OurHealth Charlottesville and Shenandoah Valley: September/October2019

Y O U R L O C A L H E A LT H R E S O U R C E

September | October 2019

COMPLIMENTARY COPY

ourhealthcharlottesville.com

LIVING WITH CHRONIC HEALTH CONDITIONS: LOCALS SHARE HOW THEY ARE DOING MORE THAN SURVIVING; THEY ARE THRIVING!

HEART HEALTHY SOUPS AND STEWS PERFECT FOR THE FALL SEASON

PROMPT CARE FOR CONCUSSIONS IN PEOPLE OF ALL AGES MAKES A SIGNIFICANT DIFFERENCE

Ladies

Taking Time for Your Own Health SHOULD BE A

TOP PRIORITY

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20 SEPTEMBER • OCTOBER 2019

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LIVING WITH CHRONIC HEALTH CONDITIONS: NOT JUST SURVIVING BUT THRIVING Thanks to advancements in technology, medicine and services, and the expertise of medical professionals available today, including here in Charlottesville and the Shenandoah Valley, people are able to slow the progression of chronic illnesses and even realize improvements in their health and vitality.

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LADIES, TAKING TIME FOR YOUR OWN HEALTH SHOULD BE A TOP PRIORITY A recent survey showed almost 80 percent of women not only rank themselves last on their health to-do list, but will put off going to much-needed medical appointments because of their commitment to managing everyone else’s health, including their spouse/ significant other, children, elderly relatives, grandchildren and pets.

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DEPARTMENTS SEPTEMBER • OCTOBER 2019

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The Pulse | People. Places. News to Know.

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Health Scene | Happenings. Who’s Who. Trending.

2019 Charlottesville Women's Four Miler. The Charlottesville Women’s Four Miler is so much more than just a footrace; it is about encouraging and empowering women to take control of their health.

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ON SOCIAL MEDIA

Healthy Observations | Educate. Eradicate. Victory.

SEPTEMBER 2019 | National Traumatic Brain Injury Awareness Month Prompt Care for Concussions in People of All Ages Makes a Significant Difference. The damage from traumatic brain injuries can take years to detect— which is why prompt medical care is essential after all falls, blows and accidents.

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Food and Fitness | Nutrition. Exercise. Prevention.

Heart Healthy Soups and Stews Perfect for the Fall Season. This fall, warm up the cool, crisp season by having delicious – and heart healthy – soups and stews headline your meal plans.

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

Join the OurHealth Community

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Funny Bone | Spot the Seven Differences

MORE THAN A MAGAZINE ONLINE

SEPTEMBER • OCTOBER 2019

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PRESIDENT/EDITOR-AT-LARGE

VICE PRESIDENT OF PRODUCTION

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CONTRIBUTING MEDICAL EXPERTS

CONTRIBUTING PROFESSIONAL

EXPERTS & WRITERS

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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions.

Copyright © 2019 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.

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The Pulse

INFORMATION • EVENTS • AWARENESS

New Partnerships, Ventures and Acquisitions

Upcoming Events

Harrisonburg Pediatrics Is Now UVA Pediatrics Harrisonburg

American Heart Association Charlottesville Heart and Stroke Walk To Be Held November 3rd

UVA Health has acquired Harrisonburg Pediatrics, and the practice is now named UVA Pediatrics Harrisonburg.

While the practice’s name has changed, its providers and staff, phone numbers, locations and hours are remaining the same.

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As a part of UVA Health, children cared for at UVA Pediatrics Harrisonburg will now have streamlined access if needed to pediatric specialists through UVA Children’s.

UVA Pediatrics Harrisonburg will continue to see patients at both its Harrisonburg and McGaheysville locations.

More information: Visit www.harrisonburgpediatrics.com or to schedule an appointment at the Harrisonburg location, call 540.434.3004 and for the McGaheysville location, call 540.437.3740.

Mark your calendars to participate in the American Heart Association Charlottesville Heart and Stroke Walk, to be held on Sunday, November 3, 2019 at Fontaine Research Park on the UVA campus. Registration begins at 12 noon with the walk starting at 1 pm. Individuals and teams can register by visiting www.charlottesvilleheartwalk.org.

The Charlottesville Heart and Stroke Walk is a non-competitive three-mile walk focused on funding groundbreaking research and community health initiatives through the passion of walking together to change lives. Additional highlights of the event will include wellness activities and education, children activities, pet-walk, and health demonstrations.

More information: Visit www.charlottesvilleheartwalk.org.

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New Leadership Announcements American Hospital Association Names Mary Mannix to Board of Trustees The American Hospital Association (AHA) has elected seven new members to its Board of Trustees for three-year terms beginning January 1, 2020. The Board of Trustees is the highest policymaking body of the AHA and has ultimate authority for the governance and management of its direction and finances. Incoming members of the AHA Board of Trustees include presidents and CEOs of respected hospital systems throughout the country.

Augusta Health’s President and CEO, Mary Mannix, FACHE, is one of these esteemed leaders that will begin her three-year term this January. Mannix is also past chair of the Virginia Hospital and Healthcare Association's (VHHA) board of directors and is past chair of the board of directors for both Virginia Solution and Solution Services Corporation. As an AHA Mary Mannix, FACHE board member, she will chair AHA's Regional Policy Board 3, she is also a member of the VHHA board of directors, serving on its executive committee and foundation board.

The AHA is a not-for-profit association of healthcare provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for healthcare leaders and is a source of information on health care issues and trends.

More information: Visit the AHA website at www.aha.org.

New Facilities and Services UVA Primary Care Waynesboro Opens at New Location UVA Primary Care Waynesboro is now seeing patients ages 13 and older at its new location: 1850 Rosser Avenue, Waynesboro, VA 22980.

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UVA Primary Care Waynesboro provides comprehensive primary care, ranging from checkups and physicals to chronic disease management and minor surgical procedures.

It is also now offering additional lab services so patients can receive more of the care they need at a single location. Appointments may be scheduled Monday through Friday from 8:15 am to 4:30 pm.

More information: Visit www.uvahealth.com or to schedule an appointment at this location, call 540.942.1200.

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Sean Brooks, MD

Matthew Bryant, MD

Michelle Bushrow, NP

Brittany Cavanaugh, DO

Monique Cornett, FNP

Sarah Dalrymple, MD

Sara De La Rosa, MD

Chelsea Gottlieb, MD

Sentara Martha Jefferson Emergency Department Charlottesville | 434.654.7150 www.sentara.com

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

Carilion Clinic Family Medicine Lexington | 540.463.9158 www.carilionclinic.org

University Physicians – Orange Orange | 540.661.3004 www.uvahealth.com

UVA Urology Clinic UVA Family Medicine Charlottesville | 434.924.2224 Stoney Creek www.uvahealth.com Nellysford | 434.297.6000 www.uvahealth.com

UVA Eye Clinic Northridge Charlottesville Pathology Charlottesville | 434.924.5485 Associates www.uvahealth.com Charlottesville | 434.654.7188 www.sentara.com

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The Pulse

Lee Jensen, MD

Ashkan Karimi, MD

Jessica Kazbour, AuD

Margaret Lynch, MD

Charles Magee, MD

UVA Medical Center Sentara Martha Jefferson UVA Family Medicine Charlottesville | 434.924.3627 Inpatient Services Charlottesville | 434.924.1622 www.uvahealth.com Charlottesville | 434.654.7580 www.uvahealth.com www.sentara.com

Jordan Moran, MD

Masahiro Morikawa, MD Charlene Oldfield, MD

Family Dermatology of Albemarle Charlottesville | 434.964.9500 www.sentara.com

Augusta Health Rheumatology Fishersville | 540.245.7170 www.augustahealth.com

Jason Pickett, MD

Stephanie Rowe, PA-C

Julie Scialla, MD

Devang Sharma, MD

David Slottje Jr., MD

Natalie Smith, PA-C

Sentara Martha Jefferson Emergency Department Charlottesville | 434.654.7150 www.sentara.com

Augusta Health Transitional Care Fishersville | 540.245.7262 www.augustahealth.com

