Carilion Clinic Living - Summer 2015

Living Inspiring better health.

SUMMER 2015

in this issue HELP FOR NEW MOTHERS 8 PRESCRIPTION DRUG ABUSE 10 GET FIT—GET ENERGY 14 CHECK OUT THE ZOO 22

THE SLEEP CRISIS: Millions of Americans Don’t Get Enough Sleep

Sleep patient Craig Moore of Christiansburg is back to doing things he loves, including walking with his two cats.

Confidence Beauty begins with

At the new Carilion Clinic Cosmetic Center, we’ve put together an exceptional team of surgeons and clinical staff hand-picked with the high-quality standards you’ve come to expect from Carilion. Combining the latest techniques with a wealth of experience and skill, our team delivers beautiful results and a new confidence that you can see and feel.

Call for a consultation.

540-853-0510

Kurtis E. Moyer, M.D.

Mark E. Feldmann, M.D. Mark Schoemann, M.D.

CarilionClinic.org/cosmetic

Gina Hunt, Master Aesthetician

2107 Rosalind Ave., Roanoke, VA

President’s Message

Did you know that more than 50 million Americans are believed to have a sleep disorder? The effect on their lives can be profound. Losing sleep is linked to many chronic illnesses, including heart disease, diabetes, and obesity. It’s also seen as a factor in car crashes, occupational errors, and industrial accidents. In our cover story, we explore this crisis and discuss how to get the valuable sleep you need.

Another public health problem is the abuse of prescription pain relievers, and how it is leading some to use heroin. Across our region, doctors and police are seeing more of these troubling cases.

But what you may not realize is who is abusing prescription drugs.

“They are your neighbors,” says William Rea, M.D., Carilion Clinic’s vice chair of psychiatry. Our story examines this challenging issue.

We also take a look at new initiatives to keep mothers and babies safer. Carilion Roanoke Memorial Hospital has introduced Carilion Clinic President and “kangaroo care,” for instance, which involves placing newborns on their mother’s bare chest immediately after delivery. This has been CEO Nancy Howell Agee meets with employees at Carilion Giles shown to stabilize the baby’s blood sugar and vital signs, improve Community Hospital. sleep, and promote breast-feeding and bonding. Babies also cry less, hearing their mother’s voice and heartbeat.

Speaking of children, have you ever seen kids light up when they encounter animals at the zoo? We invite you to read about new happenings at Roanoke’s Mill Mountain Zoo, home to more than 175 animals, including birds and reptiles. Fun programs like summer camps and Breakfast with the Animals are planned for this summer. We hope you and your family enjoy!

WARM REGARDS,

NANCY HOWELL AGEE PRESIDENT AND CEO CARILION CLINIC

Welcoming to Carilion in June PCA Healthcare and Kevin R. Dye, M.D., of Gastrointestinal Associates.

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 A. Chase is an award-winning novelist who has also written for Virginia publications such as The Richmond Times-Dispatch. She is writing a historical novel about the Declaration of Independence. She lives in Richmond.

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.

Sarah Beth Jones blogs about personal development, was an op-ed columnist for the Greensboro News & Record, and has written for publications including Valley Business FRONT, Mother Earth News online, and Today’s Woman magazine. She lives in Floyd.

CARILION CLINIC LIVING IS PRODUCED BY MARKETING, RESEARCH AND COMMUNICATIONS: VICE PRESIDENT Shirley Holland SENIOR DIRECTOR, COMMUNICATIONS Mike Dame SENIOR DIRECTOR, COMMUNICATIONS Amy Hoots-Hendrix CREATIVE SERVICES MANAGER John Griessmayer EDITOR Maureen Robb LEAD DESIGNER David Porter CONTRIBUTING WRITERS Karen Doss Bowman, Karen A. Chase, Su Clauson-Wicker, Jay Conley, Bruce Ingram, Sarah Beth Jones, Dan Radmacher, Donna Reynolds, Dan Smith, Erica Stacy, Randolph Walker, Alison Weaver PHOTOGRAPHERS Darryle Arnold, Jared Ladia

Dan Smith is an award-winning journalist and photographer, an essayist on public radio, and a member of the Virginia Communications Hall of Fame. He is the author of a novel and several nonfiction books.

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.

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 2015 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 Marketing, Research and Communications, 213 McClanahan St., Roanoke, VA 24014.

2 SUMMER 2015 | CarilionClinic.org

CONTENTS

8 14 features 5 PREGNANCY

Carilion partners with UNC Fertility.

8 INFANT CARE

New programs keep mothers and babies safer.

10 DRUG ABUSE

Prescription drug abuse can lead to heroin addiction.

13 TEXTING

departments 1 PRESIDENT’S MESSAGE Sleep deprivation is linked to many problems.

18

Bad posture is linked to “text neck.”

14 FITNESS

Functional training helps keep you young.

18 SLEEP

Losing sleep can affect your health and quality of life.

4 SUPERFOODS

22 RECREATION

6 HEALTH NEWS

27 SERVICES

What’s new at Mill Mountain Zoo?

What’s all the buzz about quinoa?

Research findings that can improve your life.

22 IN YOUR COMMUNITY Making a difference in western Virginia.

25 NEW PROVIDERS

New physicians and advanced care providers.

New physician services are available in Lexington.

22

28 RECIPE

Enjoy a mango and shrimp summer salad.

CarilionClinic.org | SUMMER 2015 3

SUPERFOODS

Superfoods: Quinoa You may have seen bags of quinoa (pronounced keen-wah) on the grain or organic food aisles of your grocery store. There are over 100 varieties of this versatile, nutrient-rich food, but three are most commonly found on local grocery shelves: white (or golden), red, and black.

While professional palates might be able to discern a greater nuttiness in black quinoa, or a crunchier texture in red, for most of us, which color we choose comes down to aesthetics.

Making the choice in the first place, though, comes down to smarts.

Though often eaten as a grain—for example, as the base of a grain salad with kale, raisins, and a lemon vinaigrette—quinoa is actually the seed of its plant and is botanically related to spinach, beets, and tumbleweed. It’s a little seed that packs a whole lot of nutritional punch.

Quinoa contains all nine of the essential amino acids, making it a complete protein and a great option for vegetarians. It’s also a good source of fiber and a host of minerals, with each cooked cup containing over half of the recommended daily allowance of manganese, a mineral that supports bone and skin health.

Also found in one cooked cup are healthy doses of magnesium, zinc, potassium, and iron—nutrients that are scarce in most of our diets. Note, though, that quinoa does contain phytic acid, which not only can prevent our bodies from absorbing a food’s nutrients but can even leech calcium from us.

Happily, there’s an easy solution that requires little more than advanced planning. Soak the uncooked quinoa in a mixture of 1 teaspoon of lemon juice or good apple cider vinegar to every cup of warm water, covered, overnight or for up to 24 hours. When you’re ready to eat, simply drain, rinse, and cook according to package directions.

So how to fill your meal plan with more of a food that the Incans considered sacred? Try substituting it for rice, adding it to pots of chili, or tossing a cooked cup or two into a green salad.

Quinoa can act as a nutritious addition to veggie or meat burgers or add texture to baked goods.

Quinoa also makes a great breakfast option. Blend cooked quinoa into a smoothie or reheat it in a few tablespoons of coconut or almond milk before topping with your favorite berries and nuts.

Either makes for a filling and delicious start to your day!

4 SUMMER 2015 | CarilionClinic.org

MEDICAL NEWS

Carilion Forms IVF Partnership with UNC Fertility Carilion Clinic has formed an in vitro fertilization (IVF) partnership with UNC Fertility, a highly regarded embryology lab at the University of North Carolina.

