CENTR A FOCUS HEALTH AND WELLNESS IN CENTRAL AND SOUTHSIDE VIRGINIA | ISSUE 3, 2016
Reason to Celebrate
Michelle Thomas’ new life after breast cancer
Home Away From Home Farmville couple keeps their independence with Centra PACE
When Disaster Strikes
Southside Community Hospital cares for tornado victims
+ MINIMALLY INVASIVE GYNECOLOGY
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Centra E.W. Tibbs Jr., RN, BSN, MBA President & Chief Executive Officer David Adams Executive Vice President & Chief Strategy Officer Rob Tonkinson Senior Vice President & Chief Financial Officer Daniel Carey, MD Senior Vice President & Chief Medical Officer Michael Elliott Senior Vice President of Operations Patti McCue, ScD, RN, MSN Senior Vice President & Chief Nursing Officer H. Lester Reed, MD Senior Vice President & President, Centra Medical Group Jan Walker Senior Vice President & Chief Human Resources Officer
Board of Directors Walker P. Sydnor Jr. Amy G. Ray E.W. Tibbs Jr., RN, BSN, MBA Albert M. Baker, MD Michael V. Bradford Julie P. Doyle H.C. Eschenroeder Jr., MD Sharon L. Harrup Hank Hubbard John R. Mack Jeffrey R. Rowan Verna R. Sellers, MD Francis E. Wood Jr. R. Sackett Wood George R. Zippel Officers David Gough David Adams
Chairman Vice Chairman President & CEO
REASON TO CELEBRATE
2
WHEN DISASTER STRIKES
8
HOME AWAY FROM HOME
12
BACK TO NORMAL
16
REACH OUT AND READ
19
CENTRA FOUNDATION
20
Michelle Thomas’ new life after breast cancer
Southside Community Hospital cares for tornado victims
Farmville couple keeps their independence with Centra PACE
Interim Treasurer Secretary
Foundation Board of Directors George A. Hurt, MD Mark D. Townsend, MD E.W. Tibbs Jr., RN, BSN, MBA Kathryn M. Pumphrey, EdD David Gough Robert R. Chapman III Melanie Christian Theodore J. Craddock Thomas J. Delaney, MD Michael J. Diminick, MD MaryJane Dolan Patsy A. Dooley Paul F. Fitzgerald, MD Robert H. Gilliam Jr. John J. Halpin, MD Janet Hickman, MD Yuille Holt III Augustus A. Petticolas Jr., DDS Mary Jane Pryor Elliot S. Schewel John H. Sorrells III Walker P. Sydnor
CONTENTS
Chairman Vice Chairman President Executive Vice President Treasurer
Minimally invasive gynecological surgery does the trick
Doctors and nurses promote early literacy
Roadmap to better health
ON THE COVER
Michelle Thomas starts a new life after beating breast cancer as chief operating officer at Southern Provisions Company in Lynchburg.
Medical Staff Officers Chris M. Thomson, MD Shawn Hayes, MD Kwabena Donkor, MD John Kerr Jr., MD
President, Centra Vice President, Centra President, Southside Community Hospital President, Bedford Memorial Hospital
Editorial Staff William Varner Angela Bryant Dana Poleski Jonathan Parker
Vice President Director Editor Assistant Editor
To place your name on our mailing list, call Centra Communications & Marketing, 434.200.4730. Centra is a regional, nonprofit healthcare system based in Lynchburg and serving central and southside Virginia. We are comprised of Centra Lynchburg General, Virginia Baptist, Southside Community and Bedford Memorial hospitals, the Centra Medical Group network of primary care practices and specialty centers and numerous other health facilities and programs throughout the state.
Contributing Photographers Andrew Wilds , Jonathan Parker, Christy Fore, Kate Kolb Contributing Writers Jonathan Parker, Kate Kolb
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2 | CENTR A FOCUS
Reason to Celebrate
Michelle Thomas’ new life after breast cancer
A
tiara fit the occasion. After beating breast cancer, Michelle Thomas deserved to feel a little like royalty as she stood before a sea of friends, family and nurses in the Healing Garden behind the Centra Alan B. Pearson Regional Cancer Center in April. Each person made a profound impact on her life during her darkest days. Each came to celebrate the end of her cancer treatments and a new beginning. Thomas pulled out her cell phone and took a selfie with her friends waving behind her. Her remarks were brief, but personal, thanking each one for caring for her during a year of chemotherapy treatments, a double mastectomy, breast reconstruction surgeries and physical therapy. Every note, email, text or gift was noted in a journal she kept close. She drew strength from those acts of kindness each day. “This town has been so amazing since the day I was diagnosed,” Thomas said. “Every day, there would be a card in the mail, flowers on the front step or a meal. I would write them down and read them often.” Thomas turned to the large brass survivor’s bell. Chimes rang out across the garden. “I think everyone that goes through this, can’t wait to ring that bell,” Thomas said. “That beautiful bell in the garden is just such a great symbol of the end of something horrible and the beginning of your life cancer free. I would ring it every day if I could.”
Getting the news Thomas felt a lump on her breast in January 2015. A screening mammogram detected a suspicious mass in her right breast. She had a biopsy, which confirmed invasive ductal carcinoma, at Centra Breast Imaging Center at Virginia Baptist Hospital. Invasive ductal carcinoma is the most common type of breast cancer, accounting for 80 percent of breast cancer cases. Invasive means that the cancer has “invaded” or spread to the surrounding breast tissues “I just kept hoping it was a cyst, that it would be something they could remove,” Thomas said. “You never want to get that phone call. You wouldn’t wish that on anyone and everything just stops.”
