OurHealth Charlottesville & Shenandoah Valley Mar/Apr 2016 Edition by OurHealth Media LLC

table of contents | march • april 2016

Pollen Allergy Sufferers

Seek Treatment Instead of Suffering

While many welcome spring’s sunny return with open arms and outdoor activities, pollen-allergy sufferers are left to simply try and survive the pollen onslaught that occurs every year for months beginning in March.

MEDI•CABU•LARY.......................8 Local experts define health-related terms

JUST ASK!.......................................10 Healthcare questions answered by local professionals

NEW & NOTEWORTHY.............12 A listing of new physicians, providers, locations and upcoming events in the Shenandoah Valley and Charlottesville communities

HEALTH POINTS.........................16 Interesting facts and tidbits about health

THE ANATOMY CHALLENGE..................................19 Are you up for the challenge? In this issue, test your knowledge when it comes to the PATHWAY OF AN ALLERGEN.

With this four-part series, OurHealth aims to provide information that parents need to guide their children on the journey to a healthcare career, if that's the path they choose to pursue.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

New Kitchen, New Nutrition, New You! Part two of the OurHealth series that highlights small changes you can make in your food prep and shopping habits that can add up to a major positive impact on your nutrition and health.

FIT BITS!........................................ 37 AQUA KICKBOXING! This innovative aquatics program combines the benefits of water’s buoyancy and resistance to increase muscle strength, endurance, agility, coordination, balance and core stability.

hello, HEALTH!.............................. 44 This article, the second in a yearlong OurHealth series about primary care, will focus on just that — doing your care. We’ll delve into your part of the patient-physician partnership.

TRANSFORMING THE FACE OF

SKILLED REHABILITATIVE CARE

Albemarle Health and Rehabilitation Center is combining the comforts of home with state-of-the-art technology to deliver a better care and recovery experience.

Capturing the spirit of those working in healthcare and of people leading healthy lives through photos.

NUTRITION.................................. 57 HEALTHY EATS: Whole Foods Market partners with Sentara Martha Jefferson Hospital to give you healthy recipes that will make your mouth water including catfish tacos, spring squash and apple soup as well as fiesta burritos.

CLOSER LOOK..............................66 Images reflecting the landscape of healthcare in the Shenandoah Valley and Charlottesville * PLUS * a chance to win prizes!

www.OurHealthCville.com

march • april 2016

read this edition of

on your tablet or smartphone

PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT CHIEF DESIGNER GRAPHIC DESIGNER PROJECT MANAGER | HR METRICS COPY EDITOR DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY ACCOUNTING MANAGER

CONTRIBUTING SHENANDOAH VALLEY & CHARLOTTESVILLE MEDICAL EXPERTS

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Deidre Wilkes Karrie Pridemore Tori Meador Heidi McClintic Bobbi Hoffman Dalton Holody Shawn Sprouse Laura Bower Jay Gillenwater, MD Kristin Koch, AuD, F-AAA Thomas L’Ecuyer, MD Daniel J. Pambianco, MD, FACG, FASGE Thomas Zumsteg, MD

CONTRIBUTING PROFESSIONAL Geri Aston EXPERTS & WRITERS Cynthia BeMent Rich Ellis Annie Shaffer Deidre Wilkes

ADVERTISING AND MARKETING Kim Wood • Vice President of Business Development 540.798.2504 • kimwood@ourhealthvirginia.com Cindy Trujillo • Senior Media Consultant 434.907.5255 • cindy@ourhealthvirginia.com Richard Berkowitz • Senior Vice President of Business Development 804.539.4320 • rick@ourhealthvirginia.com

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SUBSCRIPTIONS To receive OurHealth Shenandoah Valley/Charlottesville via U.S. Mail, please contact Deidre Wilkes at deidre@ourhealthvirginia.com or at 540.387.6482

and click on the magazine cover to view the digital edition!

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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 © 2016 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Lynchburg/Southside 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.

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LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S

“

Most infants are infected with this virus during their first year of life. RSV is usually limited to bad head cold symptoms such as a stuffy nose and cough. However in 20 to 30 percent of children the virus infects the lungs causing breathing problems due to a form of bronchitis. Some of these children may require hospitalization for monitoring and to receive oxygen.

”

- Jay Gillenwater, MD

What is Ototoxicity? In simple terms, ototoxicity means “ear poisoning”. This can happen from exposure to certain medications or less commonly from chemicals. Symptoms include tinnitus (ringing in the ears), hearing loss and/or balance problems, any of which may be temporary or permanent. Medications that are known to cause permanent damage are typically powerful and used only when necessary. High doses of aspirin, quinine and loop diuretics (used to treat certain kidney and heart conditions) are known to cause temporary damage to the ear in some cases. Speak with your physician to discuss alternative drug possibilities if you are concerned about a particular medication. When working with or around chemicals, use proper ventilation and avoid extended exposure. Regular hearing tests should be part of a normal healthcare routine to monitor hearing levels and provide treatment when needed.

What is Tetralogy of Fallot?

What is Respiratory Syncytial Virus (RSV)?

Tetralogy of fallot is a congenital heart defect consisting of a ventricular septal defect (hole between the pumping chambers) and obstruction to outflow of blood from the right side of the heart. If left untreated, this condition causes cyanosis, or a reduced oxygen level, and shortens life. Tetralogy is the most common cyanotic congenital heart defect. Surgical repair has been available for several decades. The original surgical procedure for affected infants was a shunt connecting a branch of the aorta to the lung artery. This improved the oxygen level to allow growth until the child was large enough to undergo complete repair. Complete repair consists of closing the ventricular septal defect and removing obstructive tissue to enable blood to leave the right side of the heart. With improvements in infant heart surgery, this condition is now commonly repaired in infancy without having a prior shunting procedure. The child’s oxygen level is normal after surgery, and their ability to exercise is much improved.

Respiratory Syncytial virus (RSV) is a common cause of a viral upper respiratory infection (“cold”) in children. Most infants are infected with this virus during their first year of life. RSV is usually limited to bad head cold symptoms such as a stuffy nose and cough. However in 20 to 30 percent of children the virus infects the lungs causing breathing problems due to a form of bronchitis. Some of these children may require hospitalization for monitoring and to receive oxygen. Premature infants, those with heart disease, chronic lung disease, or an immune system deficiency are at an increased risk of RSV. RSV is commonly transmitted from either an infected person or droplets on a surface. Since RSV is caused by a virus, antibiotics are not effective. Treatment involves keeping an infant’s nose clear, inclined sitting or sleeping, ensuring good hydration and monitoring for worsening breathing issues. If you think your infant is exhibiting symptoms of RSV, contact your pediatrician or healthcare provider.

Kristin Koch, AuD, F-AAA Audiologist Evolution Hearing Charlottesville | 434.270.0480 www.evolutionhearing.com

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

Thomas L Ecuyer, MD

Pediatric Cardiologist UVA Children’s Hospital and UVA Heart & Vascular Center Charlottesville | 434.924.0408 www.uvahealth.com

Jay Gillenwater, MD

Pediatrician Pediatric Associates of Charlottesville Charlottesville | 434.296.9161 www.charlottesvillepeds.com

H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS

What are some exercise guidelines for seniors? The amount and type of exercise that is recommended differs depending on current physical ability, medical conditions, personal goals and more. Some activity is always better than none!

â&#x20AC;&#x153;

All should aim to do four types of exercise: aerobic, strength, balance, and flexibility. The key is to do all four types regularly and to increase the level of intensity over time.

â&#x20AC;?

- Annie Shaffer

Seniors should strive for 150 total minutes of aerobic activity per week; benefits can be seen in doing as little as 10-minute segments. Walking, using a recumbent bike or stepper, and water exercise are great options. Balance training should include daily stability exercises and regular lower body strength training. Doing sitto-stands is one of the best strength exercises for seniors. Simply go from sitting to standing 8-12 times. Getting regular exercise reduces functional decline associated with aging. It can greatly improve functional ability and reduce the risk of falling, thereby improving quality of life and level of independence. Check with your physician to make sure you are cleared for physical activity, and then get moving!

Annie Shaffer

Wellness Director Sunnyside Retirement Communities Harrisonburg | 540.568.8518 www.sunnysidecommunities.com

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

How can a colonoscopy help prevent colon cancer? Colonoscopy is an examination of the rectum and colon in which a highly trained doctor using a long, lighted scope can inspect the inner walls of the large intestine for abnormalities. Glandular cells that normally line our colons can become aberrant growths called adenomas that begin as small benign tumors but some can progress into cancers. Removing polyps during colonoscopy at a benign stage prevents the sequence to cancer development and as such not only prevents colorectal cancer, but also reduce deaths from the disease. Colorectal cancer is one of the most common cancers in both men and women nationwide. In 2016, the American Cancer Society estimates more than 134,000 people in the United States will be diagnosed with cancers of the colon and rectum. Over 49,000 people will die from these cancers, 1,200 in Virginia. Studies by the National Cancer Institute published in the New England Journal of Medicine in 2012 showed adenoma removal reduced the chance of death from colorectal cancer by 53 percent.

Daniel J. Pambianco, MD, FACG, FASGE Charlottesville Gastroenterology Associates Charlottesville | 434.817.8484 www.cvillegi.com

Am I exposed to radiation during an MRI? The word radiation as commonly used in newspapers, magazines, the internet and on television, refers to ionizing radiation. Ionizing radiation is used in x-rays and CT scans as well as in nuclear medicine tests, which use radioactive particles. This type of radiation can damage the cells in the human body. An MRI scan uses a powerful magnetic field and radio waves to make images of the body, and there is no exposure to radiation during this process. There is no risk of cell damage in the body during an MRI. Although MRI scans have only been used for about the last 35 years, to date there is no known long term damage associated with them. Consult with your physician or radiologist to determine which type of diagnostic testing is best suited for you.

Thomas Zumsteg, MD Blue Ridge Radiologists Staunton | 540.886.0988 www.augustahealth.com

NEW

NOTEWORTHY

NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS

Carilion Stonewall Jackson Hospital Offers New Imaging Technology and Services Carilion Stonewall Jackson Hospital (CSJH) recently celebrated the arrival of an advanced nuclear imaging camera, the Optima NM/CT 640 system from GE Healthcare. The new camera allows CSJH to offer a low-dose imaging technology that delivers a fast and comfortable experience for patients, close to home. Pictured (front, left to right) Jeffrey Todd, MD, cardiologist; Chuck Carr, CSJH administrator; Philip Albert, MD, radiologist; Susan Irvine, CSJH director of Imaging Services; (back, left to right) Paul Faucher, DO, radiologist; Catherine Hargis, CNMT, nuclear medicine technologist; Aaron Glenn, CSJH director of Nursing; and Barry Armentrout, CNMT, nuclear medicine technologist.

Nuclear imaging provides detailed pictures of the body that enable physicians to assess the location, extent and severity of a condition quickly and accurately. For more information or to schedule an appointment, call 540.458.3322 or visit www.carilionclinic.org.

The officers pictured from left to right are: Special Officer M.D. Lombardi, First Sergeant M.S. Fitzgerald, Lieutenant M.R. Frost, Chief A.S. Thomas, and Captain M.E. Riley. Joining Chuck Carr (center) is Susan Irvine.

