Living Inspiring better health.
FALL 2016
in this issue BOTOX HELPS RELIEVE MIGRAINES 8 PAIN MANAGEMENT FOR KIDS 10 SPICES AND HERBS FOR YOUR HEALTH 12 FALLS ARE A GROWING PROBLEM 22
Lizbeth Clay of Salem cooks with herbs from her garden.
THE FIGHT OF THE SEASON!
GET YOUR FLU SHOT TODAY! The flu vaccine is your best protection against the flu. Call your primary care office or walk in to any VelocityCare or Carilion Clinic Pharmacy.
CarilionClinic.org/flu | 800-422-8482
President’s Message Did you know that herbs and spices can add nutritional value to your diet? Besides enhancing flavors, they have antioxidants to help fight disease. Our cover story takes a look at some of the more powerful, like ginger and garlic. Botox is an effective treatment for a range of conditions, including cerebral palsy and hyperhydrosis (excessive sweating), and Botox injections are being used to lessen the pain and frequency of migraines. We profile a New River Valley patient who shares this life-changing therapy. Over 450,000 children live with chronic, life-threatening conditions in our country. More than 53,000 of them die each year. We tell you how managing their pain and improving their quality of life is the focus of our new palliative care program. What would you say is the leading cause of traumatic injuries in our region? If you guessed preventable falls, you’re right. More elderly adults are suffering falls, many of them in their own homes. We discuss how you can help Nancy Howell Agee, president and CEO of Carilion improve your balance—or that of a loved one. Hint: The Clinic, holds the Dr. Robert L.A. Keeley Award, which best way is to stay active! was given to Dr. Julien Meyer, Jr. (right) earlier this WARM REGARDS,
year. The award honors a physician or health care professional who has made a significant impact on the health of the community. Warner Dalhouse (left), chair of the Carilion Clinic Foundation Board of Directors, is shown with them at the award presentation sponsored by the foundation.
NANCY HOWELL AGEE PRESIDENT AND CEO CARILION CLINIC
CarilionClinic.org | FALL 2016 1
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
Andie Gibson is a freelance writer and editor based at Smith Mountain Lake. She has also been the editor of Smith Mountain Laker magazine and special sections editor for The Roanoke Times.
Kathie Dickenson is an award-winning writer and editor whose work has appeared in Roanoke Business and RU, Radford University’s magazine. She has also edited books, websites, and other publications.
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 AND COMMUNICATIONS: VICE PRESIDENT Mike Dame SENIOR DIRECTOR Amy Hoots-Hendrix CONTENT MANAGER Stephanie Specht CREATIVE SERVICES MANAGER John Griessmayer EDITOR Maureen Robb DESIGNERS Dave Porter, Nicholas Buehring CONTRIBUTING WRITERS Karen A. Chase, Su Clauson-Wicker, Jay Conley, Kathie Dickenson, Patrick Dunham, Andie Gibson, Sarah Beth Jones, Heidi Ketler, Donna Reynolds, Dan Smith, Randolph Walker, Alison Weaver PHOTOGRAPHERS Darryle Arnold, Jared Ladia
Heidi Ketler has been a writer and editor for Sentara Healthcare in Norfolk and is the editor of The Triangle Physician magazine in the Raleigh-Durham-Chapel Hill region of North Carolina. She lives in Roanoke.
Jon Maher, M.D., is a Carilion Clinic orthopaedic surgeon and sports medicine physician. He has been a physician for the Boston Celtics, Harvard University’s athletics department, and the U.S. Navy.
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.
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 2016 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 and Communications, 213 McClanahan St., Roanoke, VA 24014.
2 FALL 2016 | CarilionClinic.org
CONTENTS
8
12 features 5 YOUNG PATIENTS Pediatrics unit expands in NRV.
8 HEADACHES
Botox injections for migraines.
10 CHILDREN’S HEALTH New pain management options.
12 NUTRITION
19
departments 1 PRESIDENT’S MESSAGE Herbs and spices can offer big health benefits.
28 RECIPE
Check out this chickpea salad.
18 ORAL HYGIENE Flossing benefits your entire body.
20 ORTHOPAEDICS
8 IN YOUR COMMUNITY New physicians and advanced clinical practitioners.
Take steps now to prevent problems later.
Life after a brain tumor.
Walnuts are rich in antioxidants.
26 GROWING TO SERVE YOU
16 FOOT CARE
19 NEUROSCIENCE
6 SUPERFOODS
Making a difference in western Virginia.
Spices and herbs can boost your health.
Meet our new pediatrics specialist.
20
22 FALLS
One in three elderly adults falls each year.
25 STRESS
Deep breaths help manage stress.
27 HEALTH CARE Four tools are transforming care.
CarilionClinic.org | FALL 2016 3
SUPERFOODS
Superfoods: Walnuts By Kathie Dickenson
Toss them on a sundae or a salad, grind them into bread crumbs or pesto, bake them into brownies or make them the main ingredient of a veggie burger. However you like walnuts, they’ll bring you rewards. Walnuts are high in antioxidants, which are found in the brown skin of the nut. Compared to other common nuts, walnuts contain the highest amounts of polyunsaturated fatty acids— twice as high as pecans and nearly four times as high as almonds—including omega 3s. They can lower “bad” cholesterol, reduce inflammation, and decrease arterial plaque. Walnuts add to a heart-healthy diet. Research demonstrates promise for walnuts in promoting brain health and preventing or slowing memory loss. In a 2014 study published in the Journal of Alzheimer’s Disease, mice fed a diet including the human equivalent of 1-1½ ounces per day of walnuts showed a significant improvement in memory, learning ability, anxiety, and motor development compared to a control group. 4 FALL 2016 | CarilionClinic.org
A 2012 study published in the Journal of Nutrition found that in young, healthy human adults the inclusion of walnuts in the diet significantly improved verbal reasoning. Some preliminary studies in elderly humans indicate a positive effect of walnuts on working memory. Animal studies suggest that walnuts in the diet could fight certain cancers, such as breast, prostate, colon, and kidney. Walnuts have many vitamins and minerals such as copper, folic acid, phosphorus, vitamin B6, manganese, and vitamin E. These elements promote heart, bone, nerve, immune system, and pregnancy health. A serving or two daily or even a few times a week will do. One serving equals 14 walnut halves, providing 4 grams of protein and 185 calories. So keep that handful of walnuts close, and congratulate yourself each time you reach for it.
