OurHealth Cville & ShenVA March/April 2018

march • april 2018 ourhealthcville.com

PLUS:

COSMETIC SURGERY IS

RIGHT FOR YOU?

FEMALES OVER 50:

IT’S TIME TO PUT YOUR FINANCIAL HOUSE IN ORDER

SCREENING FOR COLON CANCER: WHAT YOU SHOULD KNOW

4

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

14 20

10

28

30

36

26

TABLE OF CONTENTS MARCH • APRIL 2018

10

The Pulse | People. Places. News to Know.

14

Calendar | Things to Do in March and April for your

20

Volunteer Spotlight | Heros. Champions.

Community Minded

Q&A on Health | Questions. Answers. Knowledge.

Health A-Z | Insight. Awareness. Mindfulness for the Whole Family.

26 – Online vision screenings stop short in seeing into your total eye health

Mind, Body and Soul

Jim Kingsbury is helping make Sentara Martha Jefferson Hospital friendlier for people with handicaps like his own.

22

26

28 – Females over 50: it’s time to get your financial house fit

30

RISING STARS IN HEALTHCARE Seven professionals under the age of 40 share how they are making healthcare better for people in our communities.

36

SINCE WE CAN’T LIVE IN A BUBBLE There’s no better time than spring to take control of allergens in the places we live and work.

www.OurHealthCville.com

5

52

49

41

56

TABLE OF CONTENTS MARCH • APRIL 2018

41

Food and Fitness | Nutrition. Exercise. Prevention.

52

Let fruits and vegetables take center stage in your spring diet plans

49

Beauty | Conviction. Expression. Confidence.

Health Observances | Educate. Eradicate. Victory.

March is Colorectal Cancer Awareness Month. What do you know about screening options?

56

Is cosmetic surgery right for you? A local plastic surgeon weighs in.

Referral Reach | Expertise. Collaboration. Connection.

Richmond-based Envera Health improves the experience for consumers, patients and medical providers.

JOIN THE OURHEALTH COMMUNITY ON SOCIAL MEDIA We want to hear from you! Don’t forget to tag us, #OurHealthCVILLE

6

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

TAB LE O F CO NTENTS

www.OurHealthCville.com

7

MORE THAN A MAGAZINE PRINT MARCH • APRIL 2018

ONLINE

PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION CHIEF DESIGNER GRAPHIC DESIGNER MEDIA EDITOR DIGITAL CONTENT MANAGER DIGITAL MEDIA STRATEGY ACCOUNTING MANAGER ORIGINAL PHOTOGRAPHY

CONTRIBUTING MEDICAL EXPERTS

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Karrie Pridemore Tori Meador Elissa Einhorn Lisa Spinelli Dalton Holody Laura Bower Terry Brown Photography Kara K. Beatty MD Beth Czaplinski, LPN Saira Imaad, DDS Mark Masonheimer, RN, BSN Anita Sites, BSN, MSN, ACNP Christopher Stewart, DPM

CONTRIBUTING PROFESSIONAL Catherine Brown EXPERTS & WRITERS Brandy Centolanza Elissa Einhorn Rich Ellis Michelle McLees

ADVERTISING AND MARKETING Sharie Wilkins • Senior Media Consultant 434.471.6493 • sharie@ourhealthvirginia.com

SOCIAL MEDIA

SUBSCRIPTIONS Subscriptions are $19.95 per year.

To receive OurHealth Shenandoah Valley & Charlottesville via U.S. Mail, please contact Jenny Hungate at jenny@ourhealthvirginia.com

T

F l

@ourhealthcville

E-NEWSLETTERS

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 © 2018 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.

y 8 www.ourhealthcville.com

MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.

www.OurHealthCville.com

9

The Pulse PEOPLE. PLACES. NEWS TO KNOW. words | ELISSA EINHORN

Milestones Our Lady of Peace celebrates 25 years of excellence Our Lady of Peace residents, families, team members, board members and special guests celebrated 25 years of excellence with an Old Hollywood-themed party complete with a redcarpet entrance. The mission of Our Lady of Peace is to enhance the quality of life for each resident through personalized attention and care. They believe in preserving dignity through personal choice, respect and understanding in a comfortable and welcoming environment that brings joy and fulfillment for those who live and work there.

More Information: 434.973.1155

Research Mentored

by UVA researchers, high school students present research posters Charlottesville High School students honed their research skills thanks to a partnership with the University of Virginia’s School of Medicine and the Office for Diversity, which has worked to create partnerships with local schools in order to engage future healthcare workers and leaders in medical and scientific pursuits.

Student research and accompanying posters were created with guidance from post-doctoral mentors at the UVA School of Medicine. Students presented their research at the UVA School of Medicine’s Poster Symposium in January.

Among the participants was 16-year-old Katherine Wells whose team selected asthma as their topic in part because of the prevalence of the condition. One in 12 people suffer from asthma in the U.S., the high school junior says, adding, “Each of us has a connection with asthma.”

Students compared steroid versus non-steroid treatments in children and adults to determine their effectiveness. They found that steroids, such as injections, work to block inflammation in the airways, but don’t help during an actual asthma attack. Non-steroids, for example, rescue inhalers, can be used when an asthma sufferer feels an attack coming on or during an attack. Wells’ team also studied modifiers, a newer treatment that counteracts the hormone that secretes mucous.

Blocking the hormone prevents a build-up of mucous in the lungs. Because of the drawbacks, including the possible onset of suicidal thoughts, this is not recommended for young children.

“It was really nice being able to have someone who has been through school and has done research,” Wells says of her mentors. “The most helpful thing I learned was to go in and gather as much information as you can, based on your topic. Once you have all of the information, take a more detailed look at your articles to see what’s most useful.”

The project enables local students to engage with clinical and research faculty to hone their critical thinking and research skills in a tangible manner. The University hopes to replicate this experience in other schools in coming years.

10

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

Recognition Quality radiation oncology care earns national accreditation The American College of Radiology has reaccredited the radiation oncology program at the University of Virginia Cancer Center for meeting the highest level of quality and patient safety. The three-year accreditation follows a site visit and peer review of UVA’s radiation oncology program by radiation oncologists and medical physicists who are experts in their fields.

More Information: cancer.uvahealth.com

THE P ULSE |

Recognition

Community Alert UVA Health System notifies patients about potential privacy issue

People. Places. News to Know.

UVA physicians chosen for Best Doctors in America® List The 2017-2018 Best Doctors in America List® by Best Doctors, Inc., honored 195 University of Virginia Health System physicians among the best in their respective specialties. Selection to the list begins with a survey of the physicians named to the most recent Best Doctors list, who are asked: “If you or a loved one needed a physician in your specialty, to whom would you refer?” Best Doctors, Inc. then reviews and verifies the credentials of each physician selected through the survey before finalizing the list.

More Information: uvahealth.com/findadoctor

The University of Virginia Health System is notifying 1,882 patients that an unauthorized third party may have been able to view parts of their private health information on a UVA physician’s laptop computer and other devices between May 2015-December 2016. UVA has been working with the FBI and has also conducted an internal investigation. These investigations determined that the UVA Health System physician’s devices were infected with malicious software that allowed the third party to view the devices simultaneously.

Although the third party has been arrested and did not take, use or share patients’ information, UVA Health System has taken the precautionary step of mailing letters to patients affected, provided a dedicated call center (866.291.7429 between 9:00 am – 5:00 pm, Monday through Friday) and recommends that affected patients review insurance provider statements. To help prevent future occurrences, UVA Health System has enhanced security measures required to remotely access patient information.

More Information: uvahealth.com/privacy-notice-for-uvahealth-system-patients

Recognition UVA named to national list of great neurosurgery, spine programs A national healthcare publication honored the University of Virginia Medical Center on its list of 100 hospitals and health systems with great neurosurgery and spine programs. Becker’s Hospital Review highlighted UVA as a Blue Distinction Center+ for spine surgery from insurer BlueCross BlueShield. This means UVA meets quality measures for patient safety and outcomes as well as meeting cost measures for affordability for the more than 1,500 spine procedures performed each year. Becker’s also noted UVA’s research into treatments for glioblastoma, efforts to advance brain and spinal cord injury treatment as well as its multidisciplinary care for patients who suffer traumatic brain injuries.

More Information: uvahealth.com www.OurHealthCville.com

11

THE PULSE

Partnerships Allegheny Mountain Institute, Augusta Health collaborate to address community health needs Thanks to a new partnership with Allegheny Mountain Institute (AMI), what was historically farmland will be cultivated to provide food for Augusta Health and for the community. The goal of this joint venture is to raise awareness about the importance of healthy eating and sustainable growing practices. The “AMI Farm at Augusta Health” will cultivate new levels of wellness in the community through partnership and education, and offer a variety of opportunities for public participation.

More Information: augustahealth.com/farm

Research Alzheimer’s Association awards research grant to University of Virginia scientist The Alzheimer’s Association awarded a 2018 Research Grant Award to Dr. John Lukens, Assistant Professor in the Department of Neuroscience and Center for Brain Immunology and Glia (BIG), at the University of Virginia School of Medicine. The three-year grant supports the development of more effective strategies for detecting/treating/preventing Alzheimer’s. Dr. Lukens and his team will investigate how brain injury disrupts drainage of deleterious waste from the brain and identify how this can lead to Alzheimer’s disease.

Dr. John Lukens

More Information: alz.org

Michael Abramson, MD Clark Bernard, MD Vascular and Interventional Radiology Gainesville | 703.712.6062 uvahealth.com

Augusta Health Spine Clinic Fishersville | 540.245.7400 www.augustahealth.com

Douglas Markert, MD

Dena Menzel, RN, MSN, ANP

Vascular and Interventional Radiology Gainesville | 703.712.6062 uvahealth.com

12

Radiology and Medical Imaging Gainesville | 703.712.6062 uvahealth.com

Maddy Bosek, DPT, OCS, ATC

Michele Durland, NP

Brett Flora, PTA

Amirali Moosavi, MD

Roben Summers, NP

Stanley Washington, MD Adam Winick, MD

Augusta Health Synergy Rehab and Wellness Verona | 540.416.0530 Synergy Rehab and Wellness Primary Care Waynesboro | 540.245.7950 www.synergystaunton.com Verona | 540.416.0530 www.synergystaunton.com www.augustahealth.com

Vascular and Interventional Radiology Gainesville | 703.712.6062 uvahealth.com

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

Augusta Health Internal Medicine Fishersville | 540.213.2630 www.augustahealth.com

Vascular and Interventional Radiology Gainesville | 703.712.6062 uvahealth.com

Leandro Leite, MD

Vascular and Interventional Radiology Gainesville | 703.712.6062 uvahealth.com

Radiology and Medical Imaging Charlottesville | 434.924.9400 uvahealth.com

THE P ULSE |

New Services UVA Health System offers new primary care clinic

More Information: 434.975.7700

Welcome

Kate Robertson, PA-C, RD PHYSICIAN ASSISTANT

Innovations Anemia discovery offers new targets to treat fatigue in millions The University of Virginia School of Medicine has revealed an unknown clockwork mechanism within the body that controls the creation of oxygen-carrying red blood cells.

