Carilion Clinic Living - Summer 2013

Carilion Clinic

Inspiring Better Health | CarilionClinic.org | Summer 2013

Finding Balance in

Your Life

Medical Homes Why Patients Choose Them Keen On Kayaking New TREATMENTS FOR RESPIRATORY DISEASES

Avid gardener.

Six active grandkids, with another on the way.

Living with advanced heart failure.

Feeling out of breath and more tired than usual.

Surgery became necessary.

Left Ventricular Assist Device implanted.

A new lease on life.

Now the grandkids are busy, keeping up with grandma.

So grateful Carilion is here.

We treat heart conditions in ways others can’t.

As the only heart care team in the region with the trained experts to perform advanced procedures, such as LVAD, we’re helping extend the lives of patients who are living with congestive heart failure. We’re here to keep a close watch on your heart, care for your condition, and keep you looking forward to all the moments to come. To watch patient videos, visit CarilionClinic.org/heart.

CarilionClinic.org/heart • 800-422-8482

Carilion Clinic

SUMMER 2013­­

FEATURES

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Community There’s a new farmers’ market in town.

Pulmonary Disease

New center treats respiratory system disorders.

Orthopaedics New services available at Smith Mountain Lake.

Children’s Health When a child needs brain surgery.

Cancer Care A multi-disciplinary approach improves outcomes.

Medical Homes Why patients seek them out.

Rx for Health Create balance in your life.

Summer Sports Enjoy a kayak ride.

Tech Tips How apps and online sources can help you stay healthy.

Plastic Surgery A new medical practice offers cosmetic and reconstructive surgery.

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DEPARTMENTS

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President’s Message Finding a healthy balance.

Healthy Lifestyles Tips from Carilion Clinic medical professionals.

In Your Community Making a difference in western Virginia.

New Providers

New physicians and advanced care practitioners across our region.

Better Living Your health calendar.

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Carilion Clinic

| Summer 2013 Inspiring Better Health | CarilionClinic.org

Finding Balance in

Your Life

Medical Homes Why Patients Choose Them

On Our Cover Alexis and Travis Ratliff of Roanoke often cook together after work as a way to add balance to their lives.

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KEEN ON KAYAKING NEW TREATMENTS FOR RESPIRATORY DISEASES

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Our Contributors Carilion Clinic President and CEO Nancy Howell Agee Carilion Clinic 1906 Belleview Ave. P.O. Box 13367 Roanoke, VA 24033 540-981-7000

Karen Doss Bowman is a writer who contributes to health care publications, including the University of Virginia’s Vim & Vigor. A native of Bassett, Va., she now lives in Bridgewater.

Su Clauson-Wicker is the author of two travel books and the former editor of Virginia Tech magazine. Her articles have also appeared in The Washington Post and other publications. She lives in Blacksburg.

Jay Conley has been a reporter for newspapers including The Roanoke Times, a staff writer for Randolph College in Lynchburg, and a writer for national publications such as U.S. News & World Report.

Carilion Clinic living is produced by strategic development: Vice President of Strategic Development Shirley Holland Senior director, marketing Mike Dame BRAND MANAGER Linda Staley Editor Maureen Robb LEAD DESIGNER David Porter Designer Taryn Anderson Contributing Writers Karen Doss Bowman, Allison Buth, Su Clauson-Wicker, Jay Conley, Rich Ellis, Laura Markowski, Otesa Middleton Miles, Amy Minnix, Erica Stacy, Randolph Walker, Alison Weaver Photographer Darryle Arnold

Sam Dean, a former photographer for The Roanoke Times, has been published in The New York Times, The Washington Post, Time and People magazines, and other publications. He has won many state and national awards.

Randolph Walker is a writer and musician in Roanoke. Formerly a staff writer with The Roanoke Times, his work has appeared in many publications including Virginia Living, Valley Business Front, and The Roanoker.

Alison Weaver is a freelance writer based in Roanoke. Her work has appeared in Valley Business Front, The Roanoke Times, Good Housekeeping, Woman’s Day, Redbook, and Seventeen magazine.

Contributing PhotographerS Marino Colmano, Sam Dean Printing Chocklett Press

CarilionClinic.org | 800-422-8482

Carilion Clinic is a not-for-profit health care organization based in Roanoke, Va. Through our comprehensive network of hospitals, primary and specialty physician practices, and other complementary services, we work together to provide quality care close to home for nearly 1 million Virginians. With an enduring commitment to the health of our region, we also seek to advance care through medical education and research to help our community stay healthy and inspire our region to grow stronger.

Copyright 2013 by Carilion Clinic. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Carilion Clinic. Articles in this publication are written by journalists or authors who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional advisor. All editorial rights reserved. Opinions expressed herein may or may not reflect the views of Carilion Clinic.

If you would like to be added to or removed from the mailing list for Carilion Clinic Living, please call 800-422-8482, email us at direct@carilionclinic.org, or write to us at Strategic Development, 213 McClanahan St., Roanoke, VA 24014.

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President’s Message If you find yourself wishing for more hours in the day, you’re not alone. Many of us struggle to meet all of our commitments to work, family, and the community. But at some point, being too busy can lead to unhealthy stress. Randolph Walker’s article explores how local families are rising to the challenge of juggling careers, children, and special needs—and still finding joy and balance in their lives. See if their tips can work for you!

Another common challenge, for those with diabetes, is managing blood sugar. This once-daunting task is now easier with new medical devices and the personal care available at your own “medical home.” One success story is that of Bill St. Pierre, who had to manage his condition in order to keep his job.

His experience shows how important help from your medical home can be.

We also profile patient Sue Thompson, who learned how valuable it is to have a team of specialists on your side. After her diagnosis of breast cancer, her case was evaluated by a multi-disciplinary team of doctors at the Carilion Clinic Cancer Carilion Clinic President and CEO Nancy Howell Center, giving her the benefit of many points of view. Today, Agee speaks at the recent launch of Carilion’s after a treatment plan individually tailored for her, Thompson Stairwellness program. is enjoying life—and her grandchildren—once again.

This issue also introduces our very own Stairwellness program to encourage you “to take the stairs to good health,” and the new Farmers’ Table in south Roanoke, to make it easier to pick up fresh veggies for dinner.

And, since it’s summer, we take a look at an increasingly popular sport— kayaking. Fresh air, exercise, and the calming effect of water… what could be better on a warm sunny day?

Warm regards,

Nancy Howell Agee President and CEO Carilion Clinic

An Invitation from the President

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HEALTHY LIFESTYLES

Tips from our Medical Professionals Count on Veggies An easy way to increase healthy vegetables in your diet and keep your weight down is to fill half of your dinner plate with non-starchy (mostly green!) veggies. I like to buy the large bags of frozen veggies, pour some in a bowl, cover with a plate, and steam them in the microwave. Eating more green vegetables can help you eat smaller portions of higher-calorie foods, like the main dish, bread, or potatoes.

— Lindsay H. Sherrard, M.D. Carilion Clinic Family Medicine, Rocky Mount

Watch the Sugar Sugar, including refined sugar and high-fructose corn syrup, is considered by many experts to be a toxin to the human body. Americans consume approximately 150 pounds of the addictive substance every year. Increased consumption of sugar can lead to heart disease, diabetes, cancer, obesity, and mood disorders. Healthier alternatives to satisfy your sweet tooth include the natural sweetener, Stevia, and fruit, as it contains a natural sugar that is not as harmful to your health.

— Chassity Martin, Certified Physician Assistant Carilion Clinic Emergency Department, Roanoke Travel Safely with Medications There are several steps you can take to travel more safely with your medications.