The partnership will allow Carilion to perform IVF procedures for patients using the UNC fertility and embryology laboratories in Raleigh. It is also an outgrowth of Carilion’s hiring Emily Evans-Hoeker, M.D., who specializes in reproductive endocrinology and infertility and obstetrics and gynecology.

Dr. Evans-Hoeker joined Carilion last year after completing a fellowship in reproductive endocrinology Dr. Emily Evans-Hoeker and infertility at the University of North Carolina. She, along with Robert L. Slackman, M.D., staff Carilion’s Reproductive Medicine and Fertility practice.

A GROWING NEED

More American women than ever are seeking medical help to conceive. Infertility is said to affect 6.7 million women, or about 11 percent of the reproductive-age U.S. population. And while IVF is one of the most popular treatment options, its success depends on having access to a state-of-the-art embryology lab.

Dr. Evans-Hoeker, who will perform the IVF procedures, says the new partnership will allow her to do every step of the process for patients, “instead of sending them to another physician they do not know to perform parts of the IVF cycle.”

“What we do is very personal and can be very emotional,” she says.

Dr. Evans-Hoeker will complete most of the IVF process in Roanoke and then will travel to UNC Fertility with her patients for egg retrieval and embryo transfer.

“Much of the success of IVF has to do with how things are done in the embryology lab,” she says. “UNC Fertility is a nationally recognized lab with high success rates.”

STATE-OF-THE-ART TREATMENTS

In addition to performing IVF, Carilion’s Reproductive Medicine and Fertility practice treats both men and women at every stage of the reproductive process.

State-of-the art treatments include ovulation stimulation, intrauterine insemination (IUI)—a procedure that directly places sperm in the uterus during the time of ovulation—and donor sperm insemination (TDI). Carilion works with a variety of sperm banks to provide inseminations for couples needing donor sperm.

For women who Dr. Robert L. Slackman do not have healthy eggs, Dr. Evans-Hoeker is able to perform in vitro fertilization using donor eggs. This process involves choosing a donor from a donor bank, combining the donor eggs with sperm in the laboratory, and transferring embryos into the patient’s uterus to achieve pregnancy.

Drs. Slackman and Evans-Hoeker also care for transgender patients, women wishing to freeze their eggs for future fertilization, and patients with excess weight that affects their reproductive health. They also treat a wide variety of conditions affecting reproductive health, including irregular periods and hormonal imbalances.

In addition, they perform surgeries to correct problems with the ovaries, fallopian tubes, vagina, and uterus.

For more information or to make an appointment, call 540-985-8078.

CarilionClinic.org | SUMMER 2015 5

HEALTH NEWS

Four Main Types of Breast Cancer Identified Breast cancer isn’t a single disease but can occur as one of four major types, according to a new report. Researchers said that classifying the cancers by type of tumor could aid in treatment.

The report was issued by the U.S. Centers for Disease Control and Prevention, the American Cancer Society, and other medical groups. For more information, go to bit.ly/cancer-subtypes.

E-Cigarette Use Linked to Other Risks A new study found a striking correlation between students who smoke electronic cigarettes and those who engage in other risky activities, including smoking tobacco or marijuana, and/or binge drinking. With nearly 30 percent of college students surveyed having tried e-cigarettes, health professionals are considering policy decisions for these popular devices. Learn more at bit.ly/e-cig-use.

New Blood Pressure Guidelines Set for Heart Patients Three leading medical groups, including the American Heart Association, have issued new blood pressure guidelines for those with heart disease. They include a blood pressure goal of 130/80 for people who have had a heart attack, stroke or mini-stroke, and others with certain conditions. (Normal blood pressure is having pressure lower than 120/80 most of the time.) Read more at bit.ly/updated-guidelines.

Processed Foods Dominate the Grocery Bag Processed foods loaded with fat, sugar, and salt make up more than 60 percent of the calories in the typical American’s grocery bag, a new study found. These foods include white bread, chips, cookies, prepared meals, candy, and soda. Researchers are concerned that eating too much of such products can lead to obesity. Go to bit.ly/processed-foods for more information.

6 SUMMER 2015 | CarilionClinic.org

New Tools Aim to Help Diabetic Kids Two new devices may make it easier for parents to keep track of glucose levels in their diabetic children. Both the Apple Watch and a new system called Share transmit blood sugar readings from continuous glucose-monitoring devices to remote locations. For parents, this can mean checking in on their school-aged kids by simply looking at their phones or watches. Find out more at bit.ly/stick-free.

Purposeful Seniors Live Healthier Lives We are all uplifted by feeling as though our time is spent in productive, useful ways. A recent study suggests that for older adults, a sense of purpose may also reduce the risk of brain deterioration. It is thought to influence a part of the brain related to physical and cognitive disabilities characteristic of old age. For more information, visit bit.ly/sense-of-purpose.

Worried about Body Odor?

Your genes may play a role in whether you have excess body odor, researchers report.

New findings are said to significantly advance understanding of the mechanisms of body odor and could lead to new ways to control it. See more study results at bit.ly/body-odor.

Prenatal Yoga for Mind and Spirit Can yoga help ease depression during pregnancy? A recent study published in the journal Women’s Health Issues found a link between easing depression in pregnant women and yoga practices that incorporate a focus on mindfulness and the here and now. Learn more at bit.ly/yoga-pregnancy.

CarilionClinic.org | SUMMER 2015 7

MEDICAL NEWS

KEEPING MOTHERS AND BABIES SAFER

By Su Clauson-Wicker

When Amy Cundiff gave birth to her their mother’s bare chest immediately son at Carilion Roanoke Memorial Hos- after delivery. The technique, called pital in February, the staff immediately “kangaroo care,” is an evidence-based practice of skin-to-skin contact between placed him on her chest. Testing and mothers and infants that promotes weighing could wait until mother and breast-feeding and bonding. child bonded.

“It felt like exactly what should be happening—a natural progression,” Cundiff says. “Crosby cried at first, but when they put him on me, he became very peaceful. He had his eyes open wide, just looking at me.”

Within 90 minutes, Cundiff’s son was nursing. The first-time mother was surprised at how positive and stress-free the experience was.

“It was amazing to see his instincts in action,” Cundiff, of Roanoke, says.

“Crosby was able to manipulate his body across my chest and begin nursing. He had a lot of head control.”

Last fall Roanoke Memorial adopted the policy of placing newborns on 8 SUMMER 2015 | CarilionClinic.org

“Kangaroo care stabilizes the baby’s blood sugar and vital signs and makes breast-feeding more successful when implemented immediately after birth,” says Cindy Booth, R.N., director of the hospital’s Mother/Baby Unit. “Babies cry less. Moms are happier because they can help their babies.”

Named for its similarity to the way marsupials carry their young, the program was initially developed to care for pre-term infants in areas with no incubators. Now modern medical facilities are adopting the practice for all babies due to its benefits.

“Babies maintain their body temperature well on the mom’s chest,” says Christinne Canela, M.D., a Carilion

Clinic obstetrician/gynecologist who practiced kangaroo care with her own newborn in October. “They cry less when they’re lying on the mom, hearing her voice and heartbeat. Kangaroo care has also been shown to improve baby’s sleep, enhance weight gain, and promote successful breast-feeding and bonding. With bonding, parents become more sensitive to their newborn’s cues.”

The first hour or so after birth is a special time of bonding for mothers and babies at Roanoke Memorial, says Donna Sams, R.N., senior director of OB/GYN Quality Assurance.

