september • october 2018 ourhealthCharlottesville.com
These are the
Decades of our
Lives
What’s NEW in
HEALTH INSURANCE?
FRESH AND FABULOUS FALL PRODUCE
UNRAVELING THE
CANCER RIDDLE
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
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FEATURES
SEPTEMBER • OCTOBER 2018
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LIKE SANDS THROUGH THE HOURGLASS, THESE ARE THE DECADES OF OUR LIVES A survival guide to women’s health in each decade.
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UNRAVELING THE CANCER RIDDLE Charlottesville hospitals are making discoveries and using technologies to solve some of the mysteries that have plagued cancer researchers and doctors for decades. Breakthroughs within the past five years have been remarkable. Area resources are playing a role in the future of cancer care.
WHAT'S NEW IN HEALTH INSURANCE? Be in the know when it comes to choosing healthcare coverage for you and your family during the upcoming open enrollment period.
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DEPARTMENTS SEPTEMBER • OCTOBER 2018
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The Pulse | People. Places. News to Know.
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Calendar | Things to Do in Charlottesville and
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Health Scene | Happenings. Who’s Who. Trending.
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Health A-Z | Insight. Awareness. Mindfulness for the Whole Family. 46 - Five Ways to Maximize Family Time During Cancer Treatment: Five family coping tips inspired by Charlottesville-based journalist, Tim Wendel's book “Cancer Crossings: A Brother, His Doctors and the Quest to Cure Childhood Leukemia.”
Shenandoah Valley during July and August for your Mind, Body and Soul.
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Aging Well | Wisdom. Dignity. Support.
Josephine's Village 5K Run/Walk & Kids Dash
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Volunteer Spotlight | Heroes. Champions. Community Minded.
51 - Individualized Fast-Track Ortho Program Gives Patients Peace of Mind.
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Food and Fitness | Nutrition. Exercise. Prevention.
Robyn Ebelherr and friends develop Charlottesville Down Syndrome community organization.
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Q&A on Health | Questions. Answers. Knowledge.
Fresh and Fabulous Fall Produce: The fall harvest season brings a whole new assortment of delicious and heart-healthy fresh fruit and vegetables. Apples, pears, broccoli and Brussels sprouts are fresh in the market – or in your garden.
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Funny Bone | Spot the Seven Differences
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MORE THAN A MAGAZINE ONLINE SEPTEMBER • OCTOBER 2018
SOCIAL MEDIA
E-NEWSLETTERS
PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION CHIEF DESIGNER GRAPHIC DESIGNER ACCOUNTING MANAGER GUEST PHOTOGRAPHERS
McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Karrie Pridemore Tori Meador Laura Bower Dave Krovetz, Eze Amos and Whitney Holley
CONTRIBUTING MEDICAL EXPERTS
Corey C. Burgoyne, DMD Christopher Coslett, DC, ASCH Meg Crook, MD Paul T. Diamond, MD, FAAPM&R Katherine Schlieper, OD Eliot Smith, MD
CONTRIBUTING PROFESSIONAL EXPERTS & WRITERS
Catherine Brown Brandy Centolanza Jennifer Lamont Nanette Levin Michelle McLees Tim Wendel
ADVERTISING AND MARKETING Steve McClintic, Jr. • President/Editor-At-Large 540.355.3071 • steve@ourhealthvirginia.com 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
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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 © 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. MAIN: ourhealthvirginia.com | ourhealthroanokenrv.com | ourhealthlynchburg.com | ourhealthrichmond.com | ourhealthcharlottesville.com | Advertising rates upon request.