Lexington Police Department Make Donation to Benefit Cancer Patients The Lexington Police Department recently presented a check for $1,000 to Carilion Stonewall Jackson Hospital’s Mammography Department. The officers raised money by selling special breast cancer awareness patches as part of a charity drive. They made 100 patches in total, and sold them all within the span of several months. While many of the sales were local, several orders came from outside of the state, including one from as far away as Thailand. “It’s important for us to be involved in the community outside of our day-today work,” said Lieutenant M.R. Frost. “If we can make a difference in even one or two people’s lives, it’s really worth it.” The money will go to patients undergoing treatment who need help purchasing items such as wigs or prosthetics. For more information about Carilion Stonewall Jackson Hospital, visit www.carilionclinic.org.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

UVA Children’s Hospital and Children’s Hospital of Pittsburgh of UPMC Partner to Expand Pediatric Liver Transplantation in Virginia To increase access to care for transplant patients throughout the state of Virginia, University of Virginia Children’s Hospital is partnering with Children’s Hospital of Pittsburgh of UPMC to expand its pediatric liver transplant program. “The expertise and experience of the team from Children’s Hospital will enable us to enhance the quality care we provide and help more children from Virginia receive a liver transplant closer to home,” said Kenneth Brayman, MD, PhD, FACS, division chief of transplant surgery and director of the Charles O. Strickler Transplant Center at UVA. The Hillman Center for Pediatric Transplantation at Children’s Hospital has performed more than 1,200 pediatric liver transplants – more than any other center in the United States – according to the United Network for Organ Sharing (UNOS), with patient survival rates consistently higher than national averages. The program remains at the leading edge of expertise, innovation, and patient- and family centered care for transplant patients from all over the world. The transplant team at Children’s Hospital of Pittsburgh of UPMC will work to expand access to pediatric liver transplant services at the UVA Transplant Center, which, since 1989, has performed more than 60 pediatric liver transplants. According to the most recent data, UVA’s survival rates exceed national averages. Transplant surgeons, medical specialists and nurses from UVA and Children’s Hospital of Pittsburgh of UPMC will perform pediatric liver transplant surgeries together at UVA. For more information about UVA Children’s Hospital, call 434.243.5500 or visit childrens.uvahealth.com.

205 UVA Physicians Honored on Best Doctors in America List The 2015-2016 Best Doctors in America® List by Best Doctors, Inc., has selected 205 University of Virginia Health System physicians as among the best in their respective fields. Approximately five percent of U.S. physicians earn this award, according to Best Doctors, Inc. The honor is based on a confidential survey of more than 40,000 physicians who have been named to the most recent edition of Best Doctors in America. Survey recipients are asked: If you or a loved one needed a doctor in your specialty, to whom would you refer? Survey results are then reviewed and verified by Best Doctors, Inc., to assemble the final listing.

SCAN HERE to view the Best Doctors in America List.

To see the complete listing of the UVA physicians honored on the 2015-2016 list scan the QR code at right. Best Doctors works with the best five percent of doctors, ranked by impartial peer review, to help people get the right diagnosis and right treatment. Gallup has certified Best Doctors as using the highest industry standards survey methodology and processes in polling physicians to discover the doctors they would choose for their own care. For more information about the Best Doctors in America ® List, visit www.bestdoctors.com.

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NEW

NOTEWORTHY

NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS

New Sentara Rockingham Memorial Hospital Orthopedic Center Provides Full Range of Services A new orthopedic center is the latest addition to the Sentara Rockingham Memorial Hospital Medical Center campus in Harrisonburg. The center is home to hand services, joint replacement, general orthopedics, sports medicine, therapy services and sports performance. An array of outpatient imaging services, including MRI, CT, diagnostic X-ray and ultrasound, is also offered. Sentara RMH back and neck services will be moving to the center later this year. “The building has been designed to be a destination center for patients, a place where they can get all of their orthopedic, sports medicine, spine, imaging and rehab services under one roof and without having to leave the community,” said Adam Drumm, director, Sentara Orthopedic Service Line and Rehab. The facility is the only one of its kind in the central Shenandoah Valley. It has been in the planning stages since 2011 when the community’s need for additional orthopedic and imaging services was first noted, according to John McGowan, MD, president, Sentara RMH Medical Group. For more information or to schedule an appointment, call 540.689.5500 or visit www.sentara.com.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

Joseph Amalfitano, DO Amy Chico, FNPC UVA Spine Center Osteopathic Manipulation Charlottesville 434.243.3633 neuro.uvahealth.com

Carilion Clinic Family and Community Medicine Dayton | 540.879.4300 www.carilionclinic.org

Candyce Dorsey, CPNP Camilo E. Fadul, MD

Jay Gillenwater, MD

Kara Haladyna, CPNP

Christopher Hewitt, NP Michael S. Larue, PA-C Michael Longo, MD

Pediatric Associates of Charlottesville, PLC Charlottesville 434.296.9161 www.charlottesvillepeds.com

Joseph Ranzini, MD

Augusta Health Wound Healing & Hyperbaric Clinic Fishersville| 540.245.7230 www.augustahealth.com

Carilion Clinic Family and Community Medicine Waynesboro 540.949.8241 www.carilionclinic.org

Diana Smith, MD

Crossroads Behavioral Health Services Fishersville | 540.332.4060 www.augustahealth.com

Sandra Farnum, NP

Augusta Health Urgent Care Staunton | 540.245.7470 www.augustahealth.com

UVA Spine Center Neuro-Oncology Charlottesville 434.243.3675 neuro.uvahealth.com

Carilion Clinic Family and Community Medicine Lexington | 540.463.2181 www.carilionclinic.org

Kenneth Sternberg, DO Augusta Health Cardiology Fishersville | 540.332.4278 www.augustahealth.com

Sentara Martha Jefferson Inpatient Services Charlottesville 434.654.7580 www.sentara.com

John Gandy III, MD Sentara RMH Wound Healing Center Harrisonburg 540.689.210 www.sentara.com

Walter Paladino, MD

UVA Specialty Care Augusta Cardiology and Vascular Fishersville | 540.213.9551 www.uvahealth.com

Mikhail Vinogradov, MD Sentara Martha Jefferson Hematology & Oncology Associates Charlottesville 434.654.8390 www.sentara.com

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TI P S , T I D B I T S A ND MO R E TO I NF O R M A ND ENT ERTA I N YO U

January is Cervical Health Awareness Month

March is National Nutrition Month! A healthy lifestyle includes proper nutrition – how we provide our body with food necessary for health and growth. Here are some tips to

Be sure to check out

keep you on track:

Eat more whole foods

Avoid foods with more than five ingredients.

Plan healthy menus as a family

Work together to make healthy choices you will all enjoy.

Don’t skip breakfast

It really is the most important meal of the day.

Support your local farmer’s market

It is a great source for fresh fruits, vegetables and nuts. For additional resources on nutrition and healthy eating, visit the Academy of Nutrition and Dietetics at www.eatright.org.

Feeling blue? Get active! You usually feel happier after playing or exercising because of special chemicals called endorphins that your brain releases while you’re moving. Endorphins (pronounced en-DOOR-fins) are a natural mood-booster! Another great reason to incorporate exercise into your daily routine!

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

1797 Hydraulic Road Charlottesville, VA Providing all of your healthy eating needs, including fresh produce, dairy products, organic and gluten-free foods and much more!

Dive in! During your lifetime, you will produce enough saliva to fill TWO swimming pools!

Feeling Lucky? Shamrock 5k Trail Run

NAP TIME It isn't just for kids! According to the National Sleep Foundation,

people who don’t get enough sleep are more likely to eat more because sleep loss affects the hormones associated with hunger. However, a mid-afternoon nap can reverse the negative metabolic effects of sleep loss.

The Shamrock 5K Trail Run is a beginner run that takes place at Hillandale Park. All of the proceeds from this event will benefit the Shenandoah Valley High Rollers Wheelchair Basketball Team. DATE:

Saturday, March 19th

TIME:

9:30 am

LOCATION: Hillandale Park 801 Hillandale Avenue Harrisonburg, VA 22801 For more information and to register, scan the QR above or visit www.harrisonburgva.gov. To learn more about the Shenandoah Valley High Rollers Wheelchair Basketball Team, visit them on Facebook.

for a Cause!

VIA’s Run for Autism 5K

Did you know?

The Virginia Institute of Autism (VIA) Run for Autism 5K is a special race. Every step of the way, you are supporting the VIA and helping children, adults and families affected by autism. The course starts and finishes at Charlottesville High School, with scenic park neighborhoods along the way.

Your brain depends on your stomach

DATE:

Saturday, April 16th

to signal that it’s full, but that message

TIME:

8:00 am

takes 20

minutes to be delivered.

So slow down during meals, and you’ll be less likely to eat too much.

LOCATION: Charlottesville High School 1400 Melbourne Road Charlottesville, VA 22901 To register, scan the QR or visit www.runforautism5k.org. www.OurHealthCville.com

Local health. Anywhere you go. OurHealth magazine is Shenandoah Valley and Charlottesvilleâ&#x20AC;&#x2122;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 .

Anatomy CHALLENGE the

How much do you know about the

pathway of an airborne

allergen into your body? Complete the word search below. Next, match the correct word with the part of the body in the illustration.

[ the pathway of an allergen ]

WORD SEARCH nose

bronchi

nasal cavity

alveoli

epiglottis

left main bronchus

larynx

right main bronchus

trachea right lung left lung

____________________

For answers, visit OurHealth Shenandoah Valley and Charlottesvilleâ&#x20AC;&#x2122;s Facebook page at

____________________

____________________ ____________________ ____________________ www.OurHealthCville.com

POLLEN

ALLERGY

SUFFERERS 20

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

TREATMENT words | RICH ELLIS

SEEK INSTEAD OF SUFFERING As many welcome the brighter days and warmer temperatures, a small segment of the population quietly dreads winter’s end and spring’s return. They’re not crazy, snow loving, or winter-sports fanatics. They’re simply allergy sufferers. While many welcome spring’s sunny return with open arms and outdoor activities, pollen-allergy sufferers are left to simply try and survive the pollen onslaught that occurs every year for months beginning in the spring. They live in misery or in a heavily medicated state or both, with allergic rhinitis — swollen, itchy eyes; stuffy and running noses; and in some cases, wheezing and difficulty breathing. Forced indoors to seek relief — however minor it might be — they wait until the tree pollen’s spring bloom has subsided and, along with it, their allergy symptoms. Their relief is short-lived, however, as spring inevitably returns. Some don’t even have to wait for the following spring because their misery reappears every fall when ragweed pollinates and pollen proliferates once again. In general, tree pollen peaks during the spring, grass pollen in the summer and weed pollen in the fall.

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The life of allergy sufferers doesn’t have to be this way, and to protect their future health, it shouldn’t be. According to Madeline Dillon, MD, with Allergy Partners of Charlottesville, there is hope for allergy sufferers beyond over-the-counter or prescription medications through allergy immunotherapy. Often referred to as “allergy shots,” this proven method helps the body become desensitized to and tolerant of pollen’s effects.

What pollen is, how it invades, and the body’s reaction

Madeline Dillon, MD is certified by the American Board of Allergy and Immunology and by the American Board of Internal Medicine. Dr. Dillon sees patients at Allergy Partners of Charlottesville, with offices in both Charlottesville and Waynesboro.

Timothy Kyin, MD is certified by the American Board of Allergy and Immunology and by the American Board of Internal Medicine. Dr. Kyin is an allergist practicing at UVA Northridge Internal Medicine in Charlottesville and UVA Specialty Care in Culpeper.

There are two main types of pollen, says Timothy Kyin, MD, medical director of ambulatory and outreach in the Division of Asthma, Allergy and Immunology at the University of Virginia Health System in Charlottesville. There’s pollen spread by wind, which is light, airy and easily inhaled, and pollen spread by birds and bees that’s brightly colored, sticky and heavy, so it can be attached and transported to other locations. While this heavier pollen is the one that many people see coating their vehicles or front porches, it’s not usually the pollen that causes allergies. People who are allergic are reacting to the light, invisible, windblown pollen they inhaled. Pollen usually enters the body via the nose, and this is where the initial reaction starts in allergy sufferers. “A pollen allergy develops when someone has been exposed to airborne pollen over time and the body develops an abnormal response to it,” Dr. Dillon explains. “Normally, pollens inhaled through the nose or mouth should not cause a problem. In some people, however, their body recognizes harmless pollen as a foreign invader that needs to be dealt with. These folks form allergic antibodies, called IgE antibodies, to the specific pollens. These IgE antibodies are attached to special cells called mast cells and also in the blood on basophil cells, which are special white blood cells. When a person comes into contact with the pollen through their nose, mouth or eye and it enters the lungs, these IgE antibodies immediately recognize the allergen — pollen — and link to it. This linking of the IgE and the allergen cause the mast cell or basophils to release histamine and other chemicals, which are responsible for the classic symptoms associated with allergies, including an itchy, runny nose and congestion.”