“In this ‘golden hour’ after birth, we recommend mothers hold their newborns skin-to-skin without interruption,” Sams says. “We’re planning to designate quiet times here to allow new moms dedicated, kangaroo-care times to bond with their babies and become more comfortable with breast-feeding.”

Amy Cundiff of Roanoke holds her son Crosby.

Cundiff praises the “kangaroo care” they received at Carilion Roanoke Memorial Hospital when Crosby was born.

OTHER NEW INITIATIVES

Roanoke Memorial has the largest maternity center in the region, delivering more than 4,000 babies each year.

Kangaroo care is one of several initiatives Carilion has adopted to enhance the health of mothers and infants.

The hospital earlier introduced a program to reduce early-elective delivery before 39 weeks in favor of waiting for spontaneous labor in women with lowrisk pregnancies. According to studies by the National Institutes of Health, critical development of a baby’s brain, lungs, and liver occurs during the 37th through 39th weeks.

Unless there is a compelling medical reason, the hospital is committed to having healthy pregnant women go into labor naturally with fewer medical interventions. Usually this means lower costs and fewer complications.

“Waiting until spontaneous labor or at least 39 weeks truly does reduce the risks for the baby,” Dr. Canela says. “It’s generally better for mothers too. When there are medical complications such as hypertension, diabetes, or possible fetal issues detected in fetal monitoring, the risks of continuing the pregnancy may outweigh the benefits and we would consider an induction.

“When a baby is delivered before 39 weeks and the mom is not in labor, the baby has an increased risk of breathing problems, jaundice, temperature regu-

lation, feeding problems, and possible long-term issues. For the mom, there’s an increased risk of bleeding and infection. If her cervix isn’t ready, there’s a risk of Caesarean delivery.”

Sometimes mothers ask for inductions because their military husbands will soon deploy or because they’re concerned they won’t be able to make it to the hospital from distant homes.

“We consider their reasons; however, we want to ensure the risks of inducing don’t outweigh the benefits,” Dr. Canela says.

Roanoke MemoDr. Christinne Canela rial was recently named a top performing Virginia hospital by the March of Dimes and the Virginia Hospital & Healthcare Association for successfully reducing inductions. In the past three years, only one non-medical early induction was performed. Physician, staff, and patient education programs promoting the benefits of full-term delivery and vaginal birth are part of the initiative.

In response to guidelines from the American College of Obstetricians and Gynecologists (ACOG), Carilion also has an initiative to eliminate unnecessary Caesarean sections. A C-section is major surgery, increasing the potential for

adverse effects for mothers and babies.

In 2012, about one in three American women gave birth by C-section, a 60 percent increase since 1996.

ACOG wants to lower this percentage and has issued guidelines approving longer labor for healthy women. While C-sections can be necessary for highrisk pregnancies, they may pose a greater risk of infection and longer recovery time for the mother.

“Women undergoing C-sections lose twice as much blood as those with vaginal deliveries,” Dr. Canela says. “Ninety percent of women who have C-sections will have them for subsequent births. So we support first-time moms willing to labor a little longer to deliver vaginally.”

Since this initiative has been implemented at Roanoke Memorial, the number of C-sections for first-time births has dropped from 30 percent to 23 percent, according to Dr. Canela. This is below the national target of 24 percent.

“Our motive behind all these initiatives is to have safer deliveries for mothers and babies,” she says. “That is happening at Carilion. As we track outcomes, we’re already seeing improvements, especially among first-time mothers.”

For more information, go to CarilionClinic.org/maternity/services or watch the video at bit.ly/kangaroo-care.

CarilionClinic.org | SUMMER 2015 9

MEDICAL NEWS

PRESCRIPTION DRUG ABUSE AND HEROIN: THE GROWING PROBLEM

By Donna Reynolds Can abusing prescription pain relievers lead to using heroin?

Unfortunately, experts say the answer is yes. And across our region, doctors and law enforcement officials are seeing more of these sad cases.

Roanoke Police Chief Chris Perkins, for instance, has warned publicly of growing heroin use and deaths due to heroin overdoses. If left unchecked, the problem could soon approach epidemic levels, he predicts.

The local trend mirrors a national one.

The abuse of such pain medications as Oxycontin, Vicodin, and Demerol has risen steeply in recent years, according to the U.S. National Institute on Drug Abuse. Research suggests that abusing 10 SUMMER 2015 | CarilionClinic.org

painkillers may actually pave the way to using heroin.

In surveys of young people who inject heroin, almost half said they abused prescription painkillers before switching to heroin, the institute reports. Some said they did so because heroin is actually cheaper to buy than prescription drugs.

Deaths due to overdoses of prescription painkillers are still a bigger problem than heroin-related deaths, but the latter is a rapidly growing problem. In 2007, the Office of the Chief Medical Examiner reported 100 deaths in Virginia due to heroin overdose. In 2014, there were 238 (a preliminary number pending final toxicology test results).

“In recent years, there has been a surge

in heroin use as people who are addicted to opioids turn to heroin,” the Virginia Department of Health stated last year in a report, “Reducing Prescription Drug and Heroin Abuse.” (Opioids are drugs prescribed primarily for pain that have an effect similar to that of opium. Heroin is also an opioid but is not considered to have a legitimate medical use.)

In western Virginia, areas with a heroin problem include Roanoke, Salem, and Bedford, according to the Virginia Department of Health. In 2013, the city of Roanoke placed fourth in the top 15 Virginia jurisdictions referring heroin cases to the Virginia Department of Forensic Science.

It referred 20 percent of the state’s cases, or 197 out of 963.

Overdose Emergency Room Visits per 100K Population 2012–2013 Alleghany, Augusta, Craig, Pulaski, Rockingham

181-256

Bedford, Giles, Roanoke/Salem, Rockbridge

121-181

Floyd, Franklin, Montgomery, Smyth Bath, Bland, Botetourt, Wythe

75-121 28-74

Data source: Virginia Dept. of Health (2014). Unintentional Drug Overdoses in Virginia: Analysis of Syndromic and Death Data.

Many people who die of heroin overdose in the region began by abusing prescription drugs, says Amy Tharp, M.D., the state’s assistant chief medical examiner for western Virginia.

Heroin is relatively inexpensive and easy to get regionally, according to authorities.

WHO ARE THE ABUSERS?

There are two types of prescription drug abusers, says William Rea, M.D., Carilion Clinic’s vice chair of psychiatry.

They are patients who become dependent by overusing legally prescribed pain relievers and users seeking a high who get the drugs illegally.

“They are your neighbors,” Dr. Rea says of typical addicts in the region, and they are drawn from all age, social, ethnic, and educational groups. “But we’re seeing expanding problems in two main groups: younger people and pregnant women,” he says.

“There’s a program at Blue Ridge Behavioral Healthcare called Project Link which serves drug-abusing young mothers or pregnant women,” Dr. Rea says.

“We have a waiting list to treat them.”

According to the Roanoke Area Youth Substance Abuse Coalition, the number of teens using heroin in the region is

growing. Almost 8 percent of 10th- and 12th-graders surveyed in 2013 in the cities of Roanoke and Salem and Botetourt and Craig counties said they had used heroin. This was a 33 percent increase from 2009.

Last year the Virginia State Police spent 25 percent of its drug investigation budget in rural southwestern communities, which comprise just 1 percent of Virginia’s population. In 2013, the counties of Pulaski, Franklin, Wythe, and Montgomery all ranked in the top 15 jurisdictions referring prescription painreliever abuse cases to state authorities.

HOW TO TREAT ADDICTION?