Be aware that they are sensitive to temperature extremes. Do not keep them in the glove box or trunk. Store them in a cool dry place out of direct sunlight.

Keep them in the original containers received from the pharmacy.

Also, keep a complete list of your medications and the number of the pharmacy that fills them.

—C had E. Alvarez, Pharm.D., M.B.A. Director, Pharmacy Systems and Support

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If You Have Arthritis Eating healthy foods to maintain or lose weight puts less stress on arthritic joints, especially lower-extremity joints, and helps to preserve the longevity of artificial joints.

Regular exercise helps maintain a healthy weight and achieve good muscle strength, tone, and flexibility.

Stretching exercises for arthritic joints can maintain range of motion and improve comfort.

Stretching before and after exercising improves flexibility and reduces the risk of injury.

— Jeffrey R. Chain, M.D. Carilion Clinic Orthopaedics, Christiansburg Protect Your Skin Summer is a special time of year when we want to get outside and enjoy sunshine and activities. But protecting your skin is important. Remember, if you are taking any medication (over-the-counter or prescription) be sure to read your labels. Some medications are “photosensitizers,” making your skin more sensitive to the effects of sunlight. This may lead to a rash or other skin problems. Plan your activities, if possible, for early morning or late evening. Happy summer!

— Debra Bright, F.N.P. Carilion Clinic Family Medicine, Blue Ridge Safeguard Your Baby’s Sleep Parents can help reduce the risk of Sudden Infant Death Syndrome (SIDS) and sleep-related deaths by following a few simple guidelines. These latest guidelines recommend babies are always placed on their back for sleep in their own crib, not in the same bed as adults.

Baby’s crib mattress should be firm with a tight-fitting sheet… no soft objects, toys, loose bedding, or bumper pads. For more information, go to www.CarilionClinic.org/kiss.

— Vanessa Hedge, M.S.N., C.P.N.P., Pediatric Hospitalist Carilion Clinic Children’s Hospital, Roanoke

Farmers’ Market Opens in South Roanoke

By Maureen Robb

If you love vegetables straight from the garden, you may want to check out the region’s newest farmers’ market.

Located by the Roanoke River at Carilion Roanoke Memorial Hospital, the market is open every Thursday afternoon through October. It offers fresh vegetables and fruit, grass-pastured meats, local cheeses, herbs, and free-range eggs.

Called the Farmers’ Table, it is sponsored by Carilion Clinic and is open to the public. In a pilot program last year, the market was created for Carilion employees.

Carilion has partnered with Good Food – Good People, a farm collaborative in Floyd representing over 50 producers, to stock and manage the market. All the produce is grown, and meat produced, within a 100-mile radius of Floyd.

Guided by its mission to improve the health of the community, Carilion hopes the market will encourage more people to eat nutritious foods.

In conjunction with the market, the Mountain View Café in Roanoke Memorial is also creating vegetarian dishes. To show

that healthy eating can be easy, enjoyable, and economical, it will offer a vegetarian option every Thursday through October.

The café is also open to the public.

So far the vegetarian offerings have included “Chilly Cucumber Soup,” “Honey Lime Berry Salad,” and “Baby Spinach and Balsamic Onion Salad with Feta Cheese.” Last year, after trying a new dish, many Carilion employees picked up the recipe in the café and went to the farmers’ market, where they bought the ingredients to make it at home.

Bon appetit!

The Farmers’ Table is open each Thursday through Oct. 31 from 2 – 6 p.m. It is between the Riverwalk Parking Garage and the pedestrian bridge to the hospital. Free parking is available in a 10-minute parking zone. Recipes for vegetarian dishes created

by Carilion Clinic’s Dining & Nutrition Services are available at www.pinterest.com/carilionclinic/healthy-foods.

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In Your Community

Can’t make it to the gym today?

We’ve got your gym right here.

Take the Stairs to Good Health

Have you heard about Stairwellness? It’s a new program at Carilion Clinic to encourage employees and visitors to take the stairs. A stairwell at Carilion Roanoke Memorial Hospital was redesigned with bright color and motivational art, with messages such as, “There’s a reason why a piece of exercise equipment was designed after stairs.” Stairwells at other Carilion hospitals will be redesigned this year. And look for Stairwellness at Center in the Square in downtown Roanoke this summer.

Community Health Surveys Begin

Carilion Clinic is conducting community health needs assessments in Tazewell, the New River Valley, and Bedford and Franklin counties this year to learn about chronic illnesses, access to health care, and other factors affecting health. Last year, assessments were completed for the Roanoke Valley and Giles and Rockbridge counties. Five areas were found to need improvement in the Roanoke Valley: access to adult dentistry, primary care, and mental health services; coordination of care; and wellness initiatives.

Culinary Herb Garden Debuts

A new community culinary herb garden was planted at Carilion Clinic’s Westlake practice at Smith Mountain Lake. Its goal is to encourage healthy eating by using herbs to flavor food instead of fats and salt. The garden is in partnership with Franklin County’s Healthy Community Action Team and the Virginia Master Gardener Program. Two classes on growing and cooking with herbs will also be offered at the Westlake Library.

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Medical Helicopter Services Expand

A new helicopter base is being built in Lexington for Life-Guard 12, one of Carilion Clinic’s three emergency helicopters. The base will have a hangar and crew quarters on-site at Carilion Stonewall Jackson Hospital, significantly reducing response times. A new base was also recently built in the Westlake area of Smith Mountain Lake for Life-Guard 10. It too will reduce response times. Carilion’s third helicopter, Life-Guard 11, is based at Carilion New River Valley Medical Center.

Agee Named to 50 Most Influential Virginians List

Carilion Sponsors Girls on the Run

Carilion Clinic is a new sponsor of Girls on the Run, a program for girls in the third-to-eighth grades that creatively integrates training for a 5K run with lessons that encourage development of essential life skills. The program is just one of many running, walking, and bicycling groups and events that Carilion sponsors. Others include the Blue Ridge Marathon, the Susan G. Komen Race for the Cure, the Artie Levin Memorial Century Ride staged by the Blue Ridge Bicycle Club, Bike Month in Roanoke, and Physicians on Foot.

Nancy Howell Agee, president and CEO of Carilion Clinic, was named to the 50 Most Influential Virginians list

by Virginia Business magazine. Agee is a member of the board of The Joint Commission, which accredits more than 20,000 U.S. health care organizations and programs. She also serves on the boards of the Virginia Hospital & Healthcare Association, Roanoke Gas Co., HomeTown Bank, Solstas Lab Partners, Mill Mountain Theatre, Center in the Square, and the Virginia Tech Carilion School of Medicine and Research Institute.

Physical Therapy Services Expand Carilion Clinic opened a new facility in the New River Valley specializing in physical therapy for sports injuries, joint replacement, balance problems, stroke, and heart attack. A warm aquatic therapy pool is also available. The facility is at 120 Ponderosa Drive in Christiansburg.

Surgeon Noted in The New York Times

Orthopaedic surgeon Joseph T. Moskal, M.D., was noted in a New York Times article about the “anterior approach” to hip replacement. Dr. Moskal is chief of Carilion Clinic Orthopaedics, the leading practice in Virginia for anterior-approach hip surgeries. (He and his colleagues have performed more than 1,700 procedures since 2009.) The approach is less invasive and often results in shorter hospital stays and faster recovery than traditional hip replacement.

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New SERVICES

By Jay Conley

Lung Disease Clinic Opens Most of us are aware that workers in industries like coal mining and construction can be susceptible to work-related lung disorders. But some residents in our community also suffer from rare forms of lung diseases that aren’t job related and don’t fit into a particular category like asthma or bronchitis.

Now doctors are becoming better trained at identifying and treating both types of respiratory ailments and improving the quality of life for patients.

