coded tags fat dairy products; lean to indicate an item has any of the following nutritional attributes:

Shopping Tips

Continued on page 8

For more information visit nutritioniq.farmfreshsupermarkets.com or call (877) 932-7948

proteins including beans, poultry, fish and meat; and fresh fruits and vegetables.

local beat

Virginia Among Few States Still Reporting Regional H1N1 Activity

Virginia is among a handful of states still reporting regional H1N1 flu activity, according to the U.S. Centers for Disease Control and Prevention’s latest edition of Flu View. Due to the potential public health threat from 2009 H1N1, 18 area hospitals have agreed to maintain their current visiting policy—limited to adults 18 years and older—through March as a precaution to protect vulnerable hospital patients.

Boynton-Smith Advances to Fellow of the American College of Cardiovascular Administrators Bon Secours Hampton Roads is pleased to announce that Jennifer Boynton-Smith, CAAMA, FACCA, administrative director of the Neurosciences service line for Bon Secours Hampton Roads, has earned her place as a Fellow of the American College of Cardiovascular Administrators (FACCA). This designation represents professional achievement and expertise in cardiovascular health care.

Sentara Healthcare Named Nation’s Top-Ranked Integrated Healthcare System Sentara Healthcare has been ranked as the top Integrated Healthcare System in the nation, according to healthcare analytics company Strategic Defense Initiatives (SDI) and Modern Healthcare magazine. Sentara has been listed among the top 10 in each of the 13 years the list has been compiled and published. It was ranked number one in 2001 and is again this year. SDI’s report is regarded as the nation’s premier rating system for evaluating integrated healthcare networks on their performance and degree of integration.

VAPA Expands with New Physician Virginia Adult & Pediatric Allergy & Asthma (VAPA) physicians are pleased to welcome Ritu S. Pabby, M.D., to their Hampton Roads practice. Pabby focuses on the treatment of allergies and asthma in adults and children and is currently accepting new patients of all ages at VAPA’s Williamsburg, Newport News and Gloucester offices.

THE HEALTH JOURNAL

7

local beat

Farm Fresh Customers Can “Round Up” to Fight Childhood Cancer For the 10th year, Farm Fresh is coming to the aid of children battling cancer by launching the “Farm Fresh RoundUp,” an opportunity for customers to contribute to Children’s Hospital of The King’s Daughters (CHKD) by rounding up their grocery bill to the next even dollar (or contributing more).

This year’s Round-Up will be held from March 10 to April 3 at all Hampton Roads Farm Fresh locations. Over the last nine years, Farm Fresh has raised $5.9 million in donations for childhood cancer programs at CHKD.

Free Scoops for Free Clinics Ben & Jerry’s at Riverwalk Landing in Yorktown will partner with three local health care clinics (Lackey Free Clinic, Gloucester-Mathews Clinic and HELP) on March 23 to generate funds and raise community awareness about the growing number of uninsured Americans. From noon to 8 p.m., volunteers will dish out thousands of free scoops in hopes of collecting donations to support these clinics, which offer free medical care, dental care and prescriptions to those with no insurance and who fall below 200 percent of the poverty line.

8 THE HEALTH JOURNAL

Continued from page 7 excellent or good source of fiber—orange label

excellent or good source of calcium—blue label

low or healthier level of sodium—green label

excellent or good source of protein—yellow label

whole grains—dark orange label

low caloric content—purple label

low in saturated fat—red label

The items tagged are those that already meet basic Food and Drug Administration (FDA) guidelines as being wiser choices for consumers. The tags appear in tandem with an item’s price, unit price and bar code information.

Currently, 2,500 items are tagged, including a variety of products, not just Farm Fresh store brands. Items not tagged include those that don’t meet basic FDA health guidelines—those most customers already know to be unhealthy, such as candy, chips and soda.

Vertical signs in the aisles alert customers to shelves featuring the nutrition iQ labels. Brochures, along with the signage, explain how the color-coded system works.

Shea says products undergo a rigorous screening process in order to qualify for nutrition iQ—in some cases using criteria stricter than FDA guidelines— and adds that the collaboration with the Joslin Clinic provides independent, third-party credibility that is transparent and comprehensive.

Shea also notes that the system makes it easy for people with specific health concerns to find products that fit their dietary needs and goals. For example, shoppers with high cholesterol can look for the orange “high in fiber” tags. Those with high blood pressure can look for the green “low sodium” tags, and vegetarians can keep an eye out for yellow “excellent source of protein” tags.

Babs Benson, program manager for the “Healthy You” weight-management program at Children’s Hospital of The King’s Daughters, says such labeling provides a short-cut to help customers make sense of nutrition information—something she’d like to see at all grocery stores.

“My experience in working with families is that time is very valuable and people are not going to spend two hours in the grocery store reading labels,” says Benson. “So anything that helps point to foods that are good for you is very valuable.”

Benson says misleading packaging information is a problem for people who don’t have the time to read the nutrition labels, and provides the example of products that tout whole wheat prominently on the front of the package, though the ingredient list reveals that wheat is the tenth item down, meaning that the product doesn’t have much whole wheat at all.

“It’s easy to make bad {food} choices in our society, so anything that improves that is a good thing,” Benson says.

the

Health Journal’s First-Ever

Readers’ Choice Awards Vote for your favorites in more than 30 categories, from health care providers to fitness centers to local running events. The Health Journal will run a series of profiles on selected winners in our summer 2010 issues.

OK, let’s get started:

}

1. Check your area of residence, the area for which you will be completing this form.

Greater Williamsburg

South Hampton Roads (Virginia Beach, Norfolk, Chesapeake, Portsmouth, Suffolk)

Peninsula (Newport News, Yorktown, Hampton, Poquoson)

Other (please name)____________________________________________

2. Complete the survey on the reverse side of this page, or vote online at www.thehealthjournals.com.

3. Return this form to us (unless you’ve voted online) in one of three ways:

1 Mail completed form to:

The Health Journal—Readers’ Choice 4808 Courthouse St., Ste. 204, Williamsburg, VA 23188

2 Drop it by the address above.

3 Fax completed survey (both sides) to (757) 645-4473

RULES FOR VOTING: • One survey form per person, please.

• Deadline for entries is Friday, May 15th, 2010.

• To request extra survey forms, send e-mail to info@thehealthjournals.com.

• We encourage local medical practices and health-related businesses to make copies of this survey available to their clients or patients.

• Voters must provide a name and phone number below. This information will be kept confidential and will be used only to keep the contest fair by preventing ballot stuffing.

Name

Phone Number

THE HEALTH JOURNAL

9

2010 Readers’ Choice Ballot

Write In Your Choice For Your Favorites From The Following Categories:

Fitness And Wellness

Audiologist

Big Gym

Cardiologist

Bike Trail

Dentist (General Or Cosmetic)

Boot Camp

Dermatologist

Group Fitness Class

Ear, Nose And Throat Doctor

Pilates Studio

Eye Doctor

Running Event

Family Practitioner

Small Gym

Geriatrician

Spin Class

Neurologist

Sporting Goods Retailer

Obstetrician/Gynecologist

Weight-Loss Center

Oncologist

Yoga Class

Orthodontist

Facilities

}

Health Care Providers

Orthopedic Specialist

Community Hospital

Pain Management Physician

Emergency Room

Pediatrician

Fertility Clinic

Physical therapist

Free Clinic

Plastic Surgeon

Pharmacy

Podiatrist

Urgent Care

Spine Specialist Urologist

Vascular Surgeon

Weight-Loss Physician

Holistic Health Acupuncturist Chiropractor Doula/Lamaze Coach

Senior Services

Health Foods Store

Assisted Living/Nursing Facility

Health Spa

Home Health Care Agency

Herbalist

Senior Center/Club

Massage Therapist

Senior Living Community

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food & nutrition

So, You Want to be a Vegetarian?

Written By Alison Johnson

Local dieticians offer their advice for cutting the meat.

T

Editor’s Picks 3 (Unbelievably Easy) Meatless Meals You’ll Love

1.

2.

3.

12 THE HEALTH JOURNAL

Morning Star Farms Black Bean Burger topped with salsa and fresh avocado (non-vegans can add shredded cheese and light sour cream) Amy’s Organic Vegetable Lentail Soup topped with shredded parmesan cheese (vegans can skip the cheese) Morning Star Farms Sausage Patties, chopped and wrapped into a pancake or like a tortilla and drizzled with pure maple syrup

o many people, the word “vegetarian” essentially translates to “healthy.” But as with all types of diets, a good vegetarian plan requires work—especially when a person first makes the switch—and a focus on including a wide range of nutritious options, experts say.

Put another way, vegetarians can be very unhealthy, and even very overweight, says Lynn Earle, a registered dietician in Virginia Beach.

“You can be a vegetarian and be on a steady diet of chips and Oreos,” says Earle, whose specialties include helping clients create healthy plant-based meal plans. “You have to make sure to eat the right combinations of foods, and have variety in all categories of food, in order to get the vitamins and nutrients your body needs. You don’t want to just eat apples as fruit, let’s say—you want to add oranges, kiwi, melon and more.”

The term “vegetarian” officially covers people who don’t eat any meat, although some people who eat only seafood or poultry still call themselves vegetarian. There are two basic types: lacto-ovo vegetarians, who avoid meat but eat animal products such as milk, eggs, cheese, butter and yogurt; and vegans, who eat no animal products at all.

People generally eliminate meat to improve their health or out of a moral opposition to raising animals for consumption.

On the health side, a nutritious vegetarian diet is high in fiber, which can guard against everything from constipation to colon cancer. It’s also lower in cholesterol, which may help prevent heart disease, stroke and high blood pressure. And vegan diets in particular are likely to be low in fat as well.

At the same time, there are some risks of nutritional gaps when meat goes missing from a diet, even if people do take daily supplements and vitamins. Most people assume the main problem is protein or iron, but vegetarians generally can cover those needs by eating the right combinations of foods, Earle says. With protein, the goal is to eat “complementary proteins”—different items paired to provide all the essential amino acids the body needs from food. Luckily, the combinations that accomplish this tend to be logical: vegetarian chili with cornbread or crackers, for example, or black beans and rice or peanut butter on whole-grain bread. With iron, for example, a person should pair iron-rich plants with foods rich in vitamin C, which helps the body absorb iron. An example is spinach salad with orange slices and nuts.

Vegetarians also can drink soy milk, mix whey or soy protein powders into smoothies and buy meatless products such as “chicken patties,” “sausages” and “burgers,” adds Brooke Mercedes, a registered dietician with Bon Secours Hampton Roads. Many meatless products can be prepared in minutes in a microwave. “There is such a wide variety of choices that really taste good,” says Mercedes, who practices in Virginia Beach. “I’m not a vegetarian—I love meat—but I still buy

some [vegan-friendly foods]. It’s important to be willing to try new things.”

Probably the biggest risk of a meat-free diet, dieticians agree, is a deficiency in vitamin B12, a nutrient found in animal products that is critical to red blood cell formation and brain function. Over time, a lack of B12 can cause anemia, as well as fatigue, weakness and difficulty with balance and concentration.

Fortified breakfast cereals are one option to provide B12; another is a product called primary nutritional yeast, a flaky yellow powder that’s easy to mix into sauces or sprinkle over popcorn and other snacks. Vegetarians also can take a multi-vitamin with B-complex vitamins.

Some health risks are greater for strict vegans. A lack of calcium, which vegans can’t get through dairy products, is one, although tofu is a rich source of the bone-strengthening mineral, and dark green leafy vegetables can provide some as well. Still, many vegans take calcium supplements with vitamin D in addition to a multi-vitamin with iron, taking these at different times of the day so their bodies can optimally absorb everything (vitamin D is essential for calcium absorption). Vegans also may have to work harder than lacto-ovo vegetarians to get enough fat and calories into their diets, using techniques such as cooking with peanut, canola or olive oil and using a mayonnaise substitute on sandwiches. Parents who raise vegan children need to make sure their kids stay on a normal growth curve, Earle says.

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With many potential health benefits, what is the best way to change over to a vegetarian diet? Many dieticians recommend a gradual approach—starting with eliminating red meat—particularly for people who want to change their habits for health reasons rather than their core values. “Eliminate meat first and see how you feel about that,” Mercedes says.

“If that feels good and you want to go further, you can eliminate fish next and then move on to other animal products. You can take it to whatever level you want and feel comfortable doing.”

She also encourages people considering vegetarian diets to experiment with lots of new meals and snacks (bookstores now are well-stocked with vegetarian and vegan cookbooks) and, above all, to make their diet fun. “If you stay open-minded,” she says, “there are so many great options that are really healthy.”

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There are two basic types of vegetarians: lacto-ovo vegetarians, who avoid meat but eat animal products such as milk, eggs, cheese, butter and yogurt; and vegans, who eat no animal products at all.

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healthwire

Want Kids’ Vaccinations Up to Date?

Keep the Record

Written By Frederik Joelving NEW YORK (Reuters Health)

The timing of vaccinations is important because toddlers’ immune systems have not yet matured enough to fight off many diseases.

T

aking charge of your toddler’s vaccination record may be the best way to ensure he or she doesn’t miss any shots, a new study suggests.

“In our country, we think the doctor should have all the medical records,” said Dr. James McElligott, a pediatrician at the Medical University of South Carolina who worked on the study. “I like the idea of putting the ownership back in Mom’s hands and empowering her a little bit.”

When parents kept a ‘shot card,’ their child’s odds of being up to date on vaccinations rose by more than half.

Experts agree that kids aren’t getting the vaccines they need, from those for measles, mumps, and rubella to those for polio and the flu. Tapping into national vaccination data, McElligott and his colleague Dr. Paul Darden found that only 81 percent of two-year-olds were considered up-to-date according to national guidelines.

The service you

Deserve

But no one has figured out the best way to meet national goals. One potential solution is using shot cards.

In their study, McElligott and Darden, who is now at the University of Oklahoma, found that about 40 percent of the toddlers had a shot card, and 84 percent of these were up-to-date on their vaccinations.

By contrast, only 79 percent of the children without a card had received all their shots.

The timing of vaccinations is important because toddlers’ immune systems have not yet matured enough to fight off many diseases, said Dr. Robert M. Jacobson, a professor of pediatrics at the Mayo Medical School in Rochester, Minn., who was not involved in the study.