An oncology nurse navigator contacted Thomas, helping schedule appointments and providing support throughout cancer treatments. “Our nurse navigators are so important in helping our patients traverse our health system,” Cecilia MacCallum, MD, medical oncologist, said. “They provide amazing support to our patients.” She started chemotherapy at Centra Alan B. Pearson Regional Cancer Center within weeks. Thomas, who owned The Urban Merchant, a downtown Lynchburg boutique, put her life on hold for almost a year to recover from treatments and surgery. Her daughters, Madi Davis and Lexie Davis, worked through the summer to close the boutique. “I had to close my store because I was so sick from the chemo treatments,” Thomas said. “I was unable to work for almost a year.” Dr. MacCallum shepherded Thomas through the treatment process. “Ceci has such a calming effect,” Thomas said. “Not surviving was never an option when we talked. We were going to beat this cancer and we did.” Dr. MacCallum said every patient’s case is discussed during the cancer center’s weekly breast cancer conference. Surgeons, pathologists, radiation oncologists, medical oncologists, mammographers and oncology navigators review each patient’s mammograms and pathology reports to create a personalized treatment plan. “That’s a really important piece of our program,” Dr. MacCallum said. “We really do take each patient individually.” Oncologists treat hundreds of different cancers and each respond differently to treatment. Thomas’ specific cancer responded well to chemotherapy before surgery. “It depends on each cancer and each person because not everyone gets the same treatment. Because of Michelle’s specific case, she got a very aggressive treatment from the start,” Dr. MacCallum said. After six months of chemotherapy treatments, Thomas had a double mastectomy in September. The tumor was barely noticeable by the time she went in for surgery. During a nine-hour surgery, Peter Ploch, MD, performed the double mastectomy and Henry Wilson, MD, a plastic surgeon, completed a breast reconstruction procedure. a
ISSUE 3, 2016 | 3
In December, Thomas had an exchange surgery where Wilson took out the expanders and put in permanent breast implants. “Because of my age, I always knew I wanted the breast reconstruction surgery,” Thomas said. “It made me feel whole again. It’s bad enough that you have this awful disease. I’m so glad I had the reconstruction.” Throughout her year-long treatment, Thomas trusted her care team and physicians to provide cancer expertise. “I had the dream team,” Thomas said. “The whole staff at the Pearson Cancer Center was amazing. I never felt the need to go out of town for treatment.” Thomas continued chemo treatments until April, culminating in a celebration in the healing garden with champagne and cake. Beyond her treatment, Thomas found a support staff committed to her personal needs. Inside the Image Recovery Center, which sits inside the cancer center, Thomas was fitted for specialty bras and scarves when she lost her hair. The Image Recovery Center staff pampers patients with pedicures, manicures and oncology massages, helping them regain a sense of normalcy.
“The Image Recovery Center staff is so very capable and empathetic,” Thomas said. “They spent a lot of time sharing with me the prosthetics and support garments I would need during my journey and recovery.” The cancer center is designed to offer hope and comfort. Musicians regularly perform in the lobby. Knitting groups and Tai Chi classes are offered each week. Patients can walk the floors and admire beautiful paintings by local artists. The Healing Garden provides a peaceful area to listen to the fountain while relaxing in a rocking chair. A vegetable garden yields fresh produce, given away to patients from spring to fall. The cancer center staff doesn’t just provide treatments. They care for each patient’s unique needs.
Getting on with life Southern Provisions Company is swamped on opening day. Thomas, who joined the business as chief operating officer this spring, greets customers and offers tours. She’s in her element. “I’m lucky and grateful that my treatment is over and I can move on,” she said.
Clockwise from top: Thomas rings the commemorative bell at the cancer center during her party. She is joined by Michelle Wallace, RNII (left) and Cecilia MacCallum, MD (right). Thomas and her daughters Madi (left) and Lexie (right). A special cake to celebrate the end of Thomas' chemo treatment. Thomas' friends and family gather in the garden at the cancer center for the celebration. 4 | CENTR A FOCUS
After owning her business downtown, Thomas is glad to be dealing with customers again. “It is life-changing to go through this,” Thomas said. “I didn’t know where I would come out on the other side of this.” Thomas wants to work as a volunteer at the cancer center to share hope with patients. “I want to tell people, ‘You are going to make it. You are going to get through this.’”
As she looked out over the crowd at her celebration, she looked at her care team and MacCallum. “I thank you for my life,” Thomas said. Lots to live for and lots left to do. See more of Michelle Thomas’ cancer jouney with a special video at Cancer.CentraHealth.com. a
Dr. MacCallum said oncologists, nurses and support staff spend hours with individuals during their hardest days. “We are privileged to see these patients during one of the hardest parts of their lives,” she said. “We are always honest and share pathology reports and expected outcomes, but hope is an integral part of care.” Optimism is important in cancer treatment, Dr. MacCallum said. “Ultimately, cancer has a mind of its own so a major part of our job is to encourage our patients and keep them focused on their treatment,” the oncologist said. “Remaining positive and energized helps patients through what is often a lengthy treatment.” Thomas tells the crowd the key stats from her cancer journey. She knows them well: 388 days since being diagnosed, 55 doctor’s visits, 52 weeks of chemotherapy treatments, five surgeries, six echocardiograms, 25 physical therapy sessions and 219 days cancer free.
Thomas and her daughters enjoy walks with their poodle along Rivermont Avenue.
Thomas loves working with customers again at Southern Provisions Company on Langhorne Road in Lynchburg.
