Journal 010914

Vol. 26

No. 1

www.cnic.navy.mil/bethesda/

January 9, 2014

Military Children Recognized for their Sacrifice and Support

By Ryan Hunter NSAB Public Affairs staff writer On Jan 4, approximately 70 children and their families gathered in the Building 17 atrium for a day of singing, dancing and reading.

The event was organized by a nonprofit organization in association with a chain of national hotels in order to recognize children in families serving the armed forces.

“When one person serves the entire family serves and military life, especially for children, comes with a lot of challenges,” said Jennifer Fink, founder and CEO of the nonprofit organization. “Their experiences are so different [compared to] what their civilian peers go through. We wanted this event to celebrate and validate these children, who sacrifice so much.”

Much of the event was inspired by a children’s book written by the organization. Loren Nalewanski, vice president and global brand manager for a national hotel chain who helped organize the event, read the first two chapters of the book aloud as children encircling his rocking chair listened.

A copy of the book was given to everyone in attendance in hopes of recognizing the children of service members and educating children in civilian families about military life.

“Research shows that [children in military families] feel like their educators and civilian classmates don’t understand what they are going through,” said Debbie Fink, vice president of the organization who co-authored the book with her daughter, Jennifer Fink. “We cannot expect [civilians] to understand them without an educational tool, which is why we wrote it. [However, we also] wanted

Several elementary school age children enjoy a story reading, songs and live music performances during an event to celebrate the sacrifices of military attached children.

Photos by Ryan Hunter

Children dance with JustBecause, the volunteer mascot during an event to celebrate the sacrifices of military attached children. to show a diverse representation of military connected children and provide coping mechanisms when facing challenges.”

Being raised in a military household, Nalewanski participated in the project because he identified with the characters in the book and praised the story for its portrayal of real world concerns.

“It’s a story book that captures and identifies the lives and the things that go on in the minds of children,” said

Nalewanski. “As much as the mom and the dad go through with relocating and finding something new, there’s [also] a significant impact on the kids…It brings recognition to these child heroes, creates a better connection between the private and public sector and makes sure that children aren’t forgotten.”

After the reading, children engaged in a variety of family friendly activities. Many joined their parents in chairs and continued to read. Others

Several children hold props for Loren Nalewanski, vice president and global brand manager for a national hotel chain, as he reads “The Little C.H.A.M.P.S.” story book. retired to the gym to join in supervised basketball games and hula-hoop contests. Several musical selections were lead by Debbie Fink on violin as Jennifer Fink danced with the children. Naval Support Activity Bethesda Commanding Officer Capt. David Bitonti sang fighting songs from all

five branches of the military as children joined in, marching in place.

Approximately 20 volunteers overseeing the event were participants from the nonprofit’s newly announced baby sitters program. Volun-

See CHILDREN page 10

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The Journal

Bethesda Notebook

Commander’s Column We do three things at Walter Reed Bethesda: Accomplish our Mission; Take care of each other; Take care of our Families.

MISSION/PEOPLE--good leaders do both Happy New Year! I hope each of us had a Happy Holidays.

“The key to success is to keep growing in all areas of life — mental, emotional, spiritual, as well as physical,” said the great basketball player Julius “Dr J” Erving.

Please join our Prosperity Plan Fair, Jan. 14 and 15 in Building 9. Our fair will be a great opportunity for each of us to specify goals and develop a plan to reach those goals. Families are welcome to participate — please encourage them to join us! Sue and I look forward to seeing you there.

Wednesday is the Combined Federal Campaign donation deadline. Please consider making a CFC donation to the charity of your choice.

