Making a Difference in Heart Health Locally | Charlottesville's Nutrition, Wellness, and Fitness Resource Guide january february 2017 www.ourhealthcville.com
Heart & Lungs
MEMORY
Eye Care
Skin Care
FOOT CARE
MENTAL EXERCISE
Immunizations
Dental Care
HAIR &
SCALP
Stomach &
HEALTH
DIGESTION BONE & JOINT
Sleep
DIET &
NUTRITION
HEARING
SPORTS PHYSICALS
CARE
DIABETES
4
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
54
50
42
24
30
TABLE OF CONTENTS JANUARY • FEBRUARY 2017
8
Q&A ON HEALTH
12
PULSE
23
Healthcare questions answered by local professionals.
Keeping the pulse on local healthcare news and information including tips for healthy living, as well as a listing of new physicians, providers, locations and upcoming events in the Charlottesville & Shenandoah Valley communities.
30
17 TIPS TO THINK ABOUT FOR 2017
40
HELLO, HEALTH
42
COULD WEIGHT LOSS SURGERY BE FOR YOU?
THE ANATOMY CHALLENGE
MAKING A DIFFERENCE IN HEART HEALTH LOCALLY OurHealth shares the substantial impact the Charlottesville Chapter of the American Heart Association has on the Charlottesville & Shenandoah Valley community.
29
50
HEALTHY RECIPE SWAP
54
CHARLOTTESVILLE’S NUTRITION, WELLNESS, AND FITNESS RESOURCE GUIDE
Tricia Foley RD, MS, OurHealth's resident nutritionist, shares heart healthy recipes with healthy ingredient swap tips.
Your resource guide for nutrition, wellness and fitness in the Charlottesville & Shenandoah Valley area.
FIT BITS | Fitness Anytime, Anywhere Deidre Wilkes, OurHealth’s resident fitness specialist, shares the convenience and training benefits of ‘on-demand’ workouts and classes.
Capturing the spirit of those working in healthcare and of people leading healthy lives through photos.
For some of us, weight loss is completely out of reach. No amount of dieting or exercise is going to lead to a significant or lasting change. OurHealth explores the different types of weight loss surgeries available locally.
Test your knowledge when it comes to HEART DISEASE.
24
Every new year is a new beginning, a chance to make positive changes in your health. In this article, OurHealth provides 17 quick tips to help you step into the new year on the right foot.
58
CLOSER LOOK Images reflecting the landscape of healthcare in Charlottesville & Shenandoah Valley *PLUS * a chance to win a free year's subscription to OurHealth! www.OurHealthCville.com
5
MORE THAN A MAGAZINE january • february 2017
ONLINE
SOCIAL MEDIA
PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT CHIEF DESIGNER GRAPHIC DESIGNER DIGITAL CONTENT MANAGER | EVENT SPECIALIST DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY ACCOUNTING MANAGER
McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Deidre Wilkes Karrie Pridemore Tori Meador Heidi McClintic Dalton Holody Shawn Sprouse / www.sdsimages.com Laura Bower
CONTRIBUTING MEDICAL EXPERTS
Vihang Bajani, DPM Anthony Crimaldi, MD Y. Michael Shim, MD Evan Wenger, MD Yara White, PA-C
Rich Ellis Tina Joyce Rick Piester Fonda Sundeen Deidre Wilkes
CONTRIBUTING PROFESSIONAL EXPERTS & WRITERS
ADVERTISING AND MARKETING Kim Wood • Vice President of Business Development 540.798.2504 • kimwood@ourhealthvirginia.com
E-NEWSLETTERS
Cindy Trujillo • Senior Media Consultant 434.907.5255 • cindy@ourhealthvirginia.com Cindy Morris-Scruggs • Senior Media Account Executive 804.300.0650 • cmscruggs@ourhealthvirginia.com SUBSCRIPTIONS To receive OurHealth Shenandoah Valley & Charlottesville via U.S. Mail, please contact Jennifer Hungate via email at jenny@ourhealthvirginia.com or at 540.387.6482
PRINT @ourhealthcville
COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2017 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Charlottesville/Shenandoah Valley is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.
HEALTH H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
“
Smoking creates harmful inflammation that accelerates the decline in lung function. When a person quits smoking, the reduction in this inflammation induces relaxation of hyper-reactive airways and reduces mucus production, cutting down on airway plugging from the mucus and scarring of the airways.
”
How does quitting smoking improve a person’s lung capacity?
What are some benefits of assisted living versus living at home for seniors?
Our lungs undergo a natural aging-associated decline. Smoking accelerates this process by about three to five times. Smoking also creates harmful inflammation that further accelerates the decline in lung function. When a person quits smoking, the reduction in this inflammation induces relaxation of hyper-reactive airways and reduces mucus production, cutting down on airway plugging from the mucus and scarring of the airways. Together, these slow the decline in lung function over a few years until it approaches the rate of a person who never smoked.
Seniors who need care do not want to give up their independence, but having care when it is needed can improve quality of life and health in many ways. Some benefits of assisted living are:
Y. Michael Shim, MD
UVA Health System Charlottesville | 434.924.5210 www.uvahealth.com
– Y. Michael Shim, MD
8
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
•
Monitoring of medication, especially when the patient is on multiple medications, has dementia, or needs daily monitoring.
•
Three meals a day, providing nourishment, socialization, and even exercise in going to the dining room.
•
Activities with other seniors, which allow for socialization and friendships.
•
Allowing the adult child to once again have a parentchild relationship instead of a patient-caregiver relationship.
•
Improvement of mobility problems: staying in an assisted living setting is better than remaining in a home where stairs, bathtubs and small doorways might hinder the senior.
Overall, assisted living services can increase quality of life by providing support, services and socialization with peers. Fonda Sundeen
Director of Sales and Marketing The Legacy at North Augusta Staunton | 540.885.5454 www.thelegacyatnorthaugusta.org
What is Morton’s neuroma? Morton’s neuroma is a painful but non-cancerous enlarged growth of nerve tissue that develops in the forefoot, often between the third and fourth toes. This growth of fibrous tissue surrounds a nerve that leads to the toes, causing numbness, swelling, and sharp burning pain in the ball of the foot. Morton’s neuroma results from nerve compression in the ball of the foot. Possible causes are improper footwear, injury and biomechanical instability of the foot. Aggravating factors may include standing, walking, running or hiking for long distances or durations. Treatment options depend on severity, and early diagnosis is important to keep the condition from progressing. Typical nonoperative treatments are antiinflammatory medication, taping, orthotics, cortisone and sclerosing injections, laser therapy and physical therapy. When early nonoperative treatment fails, surgical intervention may be necessary to remove the inflamed and enlarged nerve.
Vihang Bajani, DPM
Virginia Foot and Ankle Surgical Associates Charlottesville | 434.977.8040 www.vfasa.com
www.OurHealthCville.com
9
HEALTH H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
“
Forty percent of young children have night terrors. But most childhood parasomnias are infrequent and benign, and they are usually outgrown by adulthood. However, some people’s childhood parasomnias persist into adulthood. Other parasomnias, such as acting out dreams, commonly develop later in life.
”
What is mesothelioma?
What are parasomnias?
Mesothelioma is a cancer of the mesothelium, a thin layer of tissue that covers many of the internal organs. There are 3,000 new cases in the United States each year, most of them in males. The rate of the disease is increasing. Most cases are diagnosed after the age of 65. The areas most often affected are the lining of the lungs, the chest wall, and (less often) the lining of the abdomen.
A parasomnia is an unwanted behavior that occurs during sleep. Some parasomnias are quite common, especially in childhood, such as sleep walking and nightmares. Forty percent of young children have night terrors. But most childhood parasomnias are infrequent and benign, and they are usually outgrown by adulthood.
Symptoms include shortness of breath, a swollen abdomen, chest wall pain, coughing, tiredness and weight loss. These symptoms typically develop slowly. More than 80 percent of mesothelioma cases are caused by exposure to asbestos; the greater the exposure, the greater the risk. Diagnosis is made by chest X-ray and CT scan findings and a biopsy of the cancer. Prevention of mesothelioma centers on reducing exposure to asbestos. Treatment often includes surgery, chemotherapy and radiation therapy.
Anthony Crimaldi, MD
Not all unusual sleep behaviors are benign. Some serious health issues, such as certain seizure conditions, may mimic parasomnias, so evaluation is recommended. A careful description of the episodes can be the key to determining the underlying condition. Most parasomnias require no treatment, but it may be necessary if safety is an issue. Strategies for minimizing episodes include developing good sleep habits, addressing associated medical issues, and sometimes medication.
