OurHealth Charlottesville & Shenandoah Valley May/Jun 2015 Edition

MAY/JUNE 2015 | OURHEALTHCVILLE.COM

The Resource for Healthy Living in Charlottesville and the Shenandoah Valley

table of contents | may • june 2015

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

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

What if we didn’t... Making a little sense of a mind-boggling topic May is Healthcare Workers Recognition Month at OurHealth magazine. Each year, we choose a unique angle to highlight the efforts of those who work in the healthcare industry. This year’s theme is, “What if we didn’t have _____?”

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 How much do you know about Our Anatomy?

In this issue, test your knowledge when it comes to the JOINTS and ARTHRITIS.

ur d i d y oi t e favor ce servi er p r o v i d? win

The Shenandoah Valley & Charlottesville

Senior Healthy Living Awards Results Announced in the July/August 2015 Issue

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

FIT BITS!........................................30 ABSolutely awesome abs! The summer season is upon us! Now is the time to work on ‘summer-ready’ abs. These exercises require no equipment, and, can be done anywhere — even on vacation!

NUTRITION.................................. 31 HEALTHY EATS: Eat Local! Roasted Pork loin with Green Beans, Kale and Quinoa Salad with Dates, Almonds & Citrus Dressing, and Spinach and Apple Smoothies!

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Take Care of Your HEALTH, Man!

So, for our male readers, OurHealth talked with area physicians about health conditions that commonly affect men and how to prevent them. Here’s what they had to say.

hello, HEALTH!.............................. 42 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos

44

[series]

Breaking the Silence: Bipolar Disorder

This series explores diseases that can be devastating to the individuals and families they affect—yet no one is talking about them—until now.

LOOKING BACK...........................50 Images reflecting the landscape of healthcare in the Shenandoah Valley and Charlottesville * PLUS * a chance to win prizes!

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may • june 2015

read this edition of

OurHealth Shenandoah Valley & Charlottesville

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PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT CHIEF DESIGNER ORIGINAL COVER ART WORK WEBSITE SOCIAL MEDIA INTERN ACCOUNTING MANAGER

CONTRIBUTING SHENANDOAH VALLEY &

CHARLOTTESVILLE MEDICAL EXPERTS

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Deidre Wilkes Karrie Pridemore Joseph Palotas and Selene Geier Next Generation Designs Jourdan Markey Laura Bower David L. Armstrong, OD Brian Behm, MD Jessicah S. Collins, MD Keri Hall, MD Rachel Hallmark, MD, PhD

ONTRIBUTING PROFESSIONAL EXPERTS & WRITERS Jennifer Ayers C Susan Dubuque Tricia Foley, RD Suzanne Ramsey 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

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

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@ourhealthcville

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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-at-Large: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Information in all print editions of OurHealth and on all OurHealth’s websites (www.ourhealthrichmond.com, www.ourhealthcville.com and www.ourhealthvirginia.com), social media sites 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 © 2015 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. The OurHealth Greater Richmond edition is published seven times annually by McClintic Media, Inc. 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthrichmond.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

What is ischemic colitis?

Ischemic colitis is a condition that occurs when blood flow to a part of the colon is reduced due to narrowed or blocked blood vessels. The reduced blood flow results in low levels of oxygen to the colon, which can result in damage to the cells lining the colon. Ischemic colitis is more common in people over the age of 60 and in patients that suffer from certain medical conditions, including heart failure, other disorders that lead to low blood pressure, and in patients that have atherosclerosis or narrowing of the arteries. Symptoms can include abdominal pain, bleeding and diarrhea, and may sometimes be confused with other digestive problems. Ischemic colitis may heal on its own, but in some cases may be treated with antibiotics, intravenous fluids and correction of underlying problems leading to low blood flow.

In severe cases of ischemic colitis, surgery may be required to remove the portion of colon that is damaged.

Brian Behm, MD

Gastroenterologist UVA Health System Charlottesville | 434.243.3090 www.uvahealth.com

What is Stargardt’s Disease?

Stargardt’s Disease is an inherited form of juvenile onset macular degeneration. There are over 25,000 Americans with Stargardt’s including about one in 10,000 children. It is a progressive condition affecting the macula of the eye. There is currently no cure.

Stargardt’s usually begins before age 12 with symptoms developing by age 20. Like age- related macular degeneration, Stargardt’s damages the central vision which we use for reading, recognizing faces and driving. Symptoms may include wavy vision, blind spots, blurriness, reduced color vision and difficulty adapting to dim light.

Peripheral vision is not affected by Stargardt’s. Vision loss may progress to legal blindness but will not result in total blindness. There is no way to predict how much vision will be lost or how quickly. One eye often loses vision faster than the other.

A low vision optometrist may be able to help by prescribing special microscopic or telescopic glasses which magnify, making things easier to see.

David L. Armstrong, OD

Low Vision Optometrist Charlottesville and Harrisonburg 866.321.2030 www.virginialowvision.com

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What is Facet Syndrome?

Facet syndrome refers to a special (but common) type of arthritis that can occur in the spine. The spinal column is made up of 25 bones that are connected in a chain. Facet joints (pronounced ‘fuh-set’) are a pair of joints on either side of the spinal column that connect a vertebral bone to the ones above and below.

These joints occur at every “level” of the spine, and are named according the bones that they connect (e.g.

L4-L5). These joints are about the same size as the knuckles of the hands, and similar to when people have arthritis in their hands, the facet joints can become arthritic and enlarged. When this happens in the lumbar spine, people typically experience pain in the middle of the low back, or in the buttocks. The pain is often worse with standing up and walking, and relieved somewhat with sitting down. In the neck, facet syndrome can contribute to pain, and also to significant decreases in range of motion. Facet syndrome cannot be cured, but the pain can be treated with special procedures such as steroid injection.

Rachel Hallmark, MD, PhD Augusta Health Fishersville | 540.245.7400 www.augustahealth.com

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H E A LT H C A R E QUESTIONS ANSWERED

BY LOCAL PROFESSIONALS

Can the Ebola virus mutate and become airborne?

It is extremely improbable that the Ebola virus could mutate to become airborne. Airborne infections are those that can spread by floating in the air and then be inhaled to cause infection. In order for a virus to become airborne, it must first acquire the ability to float in the air.

It must then be able to survive in the human respiratory tract and bind to the human respiratory receptors.

To acquire these abilities would require numerous mutations, and these mutations would need to not harm the virus in any way. Viruses generally do not mutate in these ways – in other words, they don’t mutate to change their mechanism of transmission. Taken together, the likelihood of such an event occurring is extremely improbable.

Keri Hall, MD

Martha Jefferson Medical and Surgical Associates Charlottesville | 434.654.5260 www.marthajefferson.org

What are some benefits of regular exercise, as it relates to ‘healthy aging’ and the senior population?

What are some risks associated with Type 2 (adult-onset) diabetes, and can it be prevented?

What used to be considered the natural and inevitable result of aging is mostly the negative result of a sedentary lifestyle. Regular exercise can have a tremendous impact on quality of life for seniors.

That’s particularly important today, when medical and technological advances can prolong life—because what good are those additional years if you’re not having any fun?

It’s a question of life expectancy versus healthy life expectancy.

Diabetes occurs when the body cannot properly use sugar, and sugar levels in the blood become too high.

Type 2 diabetes was previously called “adult onset diabetes” because it is more likely to occur with age, but children can also develop Type 2 diabetes. In Type 2 diabetes, the body becomes resistant to insulin, a hormone made in the pancreas that normally controls sugar.

Insulin levels increase, but the body becomes resistant to insulin, and the sugar remains high. Ultimately, the pancreas fails to make enough insulin, and diabetes develops.

Regular exercise, in conjunction with other wellness strategies, can help close the gap between life expectancy and healthy life expectancy. Study after study proves that physical activity supports both physical and mental health, and can produce benefits ranging from fewer hospital visits to a lower risk of chronic disease. Exercise is essential for maintaining functional fitness, key to remaining as independent as possible for as long as possible.

That, in turn, has implications for individuals, families, and communities. So the benefits of regular exercise are almost endless.

And the best news? It’s never too late to start.

Jennifer Ayers

Program Director Senior Center Charlottesville | 434.974.7756 www.seniorcenterinc.org

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Type 2 diabetes is a common medical problem that is associated with obesity. It can increase the risk of heart disease, blood vessel disease, stroke, kidney disease, blindness and peripheral neuropathy (painful nerve damage). Most importantly, Type 2 diabetes is often preventable with weight loss, healthy diet and exercise. When patients do develop diabetes, these very serious complications can be preventable with a healthy lifestyle and medications.