Carilion Children’s Expanding in the New River Valley
Dr. Kelly Henchel, chief of Carilion’s General Pediatric Clinic, will be one of the doctors seeing patients at the new pediatric unit.
Carilion Clinic’s pediatric inpatient unit in the New River Valley, closed since March for a nearly $500,000 renovation, will reopen in early 2017. “The new unit will be child friendly without being childish,” says Alice Ackerman, M.D., chair of Carilion’s Department of Pediatrics. “We’ve incorporated colors and shapes from our butterfly logo along with beautiful artwork and design features the young and young at heart can appreciate.” Alex Brendel, Carilion Children’s communication manager, coordinated the makeover. “Monitors are being installed in every room,” Brendel says. “From our nurses’ station we can see the vital signs of every patient in the unit without having to wake up the families in the middle of the night.” Sarah Kress, a child-life specialist, helped design
the new space with a focus on making it friendly and welcoming. “My favorite part is the playroom, as play is so important for the hospitalized child,” says Kress. “Through play children express themselves, process new information, and learn to cope with difficult situations. By offering a beautiful playroom, we are encouraging play and helping children heal both physically and emotionally.” The five-bed unit will be staffed with an expanded team of specially trained medical professionals. “We initiated this project to bring resources and expertise of Carilion Children’s closer to the families in the New River Valley and beyond,” says Dr. Ackerman. For more information, visit CarilionClinic.org/Kids or the Carilion Children’s page on Facebook. CarilionClinic.org | FALL 2016 5
MEDICAL IN YOUR COMMUNITY NEWS
AGEE TO LEAD AMERICAN HOSPITAL ASSOCIATION Nancy Howell Agee, Carilion Clinic president and CEO, was elected chairwoman of the board of the American Hospital Association for 2018. She will be the top elected official of the national organization that represents America’s hospitals and health systems. The group includes almost 5,000 hospitals, health care systems, and providers and 43,000 individual members.
GILES PROGRAM HELPS PATIENTS SAVE ON PRESCRIPTIONS Giles County patients saved more than $2 million in prescription costs last year thanks to the Giles Medication Assistance Program at Carilion Giles Community Hospital. Through the program, pharmaceutical companies can donate prescribed medications to qualifying individuals. For more information, call 540-922-4283.
CARILION AGAIN NAMED ‘MOST WIRED’ For the eighth year in a row, Carilion Clinic was named one of the nation’s “Most Wired” health care systems. The award, from the American Hospital Association’s Health Forum, recognizes providers that make extensive use of technology to improve patient care.
SEE OUR REPORT TO THE COMMUNITY Carilion’s
2015
Report to Our
Community, which highlights all the ways we work to improve the health of our communities, is now available. The report includes our latest community benefit figures. In 2014 alone, we gave back $146.2 million, including $57.7 million in charity care. Read the report online at CarilionClinic.org/ community-outreach.
6 FALL 2016 | CarilionClinic.org
WELLNESS NEWS
MEDICAL SCHOOL TO BECOME A COLLEGE OF VIRGINIA TECH The Virginia Tech Carilion School of Medicine will be fully integrated into Virginia Tech following a vote by the university’s Board of Visitors. The integration process is expected to take two years. The school, founded in 2008 as a partnership between Carilion Clinic and Virginia Tech, will become Tech’s ninth college.
CARILION TO CARE FOR VETERANS IN TAZEWELL
ROANOKE MEMORIAL RANKED FIFTH IN VIRGINIA
Carilion Clinic was awarded a contract by
For the second year, Carilion Roanoke Memorial Hospital
the Veterans Administration to care for
was ranked fifth in Virginia by U.S. News & World Report. It
almost 1,000 veterans in Tazewell County
was also ranked among the best in the country. Roanoke
and the surrounding areas. Care will be
Memorial was one of only 63 hospitals to receive
provided at Carilion Clinic Family Medicine
top ratings in nine key areas, including hip and knee
at Carilion Tazewell Community Hospital
replacement and heart bypass surgery; 4,500 hospitals
and will include primary care and mental
were evaluated.
health services.
STROKE CARE RECOGNIZED Carilion Roanoke Memorial Hospital was recognized for its stroke care by the American Heart Association. The hospital received the Stroke Gold Plus Achievement Award and was named to the Target: Stroke Honor Roll Elite for 2016 to recognize all the quality measures the hospital has in place to care for strokes.
CarilionClinic.org | FALL 2016 7
MEDICAL NEWS
By Maureen Robb Kerin Flattery has had migraines for years, and she’s tried every known treatment, from conventional medications to chiropractic therapy and acupuncture.
In the past 10 years, her headaches have also gotten more frequent. Most months, she had three to four migraines, with some lasting three days. At the worst, she had 15 in a month. One headache medication containing tryptamine, which narrows the blood vessels around the brain, has helped with the pain. “But you feel bad— rundown, tired, and like you have the flu when you take it,” she says. “So you either have pain, sensitivity to light, and nausea, or you just plain feel terrible. It’s Catch 22.” The three-day episodes have been especially hard. “After the pain is over, you’re worn out and feel you have to sleep a lot to recoup,” she says. “But as a nurse, mom, and wife, I can’t just go to bed for a few days.”
8 FALL 2016 | CarilionClinic.org
Kerin Flattery (left) is enthusiastic about a new treatment for migraines that has made a big difference in her life. At right, she walks with her husband Bill Flattery in the New River Valley.