The discovery was made by two independent research teams.

Shadi Khalil, an MD/PhD student studying bone marrow cells, noticed large pools of erythropoietin, a hormone that directs the bone marrow to make red blood cells. This partly explained why some people’s bone marrow cells fail to follow the hormone’s instructions.

Researcher Lorrie Delehanty was studying anemia and discovered a particular protein disappeared when the iron level dropped way down. The amount of iron in the blood affects the amount of the Scribble protein available, and Scribble controls whether the hormone receptor is welled up inside the bone marrow cells or doing its job on the outside.

The researchers hope this discovery will eventually be useful for treating anemia.

“We’ve got the key components, and we want to move up the hierarchy to the master regulatory element that’s controlling this,” says Dr. Adam Goldfarb of UVA’s Department of Pathology. “When we do that, that will get us that much closer to alternative treatments for anemia.”

More Information: med.virginia.edu

Charlottesville Gastroenterology Associates welcomes it’s newest Physician Assistant, Kate Robertson. Kate is a Western Carolina University graduate who went on to complete a dietetic internship at University of Virginia Health System.

While at UVA Health, Kate worked as a registered dietitian on the surgery nutrition support team for three years. She then went on to complete the Physician Assistant Master’s degree program at James Madison University in 2011 and served as a Physician Assistant in the orthopaedic department at UVA Health for five years following graduation.

Charlottesville Gastroenterology Associates 1139 E. High Street | suite 203 Charlottesville

434.817.8484 www.cvillegi.com

For More of The Pulse Visit: ourhealthcville.com Do you have health-related news to share for The Pulse?

Send to Stephen McClintic Jr. via email at steve@ourhealthvirginia.com.

Kate Robertson, PA-C 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

13

People. Places. News to Know.

UVA Health System is now offering a primary care clinic, located directly off U.S. 29 in northern Albemarle County. The clinic features walk-in care for mild injuries and illnesses, medical imaging, extended evening and weekend hours, on-site X-rays, EKGs, lab work, pediatric sleep medicine, pediatric pulmonology, newborn care and other services.

CALENDAR 20 THINGS TO DO FOR YOUR MIND, BODY AND SOUL DURING MARCH & APRIL 2018 words | ELISSA EINHORN

Charlottesville

CHALKFEST

Communities are stronger when we know our neighbors. Chalkfest is a multifaceted event focused on building conversation and connections and celebrating the people of Charlottesville. The day includes Share a Meal, Learn & Get Involved in the Community, Enjoy and Celebrate. Sponsored by the Experience Charlottesville, WillowTree, Inc., Ting Charlottesville and Silverchair Information Systems.

Free | 9 am – 11 pm Three Notch’d Craft Kitchen & Brewery | 520 2nd Street, SE | Charlottesville

w bit.ly/2C4NuuF

COOKING CLASS WITH TERRE SISSON

Learn to prepare a delicious meal with professional chef Terre Sisson of Charlottesville Wine & Culinary. Prepare and enjoy a three-course meal paired with First Colony wines and receive a 20 percent discount on your wine purchases that day. The flavors of pasta, sausage and fresh fennel combine for a fantastic “chase away the winter blues” meal. The individual tarts are sure to become favorites of family and friends. $68/person | 11 am – 2 pm First Colony Winery 1650 Harris Creek Road | Charlottesville w bit.ly/2C7n63d or 434.979.7105 (to reserve your spot)

SENIOR CENTER’S GRAND GALA 2018: SAFARI SUNSETS

The Grand Gala is the Charlottesville Senior Center’s annual destination-themed signature event. All proceeds benefit the mission critical operations of the Senior Center. Great food, entertaining games of chance, good conversation, and vital funds for the Center. Plus, the nationally-acclaimed band, Big Ray and the Kool Kats, will have you dancing the night away.

Black Tie Optional – Safari Attire Welcome. $175/person (Sponsorships Available) 6:30 – 11:30 pm The Boar’s Head Pavilion 200 Ednam Drive | Charlottesville

w bit.ly/2Gp5ZYF

Functional Forum Meetup For Healthcare Providers

This month the Functional Forum welcomes Melanie Dorion, NP, who discusses the ketogenic diet. Melanie practices at Downtown Family Healthcare in Charlottesville, focusing on fatigue, Lyme disease, weight management and gastrointestinal health. Also includes a video presentation about past forums.

Free | 7 – 9 pm | AquaFloat | 925 E. Jefferson Street | Charlottesville | w bit.ly/2sD1qIn

14

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

CALENDAR |

3.6 – 4.10

DIABETES SELF-MANAGEMENT

March & April

WORKSHOP

Step up to a healthier life by learning to improve the daily control of diabetes. In this six-week workshop, participants increase their understanding of how diabetes affects them, learn ways to stay healthy and discover how to increase their energy.

Free | 1 – 3:30 pm | 491 Hillsdale Drive | Charlottesville c 434.974.7756 | w bit.ly/2Hqb707

3.9 Shenandoah Valley ONE TEAM, ONE MISSION

Guests are invited to join us for this One Team One Mission event to hear real stories from real people in your community who have transformed their health, finances and lives with “It Works!” Guests have the opportunity to hear about the flagship products about health and finances. $10 | 6 – 8 pm Panera Bread 1101 Red Top Orchard Road Waynesboro | w bit.ly/2C665Gu

3.16 Inspiration for the upcoming growing season comes easy at the Shenandoah Valley Plant Symposium. Nationally renowned speakers discuss timely and insightful information from the world of horticulture, including natural landscape design, green infrastructure, container gardening and approaches to design problems. $90/person | 8 am – 4:15 pm Best Western Inn & Conference Center 109 Apply Tree Lane | Waynesboro c 540.942.6735 | w bit.ly/2GsNKlm www.OurHealthCville.com

15

CALENDAR

PACKING IN

HARD-SIDED LUGGAGE Join us for a fun and informational packing class taught by one of our in-house packing specialists. Delve into basic tips and tricks of packing efficiently and keeping your suitcase organized. Plus, learn how to pack in a hard-sided piece of luggage. Attend this class and enjoy 20 percent off any one non-sale item.

11:30 am – 12:30 pm Peace Frogs Travel/Outfitters 1043 Millmont Street | Charlottesville RSVP at c 434.977.1415 or events@peacefrogstravel.com

m

3.24 HONORING OUR HEROES 5K Sponsored by Air Force ROTC Detachment 890. Invite friends, family, and everyone you know to participate and support our local Charlottesville Police, Fire and Emergency Medical teams who help keep us safe every day. $25 | Noon – 2 pm Darden Towe Park 1445 Darden Towe Park | Charlottesville w bit.ly/2ECo2u7

3.21-3.25

2018 VIRGINIA

FESTIVAL OF THE BOOK

A signature program of Virginia Foundation for the Humanities (VFH) and the Virginia Center for the Book, the Virginia Festival of the Book brings readers and writers together for a five-day program of mostly free events including author readings, book signings, panel discussions, programs for children and more.

Free | Various times and locations in Charlottesville & Albemarle County c 434.924.3296 w VaBook.org

4.6-4.9 THE FLUID DYNAMICS OF

CRANIOSACRAL THERAPY

This course presents a unique understanding of Fluid Dynamics within the Craniosacral System. It emphasizes the energy dynamics and processes that organize body functions. The foundations of biodynamic craniosacral philosophy are described as well as an integration of craniosacral techniques and anatomy for reawakening the healing potential within us all. $524 ($599 at the door) | April 6th at 9 am – April 9th at 1 pm Ivy Yoga School | 1042 Owensville Road | Charlottesville | w bit.ly/2C7oWRJ

4.7 Charlottesville Marathon

The Charlottesville Marathon, Half Marathon, Marathon Relay, 8K & Kids K is one of the oldest and most coveted races in Charlottesville. A true community event, the race showcases the area’s natural beauty, engaging running community, historical background, architectural heritage, vibrant music and nightlife, and booming wine and craft beer industry. The course has been voted as “One of the Most Scenic in the East.”

Fees vary | 7 am: Marathon, Marathon Relays, Half Marathon and 8K | 8 am: Kids K Begins at the intersection off E. Jefferson Street & 5th Street NE w www.charlottesvillemarathon.com

16

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

CALENDAR | March & April

Exploring the Abdomen and Organ System This course is geared to familiarize the practitioner with the dynamics of the organ and visceral system. Students will be acquainted with an in-depth analysis of anatomy and physiology. The intention of the course is to teach clinical applications to the Myofascial tissue that lie within the abdominal cavity while integrating the work with Mayan Abdominal Massage. $363 | April 13th at 9 am – April 16th at 1 pm Ivy Yoga School | 1042 Owensville Road | Charlottesville w bit.ly/2FcGM4t

4.13-4.15 Bed and Breakfast MARRIAGE RETREAT

Dave Jenkins, DMin, LMPT is the director of Fredericksburg Relationship Center, LLC and a licensed marriage and family therapist. Reserve your time with Dr. and Mrs. Jenkins for some couples coaching. Make your reservation early as there are only four one-hour slots available. Sometimes you need to just get away in order to reset your relationship.

Prices Vary April 13th at 4 pm – April 15th at 11 am Brierley Hill Bed & Breakfast 985 Borden Road Lexington w bit.ly/2GoAMVC

4.14 RUN FOR AUTISM 5K Join the Virginia Institute of Autism (VIA) at its family-friendly signature event that is one of the most popular 5K races in the Charlottesville area. The day begins with a 1/4 Mile Kids’ race and winds through scenic neighborhoods surrounding Charlottesville High School, and ends with dancing and celebration. Prizes given to top age group finishers and top finishers overall, and top fundraisers.

All proceeds support life-changing programs for children, young adults, and families served by VIA. $30/adults; $15 – $30/children | 7:30 – 10 am Charlottesville High School Track 1400 Melbourne Road | Charlottesville | w bit.ly/2CtsZng www.OurHealthCville.com

17

CALENDAR

4.15 2018 Annual Arc Spring Gala Practice at the APEX: Respiratory Therapists as Influencers

This one-day conference is intended to provide insight on the engagement and professional attributes essential for Respiratory Therapists to excel in the future. $30 – $200 | 8 am – 4 pm University of Virginia Health System Education Resource Center

You are invited to Casino Royale, an elegant evening gala featuring delicious hors d’oeuvres, cocktails and table gaming to benefit The Arc of the Piedmont. Whether it’s trying your luck at the tables or locking in a safe bid in our enticing silent auction you can rest assured there is no gamble in supporting one of Charlottesville’s most long standing non-profits. Join us as we stack the deck in favor of improving the lives of our fellow community members with developmental disabilities. $125/person | 5 – 9 pm Boar’s Head Resort Pavilion 200 Ednam Drive | Charlottesville w bit.ly/2EAlufY

4.20

1240 Lee Street | Charlottesville w bit.ly/2GrQMGx

AN EVENING WITH Simon

4.29

Whether you are a skeptic or a believer, international medium and healer, Simon Hay, entertains and amazes. If you’re curious about communicating with spirit and energy healing, you will love this event. Expect a demonstration of psychic medium readings and energy healing; audience members receiving readings; and an educating and entertaining lecture about communicating with spirit and energy healing.