Jessicah S. Collins, MD Augusta Health Diabetes & Endocrinology Clinic Fishersville | 540.245.7180 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

Augusta Health Opens New Facility in Stuarts Draft Augusta Health’s newest facility, the Stuarts Draft Outpatient Center, located at 2570 Stuarts Draft Highway, is now open to patients.

For several years, the previously opened Urgent Care facilities in Staunton and Waynesboro have been experiencing a high volume of visits. Through Augusta Health’s mission to serve the community through access to convenient and excellent healthcare, the need for a Stuarts Draft location was recognized.

Services offered at the new facility include primary care, diagnostic lab and imaging services, and urgent care. Primary care providers John Atlee ‘Jay’ Snyder, DO, with Catherine Muller, NP, and Cara Goodell, MD (joining in July) will see patients in this new location during regular weekday hours. Urgent Care open every day from 8 am until 7 pm, and will not require previously scheduled appointment.

For more information, visit www.augustahealth.com.

UVA Cancer Center Earns National Radiation Oncology Accreditation For meeting national quality and patient safety standards, UVA Cancer Center has been awarded a three-year accreditation in radiation oncology by the American College of Radiology (ACR).

ACR is a national professional organization that has been accrediting healthcare facilities for 27 years with a focus on radiation oncology, medical imaging and comprehensive health services. UVA earned accreditation by meeting ACR’s specific practice guidelines and technical standards developed and following a peer-review evaluation – including a site visit – by boardcertified radiation oncologists and medical physicists who are experts in the field.

Patient care, patient safety, personnel qualifications, equipment, quality control procedures and quality assurance programs are assessed as part of the review.

“Earning accreditation following a thorough review by the ACR highlights the hard work and skill of our entire team, as well as the comprehensive, high-quality care we provide our patients,” says Thomas P. Loughran Jr., MD, UVA Cancer Center’s director.

Radiation oncology care is provided at the Emily Couric Clinical Cancer Center, the Gamma Knife Center and the Moser Radiation Therapy Center. UVA uses the latest technology and offers comprehensive, advanced treatment options – including brachytherapy, intraoperative radiation therapy and TomoTherapy – that enable UVA’s team to tailor care to each patient’s needs.

For more information, visit www.cancer.uvahealth.com.

Carilion Stonewall Jackson Hospital Offers New LowDose Mammography Patients benefit from 30 percent less radiation Carilion Stonewall Jackson Hospital has installed the Siemens MAMMOMAT Inspiration, thereby reducing patient exposure to radiation, by up to 30 percent. The MAMMOMAT Inspiration offers uncompromised image quality and greater comfort to patients.

“One in eight women in the United States will be diagnosed with breast cancer during her lifetime” says Susan Irvine, imaging director at Carilion Stonewall Jackson Hospital. “That’s why we are so dedicated to screening patients. This new technology makes the screening process better for women having annual exams.”

“So far our patients like the new technology,” says Irvine.

“Our radiologists like it as well. The MAMMOMAT offers the best of both worlds – a lower dose of radiation, but the same high-quality pictures.”

For more information, visit www.carilionclinic.org.

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

Anne Bush, MD

John Bush, MD

Augusta Health Augusta Health Primary Care Gastroenterology Waynesboro | 540.245.7950 Staunton | 540.245.7350 www.augustahealth.com Waynesboro | 540. 221.7350 www.augustahealth.com

Carol Lee-Collins, MD Harrisonburg Medical Associates | Harrisonburg 540.434.0559 www.hmahealth.com

Novant Health, UVA Discussing Northern Virginia Regional Health System Robert Davis, FNP

Augusta Health Neurology Fishersville | 540.932.5878 www.augustahealth.com

Augusta Health Heart & Vascular Center Fishersville | 540. 332.4278 www.augustahealth.com

Atrac Aryan Kay, MD, MS

Augusta Health Neurology Fishersville | 540.932.5878 www.augustahealth.com

Roy Flood, MD, FACC

Ami Keatts, MD

Augusta Health Care for Women Fishersville | 540. 213.7750 www.augustahealth.com

University of Virginia Health System and Novant Health are in discussions to create a Northern Virginia regional health system. The proposed agreement would include UVA Culpeper Hospital and all of Novant Health’s Virginia facilities, including Novant Health Haymarket Medical Center, Novant Health Prince William Medical Center and Novant Health Cancer Center.

Representatives from UVA and Novant Health have signed a nonbinding letter of intent and started discussions to create a joint operating company for UVA Culpeper Hospital and Novant Health’s Virginia operations by June 30, 2015. The discussions will include how Novant Health and UVA can integrate or coordinate cancer care across Northern Virginia, increasing access to UVA’s subspecialty cancer care throughout the regional health system.

Robert McMahon, MD Neurology UVA Health Systems Charlottesville 434.924.2706 neuro.uvahealth.com

Monvasi Pachinburavan, MD

Sentara RMH Pulmonary Associates Harrisonburg | 540.689.5600 www.sentara.com

“We believe a joint operating company will help ensure patients throughout Northern Virginia receive quality care at the right time and the right place, while also providing care in a more efficient manner.

We also look forward to expanding the use of our Be Safe initiative – our real-time problem-solving process to improve patient safety – to enhance quality care throughout the region,” says Richard P. Shannon, MD, UVA’s executive vice president for health affairs. “Novant Health has a long track record of successfully managing community health systems, making them an ideal partner for this alliance.”

Under the proposed arrangement, UVA and Novant Health intend for each of the hospitals in the regional health system to continue directly employing all existing staff.

For more information, please visit NovantHealth.org or www.UVAhealth.com.

Roshni Patel, MSN, FNP-BC, RN

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

Edward Pomicter, MD

Harrisonburg Physicians for Anesthesiology Harrisonburg | 540.879.2583

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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

Blue Ridge PACE Celebrates its One Year Anniversary In April Blue Ridge PACE hosted an open house celebrating its one year anniversary.

Blue Ridge PACE (Program of All-Inclusive Care for the Elderly) is a program that provides and coordinates all of the care you need, all by one team, all in one place, so you can continue living in your home and community rather than a nursing facility.

Blue Ridge PACE, is a partnership between Riverside Health System, The University of Virginia Medical Center, and the Jefferson Area Board for Aging (JABA), and serves seniors who live in Charlottesville and surrounding counties. PACE serves those age 55 and older who meet the state’s criteria for nursing home admission. PACE’s services help seniors remain in their homes and their communities.

For more information, visit www.riversideonline.com/blue_ridge_pace.

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

A SNAPSHOT

BENEFITTING THE WOUNDED WARRIOR PROJECT

DIABETES

Date: S aturday, June 6, 2015 Time: 8:00 am Location: University of Virginia Research Park

IN THE UNITED STATES

DIABETES

29.1 MILLION

29.1 million people have diabetes

That’s about 1 out of every 11 people

1 4 OUT OF

do not know they have diabetes

TYPES OF DIABETES

TYPE 1

BODY DOES NOT MAKE ENOUGH INSULIN

More than 18,000 youth diagnosed each year in 2008 and 2009

• Can develop at any age • No known way to prevent it

In adults, Type 1 diabetes accounts for approximately

5%

of all diagnosed cases of diabetes

In celebration of the 5th annual race, a portion of this year’s proceeds will benefit up to four additional nonprofits that provide services to wounded warriors and/or military veterans.

For additional information, and to register for the 5K and Kids Fun Run, visit ww.4thewounded5k.com.

*****

FASCINATING

FACT It only takes

TYPE 2 • Can develop at any age • Most cases can be prevented

17 SMILE, MUSCLES TO

BODY CANNOT USE INSULIN PROPERLY

Currently, at least 1 out of 3 people will develop the disease in their lifetime

More than 5,000 youth diagnosed each year in 2008 and 2009

Learn More at www.cdc.gov/diabetes/prevention or Speak to your Doctor

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The 4 the Wounded 5k has grown to become one of the top five largest foot races in the region, and raised over $380,600 for Wounded Warrior Project. The goal is to raise an additional $110,000 in 2015 that’s half a million dollars in just five years!

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

but

43 TO

FROWN *****

Arthritis Myth

vs. Fact

M y th #1: Arthritis is a condition that just causes minor aches and pains associated with getting older.

Fa ct: Arthritis is actually a complex family of musculoskeletal

May is National Stroke Awareness Month

disorders consisting of more than 100 different diseases or conditions that can affect people of all ages, races and genders.

Osteoarthritis (OA) is one of the most common forms of arthritis. It is a chronic condition in which the material that cushions the joints, called cartilage, breaks down. This causes the bones to rub against each other, causing stiffness, pain and loss of joint movement.