There is a range of approaches to treating addiction with the goal of returning patients to stable, productive lives. One approach is with the drug Suboxone, a maintenance medication that is safer and more effective than methadone, says David Hartman, M.D., Carilion’s chief of adult outpatient psychiatry.

“In 35 years of working with addicts, the success rate with Suboxone is the best I’ve seen,” he says. “Until Suboxone, results were poor.” According to Dr. Hartman, Suboxone produces an effect similar to that of pain relievers but milder, while blocking more potent drugs

Women age 15–24 have an exceedingly high overdose ER visit rate of 200 visits per 100K population.

WHERE TO FIND HELP CARILION CLINIC Carilion Clinic is a leader in addiction research, training, and care, offering comprehensive treatment options for adults and adolescents. Options include inpatient detoxification for adults and adolescents; day treatment programs; outpatient intensive treatment of adolescents; and services for high-risk groups like pregnant women and mothers with young children.

CarilionClinic.org or 800-422-8482 RESCUE MISSION OF ROANOKE Residential 12-step program. rescuemission.net or 540-777-7665 MOUNT REGIS CENTER, SALEM Inpatient and outpatient treatment. mtregis.com NARCOTICS ANONYMOUS 12-step program.

Bedford and Lynchburg: car-na.org/appalachian.htm or 1-434-709-4016 Staunton and Waynesboro: brana.org or 800-777-1515 Blacksburg, Christiansburg, Pearisburg, Pulaski, Radford, and Floyd and Giles Counties: newrivervalleyna.org or 800-777-1515 Clifton Forge, Covington, Roanoke, Salem, Rocky Mount, and Vinton: roanokena.com or 800-777-1515

CarilionClinic.org | SUMMER 2015 11

MEDICAL NEWS

Number of Fatal Heroin Overdoses Virginia: 2007-2014* Data source: Virginia Dept. of Health (2014).

250

238 213

200 150 100

135 100

107

100

89 48

50 0 2007 2008

2009

2010

2011

2012

2013 2014*

* Fatal heroin overdoses may have one or more drugs/poisons contributing to death. The number of fatal heroin overdoses in 2014 is preliminary and subject to change.

like heroin.

Unlike methadone, which is dispensed daily when used to treat addicts, Suboxone prescriptions can be written for longer periods. Dr. Hartman prescribes it for a week or more, with refills contingent on patients attending therapy sessions. “They are critical for recovery,” he says, “because addicts must completely redesign their life.” He also reports success with many patients who have become responsible parents, employees, and students.

“The problem is so enormous, I feel like I’m spitting in the ocean,” Dr. Hartman says. But he is proud of the work Carilion is doing to address the addiction crisis, including having the opportunity to show medical students and residents what can be accomplished.

A 12-STEP PROGRAM

Across town, the Rescue Mission of Roanoke employs a different treatment model: a year-long residential program based on 12-step recovery principles. It includes intensive mentoring, 12-step meetings, educational evaluation and training, and service assignments.

“Most [participants] have done a lot of damage in their lives to their friends, 12 SUMMER 2015 | CarilionClinic.org

their families, their loved ones,” says Helen Ferguson, director of programs for the Rescue Mission. “This is a way to start giving back.”

About 95 percent of those who turn to the Rescue Mission began using drugs in their teenage years, usually between 12 and 14. While in recovery, some learn to read or finish high school. One teen studied C++ programming.

The Rescue Mission’s program centers on building one-on-one relationships, and through those relationships creates accountability and a sense of community. “We talk about changing behaviors,” says Anders Sylvester-Johnson, chief operating officer. “Intrinsically, we believe that substance abuse is so much more than a substance. The problem began long before an addict picked up that substance.”

What can be done to prevent more lives from being upended? In addition to raising awareness in the community, authorities say prevention is key. Parents especially are urged to recognize the warning signs of drug abuse. Early detection can lead to successful intervention.

For more information on the warning signs of drug abuse, go to bit.ly/signs-of-addiction.

WARNING SIGNS OF DRUG ABUSE Signs of drug abuse may include: »» Bloodshot eyes or abnormal pupils »» Nosebleeds »» Sudden weight loss or gain »» Unexplained seizures, accidents, or injuries »» Deteriorating personal appearance »» Shakes, tremors »» Slurred or incoherent speech »» Decreased attendance or performance at work or school »» Apathy or social withdrawal »» Sudden personality change »» Mood swings »» Irritability »» Hyperactivity or agitation »» Lethargy, inability to focus Source: National Council on Alcoholism and Drug Dependence, Inc.

MEDICAL NEWS

‘Text Neck’:

It Can Damage Your Spine

Do you lean over your cell phone as you text or read? If so, you’re part of an epidemic being called “text neck.”

15˚ 45˚

Your head weighs about 11 pounds. Tilting it forward by only 15 degrees can put 27 pounds of pressure on your spine.

Depending on how far you lean over, poor posture can create up to 60 pounds of pressure on your spine. This degree of leaning is in fact commonly seen in offices and on streets around the world.

60lb

Multiply that by a few hours a day, 365 days a year, and you’re asking for trouble. “Text neck” can lead to pinched nerves, herniated disks, spine degeneration, and even surgery.

Doctors are seeing more patients with head, neck, or back pain caused by bad posture while using mobile technology.

Try to look at your phone by casting your eyes down—without moving your head or neck. Keep your head up and your shoulders pulled back!

CarilionClinic.org | SUMMER 2015 13

MEDICAL NEWS

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er y rcise ev e x e h ess, oug on Fitn il gets en c s n lt u u o d C ee a ident’s e in thr he Pres t o t Only on g ickly in ccordin react qu eries r o n . u n r week, a io to roc & Nutrit less able uble carrying g kids. t s ju ’t Sports ave tro h their ers aren The oth y—they may h g playtime wit tible to c joyin gen scep an emer e car or fully en them more su es like e ic diseas h k t n a o m r m o h r o c f ls e a g in nfit can ss able to mana Being u daily le . d y n it a rm their cobes ease o f d is r n d e a t p , r o a ’s he son gh t d fun s, Parkin ecome fit enou linic introduce the diabete b C le eop formerly ilion ( r p a e C lp k , e o s h n s a e To s-Ro t str Wellnes s withou t— activitie ing at Carilion uare fee q s in 0 a 0 r t . ,4 l ) tiona rts—2 ic Club studio,” tball cou e Athlet raining Roanok k three racque ur functional t llness. “We t of we “We too e space into o ls, residen h p t e d ic e domina nger v n b r a ’s u n e t k io d li il n a Car sics stro d Grey, ocus on the ba elp people get says Bu f h o t t a e tools ings th have th , stability—th k c a lower b aily lives.” d ir e h t for

14 SUMMER 2015 | CarilionClinic.org

L to R: Michael Tumulak swings kettlebells to improve his core and leg strength while Diane Smith and Shirley Jones do bicep curls to help them lift and hold everyday objects. They all work out at Carilion Wellness-Roanoke (formerly the Roanoke Athletic Club).

GETTING YOUR ENERGY BACK

Many people are doing functional training through Carilion’s FIT Rx program, in which doctors prescribe exercise, giving patients 60 days of access to all three Carilion Wellness locations, weekly personal training sessions, and an individualized plan to follow for only $60.

More than 3,300 people have completed the program since it began in 2011.

Nancy Hurdle, 61, is one of them. “When I was diagnosed [with fibromyalgia], I had no energy to do anything,” she says. “There was always something that hurt.

“When it snowed, I had to just let the snow sit in front of the house,” Hurdle says. “Now I shovel all of my walk, my neighbor’s walk, the driveway. I still get tired but I can do all those things and get them done without quitting.