GIRLS ON THE RUN CENTRAL VIRGINIA

Girls on the Run inspires girls to recognize their inner strength and celebrate what makes them one of a kind. Trained coaches lead small teams through our research-based curricula which includes dynamic discussions, activities and running games. During the 10-week program, girls in 3rd-8th grade develop skills to help them navigate their worlds and establish a lifetime appreciation for health and fitness. The program culminates with a service project and completing a celebratory 5K event.

Fees vary Noon: Registration Table Opens St. Anne’s-Belfield Learning Village 799 Faulconer Road Charlottesville info@girlsontheruncenva.net c 434.528.3767 w www.girlsontheruncenva.org/ 5K-Detail-2

and Spirit

$50 | 7:30 – 9:30 pm Open Heart Yoga Center | 1215 Monticello Road | Charlottesville w bit.ly/2BBvM0K

2ND Thursday of the Month:

Bonefish Grill of Charlottesville Benefit Day for the CASPCA Join the Charlottesville-Albemarle SPCA for the monthly benefit!

Bonefish Grill is committed to partnering with local charities to help create a better community that gives back. Mention the CASPCA to your server and Bonefish Grill will proudly donate 10% of your total check to the animals in need at the Charlottesville Albemarle SPCA! 11 am – 10 pm | Bonefish Grill | 269 Connor Drive | Charlottesville w www.bonefishgrill.com

m

For More Events Visit: ourhealthcville.com Do you have an event that our readers simply must know about?

Tell us about it by emailing Stephen McClintic Jr. at steve@ourhealthvirginia.com.

Please submit your information at least three months in advance to be considered for publication in the magazine.

18

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

www.OurHealthCville.com

19

VOLUNTEER SPOTLIGHT

Opening Doors Local volunteer Jim Kingsbury helps make a friendly hospital friendlier words | BRANDY CENTOLANZA

Jim Kingsbury has been bound to a wheelchair since 2003, so he knows the struggles of those with disabilities firsthand. As a volunteer at Sentara Martha Jefferson Hospital, Kingsbury is working to make life just a little bit easier for others in similar situations. Kingsbury dedicates his time on Wednesday afternoons at the concierge desk at the Outpatient Care Center.

“As concierge, I see a lot of different people,” says Kingsbury, who has been a hospital volunteer since 2015. “Some people struggle to get from one point to another, using canes, walkers, or wheelchairs. For those with ambulatory challenges, the bane of existence can be wrapped up in a few words: heavy doors, curbs, and stairs.”

Kingsbury particularly began to notice the difficulties those with disabilities had in opening the restroom doors behind the concierge desk.

“As a handicapped individual, I know the physical and mental distress of not being ‘normal,’” Kingsbury says. “There is actual physical pain when trying to wrench open a heavy door or when you have to ‘hold it’ when there is no accessible bathroom around.”

Kingsbury, who also serves as a member of the Sentara Healthcare ADA-Community/Employee Advisory Council, first expressed his concerns about the lack of automatic restroom doors in the spring of 2016. He was asked to do a tour of the hospital and present his findings on how Sentara Martha Jefferson Hospital could improve access for those with mobile issues, especially those in wheelchairs.

“The administration at Sentara Martha Jefferson Hospital developed a plan in 2017 to handle access problems with its facilities,” Kingsbury says. “Two pairs of public restrooms were equipped with automatic door openers in the fall of 2017 as part of a bigger plan 20

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

to equip four public restrooms per year until the job is done. My hat is off to the administration for accepting the results of a review of facilities and acting quickly to resolve the issues.”

Kingsbury, who suffers from a condition called X-linked myopathy with excessive autophagy (XMEA), has used a cane, a walker, and a wheelchair to get around. Currently, he uses a second power wheelchair.

“Having progressed from little or no problems in my adult life to using a wheelchair has given me the perspective of the whole spectrum of ambulatory challenges,” he says.

“Seeing that simple technology fixes can be done with little investment makes me wonder why more places are not as publicly accessible as they could be.”

Kingsbury, who is also active in the retirement community where he and his wife, Diane, reside, is pleased with the progress the hospital is making.

“There are mature technologies today that can be used to assist people with ambulatory challenges,” Kingsbury says. “To engage these technologies to aid people doesn’t take a lot of money and yet can bring so much in good will and safety. I am glad to see the hospital commit to helping the community in this way. I am hopeful that we have established a beginning, that through the efforts of the Sentara Healthcare ADA-Community/Employee Advisory Council and other initiatives we can show the Charlottesville community and the world at large what a truly accessible establishment looks like.”

EXPERT CONTRIBUTOR Jim Kingsburg is a volunteer at Sentara Martha Jefferson Hospital.

ON THE WEB

More at ourhealthcville.com

VO LUNTEER SPOTLI G HT | Opening Doors

21

www.OurHealthCville.com

HEALTH H E A LT H C A R E QUESTIONS ANSWERED

BY LOCAL PROFESSIONALS

“

Lipid panel guidelines for the general public are as follows: •

Triglyceride levels: 30-149 mg/dl

•

Total Cholesterol: <200 mg/dl

•

LDL: <100

•

HDL: 40-60 mg/dl is good. Above 60 is considered “protective” for heart disease.

”

What is a lipid panel and should it be included as part of my regular wellness checkup?

A lipid panel is a blood test that measures the lipids (or fats) in your blood system. These lipids are stored in your tissue and used by your body as a source of energy. They are typically broken down into two major categories: cholesterol and triglycerides.

Cholesterol is further divided into two categories which, Low-density Lipoprotein (LDL) and High-density Lipoprotein (HDL). The LDL is often called “bad cholesterol” because it tends to deposit along the arterial lining and over time can become bad enough to compromise blood flow, increasing one’s risk of heart attack and/or stroke. HDL is called the “good cholesterol” because it helps remove the excess cholesterol deposits from the arterial lining.

Lipid profile testing is one of the tools a provider uses in evaluating one’s risk for heart disease and can be very valuable in making that determination.

There are various ways for treating elevated lipids including exercise, diet and medical therapy. Your physician or provider will make the determination as to which interventions are the most appropriate for your situation.

– Mark Masonheimer, RN, BSN

22

Mark Masonheimer, RN, BSN Administrative Director, Cardiovascular Services Augusta Health Fishersville | 540.332.4000 www.augustahealth.com

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

Is there really such thing as brushing too hard?

Yes, there is definitely such a thing as brushing too hard. I often see patients with receding gum lines, called "recession," and worn away enamel (the top layer of the tooth) due to an aggressive brushing technique. This is called "toothbrush abrasion." Brushing too hard may lead to tooth sensitivity because the root of the tooth becomes exposed when the gums start receding. For people who are brushing too hard, I would recommend switching to a soft tooth brush and being mindful while brushing so as not to press the toothbrush too hard against the tooth and gums. This will prevent any further damage and tooth sensitivity.

Saira Imaad, DDS

Albemarle Dental Associates Charlottesville | 434.293.8944 www.getaperfectsmile.com

Since the same organisms can cause both conditions, which comes first: athlete's foot or toenail fungus?

Athlete’s foot is a fungal infection of the foot otherwise known as tinea pedis. This fungal infection is often a mild condition that can, in rare instances, erupt into a full blown bacterial infection requiring either oral or intravenous antifungal and antibacterial medications. Early signs of athlete’s foot include redness, scaling of the skin, irritation, small blisters and sometimes even itching. These symptoms can occur on any skin surface of the foot but are most commonly seen in between the toes where moisture gets trapped allowing the fungus to grow. This form of athlete’s foot is known as intertrigo and is best recognized by a white breakdown of the skin in between the toes – usually between the fourth and fifth toes specifically.

Tinea pedis infections usually result from exposure to fungus in the environment (carpets, sheets, showers and shoes). A less commonly recognized cause of these foot infections is fungal toenails. Fungal toenails expose socks and shoes to a "shedding" of high concentrations of the same organisms that are known to cause athlete’s foot infections. If you are experiencing recurring bouts of tinea pedis you may want to have your toenails evaluated by a NovoNail professional (NovoNail. com) to see if they are harboring these organisms.

Christopher Stewart, DPM Central Virginia Foot and Ankle Laser Center Charlottesville | 434.979.0456 www.cvillefootankle.com

www.OurHealthCville.com

23

HEALTH H E A LT H C A R E QUESTIONS ANSWERED

BY LOCAL PROFESSIONALS

“

Kidney donors are encouraged to maintain a healthy diet, weight and to stay active to decrease the likelihood of developing high blood pressure and/ or diabetes, both of which can cause kidney disease.

”

– Anita Sites, BSN, MSN, ACNP

24

How do you combat depression in assisted living communities?

It is imperative that assisted living team members are appropriately trained to look for and recognize signs and symptoms of depression.

Symptoms include, but are not limited to: overwhelming sadness, changes in appetite or sleep patterns, irritability, isolation and lack of motivation.

Creating a fun and festive environment in which residents are engaged and celebrated is the first step in combating depression in assisted living. Many seniors have a wealth of experience to share, and communities that encourage relationship building between staff and residents are more likely to have residents who feel valued and respected as individuals who will then be more inclined to share feelings of depression.

Ultimately, communities must work closely with loved ones and care partners to ensure that therapy and pharmacological options are available when appropriate.

Beth Czaplinski, LPN

Certified Dementia Practitioner RoseWood Village Charlottesville | 434.963.7673 www.rosewoodvillage.com

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

Does alcohol kill brain cells?

Alcohol can lead to altered communication between brain cells by damaging dendrites, the part of the neuron that sends messages between cells. It can also affect functions of brain cells indirectly by causing organ system failure and vitamin deficiency. People can present with different symptoms, depending on the area of the brain that is affected.

Kara K. Beatty MD

Center for Neurorehabilitation Services PC Richmond | 804.272.0114 www.centerforneurorehabservices.org

How will my lifestyle change following a kidney donation?

Recovery from kidney donation surgery takes several weeks, depending on the individual patient, but once recovered, kidney donors can continue to live a full and active lifestyle.

From a future health perspective, kidney donors are encouraged to maintain a healthy diet, weight and to stay active to decrease the likelihood of developing high blood pressure and/or diabetes, both of which can cause kidney disease.