M y th #2: Arthritis is not a very common condition.

Fa ct: Arthritis is the leading cause of pain and disability worldwide. It is actually a more frequent cause of activity limitations than heart disease, cancer or diabetes.

M y th #3: People with arthritis should avoid exercise.

Fa ct: Exercise is a valuable tool in the fight against arthritis. Exercise can actually decrease joint pain and stiffness, and improve flexibility, mobility, mood and overall wellness for those with arthritis. Exercises that are lowimpact, such as yoga and tai-chi can be performed to help with flexibility. In addition, water-based exercises can improve the use of affected joints without worsening symptoms.

To learn more about

living with arthritis, visit the

Arthritis Foundation website at

According to the National Stroke Association, a person experiencing a stroke can be treated if people have acted FAST - 80% of strokes can also be prevented.

FAST being an acronym for things to check in a suspected stroke victim: F=Face: Does the face droop on one side when the person smiles?

A=Arm: After raising both arms, does one of the arms drift downwards?

S=Speech: After repeating a simple phrase, does the persons speech sound slurred or strange?

T=Time: If any or all of the above are observed call 9-1-1 immediately, and ask for medical assistance.

For more information, visit the National Stroke Association Website at www.stroke.org.

www.arthritis.org.

DID YOU KNOW?

More than 90 percent of diseases are caused or complicated by stress.

The Haven Run for Home 8K Run/4K Walk All proceeds benefit THE HAVEN Date: Saturday, May 23, 2015 Time: 8:00 AM Location: Charlottesville Downtown Mall The race starts and finishes on the Charlottesville Downtown Mall and winds through historic and scenic downtown neighborhoods. The Haven, located in downtown Charlottesville, is a safe and welcoming day shelter for the homeless and very poor of central Virginia. Serving over 85 people daily, The Haven provides respite for the weary and transformation for the ready.

For additional details and to register, go to www.thehaven.org. www.OurHealthCville.com

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OURHEALTH IS ON THE GO PRINT + MOBILE + TABLET + ONLINE + TV

And that's just the beginning.

Enewsletters. Videos. Social Media. Contests and Sweepstakes. And so much more.

Ourhealthcville.com

the

Anatomy

CHALLENGE

How much do you know about Arthritis? First, fill in the crossword below. Next, match up the correct word with the part of the body in the illustration.

[ Arthritis in the Joints ]

CROSS WORD Across 5 joint capsule 8 inflamed synovial membrane 9 joint cavity 11 synovial membrane 12 cartilage fragments 13 yellow bone marrow

Down 1 articular cartilage 2 compact bone 3 spongy bone 4 destruction of cartilage 6 inflamed joint capsule 7 periosteum 10 ligament

____________________ ____________________

____________________ ____________________

____________________ ____________________

____________________ ____________________ ____________________ ____________________ ____________________

For answers, visit

OurHealth Shenandoah Valley and Charlottesville’s Facebook page at

____________________ ____________________ www.OurHealthCville.com

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if we didn’t... words | SUZANNE RAMSEY

Making (a little) sense of a mind-boggling topic May is Healthcare Workers Recognition Month at OurHealth magazine. Each year, we choose a unique angle to highlight the efforts of those who work in the healthcare industry. This year’s theme is, “What if we didn’t have _____ ?”

That blank includes not only the obvious, clinical staffers—people with “hands-on” jobs, like physicians, nurses and emergency medical technicians—but also those employees who work more “behind-the-scenes,” people like pharmacists, patient service representatives, medical educators, maintenance staff, housekeepers and others.

At OurHealth, we recognize—in May and throughout the calendar year that it takes a team of dedicated, skilled professionals to keep our community healthy, and that each and every member of this team plays an important role in creating healthy outcomes and positive patient experiences.

To use a baseball analogy, you’d never say, “We’ll just play without the shortstop.” A team needs its shortstop, its pitcher, its fielders, its catcher, just like a medical facility or hospital needs all of the folks on its roster. Because winning, in baseball and healthcare, is about more than just covering the bases.

To you—all of you—we say, “Thanks.”

The most rewarding experiences in pharmacy, are serving the individual needs of patients.

What if we didn’t have pharmacists?

A. Pharmacists can answer questions about prescriptions, over-the-counter medications, vitamins and herbal supplements.

What if we didn’t have pharmacists?

A.

Without pharmacists, our healthcare system would be missing a valuable part of the team.

Pharmacists are very accessible to patients and other healthcare providers, and can answer questions about prescriptions, over-the-counter medications, vitamins and herbal supplements. Pharmacists review all prescriptions and check for interactions between multiple medications, medical conditions and even foods. Without compounding pharmacists, custom medications would not be available for children, pets or people who cannot take commercially available products due to allergies and other health conditions. Pharmacists play a huge role in ensuring medications are properly dosed and dispensed to their patients in the community, hospital, long-term care facilities and other locations.

Leah Belcher, PharmD Meadowbrook Pharmacy

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If we didn’t have pharmacists today, our healthcare system would be missing an important component that ensures comprehensive treatment and keeps patient care from being fragmented. Pharmacists in various settings, whether they be in clinical, institutional or retail environments make contributions to positive patient outcomes as a part of the healthcare team. They are often the “watchdogs” as they provide safety to patients in recommending drug therapies, determining patientspecific dosing, monitoring drug interactions and improving compliance. Without pharmacists, some of the best therapy plans may fail for lack of execution related to poor adherence of drug regimens. Pharmacists play a large role in ensuring that the therapy plan designed for the patient is successful through effective communication with the physician, therapist or other healthcare professionals. Most importantly, pharmacists once thought of as people who put your medicine in a bottle, believe it is their responsibility to impart their knowledge of medications to patients so that they may receive more successful treatments and experience the best value for their healthcare dollars.

Joe Yeager, RPh Owner Fishersville Family Pharmacy

Pharmacists play a large role in ensuring that the therapy plan designed for the patient is successful through effective communication with the physician, therapist or other healthcare professionals.

— Joe Yeager, RPh

Staunton-Augusta Rescue Squad offers much to the community it serves through treatment, education, training, injury prevention and a caring environment.

What if we didn’t have emergency services providers?

A.

Lives would not be saved. Emergency medical technicians provide emergency medical care and transportation services to the critically ill and injured. This service is provided by dedicated, loyal, committed, caring professionals with considerable knowledge, skill and judgment to treat the out-of-hospital patient.

It is our mission to enhance the quality of life for each resident through personalized attention and care.

What if we didn’t have elder care professionals?

A.

We would face an elder care crisis. Those aged 85 and older are the fastest growing segment in America. As our population lives longer, more people will experience multiple chronic illnesses, disability and dependence. The need for elder care professionals in not only assisted living communities and nursing centers, but adult day programs, hospice, transportation, and in-home and community based services will continue to grow. Family members, friends and volunteers would be unable to bear this care burden without the assistance of professional caregivers.

Sara Warden Executive Director Our Lady of Peace Retirement Community

Without this, out-of-hospital medical care which provides urgent needs to our community, would not be delivered.

This is part of the healthcare system that provides safe and effective patient care, decreases morbidity and mortality associated with sudden illness and injury in the prehospital environment.

The 20 million patients in the United States that are treated annually by EMS would not receive the necessary care that would make a difference between life and death.

Pre-hospital emergency care is one of the most important links in the healthcare system. The system would be broken and lives would be lost without it. Immediate CPR, heart monitoring, management of trauma injuries, airway management, transportation to the hospital for the ill and injured, a friendly smile, a shoulder to cry on and a hand to hold would not be there for those in need. EMS offers so much to the community it serves by providing treatment, education, training, prevention of injury and a caring environment.

Kim Craig, RN, MSN, EMT-B Executive Director Staunton-Augusta Rescue Squad

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Dr. Randolph Canterbury during a recent lecture at UVA School of Medicine.

What if we didn’t have medical education providers?

A.

If we did not have medical education professors, we would cease to advance scientific knowledge and its clinical application and there would be no one to educate and train the next generation of scientists and physicians. These faculty conduct basic and translational research, provide high-quality patient care and educate our students and trainees. We are fortunate at the University of Virginia Health System to have world-class scholars in biomedical science, population science, clinical medicine and medical education. They are passionate about their work, and we can trust them to provide us with the best healthcare possible for each successive generation. I am grateful for each of them.

Randolph Canterbury, MD Interim Dean UVA School of Medicine

Without nurses, the healing touch would be missing.

What if we didn’t have nurses?

A.