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The Pulse
INFORMATION • EVENTS • AWARENESS
Announcements Augusta Health Completes Expansion of Emergency Department Augusta Health has completed the expansion of its Emergency Department, which opened for patients on August 2, 2018. A community Open House and Ribbon Cutting ceremony was held on July 21, 2018. The current Emergency Department at Augusta Health opened in 1994 and was built to serve 35,000 patients a year. In recent years, volumes have exceeded 60,000 visits per year. The original rooms, designed for equipment and technology of the 1990s, had become cramped as advanced technology has been added. Department needs also changed as patients have increased acuity and need more complex care for cardiac and stroke, trauma and behavioral health and substance abuse. With the expansion complete, the Emergency Department will now be renovated in phases over several months. When the renovation project is complete, the combined area will be nearly double the size of the current Emergency Department. To provide support for the construction and renovation of the Emergency Department, the Augusta Health Foundation’s Moments Matter Campaign was launched in March 2017. Jim Perkins of Waynesboro has served as the Campaign Chair. The fundraising effort by has been well received by the community with major gifts totaling more than $1.8 million. The Augusta Health Board of Directors, Foundation Board of Directors and Executive Leadership have 100% participation. In addition, physicians, employees, community leaders, foundations, residents and local businesses have financially supported this critical community health project. Recently Sodexo, Augusta Health’s food service partner, provided a generous $100,000 challenge grant to encourage others in the community to support the ED Expansion and meet the $2 million Campaign goal. To date, more than $58,000 has been raised to secure the match. The Public Phase of the Campaign will begin in fall 2018. Those interested in making a gift to support the Moments Matter Campaign for the Emergency Department Expansion can call the Foundation Office at 540.332.5174 and text “moments” to 41444 to make a gift right from a cellphone, or visit the website, www. augustahealth.com/foundation/make-a-gift.
Ribbon Cutters include: Barbara Carroll, ED Team Member, Environmental Services, David Fosnocht, MD, ED Team Member, Physician, Steve Hall, ED Team Member, EMT, Donna Hurst, RN, ED Team Member, Nurse, Sharon Ireland, ED Team Member, Patient Access, Mary N. Mannix, FACHE, President & CEO, Augusta Health, Dr. James Perkins, Chair, Moments Matter Campaign, Rev. John Peterson, Chair, Augusta Health Board, Gary Slaughter, ED Team Member, Security
At-A-Glance: Augusta Health Emergency Department Expansion SIZE: Two stories totaling 50,555 square feet; 17,508 square
feet renovation of existing hospital space; 33,047 square feet addition, including 16,288 square feet of shelled space (2nd floor) BUDGET: $22 million total cost funded with reserves and
private philanthropy
Planned Features: hh
48 larger, walled, private rooms (69 percent increase over current capacity)
Dedicated care areas for: hh
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Behavioral health issues, an increase from two to five rooms Stroke, heart attack and other trauma, an increase from three to four rooms Family consultation areas for private conversations Enhanced work space for EMS, police and mental health professionals New ambulatory entry with canopy, valet services and a convenient connection to the main hospital for after-hours access
More Information: www.augustahealth.com.
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New Service
New Practice
Fishersville Aesthetic Surgery Practice Introduces New FDAApproved Laser Treatment for Wrinkles
New Gynecology Medical Practice Opens in Charlottesville
Keefe Centre, an ENT and aesthetic laser and facial plastic surgery medical practice in Fishersville, has announced the addition of The Profound to its platform of laser technology for the Stephen Keefe, MD treatment of medical and cosmetic procedures. The Profound is an FDAapproved radiofrequency micro-needling system that has been clinically proven to lead to the creation of elastin, collagen and hyaluronic acid – the building blocks of the skin. The procedure is considered by Keefe Centre’s Stephen Keefe, MD to be ideal for cheeks, jawline and submental areas and an alternative to a surgical facelift.
Founder and Medical Director Kenneth I. Barron, MD previously practiced at University of Virginia Medical Center. He says he opened his independent practice in order to develop a more patient-focused practice specializing in the relief of pelvic pain, fibroids, endometriosis, and painful or heavy periods. He is the only gynecologist in Albemarle County who is fellowshipKenneth Barron, MD trained in minimally invasive surgery for non-cancerous conditions and the only local gynecologist with expertise in pelvic pain and surgical management of endometriosis. The office participates with all major medical insurance companies and will be accepting self-referrals as well as physician referrals.
Before and After PROFOUND procedure.
"Profound is a powerful tool that combines two effective technologies for even greater performance for noticeable improvement in wrinkle reduction, from a non-surgical, single treatment that creates dramatic results.” Says Dr. Keefe, a board certified ENT and facial plastic surgeon. Dr. Keefe says only one 45 to 90-minute Profound treatment is needed. Most patients resume normal activities within 24 to 48 hours. Clinical studies reveal a 100 percent response rate for wrinkles. The Profound has also been cleared by the FDA for the treatment of cellulite. In an effort to make this and other services and procedures more convenient in the Charlottesville area, Dr. Keefe has opened a second location at 908 E. Jefferson Street, Suite 101 in Charlottesville. Dr. Keefe is now accepting appointments at the new location, call 434.284.3472. More Information: www.drkeefeent.com
The Center for Advanced Gynecology, a member of Privia Medical Group, has opened at 630 Peter Jefferson Parkway and is accepting new patients.