ISSUE 3, 2016 | 5
Breast cancer symptoms
Breast reconstruction
The symptoms of breast cancer vary, ranging from skin irritation to a lump in the underarm area, and some breast cancers have no obvious symptoms at all. Often the first sign of breast cancer is a new lump or mass in the breast that you or your doctor can feel. A lump that is painless, hard and has uneven edges is more likely to be cancerous, but breast cancer also can be soft, tender, rounded or painful.
After a lengthy battle with breast cancer, many women are left with the emotional aftermath of a mastectomy. The hardest parts – the initial shock, surgery and chemotherapy – are over, but the physical and emotional healing takes time. Memories are never erased, but breast reconstruction surgery at least allows a woman to look in the mirror each day without a glaring reminder of the past.
According to the American Cancer Society, breast cancer symptoms include:
According to national statistics, half of women who undergo a full mastectomy never see a breast reconstruction surgeon. Some women are not candidates for the procedure, but many can benefit from the surgery, retrieving a sense of normalcy.
• A lump in the breast • Swelling of all or part of the breast (even if no distinct lump is felt) • A lump in the underarm area • Skin irritation or dimpling • Breast pain • Nipple pain or the nipple turning inward • Redness, scaly or thickening of the nipple or breast skin • A nipple discharge other than breast milk The above changes also can be signs of less serious conditions that are not cancerous, such as a cyst or an infection. Although many breast changes are not cancerous, it’s important to see your physician if you find a lump or any other change in your breast—even if you’ve recently had a mammogram with normal results. Research has advanced chemotherapy over the years, according to Cecilia MacCallum, MD, medical oncologist. “Women are doing very well with treatment for breast cancer now. The chemo has come a long way,” she said.
Breast cancer doesn’t just attack cells, it penetrates at an emotional level, particularly when a mastectomy – on one or both sides – is part of the treatment plan. With such a significant part of the body removed, it is not surprising that many patients express body image worries. A mastectomy is not just a major life event, but a substantial emotional loss. It is easily compared to losing a limb. Many survivors go through life constantly reminded of a difficult fight with cancer. Breast reconstruction surgery isn’t for every woman, but for many, the safe procedure allows them to get back something lost and put cancer in the rearview mirror.
Centra Medical Group Plastic Surgery Center board-certified plastic surgeons:
Dr. MacCallum encourages women to have their annual screening mammogram. “Never be afraid to discuss changes in your breasts with your primary care doctor,” Dr. MacCallum said. “Women know their bodies best.”
Cecilia MacCallum, MD medical oncologist
For more information about oncology services at the Centra Alan B. Pearson Regional Cancer Center and the Centra Breast Imaging Center, visit Cancer.CentraHealth.com.
Simon Hatin, MD
Keith Pitzer, MD
Timothy J. Silvester, MD
Henry Wilson, MD, FACS
Centra Breast Cancer Services are nationally accredited by the National Accreditation Program for Breast Centers (NAPBC). The Centra Breast Imaging Center is designated a Breast Imaging Center of Excellence by the American College of Radiology (ARC).
For more information about breast reconstruction and the Centra Medical Group Plastic Surgery Center, call 434.200.4350 or visit CentraMedicalGroup.com/PlasticSurgery. 6 | CENTR A FOCUS
Oncology breast navigators
STAR program oncology rehabilitation
Centra Alan B. Pearson Regional Cancer Center offers an oncology breast navigation program to assist patients with the many challenges that come with a cancer diagnosis. The program provides newly diagnosed breast cancer patients with the latest in treatment options and recommendations through its multidisciplinary breast cancer team.
Cancer patients benefit from the Centra Survivorship Training and Rehabilitation (STAR) program, which prepares individuals for life after cancer. The program is open to patients at any stage of cancer or recovery phase. Survivors participate in rehabilitation to manage the effects of cancer and treatment-related conditions.
This team of specialists is made up of radiologists, pathologists, medical oncologists, radiation oncologists, surgeons and oncology breast navigation nurses. The breast cancer team meets weekly to evaluate and discuss its patients. They review mammograms, breast MRls and pathology reports in order to make recommendations for further treatments. It is often difficult to understand the specific care and treatment options at a time when you may be feeling overwhelmed. The oncology breast navigators – all registered nurses – are a primary resource for breast cancer patients and the people who care for them. The navigators will help overcome hurdles often encountered during diagnosis and treatment by: • Helping understand the nature of your specific diagnosis and treatment plans • Making educational materials available • Answering questions throughout the treatment journey • Ensuring each patient has a multidisciplinary, team-based approach to care • Providing encouragement and support for the physical, spiritual and psychological needs during and after illness • Assisting in locating additional community information and resources
Nurse navigators at the Centra Alan B. Pearson Regional Cancer Center guide patients through their treatment.
L to R: Terri Lewis, RN; Amy Clemons, RN; Amanda Bruffy, RN; Lindsay Lacey, RN; and Kara Lamb, RN
For more information on the oncology nurse navigators, visit Cancer.CentraHealth.com.
Newly diagnosed patients can increase strength and endurance to prevent future medical problems. Years after treatments end, rehab interventions can improve functioning and stamina. “Cancer survivors often live with lingering effects after treatment,” said Amy Deramus, RN, business manager of Centra Outpatient Rehabilitation. “By recognizing survivorship as part of cancer care, the STAR team helps patients improve mobility and fatigue.” Centra became the first healthcare system in the nation to offer the STAR program, which provides a personalized treatment plan for individual needs. The STAR medical team includes: • • • • • • •
Physicians Occupational, physical and speech therapists Dietitians Social workers Exercise physiologists Lymphedema therapists Wellness professionals
Centra Outpatient Rehabilitation services are offered at: • • • •
Centra Virginia Baptist Hospital (Lynchburg) Jamerson Family YMCA (Lynchburg) Centra Bedford Memorial Hospital Centra Southside Community Hospital (Farmville) • Centra Gretna Medical Center • Centra Medical Group Orthopaedic & Rehabilitation Specialists (Danville) STAR program participants increase strength and endurance, helping them prepare for life after cancer.