The world is different. During our December Town Hall, I discussed our new reality: over a decade of war is winding down — the number of wounded warriors aerovac’ed to WRNMMC continues to decrease (Thank goodness!); Department Of Defense is downsizing — in number of troops and in size of budget; on Oct. 1, our Defense Health Agency was established specifically to streamline military health care and cost and to increase readiness; WRNMMC is now a part of the National Capitol Region’s (NCR) Multiservice Market which serves over 500,000 beneficiaries — we are the academic medical center of our patient-centered NCR health care system; a decade of limitless resources has been replaced by an era of limited (not limiting) resources. The world is different — we must transform.

Some things will not change: our patientcentered Mission and Vision is enduring; our

Published by offset every Thursday by Comprint Military Publications, 9030 Comprint Court, Gaithersburg, Md. 20877, a private firm in no way connected with the U.S. Navy, under exclusive written contract with the Walter Reed National Military Medical Center, Bethesda, Md. This commercial enterprise newspaper is an authorized publication for members of the military services. Contents of The Journal are not necessarily the official views of, nor endorsed by, the U.S. Government, the Department of Defense, or the Department of Navy. The appearance of advertising in this publication, including inserts or supplements, does not constitute endorsement by the Department of Defense or Comprint, Inc., of the products or services advertised. Everything advertised in this publication shall be made available for purchase, use or patronage without re-

WRNMMC Town Halls

two Foundations and six Pillars still guide our way ahead; we are the flagship of our military health system — where our nation heals its heroes: the service members and their families, retirees and their families that we are privileged to serve. Our purpose is unchanged: to provide patient friendly access to high quality health care for all we are privileged to serve. We will continue accomplish our patient-centered Mission; take care of each other; take care of our families.

So, what is our way ahead?

How must we continue to transform and to excel in our patient-centered Mission? First and foremost, we must be proactively patient friendly. We must individually and collectively be patient-centered. We must transform into a patient-centered, highly efficient, accountable, focused academic medical center.

I know you want specifics. I hope you will attend our Town Halls on Tuesday. Please join us so I can share my thoughts and decisions on our way ahead If you have not made a resolution for 2014, may I suggest the following: “Let our New Year’s resolution be this: we will be there for one another as fellow members of humanity, in the finest sense of the word,” as Goran Perrson once said. Let us resolve to take care of each other, especially during this time of immense change.

As we look forward to our way ahead, I ask that you be as proud of who we are, what we do, and most importantly, how we do it as I am to serve with you.

As always, thank you for all you do and may God bless Walter Reed Bethesda! What we do matters!

Brig. Gen. Jeffrey B. Clark MC, USA Director, Walter Reed National Military Medical Center

gard to race, color, religion, sex, national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the purchaser, user, or patron.

Editorial content is edited, prepared and provided by the Public Affairs Office, Naval Support Activity Bethesda, Md. News copy should be submitted to the Public Affairs Office, Building 11, lower level, Room 41, by noon one week preceding the desired publication date. News items are welcomed from all installation sources. Inquiries about news copy will be answered by calling 301-400-2488. Commercial advertising should be placed with the publisher by telephoning 301-921-2800.

Publisher’s advertising offices are located at 9030 Comprint Court, Gaithersburg, Md. 20877. Classified ads can be placed by calling 301-670-1700.

Town halls for Walter Reed National Military Medical Center will be Jan. 14 at 7 a.m., noon, and 3:30 p.m. in the Memorial Auditorium. All members of the WRNMMC community are encouraged to attend.

Prosperity Fair

A Prosperity Fair will be held Jan. 14-15 in Building 9 as part of the roll out of the Walter Reed National Military Medical Center’s Prosperity Plan. The event will include career counseling, goal-setting information, resiliency and pastoral care services. Everyone’s invited to attend.

CFC Drive Continues

The Combined Federal Campaign (CFC) of the National Capital Area continues at Naval Support Activity Bethesda (NSAB) and Walter Reed National Military Medical Center. For more than 50 years, CFC has been a vehicle for federal, postal and military employees to make charitable donations to approved organizations under the CFC umbrella.

Walter Reed Bethesda’s CFC reporting number is 4031502.