In principle, experts would like for at least 95 percent of children to have up-to-date vaccinations, Jacobson added. But in the real world, numbers fall well short of that. In some poor communities, it’s about 50 percent.

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The new study found that shot cards were particularly effective when mothers had little education or had many children, and when a child had multiple health-care providers.

McElligott said the findings strengthened the case for maintaining your child’s vaccination records. “It turns out that not only does it make a big difference, but it seems to work in the people who need it the most,” he said.

Pediatric societies already recommend using the shot card as a way to ensure that children get vaccinated. But some states have been more hesitant to adopt the card than others. In Indiana, for example, the researchers found that less than one in five kids had a card, while in Kansas, more than half did.

With an ever-expanding list of shots, it may be difficult for parents to keep track of which vaccines their kids already have and which ones they still need.

“You need a vaccination record in part to remind yourself and in part to share with providers when you move,” said Jacobson.

From the study, however, it is impossible to determine whether the card itself led to more vaccinations. It could be that

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the kinds of parents who are organized enough to keep their own records are the kinds of parents who remember to take their kids to the doctor regularly— or vice versa.

Nonetheless, Jacobson urges parents and providers to use the card. “The fact is that it doesn’t have a downside and it’s cheap,” he said.

Most hospitals provide an infant immunization card at the time of birth. You can also ask your child’s pediatrician about how to obtain one.

healthwire

fitness

Fitness for Every Age and Stage

Infants Early experience of physical activity sends the message that exercise can be fun.

Make Fitness a Family Affair Give kids a good start to a healthy life WRITTEN BY GAYLE PINN

Gayle Pinn is the owner of Results Personal Training Studio. She’s a certified personal trainer and spinning instructor with 12 years of experience in the fitness industry. She specializes in one-onone personal training for all fitness levels. She can be reached at resultsstudio@gmail. com.

T

he growing rate of childhood obesity may very well be America’s numberone public health crisis. In the past 30 years, the number of overweight children has more than doubled among two- to five-year-olds and 12- to 19-year-olds, and it’s more than tripled among children ages 6 to 11. This sharp rise in obesity has been linked to the dramatic increase in Type II diabetes, high blood pressure and other serious health problems in children.

Many health specialists see a link between children’s declining physical activity and increasing weight. While, on average, children consume fewer calories today than they did 30 years ago, they’re steadily getting heavier—so it makes sense to focus on the role of physical activity in the obesity epidemic.

Look around any playground: children like to be physically active. But today’s youth have fewer opportunities to do so than in the past. Some reasons include cuts in school physical education programs as well as parents’ heightened concerns about their children’s safety. For example, one in three kids are now driven to school on a bus or by their parents; 30 years ago that number was one in 10. And today parents are less likely to allow their children to play outside without supervision. At the same time, children today have more attractive indoor activities such as computer games as well as game players ranging from the Xbox to the PSP, from the iPod to the Wii. Let’s face it: The older we get, the harder it is to make healthy lifestyle changes.

Teaching children and teens healthy habits now will last a lifetime. And the best way to promote a healthy lifestyle is to make health and wellness a family affair.

Parents can set a good example for their children by being active themselves.

Early exposure to physical activity shows kids that exercise can be fun, and that is an important foundation for their future health and happiness. Parents should emphasize the “play” aspect of exercise and encourage children to do the activities they enjoy.

Toddlers All children enjoy energetic play.

Grade Schoolers Family outings promote fitness, quality time together.

Try these tips:

16 THE HEALTH JOURNAL

• • • • • • •

Visit a park, playground or swimming pool.

Walk, hike or take a bike ride together as a family.

Seek children’s clubs that involve physical activity.

Encourage children to get involved in sports.

Join a family-friendly recreation center.

Balance “screen time” with more active pursuits.

Set a good example, and be physically active yourself.

Adolescents Set a good example by being physically active yourself, and encourage a healthy lifestyle.

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Second Opinions May Prevent Regrets A friend’s misfortune provides a valuable lesson.

y friend Eric was catheterized for no good reason. That’s what sold me on second opinions. We were both in our mid-30s when we were diagnosed with kidney stones. With Eric living in Norfolk and me in Chesapeake, we went to our respective city hospitals in a similar state of extreme pain. But Eric had to further endure both the insertion of a catheter through his urethra, and finally its painful withdrawal, while I slept peacefully under a morphine drip as my kidney stones were sonically broken up by a lithotripsy machine. So was Eric’s epic discomfort the fault of the hospital, or his own?

There are no hard and fast rules to tell us when to seek a second opinion. But when given a diagnosis, especially a difficult one, there are several questions that patients should ask their doctors. Before he was catheterized, the first question Eric should have asked is, “Are there alternative treatments I should consider?”

Written By Gregory Epps

“Second opinions are a normal part of medical practice. If a doctor is offended, you should walk— no, run —away.”

—General Surgeon John B. Newman, Norfolk

According to Dr. John B. Newman, a general surgeon with Sentara Norfolk, “Patients need to feel empowered and prepared to make informed decisions regarding their individual health needs.”

Newman recommends that patients inquire about the reasons for and risks behind any procedure, as well as side effects, alternate methods of treatment, the effect a procedure may have on quality of life, and the cost of taking action versus inaction.

Dr. L.D. Britt, professor of surgery at Eastern Virginia Medical School, agrees that patients should be in charge of their health care, and that we have every right to ask for a second opinion. In fact, he recommends that we do exactly that.

“I don’t think patients utilize second opinions enough,” says Britt. “And any surgeon who is in any way intimidated by someone wanting a second opinion should reevaluate [his or her] focus. The focus should be on keeping the patient informed and comfortable.”

Continued on page 20 THE HEALTH JOURNAL

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health care decisions

Continued from page 19 Newman agrees: “Second opinions are a normal part of medical practice. If a doctor is offended, you should walk—no, run—away.”

But how do we know if we need a second opinion?

Drs. Newman and Britt agree that it’s a decision that must always be made by the patient. Patients should not hesitate to ask questions, request further guidance from specialists, or privately seek a consultation with another physician. Remember, asking for a second opinion doesn’t mean you’re cheating on your doctor. There’s no such thing as patient infidelity.

Acquiring that second opinion should not be difficult. Newman reminds patients to seek “qualified advice,” making sure that second opinion comes from a board-certified specialist. “Some insurance companies require a second opinion,” he says.

“Others may pay for a second opinion if the patient requests it.”

Britt points out that if a Asking for a second opinion patient is involved with an HMO or similar plan, he or doesn’t mean you’re cheating she may want to stick with on your doctor. There’s no physicians honored by that such thing as patient infidelity. plan or risk having to pay for the cost of the second opinion out of pocket.

In an August 2009 article posted on the CNN website, the network’s medical news correspondent Elizabeth Cohen reported on several diagnoses that call for a second opinion. Procedures like heart bypass, hysterectomy, varicose vein surgery and brain tumor surgery made the list because of either their tendency to result from misdiagnosis or because multiple treatment options are available. But both Britt and Newman believe that any diagnosis warrants a second opinion. The patient must always be aware that it’s an option.

Usually, a second opinion will simply confirm the first diagnosis and recommended course of treatment, leaving the patient with a sense of confidence and relief. But what if the second opinion is different from the first? How does the patient know which way to turn?

“That can be tough,” says Britt. “If you’re dealing with doctors who are board-certified, you’re likely going to get the same diagnosis. But if it is something different, one thing you can do is research your diagnosis and your doctor’s qualifications on the Internet.”

Newman reports that calling the local hospitals where specialists practice can be another source of information about a physician’s qualifications.

“A second opinion,” Newman says, “is not necessarily better than the first. A final decision on the course of action will be yours. It’s a decision that should be made with all the facts.”

My friend Eric didn’t have all the facts on kidney stone treatment, and he suffered some major discomfort because of it. Yes, ideally Eric’s doctor would have told him about the new stone-busting device. But also, Eric had the opportunity to ask and didn’t. Kidney stones may be easily survivable, but in a potentially life-threatening or life-altering medical situation, a second opinion can help prevent later regrets.

Premature Skin Aging:

More Than a Wrinkle in Time

skin & beauty

Written By Dr. Keith W. Schumann

Premature skin aging is not normal, and it doesn’t have to happen to you. Preventing the signs of aging is possible, and treatments are available to help erase the damage that’s been done.

There are two types of aging: intrinsic and extrinsic. The genes we inherit cause intrinsic (internal) aging, also known as the natural aging process. I’ll focus on extrinsic (external) aging, because it is here that we can make a big difference by avoiding one of the main risk factors—sun exposure.

Drooping

Wrinkles

Keith W. Schumann, M.D., is a board-certified dermatologist with advanced training in lasers. The founder of Ageless Dermatology & Laser Center, he has practiced in Williamsburg for the last 10 years. He can be reached at info@agelessderm.com.

Sunspots Dull tone

Roughened texture

Elongated upper lip

Thinning

Loss of volume

Skin laxity and sagging

Treating the Damage

Treatments for signs of premature skin aging range from topical products to laser procedures, with many options in between. The right intervention is based on the extent and type of skin damage. Three ingredients stand out in topical products: vitamin A (tretinoin, retinol), alpha hydroxy acids, and vitamin C. These products are not appropriate for all

skin types, and the form and strength of each are important to know before using products that contain them. Beyond topical care, effective and popular treatments include wrinkle fillers, botulinum toxin A, microdermabrasion, chemical peels, and laser procedures. A consultation with a qualified physician is the best way to get started.

YOUR THREE-STEP SUN-SAFETY PROGRAM

1 2 3

Avoid the sun. If your shadow is shorter than you are, seek shade.

Wear sun-protective clothing such as long-sleeved shirts, pants, widebrimmed hats and sunglasses whenever possible. Many sporting goods stores and specialty retailers sell clothing with a built-in high SPF (sun protective factor).

Detailed sun safety guidance is available at the following Web sites: www.skincancer.org/ www.skincarephysicians.com www.sunprecautions.com/ www.coolibar.com/

Use sunscreens daily.

THE HEALTH JOURNAL

21

feature

When Studies Collide

Making Sense of Cancer Screening Guidelines Written By Alison Johnson

V

ivian Vitullo had no reason to be worried when she went for a mammogram at age 40.

The Suffolk resident had gone through a scare two years earlier after discovering two lumps in her breasts, but tests had shown no signs of cancer. Without a family history or risk factors for the disease, Vitullo scheduled a mammogram simply because the American Cancer Society recommends annual screenings starting at age 40.

Even after a radiologist saw troubling deposits of calcium in her right breast, Vitullo wasn’t too concerned. But several tests later, she got a diagnosis that shocked her: ductal carcinoma in situ, or cancer within the milk ducts of her breast. Around the same time, Vitullo also found a lump in her left breast; doctors later flagged the cells as “suspicious,” though not necessarily cancerous. So in April 2007, Vitullo, a mother of three who works as a special education supervisor in Newport News, had a bilateral mastectomy. She also had reconstructive surgery and began

22 THE HEALTH JOURNAL

taking Tamoxifen, a prescription medicine that’s been shown to help prevent cancer from returning in some women.

Fast forward to this past November, when Vitullo, now 43 and with no signs of cancer, heard about new mammography guidelines from a federal advisory panel that no longer recommended routine annual screenings for women ages 40 to 49. Instead, the panel advised patients and doctors to make that decision on an individual basis, possibly delaying regular mammograms until age 50.

“I made the connection to my case right away,” Vitullo says. “I was really blown away by it. My cancer was found at the best time, when it hadn’t spread beyond the milk ducts. Another 10 years—I don’t know what that would have meant for me. I just can’t put a price on my life or the life of a lot of other younger women I’ve met since my diagnosis. I just think [those recommendations were] really, really scary.”

The proposed change for mammography was one of

several updated cancer screening recommendations within the past year that have provoked everything from confusion to concern to outcry among local patients and physicians. New suggestions from national medical organizations on cervical and prostate cancer screening also have Hampton Roads’ doctors worried that more men and women won’t catch their cancers until they are so advanced that treatment is difficult, if not impossible.

Mammography and breast cancer

The uproar over mammography began in November, when the U.S. Preventive Task Force—an independent federal advisory panel—stated that “the decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account.” Even at 50, according to the panel, most women could have the test every two years rather than annually. The task force also recommended that doctors not spend time train-

ing women to do breast self-examinations.

Task force committee members—primary care doctors and scientists with expertise in statistics—based their opinions on this data: mammography prevents one cancer death among every 1,904 women ages 40 to 49 who are screened for 10 years, compared to one death among every 1,339 women from ages 50 to 59 and one death among every 377 women from ages 60 to 69. Routine mammograms starting at 40 regardless of a patient’s risk factors, they argued, can lead to over-diagnosis, false-positive results, unnecessary biopsies and needless anxiety. Mammograms also miss roughly 10 percent of breast cancers.

But local doctors interviewed were unanimous— and passionate—in their opposition, urging women to begin annual mammograms at 40 (or earlier if they have a family history of the disease). While the task force’s decisions aren’t binding on insurance companies or federal policy, doctors fret that insurers will be more reluctant to cover routine mammograms and that women will be discouraged from screening.

Worst of all, they say breast cancer could go undetected in younger patients while they still have a treatable form of the disease. Even low-risk women need regular screenings, doctors say, given that about 75 percent of breast cancer cases come in women who have no risk factors.

“My immediate reaction was that [the panel’s recommendation] was a huge step backward for women,” says Dr. Kelley Allison, director of breast imaging at the Dorothy G. Hoefer Comprehensive Breast Center at Sentara Port Warwick in Newport News. “My fear is that we will be turning back the clock on all the progress we’ve made during the past two decades.

Basically, I believe this is financially driven—reinterpreting old data and putting a price on women’s lives.

I want women to continue to be well aware that early detection is such a key to curing breast cancer.”

Breast cancer deaths have fallen by 30 percent nationally since 1990, Allison notes, despite the fact that no large-scale new therapies have emerged during that time. “The only big advance in the past two decades has been [encouraging early] screening mammograms,” she says. “To change these recommendations is very irresponsible and doing a big disservice to women here and everywhere.”