Without nurses, the patient would not get the care that is needed. Nurses carry out the orders for the medication, care and treatments that are needed in the hospital and outpatient settings. The nurse’s assessment determines the plan that is carried out under the physician’s direction. Without nurses, the healing touch would be missing.

Marvella Rea, MSN, RN, MNML Chief Nursing Officer Augusta Health

If we did not have medical education professors, we would cease to advance scientific knowledge and its clinical application and there would be no one to educate and train the next generation of scientists and physicians.

— Randolph Canterbury, MD 24

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Frank Longaker, president of American National University (seated) with Diane Morey, vice president of academic affairs-health science education (seated), with nursing students from the Pikeville Campus.

Patient navigators provide support and guidance, which is an essential part of a patient’s treatment.

What if we didn’t have patient navigators?

A.

If we didn’t have the patient service representatives like our navigators, the whole healthcare experience would be much more stressful for both patients and their families. While they aren’t always providing direct patient care, they help answer questions, find patients the resources they need to make informed decisions, and stay by the patients side, helping them ‘navigate’ their course through what can be a long journey. They provide great support and guidance, and become an essential part of the patient’s treatment.

Lisa Cline, MSN, MBA Chief Operating Officer Augusta Health

If we didn’t have the patient service representatives like our navigators, the whole healthcare experience would be much more stressful for both patients and their families.

— Lisa Cline, MSN, MBA 26

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

What if we didn’t have medical education providers?

A.

It is imperative that anyone entering the medical field be properly trained by medical education instructors who possess a wealth of knowledge in the field that they then bring to the classroom.

Diane Morey, our vice president of academic affairs for health science education, is a stellar example of a medical education teacher who continues to make an impact on medical students as she is a registered nurse, a certified nursing educator, and holds master’s and doctoral degrees in nursing.

Diane’s expertise keeps our medical programs on the cutting edge of health science education. Programs such as our bachelor’s degree in medical health services management allow graduates from any health science associate degree program to enroll as a college junior and complete their bachelor’s degree in two years or less. Diane has also been instrumental in developing an RN to BSN 100 percent online degree that can be completed part time in just 14 months.

Frank Longaker President American National University *National American College operates 31 campuses in six states.

If we didn’t have doctors, we wouldn’t have standards of quality, or the ability to tailor treatments to specific medical and personal situations.

— R. Brian Mitchell, MD

Peer advocates know the power of friendship and community to support and lift up patients.

What if we didn’t have peer health advocate volunteers?

A.

If we did not have peer advocates, my clients would not have a solid shoulder to lean on when they are trying their best to learn new habits and change destructive behaviors. Peer advocates become health coaches who walk with clients, literally and figuratively, as they find healthier lifestyles, make new friends and recover from a variety of haunting traumas and difficult life events. Peer advocates know triggers that can pull others down, and they know the power of friendship and community support to lift them up. They know best how to find hope when others are in the dreaded despair of mental or physical hopelessness. Peer advocates do save lives and are role models for a balanced, healthy and satisfying life.

Sue Hess, MSN, RN Community Mental Health Nurse Navigator Mental Health America, CharlottesvilleAlbemarle

At Sunnyside Communities, residents benefit from award winning wellness programming for all fitness levels.

What if we didn’t have continuing care providers?

A.

Continuing care retirement communities and providers offer all levels of living – independent living, assisted living, healthcare, skilled nursing care, and memory care – within one community. One of the many benefits of a CCRC is having a team of healthcare professionals who work with and care for you as your needs change – all in one location.

Each member of the team – administrators, wellness, nutrition, activities staff, healthcare professionals, and many others – is vital to the care and support of residents.

Jack Broaddus President | CEO Sunnyside Communities

www.OurHealthCville.com

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Brenda Burns is part of a meticulous housekeeping team at one of Medical Facilities of America Rehabilitation Centers.

It is imperative that anyone entering the medical field be properly trained by medical education instructors who possess a wealth of knowledge in the field that they then bring to the classroom.

— Frank Longaker

What if we didn’t have people who are committed to keeping our healthcare facilities in top shape?

A.

One of the goals of our company is that our employees work to delight and surprise patients, residents, guests, and visitors. In fact, the greatest number of compliments on our monthly customer satisfaction surveys focuses on cleanliness and attractiveness of our healthcare centers. I once had one of our administrators, a former housekeeping director, tell me that the reason his team loved their job so much, is because they know patients feel more comfortable in a fresh and clean environment.

When entering one of our centers, there is a purposeful attack on the senses: the smell of freshly brewed coffee, food cooking in the kitchen, and the friendly greeting of the receptionist. As you continue on, you also cannot help but notice the shiny, bright, clean floors, the neat and orderly patient rooms, and the telltale smell of “clean.”

This hard work is all done by the bright and cheerful faces of a very important part of our team who understand the magnitude of that first impression. These committed, service-oriented individuals take great pride in making our healthcare centers have a world class look and feel. I am very proud of this staff’s contribution to making the total patient experience a “Legendary One!”

Keith Helmer Chief Operating Officer Medical Facilities of America *MFA is the parent company of over 30 locations of health and rehabilitation centers across the state.

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FITBITS

H EA LT H A ND Deidre Wilkes, AFAA, ACSM, Certified Personal Trainer

F I T NES S O N THE GO

ABSolutely Awesome Abs!

Deidre is a certified personal trainer with more than 15 years experience in the health and fitness industry.

She is the resident fitness specialist for OurHealth Shenandoah Valley & Charlottesville.

The summer season is upon us! Now is the time to work on

‘summer-ready’ abs. These three exercises are great for shaping and strengthening the abdominal area. These exercises require no equipment, and, can be done anywhere — even on vacation! *Consult with your physician/provider before beginning any new fitness program.

#2.

Bicycle Crunch

How to properly perform a bicycle crunch: 1. Lie on your back, bend your knees, placing your hands gently behind your head for support This is the same setup as for the basic crunch 2. Lift your shoulder blades about six inches off of the ground, resting your weight on your lower and mid-back.

#3. Forearm Plank

How to properly perform a forearm plank: 1. Lie on your stomach on the floor.

#1. Basic Crunch

3. Extend one leg straight out from your body, six inches off of the ground.

2. Place legs about hip-width apart, flex your feet and tuck toes under so the balls of your feet press into the floor.

4. Extend the other leg upward, bending at the knee with your thigh extended up from the mid section.

3. Bend elbows and place forearms on the floor, facing palms toward each other and make your hands into fists.

5. Begin the exercise by bringing the knee towards the chest and extending the opposite leg straight out. At the same time, bring the shoulder opposite the bent knee across your body towards your knee. Both should meet at your chest, right knee and left elbow or left elbow and right knee.

4. Tighten your abdominals, look down at the floor and keep your back straight -- imagine pulling your navel to your spine.

How to properly perform a basic crunch: 1. Lie on your back, bend your knees, placing your hands gently behind your head for support.

2. Contract your abs and flatten your lower back against the floor.

3. Slowly lift your shoulder blades one or two inches off the floor.

4. Exhale as you lift, keep your neck straight and chin up.

5. Hold for a few seconds (don’t hold your breath).

6. Slowly lower while keeping your abs contracted.

7. Repeat up to 20 reps, keeping good form.

Tip: Be sure not to pull on head or neck.

Focus on lifting shoulders each time, while keeping abdominal muscles contracted.

6. Reverse the process by straightening the bent knee and bringing the opposite knee up, meeting it with the reverse shoulder.

7. Repeat up to 20 reps (right/left equaling one rep), keeping good form.

Tip: Be sure not to pull on head or neck.

Focus on lifting shoulders off the ground each time, and think about bringing opposite knee toward shoulder, keeping elbows wide and abdominal muscles contracted.

5. Contract your glutes and legs and lift your hips and thighs off the floor. Avoid pushing your hips up too high or letting them sag to the floor -- your body should form a straight line from your head to your feet.

6. Breathe normally and hold this position for up to 30 seconds. If you feel pain or can’t maintain perfect form, lower yourself to your knees and relax your muscles.

Tip: Attempt to keep back as straight as possible, us a mirror if available. Keep shoulders relaxed, and, drop to knees for a modified version, keeping toes on ground.