NSAB’s reporting number is 4041400. To donate, contact your section key worker for details, and you can donate online at www.cfcnca.org (click on donate now) or at mypay. dfas.mil on the MYPAY website (use code 0990). The campaign runs until Jan. 15.

Naval Support Activity (NSA) Bethesda Commanding Officer: Capt. David A. Bitonti Acting Public Affairs Officer NSAB: John Epperson Public Affairs Office NSAB: 301-400-2488 Staff Writers

Journal Staff

MASN April Beazer Sarah Marshall Sharon Renee Taylor Cat DeBinder Ryan Hunter Katie Mollet Katrina Skinner

Managing Editor

MC2 John Hamilton

NSAB Editor WRNMMC Editor

MC3 Brandon Williams-Church Bernard Little

Walter Reed National Military Medical Center Office of Media Relations 301-295-5727 Fleet And Family Support Center 301-319-4087

NSAB Ombudsman Michelle Herrera

240-370-5421

Sexual Assault Response Coordinator Hotline

301-442-2053

Visit us on Facebook: Naval Support Activity Bethesda page: https://www.facebook.com/NSABethesda Walter Reed National Medical Center page: http://www.facebook.com/pages/Walter-ReedNational-Military-Medical-Center/295857217111107 Uniformed Services University of the Health Sciences page: http://www.facebook.com/pages/ Uniformed-Services-University-of-the-HealthSciences/96338890888?fref=ts

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New Radiation Option Offers Cancer Patients Ease, Convenience “I make the choice to drive up here every day because this is my comfort zone. I’m comfortable with my team,” Mahfouz explained during an exam with her radiation oncologist in September. “Now I’m glad that I get to [receive] this type of radiation, because I think that I’ve had less of the side effects than if I had just done regular external. I’ve been very, very pleased.”

Mahfouz traveled to Walter Reed Bethesda from where she lives at Fort Belvoir, Va., every day to receive tomotherapy for five weeks. After her daily treatment in Bethesda, she drove to Fairfax, Va., where she works as a public health technologist.

“I made the choice to drive up here for 15 minutes of therapy, that’s how

Photo by Sharon Renee Taylor

Seated on an examination table, Jolie Mahfouz (left), the first patient to receive high dose radiation at Walter Reed Bethesda, speaks with her radiation oncologist, Maj. (Dr.) Christine Ko Bang.

By Sharon Renee Taylor WRNMMC Public Affairs staff writer

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A new treatment uses a tiny source to pack a powerful punch against cancer.

Jolie Mahfouz, 42, the wife of an Army major and mother of two, became the first patient to receive high dose radiation at Walter Reed Bethesda in October.

“To be the first person to do anything is kind of exciting,” Mahfouz said.

Radiation oncologists at the Nation’s Medical Center now use high dose rate (HDR) brachytherapy. This cancer treatment places a radioactive “seed,” or source, next to or inside of a tumor to administer a high dose of radiation to the cancer.

A source, less than a millimeter in diameter contained in a capsule nearly

5 millimeters long, delivers radiation to a precise location in the body, as a device tracks the decay of the source, and modifies the treatment time accordingly, explained Army Maj. (Dr.) Christine Ko Bang, staff radiation oncologist at Walter Reed National Military Medical Center (WRNMMC).

“This type of radiation is localized therapy so wherever the treatment is administered, only the organs in that area will experience side effects,” said Bang.

Diagnosed with a virulent form of cervical cancer in June, Mahfouz received a radical hysterectomy in July using robotic technology. Mahfouz said she and her husband decided with her medical team to take an aggressive approach to her subsequent treatment, utilizing a combination of chemotherapy and external beam radiation called tomotherapy before receiving HDR in October.

impressed I am with Walter Reed Bethesda,” Mahfouz explained.

The military beneficiary obtained three single doses of HDR in October.

She completed a total of three treatments, Oct. 11. “She is doing well and tolerated the treatment well,” Bang said. The medical center treated its second HDR patient in November.