Transplant centers are required to gather information from, and follow, living donors for a period of two years after surgery. This follow up includes lab testing, blood pressure, weight, activity levels and other general functionality data on each donor. Having annual checkups with a primary care provider, however, is important for general health maintenance and to keep a check on blood pressure and kidney function long-term. It is also advised that kidney donors avoid nonsteroidal anti-inflammatory drugs (NSAIDs) as they can be toxic to a single kidney.

Part of the role of the Transplant Center is to educate donors on general short and long-term risks of donating a kidney, but they can help donors with assessing their individual risks based on medical and family history.

Anita Sites, BSN, MSN, ACNP Living Donor Transplant Coordinator UVA Health Charlottesville www.uvahealth.com

Q &A O N HEALTH | Questions. Answers. Knowledge.

25

www.OurHealthCville.com

HEALTH A-Z

Online Vision Screenings

STOP SHORT IN SEEING YOUR

Total Eye Health words | ELISSA EINHORN

In 2016, the American Optometric Association (AOA) issued a press release in response to the growth of online eye tests that attempt to determine the refraction, or lens power needed to compensate for nearsightedness, farsightedness or

5

astigmatism.

Reasons to

STAY AWAY from Online Vision Screenings

“Online vision tests are increasingly being marketed to consumers as time-saving and costefficient alternatives to in-person, personalized comprehensive eye examinations by a doctor of optometry that are an important part of general preventive healthcare,” stated the online release. “The AOA is concerned about patients receiving inferior ‘care’ and believing that online vision tests provide more than they do. Online vision tests do not include a comprehensive examination of the patient’s eye health by an eye care professional and do not take into account the patient’s overall medical history.”

Chelsea Johnson, OD, an optometrist with Primary Eyecare in Charlottesville, couldn’t agree more.

1

They don't look at the patient’s medical history

2 3

They are unable to identify possibly serious eye conditions

4 5 26

They don't exam the patient’s overall eye health

The accuracy of results is questionable

The technology can’t replace meeting with a medical professional

“Online vision tests appeared probably two years ago,” she says. “That’s when optometrists were starting to become aware of them. Patients began asking about them and I saw ads for them on Facebook and Instagram. I went online and took the test for fun. It was comical from my point of view.”

Dr. Johnson is emphatic that she would never recommend online vision tests to family or friends, noting that an algorithm is no replacement for a doctor who has years of experience to detect even the slightest change in vision.

“An app can’t detect that,” she says. “It can’t differentiate between pluses or minuses in prescriptions.”

In-person eye exams reveal more than vision issues Dr. Johnson tested her own eyesight with an online vision test to see what the experience was like for users. She has a minimal prescription with an astigmatism, or curvature of the cornea, something the testing did not note.

“When you hold a phone at a certain distance, it is only to test nearsightedness and farsightedness,” Dr. Johnson explains, adding the prescription provided to her from the online test would have given her severe headaches.

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

HEALTH A-Z | Online Vision Screenings Stop Short in Seeing Your Total Eye Health

In addition, a full, comprehensive exam is not just a visual acuity test.

Some conditions, such as glaucoma, which can lead to blindness, do not even present any signs or symptoms.

“Glaucoma sneaks up on you,” Dr. Johnson notes, adding that inperson eye exams cover more than eye health. “Recently, I had a case with a young gentleman in his early 50s. He had no complaints.

I noticed a freckle called a CHRPE (Congenital Hypertrophy of the Retinal Pigment Epithelium) on the back of his eye, which could be a sign of colon cancer.”

Through further investigation, Dr. Johnson discovered the patient had a family history of colon cancer. After seeing a gastroenterologist, who found and treated polyps on his colon, the patient returned to Dr. Johnson with open arms.

Are online exams appropriate for anyone?

According to Dr. Johnson, online tests are popular among late teens and people in their early 20s who don’t have an astigmatism. Even so, this doesn’t meet the standard of care, which includes an annual exam that most insurers cover, understanding the importance of even subtle changes of prescriptions.

Her assessment of the industry is that people risk trading health for convenience. Still, Dr. Johnson does believe that online testing will become part of the continuum of care in the optometric industry.

“Optometry has been around for 200 years,” she notes. “Optometrists take technology and turn it into something better. At our practice, we use top technology practices.”

Nothing, however, will replace the human factor, needed, for example, to read different types of tests and to rule out medical conditions, such as glaucoma and stroke.

“Technology continues to increase, but in terms of an app, it won’t ever meet the level of seeing a medical provider in person.”

Chelsea Johnson, OD Practices a full-scope of optometry for all ages, including co-management of LASIK and cataract surgery, as well as fitting contact lenses.

EXPERT CONTRIBUTOR Chelsea Johnson, OD with Primary Eyecare in Charlottesville.

ON THE WEB

More at ourhealthcville.com www.OurHealthCville.com

27

HEALTH A-Z

Females OVER

IT’S TIME TO PUT YOUR

financial house IN ORDER words | ELISSA EINHORN

The state of financial health for women older than 50 could easily read like a label on a poisonous house cleaner. Warning! Not planning for your financial future may be hazardous to your future.

A glance at select findings from several studies tells why:

14%

Percentage of women who are “very confident” in their ability to retire with a comfortable lifestyle.

A

Only 14 percent of women are “very confident” in their ability to retire with a comfortable lifestyle, compared to 17 percent of men.

B

Among Baby Boomers (born 1946 to 1964), an alarmingly low 26 percent of women have a backup plan if forced to retire sooner than expected.

C

D

26%

Percentage of Baby Boomers who have a backup plan if forced to retire sooner than expected.

E

Because of parental or caregiver responsibilities, women are more likely to work part-time than men – 28 percent versus 14 percent. This translates to a lower wage base for women and a lesser likelihood of access to employee benefits such as healthcare and retirement plans.

Of women who are offered 401(k) or similar plans, 77 percent participate, a rate that lags behind that of men (82 percent).

More than 80 percent of women between the ages of 60 and 75 failed a financial literacy quiz.

Referring to this last statistic, Jamie Hopkins, co-director at The American College of Financial Services, which administered the quiz, says, “I would expect a gap. But it was actually double.

That shocked me.”

Financial Fitness First Although several other factors are at play for women – they are more risk averse, earn 78 cents for every dollar a man earns and they are likely to outlive a partner or spouse – adhering to a financial fitness regimen can put them back on track.

28

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

H

First, Start with the Basics SKETCH OUT A BUDGET

SET UP AN EMERGENCY FUND

that reflects how much you are spending currently and how much you will need later in life.

that allows you to draw money in an emergency, without paying a penalty.

If you are working, take advantage of an

EMPLOYER’S RETIREMENT PLAN by investing enough to receive a company match, if that option is offered.

Females over 50

$

HEALTH A-Z |

w:

ho s ’ e r e

$

INCREASE YOUR FINANCIAL KNOWLEDGE with online resources.

Or, if you have available funds, consider a finance course or hiring a financial advisor.

“It’s not like you need gobs of money to get someone to work with you,” says Kerry Hannon, a contributor to Next Avenue, public media’s first and only national journalism service for America’s older population.

In fact, Hannon thinks a financial adviser or certified financial planner can be a valuable resource, especially for older women, who may not be as comfortable navigating financial planning resources online.

Second, Take Care of Yourself Women who frequently play the role of caregiver to children or aging parents do not always take care of themselves. Take college, for example. Because students have many options to help them pay for school, women might consider investing money set aside to support their child’s educational goals in a fund that would serve to meet their personal retirement goals.

80% Percentage of women between the ages of 60 and 75 who failed a financial literacy quiz.

Above All is for Women to Gain Self-confidence “Knowing where money comes from and how it works and where it’s going is important,” according to JoanAnn Natola, a managing partner at Element Financial Group. “Women need to be self-confident on financial knowledge.”

The good news is they want to be. In a report published

by The Global Financial Literacy Excellence Center, 92 percent of women said they wanted to learn more about financial planning, and 83 percent said they intended to learn more about financial planning over the next year.

28% Percentage of women who are more likely to work part-time than men. This translates to a lower wage base for women and a lesser likelihood of access to employee benefits.

The sooner the better, notes Kristen Robinson, senior vice president of women and young investors with Fidelity, who says, “If (women) don’t know enough or have enough experience, it almost paralyzes them and they won’t take that next step.”

As with any regimen, that ‘next step’ could be the first step toward reaching your financial goals.

EXPERT CONTRIBUTORS Kerry Hannon, a contributor to Next Avenue JoanAnn Natola, a managing partner at Element Financial Group Kristen Robinson, senior vice president of women and young investors with Fidelity

401 K

77%

Percentage of women who are offered 401(k) or similar plans, that participate which lags behind that of men.

ON THE WEB

More at ourhealthcville.com www.OurHealthCville.com

29

40

IN HEALTHCARE UNDER

30

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

FEATUR ES | Rising Stars in Healthcare

Meet the

MEN and WOMEN

who are making a difference in

HEALTHCARE in the

Charlottesville and Shenandoah Valley community! words | BRANDY CENTOLANZA

Whether they’ve gone into the field of healthcare intentionally or by happy accident, scores of community healthcare providers and staff are making a difference where they work and live every day.

From dentists, doctors, and nurses to those who ensure hospitals are safe environments for all who walk through the doors to others who care for the young and the elderly, those who’ve chosen to work in the healthcare realm do it because they are passionate.

They truly want to improve the health and wellbeing of their friends and neighbors in their town and beyond. Whether it’s making a cancer patient’s day less stressful or putting a smile on an ill child’s face, these young men and women who’ve been chosen as this year’s crop of Rising Stars – through their clinical and non-clinical positions – have had a positive impact on others in the medical industry as well as their patients and their families. As a result, they are paving the way for a better future in healthcare.

www.OurHealthCville.com

31

FEATURES

Innovative Care Steve Colvin, 32, wasn’t sure about a career in the medical field until a male nurse mentor introduced him to the world of healthcare shortly after high school.

“I was shown the opportunity of what a career in healthcare can do, and I’ve loved it ever since,” he says.

Now, as Director of Quality and Patient Safety at Carilion Stonewall Jackson Hospital in Lexington, Colvin works every day to ensure patients and staff at the hospital are safe. Last year, Colvin helped implement a daily safety huddle in which staff gather every morning to discuss quality and safety concerns among patients and employees that may have occurred within the past 24 hours.

“It’s been a resounding success here at the hospital,” he says. “I feel I am able to make a difference by influencing the culture of safety here at the hospital.”

Steve Colvin Director of Quality and Patient Safety

Carilion Stonewall Jackson Hospital

LEXINGTON

As a patient advocate, Colvin is also working to assist patients as they transition from their hospital stay to life at home, answering questions about medications and other areas of concern to help make adjustment easier at home.

“I feel this is the most impactful way I can help with patients,” he says. “I also helped my grandmother in Washington, DC with her home transition after she was hospitalized.”