Sentara Martha Jefferson Emergency Department Charlottesville | 434.654.7150 www.sentara.com

Sentara Martha Jefferson Augusta Health Cardiology Neurosciences Fishersville | 540.245.7081 Charlottesville | 434.654.8960 www.augustahealth.com www.sentara.com

Alicia Kinch, OD

Amanda Lutter, DPM,

Evolution Hearing UVA Eye Clinic AACFAS Charlottesville | 434.227.4100 Charlottesville | 434.924.5485 Central Virginia Foot and www.evolutionhearing.com www.uvahealth.com Ankle Laser Center Charlottesville | 434.979.0456 www.cvillefootankle.com

Sentara Martha Jefferson UVA Kidney Center Clinic UVA Urology Clinic Inpatient Services Charlottesville | 434.924.1984 Charlottesville | 434.924.2224 Charlottesville | 434.654.7580 www.uvahealth.com www.uvahealth.com www.sentara.com

Sentara Martha Jefferson Neurosciences Charlottesville | 434.654.8960 www.sentara.com

Janaki Patel, MD

Charlottesville Orthopaedic Center Charlottesville | 434.244.8412 www.cvilleortho.com

For More of The Pulse Visit:

www.ourhealthcharlottesville.com Rachel Tyree, PA

Augusta Health Cardiology Fishersville | 540-245-7081 www.augustahealth.com

Osmond Wu, MD

Alice Zhang, MD

Sentara Martha Jefferson UVA Eye Clinic Northridge Neurosciences Charlottesville | 434.924.5485 Charlottesville | 434.654.8960 www.uvahealth.com www.sentara.com

Do you have health-related news to share for The Pulse?

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

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• NEWS TO KNOW

Andrew Iannuzzi, MD

Health Scene HAPPENINGS • WHO’S WHO • TRENDING words | STEVE MCCLINTIC JR. original photography | AJ ZAPANTA PHOTOGRAPHY (WWW.AJZAPANTA.ZENFOLIO.COM)

OVER 2000 WOMEN PARTICIPATE IN CHARLOTTESVILLE WOMEN’S FOUR MILER SUPPORTING BREAST CANCER CARE AND RESEARCH Since its inception in 1983, the Charlottesville Women’s Four Miler, Virginia’s largest and oldest allwomen race, has been an opportunity for women to come together each year and support local breast cancer care and research and one another. Saturday, August 31st of this year was no different, when 2,071 runners and walkers joined together at Foxfield on Garth Road in Charlottesville to participate in the annual event that is hosted by the Charlottesville Track Club.

To date, more than four million dollars has been raised to support groundbreaking cancer research and innovative patient care programs at UVA Cancer Center’s Breast Care Program.

The Charlottesville Women’s Four Miler is so much more than just a footrace. It’s about encouraging and empowering women to take control of their health; a celebration of women and the strength of women.

This year, as in previous ones, participants were able to honor friends and family who have battled cancer by having their names displayed along the “Motivational Mile”, the last mile of the race. This valued tradition has become one of the most memorable aspects of the race.

Another part of the race that’s so special is the annual CTC Women’s Four Miler Training Program.

Now in its 26th year, participants in the CTC Women’s Four Miler Training Program gather for 11 consecutive Saturdays (beginning in June) for sessions of group training and to learn about a variety of women’s health topics from experts in the community. Visit www.w4mtp.com for additional information.

To learn more about the Charlottesville Women’s Four Miler, including race results from this year and past ones, visit www.womens4miler.org.

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3.5+ inches

Questions. Answers.

Knowledge.

Walking in high heel shoes,

ESPECIALLY 3.5 INCHES OR GREATER,

forces your ankles to maintain a plantarflexed position during the gait cycle, which strains your knees and back and can accelerate osteoarthritis developing in these joints.

How bad for my feet are my high heels?

What are early warning signs of thyroid problems?

Wearing high heels in moderation is key. I tell my patients to save their stilettos for the occasional special event that doesn't involve too much walking, and whenever possible, to pack an extra pair of comfortable shoes for rescue as the night goes on. You don't want to be walking home barefoot.

Thyroid hormone controls the metabolism in many different organs. Thyroid problems can be divided into three main categories: overactive thyroid, underactive thyroid and thyroid nodules.

Walking in high heel shoes, especially 3.5 inches or greater, forces your ankles to maintain a plantarflexed position during the gait cycle, which strains your knees and back and can accelerate osteoarthritis developing in these joints. Long term use can lead to shortened Achilles tendons, a condition called equinus (like a horse walking on their toes).

Equinus is a well-known contributor of many painful foot problems including bunions, hammertoes, neuromas and plantar fasciitis, to name a few. Moreover, by locking up ankle motion, blood circulation is restricted, which can lead to swelling and spider veins.

Fortunately, many shoe designers are mindful of both style and function in their designs. I recommend trying brands like Dansko, Naot, Rieker, ABEO, Allegria and Taos.

Amanda Lutter, DPM

Central Virginia Foot and Ankle Laser Center Charlottesville | 434.979.0456 www.cvilefootankle.com

Overactive thyroid causes things to speed up. Symptoms include anxiety, heat intolerance, weight loss, hair loss and diarrhea. There are different ways to treat overactive thyroid, depending on the cause.

An endocrinologist, a specialist who treats thyroid problems, should be consulted for treatment recommendations.

Underactive thyroid causes everything to slow down. Symptoms include weight gain, depression, constipation, cold intolerance and hair loss. Underactive thyroid is easily treated with thyroid hormone replacement medication. A primary care physician can treat underactive thyroid and monitor thyroid hormone dosage.

Thyroid Nodules can often have no symptoms. They are sometimes discovered incidentally on imaging tests like a CT scan that is done for another reason. Possible symptoms, if they appear, can be hoarseness, trouble swallowing and neck discomfort, which typically suggests a larger nodule. Nodules greater than one centimeter are biopsied to rule out cancer.

If the thyroid gland is removed for whatever reason—goiter, cancer or nodules—the patient will need to take hormone replacement therapy.

Nelly Maybee, MD

Augusta Health Diabetes and Endocrinology Clinic Fishersville | 540.245.7180 www.augustahealth.com

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

I’m suffering from pain when I sit. Could it be pudendal neuralgia?

While pudendal neuralgia (PN) is a possible diagnosis, it is relatively rare. The human body has a pudendal nerve on both sides of the body that comes from the sacral spinal nerves and provides sensation to the genital and rectal areas. The pudendal nerve is also involved in some portion of bladder and rectal function as well as the muscles of the pelvic floor. Patients with PN describe tingling, shooting, or burning pain in some part of the recto-genital area and usually on only one side of the body. Patients often have hypersensitive skin in the same area, making contact with clothing uncomfortable or painful.

Pain is usually worse with sitting on a hard surface because the nerve gets compressed where it exits the pelvis near the ‘sit bone.’ It is usually improved when lying down or sitting on a toilet seat because that relieves pressure. Proper diagnosis involves a neurosensory exam, sometimes a CT or MRI, and a diagnostic nerve block.

Kenneth Barron, MD

Center for Advanced Gynecology Charlottesville | 434.234.4903 www.virginiagyn.com

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Questions. Answers.

Knowledge.

My child dislikes using toothpaste. Is using it really necessary?

Did you know?

October is

DENTAL HYGIENE AWARENESS MONTH

Using fluoride toothpaste helps prevent tooth decay, so it plays an important role in your child’s oral hygiene habits.

Yes! Using fluoride toothpaste helps prevent tooth decay, so it plays an important role in your child's oral hygiene habits. Unfortunately, many kids dislike using it, so it helps to try different flavors and brands until you find one that your child prefers.

Make sure to perform or supervise brushing and to use the appropriate amount of toothpaste. For babies, a tiny smear is recommended, and for children ages three to six, a pea-sized amount is enough.

Jessica Moore, DDS

Children’s Dentistry of Charlottesville Charlottesville | 434.260.6836 www.childrensdentistryofcharlottesville.com

I never work out, so how did I get athlete’s foot?

How old do you have to be to join a senior center?

The simple truth is that athlete’s foot is a very common skin disorder seen in all segments of the population, not just athletes.

Athlete’s foot is a fungal infection of the skin of the foot and toes resulting in redness, scaling, and itching especially between the toes.

Fungal organisms thrive in areas of warmth and moisture, so our feet are prime targets because of our shoe and sock wear. It is generally easily treated with over-the-counter anti-fungal creams but preventing it in the first place is always preferable.

Key prevention strategies are to get out of your shoes and socks as soon as you can, especially if they are wet. Wash and dry your feet thoroughly and regularly, try a little baby powder to wick away moisture, and get into your sandals or flip flops whenever you can to allow air to get to your feet. All of these interventions can help to prevent athlete’s foot for you, whether you’re an athlete or not!

When my mother-in-law moved to town, my husband and I tried hard to get her to explore the senior center only a block from her house, but she insisted she was not old enough – even though she was passed 80. Like many people, my mother-in-law had a misconception about what today’s senior centers are like. She was still active, independent, and healthy, and those adjectives didn’t fit her picture of the kind of person who spent time at a senior center. In Charlottesville, the Senior Center recognized this common misconception was a barrier for lots of people who might otherwise come to explore the over 100 programs it offers every week, including fitness, lecture classes, travel, ballet, and a jazz band. To better reflect its mission, it has been renamed to “The Center”, which provides opportunities for active aging for people 50 and older.

John MacKnight, MD

Judy Gardner

Member and Guest Relations Coordinator The Center Charlottesville | 434.974.7756 www.thecentercville.org

UVA Health System University Physicians Charlottesville Charlottesville | 434.924.2472 www.uvahealth.com

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Living with

CHRONIC HEALTH CONDITIONS: NOT JUST SURVIVING

but Thriving

words | STEVE MCCLINTIC, JR. AND DYLAN ROCHE

Chronic health conditions, such as cancer, heart disease, lung disease and arthritis, to name a few, have traditionally led to a very poor quality of life and even premature death for those affected by them.

Broadly defined, chronic diseases are conditions that last a year or longer, require ongoing medical attention and can limit activities of daily living or both. But thanks to advancements in technology, medicine and services, and the expertise of health experts available today, including here in Charlottesville and the Shenandoah Valley, people are able to slow the progression of chronic illnesses and even realize improvements in their health and vitality. But don’t just take our word for it. Hear in their own words how people in our community are living with chronic diseases all while doing much more than just fighting to survive – they are thriving in life.

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Judith Rushia of Charlottesville

Judith Rushia LIVING WITH

DIABETES TREATING MEDICAL PROVIDER

BARBARA MARTIN, RN, NP, CDE Sentara Martha Jefferson Hospital LOCATION

CHARLOTTESVILLE photo cour

tesy of | TA

Learning What It Means to Be a Diabetic Helped Her Accept and Control It Elliott Joslin, MD, the first physician to specialize in diabetes back in the late 19th century, emphasized that the person with diabetes who knows the most about it is the one who lives the longest. Barbara Martin RN, NP, CDE, a diabetes educator with Sentara Martha Jefferson Hospital in Charlottesville, couldn’t agree more. “Diabetes is a disease that has to be managed daily to maintain your health,” she says. “To manage it effectively, those who have it need to know as much about it as they can.”

“I know so much more now and see how effective management can be.” – JUDITH RUSHIA

Instead of using scare tactics or invoking fear that often causes people to believe they are fighting an uphill battle with no chance of winning, Martin shares the whole story about diabetes, discussing both the challenges it can cause, as well as the many options available to help treat and effectively manage it.

Judith Rushia of Charlottesville discovered this firsthand. When she was first diagnosed with the disease, it was difficult for her to accept. In her defense, she’s not alone. Diabetes, especially Type 2, is a condition people can sometimes have for years before the damage it does to the body is noticed. Like many slowly progressing diseases that work from the inside out, they consequently become

Today, Rushia, who notes that learning more about the disease helped her become less intimidated about taking proper care of

“Because diabetes affects people differently, each person must find ways to manage it in a way that works best for him or her.

No two people respond the same to anything — food, physical activity or medications.”

Barbara Martin, RN, NP, CDE

ARK

out of sight and out of mind. Rushia knew she was playing roulette by ignoring that she had diabetes, but what she didn’t know was how many bullets were loaded in each chamber. In other words, she didn’t know the disease well enough to understand how serious it was.

After being referred to a diabetes educator and meeting with Martin, Rushia says that learning more about the disease was the first step in helping her understand how much she can actually control it.

words | DYLAN ROCHE

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RYN WHITL

| Sentara Martha Jefferson Hospital

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

herself, works with a dietitian who helps guide her in making food choices right for her. She also tests her blood glucose level every morning, which lets her know if she’s staying on the right path in managing her disease or needs to make adjustments.

Rushia also learned the importance of regular exercise as a part of an effective care plan for diabetes, and has found that attending water aerobics three to four times a week is a fitness routine she not only benefits from, but actually enjoys.

Attending a monthly support group where she can share her challenges and successes with others who also have diabetes and can relate to her rounds out her custom approach to taking care of herself. “It all works together to optimize my life,” she says. “Life is much better. All of these things involve attention and dedication. They all improve me.”

“Because diabetes affects people differently, each person must find ways to manage it in a way that works best for him or her,” Martin explains. “No two people respond the same to anything — food, physical activity or medications,” she says. “When we talk about the different types of diabetes, we say there are as many types of diabetes as there are people with diabetes.”

Modern technology has resulted in many advances designed to help people more effectively and conveniently manage diabetes. For example, smartphone apps are available that measure and track blood glucose levels, dietary habits and can even send reports directly to the doctor’s office so medical staff can evaluate and make changes to a patient’s treatment plan in-between regular appointments if needed. In fact, there are hundreds of tools and resources available to help people remain in control of their condition, but speak with your doctor, diabetes educator, dietitian or even pharmacist before choosing which one to use to make sure it is right for you. “The person with diabetes has to control his or her diabetes, not let diabetes control him or her,” says Martin.

For Rushia, the biggest challenges are also what bring the greatest rewards; keeping her diet in line and staying active make her feel great physically and emotionally. She is also fortunate to have support from loved ones, which makes a big difference. “I have learned so much on this journey,” she concludes.

“I have learned what I need to do to be my own best friend instead of my own worst enemy. Never underestimate the power of knowledge, especially for something as important as your health. It’s a lesson everyone should learn and embrace.”

– JUDITH RUSHIA

www.OurHealthCharlottesville.com

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Diana Amick LIVING WITH

CONGESTIVE HEART FAILURE TREATING MEDICAL PROVIDER

TAMI COLLINS, NP

Diana Amick

Augusta Health Heart & Vascular Center

with exercise physiologist Savannah Young

LOCATION

STAUNTON

Feeling Accomplished Every Day as She Fights Heart Failure

or working. Many patients have pain, secondary to the inability to exercise and move. They can become weak and deconditioned. They can also struggle with depression and anxiety related to this chronic condition.”

words | DYLAN ROCHE

An ever-growing problem in the U.S., heart failure, which is also known as congestive heart failure — a progressive condition in which the heart becomes weak and is unable to pump blood or becomes stiff and is unable to fill adequately — affects an estimated 6.5 million Americans over the age of 20, according to Tami Collins, NP a nurse practitioner with Augusta Health Heart and Vascular Center in Fishersville.

Among those affected is Diana Amick of Staunton, who was admitted to the emergency room last summer after having problems breathing. Doctors determined she was suffering from heart failure, and in order to reduce her chances of having a heart attack, they placed a stent in her, which is a tiny tube inserted into the arteries to keep them open and allow blood to flow from the heart to other parts of your body.

Despite the challenges, Amick remains positive and has made great progress. “I have done exceptionally well,” she says. “With the problems I was having when I went into the hospital, they were amazed I was out of the hospital in seven days.”

The fact that Amick is able to manage her condition is a testament to her fortitude, as heart failure presents an array of both physical and emotional challenges. “Heart failure can affect a patient's quality of life in many ways,” Collins explains. “Many times, patients may not have the energy to do simple things such as bathing, eating,

In the months that followed her diagnosis, Amick learned how to track her weight, her diet and her exercise. As a person with diabetes, she also must keep an eye on her blood sugar (glucose) levels. Although she is still aiming to lose more weight, she remains focused on adopting a healthy lifestyle.

“I enjoy going to the gym and exercising. I feel accomplished each day that I go. I feel good about me.” – DIANA AMICK She also participates in a cardiac rehab program three times a week, which provides her with support not only from medical professionals but also from others with her condition. “Having a support group is very important,” she says.

Collins emphasizes that people with heart failure should follow the advice their medical providers recommend: take medications regularly, maintain a good weight, follow a low-sodium diet, monitor fluid intake, and seek support and continued communication from loved ones. “Patients have more options these days for advanced care,” she concludes. “Heart failure is a progressive condition that usually slowly gets worse over time. Fortunately, there are newer medications that have come out that are helping people to live longer and feel better.”

“Heart failure is a progressive condition that usually slowly gets worse over time. Fortunately, there are newer medications that have come out that are helping people to live longer and feel better.”

Tami Collins, NP

| Augusta Health Heart & Vascular Center www.OurHealthCharlottesville.com

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Carey Twyman LIVING WITH

SKIN CANCER TREATING PHYSICIAN

JENNIFER TROMBERG, MD

Carey Twyman of

Dermatologic Surgery of Central Virginia LOCATION

Orange

ORANGE

Skins Spots She Thought Were Nothing Turned Out to Be Something: Skin Cancer

percent of nonmelanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.

words | DYLAN ROCHE

Carey Twyman of Orange was only 26 years old when she first noticed the two pink spots on her body; one on her shin and one on her forearm. “They would come and go and be itchy,” she says. “But I never paid much attention to them.”

A few years later, after she began working for Dermatologic Surgery of Central Virginia in Charlottesville, she saw what skin cancer looked like, making her re-think whether her spots could be something more serious. Thankfully, she did. Because what had seemed like nothing to be concerned about turned out to be skin cancer, basal cell carcinoma, in fact.

“Basal cell carcinoma, along with squamous cell carcinoma, are two types of non-melanoma skin cancers,” says Jennifer Tromberg, MD, a dermatologist and Mohs micrographic surgeon with Dermatologic Surgery of Central Virginia. Skin cancer is the most common cancer in the U.S. and worldwide, and more than 4.3 million cases of basal cell carcinoma are diagnosed every year. “Those who are at greater risk of skin cancer frequently develop more than one over a period of years,” explains Dr. Tromberg. “It’s a risk that must always be considered during daily life, especially for high-risk patients. It’s a reminder that we must always think about ways to protect ourselves from the sun while still enjoying a fulfilling outdoor life.” About 90

Twyman, who lives on a farm, admits that before her diagnosis, she wasn’t always careful when it came to protecting herself from the sun. “Since my diagnosis, I have been very diligent about wearing sunscreen, and I am always sure to have a hat on,” she says. She also gets her skin checked every six months by her dermatologist. Like many others with her history, Twyman manages to live a normal life, but must always take precautions. “I try to reassure patients that having a history of skin cancer doesn’t mean you can’t go to the beach or the pool anymore,” says Dr. Tromberg, who recommends a sunscreen of at least 30 SPF, monthly self-checks, and dermatology appointments every six to 12 months.

Twyman, who turned to running as a way to help her feel better physically and emotionally during her fight against skin cancer, encourages people to educate themselves and be aware, especially with the diagnosis and treatment of nonmelanoma skin cancers in the U.S. having increased by 77 percent between 1994 and 2014.

“I’ve learned it’s never too late to start taking care of yourself. Just as important, never dismiss something like a skin spot as nothing until it has been checked out by a medical professional. Be proactive. You’ll thank yourself later.”

– CAREY TWYMAN

“Those who are at greater risk of skin cancer frequently develop more than one over a period of years. It’s a risk that must always be considered during daily life, especially for high-risk patients.”

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Jennifer Tromberg, MD

| Dermatologic Surgery of Central Virginia

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photo cour tesy of | SUSAN KA LERGIS PHOTOGR APHY

Dr. Nicole Kelleher and family

Nicole Kelleher, MD, MPH LIVING WITH

BREAST CANCER TREATING PHYSICIAN

SHAYNA LEFRAK SHOWALTER, MD, FACS Associate professor of breast surgery in the Division of Surgical Oncology at the University of Virginia LOCATION

CHARLOTTESVILLE

Breast Cancer Makes Her Grateful words | DYLAN ROCHE

Nicole Kelleher, MD, MPH with the Emily Couric Clinical Cancer Center at UVA Health System in Charlottesville, always knew she loved her children, but she didn’t realize how deep that love ran until her battle with cancer.

“It’s an interesting thing to face any type of cancer diagnosis with little kids because it isn’t about you. It’s about your children. You always have this abstract idea of how much you love your kids, but I am so much more keenly aware of that now.” – NICOLE KELLEHER, MD, MPH

Because of a family history of cancer, Dr. Kelleher began undergoing screenings when she was 32. In March 2019, when she was 36 years old, she was diagnosed with breast cancer; several months later, in May, she underwent a bilateral mastectomy, which is the surgical removal of both breasts to treat or prevent breast cancer.

The treatment plan for every breast cancer patient is going to be different, according to Shayna Lefrak Showalter, MD, FACS, associate professor of breast surgery in the Division of Surgical Oncology at the University of Virginia. “In recent years, the focus of breast cancer treatment has been on customizing the treatment plan specific to the individual patient and their cancer,” she says.

“When formulating a treatment plan for a patient, we take into consideration that patient’s general health, their personal and family cancer history, their job or childcare responsibilities, the distance they live from the hospital, etc.”

Oftentimes, patients will undergo a mastectomy, as Dr. Kelleher did, which Dr. Showalter says is more significant and often requires reconstruction to some degree. Other patients might instead require

“I counsel patients to outsource as much of the worry as possible onto us. I want patients to live their lives without the constant fear of breast cancer recurrence. We discuss a follow-up plan in regard to physician visits and breast cancer screening.”

Shayna Lefrak Showalter, MD, FACS

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| Division of Surgical Oncology at the University of Virginia

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lumpectomy, or breast conserving surgery. After surgery, many will undergo chemotherapy, which can bring its own set of challenges, including the need to have daily radiation therapy for four to six weeks.

“I counsel patients to outsource as much of the worry as possible onto us,” Dr. Showalter says. “I want patients to live their lives without the constant fear of breast cancer recurrence. We discuss a follow-up plan in regard to physician visits and breast cancer screening.”

Throughout the process, Dr. Kelleher managed to feel her best physically and emotionally by turning to exercise. As a cancer rehabilitation physician at Emily Couric Clinical Cancer Center, she describes herself as passionate about the relationship between exercise and cancer recovery. “One of the things I’ve done is maintain a high level of exercise throughout the process as best I can,” she says, indicating that physical activity helps offset the fatiguing side effects of chemotherapy and radiation.

She also praises the support of family and friends, saying their support has been critical.

Even though Dr. Showalter emphasizes that most patients treated for breast cancer “have an excellent long-term prognosis,” Dr. Kelleher looks to the future with the understanding that her life is changed forever by her cancer journey.

“Getting any type of cancer diagnosis is like walking through a door you can never go back through. Even when I’m done with my therapies and treatments, I always have to worry about my risk of cancer in the future and manage the anxiety around that.”

– NICOLE KELLEHER, MD, MPH

Her outlook is one of hope and thankfulness, and she wants to pay that forward, particularly for people in underserved communities or who don’t live near medical centers, who might not have as much knowledge as she did. “Getting this early screening, I’m eternally grateful for it, but then I feel responsible to try to help spread that message,” she says, “to help other people be as lucky as I have been.”

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Ladies,

Taking Time for Your Own Health SHOULD BE A

TOP PRIORITY words | JENNIFER LAMONT

I was waiting in my doctor’s office recently, half-listening for my name to be called. Hunched over my phone, swiping and typing, I was returning work emails, making a grocery list, texting and looking up superhero party ideas for my grandson’s third birthday. After several minutes, the nurse opened the door and ushered me down the hall.

I took a deep breath as I followed her to the exam room. I wasn’t nervous about seeing the doctor.

This quarterly visit was part of my routine over the last three years to monitor my Hashimoto’s thyroid disease and fibromyalgia symptoms. I just needed more air. I had been holding my breath much of the time I was sitting there trying to get things done with the few minutes I had to ‘spare.’ Like many people, my breathing becomes shallow when I’m unconsciously stressed.

And I’m stressed a lot. Just like every other woman I know. As a mother, daughter, grandmother, friend, co-worker and full-time caretaker to a 91-year-old grandparent, my plate is beyond full. I often need to remind myself to stop and breathe for a minute. Of course, I’m not alone. Roles Eighty percent may be blurring, but family health needs, nurturing and caretaking of women not only continues to fall mostly on women. Naturally, or by necessity, women rank themselves last become the family’s nutritionist, health researcher, care advocate on their health to-do list, and appointment scheduler – but for everyone else. but will put off going to

Ladies, Do You Take Better Care of your Pet Than Yourself?

much-needed doctor’s appointments because they’re too busy.

Most women will take the family’s beagle to the vet before they take themselves to the doctor. A recent survey showed almost 80 percent of women not only rank themselves last on their health to-do list, but will put off going to much-needed doctor’s appointments because they’re too busy taking children, elderly parents, spouses and pets to their appointments.

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Whether it’s societal conditioning or genes, we tend to take better care of others than we do ourselves. To be honest, I had rescheduled this appointment with my primary doctor twice before when other responsibilities came up. But delaying this visit indefinitely isn’t an option.

“My doctor relies on my exam and lab results to keep my thyroid levels in optimal ranges.

Without regular visits, I don’t receive my prescriptions, so that makes it easier for me to keep the appointment. But other appointments, like specialists, dentists or diagnostic tests, can sometimes feel more optional.” – JENNIFER LAMONT As a working caregiver, I’ve learned the hard way that putting off a doctor’s appointment can turn a cough into pneumonia with a three-day hospital stay, and a shoulder injury into a full-blown torn rotator cuff. The few hours I would have spent going in for initial treatment was far less than the several weeks I needed to recover from both of those health issues. More than losing time from work, I was not able to care for anyone, let alone myself.

So, I know that making time for my regular doctor visits, like this, is a priority. But even while the nurse was taking my blood pressure in the exam room, I was wondering if I’d make it out of there in time to stop by the grocery store, pick up my grandmother’s prescription and have her dinner on the table by 5:30. To make my appointment productive, I did a few things to maximize my time. These tips not only help my doctor get the most out of our visit, they also help me better manage my health overall:

How to Help Your Doctor Help You: 4 Tips

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A

Write down any questions or concerns before the appointment on paper or a note-taking app on your phone.

B

Keep a list of all the medications with dosages and supplements you’re taking. I do this for everyone I help take care of, including myself. Keeping a list of medications, allergies and important dates right on my phone makes filling out medical forms and answering questions faster and easier.

C

If you think of a question during the visit, ask it. If there is something you don’t understand, get clarification.

D

Be honest about any symptoms or issues you’re having.

The exam went smoothly, and I left my doctor’s office that day with no changes in my lab results, which was a good thing. It’s after I walk out of her office and in between these appointments that making my health a priority is easier said than done. Finding a good balance between taking care of myself and others can be difficult while trying to get things accomplished each day. Managing my time effectively helps.

It’s Time to Be Your Own Caretaker

“To really find that balance, I need to be ‘selfish’ at times. Meaning, I need to make myself a priority for at least some small part of each day.

You know that safety demonstration you watch before every flight that tells you to put on your own oxygen mask before you apply your child’s mask? It seems counterintuitive as a parent, but you must help yourself first so you can help others. You’re no good to anyone if you run out of air.”

Making yourself a priority will not only will improve your health and happiness, but you owe it to yourself and the ones you love. There are many ways to treat yourself with the same love, respect and care you give to others.

They’re some of the very same things you’d want your best friend, spouse or child to do. Here are nine of my favorite ways to stay balanced, productive, happy and healthy:

1

Include Whole Foods While Meal Prepping.

2

Keep Yourself Strong.

3 4 5 6

– JENNIFER LAMONT

Nothing zaps your energy and health more than processed and fast foods. Spend a couple hours one day each week to cook up nutritious meals for the next seven days. Each Sunday, I cook up a few different recipes so my grandmother and I have healthy meals during the week. This saves us both time, money and frustration, while helping us eat a healthy diet most of the time.

Lifting weights is not only beneficial for women of all ages, it’s proven to reduce stress and boost self-esteem, while preventing aging and illnesses. It also helps you function better in your daily activities, making injuries less likely. Combine with walking or your favorite type of cardio to burn fat, get lean and increase those feel-good endorphins. Get outside to exercise whenever possible, but go to the gym if that’s what you prefer.

Keep Organized with To-Do Lists and a Calendar Schedule.

To-do lists allow you to not only set priorities and stay focused, but they help motivate you when you cross off completed items. Having a central calendar in the kitchen, as well as on my phone, helps me keep track of everyone’s appointments, including mine.

Take Time to Enjoy Your Friends.

Studies show the healthiest people in the world are those who have a strong support system. People who have fun on a regular basis with others – those who they like to be around – live longer and feel more purpose in life as they age. Even better, do a physical activity with your favorite friends and you get even more benefits.

Keep Your Dentist and Doctor appointments.

While women go to the doctor more frequently than men, they are just as likely to suffer from chronic conditions without getting treatment. That’s why regular checkups are so vital. You may not feel sick or be experiencing any issues, but it doesn’t always mean you are healthy.

Join a Support Group if You’re a Caregiver.

There are working caregivers everywhere. In fact, over 40 million unpaid caregivers in the U.S. are taking care of at least one family member over the age of 65 right now.

Support groups for caregivers are especially important because they understand your situation. Friends can support you, but they can’t relate or give you proper emotional support like other caregivers can.

I know that sometimes

PUTTING MY NEEDS FIRST IS NOT SELFISH; it’s essential.

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7

Increase the Gratitude and Positivity in Your Life.

8

Ask For Help and Then Take a Nap.

9

Do Nothing.

Keep a gratitude journal, even if you only write one line a day. Find the humor and positivity in situations and people. Surround yourself with those people who bring happiness, positivity and hope into your life.

Hire a cleaning service when you need it. Ask your kids, spouse or other family members to help with chores or errands. Get enough sleep at night so you can function at your best level during the day.

Sometimes you need a break from everything and everyone. It’s okay to say “no” to everything once in a while, and just be present with yourself. But it doesn’t count if you’re on your phone.

Sometimes, I find myself ‘in-between’ errands, family, working and projects where I realize I suddenly have a few minutes to myself. Here are some quick ways I de-stress and recalibrate:

Six Ways to Take Care of Yourself When You Only Have 5 Minutes: A

Breathe deeply, inhaling for 4 seconds and exhaling for 4 seconds. Set a timer for 5 minutes.

B

Do 20 wall push-ups, 20 squats or lunges, and 20 jumping jacks.

C D E

Stretch your legs, ankles, shoulders and neck.

F

Read a few lines from an actual book you hold in your hand, not an e-book on your phone.

Walk outside.

Find a quiet corner to meditate, pray or think about something for which you’re grateful.

As a woman in the unique position of being able to take care of two young grandsons and her grandmother, I know that sometimes putting my needs first is not selfish; it’s essential.

The quality of care they get from me is dependent on my own health and happiness. Putting myself first doesn’t mean I’m putting them last. It just enables me to give them the best version of myself.

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

Commonly Overlooked CONDITIONS

Who Can You Turn to in Charlottesville and Shenandoah Valley For Help?

POLYCYSTIC OVARY SYNDROME affects seven to 10 percent of women

1

Polycystic Ovary Syndrome (PCOS)

of childbearing age and is the most common cause of infertility.

What is PCOS?

What are the symptoms of PCOS?

Polycystic Ovary Syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens (male sex hormones) that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. PCOS affects seven to 10 percent of women of childbearing age and is the most common cause of infertility. In the U.S., an estimated five to six million women have the condition. PCOS is the most common hormonal disorder among women of reproductive age, but many women don’t know they have it.

Because there is such a wide range of symptoms, PCOS is defined as a syndrome, not a disease. The most common symptoms are irregular menstrual cycles, acne, weight problems, such as weight gain or upper body obesity, and abnormal hair growth. Many women also experience infertility or pregnancy loss. The ovaries often become enlarged and may contain one or more abnormal cysts. Enlarged ovaries are easily detected by transvaginal ultrasound. Many symptoms occur either early in the condition or develop gradually.

Women with PCOS, especially overweight women, may have insulin resistance and have an increased risk for diabetes and high lipids.

Where in Charlottesville & Shenandoah Valley Can I Get Help? *

How is PCOS diagnosed?

Reproductive Medicine and Surgery Center of Virginia

There is no single test to diagnose PCOS. It is diagnosed in women who have irregular menstrual cycles when blood tests or physical symptoms suggest they may have elevated levels of male hormones, hirsutism (abnormal growth of hair on a person’s face and body, especially on a woman), or the typical PCOS pattern noted on ultrasound. Many women are diagnosed with PCOS after being evaluated for miscarriages and infertility.

According to the American Society of Reproductive Medicine (ASRM), the criteria to diagnose this condition includes having two of the following three findings: • High androgen levels

Charlottesville | 434.654.8520 www.rmscva.com

UVA Diabetes and Endocrine Clinic Charlottesville | 434.924.1825 www.uvahealth.com/services/ endocrine

Augusta Health Diabetes and Endocrinology Clinic Fishersville | 540.245.7180 Lexington | 540.464.3465 www.augustahealth.com/amg/ diabetes-endocrinology-clinic

• Irregular menstrual cycles • Polycystic appearing ovaries on ultrasound www.OurHealthCharlottesville.com

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2 Where in Charlottesville & Shenandoah Valley Can I Get Help? * Ward G. Gypson, MD UVA Health Charlottesville | 434.243.5600 www.uvahealth.com/services/ autoimmune-rheumatology/ fibromyalgia

Akhtar Purvez, MD Pain and Spine Center of Charlottesville Charlottesville | 434.328.2774 www.painspinecenters.com

Fibromyalgia

What is fibromyalgia?

What are the symptoms of fibromyalgia?

For decades, medical providers misdiagnosed fibromyalgia, a condition indicated by widespread, general pain and fatigue, or simply refused to diagnose patients at all. Thankfully, physicians are more frequently – but not always – recognizing fibromyalgia for the difficult and very real issue that it is.

Around five million adults, of which 80 to 90 percent are women, suffer from fibromyalgia, which affects a person’s soft tissue. The cause is unknown, but factors could include infections, physical or emotional trauma, long-term stress and genetics.

Fibromyalgia presents much like arthritis, but doesn’t cause the same sort of joint and muscle inflammation and damage as that particular condition. In addition to widespread pain and fatigue, fibromyalgia symptoms include headaches, irritable bowel syndrome, painful menstrual periods, sensitivity to heat and cold, concentration and memory issues (often referred to as “fibro-fog”) and tingling and numbness in the hands and feet.

3

Rebecca Fox, MD FoxCare Integrative Health (Pediatrics) Charlottesville | 434.290.1210 www.foxcareintegrativehealth.com

Sentara Rheumatology Specialists Harrisonburg | 540.689.5700 www.sentara.com/harrisonburgvirginia

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At one time, physicians diagnosed fibromyalgia by checking known trigger points and pressing on certain areas of the body to determine if they were painful. Those points included the back of the head, upper chest, knees and elbows. While painful trigger points are still standard for fibromyalgia, they’re no longer the primary way to diagnose. Instead, a doctor might determine a patient has fibromyalgia if they’ve experienced general, widespread pain for at least three months and have no other diagnosable medical condition to explain it.

Chronic Fatigue Syndrome

What is Chronic Fatigue Syndrome?

Where in Charlottesville & Shenandoah Valley Can I Get Help? *

How is fibromyalgia diagnosed?

When it comes to invisible diseases, chronic fatigue syndrome (CFS) might be the most invisible of all. Little is known about the disorder, which was only recently recognized to be a legitimate condition. CFS could be the result of a viral infection such as Epstein-Barr, but researchers have yet to find a definitive link. Healthcare professionals also point to immune system problems and hormonal imbalances as potential culprits. Life with CFS can be isolating, leading to complications such as depression, increased work absences – and, as a result, difficulty climbing the career ladder – and a restriction on daily activities that can keep a person healthy and happy.

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

What are the symptoms of CFS? As the name suggests, severe fatigue is the main indicator of CFS. It gets worse after physical or mental activity, but the exhaustion doesn’t get better after rest. This form of fatigue isn’t just feeling tired, but rather an all-consuming exhaustion that has lasted six month or longer. People with CFS often experience problems with thinking and memory, as well as dizziness or weakness while standing or sitting up. They might also feel muscle or joint pain and headaches, although those aren’t symptoms experienced by everyone with the condition.

How is CFS diagnosed?

Diagnosing CFS isn’t easy – for the patient or the physician.

There isn’t a test that can plainly tell if a person has CFS, so it’s mostly a diagnosis of elimination by testing for and ruling out other diseases, such as sleep disorders, hypothyroidism and mental health issues. However, even if CFS is diagnosed, there’s no true treatment—and there’s certainly no cure. Instead, the focus is on relieving symptoms through medications such as antidepressants, cognitive therapy and a few minutes of movement a day that’s gradually increased to help reduce hypersensitivity to exercise.

Those with

IRRITABLE BOWEL SYNDROME suffer with upset stomach, cramping and diarrhea

at least three days every month.

4

Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome?

The fact that irritable bowel syndrome is often overlooked in women is ironic; the condition, also known as spastic colon, affects more females than males. Although everyone deals with an upset stomach, cramping and diarrhea on occasion, those with IBS suffer from it at least three days every month (and, for the most part, much more often than that). Although the two conditions sound similar, IBS isn’t the same as inflammatory bowel disease, which is much more serious and has drastic complications.

What are the symptoms of IBS? Irritable bowel syndrome often starts with cramping and abdominal pain, then progresses to bloating, gas, and episodes of both constipation and diarrhea. The pain will likely go away after a bowel movement, but will inevitably return. Women often have more symptoms around the time of their periods, and some say IBS gets worse during pregnancy. A change in diet to avoid “trigger” foods – including cruciferous vegetables like broccoli, kale and cauliflower, and legumes such as beans and lentils – often successfully manages the worst IBS symptoms.

How is IBS diagnosed?

Many doctors will diagnose irritable bowel syndrome based on symptoms, but some might want to do a few additional tests to rule out other potential conditions. For example, the symptoms could be caused by an infection or another disorder such as celiac disease, so the patient might need to provide a stool sample or undergo a blood test. If a doctor suspects the symptoms are being caused by a more severe disease, such as colitis, Crohn’s disease or cancer, they might perform a colonoscopy. Over the past five years, blood tests to help diagnose IBS have appeared on the market. However, it only has the potential to diagnose forms of IBS in which diarrhea is the prominent symptom, rather than constipation, so it’s not a catch-all for helping everyone who suffers from the condition.

Where in Charlottesville & Shenandoah Valley Can I Get Help? * Charlottesville Gastroenterology Associates Charlottesville 434.817.8484 www.cvillegi.com

UVA Digestive Health Center Charlottesville 434.243.3090 www.uvahealth.com/ locations/profile/ digestive-health-center

Augusta Health Gastroenterology Fishersville | 540.245.7350 www.augustahealth.com/ amg/gastroenterology

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Women develop

AUTOIMMUNE DISEASES at a rate of 2:1 compared to men, with the condition typically appearing during her childbearing years.

5 Where in Charlottesville & Shenandoah Valley Can I Get Help? * Augusta Health Rheumatology and Osteoporosis Clinic Fishersville | 540.245.7170 www.augustahealth.com/amg/ rheumatology-osteoporosis-clinic

UVA Rheumatology Clinic Charlottesville | 434.243.0223 www.uvahealth.com/locations/ profile/rheumatology-clinic

Akhtar Purvez, MD Pain and Spine Center of Charlottesville Charlottesville | 434.328.2774 www.painspinecenters.com

UVA Diabetes and Endocrine Clinic

Autoimmune Disorders

What are Autoimmune Disorders?

Rather than just one disease, autoimmune disorders are a cluster of individual conditions that occur when the immune system attacks the body’s own tissues rather than fighting infections from outside invaders. Women develop autoimmune diseases at a rate of 2:1 compared to men, with the condition typically appearing during her childbearing years.

There are more than 80 known autoimmune disorders, but common conditions include: • Rheumatoid arthritis

Charlottesville | 434.924.1825 www.uvahealth.com/services/ endocrine

• ●Lupus

Augusta Health Diabetes and Endocrinology Clinic

• ●Hashimoto’s thyroiditis

Fishersville | 540.245.7180 Lexington | 540.464.3465 www.augustahealth.com/amg/ diabetes-endocrinology-clinic

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• ●Multiple sclerosis • ●Guillain-Barre • ●Grave’s disease • ●Celiac disease

What are the Symptoms of Autoimmune Disorders?

Although autoimmune disorders aren’t just one disease, early symptoms are often similar. These include achy muscles, fatigue, swelling and redness, hair loss, numbness and tingling in the hands and feet, rashes and trouble concentrating. Some autoimmune diseases, particularly rheumatoid arthritis and psoriasis, have symptoms that come and go. These periods of time are known as “flare-ups;” when the symptoms go away, it’s known as “remission.”

How are Autoimmune Disorders Diagnosed?

No matter which autoimmune disease a person is suffering from, diagnosis typically starts with an antinuclear antibody test. If the test comes back positive, it means a person might have an autoimmune condition, but it won’t indicate exactly which one. From there, a doctor will likely take symptoms into account to diagnose the specific disorder. Because symptoms are so generalized and often come and go, some doctors might not take a person’s complaints seriously. Reaching out to a specialist that has experience dealing with specific symptoms—for example, a gastroenterologist if constipation and diarrhea are a major issue—can often help increase the chance for a diagnosis.

*The medical practices and providers listed in the Community Care Connection do not necessarily represent a comprehensive listing of professionals in Charlottesville and the Shenandoah Valley who specialize in the related conditions.

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HEALTHY OBSERVATIONS SEPTEMBER

NATIONAL TRAUMATIC BRAIN INJURY AWARENESS MONTH

PROMPT CARE for Concussions in People of All Ages

MAKES A SIGNIFICANT DIFFERENCE SEPTEMBER IS NAT I

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The damage from traumatic brain injuries can take years to detect—which is why prompt medical care is essential after all falls, blows and accidents.

BR AIN

ES

ION

Y INJUR

S

S MONTH

words | STEVE MCCLINTIC, JR.

Suffering a blow to the head can be a terrifying experience. When you get up and walk away, seemingly unscathed, you may breathe a sigh of relief that you dodged a serious injury. Then, days, weeks or even years later, you might start experiencing headaches, cognitive problems and other signs of a traumatic brain injury—the very condition you thought you had previously avoided.

For this reason alone, it’s vital for anyone with a head injury to seek medical attention as soon as possible. However, too few people realize the potential for long-term damage and delay visiting a doctor until symptoms show up. September marks National Traumatic Brain Injury Awareness Month, designed to raise awareness about the dangers of traumatic brain injuries.

Discussion about traumatic brain injuries has been on the rise recently, due to research on sports injuries that shows playing roughly on the field or court for years may lead to not only long-term physical problems but also brain damage and behavioral changes. As a result, sports teams at all levels, from youth to professional, have taken measures to overhaul safety procedures, from mandating better equipment to improving the criteria for when injured players can return. However, traumatic brain injuries can occur from falls, car crashes and combat injuries, too.

Generally, traumatic brain injuries occur when the brain tissue is bruised or damaged from a blow – or repeated blows – to the head. Some symptoms, such as dizziness and nausea, may show up immediately, but other symptoms may show up years later.

Damage can occur even in mild cases, in which the brain recovers quickly; however, a more severe injury or repeated injuries could lead to behavioral changes, memory problems, chronic pain, poor coordination and problems sleeping.

2.5 million

Some emergency room visits were related to traumatic brain injuries in 2014.

Those injuries resulted in more than

56,000 deaths.

Children logged

812,000 of those

emergency room visits and accounted for more than

2,500 TBI-related deaths.

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Center for Neurorehabilitation Services 7401 Beufont Springs Drive, Suite 205 Richmond, VA 23225 | 804.272.0114 www.centerforneurorehabservices.org OFFICE HOURS

Monday to Friday, 8 a.m. to 5 p.m.

BRAIN INJURY MEDICINE FOR THE 21ST CENTURY Since 1991, the Center for Neurorehabilitation Services has been providing comprehensive, patient-centered, medical services for individuals who have sustained brain injury as a result of trauma, stroke, infection or other causes. Its experienced team of medical professionals offers an array of disease-modifying therapies for individuals who have sustained acquired brain injuries.

Gregory O’Shanick, MD

According to the Centers for Disease Control and Prevention, some 2.5 million emergency room visits were related to traumatic brain injuries in 2014, resulting in more than 56,000 deaths. Children logged 812,000 of those emergency room visits and accounted for more than 2,500 TBI-related deaths.

Children and young adults, particularly those ages four and younger or between ages 15 and 24, are at highest risk of traumatic brain injuries says Gregory O’Shanick, MD, of the Center for Neurorehabilitation Services in Richmond. However, people age 65 and older also have a higher number of traumatic brain injuries, with four out five concussions in this age group due to falls.

Dr. O’Shanick says that he’s concerned that some doctors or emergency room personnel might not properly diagnose or address possible brain injury when treating someone with fall damage.

For instance, if the only symptom that’s observed is confusion, a physician may just send the patient home to rest without exploring the possibility of traumatic brain injuries – but a closer look could reveal internal bleeding and blood clots in the skull that could cause severe problems, or even death, at a later date. As the pressure and clots build up, the patient may only be aware of pain, feeling moody, or unbalanced, which are all easy to blame on the fall or being worn out. Eventually, though, they could experience stroke-like symptoms, seizures or coordination problems.

Luckily, with more attention to traumatic brain injuries, increased efforts are leading better methods for detecting these injuries.

A proper diagnosis can lead to faster treatment, recovery and therapy, if needed. At the Center for Neurorehabilitation Services, the staff begins by learning a patient’s medical history and then speaking to a close friend or family member who has known the patients for years, Dr. O’Shanick says. This person will be asked to describe changes in behavior or abilities before and after the patient’s traumatic brain injury, which can help the doctor more quickly diagnose the issue.

Additionally, the center now uses a more precise computer-assisted neuroimaging tool called NeuroQuant, which provides a detailed look at areas of change or tissue damage. It goes beyond traditional neural imaging which usually only spots blood clots. By accurately measuring the volume of different parts of the brain, the staff can follow the course of an injury and better assess what types of injuries could be impacting a patient’s stability and recovery.

Given the statistics and health risks, medical officials and family members of those affected welcome the extra attention on traumatic brain injuries, as do advocates who hope to reduce these types of injuries – and with National Traumatic Brain Injury Month, the word can continue to spread.

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

Food Fitness NUTRITION • EXERCISE • PREVENTION

Heart Healthy

Soups &Stews Perfect for the Fall Season words | OURHEALTH STAFF WRITER

This fall, warm up the cool, crisp season by having delicious – and heart healthy – soups and stews headline your meal plans.

No doubt about it, backyard barbeques and burgers are the benchmarks of a scrumptious summer food season. While putting a wrap on warm weather might not mean the end of outdoor cooking for the diehard grill masters among us, it does signal the start of when savory soups and stews made with nutritious fall harvest foods can take center stage on the menu, whether it’s at your next tailgate party or quick family dinner. And with so many heart healthy and flavorful ways to prepare these hearty bowls of goodness, you can be assured of pleasing even the pickiest person’s palate on your team.

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Kale and Red Quinoa Soup This protein-packed soup is an ideal dinner for busy days. Herbes de Provence lend a flavor of the French Riviera and the smoked paprika harmonizes nicely with the pepperiness of the kale.

Nutritional Information Calories: 245 | Total Fat: 6 g Saturated Fat: .5 g | Trans Fat: 0 g Polyunsaturated Fat: 1 g Monounsaturated Fat: 3 g Cholesterol: 0 mg | Sodium: 294 mg Total Carbohydrates: 40 g Dietary Fiber: 10 g | Sugars: 6 g Protein: 10 g

Slow Cooker Size/Shape: 3 to 4 ½ quart; round or oval Slow Cooking Time: 6 to 8 hours on low; 2 to 3 hours on high Ingredients | Makes 4 servings (1 1/2 cups) • • • • • • • • • • • • • • •

1 14.5-ounce can no-salt-added whole tomatoes, undrained 1 14.5-ounce can no-salt-added Great Northern beans, rinsed and drained 4 cups coarsely chopped kale (1/2 of a 5-ounce bunch), any large stems discarded 2 cups fat-free vegetable broth (low-sodium) 1/2 cup red quinoa, rinsed and drained in a fine-mesh sieve 1 medium carrot, cut into 1/2-inch slices (about 1/2 cup) 1 medium rib of celery, cut into 1/2-inch slices (about 1/2 cup) 1/2 cup chopped red onion 1 tablespoon olive oil 2 medium minced garlic cloves 3/4 teaspoon dried herbes de Provence or dried thyme, crumbled 1/2 teaspoon crushed red pepper flakes 1/2 teaspoon smoked paprika (sweet or hot) 1/4 teaspoon salt 1/4 teaspoon pepper

Directions Put all the ingredients in the slow cooker. Cook, covered, on low for 6 to 8 hours or on high for 2 to 3 hours, or until the vegetables and quinoa are tender.

Recipes courtesy of American Heart Association, Copyright © 2019

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

Black Bean Soup You will love this Simple Cooking with Heart Mexican recipe because it’s simple to make, it’s heart healthy and budget friendly.

Ingredients | Makes 4 servings • nonstick cooking spray • 1 medium onion (diced) • 1 tablespoon garlic (jarred, minced) • 2 teaspoon ground cumin • 1 jalapeño (chopped) • 2 16-oz canned, low-sodium black beans (undrained) • 1 15-oz canned, no-salt-added, diced tomatoes (undrained) • 1 cup low-sodium chicken broth • Chopped, fresh cilantro (optional)

Freshly picked foods like kale, onions and carrots, and even herbs, as well as locally raised meats are plentiful during the fall season, and can be found at many farmers markets in and around Charlottesville and Shenandoah Valley, including:

Charlottesville Farmers Market Where: 100 Water Street, Charlottesville, VA 22902 When: Open Saturdays (April – September: 8 am – noon; October – November 23rd: 8 am – 1 pm; Holiday Market: November 30th – December 21st: 8 am – 1 pm) More Information: www.charlottesvillecitymarket.com

w

Farmers in the Park Where: 300 Meade Avenue, Charlottesville, VA 22902 When: Open Wednesdays from 3 pm – 7 pm (May through October) More Information: www.facebook.com/farmersinthepark

Directions

w

A

Spray large pot with cooking spray, over mediumhigh heat add onion and cook until translucent (Five minutes).

B

Add garlic, cumin and jalapeño and cook one minute more.

C

Add beans to pot and lightly mash with a potato masher or fork.

D

Add tomatoes and broth – bring to a boil and reduce to medium heat, cover and simmer for 15 minutes.

E

SHOP LOCAL, SUPPORT LOCAL TIP

Serve topped with chopped fresh cilantro (optional).

Rockbridge Farmers Market Where: 487 Maury River Road, Lexington, VA 24450 When: Open Fridays from 9 am – 1 pm (May through October More Information: w www.fieldsofgold.org/venues/ rockbridge-farmers-market

Staunton/Augusta Farmers’ Market Where: Wharf Parking Lot, located on the intersection of Johnson Street and Central Avenue, Staunton, VA 24402 When: Open Saturdays from 7 am – noon (April 6th – November 23rd)

More Information:

Nutritional Information Calories: 245 | Total Fat: .5 g Saturated Fat: 0 g | Trans Fat: 0 g Polyunsaturated Fat: 0 g Monounsaturated Fat: 0 g Cholesterol: 0 mg | Sodium: 34 mg Total Carbohydrates: 45 g Dietary Fiber: 12.9 g | Sugars: 6 g Added Sugars: 0 g Protein: 15 g

w www.stauntonfarmersmarket.org

Stuarts Draft Farmers Market

Quick Tip Serve this black bean soup as a side to a meal or warm in microwave and use as a filling for tacos!

Where: 2964 Stuarts Draft Highway, Stuarts Draft, VA 24477 When: Open Monday – Saturday from 9 am – 6 pm; Sundays from Noon – 5 pm (April 1st – December 23rd)

More Information:

w www.stuartsdraftfarmmarket.com www.OurHealthCharlottesville.com

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Turkey Chili Warm up with this Classic American staple turkey chili that’s both savory and satisfying.

Ingredients | Makes 6 servings • Cooking spray • 1 1/2 tablespoon. canola or corn oil • 1 medium or large onion, chopped • 20 oz. ground, skinless turkey breast • 2 large garlic cloves (minced) OR • 1/2 teaspoon garlic powder • 2 teaspoon chili powder • 1/2 teaspoon pepper • 1/2 teaspoon ground cumin • 15.5 oz. canned, no-salt-added pinto beans (rinsed, drained) • 15.5 oz. canned, no-salt-added black beans (rinsed, drained) • 14.5 oz. canned, no-salt-added, diced tomatoes (undrained) • 1 3/4 cups fat-free, low-sodium chicken broth • 1 cup frozen whole kernel corn • 6 oz. canned, no-salt-added tomato paste • 4 medium green onions (green part only, sliced)

Directions A Lightly spray a Dutch oven with cooking spray. Add the oil and heat over medium-high heat, swirling to coat the bottom. Cook the onion for three (3) minutes, or until soft, stirring occasionally.

B Reduce the heat to medium. Stir in the turkey. Cook for five (5) minutes, or until browned, stirring frequently to turn and break up the turkey.

Nutritional Information Calories: 347 | Total Fat: 5 g Saturated Fat: .5 g | Trans Fat: 0 g Polyunsaturated Fat: 1.5 g Monounsaturated Fat: 2.5 g Cholesterol: 64 mg | Sodium: 129 mg Total Carbohydrates: 42 g Dietary Fiber: 10 g | Sugars: 34 g Protein: 34 g

C Stir in the garlic, chili powder, pepper, and cumin. Stir in the remaining ingredients except the green onions. Cook for five (5) to seven (7) minutes, or until heated through, stirring frequently. Just before serving, sprinkle with the green onions.

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Funny BONE HUMOR • SEARCH • CHECK

CONGRATULATIONS

DOMINICK ALLEN of Charlottesville

Can you spot the SEVEN differences between the two cartoons?

Dominick Allen of Charlottesville was the first person to email the correct seven differences in last issue’s Funny Bone.

Be the first reader to email us describing what the seven differences are and you will earn the satisfaction (and bragging rights) of having your name in print in the next edition. OK, START YOUR SEARCH!

For the full list of answers visit our facebook page @OurHealthCharlottesville.

Email info@ourhealthvirginia.com with the subject line Funny Bone Charlottesville.

Visit www.OurHealthCharlottesville.com or our Facebook page @OurHealthCharlottesville and sign up for our e-newsletter for more fun games, quizzes and contests to win great prizes!

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