For more information on the Centra STAR program and Centra Outpatient Rehabilitation, call 434.200.4668 or visit Rehab.CentraHealth.com.
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When Disaster Strikes
Centra Southside Community Hospital cares for victims of the Appomattox tornado
S
ix months after an F3 tornado ripped through the heart of Appomattox County, a tattered American flag flaps in the wind. It’s a symbol of resiliency and hope. Broken, but not defeated. All around, piles of snapped trees and new construction serve as reminders of the devastating storm that left families homeless and one person dead.
As rescue crews rushed to the disaster, Centra Southside Community Hospital’s emergency department staff prepared to care for a variety of patients injured in the tornado. Kallie Crews, RN, a shift manager, remembers walking into a wellorchestrated department ready to support devastated victims. The emergency department staff treated six patients, including two critical patients. “Walking into that ER, you would not know there had been a huge disaster. Everyone was calm and everyone was working together,” Crews said. “It made me so proud to be a Centra nurse when I walked into that department.” For one patient, the care went well beyond her physical needs. Minor cuts were sutured, but her family lost everything in the storm. They didn’t know where to go or what to do.
Survival mode Roselle and Thomas Brown with their grandson Lorenzo at the site of their new home.
Roselle and Thomas Brown pull into their driveway in Evergreen, a small community off U.S. 460, between Appomattox and Farmville. The only thing ISSUE 3, 2016 | 9
a
left of their home is a concrete pad. Broken dishes and tiny blocks mark one corner of the house. They stop for a second and look across an open field. Workers are repairing a roof ripped from a church. Their neighbor’s home was leveled too.
Concrete blocks line the pad, as the family begins to rebuild their home. The ground is muddy except for one small rose bush, which bloomed months after the twister left their home mangled. The bright red petals are poetic – life moves on.
wouldn’t budge. “Something said, ‘Look up.’ I looked up and my roof was coming off and our big pine tree was coming down,” she said. She laid on her grandson to protect him from debris whipping overhead. She slid an iPad to her grandson to calm him during the storm, which lasted only minutes, but felt like an eternity. “I was sort of in survival mode. I was very fearful, but I knew I had to do something to save my grandson. I knew I had to get on him and protect him from all of the flying debris going through the house,” she said. “I didn’t know how much my body was hit with debris until a few days later after I saw all the bruises on my back and arms. It was a miracle that my grandson and I survived.” As rain poured in, they climbed out a window. Her neighbor’s brick house was in ruins. The house to her left was badly damaged and her vehicle was totaled. Her house was badly damaged, but she and her grandson were safe. An ambulance carried them to Centra Southside Community Hospital. Thomas Brown, who was waiting at a nearby school to take children to an afterschool program, tried desperately to get in touch with his family. He drove around for an hour trying to get into Evergreen, but downed trees blocked the roads. “I was just so tore up inside because I couldn’t get to them to help them,” he said. A family friend drove him to Farmville to be with his family at the hospital. “The people at the hospital were just so great at taking care of our family. It was just amazing to see people pulling together to take care of people in this tragedy,” he said.
Beyond medicine Roselle Brown and her grandson were immediately taken to a bay in the emergency room. A nurse practitioner stitched up gashes on her head and arm. “They were very compassionate to our needs,” Roselle Brown said. “They made sure we had everything we needed.”
In the midst of tragedy, they learned more about their neighbors and community than any other time in their lives. “It was great to see that little area in Appomattox County come together and be as one to pull together and see us through all these things,” Thomas Brown said. Roselle Brown still gets jittery when the sky gets cloudy and the wind howls. She remembers February 24 well. She and her grandson, Lorenzo, were getting ready to leave. She looked out and the clouds were dark and the wind picked up. She gathered a few things and tried to open the door, but it 10 | CENTR A FOCUS
Just before discharge, Crews told her supervisor, Ginny Elder, RN, that the family would be leaving with only the clothes on their backs and no home. Elder called around to find a shelter before making a reservation for the family at a Lynchburg hotel. “They had lost everything,” Elder said. Elder asked everyone to help. Within minutes, the ED staff collected over $300 to give the family. “The staff started reaching into their pockets and digging deep. I wasn’t surprised at all because that’s who we are at Centra Southside,” Elder said. A local restaurant donated eight dinners. “They made sure we had food and a place to go,” Brown said. “We didn’t have to
worry about where we were going to go that night.” Roselle Brown had only the clothes on her back. Her shirt was ripped and bloody. A nurse walked in with a clean sweatshirt. “They went beyond the compassionate Ginny Elder, RN, and Kallie Crews, RN, work in the level of care,” she emergency department at Southside Community Hospital said. “They were and were prepared to help victims of the tornado. so personal. They just reached out and took care of me. It was just like a family taking care of family there.” Elder said the staff wanted to do anything they could to help. It was an emotional scene when the Browns left. “She laid her head on my shoulder and cried and I just held her in my arms. Taking care of people is more than just giving them medicine. It’s doing whatever we can to help them get through their day,” Elder said.
The nursing staff called to check on the family the next day, Brown said. “It was the right thing to do. Everybody just jumped in. No one thought twice. It’s complete and total healthcare – mind, body and soul,” Crews said.