“Allergic symptoms depend on the type of allergen, route of exposure and prior history of similar exposure and pertinent symptoms. For inhaled allergens, symptoms can include itching nose and/or eyes, sneezing, drainage and nasal congestion. Itching, sneezing and a runny nose usually last from several minutes to a few hours and are related to early onset, fast-acting chemicals such as histamine. Sustained nasal congestion is a feature of chronic inflammation and can last from days to months. It is related to a different set of inflammatory chemicals released during the allergic sequence.” - Arvind Madaan, MD

Not everyone is affected by pollen “We don't know why people develop allergies, but it happens,” Dr. Kyin says. “It’s like a switch that gets flipped. A family history of such allergies is usually the best predictor that someone will develop allergies. While we don't know what triggers

allergies, we do know that your body needs to have seen something once or twice before it decides that it does or does not like it. And if it doesn’t like it, then it develops the IgE guard dog against whatever it doesn't like.” Dr. Kyin uses the following analogy to explain the body’s response to pollen and help patients understand their body’s reaction. “Pretend your body is a house, and you have a dog in the front yard," says Dr. Kyin. "One day the mailman accidentally steps on your dog's tail. The dog gets startled and alerted, but nothing happens at that moment. The next time the mailman (pollen) shows up, your dog remembers what happened and barks (your allergy symptom). Now every time the mailman comes to your house, the dog will bark. This becomes your yearly symptom pattern." Dr. Kyin says that by this same analogy, "Newborns cannot have seasonal allergies because they have not seen enough seasons, or exposures, for their body to decide whether or not it likes pollen. So in a newborn or infant, a runny nose is more likely a viral infection or cold rather than allergies.” Once the body recognizes that pollen is present, its natural defense is to get rid of it, Dr. Kyin says. “That’s the whole point of the body's reaction — the sneezing, watery eyes, runny nose and mucous production. The body is trying to flush away the pollen, and within the mucous are also some things that can inactivate the pollen and germs that may be accompanying it.”

Arvind Madaan, MD, FAAAAI, FACAAI is certified by the American Board of Allergy and Immunology and by the American Board of Pediatrics. Dr. Madaan sees patients at Charlottesville Allergy and Respiratory Enterprises (CARE) in Charlottesville.

www.OurHealthCville.com

“Pretend your body is a house, and you have a dog in the front yard," says Dr. Kyin. "One day the mailman accidentally steps on your dog's tail. The dog gets startled and alerted, but nothing happens at that moment. The next time the mailman (pollen) shows up, your dog remembers what happened and barks (your allergy symptom). Now every time the mailman comes to your house, the dog will bark. This becomes your yearly symptom pattern." - Timothy Kyin, MD

Nose hair traps some pollen, which prevents it from moving into the respiratory tract, but Dr. Dillon says that doesn’t mean the respiratory tract is immune to reacting. Histamine’s release can cause reactions in the lungs, including asthma, which is the constriction of the muscles around the airways. That can, in turn, lead to chest tightness, wheezing and coughing. A pollen-allergic reaction can also cause swelling of the tissues inside the bronchial tubes and mucus production there, causing symptoms consistent with airway muscle constriction.

Seeking relief through immunotherapy and medications While some people’s allergies can wane over time, this is not a typical response, Dr. Dillon says. She recommends working with an allergist. “Allergists can perform skin testing in the office to find out what you are allergic to in order to come up with a comprehensive plan for treatment, including medications, avoidance of allergens, and for selected people, immunotherapy.” Immunotherapy is the gold standard in allergy treatment because it works directly on the immune system. More commonly referred to by patients as “allergy shots,” it addresses patients’ symptoms as well as the cause of respiratory allergies, by reducing allergic sensitization. Arvind Madaan, MD, a physician with Charlottesville Allergy & Respiratory Enterprises (CARE) in Charlottesville, explains that allergen immunotherapy — in a variety of routes, formats and protocols — has been shown for more than 100 years to alter the natural history of the process and is a substantively better long-term treatment option. “Depending on a patient's clinical and allergy test profile, an appropriate regimen can usually be designed successfully,” Dr. Madaan says. “This ‘natural’ treatment is typically administered monthly at maintenance.” Patients who don’t choose immunotherapy might find temporary relief in over-thecounter or prescriptions medications. “Medications fall into pharmaceutical and biological categories,” says Dr. Madaan. “Pharmaceuticals — or drugs — are chemicals that essentially block symptoms but do not cure the ability to have symptoms. For upper airway symptoms, medications such as antihistamines block symptoms of itching, sneezing, runny nose, itchy eyes, etc., but have little impact on nasal congestion. Nasal steroid sprays and leukotriene (a chemical produced by the body that causes nasal passage swelling and airway constriction) blockers are better at reducing nasal congestion.” Dr. Kyin also recommends immunotherapy for patients who don’t respond to medications or don’t like the idea of taking medications every year. “With medications, all you are doing is treating symptoms — it does not actually change the underlying problem of being allergic,” he says. “With immunotherapy, the injections usually start off as weekly, and each time you receive an increasing dose of pollen with the goal being to desensitize the body to it. Once you have reached the highest dose, the shots are then spaced to be monthly injections that are carried out for three to five years, at the end of which the majority of people become desensitized and tolerant of the pollen.” Another step allergy sufferers who’ve been exposed to pollen can take to help alleviate their suffering is to reduce their exposure. Remaining indoors with the windows closed and the air conditioning on to filter out the pollen helps lower

pollen exposure levels. Taking a shower immediately after being outside also helps remove pollen and further reduce exposure. Once they’ve reduced their exposure, allergy sufferers should work with their physicians to determine which of the various prescription and overthe-counter medications available help alleviate — but not cure — the symptoms they experience, and if immunotherapy is right for them.

“A pollen allergy develops when someone has been exposed to airborne pollen over time and the body develops an abnormal response to it,” Dr. Dillon explains. “Normally, pollens inhaled through the nose or mouth should not cause a problem. In some people, however, their body recognizes harmless pollen as a foreign invader that needs to be dealt with." - Madeline Dillon, MD

With the help of a skilled team of allergists, allergy sufferers can improve both their quality of life and their health by first reducing exposure to pollen and using medications that alleviate the immune system’s reaction and accompanying symptoms following pollen exposure, while pursuing the long-term solution that only immunotherapy can provide.

Expert Contributors: Timothy Kyin, MD with UVA Northridge Internal Medicine in Charlottesville and UVA Specialty Care in Culpeper. Arvind Madaan, MD, FAAAAI, FACAAI with Charlottesville Allergy and Respiratory Enterprises (CARE) in Charlottesville. Madeline Dillon, MD with Allergy Partners of Charlottesville, with offices in both Charlottesville and Waynesboro.

ON THE WEB

More at ourhealthcville.com

read this edition of

on your tablet or smartphone

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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

the

2016

OurHealth Charlottesville and Shenandoah Valley

HOW TO IN HEALTHCARE SERIES: an issue-by-issue overview

words | CYNTHIA BEMENT

PART ONE

Preparing for a Career in Healthcare as early as high school.

March | April

PART TWO

OurHealth’s four-part series entitled:

HOW TO IN HEALTHCARE,

Choosing the right undergraduate school for your healthcare specialty.

May | June

is a step-by-step guide for those interested in pursuing a CAREER IN MEDICINE.

Compassion for others. Grace under pressure. A thirst for knowledge and a commitment to excellence in the classroom and beyond. You recognize these qualities in your child, and as he or she grows and develops throughout high school and your conversations turn to possible career paths, one or both of you wonder if a career in healthcare would be a good fit. The ability to save someone's life; to make a difference in the well-being of people by preventing disease, fighting illness and improving their every-day lives by helping them see, walk, breathe, move and speak better (just to name a few) - these can be rewards of a healthcare career. But to get into that “it’s a matter of life and death” career space, a job in healthcare requires a deep commitment, on any level. A diligent approach to studying, the potential of many years in school, dedication to accuracy on the job and, most of all, an unwavering desire to help others is what it takes to achieve and sustain a successful career in this exacting field. What if your child is not a great fit for the rigors of medical school or doesn't want to spend that much time in school, but still shows passion for impacting the lives of others? Take heart: healthcare is a booming field, and the commonly imagined paths of doctor or nurse are but two points of entry into the 21st century world of healthcare, one whose enormity now offers a widely varied number of steady jobs that don't require a medical license (which means less time spent in school).

PART THREE

Entering graduate school and residency/fellowship/ clinical training.

July | August

PART FOUR

Insight on how to find the right job in your field of specialty.

September | October

HOW TO BUILD A FOUNDATION FOR

SUCCESS

Help your child develop SOLID STUDY SKILLS

Teach your child SELF-SUFFICIENCY

Exercise CRITICAL THINKING

Encourage your child to ASK QUESTIONS

In December, 2015 the Bureau of Labor and Statistics (BLS) reported that healthcare will be the fastest growing industry in the United States and will add more jobs than any other to the employment sector between 2014 and 2024. Together with the social assistance sector, healthcare is poised to add another 3.8 million jobs to our economy during this period. How do you figure out if healthcare is right for your child? And if they are already interested, what needs to be done in high school to get on the path toward a healthcare career? With this four-part series, OurHealth aims to guide you so that you can guide your child on the journey to a career in healthcare. In our first four installments, we will cover high school, undergraduate, graduate curricula/clinical studies and finding a job in your chosen healthcare career, respectively (see our sidebar at the beginning of the article). Following the fourth installment, we will begin an ongoing series in which we will focus on one position in healthcare and describe the specific steps one must take from high school through the first day on the job.

BUILD A FOUNDATION

FOR SUCCESS “First, set your child up for success. That means creating solid study skills that will serve well in high school and college. Help your student become an independent learner and self-sufficient in managing school responsibilities” - Kathy Hudson, PhD

Kathy Hudson , PhD is dean of health and life sciences at Piedmont Virginia Community College in Charlottesville.

While a career in healthcare is more accessible than ever before, it still requires advanced planning and a strong high school transcript that includes extra-curricular activities, high SAT and/or ACT scores and a spotless personal conduct record to gain entry onto its path. After all, the reason healthcare careers are so demanding is because they focus on the health and lives of people, an area where there is no room for error. Starting in 9th grade, when most students enter high school, a child’s transcript becomes an official record of his or her success, one that’s scrutinized for acceptance to colleges and universities. So it’s important to start out strong from the gate, both for producing a competitive high school track record and to build the necessary skills with which to error-proof oneself as much as possible over the long haul of studying for and performing in a healthcare career. "First, set your child up for success. That means creating solid study skills that will serve well in high school and college. Help your student become an independent learner and self-sufficient in managing school responsibilities,” says Kathy Hudson, PhD, dean of health and life sciences at Piedmont Virginia Community College in Charlottesville. “Make sure your children are responsible for meeting deadlines for assignments, and if a problem with a teacher arises, have your child schedule a discussion with the teacher before a parent gets involved.” At the foundational level of learning, it may prove beneficial to discover and work with the student’s natural learning style first, prior to focusing on study skills. Visit (Continue on page 30...)

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

OurHealth HEALTHCARE ACADEMIC PROGRAMS

Monticello High School Health and Medical Sciences Academy The Health and Medical Sciences Academy (HMSA) provides opportunities for high school students interested in healthcare careers. Students will explore an integrated curriculum through the lens of health sciences and research. During their junior and senior year, students will have additional opportunities to support their academic aspirations that may include case studies, internships, clinical rotations, site visits/tours and college visits. ELIGIBILITY

This program is offered at Monticello High School, but is available to all Albemarle County Public School students, grades 9-12. APPLICATION

HEALTH

FAIRS & SEMINARS Inside UVA Students will get a tour of the hospital, including the CT room and the rooftop helipad. They will then attend a Health Career Fair, where they learn about different types of career paths within the field of medicine. Students visit both the School of Nursing Simulation Center, and the School of Medicine Simulation Center where they learn about the computers behind the Patient Simulator Manikins. They will also visit the server room of the Simulation Center so they can view all of the STEM aspects of working within a medical school. DATES

March 4 and March 25 CRITERIA

Department of Medicine staff will host 7th graders from Buford Middle School in Charlottesville

Submitted through high school guidance counselor, by deadline set each year.