Dr. Barron, a graduate of the University of Virginia, completed his residency in obstetrics and gynecology at the University of Massachusetts in 2009. He later spent two years in Orlando, completing an accredited American Association of Gynecologic Laparoscopists fellowship with a specific focus in chronic pelvic pain under the nationally recognized pelvic pain expert Georgine Lamvu, MD, MPH; current chairwoman of the International Pelvic Pain Society. Additionally, Dr. Barron pursued a second fellowship in endometriosis surgery at the Center for Endometriosis Care in Atlanta under Ken Sinervo, MD. He has been faculty at Brown University, University of Central Florida, and the University of Virginia. Areas of expertise include laparoscopic surgery, hysteroscopic surgery, abnormal bleeding, endometriosis, fibroids, interstitial cystitis, menopause symptoms, ovarian cysts/tumors, painful intercourse, abnormal pap smears, pelvic pain, pudendal neuralgia, vulvar dermatoses, vulvodynia. “Opening my own practice will allow me to individualize care to meet patient needs in a comfortable environment,” says Dr. Barron. “I can offer my patients the most current and effective treatments I’ve learned from my advanced fellowship training.” More Information: 434.234.4903 or at info@virginiaGYN.com or visit www.virginiagyn.com
New Location Local Pediatric Practice Opens New Location Pediatric Associates of Charlottesville happily announces the opening of their fourth location. The new Zion Crossroads location is located at 71 Jefferson Court in the Spring Creek Medical Park. Drs. Alaina Brown and Amy Malek will be based out of this location with several other providers rotating through as needed. The practice is now open and is currently accepting appointments between the hours of 8:30 am and 5 pm. More Information: 540.406.4100 or visit www.charlottesvillepeds.com. www.OurHealthCharlottesville.com
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The Pulse
• NEWS TO KNOW
Recognitions University of Virginia Medical Center Ranked #1 Hospital in Virginia For the third consecutive year, U.S. News & World Report has ranked University of Virginia Medical Center as the No. 1 hospital in Virginia. The publication’s 2018-2019 “Best Hospitals” guide also recognizes nine UVA specialties for adults among the best in the U.S.
Five specialties are in the top 50 nationally: hh
Ear, Nose & Throat: 18th
hh
Nephrology: 42nd
hh
Urology: 30th
hh
Cardiology & Heart Surgery: 44th
hh
Cancer: 40th
Four specialties are rated “high performing,” placing them among the 10 percent nationally: hh
Gastroenterology & GI Surgery
hh
Orthopedics
hh
Neurology & Neurosurgery
hh
Pulmonology
UVA is also rated “high performing” in eight common procedures or conditions: abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery, heart failure, colon cancer surgery, hip replacement, knee replacement and lung cancer surgery. These ratings are generally based on care provided to inpatients ages 65 and older. “These national honors showcase the wide range of high-quality, specialized care that our physicians and team members provide to patients from across Virginia and beyond,” says Pamela M. Sutton-Wallace, chief executive officer of UVA Medical Center. U.S. News bases its rankings and ratings on factors that include patient safety, patient outcomes, advanced technologies, patient services, physician Pamela M. Sutton-Wallace surveys and accreditations from outside groups such as the National Cancer Institute (NCI) and Magnet recognition for nursing care from the American Nurses Credentialing Center. UVA has earned Magnet recognition and is one of 70 NCI-designated cancer centers nationally. Earlier this year, U.S. News recognized UVA Children’s Hospital in its 2018-2019 “Best Children’s Hospitals” guide. Six specialties at UVA – neonatology, pediatric diabetes & endocrinology, pediatric neurology & neurosurgery, pediatric cardiology & heart surgery, pediatric urology and pediatric gastroenterology & GI surgery – were rated in the top 50 nationally. More information: www.uvahealth.com
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Welcome
Amy M. Malek, MD PEDIATRICS Pediatric Associates of Charlottesville is excited to welcome Dr. Amy Malek! Dr. Malek provides comprehensive pediatric care from infancy to young adulthood. Services include, but are not limited to: • New patient and prenatal consultations • Routine well-child check ups • School and sport physicals • Health screenings • Newborn care • Immunizations • Acute and chronic illness management • Sick-child visits and more!