External beam radiation is exactly as it sounds, the radiation oncologist explained. It’s external — it comes from the outside. “The radiation will pass through certain organs before it hits the target, so we do everything to minimize the radiation to those

See CANCER page 8

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The Journal

WRNMMC’s Nephrology Chief Awarded for Academic Excellence

By Sarah Marshall WRNMMC Public Affairs staff writer Walter Reed Bethesda’s Chief of Nephrology, Col. (Dr.) Kevin Abbott, recently earned the Surgeon General’s Award for Military Academic Excellence, for his contributions to military medicine, patient care and provider education.

The award, also referred to as the Lewis Aspey Mologne Award, is named after the first West Point graduate to become a general officer in the Army Medical Department. Mologne also commanded the former Walter Reed Army Medical Center (WRAMC), from June 1983 to August 1988, and passed away shortly after his retirement in 1988. The award that bears his name is presented to the active duty colonel who most emulates Mologne. Nominees must demonstrate academic excellence, as they provide residency training, participate in research, as evidenced by scientific publications and hold office with professional societies.

“Dr. Abbott’s accomplish-

ments as a caregiver, officer, leader, educator and clinical researcher are among the best ever described for this award, given annually to [one] Army colonel,” said Col. (Dr.) Michael Nelson, deputy commander for education, training and research at Walter Reed National Military Medical Center (WRNMMC).

Abbott was presented the award by Army Surgeon General, Lt. Gen. Patricia Horoho, during the Army Office of the Surgeon General Consultant’s meeting on Dec. 3.

“It’s an honor to be recognized,” Abbott said. “It’s also a responsibility, to be worthy of that.”

Abbott added he has been fortunate to have had a number of virtuous mentors, and tries to pay it forward as best he can. The nephrologist also believes quality care begins with education and fostering an environment where medical students aren’t afraid to ask questions.

“We need to teach in an atmosphere of scholarly inquiry,” Abbott said. Thanks to such an environment at WRNMMC,

fellows frequently raise questions that lead to innovative findings. Fellows have helped discover patients on dialysis have an increased risk for pulmonary embolism, a blood clot to the lungs. They’ve also conducted research, finding that patients with kidney disease should take certain precautions when preparing for colonoscopies.

Abbott noted the Nephrology Department works closely with various specialties, such as Gastroenterology, Infectious Diseases, Hematology, Rheumatology, Endocrinology and Pulmonary Medicine. This allows residents and fellows to continue finding opportunities for further research and education, he said.

“Having education is a great stimulus to our clinical care, because the work we do every day, leads us to better answers for clinical care,” Abbott said.

Abbott began his military Courtesy photo career in 1983, knowing he Col. (Dr.) Kevin Abbott, Walter Reed Bethesda’s wanted to go into medicine.

Growing up with parents who chief of nephrology, recently earned the Army Surwere both Department Of De- geon General’s Award for Military Academic Excel-

lence, for his contributions to military medicine, paSee AWARD page 7 tient care and provider education.

New Chief of Staff Leads with Quiet Candor

By Sharon Renee Taylor WRNMMC Public Affairs staff writer Eleven years after she first walked the halls of the thenNational Naval Medical Center (NNMC) as a medical-surgical nurse caring for wounded warriors, Navy Capt. Sarah Martin returned here once again, as the new chief of staff at the now Walter Reed National Military Medical Center (WRNMMC), in August of 2013.

Reflecting on her 26-year military career she said she never imagined she would return to Bethesda in the position she now holds.

“The opportunity to return to Walter Reed Bethesda is huge,” Martin explained.

Martin oversees a staff of more than 7,000 doctors, nurses and other professionals comprised of civilians, contractors and uniformed service members of the Air Force, Army, Navy and Public Health Service at the nation’s largest joint military medical center.