Colvin is honored to be recognized for his efforts in making Carilion Stonewall Jackson Hospital a better place.

“I am humbled by it,” he says. “It also reminds me that I picked the right organization to work for. I like being able to lead programs and see how they directly impact patients here. I like working in a place where they embrace new ideas because I am an innovator.”

Care Logistics Kathy Pickral credits her sister for steering her toward a career in healthcare.

“My sister is a pharmacist and she encouraged me to apply to X-Ray school,” Pickral says. “I didn’t have a clue what I was getting myself into, but I am so thrilled that I did it. I had no idea how much of a peoplepleaser I was until I stepped into healthcare. I love taking care of all patients.”

Pickral, 34, oversees the CT and X-Ray departments at Sentara Martha Jefferson Hospital in Charlottesville.

“I am on the floor daily helping with patient care and the flow of the departments,” she explains. “I like the ability to meet so many different people and have the opportunity to impact their lives.”

Pickral and her team strive to make her departments the best they can be for patients.

Kathy Pickral

X-Ray/CT Team Coordinator

Sentara Martha Jefferson Hospital

CHARLOTTESVILLE

“Saving lives every day is my motto in the departments,” she says. “We keep taking the new technology and running with it. We are now a stroke center, and enjoy the new things we get to do daily.”

Pickral states she is very proud of all people on her teams. “Without having a solid foundation of people, we would not make it daily,” she continues. “Everyone is committed to our patients and enjoy what they do.

I have had the opportunity to cross train a few staff between the X-ray and CT departments, which has been very beneficial.”

Spending time with patients is her favorite aspect of the job.

“My quick, yet rewarding interaction with patients allows me to realize that I have positively impacted them,” she concludes. “I love to bring humor into everything I do, so to make a patient smile or laugh makes my day.”

32

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

FEATUR ES |

Serving Through Science

Rising Stars in Healthcare

“Healthcare is a marriage between my two primary passions: I love serving, and I’m a science nerd,” says Hannah Spencer Fitzhugh. “Every minute is unpredictable in healthcare. Your priorities shift without expectation based on patient care. An electricity or phone outage could quickly become a life-threatening event. Going into a job with core values of patient and team safety make for an exciting and fulfilling day, every day.”

Fitzhugh, 32, is the manager of Patient Access for Community Oncology at the University of Virginia Medical Center. Her focus is on improving access to cancer care in communities so that patients don’t have to travel for treatment.

“My goal is to remove barriers to care access so that patients and their medical teams can better focus on treatment and survivorship,” Fitzhugh explains. “One of my most enjoyable program development projects was the implementation of the first telemedicine lung cancer screening clinic in the nation. Telemedicine brings cancer services to the corners of the nation that need it the most, areas with low medical resources that tend to have the highest cancer service needs. We are currently undertaking a new telemedicine project to bring genetic counseling services to our breast cancer patients in their local communities.”

Like others involved in the healthcare field, Fitzhugh finds working with patients most rewarding.

“I am most proud when we have given a cancer patient precious time back in their day by delivering timely care close to their home,” Fitzhugh says. “There is an intimacy and vulnerability that humans experience when they are very sick and being cared for. Being a part of that care is a privilege and allows you get to know someone under a pivotal time in their lives.”

Hannah Spencer Fitzhugh Manager of Patient Access for Community Oncology University of Virginia Medical Center

CHARLOTTESVILLE

Keeping Seniors on the Go When Anna Manikus first started college, she sought a career in education, but plans changed.

“My intention was to be a special education teacher, but then I began volunteering at a retirement community close to my school and decided I wanted to make an impact on that population,” says Manikus.

Manikus, 34, is the Independent Living Events/Wellness Coordinator at Summit Square Retirement Community.

“I oversee all wellness programing for Independent Living Residents as well as plan events, activities and trips for these residents,” she says. “I love the stories our residents tell. A person in their 90s has certainly seen a lot over nearly a century of living. How can we not listen to someone with so much life experience?”

Manikus also pays close attention to the daily needs of those living at Summit Square.

“Every day, I have the chance to enrich someone’s life,” she explains. “I am the one who gives that resident who can no longer drive the chance to go out to eat or to see a musical. Or that resident who is alone in their apartment the chance to participate in a small discussion group. Or even that resident who says they can’t do something anymore due to physical limitations the chance to possibly prove them wrong by creating an individualized fitness plan.”

Her goal is to one day work in a management position in wellness, events, and life enrichment programming, but, for now, Manikus is content in growing the wellness programs at Summit Square, particularly in post-therapy exercises.

Anna Manikus Independent Living Events/ Wellness Coordinator

Summit Square Retirement Community

WAYNESBORO

“Not everyone is fortunate enough to have a job that doesn’t actually feel like a job,” Manikus says. “But I am thankful for the chance to take what I love and make a career out of it.”

www.OurHealthCville.com

33

FEATURES

Healthy Lifestyle Liaison A personal health issue is what led Krystal Moyers, Community Outreach Manager for Augusta Health, to pursue a career in healthcare.

“After suffering an acute illness while I was in college, helping others realize happy and healthy lives became my passion,” Moyers says. “I switched career paths from business to health education in the hopes that I could assist others.”

Moyers, 32, works to assess the health needs of the community that Augusta Health serves – Staunton, Augusta County, and Waynesboro – and helps implement programming and services that improve the overall health of those living in these areas.

“I work hands-on with individuals through health fairs, screening events and community partnerships,” she explains. “I enjoy meeting a wide-range of members in the community, hearing their stories and learning firsthand how Augusta Health can best implement programs to serve their needs.”

Krystal Moyers

Community Outreach Manager Augusta Health

AUGUSTA COUNTY

Moyers is proud to be a part of a new collaborative community partnership this year that will bring a farm to the campus of Augusta Health in Fishersville.

“The goal of the farm is to increase education about and access to healthy foods,” Moyers says. “The food grown on the farm will be used for patient and visitor meals as well as provide fresh, locally grown produce for our community health initiatives.”

Moyers is pleased to be a part of the healthcare field, which allows her to provide community members with information they need for optimal wellbeing.

“One of my favorite things about my job is developing and implementing new initiatives that will help people achieve a healthier lifestyle while expanding the mission of Augusta Health,” she concludes.

Helping Patients, Empowering Peers “I have always enjoyed science, helping others, and problem solving,” says Hunter Choate. “Healthcare was an easy decision I made in my childhood, and I never wavered.”

As Director of Critical Care, PCU, Cardiovascular Quality and Nursing Education with Augusta Health, Choate, 38, oversees the Intensive Care Unit and Progressive Care Unit. He also works with nurse educators and other nurse leaders to ensure comprehensive training is available for all staff.

“The Cardiovascular Quality component of my job allows me to enact changes to improve the care provided to our cardiac patients across the entire care continuum from the emergency department to outpatient care after discharge,” Choate adds.

Most of the patients he works with have a critical need for care.

Hunter Choate

Director of Critical Care, PCU, Cardiovascular Quality & Nursing Education August Health

FISHERSVILLE

34

“Healthcare is a field where you can have a profound impact on someone’s life,” he explains. “Whether helping a critically ill patient recover or being there for a family during a difficult time in their life, we have the ability to ease suffering whether physical or emotional. The success stories that I have been a part of have been rewarding and motivating.”

Choate is part of a team that established new service lines and new treatments within Augusta Health to provide care patients need.

“I am most proud of the changes I have made to our cardiovascular service line as it has the greatest reaching effect, impacting a large number of patients,” Choate continues. “My job allows me to affect the quality of care and the patient experience of a multitude of patients. I can implement process changes that will not only improve patient care, but also the experience of the staff. If you can go home at the end of the day knowing that you have helped patients and have empowered those you work with, that’s a good feeling.”

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

FEATUR ES |

Care Delivery Jesse Johnson started out his career in healthcare in the field of radiology.

Rising Stars in Healthcare

“Radiology seemed like a good fit due to my affinity for technology and the evolving role it plays in patient care,” says Johnson. “I love working with patients because I enjoy helping them navigate the world of diagnostic testing and reducing exam related anxiety that can occur due to uncertainty.”

Now, as Director of Process Management at August Health, “I enjoy working with teams to implement new technology and processes,” Johnson notes. “When this work creates positive impacts for the patients in the community, it is very satisfying.”

Johnson, 34, made the switch from radiology “to perform work that improves job satisfaction for staff members by working with them to improve their daily work,” he explains. “Working with frontline team members to develop better ways to deliver care to our patients is rewarding.”

For example, “We now have teams that are routinely performing projects that improve quality outcomes, reduce expenses and mitigate safety issues before they occur,” Johnson says. “It is exciting to work with teams as they utilize these principles, skills and tools to complete projects and realize objectives. Across the organization, individuals have been inspired to seek out opportunities for improvement and work to improve the delivery of care for our patients.”

Johnson can’t see himself working in any other field.

“Healthcare is a dynamic environment, and I enjoy working to meet the constant changes that arise,” Johnson says. “Eventually, we are all in a position where we need some type of healthcare service, and it is exciting to work with cross functional teams of passionate, empathetic individuals to ensure that these services are delivered in the best possible way.”

Jesse Johnson

Director of Process Management Augusta Health

FISHERSVILLE

CONGRATULATIONS Rising Stars!

Thank you for the impact you continue to make in the Charlottesville & Shenandoah Valley healthcare community.

ON THE WEB

More at ourhealthcville.com

www.OurHealthCville.com

35

36

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

SINCE WE CAN’T

LIVE IN A

BUBBLE...

How allergen prevention helps with allergy symptoms. words | ELISSA EINHORN

Allergies are on the rise in the United States, affecting as many as 30 percent of adults and 40 percent of children, according to the Asthma and Allergy Foundation of America (AAFA). The AAFA also reveals other alarming statistics about the condition it defines as “when your immune system reacts to a foreign substance, called an allergen.” These include allergic conditions being the most common health issues affecting children in the country, and in 2015, 8.2 percent of adults and 8.4 percent of children were diagnosed with hay fever.

“Common indoor allergens are predominantly dust mites, animal dander and certain types of mold,” explains Timothy Kyin, MD, assistant professor of medicine in the Allergy and Clinical Immunology division at the University of Virginia Health System. “In the inner city setting, mice and cockroaches are also factors. Pollen can be a factor when windows are opened during pollen season.”

Dr. Kyin is quick to point out that in addition to allergens, pollutants also are a factor in both the home and workplace.

Small particles produced by cigarette smoke, wood-burning stoves and fireplaces, can be inhaled and set off conditions such as asthma.

“Nitrogen dioxide (NO2), which we typically think of as a byproduct of traffic and other combustion activity, can also be found in lower levels in the home as a result of gas heat and appliances,” Dr. Kyin explains.