Dr. Elizabeth Harden, a medical oncologist with Virginia Oncology Associates in Newport News, seconds those opinions. Like Allison, she notes that breast cancer tends to be more aggressive in women in their 40s than it does later on. “Generally speaking, I’m much more worried about a woman in her 40s who gets cancer,” Harden says. “Nobody wants a patient to go through unnecessary anxiety, but I think a woman would much rather go through that than to find out years later that a cancer was missed, when it may be at a late-stage, advanced point that is too late for

New guidelines on cervical cancer, released by the American College of Obstetrics and Gynecologists, came out in November, right on the heels of the mammography controversy, although the group called the timing purely coincidental. treatment. Women need to be in the mindset of being screened.” [Read The Health Journal’s profile of Dr. Harden on page 7 of last month’s edition.]

Dr. Kimberly Schlesinger, chair of the Riverside Breast Cancer Committee and an oncologist at Peninsula Cancer Institute in Newport News, agrees: “There are no perfect tests, but that is no reason to disregard the test as a whole, particularly in a population which tends to have more aggressive tumors. The implication that the risks of putting a woman through a biopsy for a lesion that is later found to be negative, with the biopsy’s incipient emotional toll, may outweigh the benefits of potentially identifying a cancer in its earliest stage, undermines the message breast cancer advocates and medical professionals have been discussing for years—that knowledge is power. This is my main concern—that women will postpone routine mammograms, thus forfeiting early detection and the best chance for cure.”

The panel didn’t tell doctors anything they didn’t already know, Harden adds; mammograms aren’t perfect, particularly in younger women with denser breasts, and the incidence of cancer is lower in women in their 40s than it is in women 50 and older.

“I got the sense they were putting a dollar value on a life,” she says. “It doesn’t seem based on any real clinical insight.”

As for self-exams, Harden has treated many women who first discovered an abnormality on their own, and she still teaches the technique to patients. She advises all women—and men—to know their own breasts and look for changes that may be signs of trouble, including lumps, skin dimpling, retracted nipples and discharge from the nipples. “So many women will know if something just isn’t right,” she says. As Schlesinger puts it, “There is a learning curve to breast self-examination, and it is true that mammograms are generally able to pick up masses before they are palpable, but to ignore a free and easy manner of self-care seems quite silly to me.”

Pap smears and cervical cancer

To many local gynecologic oncologists—doctors who treat cancers of the female reproductive system—new guidelines released by the American College of Obstetrics and Gynecologists (ACOG) on cervical cancer are equally frightening. ACOG’s recom-

feature

mendations came out in November, right on the heels of the mammography controversy, although the group called the timing purely coincidental.

Previous ACOG guidelines directed women to have an annual Pap smear—a test that looks for abnormal cervical cells among cells gathered during a vaginal exam—within three years of their first sexual intercourse but no later than age 21. The organization now states that women should have that first test at 21, and that women older than 30 can schedule screenings once every three years if they have three consecutive normal tests and no history of seriously abnormal findings. The ACOG now states that women between 65 and 70, meanwhile, can stop having Pap smears if they have three normal tests in a row and no abnormal results in the past 10 years.

ACOG’s goal is to decrease unnecessary follow-up testing and patient anxiety as well as potentially harmful treatment. Cervical cancer typically grows slowly, and young women are particularly prone to developing abnormal lesions (dysplasia) that appear to be precancerous but often will go away if left alone, says Dr. William Irvin, a gynecologic oncologist with Riverside Gynecologic Oncology in Newport News. Treating mild to moderate dysplasia with surgery, on the other hand, can injure the cervix and lead to problems when a woman becomes pregnant, putting her at higher risk for premature birth and Caesarean sections.

Once women are exposed to the human papillomavirus, or HPV, which can cause cancer, about 80 percent will clear the viral infection in two or three years, Irvin says. The other 20 percent will be at risk of developing cancer, but that process can take 10 to 20 years—progressing from low-grade to moderate to high-grade dysplasia and then to cancer. “The general thought is that we have been too aggressive in treating dysplasia in young women, that if we had just monitored them it would have been better,” Irvin says. “The new thought is we should focus more on women in their 20s, 30s and 40s, who are more at risk for having sustained infections.” Women who have a normal Pap smear, he adds, have less than a one percent chance of developing a high-grade lesion over the next three years.

Irvin believes the new guidelines are “appropriate” as long as women continue believing that Pap smears are potentially life-saving tests. On the contrary, they have dramatically reduced deaths from cervical cancer in the United States, he says. “Women need to know that it works,” Irvin says. “It’s up to doctors to continue to educate them about that fact.”

But other local doctors disagree with the new recommendations. Dr. Robert Squatrito, a gynecologic oncologist with Virginia Oncology Associates in Norfolk, feels women who become sexually active as young teenagers need their first Pap smear before 21. “I’ve Continued on page 25 THE HEALTH JOURNAL

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feature

“My fear is that we will be turning back the clock on all the progress we’ve made during the past two decades….I want women to continue to be well aware that early detection is such a key to curing breast cancer.”

—Dr. Kelley Allison, mammographer Dr. Kelley Allison Continued from page 23 taken care of people who are 15 and 16 with highgrade dysplasia,” Squatrito says. “I believe [the ACOG’s new recommendation] is an economically driven analysis, not one that takes individual needs into consideration.” He says that extending the time between screenings for older women would be particularly problematic for those who have had numerous sexual partners in the past year or have a husband who isn’t monogamous.

Dr. Daynelle Dedmond, a gynecologic oncologist with offices in Williamsburg and at Sentara CarePlex in Hampton, has treated girls as young as 12 with abnormal Pap smears and had a 19-year-old patient die of cervical cancer. As for letting older women wait three years between screenings, she notes that Pap smears become more accurate if done in consecutive years. A one-time test has a 60- to 70-percent chance of identifying cancer in patients with the disease, she says, while the number rises to 90 percent with three consecutive annual tests. “If we make [the ACOG’s] changes,” she argues, “we absolutely are going to miss women where cancer could have been prevented or caught in time to treat.”

Dedmond doesn’t dispute that some women with low-grade and moderate dysplasia have had unnecessary treatments. But she argues that instead of reducing screening, ACOG and other organizations should do more to educate doctors and patients on treatment options more conservative than surgery.

Squatrito, meanwhile, is concerned that women will start to downplay Pap smears and annual visits to a gynecologist. “That’s another side of this issue that people don’t want to talk about,” he says. “I think we would start missing ovarian problems and other concerns that would come up during an annual vaginal exam.”

And Irvin notes that even women who have had one of the newer vaccinations against HPV [like Gardasil] still need Pap smears: “The vaccine doesn’t protect against all types of HPV that cause cancer, so screening continues to be very important.”

PSA and prostate cancer

The debate over the effectiveness of the prostatespecific antigen, or PSA, test isn’t a new one. The

blood test measures levels of proteins produced by cells in the prostate; increased levels can be a sign of cancer. Doctors use the PSA in combination with a digital rectal exam, or DRE, during which they feel the prostate gland through the rectal wall to check for abnormalities. In March 2009, two reports published in the New England Journal of Medicine raised more questions than answers about whether regular testing causes more benefit than harm—a concern that has persisted for years, says Dr. Richard Rento, a urologist with Riverside Health System in Newport News.

Side effects of prostate cancer treatment (surgery, chemotherapy, radiation, etc.) can include erectile dysfunction and incontinence, which may be needless difficulties for men who have a slow-growing form of cancer.

Guidelines generally have called for men to begin annual PSA screenings at age 50, or at 45 if they are African-American or have other risk factors such as family history. But last year the American Urological Association, or AUA, weighed in with new recommendations: PSAs should be offered to “well-informed” men ages 40 and older who have a life expectancy of at least 10 years. After that point, the AUA said, the decision to test should be based on individual conversations with a doctor. That approach, according to the AUA, would allow for “earlier detection of more curable cancers and may allow for more efficient, less frequent testing”—in other words, possibly not every year.

Local doctors do believe patients need more information about the pros and cons of the PSA, including the concepts of over-diagnosis and over-treatment and the fact that the test doesn’t catch up to 20 percent of prostate cancers. Doctors also have no easy way of determining how a diagnosed cancer is going to behave. Nevertheless, no one should forget that the screening method is a life-saver, Rento says: before PSA testing began around 1990, just 68 percent of men initially diagnosed with prostate cancer had localized, curable disease (the cancer produces no symptoms until it is too late to cure). Today, 91 percent are identified at that point.

“Until an alternative exists, PSA testing with a DRE is the best option we have to make an informed deci-

sion,” says Rento, who believes every man should be screened by age 50 and high-risk men by 40. “Men have a choice: undergo testing and, if there is cancer, make an informed choice for treatment or observation, or [avoid testing] and take the risk of a diagnosis obtained too late to cure. In my experience, the vast majority of men choose to know.” Treatments are improving, he notes, and doctors increasingly are choosing watchful waiting over surgery and other invasive procedures in certain cases. Doctors who want to eliminate PSA testing from annual checkups “owe it to their patients to have this discussion,” Rento says.

Dr. John Lasater, a urologist with the Advanced Urology Center at Sentara CarePlex Hospital, echoes the belief that every man should be screened by age 50. Lasater also finds it “reasonable” to do a one-time PSA when a man reaches 40 to make sure levels are normal. “If prostate cancer is diagnosed, one of the many ‘treatment’ options can be no treatment, or active surveillance,” he says, “but at least you have knowledge of your disease and can make an informed decision as opposed to prostate cancer going undiagnosed and untreated.” The incidence of prostate cancer death in the U.S. has fallen by 40 percent over the past 15 years, he points out; aggressive screening likely is an important factor even if no study has proven the link.

Making every potential PSA patient a “well-informed” one also may be difficult for primary care physicians already strapped for time, doctors add. “You can’t expect a physician to cover this complex topic with every man in detail and still complete their yearly physical in a 30-minute appointment,” Rento says.

The bottom line

Amid all the swirling opinions, doctors say the best general advice is for patients to have as detailed as possible a conversation with their physician about individual needs—and, if necessary, push for screening tests they feel they should have. Vivian Vitullo plans to do that with mammography for her two daughters, ages 20 and 15. “It’s frightening for me to think about them,” she says. “I want them to be screened early, absolutely, and it scares me that someone might try to take that option away.”

THE HEALTH JOURNAL

25

healthwire

Ubiquitous Flame Retardant May Affect Fertility Though two types of PBDEs are already banned in several states, these ‘hormone-disrupting pollutants’ linger in many home products made before 2004. And manufacturers can freely use a third type until 2013.

Written By Laura Buchholz

NEW YORK (Reuters Health)

H

aving difficulty getting pregnant?

Perhaps your sofa is to blame. Or your stereo or carpet or any of the things in your house that contain common flame-retardant chemicals “polybrominated diphenyl ethers,” or PBDEs—what a new study suggests may be associated with decreased fertility.

PBDEs are hormone-disrupting pollutants that build up in the blood and tissues. In a study appearing in a recent issue of Environmental Health Perspectives, researchers found that for each 10-fold increase in PBDE blood concentration, women experience a 30-percent deAccording to data crease in the odds of getting pregnant each month. from the National PBDEs have been associHealth and Nutrition ated with reproductive and hormonal effects in animals, Examination Survey, but this is the first study to 97 percent of examine their association American adults have with human fertility, lead researcher Dr. Kim G. Harley detectable levels of of the Center for Children’s Environmental Health PBDE in their blood.

Research at U.C. Berkeley’s School of Public Health in California and colleagues note in their report.

The researchers measured PBDE levels in blood samples from 223 pregnant women enrolled in a long-term study examining environmental exposures and reproductive health. The investigators also asked the women how many months it had taken them to become pregnant.

They found that women with the highest blood concentrations of PBDE took the longest to become pregnant—up to 12 months.

The study cut off at 13 months. In addition, the 107 women who were actively trying to become pregnant were half as likely to conceive in any given month if they had high levels of PBDE in their blood.

Experts say most women become pregnant within the first six months of trying. After 12 months of trying with no pregnancy,

26 THE HEALTH JOURNAL

Most of the women in the current study women will be classified as “infertile,” Harwere immigrants from Mexico, where PBDEs ley added, even though they will likely go on to conceive after that. After 12 months of are less common. Harley emphasized that unprotected intercourse, roughly 85 percent the study population actually had somewhat lower PBDE levels in their blood than of women younger than age 35 will become the general population, pregnant, while half of although the range varied women older than 35 will.

For each 10-fold widely. The women in the Infertility treatment typistudy with the highest cally doesn’t start until a increase in PBDE concentration of PBDEs couple has been trying for blood concentration, were the ones who had a year, with no luck. lived in the United States “We aren’t looking at inwomen experience a the longest. fertility, just ‘subfertility,’ 30-percent decrease Of the three types of PBbecause all of the women DEs that have been develin our study eventually in the odds of getting oped and used as commerbecame pregnant,” Harley pregnant each month. cial flame retardants, two noted in a universityhave already been banned issued statement. “Had we in several states, including included infertile couples California. These banned PBDEs, however, in our study, it is possible that we would persist in home products made before 2004. have seen an even stronger effect from According to a recent EPA agreement, PBDE exposure.”

The researchers controlled for factors such a third type of PBDE will be phased out of manufacturing by 2013. Until then, the as pesticide exposure, irregular menstrual fertility risk of exposure remains present, cycle, intercourse frequency, smoking, alcoif unclear. Harley’s study also points to the hol and caffeine consumption, body weight need to examine fertility effects PBDEs before pregnancy, and birth control pill use might have on men. in the year before conception.

“The bad news,” Harley told Reuters “This study is the first to report that Health in a phone interview, “is that higher PBDE concentrations in women’s it’s really hard to know which products blood are associated with significantly contain high levels of PBDEs.” Products longer time to pregnancy, and this [study] needs to be replicated in other populations,” containing polyurethane foam, like chairs and sofas, can have a wide range of PBDE the researchers wrote. levels, she said, making it impractical to “If confirmed, this finding would have strong implications for women trying to con- try to just throw away possible sources of the chemical. ceive given that exposure to PBDEs is nearly Harley also pointed out that it’s hard to universal in the United States and many test for PBDEs in the blood except for in a other countries,” they add. research environment. However, she did According to data from the National Health and Nutrition Examination Survey, 97 acknowledge that the main exposures happen through dust, air and food. Therefore, percent of American adults have detectable she suggests that people concerned about levels of PBDE in their blood. Concentrations PBDEs use wet mops and/or vacuum cleanhave been doubling about every five years ers with HEPA filters, wash their hands since the 1970s, noted Harley, and California residents, perhaps because of strict fire regu- frequently, and cut down on eating meat, as PBDEs tend to lodge in fatty tissue. lations, have the highest levels of exposure.