Flattery, a registered nurse, is a coordinator with the patient-centered learning program at the Virginia Tech Carilion School of Medicine. She and her husband Bill have five boys. “The migraines affected my whole life,” she says. “I used to get anxious and sometimes even depressed because I never knew when the next one would start and how it would affect our plans.” Flattery did see a neurologist who put her on beta blockers, which block the effects of adrenaline in the body, and she tried other medications in an attempt to tame her headaches. None really worked. Taking prescribed seizure medications also caused her to “zone out” and to lose 10 pounds. “I wasn’t functioning very well while taking it,” she says. “Finally, I heard Botox injections were available and were helping people like me.” THE PAIN OF MIGRAINES
If you’ve ever suffered from migraines, you know how disabling they can be. The severe headaches, which often cause throbbing pain and nausea, affect about 10 percent of Americans. But the new treatment using Botox injections is helping many who’ve been laid low by migraines all their life. “For migraine patients, the Botox treatment decreases their headaches by about 50 percent,” says Sabrina Johnson, R.N. “I have seen my patients have a decrease in frequency, severity, and length of migraine.” Johnson is one of the Carilion Clinic health care providers who performs the treatment. The injections, which feel like tiny pinpricks, are administered in the neck and head. They work by temporarily paralyz-
ing certain muscles to inhibit pain. Johnson discusses the procedure with patients who might be good candidates. “I tell them it is an excellent option for those who have tried and failed other treatments.” Most insurers cover the injections, but there is a prior authorization process. “Patients have to try and fail multiple other treatments before most carriers will pay for the procedure,” Johnson says. “I think as the public becomes more aware of Botox for migraines, there will be a push for greater coverage,” she adds. “There is such a loss of productivity in the workforce related to migraines that we as a medical society need to utilize all available options for treating this debilitating disease.” Botox injections are now also being used to treat other conditions such as cerebral palsy, stroke spasticity, and hyperhydrosis (excessive sweating). Ralph D. Brown, Jr., M.D., of Carilion, who provides these other treatments, foresees even more potential for Botox injections. “Botox is a unique and very effective treatment for many problems and will probably be found in the future to be able to treat more conditions,” he says. A HUGE DIFFERENCE
“Getting the injections has made a huge difference in my life,” says Flattery. “It’s like night and day. The migraines haven’t completely gone away, but the duration, frequency, and the intensity are all less. It works.” “It’s hard to watch someone you love be debilitated by pain,” says Bill Flattery,
who has twice had to drive his wife to the Emergency Room at Carilion New River Valley Medical Center, where he is the hospital CEO and western region vice president for Carilion. “Nothing she took worked.” “For the first time, she has hope,” he says. “Before she was always treating the symptoms, but the injections are helping to actually prevent the migraines. It’s nice to finally have found something that works.” Kerin Flattery’s first treatment was a year ago, and she gets the injections repeated every three months. “It goes fast,” she says. “It takes no longer than 10 minutes.” Flattery, whose treatments are done by Johnson in the New River Valley, says Johnson and her support staff “really take their time to get to know your symptoms and particular migraine triggers. They help you uncover things you may not have known are triggers, because they’re different for everybody.” “I want to get the word out,” Flattery says. “We have this wonderful resource right here, so people can get the help they need, and families can get back to normal.” “It’s been such a relief,” she adds. “Really a life changer!” For more information on Botox injections, call 800-422-8482. CarilionClinic.org | FALL 2016 9
MEDICAL NEWS
A CHILD’S ILLNESS:
New Steps to Ease Pain and Improve Quality of Life 10 FALL 2016 | CarilionClinic.org
By Laura Mitchell Over 450,000 children live with chronic, life-threatening conditions in the United States. More than 53,000 infants and children die each year, and only 5,000 of them receive hospice care.
How can we manage their pain and improve their quality of life? That is the focus of a new effort at Carilion Children’s led by pediatric hematologist and oncologist Violet M. Borowicz, M.D. “I want to change the way people see palliative care,” she says. “It encompasses everything involved with quality of life, for patients and their families, throughout the course of their illness. That also includes bereavement support for families who do lose their child.” Dr. Borowicz is also leading the way for pediatric palliative care to become a focus area at Carilion Clinic. A SUPPORT NETWORK
Use the term “palliative care” and most people will think of hospice. For many years, palliative care described end-of-life pain management for people with terminal illnesses. That is often still the case, especially for adults. But for pediatric patients, palliative care is also about providing a support network for patients and their families as they manage both death and life with complex chronic illnesses. Dr. Borowicz is determined to make that distinction clear. Carilion Children’s’ approach is modeled on the World Health Organization’s definition: “Palliative care for children is the active total care of the child’s body, mind and spirit, and also involves giving support to the family. It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease.” “I don’t manage their disease,” Dr. Borowicz says. “Other Carilion Children’s pediatric providers and sub-specialists do that. I make sure they are listened to and that they are getting what they need in terms of overall well-being and quality of life for the child and their family.”
Dr. Violet M. Borowicz is leading a new effort to improve the lives of local children who live with chronic, life-threatening conditions.
Through direct care to pediatric patients and their families, combined with ongoing education for medical students at Virginia Tech Carilion School of Medicine and residents at Carilion Roanoke Memorial Hospital, Dr. Borowicz envisions an integrated care team that includes community resources and extended family and friends as well as clinical care practitioners. A CARE COMMITTEE
This vision is already becoming a reality with the formation of the NICU Palliative Care and Pain Committee, which refers the majority of Dr. Borowicz’s palliative care patients to her. In the neonatal intensive care unit (NICU), nurses provide 24/7 care and are often the caregivers with whom families connect most closely. So it was natural that a holistic approach to meeting the needs of NICU patients and their families at Carilion Children’s would originate with the nursing team. Several NICU nurses developed and sit on the committee, which also includes pediatric specialists, a licensed clinical social worker, hospital chaplain, parent educator, child-life specialist and other clinical professionals appropriate to each family. Nurses on the committee undergo
specialized training from the End-of-Life Nursing Education Consortium through the American Association of Colleges of Nursing. “Palliative care patients on our unit are assigned to ELNEC-trained nurses,” says Angela Alderman, R.N. “With additional training, we are able to help families more consistently with bereavement and endof-life care as well as complicated chronic illnesses.” Crucial to success is engaging the palliative care team early in the process. “It is important for families to have an ongoing relationship with a provider they trust,” says Dr. Borowicz. “It makes those difficult conversations and decisions easier for them.” Consultations can start as early as prenatal care during a high-risk pregnancy, and care extends as long as the patient or the family needs it. PAIN MANAGEMENT
Pain management plays an important role. Patients at Carilion Children’s have access to many tools to manage pain, including: • Physical measures such as cuddling, massage, heat, ice, and physical and occupational therapy • Cognitive-behavioral measures such as guided imagery, hypnosis, distraction, storytelling, music, and art therapy • Healing touch: Reiki, acupuncture • Others such as aromatherapy for nausea and low lighting and music for delirium. Many of these are used by patients with lifelong illnesses to manage their symptoms away from the hospital. For Dr. Borowicz, the palliative care program is a labor of love, and Alderman sees the results of her dedication every day. “Dr. Borowicz is not just there when things are ok, she’s there when the families need her,” Alderman says. “Pediatric patients who have taken advantage of palliative care have definitely benefited from it.” For more information, go to CarilionClinic.org/hospice/palliative-care. CarilionClinic.org | FALL 2016 11
COVER STORY
12 FALL 2016 | CarilionClinic.org
L to R: Sarah Cuthbertson checks out a mint plant in her garden. Lizbeth Clay, who grows a variety of herbs and spices, relaxes in her garden. Inset: Clay cooks with fresh herbs in her kitchen.