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Healthy Eats Roasted Pork Loin with Green Beans

Pork Directions:

Green Bean Directions:

1. Prior to roasting, take the pork out of the fridge and let it sit at room temperature (30 minutes).

1. In a large stock pot of boiling water, add green beans until bright green.

Ingredients for Roasted Pork Loin:

2. Preheat oven to 450°F.

3. Heat a large skillet over medium heat.

1 3-4 pound boneless, center-cut

pork loin

3. In a small bowl, combine the oil, garlic, salt, pepper and herbs; then mix until a paste forms.

4. Add oil, garlic and red pepper flakes.

Makes 8 servings

4 garlic cloves, minced 1 tablespoon sea salt 1 tablespoon fresh, minced sage 1 tablespoon fresh, chopped rosemary 1 tablespoon fresh, chopped thyme 1 teaspoon fresh, ground black pepper 2 tablespoons olive oil

Ingredients for Green Beans: 2 pounds green beans, ends trimmed 2 tablespoons extra virgin olive oil 2 large garlic cloves, minced 1 teaspoon red pepper flakes 1 tablespoon lemon zest

Salt and pepper to taste

4. Pat the pork dry with a paper towel, and coat with the seasoning paste.

5. Set on a rack in a shallow roasting pan 6. Roast for 15 minutes, and then turn the oven temperature down to 300°F. 7. Let the loin continue roasting for another 30-40 minutes.

8. Use a meat thermometer to ensure the internal temperature reaches 135°F. 9. Remove the roast from the oven and cover with foil.

10. Allow 10-15 minutes of resting time.

Then slice and serve.

2. Drain and shock beans in ice water.

5. Sauté for about 30 seconds, and then add beans and continue to sauté until beans are coated and heated throughout.

6. Add lemon zest and salt and pepper, as desired.

Local Pork from: Polyface Farm | 43 Pure Meadows Lane Swoope VA 24479 | 540.885.3590 www.polyfacefarms.com Polyface, Inc. is a family owned, multi-generational, pasture-based, beyond organic, local-market farm and informational outreach in Virginia’s Shenandoah Valley.

The farm is driven using unconventional methods with the goal of "emotionally, economically and environmentally enhancing agriculture". At Polyface, you can find pastured-poultry, grass-fed beef and the rotation method which makes the farm more like an ecological system than a conventional farm. Polyface Farm operates a farm store on-site where consumers go to pick up their products. Or visit their website for MANY locations throughout Charlottesville and the Shenandoah Valley.

Tricia Foley says

USE LOCAL INGREDIENTS Tricia Foley is OurHealth Magazine’s resident nutritionist.

HealthyEats

12. Wash thoroughly and spread on a towel to dry.

13. Dice the figs and chop the almonds.

Directions for Dressing: 1. Whisk the juices together (you should have about 1/4 cup total of juice).

Kale & Quinoa Salad with Dates, Almonds & Citrus Dressing Makes 6 servings

Salad Ingredients: 1 tablespoon coconut oil 1 large white onion, diced

Salt to taste

1/2 cup white quinoa 1 small clove garlic, minced 1 bunch kale (3/4-1 pound, with stems) 1/2 cup dried fig, diced 1/2 cup roasted salted whole almonds

Dressing Ingredients: 1 Clementine, juiced 1/2 lime, juiced 2

teaspoons local honey

1/4 cup extra-virgin olive oil

3. Cook, stirring occasionally, for about 20 minutes; or until the onion has a toasty brown appearance and smells caramelized.

2. Whisk in the honey and olive oil. The dressing will be thin.

4. Remove from the heat and set aside.

3. Stir about 2 tablespoons of the dressing into the quinoa after it finishes cooking.

5. Rinse the quinoa in a fine mesh strainer.

Making the Salad:

6. In a pan, add garlic and quinoa and sauté over medium-high heat for about a minute.

7. Add 1 cup water and 1/2 teaspoon salt, and bring to a boil.

8. Cover and turn the heat to low; cook for 15 minutes.

9. Remove from heat, but leave the lid on for an additional five minutes.

1. Mix the kale with the quinoa and caramelized onions.

2. Toss with about half the dressing and taste.

3. If desired, add the remaining dressing, and then toss in the figs and almonds.

10. After five minutes, remove the lid and stir.

11. Meanwhile, slice off the bottoms of the kale stems, and slice the leaves into fine strips.

Salt and freshly ground black pepper

Directions: 1. Heat the coconut oil in a wide sauté pan over medium heat.

2. Add the onion and sprinkle lightly with salt.

Tricia Foley says

GREENS ARE POWERFUL Tricia Foley is OurHealth Magazine’s resident nutritionist.

HealthyEats

Spinach & Apple Smoothie

½ apple, chopped

Local Produce from:

Makes 1 serving

2-3 mint leaves

Charlottesville City Market | 100 Water Street Charlottesville | Open Saturday | 7 am–12 noon

Ingredients Step One:

Truvia to taste

2 cup organic spinach

Directions:

1/2 apple, chopped

For step one: mix spinach, milk, ice cubes, ½ apple and the lime juice together and blend. Pour in a glass and set aside.

Rinse blender and then combine all of the ingredients from step two and blend.

Add this to your glass and enjoy!

1/2 cup milk (or milk substitute:

almond, coconut, rice, etc) 4 ice cubes 1 lime, juice only

Ingredients Step Two: ¼ cup milk (or substitute)

Charlottesville City Market offers fresh produce, herbs, plants, grass fed meats, crafts, and baked goods from local vendors. The market features over 100 vendors every Saturday, April through December. SNAP customers can redeem their benefits at the market for fresh produce.

½ cup plain Greek yogurt

Tricia Foley says

DRINK YOUR SPINACH! Tricia Foley is OurHealth Magazine’s resident nutritionist.

words | SUZANNE RAMSEY

Take care of YOUR

HEALTH MAN!

In a filing cabinet at my house, there’s a 2-inch-thick manila folder labeled “Suzanne Medical” that contains documentation from a decade or so of medical appointments — mammograms, annual physicals, that time I thought I had a gallstone, you name it.

And my husband’s file? Yeah, right. What file?

It’s no secret. Men are known for not seeking medical help until a limb is dangling or they’re bleeding to death or both. But like women, they’re not immune to health problems. In fact, WebMD reports that “of the 15 leading causes of death, men lead women in all of them except Alzheimer’s disease, which many men don’t live long enough to develop.”

Why the aversion to the physician’s office? According to William Jones, III, MD, of Blue Ridge Urological, it’s pretty simple.

“Fear of the unknown,” he says.

So, for our male readers, OurHealth talked with area physicians about health conditions that commonly affect men and how to prevent them. Here’s what they had to say.

“Do not start to smoke. If you smoke, quit immediately.”

Lung Cancer The American Cancer Society says one in 13 men will be diagnosed with lung cancer during their lifetime. This includes smokers and nonsmokers, although a smoker’s risk is much higher than a nonsmoker’s. Asked about risk factors, Alex Schult, MD, pulmonary medicine specialist with Martha Jefferson Medical and Surgical Associates, says smoking is most often to blame.

“Additional risk factors include a family history of lung cancer and a personal history of chronic lung disease, such as chronic obstructive pulmonary disease, emphysema, chronic bronchitis or pulmonary fibrosis,” Dr. Schult says. Occupational exposure to substances like arsenic, asbestos, diesel fuel and other lung carcinogens and radon — at home or in mines, for example — also increases risk.

Alex Schult, MD is a pulmonary medicine specialist with Martha Jefferson Medical and Surgical Associates in Charlottesville and is certified by the American Board of Internal Medicine.

Symptoms of lung cancer include things one might expect, such as coughing up blood, as well as more subtle indications, like unexplained weight loss, chronic pneumonia, chest pain or a cough that won’t go away.

Or, “there may not be any warning signs whatsoever,” cautions Dr. Schult.

As for prevention, physicians say that not smoking is the best thing men can do.

“Do not start to smoke. If you smoke, quit immediately,” Dr. Schult says. Lung cancer risk decreases significantly after about 15 years of quitting. “Make a point to educate others about risk factors that cause lung cancer. Visit somebody who has had lung cancer to get a closer experience.”

Heart Disease and Stroke Heart disease is the leading cause of death for men in the United States. According to the Centers for Disease Control and Prevention, heart disease killed 307,225 men in 2009, which translates to one in four male deaths. The CDC reports that 70 to 80 percent of sudden cardiac events occur in men, and half of the men who die suddenly of coronary heart disease have demonstrated no previous symptoms.

“It is important to note that not all patients present the same, and any concerning symptoms should be evaluated,” says Jamie Bourque, MD, medical director of nuclear cardiology at the University of Virginia Heart and Vascular Center.