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Left to right: Emergency room doctors Dave Cash of Sentara Williamsburg Regional Medical Center and Charles Graffeo of Sentara Norfolk General Hospital have served together on many a relief mission, from hurricanes and other natural disasters to terrorist attacks on U.S. soil. Their most recent journey, however—a week in quake-stricken Port Au Prince, Haiti—was an unexpected assignment that turned out to be the experience of a lifetime.

Healing Haiti Written By Page Bishop-Freer

Two ER doctors reflect on their mission trip to earthquake-stricken Haiti, from the joy of saving three lives to their concerns for the country’s future.

As emergency room physicians, Drs. David Cash and Charlie Graffeo are trained to respond quickly to any medical crisis that comes through their ER. But on the eve of Jan. 12, as they caught glimpses of news reports announcing that a massive earthquake had hit Haiti—leaving hundreds of thousands dead and countless more injured—the doctors felt powerless to help.

Cash and Graffeo are no strangers to large-scale disasters; as lead physicians of the Virginia Task Force 2 (VATF2), a volunteer search-and-rescue team that’s part of the Federal Emergency Management Association (FEMA), they’d been among the first to reach New Orleans’s battered coast in 2005 after Hurricane Katrina swept inland. And before that, when the Pentagon was attacked on Sept. 11, 2001, their team was immediately mobilized for action.

In fact, it was Cash’s vivid recollections of his relief work after the Oklahoma City bombing in 1995 that inspired Graffeo to join the team that same year.

Normally, VATF2 responds to U.S. disasters only, leaving international missions up to two large teams from Fairfax County, Va., and Los Angeles County.

But the severity of destruction in Haiti caused President Barack Obama to call on five domestic teams, among them VATF2, to assist in relief efforts.

“None of us were expecting to go,” says Cash, who, on Jan. 13, received a latenight confirmation that the team would be leaving for Haiti that night.

Graffeo was also caught off-guard: “[Around 11 p.m.] my pager went off. We were getting deployed.”

Shortly after midnight, Cash, Graffeo and 80 fellow VATF2 crew members reported to the Virginia Beach training center that houses their equipment.

The team is comprised of two physicians, scores of firemen and other rescue personnel, four K9s (and their handlers) and various other search-andrescue specialists.

“Our cache is ginormous,” says Graffeo of the team’s gear—so big that it took two semis and four pickups to haul it all to Norfolk Naval Base, where, many hours later, they were met by two C-17 military aircraft that would deliver the team and all its equipment to Port Au Prince, Haiti. Though they’d prepared as best they could for medical problems they’d most likely encounter there (i.e., malaria, Dengue fever and Haitians infected with HIV/AIDS), Graffeo and Cash had no way of predicting what circumstances awaited them on the ground.

28 THE HEALTH JOURNAL

Touching Ground According to Cash, when the planes touched down on Haitian soil, Port Au Prince was in a state of “absolute, unmitigated chaos.” Located to the north of the city, the single-runway airport (badly damaged in the quake) had become a makeshift camp for teams from some 56 countries. Three field hospitals had been established to treat the wounded; Cash and Graffeo’s purpose there was to ensure the health of the VATF2 team and stabilize any survivors they might find.

The crew set up camp by the runway and reported to the United Nations (UN) headquarters, where they were provided with a grid of the city and little else.

“It was very unstructured there,” explains Graffeo. “No one to welcome us or tell us where to go.” Nonetheless, Cash says the UN was relieved to see their team arrive with tools and equipment that would prove useful in the days to come.

The next morning the crew, escorted by 12 armed guards, traversed the hot, hectic and hilly streets of Port Au Prince in search of survivors who might be trapped underneath collapsed buildings as well as any information that could point them in the right direction. “The intelligence came from locals,” says Graffeo, “but we only wanted to hear about live victims” and not the dead.

The first two days’ searches turned up empty, though the team found its share of fatalities. At one site, an estimated 150 dead lay buried beneath a collapsed three-story building. By this time the scent of decomposing bodies and exposed sewage had started to saturate the air. The sounds of speeding, traffic, power generators and the occasional gunshot faded together into a hum of white noise.

Life is found Among the Rubble On the fifth day following the earthquake, the VATF2 crew was given a special assignment: UN officials had a hunch that the yet-unaccountedfor Danish ambassador Jens (pronounced “Yahns”) Christiansen had been working in a six-story building across town when the earthquake happened.

The teams made their across Haiti’s rolling landscape—what Cash and Graffeo compare to the streets of San Francisco—to the site in question.

Experienced rescuers eyed what appeared to be a collapsed stairwell.

Continued on page 31

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local beat

Continued from page 28

Pulses quickened when a search dog picked up a scent.

The crew cut through concrete slabs and long, metal ropes—the typical cheap reinforcement for buildings there—and filled bucket after bucket with debris, passing them down the line in a “bucket brigade.” The objective? Get closer to the victim without jeopardizing his safety. Cash remembers the process as a “high-stakes game of pick-up-sticks.” In other words, “If you pick up the wrong stick, they’ll all come toppling down.”

“For me, going to Haiti really put into context how important a career of service is, in any capacity....”

—Dr. Charles Graffeo

The UN’s instincts were on-the-mark: Far beneath layers of dust and debris, within the conclave of his desk, was Jens Christiansen, alive, yet in very poor health after five days trapped without food or water. The team was surprised by what came out of the tunnel first—not a hand, head or foot as they’d imagined. Christiansen first pushed out his shoes, followed by his laptop. Later they learned that Christiansen had given up hope of being found .

He’d composed his last will and testament before his computer’s batteries had run out. As for his shoes, they’d been his pillow for the past five days—he was not going to part with them for the world.

“Elation; pure elation,” is what Graffeo felt as Christiansen appeared from the opening of the tunnel and was carried down a line of firemen to where the doctors were waiting. “It’s such a feeling of pride…more than I can put into words.”

This was an especially memorable moment for most of the VATF2 crew—after 20 years of searching, Christiansen was the first live victim they’d found.

A miracle outside port au prince As experienced rescuers know, the more time that passes, the less likely it is that survivors will be found. By day seven, UN officials started to shift their focus from rescuing people to recovering bodies. It was that day, when the team was headed back to the airport without a rescue, that a group of locals stopped VATF2’s motorcade. Rumors were circulating about two children trapped alive under a building across town.

The team followed the tip to the outskirts of the city, down a dark, narrow and steep road—hundreds of feet down, by Cash’s estimates—to a collapsed four-story residential building. Onlookers said they could hear small cries from within. Any skepticism on the crew’s behalf was quelled when a microphone

picked up the voices. A call uphill for generators and other tools sparked the full-scale rescue mission. Workers dug deeper and deeper into the debris, circumventing the occasional dead body that lay in their path.

Outside, Cash (Graffeo was stationed at the base camp that afternoon) and a New York physician prepared the medications needed to stabilize the children, all the while praying silently for their safety.

“Nobody was happier than me when [the boy] popped out of the tunnel first, arms outstretched and smiling,” says Cash.

Minutes later the boy’s sister appeared in the opening, severely dehydrated and in “complete shock,” recalls Cash, who firmly believes that if the girl had not been found right then, “she would not have made it through the night.”

The next day the UN called off all search-andrescue missions. VATF2 volunteers were anxiously awaiting their orders when they received a surprise visit from Jens Christiansen, who, in a heartfelt thank-you speech, announced that he’d been “reborn” and would henceforth re-dedicate his life to helping others. But in Cash’s view, it’s Christiansen who deserves the real thank-you. “He waited for us for five days,” says Cash, “but some of us have been waiting 20 years to find him.”

Exactly one week after arriving in Port Au Prince, the team was heading home on a commercial flight (sending their supplies by boat), and Cash and Graffeo returned to their lives and jobs, though their thoughts were still very much with Haiti.

Plagued by a long history of poverty, corruption, violence and all-around misfortune, Haiti faces an uncertain future. From a medical standpoint, Cash wonders what will become of the country’s health care system when the triage tents and field hospitals close up shop. Perhaps his biggest concern is those children who lost a limb—either from a crushed building or from an infection that wasn’t treated in time—and have no access to a prosthesis or physical therapy.

“I feel like I fixed what I could when I was there, and I am grateful for that. But nobody can fix Haiti’s problems. If I knew in my heart there was a way for the country to improve, I’d feel OK. I just don’t know for the life of me how that’s possible. Not having an answer—that’s the hardest part.”

As for Graffeo, he’s eager to share with others what he has gleaned from his time in Haiti. In the month since his return, his audiences have ranged from medical students at Eastern Virginia Medical School (where he is a professor of emergency medicine) to third and fifth graders at Virginia Beach’s John B. Dey Elementary School. (Graffeo was humbled when, after his presentation, some of the children gave him their lunch money to send to Haiti.)

“For me, [going to Haiti] really put into context how important a career of service is, in any capacity, and to spread that word—it’s definitely a message worth delivering to people.”

Graffeo chats with three Haitian friends.

Multi-level buildings saw the most damage.

Crew search a collapsed UN building.

Top: Christiansen is carried to safety.

Below: A brother and sister are rescued.

THE HEALTH JOURNAL

31

the specialist

You Want Me to Put What Under My Tongue?

Sublingual immunotherapy: An alternative to allergy shots Written By Joseph K. Han, M.D.

The primary advantage of sublingual immunotherapy is its convenience.

Dr. Joseph K. Han is the director of the new Eastern Virginia Medical School Allergy Division as well as the director of Allergy, Rhinology and Endoscopic Sinus and Skull-Based Surgery within the Department of Otolaryngology/Head & Neck Surgery. He is one of only a handful of physicians in the United States to have completed a fellowship in Rhinology, Sinus Surgery and Allergy. He is board-certified in otolaryngology/head and neck surgery and a fellow of the American Academy of Otolaryngic Allergy. He is also a member of EVMS Health Services, a not-for-profit medical practice through Eastern Virginia Medical School.

32 THE HEALTH JOURNAL

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here is growing evidence to support a startling new treatment for allergies.

Several U.S. studies are finding that putting particles of grass and other allergens under the tongue is a safe and effective treatment for certain allergies—not to mention a lot less painful than shots.

An allergy is an abnormal reaction to an ordinarily harmless substance called an allergen. Allergens are simply small proteins that trigger an allergic response when absorbed into the bodies of certain allergic people. Following an exposure, these individuals may experience symptoms such as a runny nose, watery eyes, itching and sneezing.

The most common allergens are grass or tree pollens, molds, dust mites, animal dander, foods, cockroach droppings and insect stings. Allergies are quite common in the United States, affecting about one in six people.

The easiest way to control an allergic reaction is to avoid exposure entirely. Since that isn’t always possible or realistic, many people use medications that can block the allergic response (such as antihistamines) or treat its symptoms (decongestants).

For a more targeted treatment for a specific allergen, we must first determine specifically what the patient is allergic to via allergy testing. Allergy testing can be conducted using either a blood test or skin test. Allergy experts can either study a blood sample to determine which allergens affect the patient or place a small amount of an allergen onto the skin and examine how the patient’s body responds.

If histamine blockers or other allergy medications fail, subcutaneous immunotherapy (more commonly known as allergy shots) is the next line of defense and the most common method of allergy treatment. But some U.S. doctors are now adding a new therapy to the allergy treatment mix—sublingual immunotherapy, or SLIT. Presently, SLIT is not commonly practiced within the U.S. but it has been popular throughout Europe and Asia for years. SLIT involves placing very small amounts of an allergen, such as grass particles in oral drops, under a patient’s tongue for a few minutes.

Studies have shown that SLIT works in a fashion similar to traditional allergy shots and has proven to be just as effective. The same extracts used in subcutaneous allergy injections are found in these oral allergy drops; and, as with allergy shots, patients must take the drops for three to five years for the treatment to work.

What is the difference between an allergy shot and sublingual therapy?

Allergy shots involve placing, over time, increasing amounts of an allergen under the skin via injection. After repeated exposure to the allergen, the patient eventually becomes less allergic to the substance because the gradual introduction of the allergen allows the patient to build a natural immunity or tolerance. However, this type of therapy requires quite a bit of time and effort because patients must schedule weekly doctor visits for the shots. In addition to the pain associated with the injections, some side effects include localized swelling at the injection site or systemic reactions such as wheezing, sneezing and nasal congestion. Anaphylactic reaction, a rare but potentially life-threatening allergic response, is also a risk. For this reason, doctors require patients to stay at the practice 30 minutes after a shot is given to evaluate any possible side effects.

In contrast, the primary advantage of sublingual immunotherapy is its convenience. SLIT can be administered at home on a daily basis instead of requiring weekly office visits. Some studies have also shown that sublingual therapy may result in fewer systemic adverse reactions than allergy shots, making it a potentially safer option. The most common reported side effects of the drops are tingling of the tongue following ingestion.

There are a few disadvantages to sublingual therapy. First, since it is a relatively new type of treatment, there are only a few published studies to support its efficacy. Despite this, there is sufficient data to demonstrate that it works. Second, there is no general consensus on the optimal amount of allergen that is required for sublingual administration. Doctors can, however, follow a set of guidelines developed by the American Academy of Otolaryngic Allergy for administering sublingual therapy to patients.

The bottom line?

All of the above therapies will help control and prevent allergic reactions. Some questions about SLIT still need to be answered with further scientific research, but luckily, patients and their doctors have several good treatment options from which to choose. The best way to determine which allergy treatment is best for you is to talk with your doctor.

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snapshots

Chesapeake Regional Health Foundation’s annual gala raised more than $150,000 to benefit cancer services at Chesapeake Regional Medical Center. With a theme of “City of Bridges, A Venetian Masquerade,” the event resembled a Venetian wonderland, complete with gondolas, an Italian villa and a village center fountain. (1) WVECTV Anchor Vanessa Coria, posing with her date Kerry Krell, served as the event’s emcee. (2) Attendees included Congressman Randy Forbes and his wife Shirley, as well as (3) Drs. Moemi Romano, Patty Jolly, Sonal Saini, Janice Sharma and Cynthia Romero.

1, 2, 3

Based on online patient reviews, Alison Lex, M.D., of Bon Secours Medical Associates in Virginia Beach received the “Patient’s Choice Award” from MDx Medical, Inc. The award factors in patient ratings on bedside manner, doctor-patient face time, degree of follow-up, courtesy of office staff and overall satisfaction with care.