71 Jefferson Court Zion Crossroads 540.406.4100
charlottesvillepeds.com Dr. Malek is excited to begin accepting new patients in Pediatric Associates of Charlottesville’s newest location! Scan here for more information about our services and providers.
The Pulse
Kevin P. Miller, DO DERMATOLOGY
Matthew Bender, MD
Augusta Health Hospitalists Fishersville | 540.332.4075 www.augustahealth.com
Christopher Bunn, DO
Augusta Health Cardiology Fishersville | 540.245.7080 www.augustahealth.com
Shenandoah Dermatology and Aesthetics is excited to welcome Dr. Kevin Miller! Dr. Miller is a Virginia native who completed his degree at the Virginia College of Osteopathic Medicine. He then completed a combined internal medicine and pediatrics residency at Geisinger Medical Center in Pennsylvania then a dermatology residency at Hackensack Medical Center in New Jersey.
Donald Carmichael, MD
Michael E. Devitt, MD
Augusta Health Surgery Fishersville | 540.245.7705 www.augustahealth.com
UVA Hematology/Oncology Charlottesville 434.924.9333 cancer.uvahealth.com
Charles Goff, MD
Paul Hudson, MD
Tonia Martin, NP
Matthew Meade, MD
Trish A. Millard, MD
Amit Patel, MD
Katherine Schlieper, OD
Andrew Starr, MD
Augusta Health Surgery Fishersville | 540.245.7705 www.augustahealth.com
UVA Hematology/Oncology Charlottesville 434.924.9333 cancer.uvahealth.com
Augusta Health Hospitalists Fishersville | 540.332.4075 www.augustahealth.com
Augusta Health Hospitalists Fishersville | 540.332.4075 www.augustahealth.com
Augusta Health Surgery Fishersville | 540.245.7705 www.augustahealth.com
Primary Eyecare Charlottesville 434.760.2020 www.CvilleEyecare.com
Augusta Health Hospitalists Fishersville | 540.332.4075 www.augustahealth.com
Augusta Health Hospitalists Fishersville | 540.332.4075 www.augustahealth.com
1600 N. Coalter Street, #19 Staunton | 540.885.4500
shenandoahdermatology.com Dr. Miller is excited to begin accepting new patients in all three of our office locations, Staunton, Afton and Lexington. Scan here for more information about our services and providers.
READ THIS EDITION OF
OurHealth Charlottesville & Shenandoah Valley William Thompson, MD
ON YOUR TABLET OR SMARTPHONE
Augusta Health Surgery Fishersville | 540.245.7705 www.augustahealth.com
www.OurHealthCharlottesville.com
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• NEWS TO KNOW
Welcome
SEPTEMBER • OCTOBER
CALENDAR
INFORMATION • EVENTS • AWARENESS
9.6 SUPER
SEVEN 9.8
ORGANIC NUTRITION
Come out and join master herbalist, Aaron Mason, as he discusses how some of the items in your pantry, such as cayenne and molasses, can help play a significant role in nourishing and improving your body and health over time! This event is for adults, but children ages 12-17 may attend when accompanied by a registered adult. $25 | 7 pm – 8:30 pm Floyd T. Binns Middle School 205 E. Grandview Avenue | Culpeper MORE INFORMATION: w www.ourhealthvirginia.com/ events/super-7
9.8 5TH ANNUAL
PANCAKE 5K Brought to you by Chiles Peach Orchard and Crozet Running, the 5th Annual Pancake 5K helps raise funds to support the Western Albemarle Rescue Squad. At the end of the race, participants may enjoy an all-you-can-eat pancake breakfast (included in race registration)!
