Carilion Clinic
Inspiring Better Health | CarilionClinic.org | Spring 2012
Commuting by Bike It’s Taking Off New Heart Treatments Approved Drugs Known as ‘Bath Salts’ Pose Growing Danger
Carilion Clinic
Spring 2012 FEATURES 7 Drug Alert
Bath salts are a growing danger.
12 In Case of Accident
p. 8
Living near a trauma center could save
your life.
14 Your Baby
When a newborn needs intensive care.
17 Doctor Q & A
18 20
Commuting by Bike
It’s doubled over the past 10 years.
Look for the Gold Seal of Approval ™. Audiences 26 Live Theatre are applauding. 25 Quality Care
29 Heart Failure
Prolonging life for the sickest patients. DEPARTMENTS President’s Message
3
An interview with Dr. Janet Osborne. Heart Valve Disease New treatments are saving lives.
p.14
Exercise can improve your quality of life.
Lifestyles Healthy from Carilion Clinic 5 Tips medical professionals.
Benefit Community southwest Virginia. a difference in 8 Making
New Physicians 30 New doctors across our region.
p.20
Better Living 32 Your health calendar.
Carilion Clinic
| Spring 2012 Inspiring Better Health | CarilionClinic.org
Commuting by Bike It’s Taking Off New Heart Treatments Approved Drugs Known as ‘Bath Salts’ Pose Growing Danger
On Our Cover Michelle Scarfe, a pediatric speech and language pathologist with the Roanoke City Schools, is an avid bicycler who often commutes 3 miles from her Roanoke home to work.
p.26 CarilionClinic.org | Spring 2012
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
Karen Doss Bowman is a writer who contributes to health care publications, including the University of Virginia’s Vim & Vigor. A native of Bassett, Va., she now lives in Bridgewater.
Lois Caliri is a former award-winning business writer for The Roanoke Times and editor of Soundings Trade Only, a magazine covering the marine industry.
Jay Conley has been a reporter for newspapers including The Roanoke Times, a staff writer for Randolph College in Lynchburg, and a writer for national publications such as U.S. News & World Report.
CARILION CLINIC LIVING IS PRODUCED BY STRATEGIC DEVELOPMENT: VICE PRESIDENT OF STRATEGIC DEVELOPMENT Shirley Holland DIRECTOR OF MARKETING Mike Dame EDITOR Maureen Robb LEAD DESIGNER David Porter DESIGNERS Taryn Anderson, John Cornthwait CONTRIBUTING wRITERS Karen Doss Bowman, Mary Brewer, Allison Buth, Lois Caliri, Jay Conley, Laura Markowski, Wendy Maxey, Otesa Middleton Miles, David Perry, Matthew Sams, Erica Stacy PHOTOGRAPHER Darryle Arnold CONTRIBUTING PHOTOGRAPHER David Hungate
David Hungate is an award-winning photographer who has worked in television news and whose Roanoke-based commercial photography business takes him to photo shoots around the United States.
Otesa Middleton Miles has been a medical reporter for Dow Jones Newswires, a features writer for the Richmond Times-Dispatch, and a Knight-Wallace Journalism Fellow. She lives in Richmond.
David Perry is assistant director of the Western Virginia Land Trust and a freelance writer whose articles have appeared in The Roanoker, Blue Ridge Country, and other magazines. He is a native of Blacksburg.
PRINTING Chocklett Press
CARILIONCLINIC.ORG | 800-422-8482
Carilion Clinic is a not-for-profit health care organization serving nearly one million people in Virginia through a multi-specialty physician group, advanced primary care practices, hospitals, and outpatient centers. Led by clinical teams with a shared philosophy that puts the patient first, Carilion is committed to improving outcomes for every patient while advancing the quality of care through medical education and research. Copyright 2012 by Carilion Clinic. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Carilion Clinic. Articles in this publication are written by journalists or authors who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader's physician or professional advisor. All editorial rights reserved. Opinions expressed herein may or may not reflect the views of Carilion Clinic. If you would like to be added to or removed from the mailing list for Carilion Clinic Living, please call 800-422-8482, email us at direct@carilionclinic.org, or write to us at Strategic Development, 711 S. Jefferson St., Roanoke, VA 24016.
2
Spring 2012 | CarilionClinic.org
President’s Message We all know we should exercise regularly. But for many, it’s a challenge to fit the recommended 30 minutes a day into a busy schedule. As you can read in our cover story, a growing number of people in our region are solving that problem by commuting by bike. See page 20 for their stories—and for practical tips that might work for you. In this issue we also discuss treatments for advanced cases of heart failure and heart valve disease. New treatments are being introduced for both, and our physicians are enthusiastic about the lives they will save. The stories appear on pages 18 and 29. For those who enjoy the theatre, there is good news indeed. Theatre companies are opening across our region, and their repertoire is eclectic. From classic dramas to edgy contemporary plays, there is something for everyone. Together, they engage our imaginations, open our minds to new possibilities, and add to the vibrancy of our community.
wARM REGARDS,
NANCY HOwELL AGEE PRESIDENT AND CEO CARILION CLINIC
AN INVITATION FROM THE PRESIDENT If you live in the Roanoke Valley, Carilion Clinic and New Horizons Healthcare invite you to take part in a survey. The survey will assess the community’s health care needs and help determine barriers and access to care. Please take the survey online at inspired.cc/rvhs or by phone at 540-981-7079 through March 31, 2012.
CarilionClinic.org | Spring 2012
3
Left to Right: Carl Musser, M.D., Joann Journigan, M.D., and Peter Mikhail, M.D., are part of the largest group of cardiologists and cardiac surgeons in southwest Virginia.
Advanced Heart Care is Here, In Your Community Setting new standards in cardiac care When it comes to heart disease, every second counts. For more than 30 years, Carilion Clinic’s heart care team has been leading the way in cardiac care and open heart surgery. Our specialists and surgeons offer the most advanced techniques available to patients and treat heart attack patients 30 minutes faster than the national average. So when you or a loved one needs heart care, there is no reason to travel far for treatment. You can get the care you need, right here at home.
Inspiring better health.™ CarilionClinic.org | 800-422-8482
Healthy Lifestyles
Tips from our Medical Professionals Choose Your Splurges The workplace can be tempting for those trying to live a healthy lifestyle. Candy jars are often filled with easy-to-grab sugary treats, and co-workers often celebrate special occasions with unhealthy foods. Unnecessary calories can quickly add up, leaving you with unwanted pounds. But instead of celebrating every birthday or promotion with food, choose a few special occasions throughout the year to indulge—and keep your healthy lifestyle on track. — Rebekah McKelvey, R.N., Carilion Franklin Memorial Hospital, Rocky Mount
Dental Health for Kids Cheese is one of the healthiest snacks for your child’s teeth. Along with providing much-needed calcium, cheese helps to fight cavities, especially when eaten as a snack or after a meal. Eating cheese also protects enamel by reducing plaque loads in the mouth and neutralizing acids on teeth, while the calcium and phosphorous in cheese re-mineralize enamel. — Michelle J. Anderson, D.M.D., Carilion Clinic Dental Care, Roanoke
Get the Most Out of Your Medicine 1. Take all doses of an antibiotic, even if the infection is getting better. 2. Side effects are common to all medicines. Tell your doctor or pharmacist about any side effects you may have. Some can be managed or may go away over time. 3. NEVER stop taking your medicine without talking to your doctor. — Paul Bisbee, pharmacist, Carilion Stonewall Jackson Hospital, Lexington
Fight Fat with Muscle Unfortunately our metabolic rate drops 8 to 12 percent per decade after the age of 30. The good news is you can fight age-related weight gain and fat with fire... muscle fire, that is. Resistance training as little as twice a week helps build lean muscle tissue, the critical element of your body composition that helps fight fat by burning more calories at rest and during exercise! — Allison Bowersock, program director, Jefferson College of Health Sciences, Roanoke
Be Alert to Sleep Apnea Get Moving The human body was meant to move. For thousands of years humans hunted, gathered, then farmed. Now we sit at desks and drive everywhere. My health tip is to increase how much you move. I have one patient who has three kids and works from home. She simply walks up and down a flight of stairs in her house for five minutes three or four times per day! Find a way to move your body more and see how great you can feel. — Sarah Bradford, M.D., Carilion Clinic Family & Obstetric Medicine, Christiansburg
Many people may think sleep apnea affects only overweight middle-age men. But women and children may be affected as well. Regardless of age or gender, the triad of loud snoring, apneas witnessed by the bed partner, plus excessive daytime sleepiness should raise a strong suspicion for sleep apnea. Untreated, it may predispose you to hypertension, heart disease including arrhythmias and heart attacks, stroke, diabetes mellitus, obesity, and susceptibility to auto accidents due to sleepiness while driving. — William S. Elias, M.D., Carilion Clinic Sleep Center, Roanoke
CarilionClinic.org | Spring 2012
5
Resources to Keep You Healthy Nurse Line Our physician referral and health information service is here to help. Call us at 540-266-6000 or 800-422-8482, or email us at direct@carilionclinic.org.