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Bon Secours Virginia Health System, along with local humanitarian organization Operation Blessing International and The New Life Christian Center of Norfolk, revitalized and expanded The Store House, a community food pantry, after it was severely damaged by the November 2009 nor’easter.

Lucy’s Inc., the Norfolk-based company that specializes in gluten-free and allergen-friendly products, now has products featured in over 7,000 stores in the U.S. and Canada, including Starbucks, Whole Foods Market, Giant, Stop & Shop, Sprouts Farmers Market and more. Read The Health Journal’s in-depth coverage of Lucy’s—founded by former emergency room physician Dr. Lucy Gibney— in the May 2008 issue, available online at www.thehealthjournals.com.

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The Department of Internal Medicine at Eastern Virginia Medical School netted several honors at the Jan. 23 Norfolk meeting of the American College of Physicians–Virginia Associates.

Associate Professor of Internal Medicine Mark C. Flemmer (second from the right) was Clinical Faculty Member of the Year. In addition, Jody Boggs, M.D. (far left), Michael Gonzales, M.D., and Jennifer Hofstra, M.D., won the “Medical Jeopardy” competition during the conference.

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Suffolk community leaders, physicians, Chesapeake Regional Medical Center staff, Chesapeake Hospital Authority members and other VIPs joined the physicians and staff of Riverfront Family Medicine and Specialty Care for a grand opening ceremony held Jan. 23. This is Chesapeake Regional’s first family practice in Suffolk. Left to right: Bob Oman of the Chesapeake Hospital Authority, Chesapeake Regional Interim President and CEO Wynn Dixon, Suffolk Mayor Linda Johnson and primary care physicians Drs. Attiyah Ismaeli-Campbell, Scott Fowler and Dena Hall.

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8 Send us your snapshots!

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9 34 THE HEALTH JOURNAL

along with a brief description to

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Three-year-olds at St. John the Apostle Catholic School practice coordination and balance skills with Physical Education Teacher Aimee Kram.

9

the

Health Journal Williamsburg Edition

Health Directory Allergists & ENT Physicians

Cardiology

Allergy & Asthma of Oyster Point-Williamsburg 217 McLaws Cir., Suite 5 Williamsburg (757) 873-3882

Advanced Cardiovascular Institute 5215-A Monticello Ave. Williamsburg (757) 229-1440

Hampton Roads Ear, Nose and Throat 120 Kings Way, Suite 2600 Williamsburg (757) 253-1832 Riverside Williamsburg Ear, Nose, Throat & Allergy Clinic 120 Kings Way, Suite 2600 Williamsburg (757) 345-2600 VA Adult & Pediatric Allergy & Asthma PC 1144 Professional Drive Williamsburg (757) 259-0443 Williamsburg ENT - Allergy 400 Sentara Circle, Suite 300 Williamsburg (757) 253-8722

Assisted LIVING, NURSING HOMES & Adult Day Care Chambrel of Williamsburg 3800 Treyburn Dr. Williamsburg (757) 220-1839 Colonial Manor 8679 Pocahontas Trail Williamsburg (757) 476-6721 Consulate Health Care 1811 Jamestown Rd. Williamsburg (757) 229-9991 Dominion Village of Williamsburg 4132 Longhill Rd. Williamsburg (757) 258-3444 Heritage Commons 236 Commons Way Williamsburg (888) 711-6775 Madison Retirement Center 251 Patriot’s Lane Williamsburg (757) 220-4014 Morningside Of Williamsburg 440 McLaws Circle Williamsburg (757) 221-0018 Patriots Colony at Williamsburg 6000 Patriots Colony Dr. Williamsburg (757) 220-9000 Riverside Adult Daycare 3435 John Tyler Hwy., Bldg. 2, Ste. 1-A Williamsburg (757) 565-5305 Ruxton Health of Williamsburg 1235 S. Mt. Vernon Ave. Williamsburg (757) 229-4121 Spring Arbor 935 Capitol Landing Rd. Williamsburg (757) 565-3583 Verena At The Reserve 121 Reserve Way Williamsburg, VA 23185 757-345-2995 Williamsburg Landing 5700 Williamsburg Landing Dr. Toll-Free (800) 554-5517 WindsorMeade of Williamsburg 3900 Windsor Hall Drive Williamsburg (757) 941-3615

audiologists Beltone/Ledford Audiology & Hearing Aid Center 1303 N. Mount Vernon Ave. Williamsburg (757) 220-8975

Cardiovascular Health 117 Bulifants Blvd., Ste. B Williamsburg (757) 259-9540 Sentara Cardiology Specialists 500 Sentara Cir., Ste. 100 Williamsburg (757) 984-9800 TPMG Williamsburg Diagnostic Cardiology 4125 Ironbound Rd., Ste. 201 Williamsburg (757) 565-0600

Chiropractic & Acupuncture Acupuncture Works, Inc. 362 McLaws Circle, Suite 2 Williamsburg (757) 565-9611

Williamsburg Orthodontics 4097-A Ironbound Rd. Williamsburg (757) 253-1200

Williamsburg Family Physicians 227 McLaws Circle Williamsburg (757) 564-8182

Peter S. Evans, DDS 120 Kings Way, Ste. 1300 Williamsburg (757) 220-1999

Williamsburg Dental Group 1319 Jamestown Rd. Williamsburg (757) 229-7210 106 Bacon Ave. Williamsburg (757) 229-3099

Williamsburg Internal Medicine 400 Sentara Circle, Suite 400 Williamsburg (757) 345-4600

Williamsburg Family Dentistry 213 Bulifants Blvd., Ste. 15-E Williamsburg (757) 345-5500

Colonial Gastroenterology 400 Sentara Circle, Suite 350 Williamsburg (757) 253-5771

Williamsburg Periodontics & Implants 200 Packets Court Williamsburg (757) 221-0249

TPMG Specialist Center 4125 Ironbound Rd. Williamsburg (757) 903-4807

Walter G. Winneberger, DDS 104 Bypass Rd., Suite 202 Williamsburg (757) 229-6960

Williamsburg Gastroenterology 457 McLaws Circle, Suite 103 Williamsburg (757) 221-0750

Wyatt Orthodontics 7151 Richmond Rd., Suite 303 Williamsburg (757) 565-3737

General Surgery

Gisela K. Fashing, DDS 325 McLaws Circle, Suite 1 Williamsburg (757) 229-8991 Gilbert J. Frey, DDS Lawrence R. Samiere, DDS 1161 Professional Dr. Williamsburg (757) 253-0400 Terry H. Hake, DDS 1761 Jamestown Rd. Williamsburg (757) 229-4115 Hampton Roads Neuromuscular & Aesthetic Dentistry 1313 Jamestown Rd., Ste. 205 Williamsburg (757) 229-3052 Hampton Roads Oral & Maxillofacial Surgery 1147 Professional Drive Williamsburg (757) 258-8913

Chiro Care Plus, PC 3204-A Ironbound Rd. Williamsburg (757) 565-6464

Paul Hartman, DDS 1323 Jamestown Rd., Suite 203 Williamsburg (757) 253-2393

Commonwealth Family Chiropractic 140 Professional Cir. Williamsburg (757) 220-9670

Adam J. Kadolph, DDS 7151 Richmond Rd., Suite 303 Williamsburg (757) 565-3737

Christopher Connolly, DC 5252 Old Towne Rd. Williamsburg (757) 220-0060

Lifetime Family Dental 7349 Richmond Rd. Williamsburg (757) 564-8942

Teresa Green, L Ac 7131 Richmond Rd., Ste. 302 Williamsburg (804) 561-1258

Carol F. Morgan, DDS 1130 Old Colony Ln. Williamsburg (757) 220-6727

Integrative Chiropractic & Acupuncture 1318 Jamestown Rd., Suite 102 Williamsburg (757) 253-1900

Thomas J. Morris, DDS 491 McLaws Cir., Suite 1 Williamsburg (757) 253-0598

Performance Chiropractic 1307 Jamestown Rd., Suite 103 Williamsburg (757) 229-4161 Pinto Chiropractic & Rehabilitation 5408 Discovery Park Blvd., Ste. 200 Williamsburg (757) 645-9299 Platinum Chiropractic 3709-D Strawberry Plains Rd. Williamsburg (757) 229-6069 Tai Acupuncture 362 McLaws Cir., Ste. 2 Williamsburg (757) 565-9611 The Spine Center of Williamsburg 219 McLaws Cir. Williamsburg (757) 259-1122 Walsh Family Chiropractic, PC 1309 Jamestown Rd. Williamsburg (757) 220-4917 Williamsburg Chiropractic Clinic 5252-A Olde Towne Rd. Williamsburg (757) 220-0060

Dentistry & Oral Health Boxx, Blaney Lachine & Bowe 1118-A Professional Drive Williamsburg (757) 229-5570 D. W. Cherry, DDS 2225 S Henry St. Williamsburg (757) 253-2500

Bowers Assistive Hearing Service 113-L Palace Lane Williamsburg (757) 220-3674

Michael J. Coleman, DDS 6969 Richmond Rd. Williamsburg (757) 564-0041

Colonial Center For Hearing 337 McLaws Circle, Suite 3 Williamsburg (757) 229-4004

Curry Dental Center 312-H Lightfoot Rd. Williamsburg (757) 220-3450

Hearing Evaluation & Noise Protection Assoc., Inc. 1321 Jamestown Rd., Suite 104 Williamsburg (757) 229-4335

Bruce DeGinder, DDS 240 McLaws Circle, Ste. 153 Williamsburg (757) 220-9492

Moran Hearing Aid Center 1158-C Professional Dr. Williamsburg (757) 564-5902

Sam E. English, DDS 4680-16A Monticello Ave. Williamsburg (757) 258-1042

Beverly E. Boone, DC 213 McLaws Circle, Ste. 1 Williamsburg (757) 596-7605

Terry Lieber, DC, CST 489 McLaws Cir., Ste. 1 Williamsburg (757) 565-6363

John P. Doley, DDS 1116-A Professional Dr. Williamsburg (757) 229-4181

We’ve done our best to include every health care service provider in Greater Williamsburg. If your organization is not listed, or if your listing is not current, send your updates to info@thehealthjournals.com.

Robert F. Morrison, DMD William Broas, DDS Pete Foster, DDS Ira Goldstein, DDS Shanail Moorman, DDS Stephen L. Murphy, DDS 1131 Professional Drive Williamsburg (757) 220-0330 7151 Richmond Rd., Ste. 305 Williamsburg (757) 258-7778 Mark M. Neale, DDS, MAGD 5000 New Point Rd., Ste. 2101 Williamsburg (757) 229-8050 Sebastiana Springmann, DDS Maria Freyfogle, DMD, MAGD, ABGD Sarah Allen, DDS Sonia Tao-Y, DDS 4939 Courthouse Street Williamsburg (757) 259-0741

Ronald J. Smalls, DDS 1309 Jamestown Rd., Suite 103 Williamsburg (757) 229-0620 K. L. Tankersley, DDS, MD 1147 Professional Dr. Williamsburg (757) 258-8913 David G. Walker, DDS 813 Richmond Rd. Williamsburg (757) 229-6278 Williamsburg Oral & Maxillofacial Surgery 195 Strawberry Plains Rd. Williamsburg (757) 229-6692

Therapeutic Holistic Wellness Care 311 Raven Terrace Williamsburg (757) 645-2926

Hospitals & Clinics Angels of Mercy Medical Clinic 7151 Richmond Rd., Suite 401 Williamsburg (757) 565-1700

TPMG Specialist Center 4125 Ironbound Rd. Williamsburg (757) 345-2071

Berkeley Outpatient Medical & Surgical Center 136 Professional Circle Williamsburg (757) 253-2450

Dermatology Center of Williamsburg 5335-A Discovery Park Blvd.

Williamsburg (757) 645-3787

Williamsburg Surgery, PC 500 Sentara Circle, Ste. 202 Williamsburg (757) 984-9850

First Med of Williamsburg 312 Second St. Williamsburg (757) 229-4141

Dermatology Specialists 475 McLaws Cir., Suite 1 Williamsburg (757) 259-9466

Hand Surgery

Lackey Free Family Medicine Clinic 1620 Old Williamsburg Rd. Yorktown (757) 886-0608

Joseph W. Musgrave, MD 1139 Professional Dr. Williamsburg (757) 220-2266 Pariser Dermatology Specialists 207 Bulifants Blvd., Suite C Williamsburg (757) 564-8535

diagnostic imaging Cranial Facial Imaging Center 7151 Richmond Rd., Ste. 306 Williamsburg (757) 476-6714 Riverside Diagnostic Center 120 Kings Way, Suite 1200 Williamsburg (757) 345-6700 Tidewater Diagnostic Imaging 100 Sentara Circle Williamsburg (757) 984-6000 Women’s Imaging Center 100 Sentara Circle Williamsburg (757) 984-6000

Endocrinology Williamsburg Endocrinology, Inc. 207 Bulifants Blvd., Ste. D Williamsburg (757) 565-9586

family practice

Nancy Yang Schumann, DDS 5309 Discovery Park Blvd.

Williamsburg (757) 564-0900

Riverside Hospice 12420 Warwick Blvd., Ste. 7-D Newport News (757) 594-2745

Ageless Dermatology & Laser Center 5309 Discovery Park Blvd.

Williamsburg (757) 564-1200

Edward A. Owens, DMD 211 Bulifants Blvd.,Ste. 14-A Williamsburg (757) 229-6414

Richard A. Pugliese, DDS 502 Strawberry Plains Rd. Williamsburg (757) 259-9703

Riverside Home Care 856 J. Clyde Morris Blvd., Ste. C Newport News (757) 594-5600

Dermatology

Riverside Diabetes Education 120 Kings Way Williamsburg (757) 534-5918

Christine Piascik, DDS 1769 Jamestown Rd., Suite B Williamsburg (757) 229-8920

Sentara Home Care Services 1100 Professional Dr. Williamsburg (757) 259-6251

Hampton Roads Surgical Specialists 120 Kings Way, Ste. 2800 Williamsburg (757) 345-0141

Norge Dental Center 7450 Richmond Rd. Williamsburg (757) 564-0804

Parks Orthodontics 1116-A Professional Dr. Williamsburg (757) 253-0521

Gastroenterology

Personal Touch Home Care & Hospice of Va. 5581 Bulifants Blvd.

Williamsburg (757) 564-6455

Family Care of Williamsburg 117-A Bulifants Blvd.