Sentara Martha Jefferson Hospital

CONTACT

Hospital tours are available for high school groups. Contact Jacklene G. Martin, Director Community Benefit, by phone 434.984.5655 or email jgmarti1@sentara.com for more information or to set up a tour.

For more information about HMSA, you may contact Katina Dudley, Director HMSA, kdudley@k12albemarle.org.

Charlottesville and the Shenandoah Valley on Social Media!

â&#x20AC;&#x153;High school students need to do a lot of exploring of their options before making a decision to be in healthcare.â&#x20AC;?

- Eileen Oswald

Eileen Oswald is the director of admissions for the University Of Virginia School Of Medicine in Charlottesville.

www.OurHealthCville.com

(Continued from page 28...)

HEALTHCARE CAMPS

Sentara Martha Jefferson Spring Break Camp This two-three day camp, held during Spring Break, is geared toward middle school students who are interested in learning about healthcare careers, nutrition and fitness. DATES

April 4-8, 2016 Application Contact: 800.SENTARA REGISTRATION DEADLINE

Registrations are accepted beginning March 1, 2016

ACES Middle School Camp The goal of the Augusta Career Explorers Camp (ACES) is to expose middle school students of various backgrounds and academic levels to health career options. During the camp sessions, students are exposed to a variety of healthcare professions through hands-on activities. The goal of the camp is to spark an interest in the healthcare field, motivate students to achieve in high school and consider their future aspirations. DATES

July 11-15, 2016 8:00 am – 12:30 pm

COST

Free

CRITERIA

Open to current 6th, 7th and 8th grade students in Staunton, Augusta and Waynesboro APPLICATION CONTACT

Krystal Moyers Augusta Health Community Outreach 540.932.4976 kmoyers@augustahealth.com DEADLINE TO REGISTER

May 20 (open camp slots will be given to the first fully completed, eligible applications received)

www.vark-learn.com and www.educationplanner.org for learning style self-assessment questionnaires for students to determine if they fall into visual (learning by seeing), aural (learning by hearing), read/write (learning by reading and taking notes), or kinesthetic (learning by simulation/demonstration) and for strategies to help your student learn better using his or her style. In building sound study habits, one strategy that Hudson encourages students to adopt is to revisit lessons within a day of first learning new material. “For optimal retention, students need to revisit the material they’ve read or studied or heard in class for at least 15 minutes within the first 24 hours after leaving the material. Students who do that retain 70-80% more than students who just walk away from the material and then come back the night before a test and try to cram.” Test taking is a big part of the study skill set and one to actively develop, even if your student already gets good grades. Though school and good grades may come easily for your student, it’s not necessarily an indicator that study habits and test-taking skills are naturally well-developed. Invest time now in creating study and test taking skills that will help your student perform at a high level through more than four years of college, as well as any board certifications or licenses associated with a chosen career. One way to become a better test taker, according to researchers at Washington University in St. Louis, Missouri, is to incorporate what they call “retrieval practice” into a student’s study habit skill set. Retrieval practice is as it sounds – the practice of calling up information from memory. Once a student is asked to recall or produce a piece of information (who was the fourth president of the United States, for example) he/she is much more likely to remember it in the future. While retrieval is often used as a method for assessing how much a student has learned (test taking), being tested multiple times on facts a student needs to know for a test before taking the actual exam is more effective than simply reviewing those facts, according to Washington University researchers. In short: start taking practice tests. Encourage your student to ask teachers for any available practice tests on course material rather than simply reviewing books and notes, and offer to test your student periodically prior to exam time. (For a more on retrieval practice, visit Washington University’s www.retrievalpractice.org.)

DO YOUR HOMEWORK ON HEALTHCARE CAREERS

With the foundation in place, do some exploring. According to Eileen Oswald, director of admissions for the University of Virginia School of Medicine in Charlottesville, exploration is paramount to determining a child’s educational career path, even early in high school. “High school students need to do a lot of exploring of their options before making a decision to be in healthcare.”

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

VIRGINIA

Research career options in the healthcare field with your child, says Paul Deeble, an associate professor of biology and Carolyn Rose Hunt distinguished chair of natural sciences at Mary Baldwin College in Staunton, because the industry offers a wide variety of positions that extend beyond a doctor or nurse. “Given where our healthcare reform is going and the demand for everything from a bachelor's level nursing career to skilled nursing to nurse practitioners to laboratory sciences – the opportunities in healthcare are huge,” he says. “You as a parent are your child's best resource when it comes down to it.” he says. Healthcare career options don’t always require an advanced degree and licensure – some administrative and support staff positions can require a four-year degree or a two-year associate’s degree, along with additional training and certification in some cases. Medical health services managers, for instance, are responsible for the day-to-day administrative management of physician offices, hospitals and clinics and typically require a four-year Bachelor’s degree in health administration (offered by Mary Baldwin College). A diagnostic medical sonographer (sometimes called a sonographer) takes images of body tissues and organs using ultrasound technology, in order for doctors to diagnose and monitor conditions such as pregnancy, heart disease and cancer. Sonography involves a lot of patient interface as well as technical proficiency – a sonographer is often the first person a patient sees in order to make images for a doctor to review, prior to seeing the patient. Diagnostic medical sonography is typically offered as an associate’s degree (such as at Piedmont Virginia Community College) and while it has no formal licensure requirement in most states, sonographers must obtain a certification from the American Registry of Diagnostic Sonographers and may also need to perform additional fieldwork in a clinical setting. U.S. News and World Report ranked diagnostic medical sonography 5th on its best healthcare support jobs list and 42nd on its Top 100 Jobs list for 2016. Consult online resources for healthcare career information with your student as well – websites such as www.explorehealthcareers.org, www.allalliedhealthschools.com and www.healthcarepathway.com offer specific information on a vast number of healthcare careers, including individual career educational requirements, links to schools that offer those required degrees, cost of education and job market predictions for specific positions. Research colleges online and ask questions of admissions representatives to find out what their graduate placement rates are in your student’s healthcare interest area. Also consider making appointments with colleges as early as 9th and 10th grade. Take a campus tour and make appointments with admissions representatives to ask about specific degree options. Find out what the corresponding course maps are to get an idea of what your student’s actual classwork might look like at that institution. Ask about opportunities for your student to sit in on actual classes in an area of interest.

SCHOLARSHIP OPPORTUNITIES

SCAN HERE FOR A FULL LIST

According the National Center for Education Statistics (NCES), the percentage of first-time, full-time four year, degree-seeking students receiving some kind of financial aid increased from 80% to 85% from the 2007-2008 to the 2012-2013 academic year.

It’s smart to research scholarship opportunities while you’re exploring careers. Together with AP and dual enrollment classes offered by high schools, considerable savings on tuition await. In fact, according (Continue on page 33...) www.OurHealthCville.com

Augusta Health Teen Summer Program

HEALTHCARE VOLUNTEER & MENTORING PROGRAMS

Augusta Health Medical Explorers Medical Explorers Post 390 is a worksite based program sponsored by the Boy Scouts. This Post is designed to help those who are interested in the field of medicine, to gain career insight through hands-on activities and tours of different departments. DATES

Meetings held once per month in the evening, during the school year (September-May) CRITERIA

For teens trying to decide on a healthcare career path or looking to gain volunteer experience in the medical field. DATES

6-week period, during summer months CRITERIA

Students at least 14 1/2 , who have completed the 9th grade and demonstrate a serious interest in gaining work experience in a healthcare setting. Students are selected for positions based on their maturity, potential to accept responsibility, and the ability to work cooperatively with others. APPLICATION PROCESS

Applications are available the beginning of March, and due by the end of April. They may be picked up from high school guidance counselors or the Augusta Health Volunteer Services Office.

Students/young adults between ages of 14-20 APPLICATION PROCESS

Contact Volunteer Services at 540.332.4740. *This is a fee-based program

Augusta Health Teen Mentorship Program Augusta Health accepts students throughout the year from area high schools and home school for mentorship programs. Mentorship is offered in several healthcare areas, including: nursing, radiology, pharmacy, therapies, marketing and public relations, laboratory services. DATES

One semester during school calendar year.

CRITERIA

To participate, students must have a senior class standing. APPLICATION PROCESS

Apply for this program through school guidance department or by contacting Augusta Health volunteer services at 540.332.4740.

Sentara Martha Jefferson Summer Junior Volunteer Program The competitive program gives students exposure to hospital staff including clinicians, as well as patients, and families to help them decide if a career in healthcare is really for them. Students are placed on inpatient units, in the emergency or medical imaging departments DATES

Two 4-week sessions, from mid-June through mid-August CRITERIA

High school students, ages 15-18, required to complete 25 hours of service over the 4-week session. APPLICATION

Application packets available online, beginning early March. INFORMATION

For more information, contact Jacklene G. Martin, Director Community Benefit, by phone 434.984.5655 or email jgmarti1@sentara.com.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

UVA Medical Center Junior Volunteer Summer Program Volunteers graciously commit their time and energy over the summer months to serve the medical center and give back to the community. While donating their time, teens have the opportunity for career exploration, to learn new skills and to see firsthand how a hospital operates. The skills that junior volunteers acquire can be beneficial in future careers or educational endeavors. Teens are mentored and guided by staff. DATES

Eight week program during summer months CRITERIA

High school youth, ages 14-18, must volunteer at least one full weekday over the course of the program. APPLICATION

Submit an online application, and attend a junior volunteer information session. DEADLINE TO APPLY

The application period for summer 2016 has closed, but the application period for summer 2017 will open in early February 2017. INFORMATION

www.uvahealth.com/ about/volunteering/juniorvolunteer-summer-program

HEALTHCARE INDUSTRY STATISTICS

(Continued from page 31...)

to the National Center for Education Statistics (NCES), the percentage of first-time, full-time four year, degree-seeking students receiving some kind of financial aid increased from 80% to 85% from the 2007-2008 to the 2012-2013 academic year. Research a wide variety of scholarships online via the College Board’s Big Future (www.bigfuture.collegeboard.org) and the U.S. Department of Education’s federal student aid site (www.studentaid.ed.gov).

Healthcare occupations and industries are expected to have the fastest employment growth and to add the most jobs between 2014 and 2024, according to a report issued in December, 2015 by the U.S. Bureau of Labor Statistics.

Explore through school, too. Many high schools offer an introduction to health occupations course, which can give students a taste of what it’s like to work in healthcare on a daily basis. Some colleges also offer exploration opportunities for high schoolers through “healthcare camps”, which provide introductory information about healthcare careers (see Healthcare Volunteer & Mentoring Programs sidebar on page 32).

According to the study, healthcare support occupations and healthcare practitioners and technical occupations are projected to be the two fastest growing occupational groups during this period. These groups are projected to contribute the most new jobs, with a combined increase of 2.3 million in employment representing about one in four new jobs.

MAKE HIGH SCHOOL

U.S. NEWS AND WORLD REPORT TOP 10 HEALTHCARE JOBS FOR 2016

Strength of schedule should be a top high school priority in addition to making good grades. That means math, says Hudson. “Starting in ninth grade, students need to take four years of math,” she says. “Most colleges and universities will require placement testing and you also have SATs to take for admission to four-year schools. You want to have all those skills fresh in your mind so that you don't test poorly.”

These rankings are based on greatest hiring demand, or, in other words, those with the highest projected number of openings from 2014 to 2024, as categorized by the U.S. Bureau of Labor Statistics.