“well Said” Speaker’s Bureau If you’d like a speaker on a health topic for your community group or workplace, call 540-224-4961 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 finder • Interactive maps to help you find your way to our locations • Health and wellness content, including an A-Z library • A community health education and events calendar
News Blog Keep up with the latest news, photos, videos, and more at Carilion Clinic’s news blog. Visit newsblog.CarilionClinic.org.
Social Media Stay connected through Facebook, Twitter, YouTube, and LinkedIn: facebook.com/carilionclinic twitter.com/carilionclinic youtube.com/carilionclinic linkedin.com/companies/carilion-clinic
Publications Pick up a copy of Carilion Clinic Living at magazine racks throughout our facilities, or access the digital edition at CarilionClinic.org/publications, where you can also read past issues of our publications. For health tips and news about upcoming health screenings events, subscribe to Living’s monthly e-newsletter at CarilionClinic.org/living.
Support Groups Support groups are available for a wide range of health needs, including gynecologic and breast cancer. Learn more at CarilionClinic.org/support.
Children’s Health For the latest news and perspectives on children’s health care, read Close to Home, a blog by Dr. Alice Ackerman, chair of the Department of Pediatrics at Carilion Clinic.
6
Spring 2012 | CarilionClinic.org
Giving to Carilion Clinic Foundation Be part of improving the health and vitality of communities in western Virginia. Make a gift at CarilionClinic.org/giving.
BATH SALTS: The Growing Danger By Jay Conley
Is your teenager getting high on new drugs called bath salts? If so, you both could be in for a nasty surprise. Across the country, people are experimenting with new stimulant drugs that resemble bath salts, hence the name. The psychoactive chemicals, which come in powder and crystal forms, are snorted, smoked, or injected. But as with LSD, the results can be unpredictable. Some people turn violent; others become suicidal. Until recently, the stimulants were sold in convenience stores and head shops under names like Ivory Wave and Vanilla Sky. They may still be available on the Internet. According to the U.S. Drug Enforcement Administration, the drugs cause disorientation, paranoia, and violent episodes, similar to the effects of LSD or methamphetamines. Bath salts are a growing problem in Virginia. John H. Burton, M.D., chair of the Department of Emergency Medicine at Carilion Clinic, first encountered cases of the drugs last year. He was at Carilion Tazewell Community Hospital when two young men were brought in by police in separate incidents. Both displayed the same bizarre behavior. Both had taken bath salts.
He soon learned from the ER staff in Tazewell that they’d seen a number of recent patients suffering from similar hallucinogenic effects. Carilion Giles Community Hospital reported the same. “They were difficult cases to manage,” Dr. Burton says, recalling how one of the disoriented men tried to attack a police officer in the emergency room. Similar cases have become common in hospitals across the country, despite efforts by authorities to ban bath salts. Virginia and 36 other states enacted laws last year that either prohibit or limit the sale and possession of bath salts. In October, the DEA banned three synthetic stimulants found in them: mephedrone, methylenedioxypyrovalerone (MDPV), and methylone. The bans come as the American Association of Poison Control Centers reports a dramatic increase in the number of calls regarding exposures to bath salts, up from 303 calls in 2010 to more than 5,600 as of November 2011. Roanoke Commonwealth’s Attorney Donald Caldwell says he is not aware of any significant criminal cases related to bath salts so far. For more information, visit 1.usa.gov/salts and bit.ly/saltfacts.
CarilionClinic.org | Spring 2012
7
SPECIAL SECTION 2011 REPORT TO THE COMMUNITY
YOUR STORIES, OUR INSPIRATION 4XDOLW\ LQ KHDOWK FDUH FDQ EH GLI¿FXOW WR PHDVXUH 6RPH ORRN WR SUR¿WV DQG JURZWK ZKLOH RWKHUV FRXQW SDWLHQWV WUHDWHG RU LQYHVWPHQWV LQ QHZ WHFKQRORJ\ :LWKLQ RXU 5HSRUW WR WKH &RPPXQLW\ \RX¶OO ¿QG PDQ\ RI WKRVH VWDWLVWLFV %XW \RX¶OO DOVR ¿QG VRPHWKLQJ WKDW ZKLOH PXFK KDUGHU WR TXDQWLI\ LV RXU JUHDWHVW VRXUFH RI HQFRXUDJHPHQW DQG LQVSLUDWLRQ 2XU SDWLHQWV t .FFU #JMM 8IJUNFS +LV )RUG 0DLQOLQH ZDVQ¶W WKH RQO\ WKLQJ UHVWRUHG 6R ZDV KLV KHDUW t .FFU %SFBNB 1PPSF +HU IDVFLQDWLRQ ZLWK WKH GDUN ZRUOG RI YDPSLUHV IXHOHG KHU UHFRYHU\ IURP WKH GDUN ZRUOG RI OXQJ FDQFHU t .FFU +BEZO +POFT $ YLOODJH RI SHRSOH VKH EDUHO\ NQRZV FDUHV IRU KHU ZLWK WKH VDPH DWWHQWLYHQHVV DV WKH VFRUHV RI IDPLO\ DQG IULHQGV ZKR ORYH KHU 6HUYLQJ %LOO 'UHDPD -DG\Q DQG \RX LV RXU SULYLOHJH <RXU SHUVRQDO VWRULHV RI FDUH DQG SHUVHYHUDQFH MXVW OLNH WKHLUV DUH ZK\ ZH RIIHU D EHWWHU NLQG RI KHDOWK FDUH +HDOWK FDUH GH¿QHG E\ WKH EHVW DYDLODEOH GRFWRUV DQG QXUVHV WKH ODWHVW WHFKQRORJ\ ZRUOG FODVV UHVHDUFK DQG HGXFDWLRQ DQG D FHQWXU\ ROG FRPPLWPHQW WR RXU FRPPXQLW\ #F JOTQJSJOH 4IBSF ZPVS PXO TUPSJFT SFBE ZPVS OFJHICPST PS SFBE UIF SFTU PG $BSJMJPO $MJOJD T 3FQPSU UP UIF $PNNVOJUZ BU inspired.cc 'PS NPSF JOGPSNBUJPO DBMM
LOOK WHOâ&#x20AC;&#x2122;S INSPIRED From the top: Bill Whitmer, Dreama Poore, and Sally Slaubaugh with her daughter, Jadyn Jones.