That’s the goal of Carilion Clinic’s new Occupational and Rare Lung Disease program, the first of its kind in the region. It will open in July near Carilion Roanoke Memorial Hospital.

“There’s definitely a need for it,” says Anthony Loschner, M.D., whose post-graduate medical training included a three-year fellowship working with global experts in occupational lung disease at West Virginia University.

“It takes a specialized physician who is skilled in managing a particular lung disease.”

He and Dr. Jose Goyos are pulmonologists who will initially treat patients two days per week as part of their regular duties at Carilion’s Pulmonary and Sleep Medicine practice in Roanoke. Hours will be added as patient demand increases.

Lung cancer affects more than 370,000 Americans a year, causing more deaths than colon, breast, and prostate cancers combined, according to the American Lung Association.

Occupational lung disease is caused by workers inhaling foreign matter such as coal dust, masonry dust, or asbestos. The inhalants can scar the lungs and cause a range of respiratory problems. Rare lung diseases have a range of causes and can be related to a person’s work or home environment.

Edmundo Rubio, M.D., chief of Carilion’s Pulmonary and Critical Care Medicine, says many job-related lung disorders often aren’t recognized because a patient’s symptoms are similar to other lung disorders.

“Some people present simply with asthma, but their asthma may only occur in certain places,” he says. “Their lungs react to something in the work environment, like a farmer who is exposed to hay.”

Recognizing a patient’s type of lung disease is important for proper treatment. While many forms are chronic and incurable, a patient’s quality of life can be improved with a range of drugs to suppress symptoms and decrease shortness of breath.

“Most pulmonologists have limited experience with both rare and occupational lung disease,” says Dr. Loschner. “We feel comfortable managing these patients.”

Evaluation for such patients will be expedited, according to Dr. Loschner.

For more information, call 540-985-8505.

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Orthopaedic Services Expand to Westlake Carilion Clinic has extended its orthopaedic services to the Westlake Center at Smith Mountain Lake.

Tuesdays and orthopaedic surgeon Douglas Kells, M.D., on Thursdays.

Office hours will expand as demand Smith Mountain Lake’s lure of outincreases. door living and abundant recreation “There’s a need for both general orthoThe new services are part of a conhas made it one of the fastest growpaedic and podiatry care at the lake,” says tinuing effort to better serve residents ing areas in the region. But that William Jacobsen, vice president and at the lake and complement Carilion’s active lifestyle can cause sprains administrator of Carilion Franklin Meand strains for residents. A growexisting urgent care, cardiology, imagmorial Hospital. “Carilion has provided ing retiree population also creates ing, internal medicine, sleep lab, and both primary and urgent care services for the need for orthopaedic services, patient transport services there. years there, and we see many cases that which focus on the body’s bones, Carilion also recently expanded its require orthopaedic follow-up.” joints, muscles, and tendons.

Westlake internal medicine practice Lake-area residents with injuries who and is doing a community health needs need surgery or have osteoarthritis issues assessment for Franklin and Bedford that warrant joint replacement can be screened at Westlake counties. And a new hangar and crew quarters were just built and referred to a Carilion surgeon. for Carilion’s Life-Guard 10 helicopter and its crew.

“Orthopaedics is another specialty we can offer to lake resi“Carilion has been part of the Franklin County community dents to be more convenient for them,” says Don Love, senior for over 60 years,” says Shirley Holland, Carilion’s vice presidirector of musculoskeletal services. “It touches every age dent of strategic development. “It’s important that what we group, whether you bang your arm, have back pain, or any offer is in sync with the needs of the community.” musculoskeletal problem.”

For more information, call 540-725-1226 or 540-266-6000.

Patients may see podiatrist John L. Clements, D.P.M., on

Care Close to Home

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Medical news

When a Baby Needs Brain Surgery

By Erica Stacy

Medical Expertise and Timing Count Olivia Grace Call is a happy, energetic six-year-old who loves animals, especially horses. She is also a Girl Scout, takes swimming lessons, and plays sports.

In many ways, she’s just like hundreds of other first-graders in Roanoke.

Except one.

When she was 5 1/2 months old, Olivia began bleeding in her brain and suffered a stroke.

She underwent emergency surgery and was found to have a large arteriovenous malformation (AVM) in her brain—a tangle of blood vessels that don’t perform properly. They are a sort of “short circuit” in the system.

AVMs are very rare, occurring in less

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than 1 percent of the population, and may appear in different areas in the body. They are usually present from birth, but until symptoms develop, they go unnoticed.

Warning Signs In the hours before her stroke, Olivia had been fussy, according to her mother, Kristy Call of Roanoke. She’d also vomited while being fed. Then she seemed tired and fell asleep several hours earlier than usual, and her sleep was fitful. Her father, Brian, slept with her in a recliner for several hours during the night.

Early in the morning, Olivia seemed to be resting peacefully, but Brian noticed that her arms and legs were stiff. He

New Options in Neurosurgery

Left: Six-year-old Olivia Call, who needed brain surgery for a life-threatening condition as a baby, is shown with her mother, Kristy.

Top: Olivia examines a plasma sphere on exhibit by the Science Museum of Western Virginia at Tanglewood Mall in Roanoke.

tried to wake her, but she was unresponsive.

“I tried to rouse her, too, but she wouldn’t wake up,” says Kristy. “Her left pupil was dilated. We knew that something was terribly wrong, so we dialed 9-1-1.”

When the Call family arrived in the Emergency Room, they were shocked to learn that their infant daughter was bleeding on the left side of her brain.

Later, they learned she had suffered a stroke.

When a child has bleeding in the brain not related to an injury, neurosurgeons have a high suspicion for some type of vascular malformation. “In Olivia’s case, we were able to remove the AVM and repair the blood vessels,” Dr. Apfel says.

As a result of the bleeding, though, Olivia did suffer some brain damage.

At Carilion Clinic, neurosurgeons often treat children who have experienced traumas related to accidents or sports injuries or who have abnormal bone fusions. They also remove brain and spine tumors and repair damage associated with birth defects such as spina bifida.

One of the most exciting options available in the region for both children and adults is endoscopic neurosurgery, a minimally invasive alternative to open brain surgery in some cases. Endoscopic surgeries have fewer side effects and complications, faster recovery times, minimal scarring, and less trauma to nerves and brain tissue at the surgical site.

Endoscopic surgery uses a flexible tube with a camera, through which other instruments may be passed in order to complete a surgical procedure. The endoscope may be inserted through a small incision or a natural body opening, such as a nostril.

Using an endoscope, neurosurgeons can reach tumors and lesions at the base of the skull and deep in the brain without affecting the surrounding tissue.

Endoscopic procedures may be used to remove tumors (such as pituitary tumors), drain cysts, and treat hydrocephalus, or water on the brain.

Making Strides Over the next five years, Olivia underwent three more surgeries at Carilion Clinic Children’s Hospital to fully repair her skull. And with speech, physical, and occupational therapy, she has made tremendous strides.

“Carilion linked us up with Easter Seals and their early intervention program and also Brain Injury Services of Southwest Virginia—both of which proved to —Lisa Apfel, M.D. Neurosurgeon, Carilion Clinic be invaluable resources,” says Kristy.

Olivia is also benefiting from an aquatics program at Aquatic Adventures Minutes Matter condition like hers can be overcome. and therapeutic horse riding through “I was on call when Olivia was brought “Her right side is still weaker than her Healing Strides of VA. In addition, she to the ER,” says Lisa Apfel, M.D., the left,” says Kristy. “But as more time is active in Awana, a church group in Carilion Clinic pediatric neurosurgeon passes, she gets stronger, and her limitawhich she sings, does arts and crafts, who performed her surgery. “Her contions seem to be less noticeable.” and goes to the gym. dition was very serious. Just minutes “Dr. Apfel and the team at Carilion longer, and it is possible that she would Clinic saved our daughter,” Kristy says.