CURRICULUM COUNT

ORTHODONTIST

DENTIST

NURSE ANESTHETIST

PHYSICIAN ASSISTANT

NURSE PRACTITIONER

Also, science and math classes encourage critical thinking and because math and science are covered on the SAT and ACT, taking these classes all four years keeps skills sharp come exam time.

PSYCHIATRIST

PEDIATRICIAN

WIDEN YOUR SCOPE

ANESTHESIOLOGIST

OBSTETRICIAN AND GYNECOLOGIST

Science is also crucial. Most high schools require three years of math and science for a standard diploma and four for an advanced diploma, and many health career education programs require four years of both for acceptance, including biology, chemistry, and algebra I and II. The great news in these subjects is that dual credit and AP options are plentiful. They not only give your student a leg up by transcript strengthening, they also provide valuable experience in college course work while earning college credits.

TO STAND OUT

Becoming an attractive prospect to colleges, especially those on a career path to healthcare, is about more than a 4.0. Colleges are seeking applicants who can distinguish themselves from the pack via demonstration of their abilities to get good grades while also contributing to the world around them, both from a socially conscious perspective and a time management perspective.

ORAL AND MAXILLOFACIAL SURGEON

www.OurHealthCville.com

"Take time to research career options with your child." - Paul Deeble

Community service, extra-curricular activities, and school leadership roles show that a student can take on more than just an accelerated course load. The same volunteer activities your child performs can also serve dual purpose as discovery and experience in real-world healthcare settings during the exploration phase. Look for opportunities for your child to volunteer in healthcare settings that involve some type of caregiving component, such as hospitals, nursing homes, homeless shelters or animal shelters. â&#x20AC;&#x153;If you're aiming for a competitive university where you are competing with a lot of other people to gain admission, you need to round out what you're doing in terms of extra-curricular activity,â&#x20AC;? says Hudson. By broadening the scope, your child can seek to develop and showcase well-roundedness, while simultaneously getting some real-world exposure to caregiving situations. This will help in deciding if the environment might be a good fit for a future career.

Paul Deeble is an associate professor of biology and the Carolyn Rose Hunt Distinguished Chair of Natural Sciences at Mary Baldwin College in Staunton.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

REPUTATION

MANAGEMENT MATTERS Finally, on the social side of the equation, students seeking a healthcare career need to be cognizant of their conduct and reputations outside of the classroom. In today’s lightning-fast information age, it’s more important than ever to be aware of what’s circulating on social media and the internet and how their conduct could affect them for years to come. “Everything that you put on social media is out there for everyone in the world to see. That can be an issue,” says Hudson. “If you're looking at a healthcare career, there are few that don’t require some type of background check and/or drug screening,” she adds. The process of discovering and navigating an educational career path into healthcare can seem overwhelming at first. Focus on creating a partnership with your child that fosters exploration, research, and a drive to do one’s best right from the start. Your student’s passion will begin to emerge and ‘click’ into place along the road to the healthcare field.

WHAT’S NEXT? We hope the information and resources available in this article will help you and your child begin a journey to your career in healthcare. Throughout this series, we will provide additional information on our website, www.ourhealthcville.com. Look for Part II of the How to in Healthcare series where we will focus on your students plan for undergraduate school. If you have additional questions that you would like to see highlighted in our series, please reach out to us anytime by email at steve@ourhealthvirginia.com. We are proud to be a resource in your plan for an education in healthcare.

SOURCES

OTHER HEALTH TRAINING

American Heart Association Family & Friends CPR Training

offered at Sentara Martha Jefferson Hospital

Students learn CPR for adults, children and infants, AED use in adults, relief of choking in adults, children, and infants. They also receive a free kit to practice their skills at home. DATE

April 9th, 2016 CRITERIA

Must be 12 years-old or older REGISTRATION

American Red Cross Babysitter's Training with Certification offered at Sentara Martha Jefferson Hospital

Students learn how to supervise children and infants, how to perform basic child-care skills, how to identify safety hazards and prevent injuries and care for common injuries and emergencies. DATE

June 2016, date to be determined CRITERIA

Boys and Girls ages 11-15 REGISTRATION

American Association of Colleges of Nursing – www.aacn.nche.eud National Center for Education Statistics – www.nces.ed.gov US Bureau of Labor Statistics – www.bls.gov

EXPERT CONTRIBUTERS Paul Deeble with Mary Baldwin College in Staunton Kathy Hudson, PhD with Piedmont Virginia Community College in Charlottesville Eileen Oswald with University Of Virginia School Of Medicine in Charlottesville

ON THE WEB

Red Cross Youth Join the Red Cross Youth – join or start a Red Cross Club in your high school. There are many volunteer opportunities for teens within the Red Cross, from blood drive services to health and safety preparedness and disaster recovery. Speak to your guidance counselor to find out if your high school has a Red Cross Club, or visit www.redcrossyouth.org for more information on starting a club in your school.

More at ourhealthcville.com www.OurHealthCville.com

FIT BITS

Deidre Wilkes, AFAA, ACSM

Certified Personal Trainer

Deidre is the resident fitness specialist for OurHealth Shenandoah Valley and Charlottesville

H EA LT H A ND F I T NES S O N THE GO

WHERE LAND MEETS WATER

AQUA KICKBOXING Have you ever tried a kickboxing class?

It’s an energizing, powerful, uplifting and effective way to burn calories and tone muscles – but, it is also very tough on the joints. Kickboxing in water helps prevent injuries by lessening joint impact, but the additional resistance created by the water strengthens and tones muscles for an extremely intense and effective workout!

SMITH AQUATIC & FITNESS CENTER Charlottesville www.charlottesville.org

ACAC Charlottesville www.acac.com

This innovative aquatics program combines the benefits of water’s buoyancy and resistance to increase muscle strength, endurance, agility, coordination, balance, and core stability.

IO CA RD

EN GT H ST R

G TO NI N

BA LA N

Aqua kickboxing is an innovative way to combine the benefits of water’s buoyancy and resistance to increase muscle strength, endurance, agility, coordination, balance, and core stability. By incorporating traditional kickboxing moves – kicks and punches in the water. Work at your pace while gaining new skills to boost overall fitness. This workout is suitable for all fitness levels.

AQUATIC CLASSES NEAR YOU:

MODERATE INTENSITY

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New Kitchen New Nutrition New You! words | CYNTHIA BEMENT and TRICIA FOLEY, MS, RD

In 2016, our New Kitchen, New Nutrition, New You series puts the focus on helping you get healthier in the kitchen — one ingredient at a time. Each edition of OurHealth will highlight small changes you can make in your food prep and shopping habits that can add up to a major positive impact on your nutrition and health. Our goal is to present you with suggestions you can use and build on that will help you create a healthier kitchen — and life — by year's end. Spring. It’s that wonderful time of year when blooms burst, the landscape turns green and life seems to offer a fresh, new start. This sense of renewal carries over to our tables — salads and fresh produce are the stuff of al fresco dining dreams. But alas, not all salads have your best nutritional interest at heart. Here, we show you how to take your spring fling with salads to the healthiest level possible by building them right, from the plate up, with healthy swaps from our resident nutritionist that will please your taste buds without foiling your nutrition goals.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

Keep it green A truly healthy green salad starts with lots of — you guessed it — greens. Start by searching out a better salad base by deepening the color of your greens, as we’ve done in our Cobb salad. “Swapping out the iceberg lettuce for a blend of arugula and romaine lettuce increases the nutrient value of the salad without adding a lot of calories,” says Tricia Foley, OurHealth’s resident nutritionist and a member of the Southwest Academy of Nutrition and Dietetics.

“Arugula contains about eight times the calcium; five times the vitamin A, vitamin C and vitamin K; and four times the iron as the same amount of iceberg lettuce,” Foley says. And substituting romaine for iceberg lettuce brings 10 times more vitamin A to the salad and contains vitamin K that supports bone health and blood clotting.

Capitalize on the crunch After upgrading your base, look to the vegetable content in your salad and add some smart extras for crunch, flavor, texture and juiciness. Colorful, nonstarchy veggies like peppers and tomatoes are great options; according to Foley, both are rich in vitamins C and A and potassium. For many, the crispy allure of croutons is tough to avoid, but they can load on calories without providing any nutritional value. In our Cobb salad, we’ve swapped these nutritional saboteurs for almonds. “Almonds have polyunsaturated fat that can help raise good cholesterol while lowering bad cholesterol levels,” says Foley. “Using a small amount will provide a nice crunch without bombarding the salad with calories."

Skip salad sabotage Let’s face it: salad toppings are fun. Along with the aforementioned croutons, most salad bars offer nuts, seeds, dried fruits and cheeses that can spice up a potentially boring salad. Choose these additions wisely, however, to avoid downgrading the nutritional value of your salad. Skip dried fruits, which can add high concentrations of sugar and calories, and pay careful attention to the quantity of seeds and nuts you’re adding so as not to drive up the calorie and fat content, as in our unhealthy version of the Cobb. You don’t have to skip these entirely though.

“Using a garnish is a great way to incorporate color, taste and interest into a salad without overdoing the calorie content. Using a light coating of cheese, for example, does the trick,” says Foley. One salad garnish that should be managed carefully, says Foley, is avocado. Though they are nutritional all-stars (they’re high in folate, as well as B, C and E vitamins and potassium), avocados are high in monounsaturated fat, which — while great for lowering LDL or bad cholesterol — still comes with a high calorie and fat price tag. “Although avocados are very heart healthy, a small amount can go a long way,” says Foley, noting that one-fifth of an avocado is considered a serving, so use them sparingly in your salad.

Darker Greens: A truly healthy salad starts with lots of greens. Try deepening the color of your greens such as romaine or arugula. The deeper the green, the more nutritional value.

Veggie Love: Look at your vegetable content. Colorful, nonstartchy veggies like peppers and tomatoes add crunch, flavor, and juiciness to your salad. They are also both rich in vitamins C and A.

Watch Toppings: Avoid downgrading the nutritional value of your salad with fatty toppings. Avoid dried fruits, which can add high concentrations of sugar and calories, and pay attention to the quantity of seeds, nuts and croutons.

Balance it out with (the right) protein

Protein Punch: It is important to pick the right proteins for your salads. While protein is a very important nutrient, the inclusion of protein can introduce unwelcome fat and calories. Make sure you consider all your protein sources including meat, eggs, seeds, nuts and cheeses.

Dress it Right: Too much fatty dressing can potentially negate the nutritional benefit of a salad. Try to pour one serving of bottled dressing (as defined on the nutrition label) into a small bowl and use only that much. In doing this you will become adept at eyeballing a serving size so that when eating out you can use the same amount.

While protein is always an important nutrient, when it comes to your salad, the inclusion of protein can often introduce unwelcome fat and calories. Getting the protein right in your salad, both in type and quantity, requires some scrutiny. In our Cobb salad recipe, we substituted grilled chicken for fried chicken. “By simply switching out the fried chicken for grilled, we save on calories from unhealthy fats and refined carbohydrates used to coat the chicken,” says Foley. When creating your salad, consider all the protein sources you’re using in addition to meat — eggs, seeds, nuts and cheeses all contain protein and will contribute to the total amount you’re getting.

How much is enough protein? “On average, women should aim for about three to four ounces of protein per portion (21-28 grams) and men four to five ounces (28-35 grams),” Foley says. One egg, one-quarter cup of cheese and 20 almonds each equal one ounce of protein.

Dress it up right The dressing might be the icing on the cake, but it’s another salad saboteur if you choose the wrong one. Most people know that full-fat and -calorie salad dressings poured on in pool-like quantities will essentially negate the nutritional benefit of a salad, but the kind of dressing you choose (or make) can also play a significant role in the salad’s healthfulness. “This healthy dressing swap has a Greek yogurt base, which is low in fat and rich in protein,” says Foley. “This allows the creamy texture to be enjoyed without all the saturated fat and calories that mayonnaise and sour cream tend to add in traditional cream-based dressings.” An oil-based dressing is also a wise choice, and Foley’s personal choice is to make her own (use our simple recipe and try it yourself). If you’d like to add spices to your dressing, Foley suggests experimenting with your own blend of dried or fresh herbs instead of buying packet dressing mixes, which can contain hidden sugars and maltodextrin — a common food additive made by partial hydrolysis of starch. Check the labels of low-fat and nonfat versions of your favorite bottled dressings as well because they are often high in sugar. Choose versions that contain no more than four grams of sugar per serving, Foley advises. Lastly, some vinaigrettes can also lead your salad into the danger zone.