Jamie Bourque, MD is the medical director of nuclear cardiology at the University of Virginia Heart and Vascular Center and is certified by the American Board of Internal Medicine.

www.OurHealthCville.com

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“Be knowledgeable of your individual stroke “The classic warning signs and risk factors. Chronic symptoms for coronary artery cardiovascular diseases disease include substernal chest such as high blood discomfort that is dull or heavy, comes on with exertion or emotional pressure, cholesterol stress and is relieved by rest,” says and diabetes need Dr. Bourque, referring to pain below the sternum or breastbone. to be tightly controlled.”

“This pain can sometimes radiate down the arms or into the jaw,” Bourque continues. “Concerning symptoms that can also be present include trouble breathing, sweating and nausea. If symptoms such as these appear suddenly at rest and do not resolve, this could be a sign of an ongoing or impending heart attack.”

Dr. Bourque says the most common risk factors for heart disease include increasing age, male gender, sedentary lifestyle, overweight or obese status — especially excess belly fat, high cholesterol and high blood pressure, tobacco use in any amount, family history and diabetes.

As for ways to avoid heart disease, Dr. Bourque recommends regular exercise, monitoring blood pressure and cholesterol and eating a healthy diet.

Andrew Southerland, III, MD, is an assistant professor in the Division of Vascular Neurology, Departments of Neurology and Public Health Sciences in the University of Virginia Health System and is certified by the American Board of Psychiatry & Neurology.

“A Mediterranean-style diet has been shown to be the best,” he says, “with lots of fruits and vegetables, whole grains, olive and canola oil, lean meats and fish and lower amounts of everything else.”

Heart disease also puts men at risk for stroke.

“It’s an important risk factor for stroke, particularly coronary artery disease caused by the same atherosclerotic process that leads to narrowing and plaque buildup in the arteries supplying the brain,” says Andrew Southerland, MD, general neurologist with the University of Virginia Health System.

“One of the most important cardiac-related risk factors for stroke is the abnormal heart rhythm — atrial fibrillation — that can cause blood clots to travel up into the brain, blocking the normal flow of blood,” Dr. Southerland explains.

Among other stroke risk factors, Dr. Southerland lists family history, advanced age, genetic conditions, kidney disease and obstructive sleep apnea — a condition in which a person starts and stops breathing during sleep.

“The most important thing people can do to prevent stroke is to work with their primary care physician and be knowledgeable of their own individual stroke risk factors. Chronic cardiovascular diseases such as high blood pressure, cholesterol and diabetes need to be tightly controlled. Smoking is an absolute no-no. Adopting a healthy lifestyle that incorporates a

What are the signs of stroke?

• Sudden numbness or weakness of the face, arm or leg (especially on one side of the body).

• Sudden trouble walking, dizziness, loss of balance or coordination.

• Sudden confusion, trouble speaking or understanding speech.

• Sudden severe headache with no known cause.

• Sudden trouble seeing in one or both eyes.

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• Source: National Institute of Neurological Disorders and Stroke

nutritious and well-balanced diet with regular exercise is vital,” says Dr. Southerland.

Depression and Suicide While women are more likely to report a suicide attempt, men are more likely to succeed in killing themselves. This is according to the CDC, which reports that “men are about four times more likely than women to die from suicide.” Men represent more than 79 percent of all U.S. suicides.

“The experience of many adverse life events, such as divorce or the death of a loved one, are times when we are at increased risk for becoming depressed.”

As for why an estimated 40,000 people — about 31,600 of them men — kill themselves each year in the U.S., the online support group suicide.org reports that untreated depression is the number one cause of suicide. But why so many men?

“The question is a complex one,” says David Hamilton, MD, assistant professor in the Department of Psychiatry and Neurobehavioral Sciences at the University of Virginia Health System. “What I can say on the basis of my clinical experience is that men are socialized to equate their value with their strength: physical strength, financial strength and also emotional strength.

“In our culture, an emotionally strong man is Atlas, able to bear the weight of the world on his shoulders without complaint. The only emotion that is allowable is anger, another experience of strength and power. For men suffering with depression, this is a particularly toxic mix.

“Feeling powerless in the despair of their depression, men are more likely to complete suicide.

I think many of these men see suicide as the final expression of their strength, one last act in which they have the power to control the direction of their lives. I think that this narrowly circumscribed understanding of what are demonstrable, valid emotions for men is broadening, though slowly.”

Dr. Hamilton adds, “We all have the potential to become depressed, and recent studies indicate that 17 percent of us will meet the diagnostic criteria for major depressive disorder at some point in our lives.”

David Hamilton, MD, is the assistant professor in the Department of Psychiatry and Neurobehavioral Sciences at of the University of Virginia Health System, and is certified by the American Board of Psychiatry & Neurology.

There are many risk factors for depression, among them genetics, alcohol and drug use and life in general.

“The experience of many adverse life events, such as divorce or the death of a loved one, are times when we are at increased risk for becoming depressed,” Dr. Hamilton says. Major medical issues

Warning signs of depression • Feelings of sadness or irritability.

• Change in appetite, eating more or less.

• No longer taking pleasure in activities that used to bring joy.

• Physical pain or flu-like symptoms.

• Feeling hopeless or helpless about the future.

• Increased use of drugs or alcohol.

• Feeling guilty.

• Change in sleep habits.

• Lack of energy and concentration.

• Withdrawing from social life.

• Missing work.

• Psychotic symptoms (hearing or seeing things that aren’t there).

Source: David Hamilton, MD www.OurHealthCville.com

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Warning signs of diabetes

such as cancer, heart disease and diabetes increase the risk, and living with high degrees of unmanaged stress is another risk factor for depression.

• Increased thirst.

“People do not have to live their lives under the cloud of feeling depressed,” Dr. Hamilton says.

• Increased hunger (especially after eating).

Diabetes

• Dry mouth.

• Frequent urination or urinary tract infections.

• Unexplained weight loss (even though eating and feeling hungry).

• Fatigue (weak, tired feeling).

• Blurred vision.

• Headaches.

Fortunately, there are a variety of treatment options for depression, everything medication and psychotherapy to yoga, meditation and exercise.

According to the 2014 National Diabetes Statistics Report, more than 29 million people — more than 9 percent of U.S. adults — have diabetes, a disease caused by having too much glucose, or sugar, in the blood. Of these, 15.5 million, more than 53 percent, are men.

Of these cases, most are Type 2 diabetes — what used to be called adult-onset diabetes. Angela Sutton, MD, of Augusta Health Diabetes and Endocrinology Clinic in Fishersville, says.

“Uncontrolled diabetes can lead to multiple complications, including vascular disease and increased risk for heart attack, stroke, amputation, kidney disease, blindness and nervous system dysfunction.”

When asked about the primary causes, Dr. Sutton cites multiple factors that influence the development of diabetes, among them genetics, ethnicity, diet, exercise and body mass.

Source: WebMD

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

“There is definitely a genetic component, and there is a higher risk of diabetes in certain ethnic groups,” she says. “A healthy diet and regular exercise can help regulate blood glucose levels and decrease the risk of progression to diabetes in susceptible individuals.”

“Uncontrolled diabetes can lead to multiple complications, including vascular disease and increased risk for heart attack, stroke, amputation, kidney disease, blindness and nervous system dysfunction.”

As both a method of prevention and an initial treatment option, Dr. Sutton recommends that patients “eat a healthy balanced diet including fruits, vegetables and lean protein. Minimize fats, simple sugars and fried and processed foods.

And above all, don’t overeat. If your body cannot use it when you consume it, it will be processed, stored and converted to fat. This process leads to weight gain, increased insulin resistance and potential glucose dysregulation.”

Because obesity and body mass have been linked to Type 2 diabetes, physicians say losing weight can be helpful in preventing and managing the disease.

“Even a modest amount of weight loss, 5 to 10 pounds, can decrease insulin resistance and improve insulin sensitivity at the cellular level. In addition to promoting weight loss, regular exercise has a significant impact on glucose regulation,” says Dr. Sutton.

Angela Sutton, MD, of Augusta Health Diabetes and Endocrinology Clinic is certified by the American Board of Internal Medicine.

“Actually, exercise can decrease blood glucose levels and promote appropriate utilization of glucose, but consistent exercise has been linked to decreasing insulin resistance long-term and improving blood glucose levels.”

Skin Cancer Those youthful, shirtless summers can come back to haunt men in the form of melanoma — a deadly form of skin cancer that the Skin Cancer Foundation estimates will kill 6,640 men in 2015.

“There are two main contributing factors to skin cancer risk: sun damage and genetics,” says Deborah Elder, MD, a dermatologist with Charlottesville Dermatology. “Sun damage, particularly sunburns, increases the risk for melanoma skin cancer. Many men, as teens, get sunburns on their backs from going shirtless, either while working outdoors or on vacation. These sunburns, especially if they are blistering burns, increase the risk for melanoma skin cancer, which is one reason that melanomas are most likely to occur on the back in men.”