8
Spring 2012 | CarilionClinic.org
INSPIRED EXPONENTIALLY
&DULOLRQ ZDV IRXQGHG LQ DV D QRW IRU SUR¿W RUJDQL]DWLRQ GHGLFDWHG WR FDULQJ IRU WKH VLFN DQG LQMXUHG UHJDUGOHVV RI WKHLU DELOLW\ WR SD\ :LWK D FRPPLWPHQW WR VHUYLFH &DULOLRQ FRQWULEXWHV WR RXU FRPPXQLW\ LQ PDQ\ ZD\V VXFK DV RIIHULQJ IUHH GLVFRXQWHG DQG VXEVLGL]HG FDUH DV ZHOO DV FULWLFDO PHGLFDO VHUYLFHV WKDW ZRXOG QRW RWKHUZLVH EH DYDLODEOH LQ VRXWKZHVW 9LUJLQLD :H KDYH EHJXQ WR PHDVXUH WKHVH FRQWULEXWLRQV DQG FRPSDUH WKHLU YDOXH ZLWK WKH WD[ GROODUV ZH ZRXOG SD\ DV D IRU SUR¿W EXVLQHVV ,Q DFFRUGLQJ WR ,56 JXLGHOLQHV &DULOLRQ JDYH EDFN PLOOLRQ WR WKH FRPPXQLW\ LQFOXGLQJ DQ DYHUDJH RI PRUH WKDQ LQ XQFRPSHQVDWHG FDUH HDFK GD\ Stated another way, for every dollar of tax exemption in 2010, Carilion provided LQ FRPPXQLW\ EHQH¿W
Other ways Carilion Clinic gives back: ·
Carilion is the largest employer in the region, providing jobs for nearly 11,000 residents and a payroll totaling $623 million.
·
Despite being tax exempt, Carilion paid more than $760,000 in real estate, meals, and other taxes.
·
Employees contributed more than $500,000 to area United Ways in our annual workplace giving campaign.
·
Other jobs and taxes were generated in the region through the $2 million renovation of Carilion Tazewell Community Hospital, the opening of a new RAC Xpress fitness center, and an Aetna office with more than 20 employees in downtown Roanoke.
·
Students from Jefferson College of Health Sciences filled 150 units in the newly renovated Patrick Henry Hotel, bringing new life to downtown Roanoke, while stimulating the local economy.
UNCOMPENSATED CARE: $117.9 MILLION (CHARITY CARE: $63M)
EDUCATION: $21.9 MILLION COMMUNITY OUTREACH: $5.2 MILLION RESEARCH: $.7 MILLION
COMMUNITY BENEFIT: $145.7 MILLION
$145.7 Million COMMUNITY BENEFIT
TAX EXEMPTION: $26.6 MILLION CarilionClinic.org | Spring 2012
9
SPE SPECIAL CIAL SE SECTION CTION INSPIRED INSP IRED BBYY A CCLASSIC LASSIC
SCAN SCAN THE QR QR CODE CODE NOW TO SEE MORE ONLINE.
PPUTTING UT TING CCARDIAC ARDIAC AARREST RREST ON IICE CE :KHQ %LOO :KLWPHU ZHQW WR SLFN XS DQ DQWLTXH FDU ODVW \HDU KH QHYHU WKRXJKW KH¶G EH WKH RQH QHHGLQJ D UHVWRUDWLRQ 7KDW PRUQLQJ %LOO MRLQHG KLV VRQ LQ ODZ -DPHV &DUWHU RQ D EULHI ULGH WR %HGIRUG WR FROOHFW D )RUG 0DLQOLQH 6KRUWO\ DIWHU ORDGLQJ WKH YHKLFOH RQWR WKHLU WUDLOHU -DPHV KHDUG D WKXG %LOO KDG FROODSVHG VXIIHULQJ D KHDUW DWWDFN -DPHV SHUIRUPHG &35 XQWLLO SDUDPHGLFV DUULYHG WKHQ VWD\HG ZLWK KLV IDWKHU LQ ODZ RQ WKH ULGH WR %HGIRUG 0HPRULDO +RVSLWDO %HFDXVH RI %LOO¶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
JOIN THE CCONVERSATION ONVERSA VERSAATION AATT
IINSPIRED.CC NSPIRED.CC 10
Spring 2012 | CarilionClinic.org
HHEALTH EALTH CCARE ARE PPROVIDERS ROVIDERS IINVOLVED NVOLVED IINN BBILLâ&#x20AC;&#x2122;S ILLâ&#x20AC;&#x2122;S CCASE ASE
86
Nationally Nationally rrecognized ecognized ogram Our program Our cardiac cardiac care care pr continued tto o ear n national national continued earn or qualit recognition ffor qu recognition qualityy in 2011, ond-time B eacon including a sec second-time Beacon merican A ward fr om the A Award from American ritical-Care A Association ssociation of C Critical-Care for Nurses and A ccreditation for Accreditation cellence™ by by C ardiovascular Ex Cardiovascular Excellence™ the SSociety ociety for for Cardiovascular Cardiovascular Angiography and IInterventions nterventions Angiography American College College of and the American Cardiology. Cardiology.
SIGN ON AND TELL YOUR STORIES US YOUR TTEMPERATURE EMPERATURE OOFF TTHE HE BBODY ODY DU DURING RING HHYPOTHERMIA YPOTHERMIA TTHERAPY HERAPY O O
32 34 C -
"OE MPPL GPS "OE MPPL GPS UIF SFQPSU UIF SFQPSU PO ZPVS OFYU P O ZPVS OFYU $BSJMJPO $MJOJD $ BSJMJPO $MJOJD WJTJU W JTJU
INSPIRED. INSPIRED.CC CC CarilionClinic.org | Spring 2012
11
Medical News
e t u n i n e M h y w ver nts E ou C B
dy en W y
y xe a M
Even a few minutes can mean the difference between life and death if you’re hurt in an accident. But about 25 percent of Americans now live farther from the nearest trauma center than they did 20 years ago because hospitals have closed hundreds of trauma units. “Bad things happen every day,” says Kinga Powers, M.D., Ph.D., a trauma surgeon at Carilion Roanoke Memorial Hospital. She speaks from experience. On a recent day, four children were admitted to the hospital’s trauma center due to separate accidents. Three were able to go home later. One was not. Kinga Powers, M.D. Dr. Powers, who moved to Roanoke from Boston in November, is one of several highly skilled trauma physicians to join Carilion Clinic in recent months. Together, they bring considerable expertise to Carilion’s Level I Trauma Center— the only one in southwest Virginia.
12
Spring 2012 | CarilionClinic.org
Levels of Expertise Trauma centers in Virginia are ranked as Level I, II or III, with Level I being the highest. There are only five such trauma centers in the state. A Level I designation means a center offers the most comprehensive emergency services and specialists. Roanoke Memorial’s trauma center, now in its 30th year, was Virginia’s first Level I center. Research shows that Level I centers reduce the risk of death from injury by 25 percent compared with treatment at standard hospitals.
The trauma center at Roanoke Memorial offers the highest level of emergency care to 1.5 million people in southwest Virginia.
As a Level I trauma center, Carilion Clinic must maintain an extensive staff of specialists —from neurosurgeons to orthopaedic surgeons. These specialists must also be available around the clock, seven days a week. And the center must offer a surgery residency program, sponsor educational outreach on injury prevention, and participate in disaster preparedness. Recently Carilion Clinic and three local ophthalmologists also agreed to collaborate to provide eye care to trauma center patients. Under the agreement, Vistar Eye Center, Eye Care & Surgery, and Blue Ridge Eye Center will provide 24/7, on-call service for the trauma center, along with other types of eye care for emergency, urgent care, and hospitalized patients.
program director for the Carilion Clinic Department of Surgery. Mark Hamill, M.D., section chief of surgical critical care, specializes in trauma and critical care surgery. He completed his residency at the Medical UniverMark Hamill, M.D. sity of South Carolina and a fellowship in surgical critical care at the University of Texas Southwestern Medical Center. Kelly Hyde, M.D., is a trauma surgeon who received his medical degree from the University of Texas and completed his residency at Carilion Clinic.
New Trauma Physicians
(For more information on each new trauma physician, see pages 30 and 31.)
Carilion Clinic’s newest trauma doctors were recruited for their specific expertise. Dr. Powers, for example, is a trauma, general, and bariatric John Ferrara, M.D. surgeon who did her residency at the University of Toronto. She then completed a fellowship in advanced minimally invasive surgery at Harvard Medical Center. She also serves as an assistant professor at Virginia Tech Carilion School of Medicine. John Ferrara, M.D., is a surgeon who completed his residency in trauma and general surgery at Ohio State University. He also serves as
when Accidents Happen “People don’t expect trauma; it just happens to them,” says Andi Wright, program director of trauma services. “But as a top-tier trauma center, we are trained at the highest level to help injured people in our community.” Trauma response teams at Roanoke MemoKelly Hyde, M.D. rial include all types of specialists. “We involve speech therapists, rehab specialists, physician assistants, case managers, social workers, surgeons of many specialties, you name it,”
Local Trauma Cases Carilion Clinic’s trauma center treats about 2,200 patients a year — most due to motor vehicle crashes and falls. About 37 percent are referred by other hospitals and medical centers in the region. Of the patients treated last year: · 66 percent were male · 29 percent had multiple injuries, most often injuries to the spine and ribs · 23 percent were 64 or older The center saw an average of 37 patients daily, most between 4 p.m. and midnight.