“Vinaigrettes should be used with caution because many of the fruited vinaigrettes are high in sugar and use high fructose corn syrup as an additive,” says Foley. “Look for Greek or Italian vinaigrettes instead.” The amount of dressing you use, of course, is also a factor. One way to ensure a light hand while still maximizing flavor is to pour some dressing into a small bowl and dip your fork into it before the salad. Another is to pour one serving of bottled dressing (as defined on the nutrition label) into a small bowl and use only that much. You will become adept at eyeballing a serving size so that when eating out — after ordering the dressing on the side — you can use the same amount.

WATCH FOR IT IN OUR NEXT ISSUE

Get restaurant-ready Are salads a sure bet when you eat out? There are no guarantees, and in fact some restaurant salads, by nature of their large portion sizes and ingredients, can equal or surpass the fat and calorie content of a burger and fries meal — and that’s before the dressing is factored in. The key: Plan ahead when possible by checking out the restaurant’s menu and the nutrition information for its salads. At fast food chains, check to see if ingredients like dried cranberries, croutons, seeds and cheeses come in their own packages instead of being premixed into the salad. Foley notes that cheeses like feta, cheddar and blue can add 80-100 calories and 10-plus grams of fat per serving. And while dried fruits hardly seem like salad disaster, they can be. “After reviewing a popular fast food salad, we found that omitting the Craisins saved about 100 calories and 18 grams of sugar,” says Foley.

Healthy Summer Barbeque Tips

Armed with our healthy swaps, nutrition-savvy tips and a little planning, you can uphold salad’s good name as a fresh and healthy mealtime option in your new kitchen, new nutrition arsenal — one that you can serve to your family with confidence this spring and year-round. Watch for it: In our next issue, we’ll be grilling out with healthy summer barbeque tips and tricks in part 3 of New Kitchen, New Nutrition, New You.

Check out the Healthy SWAP recipe on the next page!

www.OurHealthCville.com

Tricia Foley’s

COBB SALAD Tricia Foley is OurHealth Magazine’s resident nutritionist.

Looking for more? For more healthy recipes with similar ingredients, scan here or visit our website at www.OurHealthCville.com!

Healthy Regular Ingredients serves 4

SWAP

Healthier Ingredients serves 4

ounces fried chicken

ounces grilled chicken

cups iceberg lettuce

60 croutons

cups romaine lettuce or 8 cups arugula lettuce

black olives

cup of slivered almonds

boiled eggs, diced

4 boiled farm fresh eggs, diced

yellow onion, chopped

black olives

cup cheddar cheese, shredded

red bell pepper, sliced

cup bacon bits

green bell pepper, sliced

cup sunflower seeds

yellow onion, chopped

cherry tomatoes

cup bacon bits

cup cheddar cheese, grated avocado-for garnish

Dressing Ingredients 1 avocado 1

tablespoon chives

garlic clove

tablespoon parsley

Dressing Ingredients

lime, juiced

⅔

cup plain Greek yogurt

tablespoon mayonnaise

tablespoon olive oil

teaspoon pepper

garlic cloves, crushed

teaspoon salt

tablespoons capers, finely chopped

tablespoons white wine vinegar

tablespoons freshly grated

cup butter milk

Parmesan cheese

1½

tablespoons sour cream

lemon, juiced

salt and pepper for seasoning

Instructions: Instructions:

Rinse lettuce and chop, then add to a large bowl, add cooked chicken, olives, diced eggs, onion, cheese, bacon bits, seeds and croutons to bowl, toss and set aside.

Rinse lettuce, chop, then add to a large bowl. Add cooked chicken, all vegetables, cheese, bacon bits and almonds, toss

To make the salad dressing first peel avocado and remove seed.

and divide into 4 portions. Garnish each portion with sliver of

Then combine all ingredients into a blender or food processor.

avocado and cheddar cheese, set aside.

Blend until smooth and add to salad. Makes 4 servings.

To make the salad dressing first combine yogurt, oil, garlic,

Nutrients in salad without dressing (per serving):

capers, lemon juice and Parmesan. Then whisk until well

634.5 calories, 39.75 grams fat, 33.75 grams protein

combined; add salt and pepper to your tastes, and whisk again. Nutrients without dressing (per serving): 313.7 calories, 25.75 grams protein, 12 grams fat

Total nutrients with dressing (per serving):

783.5 calories, 50.15 grams fat and 33.75 grams protein

Total nutrients with dressing (per serving):

388.45 calories, 16.7 grams fat and 32 grams protein www.OurHealthCville.com

Photos courtesy of Competition Imaging, LLC

Baby, it was cold! But, that didn’t stop this hearty group and their LOVE for running! What better day to show it than Valentine’s Day! The Adam and Eve Half Marathon is Charlottesville’s first social run. Whether single or in a relationship, there were categories for everyone – designated by shirt color – a red shirt for those in a relationship, green for those single and ready to mingle, or yellow for those in a complicated situation! What a fun way to meet new friends who share a passion for running. Who knows, there may even have been a few relationship status changes in the process!

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

ON THE WEB

More at ourhealthcville.com

www.OurHealthCville.com

the 2016 OurHealth Charlottesville and Shenandoah Valley Primary Care Series: an issue-by-issue overview

+++

| february

january

KNOW YOUR CARE:

T II PAR

understanding your health and how to maintain it

+++ march

| april

DO YOUR CARE: taking action with your health

DO YOUR

care words | GERI ASTON

Your health is as unique as you are.

+++ may

setting good examples for others to learn and live by

+++ july

Taking action with your health

It’s shaped by a combination of many factors — age, weight, gender, genetics, environment and lifestyle choices. In your first visit with your primary care provider, the doctor assesses each of these components and develops a care plan specific to you. Then it’s your turn. You have to act on that plan. You have to “do your care.”

This article, the second in a yearlong OurHealth series about primary care, will focus on your part of the patient-physician partnership.

Eating healthy Although you can’t change your age, gender or genetics, you can change the lifestyle choices that affect your health. Helping patients make healthier choices is a major focus for David Sutton, MD, a family medicine physician at Augusta Health Family Medicine in Staunton. Often, patients may have diabetes or prediabetes, high cholesterol, high blood pressure or a combination of these conditions. The underlying reason for each of these conditions more often than not is the same — being overweight.

| june

SHARE YOUR CARE:

| august

INSPIRE YOUR CARE: keeping creative with fresh care ideas

+++ september

| october

MEASURE YOUR CARE:

tracking your efforts to ensure you’re on the right path

+++ november

| december

CELEBRATE YOUR CARE:

rejoicing the rewards realized from taking good care of yourself

www.OurHealthCville.com

Dr. Sutton spends time emphasizing moderation in his patient’s diets. When more direction is needed, he refers patients to an Augusta Health dietitian. “Any patient with significant obesity, metabolic or cardiovascular disease should take time to sit down with a dietitian to review their habits and seek improvements,” says Dr. Sutton.

Preventing portion distortion

Eating healthy starts before going to the grocery store. It means planning healthy

The type of food on your plate is important, but so is the amount. Did you know that portion sizes in America have increased over time? Many restaurants serve oversized portions, sometimes big enough for two people. Many food makers package food and drinks in large sizes to sell more of their product. For example, 20 years ago, the typical bagel was three inches in diameter and 140 calories. Today’s bagels are often six inches and 350 calories.

meals in advance, shopping often enough to have nutritious options on hand and reprioritizing your grocery budget.

As portions have grown, so have Americans’ waistlines. If you’re trying not to overeat when you’re at a restaurant, how can you tell how much is the right amount when you don’t carry measuring spoons or cups? It turns out you hand, literally.

have

portable

measuring

tool

The recommended serving size of meat is roughly the size of your palm.

Limit the butter on toast to a teaspoon, or the size of your fingertip.

A clenched fist is roughly one cup, or a double-serving of ice cream. Using your hands to estimate serving sizes helps avoid overeating at home and at restaurants.

Healthy eating is just as important while dining out. Look at restaurant menus before you decide where to dine. If the restaurant makes it available, check the nutrition information too. “Limiting ‘white foods’ like potatoes, and those with added sugar or flour is also important,” says Dr. Sutton. It’s usually not feasible for everyone in the household to eat different meals, so “it’s important to get the entire family on board,” says Dr. Sutton. “My hope is that my patient’s new healthy eating habits become their normal eating habits.”

Get up and go Diet alone isn’t enough to achieve a healthy weight. The other half of the equation is exercise. Many people think of going to the gym when they think exercise. For people who can afford it and are motivated, joining a gym or working with a personal trainer may be beneficial. But for others, a membership is nothing more than a donation to the gym. Going to a health club isn’t for everyone. If that’s the case with you, the most important thing is to find an activity you like to do because you’re more likely to stick with it. It’s okay to start out slow, says Samuel Caughron, MD, a family medicine physician with MDVIP in Charlottesville. Start with 10 minutes of activity three times a week and add time when it gets too easy.

Sometimes, starting out small is the healthiest approach. Taking up running or an organized sport you haven’t played for years could result in an injury because your muscles aren’t conditioned for it. (Continued on page 51...)

HEALTHY PROTEIN

WHOLE GRAINS

Choose more fish, poultry, beans and nuts. Try to limit red meat and cheese. Avoid processed meat such as bacon and lunch meat.

Eat a variety of whole grains such as whole-wheat bread and pasta. Limit refined grains such as white bread and rice.

HEALTHY OILS

FRUITS

WATER

Use healthy oils such as olive or canola oil. Limit butter and try to avoid trans fat.

Eat plenty of fruit of all different colors.

Drink water, tea, or coffee with little to no sugar. Limit dairy to 1-2 servings a day and juice to one small serving a day. Avoid sugary drinks.

VEGETABLES Pile on the veggies, but remember to try to mix it up. The more variety, the better.

WHAT A HEALTHY MEAL LOOKS LIKE The Healthy Eating Plate, developed by Harvard University, shows people what a healthy meal looks like (illustrated above). The U.S. Department of Agriculture has a similar tool, called MyPlate. To learn more, visit their website at www.choosemyplate.gov. The American Diabetes Association offers Create Your Plate to help people control their blood sugar. To learn more visit their website at www.diabetes.org. You can ask your primary care provider whether one of these meal plans or a different one is right for you.

SCAN HERE

to view the American Diabetes Association's Create Your Plate.

HONESTY AND ACTION An individualized eating and exercise plan can keep chronic conditions like diabetes, high blood pressure and high cholesterol in check without medication or with a lower dose. Think of diet and exercise as medicine.

Samuel Caughron, MD is certified by the American Board of Family Medicine. Dr. Caughron is a family medicine physician with MDVIP in Charlottesville.

Your plan will only be successful if you’re honest with your physician at the outset and as you work toward your goals. Be frank about how much exercise you get, what you eat and what your weaknesses are. If your only exercise is to walk to the mailbox and back, that’s what you should tell your doctor. Truthful information will help your physician determine what your first activity goals should be. Some patients are very motivated to change their habits, while others find it a struggle. Some patients falter, don’t let their doctor know and give up. If you have a hard time meeting your goals, your primary care provider would much rather you reach out to them for help than give up. They can offer tips to keep up your momentum when you hit a roadblock. For example, you’re able to reach 4,000 steps a day, but your goal is 10,000. It’s OK to send your doctor or nurse a quick message asking for advice on how to increase your steps. When emailing, a short, direct message is best. If you really are unable to change your behavior, you have to be honest about that, too. If you have high cholesterol but keep eating at McDonalds, a cholesterollowering statin drug might be your best choice.

C. David Sutton, MD is a family medicine physician with Augusta Health Family Medicine in Staunton. Dr. Sutton is certified by the American Board of Family Medicine.