Central Virginia Radiation Oncologists Charlottesville | 434.654.8125 www.sentara.com
– Evan Wenger, MD
10
However, some people’s childhood parasomnias persist into adulthood. Other parasomnias, such as acting out dreams, commonly develop later in life.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Evan Wenger, MD
Augusta Health Sleep Center Fishersville | 540.932.4169 www.augustahealth.com
What are some treatment options for sun or age spots? There are great treatments for lentigos, often called age spots, sun spots or liver spots. Hydroquinone is a topical cream that gradually lightens dark spots. It is available over the counter, but prescription strength is often more effective. Another option is IPL laser treatment, which is quick and effective with no downtime. There is also Fraxel laser treatment, which treats not only lentigos but also fine lines and wrinkles, and improves overall skin tone. Of course, the first line of treatment is always preventing sun damage in the first place with sunscreen and sun avoidance measures. Consult a dermatologist to discuss the best treatment options.
Yara White, PA-C
Savola Aesthetic Dermatology Center, PLC Fishersville | 540.451.2833 www.savoladermatology.com
www.OurHealthCville.com
11
KEEPING THE PULSE ON HEALTH
Make Sure you Don't Miss
NEW TECHNOLOGY AT AUGUSTA HEALTH >> Additional surgical procedures are now available at Augusta Health with the recent acquisition of the latest robotic technology, the da Vinci Xi Surgical System. For patients, robotic surgery means faster recoveries, fewer complications, less blood loss, less scarring and a shorter hospital stay. Current robotic-assisted surgical procedures at Augusta Health include colorectal, gynecologic, urologic and general surgeries. The da Vinci Xi is the most advanced robotic system available in the Shenandoah Valley, and has increased capabilities for complex procedures at Augusta Health. For more information about surgical procedures available at Augusta Health, visit www.augustahealth.com.
OURHEALTH CHARLOTTESVILLE'S
NUTRITION + WELLNESS + FITNESS
RESOURCE GUIDE
54 on page
12
OUR LADY OF PEACE NAMED A TOP NURSING HOME BY U.S. NEWS & WORLD REPORT >> The newly released list of Best Nursing Homes in the country from the U.S. News & World Report, includes local retirement community Our Lady of Peace. Providing independent living, assisted living, nursing care and memory care, Our Lady of Peace is one of 38 communities in Virginia included on the Best Nursing Homes list by the U.S. News and World Report, and the only community in the entire Charlottesville area. Open since 1992, Our Lady of Peace is located on Hillsdale Drive and is home to 168 residents. For the complete list of Best Nursing Homes, visit health.usnews.com/best-nursing-homes. For more information, call 434.973.1155 or visit www.our-lady-of-peace.com.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Welcome
Yara White, PA-C DERMATOLOGY
Vihang Bajani, DPM Virginia Foot & Ankle Surgical Associates Charlottesville 434.977.8040 www.vfasa.com
Emily Christman, MD Rocky Fowler, MD Charlottesville Gastroenterology Charlottesville 434.817.8484 www.cvillegi.com
Sentara East Market Street Health Center Harrisonburg 540.564.5666 www.sentara.com
Tolvert Fowler Jr., MD Sentara East Market Street Health Center Harrisonburg 540.564.5666 www.sentara.com
Services Provided:
Sarah Goodwin, MD Sentara RMH Pediatrics Harrisonburg 540.689.1110 www.sentara.com
Sheila Helms, Licensed Aesthetician
Dr. Stephen D. Keefe, MD Fishersville | 540.245.7027 www.drkeefeent.com
Mark Knestrick Jr., MD Arun Mannem, MD Hematology Oncology Associates Harrisonburg 540.689.7000 www.sentara.com
Charlottesville Gastroenterology Charlottesville 434.817.8484 www.cvillegi.com
•
Skin cancer screening and treatment
•
Skin care wellness and facial rejuvenation
•
Laser and light treatment
•
Collagen vascular diseases treatment
•
Skin, hair and nail disorders
•
Aesthetic services for cosmetic and medical conditions
“I feel privileged to have the opportunity to improve access to professional, high quality, timely care for patients in the Shenandoah Valley and surrounding areas, who sometimes have had to wait months to be seen in the past.” James McGowan, MD Sentara Martha Jefferson Orthopedics Charlottesville 434.654.5575 www.sentara.com
Rachel Mehaffey, MD Sentara Martha Jefferson Internal Medicine Charlottesville 434.654.8930 www.sentara.com
Yinghao Riffee, MD
Sentara Martha Jefferson Inpatient Services Charlottesville 434.654.7000 www.sentara.com
Kunjan Shakya, MD
Harrisonburg Community Health Center Harrisonburg 540.433.4913 www.hburgchc.org
Savola Aesthetic Dermatology Center, PLC. 66 Parkway Lane Suite 101A | Fishersville Dermatology: 540.451.2833 Spa: 540.451.2836
www.SavolaDermatology.com Yara White, PA-C is now accepting new patients. Guaranteed appointment availability within the next week if not earlier. Laura Stump, MD
Family Medicine of Albemarle Charlottesville 434.973.9744 www.fmoa-online.com
J. Kyle Swingle, MD
Sentara Martha Jefferson Inpatient Services Charlottesville 434.654.7000 www.sentara.com
Scan here for more information about our services and providers. www.OurHealthCville.com
13
LOCAL NEWS
You Won't Want to Miss
BRIDGEWATER HEALTH CENTER COMING IN 2017 >> Sentara RMH Medical Center announces plans for the
Bridgewater Health Center coming in late 2017. The 10,800-square-foot facility, at the corner of Dinkle Avenue and Don Litten Parkway in “Bridgewater, will house Sentara Lab Services and Sentara Therapy Services, which will both move from their current location in Bridgewater to the new facility. In addition, Sentara Imaging Services will also be available, providing expanded healthcare offerings in one centralized location.
Could WEIGHT LOSS SURGERY be right for you?
14
42 on page
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Sentara RMH Medical Center is also partnering with Carilion Clinic on the project. Carilion Clinic will be moving its family practice clinic, currently located at 200 High Street, into the facility as well. The center is expected to open in the fall of 2017. For more information, visit www.sentara.com or www.carilionclinic.org.
www.OurHealthCville.com
15
HEALTHY LIVING
WINTER PET HEALTH >> Tips for your pets during the cold months
The cold weather can be as difficult on pets as it is on their ‘human’ families. Remember, if it’s too cold for you, it’s probably too cold for your pet. Domestic animals should be kept inside during severe cold. Other tips pet owners should be aware of include: •
PAMPER THE PAWS. Salt and other chemicals used to melt snow and ice can irritate a pet’s paws. Wipe their paws with a damp towel before your pet licks them and irritates their mouth.
•
EXTRA KIBBLE TO NIBBLE. Pets burn extra energy by trying to stay warm in the winter. Feeding your pet a little bit more during the cold winter months can provide much needed calories.
•
LET THEM ROCK THE SHAGGY LOOK. Never shave your dog down to the skin in winter, as a longer coat will provide more warmth.
•
NO MORE BATHS, OR AT LEAST LESS. Bathe your pets as little as possible during cold spells. Washing too often can remove essential oils and increase the chance of developing dry skin. In addition, repeatedly coming out of the cold into the dry heat of your home can cause itchy, flaking skin. Keep your home humidified and towel dry your pet as soon as he or she comes inside, paying special attention to the feet and in between the toes. Remove any snow balls from between the foot pads.
Winter Gardening
16
>> The benefits of indoor herb gardening Gardeners take heart! Indoor winter herb gardening is rewarding and provides fresh herbs year round! The following selection of herbs do well in containers, and offer a nice pantry mix to spice up soups, chilis and casseroles for the cold winter ahead! Here are five herbs that you can safely grow indoors this winter:
Mint
Parsley
Chives
Rosemary
Basil
Mint grows heartily throughout the year for indoor container herb gardens. Mint plants require a good deal of moisture and partial shade to thrive.
Parsley requires well-drained soil and can tolerate some shade during the winter months but tends to grow at slower rates than other months of the year without full sun.
Chives make a delicious herb to grow in the winter. Gardeners should use organically-rich and well-drained soil in potting containers for growing chives.
Rosemary is a vigorous herb that does well outdoors or indoors during the winter.
Basil grows well indoors for the winter in well-drained containers.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
DID YOU KNOW:
Gardening is a proven stress reliever?
Surviving the Drive Through Winter >> Tips for getting your car through the
harsh winter weather When it comes to safe driving and your vehicle, winter weather presents a unique set of challenges. While regular, preventive vehicle maintenance is important no matter the season, it becomes even more so when the temperature dips below freezing and the snow flies. Several vehicle systems are critical to driver and passenger safety, vehicle reliability and vehicle performance in winter weather, and should be checked before it snows to ensure they’re functioning properly. •
TIRES
•
WIPERS – Road salt, snow and ice are constant threats to clear visibility in winter driving. To help
– Examine the tires for both tread depth and inflation pressure. Tires lose air pressure in cold weather and should be inflated to the pressure indicated on the driver’s side door, door frame or owner’s manual, not to the maximum pressure listed on the tire sidewall. After checking your tires inflation pressure it is crucial to also check your tires tread depth. Tires that have shallow tread depth won’t deliver the traction or steering needed to drive in snow- or slush-covered roads. Purchase an inexpensive tread depth gauge or have the tires evaluated by a professional tire installer. ensure maximum wiping performance and visibility, windshield wipers that are more than six months old should be replaced.