That sense of accomplishment makes you want to work even harder to do more things.”

Though she’s graduated from FIT Rx, Hurdle has continued with the functional training program for motivation, accountability, and to ensure that she continues to do the

prescribed exercises correctly. “With fibro fog [concentration challenges experienced by many with fibromyalgia], I sometimes can’t remember how to do things from week to week,” she says.

According to Christin Vernick, functional training manager at Carilion Wellness, a person’s motivation is the key to success. “The biggest thing is people have to want it for themselves,” she says.

“For example, a person who is told he is pre-diabetic and thinks, ‘I don’t want to give myself insulin, I don’t want to have to worry about that. I just want to be able to keep up with my family.’ Those are the people who experience the best outcomes.”

That describes Diane Smith. The 55-year-old law firm office manager began functional training in the hopes of losing weight, reducing her need for prescription medicines, and to “just feel better.”

“Truthfully, I did not really look forward to it,” says Smith, “but the trainers made it fun.”

Smith is now 40 pounds lighter, on track to getting off CarilionClinic.org | SUMMER 2015 15

MEDICAL NEWS

Clockwise: Michael Tumulak gets guidance on proper weightlifting technique from Leonard Jones, a trainer at Carilion Wellness-Roanoke; Leonard Jones works out with battle ropes, which conditions the upper body and stabilizes the core. Shirley Jones uses a stretching bar.

her blood pressure medications, and is noticing significant changes in her daily life. “Carrying six or seven bags of groceries up the stairs isn’t a big deal anymore.

Neither is putting a five-gallon bottle of water on the cooler.”

Because her training included exercises that require no special equipment, Smith is continuing on her own but with the comfort of knowing, “Support is there if I need it.”

A FOCUS ON BALANCE AND STRENGTH

Shirley Jones, 64, has noticed similar benefits from functional training; her progress has been a welcome success in a two-year stretch that included diagnoses of both rheumatoid arthritis and Parkinson’s disease, as well as the loss of her husband and mother.

To counteract the deterioration caused by both diseases, Jones’s trainer has fo16 SUMMER 2015 | CarilionClinic.org

cused on balance, whole-body strength training, and special attention to her posture to avoid the stooped carriage so often caused by Parkinson’s.

Though there is no cure for either disease, Jones is steadier on her feet and able to do work she couldn’t have imagined just last year, including tending her garden. “I have four flower beds and last year I laid some sod,” she said.

“A person doesn’t have to be in the FIT Rx program, though,” says Grey. “Anyone can walk in and do functional training.”

Michael Tumulak, 46, has been using the functional training room since it first opened, often spending time there five or six days a week despite also juggling jobs at UPS and as a landscaper. As a person with a passion for obstacle course races, he has found that the diverse strength training available in the functional studio has helped him finish races at a faster pace.

“I do lots of the classes,” says Tumulak.

“I’m hooked on the GRIT classes because they’re only about 30 minutes long and incorporate strength, plyo [plyometrics, also known as jump training], and cardio.

The instructors are great at pointing out things to work on and the right form to avoid injury.”

On the weekends, Tumulak’s wife joins him while their kids, ages 10 and 13, spend time in the youth center.

“Whether it’s in this program or any other program—the biggest thing I want to get across to people is not to be intimidated by movement,” says Vernick. “Your body craves it. Your body needs movement as much as it needs nutrition. Any way you can get moving, it’s going to do wonders for you.”

For more information, go to CarilionWellness.com or call 540-853-0000.

RESOURCES

RESOURCES TO KEEP YOU HEALTHY CARILION DIRECT

Our physician referral and health information service is here to help. Call us at 540-266-6000 or 800-4228482, email us at direct@carilionclinic.org, or chat with us online @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 and symptom checker »» A community health education and events calendar

SOCIAL MEDIA Stay connected to Carilion Clinic through social media: facebook.com/carilionclinic twitter.com/carilionclinic youtube.com/carilionclinic google.com/+CarilionClinicVA pinterest.com/carilionclinic

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.

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 health care 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. If you are interested in MyChart, speak with your doctor.

NEWS BLOG Keep up with the latest news, photos, videos, and more at Carilion Clinic’s newsroom.

CarilionClinic.org/blogs/newsblog.

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 health care, 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.

GIVING TO CARILION CLINIC FOUNDATION Be part of improving the health and vitality of communities in western Virginia. Make a gift at CarilionFoundation.org.

CarilionClinic.org | SUMMER 2015 17

COVER STORY

THE SLEEP CRISIS: MILLIONS OF AMERICANS DON’T GET ENOUGH SLEEP

By Randolph Walker Craig Moore is happy in his work as an engineer with the Virginia Department of Transportation. But years ago, his life nearly took an opposite turn.

As a freshman engineering student at Virginia Tech, he was struggling.

“I was feeling tired, worn out,” recalls Moore, now 43. “I had headaches, but I thought that was a natural way of life.”

Coping with a demanding curriculum, while chronically exhausted, was more than he could handle. He withdrew in the spring of his freshman year.

Moore, of Christiansburg, went to work in his father’s grading and excavating business. Alarmingly, he caught himself nearly falling asleep while driving heavy machines. He never had an accident, but he worried to the point of seeking medical advice.

18 SUMMER 2015 | CarilionClinic.org

His family physician sent him to see William Elias, M.D., a Carilion Clinic sleep medicine specialist. Noting Moore’s headaches and exhaustion, Dr. Elias suspected that Moore had a sleep disorder. He recommended a sleep study.

During a sleep study, a patient spends the night in a bedroom-like facility, while brain activity, breathing, Frank H. Biscardi, M.D., heart rate, and other medical director of the functions are mon- Carilion sleep centers. itored.

In Moore’s case, the results confirmed Dr. Elias’s suspicions. Moore had sleep apnea, a condition in which the patient repeatedly

experiences interruptions in breathing.

“They realized I had around 15 apneas an hour,” Moore says. “My oxygen level dropped considerably, and they decided to put me on a CPAP machine.”

At bedtime, Moore began donning a breathing mask that exerts continuous positive airway pressure (CPAP) and keeps his airway open. He started feeling better, and his headaches disappeared. Returning to his dream of an engineering career, he went to Virginia Western Community College, then back to Virginia Tech where he completed his engineering studies.

Today he’s an assistant district location and design engineer at VDOT’s Salem office, working on road projects and supervising a team of other engineers.

Moore is willing to take time out of

Craig Moore likes walking outdoors with his cats Chickpea (with white markings) and Gremlin, whom he and his wife Paula rescued eight years ago when the cats were only two-weeks-old and abandoned by the side of the road. The Moores also like to travel with the cats and have taken them to such spots as Norfolk and Nags Head. Craig Moore says he has been able to enjoy more outdoor activities as a result of managing his sleep apnea.

his day to talk about his experience, because he knows how devastating sleep disorders can be—and how the correct diagnosis and treatment can change someone’s life.

A NATIONAL SLEEP DEFICIT

According to the Centers for Disease Control and Prevention (CDC), an estimated 50 to 70 million Americans have a sleep or wakefulness disorder. The consequences are more than just red eyes in the morning. Insufficient sleep is associated with a number of chronic illnesses, including diabetes, cardiovascular disease, obesity, and depression.

In what it calls a public health epidemic, the CDC says insufficient sleep is linked to motor vehicle crashes, occupational errors, and industrial accidents. It says that nodding off while driving, unintentionally falling asleep, and having trouble doing daily tasks due to sleepiness may

all contribute to these problems.