By Randolph Walker Can adding herbs and spices to your diet improve your health?
There’s a growing consensus that it can. Researchers are increasingly linking plant-based foods, including herbs and spices, to a lower cancer risk. “I think of them like I do other plant foods,” says Angela Charlton, a Carilion Clinic oncology dietitian who works in cancer prevention and with patients fighting cancer. “They’re a wonderful source of phytonutrients, or plant-based substances that have health-promoting properties,” she says. “Spices, especially in the dried form, have been found to have very high concentrations of antioxidants,” which help prevent cell damage. Spices might indeed reduce the risk of cancer, says Padmaja Mallidi, M.D., an oncologist-hematologist at Blue Ridge
Cancer Care who serves on Carilion’s cancer committee. She is the medical director of the Oncology Unit at Carilion Roanoke Memorial Hospital and has a particular interest in nutrition to prevent disease. “I suggest that most of my patients and their families incorporate turmeric, ginger, and garlic in their diet because of the general health benefits and to decrease cardiovascular risk and inflammation,” she says. How to incorporate them into daily eating? “Try seasoning your food with turmeric, curry powder, ginger, garlic, and chili peppers,” Dr. Mallidi says. “They are ideal for reducing salt and sugar traditionally used for flavor.” That goes for everyone, whether they’re healthy or receiving treatment, she notes. Dr. Mallidi points to a trial by Johns Hopkins investigators that showed that
a pill combining chemicals found in turmeric with quercetin (an antioxidant found in onions) reduced both the size and number of precancerous lesions in the intestinal tract. Turmeric, a yellow spice that is one of the most widely studied of all the herbs and spices, “does seem to have antiinflammatory, antitumor, antimicrobial, and antioxidant effects,” Charlton says. Its active ingredient is curcumin, which also helps counteract the effects of diabetes, allergies, asthma, and Alzheimer’s disease, according to a study published in Advances in Experimental Medicine and Biology. OTHER FAVORITES
Garlic is another spice that has been studied extensively. “Like turmeric, garlic has powerful anti-inflammatory, anti CarilionClinic.org | FALL 2016 13
COVER STORY
L to R: Fresh ginger and turmeric (at top) are staples in Sarah Cuthbertson’s kitchen. To make tea, she brews together a mixture of caraway seed, mustard seed, fennel seed, and cumin seed (shown below). Jessica Wright holds a basket of herbs and flowers from her garden.
oxidant, antimicrobial, and antitumor properties,” says Charlton. “Garlic is basically a vegetable, but because it’s used for seasoning it’s generally referred to as a spice.” Its potency comes from compounds that are only formed once garlic is crushed or chopped. “You crush or chop it and wait 10 or 15 minutes before you
BUYING AND STORING If you don’t grow your own spices and herbs, the Roanoke Natural Foods Co-op offers seasonal fresh herbs as well as dried herbs and spices year-round, says Angela Charlton, a Carilion Clinic oncology dietitian. Charlton offers these tips on storage: “Dried herbs and spices, like a powder, can be kept up to a year and ideally should be in a dark, cool place. If they are whole, like a clove or a black peppercorn, up to two years.” Fresh herbs can be kept a week or two in a refrigerator.
cook with it and consume it,” Charlton says. The World Health Organization recommends consuming one clove or 0.4 to 1.2 grams of dried garlic powder per day. Cinnamon, meanwhile, has been linked to reduced blood sugar in people with Type 2 diabetes. “About a half teaspoon a day of cinnamon does seem to increase insulin sensitivity,” and help the body better metabolize sugar, says Charlton. Black pepper, now found on every table, was once called “black gold.” Native to south India, black pepper has been used for medicinal purposes since ancient times. “It has been shown to increase the bioavailability of other phytonutrients, which increases the effects of what you get from some of our other herbs and spices,” Charlton says. For nausea, related to either pregnancy or chemotherapy, Dr. Mallidi recommends ginger, either fresh, or in tea or extract form. Both Charlton and Dr. Mallidi say it’s usually better to incorporate herbs and spices into cooking or teas, rather than taking them as supplements. A GROWING DEMAND
Local interest in the health benefits 14 FALL 2016 | CarilionClinic.org
of herbs and spices is growing, fueled in part by baby boomers who are seeking natural substitutes for some medications or general health aids. Area residents like Sarah Cuthbertson, a physical therapist at Carilion Clinic, are also enthusiastic about finding ways to incorporate herbs and spices in their diet. “I grow oregano, basil, lavender, rosemary, mint, sage, cilantro, and thyme,” says Cuthbertson, who lives in Roanoke. “Oregano for salad, basil for making pesto, lavender to put in my closet and dresser, rosemary for various things, mint in drinking water and on potato dishes, and combinations of these for all my cooking.” “Rosemary can help with clearing sinuses,” Cuthbertson says. “You can pick it and crush it a little bit with a pestle and mortar to release the scent and inhale that.” At night, she uses lavender to help ease menopause symptoms. “I can be a pretty bad insomniac, and it helps me relax and wind down,” she says. “I use it in an oil form. I find if I put a couple of drops on my wrist or behind my ear like any other perfume, it seems to help me sleep at night.” When she’s bothered by arthritis in
L to R: Fresh herbs and lamb’s quarters (leafy greens often used in salads) are sautéed with garlic, goat cheese, and olive oil in Lizbeth Clay’s kitchen. Dr. Padmaja Mallidi, a cancer specialist with a particular interest in nutrition to prevent disease, recommends adding spices to your diet.