Advances in the Field not have survived.”

“How can you measure the value of a mir“Every day, pediatric neurosurgery is During the surgery at Carilion Roaacle? We find the answer every day in noke Community Hospital to relieve the evolving and changing,” says Dr. Apfel.

Olivia’s smile. It’s priceless.”

“We are seeing advances now that make a pressure on Olivia’s brain and remove real difference for children and families. Dr. Lisa Apfel joined Carilion Clinic in excess blood, Dr. Apfel identified the “Treating neurosurgical emergencies September 2006, just one month before cause of Olivia’s bleeding as an AVM. successfully is also about timing.

Olivia’s Olivia’s stroke. One of six Carilion neuro“Unfortunately, there are often no surgeons, Dr. Apfel specializes in pediatrics clear prior warning signs for AVMs,” she situation was dire, but our entire medical team, working together, made the and trauma. For more information on says. “When the symptoms develop, difference.” pediatric neurosurgery in the region, call they may be serious, and the condition Olivia is proof that a life-threatening 540-266-6000 or 800-422-8482. becomes an emergency.”

“We are seeing advances now that make a real difference for children and families.”

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MEDICAL NEWS

Fighting Cancer A Team Improves Care

By Allison Buth

No one was more surprised than Sue Thompson when she was diagnosed with breast cancer after a routine mammogram.

Thompson, who had no family history of breast cancer, was called back to Carilion Clinic’s Breast Care Center for a sonogram and a biopsy after the mammogram.

“The results confirmed that it was in fact breast cancer,” says Thompson, 63, of Vinton. “I was in shock. I did not expect a cancer diagnosis. Thankfully a group came together immediately to figure out a treatment plan for me.”

Right after her diagnosis, Thompson’s case was evaluated by a team of specialists who discussed treatment options.

Carilion Clinic’s Cancer Center, in collaboration with Blue Ridge Cancer Care, provides the team, which meets weekly to evaluate all cancer cases. It includes medical and radiation oncologists, surgeons, pathologists, nurse practitioners, radiologists and

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What Is Cancer?

After her treatment for breast cancer, Sue Thompson enjoys frequent trips to Vinyard Park in Vinton with her grandchildren.

imagers, and technologists who use a multidisciplinary approach to treat cancer.

“Our team really empathizes with our patients,” says James Mullet, M.D., a Carilion radiologist. “The period of time between screening to biopsy and waiting for results is a tremendously anxious time. We try to have a plan for therapy as soon as reasonably possible.”

And for breast cancer patients, clinical nurse specialist Catherine Hagan is there to provide support during the entire treatment process.

“My role is to work with the physicians,” Hagan says. “I’m their right arm when a patient has a problem. I give patients information regarding their diagnosis and about our support group.

I’m accessible to patients 24 hours a day, seven days a week.”

“Everyone who works here has chosen this challenging area of medicine,” Hagan says. “It’s our passion, and we all want to give cancer patients the very best care.”

“Cancer” is not a single disease but a broad name for a group of more than 100 diseases. Every type of cancer behaves differently—each grows at different rates and responds differently to treatments.

That is why it is so important that cancer patients get specialized treatment for their individual case.

Individual Treatment Today, nine months after her diagThompson’s treatment plan meant nosis, Thompson enjoys attending her surgery. One month after her diagnosis, she entered surgery with breast surgeon breast cancer support group. At first she went to ask questions; now she goes to Roxanne Davenport, M.D. help others and share her experience.

“We try to tailor the treatment based “I am so grateful to Carilion and their on the individual’s cancer,” says Dr. approach to treating cancer,” she says.

Davenport. “When we evaluated Sue’s “The doctors all work together so beautibreast MRI, the potential extent of her fully.

Everyone went above and beyond. malignancy was great enough that we felt a lumpectomy would be too disfigur- Dr. Mullet stayed late on a Friday night ing. We recommended she have a unilat- to read my results, and the surgeons came in on the weekend to accommoeral mastectomy.” date my schedule. Catherine was always Having faith in their advice, Thompavailable to me. You couldn’t ask for son had the mastectomy. “I appreciated more.” all of the doctors getting together to discuss best options, and I chose to go with Breast cancer screening is available at their recommendation and have my left Carilion Clinic Breast Care Centers at 1211 breast removed,” she says.

S. Jefferson St. (540-985-9885); 3707 During surgery, Dr. Davenport reBrambleton Ave. (540-772-7401); and moved a lymph node and had it tested 6415 Peters Creek Road (540-265-5545), for any evidence of cancer. Thompson all in Roanoke. Outside Roanoke, screening was happy to learn there was none— is offered at Carilion hospitals. To locate allowing her to take a pill form of cancer the hospital closest to you, call 540-266therapy that doesn’t require radiation or 6000 or 800-422-8482. chemotherapy.

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specialty care

Medical Homes

Why Patients Seek Them Out

By Karen Doss Bowman

Bill St. Pierre believes a team approach to his medical care saved his job—and maybe his life.

A long-haul truck driver since 1963, St. Pierre, who has diabetes, feared losing his livelihood when his blood sugar levels got so high that his doctor put him on insulin.

“Insulin is a no-no in the truck driving world,” explains St. Pierre, of Floyd, who also has coronary artery disease and hypertension.

“If I couldn’t control my blood sugar, I could lose my CDL [commercial driver’s license].

That thought really depressed me.”

St. Pierre was being treated at Carilion Clinic’s Family Medicine practice in Floyd. It is one of Carilion’s patient-centered “medical homes” with an innovative, team-based approach to primary care.

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Aware of his distress, Gail Tankersley, L.P.N., the practice’s care coordinator, asked certified diabetes educator Lynne Metzler, R.D., C.D.E., to help him. Metzler talked to St. Pierre about proper nutrition, encouraged him to exercise, and advocated for him to be taken off insulin.

Though St. Pierre admits that he’s not “100 percent” where he needs to be, he made improvements in his lifestyle, and his blood sugar levels went down.

“My CDL was not revoked, and I went back to work,” he says. “Everything turned out good. Now I’m more conscious about my blood sugar and try to be aware of what I eat.”

Patient-Centered Care Carilion was the first health care system in Virginia with a Level 3-recognized medical home (the highest rating), where physician-led teams include other providers, lab technicians, pharmacists, front staff, and office managers. A designated care coordinator at each medical home closely monitors and stays in touch with patients—especially those with chronic conditions such as diabetes, hypertension, or chronic lung disease— to remind them about important health screenings and to answer questions.

“With this team-based model, we can better identify patients at risk and reach out to them, instead of acting on the back end when somebody gets sick or

Benefits of a Medical Home » Health coaching designed to meet your individual needs » Reminders about important health screenings to keep you as healthy as possible » Follow-up after a hospital discharge or emergency room visit » Improved access to and communication with your health care team » Being an informed partner in your medical care and in the improvement of your health

there’s an emergency,” says Anne Jessie, M.S.N., R.N., senior director of Carilion’s Ambulatory Nursing Practice, who oversees the care coordinators. “It’s a more proactive approach to health care.”

The care coordinators also follow up with patients who were recently hospitalized or visited the emergency room.

They may help schedule appointments with specialists or connect patients to other health professionals, such as nutritionists or physical therapists.

The medical home approach improves patients’ access to the entire health care team while also encouraging them to take an active role in their own care.

“By having one designated resource person, whom the patients know and can go to for answers, we can build

a rapport with patients,” says Gina Hoover, R.N., a Carilion care coordinator in Roanoke.