$10-$25 | 8 am Chiles Peach Orchard 1351 Greenwood Road | Crozet MORE INFORMATION: w www.ourhealthvirginia.com/ events/pancake-5k-2018
WALK TO END ALZHEIMER’S
GREATER AUGUSTA
The Kiwanis Club of Charlottesville, in conjunction with the Charlottesville Track Club, and with major support from Better Living Inc., presents the 35th Annual Kiwanis Independence Day 5K Race at Forest Lakes North subdivision. Proceeds benefit Camp Holiday Trails, a camp for children with special health needs. Over the past three decades, the Kiwanis Independence Day race has raised more than $125,000. Open to runners of all ages. FREE to Walk (Join a team to help fundraise) | 8 am Gypsy Hill Park | 300 Churchville Avenue | Staunton MORE INFORMATION: w www.ourhealthvirginia.com/events/2018-alz-augusta
9.10 UVA RYAN WHITE HIV
CLINIC BENEFIT DINNER
Come out for a delicious, three course Italian meal and silent auction while raising money for emergency services that are not covered through program funding during this benefit dinner. Orzo Kitchen & Wine Bar in Charlottesville will donate $25 for every adult ticket and $10 for every children’s ticket to the Ryan White HIV Clinic. Tickets can be purchased at the door. If you would like to support the benefit but will be unable to attend the dinner, the requested donation is $50. For more information on how to donate or to purchase tickets in advance, contact Pam Bickley via email at pab2u@virginia.edu. $50/adults and $20/children | 5:30 pm – 8:30 pm Orzo Kitchen & Wine Bar 416 W. Main Street | Charlottesville MORE INFORMATION: w www.ourhealthvirginia.com/events/ryanwhite-orzo-dinner
Calendar • SEPTEMBER • OCTOBER
9.15
PACKING WORKSHOP:
MEDS AND MOBILITY
Learn best packing practices that include tips for traveling with medications, as well as traveling with mobility issues. In addition, a complimentary private packing demonstration that teaches how to pack for your specific travel needs will be offered. Please RSVP by Wednesday, September 12. Free | 11 am Peace Frogs Travel/Outfitters 1043 Millmont Street | Charlottesville | 434.977.1415 MORE INFORMATION: w www.ourhealthvirginia.com/ events/peacefrog-travel
9.22 NATIONAL
PUBLIC LANDS DAY
Get a breath of FRESH air while celebrating National Public Lands Day at Shenandoah National Park! One of the largest wilderness areas in the eastern United States, Shenandoah National Park offers health-renewing opportunities for solitude, scenic views, wildlife sightings and more. National Public Lands Day is one of only five calendar days a year offering fee free park entry! FEE FREE DAY! | 9 am – 4 pm Shenandoah National Park 3655 US Highway 211 East | Luray MORE INFORMATION: w www.ourhealthvirginia.com/ events/lands-day-2018
www.OurHealthCharlottesville.com
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Calendar
• SEPTEMBER • OCTOBER
9.29 VEGAN
ROOTS FEST 2018
Come on out for awesome food, engaging speakers and yummy local drinks of all kinds while learning all about the healthy ways that a veganism lifestyle provides for people, animals and the planet. Experts will be on hand who can talk nutrition, menus, shopping and more for those who are new to the practice of veganism. Free | Noon – 6 pm Booker T. Washington Park 101 Preston Avenue | Charlottesville MORE INFORMATION: w www.ourhealthvirginia.com/events/ vegan2018
10.8
CARBOHYDRATE COUNTING 101
In this 90-minute course, a variety of topics related to healthy eating will be covered, including carbohydrate counting, nutrition label reading, meal planning and preparation and how to make better choices while dining out. This is an excellent opportunity to learn from registered dieticians and other experts about healthfully eating while still enjoying some of your favorite foods! *Please Note: a physician referral is necessary to attend this course. Free with referral | 5 pm – 6:30 pm Mannix Conference Room at Augusta Heart & Vascular Center 78 Medical Center Drive | Fishersville MORE INFORMATION: w www.ourhealthvirginia.com/ events/carb-101
HARVEST
DINNER AT SUNSET
Be a part of the effort to transform a landfill property into beautiful Sunset Park that will serve our current and future generations by participating in the Harvest Dinner at Sunset fundraiser! Show your support while enjoying the latest in outdoor dining experiences with a delicious, local meal served by Autumn Olive Farms and BlueOregano and paired with micro-brews from Basic City Beer Co. This is the first of many events to be hosted at Sunset Park throughout its development. $80 per person (table sponsorships available for $1000) 6 pm | Future Sunset Park Location 300 N. Winchester Avenue | Waynesboro MORE INFORMATION: w www.ourhealthvirginia.com/ events/dinner-at-sunset
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
MENTAL HEALTH FIRST AID TRAINING