Because the back is a difficult spot for self-examination, she recommends men have regular dermatological visits.

“Since this is an area that is not visible, a suspicious lesion may not be detected by the patient,” she says. “That’s why skin exams are so important. Melanoma is the most aggressive and potentially fatal type of skin cancer, and melanomas on the back tend to be diagnosed late, so they can have a worse prognosis.”

Dr. Elder says those with red hair, a freckled complexion or more than 50 moles on their body are at higher risk for developing melanoma and should have annual skin exams to monitor for new or changing lesions. She also recommended using sunscreens and wearing protective clothing and hats.

Deborah Elder, MD, of Charlottesville Dermatology is certified by the American Board of Dermatology.

“There are two main contributing factors to skin cancer risk: sun damage and genetics. Sun damage, particularly sunburns, increases the risk for melanoma skin cancer. ” www.OurHealthCville.com

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William Jones, III, MD, of Blue Ridge Urology is certified by the American Board of Urology.

Urological Problems Turn on the television and you’re bound to see ads touting the latest treatments for erectile dysfunction, low testosterone and other men’s health issues. It appears, at least on TV, that men are all too happy to visit their urologist, at least when it comes to taking care of ... well, you know.

While sexual dysfunction and prostate cancer have received wide media exposure, there are other conditions that should prompt a visit to the urologist, among them what physicians call “voiding dysfunction,” which includes things like having trouble urinating and getting up repeatedly during the night to urinate.

“We can help with that,” says Dr. Jones of Blue Ridge Urological, who points out that there are medical, surgical and alternative treatments for the condition. “Most of the time, we can make things better. We can’t always make them perfect, but most of the time we can make them better.”

Ask Dr. Jones what brings most people to his office, however, and he’ll tell you: blood in the urine. It can be “a sign of absolutely nothing,” he says, or a sign of an infection, kidney stones or serious things like kidney or bladder cancer.

The important thing is to get patients in the office to sort out what is and isn’t a problem, which takes us back to men and their “love” for physicians.

“If they don’t come in for awhile, it’s fear of the unknown,” Dr. Jones says.

“That’s a majority of what we do is relieve some of those fears and answer questions that may not be answerable without some investigation. That’s a big part of my job, taking things that may be a problem and making sure they’re not, or finding out there’s a problem and taking care of it.”

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UVA

HEALTH AND WELLNESS Active Members of the University Community Play on Grounds!

For University of Virginia students, current and retired employees, alumni and their families who want to maintain a healthy, active lifestyle, UVA Intramural-Recreational Sports offers state-of-the-art recreation facilities and programming, sports teams, exercise instruction, equipment and wellness services.

Facilities include the Aquatic & Fitness Center, North Grounds Recreation Center, Memorial Gymnasium, Slaughter Recreation Center, Snyder Tennis Center, Outdoor Recreation Center, The Park and the University of Virginia McArthur Squash Center located at the Boar’s Head Sports Club.

These facilities offer a variety of cardiovascular and strength training equipment, basketball, volleyball, squash, racquetball, handball and wallyball courts; as well as indoor running tracks, swimming pools and an outdoor equipment rental center.

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photos courtesy of UVA Intramural-Recreational Sports

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Breaking the Silence Bipolar Disorder words | SUSAN DUBUQUE

This series explores diseases that can be devastating to the individuals and families they affect—yet no one is talking about them. That is, until now. In each edition of OurHealth, we bring these medical issues into the light—and dedicate these stories to the courageous patients and families living with them and the providers and researchers who commit their lives to treating and seeking cures for these silent killers.

Jeffrey’s Story For most 24-year-olds, life is on the brink of exciting change and discovery—moving from a state of youthful dependency into young adulthood. But for Jeffrey Allen Bogard, this was a period of emotional pain.

And, ultimately the misery became so intense that death seemed to offer the only hope of relief. After ingesting 30 pain pills, Jeffrey was admitted to a local hospital and then transferred to Western State, where he received psychiatric treatment for six months. It was during this inpatient stay that a diagnosis was made—Jeffrey suffers from bipolar disorder, compounded by anxiety and alcohol abuse.

“Hopeless,” says Jeffrey, “that’s how I was feeling most of the time. My moods would swing dramatically from feeling really good to being mad and angry. And the most frustrating part was that people didn’t understand what I was going through. They thought I was faking it. They didn’t know I was really sick.”

“I was married for two years, from 1992 to 1994, and I have a 22-year-old daughter,” shares Jeffrey. “But my wife had mental health problems too, and we were in no condition to care for each other or for a child.” Jeffrey’s daughter was raised by her grandparents, but Jeffrey maintains close contact with her, talking by phone several times a week.

Bipolar disorder has been a lifelong struggle for Jeffrey. From 1991 to the present, he has been admitted to the hospital more than 150 times. The longest period without inpatient care was one year and he is six months out from his last admission. Jeffrey comes by his disorder honestly. His grandfather and father both had severe mental health problems.

“With bipolar disorder, staying on my medication has been the toughest part,” explains Jeffrey. “When I would feel better, I would go off my meds and then I would crash and get in trouble again. And for a lot of people, the side effects make it really hard to stick with your medication.”

Today, Jeffrey works hard to simply maintain balance. He credits his ability to do so on the incredible level of support he receives from the Region 10 Community Services Board. Region 10 is part of a statewide network of 40 community services boards that provide mental health, intellectual disability and substance abuse services to the residents of Charlottesville and Albemarle, Fluvanna, Greene, Louisa and Nelson counties.

He participates in a Dual Recovery Program designed for individuals with both mental health and substance abuse diagnoses. “I spend every weekday morning at the Blue Ridge Club House doing activities and therapy. Then in the afternoons, the Region 10 staff helps me with daily activities like going to the doctor, food shopping or cleaning my apartment.” Jeffrey used to work, but since becoming ill, he has been unable to hold down a job and receives housing support and disability payments.

“The weekends are hard for me,” says Jeffrey. “Without having a program to attend, I just stay in my apartment and watch TV.” But he is making a concerted effort to change that. “I’ve started going to the gym and working out on the treadmill, and attending church and AA meetings on weekends.” It’s all part of his desire to reclaim a more normal life. Jeffery dreams of someday even having a family. “But first, I know I need to work on myself—getting in better shape physically and mentally.”

“I know what my problems are and how important taking medication is for me to stay straight,” notes Jeffrey. In addition to being self-aware, Jeffrey is willing to share his story so other people can benefit. His advice to others with bipolar disorder is simple: “When you are stable and symptom free, that’s the time to explain to the people in your life what’s going on. It’s a hard disease to understand.

But maybe if we bring it out of the closet, more people would be willing to get help and to stick with treatment.”

With that very goal in mind—bringing bipolar disorder out into the light—let’s learn what this disorder is, the signs and symptoms, how it is diagnosed and treated and what the future holds.

David Hamilton, MD, is the assistant professor in the Department of Psychiatry and Neurobehavioral Sciences at of the University of Virginia Health System, and is certified by the American Board of Psychiatry & Neurology.

What is bipolar disorder?

Bipolar disorder—also known as manic-depressive illness—is a brain disorder that causes unusual shifts in mood, energy and activity levels that occur in distinct periods called “mood episodes.” An individual may go from an overly joyful or excited state called a manic episode, to an extremely sad or hopeless state called a depressive episode. Sometimes symptoms of both mania and depression occur during the same episode, which is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.

Bipolar is an equal opportunity illness—roughly the same number of men and women develop the disorder and it occurs in all ages, races, ethnic groups and social classes.

“Everyone experiences highs and lows,” says David Hamilton, MD, MA, department of psychiatry and neurobehavioral sciences at UVA Health System. “But we’re talking about symptoms that impair one’s ability to function. If left untreated, bipolar disorder can result in damaged relationships, poor job or school performance and even suicide.”

Bipolar is not only a serious medical condition, but it is one that affects many people.

According to the World Health Organization, bipolar disorder is the sixth leading cause of disability in the world, affecting approximately 5.7 million adult Americans.

To put that in perspective, more people lose productive time due to bipolar disorder than all forms of cancer combined.

Bipolar is an equal opportunity illness—roughly the same number of men and women develop the disorder and it occurs in all ages, races, ethnic groups and social classes.

According to Dr. Hamilton, “The disorder typically emerges in young adulthood. We tend to see it appear in men a little earlier—age 18 to 24—and women a few years later, as estrogen appears to offer women a little protection.”