The most common sleep disorders include: » Sleep apnea, which affects some 18 million Americans, according to the National Sleep Foundation. The vast majority are thought to be undiagnosed

DO YOU GET ENOUGH SLEEP? The Centers for Disease Control and Prevention recommends these daily sleep amounts: Newborns: 16-18 hours Preschool children: 11-12 hours School-aged children: At least 10 hours Teens: 9-10 hours Adults: (including the elderly): 7-8 hours

and untreated. » Insomnia: Difficulty going to sleep or staying asleep. Many sufferers wake up too early and can’t get back to sleep. » Narcolepsy: Attacks of excessive daytime sleepiness combined with sudden muscle weakness. » Restless Legs Syndrome: Unpleasant sensations or aches in the legs, often relieved by moving or kicking the legs.

Dr. Elias has seen all of these at the Carilion Clinic Sleep Center in Roanoke, where he advises on testing and interprets results. The main complaints?

Trouble getting to sleep or staying asleep, or being excessively sleepy during the day in spite of sleeping at night.

“It ranges all the way from something serious, like someone falls asleep and has an automobile accident, to just chronically feeling nonrefreshed,” Dr. Elias says. “Also, complaints of snoring and interrupted breathing at night. That CarilionClinic.org | SUMMER 2015 19

COVER STORY

FACTS ABO

13,200 FEET Altitude at which sleep disturbance becomes greater.

SLEEP WELL The National Sleep Foundation offers these tips for how to sleep well:

36%

Percentage of Americans who drive drowsy or fall asleep while driving.

»» Practice a relaxing bedtime routine, away from bright lights and free of anything that causes stress or anxiety.

»» Sleep on a comfortable and supportive mattress. Most good quality mattresses have a life expectancy of nine or 10 years. »» Avoid bright light in the evening, and get sunlight in the morning.

This will keep your circadian rhythms in balance. »» Avoid alcohol, cigarettes, and heavy meals in the evening. Finish eating at least two or three hours before bedtime. »» Avoid electronics before bed or in the middle of the night. The light from these screens activates the brain. »» If you can’t sleep, go into another room and do something relaxing until you feel tired. »» Take work materials, computers, and televisions out of the sleeping environment.

20 SUMMER 2015 | CarilionClinic.org

One of the primary causes of sleepiness among Americans.

SHIFT WORKERS are at increased

risk for a variety of chronic illnesses such as cardiovascular and gastrointestinal diseases.

»» Avoid naps. Exercise daily.

»» Your bedroom should be cool (60 to 67 degrees), quiet, and dark.

Consider using blackout curtains, eye shades, ear plugs, and “white noise” machines.

SELF-IMPOSED SLEEP DEPRIVATION

requires the observation of a bed partner.

A lot of times, people are surprised that the bed partner reports that they are extremely restless in their sleep.”

TREATMENT OPTIONS

Not every sleep patient requires overnight testing.

After referral by a primary care physician, many patients are diagnosed and Teresa Carroll treated at Carilion Pulmonary and Sleep Medicine in Roanoke. Its medical team, led by Edmundo Rubio, M.D., includes physicians certified in sleep medicine.

Home testing for sleep apnea may be available based on initial clinical evaluation for some patients.

Other patients are referred for more comprehensive overnight sleep studies “so we can see your stages of sleep,” says Teresa Carroll, manager of the Carilion sleep centers. This network of sleep

centers, the largest in western Virginia, includes four overnight sleep labs.

The lab in Roanoke has eight patient bedrooms, including one pediatric room, says Carroll. There are also two beds at Carilion’s Westlake Center, two at Carilion Stonewall Jackson Hospital, and four at Carilion New River Valley Medical Center. All are staffed by registered sleep technologists, and patients typically check in at 8:30 p.m. and check out at 7 a.m.

Yet another option is behavioral sleep medicine. Carilion’s new sleep specialist, clinical psychologist Barbara Hutchinson, Psy.D., practices cognitive behavioral therapy, a relatively new approach to treating sleep disorders. “I’m more like a sleep coach,” Dr. Hutchinson says.

“I help retrain people to get a good night’s sleep.”

Retraining involves changing counterproductive behaviors. “For insomnia, the behavioral approach is considered the most effective treatment and has just as good short-term results as medi-

OUT SLEEP People who don’t get enough sleep have

SLEEP

is just as important as diet and exercise.

SNORING

BIGGER APPETITES

due to low leptin levels.

is the primary cause of sleep disruption for 90 million American adults.

TEENS AND SLEEP

CAFFEINE

has been called the most popular drug in the world.

Does your teenager seem chronically tired? He or she may not be getting enough sleep.

Source: The National Sleep Foundation.

cation, and long-term better impact,” Dr. For people who can’t unwind at night, Hutchinson says.

Dr. Hutchinson provides relaxation “Rather than sedating people, we’re training. “A lot of times people don’t working to correct whatever is causing allow enough time to relax before bed,” their trouble sleeping,” she notes. For she says. example, some people force themselves Whether it is through traditional sleep to go to bed at the testing or cognitive behavioral therapy, same time every sleep treatment is helping many people night, whether lead more productive and fulfilling lives. they’re sleepy or Nobody knows that better than Craig not. Dr. Hutchinson Moore. Even after all these years, he advises waiting until becomes visibly emotional when talking you are sleepy. about the Carilion team who helped him, “A lot of people including Dr. Elias. have this misconcep- Dr. Barbara Hutchinson “If it hadn’t been for him saying, ‘You’re tion that they should a candidate for a sleep study,’ my life fall asleep the second their head hits the would have turned out a whole lot differpillow, and they should sleep soundly ently,” Moore says. “I wouldn’t have gone throughout the entire night without back to college. waking up,” she says. “Ten to 30 min“It’s had a tremendous impact,” he says. utes is a more realistic time to expect to “It’s an emotional thing because the differfall asleep. And most people, especially ence it made in my life is phenomenal.” adults as we age, wake up one to three For more information, go to CarilionClinic. times a night. As long as you’re getting org/pulmonary/sleep-medicine or call 800back to sleep in 30 minutes or less, that’s 422-8482. fine.”

The average teen should sleep about nine hours a night, but most get closer to seven and a half, according to the National Sleep Foundation.

“There is plenty of data to suggest that, especially for teenagers, schools need to start later,” says sleep expert and author Michael Breus, Ph.D. “The data shows that everything from grades, to emotions, to driving skills are affected by not enough sleep for teens.”

The American Academy of Pediatrics (AAP) last year issued a new recommendation that middle and high schools start no earlier than 8:30 a.m.

“Studies show that adolescents who don’t get enough sleep often suffer physical and mental health problems, an increased risk of automobile accidents, and a decline in academic performance,” the AAP said in a statement. “But getting enough sleep each night can be hard for teens whose natural sleep cycles make it difficult for them to fall asleep before 11 p.m.—and who face a first-period class at 7:30 a.m. or earlier the next day.”

CarilionClinic.org | SUMMER 2015 21

REGIONAL INTEREST

?

O O Z E H T T A W E WHAT’S N

By Alison Weaver Lucy Cook has had little time to catch her breath since becoming executive director of Mill Mountain Zoo in January. Coming from Buffalo, N.Y., she arrived just in time for one of Roanoke’s coldest and snowiest winters on record. “Everyone joked that I brought the bad weather with me,” she says.

With more than 30 years of nonprofit management experience, Cook is jumping in to develop new exhibits and programs. “But first and foremost, our focus is on the stewardship of the animals,” she says. “Their care and well-being is our primary goal.”