“Appropriate ventilation is key for these pollutants.”

www.OurHealthCville.com

37

FEATURES

Avoid and Reduce

HYGIENE HYPOTHESIS: A hypothesis that proposes that childhood exposure to germs and certain infections helps the immune system develop. This teaches the body to differentiate harmless substances from the harmful substances that trigger asthma. In theory, exposure to certain germs teaches the immune system not to overreact.

So

urc e: w ww .ma yoclin ic.org

Because allergens cannot be prevented from entering the home, unless, as the physician says, “You literally live in a closed-off bubble,” treatment is key—in other words, allergen avoidance and reduction. In Charlottesville and the Shenandoah Valley, standard indoor allergens mimic those found in most parts of the country: dust mites, animal dander and molds that tend to be year-round problems.

Whether addressing allergens in the home or the workplace, Dr. Kyin recommends three main strategies:

A B C

SOURCE REMOVAL: re-homing a pet or removing the carpet SOURCE CONTROL: keeping in-door pets out of the bedroom and carpeted areas MITIGATION STRATEGIES: frequent vacuuming, dust mite covers for bedding and air filters

Common outdoor agents Dr. Kyin and his colleagues screen for include trees; grasses; weeds and ragweed; and leaf mold in the fall. Even given this list of seasonal allergen producers, the doctor says that allergic reactions depend on the person, not the time of year.

Tell that to the 109 million allergy sufferers—that’s one-in-three Americans—who live across the United States. For them, an intricate combination of genetics and the environment leads to well-known signs like itchy noses, watery eyes, congestion and sneezing, plus lesser-known symptoms such as migraines, eczema and even gastrointestinal distress.

Allergy-Proofing Your Home The first step toward allergy prevention is determining whether one even has an allergy.

“The classic case is the patient who feels like they’ve come down with a cold the same time every year,” notes Dr. Kyin. “They may have tried antibiotics for a sinus infection or bronchitis, but they don’t really respond. They eventually just get better after a few weeks.”

Given the lack of respite from the offending elements, the Mayo Clinic offers nearly three dozen strategies to reduce allergens for those who suffer from hay fever or asthma.

Approaches for overall allergen reduction are to: Keep the relative humidity no higher than 50 percent.

Timothy Kyin, MD An allergist in the UVA Health System. Dr. Kyin is certified by both the American Board of Allergy and Immunology and by the American Board of Internal Medicine. He sees patients at UVA Medical Park Northridge and UVA Pediatrics Culpepper.

Clean or replace small-particle filters in heating and air conditioning systems monthly.

Use traps to control pests or hire an exterminator.

Close doors and windows during the warm weather to prevent mold and remove materials such as carpeting.

Damp mop and vacuum floors, tops of doors, windowsills and window frames.

Don’t allow smoking inside your house.

38

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

FEATUR ES | Since We Can’t Live in a Bubble...

Joel Loving, owner and operator of Environmental Health Consultants Inc. in Charlottesville, finds it interesting that the field of mold remediation didn’t even appear until 10 or 15 years ago. Loving, who was on the UVA faculty for 25 years before becoming a business owner, believes the ‘mold boom’ is due, in part, to either moisture or water intrusion, commenting that the days when everyone gathered in grandma’s damp basement without giving it a thought are gone.

“People lived with mold all of the time,” he remarks. “All of a sudden, mold delivers toxins and allergens. Companies that have evolved for mold remediation are booming.”

You’ve Treated Your Home. Now Treat Your Body.

Treating the body also involves several different regimens depending on presenting symptoms and what a person can tolerate. The easiest and most popular with children is an oral version of antihistamines.

Sinus saline rinses are also a great option if you can tolerate water traveling up your nose. This is a non-medicated way to help expedite your body’s natural response to allergens or irritants. As Dr. Kyin explains, “When you are exposed to something your body doesn’t like, it tries to purge it from the body, for example, through a runny nose, watery eyes or cough. The rinse helps to remove the allergen from the sinus cavity and nasal passages. If you get rid of the allergic trigger, you don’t get the allergic reaction.”

But is the allergic reaction itself a genetic predisposition? Dr. Kyin points to a study known as the ‘Hygiene Hypothesis’ that looked at the development of allergies and asthma in two distinct Amish communities. One group subscribed to the old tradition of actually working the land by hand and living next to the barn, while the other was more modernized, using farm equipment and living further away. The group that got down and dirty with daily exposure to the land and farm animals ended up with less allergies.

So, while a genetic predisposition to allergies exists, Dr. Kyin points out, “It is not as clear-cut as what we learned in high school about Mendelian genetics. There is an environmental role as well, meaning, the dirtier the exposure early in life, the better.”

EXPERT CONTRIBUTOR Timothy Kyin, MD of University of Virginia Health System Joel Loving, Environmental Health Consultants, Inc.

ON THE WEB

More at ourhealthcville.com

www.OurHealthCville.com

39

40

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

FOOD & FITNESS FOOD & FITNESS |

Spring Clean

Spring Clean Your Diet

Your Diet

words | MICHELLE MCLEES, SPECIAL CONTRIBUTOR FROM THE AMERICAN HEART ASSOCIATION

He althy Plate

Starting in mid-to-late spring, lots of fruit and vegetables are coming into season. In case you forgot, fruits and vegetables are the best – they’re typically high in vitamins, minerals and fiber and low in calories and sodium.

Fill at least half your plate with them to get the recommended five cups of veggies and four cups of fruits each day.

The good news is that all produce counts, which means canned, fresh, frozen and dried varieties can help you reach your goal. Just be sure to compare food labels and choose the products with the lowest amounts of sodium, saturated fat and added sugars. Stick with the simplest forms, without heavy sauces or syrups.

If you’re already eating plenty of fruits and veggies every day, you may be ready for the next step: include more color. All fruits and vegetables contain vitamins, minerals and other nutrients that may help prevent heart disease, cancer and other illnesses. Some of these nutrients are fiber, potassium, folate, and vitamin A and C.

The best way to get all the various nutrients is to eat fruits and vegetables of many different colors. And yes, white and brown count, too! Eat as many different colors as you can each day.

Challenge yourself for just one day.

How many cups of fruits and veggies can you commit to eating tomorrow?

50% Fruits & Vegetables

Try to pick non-starchy fruits and veggies such as carrots, Brussels sprouts, apples, and berries.

25%

Starchy Foods Such as potatoes, corn, rice or peas.

25% Protein

Preferably chicken, fish or beans.

www.OurHealthCville.com

41

42

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

FOOD & FITNESS

Mouth-Watering

FOOD & FITNESS |

Lasagna 8 servings

Spring Clean Your Diet

This classic Italian recipe has a healthy twist to include lots of veggies along with some other nutritious ingredients to make it a heart healthy entree that tastes delicious!

INGREDIENTS

DIRECTIONS

1

tablespoon extra virgin olive oil

Preheat oven to 350° F.

4

clove fresh, minced garlic OR 4 tsp. jarred, minced garlic

A B

1

small onion (chopped)

C

In a saucepan, heat oil. Add garlic and onion and cook over medium heat for about 4 minutes. Add kale (or spinach), tomatoes and eggplant (or squash) and pepper and cook 3 minutes. Turn up heat to mediumhigh, add ground beef or turkey and cook until meat browns slightly and liquid is absorbed. Add mushrooms, beans, vinegar, tomato paste, and tomato sauce. Stir in red pepper flakes, 1 teaspoon dried herbs, ½ teaspoon of pepper. Simmer for 15 to 20 minutes, stirring occasionally.

D E

Mix together mozzarella and one teaspoon dried herbs.

1 1/2 cups fresh, chopped kale (about 3 leaves), cut into bite-size pieces, stems discarded OR 1 1/2 cups frozen spinach (thawed) 3

cups fresh spinach (stems discarded, packed tightly)

21/2 cups eggplant or summer squash, (about 1 small eggplant or 2 squash), cut into 1/2-inch cubes 11/2

cups tomatoes (diced) OR 14.5 ounces canned, no-salt-added tomatoes (diced)

1

pound extra-lean, ground beef or turkey, 95% lean or more

2 1/4 cups white mushrooms (sliced) 1

cup low-sodium, or, no-salt-added cannellini beans (drained, rinsed)

3/4

teaspoon black pepper (divided use)

2

teaspoon dried, salt-free herbs, Italian blend, divided use

1/2

cup low-moisture, part-skim mozzarella (shredded)

1/2

teaspoon crushed red pepper

3

tablespoon red wine vinegar

1/2

cup low-fat ricotta cheese

9

whole-grain sheets lasagna noodles

1

tablespoon no-salt-added tomato paste

8

ounces canned, no salt added tomato sauce

Cook lasagna noodles according to package directions; omitting salt, butter and oil.

In a 9x13 ovenproof dish, place 3 lasagna sheets, one third of lasagna filling and half of ricotta in small clumps. Repeat placing the lasagna sheets, filling and ricotta step. Top with 3 more lasagna sheets, remaining filling and top with mozzarella mixture. Bake for 30 minutes.

COOKING TIP: This can be made ahead and frozen or leftovers can be frozen and served again another time.

Bake at 350° F degrees for 30-45 minutes, until lasagna is bubbly and cheese is melted.

NUTRITION FACTS: Per serving. Calories 299, Total Fat 7.5 g, Saturated Fat 2.5 g, Trans Fat 0.0 g, Polyunsaturated Fat 1.0 g, Monounsaturated Fat 3.0 g, Cholesterol 39 mg, Sodium 129 mg, Total Carbohydrate 37 g, Dietary Fiber 7 g, Sugars 5 g, Protein 24 g Recipe copyright © 2016 American Heart Association. This recipe is brought to you by the American Heart Association’s Simple Cooking with Heart ® Program. For more simple, quick and affordable recipes, visit heart.org/simplecooking. www.OurHealthCville.com

43

44

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

FOOD & FITNESS FOOD & FITNESS | Spring Clean Your Diet

Chilled Avocado Gazpacho with Shrimp 8 servings

This no-cook dish with its vibrant color makes a great appetizer or starter soup.

INGREDIENTS

DIRECTIONS

2 1/2

cups water

A

1

medium avocado

In a food processor or blender, process the water, avocado, and vinegar until smooth.

2

tablespoon red wine vinegar

B

Add 2 cups yellow cherry tomatoes, the cucumber, bell pepper, onion, jalapeño, garlic, and salt, processing until smooth.

2

cups yellow cherry tomatoes and (optional) 8 cherry tomatoes, divided use

C

Cover and refrigerate the soup for at least 1 hour (it may be foamy and will need time to settle).

1

large cucumber (peeled, cut into 1-inch pieces)

1

medium green bell pepper (chopped)

D

1

tablespoon minced, fresh jalapeño (seeds and ribs discarded)

Using 8 cocktail skewers, pierce 1 shrimp and 1 of the remaining 8 cherry tomatoes with each skewer. Garnish the soup with the skewers.