“We’re setting a trend here

in military medicine,” said Martin, who is working to reinforce the seamless level of care between WRNMMC and other military treatment facilities by strengthening the resilience, training and morale of the medical center’s staff. She explained she hopes to capitalize on what’s already been established by Army Col. Charles W. Callahan, who served as the medical center’s first chief of staff, and Army Col. Ramona M. Fiorey, the second to hold the position whom Martin succeeded.

Martin describes her management style as one of a coach, and attributes her candor and openness to her Minnesota-upbringing. The eldest of three siblings was the first to join the military after earning her Bachelor of Arts degree in nursing at Gustavus Adolphus College in St. Peter, Minn. Her two brothers attended the United States Military Academy at West Point, and served in the Army, but Martin was the only to make the military a career.

Following her first tour as

an ensign at the Naval Hospital in Oakland, Calif., in 1987, she transferred overseas to the Naval Hospital in Yokosuka, Japan, where she served as a staff nurse and Assistant Division Officer. After a deployment to Somalia from 1992 to 1993, subsequent assignments led her to Twentynine Palms, Calif., Naval Hospital Bremerton, Wash., and the Naval Personnel Command in Millington, Tenn. She earned a master’s degree in nursing at the University of Washington.

Assigned to the Washington, D.C., area in 2002, Martin first served in the former Navy Annex Clinic in Arlington, Va., and later at the former NNMC. Over the next several years she served as a clinic director, senior nurse executive to the Branch Clinic Directorate, department head for the Surgical Inpatient/ Wounded Warrior Ward and executive assistant to the commander until 2009. She transferred to the Naval Hospital Camp Lejeune, N.C., to serve as the senior nurse executive before returning to Washing-

ton, D.C., as the deputy director, Navy Nurse Corps at the Navy Bureau of Medicine and Surgery for two years, prior to assuming her current position as chief of staff at WRNMMC. Martin enjoys the outdoors and riding on the back of a Harley Davidson motorcycle — with her husband retired Navy Cmdr. Marty Martin — in her free time. With a visit to her office at the medical center, you may discover a subtle burst of pink flamingos that decorate her desk, bookshelves and cabinets — more than a dozen.

The bird-of-feather became a trademark of sorts after she and a colleague discovered a barren spot of land cleared for the building of a new hospital in Bremerton, Wash., in 1999.

Devoid of both trees and color, staffers secretly placed a pink flamingo amidst the mound of dirt, and a tradition was born.

Afterwards, Martin began receiving flamingos in all shapes and sizes: wooden, stuffed, in needle-point and drawings.

“They just started showing up,” she smiled.

Photo by Sharon Renee Taylor

Navy Capt. Sarah Martin, chief of staff at Walter Reed National Military Medical Center (WRNMMC), says it’s “setting a trend in military medicine,” providing patient-centered care while reinforcing the seamless level of care between WRNMMC and other military treatment facilities.

She sits in her office, decorated with pink flamingos, which begin when a staff member secretly placed one in her office.

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WRNMMC Pathologist Receives Public Service Award

Medical Director of Cytopathology Recognized for Civic Accomplishments, Work

By Cat DeBinder WRNMMC Public Affairs staff writer Army Col. Barbara Crothers, the National Capital Consortium (NCC) program director and the director of cytopathology, recently received the College of American Pathologists (CAP) Public Service Award. She received the award at the college’s annual meeting in Orlando, Fla., in October.

The award is given to a fellow of the college who “best exemplifies the political, citizenship, and leadership qualities of the late Dr. Frank C. Coleman, (the sixth president of the CAP), according to Julie Monzo, senior manager, communications, for CAP. “It is the college’s highest honor for outstanding accomplishments and dedication to political and civic life and to public service in the USA. It is presented when mer-

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ited, not necessarily annually,” she added.

Pathologists are physicians who use laboratory medicine and technology to identify and diagnose disease. According to the CAP, more than 70 percent of all decisions about diagnosis, treatment, hospital admission and discharge rest on the pathologist’s report.