After the storm The Browns are living with family as they rebuild their family home. “Evergreen is our home and we are rebuilding,” Roselle Brown said. “You don’t know the love until a tragedy happens and everyone comes together.” Support pours in from churches and non-profit organizations to care for the tornado victims. Neighbors check on each other regularly. “Our neighborhood came together as one to help out everybody that was in our neighborhood,” Thomas Brown said. “That was outstanding. That was God’s work.” Brown keeps the sweatshirt close, a sentimental reminder of selfless acts during a time of need. “It represents warmth and comfort to me, knowing the nurse gave it to me for protection from the elements, but more than that, there was love there,” Brown said, tears streaming down her face. See more of the Brown’s story with a special video at SCH.CentraHealth.com.
Join the relief effort GLEANING FOR THE WORLD, based in Appomattox County, is collecting monetary donations for tornado victims. Donations can be sent to Gleaning for the World, P.O. Box 224, Appomattox, VA 24522 and marked “Appomattox Tornado Relief.” For more information, visit GFTW.org/Appomattox-Tornado. The LYNCHBURG CHAPTER OF THE AMERICAN RED CROSS is providing long-term support for storm victims, including counseling, referrals to other programs and financial assistance. For more information, visit RedCross.org/Local/Virginia. The UNITED WAY OF CENTRAL VIRGINIA can connect victims with resources and utilities assistance through 211Virginia.org.
ISSUE 3, 2016 | 11
Home Away From Home How a Farmville couple keeps their independence
John and Jackie Gray 12 | CENTR A FOCUS
ISSUE 3, 2016 | 13
J
ackie Gray sits quietly at a table putting a puzzle together with a friend. Her husband John is an arm’s length away watching old westerns on the computer.
They aren’t at home. It just feels like it. The Grays make weekly visits to Centra Program of AllInclusive Care for the Elderly (PACE) in Farmville, enjoying recreational activities, delicious meals and friendships. On-site physicians, nurses and physical therapists manage the Grays’ healthcare inside the PACE center, making the program a one-stop shop for their needs. The program serves as an alternative to a nursing home, allowing seniors to live independently at home and still have their healthcare closely monitored and managed. The model fits the Grays perfectly. The couple is used to living with freedom and the PACE center makes that a reality. “I don’t know where we’d be without PACE. Our children live hundreds of miles away and we are able to stay in our own home because of the support we receive,” Jackie Gray said. “We can do what we want in our own home. It is wonderful.”
The nonprofit care program helps patients who are at least 55 years old and qualify for Medicaid, Medicare, or in most cases, both. PACE services – all located inside the center – include prescription drugs, rehabilitation and therapy services, 24-hour on-call physician services, vision, hearing and dental care. The facility refers clients to hospital care as needed. All of it is coordinated by a PACE interdisciplinary care team. In addition to individualized medical services for chronic healthcare needs, the program provides social interaction, nutritious meals and transportation to and from the center. The Farmville center is housed in a renovated movie theater in a shopping plaza. The Grays walked into the facility a year ago to explore. Within two months, they were program participants, driving in once a week. John Gray, who has COPD and asthma, said the in-house clinic allows immediate care when needed. Months ago, he had the flu and a nurse delivered his prescriptions to their home on a Sunday night. “Where else can you go to your own personal doctor and they’ll come in and see you then?” Jackie Gray said. “There are no sitting appointments next week or next month because there are always doctors and nurses available 24 hours a day.”
About PACE The program is designed to help seniors with serious health problems live at home as long as possible while receiving coordinated, comprehensive medical and social services. Centra operates the PACE program in Lynchburg, Farmville and Gretna, which opened this summer in the former Centra Medical Group – Gretna primary care office on U.S. 40. “We help manage participants’ medical and preventive care with the idea of keeping them as healthy as possible," said Verna Sellers, M.D., Centra PACE medical director. Dr. Sellers is board-certified in geriatric medicine, hospice and palliative medicine and has worked with the Lynchburg PACE program on Federal Street since it opened in 2009. To be eligible for PACE, seniors also must live in the PACE service area, be able to live safely in the community with support from PACE and meet Virginia criteria for nursing home-level care.
Above: Jackie Gray and her friend Lloyd Kenner tackle an ongoing puzzle while John Gray watches old westerns on the internet. Opposite page: John Gray spends time in the garden with recreation therapist Elise Hemmer.
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If an applicant is eligible for Medicaid and Medicare – or Medicaid only – there may be no fee to join the program or to receive services provided by Centra PACE. If the participant is eligible for Medicare only, there is a monthly fee. Participants who do not qualify for Medicare or Medicaid may still join PACE for a fee.
As the couple walks through the center, staff members call them by name and stop to chat. For the Grays, it’s much deeper than a cordial relationship. The staff is family. “From the moment we walk in the front door, we know we are going to be met with smiles,” Jackie Gray said. “Everyone pulls together to make sure our experience is wonderful. We just feel like we are family.”
Living with freedom An amateur radio operator, John Gray wants to be at home so he can communicate with people across the world. PACE gives the couple the freedom to stay at home by managing their health needs. “They do a super job. We just really enjoy being here,” John Gray said. The Grays are used to living independently. Both worked in insurance sales for years, traveling to all 50 states, the Caribbean islands and Europe for reaching sales goals. The couple, who has four children, three grandchildren and one great-grandchild, keep a busy lifestyle in retirement, thanks to PACE. “It’s a wonderful, wonderful program,” Jackie Gray said. The in-house medical staff knows their medical history well. During weekly visits to the center, the couple take turns in the physical therapy gym, using the stationary bike. “Our lives felt like everything was going downhill because we were spending most of our time and money going back and forth to doctor’s appointments,” Jackie Gray said. “Then we found PACE.” The couple takes advantage of weekly shopping trips and local events organized by the PACE staff. The transportation team picks up clients and takes them home each day. “There are so many fun activities for us to enjoy at the center,” she said.