2

medium garlic cloves

1/2

teaspoon salt

NUTRITION FACTS: Per serving. Calories 56, Total Fat 4 g, Saturated Fat 1 g, Trans Fat 0 g, Polyunsaturated Fat 1 g, Monounsaturated Fat 3 g, Cholesterol 0 mg, Sodium 159 mg, Total Carbohydrate 6 g, Dietary Fiber 3 g, Sugars 1 g, Protein 1 g, Dietary Exchanges: 1 fat, 1 vegetable

8

large cooked shrimp

Copyright © 2018 American Heart Association, Healthy For GoodTM, heart.org/healthyforgood

5 HEALTH BENEFITS OF AVOCADOS

A Packed full of VITAMINS

B Loaded with heart-healthy monounsaturated fatty acids

C Great sour of FIBER

Source: Mayo Clinic

D Contains POWERFUL ANTIOXIDANTS

E Can Improve CHOLESTEROL

www.OurHealthCville.com

45

46

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

FOOD & FITNESS FOOD & FITNESS |

Homemade

Frozen

Yogurt Pops with Peaches

Spring Clean Your Diet

6 servings

Two cups of chopped fresh or frozen fruit can be subbed for the peaches, so you can constantly experiment with these refreshing popsicles.

INGREDIENTS

DIRECTIONS

16

ounces packaged, plain, no-sugar-added, frozen, sliced, thawed peaches (divided, no sauce added)

A

1

cup fat-free, plain yogurt

In the bowl of a food processor, add 1 ½ cups thawed peaches from bag, yogurt, and honey. Process about 1 minute until mixture turns into a puree. (Alternatively, add ingredients into a bowl and puree with an immersion blender.)

1

tablespoon honey

B

Transfer puree to a bowl or large liquid measuring cup with a spout for easy pouring. Chop remaining peaches into bitesized pieces and add into the bowl, along with any lingering peach liquid from the bag.

C

Divide mixture among popsicle molds, filling each one almost to the top. Place in the freezer overnight.

D

To remove from molds, hold under warm water until popsicle can be easily pulled free.

COOKING TIP: This recipe yields around 3 cups; the amount of popsicles may vary depending on the size of your popsicle molds.

KEEP IT HEALTHY: Decrease the amount of fruit by ½ cup and add ½ cup granola into the mix to turn these into breakfast popsicles.

TIP: Don’t have popsicle molds or sticks? Try pouring the mixer into an ice tray, covering with plastic wrap and poking toothpicks through the plastic into the center of each cube. Once they’re frozen, pull off the plastic wrap and eat a bite-size popsicle.

NUTRITION FACTS: Per Serving. Calories 66, Total Fat 0.5 g, Saturated Fat 0.0 g, Trans Fat 0.0 g, Polyunsaturated Fat 0.2 g, Monounsaturated Fat 0.2 g, Cholesterol 1 mg, Sodium 32 mg, Total Carbohydrate 13 g, Dietary Fiber 2 g, Sugars 9 g, Protein 3 g. Dietary Exchanges: 1/2 fruit, 1/2 other carbohydrate.

Recipe copyright © 2016 American Heart Association.

www.OurHealthCville.com

47

48

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

BEAUTY

words | CATHERINE BROWN

Did you know that Lisa Kudrow from the popular sitcom Friends underwent rhinoplasty (commonly known as a “nose job”) when she was just 16? In the past several years she has talked openly about how drastically the procedure improved her self-esteem. Celebrities used to keep mum about work they’d had done, but now many share their experiences with cosmetic surgery, from Jane Fonda’s openness about her chin, neck and eye work to Anna Faris’ candidness about her breast augmentation.

Cosmetic surgery is not for everyone. There are risks involved, as there are anytime you undergo surgery. In addition, the high costs of cosmetic surgery can make it prohibitive for many people. Others prefer to live naturally, even if that means showing signs of aging or living with imperfections. Beauty is in the eye of the beholder, after all.

For many people, however, the benefits of cosmetic surgery outweigh the costs. Statistics have shown that cosmetic surgery is becoming more widespread.

In 2016, Americans spent more than ever--over $16 billion--on cosmetic surgery and minimally invasive procedures. In another change from the past, men now account for nearly 1 in 10 cosmetic surgery procedures performed.

1 in 10

Cosmetic Surgery Procedures are Performed on MEN.

www.OurHealthCville.com

49

BEAUTY

The FIVE MOST COMMON Cosmetic Surgery Procedures Breast Augmentation. Breast augmentation

surgery involves transferring fat or using breast implants to increase breast size or restore volume.

Liposuction. Commonly referred to as “lipo,” this

procedure reshapes parts of the body by removing excess fat.

Nose Reshaping. This procedure, also known

as rhinoplasty, improves the proportions of the nose to help develop better facial balance. Rhinoplasty can also improve breathing caused by structural issues.

Eyelid Surgery. Also known as blepharoplasty,

eyelid surgery improves the appearance of the eye, from eliminating bags, wrinkles and sagging to getting rid of fatty deposits that cause puffiness.

Facelifts. A facelift, or rhytidectomy, can help

eliminate signs of aging in the face and neck, by getting rid of excess skin or fat, improving the appearance of wrinkles, and filling in lost fatty volume.

Why People Have Cosmetic Surgery Why are more people having cosmetic surgery? Because it can improve self-esteem and help people feel better about themselves.

Psychologists acknowledge that an attractiveness bias leads people to judge those who are attractive as more likely to have other socially desirable qualities, like intelligence, competence or good morals. Those perceptions can affect both hiring decisions and dating choices.

Because the focus on attractiveness pervades so many facets of life, many people experience lower selfesteem when they show signs of aging or have a physical feature they deem unattractive. Sometimes that insecurity can negatively affect quality of life and relationships. When people feel bad about an imperfection, cosmetic surgery can boost self-confidence and decrease the intensity of negative body image emotions. A recent study found that cosmetic surgery can also improve a patient’s quality of life.

96%

of people surveyed reported they felt better immediately following the procedure and over time.

Before you Have Cosmetic Surgery If you are considering cosmetic surgery to repair an issue that causes distress, make sure you are doing it because making a change matters to you, not because it will make someone else happy. Enter into the procedure aware of the risks and with realistic expectations. Consult with your surgeon ahead of time to confirm you share the same vision and that the outcome will match your goals.

If, after weighing your options, you do choose to have cosmetic surgery, be confident in the choice you are making. With the increasing prevalence of cosmetic surgery, you will be in good company.

ON THE WEB

More at ourhealthcville.com

READ THIS EDITION OF

OurHealth Charlottesville & Shenandoah Valley ON YOUR TABLET OR SMARTPHONE

50

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

www.OurHealthCville.com

51

HEALTH OBSERVATIONS

SCREENING FOR

COLON CANCER:

What you should know words | CATHERINE BROWN

One in 20. That is an average person’s chance of being diagnosed with colon cancer.

Colon cancer is third on the list of most diagnosed cancers and second in cancercausing deaths. Fortunately, multiple studies have confirmed that colon cancer

1 in 20

Americans are diagnosed with

COLON CANCER Colon cancer is the

THIRD

most diagnosed cancers.

Colon cancer is

SECOND

in cancer-causing deaths.

60-90%

of colon cancer deaths can be prevented if everyone over 50 had a

COLONOSCOPY Experts can detect

95%

screening tests improve colon cancer survival rates.

WHEN SHOULD YOU BE SCREENED? Physicians recommend that patients with an average risk of colon cancer undergo screening beginning at age 50. Patients with a family history of colon cancer or a genetic link to colon cancer should to talk to their physicians about being screened earlier.

WHAT SCREENING METHOD SHOULD YOU USE? There are currently multiple colon cancer screening methods available, but there are no headto-head comparisons showing that one screening test is more effective than another. Each screening test has varying levels of evidence supporting their effectiveness, and each test has its own strengths and weaknesses. Keep in mind that anyone experiencing symptoms like, but not limited to, abdominal pain, blood in the stool, a change in bowel habits or weight loss should see their physician to be evaluated and have the appropriate tests performed. The screening tests described in this article are designed to be performed in patients who are not experiencing GI symptoms.

Although there are many screening options available, the colonoscopy is the most comprehensive test.

Arun Mannem, MD, a gastroenterologist with Charlottesville Gastroenterology Associates, explains, “the colonoscopy not only provides direct visualization of the whole colon but has the added benefit of enabling the removal of precancerous polyps.” If any other screening tests are positive, patients will most likely have to undergo a subsequent colonoscopy to further evaluate or confirm the diagnosis.

more cancers and large polyps during a

COLONOSCOPY

52

While the colonoscopy is an effective and safe test, there may also be reasons why another screening test is performed. A colonoscopy requires a person to undergo a thorough bowel preparation and generally requires some form of sedation. Some patients may have difficulty

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

HEALTH OBSERVATIONS |

completing a bowel preparation and may have had difficulties with anesthesia in the past. In addition, the availability and the cost of the procedure may be prohibitive.

The US Multi-Society Task Force for Colorectal Cancer recommends that a patientâ&#x20AC;&#x2122;s first screening test be a colonoscopy or a Fecal Immunochemical Test (FIT), both of which are designated as Tier 1 Screening Tests. There are several other screening methods designated as Tier 2 Screening Tests. These tests are either stool-based, like the FIT test, or direct visualization tests, like the colonoscopy.

Colonoscopy [ Tier 1 Screening Test ] What is it? For a colonoscopy, a doctor uses a colonoscope to screen the entire colon for polyps or cancers. The doctor can pass instruments through the scope to biopsy and/or remove abnormalities. Although the procedure typically takes about 20 minutes, it can take longer if a polyp needs to be removed.

How often should it be performed? It should be done every ten years if the results are normal. People who have had polyps, inflammatory bowel disease or have a family history of colon cancer/colon polyps may need to be tested more frequently.

March: Colon Caner Awareness Month

DIRECT VISUALIZATION TESTS

COLON CANCER RISK FACTORS

50+ Being older than 50 years of age

Pros: The colonoscopy provides a view of the entire colon, enabling the gastroenterologist to view polyps, inflammation and abnormal tissue. It also enables physicians to biopsy and remove polyps.

Cons: The colonoscopy needs to be done by a specialist and can be expensive.

It requires full bowel prep, sedation and recovery time. It carries a small risk of bleeding, infection and tears. The procedure can miss small polyps.

Excessive use of alcohol and/or tobacco

Statistic: It is estimated that 60-90 percent of colon cancer deaths could be prevented if everyone over 50 had a colonoscopy. A colonoscopy enables experts to detect 95 percent of cancers and large polyps.

CT colonography, or virtual colonoscopy [ Tier 2 Screening Test ]

Lack of physical exercise

What is it? For this test, a doctor takes a CT scan of the colon and rectum. Unlike a regular x-ray, the CT takes multiple pictures that are then combined by a computer into detailed 2-D and 3-D images of the colon and rectum. Doctors can look for polyps and other abnormalities.