All Carilion primary care practices will adopt the medical home approach by the year’s end.

Improving Lives The medical home model offers “a systematic approach” to care that leads to better outcomes by addressing health concerns before they get out of control, says Anthony Stavola, M.D., vice chair of Carilion’s Department of Family and Community Medicine.

“We think it’s a worthwhile investment,” Dr. Stavola says. “By managing their chronic conditions and focusing on preventative care, our patients should have less need for the very expensive, invasive procedures and hospitalizations.”

St. Pierre, for one, appreciates the care he’s received and believes his providers’ compassion helped improve his quality of life.

“I feel like they gave me back my life,” says St. Pierre, who at 72 is still driving his truck and monitoring his diabetes closely. “It’s good that Carilion offers that kind of support and has people who care enough to sit down with you and explain everything. I couldn’t have a better staff of people working with me.”

For more information about medical homes, call 540-266-6000 or 800-422-8482.

CarilionClinic.org | SUMMER 2013 15

Cover story

Finding Balance in

Your Life

By Randolph Walker

Is your life well-balanced?

If it is, you may be in the minority.

Eighty percent of Americans say they want better work-life balance, according to a survey published last year by Randstad, a global human resources and consulting firm.

The national best-seller The Overworked American also describes how many of us feel squeezed for time. And evidence is mounting that being connected 24/7 makes it more difficult for people to disengage from work.

Increasingly, Americans are describing their lives as overscheduled, overcommitted, and stressful. Not surprisingly, they are searching for balance.

16 SUMMER 2013 | CarilionClinic.org

To create balance in their lives, Susie Shullman (left front) practices yoga at The Yoga Center in Roanoke, and the Robinson family of Troutville (above) plays foosball together. Right: Bailey Robinson, 12, takes a time out to go online.

A Daily Juggle A common challenge for couples with young children is balancing work and family. Alexis and Travis Ratliff are no exception. She works for a large, regional bank, and he is the co-owner of a painting business. “We’re often tired when we get home from work, but that is also the start of our second job—parenting our 5-year-old son, Anderson,” says Alexis.

They cook dinner, give Anderson a bath, go over homework, prepare lunch for the next day, and then relax. “Our schedule will be put to the test this August with the arrival of our second son,” Alexis says. “We’ll need to work in pick-ups at daycare, baby feedings, and of course, diaper changes.”

But the family has taken positive steps to create balance. On Saturday, the three of them choose healthy recipes to cook the next week. Then they shop and often cook together. “During the week, my husband is typically home earlier than me and he will start the cooking,

with Anderson helping, maybe with the salad,” Alexis says.

They also enjoy tending their own backyard vegetable garden, and after dinner in the spring and summer, they

Chronic stress

27%

raises your risk of a heart attack by

according to a new study at Columbia University Medical Center.

take walks together to stay in shape and catch up on the day’s events.

In addition, Alexis devotes time to volunteer activities at the Junior League, Ronald McDonald House, and Junior Achievement. “This means more juggling, but it’s also a way to teach our son to start helping others who may be less fortunate,” she says. “He’s even helped me bake cookies for the Ronald

McDonald House.”

Another challenge is being a parent to triplets, or a special-needs child. But Julia and Dwayne Robinson of Troutville have grown adept at both. Julia, a speech therapist, and Dwayne, a sales manager, are parents to fraternal triplets Sydney, Tristan, and Bailey, age 12.

Bailey has autism.

“Bailey requires a little extra time, a little extra care,” says Julia. “He is different, and he has to be treated differently. But even though he needs special attention, my husband is really good at making sure each child gets their own individual time.”

Like any other family, they also juggle practice for sports and school activities, dealing with schedule conflicts daily.

“I’m telling you, my life is crazy,” says Julia, sitting for a quiet moment in her living room. “But it’s just part of our daily life, and we make it work.”

“People say we’re really calm,” says Dwayne. “But it’s become ingrained that CarilionClinic.org | SUMMER 2013 17

Suzanne Parsells takes a moment to enjoy nature and relax in her Roanoke County backyard.

there’s going to be stuff that’s not going to go smoothly.”

How do they make it work? “We’re really good teammates,” Julia says. “We’ve got each other’s back.” The kids are in bed by 9:30 so they have time to talk.

They take one couple vacation per year.

They go on dates.

They’re also quick to give credit to friends and family (including an adult daughter, Cassie, and their moms), and their church for its “parents night out.”

Even so, says Dwayne, there are times —like when he and Julia were in Hawaii and classes at Botetourt schools were unexpectedly canceled—that “it’s a shell game to make it work.”

Health Effects The Robinsons may have more stress than some families, but the need to find balance in life is almost universal.

Family practice doctors are well acquainted with the health effects of stress. Many office visits result from a combination of stress and the ways people cope with it, such as unhealthy eating habits, says Michael Jeremiah, M.D., chair of the Department of Family and 18 SUMMER 2013 | CarilionClinic.org

Community Medicine at Carilion Clinic.

“It’s stress about all the things they’re dealing with, including their health,” Dr. Jeremiah says. “It’s amazing how prevalent it is. And it often leads to high

How to create more balance in your life?

Experts recommend: • Spend time with friends and family • Make time for yourself • Don’t spread yourself too thin • Get enough rest • Make exercise a priority

blood pressure, diabetes, weight-related problems, sleep apnea. Stress has an incredible impact on how people feel, and their health.”

A recent study highlights how damaging stress can be. People who report high stress levels have a 27 percent higher risk of suffering a heart attack, accord-

ing to a study at Columbia University Medical Center. Researchers reviewed data from six heart studies involving nearly 120,000 people; their findings were published in the American Journal of Cardiology.

Aim for Resilience Are you feeling stressed out just reading this? Relax, there’s good news ahead!

Strategies are available to help families and individuals cope with the demands of jobs, relationships, illnesses, and the inevitable changes in life.

“When you’re looking at achieving balance, you’re actually trying to create resilience in your life,” says Ken Redick, manager of Carilion’s Employee Assistance Program and a professional certified coach. “The definition of resilience is a person’s ability to absorb high levels of stress or disruptive change and bounce back as quickly as possible.

“One key trait of a highly resilient person is their ability to realistically assess their own problems and then to create an action plan that transforms them,” he says. Another is persistence—“looking at an issue that’s difficult to solve

The Ratliff family prepares dinner together as a way of increasing their “family time.”

and not giving up on it after a couple of tries.”

When setbacks do occur—such as the loss of a job—it helps to remember that others face challenges too. “A key feature of balancing one’s life and being resilient is contributing to the well-being of others,” says Robert Brooks, a psychologist at Harvard Medical School and co-author of The Power of Resilience: Achieving Balance, Confidence, and Personal Strength in Your Life.

“Thus, even when one is under economic stress, it is quite therapeutic for an individual or a family to do volunteer work or raise money for one’s favorite charity,” he says. “This provides a sense of meaning and purpose to one’s life, which offsets a sense of failure.”

Service to others occupies a prominent place in many faiths. As do religious retreats or practices such as meditation.

Holy Cross Abbey, in Clarke County, Va., for instance, offers silent retreats for prayer and meditation. “The majority of people want time to come away from the business of their everyday lives,” says Carol Hensley, retreat house business manager. “They may have come

through a divorce, loss of a job, death in the family. We have guests who come regularly, twice a year. Some come once a month to fill up their gas tank and go back out into the world.”

Resources www.CarilionClinic.org/healthrisks my.clevelandclinic.org/wellness/ www.nationalwellness.org/ www.drrobertbrooks.com www.carilionfitness.com Mayo Clinic: www.bit.ly/stress-management1 National Institutes of Health: www.bit.ly/medline-stress Carilion Employee Assistance Program: www.CarilionClinic.org/eap

When getting away isn’t possible, there are other ways to recharge one’s batteries.