Williamsburg (757) 565-5440 Tommy Johnson, MD 1313 Jamestown Rd., Ste. 103 Williamsburg (757) 229-1259 Bruce Mayer, MD, PC 4622 Rochambeau Drive Williamsburg (757) 566-2045 New Town Family Practice 4374 New Town Ave., Ste. 200 Williamsburg (757) 220-2795 Riverside Williamsburg Medical Arts Family Practice 120 Kings Way, Suite 1400 Williamsburg (757) 345-2555 Riverside Williamsburg Medical Arts Urgent & Primary Care 5231 John Tyler Highway Williamsburg (757) 220-8300 TPMG Family Medicine 132 Professional Circle Williamsburg (757) 645-2981 TPMG Norge Family Practice 7151 Richmond Road., Suite 405 Williamsburg (757) 564-3700

Robert A. Campolattaro, MD Nicholas Smerlis, MD 5208 Monticello Ave., Suite. 180 Williamsburg (757) 206-1004

Health departments James City County Health Department 101 Mounts Bay Road, Williamsburg (757) 253-4740 Peninsula Health District 1126 Professional Drive Williamsburg (757) 253-4813

Hospice & Home Care Agape Home Care 354 McLaws Circle, Suite 1 Williamsburg (757) 229-6115

MedExpress Urgent Care 120 Monticello Ave. Williamsburg (757) 564-3627 New Town Urgent Care 4374 New Town Ave., Ste. 100 Williamsburg (757) 259-1900 Olde Towne Medical Center 5249 Olde Towne Rd. Williamsburg (757) 259-3258 Riverside Williamsburg Medical Arts Urgent & Primary Care 5231 John Tyler Highway Williamsburg (757) 220-8300 Sentara Outpatient Care Center 301 Sentara Circle Williamsburg (757) 984-9900

At-Home Care 366 McLaws Circle, Suite 2 Williamsburg (757) 220-2112

Sentara Williamsburg Regional Medical Center 100 Sentara Circle Williamsburg (757) 984-6000

Bayada Nurses 7151 Richmond Rd., Suite 201 Williamsburg (757) 565-5400

Travel Health of Williamsburg 287 McLaws Cir., Suite 2 Williamsburg (757) 220-9008

Brookside Home Health 460 McLaws Circle, Ste. 250 Williamsburg (800) 296-2536

Internal Medicine

Comfort Keepers 15441-A Pocahontas Trail Lanexa (757) 229-2777 Concordia Group 1524-C Merrimac Trail Williamsburg (757) 229-9930

Kevin R. Bedell, MD 4622 Rochambeau Dr. Williamsburg (757) 566-4246 Internal Medicine of Williamsburg 227 McLaws Circle Williamsburg (757) 564-8182

Hand 'N' Heart 461 McLaws Circle, Ste. 3 Williamsburg (757) 565-0216

Sentara Internal Medicine Physicians-Kingsmill 477 McLaws Circle, Suite 1 Williamsburg (757) 208-0005

Harmony Care 106 Queen Anne Dr. Williamsburg (757) 784-7650

The Massey Clinic 322 Monticello Ave. Williamsburg (757) 229-0919

Hope In-Home Care 4512 John Tyler Hwy., Ste. G Williamsburg (757) 220-1500

New Town Internal Medicine 4374 New Town Ave., Ste. 102 Williamsburg (757) 259-6770

Hospice of Virginia 7231 Forest Ave., Ste. 100 Richmond (804) 281-0451

Riverside Norge Internal Medicine & Pediatrics 7364 Richmond Rd. Williamsburg (757) 345-0011

Hospice Support Care 4445 Powhatan Pkwy.

Williamsburg (757) 253-1220 Intrepid USA 212 Packets CT., Williamsburg (757) 220-9331 Karya Home Care, Inc. 376 McLaws Circle, Ste. B1 Williamsburg (757) 259-7411

Riverside Williamsburg Primary Care 5231 John Tyler Hwy. Williamsburg (757) 220-8300 Williamsburg Internal Medicine 400 Sentara Circle, Suite 400 Williamsburg (757) 645-3150 Williamsburg Personalized Medicine 332 North Henry St. Williamsburg (757) 984-1275

THE HEALTH JOURNAL

35

Nephrology & Renal Health

5800 Mooretown Rd. Williamsburg (757) 564-0001

DaVita Williamsburg Dialysis 500 Sentara Circle, Suite 103 Williamsburg (757) 206-1408

The ARC of Greater Williamsburg 202-D Packets Ct. Williamsburg (757) 229-3535

Renal Advantage, Inc. 4511-J John Tyler Hwy. Williamsburg (757) 229-5701 7364 Richmond Rd. Williamsburg (757) 229-5890

The Center for Excellence in Aging and Geriatric Health 3901 Treyburn Dr., Ste. 100 Williamsburg (757) 220-4751 United Way 312 Waller Mill Rd., Suite 100 Williamsburg (757) 253-2264 Help Line: (757) 229-2222

Sentara Nephrology Specialists 500 Sentara Circle, Suite 102 Williamsburg (757) 984-9700 TPMG Williamsburg Nephrology 105 Bulifants Blvd., Ste. B Williamsburg (757) 903-4807

Hampton Roads Neurosurgical & Spine Specialists 120 King's Way, Suite 3500 Williamsburg (757) 220-6823 Riverside Williamsburg Neurology & Sleep Disorders Center for Adults & Children 120 Kings Way, Suite 2700 Williamsburg (757) 221-0110 Sentara Neurology Specialists 400 Sentara Circle, Suite 305 Williamsburg (757) 388-6105

Non-Profit Organizations Alzheimer’s Association 213-B McLaws Circle Williamsburg (757) 221-7272

Richard K. Lodwick, OD Pamela Lundberg, OD 101-A Bulifants Blvd.

Williamsburg (757) 564-1907 Carter Murphy, OD 5251 John Tyler Hwy. Williamsburg (757) 229-8660

Obstetrics & Gynecology TPMG Williamsburg OBGYN 105 Bulifants Blvd., Ste. B Williamsburg (757) 903-4807

Forest Schaeffer Monticello Marketplace Williamsburg (757) 258-1020

Wetchler and Dineen Gynecology 217 McLaws Cir., Suite 5 Williamsburg (757) 229-3254

Williamsburg Eye Care 101 Bulifants Blvd., Ste. A Williamsburg (757) 564-1907

Williamsburg Obstetrics & Gynecology 1115 Professional Dr. Williamsburg (757) 253-5653

Orthopedics & Sports Medicine

Womancare Of Williamsburg 120 Kings Way, Suite 3400 Williamsburg (757) 253-5600

Riverside Orthopedics & Sports Medicine 120 Kings Way, Ste. 3500 Williamsburg (757) 838-5055

Oncology

American Red Cross 1317 Jamestown Rd., Suite 105 Williamsburg (757) 253-0228

Hampton Roads Eye Associates 120 Kings Way, Suite 1300 Williamsburg (757) 345-3004

Rosser Optical 150-B Strawberry Plains Rd. Williamsburg (757) 220-2020 Jeanne I. Ruff, OD, LLC 1107 Richmond Rd. Williamsburg (757) 229-4222

Williamsburg AIDS Network 479 McLaws Circle, Suite 2 Williamsburg (757) 220-4606

Neurology & Neurosurgery

Eyewear Plus Optometric Center 101 Tewning Rd. Williamsburg (757) 229-1131

Hampton Roads Surgical Specialists 120 Kings Way, Suite 2800 Williamsburg (757) 873-6434

W e

A r e

Tidewater Orthopaedic & Spine Specialists 5208 Monticello Ave., Suite. 180 Williamsburg (757) 206-1004

C o m f o r t

Arthritis Foundation-Va. Chapter Toll-Free (800) 456-4687

Peninsula Cancer Institute 120 Kings Way, Suite 3100 Williamsburg (757) 345-5724

Avalon 312 Waller Mill Rd., Ste. 300 Williamsburg (757) 258-9362

Radiation Oncology Specialists 3901 Treyburn Dr., Ste. B Williamsburg (757) 220-4900

PhArmacies Olde Towne Pharmacy 4854 Longhill Rd. Williamsburg (757) 220-8764 Professional Pharmacy 11302 Mount Vernon Dr. Williamsburg (757) 229-3560 Williamsburg Drug Co. 240 McLaws Circle Williamsburg (757) 229-1041

Physical Therapy & REHABILITATION BonSecours In Motion Physical Therapy & Sports Performance 5700 Warhill Trail Williamsburg (757) 221-0101 Comber Physical Therapy 101-B Bulifants Blvd.

Williamsburg (757) 229-9740 5388 Discovery Park Blvd., Ste. 100 Williamsburg (757) 903-4230 Dominion Physical Therapy & Associates, Inc. 243 McLaws Cir., Suite 102 Williamsburg (757) 564-9628 Norge & The Lymphedema Treatment Center 7151 Richmond Rd., Ste. 191 Williamsburg (757) 345-0753 PEAK Physical Therapy & Sports Rehabilitation 344 McLaws Circle Williamsburg (757) 564-7381

K e e p eReach r for s ®Performance, Inc.

TPMG Orthopedics Spine/Sports Medicine & Virginia Center for Athletic Medicine 4125 Ironbound Rd., Suite 200 Williamsburg (757) 345-5870 Virginia Orthopedics

312-J Lightfoot Rd. Williamsburg (757) 258-1221 Riverside Rehabilitation Outpatient Therapy at Williamsburg 120 Monticello Ave., Suite 200 Williamsburg (757) 345-3795

& Sports Medicine Sentara Pediatric ® provides Comfort the W e K e 5335-B e p Discovery eKeepers r s ®Park Blvd.

Rehabilitation Services Williamsburg (757) 253-0603 Virginia Oncology Associates 5301 Longhill Road Child Development Resources care(757) 984-9900 500 Sentara Circle, Suite 203kind of trusted, in-home Williamsburg 150 Point O' Woods Rd. • Companionship Williamsburg (757) 229-2236 Norge (757) 566-3300 Pain Management Sentara Rehabilitation that helps people maintain full Services • Cooking, Light 301 Sentara Circle DreamCatchers Tushar U. Gajjar, MD Ophthalmology Housekeeping Williamsburg 10120 Fire Tower Road Sentara Circle and 400 independent lives, right in(757) 984-9900 Toano (757) 566-1775 Williamsburg (757) 345-4400 Advanced Vision Institute • Errands, Shopping K. Sullivan, Ed Monticello Ave. Keepers the®comfort their own Anne home.

Comfort providesofthe 1769 Jamestown Rd., Ste. R Faith in Action s e r v i C e s 5215 Tidewater Pain Management Williamsburg (757) 229-4000

i Cf e A r es e Cr ov m o sr t

• Incidental Williamsburg (757) 564-7002 4125 Ironbound Rd. kind ofCenter trusted, in-home care Williamsburg (757) 258-2561 Cullom Eye & Laser Transportation TPMG iSTRIVE 120 Kings Way, Suite 1300 our Comfort Keepers® arePersonal Training 5400 Discovery Park Blvd.

Historic Triangle that helps people maintain full • Cooking, Light Williamsburg (757) 345-3001 • Laundry Pediatrics Williamsburg Substance Abuse Coalition carefully screened, trained,(757) 345-2512 161-A JohnHousekeeping Jefferson Square and independent lives, right in Anthony J. DeRosa, MD Pediatric Associates of Williamsburg • Recreation, Crafts TPMG Virginia Center for Williamsburg (757) 476-5070 Tewning Rd. • Errands, Shopping 101 Bulifants Blvd.

Physical Therapy and insured.

Williamsburg (757) 223-5321 the comfort ofbonded, their119 own home.

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• Grooming, Dressing 5400 Discovery Park Blvd., Ste. 301 La Leche League of Virginia • Incidental Williamsburg (757) 345-2512 Williamsburg (757) 220-9187 Guidance Paul J. McMenamin, MD Riverside Norge Internal Medicine Transportation 1155 Professional Dr. Williamsburg, & Pediatrics our Comfort Keepers® are Williamsburg Hand Therapy Center National Alliance on Mental Health Williamsburg (757) 565-2500 • Medication 7364 Richmond Rd. 156-B Strawberry Plains Rd. Williamsburg Area • Laundry West Point and Williamsburg (757) 345-0011 screened, trained, Williamsburg (757) 565-3400 P.O. Box 89 Retinacarefully & Glaucoma Associates Reminders • Recreation, Crafts Williamsburg (757) 220-8535 113 Bulifants Blvd., Suite A surrounding areas: Williamsburg Physical Therapy bonded, and insured.

Williamsburg (757) 220-3375 • Alzheimer's,

• Grooming, Dressing 4125 Ironbound Rd., Suite 100 National Federation of the Blind Williamsburg Pediatric, 804-966-1997 Williamsburg (757) 220-8383 Williamsburg (757) 565-1185 Dementia Care Guidance Adolescent & Sports Medicine 354 McLaws Circle Williamsburg (757) 258-5890 • Companionship

OPTometry

Senior Services Coalition • Medication 161-A John Jefferson Sq. Reminders Williamsburg (757) 220-3480 SpiritWorks Foundation

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Williamsburg, 4374 New Town Ave., Ste. 202 (757) 253-5757 West Point and Williamsburg 400 Sentara Circle, Ste. 310 Williamsburg (757) 253-5757 surrounding areas:

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36 THE HEALTH JOURNAL

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Is someone you know confined at home? Is he or she in need of special assistance to meet the challenges of daily living? At COMFORT KEEPERS, our knowledgeable staff will help you select the best solution for your t K e e p e r s . C o m needs. Call (757) 229-2777 or (804) 966-1997 for more information. Please inquire about our Alzheimer’s and dementia care services. Our non-medical care is available 24/7. Comforting Solutions for In-Home Care. We employ only the most dependable, caring and friendly staff.