•
BATTERY – The heat of summer weakens batteries, and the cold of winter kills them. Have your battery and charging system tested for free at one of the many auto parts stores offering the service.
•
LIGHTS – Fewer hours of daylight and bad weather mean more time spent driving with the lights on during winter months. Consider replacing headlights with new bulbs that utilize lighting technology to increase down-road visibility.
•
HEATER & BLOWER – Maintaining a comfortable temperature for passengers and keeping the windshield free of ice and fog depend on a properly functioning heating system. If any of the system’s components isn’t functioning properly or is making odd noises, it needs to be evaluated and fixed before driving in colder temperatures.
•
VEHICLE Emergency Kits ARE A MUST! An emergency kit stored in the trunk or cargo area can improve your chances of surviving plummeting temperatures, or even help get the vehicle unstuck. The kit should include water, food, blankets, emergency flares, a flashlight, extra batteries, jumper cables, a small shovel, sand or cat litter for traction, a first aid kit, foam tire sealant, and a fire extinguisher.
ANTIFREEZE – It prevents the engine from freezing in winter and from overheating in summer. Make sure to take the time to check the antifreeze levels in your car. Not all antifreeze or coolant is the same; many vehicles require a specific type. Refer to the owner’s manual for recommendations.
www.OurHealthCville.com
17
RECOGNITION CALENDAR
7 1 0 2
Y R A U JAN SUN
1
TUE
MON
3
2
WED
4
THU
5
FRI
6
SAT
7
14 3 1 2 1 11 0 1 9 8 1 2 0 2 9 1 8 1 7 1 15 16 8 2 7 2 6 2 5 2 4 2 22 2 3 1 29 30 3 SUN
5
2 01 7
FEBRUAR Y MON
TUE
WED
1
6
7
THU
2
FRI
3
8
SAT
4
9 10 11 12 13 1 4 15 16 17 18 19 20 2 1 22 2 3 24 25 2 6 27 2 8 18
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
National Blood Donor Month The month of January provides an opportunity for people to donate blood or pledge to give blood at a time of year when it is typically in short supply.
Week-long Observances JANUARY 16-20
Healthy Weight Week Healthy Weight Week is a time to celebrate healthy diet-free living habits that last a lifetime and prevent eating and weight problems.
JANUARY 22-28
National CRNA Week Established by the American Association of Nurse Anesthetists, this week is an opportunity for Certified Registered Nurse Anesthetists (CRNAs) to celebrate their history and accomplishments while educating the public on the important contributions they make to America’s healthcare system.
JANUARY 23-27
National Medical Group Practice Week The fourth week of January is National Medical Group Practice Week. A medical group practice is defined as three or more healthcare providers working together and sharing resources like facilities, personnel, and records. Medical Group Practice Week is a great time to celebrate with your staff and to raise awareness in the community of your practice.
Recognition Days JANUARY 25
National IV Nurse Day First celebrated in 1981, it is a day that means a great deal to the many who have dedicated their lives to providing the best infusion care possible.
American Heart Month During American Heart Month, the American Heart Association’s Go Red for Women movement works to save women’s lives and beat heart disease.
VISIT OUR WEBSITE FOR A FULL CALENDAR OF
Local Health Events! www.ourhealthcville.com
Week-long Observances FEBRUARY 5-11
National Burn Awareness Week Established by the American Burn Association, this week is designed to provide an opportunity for burn, fire and life safety educators to unite in sharing a common burn awareness and prevention message in our communities.
FEBRUARY 12-18
Cardiovascular Professionals Week This week celebrates the contribution cardiovascular professionals (including cardiovascular and radiological technicians and nurses in all cardiac specialties) make to healthcare and to patients with heart disease.
FEBRUARY 12-18
National Cardiac Rehabilitation Week This week focuses attention on cardiac rehabilitation’s contribution to improving the health and physical performance of people at risk for heart disease, as well as those who have been diagnosed with heart dysfunction.
Recognition Days FEBRUARY 3
National Wear Red Day: Go Red for Women The American Heart Association’s National Wear Red Day movement works to save women’s lives and beat heart disease – the number-one killer of women. Show support by wearing red. www.OurHealthCville.com
19
BOOK REVIEW words | RICK PIESTER
>> Showcasing some of the most authoritative books on how to get and stay healthy Americans have become very health-conscious in recent years. Thanks to that, there’s no end to the articles, books, websites, and folklore on how to stay healthy. Sifting through all of these sources of information can get confusing, so OurHealth Virginia is beginning a regular feature to highlight some of the most-respected and readable books on how to be healthy. We’ll start with two respected books that deal with Alzheimer’s, a disease that has touched one out of every two families in America. One of these is among the first and most respected books on the disease, and the second is a relative newcomer. Additionally, February is American Heart Month, a perfect time to bone up on all of the lifestyle changes — both large and small — that can lead to good heart health. There’s no lack of books on the subject, but here’s one that seems to rise above the rest.
The 36-hour Day
A Family Guide to Caring for People who have Alzheimer Disease, Related Dementias, and Memory Loss (5th Edition) By Nancy L. Mace and Peter V. Rabins, MD, PhD Johns Hopkins Press | 384 pages Published originally in 1981 (the newest edition is from 2011), this is the book that experts call the “go-to” information source for caregivers, family members, and anybody else who loves someone who is affected by this progressive disease. The information is clear, compassionate, and complete, making this the best guide of its kind. It is also available in Spanish as “Cuando el Dia Tiene 36 Horas.”
20
Before I Forget
Heart 411
By B. Smith and Dan Gasby with Michael Shnayerson
By Marc Gillinov, MD and StevenNissen, MD
Harmony Books | 319 pages
Three Rivers Press | 550 pages
Lifestyle maven B. Smith never expected to become an Alzheimer’s patient, but at 66, she and her husband Dan Gasby found themselves dealing with the dayto-day challenges of this disease that one person around the world develops every 67 seconds. Their story, which is as much a love story as an informational guide, is told in alternating chapters that weave valuable, practical tips and advice throughout their narrative. This book is a gem.
Don’t be misled by the subtitle, which was probably dreamt up by the publisher’s marketing department with an eye on sweetening sales. In truth, the constant research tends to change the way that medicine deals with heart disease on a regular basis. That aside, this book is an accessible, wide-spectrum work by two respected cardiac specialists at Cleveland Clinic. They provide a down-to-earth discussion of the many questions about heart health that their own patients have raised over the years.
Love, Hope, Help and Acceptance in Our Fight Against Alzheimer’s
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
The Only Guide to Heart Health You’ll Ever Need
www.OurHealthCville.com
21
How much do you know about the
Heart Disease? 2. Every ___________ someone dies from heart disease or stroke.
1. True or False: Heart disease is the leading cause of death in the United States.
A:
B:
17 seconds
D:
C:
39 seconds
4. True or False:
3. On average, ___________ deaths in the United States is caused by heart disease and stroke. A:
B: 1 of 6
1 of 7
99
percent
B:
75
percent
C:
7. True or False: Lowering your blood pressure can decrease your risk of heart disease by about 50 percent.
9. Common heart attack warning signs include all of the following EXCEPT:
A: Chest Discomfort
B: Shortness of breath
50
percent
women die from heart disease each year.
1 of 3
1 of 5
5. On average, ___________ of Americans need to improve their heart health. A:
More men than
D:
C:
D:
60 seconds
52 seconds
6. Which of the following methods improve heart health?
25
percent
8. Which of the following is NOT a risk factor of heart disease?
A: Understand your heart risk
A: High cholesterol
B: Healthy diet and exercise
B: High blood pressure
C: Minimize stress and get enough sleep
C: Diabetes D: All of the above are risk factors
D: All of the above 2. B
3. D
4. False
5. A
6. D
7. True
8. D
9. C
Source: www.heart.org
D: Nausea
1. True
C: Metallic taste in mouth
www.OurHealthCville.com
23
24
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Making a
DIFFERENCE
in
Heart Health LOCALLY
Charlottesville chapter of the American Heart Association focuses on improving heart health locally. words | RICH ELLIS
Heart disease is the leading cause of death in the United States, killing more than 370,000 people annually according to the American Heart Association. When statistics for stroke and other cardiovascular diseases are combined with heart disease, the number of deaths attributable to one of those three causes rises to approximately one in three deaths in the U.S. – more than 800,000 people in 2013, the most recent year for which data is currently available.