Suzanne Parsells of Roanoke County works full-time assisting people with

severe mental illness, and helps care for her mother, who has dementia. Yoga classes at Roanoke County’s Department of Parks, Recreation & Tourism help her stay balanced. “When I go there, I can walk in that door and leave everything behind—no one wanting a piece of me.”

Another county resident who uses yoga as a respite from care giving is Susie Shullman, whose husband has Parkinson’s disease. She also enjoys more vigorous exercise at the gym. “I do it not so much for the physical [benefits], but for the mental. It works on my head,” she says.

Another way she stays upbeat is by looking at the positive. “I have focused on realizing how fortunate we are to have a home-health aide, and that my daughter and grandkids are next door,” she says. Despite her husband’s long-term illness, Shullman, taking a page from self-help books, stays in balance by living “one day at a time.”

Yoga classes are also available five days a week at the Roanoke and Botetourt Athletic Clubs. For more information, go to www.carilionfitness.com or call 540-989-5758 (RAC) and 540-992-2993 (BAC).

CarilionClinic.org | SUMMER 2013 19

REGIONAL INTEREST

Keen on Kayaking Cheryl Ruggiero was over 60 when she first stepped into a kayak.

“I wasn’t sure it would work out, but I tried it,” says the retired Virginia Tech English instructor. “I thought kayaks were for younger, skinnier people. But I was delighted with the quiet, stable way it handled. I could sneak up on turtles and view nature from a different angle. I picked up how to paddle it right away.”

Since that experience on a pond five years ago, Ruggiero has kayaked in the ocean and on the New River. At 67, she’s in the process of buying her own sit-in kayak.

“It’s good exercise,” she says.

People of all ages are taking up the double-bladed paddles and kayaking on western Virginia’s lakes and rivers. Favorite kayaking waters include Smith Mountain Lake, the Shenandoah River in Rockingham County, and the New River on its northward course through Claytor Lake up to Giles County on the West Virginia border.

Other popular kayaking spots are the upper section of the James River and tributaries of the Maury, Cowpasture, and Jackson rivers in central and western Virginia. Sections of the Roanoke River, the Dan River past Danville, and the Clinch River in Tazewell County can also be kayaked.

Whether you throw in a fishing pole or birding glasses, the kayak is your vehicle to explore places that are inaccessible without this light craft.

By Su Clauson-Wicker

Plastic kayaks under $300 are fine for beginners; most recreational kayaks run between $200 and $900. (With rentals at $30-$60 a day, folks who love the sport soon end up buying.) Done right, kayaking exercises the whole body, strengthening arms, shoulders, backs, and stomach muscles.

Tangent Outfitters, near the New River, sells and rents kayaks to people who like river paddling. The outfitter deals in both sit-in and sit-on-top kayaks, as well as inflatable crafts and stand-up, paddle-board/kayak hybrids.

With a sit-in kayak, you sit lower to the water, often using a spray skirt attached to the cockpit rims to seal you into the boat and keep you dry. But they are harder to enter and exit in the water. You should learn the Eskimo roll in case you need to right the boat in water.

Sit-on-top kayaks are easy to get in and out of, but they are shorter and wider, making them a little slower. And you’re guaranteed to get splashed.

A Learner’s Haven The calm waters of Smith Mountain Lake are a safe place to learn kayaking, says David Oliver, owner of Parrot Cove Boat Rentals in Moneta. Although Parrot Cove is known primarily for its large fleet of houseboats, families often rent its tandem kayaks for additional recreation when they take out a houseboat.

“They like exploring the coves and getting some exercise,” Oliver says. He and Johnny Garrett, owner of Claytor Lake Water Sports, agree that it takes about 15 minutes to teach Who Kayaks? someone the basic skills for lake kayaking.

“My customers run the spectrum, from 10 years old to Kayaks began as skin-and-wood crafts built by the Eski80—men, women, and children,” says Shawn Hash, owner mos 4,000 years ago and are now available in wood, fiberof Tangent Outfitters in Pembroke. “My own kids started glass, and plastic, and as inflatable, vinyl vessels so light a when they were old enough to paddle. On family raft trips, single person can pull them out of the back of a car, inflate they’ll kayak alongside until they get tired.” them, and push them into the water.

Kayaks are growing in popularity because they handle well, With a life jacket, sun block, and a paddling buddy, the can be learned quickly, and are easier to finance, store, and kayaker is ready to explore. transport than full-sized boats or even canoes. With a low center of gravity, they aren’t especially likely to capsize.

20 SUMMER 2013 | CarilionClinic.org

A Few Good Terms for “Yakers” Bow – The front of a boat/kayak Stern – Rear of a boat/kayak Tandem – A kayak designed for two paddlers, with two cockpits Tracking – The linear straightness of a kayak course through water.

Generally, a longer hull will travel straighter, but turns with more difficulty.

Resources www.paddling.net/places/VA www.livestrong.com/kayak www.newriversedge.com www.tangentoutfitters.com www.canoevirginia.net www.parrotcove.com www.claytorlakewatersports.com www.canoe4u.com www.roanokeoutside.com/clubs/ rivers

Kayakers enjoy rides on the New River (top and right) and on Smith Mountain Lake (below).

CarilionClinic.org | SUMMER 2013 21

To Stay Healthy

Take Advantage of Personal

Technology

By Laura Markowski

Are you making the most of the personal technology available to help you manage your health?

A world of information is at your fingertips— just an app or a keyboard away.

Here’s a sample of resources available locally: MyChart. Since 2008, Carilion Clinic has offered MyChart, western Virginia’s first online health care management tool. It connects patients to their electronic medical record and lets them get test results, renew prescriptions, ask their physician a question, and more.

“We saw a need to offer our patients a more secure portal than e-mail,” says Chief Medical Information Officer Stephen Morgan, M.D. “In fact, our patients were expecting it.” MyChart now has more than 26,000 users.

MyChart also helps patients to better manage their health conditions. “If you’re a diabetic, MyChart allows you to input daily blood sugar readings and insulin levels and notify your doctor immediately,” Dr. Morgan says.

“The physician can then manage a patient’s condition virtually, which saves patients unnecessary visits to the doctor’s office.”

MyChart Mobile App. In 2012, Carilion expanded MyChart with a mobile app for smartphones. “Prior to this access, patients were tied to their computers,” Dr. Morgan says. “But research shows people are now mainly using smartphones to stay connected.”

Mobile Health Resource App. Because so many people are using smartphones, Carilion also just released the free Mobile Health Resource app. It offers an interactive symptom checker and first-aid section. And users can find the health care provider, hospital, or urgent care center closest to them.

“Patients are more mobile and have busy lives, and being able to access their health information or find a provider near them, on their

22 SUMMER 2013 | CarilionClinic.org

schedule, is not only critical but is good customer service,” says Marcus L. Speaker, M.D., of Carilion Clinic Family Medicine.

Health & Wellness Portal. Carilion’s website also has a new Health & Wellness section. It offers a wide range of health information, including a monthly calendar of wellness events and screenings, a digital health library, health risk assessments, and healthy recipes.

“Technology is essential for the future of health care,” says Dr. Morgan. “Not just with medical advancements, but with the way physicians help their patients live healthier lives.”

To download the new apps, go to www.bit.ly/mychartApple; www.bit.ly/mychartAndroid; and www.bit.ly/ccmobilehealth.

Carilion Offers Plastic and Reconstructive Surgery Carilion Clinic has opened a new practice to provide the full spectrum of plastic and reconstructive surgery.