While there is no single gene identified with bipolar disorder, the family ties are definitely apparent. More than two-thirds of people with bipolar disorder have at least one close relative with the illness or with major depression. “And, if one identical twin has the illness, there is a 40 percent chance that the other twin will too,” observes Jorge Castro-Alvear, MD, department of psychiatry and neurobehavioral sciences at UVA Health System.

Signs and Symptoms So what does bipolar disorder look like? Well, it all depends. The signs and symptoms will vary depending upon the type of episode an individual is experiencing at that time.

Symptoms of mania or manic episodes include: • A long period of feeling “high,” or an overly happy or outgoing mood • Extreme irritability • Talking very fast, jumping from one idea to another, having racing thoughts • Being easily distracted • Increasing activities, such as taking on new projects • Being restless • Sleeping little or not feeling tired • Having an unrealistic belief in one’s abilities • Behaving impulsively and engaging in pleasurable, high-risk behaviors • Signs of hypomania—or a less severe form of mania—include: • Feeling euphoric, energetic and productive. (To others this may simply looks like the individual is unusually happy.)

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• Able to carry out day-to-day activities and never lose touch with reality • May lead to bad decisions that harm relationships, careers and reputations • Often escalates to full-blown mania or is followed by a major depressive episode • Depression or depressive episode symptoms include: • A long period of feeling worried or empty • Loss of interest in activities once enjoyed, including sex • Feeling tired or “slowed down” • Having problems concentrating, remembering and making decisions • Being restless or irritable • Changing eating, sleeping or other habits • Thinking of death or suicide, or attempting suicide

Diagnosing Bipolar Disorder Bipolar disorder may not be recognized as an illness, and people may suffer for years before it is diagnosed and treated. Perhaps the most important diagnostic tool is talking openly with a healthcare provider about mood swings and changes in behavior and lifestyle habits such as in diet, sleep and use of drugs and alcohol.

Jorge Castro-Alvear, MD is a psychiatrist in the department of psychiatry and neurobehavioral sciences at UVA Health System.

People with bipolar disorder are more likely to seek help when they are depressed than when experiencing mania or hypomania. Therefore, a careful medical history is needed to assure that bipolar disorder is not mistakenly diagnosed as major depression. Unlike people with bipolar disorder, people who have depression only (also called unipolar depression) do not experience mania.

The healthcare provider will also conduct a physical exam and take a complete family history. While bipolar disorder cannot be identified through a blood test or a brain scan, these tests may help rule out other medical issues that may contribute to mood problems, like a stroke, brain tumor or thyroid condition.

There are challenges to diagnosing bipolar disorder. “We’re not dealing with a single disease,” adds Dr. Hamilton. “Bipolar syndrome occurs across a spectrum.” Three forms of the disorder along this continuum are:

Bipolar I Disorder is a severe form of the illness and is

characterized by episodes of both mania and depression. During the manic phase a patient may become psychotic—that is, have a break with reality. This may involve delusions—false beliefs— and hallucinations—seeing or hearing things that aren’t there.

Fortunately, Bipolar I Disorder is rare, says Dr. Castro-Alvear.

In Bipolar II Disorder the individual experiences hypomania—milder than full-blown mania—and episodes of severe depression. This form of the illness is more common than Bipolar I Disorder, but may be misdiagnosed as major depression.

Cyclothymia is characterized by mood swings that cycle

between hypomania and mild depression. You might think of cyclothymia as “low grade” bipolar disorder. The cycles between www.OurHealthCville.com

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moods tend to happen more quickly and be of shorter duration, and overall this form of the illness is less disabling.

“When we look to the future, there are two areas of exciting development in our effort to conquer bipolar disorder,” predicts Dr. Hamilton.

“New neuroimaging techniques mean we will eventually be able to see what is happening in the brain.” This may be particularly beneficial in distinguishing bipolar disorder from major depression.

Bipolar disorder can co-occur with other medical and mental health conditions.

Substance abuse is common among people with bipolar disorder, but the reasons for this link are unclear. Some individuals may try to treat their symptoms with alcohol or drugs. But, substance abuse may trigger or prolong bipolar symptoms, and the behavioral control problems associated with mania can result in a person who drinks too much.

Anxiety disorders—like post-traumatic stress disorder (PTSD) and social phobia— often appear with bipolar disorder. And attention deficit hyperactivity disorder (ADHD) has some symptoms that overlap with bipolar disorder, such as restlessness and being easily distracted.

People with bipolar disorder are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity and other physical illnesses. These illnesses may cause symptoms of mania or depression and they may also result from treatment for bipolar disorder.

Treatment Options There is no cure for bipolar disorder, however there are a number of treatments available to help people gain better control of their mood swings and manage their symptoms.

“Three general types of medication used to treat bipolar disorder are mood stabilizers, atypical antipsychotics and antidepressants,” says Dr. Hamilton. “Not everyone responds to medication the same way. So patients may have to try several different drugs or combinations of drugs before finding what works the best.”

The initial choice for medication is usually a mood stabilizer. Lithium was the first mood stabilizer approved by the FDA in the 1970s for treating both manic and depressive episodes. Individuals who take lithium must have regular blood tests to monitor thyroid and kidney function. Anticonvulsant medications, originally developed to treat seizures, are also beneficial in controlling moods.

Antipsychotic medications, often taken in combination with an antidepressant, can treat manic or mixed episodes or psychosis. These medications can cause major weight gain and changes in metabolism, which may increase the risk of getting diabetes and high cholesterol. Patients taking this type of medication must have their weight, glucose levels and lipid levels monitored regularly.

Antidepressants are sometimes prescribed to treat symptoms of depression in bipolar disorder. However, taking an antidepressant alone can increase the risk of switching into mania or hypomania. To prevent this mood swing, doctors may also prescribe a mood stabilizer.

“Treating bipolar disorder requires patience and tenacity,” advises Dr. Castro-Alvear.

“Medications take time to produce results. And once a patient is feeling better, there is a tendency to think that treatment is no longer needed. Different medications used to treat bipolar disorder may have a variety of side effects—ranging from dry mouth, dizziness and drowsiness to blurred vision and rapid heartbeat. It is important that patients talk with their physicians if they are experiencing any annoying or worrisome side effects—and not just stop taking their medications.”

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Talk therapy, when used in combination with medication, can provide education and support to people with bipolar disorder and their families. “Cognitive behavioral therapy helps patients explore their thoughts and perceptions of their illnesses,” comments Dr. Castro-Alvear, “and change negative thought patterns and behaviors.”

“I think of treating bipolar disorder as a three-legged stool,” says Dr. Castro-Alvear, “and the third leg is basic habits and lifestyle changes like good nutrition, exercise, rest and avoiding drugs and alcohol.”

When medication and therapy are not sufficient in managing the symptoms of bipolar disorder, electroconvulsive therapy (ECT) may be tried. Formerly known as “shock therapy,” ECT had a negative, frightening reputation in the past. But the treatment has improved dramatically in recent years and may provide relief for patients suffering from severe depressive, manic or mixed episodes.

“Determining the best course of treatment for a bipolar patient is a little like threading a needle,” says Dr. Hamilton. “It is important to understand each individual’s goals and how they want to function in the different domains of life. Then we can work together to hit the right level of balance of symptom control without making the patient feel emotionally numb.”

What does the future hold?

“When we look to the future, there are two areas of exciting development in our effort to conquer bipolar disorder,” predicts Dr. Hamilton. “New neuroimaging techniques mean we will eventually be able to see what is happening in the brain.” This may be particularly beneficial in distinguishing bipolar disorder from major depression.

Genetic testing offers the promise of earlier identification for individuals at risk for bipolar illness. And starting treatment earlier means a better chance for a better outcome. “Bipolar is a ‘neurodegenerative’ disease,” explains Dr. Castro-Alvear.

“Without proper treatment, a patient’s episodes may become more frequent or more severe over time. That means it is important to get a patient into treatment early and maintain symptom control. But bipolar is a chronic condition just like diabetes—and treatment is a life-long journey.”

Resources • National Institute of Mental Health - nimh.nih.gov • Mental Health America - nmha.org

Medical Experts • Jorge Castro-Alvear, MD, assistant professor, Department of Psychiatry and Neurobehavioral Sciences, UVA Health System • David V. Hamilton, MD, MA, assistant professor, Department of Psychiatry and Neurobehavioral Sciences, UVA Health System

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“I think of treating bipolar disorder as a three-legged stool,” says Dr. CastroAlvear, “and the third leg is basic habits and lifestyle changes like good nutrition, exercise, rest and avoiding drugs and alcohol.”

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