Virginia is no exception to these sobering national statistics, but there is some good news. The number of deaths in Virginia that are attributable to heart disease and stroke has been declining for more than a decade, and some of the credit for this decline undoubtedly lies with efforts put forth throughout the Commonwealth by the American Heart Association’s local chapters, including the one in Charlottesville. Cyndi Bade, vice president of development for the American Heart Association (AHA) in Charlottesville, has outlined the organization’s goals that help guide efforts at both the local and national levels. “Our mission is building healthier lives, free of cardiovascular diseases and stroke,” Bade says. “The goal by 2020 is to improve all Americans’ cardiovascular health by 20 percent while reducing the deaths from cardiovascular disease and stroke by 20 percent.”
www.OurHealthCville.com
25
With backing from their parent organization, Bade and her staff have a powerful ally in their local fight. The American Heart Association is the
“Our mission is building healthier lives, free of cardiovascular diseases and stroke,” Bade says. “The goal by 2020 is to improve all Americans’ cardiovascular health by 20 percent while reducing the deaths from cardiovascular disease and stroke by 20 percent.” CYNDI BADE
Vice president of development for the American Heart Association (AHA) in Charlottesville
The American Heart Association Impacts Local Communities By:
nation’s oldest and largest voluntary organization that is dedicated to fighting heart disease and strokes. Founded by six cardiologists in 1924, today’s AHA includes more than 22.5 million volunteers and supporters, 156 local offices and 3,000-plus employees funding innovative research, fighting for stronger public health policies and providing critical tools and information to save and improve lives.
Bade points to some of her organization’s specific and local community efforts that are aimed at helping improve heart health and lives throughout Charlottesville. “For starters, we’re working to end obesity,” she explains. Approximately 35 percent of Virginia adults are overweight, and another 28 percent are obese. Additionally, 30 percent of Virginia’s 10- to 17-year-olds are overweight or obese, and Virginia ranks first in the United State for childhood obesity rates among 2- to 5-year-olds. To help lower those alarming rates, the American Heart Association is supporting a local Virginia advocacy priority this year that ensures that healthy food and beverage options are available in public places, such as parks, recreation centers, libraries and other buildings. Locally, AHA supporters are advocating for the creation of the Virginia Grocery Investment Fund, which could increase the healthy food retail options in Charlottesville and the surrounding counties. In addition to combating obesity, Bade says that her organization’s staff and volunteers are also focused on helping people control and reduce high blood pressure. “It’s estimated that 80 million Americans have high blood pressure, and in about half of them it’s uncontrolled, increasing the risk of heart disease,
Funding Innovative Research
stroke and other major health problems,” she explains. “Approximately 28 percent of Virginia residents have been told by their doctor they have high blood pressure. The good news, however, is that high blood pressure can be controlled, and AHA is working with local medical partners throughout Virginia through a nationwide initiative called Target: BP to help patients with high blood pressure reduce it to healthy levels.”
Fighting for Stronger Public Health Policies
Providing Critical Tools and Information to Save and Improve Lives
26
Bade says that her organization also advocates for laws at the local, state and national levels that improve the health of all individuals. In 2013, for example, advocates for the American Heart Association were instrumental in passing Gwyneth’s Law, which requires that all Virginia high school students be trained in CPR before they graduate. Based on enrollment data and as a direct result of this law, hundreds of lifesavers will be added annually to the Charlottesville community. In 2014, furthermore, AHA advocates helped to pass legislation requiring all newborns in Virginia to receive pulse oximetry screening to detect congenital heart defects, the most common birth defect in infants worldwide.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
AHA’s deep commitment to cutting-edge research benefits the Charlottesville community. “Only the federal government funds more cardiovascular research than we do,” Bade says. “AHA does this by convening top scientific and medical experts to annually review thousands of submitted research proposals and then choose the most deserving studies, which are then funded through support from our donors. While the researchers are nationwide, we are proud to have active research studies being conducted right here in Virginia at Virginia Commonwealth University, the University of Virginia, McGuire VA Medical
Photos from the 2016 Charlottesville Heart Walk at Boar's Head.
Center and Virginia Tech.”
AHA’s research is yielding important results, with AHA funding 13 Nobel Prize winners as well as enabling breakthroughs in treatment and prevention, including advancements in CPR techniques, the first artificial heart valve, implantable pacemakers, cholesterol inhibitors, microsurgery and drug-coated stents. “We also bring science to life so that we can stop heart disease before it starts,” Bade explains. “We fund the development of evidence-based guidelines that help physicians treat patients using the latest scientific findings, and we promote these standards by educating consumers, healthcare providers and scientists.” Sadly, adults aren’t the only population affected by heart-related health issues. Children also suffer, as congenital heart defects (CHDs) are the world’s most common type of birth defects. AHA’s Charlottesville chapter assists local children by helping further lifesaving research on CHDs through a joint initiative formed by the American Heart Association/American Stroke Association and the Children’s Heart Foundation. This new alliance will not only provide $29 million in grants for conducting research over the next five years, but will also offer an outlet to encourage conversations among parents and caregivers through the Patient Support Network. This network connects people who are living with heart disease and stroke with others who are undertaking similar journeys and offers an online community as well as materials for starting face-to-face community support groups. In addition, both organizations will continue to raise awareness about CHDs, the need to address national policies for early CHD detection, and health advances that can change the life expectancy of babies that are born with congenital heart defects.
The funds that are raised here stay here. To help fund all of this groundbreaking research, AHA’s Charlottesville chapter hosts several annual fundraising events, including the Heart Walk and the Heart Ball. Through these signature events, the community raises around $400,000 annually to help support cutting-edge cardiovascular and stroke research at the University of Virginia.
www.OurHealthCville.com
27
For every dollar raised through these fundraisers, 75 cents stay within the Mid-Atlantic Affiliate of which Virginia is a member, with 20 percent of this being allocated to supporting regional research projects, while the other 80 percent funds local mission programs and operations. The remaining 25 cents of every dollar helps fund nationwide programs, research and operations. “Pooling our dollars with the other six AHA affiliates across the country and with the national center enables AHA to provide higher-quality programs and resources to local communities,” Bade says. “For example, we know that research performed in Boston about congenital heart defects and why they form will benefit all children, not just those in Boston.”
Looking forward to 2017 In addition to all of the local events planned, Bade explains that the AHA’s Charlottesville chapter is helping the organization to reach its 2020 impact goal by building a “culture of health.” In this type of culture, the healthy choice becomes the easy and popular one. A few ways that we will do this is by continuing to support and advocate for laws and public policies that change communities, focusing on areas where we can make the biggest impact (including high blood pressure control), and providing education and resources to our underserved populations. Individuals
or
organizations
that
are
interested in donating to the American Heart Association’s Charlottesville chapter or want to receive information about local sponsorship opportunities should contact Tori Sancho-Bonet at 804.965.6587.
ON THE WEB
More at ourhealthcville.com
28
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
FITBITS H EALT H AN D FIT NE S S O N T HE G O
FITNESS
ANYTIME, ANYWHERE words | DEIDRE WILKES
It’s cold. It’s dark. The weather’s bad. It’s WINTER. These obstacles can make getting to the gym difficult. Now, with today’s technology, there is an alternative. Virtual or ‘on-demand’ workouts and classes can be done anytime and anywhere. Virtual classes are ‘live’ and streamed into your home or studio, which gives the same look and feel as being in a group class, rather than a traditional DVD workout. You can participate in real-time classes at some of the best studios in cities like Chicago, Los Angeles and New York without ever leaving the comfort of your home gym or living room!
DAILY BURN At only $12.95 per month, the website offers diverse workouts from in-house instructors, including pilates, yoga, weightlifting, and cardio. Easy-to-follow meal plans are also included. www.dailyburn.com
LES MILLS ON DEMAND This popular franchise now offers virtual workouts for six of their signature programs – Body Pump, Body Combat, Body Balance, CXWorx, Sh’bam, and RPM. Subscriptions start as low as $12.99 per month. www.lesmills.com
WORKOUTS ON DEMAND This subscription offers access to a library of over 210 fitness workouts to chose from, with new workouts constantly being added. There are several membership options that range from $5 to $12 per month. www.workoutsondemand.com
Deidre Wilkes, AFAA, ACSM Certified Personal Trainer
Deidre is the resident fitness specialist for OurHealth Charlottesville & Shenandoah Valley. www.OurHealthCville.com
29
BONE & JOINT CARE
MENTAL HEALTH
30
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
172017 for
to think about
Setting off on a year of better health words | RICK PIESTER
Every new year is a new beginning, a chance to make positive changes in our behavior, lifestyle, choices and health. Making significant changes, though, is a big undertaking. It’s best to start small, and we all need help. So in that spirit, we’ve assembled 17 quick tips that we hope will make the job a little easier. These tips are not meant to be all-inclusive, obviously, but think of them as a tasting menu on your trip to good health.
www.OurHealthCville.com
31
DENTAL CARE: When to brush.