“Pathologists have rotating schedules where we perform macroscopic examination and description of specimens, alternating with quality control review of our peers’ work, intraoperative consultations, laboratory management, and review of cases for send-out,” said Crothers.

In addition, Crothers said they prepare for tumor board presentation of cases; teach residents, students and other specialists; advise providers on appropriate transfusions, order lab test or specimen collection.

Crothers was nominated by Barbara Blond, a CAP staff member who has worked with her for several years on the CAP Cytopathology Committee.

Blond said she nominated her because of her “contributions to theater pathology and high quality cytopathology services in the military.”

“As the director of cytopathology, I review cases with the cytotechnologists, select testing platforms, recommend practice guidelines based on national consensus, monitor the quality of pap tests and cytology specimens, perform cytology-histology correlations, monitor technologist performance and general troubleshoot any section problems,” said Crothers.

Photo by Cat DeBinder Crothers said the reason she chose to be a pathologist Army Col. Barbara Crothers recently received the was the variety of work, and College of American Pathologists Public Service the ability to have the “final Award for accomplishments in political and civic life

See NCC page 7

and dedication to public service in the United States.

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The Journal

Photo spread by Mass Communication Specialist 3rd Class Brandon Williams-Church

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WRB Transplant Surgeon Wins Outstanding American by Choice Award

By Katrina Skinner WRNMMC Public Affairs staff writer “I am an American, not by accident of birth, but by choice.

I voted with my feet and became an American because I love this country and I think it is exceptional and will continue to be exceptional … I love this country for many reasons – the most important is that this is the only country where immigration is celebrated.”

These were words spoken by Dr. Rahul Jindal, an Indian-American transplant surgeon at Walter Reed National Military Medical Center (WRNMMC), when he accepted the Outstanding American by Choice award on Nov. 13, 2013 in Washington, D.C. The U.S. Citizenship and Immigration Services, presents the government award in recognition of the recipient’s civic participation, professional achievement, and responsible citizenship efforts.

When asked why he became a U.S. citizen, Jindal, a native of Ahmedabad, India, said: “I came to this country because I wanted to give my children an equal opportunity; I wanted to contribute to society; and I wanted to participate in the political process.”

Jindal’s philanthropy work was one contributing factor for him receiving the award. As the director of the National Blood and Bone Marrow Drive Campaign, he assists south-

AWARD Continued from 4 fense (DOD) teachers, constantly surrounded by various services, he said the military “seemed like home.” He chose nephrology, because he liked the numerical aspect, looking at numbers, and in a way that is meaningful and helpful, he said. Also, some of his most admired mentors in medical school were in nephrology, he added. He came to WRAMC in 1996 when, at the time, WRAMC had the only nephrology residency program.

He transitioned to WRNMMC when WRAMC and the former National Naval Medical Center integrated in 2011.

The nephrologist said he also credits his wife, Mary, for pointing his research interests in a key direction early on. “We both attended a semi-

east Asian-Americans in need of a transplant to find possible donors. This initiative has been sponsored by almost 600 U.S. temples that assist with the registration of south AsianAmericans to a marrow registry where people in need of a transplant can find them.

The doctor has also performed pioneering work in developing countries, setting up the first comprehensive kidney dialysis and kidney transplant program in Guyana, South America. Jindal and his team performed the country’s first living kidney transplant operation in July 2009, and he is working towards setting up a similar program in Antigua and Trinidad and Tobago, he explained.

Also professor of global health at the Uniformed Services University of Health Sciences on Naval Support Activity Bethesda, Jindal is a clinical professor of surgery at the George Washington University.

He’s authored more than 150 medical manuscripts, and coauthored a standard textbook used in programs around the world.