Wright says. A multidisciplinary approach ensures that several key specialists work with trauma patients from admission to follow-up. Carilion Clinic’s trauma center also serves a large rural area. Patients from all over southwest Virginia are transported to Roanoke Memorial from smaller medical centers not equipped to treat their injuries. “Our regional trauma system is set up to get an injured patient the right treatment as quickly as possible,” says Christopher Baker, M.D., chair of the Department of Surgery.
CarilionClinic.org | Spring 2012
13
Specialty Care
Saving a Baby’s Lıfe wHEN A DELIVERY
Requires Intensive Care By Mary Brewer
14
Spring 2012 | CarilionClinic.org
When Alyson Crater became pregnant, she never expected her baby to be born prematurely. But after Alyson was diagnosed with placenta previa—which can cause abnormal bleeding —the baby had to be delivered more than two months early. Evangeline Jaye Crater entered this world at only 3 pounds, 8 ounces, lacking fully developed lungs. “I was admitted to the hospital early because I was having bleeding and contractions for a week,” Alyson says. “I knew if I had the baby then, she was going to go to the NICU.” Evangeline in fact spent almost six weeks in Carilion Clinic’s Neonatal Intensive Care Unit, or NICU. Alyson’s experience is not unusual. Nearly 13 percent of babies born in the United States each year require care in a NICU. Many factors account for this, but “very low birth weight accounts for a majority of our admissions,” says Manuel Peregrino, M.D., Carilion Clinic section chief of neonatology. Babies with inherited disorders and infections also often need intensive care. “While all expectant mothers hope for the best, there can be peace of mind knowing you are delivering in a hospital with a NICU, and that highly specialized pediatricians are only a floor away,” says Alice D. Ackerman, M.D., chair of the Department of Pediatrics.
Third Largest NICU in Virginia “We have a treasure here in the Roanoke Valley in our NICU,” says Dr. Peregrino. “We are the third largest NICU in all of Virginia, with 60 beds. We have the advanced technology that people with highrisk pregnancies need right here in the Valley. Newborns can become high risk in a heartbeat, but we’re ready.” The NICU, which cares for about
Alyson Crater holds her daughter Evangeline, who was born weighing only 3 pounds, 8 ounces.
High-Risk Pregnancies Women with high-risk pregnancies may be referred to a maternal-fetal medicine specialist, who will work with their obstetrician. Such specialists include obstetricians who specialize in the diagnosis, treatment, and ongoing care of highrisk expectant mothers and their unborn babies. In southwest Virginia, Carilion Clinic provides the only maternalfetal medicine program. Two physician specialists and two certified genetic counselors work closely with a patient’s obstetrician, the staff of the NICU, and other medical specialists to provide full-spectrum care.
(continued on next page) CarilionClinic.org | Spring 2012
15
Kara Dickinson (right), a parent educator in the Carilion Clinic NICU, reviews health care information with Keisha and Todd Agnew, new parents of Kannon.
Miracle Network Hospitals, it serves as a neonatal and pediatric mobile intensive care unit and transports critical young patients from other hospitals in the region to the Children’s Hospital. 700 babies each year, is located in Carilion Clinic Children’s Hospital at Carilion Roanoke Memorial Hospital. Eighteen other hospitals in southwest Virginia send mothers with complicated pregnancies to Roanoke Memorial— or their critically ill babies to the NICU for lifesaving technology. “The staff is amazing,” says Dr. Peregrino. “The nurses alone have tremendous credentials —some have over 30 years of NICU experience.” Also caring for the infants are neonatologists, pediatric and surgical subspecialists, pharmacists, speech therapists, occupational and physical therapists, registered dietitians, respiratory therapists, social workers, and other highly specialized staff. “They provide the highest quality care for these infants and their families,” Dr. Peregrino says. While in the NICU, babies are cared for with the most advanced technology to regulate their body temperature, blood pressure, heart rate, and oxygen levels. Because babies are not able to adapt as well as adults to temperature changes, a variety of methods are used for keeping them warm, including radiant warmers and isolettes. A new ambulance especially for children is also operated by Carilion Clinic Children’s Hospital. Funded by a gift of $350,000 from Children’s
16
Spring 2012 | CarilionClinic.org
Caring Staff “The NICU is staffed with some of the most caring and amazing people I’ve ever met,” Alyson says of her experience. “The nurses, nurse practitioners, and doctors not only provided the best health care, but were a source of great comfort to us. I can’t say enough about the Roanoke Memorial NICU. They took Evangeline from a frail baby with monitors, IVs, and breathing tubes to my sweet and strong little angel.” Evan, as mom Alyson calls her, is now at home and doing well. Alyson was also so impressed by and grateful for the care she and Evan received that she has been raising money for the NICU, so that other families in the region who need such care can get it. “My hope is to raise enough money to buy preemie gowns and supplies for the babies and gas cards and food for parents who have to come from out of town,” she says. “Even from the very beginning, it was a fabulous experience,” Alyson notes. “When the doctor explained what to expect and what we could do to help her, they gave my husband and me lots and lots of information. “When Evan was born, all the nurses and doctors were available for support at all times. My experience was amazing.”
when Pregnancies Become High Risk These are some of the factors that can increase the chances of a baby being admitted to a NICU: • Mother younger than 16, or older than 40 • In utero drug or alcohol exposure • Mother with diabetes or high blood pressure, or sexually transmitted diseases • A multiple pregnancy (twins, triplets, etc.) • Breech birth • Premature birth • Birth weight of less than 5 pounds, 8 ounces or over 8 pounds, 13 ounces • Birth defects • Respiratory distress including rapid breathing, grunting, or apnea (stopping breathing) • Infections such as herpes, Group B streptococcus, chlamydia • Seizures • Hypoglycemia (low blood sugar) • Need for extra oxygen or monitoring, intravenous (IV) therapy, or medications • Need for special treatment or procedures such as a blood transfusion
Q & A with Dr. Janet Osborne, Gynecologic Oncologist Janet Osborne, M.D., of Carilion Clinic Gynecologic Oncology, treats women with gynecologic cancers By Matthew Sams such as ovarian or uterine cancer. Q. Why did you choose to become a gynecologic oncologist? A. In this field, I’m taking care of women at a time in their lives where they’re often faced with fear and crisis, and I’m able to help waylay some of those fears and get them through. Many times, I’m able to give happy news — that the surgery we did turned out not to be cancer or turned out to be very early. Other times, we have to give news that is less than ideal. But as a gynecologic oncologist, I’m there for their entire journey. So we not only do their surgery, but we see them afterward for follow-ups and oversee their chemotherapy.
Q. What exactly is gynecologic oncology? And how do you help women? A. We first do general training in OB/GYN and then we do three extra years of fellowship training that gives us the expertise we need for more advanced surgical problems. We’re also trained in the comprehensive, overall treatment with chemotherapy, and working with the radiation oncologists for those patients where radiation is part of their treatment. So it’s a very comprehensive care of women with any of the gynecologic cancers.
Q. How does your practice benefit women in southwest Virginia? A. We are able to do minimally invasive cancer surgeries. We have the technology here to do the robotic, or da Vinci-type systems, so patients who have uterine cancer often have their surgery and go home the next day, which means quicker recoveries. We’re also part of a national gynecologic oncology group that is responsible for all the major clinical trials that essentially become the standard of care for treatment of these cancers. So patients who are under our care have access to the same trials they would if they wanted to travel somewhere far like Duke, Sloan-Kettering in New York, MD Anderson [in Texas], or the Mayo Clinic.