Three plastic surgeons who recently joined Carilion have expertise in performing a range of such surgeries.

Reconstructive surgery offered includes procedures to treat face and body deformities, and reconstruction after a traumatic injury or cancer. This includes surgery to correct facial fractures, scars, and soft tissue defects, and breast reconstruction and microsurgical reconstruction of the head and body after cancer.

With cosmetic surgery more popular than ever, an array of procedures is available. These include face lifts, breast augmentation, liposuction and tummy tucks, Botox and filler injections, rhinoplasty (nose reshaping), eyelid surgery, and body contouring (after gastric-bypass surgery or significant weight loss).

A medical aesthetician will soon join the practice to provide skin-care product consultation, microdermabrasion, chemical peels, and laser hair removal.

Doctors in the practice are Kurtis Moyer, M.D., F.A.C.S.; Mark Feldmann, M.D.; and Joshua Farrar, M.D. “Our patients can feel confident that they are being seen by plastic surgeons who have trained in accredited plastic surgery programs,” says Dr. Moyer, chief of the practice. “Our mission is to provide the most effective cutting-edge techniques with

patient safety being of the utmost importance.”

Dr. Moyer most recently served as medical director of the Hershey Cosmetic Surgery Center at the Penn State Hershey Medical Center in Hershey, Pa. He completed his residency in general surgery at Penn State College of Medicine and his fellowship in plastic and reconstructive surgery at Duke University Medical Center. He is double board-certified in general surgery through the American Board of Surgery and plastic surgery through the American Board of Plastic Surgery.

“I was excited about the opportunity to build a plastic surgery program here at Carilion,” he says.

Dr. Feldmann completed his residency in general surgery at the Medical University of South Carolina and his fellowship in plastic and reconstructive surgery at Virginia Commonwealth University Hospital. He is board-certified in general surgery by the American Board of Surgery.

Dr. Farrar completed residencies in otolaryngology (ENT) and head and neck surgery, and his fellowship training in plastic and reconstructive surgery at the Medical University of South Carolina. He is board-certified in otolaryngology by the American Board of Otolaryngology.

The new practice is located at 3 Riverside Circle in Roanoke. To learn about other procedures available or to make an appointment, call 540-224-5170.

CarilionClinic.org | SUMMER 2013 23

New Providers Lung Specialist Joins Carilion Clinic Anthony L. Loschner, M.D., a specialist in pulmonary and critical care medicine, has joined Carilion Clinic.

Dr. Loschner brings to Carilion special expertise in occupational and rare lung diseases. He will be one of the physicians treating patients at Carilion’s new Occupational and Rare Lung Disease Clinic, the first such clinic in the region.

His post-graduate training included a three-year fellowship in pulmonary and critical care medicine at West Virginia University, where he worked with global experts in occupational lung disease.

Dr. Loschner also treats common lung disorders such as chronic obstructive pulmonary disease (COPD), asthma, lung cancer, sarcoidosis (an inflammatory disease) and interstitial lung disease, a group of disorders that can cause scarring of lung tissue.

He received his medical degree from Charles University in Prague and completed his internship and residency in internal medicine at the New Hanover Regional Medical Center in Wilmington, N.C. He is board-certified by the American Board of Internal Medicine and the American Board of Pulmonary Disease and Critical Care Medicine.

Dr. Loschner has published in the Journal of General Internal Medicine and elsewhere and has given lectures on topics including stroke, temperature regulation emergencies, and pulmonary complications of rheumatological diseases, HIV, and pulmonary complications of bone marrow transplants.

He is a member of the American College of Chest Physicians, American Thoracic Society, and American College of Physicians.

In addition to his clinical duties, he serves as an assistant professor at the Virginia Tech Carilion School of Medicine.

Dr. Loschner joined Carilion’s Pulmonary and Sleep Medicine practice last year. He practices at 2001 Crystal Spring Ave. in Roanoke and can be reached at 540-985-8505.

Orthopaedic Surgeon Joins Carilion Clinic Trevor M. Owen, M.D., a surgeon who recently completed a fellowship in orthopaedic trauma at Harvard Medical School, has joined Carilion Clinic. His specialties include limb reconstruction, limb deformity correction, and osteomyelitis (bone infection).

Dr. Owen received his medical degree from Tulane University School of Medicine in New Orleans and completed his internship and residency at Ochsner Healthcare System, also in New Orleans.

The Journal of Orthopaedic Trauma named him “Best Orthopaedic Teaching Resident of the Year” in 2009 for his work during his third post-graduate year. He was also named to the Gold Humanism Honor Society, which recognizes medical students, residents, and physician teachers for excellence in clinical care, leadership, compassion, and dedication to service.

Dr. Owen has conducted research on numerous topics, including joint replacement; agreement between emergency physicians and paramedics on spinal issues; and assessment of risks for deep vein thrombosis (blood clots deep in the body).

He has also published in the journal Experimental Gerontology and given presentations to medical audiences.

He joins Carilion Clinic Orthopaedics, which is certified by The Joint Commission for joint replacement. Becker’s Hospital Review has also recognized Carilion Roanoke Memorial Hospital for having one of the top orthopaedic programs in the country.

Dr. Owen practices at 3 Riverside Circle in Roanoke and can be reached at 540-725-1226.

24 SUMMER 2013 | CarilionClinic.org

advanced care providers

Physicians Walter S. Davis, M.D. Physical Medicine and Rehabilitation

Jason P. Meador, P.A.-C. Physician Assistant, VelocityCare

Education: Duke University Medical Degree: Wake Forest University School of Medicine Residency: Rehabilitation Medicine, University of Texas Health Science Center at San Antonio 3 Riverside Circle, Roanoke, VA 24016 540-224-5170

Undergraduate Degree: Roanoke College Graduate Degree: Mountain State University 434 Peppers Ferry Road, Christiansburg, VA 24073 540-382-6000

Joseph Hughes, M.D. Interventional Radiology

Donna Robertson, N.P. Nurse Practitioner, Family and Internal Medicine

Education: James Madison University Medical Degree: Virginia Commonwealth University School of Medicine Residency: Diagnostic Radiology, Penn State Milton S. Hershey Medical Center Fellowship: Cardiovascular and Interventional Radiology, Penn State Milton S. Hershey Medical Center 1906 Belleview Ave., Roanoke, VA 24014 540-981-7122

Tony McClure, D.D.S. Pediatric Dentistry Education: Boston University Medical Degree: University of Missouri-Kansas City School of Dentistry Residency: Pediatric Dentistry, University of Louisville School of Dentistry 101 Elm Ave., Roanoke, VA 24013 540-224-4380

Undergraduate Degree: Virginia Commonwealth University Graduate Degree: Duke University School of Nursing 1107A Brookdale St., Martinsville, VA 24112 276-670-3300

Tracy Scott, P.A.-C. Physician Assistant, General and Breast Surgery Undergraduate Degree: Radford University Graduate Degree: Jefferson College of Health Sciences 3 Riverside Circle, Roanoke, VA 24016 540-224-5170

James E. Thompson, M.D. Family Medicine Education: University of Virginia Medical Degree: University of Virginia School of Medicine Residency: Family Medicine, Carilion Clinic 2145 Mount Pleasant Blvd., Roanoke, VA 24014 540-427-9200

Edgar N. Weaver Jr., M.D. Neurosurgery Education: Hampden-Sydney College Medical Degree: University of Virginia School of Medicine Residency: Neurosurgery, Tulane University 3 Riverside Circle, Roanoke, VA 24016 540-224-5170

CarilionClinic.org | SUMMER 2013 25

Resources to Keep You Healthy Nurse Line Our physician referral and health information service is here to help.

Call us at 540-266-6000 or 800-422-8482, or email us at direct@carilionclinic.org.

“Well Said” Speaker’s Bureau If you’d like a speaker on a health topic for your community group or workplace, call 540-266-6561 or visit CarilionClinic.org/speakers.

Community Health Screenings Health screenings are available at little or no cost. Call 540-266-6000 or 800-422-8482, or email us at direct@carilionclinic.org.

Website Tailored for You Check out these features at CarilionClinic.org: • Easy-to-use physician/provider finder • Interactive maps to help you find your way to our locations • Health and wellness content, including an A-Z library • A community health education and events calendar

News Blog Keep up with the latest news, photos, videos, and more at Carilion Clinic’s news blog. Visit newsblog.CarilionClinic.org.

Social Media Stay connected to Carilion Clinic through social media: facebook.com/carilionclinic twitter.com/carilionclinic youtube.com/carilionclinic google.com/+carilionclinic pinterest.com/carilionclinic

Giving to carilion clinic foundation Be part of improving the health and vitality of communities in western Virginia. Make a gift at CarilionFoundation.org

Mobile Resources Stay connected with our mobile apps, available for iPhone and Android: Carilion Clinic Mobile Health Resource – Use our interactive symptom checker to access the most relevant information in our digital health library, then connect with Carilion services by using the search feature to find Carilion healthcare providers, hospitals, and urgent care locations near you.

MyChart – Access your medical record, request an appointment or prescription refill, and stay in touch with your doctor, all while on the go.

Publications Pick up a copy of Carilion Clinic Living at magazine racks throughout our facilities, or access the digital edition at CarilionClinic.org/living, where you can also read past issues. For health tips and news about upcoming health screenings events, subscribe to Living’s monthly e-newsletter at CarilionClinic.org/living.

Support Groups Support groups are available for a wide range of health needs, including gynecologic and breast cancer. Learn more at CarilionClinic.org/support.

Children’s Health For the latest news and perspectives on children’s healthcare, read Close to Home, a blog by Alice Ackerman, M.D., chair of the Department of Pediatrics at Carilion Clinic. Visit CarilionClinic.org/blogs/ackerman.

26 SUMMER 2013 | CarilionClinic.org

Living with Celiac Disease: Gluten-Free Expo Draws Crowds

By Alison Weaver

Registered dietitian Tina Renick knows the challenges of following a gluten-free diet. Her daughter, Anna, was diagnosed with celiac disease just after she turned 3.

Anna suffered from “failure to thrive,” a term used for children and babies whose weight and growth lag far behind normal. “She never wanted to eat, she’d wake up crying and just seemed in distress,” Tina recalls. “That stopped one week after we eliminated gluten from her diet.”

Patients with celiac disease have an intolerance to gluten— found most often in wheat, barley, and rye—that causes damage and scarring in the small intestine. “Celiac disease is very common. As many as 1 in 135 people have it,” says Michael Hart, M.D., Carilion Clinic chief of pediatric gastroenterology.

“There’s no cure, but it’s very controllable by eliminating gluten from the diet,” he says.

Tina, a dietitian with Carilion for 13 years, emphasizes that celiac disease is not the same as an allergy or gluten sensitivity.

“This isn’t the sort of diet where you can cheat and sneak a bit here or there. Even a few morsels can damage the small intestine.”

Although gluten is commonly associated with cereals, breads, and pasta, it also lurks in myriad condiments, commercial foods, and beverages. As Tina struggled to find appropriate foods for her daughter, she reached out to others with celiac disease and began sharing information and providing education about the disease.

“It’s easy to feel isolated,” she says. “You feel like you can’t eat out, and you really have to plan ahead if you’re traveling.

The specialty foods can be really expensive, and we threw away a lot of stuff because it tasted so bad.”

In 2007, Tina started a kids’ group that centered around having potlucks where parents and children could sample gluten-free packaged foods and share tips and recipes. The popu-

Tina Renick and her daughter Anna.

larity of those meetings inspired Tina to think even bigger.

“Last year, Tina pretty much single-handedly planned a Gluten-Free Expo at Tanglewood Mall that attracted hundreds of people,” Dr. Hart says. “Gluten-free diets have gained a lot of appeal, and not just for people with celiac disease. It can also reduce symptoms in patients with Crohn’s disease, irritable bowel syndrome, and other auto-immune illnesses.”

This year, Carilion Clinic and Kroger sponsored a second expo on April 13 that drew more than 400 people. Assisted by student interns in Virginia Tech’s dietetics program, Tina enlisted 18 vendors and restaurants that shared their gluten-free foods.

“The response was overwhelming—people sharing stories, sampling foods,” Tina says. “It’s a great outlet for education and for people to see that they’re not alone. It’s a win-win for everybody.”

For more information about celiac disease, go to www.csaceliacs.org; www.celiac.com; or www.celiachealth.org.

CarilionClinic.org | SUMMER 2013 27

BETTER LIVING

Your CaLendar for Better Health

SUMMER 2013 Look Good, Feel Better

July

1

For women undergoing cancer treatment 10 a.m.

Bedford Memorial Hospital To register, please call 540587-3308.

Blood Pressure Screening

Visit on Carili g .or Clinic e For mor info.

Screenings will be held in Roanoke, the New River Valley, and Franklin and Bedford counties throughout the summer.

For more information, go to CarilionClinic.org/calendar or call 540-266-6000.

Women’s Health University

Aug “Putting Your Health First, at Any Age” 11:30 a.m. – 1:30 p.m.

Fitzpatrick Hall at the Jefferson Center, Roanoke $15, includes lunch To register, please call 800422-8482.

1

Physicians on Foot

8:30 a.m.

Every Meet at the corner of Hamilton ay Saturd Terrace and Belleview Avenue (in front of Carilion Roanoke Memorial Hospital). Rain location: Tanglewood Mall.

For more information, please call 800-422-8482 or visit CarilionClinic.org/walking.

4th Friday Dance

Car Seat Safety Check

Every Third ay Thursd

Third Thursday of each month 4 - 6 p.m.

Roanoke City Fire Station #6, 1333 Jamison Ave. S.E.

28 SUMMER 2013 | CarilionClinic.org

Every 4th Friday Every All levels are welcome for a Fourthy one-hour dance lesson. Stay Frida and continue dancing until 10:30 p.m. Latin and swing music. No partner is required!

7:30 - 10:30 p.m.

Roanoke Athletic Club $10/non-members; $8/members For more information, please call 540-772-2238.

For more events, classes, and screenings, visit CarilionClinic.org/calendar or call 540-266-6000.

Valeta Pittman Roanoke, Va.

. e s u f o s r a e y y b n

.

N O I L I R A C Y B T L I U B RE

w o d n r o Hip w

We partner closely with patients to keep them healthy and out of the hospital. But when surgery becomes necessary, you can trust the region’s most experienced orthopaedics team. Our highly trained surgeons are pioneering new techniques and technologies, including the anterior approach to hip replacement, to help patients recover faster. Just ask Valeta Pittman, who can now tee off without pain. Let us help you rebuild from an unexpected injury or ongoing health condition. It’s what we do every day.

Carilion Clinic Orthopaedics has performed

more than 1,700 anterior approach hip replacement surgeries since 2009.

carilionclinic.org/ortho • 800-422-8482

Carilion Clinic P.O. Box 13727 Roanoke, VA 24036-3727

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handling a boo-boo like a big girl

Helping you bounce back and never look back.

Carilion Clinic is committed to helping you be your healthiest and stay that way. It’s why we’re here, and it guides everything we do to keep our community well and our region strong.

From moment one.

CarilionClinic.org • 800-422-8482