To learn more about Centra PACE or to find out if PACE is a program that will meet your needs or a family member’s needs, please call 434.200.6516 (Lynchburg), 434.315.2890 (Farmville) or 434.656.4800 (Gretna).
Centra PACE offers access to a broad range of services: • • • • • • • • •
Adult day healthcare Primary care physician and preventive health services Transportation Home health and personal care services Physical therapy, occupational therapy and speech therapy Skilled nursing facility and nursing facility services Inpatient and outpatient services All Medicaid and Medicare covered services Medical equipment and supplies, lab tests and prescription medications • Medical care provided by a physician and interdisciplinary team of healthcare professionals familiar with the history, needs and preferences of each participant LYNCHBURG 407 Federal Street Lynchburg, VA 24504 434.200.6516
GRETNA 1220 W. Gretna Road Gretna, VA 24557 434.656.4800
FARMVILLE 1530 S. Main Street Farmville, VA 23901 434.315.2890
ISSUE 3, 2016 | 15
Back to Nor m a l
Centra Virginia Baptist Hospital was recently recognized as the region’s first Center of Excellence for Minimally Invasive Gynecology by the American Association of Gynecologic Laparoscopists. The designation recognizes surgeons and hospitals that have a proven commitment to safe, effective and evidence-based care.
T
he 50-minute workouts are grueling. A quick combination of squats, pull-ups, running and burpees, a mix between a lunge and squat. Pamela Robinson got her first taste of CrossFit last September. The exercise routines were tough. “It was a killer. I wasn’t able to do it and I felt defeated,” Robinson, who wanted to lose weight, said. “I kept going back and now I can do it all. I’ve come a long way.” She’s also lost nearly 40 pounds and feels great. The biggest change was being able to get to the gym at all.
“You don’t have to live this way. Periods should not affect your life. They shouldn’t affect your exercise, your work, your family or your activity,” Dr. Marraccini said.
Robinson faced a common problem for women in their mid to late 40s: heavy and irregular periods, sometimes lasting two weeks. Like many women, Robinson thought it was just part of aging and something to live with. Heavy bleeding kept her from being able to work out. Pamela Robinson works out at CrossFit in Lynchburg with trainer Pelle Ringi.
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The problem also went well beyond discomfort and inconvenience. Heavy periods lowered her iron levels and kept her energy level flat. “I felt bad and I just felt low. I didn’t feel good doing anything and couldn’t stick with working out,” Robinson said. A friend, who had struggled with heavy periods, encouraged her to talk with a doctor about surgical options. Christine Marraccini, MD, of Women’s Health Services of Central Virginia, met with Robinson about a minimally invasive ablation procedure, which safely burns the lining of the uterus and significantly decreases bleeding.
“My best friend had this done three or four years ago. She said, ‘Pam, it’s the difference between day and night,’” Robinson said. “I decided I was not going to live with this.”
Minimally invasive surgery Dr. Marraccini performed the outpatient surgery two summers ago at Centra Virginia Baptist Hospital. The surgery, which uses minimally invasive techniques, also allows women to avoid a full hysterectomy. Robinson also suffered from small uterine fibroids, which cause increased bleeding. The doctor said heavy, irregular bleeding is the most common problem among women ages 40 to 55. Increased bleeding is caused by the hormone estrogen, which often builds up in fatty tissue, causing the lining of the uterus to carry more of the hormone than usual. An overabundance of estrogen is especially common among overweight women. “It’s gradual over time,” Dr. Marraccini said. “Women sometimes don’t realize it and then heavy periods become a part of their life. They are just living around their period.” Dr. Marraccini said – while common – heavy, irregular periods are not normal. “You don’t have to live this way,” she said. “Periods should not affect your life. They shouldn’t affect your exercise, your work, your family or your activity.” Gynecologists have utilized surgical techniques to help with irregular bleeding for years, the rise of minimally invasive techniques allow for smaller incisions and shorter recovery time. The surgery options reduce infection risk, pain, and recovery time. Minimally invasive surgery is performed through dime-sized incisions, much smaller than traditional surgery, which typically requires six- to 12-inch incisions. For many procedures, physicians can also utilize a robotic surgical system, which puts a surgeon’s eyes and hands at the controls of a state-of-the-art robotic platform. A surgeon operates the console’s master controls to maneuver the robot’s four robotic arms, which boosts precision and accuracy.
The surgery system uses 3-D imaging and 10 times magnification. Surgeons operate the state-of-the-art surgical system with jointed-wrist instruments, using robotic hands inside for safe and effective surgeries. “Minimally invasive gynecologic surgery is about helping women cure their GYN health issues with the least amount of pain and disruption to their busy lives,” Dr. Marraccini said. “Women don’t have time for pain or bleeding, much less, for surgery to have these issues fixed.”