Q. How would you describe your experience here so far? (Dr. Osborne joined Carilion Clinic in April 2011.)
A. I’ve been able to join a really great team. My colleague, Dr. Dennis Scribner, is an amazing partner and has made such a big impact in this community. Our nurse practitioner, a key person on our team, helps us oversee our patients with chemotherapy and some of their post-surgical care. We have excellent oncology nurses. I’ve been really fortunate to walk into an environment that’s already been built and be part of the next generation of changes that we’re trying to bring here. For more information on Dr. Osborne or Carilion Clinic Gynecologic Oncology at 1 Riverside Circle in Roanoke, call 540-266-6000 or 800-422-8482.
To watch a video of the interview with Dr. Osborne, scan this code.
CarilionClinic.org | Spring 2012
17
Specialty Care
Carilion Clinic
Brings Advanced
Heart Valve Treatments to Region By Erica Stacy
Each year almost 5 million people in the United States learn they have heart valve disease. Left untreated, it may lead to heart failure, stroke, or even sudden death. To care for such patients, Carilion Clinic is launching an advanced valve care program. It will offer new, minimally invasive procedures and shorter recovery times for some of the region’s sickest heart patients. As part of the program, a “hybrid” operating room that includes a catheterization lab and advanced imaging equipment will be used. This will allow different specialists such as interventional cardiologists, cardiothoracic surgeons, vascular surgeons, interventional radiologists, and others to work together in one room to perform the new minimally invasive procedures. As a result, some patients who would have required openheart surgery in the past will be able to be treated via a catheterization procedure instead.
Cutting-Edge Treatment One new procedure to be offered is Transcatheter Aortic Valve Implantation, or TAVI. It is intended for patients who are too high-risk for open-heart surgery, and
18
Spring 2012 | CarilionClinic.org
it must be performed in a hybrid operating room. Carilion Clinic has been selected by Edwards Lifesciences, maker of the SAPIEN transcatheter heart valve, to offer this new, advanced procedure to help those with a severely narrowed aortic valve. This condition can lead to loss of independent living, heart failure, chest pain, heart attack, and death. During the procedure, a special heart valve made of cow tissue and stainless steel is passed through an artery in the leg up to the heart using a tube, or catheter. Special imaging equipment helps guide the valve into place. “It may sound simple,” says interventional cardiologist Timothy C. Ball, M.D., Ph.D., “but the surgery is challenging, and there are significant risks. However, TAVI offers a survival advantage for those patients who have no other options.” The procedure takes up to two hours to perform and will be available later this spring.
Heart valve disease can be present at birth or may be caused by infections, heart attacks, heart disease, or damage from an accident or injury. If a heart valve doesn’t close properly, blood may leak back into the heart chamber, and the valve can thicken and not function properly. This can make a heart work harder and affect its ability to pump blood. A red heart glows from atop Carilion Roanoke Memorial Hospital during American Heart Month in February.
Warning signs of heart valve disease include: • Shortness of breath • Weakness or dizziness
Valve Clinic Opens As part of the new program, a Valve Clinic has opened to evaluate and manage advanced heart valve disease patients — many of whom can be treated medically and without intervention. “The Valve Clinic will provide a multidisciplinary clinic where cardiologists (interventional, imaging, and medical) as well as a surgeon can evaluate a patient with heart valve disease and determine the
best strategy for management,” says cardiac surgeon Joseph Rowe III, M.D. “That approach may be surgery, cardiology/surgery hybrid intervention, or medical treatment.” The medical director of the clinic is Jacek Slowikowski, M.D., a cardiologist whose specialties include echocardiography and nuclear cardiology. “The clinic will provide patients in southwest Virginia with a state-ofthe-art evaluation and treatment
The hybrid operating room will allow a variety of medical specialists to work together in one location to treat patients.
• Chest discomfort • Palpitations • Swelling in the ankles, feet, or abdomen • Rapid weight gain • Passing out
plan, where before these patients had few options,” Dr. Rowe says. “This situation has been frustrating to patients, families, and their physicians.” “TAVI in particular is an exciting new technology that would have been considered a futuristic, SciFi fantasy only a few years ago,” adds David Sane, M.D., Carilion Clinic section chief of cardiology. “Today it is a reality: Working together, interventional cardiologists and CT surgeons can implant a valve using a catheter! TAVI is one of the most revolutionary developments in cardiology in the past decade.” Initially, the Valve Clinic will be open one day a week. Expansion will be based on patient demand. For more information, call 540-266-6000 or 800-422-8482.
CarilionClinic.org | Spring 2012
19
Regional Interest
Commuting by Bike It’s Taking Off Have you ever thought of commuting by bike? If so, you have company. More and more people across southwest Virginia are donning bicycle helmets and strapping on backpacks for an energizing ride to work. “There’s no doubt Roanoke is seeing an increase in the amount of people commuting by bike,” says Pete Eshelman, director of outdoor branding for the Roanoke Regional Partnership. “Just walk around town and take note of all the bicycles in front of businesses. It wasn’t like this five years ago.” In fact the whole region is becoming a bicycle hot spot, Eshelman says. According to the U.S. Census Bureau’s 2010 American Community Survey, bicycle commuting in the region has doubled in the past 10 years. Jeremy Holmes, program director of Roanoke-based Ride Solutions, is pleased. Ride Solutions promotes alternative transportation, including commuting by bike, and it offers a wealth of information such as bicycle route maps, information
20
Spring 2012 | CarilionClinic.org
By David Perry
Left: Professor George Simmons, 69, commutes by bike from his Blacksburg home to Virginia Tech. Top: Simmons in his office on campus.
on gear, and instructional videos. Ride Solutions, sponsored by the Roanoke Valley-Alleghany Regional Commission and the New River Valley Planning District Commission, also offers a Guaranteed Ride Home program for registered bike commuters. If they have an emergency or encounter bad weather, the program pays for a free ride home up to four times a year.
Civic and Corporate Backing All types of bicycling are taking off in southwest Virginia —recreational biking on weekends, commuting, and racing. Mirroring a national trend, the region is seeing an increase in bike lanes and a growth in public awareness of bicycling. There is an interplay between supply and demand, Holmes says.
Clifford Nottingham III, M.D.
“A certain mass of people triggers the justification to put the infrastructure in,” he says. “Then, when you put that bike lane in, more people feel safe and come out and use it.” Gas prices are also seen as a motivator. According to GasBuddy.com, local gasoline prices have more than doubled since the fall of 2008. The city of Roanoke in particular has taken steps to become more bicycle-friendly by creating new greenways and other amenities. Roanoke was recently recognized as a Bicycle Friendly Community at the bronze level by the League of American Bicyclists. This year it will apply for a higher level of recognition, says Clifford Nottingham III, M.D., of Carilion Clinic. Dr. Nottingham, an avid bicyclist
CarilionClinic.org | Spring 2012
21
Regional Interest
Left: Beth Lohman of Blacksburg rides the Smart way bus to Roanoke and then pedals her bike 4.5 miles to her office. Below: Lohman at her job at the Virginia Department of Environmental Quality.
and a member of the city’s Bicycle Advisory Committee, also chairs a Carilion Clinic committee on biking. Carilion, the region’s largest employer, plans to apply for the designation of Bicycle Friendly Business from the League of American Bicyclists. Its Riverside campus, for instance, provides bike racks and access to bike trails along the Roanoke River. In both cases, gaining recognition for being bicycle-friendly will help discourage driving and promote safer bicycling, says Dr. Nottingham. “We also think Roanoke would become more attractive to potential employees,” he says.
Changing Habits in Blacksburg George Simmons is a Virginia Tech biology professor who seven years ago was motivated to give bike commuting a try by a colleague who pedaled to work. Says Simmons, “I’d go by him in that big Silverado I was driving,
22
Spring 2012 | CarilionClinic.org
which got about eight miles to the gallon, and I would think, ‘Why am I driving this stupid truck to go nowhere? Why don’t I get a bicycle?’” He also wanted to help reduce the country’s dependence on foreign oil. Shortly thereafter, Simmons’ son sent him a mountain bike. “I started riding it, and I promised myself if I stuck with it for a year that I’d buy myself something nice,” Simmons says. Soon he was commuting to work at Virginia Tech and riding all over town. “I sold my truck. I got to the point I wasn’t driving it any more.” He also claims to be healthier and take more of an interest in things on his route to work. “Blacksburg is a very bicycle-receptive community, and it seems to be getting better,” says Simmons, who now serves on a town greenway and bikeway committee. “If you invest in greenways, people will see this as an upscale community and want to move here.”