HEALTH TIP
Since childhood, we’ve been told to brush our teeth after every meal, at least three times a day. But now dentists know that that’s not quite right. Don’t brush your teeth immediately after every meal, especially if your food or drink was acidic. High-acid foods such as citrus fruits and tomatoes, as well as sports drinks and soft drinks, soften tooth enamel. Brushing your teeth when the enamel is slightly softened can speed up the effects of acid, eroding both the enamel and the layer under it. Better to wait 30 to 60 minutes after eating to brush.
“Only you can make time for 15+ minutes per day of exercise, eat a healthy diet and do monthly breast exams! Keep those healthy check-up appointments; YOU are in charge of your own health!" EDWARD WOLANSKI, MD Charlottesville | 434.293.9800 www.wolanskiobgyn.com
HAIR AND SCALP:
Brushing your way to healthier hair.
2
You know that gently brushing your hair is a good thing, but giving your hair a light brushing just before you step into the shower can be a big help. It will remove dead skin cells so that they can’t clog hair follicles and interfere with the growth of new hair. Brushing the hair stimulates circulation of the scalp, and it spreads natural oils down the shaft of hairs to moisturize dry ends. But plastic bristle brushes can’t distribute those oils. Invest in a natural bristle brush for best results.
SLEEP: The he is hot while she is cold dilemma. A constant demolisher of good sleep is losing all of your covers to your bed partner. If that happens to you a lot, or if one of you shivers while the other one sweats, try this: Make the bed with separate sets of sheets. Use one fitted sheet to start. Then top it off with twin-size flat sheets and blankets to match each person’s comfort needs. Don’t worry that it might look weird. You can top the whole thing off with a single comforter when making the bed each morning.
32
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
HEALTH TIP “Make it your New Year's resolution to spend at least eight hours in bed every night. Don't worry if it takes a little time to fall asleep or if you wake up at night. Rest can be almost as beneficial to the body as sleep!” W. CHRISTOPHER WINTER, MD Charlottesville Neurology and Sleep Medicine Charlottesville | 434.293.9149 www.cvilleneuroandsleep.com
HEALTH TIP “When it comes to colon cancer screening, we often say that no one should die of embarrassment. Colon cancer is both preventable and treatable, if
4
5
caught early. If you are over age 50 and have not yet had a colonoscopy, discuss your screening
MENTAL HEALTH:
options with your doctor.”
Hugs, good for the soul.
DAVID BALABAN, MD
Get a hug and give a hug. It’s fun, and science has learned that hugging releases oxytocin, the hormone that makes us feel good, as well as reducing levels of the stress hormone cortisol.
Charlottesville Gastroenterology Associates Charlottesville | 434.817.8484 www.cvillegi.com
DIABETES: Superfoods to the rescue. The American Diabetes Association maintains a handy list of ten “superfoods” that are less likely to affect your blood sugar than other foods. The list includes beans, leafy dark green vegetables, citrus, sweet potatoes, berries, tomatoes, fish high in omega-3 fatty acids, whole grains, nuts and fat-free milk and yogurt. Post a copy of this list on your refrigerator and refer to it when you plan your meals or reach for a snack.
HEALTH TIP “Replace screen time with green time…Go out for a walk—your heart will thank you!” ARUN PRAHASH, MD Augusta Health Cardiology Fishersville | 540.332.4278 www.augustahealth.com
SKIN CARE: Sun exposure, inside and out. You’ve heard that it’s wise to avoid overexposure to the sun. But you should remember that when it’s sunny outside, it’s also sunny inside, and staying out of direct sunlight doesn’t fully protect you. Damaging UVA rays travel through the windows of your home, your workplace and your car. UVA rays weren’t considered a problem until recently, because UVB light causes the most damaging sunburns. But scientists have determined that UVA light is carcinogenic. UVA light is what causes the grayish-yellow cast on the skin of older people. The lesson: Unless you spend all your time deep in a cave, wear a broad-spectrum sunscreen all year, rain or shine. www.OurHealthCville.com
33
1 7 HEALTH TIP
MEMORY: Make note of it.
To be sure you remember something important, break the routine around it. For example, if you constantly forget to turn the heat down at night, make a small sign to remind you (write “HEAT” on it) and post it where you are bound to see it — on the steps going upstairs, or on the bathroom counter. Or if you normally keep your car keys in your right-hand pocket, put them in your left-hand pocket to trigger a reminder of something that must be done during the day.
“Anyone can lose weight…learning how to keep the excess pounds off after dieting should be your ultimate goal.”
CHRISTINA BOVE, MD, FACC Blue Ridge Medical Weight Loss Clinic Charlottesville | 434.962.2533 weightlosscharlottesville.com
HEARING: Turning down the volume.
About 15 percent of Americans have hearing loss that is induced by loud work or leisure environments. Any place that is noisy enough to force you to shout so that the person next to you can hear you is an area with a dangerous level of sound. To conserve your hearing, try using earplugs. They are easy to obtain, and you can have them custom made by a local hearing care provider. Otherwise, give yourself about 16 hours of quiet for your ears to recover from about six hours of loud noise.
HEALTH TIP “You go to the doctor for your yearly physical, the eye doctor for your yearly eye exam. It is also important to get your yearly hearing test. At Virginia Hearing Group, it's free.” KAREN KLOTZ Virginia Hearing Group Verona | 540.248.1670 www.virginiahearinggroup.com
34
PAIN: Heat vs. cold. Applied correctly, both heat and cold can help reduce pain. But there’s a great deal of confusion about what to use when. As a general rule, heat is best used to take the edge off of muscle spasms and chronic pain such as back or neck pain. Ice is a mild, drug-free way of dulling the pain of damaged tissue that is red, inflamed or swollen. Keep in mind that heat can make inflammation worse, and cold can make muscle tension and spasms worse, so be careful.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
10 EYE CARE: The 20-20-20 rule.
The hours we spend staring at computer screens can seriously strain our eyes, disturb sleep patterns, and wipe out concentration. Heavy computer use doesn’t damage long-range vision; the eye strain comes from constantly focusing on something that’s about 18 inches away, rather than switching your gaze between objects of varying distances from your eyes, say by looking around a room. So follow the 20-20-20 rule: Every 20 minutes, focus on something that is 20 feet away for 20 seconds.
HEALTH TIP “For the New Year, take special care of your eyes when viewing digital devices, such as your computer, tablet and smartphone by wearing specialized digital contact lenses and eyeglasses that can prevent digital eye syndrome. Also, be sure to wear sunglasses that will protect you from harmful UV rays, especially on ski and snowboarding trips.” JOSEPH DIGIROLAMO, OD Primary Eyecare Charlottesville | 434.977.2020 www.cvilleeyecare.com
www.OurHealthCville.com
35
11
DIET AND NUTRITION: Filling your plate. A good general rule to follow when plating food is to fill half of a dinner plate with vegetables (non-starchy veggies such as carrots, Brussels sprouts or asparagus). About a quarter of your plate should be reserved for starchy foods (potatoes, corn, rice or peas), and the remaining quarter should be filled with protein (preferably chicken, fish or beans). Use caution with baked goods and pasta, especially if you have high blood sugar.
50% Vegetables 25% Starchy Foods 25% Protein
36
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
HEALTH TIP 1.
“Avoid the appeal of ‘fad diets’. Try to focus on sustainable diet modifications and lifestyle changes.
2.
Don’t start “tomorrow” when you can start right now! Avoid making excuses to start a change later when you can start making changes immediately.
3.
Weight as a number is not always the best representation of your progress toward weight loss goals. Instead, focus on how your clothes fit, your mood and your energy level.
4.
Don’t be bogged down by a few setbacks; remember to keep moving forward.” KATHERINE SHOOK, RD Augusta Health Fishersville | 540.213.2537 www.augustahealth.com
12
STOMACH AND DIGESTION: Chew, chew, chew.
Chewing your food is the first step in proper digestion, so do it thoroughly. Chewing breaks your food down into smaller pieces, allowing saliva and enzymes in your mouth to act on the surface of food to chemically break it down. More chewing creates more surface areas, better enzyme action and better digestion.
13 EXERCISE:
30 minutes a day keeps the doctor away.
Experts say that it’s important to get at least 30 minutes of exercise each day, but what if you’re too busy to find a half-hour? You can break it up into two or three shorter periods of exercise. For example, do ten minutes of strength training in the morning. At lunchtime, take a brisk ten-minute walk. And then after work in the evening, take the dog for a walk, or do another brisk stroll. The combination can help a lot in keeping up your health.
HEALTH TIP “Instead of getting overwhelmed by changing your lifestyle all at once, make one small change each month of the year—such as increasing your servings of vegetables each day in January and walking 10,000 steps each day in May. Keep them up all year, and by the end of the year, you’ll have a brand new you with a brand new lifestyle.” JANE BLOSSER, MS, RD, CED Augusta Health Fishersville | 540.213.2537 www.augustahealth.com
14
SPORTS PHYSICALS: When is the best time to go?