her knees or back, she turns to turmeric for its anti-inflammatory qualities. She puts half a teaspoon on rice or quinoa (a grain), or mixes it into stir-fry vegetables. Lizbeth Clay lives with her husband near Dixie Caverns. She grows, gathers, and buys a variety of spices and herbs. “Garlic, turmeric, and ginger are some of the main ones I use,” she says. “I use these all raw. I’m not buying the powders; I’m buying the rhizomes and juicing them, and then we add them into some of our beverages.” A rhizome, also called a rootstock, is an underground part of a plant that sends out roots and shoots. Clay uses garlic for immune functioning, cholesterol, and heart health, and sage for hormonal balancing. She also makes homemade herbal vinegar. Steeping herbs in vinegar “brings out all the minerals and makes them available to the body and to the bones,” she says. And she makes herbal tea and uses herbs to make mead, a fermented honey beverage. Jessica Wright grows herbs on her property in mountainous southwest Roanoke County. She uses nettle, oat straw, and lemon verbena as detoxifiers and hormone balancers. “The nettle predominantly and oat straw—those are
two go-to herbs for women’s health,” she says. “I’ll use them raw in things, or in teas.” Another favorite is oregano, for its anti-viral properties. She lets it steep in olive oil, or presses it to extract the oil. Of course herbs and spices have been valued for their health benefits for centuries by people around the globe. In traditional Chinese medicine, they are used for flavor and also for their medicinal qualities, says Greg Johnston of Dancing Crane Center of Chinese Medicine in Salem. But the current growth in interest is being noticed by local farmers and businesses. In Floyd County, for instance, the new Appalachian Herb Growers Consortium is meeting a demand for locally grown herbs. Bedford County residents Ray and Jean Oostdyk, who followed their passion for herbs and opened an herbal medicine store, Herbs777, are also seeing a trend. “We have been in business in Roanoke for over eight years and find more and more a growing interest in using herbs and herbal formulas for well-being,” says Ray. Check with your doctor before using herbal supplements, as some may interact with prescription medication.
HEALTH BENEFITS Popular herbs and spices, and their benefits, include: Black pepper: Reduces cholesterol uptake. Cayenne pepper: The active ingredient, capsicum, increases circulation and promotes weight loss. Cinnamon: Improves the body’s ability to use sugar. Garlic: Antioxidant, antiinflammatory, antimicrobial, antitumor. Ginger: Relieves nausea. Green tea: Contains catechins, antioxidants that fight cell damage. Lavender: Traditionally used for its calming effect. Mint: Traditionally used for digestive complaints. Peppermint oil may relieve irritable bowel syndrome. Turmeric: Its active ingredient, curcumin, has anti-inflammatory, antitumor, antimicrobial, and antioxidant effects.
CarilionClinic.org | FALL 2016 15
MEDICAL NEWS
16 FALL 2016 | CarilionClinic.org
Be Kind to Your Feet Why do your feet hurt?
There could be many reasons. Foot pain is a common problem that many people try to ignore until walking becomes too painful. For women, wearing high-heeled or tight-fitting shoes can lead to cramping, tingling, pain in the balls of feet, or even more severe conditions like bunions—a bump on the side of the foot related to a deformity of the big toe. But there are many foot conditions that can affect us, particularly as we age. In fact, foot size and width can vary at different ages, so it’s a good idea to get measured every year to ensure correct shoe size and fit. Genetics also affect our feet. Women in general have narrower heels and weaker joints than men, and lower-fat diets can decrease their bone mass, putting women at a higher risk for sprains, dislocated bones, and stress fractures. “A common foot issue seen in women is stress fractures from post-menopausal osteoporosis,” says J. Randolph Clements, D.P.M., co-chief of Foot and Ankle for Carilion Clinic. “An important way women can protect their feet is by preventing or controlling osteoporosis. Make bone health a priority.” Remaining active can help prevent osteoporosis, and a healthy diet is key. Dr. Clements recommends taking vitamin D, which helps the body absorb calcium. The fat pads on the soles of our feet can also thin as we age. This means bones in the foot are more prominent and more at risk for injury. Arthritis is another concern. “The joints of the foot are no different than those of the knees, hips, and hands,” Dr. Clements says. “Your feet undergo degenerative changes after years of walking and daily activities. The cartilage can wear
down and arthritis develops. “You’d probably notice the most discomfort in the shower or on tile or hardwood floors, where the surface is not cushioned,” he says. “I recommend people add a mat in the shower and wear thick slippers around the house instead of walking in bare feet for better protection.” But back to high heels: Doctors recommend that women not stand or walk in heels higher than 2 inches for more than four hours straight. Using sole inserts for added support when wearing heels or even flat shoes can help. “High heels generally do not cause primary foot problems for women,” says Dr. Clements. “But shoes can definitely be aggravators.” ”The elevation of the heel forces the foot into a posture that markedly overloads the front of the foot, causing pain in the ball of the foot and possible stress fractures,” says orthopaedic surgeon James T. Chandler, M.D., co-chief of Foot and Ankle at Carilion. “It puts the ankle in a position where it is much more likely to be sprained with a missed step,” he says. High heels and narrow-toed shoes may also increase the chances of developing bunions and hammertoes for women who have a strong family history of them, Dr. Chandler says. How to be both fashionable and safe? “If you are standing and walking all day, keeping the heel to an inch and a half or less, with a more rounded toe box, will keep your feet happy longer, and you can save your high heels for nice occasions,” Dr. Chandler says. Issues with feet don’t happen overnight, so take small steps now to prevent foot problems later. Healthy feet are happy feet.
CarilionClinic.org | FALL 2016 17
MEDICAL NEWS
Flossing Could Save Your Life The condition of our mouths can affect our overall health. Studies link poor oral hygiene to heart disease, diabetes, stroke, lung disease, and even Alzheimer’s disease.
IF YOU DON’T FLOSS, dental plaque can build up on your teeth and cause gum disease.
GUMS can get red and
LEFT UNTREATED,
swollen and bleed as you brush.
gum disease can loosen teeth or make eating difficult.
THE GOOD NEWS? Gum disease is preventable and spotted early, is easy to treat.
SEE YOUR DENTIST
for treatment and guidance!
Source: Carilion Clinic Dental Care 18 FALL 2016 | CarilionClinic.org
Recovering from a Brain Tumor Doug Moore was returning from a kayaking and fishing trip with friends on the Maury River when he slipped on a rock and hit his head. The next day, he started staggering, and soon his vision was skewed. The whole room appeared to be on an angle, and it kept rolling over and over.