Commuting by Bus and Bike Beth Lohman is another member of the Blacksburg biking committee who commutes from the New River Valley to her job with the Virginia Department of Environmental Quality in Roanoke. Her husband also works there. “We take turns telecommuting from home —him three days a week and me two days a week,” she says. On the other days, they take the Smart Way bus from Blacksburg to Salem and then ride their bikes the remaining 4.5 miles to their office on Peters Creek Road. Their savings have been substantial. “Since we started commuting by bike and bus in 2008, we have saved over $5,000 in fuel and maintenance costs,” Lohman says. “That’s a conservative number.” Lohman also enjoys her trip. “I have had overwhelmingly good experiences riding to work,” she says. “When I signal to change lanes on Route 419, most people yield and
Jamie Helmer enjoys her bike commute from the Hollins area to her job at Norfolk Southern in Roanoke.
let me move over to get to the leftturn lane. When I’m stopped at the traffic light at the I-81 southbound exit ramp, guys on motorcycles will pull up next to me and chat. I had a good chat about gardens one morning.” “I try to make eye contact with people, smile, and wave,” she says. “That seems to go a long ways with folks.” As for appearances at work, Lohman typically leaves a few sets of clothes at the office, along with soap, shampoo, and deodorant. “I cycle wearing just regular old cotton shorts or pants and typically a breathable shirt with a screaming yellow reflective vest,” she says. “In the spring and fall, I can ride casually enough so that I don’t perspire too much. In the heat of the summer, when it’s 75 degrees and 98 percent humidity at 7:15 a.m., I have access to a shower at my office so I can freshen up.”
Lexington Riders Andy Hunter, owner of the Lexington Bicycle Shop in Rockbridge County, says that while bicycle commuting isn’t necessarily increasing in the town of 7,000, it has always been around. “When you have a small town, and you have colleges, you’re going to have a certain percentage of administration, faculty, and students that are going to ride their bicycles to school for convenience,” Hunter says. The small-town nature of Lexington also contributes to a relaxed bicycling experience. “We don’t have that big, four-lane divided boulevard,” Hunter says. “Main Street right in front of my shop is 25 miles an hour, if that. Such environments
have always been more conducive to cycling than the higher-speed, busier roads.”
From Roanoke County to Downtown Jamie Helmer can’t shower at the office yet, but her employer is working on it. “We have locker rooms and men’s and women’s bathrooms,” she says of her job site at Norfolk Southern’s downtown Roanoke shops. “They’re in the process of building showers.” Helmer commutes about six miles from the Hollins area for several reasons. “The downtown parking
situation isn’t ideal, so I feel like I’m walking halfway to work anyway,” she says. “I’d like to get a workout in, and this pretty much guarantees it. Once you’re out the door, you know you have to get to work and you have to get home.” And while her 12 miles a day don’t go far in terms of saving money or helping the planet, “I’m a firm believer that every little bit
If You Can’t Commute Not all bicycle enthusiasts choose to bike to work. Some enjoy riding on the region’s winding rural roads in the evenings and on weekends. Consider Jay Turner, owner of J.M. Turner & Co. general contractors of Roanoke. He bikes frequently to stay in shape. After joining the Marine reserves, where he lost 40 pounds, Turner vowed never to gain back the weight. He says Roanoke is great for cycling because you can go out your front door and be in the country in minutes. Or Nancy Galli, proprietor of Nancy’s Candy Co. in Meadows of Dan. She rides about 70 miles a week from spring through fall. “I ride and soak up the outdoors,” she says. “Riding is such a pleasure that it really improves my stress level and puts a smile on my face.” Glen Johnson of Roanoke, who is retired, gets in an average of 100 miles a week. “During the week I ride the Parkway, southwest Roanoke County, and the Roanoke Greenway,” he says. “On weekends we’ll throw the bikes in the car and hit the country roads in Botetourt, Craig, and Giles counties.” The main reason he rides? “Because it’s fun!”
CarilionClinic.org | Spring 2012
23
Regional Interest helps,” says Helmer. Her route along Plantation Road in northeast Roanoke does bring her into proximity with truck traffic. “It makes you a little nervous sometimes,” she says. But weather is mostly a non-factor. “Weather doesn’t really bother me, although if it’s icy, chances are I’m probably not going to ride.” Helmer, who has been commuting by bike for three years, finds Roanoke to be tolerant of cyclists. “There hasn’t been any rudeness,” she says. “People have been quite accommodating for the most part.” Her advice to those considering bicycle commuting? “I’d encourage
people to give it a shot,” she says. “The hardest thing is the first time. Once you do it and you know you can do it, the rest is easy.”
Easing Barriers Of course safety is paramount. But, says Holmes of Ride Solutions, “drivers are more scared of you as a cyclist than you are of them. They don't know what you’re going to do.” Holmes, who commutes by bike about 2.5 miles each way in a suit, says many obstacles can be overcome. Weather, for instance, is a poor excuse not to ride, he says. “It rains all the time in Portland [Oregon], and yet about 6 percent of the residents there bike to work.” Also, just because you drive on a certain road doesn’t mean you should bike on it, he says. “If you’re
wowing the world The world is taking notice of Aaron Dykstra, owner of SixEleven Bicycle Company of Roanoke. Dykstra’s handmade bicycles have been featured in publications across Europe and Asia, and he has built bikes for customers in Indonesia, Singapore, Hong Kong, and Europe, as well as throughout the United States. He has received two best-of-show awards at the North American Handmade Bicycle Show. “I want to create something that has value,” says Dykstra, noting that the majority of bikes made today are mass-manufactured at a handful of factories in Taiwan. “I believe that the integrity of the craftsman translates into the integrity of the product. And that very rarely happens on a foreign manufacturing line.” Dykstra, a Roanoke native who has lived in New York and Chicago, returned home with his wife Michelle in 2008. They started Six-Eleven in their basement and have since relocated it to downtown Roanoke. Why does he hand-build bikes? Because he loves it. And, he says: “We need more quality in our lives.” 24
Spring 2012 | CarilionClinic.org
Jeremy Holmes of Ride Solutions. concerned about biking on Brandon Avenue (a busy thoroughfare in Roanoke), you can go over to Windsor.” “If you’re interested, people here would love to help,” he says. “There’s a ton of support available. “We’re at the cusp of making biking a thing normal people do.”
Resources Ride Solutions www.ridesolutions.org Go Green NRV www.gogreennrv.com Roanoke Outside.com www.roanokeoutside.com Roanoke Cycling Organization www.roanokecycling.org Blue Ridge Bicycle Club www.brbcva.org New River Valley Bicycle Association www.nrvbike.org Blacksburg Bike Co-op www.bikeblacksburg.org Bike Shops www.roanokeoutside.com/stores/bikes
Earning the Gold Carilion Clinic Recognized for the Highest Standard of Care By Laura Markowski • Compliance with national standards; • Effective use of evidence-based clinical practice guidelines; and • An organized approach to performance measurement and improvement activities. The hospital’s heart failure and acute myocardial inJoint Commission surfarction, or heart attack, veyors examine medical programs were awarded protocols, safety procetheir first disease-specific dures, and overall quality care certification last of care. year. Programs for hip “Our entire team was and knee joint replaceproud to share their stoment and stroke were — Cindy Smith, R.N., ries and experiences with granted renewed certificaDirector of Cardiothoracic and Vascular Services the Joint Commission,” tion. Carilion Roanoke Memorial Hospital says Cindy Smith, R.N., The recognition means director of Cardiothoracic that Carilion Roanoke and Vascular Services at Roanoke Memorial. “We are Memorial Hospital meets the highest national stanfocused on providing quality care to every patient, every dards in treating these conditions. The Joint Commisday.” sion, an independent, not-for-profit organization, is the nation’s leading accrediting body in health care. All Carilion Clinic hospitals are accredited by The Joint To earn national certification, hospitals must unCommission. In addition, The Joint Commission awards dergo stringent on-site reviews. Disease-specific certifidisease-specific certifications to those hospitals that cation is awarded for two years for: meet stringent criteria.