Participating in school or community sports teams is a great way for children to stay in shape, but it’s important that they see a healthcare provider for a sports physical to make sure that their bodies are ready for the season ahead. Most experts say that six to eight weeks ahead of the sports season is the best time to schedule a physical. That way, if the child has a condition that needs treatment, needs to see a specialist or needs any follow-up care, there will be enough time before play starts.
www.OurHealthCville.com
37
BONE AND JOINT CARE: Get up and move!
EYour joints may be painful, but don’t be inactive. Sitting at a desk all day or refusing to move around because it hurts can either cause joint pain or make it worse. You need to vary your routine, giving your body and your joints rest as well as activity. If you have to sit for long periods of time, try to remember to get up and move around every couple of hours.
HEALTH TIP “An ounce of prevention is worth a pound of cure. Healthy heart habits can improve longevity.” DAVE VARMA, MD Augusta Health Cardiology Fishersville | 540.332.4278 www.augustahealth.com
HEART AND LUNGS: Dangers of smoking. You’ve doubtless heard it before, but it’s well worth repeating: If you are a smoker, stop. Smoking is the leading cause of preventable death in the United States. It causes heart disease, stroke, lung disease, osteoporosis, and cataracts, among other ailments. But don’t try to quit “cold turkey.” Smoking is an addiction, so take a little time to prepare. Research methods, such as classes, counseling, medication or hypnosis, that will help you quit successfully. But determine that you are going to quit, and get to work on it.
IMMUNIZATIONS: Build up the antibodies. For many years, it was almost standard practice to give babies a dose of acetaminophen (Tylenol, for example) when it was time for their first vaccinations. But now pediatricians are warning against it since research has shown that the medication causes babies’ bodies to produce fewer diseasefighting antibodies, which reduces the effectiveness of the vaccinations. It’s best to give fever-reducing medicine only if a child’s fever is dangerously high, or if doing so has been recommended by your physician.
ON THE WEB
More at ourhealthcville.com
38
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
www.OurHealthCville.com
39
Photos courtesy of Rachel Wilson and John Robinson
Baby, Baby, Baby – the stork delivers! With over 1,000 registrants, it was a great day to celebrate Edward Wolanski, MD and his commitment to the Charlottesville community! The Wolanski 2 Miler Celebration is a community event celebrating the OB career and impact of Dr. Wolanski. The run/walk held at Sentara Martha Jefferson, was a fun opportunity for the whole family to celebrate Dr. Wolanski’s OB career, even though he will continue to provide gynecological services to the community for a long time to come! The finish line was decorated with photos of ‘Wolanski Kids’, and Dr. Wolanski offered personal greetings to participants – young and old – many of whom he delivered! All proceeds from the Wolanski 2-Miler support the Family Birthing Center and Special Care Nursery at Sentara Martha Jefferson.
40
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
ON THE WEB
More at ourhealthcville.com
www.OurHealthCville.com
41
Could
WEIGHT LOSS SURGERY be right for you? It’s not a cure-all, but it can be a dramatic help. words | RICK PIESTER
This is the time of year when many of us are trying to make good on our New Year’s weight-loss resolutions. We’re furiously dieting and steadfastly working out, trying to get our bodies down to that elusive “ideal weight” goal. But for some of us, the goal isn’t merely elusive: It’s completely out of reach. No amount of dieting or exercise is going to lead to significant and lasting weight loss. We are — in medical terms — obese. And the more obese we are, the less likely we are to lose weight and keep it off through diet and exercise. Some people who have made repeated serious-but-failed attempts at traditional weight loss programs are now turning to weight-loss surgery, called “bariatric” surgery. This alters the digestive system to help people lose weight by limiting how much they can eat. Bariatric surgeries have become so popular that about 200,000 of them are performed each year in the U.S. alone, a tenfold increase since the early 1990s. Although they were considered to be rather exotic, high-risk procedures not long ago, they have become a safe and relatively standard surgical approach to a lifestyle problem.
42
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
www.OurHealthCville.com
43
They have become so effective that many healthcare insurers in Virginia and at least 47 other states as well as Medicare and Medicaid cover them as long as the somewhat stringent eligibility and patient education requirements are met. In Charlottesville, Bruce Schirmer, MD, is part of the University of Virginia Health System’s bariatric surgery department, accredited by the American College of Surgeons as a Level 1 Bariatric Surgery Center. Dr. Schirmer says that UVA’s criteria for people seeking bariatric surgery is fairly straightforward and is determined in large part by healthcare insurers. “It’s important that people understand that surgery is a tool to help meet weight loss goals,” he notes. “People still have to be mindful of what they eat — that the operation doesn’t force you to eat the right foods and the right portion sizes.” For that reason, candidates for surgery at UVA complete an evaluation by hospital dietitians, pre-surgery educational programs run by dietitians and nurses from the bariatric surgery department, an assessment of any related health problems such as diabetes or heart disease and a psychological assessment. Preparation for surgery typically takes between four weeks to three months, Dr. Schirmer says, based upon individual patients’ health insurance requirements. (State employees, however, must participate in an organized diet program for a year before the surgery is approved by insurance.) After-surgery care consists of frequent contact with surgeons, dietitians and nurses from the department. “It’s important that people understand that surgery is a tool to help meet weight loss goals. People still have to be mindful of what they eat — that the operation doesn’t force you to eat the right foods and the right portion sizes.” BRUCE SCHIRMER, MD University of Virginia Health System’s Bariatric Surgery Department
A key criteria for surgery is having a body mass index (BMI) of 40 and above, if there are no accompanying medical problems. If a person has diabetes, blood pressure issues, sleep apnea, reflux, or any other weight-related ailments, the BMI requirement drops to 35, Dr. Schirmer notes.
BODY MASS INDEX BMI is a measurement of body fat based on each person’s weight and height. It’s a numerical score that applies to both women and men, used to indicate whether a person is underweight, of normal weight, overweight, obese, or severely obese. If you score a BMI between 18.5 and 25, you are considered to have a normal weight for your height. If your BMI is between 25 and 30, you are considered to be overweight, and medical professionals consider you obese if your BMI is 30 or higher. A BMI of 40 or higher indicates severe obesity. (Continued on page 47...)
44
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
HOW TO CALCULATE YOUR
BODY MASS INDEX STEP 1
(weight in pounds) x
STEP 2
(height in inches) x
.45
.025
STEP 3
(answer from step 2) 2
STEP 4
(answer from step 1) (answer from step 3)
www.OurHealthCville.com
45
FOUR TYPES OF
BARIATRIC SURGERY
GASTRIC BYPASS In this surgery, the stomach is made smaller by creating a small pouch at the top using surgical staples. The smaller stomach is connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine.
46
SLEEVE GASTRECTOMY
GASTRIC BANDING
In this surgery, the stomach is surgically narrowed to resemble a sleeve. The smaller pouch, about 15 percent the size of the “original,� has a capacity that is reduced from about 11/2 quarts to between 4 and 6 ounces.
In this surgery, a device is wrapped around the upper part of the stomach to form a ring. A thin tube is attached to the ring, and an access port in the body allows surgeons to tighten or loosen the band by injecting saline solution.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
INTRAGASTRIC BALLOON In this surgery, a saline-filled silicone balloon is placed in the stomach to limit how much a person is able to eat. The balloon stays in place for roughly 6 months and is especially suited for short-term weight loss.
(...continued from page 44)
About two out of every three American adults are overweight, and one out of every three can be said to be obese. In 1990, hardly any states had obesity rates of more than 15 percent; today, all 50 states have obesity rates of at least 20 percent. A 2012 study in the Journal of Health Economics estimated the medical care costs of obesity in the U.S. in 2005 to have been as high as 190 billion dollars, a figure that is steadily increasing. Weight gain also gives rise to looming health risks. The physical ailments associated with obesity include higher rates of heart disease and stroke, diabetes, sleeping difficulties, joint problems and an increased risk of certain types of cancers. Obesity, in fact, has become second only to tobacco as a major killer in the United States. This is part of the reason that healthcare insurers cover bariatric surgery. The surgery helps avoid the costs of serious weight-related diseases.
“A key criteria for surgery is having a body mass index (BMI) of 40 and above, if there are no accompanying medical problems. If a person has diabetes, blood pressure issues, sleep apnea, reflux, or any other weight-related ailments, the BMI requirement drops to 35.” BRUCE SCHIRMER, MD University of Virginia Health System’s Bariatric Surgery Department
Bariatric surgeries do not remove fat tissue. Instead, surgeons rework the stomach and intestines so that a person feels full more quickly, ingests fewer calories, or both.