He went to the Emergency Room and got a CAT scan. As it turned out, his symptoms had nothing to do with his fall. “They came back and said: ‘The good news is, there’s no fracture. The bad news is, we found a tumor the size of a golf ball,’ ” Moore recalls. Moore, an investment adviser who also referees high school and college sports, was immediately admitted to intensive care and prepped for major surgery on the right front lobe of his brain. “Mr. Moore sustained a concussion-like head injury, and certainly his symptoms may have been exacerbated by the fall,” says Gary Simonds, M.D., chief of neurosurgery at Carilion Clinic’s Institute for Orthopaedics and Neurosciences. Dr. Gary Simonds “But he already had a fair amount of what we call hydrocephalus, or water on the brain, caused by blockage from the tumor.” Moore’s surgery was successful, and he began the process of recovery. “When I first got home, I could barely walk,” he says. “I started taking the dog out for a walk, and that really helped recapture my strength.” Two months after surgery, he was back officiating high school football and basketball games and girls’ high school and college lacrosse. “His outlook is quite good right now,” says Dr. Simonds, who performed Moore’s surgery. Looking back, Moore can’t say enough about the care he received. “Dr. Simonds is without a doubt one of the best surgeons you’ll ever come across,” he says. “I feel like I’m fully recovered.” Moore also has praise for the medical team associated with the institute. “The care was exceptional. The nursing staff was great. Dr. Simonds’ team did a great job. “It was a fantastic experience,” Moore says. For more information on the Institute for Orthopaedics and Neurosciences, go to CarilionClinic.org/ion. To watch Doug Moore’s and other patients’ stories, go to CarilionClinic.org/goals. CarilionClinic.org | FALL 2016 19
MEDICAL NEWS
CHANGING CHILDREN'S LIVES:
A Surgeon's Story By Andie Gibson
Life had become exceedingly bleak for Beza,* an 18-year-old girl with legs so badly formed she could no longer walk.
Banished to the streets of her hometown in Ethiopia, Beza was ridiculed and abused because she suffered from brittle bone disease, a disorder that results in fragile bones that break easily. When Julie Zielinski, M.D., arrived on a medical mission trip, hospital officials arranged for her to meet Beza, whose dream was to walk again and one day open a dress shop. Dr. Zielinski performed surgery that corrected the deformity. “After the procedure her legs were straight, and she just sobbed,” Dr. Zielinski says. “A few days later, when I stopped by to see her before I left to return to the U.S., she beamed, hugged me, and said, ‘Thank you very much’—a phrase she had learned in English just for me and had been practicing all day.” For Dr. Zielinski, the newest member of Carilion Clinic’s orthopaedic team of pediatric specialists, the experience underscores a big reason she chose a career in pediatric orthopaedics. “The under-18 age group is amazing—from the bright-eyed innocence of toddlers and young children to the teenagers looking for a role model,” she says. “I love the idea of helping them be the best they can be.”
* Name changed to protect privacy. 20 FALL 2016 | CarilionClinic.org
Dr. Julie Zielinski, a pediatric orthopaedic surgeon, is the newest member of Carilion’s team of pediatric specialists. To calm children’s fears when she examines them, Dr. Zielinski wears a tie-dyed white coat.
For Dr. Zielinski, that means caring for just about anything involving bones, muscles, tendons, and joints—from shoulder to fingertip and hips to toes— in children and adolescents. Examples include trauma injuries, sports injuries, congenital issues or birth defects, cerebral palsy, hip dysplasia, and deformity correction. She also works with a Carilion team of fellowship-trained orthopaedists who treat pediatric patients in specialties such as spine conditions or sports injuries. “We can truly make a difference that can affect a child’s entire life— whether it’s back to sports for the college scholarship, straightening a deformity to help with self-esteem, working on contractures so the child with cerebral palsy can walk, or helping a baby’s hips develop properly after birth,” she says. Dr. Zielinski emphasizes her belief that pediatric patients require not only different care than adults, but different approaches to care, as well as a childfriendly environment—all of which are available at Carilion Clinic. Carilion offers the region’s only dedicated hospital for children, with a staff of more than 350 medical professionals specially trained to provide care to
neonatal, pediatric, and adolescent patients. Services include diagnostic care, outpatient specialty care, treatment and consultation during a hospital stay, and follow-up treatment back in the clinic setting. “Honestly, everyone I have met so far is here to help children. They stay late, come in early, and do whatever it takes to provide the best care,” Dr. Zielinski says. “It’s a big reason I took the job.” A native of Ohio, Dr. Zielinski earned a Bachelor of Science in biomedical engineering from Northwestern and a Master of Science in mechanical engineering from the University of Michigan. She worked for three years as a structural test engineer at General Motors before enrolling in medical school at Wayne State University. After medical school, she completed a fellowship in pediatric orthopaedic surgery at Arnold Palmer Hospital for Children in Orlando and then had a medical practice in Chattanooga for nearly 6 years. She moved to the Roanoke Valley in June. In her free time, she says she’s enjoying the many recreational opportunities the region offers, including hiking, kayaking, and running. “I love the vistas on the Appalachian Trail and pretty much any waterfall,” she says. “I also really enjoy exploring the smaller towns with the local farmer’s markets, sports teams, family shops, and outdoor festivals. Extended free time usually means traveling somewhere. “I feel blessed to have my job and opportunities to help people. In my fellowship training, I expressed my desire to travel overseas to help communities that didn’t have the health care we do. I was put in contact with a surgeon working in Ethiopia. That was my first mission
PEDIATRIC SPECIALTY CARE In addition to pediatric medicine, adolescent medicine, and a child development clinic, Carilion Children’s offers these specialty pediatric services: • Allergy • Behavioral Medicine • Cardiology • Clinical Genetics • Dentistry • Endocrinology • Gastroenterology • Gynecology • Hematology/Oncology • Nephrology • Neurology • Neurosurgery • Occupational Therapy • Orthopaedics • Pulmonology • Physical Therapy • Speech Therapy • Surgery
trip. I loved it. I now go somewhere once every year during my own vacation time.” In addition to Ethiopia, Dr. Zielinski has worked in Nicaragua, Costa Rica, Myanmar, and Ghana. “The next few destinations will likely be the Dominican Republic, Uganda, and the Philippines,” she says. “I tend to choose places I have never been so I can see and learn about a new culture.” For more information, visit CarilionClinic.org/pediatric-specialty-care. CarilionClinic.org | FALL 2016 21
MEDICAL NEWS
Falls by Older Adults: A Growing Problem By Hannah Cline What would you say is the leading cause of traumatic injuries in our region? Car crashes? Violent crime?