Five specialty care programs at Carilion Roanoke Memorial Hospital have been awarded national certification and the “Gold Seal of Approval™” by The Joint Commission.
“We are focused on providing quality care to every patient, every day.”
CarilionClinic.org | Spring 2012
25
Regional Interest
F O R L L O O V V E E
T H E O O F F
T H E AT R E By Otesa Middleton Miles
There’s never been a better time to enjoy a night out at the theatre. From classic dramas to edgy contemporary plays, southwest Virginia’s theatre companies are staging it all. “There’s something for everybody,” says Ginger Poole, Mill Mountain Theatre’s managing director and director of education. “It’s a perk of living in our area, and it’s exciting to see new theatre companies popping up and having sustainable seasons. It’s a testament to what this region can do.” Mill Mountain, with an annual budget of $1.2 million, will produce three to five shows in 2012. It is temporarily staging productions at the 125-seat Waldron Stage theatre at 20 Church St. while its 345-seat venue at Roanoke’s Center in the Square is renovated. Mill Mountain’s conservatory also offers year-round classes in theatre and dance to children and adults. “In today’s economy, it puts a smile on my face that a large group of people are still willing to support live theatre in this area,” Poole says. Indeed, live theatre is getting more attention all over the region, says Michael Anthony Williams, co-founder and producing artistic director of the Actors Theater of Blacksburg. “The scene is growing,” he says. Williams, a professional actor who has a role in Steven Spielberg’s upcoming movie, Lincoln, moved to the area to teach at Virginia Tech four years ago. The Actors Theatre produces “edgy professional scripts,” he says, along with original scripts featuring professional artists from around the country. It also provides acting lessons through its conservatory and youth summer camps. The Actors Theater of Blacksburg plans to produce three shows in 2012.
L to R: Scenes from the Roanoke Children’s Theatre production of A Year with Frog and Toad; the New River Stage production of Once Upon a Mattress; and the Gamut Theatre production of The Lover by Harold Pinter. 26
Spring 2012 | CarilionClinic.org
In a recent survey, residents of the region said they seek these elements in arts and cultural events: • Not just entertainment, but educational engagement for adults and their children and grandchildren • More arts and cultural events for children • More visual art • Opportunities for professional and client entertainment • Variety in offerings • More international exposure and events that showcase different cultures SOURCE: THE CENTER FOR THE ARTS AT VIRGINIA TECH.
CarilionClinic.org | Spring 2012
27
Knights and ladies dance in a scene from Once Upon a Mattress, produced by the New River Stage.
where to Find Live Theatre Mill Mountain Theatre Roanoke www.millmountain.org Studio Roanoke www.studioroanoke.org Hollins Theatre Roanoke www.hollins.edu/theatre Also focusing on original works is Studio Roanoke, which produces eight shows annually for an intimate audience of about 50 people. “Our focus is on original, edgier, less traditional work,” says Ben R. Williams, the general manager. Studio Roanoke also hosts a combination of stage readings and live music. With numerous opportunities available to see live performances, Kathy Guy, managing producing director of Gamut Theatre, calls the theatre scene “thriving.” “Roanoke is experiencing a renaissance in the arts,” says Guy, whose shows are performed at various venues, including the 130-seat June M. McBroom Theater in the new Community High School of Arts & Academics downtown. “For a city of this size, it’s really got a lot of creative energy.” Jeanne Truesdell, treasurer of New River Stage in Blacksburg, says her group is a true community theatre that even has a partial volunteer orchestra for some performances. “Everybody does it because they love theatre. They donate all of their time,” she says. New River Stage offers both adult and children’s theatre productions, summer theatre camps, and afterschool workshops for children.
28
Spring 2012 | CarilionClinic.org
Young actors are always the focus at the Roanoke Children’s Theatre, which stages four major productions a year featuring professional and amateur child actors. The theatre also offers programs and classes for area schools —and a theatre school for budding acting talents. The Children’s Theatre, located at the Taubman Museum of Art in Roanoke, teaches 700 students inhouse and around the region annually and has a youth board of directors. “Most of our plays are based on books,” says Pat Wilhelms, the theatre’s artistic director. “It’s a way to bring the [school] curriculum alive.” Then there is the Barter Theatre of Abingdon, where during the Depression, playwrights such as Noel Coward, Tennessee Williams, and Thornton Wilder accepted Virginia ham in lieu of royalties. The theatre is also known for an illustrious roster of actors who later went on to fame and fortune, including Gregory Peck, Patricia Neal, Ernest Borgnine, Hume Cronyn, and Kevin Spacey. Today the theatre attracts more than 140,000 patrons a year from many states. Truly, southwest Virginia theatre lovers never had it so good.
Showtimers Roanoke www.showtimers.org Actors Theater of Blacksburg Performances at the Jefferson Center, Roanoke and at the Lyric Theatre, Blacksburg www.actorstheaterofblacksburg.org Gamut Theatre Salem www.gamuttheatre.com Roanoke Children’s Theatre At the Taubman Museum of Art www.roanokechildrenstheatre.org Attic Productions Fincastle www.atticproductions.info New River Stage Blacksburg www.newriverstage.com Summer Musical Enterprise Virginia Tech Blacksburg www.civic.bev.net/sme Barter Theatre Abingdon www.bartertheatre.com
New Treatment Approved for Advanced Heart Failure By Karen Doss Bowman
Heart failure patients in southwest Virginia now have a new treatment option. Carilion Clinic has been approved to implant a device that can prolong the lives of advanced heart failure patients by several years. Carilion will be one of only two sites in Virginia implanting the device that do not do heart transplants. The other is in Richmond. The device, called HeartMate II, is a mechanHeartMate II ical pump that circulates blood throughout the body. Implanted in the patient’s chest or abdomen, the device takes over the pumping function of the left ventricle, the main pumping chamber of the heart. “From a cardiovascular standpoint, the device takes over the function of the heart and gives patients a normal cardiac output,” cardiologist Stephen Phillips, M.D., says. “Many patients can have a pretty normal functional status in terms of going back to work and doing the things they enjoy.” “Being able to offer HeartMate in Roanoke is going to mean peace of mind for area patients because they’ll be closer to their implant facility,” says Shayna Haga, R.N., HeartMate coordinator for Carilion Clinic. The device will be available for two types of patients. Those who are on the waiting list for a heart transplant may receive the device as “a bridge to transplant,” says cardiothoracic surgeon Scott Arnold, M.D. Transplant candidates will then be referred to the University of Virginia or other regional transplant centers. Patients who are not candidates for heart transplants due to age or other medical conditions may be given the device as “destination therapy,” potentially prolonging life expectancy and improving quality of life. Former U.S. Vice President Dick Cheney, for instance, has received an implant as destination therapy. HeartMate II, a left-ventricular assist device (LVAD), is manufactured by Thoratec Corp. Thoratec research suggests that most patients can expect HeartMate II to last at least five years. “This new treatment represents ongoing progress in the development of our heart failure program,” says Dr. Arnold. “We remain committed to providing the best and most advanced therapies in cardiac care to our community.” For more information, call 540-266-6000 or 800-422-8482.