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Plastic Surgery Center of Hampton Roads 4374 New Town Ave., Ste. 205 Williamsburg (757) 873-3500

podiatry Michael Dente, DPM, PLC 120 Kings Way, Suite 2900 Williamsburg (757) 345-3022 Lightfoot Podiatry Center 213 Bulifants Blvd., Suite A Williamsburg (757) 345-3679 TPMG Podiatry 4125 Ironbound Rd., Ste. 200 Williamsburg (757) 345-5870 Williamsburg Foot & Ankle Specialists 453 McLaws Cir., Ste. 1 Williamsburg (757) 220-3311

Anne K. Sullivan, EdD, LCP 1769 Jamestown Rd., Ste. R Williamsburg (757) 564-7002 Williamsburg Center for Therapy 217 McLaws Circle, Suite 2 Williamsburg (757) 253-0371 Williamsburg Psychiatric Medicine, PLLC 372 McLaws Circle, Suite 1 Williamsburg (757) 253-7651 Your Next Chapter Coaching & Counseling Services 1769 Jamestown Rd. Williamsburg (757) 258-0853

PULMONOLOGY & SLEEP DISORDERS

Preventative Medicine

Pulmonary & Sleep Consultants of Williamsburg, PC 120 Kings Way, Suite 2200 Williamsburg (757) 645-3460

Reneau Medical 120 Kings Way, Ste. 2550 Williamsburg (757) 345-3064

Sentara WRMC Sleep Center 400 Sentara Circle Williamsburg (757) 345-4050

Renaissance Integrative Therapy 1158 Professional Dr., Suite D Williamsburg (757) 220-4996

Sleep Disorders Center at Williamsburg Neurology 120 Kings Way, Suite 2700 Williamsburg (757) 221-0110

Williamsburg Health Evaluation Center 332 N. Henry St. Williamsburg (757) 565-5637

Psychiatry & Mental Health ADR Clinical Associates 1309 Jamestown Road, Suite 101 Williamsburg (757) 220-8800 Colonial Services Board 1657 Merrimac Trail Williamsburg (757) 220-3200 Lester Dubnick, EdD 1309 Jamestown Road, Suite 101 Williamsburg (757) 220-0645 Eastern State Hospital 4601 Ironbound Rd. Williamsburg (757) 253-5161 Jose A. Erfe, MD and Associates 481 McLaws Circle, Suite 1 Williamsburg (757) 229-9286 Family Living Institute 1318 Jamestown Rd., Ste. 101 Williamsburg (757) 229-7927

Rheumatology Arthritis & Rheumatic Diseases, PC 329 McLaws Circle Williamsburg (757) 220-8579

Urology Hampton Roads Urology 120 Kings Way, Suite 3200 Williamsburg (757) 253-0051 TPMG Williamsburg Urology 105 Bulifants Blvd., Ste. B Williamsburg (757) 903-4807

vascular surgery Peninsula Vascular Surgery 156-A Strawberry Plains Rd. Williamsburg (757) 229-7939 Pitman Surgical Associates 326 Monticello Ave. Williamsburg (757) 229-4958

Insight Neurofeedback & Counseling 354 McLaws Circle, Suite 3 Williamsburg (757) 345-5802 Charles L. Koah, LPC 1769 Jamestown Road, Suite 104 Williamsburg (757) 871-3693 New Horizons Family Counseling Center 205 Jones Hall Williamsburg (757) 221-2363 Poplar Creek Psychological & Counseling Center 3305 Poplar Creek Ln. Williamsburg (757) 564-8522 Psychological Associates of Williamsburg 1313 Jamestown Rd., Suite 105 Williamsburg (757) 253-1462 Paul D. Reilly, MD 1115 Old Colony Lane Williamsburg (757) 253-0691 Richmond Road Counseling Center 1001-A Richmond Rd., Ste. 2 Williamsburg (757) 220-2669

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local beat Williamsburg mom Shannon Monte brings children David, 5, and Jocelyn, 3, to CDR’s developmental playgroup. Read their story on page 39.

Written by Amy Johnson

CDR’s Annual Fundraiser Helps Families Like These Three local families share what Child Development Resources means to them; show your support for CDR at this month’s Bid ’n’ Buy Auction on March 14.

S

ome describe Williamsburg’s Child Development Resources (CDR) as a hidden treasure. But for the families serviced by CDR, it is more than a treasure; it is a blessing, an answer to a prayer, and some even say a “Godsend.” Though its main facility is tucked away in Norge, its services reach far and wide into the entire Greater Williamsburg community.

CDR provides early intervention services for children with developmental delays and for those at risk of delays due to factors ranging from poverty to low birth weight to an incarcerated parent, among others, explains Paul Scott, executive director of CDR. Services include: home visits, developmental assessments, therapy, developmental playgroups, child care programs, parent groups and teacher training among others. Additionally, says Scott, 95 percent of CDR’s services are offered in the most natural setting—such as the home—where the child will be most comfortable and will be best impacted. The cost? Free for families whose children qualify.

Funding for some of its services and programs comes from grants and donors, but the annual CDR Bid ’n’ Buy Auction, scheduled this year for March 14, is the organization’s biggest source of funding.

“It’s a special event,” says Scott. “Our programs are under tremendous financial pressure, and the next few years will be tough for us.”

Continued on page 38

Who: Child Development Resources What: 32nd Annual CDR Bid ’n’ Buy Auction When: March 14, 2010 / Doors open

at 11:30 a.m.

Where: Lafayette High School

(childcare provided) More than 300 items will be auctioned, including: Vacations to Outer Banks, Disney, and Massanutten Bed & Breakfast stays Pet care Gift baskets Artwork Jewelry Designer Handbags Restaurant gift certificates

THE HEALTH JOURNAL

37

local beat

Continued from page 37 Aside from supporting CDR financially, Scott adds: “[The auction] is casual, fun and great for the whole family. We offer activities for the children, and you can find some really great deals and learn about CDR in the process.”

Tracey & Miles Kosloff, son Niles, 2 Until now, Tracey Kosloff of Williamsburg couldn’t help but compare her son Niles to other kids. “Why isn’t he talking?” she’d wonder. Her concern led her to the Internet, where she came across Child Development Resources. Soon after making the call to CDR, the Kosloffs received a home visit from one of CDR’s trained therapists, who found delays in several areas.

Soon a speech therapist began coming to the Kosloffs’ home once a week, “and we saw great improvement,” says Tracey.

In addition to the therapy sessions, Tracey also enrolled Niles in a developmental playgroup to help him with his socialization skills, and now he attends preschool one day a week. “[CDR] not only helped Niles but also helped me,” says Tracey. “[The therapist] taught me how to work with him. I know Niles wouldn’t be where he is now if it weren’t for CDR.”

“It’s just amazing,” says Kathy Fagerland.

“He’s happy, we’re happy, his little brother is happy. If it wasn’t for CDR, we’d be on a completely different path.”

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Kathy took action after a happy play date turned sour—Cameron had spontaneously bit her on the shoulder.

“That night I filled out a form on CDR’s website,” she remembers. “I knew about them but wasn’t sure what to expect.”

Almost immediately CDR sent a therapist to the family’s home for an evaluation. “We found out Cameron had sensory processing disorder,” says

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Kathy—a condition that exists when sensory signals don’t get organized into appropriate responses. “It was wonderful to have a title [for his behavior] and to have some plan of attack. It was a complete blessing.”

Cameron received therapy and occupational therapy as well as attended a developmental playgroup. Now four, Cameron attends Bright Beginnings, a preschool-age intervention program at Norge Elementary School. He is wellprepared for kindergarten, and though he is still a little “impulsive,” he is learning how to control and manage those impulses.

“It’s just amazing,” says Kathy. “He’s happy, we’re happy, his little brother is happy. If it wasn’t for CDR, we’d be on a completely different path.”

Shannon & Brian Monte, son David, 5, and daughter Jocelyn, 3 “They move mountains,” says Shannon, when asked about her experience with CDR. “They pointed me in so many good directions.”

When Shannon’s son David was two, he had a vocabulary of just four words.

Since David was her first child, Shannon didn’t think much of it until her sister suggested she call CDR. After a home visit, David joined the developmental playgroup along with his younger sister Jocelyn. Both children needed to learn social interaction, and Jocelyn needed motivation to begin crawling.

Most importantly, David began receiving speech therapy sessions. Because he couldn’t make closed-mouth sounds, he’d never said the word “Mommy.” When it finally happened, around Christmas, Shannon was ecstatic.

“He had called me ‘honey’ for so long because that’s what my husband calls me,” says Shannon, “but to hear the word ‘Mommy’ was the best present I could ask for.”

local beat .

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MarchCalendar 6

th

Free Yoga Class

Drop by B-defined Innovative Personal Training and Wellness (located inside the SunTrust building in New Town) at 10 a.m. for a free 30-minute yoga class and demo. Call (757) 345-6801 to sign up.

10 th 10

th

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23

Join Pediatric Associates of Williamsburg (119 Bulifants Blvd.) at 5:30 p.m. for a complimentary open house for new and expectant parents seeking a pediatrician. Call (757) 564-7337, option 8, to register.

In memory of Ali Kaplan, who died in 1999 of aplastic anemia at age 12, community members are invited to participate in the 6th Annual 5K Run/Walk in conjunction with the 19th Annual W&M Allan Buzkin Memorial Bone Marrow Drive beginning at 9 a.m. This event will help raise money to provide bone marrow transplants for those diagnosed with potentially fatal blood diseases. Registration is $15 prior to the event and $20 the day of the race at the William & Mary School of Law. For more information, contact apreeve@wm.edu.

11

18

Need a Pede?

Ali’s Run

th

Colon Health

Registered Dietician Karen Godette, R.D., will discuss ways to maintain good colon health through nutrition during a free presentation from 10 to 11 a.m. in the Williamsburg Conference Room at Sentara Williamsburg Regional Medical Center. Call 1-800-SENTARA to register.

Infant Massage

Learn the benefits of infant massage in a free class held from 5:30 to 6:30 p.m. at Pediatric Associates of Williamsburg (119 Bulifants Blvd.). Call (757) 564-7337, option 8, to register.

Learn Reiki

rd

Learn basic Usui Reiki technique and how to use Reiki to heal yourself and others during a special presentation, “Reiki: Level I,” to be held from 7 to 9 p.m. at Williamsburg Landing. You’ll gain an understanding of basic energy healing techniques while becoming more aware of the healing process. Cost of class is $100. Visit www.wuu.org/walt to register.

25

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Long-Term Care

Considering the financial impact of health care in your senior years? What are your options for long-term care and other issues of retirement? Join Bill Forloine, a former life insurance company president, from 5:30 to 6:30 p.m. at the Williamsburg Chamber of Commerce (421 North Boundary). Cost of class is $15. Visit www.wuu.org/walt to register.

Shop Smart, Eat Better

Learn how to read nutrition labels and make healthier food choices during a free grocery store tour with a registered dietician at 10 a.m. at Ukrop’s (4660 Monticello Ave.). Availability is limited; call 1-800-SENTARA to register early.

31

st

40 THE HEALTH JOURNAL

2010

Free Preparation of Wills

Thanks to the Peninsula Agency on Aging and Williams Mullen law firm, area seniors can prepare three important life planning documents—a will, a durable power of attorney and an advance medical directive (“living will”)—at a designated site in New Town. If you qualify, all services are free and confidential. Appointments are limited. Call (757) 873-0541 between 9 a.m. and 5 p.m., Monday through Friday, to register or for more information.

Support Groups Abortion Recovery Group Mary Immaculate Hospital Tuesdays, 7 p.m.

(757) 886-6364

Abuse Dating Violence Wednesdays, 4:30 p.m.

(757) 221-4813 Domestic Abuse/Assault Mondays, 7 p.m.

(757) 258-5022 Williamsburg Baptist Church Mondays, 7 p.m.

(757) 258-9362

Williamsburg United Methodist Church 3rd Tuesday, 11 a.m.

(757) 724-7001 Eden Pines 2nd Tuesday, 7 p.m.

(757) 826-5415 Second Presbyterian Church 1st Tuesday, 7 p.m.

(757) 930-0002 James River Convalescent Center 2nd Friday, 10 a.m.

(757) 595-2273

ADDiction

The Chesapeake 3rd Tuesday, 1 p.m.

(757) 223-1658

Gamblers Anonymous Williamsburg Place Mondays, 7 p.m.

(800) 522-4700

Family Centered Resources 3rd Thursday, 1:30 p.m.

(757) 596-3941

Sexaholics Anonymous E-mail for dates/locations. hrsa@hotmail.com

Aids

Williamsburg AIDS Network 2nd & 4th Wednesday (757) 220-4606

Alcohol & Drug Recovery Colonial Chapter Meets monthly.

(757) 253-4395

Bethel Restoration Center Mondays, 7 p.m.

(757) 220-5480 Kids’ Group Spirit Works (757) 564-0001 Parents’ Group Bacon Street Mondays, 6 to 7:30 p.m.

(757) 253-0111 Women Only Spirit Works Wednesdays, 7 to 8:30 p.m.

Thursdays, 2:30 to 4 p.m.

(757) 564-0001 Al-Anon/Alateen Meetings held daily.

Visit www.va-al-anon.org Alcoholics Anonymous Meetings held daily.

Visit www.aa.org.

Marijuana Anonymous Tuesdays, 7 p.m.

Mt. Pleasant Baptist Church (757) 476-5070 Narcotics Anonymous Meetings held daily.

Visit www.na.org.

Suboxone Therapy Mary Immaculate Hospital 3rd Wednesday, 7 p.m.

(757) 886-6700

Alzheimer’s Disease

Warwick Forest 2nd Thursday, 7 p.m.

(757) 867-9618 Family Connections 2nd Tuesdays, 1 to 3 p.m.

Registration required.

(757) 221-7272 Early Memory Loss Mary Immaculate Hospital 2nd Tuesday, 10 a.m.

(757) 599-6847 or (757) 930-0002

Arthritis

Mary Immaculate Hospital 4th Tuesday, 10:30 to noon (757) 886-6700

Autism

Peninsula Autism Society King of Glory Lutheran Church Last Thursday, 7:30 p.m.

(757) 259-0710 Grafton Baptist Church 2nd Monday (757) 564-6106

Bereavement/Grief Sentara CarePlex Hospital 2nd & 4th Wednesday 5 to 6:30 p.m.

(757) 827-2438 Hospice House 2nd Monday, 7 p.m.

(757) 258-5166 or (757) 229-4370 Mary Immaculate Hospital 1st & 3rd Thursday, 7 p.m.

(757) 886-6595 Mary Immaculate Hospital 2nd & 4th Monday, 6 p.m.

(757) 737-2287 Child Loss Williamsburg Hospice House 2nd Monday (757) 645-2192 St. Luke’s United Methodist Church 1st Monday, 7:30 p.m.