Center of Excellence Centra Virginia Baptist Hospital was recently recognized as the region’s first Center of Excellence for Minimally Invasive Gynecology (COEMIG) by the American Association of Gynecologic Laparoscopists. The designation recognizes surgeons and hospitals that have a proven commitment to safe, effective and evidence-based care. “The COEMIG designation not only shows our commitment to performing minimally invasive surgeries, but also our continued dedication to perform these surgeries at the highest standard in order to have the best possible outcomes for our patients,” Matt Tompkins, MD, Lynchburg Gynecology, said. Tompkins said COEMIG offers a database to compare surgeries around the world to help physicians continually improve patient experience and outcomes. “The COEMIG designation is reflective of the excellent care given by the minimally invasive team at Virginia Baptist Hospital. The minimally invasive approach allows our patients to get back to their normal routine with only a minor disruption in their lives,” Lynnett Schindler, MD, Women’s Health Services of Central Virginia, said. Gynecologists consistently treat women for irregular bleeding. It’s an uncomfortable topic for many women and often, they just suffer in silence. “That’s not how it should be,” Dr. Marraccini said. “People suffer in quiet because it’s not something women want to talk about.” Women have safe and effective surgical options to get back to normal periods. “All of the sudden there is the realization that there is something we can do about this,” Dr. Marraccini said. “You can fix the problem with a procedure you walk away from and do regular activity. With many procedures, patients are able to be back at work the next day.”
Back to normal For Robinson, the surgery was life-changing. She had the procedure done in the morning and walked a trail in Lynchburg with her family that evening. “I am just feeling so much better,” Robinson said. She and her husband of 25 years spend time riding bikes with their two teenagers in the evening. She works out three times a ISSUE 3, 2016 | 17
a week, completing exercises that were impossible months ago. “After I had the surgery, my energy level went up and I lost 38 pounds,” she said. “I was able to go to the gym and work on my eating habits because I wasn’t feeling so bad.” Robinson found a personal CrossFit trainer, Pellegrino Ringi, who helped her get in shape. “I couldn’t do it before,” Robinson said. “I feel like a new person.” Robinson knows other women struggle with irregular and heavy periods. Her message is clear: talk to a physician and pursue treatment. “I think as women, we think we just have to live with it and go along with it,” she said. “It’s not normal. You don’t have to live like that.”
COEMIG designated surgeons The surgery system uses 3-D imaging and 10-times magnification. Surgeons operate the state-of-the-art surgical system with jointed-wrist instruments, using robotic hands inside for safe and effective surgeries.
Lynchburg Gynecology Lewis Dabney, MD
For more information on minimally invasive surgical options, visit WC.CentraHealth.com.
Pelvic floor specialty Women experience body changes over the years. Some cause discomfort, embarrassment and include frequent trips to the bathroom, pain during intimacy and pelvic area pressure. These are called pelvic floor disorders. The good news is pelvic floor disorders are common and treatable by specially trained physical therapists at Centra Rehabilitation. At least one third of all women are affected by pelvic floor disorders occurring from childbirth, genetics, obesity, repetitive activities, menopause and aging.
Matt Tompkins, MD
Sarah Woods, MD
Women’s Health Services of Central Virginia
Childbirth is the most common cause of pelvic floor disorders. After the physical trauma of childbirth, many women struggle with pelvic discomfort and pain. Some women also don’t realize they hold stress in their pelvic floor. Physical therapists can offer treatment and exercises to help women relax and improve symptoms. Common pelvic floor disorders include: • Urinary incontinence – involuntary leakage of urine • Overactive bladder – urgency or frequent leakage • Urinary voiding dysfunction – difficulty emptying the bladder • Pelvic organ prolapse – dropped bladder or loss of uterine or rectal support • Bowel dysfunction or constipation • Fecal incontinence • Post-partum injury after childbirth • Interstitial cystitis or painful bladder syndromes • Sexual dysfunction – painful intercourse, low sex drive
Centra Rehabilitation provides treatment for pelvic floor disorders. To schedule a private, one-on-one appointment, please call 434.200.6623. 18 | CENTR A FOCUS
Christine Marraccini, MD
Wade Neiman, MD
Lynnett Schindler, MD
Tracy A. Wheelock, MD
Reach Out and Read
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Doctors and nurses promote early literacy
ccording to statistics, only 65 percent of Lynchburg third graders read at grade level. Doctors across central Virginia are joining the cause by giving away books at routine visits and taking the time to read aloud through a national program called Reach Out and Read. Reach Out and Read is a nonprofit organization that gives young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together. Children build little libraries with each routine doctor’s visit.
book at every well-child visit – a total of 10 – starting at six months until their five-year check-up. The goal is to help each child develop a library of at least 10 books before entering kindergarten.
Toyosi Omojara, MD (left) at the Pediatric Center in Centra Lynchburg General Hospital sees the many benefits of the Reach Out and Read program.
“Reach Out and Read can be a big part of improving third grade reading rates,” Melody Ailsworth, DO, of Richeson Drive Pediatrics, said. “By engaging parents when they are in our offices, clinics and Melody Ailsworth, DO, of Richeson Drive Pediatrics routinely reads with her young patients and their parents. the emergency room, the local medical providers can make a difference.” “Making reading a part of the family’s bed time routine helps with building better brains, relationships, sleep skills and a long lasting love for books,” Ailsworth said. Several years ago, doctors joined together to form the Lynchburg Coalition for Reach Out and Read, giving out over 16,000 books a year. Reach Out and Read practices include: yy Centra Lynchburg General Hospital Pediatric Center and Emergency Department yy Centra Medical Group – Lynchburg Family Medicine Residency yy Centra Medical Group – Altavista, Bedford, Gretna, Village yy Johnson Health Center, Lynchburg and Bedford yy Richeson Drive Pediatrics
Starting young Ailsworth said participating pediatricians give out a free
Dr. Christopher Russo, MD, Director of Pediatrics for Centra Medical Group and a pediatric hospitalist, said the Pediatric Center at Centra Lynchburg General Hospital provides an ideal setting to promote literacy. “The Reach Out and Read program is an important part of what we do during a child’s hospital stay. The pediatrician uses the book during the encounter as part of the child’s developmental assessment,” Dr. Russo said. “We model reading techniques and can offer ageappropriate tips to encourage parents to read aloud to their children.”