CarilionClinic.org | Spring 2012
29
Physicians
New Physicians Ear, Nose and Throat Specialist Joins Carilion Clinic Otolaryngology William P. Magdycz, M.D., an otolaryngologist and head and neck surgeon, has joined Carilion Clinic. He has particular interests and expertise in head and neck cancer surgery, thyroid, substerWilliam P. Magdycz, M.D. nal goiter and parathyroid surgery, and vocal cord paralysis. Dr. Magdycz comes to Carilion from the Naval Medical Center in Portsmouth, Va., where he was the attending surgeon of Head and Neck Surgical Oncology and residency program director of the Department of Otolaryngology/Head and Neck Surgery. He also served as assistant professor of surgery at the Uniformed Services University School of Medicine, where he earned his M.D. degree. He completed his residency in otolaryngology/head
and neck surgery at Walter Reed Army Medical Center and a fellowship in head and neck oncologic, cranial base, and microvascular reconstruction surgery at Vanderbilt University Medical Center. He is certified by the American Board of Otolaryngology and the National Board of Medical Examiners. Dr. Magdycz has lectured on a range of topics, including head and neck cancer; injury and trauma on the battlefield; hyperthyroidism; skin cancer risk and prevention; and sinusitis vs. migraine. His publications include papers on tongue reconstruction and Graves disease. As a colonel in the U.S. Army Medical Corps, Dr. Magdycz was deployed to Baghdad, Iraq in 2007 as the theater surgical consultant, and he has volunteered for 11 non-military medical missions to Haiti since 1996. Dr. Magdycz practices at 1 Riverside Circle in Roanoke and can be reached at 540-581-0180.
Pediatric Endocrinologist Joins Carilion Clinic Erica B. Reynolds, M.D., a specialist in pediatric medicine and pediatric endocrinology, has joined Carilion Clinic. Dr. Reynolds comes to Carilion from Cincinnati Childrenâ&#x20AC;&#x2122;s Hospital Medical Center, where she Erica B. Reynolds, M.D. completed a fellowship in pediatric endocrinology. She earned her M.D. degree from Eastern Virginia Medical School in Norfolk and her masterâ&#x20AC;&#x2122;s in medical education degree from the University of Cincinnati. She completed her pediatric residency at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., where she also served as clinical instructor of pediatrics. She has a clinical interest in patients with Types 1 and 2 diabetes and disorders of the pituitary, thyroid, growth, puberty, and sexual development. She
30
Spring 2012 | CarilionClinic.org
also has an interest in international medical volunteering and has worked at medical clinics in Guatemala, Haiti, and the West Bank of Israel. While at Wake Forest, she was honored for her exemplary commitment to patient care. Dr. Reynolds has published research on heart rates in obese patients with sleep apnea and physical activity among overweight Latino children. Her most current research is in fatty liver disease in youth with Type 2 diabetes. She also has a strong interest in medical education and will be serving as director of the third-year medical student clerkship in pediatrics for the Virginia Tech Carilion School of Medicine. She practices pediatric endocrinology at 102 Highland Ave. in Roanoke (540-224-4545) and sees general pediatric patients at 4040 Postal Drive in Roanoke (540-772-4453).
Eric Hong-Wen Chen, M.D. Family Medicine
Kelly V. Hyde, M.D. Trauma Surgery
Education: College of William and Mary Medical Degree: University of North Carolina at Chapel Hill Residency: MAHEC-Hendersonville Rural Family Medicine Fellowship: Family medicine with obstetrics, University of Utah and Community Health Centers 2145 Mount Pleasant Blvd., Roanoke, VA 24014 540-427-9200
Education: Texas Tech Medical Degree: University of Texas Residency: Carilion Clinic 3 Riverside Circle, Roanoke, VA 24016 540-224-5170
Daliborka Danelisen, D.O. Psychiatry
Kinga A. Powers, M.D., Ph.D. Trauma, General and Bariatric Surgery
Education: University of North Carolina at Greensboro Medical Degree: Edward Via Virginia College of Osteopathic Medicine Residency: Virginia Commonwealth University 2900 Lamb Circle, Christiansburg, VA, 24073 540-731-7311
Education: University of Toronto Medical Degree: Queens University Residency: University of Toronto Fellowship: Advanced minimally invasive surgery, Beth Israel Deaconess Medical Center, Harvard Medical Center 1906 Belleview Ave., Roanoke, VA 24014 540-224-5170
John J. Ferrara, M.D. Trauma and General Surgery
Ricardo Riegodedios, M.D. Radiology
Education: St. Louis University Medical Degree: St. Louis University Residency: The Ohio State University 3 Riverside Circle, Roanoke, VA 24016 540-224-5170
Education: University of South Carolina Medical Degree: University of South Carolina Residency: Naval Medical Center – Portsmouth 1906 Belleview Ave., Roanoke, VA 24014 540-981-7000
Mark E. Hamill, M.D. Trauma and Critical Care Surgery
Jennifer K. Rypel, D.M.D. Dentistry
Education: Long Island University – C.W. Post Campus Medical Degree: State University of New York Upstate Medical University’s College of Medicine Residency: Medical University of South Carolina Fellowship: Surgical critical care, University of Texas – Southwestern Medical Center 3 Riverside Circle, Roanoke, VA 24016 540-224-5170
Education: The University of Alabama at Birmingham Medical Degree: University of Alabama School of Dentistry Residency: St. John’s Mercy Medical Center 2017 S. Jefferson St., Roanoke, VA 24014 540-981-7128
Corey Heitz, M.D. Emergency Medicine Education: University of North Carolina, Wilmington Medical Degree: Eastern Virginia Medical School Residency: Wake Forest University Baptist Medical Center Fellowship: Faculty and academic development, Boonshoft School of Medicine – Wright State University 1906 Belleview Ave., Roanoke, VA 24014 540-981-7000
CarilionClinic.org | Spring 2012
31
Better Living
Your Calendar for Better Health Spring 2012 SMOKE-FREE
March
12
Noon – 1 p.m. Bedford Memorial Hospital Please call 540-587-3308 to register.
GET FIT FOR HEALTH MAMMOGRAMS/GYNECOLOGY SCREENINGS
April
28
7 a.m. – 2 p.m. Carilion Giles Community Hospital $20 Please call 800-422-8482 to register.
wOMEN’S LIFESTYLE ExPO
April
14
10 a.m. – 3 p.m. New River Valley Mall, Christiansburg Please call 540-731-2000 for more information.
BOY TALK
May
2
CHOLESTEROL SCREENING/HEALTH FAIR (12-hour fast required)
April
19
8 – 10 a.m. Berkshire Health and Rehab, Vinton $15 Please call 540-266-6000 to register.
April
23
32
A discussion of issues surrounding puberty for girls ages 9-12 and parents/ caregivers 6 – 9 p.m. Carilion Roanoke Memorial Hospital $5 per person Please call 800-422-8482 to register.
Spring 2012 | CarilionClinic.org
• A 60-day membership for $60 • Full access to the Roanoke and Botetourt Athletic Clubs and the new RAC Xpress in downtown Roanoke • Two fitness consults • An individualized fitness plan to follow • Weekly one-on-one training sessions with a certified personal trainer For more information, visit carilionfitness.com.
wOMEN’S HEALTH UNIVERSITY
May
3
GIRL TALK
A discussion of issues surrounding puberty for boys ages 9-12 and parents/caregivers 6 – 9 p.m. Carilion Roanoke Memorial Hospital $5 per person Please call 800-422-8482 to register.
If you’re looking for ways to improve your health, the Carilion Clinic Fit Rx Medical Membership Program may be for you. It includes:
All about back health 11:30 a.m. – 1:30 p.m. Jefferson Center, Roanoke $15 (includes lunch) Please call 540-266-6000 to register.
PHYSICIANS ON FOOT
8:30 a.m. Every ay Tanglewood Mall Saturd For more information, call 540-266-6000 or visit CarilionClinic.org/walking.
For more events, classes, and screenings, visit CarilionClinic.org/calendar or call 540-266-6000.
CARILION CLINIC P.O. BOx 13727 ROANOKE, VA 24036-3727
NON-PROFIT ORG. U.S. POSTAGE
PAID ROANOKE, VA PERMIT NO. 247
▼ Scan this code to sign up for the Carilion Clinic Living e-newsletter. Learn more at CarilionClinic.org/qrcode
For Urgencies THAT AREN’T
Emergencies
When life happens, VelocityCare is here for you. VelocityCare is your community choice for urgent care services. Bridging the gap between primary care and the emergency room, VelocityCare will soon be open seven days a week, with extended hours for your convenience. Appointments are not required. And if you need a referral, VelocityCare will be the only urgent care service in southwest Virginia with direct access to Carilion Clinic’s comprehensive network of primary and specialty care physicians.
For more information, visit VelocityCareByCarilion.com or call 540-266-6800.