At Carilion Roanoke Memorial Hospital, it is actually preventable falls. Last year falls accounted for a majority of admissions to Carilion Clinic’s Level I Trauma Center, ahead of the previous leading cause: motor vehicle and motorcycle accidents. A similar trend was seen across the nation. This is due, in large part, to an aging population. As the population grows older, health conditions, physical changes, and even medications can increase the risk of falling. Sarah Dinwiddie, R.N., Carilion Clinic’s 22 FALL 2016 | CarilionClinic.org
trauma outreach coordinator, reports that the population most affected by falls are those ages 65 years or older. “We see a lot of elderly patients come in due to ground-level falls,” says Dinwiddie. “They are just doing something like walking across the house to get to the bathroom and they fall.” One in three older adults falls each year and 60 percent of these falls occur in private homes. As most falls are preventable, there are several easy safety tips Dinwiddie recommends. STAY ACTIVE
The number one way to prevent falls is to stay active. Exercise and movement
can help prevent falling by improving motor skills, core strength, and balance. Walking and gentle exercises help build and maintain strength and coordination. All of these can help keep you independent and at home. “Research is telling us exercise is the best method of fall prevention,” says Dinwiddie. “Walk in circles at your house or outside. Even simple chair raises can keep someone strong and healthy.” DE-CLUTTER
Keep paths clear to frequently used rooms in your house, such as the bathroom and bedroom. Clear clutter from the floors and be cautious of trip
FALLS ARE SERIOUS AND COSTLY One out of five falls causes a serious injury such as broken bones or a head injury
MORE THAN
95%
EACH YEAR,
2.5 MILLION
older people are treated in emergency departments for fall injuries
Each year at least
of hip fractures are caused by falling, usually by falling sideways
250,000
older people are hospitalized for hip fractures
Adjusted for inflation, the direct medical costs for fall injuries are
$34 BILLION ANNUALLY. Hospital costs account for two-thirds.
OVER
700,000
patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture
Falls are the most common cause of traumatic brain injuries
Source: Centers for Disease Control and Prevention
hazards such as animals or children. Remove throw rugs as they can increase your risk of falling, and keep items in easy-to-reach places. Wear comfortable shoes with good soles, avoiding big slippers and shoes with slick soles. CHECK YOUR VISION
Be sure to get regular eye exams to help improve your vision. If you have glasses, remember to wear them to help better spot any fall hazards. Turn the lights on and avoid walking in the dark. You may also want to install night lights in hallways and bathrooms as an extra precaution. Remaining independent can be a concern for an aging population, but taking steps to prevent avoidable falls can help ease the anxiety. “Slow down, de-clutter your house,
exercise, and take care of yourself,” says Dinwiddie. “These are crucial steps to help you or your loved ones stay home and stay independent.”
One in three elderly adults falls each year and 60 percent of these falls occur in private homes. But most falls are preventable. Carilion Wellness offers free classes to improve strength, flexibility, and endurance to its members age 60 and up. The Senior Moments program rewards physical activity and offers social events as motivation to get fit, have fun, and make friends. For more information, go to bit.ly/carilionsenior-moments or call 800-422-8482.
WHAT MAKES YOU MORE LIKELY TO FALL? • Lower body weakness • Vitamin D deficiency • Vision problems • Foot pain or poor footwear • Home hazards such as throw rugs or uneven steps • Taking medicines. Even some overthe-counter medicines can affect your balance. • Difficulties with walking and balance Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater the chance of falling. Source: Centers for Disease Control and Prevention CarilionClinic.org | FALL 2016 23
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, 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 540-983-4035 or visit CarilionClinic.org/speakers.
COMMUNITY HEALTH SCREENINGS
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 bit.ly/ living-newsletter.
MYCHART
Health screenings are available at little or no cost. Call 540-266-6000 or 800-422-8482, or email us at direct@carilionclinic.org.
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.
WEBSITE TAILORED FOR YOU
SUPPORT GROUPS
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
Support groups are available for a wide range of health needs, including gynecologic and breast cancer. Learn more at CarilionClinic.org/support.
SOCIAL MEDIA Stay connected to Carilion Clinic through social media: Facebook.com/carilionclinic Twitter.com/carilionclinic YouTube.com/carilionclinic Pinterest.com/carilionclinic Instagram.com/carilionclinic
ONLINE HEALTH NEWS For the latest health and wellness news, and expert advice from Carilion’s own providers, visit our online Carilion Clinic Living news site at CarilionClinicLiving.com.
NEWS BLOG Keep up with the latest news, photos, videos, and more at Carilion Clinic’s newsroom. CarilionClinic.org/blogs/newsblog.
24 FALL 2016 | CarilionClinic.org
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.
WELLNESS Carilion Wellness offers programs to help people of all ages and fitness levels improve their health. Visit CarilionWellness.com.
GIVING TO CARILION CLINIC FOUNDATION Be part of improving the health and vitality of communities in western Virginia. Make a gift at CarilionFoundation.org.
a e t r B he
ADDRESS STRESS THE EASY WAY
By Laura Mitchell
Feeling stressed? Here’s a quick antidote: Take a slow, deep breath in through your nose while counting to three, then take the same amount of time to exhale slowly through your mouth.
How is your stress level now? It is a cliché to say “stop and smell the roses,” but we live in such a fast-paced world and have so many pressures to respond to requests immediately, given current technology, that we often don’t take the time to do that. According to Tara Mitchell, Ph.D., a licensed clinical psychologist at Carilion Tara Mitchell Children’s, just one minute of closing your eyes and taking some deep breaths, pushing out life’s stressors, can be very effective. “Ironically, taking the time to stop for a moment and breathe will actually make a person even more productive because they have reduced their stress level,” says Mitchell. “This is because deep breaths
will lower blood pressure, slow down the heart rate, and increase the brain’s ability to concentrate.” And you don’t have to change your routine to benefit from deep breathing. While finding a spare half-hour or more for meditation may be a challenge, most of us have multiple opportunities for mini-meditations throughout the day. They may include: • When stopped at a red light • When climbing stairs or riding the elevator • Before reading an incoming text or answering the phone • When switching from one task to another at work • When chopping vegetables for dinner. Essentially, anytime you are waiting—and tempted to reach for your smartphone—stop and take a few slow, deep breaths. Take in your surroundings, feel the air fill your lungs, imagine the oxygen enriching your blood and exhale.