When you’re exercising and changing your eating habits because of a chronic illness, your doctor will make plans for follow-up visits. It’s important to keep those appointments so your physician can make sure your plan is working and make needed changes if it’s not. If it’s possible, make your next appointment before you leave your primary care provider's office. That way, your follow-up visit won't fall through the cracks.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

(Continued from page 48...)

Walking is a great alternative. It doesn’t stress the joints as much as running. Plus it’s free! A commonly heard goal is 10,000 steps a day, but that’s not an official government health recommendation. “Walking is a great choice,” says Dr. Caughron. “30 minutes of walking five days a week, is what I currently recommend,” he says. “Plus, try weight resistance exercises to improve muscle strength two to three times a week.” Try tracking your steps through the use of something like a FitBit, a smart phone app or a pedometer — to measure how far you’re walking and to gauge progress as you work toward reaching a goal over time. Dr. Caughron can also offer community referrals for more structured exercise programs at local gyms or programs through your local senior center. Obese people have to take special care when starting their physician-recommended exercise routine because the extra weight puts pressure on their joints. Exercising in a pool is often the best option because it’s easier on the joints. People who don’t like water or are shy about putting on a bathing suit can still safely add to their activities. Even getting up and moving about during TV breaks helps. You can gradually add more activity as time goes on.

Mental health Almost everyone experiences times in their life when they’re anxious or depressed. It’s important to let your primary care provider know when it happens to you. Your physician can help you determine whether your feelings are normal or a sign of a mental health problem.

“At a prenatal meeting or the first infant visit we let parents know that all adults in an infant's life, including parents, grandparents, aunts, uncles, and babysitters should have an up to date pertussis (whooping cough) booster.”

If you are having a mental health problem, your doctor will likely refer you to a counselor who can help you work through it. Counselors also teach coping skills that you can use through your life. Some physicians may recommend counseling to overweight patients who are unable to change their eating habits. Often, patients have a dysfunctional relationship with food that stems

- Alaina Brown, MD

Alaina Brown, MD is a pediatrician with Pediatric Associates of Charlottesville. Dr. Brown is certified by the American Board of Pediatrics.

from emotional issues. Counseling can help in figuring out what is blocking more healthy eating habits. It’s important to find a counselor who is right for you. Your primary care physician can refer you to someone that will be a good fit for you based on your conversation.

Mental Health: Know the Warning Signs

In many communities there aren’t enough counselors to meet demand, so you might experience a wait for an appointment. That’s why it’s important to call counselors without delay.

Trying to tell the difference between normal feelings, especially in times of stress or loss, and what might be the signs of a mental illness can be hard. Tell your doctor if you are experiencing any of these common signs of mental illness in adults and adolescents.

Exercise also helps to relieve mental health problems. Sunshine and exercise boost the level of serotonin — a chemical produced by your body that is important for brain function.

•

Excessive worrying or fear.

•

Feeling excessively sad or low.

•

onfused thinking or problems concentrating C and learning.

•

xtreme mood changes, including uncontrollable E “highs” or feelings of euphoria.

•

Prolonged or strong feelings of irritability or anger.

•

Avoiding friends and social activities.

•

Difficulties understanding or relating to other people.

•

Changes in sleep habits or feeling tired and low energy.

•

hanges in eating habits such as increased hunger or C lack of appetite.

•

Changes in sex drive.

•

ifficulty perceiving reality (delusions or D hallucinations, in which a person experiences and senses things that don't exist in objective reality).

•

I nability to perceive changes in one’s own feelings, behavior or personality.

•

Abuse of substances like alcohol or drugs.

•

ultiple physical ailments without obvious M causes (such as headaches, stomach aches, vague and ongoing aches and pains).

•

Thinking about suicide.

•

I nability to carry out daily activities or handle daily problems and stress.

•

n intense fear of weight gain or concern A with appearance (mostly in adolescents).

Meditative yoga can be a particularly good exercise option. The typical yoga studio has lessons for beginners, and staff members can help you decide what type of yoga is best for you. Sometimes counseling and exercise aren’t enough, and medication is needed. Primary care doctors handle prescribing for common mental health problems. For serious mental health disorders, the doctor will usually refer the patient to a psychiatrist. Most mental health medications take up to six weeks to take full effect. The doctor will typically schedule a follow-up appointment a month or two after prescribing the medication to make sure it’s working.

Take your meds By some estimates, more than half of all prescription drugs either aren’t taken at all or aren’t taken according to the doctor’s instructions. The result is that a lot of people are in poorer health than they should be, and some even die. “There are many reasons why patients don’t take medicine,” says Ursulla Courtney, MD, a family practice physician with UVA Health System’s Forest Lakes Health Center. “Forgetting to actually take the medications, fear of unpleasant side effects from the medication, cost, or not understanding the reason why they need to be taken,” she says.

(Continued on page 54...)

THE PHYSICIAN HOUSE CALL IS BACK AUGUSTA HEALTH LAUNCHES MEDICAL HOUSE CALL PROGRAM

Before 1960, 40 percent of physician visits were by way of the house call. By 1960, this figure dropped to one percent. The oldest segment of our population is growing the fastest and has resulted in an increasing number of folks finding themselves or loved ones homebound due to chronic medical conditions. The good news is that the physician house call is making a comeback. With recent advances in technology a very high quality of care can now be delivered in the home. The availability of GPS on a smartphone, for instance, allows the patient’s home to be located easily. Once in the home, tools can now be used that previously were limited to use only in the office and hospital setting. Mobile diagnostics is a growing area of healthcare services which includes things like blood testing, x-rays, electrocardiograms and ultrasounds (to name just a few) which all can be performed in the home. With a laptop computer the physician can view the patient’s electronic chart, place orders with a pharmacy, perform certain “If you think this tests and order additional testing if needed.

A. Ursulla Courtney, MD is a family medicine physician with UVA Health System’s Forest Lakes Health Center. Dr. Courtney is certified by the American Board of Family Medicine.

service could be helpful to you or someone you know please call 540.245.7509 for additional information. ”

Multiple medical studies have shown that physician directed house call programs can not only deliver excellent care but also save money for families and Medicare. These studies have shown such benefits as reductions in emergency room visits, readmission rates after leaving the hospital and nursing home placement. This approach to caring for the homebound provides tremendous help to patients and their families. The Augusta Health Medical House Call Program was recently launched with the goal of providing the highest quality of care possible for the homebound population of our community. The type of care delivered is known as “Home Based Primary Care” wherein the patient receives full primary care services just like they would in an office. The only requirements for enrollment in the August Health Medical House Call Program are that the patient must be homebound, enrolled in Medicare and referred from their primary care provider. “Homebound” simply means that it requires a great effort to safely get to a doctor’s office such as occurs with many medical conditions. One of the main objectives of this program is to assist our local primary care providers and families in reaching their goal to always obtain the best medical care for those who they care about.

- Thomas A. Shapcott, MD

Thomas A. Shapcott, MD is the Medical Director for Augusta Health Medical House Call Program. He is certified by the American Board of Family Medicine.

If you think this service could be helpful to you or someone you know please call 540.245.7509 for additional information.

www.OurHealthCville.com

(Continued from page 52...)

Regardless of the reason, your primary care doctor wants to know if you’re not taking your medication, why you're not taking it and if you’re confused about how to take it. Tell them right away. They don’t want you to wait until your condition gets worse to find out there is a problem with your medication. If a medication is too expensive, your doctor often might be able to prescribe a less-expensive option. Some pharmaceutical makers offer free or discounted drug programs.

How to be "Medicine Smart" Patient who understand their medications are more likely to take them. Here are 10 questions you can ask your doctor or nurse to get the information you need to use medicines appropriately.

If you’re experiencing side effects, your doctor can find a different drug that will work better for you. If you hear a troubling rumor about the medication, your doctor or nurse can talk it over with you. But they must know of the problem in order to be helpful.

1. What is the name of the medicine and what is it for? Is this the brand name or the generic name? 2. Is a generic version of this medicine available?

Sources:

3. How and when do I take it — and for how long?

Centers for Disease Control and Prevention – www.cdc.gov National Alliance on Mental Health – www.nami.org

4. What foods, drinks, other medicines, dietary supplements or activities should I avoid while taking this medicine?

National Council on Patient Information and Education – www.talkaboutrx.org National Heart, Lung, and Blood Institute – www.nhlbi.nih.gov

5. When should I expect the medicine to begin to work, and how will I know if it is working? Are there any laboratory tests required with this medicine?

Expert Contributors: Alaina Brown, MD with Pediatric Associates of Charlottesville

6. Are there any side effects, what are they, and what do I do if they occur?

Samuel Caughron, MD with MDVIP A. Ursulla Courtney, MD with UVA Health System’s Forest Lakes Health Center

7. Will this medicine work safely with the other prescription and nonprescription medicines I am taking? Will it work safely with any dietary or herbal supplements I am taking?

David Sutton, MD with Augusta Health Family Medicine

ON THE WEB

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8. Do I need to get a refill? When? 9. How should I store this medicine? 10. Is there any written information available about the medicine?

read this edition of

on your tablet or smartphone

HealthyEats

proudly sponsored by Sentara Martha Jefferson Hospital & Whole Foods Market

“Catfish is an excellent source of lean protein! Just make sure to purchase wild caught as opposed to farmed catfish to avoid harmful chemicals. Coconut oil would be a great choice to grill with as it will complement this exciting flavor combination.” Kelli Hughes, RD, CDE Sentara Martha Jefferson Hospital

CATFISH TACOS WITH THAI CABBAGE SLAW Taco Ingredients: (serves 6) 2 pounds catfish fillets (about 3 fillets) 1 Avocado, thinly sliced

Thai Slaw Dressing Ingredients: (serves 6) 1 tablespoon fish sauce

Flour tortillas

1/4 cup freshly squeezed lime juice (from about 2 juicy limes)

Fresh cilantro leaves

2 teaspoons sesame oil

Lime wedges

1 teaspoon red chile paste

Oil for the grill

Thai Slaw Ingredients: (serves 6) 2 cups thinly sliced red cabbage (about 1/4 to 1/2 of a small cabbage) 2 carrots, shredded 1 daikon radish, shredded 1/2 medium red onion, thinly sliced

1/2 cup coconut milk, more if needed 1/2 cup peanut butter 1 teaspoon honey, more to taste Red pepper flakes (optional)

Nutrition:

Per Serving: Serving size: About 1½ tacos, 660 calories (330 from fat), 36g total fat, 10g saturated fat, 90mg cholesterol, 790mg sodium, 43g carbohydrates, (7 g dietary fiber, 7g sugar), 43g protein.

Directions:

To make the Slaw Dressing, whisk fish sauce, lime juice, sesame oil, chili paste, coconut milk and peanut butter together in small pot over mediumlow heat. Cook, stirring often, for 5 minutes. Thin with coconut milk if needed to obtain a sauce that pours easily. Taste and adjust seasoning with honey and red pepper flakes. To make the Thai Slaw, combine red cabbage, carrots, daikon and red onion in a large bowl. Toss with half of slaw dressing. Set remaining dressing aside for serving with tacos. Preheat grill to medium heat. Rub both sides of fish with a little oil. When grill is hot, use tongs to rub the grate with an oiled paper towel. Grill fish 5 to 7 minutes on each side or until fish is opaque and flakes easily with a fork. Meanwhile, wrap a stack of tortillas in foil and place on grill over low heat, turning once while fish cooks. When fish is done, remove it from the grill and cut into pieces. Pile fish in warm tortillas. Top with Thai slaw, sliced avocado, cilantro leaves and extra Thai slaw dressing. Serve with lime wedges. www.OurHealthCville.com

HealthyEats

proudly sponsored by Sentara Martha Jefferson Hospital & Whole Foods Market

“Soup season is always in and the trick is to avoid excess salt and fat! This squash soup recipe does just that and is a rich source of phyto-nutrients, vitamin A and Fiber. This vegan recipe is sure to satiate your pallet and your appetite.” Kelli Hughes, RD, CDE Sentara Martha Jefferson Hospital

SPRING SQUASH AND APPLE SOUP

Ingredients: (serves 4-6) 3 pounds winter squash such as butternut, kabocha, acorn or delicata, peeled and cut into 1-inch chunks (about 8 cups) 2 Granny Smith apples, peeled, cored and cut into 1-inch chunks 1 yellow onion, chopped 4 cloves garlic, sliced 1 teaspoon ground ginger 3 cups low-sodium vegetable broth 2 tablespoons nutritional yeast 1/4 cup chopped fresh parsley

Nutrition:

Per Serving: 220 calories (5 from fat), 0.5g total fat, 105mg sodium, 53g carbohydrates, (14 g dietary fiber, 17g sugar), 6g protein.