A welcomed distraction Nurses give away hundreds of books to children in the emergency department at Centra Lynchburg General Hospital. Tom Forsberg, MD, knows the emergency department can be an unsettling place for kids. Bringing books to young patients can ease anxiety and serve as a distraction. Emergency room doctors and nurses care for many patients that do not have a primary care provider and may not have the financial means to purchase books. “This gives us an opportunity to introduce children to books, if not for the first time, one of the first times and also read with them together,” Forsberg said. For more information on the Reach Out and Read program, visit RORVA.org. The Lynchburg Coalition for Reach Out and Read is supported by Barnes and Noble, Centra Foundation, Children’s Miracle Network and Lynchburg Community Trust. ISSUE 3, 2016 | 19
Roadmap to better health
B
y the end of this year, 1 in 8 women will be diagnosed with breast cancer.
They will sit in an office at an appointment and hear the news that no one wants to hear. They will begin treatment plans, and talk with doctors and family members to make decisions that will impact the rest of their lives. But, what about the women who don’t have access to the healthcare necessary
throughout central Virginia, visiting over 80 businesses, clinics, churches, senior centers and other organizations. Nearly 3,800 women each year in our region have been granted access to mammograms onsite when they would have otherwise not been able to receive care.
women who cannot afford them and also raise awareness of the importance of yearly mammograms. New features of the coach will include a private registration area, private changing room and separate examination room. The 40-foot-long, heavy duty coach also has a pull-out section with an awning.
At the heart of this mission is the ability to reach communities by using a vehicle that is outfitted with the same state-of-the-art digital mammography
Centra’s mobile mammography service has truly changed lives. Early detection has been key to these women having access to care in their own
Conceptual illustration of Centra's new mobile mammography coach
to catch the disease in its early stages? Twenty-five years ago, Centra saw a group of underserved women in our area that did not have that chance at treatment — the women who did not have access to the life-saving technology of mammograms.
equipment used in Centra’s six mammography centers. The current mammography van has been on the road for the past 15 years, and has been in need of an upgrade to continue expanding the reach of this important program.
It was with that need in mind that the Centra Mobile Mammography program was created. Since 1991, this mobile service has provided tens of thousands of screening examinations and educated women on the importance of early detection and breast selfawareness. Many of the women served by this unit are uninsured or underinsured.
Through contributions from many individuals and businesses in our community, the Centra Foundation has recently been able to completely fund the cost of purchasing a new mammography coach, and the Mammograms Annually A Must (M.A.A.M.) Committee will fund the designed wrap of the vehicle.
Centra’s mobile mammography coach currently travels to 10 counties 20 | CENTR A FOCUS
M.A.A.M. is a committee of the Centra Foundation whose mission is to raise funds to provide free mammograms for
communities, without having to travel far from home. The Centra Foundation is particularly proud to partner with this effort that allows all women to have mammography screenings, whether or not they have insurance. No one is turned away because of an inability to pay.
If you have questions about the mission or work of the Centra Foundation, please call Kathryn Pumphrey, Ed.D., CFRE, executive vice president, at 434.200.4790 or visit CentraFoundation.com.
The advantage of focus. Helping you choose the right path.
PIEDMONT COMMUNITY HEALTHCARE
When it comes to Medicare, do you feel lost or confused by all the choices? Understanding your Medicare options can often be difficult. It is important that you are equipped with tools to help you choose the health plan that best fits your needs.
Let Piedmont Medicare Advantage (PPO) help. We can provide you with the information you need to help you make an informed decision about your healthcare coverage. Our plans specialize in convenience, reliability and personal service. We have an extensive network of healthcare providers in South and Central Virginia. And because we’re local, you can meet with one of our representatives face to face at our office or in your home.
Piedmont Medicare Advantage can help you choose the right path.
Call 434-509-4857 to get the information you need. TTY users call 7-1-1 Hours of Operation: February 15 - September 30. 8am - 8pm, Monday - Friday October 1 - February 14. 8am - 8pm, 7 days a week.
Piedmont Medicare Advantage is a PPO plan with a Medicare contract. Enrollment in Piedmont Medicare Advantage depends on contract renewal. The provider network may change at any time. You will receive notice when necessary. Piedmont Medicare Advantage plans are available to Medicare eligible beneficiaries residing in the following counties in Virginia: Amherst, Appomattox, Bedford City, Campbell, Charlotte, Halifax, Lynchburg City, Pittsylvania, Prince Edward and portions of Bedford County (excluding zip codes: 24064, 24101, 24139, 24178 and 24179). H1659_2016ChoicesRR Accepted 06062016
Non-Profit Org. U.S. Postage
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Lynchburg, VA Permit #13
1920 Atherholt Road Lynchburg, Virginia 24501
Cardiac cath lab in Farmville
Centra Southside Community Hospital’s new cardiac cath lab further strengthens and streamlines heart care for patients throughout the region. When it comes to your heart, time is of the essence. If you notice symptoms of heart disease or a change in how you feel, you should take immediate action. Now with Centra’s new cardiac cath lab and cardiologist Rakesh Jain, MD, in Farmville, you no longer need to drive an hour away for care.
To learn more about the cath lab or to schedule an appointment with Dr. Jain, call the Centra Medical Group Stroobants Cardiovascular Center in Farmville
434.392.4370 CentraSouthside.com | 800 Oak Street | Farmville