TYPES OF SURGERY Within the UVA Health System, surgeons perform four types of bariatric operations, all of them laparoscopic surgeries in which small “keyhole” incisions rather than larger open incisions allow surgeons to introduce a video camera and surgical instruments. GASTRIC BYPASS SURGERY Gastric bypass surgery is the “old faithful” of the bariatric operations. It has been in use for the longest time and often offers the best and longest-lasting results. In this surgery, the stomach is made smaller by creating a small pouch at the top using surgical staples. The smaller stomach is connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine.
www.OurHealthCville.com
47
SLEEVE GASTRECTOMY SURGERY In a sleeve gastrectomy, the stomach is surgically narrowed to resemble a sleeve. The smaller stomach pouch, about 15 percent the size of the “original,” has a capacity that is reduced from about 1½ quarts to between 4 and 6 ounces. GASTRIC BANDING SURGERY “About two out of every three American adults are overweight, and one out of every three can be said to be obese.”
The third approach, gastric banding, is falling out of favor with surgeons and patients alike because of the intensive level of follow-up needed, Dr. Schirmer says. In the surgery, a device is wrapped around the upper part of the stomach to form a ring. A thin tube is attached to the ring, and an access port in the body allows surgeons to tighten or loosen the band by injecting saline solution. INTRAGASTIC BALLOON SURGERY
“In 1990, hardly any states had obesity rates of more than 15 percent; today, all 50 states have obesity rates of at least 20 percent.”
1st 2nd
3rd
“Obesity has become second only to tobacco as a major killer in the United States. This is part of the reason that healthcare insurers cover bariatric surgery. The surgery helps avoid the costs
A newer option at UVA is intragastric balloon surgery, during which a saline-filled silicone balloon is placed in the stomach to limit how much a person is able to eat. The balloon stays in place for roughly 6 months and is especially suited for short-term weight loss if a person needs to lose weight quickly to prepare for another surgery, such as a hip replacement. This procedure allows patients with a BMI of between 30 and 40 to qualify for the surgery. The recovery time is relatively rapid with all approaches, with most patients going home a day or two after surgery and getting back to work between a week and a month after surgery, depending on the kind of work they do. In 2017, the bariatric surgery department at UVA also plans to launch a program in endoscopic balloon gastric surgery. This will be an outpatient, non-surgical procedure in which physicians insert a balloon through the mouth and into the stomach. Once inside, the balloon is filled with saline, which expands it to the size of a grapefruit. After six months, the balloon is removed during a second outpatient procedure. However, health professionals do assert that bariatric surgery does not signal an end to the fight against obesity. Surgery can create new and different nutritional, medical and physical challenges along with changes in an individual’s emotions and behavior. EXPERT CONTRIBUTERS Bruce Schirmer, MD with University of Virginia Health System’s Bariatric Surgery Department in Charlottesville.
of serious weight-related diseases.”
ON THE WEB
More at ourhealthcville.com 48
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
www.OurHealthCville.com
49
Healthy Ideas
Tricia Foley’s
ARTICHOKE DIP Ingredients
LOW SODIUM WHITE BEANS Using low-sodium white beans instead of Alfredo sauce (typically found in many artichoke dips) will reduce sodium while improving the overall nutrition.
2 1 4 1 2
cups artichoke hearts tablespoon black pepper cups chopped spinach teaspoon minced thyme cloves garlic, minced
1 tablespoon minced parsley 1 cup low-sodium white beans, prepared 2 tablespoons parmesan cheese ½ cup fat-free sour cream
Directions
Heat oven to 350 degrees. Meanwhile, in a medium bowl, mash the white beans and fat-free sour cream together until a paste is formed. In an 8 x 8 inch-baking dish, combine all of the ingredients and blend them together, spreading evenly. Bake the mixture in the oven for 30 minutes, then serve warm with whole-grain pitas or vegetables for dipping.
Nutrition
(Nutrition per serving, 1/2 cup) 120 calories, 14 grams carbohydrates, 6 grams fiber, 71 milligrams sodium, 2 grams fat, 0 grams saturated fat and 4 grams protein. Source: www.mayoclinic.org
FAT FREE SOUR CREAM Using fat free sour cream instead of full-fat sour cream, will save six grams of saturated fat .
SPICE IT UP Thyme and parsley enhance the flavor that otherwise would have been lost when removing the Alfredo sauce, which is usually seasoned.
50
OLIVE OIL Searing the chicken in olive oil instead of butter reduces saturated fat and gives the dish a healthy dose of monounsaturated heart healthy fats.
Tricia Foley’s
CHICKEN WITH MUSHROOMS AND RICE Ingredients (serves 6) 1 6 1 2 1½ 1 1/4 1/4
tablespoon olive oil (4-ounce) chicken breasts pound white mushrooms, thinly sliced cups low-sodium chicken broth or vegetable broth cup water cup uncooked Brown rice teaspoon salt cup fresh cilantro or parsley, chopped Salt and pepper
Directions
Heat a large skillet on medium-high heat until hot. Add olive oil. Season the chicken breasts with salt and pepper. Sear the chicken for five minutes. Flip the breasts to the other side and sear for two more minutes on medium heat. Remove from the skillet (they will not be cooked through). In the same skillet, add the thinly sliced mushrooms and cook on medium heat for about one to two minutes, until the mushrooms soften. Add the chicken broth, water, uncooked rice, and ¼ teaspoon salt and bring to a boil. Mix everything well. Put the chicken breasts on top, making wells for them in the rice. Reduce the heat to a low boil simmer. Cover the skillet and simmer for 15 to 20 minutes until the rice is soft and the chicken is completely cooked. Sprinkle with chopped fresh cilantro before serving.
Nutrition (Nutrition per serving): 337 calories, 6.7 grams fat, 0.5 grams saturated fat, 468 milligrams sodium, 26 grams carbohydrates, 3 grams fiber and 38 grams protein. Source: www.Juliasalbum.com
SKINLESS CHICKEN BREASTS Using skinless chicken breasts instead of chicken thighs saves nearly 14 grams of fat, about 5 grams of saturated fat, and 116 calories per serving.
BROWN RICE Substituting brown rice instead of white rice adds more than 2 grams of fiber per serving.
FRESH MUSHROOMS Using fresh mushrooms instead of condensed soup reduces sodium and adds a healthy dose of vitamins and antioxidants to the meal. www.OurHealthCville.com
51
Healthy Ideas
Tricia Foley’s
BAKED APPLES Ingredients (serves 6)
SUBSTITUTE BROWN SUGAR By substituting honey and applesauce for brown sugar, we are able to maintain the flavors and sweetness of the dessert while cutting back on the calories.
6 2 1/2 ¼ 1 1
honey crisp apples tablespoons butter cup unsweetened applesauce cup honey tablespoon apple pie spice (blend of cinnamon, nutmeg and allspice). ounce chopped pecans
Directions
Heat oven to 375 degrees. Wash and core apples, leaving enough of the core at the base of the apple to contain the filling. Combine the butter, honey, applesauce, apple pie spice, and chopped pecans in a small bowl. Spoon the contents evenly into each apple to fill the core. Fill a baking dish with ¾ cup water. Place the apples upright and bake them for about one hour until the apples are soft and the filling is browned.
Nutrition
(Nutrition per serving): 161 calories, 7.4 grams fat, 2.4 grams saturated fat, 2 milligrams sodium, 26 grams carbohydrates, 23.9 grams sugar, 4.5 grams fiber and 0.5 grams protein. Source: www.foodnetwork.com
GLAZED PECANS Substituting regular chopped pecans for glazed pecans also reduces the sugar while still maintaining the crunch of the original dish.
SPICE IT UP By decreasing the butter and adding more spices, we are able to maintain the flavor while cutting back on the saturated fat.
52
2121 Ivy Road, Charlottesville
434.296.6131
Monday – Saturday: 7:30 am – 8 pm Sunday: 10 am – 6 pm www.foodsofallnations.com
FOODS OF ALL NATIONS HEALTHY FOOD FOR ALL PEOPLE
>> Featuring a locally sourced gourmet food store in Central Virginia words | RICK PIESTER
You’re in Charlottesville for the day, maybe for a visit to the hospital at the University of Virginia, maybe on business, or maybe just for some shopping. Whatever the reason, it’s about time for lunch. You’re hungry, but you’ve been trying to eat healthy, even when eating out. And Charlottesville is a foodie town, boasting more restaurants per capita than many larger cities. So...where should you go? And what should you order? For generations of locals and visitors alike, the venerable Foods of All Nations has been at the top of the list. It’s a stone’s throw from the UVA campus as well as the Barracks Rd./ Route 29 commercial corridor. And recently, this combination international foods market and café has embarked on a mission to boost the health value of its offerings, expanding the range of its locally sourced foods and fresh, unprocessed ingredients while maintaining the topdrawer reputation that the business has enjoyed for about 50 years. Store manager Geoffrey Garbaccio has been on-site for about a year, following work experience at his parents’ gourmet food store in his native New Jersey and, more recently, a decade with Whole Foods markets, including his work helping to open the Charlottesville Whole Foods location.