Directions:

Preheat oven to 400°F. Line two rimmed baking sheets or shallow roasting pans with parchment paper. In a large bowl, toss squash, apples, onion, garlic, and ginger until mixed well. Spread mixture on baking sheets in a single layer. Roast squash mixture until tender and beginning to brown, about 45 to 50 minutes, rotating pans between oven racks halfway through baking. Remove from oven and purée squash mixture with broth, 1 cup water and nutritional yeast in a blender or food processor in two batches until smooth. Transfer to a medium saucepan and bring to a simmer over medium heat. Add more water if needed to thin soup to desired consistency. Serve garnished with parsley.

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HealthyEats

proudly sponsored by Sentara Martha Jefferson Hospital & Whole Foods Market

“A burrito recipe that only has 10g of sugar and boasts 12g of fiber is a rare find! This is a great way to enjoy a meatless meal without going overboard on the carbs. Engine 2 grain blends and tortillas are GMO free, nutrient dense and full of fiber for a winning combination.” Kelli Hughes, RD, CDE Sentara Martha Jefferson Hospital

DELICIOUS ENGINE 2

FIESTA BURRITOS Ingredients: 1 small white onion, diced 1/2 teaspoon cumin seeds 1/4 cup low-sodium vegetable broth 1 (14.5-ounce) can no-salt- added diced fire-roasted tomatoes 2 tablespoons cider vinegar 2 tablespoons finely chopped pitted dates 1 teaspoon finely chopped chipotle pepper in adobo sauce, plus more to taste 2 cups frozen Engine 2 Plant-Strong® Organic Fiesta Blend Grain Medley

Nutrition: 2 tablespoons finely chopped fresh cilantro 1 green onion, finely chopped 4 Engine 2 Plant-Strong® Organic Sprouted Ancient Grains or Brown Rice Tortillas 8 Bibb or butter lettuce leaves 1 avocado, sliced

Per Serving: 330 calories (90 from fat), 10g total fat, 1.5g saturated fat, 160mg sodium, 51g carbohydrates, (12 g dietary fiber, 10g sugar), 10g protein.

Directions:

Heat a large skillet over medium-high heat until hot. Add onion and cook, stirring occasionally, until beginning to brown and stick to the pan, 2 to 3 minutes. Stir in cumin. Add broth and cook until onion is soft and browned, 1 to 2 minutes. Lower heat to medium and add tomatoes, vinegar, dates and chipotle. Simmer for 2 minutes. Stir in grain medley, cilantro and green onions and cook until heated through, 3 to 4 minutes. Remove from heat. Briefly heat tortillas in a dry skillet over medium heat, flipping with tongs to warm each side. Lay tortillas on serving plates. Top with lettuce and avocado and then grain mixture. Roll up tortillas and serve. www.OurHealthCville.com

TRANSFORMING THE FACE OF SKILLED

REHABILITATIVE CARE IN CHARLOTTESVILLE words | CYNTHIA BEMENT

“

This is not a vacation destination, however, it’s a recovery destination - and the masterminds behind the 65,000 square feet of Albermarle Health and Rehabilitation Center (AHRC) in Charlottesville will be delighted if you can’t quite believe that when you arrive.

“

Albemarle Health and Rehabilitation Center is combining the comforts of home with state-of-the-art technology to deliver a better care and recovery experience. Its lobby is filled with plush couches, coordinating paintings, patterned carpet and on-point accent furnishings that give off a vacation hotel vibe. Immediately beyond is a glass wall that reveals a 3,900 square-foot, wood-floored gym with the latest technology in cardiovascular, resistance and balance machines, including a space-age, antigravity treadmill called an AlterG, which was designed using NASA technology and can bear some — or nearly all — of a person's body weight while walking on it. The entire building is drenched in natural light and seems uniquely qualified to show its guests a good time. This is not a vacation destination, however. It’s a recovery destination, and the visionaries behind the 65,000 square feet of Albemarle Health and Rehabilitation Center will be delighted if visitors can’t quite believe it. Albemarle Health and Rehabilitation Center, which opened its doors to patients in February of this year, is the 41st facility and the second of five planned new centers like it to be built by Medical Facilities of America, a family-owned company that’s the largest provider of skilled rehabilitation care in Virginia. Following in the footsteps of the Princess Anne Health and Rehabilitation Center in Virginia Beach that opened last May, Albemarle Health and Rehabilitation Center hopes to change the way people think about short- and long-term rehabilitation facilities with its unique fusion of high-tech and a wellness-based philosophy of care.

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The focus at Albemarle Health and Rehabilitation Center is on wellness during recovery and after and on getting patients home to resume their independent lifestyles as quickly as possible. The combination of facility attributes and a highly evolved philosophy of care helps set Albemarle Health and Rehabilitation Center apart from other skilled care facilities in the area.

Knee surgery, a cardiac event, stroke, hip fracture or auto accident — none of these situations is something anyone likes to think about. When they occur, the patient enters the hospital for urgent treatment and is discharged once the immediate health threat has been addressed. When it’s time to go home from the hospital, patients aren't necessarily ready to resume life as it was before the illness, injury or surgical procedure (nor would it be safe for them to). This is when a person might need a skilled care or rehabilitation facility — they're not sick enough to stay in the hospital but not well enough to go home. “A lot of the time you think of physical rehabilitation and you think of hip fractures, joint replacements, stroke and amputations,” says Ron Selzler, a physical therapist and vice president of rehabilitation services for Medical Facilities of America. “Aside from that, for anybody who has been in the hospital and doesn't need that intensity or cost of services any longer but isn't ready to go home, we can be that bridge, whatever the diagnosis. That may mean weeks, that may mean days. I think people think this is a place you go long-term. It's really not — it can be as short as a few days. But just that short stay can make the difference between going home and staying home and going home and then coming back through our doors again.”

The words “rehab center” often conjure up a no-man’s land, characterized by crowded, suboptimal conditions and care, where patients can feel scared, forgotten and isolated from family. Medical Facilities of America has been working to change that perception for more than four decades, and its latest concept in facilities, epitomized by Princess Anne Health and Rehabilitation Center in Virginia Beach, has made strides toward fusing rehabilitation and wellness — two words not normally used in the same sentence.

RON SELZLER, PT Vice president of rehabilitation services for Medical Facilities of America

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The focus at Albemarle Health and Rehabilitation Center is on wellness during recovery and after and on getting patients home to resume their independent lifestyles as quickly as possible. In promoting this philosophy, the center itself doesn’t just take design cues from elegant hotels and showcase all the latest fitness equipment. Rather, it features extra-wide hallways, four "neighborhoods" of 30 large private rooms each, many with their own tiled showers, restaurant-style dining with plated, fresh entrées (each neighborhood has its own café) and family lounging areas with big-screen televisions. Everything about the facility is aimed at welcoming patients and making room for their families too, which they believe speeds recovery and keeps patients’ spirits high during their stays. The combination of facility attributes and a highly evolved philosophy of care helps set Albemarle Health and Rehabilitation Center apart from other skilled care facilities in the area. “We set up a partnership right away, so at the patient’s admission, we've read their charts; we've received their information and our therapists, nurses and medical directors have looked at it; and we've formed our initial plan of care,” says Brian Lancenese, Medical Facility of America’s vice president of operations. “Then we sit down with the family and the patient and say, 'This is what we've read, this is what we think, and you talk to us now. Tell us what your goals are, tell us what your impediments have been, and then let's work as a team — family, patient and us — to overcome those impediments so you can live a safe, independent life again.’” That philosophy worked for Violetta Capers of the Virginia Beach area when she transitioned to Princess Anne after initially choosing another area rehab center for her recovery after knee surgery

“

“I’ve been in several healthcare buildings, and Princess Anne Health and Rehabilitation Center by far has the best care I have ever seen. The staff were well-trained and always gave me the assurance I needed to get well.”

- Violetta Capers, of the Virginia Beach area

Part of that assurance comes in the form of what Medical Facilities of America calls its “recovery map” — a preprinted, visual and literal map used by the centers for a patient’s recovery process. The guide serves as the common ground from which patient and care team work together. “This is something that has evolved over time to where it is now; it's not new, and it's something that has been tested and has been built on over the years,” says Selzler. “The idea when we started it was, we needed a simple way to communicate, one page if possible, that explained the journey from hospital to home. Clinical jargon is hard to understand, but anyone can understand this map to getting better. It really helps us communicate with patients and family better and to help them visualize the path to recovery. It gets rid of the jargon.” The recovery map is also a unifier for all staff members to act in a patient’s best interests and to encourage his or her active participation in the recovery process. “What we have is a specific operational program where from day

What is LifeWorks rehab? one, we're partnering with patients to help them own their recoveries,” says Jeremiah Davis, Albemarle Health and Rehabilitation Center administrator. “Everything that we do — from therapists, certified nursing assistants, nurses, housekeeping, dietary staff — we are always pulsing on that patient, asking them how their recovery is going. There's always that pulse there.” Another priority for Albemarle Health and Rehabilitation Center is to prepare its patients for their return home by training them for real-life situations at and around their homes. One key tool is the indoor mobility garden, a 2,000 squarefoot room that houses real-life surfaces like stones, pavers, steps, sand and a wooden boardwalk — terrain that patients might need to negotiate around their homes. The center also sends staff members to conduct in-home visits as a patient nears release; they measure stairs, hallways and bathroom widths in order to replicate the home environment on the equipment in the center so the patient can train specifically to negotiate his or her home. A full kitchen, a bathroom with tub and shower and a washer and dryer are at the back of the gym. Patients use them to rebuild basic mobility skills like moving around their kitchens, getting in and out of the bathtub and doing laundry.

LifeWorks Rehab is a uniquely comprehensive rehabilitation program rooted in compassionate, outcome-driven care at the forefront of technology. LifeWorks Rehab is an exclusive program (available only at LifeWorks rehab centers) based on proven clinical pathways, and offering a range of individualized treatment, therapies, services and recovery tools that few other programs can match. The exclusive LifeWorks recovery map and personal report card track progress; no other program

As a patient’s recovery nears completion at Albemarle Health and Rehabilitation Center, the staff intensifies the daily sessions to maximize a patient’s recovery. This is called the acceleration zone on the Recovery Map, which includes up to three hours a day of therapy. Many patients utilize the high tech equipment such as the AlterG (only available at Albemarle), cybercyles and other fitness equipment during this point on the recovery map.

offers these tools. Treatments are

One unique resource designed to enhance the patient experience at Albemarle is the LifeWorks Plus Coach (Certified Trainer). The LifeWorks Plus coach works with many patients in the therapy gym or mobility garden to enhance the experience beyond therapy services.

available. Recovery is guided by

carefully planned and supervised by medical professionals in a rehabilitation environment that offers the most modern technology a team of nurses, therapists and other staff members who are with the patient every step of the way.

Though the staff at Albemarle Health and Rehabilitation Center regrets that its patients come through their doors to recover from an injury, illness or surgery, they want to encourage people to visit before any planned surgery. By meeting with the clinical team, asking questions and touring the center, it provides the opportunity for pre-registration. And when it’s time to get out of the hospital but it’s not yet safe to go home, they want to see patients through their rehabilitation by welcoming them into their culture of recovery, where wellness and rehab are intertwined.

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