How often should it be performed? It should be done every five years.

Pros: The procedure is relatively quick; it takes only about ten minutes. It is relatively safe and does not require sedation. The test enables practitioners to see the entire colon.

Cons: The procedure can miss small polyps and can yield false positive results. It requires full bowel prep, but polyps cannot be removed during the test. The test is expensive, and a follow-up colonoscopy might be required to further view or remove polyps.

Low fiber diet

Personal history of inflammatory intestinal conditions

Statistic: According to a recent study, a CT colonography is 90 sensitive for the detection of polyps 1cm or larger in size.

Flexible Sigmoidoscopy [ Tier 2 Screening Test ] What is it? In this screening test, the doctor uses a sigmoidoscope, a two-foot lighted tube with a small video camera to look at the rectum and lower part of the colon. The sigmoidoscope enables the doctor to see abnormalities, like ulcers, polyps or swollen tissue, on a video screen.

During the procedure, the doctor can also remove the polyp with a small instrument through the scope and/or biopsy abnormal tissue.

Family history of colon cancer

www.OurHealthCville.com

53

HEALTH OBSERVATIONS How often should it be performed? It should be done every five years.

Pros: This procedure, which can be performed by a family physician or nurse practitioner, is relatively quick, taking about ten minutes. It is also relatively safe because it does not require sedation, is less invasive than a colonoscopy and thus has a low risk of the colon being perforated. It also does not require full bowel prep, but it does require cleaning out the colon.

The US Multisociety Task Force for Colorectal Cancer (consensus of 3 GI professional societies)

offers their recommendations for screenings.

TIER

1

SCREENING TESTS •

Colonoscopy every 10 years or annual FIT testing

TIER 2 SCREENING TESTS •

CT colonography every 5 years

•

FIT-fecal DNA every 3 years

•

Flexible sigmoidoscopy every 5-10 years

TIER 3 SCREENING TESTS •

Capsule colonoscopy every 5 years

Cons: This test only allows the physician to see about a third of the colon. As a result, the test can miss some polyps. The procedure doesn’t enable the practitioner to remove all polyps. For these two reasons, a follow-up colonoscopy may be needed. Flexible sigmoidoscopy can cause some discomfort and carries a small risk of bleeding and infection.

Statistic: Research sponsored by the National Cancer Institute found that colon cancer mortality was reduced by 26 percent and new cases were reduced by 21 percent because of flexible sigmoidoscopy screening.

STOOL-BASED TESTS Fecal immunochemical test (FIT) [ Tier 1 Screening Test ] What is it? Also called the immunochemical fecal occult blood test, the fecal immunochemical test looks for hidden blood in the stool. It reacts to part of the hemoglobin protein found in red blood cells.

How often should it be performed? The FIT test must be done yearly.

Pros: The FIT test is more specific than the guaiac fecal occult blood test and only requires one stool sample. It is inexpensive and can be done at home, and there are no dietary restrictions. Because it is non-invasive, there is no risk to the colon, and it does not require bowel preparation.

Cons: The FIT test can miss some polyps and cancers and can produce falsepositive results. It needs to be done every year, and, if results are positive, a followup colonoscopy is required.

Statistics: The FIT test has 70-90 percent sensitivity and over 90 specificity.

Stool DNA test [ Tier 2 Screening Test ] What is it? With a stool DNA test, physicians look for abnormal sections of DNA from cancerous or pre-cancerous polyp cells. One of the tests, Cologuard, also screens for blood in the stool.

How often should it be performed? The test needs to be done every three years.

Pros: This test has a higher sensitivity than other stool-based tests. Because it is non-invasive, it poses no risk to the colon and does not require bowel prep. The test can be done at home and does not require pre-test diet changes.

Cons: This test can miss polyps and some cancers and can produce false-positive results. The stool-based DNA test is expensive, and if the test yields positive results, a follow-up colonoscopy may be needed.

Statistic: Studies have shown that, as a one-time test, Cologuard is 92 percent sensitive for cancer and 42 percent sensitive for large cancerous polyps.

Guaiac-based fecal occult blood test (gFOBT) What is it? This test uses the chemical guaiac, derived from wood resin of Guaiacum trees, to detect heme – the iron-containing component of the blood protein hemoglobin – in stool. It is 54

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

How often should it be performed? This test needs to be done yearly.

Cons: The test requires multiple stool samples and could potentially be altered by diet. Also, the test can detect blood but cannot determine where the blood is coming from, so a follow-up colonoscopy is often required. The gFOBT is also not good at detecting advanced polyps and has a high false positive rate.

Statistic: The sensitivity of the test ranges from 60-80 percent, and specificity is over 90 percent.

THE TAKE-AWAY If you are approaching fifty or if you have a family history of colon cancer, become familiar with your options and talk to your physician about any questions or concerns. Most importantly, get screened.

â&#x20AC;&#x153;Only about 40% of Virginians get colon cancer screening. A screening test is only useful if a patient is willing to undergo the test; therefore, physicians will accept any approved screening tests.â&#x20AC;?

ARUN MANNEM, MD is a gastroenterologist with Charlottesville Gastroenterology Associates.

EXPERT CONTRIBUTOR Arun Mannem, MD is a gastroenterologist with Charlottesville Gastroenterology Associates.

ON THE WEB

More at ourhealthcville.com

READ THIS EDITION OF

OurHealth Charlottesville & Shenandoah Valley ON YOUR TABLET OR SMARTPHONE

March: Colon Caner Awareness Month

Pros: This test does not require any bowel preparation, and, because it is non-invasive, there is no risk to the colon. The test is inexpensive and can be performed at home.

HEALTH OBSERVATIONS |

generally thought that the blood vessels in larger colorectal polyps are easily damaged by the passage of stool and thus will bleed into the colon.

REFERRAL REACH

Virginia-based Envera Health

offers a “one touch” experience so providers get the whole story. words | RICH ELLIS

photos | TERRY BROWN PHOTOGRAPHY

At the forefront of technology and armed with the knowledge that healthcare providers need support in treating the “whole” patient, Envera Health is unlike many other committed to fixing what’s wrong with our current health system. Their solution—a unified front door approach—improves the experience for consumers, patients and providers.

Founded in 2015, Envera Health is an “engagement services partner.” Their approach offers the components of an effective health system. These services are a continuum of managed services and hands-on solutions to advance consumer-driven care to make healthcare better.

“One-touch” creates a good healthcare system Brett Butler, Envera’s vice president of client success, explains that the company partners with providers and health systems to unify their entry points. They serve as a unified front door that spans across all of a health systems’ functions to deliver a one-touch experience.

“There’s great work happening in health systems across the country, but that work typically happens in a silo,” Butler says. “For example, a medical group, hospital, and marketing campaign each offer a different experience and they typically don’t talk [to one another] – they’re led by different departments, different data systems, different teams. Through our advanced engagement (call) center and unique CRM-enabled full consumer view, we integrate all of that work into one touch or one conversation.”

Unique technology gives Envera a full 360-degree view of the customer At the heart of Envera’s services is the company’s state of the art Engagement Center Platform.

Built with proprietary technology, this unique nerve center is customer relationship management (CRM)-enabled, creating a full 360-degree view of the consumer.

56

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

Think of a patient calling their physician’s office to inquire about a prescription refill. That call could be answered by an Envera Agent, and while the patient is on the line, the agent takes the opportunity to remind them that they’re overdue for a mammography screening and offers to set up an appointment. The agent also sees that this patient responded to a recent marketing campaign for orthopedics and asks if they are interested in registering for an upcoming orthopedic seminar.

Prevention is an important focus for Envera’s services, Butler says, as is simplifying patient communication. After a hospital stay or doctor visit, patients can get overwhelmed by multiple calls (sometimes as many as six) related to that visit. With Envera’s services, there can instead be one conversation or one touch via phone, email or text, based on the patient’s preferences.

delivers solutions by providing:

GROWTH

“Envera is a pure services organization,” Butler explains. “In terms of how we partner, we don’t come in and rip things out that are working well. Instead, we meet our partners where they are, and offer services to support what they may be missing.”

Envera Health delivers health solutions for provider partners through three distinct service lines Envera custom tailors its services by driving growth, increasing access and coordinating care.

The company’s growth services focus on identifying immediate opportunities to increase new patient growth and retain existing patients for specific services, such as weight-loss surgery or mammography screenings. In this situation, Envera serves as an extension of the provider team, working across marketing and clinical operations to create a more unified consumer experience while showing the attributable value that marketing can bring to the health system. They analyze and provide measurable results so providers know they’re offering the best care for patients.

ACCESS

CARE COORDINATION

Envera’s access services go beyond scheduling and appointment reminders. “Every time you call your provider, having someone answer the phone – that’s a basic level of expectation,” Butler www.OurHealthCville.com

57

REFERRAL REACH

explains. “Our goal is to meet the needs of the “whole” patient with a one-call resolution— keeping them loyal and building relationships that last. In addition, Envera might also conduct a comprehensive audit of a partner’s phone system to gauge its effectiveness. For example, there could be 15,000 different phone numbers in a healthcare system but 3,000 of those lines are dead ends as a result of changes that occurred but were never recorded over the years.”

“We’re looping the patient back to the health system, letting them know we care and want them to recover and stay healthy.”

Envera Health representatives proactively contact every patient who has interacted with the health care system or provider through its coordinated care or transition solutions. This connected experience creates more patient satisfaction and closes care gaps.

“As patients leave the emergency room, their provider says, ‘We care about you. We want to know that you’re getting better. Expect a phone call as we’re going to reach out and ask you a couple questions.’ That’s our way of knowing you’re getting better,” Butler explains. “That’s what we do for our partners. And on that call, patients can also talk with a live nurse and ask him or her questions – ‘Should my wound look like this? Should I still have a fever?’ We’re really trying to bring that comfort and peace of mind to the patient. We found that it reduces hospital readmissions and significantly improves patient satisfaction.

And it works in a hospital or emergency room or even if you go down the street to an imaging center. We’re looping the patient back to the health system, letting them know we care and want them to recover and stay healthy.”

Finding joy at work In 2017, Envera Health opened their new 27,000-square-foot headquarters in downtown Richmond.

Brett Butler

Vice President, Client Success Envera Health

“There aren’t many companies out there doing what Envera does, and our new office adds one more differentiator,” Butler adds. “Since so many of our employees spend their days speaking by phone with patients who are trying to solve a healthcare problem, they need to find joy in helping patients in those moments of need. So we created a warm physical environment to support making that happen.”

Now located along the canal in the heart of Richmond, Envera employees enjoy a full view of the James River. “This really is a differentiator,” Butler adds. “We’re so proud of this new space and encourage site visits. Just reach out and come see it for yourself.”

EXPERT CONTRIBUTOR Brett Butler, Envera’s vice president of client success.

58

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

ON THE WEB

More at ourhealthcville.com

www.OurHealthCville.com

59