“Dr. Jindal is the epitome of what it means to be an American, and his story is another example of what makes American civilization exceptional,” said Kumar Barve, majority leader of the Maryland House of Delegates and one of the first Indian-American to be elected to a state legislature in the United States. nar on hepatitis C, at her suggestion, and I found it very useful and it got me thinking along a very useful line of inquiry, in terms of the interrelation between Hepatitis C and kidney disease.”

Throughout his career, Abbott has received numerous accolades, including the Crosby Research Award, and the Chennault Award. He remains humble, attributing much of his success to having supportive colleagues and mentors, who he says he often tries to emulate. The most rewarding aspect of his job, he said, is seeing others doing great work.

“It’s really amazing to be at an institution where you have so many talented and motivated people who, if you give them a little bit of a point in the right direction, it’s no telling what they can do,” Abbott said.

Courtesy photo

Dr. Rahul Jindal, a transplant surgeon at Walter Reed National Military Medical Center, recently received the Outstanding American by Choice award from the U.S. Citizenship and Immigration Services for the recipient’s civic participation, professional achievement, and responsible citizenship efforts.

NCC Continued from 5 answer,” said Crothers.

“80 percent of diagnoses are made by pathologist or through results that come from laboratory testing,” she added.

“Diseases and tumors are fascinating and I like the ability to actually see them microscopically; sometimes I feel as if I am spying on the lives of cells,” said Crothers.

While it is very rewarding, it also has its challenges, said Crothers.

“The most challenging aspect of my job is juggling the many roles that pathologists play, such as consultant to clinicians, diagnostician, subspecialty expert, laboratory manager, researcher,

teacher, and advisor.”

Crothers said she attributes her success to the wonderful opportunities that have been afforded her and the mentors that have helped her throughout her career by “believing in my abilities.”

“I don’t really see this as ‘my’ award, but rather an award that I share with my military pathology and CAP colleagues,” she said. “We perform public services as a team.”

“I was very honored and surprised about winning the award,” said Crothers.

Earlier in her career, Crothers served as a pathology consultant and chief of anatomic pathology for Operation Iraqi Freedom at the 44th Medical Command (MEDCOM) 10th combat support hospital in Baghdad, and held similar posts in ser-

vice to the 18th MEDCOM in Seoul, South Korea.

“I am in constant awe of the dedication, selflessness and compassion of those in the military,” Crothers said.

“It has been my great privilege to [help] bring cuttingedge pathology expertise to the services and improve medical care for our active duty personnel, veterans, and their families.”

Crothers currently chairs the CAP’s cytopathology committee, a group instrumental in advancing pathologists in new and improved practice techniques. Her other leadership and clinical associations include the American Society of Cytopathology, the Papanicolaou Society of Cytopathology, the American Osteopathic College of Pathologists, and the United States & Canada Academy of Pathologists.

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CANCER Continued from 3 areas. Some patients require bigger field treatments — such as the pelvic lymph node region — and with those patients we accept that we’ll have a bit more toxicity,” she said.

“What we’re doing [with HDR] is placing the radiation exactly where it needs to be, and because the dose falls off really quick, the adjacent areas don’t receive as much radiation,” Bang explained. With fewer areas and organs in the body exposed to radiation, the patient may experience fewer side effects with HDR than external beam radiation, she said.

Most patients treated with HDR radiation receive the treatment as outpatients, under sedation in the clinic or in the OR, according to Bang. She explained a wide range of patients can be treated with HDR brachytherapy, the most standard use is in gynecological cancers, depending on the stage or extent of the cancer. The placement of the applicator, the device through which the source travels in and out of the

The Journal patient, can be done with or without sedation.

Post-operative cervical cancer and endometrial cancer patients are treated with HDR using a cylinder device inserted in the uterus, Bang said. The radiation oncologist explained prostate and breast cancer patients may be next for HDR brachytherapy at WRNMMC. Currently, prostate cancer patients at WRNMMC are treated with low dose rate brachytherapy, radiation in the form of Palladium or Iodine, implanted like seeds in the prostate.