The zoo is home to more than 175 animals, including mammals, birds, reptiles, and invertebrates—including 21 vulnerable species. Among them are the cougar, snow leopard, wolverine, Japanese 22 SUMMER 2015 | CarilionClinic.org

macaque, fishing cat, blue-bellied roller, dwarf zebu, and eastern screech owl.

Nestled atop Roanoke’s Mill Mountain, the zoo was founded in 1952 and is fully accredited by the Association of Zoos and Aquariums. It offers year-round educational and recreational opportunities.

One of them is Breakfast with the Animals. Every third Saturday from May to October, zoo guests can enjoy a light breakfast buffet, meet one of the zoo’s animals, and learn about its diet, behavior, and personality. A chat with the zookeepers follows.

On Saturday, June 20, the zoo will hold Relish with Rodents. Visitors will have breakfast and learn about some of the zoo’s intriguing resident rodents.

Children will get to design an easy foamblock print of their favorite.

The zoo continues to offer summer

camps for children. Each is designed to engage kids in the natural world through fun, hands-on activities. These include animal encounters, talks with zookeepers, games, arts and crafts, scavenger hunts, and scientific explorations.

Field trips to the zoo by school, church, and civic groups are also welcome. But if you can’t visit, the zoo may be able to visit you. Zoo staff members go into schools and homes to introduce four or five “animal ambassadors” during a 45-to-60-minute interactive, educational program. A three-week series of classes is also designed for home school groups.

ENDANGERED SPECIES

Red pandas are one of the zoo’s most remarkable success stories. An endangered Asian species, red pandas have a

Far left: Mill Mountain Zoo’s sign welcomes visitors. Top L to R: Zoo residents include Archibald, a red panda; China, a snow leopard; and Count Dooku, a red-billed blue magpie. Bottom L to R: Jayden, a Eurasian lynx, looks out over the zoo; Joe Francis, 10, is a frequent zoo visitor; Lucy Cook is the zoo’s new executive director.

low rate of survival when born in captivity. “Fifty percent do not survive the first month,” says zoo curator Robin Lentz.

“During the weaning period, another 25 percent don’t make it.”

When two cubs were born at the zoo last year, the mother rejected the male cub. Lentz and zookeeper Jessica Fizer dedicated themselves to raising him— feeding the cub every three hours, day and night, for months. Archibald, his sister, Beatrix, and an orphaned cub who joined the zoo last year are now thriving.

“To have one cub survive beats more than 4-to-1 odds, so to have three make it through the first year is astounding,” Cook says. “We are extremely fortunate to have Robin.”

The zoo also hopes to announce the arrival of Pallas kittens after this breeding season or next year’s. The Pallas cats are

part of the zoo’s Species Survival Plan breeding program.

Joe Francis, a 10-year-old Roanoker, has been coming to the zoo for longer than he can remember. “He was in an infant stroller when we first visited,” says his mother, Jeanie Francis.

For the Francis family, the zoo is a package deal. “The city of Roanoke has a great playground and picnic area beside it, there’s the [Mill Mountain] Star, a beautiful wildflower garden, and walking trails,” Jeanie says. “The natural beauty of this site is spectacular. I love the serenity.”

Joe, who wants to be an actor, a comedian, and the lead singer for a band when he grows up, seems to know everything about Mill Mountain Zoo. He knows the names of most of the animals, except for the ones in the Reptile House, where he

is somewhat reluctant to venture.

“A skink? I don’t think I know what that is,” he said, peering in at the large lizard one day this past spring. He studied the skink’s prehensile tail—used for gripping branches—and listened in wonder as he heard that this species is different than most reptiles because the mother raises the babies for six months and the father guards and protects them. “Cool! Very cool,” Joe exclaimed.

Expanding the somewhat cramped marmoset exhibit is on the zoo’s wish list.

By early summer, zoo officials hope to confirm funding for a new facility thanks to a benefactor.

“The community support for this zoo is overwhelming,” Cook says.

CarilionClinic.org | SUMMER 2015 23

IN YOUR COMMUNITY

CHILDREN’S HOSPITAL PLAYGROUND OPENS IN ELMWOOD PARK Carilion Clinic Children’s Hospital Playground is now open in Elmwood Park in Roanoke. A partnership between Carilion and the city of Roanoke, the park provides a fun place for children to be active and stay healthy. The park is an outgrowth of the community health needs assessments that Carilion has been conducting in the region. To fill a need for more exercise venues for children, and to encourage them to form a life-long habit of exercise, Carilion teamed with the city to create its first themed playground—built around the story of Peter Pan.

ASK THE DIETITIAN Have a question about your health or diet?

Why not ask a Carilion dietitian? Just submit your question, and you’ll receive a response online on Carilion’s home page. Go to CarilionClinic.org/blogs/dining-nutrition.

HEALING ARTS PROGRAM SPONSORS ART SHOW

JEFFERSON DEGREE PROGRAMS NATIONALLY RECOGNIZED Jefferson College of Health Sciences’ Master of Healthcare Administration and Bachelor of Science in Healthcare Management degree programs have been ranked among the top 20 programs in the nation by the website Healthcare Management Degree Guide. The two programs were paired and ranked 17th among those of all other U.S. colleges and universities that offer similar degrees.

Art by 97 Carilion employees, volunteers, and immediate family members was on display at Carilion’s second annual Employee Art Show this spring. The show is an initiative of the Dr. Robert L.A. Keeley Healing Arts Program, conducted in partnership with The National Arts Program. The art was shown in the lobby of Carilion Roanoke Memorial Hospital and judged by professional artists for cash prizes. To view the paintings, works on paper, photography, sculpture, and craft works that were entered, go to CarilionClinic.org/art-show.

24 SUMMER 2015 | CarilionClinic.org

PHYSICIANS TO WOMEN CELEBRATES 75TH ANNIVERSARY Physicians to Women, the Roanoke practice providing obstetric and gynecological care, celebrates its 75th anniversary this year. Founded in 1940 by Julien H. Meyer, M.D., and his wife, Dorothy, who was also his nurse, the practice has grown steadily over the years. When Dr. Meyer retired in 1993, he had delivered more than 6,000 babies. The practice has since expanded to include 10 physicians, who participate in Carilion’s OB/GYN training program, as well as physician assistants and nurse practitioners.

Physicians to Women also sponsors or supports many women’s health events in the community.

FACT CHECK CAN HELP Carilion has launched a new online feature, Fact Check, that addresses common myths and misconceptions about health topics.

Fact Check postings so far have included recommendations on how to keep kids safe, along with advice on supplements, vitamins, and cold remedies. Watch for future Fact Checks by Karen McNew on CarilionClinic.org.

VELOCITYCARE TO OPEN AT TWO NEW LOCATIONS Carilion will open two new VelocityCare urgent care centers this summer in Salem beside Walmart and in Roanoke across from Keagy Village. They will bring the number of VelocityCare locations

to seven. VelocityCare provides treatment of common illnesses and injuries and on-site lab and X-ray services. All locations are open seven days a week, with no appointments necessary.

NEW ORTHO-NEURO INSTITUTE TAKES SHAPE What does it take to transform a grocery store into a stateof-the-art medical center? See for yourself [at right]. Work is continuing on the renovation of the former Ukrop’s market in Roanoke. When it is complete, Carilion Clinic will open an outpatient center specializing in neuroscience and orthopaedics. It is tentatively scheduled to open in early 2016.

25+ tractor-trailer loads

301

770

steel tons of structural

cubic yards of concrete poured

6,316

Nelson studs welded to beams

CarilionClinic.org | SUMMER 2015 25

NEW PROVIDERS PHYSICIANS

ADVANCED CARE PROVIDERS

Mohamed Elgabaly, M.D.