His efforts have resulted in Foods of All Nations carrying “much more locally sourced produce than any other store,” he says, including items from nearby Schuyler Greens, a “huge” variety of local eggs, and fresh-daily breads from Charlottesville’s MarieBette Bakery and Newtown Baking in Staunton. The lunch selections are headlined by a long list of housemade sandwiches, soups, salads, and hot entrees. Two standouts include the In-House Vegetarian Chili and what the store calls a Veg Head Sandwich. The chili ($9.99) is a tasty blend of kidney beans, chili sauce, eggplant, green and yellow squash, bell pepper, onion, corn and spices. The Veg Head ($5.29) is built on a foundation of fresh hummus and includes roasted tomatoes, cucumbers, sweet peppers, sprouts and lettuce on a crisp baguette. Another big part of the lunch business at Foods of All Nations is the creations of the store/café’s sushi chef, who Garbaccio calls the “best in the area,” producing “impeccable product quality.” So if you haven’t yet been to Foods of all Nations, it’s well worth a visit for the food, the staff, the shopping, and the health.
ON THE WEB
More at ourhealthcville.com www.OurHealthCville.com
53
C H A R LOT T E S V I L L E & S H E N A N D O A H VA L L E Y
NUTRITION WELLNESS FITNESS
RESOURCE GUIDE
54
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
OURHEALTH CHARLOTTESVILLE'S
NUTRITION + WELLNESS + FITNESS RESOURCE GUIDE
FITNESS CENTERS 9Round Kickbox Fitness Pantops | 434.295.9000 Timberwood Blvd. | 434.974.9000 www.9round.com
ACAC Fitness and Wellness Albemarle Square 434.978.3800 Crozet | 434.817.2055 Downtown | 434.984.3800 www.acac.com
Fishersville Sports and Conditioning Fishersville | 540.337.4729
Charlottesville | 434.218.0580 www.alliedyoga.com
Fitness Your Way
Annese Martial Arts
Lexington | 540.817.9387 www.fitnessyourwayrockbridge.com
Stuarts Draft | 540.337.2525 www.annesemartialarts.com
Gold’s Gym
Ashtanga Yoga Charlottesville
Charlottesville | 434.973.1307 www.goldsgym.com
Charlottesville | 434.531.5441 www.ashtangacharlottesville.com
Jazzercise
b:core Methods
Charlottesville | 434.974.6221 Crozet | 434.466.9933 www.jazzercise.com
Charlottesville | 434.724.9034 www.bcoremethods.com
Planet Fitness
Charlottesville | 434.296.2363 www.bendcville.com
Charlottesville | 434.202.0437 Waynesboro | 540.471.8265 www.planetfitness.com
Powerhouse Gym Waynesboro | 540.942.9466 www.powerhousegym.com
Piedmont Family YMCA Anytime Fitness Charlottesville | 434.971.5566 Orange | 540.672.1252 Palmyra | 434.591.1105 Rivanna | 434.202.8615 Ruckersville | 434.985.3523 Zion Crossroads | 540.832.0434 www.anytimefitness.com
Augusta Health Fitness Fishersville | 540.332.5433 www.augustahealth.com
Barre.[d] Charlottesville | 434.973.2030 www.barredstudio.com
Boar’s Head Sports Club Charlottesville | 434.972.2237 www.boarsheadinn.com
Crossfit Charlottesville
Charlottesville | 434.974.9622 www.piedmontymca.org
Pure Barre
Charlottesville 434.245.1119 www.purebarre.com Snap Fitness
Charlottesville | 434.245.2288 www.clayfitness.net
Charlottesville Brazilian Jiu-Jitsu Charlottesville | 434.825.6202 www.cvillebjj.com
Charlottesville Budokan, LLC Crozet www.crozetyoseikan.com
The Elements Hot Yoga Charlottesville | 434.381.0104 www.ehotyoga.com
Hot Yoga Charlottesville
Charlottesville | 434.218.2111 www.solidaritycrossfit.com
Staunton Health and Fitness Staunton | 540.886.5888 www.stauntonhealthandfitness.com
7 Tigers Taekwondo and Hapkido
Clay Fitness
Lexington | 540.462.2944 www.lexingtoncenterofgravity.com
Solidarity Crossfit
Crozet YMCA
Staunton | 540.886.0262 www.curves.com
Center of Gravity Yoga and Pilates
FlyDog Yoga
MIND + BODY
Curves
Bend Yoga
Charlottesville | 434.973.0587 Hollymead | 434.270.8875 www.snapfitness.com
Charlottesville | 434.260.0209 www.crossfitcharlottesville.com
Crozet | 434.205.4380 www.piedmontymca.org
Allied Yoga
Hollymead | 434.296.9933 www.7tigers-jidokwan.com
A Place to Breathe Charlottesville | 434.245.8080 www.aplacetobreathe.com
Akido of Charlottesville Charlottesville | 434.531.1803 www.akidocharlottesville.org
Charlottesville | 434.964.1964 www.flydogyoga.com
“At ACAC Fitness and Wellness, we always recommend you set reasonable goals. Nobody is perfect and can get all of their workouts and healthy eating right all the time. Aim for being close to perfect 80% of the time and be proud of that. Allow for a little leeway the other 20% of the time.” MAGEN CAPLINGER Personal Training and Fitness Director, ACAC Downtown
Charlottesville | 434.220.1415 www.hotyogacville.com
MMA Institute of Charlottesville Charlottesville | 434.975.6624 www.martialartscharlottesville.com
Momentum Pilates Studio Charlottesville | 434.293.2635 www.momentumpilatesstudiova.com
Opal Yoga Charlottesville | 434.284.1020 www.opalyoga.com
Posture Studio Pilates Charlottesville | 434.293.7611 www.posturestudio.com
www.OurHealthCville.com
55
Simply Yoga
The Vitamin Shoppe
Charlottesville | 434.760.3669 www.simplyyogacville.com
Charlottesville | 434.964.1213 www.vitaminshoppe.com
Thinking Body Pilates Studio
Whole Foods
Charlottesville | 434.975.0336 www.thinkingbody.com
Tru Pilates Charlottesville | 434.975.3800 www.trupilates.com
Charlottesville | 434.973.4900 www.wholefoodsmarket.com
PERSONAL TRAINING Bar-G Fitness
NUTRITION AND WELLNESS Anne Wolf, MS, RD & Associates Charlottesville | 434.977.2859 www.amwolf.com
Complete Nutrition Charlottesville | 434.202.7653 www.completenutrition.com
Charlottesville | 434.218.0840 www.bar-gfitness.com
Bill Burnett’s Success Studio Charlottesville | 434.984.2277 www.successstudiopt.com
Club Mo Fitness Charlottesville | 434.296.6676 www.clubmopro.com
M2 Personal Training, LLC Charlottesville | 434.962.2311 www.m2personaltraining.com
Cool Spring Organic Market Lexington | 540.463.6506
Foods of all Nations Charlottesville | 434.296.6131 www.foodsofallnations.com
SPORTS PERFORMANCE AND TRAINING Edge Charlottesville | 434.817.4286 www.edgecville.com
GNC Various locations www.gnc.com
TEAMS Training Center Charlottesville | 434.529.8370 www.teamstrainingcenter.com
Healthy Habits Waynesboro | 540.943.1655
Integral Yoga Natural Foods Charlottesville | 434.293.4111 www.iyfoods.com
Integrative Health Charlottesville | 434.244.2663 www.leadingforth.com
Make sure to visit the
On Track Nutrition & Fitness Consulting Charlottesville | 434.227.0774 www.ontracknutrition.com
website for even more health resources!
Rebecca’s Natural Food Charlottesville | 434.977.1965 www.rebeccasnaturalfood.com
Sunrise Herb Shop Charlottesville | 434.984.2665 www.sunriseherbshop.com
56
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
SCAN HERE or visit us at www.ourhealthcville.com
Local health. Anywhere you go. OurHealth magazine is Shenandoah Valley and Charlottesville’s only resource entirely dedicated to delivering information about local healthcare services and healthy living topics. Pick up our print edition at more than 650 locations throughout the area or get the digital edition by visiting
ourhealthcville.com .
www.OurHealthCville.com
57
closer LOOK
Can you identify which local practice the image belongs to?
E E R AF
n N o I i t W crip
h s t b l u a S e H r ne! u O To agazi M
58
Like OurHealth on Facebook and leave your answer in the comments section of the CloserLook post by FEBRUARY 7TH for a chance to WIN a FREE subscription to OurHealth Shenandoah Valley & Charlottesville. The winner will be announced on our Facebook page by FEBRUARY 20TH
SCAN HERE to go directly to
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville