OurHealth Charlottesville & Shenandoah Valley Sep/Oct 2016 Edition by OurHealth Media LLC

PROSTATE’S BIG SEVEN

TASTY TAILGATING RECIPES

WHAT’S THE HYPE WITH HIIT?

table of contents | september • october 2016

To help observe September as Prostate Cancer Awareness Month, we talked with some local experts about prostate cancer, how it's detected, and treatment options.

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 STAGES OF PROSTATE CANCER.

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

When breast cancer backed these four women into a corner, they found the drive to move forward with courage, determination and the power of positive thinking.

IV RT PA

38 The final in our series, part IV of OurHealthâ&#x20AC;&#x2122;s four-part series explores how to obtain a job in healthcare by creating an appealing, hire-worthy portfolio.

hello, HEALTH!.............................. 24 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos.

FIT BITS!........................................ 37 What's the Hype with HIIT? This article, the fifth in a yearlong OurHealth series about primary care, focuses on how you can Measure Your Care. Weâ&#x20AC;&#x2122;ll delve into your part of the patient-physician partnership.

Deidre Wilkes, OurHealth's resident fitness specialist, shares the many training benefits of high intensity workouts.

CLOSER LOOK.............................. 58 Images reflecting the landscape of healthcare in Shenandoah Valley and Charlottesville * PLUS * a chance to win prizes!

HealthyEats OurHealth presents recipes perfect for tailgating such as parmesan and garlic chicken wings, prosciutto potato salad and ramen coleslaw salad.

www.OurHealthCville.com

MORE THAN A MAGAZINE PRINT

september • october 2016 PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT CHIEF DESIGNER GRAPHIC DESIGNER DIGITAL CONTENT MANAGER | EVENT SPECIALIST COPY EDITOR DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY ACCOUNTING MANAGER

ONLINE

CONTRIBUTING MEDICAL EXPERTS Robert Childers, MD Meg Crook, MD Robert Dreicer, MD, MS, FACP, FASCO Deborah Elder, MD Ami Keatts, MD

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 / www.sdsimages.com Laura Bower

Kristin Koch, AuD, F-AAA Michael Potter, MD Brian Stisser, MD Andrea Tribastone, MD Claiborne Whitworth, IV, MD

CONTRIBUTING PROFESSIONAL Geri Aston EXPERTS & WRITERS Susan Dubuque Tina Joyce Rick Piester 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

SOCIAL MEDIA

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E-NEWSLETTER 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 Charlottesville/Shenandoah Valley is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.

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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

Ganglion cysts are the most common type of mass seen in the upper extremity. Typically, they appear as a lump or swelling in the wrist or fingers. They are often painless and may change in size and appear or disappear spontaneously.

“

Zika, first identified in Uganda in 1947, is a virus transmitted primarily through the bite of an infected Aedes mosquito. The virus can be spread to others through mosquito bites, sexual intercourse and from a mother to her fetus.

”

– Robert Childers, MD

What are Ganglion Cysts, and how can they be treated?

The cyst arises from a joint or a tendon like a balloon on a stalk. It is filled with a thick fluid similar to the normal lubricating fluid of the joint. Ganglion cysts are not dangerous, and in many cases, no treatment is required. If the mass is painful or interferes with activity, the most common treatments are aspiration (withdrawing fluid from the cyst with a needle) or surgical removal under local anesthetic. Aspiration has a high rate of cyst recurrence because it does not address the “root” or “stalk” of the cyst. Recurrence after surgery is less frequent but can still occur.

Michael Potter, MD

Sentara Martha Jefferson Orthopedic Services Charlottesville | 434.654.5574 www.sentara.com

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

What is the Zika virus? Zika, first identified in Uganda in 1947, is a virus transmitted primarily through the bite of an infected Aedes mosquito. The virus can be spread to others through mosquito bites, sexual intercourse and from a mother to her fetus. Common symptoms include fever, joint and muscle pain, headache, conjunctivitis and rash. These symptoms are usually mild and persist for about one week, requiring no specific treatment. People who have contracted the virus are advised to drink fluids, rest and seek medical care if symptoms worsen. Laboratory tests can confirm Zika infection. So far, there is no vaccine available. Protection against mosquito bites is a critical step in Zika disease prevention as are active steps to prevent or limit their preferred breeding areas. The Aedes mosquito prefers to breed in small containers of standing water and typically bites in daytime. Therefore it is important to apply insect repellents containing DEET, or IR3535, wear clothing that covers arms and legs and use screens on doors and windows when they are open.

Robert Childers, MD

Carilion Clinic VelocityCare Lexington | 540.462.3950 www.carilionclinic.org

What are Actinic Keratoses? Actinic Keratoses (AKs) are dry, scaly patches of skin that normally appear on sun-exposed areas, most commonly on the face. AKs are usually scaly, feel like sandpaper to the touch, range from pink to brown and can be flat or raised. Occasionally they are sensitive to touch or sting. Some AKs are as small as a pinhead, others as large as a quarter. AKs are most commonly found in men and women over 40, people with light skin and hair or freckles, and patients who have weakened immune systems. AKs are precancerous skin lesions, and left untreated may develop into squamous cell carcinoma. Patients with AKs are more at risk for developing other types of skin cancer such as basal cell carcinoma or melanoma. Diagnosed early, AKs are treatable. You can help to prevent AKs by performing skin self-exams, protecting your skin with sunscreen, clothing and hats and avoiding tanning beds. A full skin exam is the best way to diagnose AKs, and often they can be treated during the same office visit.

Deborah Elder, MD

Charlottesville Dermatology Charlottesville | 434.984.2400 www.cvillederm.com

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

“

Obesity is rarely the result of a hormonal imbalance. Obesity rates are increasing due to increased consumption of refined sugars and fat. In addition, people have a more sedentary lifestyle compared to 20 years ago.

”

– Meg Crook, MD

Are there any accessories or attachments that make cell phone connections better for people with hearing aids? The technology inside hearing devices has improved dramatically over the past several years. Along with advancements that have enhanced the sound quality and look of hearing aids, other features typically found in cell phones and computers are becoming standard in hearing devices. One of those features is Bluetooth or “streaming” capabilities. Several major hearing aid manufacturers are now offering hearing aids that connect directly to popular cell phones, allowing phone calls, music, videos and podcasts to be heard in both hearing aids without earbuds or cords. Other options include pairing a set of hearing aids to a Bluetooth streamer or a different type of accessory. These abilities allow for effortless understanding of speech, especially in more challenging situations. The world of hearing aids is often an overwhelming one. Finding a good audiologist to navigate through the options and recommend the ideal type of hearing aid for your needs and budget is the best way to get started.

Kristin Koch, AuD, F-AAA Audiologist/Owner Evolution Hearing Charlottesville | 434.227.4100 www.evolutionhearing.com

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

What health risks are related to premature menopause in women younger than age 40? When ovarian function ceases, a woman is considered to be in menopause. Menopause is defined as no menstrual bleeding for 12 months. The average age of women at the time of menopause is 51. Some women will experience menopause at an earlier age. Causes of early menopause include chemotherapy, certain medications, autoimmune diseases, viral infections or surgeries that interrupt blood flow to the ovaries. Women who smoke cigarettes tend to go through menopause earlier than non-smokers. Health conditions for women who have gone through early menopause include bone density loss, hot flashes, mood changes, vaginal dryness and/or an increased risk of heart disease. When a woman experiences menopause, hormone replacement can help decrease hot flashes and estrogen can decreases bone loss. Non-hormonal options can also help alleviate symptoms. There are risks associated with all types of treatments that should be discussed with your healthcare provider.

Ami Keatts, MD

Augusta Health Care for Women Fishersville | 540.213.7750 www.ahcfw.com

Can hormonal imbalances contribute to obesity? Obesity is rarely the result of a hormonal imbalance. Obesity rates are increasing due to increased consumption of refined sugars and fat. In addition, people have a more sedentary lifestyle compared to 20 years ago. But even when calorie intake and energy expenditure are held steady, the average body mass index has increased two points over the last 20 years. Other factors that may contribute to this pattern include epigenetics and changes to gut bacteria. Epigenetic changes – which affect how genes are expressed and can affect metabolism – can occur while babies are in the womb. Pregnant mothers with excess weight appear to increase the risk of excess weight in their children, which helps explain why each generation is having more difficulty with obesity. Some studies and anecdotal evidence also suggest that altered gut bacteria affect metabolism. Some gut bacteria help us gain more calories from our food and increase our risk for obesity. We do not know how to alter gut bacteria or epigenetic changes at this time.

Meg Crook, MD

UVA Blue Ridge Endocrinology Charlottesville |434.293.7811 www.uvahealth.com

www.OurHealthCville.com

NEW

NEW PHYSICIANS,

NOTEWORTHY

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

UVA Receives Honors

Sentara Martha Jefferson Hospital Announces Opening of New Helipad This medevac service allows faster transport to Sentara Martha Jefferson Hospital for critically ill patients, including patients experiencing a stroke or heart attack. Highly-trained personnel using advanced medical equipment are now available to bring patients via helicopter directly to the emergency department from outlying counties for services not available in those areas. Sentara Martha Jefferson Hospital will accept patients from AirCare5, as well as from Pegasus. “One of our goals is to provide easy access to the care that our community needs, especially in areas of the Blue Ridge region that need access to emergency care,” notes Jonathan Davis, president of Sentara Martha Jefferson Hospital. “When a patient lives in a distant community and is experiencing an emergency, air transport service is the best way to get that patient to the hospital quickly. We are pleased to now be able to support air ambulance services offering that fast transport to our more rural patients.” Once they arrive at the hospital, the helicopters will land outside of the emergency department. This location represents the quickest access point to emergency services as well as to an alternate entry to the main hospital, bypassing the emergency room to send the patients straight to heart and stroke procedural areas. “As a not-for-profit hospital, our mission is to improve the health of our community members every day; and by opening this helipad we are doing just that,” adds Davis. “We are offering more timely access to the advanced care patients need, in the community hospital setting they want.” For more information on Sentara Martha Jefferson Hospital, visit www.sentara.com.

UVA Rated in Top 1 Percent Nationally for Maternity Care University of Virginia Women’s Services and UVA Children’s Hospital are among just 1 percent of reporting U.S. hospitals to meet all four maternity care standards from the Leapfrog Group, a national patient safety organization. “This is the second honor UVA has earned recently for its maternity care”, says Christian Chisholm, MD, UVA’s medical director of Labor and Delivery. UVA has also received a five-star designation from the Virginia Maternity Center BreastfeedingFriendly Designation Program for its efforts to support breastfeeding.

UVA Stroke Program Honored with Two National Quality Awards For meeting national guidelines to provide fast, high-quality stroke care, the University of Virginia Health System’s stroke program received two national awards from the American Heart Association and American Stroke Association. UVA earned the 2016 Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award and was also named to the Target: Stroke Honor Roll Elite. According to the American Heart Association, the awards recognize UVA’s commitment to providing stroke care using nationally recognized guidelines based on the most recent research.

UVA Transitional Care Hospital Earns National Certification for Wound Care The University of Virginia Transitional Care Hospital is the first hospital in Virginia to receive The Joint Commission’s Gold Seal of Approval® for Wound Care certification. According to The Joint Commission, hospitals earning a disease-specific certification must demonstrate compliance with consensus-based national standards, effective use of evidence-based clinical practice guidelines, and an organized approach to performance measurement and improvement For more information, visit www.uvahealth.com.

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

Carilion Clinic Offers Expanded Specialty Services in Lexington Carilion Clinic is pleased to offer expanded specialty services in the Lexington area, while continuing the highest quality of care. Expanded services include cardiology, general surgery and wound care, home health, imaging, oncology (provided by Blue Ridge Cancer Care), orthopaedics including sports medicine, spine, foot and ankle, and hand surgery, outpatient therapy, digital mammography, allergy and immunology, pediatric cardiology, pediatric gastroenterology and urgent care. For more information on any of these services, or to learn more about Carilion Clinic, call 800.422.8482 or visit www.carilionclinic.org.

Welcome

Emily Christman, MD GASTROENTEROLOGY

Staunton Medical Associates Joins Augusta Medical Group Staunton Medical Associates, the primary care practice of Kerry Alexander, MD, Stephanie Pitsilos, MD and Susan Becker, FNP-C joins Augusta Medical Group, as of October 1. “Dr. Alexander, Dr. Pitsilos and Ms. Becker are excellent providers and well respected by both patients and healthcare providers in the area,” says Scott Just, MD, Vice president and chief medical officer of Augusta Medical Group. “This new relationship will allow us to work even more closely with them to bring high quality medical care to the community.” “This exciting new endeavor—joining Augusta Medical Group—will better equip us to care for our patients in the future and work together to improve their health and the health of our community as a whole. We realize that any change, even a positive one, can lead to questions and concerns. Our patients at Staunton Medical Associates can rest assured that we will be sending them a detailed, formal letter as we get closer to October,” adds Dr. Pitsilos. The group continues to practice at the same location—42 Lambert Street, Suite 511 in Staunton—with the same phone number and staff. Current patients do not have to take any action to continue to be seen. All records and appointments will remain in place. For more information about Augusta Health, its programs or services, visit www.augustahealth.com.

Carilion Clinic VelocityCare Offers Flu Shots The flu vaccine is the best protection against the flu! It’s important to get a flu shot early in the fall before flu season gets fully underway, as it takes two weeks to build up antibodies in the body to provide protection against the flu. Based on findings from the Centers of Disease Control and Prevention (CDC), the nasal spray flu vaccine will not be offered this year. This decision is based on data from the previous three flu seasons that concluded the nasal spray was not nearly as effective as the flu shot. For more information or to make an appointment, call your primary care office, or walk-in to any VelocityCare beginning October 1. For locations and flu facts, visit www.CarilionClinic.org/flu.

Services Provided: • Upper Endoscopy • Colonoscopy • Capsule Endoscopy • Esophageal Motility/pH Testing • Colon Cancer Screening • Obesity/Nutrition Management

“I grew up in Charlottesville, received my medical training in Washington, DC, Florida and Oklahoma, and I am excited to return to Charlottesville and have the opportunity to provide specialized GI care to our community.” Charlottesville Gastroenterology Associates 1139 E. High Street | Suite 203 Charlottesville, VA 434.817.8484

www.cvillegi.com Dr. Christman is currently accepting new patients. Charlottesville Gastroenterology Associates accepts most insurance plans.

Scan here for more information about our services and providers. www.OurHealthCville.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

U.S. News Ranks UVA No. 1 Hospital in Virginia and Honors Eight Specialties “We are pleased to see these ratings highlight the dedication of all of our team members to enhance the quality of care we provide our patients,” says Richard P. Shannon, MD, executive vice president for health affairs at UVA.

U.S. News and World Report’s 2016-2017 Best Hospitals guide recognizes eight University of Virginia Health System specialties and ranks UVA as the No. 1 hospital in Virginia. Three UVA specialties rank among the top 50 in the U.S.: • Cancer – 31st

• Urology – tied for 43rd

• Nephrology – tied for 46th

Only approximately three percent of U.S. hospitals have a ranked specialty. Five additional specialties – cardiology and heart surgery, diabetes and endocrinology, neurology and neurosurgery, orthopedics, and pulmonology - were honored as “high performing,” placing them among the top 10 percent of their respective specialties. This year’s guide also includes hospital ratings for nine common conditions or procedures based on care received by patients ages 65 or older. UVA is rated as “high performing” – the best possible rating – for all nine: abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery, heart failure, colon cancer surgery, chronic obstructive pulmonary disease, hip replacement, knee replacement and lung cancer surgery. “We are pleased to see these ratings highlight the dedication of all of our team members to enhance the quality of care we provide our patients,” says Richard P. Shannon, MD, executive vice president for health affairs at UVA. The ratings and rankings compiled by U.S. News take several factors into account, including patient safety, patient outcomes, the availability of advanced technologies and programs, a survey of physician specialists, how many patients receive care and accreditations from certain third-party organizations such as the National Cancer Institute (NCI) and Magnet recognition for nursing care from the American Nurses Credentialing Center. UVA is an NCI-designated cancer center and earned Magnet recognition in 2015. These honors for UVA follow recognition from U.S. News for UVA Children’s Hospital, which has four specialties – urology, cardiology/heart surgery, neonatology and nephrology – recognized in the 20162017 Best Children’s Hospital guide. For more information about University of Virginia Health System, visit www.uvahealth.com.

Julius Aitsebaomo, MD

Augusta Health Cardiology Staunton | 540.332.4278 Waynesboro | 540.932.4278 www.augustahealth.com

Salman Allana, MD Harrisonburg Medical Associates Harrisonburg 540.434.0559 www.sentara.com

James Allison, MD

Blue Ridge Radiologists Fishersville | 540.886.0988 www.augustahealth.com

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

Cristina Armengol, MD Alan Brijbassie, MD Augusta Emergency Physicians Fishersville | 540.932.4444 www.augustahealth.com

Sentara Martha Jefferson Medical & Surgical Associates Charlottesville 434.654.5260 www.sentara.com

Katelyn Blondino, MS Sentara Martha Jefferson Hospital Charlottesville 434.654.8390 www.sentara.com

William Brooks, MD

Yulin Chen, PA

Anthony Crimaldi, MD Central Virginia Radiation Oncologists Charlottesville 434.654.8125 www.sentara.com

William Goodwin II, DDS Goodwin Oral & Facial Surgery Harrisonburg 540.705.0195 goodwinofs.com

Tyler Green, MD

Eleanor Hutchens, MD

Virginia Kockler, MD

William Leighton, DO

Maryam Mahmoodian, MD Family Practice of Maryam Mahmoodian, MD Harrisonburg 540.209.0287

Linda Martin, MD, MPH UVA Cancer Center Charlottesville 434.243.6443 cancer.uvahealth.com

Lukasz Myc, MD

Aaron Quitmeyer, DDS

Robert Taylor, MD

Augusta Emergency Physicians Fishersville | 540.932.4444 www.augustahealth.com

Augusta Pediatrics Fishersville | 540.932.0980 www.augustapediatrics.com

Hedy Reese, FNP

Augusta Pediatrics Fishersville | 540.932.0980 www.augustapediatrics.com

Augusta Health Cardiology Staunton | 540.332.4278 Waynesboro | 540.932.4278 www.augustahealth.com

Harrisonburg Physicians for Anesthesiology Harrisonburg 540.897.2583 www.sentara.com

Charlottesville Pathology Charlottesville 434.654.7188 www.cvillepathology.net

Augusta Health Hospitalists Fishersville | 540.932.4075 www.augustahealth.com

maryammahmoodianmd.com

Lewis Siegel, MD

Jennifer Silber, MD

Augusta Emergency Physicians Fishersville | 540.932.4444 www.augustahealth.com

Christopher Simpson, MD Harrisonburg Physicians for Anesthesiology Harrisonburg 540.897.2583 www.sentara.com

Jessica Srstka, MD

Shalendra Varma, MD

Dustin Walters, MD

William Weaver, MD

Chun-Po Yen, MD

Augusta Health Cardiology Staunton | 540.332.4278 Waynesboro | 540.932.4278 www.augustahealth.com

Augusta Health Diabetes and Endocrinology Clinic Staunton | 540.245.7180 Waynesboro | 540.221.7180 www.augustahealth.com

UVA Cancer Center Charlottesville 434.243.6443 cancer.uvahealth.com

Harrisonburg Physicians for Anesthesiology Harrisonburg 540.897.2583 www.sentara.com

Augusta Health Hospitalists Fishersville | 540.932.4075 www.augustahealth.com

Shenandoah Oral and Facial Surgery, PLC Harrisonburg 540.433.1751 www.pandolfidmd.com

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

UVA Neurosurgery Charlottesville 434.924.5508 www.uvahealth.com

www.OurHealthCville.com

T I 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

FASCINATING FACT

September is National Childhood Obesity Month Not only is September back-to-school time, it is also NATIONAL

CHILDHOOD OBESITY MONTH.

1 IN 3 CHILDREN IS

obese or overweight

Your eyeballs stay the same size your whole life, but your nose and ears

NEVER

STOP GROWING!

Obese children are 80 PERCENT MORE LIKELY to become obese adults, which puts them at risk for associated adult health problems such as heart disease, type 2 diabetes, sleep apnea, stroke, several types of cancer and osteoarthritis. Source: American College of Sports Medicine

SIMPLE LUNCHBOX MEALS THAT WILL BE FUN TO EAT, AND HEALTHY TOO!

BRUNCHBOX – pancakes, strawberries, vanilla yogurt tube and hard-boiled egg ABCD LUNCHBOX – Applesauce, Berries and Chicken strips with Dipping sauce ORANGE CRUSH LUNCHBOX – macaroni and cheese, roasted sweet potatoes, clementine orange and cheddar bunnies

SANDWICH ON A STICK – layer a kabob stick with small pieces of bread, deli meat, cheeses and black olives with apple slices and low-fat vanilla yogurt for dipping

IT’S A ‘WRAP’ – tortilla wrap rolled with low fat cream cheese and strawberry jelly with popcorn, sliced cucumbers and grapes Source: American College of Sports Medicine

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

Lunch

Packing Tip:

Encourage kids to come up with their own unique themes and ideas using healthy choices. Allowing kids to choose and prepare their own lunch piques interest in the meal and makes it more likely they will eat their own creations.

Why sa y OM?

SEND THEM TO THE

BUS STOP!

School buses are the safest form of ground transportation – approximately

40 TIMES SAFER than the family car!

Ever Wonder?

What does OM – the mantra that is traditionally chanted at the beginning and end of yoga sessions – mean? It is said to be the sound of the universe. Everything that exists pulsates and creates a rhythmic vibration that the ancient yogis acknowledged with the sound of OM. As a result of its calming effect, practicing yoga can help lower blood pressure and reduce insomnia.

Source: National Safety Council

Money raised from this run goes directly to the Local Area 3 Special Olympics. All funds are used to pay for equipment, uniforms, travel expenses and education materials. Come out and run or walk this beautiful, gently rolling course!

Date: Time: Location:

Saturday, September 17, 2016 8:00 am

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Meriwether Lewis Elementary 1610 Owensville Road | Charlottesville

For more information and to register, go to www.pepsi10krun.com.

Source: American Osteopathic Association

MAN OF STEEL? Ounce for ounce, human bones are

FIVE TIMES STRONGER than steel!

The Autumnfest 5K is part of the annual Autumnfest Fall Festival in Woodstock. The out and back course starts and ends at Fairview Park, and offers a mixture of mountain views and residential neighborhoods, with a country field surrounding the historic Mary E. Wetzel house and farmstead. This event is walker and dog-friendly. All-terrain strollers are also welcome. Be sure to stick around for the awards ceremony and post-race food before heading over to the Shenandoah County Fairgrounds for Autumnfest!

Date: Saturday, October 15, 2016 Time: 9:00 am Location: Fairview Park | 716 West North Street | Woodstock For more information and to register, go to www.corkscrewracing.com.

THE SECOND ANNUAL

BEST

BEDSIDE MANNER

AWA R D S IN THE

S H ENAND OAH VALLEY & CH ARLOT T ES VILLE

LOO K F O R TH E R ES U LT S I N TH E NO V E M BE R /DE CE M BE R E DI TI ON OF

OURHEALTH CHARLOTTESVILLE AND SHENANDOAH VALLEY

F OR M ORE INF ORM AT ION SCAN HE RE OR GO TO WWW.OURHEALTHCVILLE.COM 18

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

Anatomy CHALLENGE the

How much do you know about the Stages

of Prostate

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

[ Stages of Prostate Cancer ]

WORD SEARCH bladder

stage II

lymph nodes

stage III

prostate gland

stage IV

seminal vesicle

tumor

stage I

urethra

_____________ _____________

_____________ _____________ _____________

_____________

_____________ _____________ For answers, visit OurHealth Charlottesville and Shenandoah Valley's Facebook page at

www.OurHealthCville.com

words | RICK PIESTER

September is Prostate Cancer Awareness Month, a time set aside each year to focus on the disease that is the second largest cancer killer of men in the United States. The good news, however, is that if prostate cancer is caught early, the five-year survival rate is almost 100 percent. To help observe the special month, we talked with some local experts about prostate cancer, its detection and its treatment. Here's what they say to help you keep ahead of the game, and possibly avoid prostate cancer.

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

At what age should men begin getting a prostate exam? "This remains a very controversial subject. In general, screening for prostate cancer is not recommended in men younger than 55 unless a man is at an increased risk to develop prostate cancer. Groups at higher risk for prostate cancer are men with fathers, uncles or brothers with prostate cancer or African-American men. Men in these higher-risk groups should discuss the role of screening with their physicians."

What is involved in testing for prostate cancer?

Robert Dreicer, MD, MS, FACP, FASCO is the deputy director of the University of Virginia Cancer Center and co-director and Paul Mellon Urologic Cancer Institute. Dr. Dreicer is certified by the American Board of Internal Medicine with a subspecialty in Medical Oncology.

"Typically, screening for prostate cancer involves a combination of a prostate specific antigen (PSA) blood test and a digital rectal exam (this exam involves having a lubricated, gloved finger inserted into your rectum to feel part of the prostate gland)."

If I have prostate cancer, what are the first steps I need to take? "Seek opinions from a multidisciplinary group, including your urologist and both medical and radiation oncologists. Together, these specialists will help you make decisions about your course of treatment based on how aggressive your cancer is and whether or not it has spread."

Robert Dreicer, MD, MS, FACP, FASCO University of Virginia Cancer Center Charlottesville | 434.924.1775 www.uvahealth.com

In 2016, about

181,000

new cases of prostate cancer will be diagnosed.

www.OurHealthCville.com

Am I at a higher risk for developing prostate cancer based on my race? "There is a significant disparity in prostate cancer rates between races. African Americans are 1.6 times more likely to be diagnosed than Caucasian males and 2.4 times more likely to die of the disease. On the other hand, Hispanics and Asian Americans are less likely be to diagnosed during their lifetime. Several possible explanations for these differences include genetic variants between races, screening techniques and variable access to healthcare. Although mortality rates from prostate cancer have declined in recent years due to improved treatments and screening tools, African Americans are more likely present with advanced disease at diagnosis."

Brian Stisser, MD is a urologist with Blue Ridge Urological, PC in Fishersville. Dr. Stisser is certified by the American Board of Urology.

Brian Stisser, MD Blue Ridge Urological, PC Fishersville | 540.932.5926 www.blueridgeurological.com

FREE Prostate

Health Assessments wAugusta Health Cancer Center presents FREE Prostate Health Assessments at the African American Festival at Gypsy Hill Park Gymnasium!

The American Cancer Society estimates about 1 in 7 American men will receive a diagnosis of prostate cancer in their lifetime.

Saturday, September 17th from 1-3pm 540.932.4976

600 Church Avenue Staunton, VA For men age 40 and over or high risk men starting at age 35.

SEPT

EMB

What are the symptoms of prostate cancer? "Prostate cancer is most commonly diagnosed in a man who has minimal or no related symptoms. The presence of urinary symptoms like urinary frequency, urgency, and slow stream can occur with more advanced disease. Sexual symptoms like erectile dysfunction may also indicate prostate disease and possibly prostate cancer. Early detection with prostate cancer screenings is the key component to diagnosing prostate cancer."

Claiborne Whitworth, IV, MD Claiborne Whitworth, IV, MD is a urologist with Urological Associates, Ltd in Charlottesville. Dr. Whitworth is certified by the American Board of Urology.

Urological Associates, Ltd Charlottesville | 434.295.0184 www.cvilleurology.com

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

What are the different types of self-examinations for prostate cancer that I should be aware of? "There are no self-examinations that patients can do at home to screen for prostate cancer. Your doctor can perform screening tests such as a blood test called a PSA (prostate specific antigen) and a digital rectal exam (to feel the prostate), but these tests are often not appropriate. If you are concerned about prostate cancer, the decision of if, and how, to screen for prostate cancer should be discussed with your doctor."

Andrea Tribastone, MD Sentara Forest Lakes Family Medicine Charlottesville | 434.654.4600 www.sentara.com

Andrea Tribastone, MD is a family medicine physician with Sentara Forest Lakes Family Medicine in Charlottesville. Dr. Tribastone is certified by the American Board of Family Medicine.

Prostate cancer is most common in men age 65 and older, although younger men can be diagnosed with it as well.

Can prostate cancer be prevented? Unfortunately, according to the American Cancer Society, prostate cancer cannot be prevented because these risk factors (age, race, and family history) cannot be controlled. But there are some things you can do that might lower your risk of prostate cancer. Keeping healthy servings of fruits and vegetables in your diet, staying physically active, and maintaining a healthy weight can help lower your risk of prostate cancer. Schedule a visit with your local provider to make sure you are on the right track. Sources National Cancer Institute - www.cancer.gov American Cancer Society - www.cancer.org

Expert Contributers Robert Dreicer, MD, MS, FACP, FASCO with the University of Virginia Cancer and Paul Mellon Urologic Cancer Institute in Charlottesville. Brian Stisser, MD with Blue Ridge Urological, PC in Fishersville.

YOUR CENTER A Source of Support and Research from UVA Cancer Center Your Center is UVA Cancer Centerâ&#x20AC;&#x2122;s new blog filled with information for patients and caregivers in helping them cope and grow through their cancer experience and to give those without cancer the information they need to prevent it as best they can.

Prostate Cancer: How Exercise Can Help Your Treatment

Andrea Tribastone, with Sentara Forest Lakes Family Medicine in Charlottesville. Claiborne Whitworth, IV, MD with Urological Associates, Ltd in Charlottesville.

ON THE WEB

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Be sure to mark your calendars for next year's

Babypalooza! August 5, 2017

Photography by KG Thienemann

Oh, baby! Augusta Health’s second annual Babypalooza offered all things baby and child-related for expecting mothers, parents and primary caregivers with children under the age of three. The free event, with close to 500 attendees, provided a fun-filled morning of information and giveaways, including a free Babypalooza swag bag filled with products and coupons. “It’s great to get samples of products and all this information about the baby and my pregnancy," says Kristin, a mom-to-be from Verona. "I was interested in learning more about breastfeeding, so it was helpful.” With 28 local vendors and health providers on hand, attendees had the opportunity to learn about health and wellness services available in the Shenandoah Valley area. “It’s been very helpful," shares Kim, a grandmother from Stuarts Draft who has twin grandchildren. “I didn't realize that dentists recommend baby's first visit by age 1." “This is a great way to see what’s out there and where to find everything", says Steward, a new dad from Waynesboro who is also new to the community. To see even more photos captured during Babypalooza as well as a complete list of local vendors who volunteered their time, visit our website at www.ourhealthcville.com.

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

ON THE WEB

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www.OurHealthCville.com

words | SUSAN E. DUBUQUE original photography | KG THIENEMANN

The stories of four women striving to cope with breast cancer with a drive to move forward. Whether you are a man or woman, adult or child, old or young, we are all touched by breast cancer. It may be your mother, aunt, sister or friend who has suffered. Or perhaps you have been personally affected. Among the more than three million women in the U.S. who have breast cancer, many serve as inspirations to us all. Women who demonstrate grace and dignity in the face of a life-threatening illness. Those who transform a devastating medical condition into a positive, life-altering opportunity. And still more who selflessly extend a hand to others rather than focusing on their personal circumstances. This article is a tribute to four of these amazing women. It is our hope that their stories will offer insight and guidance to even more women who now â&#x20AC;&#x201D; or in the future â&#x20AC;&#x201D; must face the challenges of breast cancer.

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Danielle’s support system includs many friends and family. Pictured below, left to right, back row: Barbara Carter (stepmother), Daniel Carter (father), Mike (husband), James and Tammy Carter (brother and sister-in-law), and Caleb (nephew). Front row: Jacob (son), Harper (niece), Jackson (nephew), Cullen (nephew), and Blake (daughter).

Danielle’s Story Early in the morning of Feb. 14, 2016, Danielle Bosserman was awakened with a start. Her mother, who had passed away the previous November, had appeared in Danielle’s dream and urged her daughter to start taking better care of herself. One month later, Danielle realized how prophetic her dream really was. Danielle’s family had t-shirts made as a symbol of their united effort in her struggle with cancer. Danielle wrote the inspirational words on the back of the shirts:

By His STRIPES we are HEALED. By His WORD we are STRENGTHENED. By His LOVE we are COMFORTED. 28

Danielle, 41, is the poster child for breast self-examination. She carefully checks her breasts every month without exception. That’s why she was startled to discover a large lump in her right breast, beneath her arm. She didn’t waste any time and made an appointment that afternoon to see her OB-GYN, Cindy Bailey CNM, of Augusta Health Care for Women. Bailey assured Danielle that it was probably nothing to worry about, but she ordered a mammogram and ultrasound just to be sure. That was followed by a biopsy on March 15. Three days later, Danielle and her husband, Mike, were stunned to hear the results: Danielle had breast cancer. The entire family was in shock. During the previous four years, Danielle had lost two uncles and her mother to cancer. Having witnessed her mother suffer from non-Hodgkin’s lymphoma, Danielle’s initial response was to panic. But with loving support of her family and friends, she soon regained her composure and made the conscious decision to travel a very

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different journey. “I want my cancer experience to inspire others,” Danielle says. “I want to reach out every day and touch someone else with a smile or a kind word. Perhaps this opportunity to tell my story is God’s way of opening a door for me to do just that.”

Danielle attributes her positive and hopeful spirit to four things:

Faith. “My father is a steadfast Christian and so am I,”

Danielle says. “My dad rushed home from vacation the minute he learned about my cancer, and he shared healing scriptures and prayers that helped me calm down and feel a sense of trust that everything would be OK. It lifted the cloud of anxiety that was weighing me down.”

Family.

“My family has been here to see me through every step of the way. My wonderful husband, four children, father and stepmother, brother and the rest of the family were huge players in my support group,” Danielle reports.

Friends.

“Shortly after I received word that I had cancer, I sent out a mass text to my four high school girlfriends — Jenny, Misty, Christina and Meredith — and the phone started ringing off the wall,” Danielle says. Women are warriors when it comes to rallying around their friends in times of illness or heartache.

Facility. “I can’t say enough about the care I received

at Sentara Martha Jefferson Hospital,” Danielle says. “When I first met my surgeon, Dr. [Linda] Sommers, and my oncologist, Dr. [Erika] Struble, the doctors shook hands with my father and husband, but they both hugged me. It made me feel like they were really there to care for me. In fact, the entire staff is wonderful. They know me by name. They make me feel at home.”

Danielle completed four cycles of AC (Adriamycin and cyclophosphamide) chemotherapy over an eight-week span and a 12-week course of the chemotherapy drug Taxol. She will have surgery to remove her tumor that has now shrunk from nearly 5 cm to only 1.2 cm, followed by radiation.

“People diagnosed with cancer have attitudes, emotions, and moods that can change from day to day, and even from hour to hour. This is a normal response and with time, many people are able to adjust to cancer and move forward. A positive way of thinking has been shown to help facilitate this transition by increasing effective coping skills, compliance with treatment, speeding recovery from surgery, and may even help boost immunity. Even if cancer patients cannot control their diagnosis, or other circumstances of their lives, they can positively impact their attitude, and this may be helpful, in and of itself.” Kim Penberthy, PhD, ABPP

is a psychologist at UVA's Emily Couric Clinical Cancer Center in Charlottesville.

“When I was in the midst of treatment and feeling a little depressed and sorry for myself, my mother came to visit me again in a dream,” Danielle says. “She told me, ‘You can’t give up. Your battle is already won. You have to keep going.’ I truly believe that I have won this battle and know I will be fine. So now I can get outside myself and see if I can help a few other people along the rest of my journey.” www.OurHealthCville.com

Tanya’s Story Pictured above: Tanya spending time at a local coffee shop.

“I’ve had my moments of feeling down,” shares Tanya, “but believe it or not, there have been good things that have come out of this experience. For one thing, I have a better relationship with God.”

At age 38, Tanya Walker’s career was on an upward trajectory. As a Six Sigma Black Belt, she facilitated change for her employer, a medical device manufacturer. But the biggest change of Tanya’s life came about when she discovered a lump in her breast. “Even my doctor wasn’t overly concerned when I found the first lump in my breast,” Tanya says. “The decision was to ‘wait and see’ since I was so young.” But four months later, Tanya was diagnosed not only with cancer, but with two different types of cancer — one type in each breast. Tanya was determined to battle her cancer aggressively and turned to Augusta Health in Fishersville for her care. She opted for a double mastectomy and chemotherapy to be followed by reconstructive surgery. She will also receive Herceptin for 10 months — a treatment that reduces the risk of breast cancer recurrence after the initial surgery “At the time I learned I had cancer, I was in the middle of leading a Kaizen event for my company. This is a week-long program designed to improve efficiency,” Tanya says. Once I got over the initial shock, I felt this huge desire to really focus on my job. My employer was great, but I put pressure on myself to remain active and productive. Work became my therapy. It made me feel normal while I was dealing with my illness. Even before her diagnosis, Tanya recognized that she is a bit of a workaholic. “I had been struggling with work-life balance,” Tanya admits. “But there is nothing like a case of cancer to give you a whole new perspective.” Since starting her treatment, Tanya now works hard at working a little less. “I’m

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

so fortunate that I love my job and what I do every day. But I’m now planning a vacation, and I occasionally leave the office a little early.” “I’ve had my moments of feeling down,” shares Tanya, “but believe it or not, there have been good things that have come out of this experience. For one thing, I have a better relationship with God.” Tanya never prays for a cure; rather, she asked for strength and courage to see her through. “I have a better relationship with the people I care about,” says Tanya. “I don’t have any family in the area — they all live in Oregon. But my friends and colleagues have been wonderful — serving as my segregate family through this whole ordeal.” Tanya has always been a fiercely independent person. “I never wanted to appear weak or needy, but having cancer has taught me that it is it OK to graciously accept help from others. There are so many people at work and in the community who brought me meals and helped me in so many ways. I now understand that my friends truly want to help and that I can lean on them for support.” Having breast cancer has been like an adventure for Tanya. “I see this as a journey and I wonder what the next 10 years will bring. What will I accomplish? What lessons am I supposed to learn? And who can I help along the way?”

“Positive thinking can give you strength, and empower you to fight like a warrior to combat your breast cancer diagnosis. Look every day for reasons to be positive. They can be hidden in plain sight.” Donna Berdeaux, RN, BSN is a Breast Cancer Navigator at Augusta Health in Fishersville.

For Tanya, cancer has been an agent of change that has enriched her life in many ways.

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Patty’s Story Pictured above: Donna (left), a nurse navigator at Augusta Health with Patty (right).

“Whenever I had a question or I was feeling afraid or a little down, I knew I could call Donna,” says Patty.

From the moment Patricia “Patty” Piccinino was diagnosed with breast cancer, she knew that high quality medical care was essential to her recovery. But she soon discovered that her emotional and spiritual well-being were just as vital to renewing her health. Because Patty has dense breast tissue, her physician recommended mammograms every six months rather than the typical annual checkups. Patty never missed an appointment. Last summer, her results were clear. But in late February, she was stunned to learn she had lumps in her right breast. A biopsy revealed that it was invasive ductal carcinoma — sometimes called infiltrating ductal carcinoma — the most common type of breast cancer. “The same day as my biopsy, I saw my surgeon, Dr. [William] Thompson,” Patty recalls. “It was such a blessing and a huge relief not to have to wait. So much of cancer care is about waiting.” Following a lumpectomy in March, Patty was preparing herself up for a long and difficult course of treatment. “It was at this point that my doctor introduced me to Donna Berdeaux, the breast cancer nurse navigator for Augusta Health,” Patty says. “Donna was a guiding light throughout my chemotherapy and radiation treatments. Whenever I had a question or I was feeling afraid or a little down, I knew I could call Donna.”

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

Many people offered Patty emotional support along the way. “My husband, Steve, and son, Nicholas, my extended family and friends have all been there for me,” says Patty. “My sister, Janet, lives two hours away, but she came to be with me for a few days every time I had chemo. She would cook and clean, but most of all, just having her there was a tremendous comfort.”

Patty offers sound advice for anyone who cares about a cancer patient. “A homemade meal, a funny card or a warm hug are all welcomed gifts. But the best support you can give is to simply understand the emotional rollercoaster that your loved one is on,” Patty advises. “These tokens of kindness are a blessing to the patient, but they also are a blessing to the person offering them.” “I knew the physical effects of cancer and cancer treatment would be intense, but I didn’t have a clue how rough the emotional journey would be,” Patty admits. “One day I would wake up feeling upbeat and hopeful — and just a few hours later I would feel demoralized and depressed.” Patty thought her faith might be tested as a result of her breast cancer, but just the opposite proved to be the case. “Initially I thought that I might feel angry at God or bitter for allowing this to happen, but I actually felt closer. I am so thankful that God has given me strength and guided me through this ordeal. And he gave me access to such wonderful healthcare,” Patty says.

“It may sound trite, but having a positive attitude can go a long way when you are going through treatment,” says Patty. “I’ve really come to appreciate the importance of the mindbody connection in healing.” For other women going through the same experience, Patty offers this insight: “You will surprise yourself with your own strength. Just take it one step at a time, one day at a time. Focus on the near future. You can get through this.”

“Our breast cancer patients with positive attitudes have a transformative effect on the persons in their immediate contact, and often change the mood of the entire infusion center. Their positive attitudes are infectious at times, providing emotional benefit to other’s who are in similar or more difficult situations.” J. Mark Prichard, MD

is an oncologist with Sentara Martha Jefferson Hematology and Medical Oncology Associates in Charlottesville. Dr. Prichard is certified by the American Board of Internal Medicine with a subspecialty in Hematology and a subspecialty in Medical Oncology.

Patty’s amazing sense of resilience and calm in coping with her breast cancer serve as an inspiration and guiding light for many other women who will face the same challenge.

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Jean’s Story Pictured above: Jean spends a quiet moment enjoying the butterfly bush at her mother’s house.

"There is little doubt that Jean will be there to ring the bell with many other cancer survivors, sharing her strong will and desire to live every minute of her life to the fullest.”

In May 2016, Margaret “Jean” Norford was thrilled to ring the bell to celebrate her last chemotherapy session. She rang it again in July to mark her final radiation treatment. But she was just as happy to ring the bell with her “sister in breast cancer,” Danielle, this August. It started as a routine mammogram last October. Jean wasn’t even too concerned when she was called back to have a repeat mammogram. But it was when the technician said, “I think we need to do an ultrasound,” that alarm bells started going off. “I went directly from the mammography suite at Sentara Martha Jefferson Hospital to the surgeon’s office and had a biopsy performed by Dr. [Lynn] Dengel that same day,” Jean remembers. On Nov. 5, 2015, Jean was told she had breast cancer. She had a lumpectomy on November 19, 2015 and a second surgery that December to remove more tissue and ensure that the margins were clear of cancerous cells. Because Jean was diagnosed with triple-negative breast cancer — a particularly aggressive form of the disease — her medical oncologist, Mikhail Vinogradov, MD, and radiation oncologist, Cynthia Spaulding, MD, recommended an equally aggressive treatment plan that included both chemotherapy and radiation therapy. But no matter how arduous the treatment, Jean was determined to keep an upbeat attitude. “I’d walk into my ‘chemo parties’ each time and ask the nurse to bring me my cocktail,” Jean says.

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

One of the positive outcomes of her treatment regimen was a friendship formed between Jean and Danielle Bosserman. “No one knows what it’s like until you sit in the chemo chair,” Jean says. “Danielle and I went through this together, and we really bonded. I know we will be lifelong friends because of it.” Jean’s family offered tremendous support throughout her ordeal. “My husband, David, or my son, Paul, came with me to every single session, and I went to my mom’s house to recover after surgery. My family was my rock.” Jean continued working as much as 27 to 30 hours a week in her job as a meat manager for a local family-owned grocery store. “During cancer treatment it’s important to just keep going,” Jean advises. “Don’t dwell on being sick. Focus on getting better.” When Jean is in public, she experiences a wide variety of reactions from strangers. “Some people are uncomfortable looking at me, or they have pity in their eyes. Some actually come up to give me a hug or say, ‘God bless you.’ I do feel that I am a blessed person and I have a lot to live for.” Ten years from now, Jean hopes she is still cancer-free. But if the cancer comes back, she promises to fight again. Jean’s philosophy is simple: Have faith, be strong and accept support from those who love you.

When Jean is fully recovered, she would like to volunteer at the cancer center where she was treated. “I would enjoy sitting with people who come in for their chemotherapy without a family member. No one should have to go through this alone.” There is little doubt that Jean will be there to ring the bell with many other cancer survivors, sharing her strong will and desire to live every minute of her life to the fullest.

Expert Contributers Donna Berdeaux, RN, BSN with Augusta Health in Fishersville. Christiana Brenin, MD with UVA's Emily Couric Clinical Cancer Center in Charlottesville. Kim Penberthy, PhD, ABPP with UVA’s Emily Couric Clinical Cancer Center in Charlottesville. J. Mark Pritchard, MD with Sentara Martha Jefferson Hematology and Medical Oncology Associates in Charlottesville.

Many people feel that things are out of their control when faced with a diagnosis of cancer. A positive outlook can help in many ways. •

It can help provide a sense of control, a sense of making a difference in one's care.

•

It can help provide hope and further support a patient emotionally through this difficult diagnosis.

•

It can help stimulate the immune system in a way which can boost immune response to therapy. Stress can only harm and further weaken one's immune system. Laughter and a positive outlook on life can do the opposite.

Patients who have a positive attitude always seem to do better in many ways – emotionally as well as physically, including tolerance to therapy and response to treatment. Working with your healthcare team with a positive collaborative attitude can only bring out the best in everyone involved in your care, including yourself! Christiana Brenin, MD

is an oncologist specializing in breast cancer at UVA's Emily Couric Clinical Cancer Center in Charlottesville. Dr. Brenin is certified by the American Board of Internal Medicine with a subspecialty in Medical Oncology.

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S T I ITB

words | DEIDRE

WILKE

ND TH A HEAL N SS O FITNE O THE G

Certified Personal Trainer

WHAT

’S THE

Deidre Wilkes, AFAA, ACSM Deidre is the resident fitness specialist for OurHealth Charlottesville & Shenandoah Valley.

HYPE W

HIIT – no, it’s not a typo, and there isn’t any actual hitting involved – stands for High-Intensity Interval Training. It is

ITH HII

a training technique that involves 100 percent effort through quick, intense bursts of exercise, followed by short, sometimes active, recovery periods.

A high-intensity workout increases the body’s need for oxygen during the effort and creates an oxygen shortage, causing the body to ask for more oxygen during recovery. This after burn effect is referred to as excess post-exercise oxygen consumption (EPOC) and is the reason why intense exercise will help burn more calories in less time than aerobic and steady-state workouts. An additional benefit from EPOC is the metabolism boost that will last for up to 48 hours after a complete HIIT workout!

Ready for a challenge? Try your hand (or full body, rather) at a class offered at the local facilities* listed below.

FIND A HIIT CLASS: Check out these local facilities that offer HIIT classes and training: *membership and/or class fees may be required

Piedmont Family YMCA

Clay Fitness

Charlottesville | 434.974.9622 www.piedmontymca.org

Charlottesville | 434.245.2288 www.clayfitness.net

WORKOUT STATS: HIGH INTENSITY LOW

STRENGTH

MODERATE

ENDURANCE

HIGH

CARDIO

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the

2016

OurHealth Charlottesville and Shenandoah Valley

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

RT PA

TIME TO

PUT THE SKILLS TO

THE TEST

words | TINA JOYCE

OurHealth Charlottesville and Shenandoah Valley magazine’s series “How-to in Healthcare” is a step-by-step guide to pursuing a career in healthcare. In Part I, OurHealth offered insights into the fascinating world of healthcare education. Anyone with a passion for serving others, a love of science or a fascination with the way the body works is a prime candidate for a career in healthcare. These traits often develop in childhood, which is why we began our expert advice with tips for the families of students interested in healthcare opportunities in college. In Part II, college and university professionals gave advice on certificate and degree programs for students transitioning into healthcare professions after completing two- or four-year degrees. In Part III, we began outlining the steps for entering graduate and medical school programs and exploring the best options for individual students. Now, in our fourth and final article, we seek to open the doors to employment. Even when students are diligently focused on completing their educational requirements, they can easily lose sight of the details of creating an appealing, hire-worthy portfolio.

PART FOUR

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

September | October

BE PROACTIVE Education plus experience should equal employment. Why, then, are so many graduates moving back in with their parents to pay off their college debt? According to the Association of American Medical Colleges,1 78 percent of medical school graduates have $180,000 in debt upon graduation. This certainly isn’t the figure their parents will boast about in the next Christmas letter. But if medical students and graduate students seek careers proactively, beginning early in the

educational process, they can lighten these financial burdens and broaden their future opportunities. Of course, not everyone seeking a career in healthcare has to complete four years of undergraduate work and medical school. But training for any healthcare profession takes time and financial commitment. These are valuable commodities and should be used wisely. Students should seek wisdom, education and experience. One of the best ways to gain wisdom is to ask the wise. By gathering information from people working in or retired from the healthcare professions, you create opportunities to learn from others—both from their successes and from their mistakes. As early as high school, students can start preparing their professional portfolios to include pertinent work experience and positive references. Building relationships is crucial. You might admire a particular educator or medical professional you meet through study, practicums or residencies. If you want their help, simply ask. "I encourage prospective employees to identify what they like in a patient care setting and foster networks with those who match their preferences. Many of our employees come to us after doing a clinical rotation in one of our centers while they are in school. Others seek us out based on our reputation or insight they have gained from a family member or friend. At Medical Facilities of America, our positions are advertised on our company websites and on www.Indeed.com. To learn more, just go to

QUESTIONS STUDENTS SHOULD ASK HEALTHCARE PROFESSIONALS: •

What was your path through education?

•

What would you do differently?

•

What was the best advice you received in school?

•

What was your greatest professional struggle?

•

What was your greatest professional reward?

•

What was your first job in the field?

By the time a student is in the final stages of education, a career path will hopefully have become clear, and the student can focus on landing the job or career of their choice. It is important to be flexible, persistent, and patient.

•

What’s the most important thing I can do to prepare for my first interview?

Whether you can choose a particular location for work depends on several factors. Can you relocate, and are you willing to? What connections do you have at a particular facility? (Do you know someone who works there now or has in the past?) Does your educational institution offer career placement services? What credentials (academic or experiential) does the facility require for employment?

•

What stands out the most to you in a résumé or CV?

•

What healthcare associations do you belong to, and which do you benefit from the most?

Students completing residency programs are often approached by recruiters. Drug companies and staffing companies that focus on healthcare recruitment might contact residents or graduating students about opportunities. It is vitally important to examine every employment offer with discernment. Proceed cautiously and do your research.

•

What have you learned the most about from your patients?

www.mfa.net/careers." TODD PUTNEY

Vice President of Human Resources Medical Facilities of America

It is especially advantageous to get to know someone at the facility you’d like to work in. Volunteering and working part time are great ways to gain insight into an organization before applying for permanent employment. If you earn the respect of employees, board members, or supervisors, your chances of being asked to submit a resume and of gaining an interview increase drastically. www.OurHealthCville.com

“It is important to develop a strong resume which accentuates not only the education and certifications received, but the skills, strengths, and abilities which will help that candidate stand out from others. The other key piece of advice is to network within the chosen field and study the options of healthcare facilities that offer that career; applying to all opportunities that meet the candidates short and long term goals and be open to options that may not be the most direct path to the desired goal. Finally, given the overall competitiveness of the healthcare industry, stay positive and have patience!”

STEVE SNYDER

Director of Talent Acquisition University of Virginia Health System

BUILDING YOUR

RÉSUMÉ OR CV Students should consider several factors when building a résumé or a curriculum vitae. First, the difference between them is important. A résumé simply and concisely presents your skills and your qualifications for a particular position or career. It should be one or two pages long. A CV includes a more complete history of your academic credentials. CVs are used by students seeking fellowships, grants, postdoctoral positions and teaching and research positions at postsecondary colleges and universities. The length can vary a lot.2 A résumé or CV cannot be built overnight. Compiling accolades and experience takes time, and if you wait until graduation to start, then by industry standards you are far too late. Many key components of a résumé can be acquired only through volunteer work, hours of commitment to a job or residency program or rigorous academic training. Regardless of age or year of school, students should always be thinking about building a résumé. It takes far more work than checking a box to indicate “done” on an application. Volunteer work and work experience should reflect not only your values but your passion. Employers are always seeking the “best fit” employees for their organizations. Students should also seek the “best fit” employers to help them fulfill their goals and purposes. "A good first impression is extremely important when looking for a job in healthcare. Recruiters’ and hiring managers’ first impression of any candidate is through their application and resumes or curriculum vitae. A resume needs to be complete and professional but also provide information that allows you stand out from other candidates. Incorporate professional accomplishments, community services and career goals." DONNA MIKOLAY, RN

Nurse Recruiter Augusta Health

CREATING A NETWORK Forbes magazine published a “top ten” list of contacts you should have in your network. “The trick,” the article says, “is to make sure you are building a diverse network by adding people from different industries, backgrounds, age groups, ethnic groups, etc. that fit into different roles. Building a deep network by only including people from your current profession or business focus leaves too many stones unturned, limiting potential opportunities.” An active network naturally encourages dialog about new employment opportunities. Lunch with an association president or local hospital board member can lead to insights about upcoming job openings. Regardless of whether you are pursuing a new job or planning to change jobs in the medical (Continued on page 42...)

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

A TYPICAL RÉSUMÉ

INCLUDES THE FOLLOWING INFORMATION: •

•

A TYPICAL CV INCLUDES THE FOLLOWING INFORMATION: •

NAME AND CONTACT INFORMATION: Contact information at your current institution or place of employment might work best.

•

AREAS OF INTEREST: List your varied academic interests.

•

EDUCATION: Specify your degrees, earned or in progress, institutions and years of graduation. You might include the title of your dissertation or thesis here.

•

EDUCATION: List your degrees and certifications and the educational institutions and programs you attended.

GRANTS, HONORS, AND AWARDS: List any grants you have received, honors bestowed on you for your work and awards for your teaching or service.

•

WORK EXPERIENCE: List the companies or organizations you have worked for, the location of each, the dates you worked for them and your job titles and duties.

PUBLICATIONS AND PRESENTATIONS: Give a list of your published articles and books and presentations you have given at conferences. If there are a lot, you might make one section for publications and another for presentations.

•

EMPLOYMENT AND EXPERIENCE: This section can include separate lists for teaching experience, laboratory work, field work, volunteering, leadership and other relevant experiences.

•

SCHOLARLY OR PROFESSIONAL MEMBERSHIPS: Here you list the professional organizations you belong to. If you have held an office or position in one of them, you can say so here or in the Experience section.

•

REFERENCES: This is a list of people willing to write letters of recommendation for you, including their contact information.3

COVER LETTER: This provides a permanent written record of the submission of the resume. It says what is being sent, to whom and by whom. NAME AND CONTACT INFORMATION: Your residential address might be the most appropriate.

REFERENCES (POSSIBLY) : This is a list of people willing to write letters of recommendation for you, including their contact information

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(... continued from page 40)

TOP QUESTIONS FOR INTERVIEWING HEALTHCARE EMPLOYEES •

Tell me about your last performance review. What was mentioned about how you could improve? Any re-occurring themes?

•

What situations kept you from fulfilling your job duties or from coming to work on time at your last job?

•

Tell me about the most recent problem you had with a coworker. Listen and then ask, how did you handle it?

•

What about your character makes you a good candidate for this job?

•

Priorities often change suddenly throughout the day. If you are asked to quickly do another task, how does that affect your mood? What if it's the third time before noon?

•

What do you feel is an acceptable amount of days to be absent in a calendar year?

•

How do you handle situations that could cause you to be tardy or absent?

•

How did you fill downtime at your last job?

•

How have you responded in the past when you found another employee was stealing?

•

How have you responded in the past when your replacement calls in sick and a substitute will take over an hour to come in?

•

24/7 operations are like relay races where you take the baton, run with it and then pass it on smoothly. How do you make seamless transitions on shift changes?

•

During the last year, when your replacement hasn’t shown up and your manager asked you to stay late, what percentage of the time have you stayed late?

•

Think about the last time your manager critiqued your work. How did you respond?

•

Give an example of when you did something without being asked. Can you give me another example?

•

Describe a recent problem you had with one of your manager's decisions. Listen and then ask, how did you handle it?

•

Tell me about your most frustrating experience as a __________(job title). How did you handle it?

community, you should remain active and involved in organizations that fit your personal and professional interests.4

PREPARING FOR

AN INTERVIEW Once you’ve made contact with a potential employer or have an interview scheduled, there are steps you can take to ensure it’s a positive interview. First, conduct more in-depth research. Before seeking an interview, a student should ideally have done research and applied only to organizations that share their mission or goal. It would be a waste of time, and misleading to an employer, to take an interview for a job you have no intention of accepting. Learn about the organization, its history and its vision. Learn who the key stakeholders are and who makes the final hiring decisions. Then ponder interview questions and prepare appropriate, honest answers. "Potential candidates should specifically address how their skills and experience meet the requirements of the position they are applying for. They should always be on time for the interview, honest, flexible, accessible and able to follow specific directions given in the position description." LEE BARLOW

Human Resources Coordinator Rosewood Village

According to the Integrity Training Institute, “Most managers hire for skills, but fire for character. Because of the overwhelming problems associated with hiring employees who lack required character traits, more and more healthcare managers are asking characterdiscerning questions when interviewing employees.”6 Being a sought-after employee or student should be a goal. Joining business associations or healthcare organizations can also add to (Continued on page 44...)

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

FIVE TIPS TO BUILD

AND EXPAND YOUR PROFESSIONAL NETWORK To assist in exploring employment opportunities, the following five tips may build and expand a professional network according to the Harris Casel Institute.5

STEP #1: MAINTAIN AN ACTIVE LINKEDIN PROFILE

This vast professional platform is a great way to network with others if you stay active. Create a profile and market your experience for free. On LinkedIn, you can stay up-to-date on healthcare news and advances. Actively optimize your profile with keywords that relate to your specific healthcare profession.

Here are some ways you should use LinkedIn:

STEP #3: EVENTS Keep your eye out for healthcare events. You can search through forums, LinkedIn, and healthcare websites to see if there are any events in your area where you can network with healthcare professionals. Events are a great way to network with others. If you show up to events frequently, people may start to recognize you.

•

Start conversations: Comment, share, and start

STEP #4: VOLUNTEER

conversations with other healthcare professionals. You can get your name out there by asking crucial questions or asking others to keep you in mind when they give updates. Commenting on other blog posts regularly could help you become a part of a wider conversation. Remember to give positive feedback on other professionals’ blog posts to build your online presence.

You can show your passion for your healthcare profession by volunteering at a local healthcare facility or organization. Volunteering will not only look good on your résumé and benefit the community, but you can meet others who are just as passionate about improving the health of others. Volunteering gives you the opportunity to expand your network and learn new developments about the healthcare world.

•

Endorse colleagues: On LinkedIn, you can endorse others as a friendly gesture. If you endorse others, there’s more of a chance they will endorse you back. Endorsements look good to potential employers.

STEP #5: BUILD YOUR

•

Include a picture: A profile picture can increase

your chances of endorsements and consideration from employers. It also helps personalize your profile. A picture helps put a name to a face and will help others notice you when you’re at events.

STEP #2: GET INVOLVED IN

HEALTHCARE ORGANIZATIONS Getting involved is a crucial part of networking. You may want to search for associations, societies, and groups that revolve around a particular healthcare specialty of your expertise or interest. If you’re interested in Medical Assisting and its many aspects, you may want to join the American Association of Medical Assistants. If you become a member of an organization, you could learn new developments in your field and take part in all the benefits of being part of a local or national healthcare community.

PROFESSIONAL PRESENCE It’s always positive to differentiate yourself from the rest of your competition. Make sure your online presence and interpersonal skills stand out. Highlight personality traits that are seen as good or unique. For example, you could become recognized for your passion on a specific healthcare subject. If you build upon a certain trait, you may become known for it, which could help you to stand out from the crowd. With dedication and a positive attitude, you could start to make strong professional relationships with others in your healthcare field. You may expand your knowledge and professional horizons, which could lead you to advance your career and build upon your technical skills.

SOURCE: www.harriscasel.com

www.OurHealthCville.com

(... continued from page 42)

a student’s résumé. However, nothing can replace focus, hard work and strong relationships.

Students should acquire academic integrity and valuable experience and build reputable references in the healthcare field. In Part I, OurHealth gave parents and students direction for finding a course load suited to entering a healthcare profession. Parts II, III and IV of the series showed how students should begin with academic focus, work hard to earn stellar grades and then build connections with people in their educational institutions and professions. As individuals progress and mature, by asking key questions and seeking wise counsel they can ensure they are guided down a path to success, not toward fear of graduation. SOURCES: 1 The American Association of Medical Colleges. www.aamc.org 2 The University of California at Davis. www.icc.ucdavis.edu/materials/resume/ resumecv.htm 3 The University of North Carolina at Chapel Hill. www.writingcenter.unc.edu/ handouts/curricula-vitae-cvs-versusresumes 4 How to Build a Powerful Professional Network. www.forbes.com/job-search www.harriscasel.com/networking-tipsfor-budding-professionals

The Integrity Institute. www. characterbasedleadership.com/health1.html

ON THE WEB

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PART

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

+++ january

| february

KNOW YOUR CARE: understanding your health and how to maintain it

+++ march

| april

DO YOUR CARE: taking action with your health

+++

MEASURE YOUR

care words | GERI ASTON

Improving your health requires lasting lifestyle changes that affect the way you eat, your activity level, your mindset and your interactions with your doctor.

Tracking Your Efforts to Ensure You’re on the Right Path!

Oftentimes the plan includes losing weight because overweight and obesity play a major role in many chronic conditions — high blood pressure, heart disease, diabetes, arthritis and sleep disorders, for example. The temptation is to measure your success by your weight. But the scale is just one measuring tool, and it doesn’t capture the full impact of the lifestyle changes you’ve made.

This article, the fifth in a yearlong OurHealth series about primary care, examines other ways to keep tabs on your progress toward better health.

may

| june

SHARE YOUR CARE: setting good examples for others to learn and live by

+++ july

| 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

“Raid” the Fridge Storm your fridge and pantry — not to grab a snack, but to check their contents.

STOCK THE FRIDGE with Fresh Foods •

Load up on the fruits and vegetables

•

Shop for simple foods with real ingredients

•

Start reading the labels of the foods in your pantry, the fewer the ingredients, the better

•

Avoid foods with unrecognizable ingredients

•

Avoid high doses of salt, saturated fat and/or trans-fat

Primary care providers we have interviewed for this OurHealth series have recommended that people move away from foods made in a factory, sweets, sugary beverages and junk food. Instead, they have suggested that people eat more fresh foods, especially vegetables and fruit. If money is tight, frozen vegetables and fruits can be good, less-expensive alternatives. Is your fridge stocked with fresh items? Are there plenty of vegetables and fruits? If so, you’re on the right track. If not, it’s time to re-evaluate your buying choices. Doctors have also recommend that people shop for simple foods with real ingredients. Read the labels on the food in your cupboard or pantry. Do the items have just one or only a few ingredients that you don’t recognize? Are they low in sugar, salt and (Continued on page 50...)

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

GETTING YOUR ZZZZ’S Getting a good night's sleep does more than keep you feeling refreshed. According to the National Heart, Lung, and Blood Institute, it plays an important role in your physical and mental health. In the extreme, the damage from not getting enough sleep can occur in an instant, such as a car crash, the National Institutes of Health notes. Meanwhile, the National Highway Traffic Safety Administration estimates that 83,000 crashes annually between 2005 and 2009 were related to drowsy driving. Over time, the lack of sleep can hurt your health in a number of ways, NHLBI says. Sleep is involved in the healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure and stroke. Sleep helps maintain a healthy balance of important hormones, including the ones that make you feel hungry or full. Lack of sleep makes you feel hungrier and increases your risk for obesity. Sleep also affects the hormone that controls your blood glucose (sugar) level. Sleep deficiency results in a higher than normal blood sugar level, which over time can increase the risk for diabetes. Your immune system relies on sleep to stay healthy. Ongoing sleep deficiency can change the way your immune system responds, for example, by making it more difficult to fight common infections. Sleep also helps your brain work properly, NHLBI says. During sleep your brain is preparing for the next day — it's when your brain forms new pathways to help you learn and remember information. If you don’t get enough sleep, you may have trouble making decisions, solving problems, controlling your emotions and behavior and coping with change. Sleep deficiency also has been linked to depression and suicide.

Sleep also helps your brain work properly. During sleep your brain is preparing for the next day — it's when your brain forms new pathways to help you learn and remember information. If you don’t get enough sleep, you may have trouble making decisions, solving problems, controlling your emotions and behavior and coping with change. Sleep deficiency also has been linked to depression and suicide. Source: National Heart, Lung, and Blood Institute

How do you know if you’re getting enough sleep? Last year, the National Sleep Foundation came out with the following recommendations for healthy amounts of sleep.

Age Young Adults (18-25)

Adults (26-64)

Older Adults (65+)

Recommended

May be appropriate

Not recommended

7 - 9 hours

6 hours; 10 - 11 hours

< 6 hours or > 11 hours

7 - 9 hours

6 hours; 10 hours

< 6 hours > 10 hours

7 - 8 hours

5 to 6 hours; 9 hours

< 5 hours > 9 hours

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(... continued from page 48)

saturated fat and contain no trans fat? If you answered “yes,” it’s a sign you’re eating right. Or is your pantry full of chips, sweets and other products with long lists of unrecognizable ingredients and high doses of sugar, salt, and saturated or trans fat? If you answered “yes,” you need to shop healthier.

The Lowdown on CHECKUPS FOR ADULTS Regular checkups are important even for people who feel well. They give your doctor a chance to screen for diseases, determine if you’re at risk for future medical problems and update vaccinations. Checkups also help you maintain a relationship with your doctor so he or she can better help you when you are ill.

Put Pep in Your Step Keeping physically active is part of a healthy lifestyle. The health improvement plan you developed with your doctor likely includes some goals for being more active.

But how often do you need a checkup?

One way to measure success is

Here are some recommendations.

to monitor how much physical activity you weave into your day

Eye Exam

or week. The Centers for Disease

18 to 39: Every 2 years if you have a vision problem, more often if recommended by your eye doctor.

typical adults should get two

Control and Prevention says and a half hours of moderate activity a week and perform

40 to 54: Every 2 - 4 years

muscle strengthening activities

55 to 64: Every 1 - 3 years

two or more days a week. Moderate activity means exercise

65 and older: Every 1 - 2 years

you could do while carrying on a conversation without getting out

Dental Exam

of breath, like brisk walking.

Adults should go to the dentist once or twice a year for an exam and cleaning. Your dentist will decide if you need more frequent visits.

Physical/Wellness Visit There’s no rule of thumb about when to get a physical. It depends on how healthy you are in addition to your age. Under 30: If you’re healthy — don’t smoke, have no disease risk factors (including being overweight) and don’t take prescription medications — get a checkup every 2-3 years. Others should ask their doctors how often they need a physical. 30-40: Healthy individuals should get a physical every other year. 50 and over: Annual physicals are recommended.

Tracking the amount of activity you get is just one measure, though. It’s also helpful to evaluate the effect your activity has had on the way you feel and on your endurance. If your goal was to improve your fitness by walking, are you feeling more energetic? Are you able to walk farther than before? Do you breathe easier while you walk? The same measures apply to jogging. Maybe your increased activity level has given you the ability to do something you weren’t in shape to do before, like taking an aerobics class, walking the golf course instead of riding a cart or chasing after your grandchildren in the park. These would all be positive signs of a healthier you.

Minding your Mind Improving your health isn’t a neck-down endeavor. Positive mental health is part of the whole picture.

Research shows that exercise can help reduce anxiety and improve mood. Sunshine and exercise boost the level of serotonin, a chemical your body produces that is important for healthy brain function. Exercising with friends or family is good for your physical and mental health because socializing eases anxiety and depression. If youâ&#x20AC;&#x2122;re nine months into your health improvement plan, itâ&#x20AC;&#x2122;s time to take stock of its impact on your mental health. Are you feeling more motivated, happier or less stressed now than you were before? Sometimes a mental health problem can block efforts to improve your physical health. Depression can make a person unmotivated to exercise, eat right or take their medications. That can lead to a chronic illness or worsen an existing one. An underlying mental health issue could be the reason for a physical problem such as obesity.

www.OurHealthCville.com

MEASURING

MENTAL HEALTH When mental health symptoms affect your ability to work or to enjoy relationships or your life, doctors recommend getting help from a mental health professional. YES NO

Have you made an appointment yet?

YES NO Are you continuing to keep your

appointments? YES NO If you were prescribed mental health

medications, are the they working? If you answered YES to these questions, it’s a good measure that you’re on the way toward better mental health. If you answered NO, it’s time to check in with your doctor to figure out what’s going on and come up with solutions.

When mental health symptoms affect your ability to work or to enjoy relationships or your life, doctors recommend getting help from a mental health professional. If that’s the case with you, have you made an appointment yet? If you have, are you continuing to keep your appointments? If you were prescribed mental health medications, are they working? (Many medicines for mental health don’t take full effect for several weeks or months.) If you answered “yes” to these questions, it’s a good indication that you’re on the way toward better mental health. If you answered “no,” it’s time to check in with your doctor to figure out what’s going on so you can come up with solutions.

Better Labs and Less Medicine People with chronic diseases often need to get regular lab tests. The results help you and your doctor measure whether your lifestyle changes and medication are working. At nine months into your health improvement plan, have your lab results improved? If you’re diabetic, is your blood sugar in better control? If you’ve got high blood pressure or high cholesterol, are those numbers coming down? If so, keep up the good work. If not, it’s time to contact your physician. Primary care physicians interviewed for this series urge their patients to call their office when they’re having trouble sticking with a health improvement plan. More often than not, doctors can suggest solutions. But doctors can’t help if they don’t know there is a problem. It’s also important to keep follow-up appointments and get the lab tests your doctor suggests. Life is busy, but you have to make time for your health. A reduction in the amount of medication you need to take can also serve as a measure of your success. Maybe because you’re eating better and exercising, you’ve gotten healthy enough for your doctor to lower the dose of your blood pressure medicine. Or perhaps your healthier lifestyle means you’re reaching less often for the pain relievers in your medicine cabinet.

Positive results like these count whether you’ve lost weight or not.

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

Don’t Give Up What if you don’t see the results you hoped for when you started on your health improvement plan? Doctors say you shouldn’t give up or beat yourself up over it. Talk to your physician about your concerns to get advice on how to achieve the change you want. If any of your results are negative, you can use them as motivation to improve. Everyday is a new day to make good health choices.

Next in Our Series Part V of OurHealth magazine's six-part series, “The Bridge to Better Health Starts With Primary Care,” examines ways you can celebrate the rewards realized from taking good care of yourself. Be on the lookout for Part VI in the November/December issue!

Sources “How Much Sleep Do We Really Need,” National Sleep Foundation, www.sleepfoundation.org. “Physical Exam Frequency,” MedLinePlus, National Institutes of Health, National Library of Medicine, www.medlineplus.gov. “Research on Drowsy Driving,” National Highway Traffic Safety Administration, www.nhtsa.gov. “Should you get an annual physical?” DukeHealth, www.dukehealth.org. “Why Is Sleep Important?” National Heart, Lung, and Blood Institute, www.nhlbi.nih.gov.

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read this edition of

on your tablet or smartphone

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HealthyEats or G f t fec TIN r e P GA

I A T

PARMESAN & GARLIC

CHICKEN WINGS

INGREDIENTS 3

quarts cold water

DIRECTIONS 1

1/3 cup Traditional Balsamic Vinegar

tablespoon freshly ground black pepper

teaspoons red pepper flakes

cup salt

bay leaf

teaspoon dried thyme

pounds chicken wings (separated at joints, tips discarded)

teaspoon dried oregano

tablespoons bread crumbs

teaspoon dried rosemary

cloves garlic, minced

cup grated parmesan- reggiano cheese, divided

Pinch of salt 3

tablespoons Garlic Olive Oil (plus as needed to coat foil)

Preheat oven to 450 degrees. Line a baking sheet with foil and coat foil with Garlic Oil. Combine water, balsamic vinegar, ¼ cup salt, bay leaf, thyme, oregano and rosemary in large stockpot and bring to a boil. Add chicken wings, return to a boil and cook 15 minutes. Remove chicken wings with a slotted spoon to a cooling rack and allow to dry for 15 minutes. Mash garlic and pinch of salt until smooth. Combine mashed garlic, olive oil, black pepper and red pepper flakes in a large bowl. Add chicken wings, bread crumbs and ½ cup cheese, toss to coat. Transfer to the prepared baking sheet and sprinkle with remaining cheese. Bake until browned, 20-25 minutes. Enjoy hot or cold!

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HealthyEats or G f t fec TIN r e P GA

I A T

PROSCIUTTO POTATO SALAD AIOLI INGREDIENTS

AIOLI INGREDIENTS

DIRECTIONS

egg yolk

pounds small potatoes

tablespoons Sicilian Lemon White Balsamic Vinegar

slices prosciutto

tablespoon Dijon mustard

To make aioli: Place egg yolk, mustard, chives and garlic in food processor or blender and process until finely chopped. Gradually add the oil in a thin, steady stream until the mixture is thick. Season with salt and pepper to taste.

teaspoons chopped fresh chives

garlic clove, crushed

Â˝ cup Herbes de Provence Olive Oil Salt and pepper

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

To make salad: Cook potatoes in a pot of salted boiling water for 15 minutes or until tender. Drain and set aside for 10 minutes to cool. Cut potatoes in half. Preheat oven to broil. Place prosciutto on baking pan and broil for 2 minutes or until golden and crispy. Set aside to cool. Break into small pieces. Combine potatoes and aioli in a bowl and top with the prosciutto to serve.

HealthyEats for G t c IN rfe

Pe GAT L

I TA

RAMEN COLESLAW SALAD INGREDIENTS

DIRECTIONS

1/3 cup Thai Lemongrass Mint White Balsamic Vinegar

tablespoons Toasted Sesame Oil

pound shredded cabbage (or coleslaw mix)

½ pound baby carrots, cut lengthwise into matchsticks ½ cup green onion, sliced 1

package Ramen noodles, broken into pieces

tablespoon sesame seeds

tablespoon sunflower seeds

tablespoons slivered almonds

tablespoon Harissa Olive Oil

Place shredded cabbage and carrots in large bowl. Combine balsamic vinegar with Toasted Sesame Oil to emulsify, then pour over the cabbage and carrot mixture. Mix well. Sauté the green onion in Harissa Olive Oil, add the Ramen noodles, sesame seeds, sunflower seeds and almonds, stirring just until they brown. Combine the noodles with the cabbage mixture, then serve.

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