Jill Bloom, P.A.-C.

Joni Sessor, W.H.N.P.

Ido Heletz, M.D.

Ashley Houk, N.P.

Sarah Shepherd, N.P.

Ernest Moore, D.D.S.

Katy Meinbresse, F.N.P.

Sherry Tompkins, N.P.

Michael B. Priest, M.D.

Parrisa Rupe, P.A.-C.

Emily Turner, N.P.

Neuro-Interventional Radiology 1906 Belleview Ave., Roanoke, VA 24014 540-981-7122

Cardiology 2001 Crystal Spring Ave., Roanoke, VA 24014 540-982-8204

Dentistry 2017 S. Jefferson St., Roanoke, VA 24014 540-981-7128

Family Medicine 282 Westlake Road, Hardy, VA 24101 540-721-2689

Urology 120 Akers Farm Road, Christiansburg, VA 24073 540-382-3440

Family Medicine 199 Hospital Drive, Galax, VA 24333 276-236-5181

Family Medicine 428 S. Magnolia Ave., Waynesboro, VA 22980 540-949-8241

Family Medicine 1375 W. Ridge Road, Wytheville, VA 24382 276-228-8686

OB/GYN 902 S. Jefferson St., Roanoke, VA 24016 540-985-9862

Pediatrics 1030 S. Jefferson St., Roanoke, VA 24016 540-224-4520

Psychiatry 2900 Lamb Circle, Christiansburg, VA 23074 540-731-7311

Family Medicine 911 E. Main St., Floyd, VA 24091 540-745-2031

GASTROINTESTINAL ASSOCIATES JOINS CARILION CLINIC Kevin R. Dye, M.D., and his practice, Gastrointestinal Associates of Roanoke, have joined Carilion Clinic.

Dr. Dye, with more than 25 years of experience, will continue to see patients at 1201 Franklin Road S.W. For an appointment, call 540-985-0244.

PCA HEALTHCARE TO JOIN CARILION CLINIC PCA Healthcare, whose 17 physicians see patients in Salem, Floyd, and Daleville, will be joining Carilion Clinic in June.

The physicians will join Carilion family and community medicine practices, and their patients will have greater access to Carilion’s network of health care providers and its MyChart online patient portal. MyChart gives patients access to their medical records and lets them exchange secure messages with their doctors and other providers.

26 SUMMER 2015 | CarilionClinic.org

REGIONAL NEWS

Clockwise: The entrance to Carilion Stonewall Jackson Hospital in Lexington; a statue of Stonewall Jackson at the Virginia Military Institute; a historic street in downtown Lexington.

LEXINGTON HOSPITAL EXPANDS SERVICES

By Dan Smith Carilion Stonewall Jackson Hospital in Lexington is adding family medicine physicians and specialists to serve patients in Rockbridge County.

The new specialists include a gynecologist, oncologists, and orthopaedists from nearby independent practices or other Carilion Clinic locations.

“Adding the family physicians will allow them to create a close relationship with the specialists,” says hospital President and CEO Charles Carr. “This is important to the patient.”

The new physician specialty services will be provided parttime to meet demand.

Stonewall Jackson has also introduced specialized equipment unusual for hospitals of its size (25 beds). In the past two years, the hospital invested $4.5 million in state-of-theart technology, which included: » A new low-dose digital mammography system, Mammomat Inspiration Prime, which reduces radiation exposure by up to 30% over conventional mammogram systems. » A wireless, minimally invasive surgical system for arthroscopy and laparoscopy procedures. » A medication-dispensing system that offers added safety for patient care.

Over the coming year, the hospital will also spend $500,000 for a nuclear heart scan camera.

New developments at the hospital have not gone unnoticed.

Professional Research Consultants gave it a 5-Star Award for physician communication with patients. Hospitalist Rob Marsh, M.D., was also named the nation’s Country Doctor of the Year by AMN Healthcare, a consultant to the industry.

THE NEW DOCTORS Family medicine physicians serving the hospital are: • Thomas S. Peck, M.D., formerly of Fairfield Medical Associates; Thomas F. Hamilton, M.D., formerly of Buena Vista Family Medicine; and Robert Pickral, M.D., and Laura Lanier, M.D., formerly of Lexington Family Medicine. Their three practices have joined Carilion Clinic.

• Ralph Caldroney, M.D., who joined Carilion last fall.

• Ayesha J. Kelly, M.D., and John D. Sedovy, M.D., of Carilion Clinic General Surgery. They also see patients at Stonewall Jackson.

The new specialists will be: • Ido Heletz, M.D., who will join Jeffrey Todd, M.D., in his cardiology practice in Lexington.

• Robert L. Slackman, M.D., whose specialties are gynecology and infertility and reproductive medicine.

Dr. Slackman practices at Carilion Clinic Reproductive Medicine and Fertility in Roanoke.

• Oncologists Padmaja V. Mallidi, M.D., and William A. Fintel, M.D., of Blue Ridge Cancer Care in Roanoke. They will rotate weekly visits to the hospital.

In addition, three Carilion orthopaedic specialists are available: • J. Randolph Clements, D.P.M. (podiatry); Hugh J. Hagan, III, M.D. (hand surgery); and certified physician’s assistant Jason Peery (orthopaedic spine).

The three will complement the general ortho and sports medicine services that Edward S. Hemphill, M.D., of Carilion Clinic Orthopaedics has been providing to local schools and the Lexington and Rockbridge areas.

CarilionClinic.org | SUMMER 2015 27

RECIPE

ENJOY A TROPICAL SUMMER SALAD The evenings are warm, and the sun is setting late. Why not have a relaxed dinner outdoors and enjoy a grilled shrimp and mango salad?

Mangoes are not only a sweet complement to the shrimp, they are packed with antioxidants, fiber, potassium, and vitamins A and C.

GRILLED SHRIMP AND MANGO SALAD INGREDIENTS

• • • • • • •

1 lime, zest and squeezed 2 tablespoons olive oil 2 large mangoes, peeled and pitted 2 avocados, pitted and diced 1 /3 cup green onion, sliced thin 1 /3 cup cilantro, chopped 1lb. large raw peeled and deveined shrimp • Salt and fresh ground pepper • 3/4 cup blueberries, fresh or frozen PREPARATION 1. Slice mangoes into long thin strips. Place

mangoes, avocado, onion, olive oil, and lime zest in a bowl. Do not toss or stir yet.

2. Set grill to highest setting. Grill the

shrimp 3-4 minutes until pink.

3. Place the shrimp in the bowl with the

other ingredients. Season with salt and pepper. Toss gently.

4. Top with cilantro before serving.

28 SUMMER 2015 | CarilionClinic.org

URGENT CARE

FOR LIFE’S UNEXPECTED MOMENTS

When it comes to those everyday, unexpected moments, count on VelocityCare. From treatment of common illnesses and injuries to on-site lab and X-ray services, VelocityCare is the solution to your urgent care needs. We’re open seven days a week, with no appointments necessary. Our goal is to get you feeling better as quickly as possible.

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Sunday, 10 a.m. - 6 p.m.

LOCATIONS: BLACKSBURG | 540-961-8040 215 Gilbert St. CHRISTIANSBURG | 540-382-6000 434 Peppers Ferry Road DALEVILLE | 540-591-9440 46 Wesley Road HARDY | 540-719-1815 13205 Booker T. Washington Highway ROANOKE | 540-772-8670 4035 Electric Road, Suite A NEW! VelocityCare locations coming to

Salem and Oak Grove this summer!

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