As Mitchell says, “It really can take just a moment to rejuvenate your brain, which in turn will affect your mood, your level of stress, and your interaction with others.” Who knows, you may find those few slow, deep breaths so relaxing that a half-hour of meditation doesn’t seem so challenging after all.
CarilionClinic.org | FALL 2016 25
GROWING TO SERVE YOU PHYSICIANS Ryan Fulton, D.O.
Philip Wakefield, M.D.
Denise R. Jones, N.P.
Edward D. Habeeb, M.D.
Julie Zielinski, M.D.
Kristen Karas, N.P.
Pediatrics 60 Market Center Way, Daleville, VA 540-992-1251
Orthopaedic Surgery 2331 Franklin Rd., Roanoke, VA 540-725-1226
Dermatology 1 Riverside Circle, Suite 300, Roanoke, VA 540-581-0254
Pediatric Orthopaedics 2331 Franklin Rd., S.W., Roanoke, VA 540-725-1226
Cardiology 2001 Crystal Spring Ave., Suite 203, Roanoke, VA 540-982-8204
Psychiatry and Behavioral Medicine 2900 Lamb Circle, Christiansburg, VA 540-731-7311
ADVANCED CLINICAL PRACTITIONERS Gary J. Harpold, M.D.
Angela M. Algire, P.A.-C.
Leslie E. Peterson, N.P.
Steven E. Herold, M.D.
Courtney Brooks, P.A.-C.
Mary Jo Toothman, C.N.M.
A. David Salzberg, M.D.
Dana R. Garnand, N.P.
Jordan A. White, N.P.
Paul Skolnik, M.D.
James W. Gills, P.A.-C.
Robert Taylor, M.D.
Tina Hahn, N.P.
Neurology 3 Riverside Circle, Roanoke, VA 540-224-5170
Pediatric Cardiology 102 Highland Ave., Suite 101, Roanoke, VA 540-224-4545 2900 Lamb Circle, Christiansburg, VA 540-224-4545
General Surgery 3 Riverside Circle, Roanoke, VA 540-224-5170
Infectious Disease 2001 Crystal Spring Ave., Suite 301, Roanoke, VA 540-981-7115
Family Medicine 428 S. Magnolia Ave., Waynesboro, VA 540-949-8241
26 FALL 2016 | CarilionClinic.org
Sleep Medicine 1900 Lamb Circle, Suite 7-700A, Christiansburg, VA 540-731-7460
Neurosurgery 2331 Franklin Rd., Roanoke, VA 540-224-5170
Urology 120 Akers Farm Rd., N.E., Christiansburg, VA 540-382-3440
Orthopaedic Surgery, Sports Medicine 2331 Franklin Rd., Roanoke, VA 540-725-1226
Family Medicine 200 High St., Bridgewater, VA 540-828-2634
Reproductive Endocrinology and Fertility 1231 S. Jefferson St., Roanoke, VA 540-985-8078
Obstetrics and Gynecology 2900 Lamb Circle, Suite 202, Christiansburg, VA 540-731-4578
Family Medicine 150 Market Ridge Lane, Daleville, VA 540-966-0400
FOUR TOOLS TRANSFORMING CARE AT CARILION The future of health care will involve making care accessible whenever it’s needed, and making caregivers and patients true partners in health. At Carilion, these four tools are now leading the way:
The MyChart app and website offer patients 24/7 secure access to medical records, prescriptions, lab results, and more.
E-visits will soon be available to Carilion patients, enabling remote diagnosis and prescriptive care.
With the tap of a button on a smartphone, the iTriage app lets VelocityCare urgent care patients send information so physicians and staff can be ready for their arrival.
Video visits between Carilion practices began in 2015 and offer greater access to care via a real-time online video link, connecting patients and providers virtually anywhere.
CarilionClinic.org | FALL 2016 27
RECIPE
PAN-FRIED CHICKPEA SALAD
SERVES: 6
Whether you call them chickpeas or garbanzos, these legumes deliver flavor and nutrition. Paired with leeks, garlic, lemon, and spices, they are also delicious as a salad or as part of a vegetarian meal.
INGREDIENTS
PREPARATION
• 1 tablespoon olive oil • 2 cups cooked chickpeas (garbanzo beans), patted completely dry with clean dish towel • 1 cup of chopped leeks • 1 medium clove of garlic, minced • zest of one lemon • 1/3 cup plain yogurt • 1 1/2 teaspoons Indian-style curry powder • Scant 1/4 teaspoon fine-grain sea salt • 1 or 2 tablespoons warm water • 1/2 cup of loosely packed fresh cilantro, chopped • 1/2 cup of red onion, chopped
1. Heat the olive oil in a large skillet and
NUTRITION
Per serving: 116 Calories; 16g Carbohydrates; 3g Fat; 4g Protein; 285mg Sodium; 3g Sugar Source: Carilion Clinic Dining and Nutrition Services 28 FALL 2016 | CarilionClinic.org
add the chickpeas. Sauté over mediumhigh heat, stirring occasionally, until they start getting a bit golden in color. Stir in the leeks and cook until the chickpeas are more golden and the leeks have browned a bit as well, roughly seven to 10 minutes total. At the last minute stir in the garlic and the lemon zest. Remove from heat, and set aside. 2. While the chickpeas cool, combine the
yogurt, curry powder, and salt in a small bowl. If the yogurt mixture is too thick, add the water to thin it. 3. When you are ready to serve the salad,
toss the chickpea mixture with most of the cilantro and most of the chopped red onion. Add about half of the yogurt dressing and toss again. Serve on a platter sprinkled with the remaining onions and cilantro.
GOAL :
Rebecca Dodson thought her back pain would prevent her from walking down the aisle. Our doctors thought differently. To see how our team worked together to help Rebecca reach her goal, visit CarilionClinic.org/Goals. Common ground. Common goal.
Blacksburg Christiansburg Franklin Galax Giles Lexington Martinsville Roanoke Rocky Mount Wytheville
Institute for Orthopaedics and Neurosciences 800-422-8482 | CarilionClinic.org/ION
CARILION CLINIC P.O. BOX 13727 ROANOKE, VA 24036-3727
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ROANOKE, VA PERMIT NO. 247
Can the flu shot give you the flu?
Get the answer to this and many other health questions from Carilion Clinic Living’s Fact Check, hosted by Karen McNew. A new video is posted every Friday, so you’ll never have to wait long to find out what’s myth and what’s good medicine.
CARILIONLIVING.COM/FACTCHECK