(757) 886-0948

Immaculate Conception Church 2nd Monday, 1 p.m.

(757) 873-0541

Riverside Hospice 2nd Thursday, 7 p.m.

(757) 594-2745

Morningside Assisted Living 3rd Wednesday, 2 p.m.

(757) 221-0018

JCC/W Community Center 1st Tues., 7:30 to 8:30 a.m.

(757) 253-1220 or allysimone@hotmail.com

Morningside Assisted Living 2nd & 4th Wed., 5:30 p.m.

(757) 594-8215

Miscarriage / Stillbirth Mary Immaculate Hospital 3rd Thursday, 7:00 p.m.

(757) 886-6791

Dominion Village 3rd Thursday, 2 p.m.

(757) 258-3444

Suicide Catholic Charities 3rd Tues., 7 p.m.

(757) 875-0060

Young Widow/Widower Williamsburg Hospice House 1st Monday (757) 645-2192

Breastfeeding

La Leche League of Va. Church of the Nazarene 1st Tuesday, 10:30 a.m.

3rd Thursday, 6:30 p.m.

(757) 766-1632 or (757) 224-8879 Sentara Williamsburg Regional Medical Center Yorktown Room M., W., Thurs., 10 a.m.

(757) 984-7299 Riverside Cancer Care Center Mondays, 11 a.m.

(757) 594-3399

Cancer Breast Cancer Riverside Cancer Care Center 2nd Thursday, 7 to 8:30 p.m.

(757) 594-4229 Mary Immaculate Hospital 3rd Wednesday, 7:30 p.m.

(757) 874-8328 Sentara CarePlex Hospital 3rd Tuesday, 7 to 8:30 p.m.

(757) 594-1939 Young women's group 3rd Sunday, 2 p.m.

Call for location.

(757) 566-1774 Post-menopausal group 1st Monday, 1:30 p.m.

Call for location.

(757) 258-4540 Colorectal Cancer Sentara CarePlex Hospital 3rd Wed., 1 to 2:30 p.m.

(757) 736-1234 Leukemia/Lymphoma Sentara CarePlex Hospital 1st Tuesday, 7 to 8:30 p.m.

(757) 827-2438 The Leukemia and Lymphoma Society Young Adult Group Call for meeting dates, times and locations.

(800) 766-0797 "Look Good, Feel Better" Sentara CarePlex Hospital 2nd Monday, 2 to 4 p.m.

(757) 827-2438 Sentara Williamsburg Regional Medical Center 2nd Monday, bi-monthly (757) 984-1218 Lung/Respiratory Cancer Sentara CarePlex Hospital 1 to 2 p.m., call for dates.

(757) 827-2438 Prostate Cancer Sentara CarePlex Hospital 2nd Tuesday, 7 to 8:30 p.m.

(757) 827-2438

Caregiver support Mary Immaculate Hospital First Wednesday, 1 p.m.

(757) 886-6700

Colonial Heritage Clubhouse 3rd Thursdays, 2:30 p.m.

(757) 253-1774 or (757) 345-6974 York Public Library Community Room 2nd Tuesday, 7 p.m.

(757) 890-3883

Celiac Disease

Monticello Ukrop’s Call (757) 564-0229

Riverside Regional Medical Center 4th Wednesday, 7 p.m.

(757) 875-7880

Chronic Fatigue SyndromE

Recovery Denbigh Church of Christ 1st & 3rd Thursdays Call for time.

(757) 850-2279 St. Stephen Lutheran Church 1st Tuesday, 7 p.m.

(757) 220-8535

Crohn’s Disease/Colitis

Depression/Bipolar St. Mark’s Episcopal Church 2nd & 4th Wed., 10:30 a.m.

(757) 247-0871

Historic Triangle Senior Center 2nd & 4th Wed., 5:30 p.m.

(757) 220-0902

Obsessive-Compulsive Riverside Behavioral Health Center 3rd Thurs., 7:30 p.m. to 9:30 p.m.

(757) 827-1001

Polio

Multiple Sclerosis

R. F. Wilkinson Family YMCA 3rd Wednesday, 4 to 5 p.m.

(757) 984-9900

Charcot-marie-tooth (CMT) Williamsburg Regional Library Sat., 2:30 to 4:30 p.m.

Every other month (757) 220-3578 (804) 693-5806 Mary Immaculate Hospital 1st Thursday, 7 p.m.

(757) 886-6700

Sentara CarePlex Hospital 1st Saturday, 1 p.m.

(757) 736-1234

Diabetes

Mary Immaculate Hospital 2nd & 4th Tuesday, 1 p.m.

(757) 886-6100 Sentara Williamsburg Regional Medical Center Call for day and time.

(757) 984-7106 or (757) 984-7107 Sentara Center for Health and Fitness 3rd Wednesday, 4 to 5 p.m.

(757) 827-2160 Mary Immaculate Hospital 3rd Tuesday, 1 p.m.

(757) 886-6700 Type 2 Diabetes Riverside Regional Medical Center 3rd Tuesday, 11 a.m.

(757) 534-5918 Insulin Pump Riverside Regional Medical Center 4th Tuesday, 7 p.m.

(757) 534-5918

Eating Disorders

JCC/W Community Center 2nd & 4th Wed., 5:30 to 7 p.m.

(757) 220-0902 African-Americans Hampton Public Library 1st Thursday, 10:30 a.m.

(757) 490-9627

Myasthenia gravis James City County Library Every other month on the 4th Sat., 1 p.m.

(757) 810-1393

Ostomy

Sentara Williamsburg Regional Medical Center 1st Sun., 3 p.m.

Meets Quarterly.

(757) 259-6033

ParentIng

JCC/W Community Center Thursdays, 6 to 7:30 p.m.

(757) 229-7940

Mary Immaculate Hospital 3rd Wednesday, 1 p.m.

(757) 886-6381

PMS

Sentara CarePlex Hospital 3rd Saturday, 2 to 4 p.m.

(757) 596-0029

Stroke/Brain Injury

Va. Peninsula Stroke Club Riverside Rehabilitation Institute 1st Wednesday, 10 a.m.

(757) 928-8327 Riverside Rehabilitation Institute Wednesdays, 3:30 p.m.

(757) 928-8327 Riverside Rehabilitation Institute Last Wednesday, 4:30 p.m.

(757) 928-8050

vasculitis

Mary Immaculate Hospital 1st Sat., 10 a.m. to noon (928) 380-0319

Vision Loss

1st Saturday, 1 p.m.

JCC/W Community Center (757) 565-1185

Weight ManagEment

Overeaters Anonymous Chestnut Memorial Church Mondays, 7 p.m.; Thursdays, 11 a.m.

(757) 898-3455

Children with Disabilities St. Martin’s Episcopal Church 2nd Thursday, 6:30 p.m.

(757) 258-0125

Warwick Memorial United Methodist Church Wednesdays, 9 a.m.

(757) 850-0994

Fibromyalgia

JCC/W Community Center 1st Tuesday, 12 to 1 p.m.

(757) 221-9659 or e-mail stuarts@wjcc.k12.va.us

St. Mark’s Methodist Church Thursdays, 8:30 a.m.

(757) 850-0994

Williamsburg Library 2nd Tuesday, 1 p.m.

(757) 879-4725

Hearing Loss

Hearing Loss Association 2nd Sat., 10:30 a.m.

(757) 564-3795

Heart Disease

Riverside Regional Medical Center Call for dates/times.

(757) 875-7880 Women Only Sentara Williamsburg Regional Medical Center 1st Monday, 7 p.m. womenheart@aol.com

Huntington’s Disease Mary Immaculate Hospital 3rd Friday, 7 p.m.

(757) 886-6700

Kidney disease

Sentara CarePlex Hospital 1st Wed., 6 to 7:30 p.m.

(757) 244-3923

Lou GeHrig's disease (ALS) St. Luke's United Methodist 4th Thurs., 6:30 p.m.

(866) 348-3257 or www.alsinfo.org

Mental Illness Support St. Stephen Lutheran Church 1st Tuesday, 7 p.m.

(757) 220-8535 500-C Medical Drive Wed., 6 to 7:30 p.m.

(757) 503-0743 NAMI - Williamsburg Area St. Stephen Lutheran Church Tues., 7:00 p.m.

(757) 220-8535

Fathers Only York River Baptist Church 1st & 3rd Mondays, 6 to 8 p.m.

(757) 566-9777 Grandparents as Parents Williamsburg Library Conference Room C 2nd Tuesday, 10 a.m.

(757) 253-2847 Hispanic Parents Wellspring United Methodist Church 1st & 3rd Fri., 10 a.m.

Transportation available.

(757) 566-9777 New Mothers Sentara Williamsburg Regional Medical Center Thursdays, 10 to 11:30 a.m.

(757) 259-6051 St. Mark Lutheran Church Thursdays, 10 to 11:15 a.m.

(757) 898-2945

Hope Lutheran Church Mondays, 5:45 p.m.

(757) 850-0994 First Christian Church Thursdays, 6:00 p.m.

(757) 850-0994 Fox Hill Road Baptist Church Mondays, 6:30 p.m.

(757) 850-0994 Olive Branch Christian Church Tuesdays, 9:45 a.m.

(757) 850-0994 Mall Walking Club Meets at Patrick Henry Mall Call for date/time.

(757) 249-4301

Women's issues Williamsburg Baptist Church Mondays, 7 p.m.

(757) 258-9362

Stay-at-Home Moms Olive Branch Christian Church Fridays, 10 a.m.

(757) 566-3862 Stepfamilies Williamsburg United Methodist Church 4th Monday, 7 p.m.

(757) 253-2971

Parkinson’s Disease Sentara CarePlex Hospital 1st Tuesday, 3 p.m.

(757) 827-2170 Williamsburg Landing 2nd Monday, 1:30 p.m.

(757) 898-6674

THE HEALTH JOURNAL

41

ldren on; Chi

nd, R : Husba y l i m a F halie nd Nat Chad a

,

Kriston

profile

Age: 49

te of Gradua : s n o i t ions ertifica rtificat C / e c n ; o i y t t a i Educ gth nivers n Stren nion U o i l i m c o D n Old al Cou Tufts Nation ning), e Jackson designed her gym much like she approaches i h a t r t l m o a fr well on s s r a e ) p t ( s i s l fitness—with a well-rounded style and attention nes specia and Fit trition tness, i u F n to detail. A beautiful lobby, plush locker rooms, a ( p u y o t r si cling y mary G Univer i C r P s cycling room with a view of downtown, and an s e A tn AFA d ProFi n a as from , g outdoor boxing area offered the building a new life n ickboxi K d I n A a A h t and Jackson’s clients the perfect setting to start A A Heal n o r of IDE l e reaching their goals. Her all-round approach to i b c m n e u tions: M onal Co i a t i c a o fitness includes educating clients on the benefits N s s , A n sociatio s A s s and proper use of strength training, cardiovascular e Fitn Fitness d n a h conditioning, nutrition and flexibility to achieve t g, Streng ardenin g , total wellness. “My philosophy is that you have to g n i k and ng, coo i g t n a i o n do it all to make a healthy change,” says Jackson.

B i : a t s Hobbie g, enter s n d i l n e e v i a r g, tr and f dancin family h What she loves about Hampton Roads: I love t i w e g tim that it’s surrounded by water—and I love the climate and spendin its close proximity to the mountains and Washington, D.C.

How she developed an interest in fitness: I was always very physically active. I was a majorette, ran cross-country track and skied. I was in the Miss Norfolk pageant at age 20. After the birth of my last child, I went to several different gyms before choosing Wareings. And that’s how I got started.

Julie Jackson

Interview By Sharon Miller Cindrich Photography By Dawn Griffith

A

fter years of training, Julie Jackson has crossed a finish line of sorts.

Nearly 19 years in the fitness industry has led this passionate personal trainer to open her own gym and share her love of health and wellness with the Hampton Roads community. Fitness First Health and Wellness Center opened its doors Feb. 1 this year on Tazewell Street in Norfolk.

Jackson’s passion for fitness started in 1991 when she began teaching group fitness classes at Wareings Gym in Virginia Beach. “I was a member at Wareings and was approached by the director, who said, ‘Why don’t you start teaching for me?’”

Jackson enjoyed the teaching experience so much that she became a certified personal trainer and spent the next two decades expanding her repertoire of fitness certifications and specialties. In 2001 she became a Body Bar Master Trainer and conducted workshops for the BOSU® and Body Bar® fitness companies as well as designed fitness programs for children and teens while at Wareings.

“I have a passion for it,” Jackson says, explaining that over the years she became focused on helping others attain their fitness goals. She continued her education by attending national conferences and workshops where she was inspired to expand her range of professional abilities. After she left Wareings in 2007, Jackson directed group fitness classes at a Suffolk facility before deciding to open her own gym in a century-old building once owned

by Landmark Communications and home of Norfolk’s former daily newspaper The Ledger Star.

42 THE HEALTH JOURNAL

How she balanced family and fitness: My two youngest children grew up in Wareings gym. The gym had childcare, so they would come with me. By the time they got older I would go work out when my husband could stay home with them. I was passionate about both family and my personal fitness—you just have to learn time management and do what you can to achieve balance.

Her advice to people who don’t think they are athletic: That is the biggest obstacle in the business. We Americans have created a lifestyle of laziness and fatigue. It’s so much easier to get in the rut of not doing something than it is to do something. I know what it’s like to feel better when I eat right and exercise, but it’s hard to explain that to people. In my job I have to educate them—to let them know that if they stay inactive, their aversion to exercise (or ability to do it) will only get worse as they grow older.

What makes her gym different: Personal attention. I want my staff to speak to our clients and pay attention to their needs. I personally will call clients, check in on them, ask if they’ve been to the gym. You have to create a relationship with your clients and earn their trust. That’s what creates success.

Who she admires: Certain people in the fitness industry. My husband, who gives me strength. He was never a person to say, “You can’t.” He supported me 100 percent. He’s always been that way. He’s always told me that I am a strong, amazing, wonderful wife and mother.

Her most memorable professional moment: Teaching my last class at Wareings Gym after working there for 16 years. I was really sad about leaving, and everyone came to bid me farewell and wish me luck.

The one thing she would have done differently: I would have started working in the health and fitness industry 30 years ago instead of 18.

Favorite quote: “It is amazing how much crisper the general experience of life becomes when your body is given a chance to develop a little strength.” Frank Duff, Missionary

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