The “seeds” will permanently remain in the patient. Treatment of the same patient with HDR, where the radioactive source travels in and out of a patient during therapy, could be as little as 30 minutes. With an HDR source, the activity of the source is higher, delivering more radiation in a fraction of the time, explained retired Army Lt. Col. Charlie Brannon, who serves as Radiation Safety Officer for Walter Reed Bethesda.

In June, the medical center received a joint permit from the Navy Marine Corps Public Health Center to obtain and administer the powerpacked HDR source after a 24-month

process of submitting critical paperwork to attain the approval.

Time is a big factor in HDR, Brannon said. While the actual treatment time is short, as little as 10 to 15 minutes—based on the radiation rate, location and type of cancer—the longest period of time is taken before the treatment is administered: nearly an hour before. During this time, the radiation oncologist works closely with a medical physicist to ensure the treatment plans are executed precisely. Walter Reed Bethesda medical physicist Scott Borzillary uses a computer to verify standards are maintained prior to treatment.

Bang said patients treated with HDR save time in treatment along with other benefits such as convenience and ease. Since HDR is an outpatient therapy, they don’t have to be admitted and spend time away from their family. The treatment offers a reduction of radiation exposure to staff and family members. It also reduces the chance for the patient to develop Pulmonary Embolism or Deep Vein Thrombosis, which is greater risk for low dose rate patients who may be immobilized for a few days, she said.

Photo by Army Sgt. Molina Rivera, AFFRI

A source, less than a millimeter in diameter contained in a capsule nearly 5 millimeters long (shown above), delivers a high dose of radiation to a precise location in the body. The tiny source packs a powerful punch against cancer.

Stay Active this Winter with MWR Fitness Classes

By Ryan Hunter NSAB Public Affairs staff writer Cold weather may deter base staff and residents from going outside, but it shouldn’t deter them from being active. For those having trouble keeping up with a New Year’s resolution to lose weight after weeks of Holiday feasting and hibernation, Morale Welfare and

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Recreation has provided their fitness class schedule for the month of January. To find out more information about any of these events, follow Naval Support Activity Bethesda on Facebook or Twitter, visit their website for the latest schedules and calendars at Cnic.navy. mil/Bethesda or sign up for the MWR Bethesda Blas by emailing NSABMWR@gmail.com.

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Loren Nalewanski, vice president and global brand manager for a national hotel chain, picks several elementary school age children to help him as he reads “The Little C.H.A.M.P.S.� story book.

CHILDREN Continued from 1 teers consist mainly of local college students who have passed background checks and completed courses in military cultural competence, basic child care, CPR and basic first aid.

Towards the end of the program, Nalewanski spoke to children about personal responsibility, urging them to

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volunteer and help those in need. The national hotel chain he represented provided stitch-less blankets and encouraged children to assemble as many as possible. The blankets were later donated to children in the Walter Reed Military Medical Center Pediatrics Ward by the volunteer program’s giant dog mascot.

If you would like to learn more about Operation C.H.A.M.P.S or its programs contact Jennifer Fink at 301-758-6717 or Debbie Fink at 301-518-1715.

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The Journal

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Featuring: Oversized 2 & 3 Story Townhomes 21/2 & 31/2 Baths 3, 4 & 5 Bedrooms . 1,400 to 2,100 Sq. Feet

Included Amenities

q Pre-wired for FIOS cable & high-speed internet q Newly redesigned kitchen & appliances q Hardwood floors w/inlay q Ceramic tiled bath q 2" Plantation blinds q Cherry finish kitchen cabinetry q Self-cleaning ranges

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Side-by-side refrigerator/freezer Garbage disposal Stainless steel sinks Built in Microwave Dishwasher Full-size washer & dryer Private entry patio w/additional storage

301-949-4466

1040941

1041301

11300 - 11476 Connecticut Avenue, Kensington, MD 20895 . www.rcptownhomes.com

01041185