Similar to First Aid and CPR, Mental Health First Aid helps individuals to support those experiencing mental health problems and aids in getting people the professional help they may need. This interactive 8-hour course teaches a 5-step action plan to offer initial help to people with the signs and symptoms of mental illness, or in a crisis, connect them with an appropriate professional, peer, social or self-help care. $25 | 8 am – 5 pm | Region Ten 500 Old Lynchburg Road | Charlottesville MORE INFORMATION: w www.ourhealthvirginia.com/ events/mental-health-first-aid
Calendar
10.20
WALK TO END ALZHEIMER’S CHARLOTTESVILLE
Held annually in more than 600 communities nationwide, the Alzheimer's Association Walk to End Alzheimer’s® is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. This inspiring event calls on participants of all ages and abilities to join the fight against the disease! FREE to Walk (Join a team to help fundraise.) 9 am | IX Art Park 522 2nd Street | Charlottesville MORE INFORMATION: w www.ourhealthvirginia.com/ events/2018-alz-cville
CHILDREN’S MEMORIES OF PREVIOUS LIVES
Researchers at the University of Virginia, beginning with psychiatrist Ian Stevenson, have investigated children’s reports of memories from previous lives for the past fifty years, studying more than 2,500 cases from around the world. Join Jim Tucker, MD, Associate Professor of Psychiatry and Neurobehavioral Sciences at UVA, as he discusses the research and details of recent American cases during this informative and engaging event. FREE | 10 am – 11 am Alumni Hall, Ballroom (Rain location: Maury Hall, Room 209) 211 Emmet Street South | Charlottesville MORE INFORMATION: w www.ourhealthvirginia.com/events/ memories
www.OurHealthCharlottesville.com
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• SEPTEMBER • OCTOBER
10.27
Health Scene HAPPENINGS • WHO’S WHO • TRENDING
JOSEPHINE'S VILLAGE 5K RUN/WALK & KIDS DASH The Inaugural Josephine’s Village 5K Run/Walk and Kids’ Dash Honoring Josephine Gleason and other heart angels while raising awareness and support for those with congenital heart defects. On Saturday, August 18th, more than 500 people gathered at UVA Alumni Hall to participate, volunteer and cheer on racers in the inaugural Josephine’s Village 5K Run/Walk & Kids’ Dash. Josephine’s Village works to bring awareness of Congenital Heart Defects (CHD) to the community and offer support to families who have been affected by the condition. The cause was established by Jessica and Jeff Gleason in honor of their daughter, Josephine Marie Gleason, a beautiful baby girl who sadly lost her life to CHD at just 20 weeks of age following two open-heart surgeries. Proceeds raised from Josephine’s Village 5K are given to local organizations that help provide needed resources to the children, parents and families affected by CHD. The organizations that received proceeds from this year’s event include the UVA Heart Healthy Family Fund, which help meet the financial needs of families with children at the UVA Children’s Hospital Heart Center and Mended Little Hearts of Charlottesville, a support network providing education, advocacy, awareness and outreach for families with children affected by heart defects and disease. The inaugural Josephine’s Village 5K was truly special and included several large teams participating, including those from Solidarity Endurance, Johnson Elementary, Pediatric Associates of Charlottesville, Team PICU, Orangetheory Fitness and The Brow House, to name a few. Pediatric Associates of Charlottesville and The Brow House were both top donors at the PINK Heart sponsorship level. Thanks to everyone’s support and efforts, Josephine’s Village successfully met and exceeded its fundraising goal of $20,000 for 2018! For more information about Josephine’s Village, including details for the 2019 5K event and how to become involved, visit www.josephinesvillage.com.
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photos | DAVE KROVETZ, EZE AMOS, WHITNEY HOLLEY
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Health Scene www.OurHealthCharlottesville.com
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VOLUNTEER
Spotlight HEROES • CHAMPIONS • COMMUNITY-MINDED
Robyn Ebelherr and Friends
DEVELOP
CHARLOTTESVILLE
COMMUNITY ORGANIZATION words | CATHERINE BROWN
Pictured above: Robyn Ebelherr and daughter Sage.
In college, Robyn Ebelherr decided to switch her major from psychology to special education because she wanted to make a difference and pursue a field she felt was more worthwhile. After teaching for a while, she got married and had her first child. “We were gifted with Sage, who was born with Down syndrome (DS),” says Ebelherr. “I was grateful for the experience I had teaching and witnessing the joy families with a DS child have.”
Now that Sage is almost 17, Ebelherr is amazed at all the advancements she has made. She is fully included in her general high school classes, and she participates in community sports. She has become a bit of a socialite, Ebelherr says, and she loves spending time with her teen friends. “It truly is remarkable,” Ebelherr says. “When you don’t shut the door on her abilities, the more she takes from situations and learns and advances.”
Because of her special education background, Ebelherr was driven The Charlottesville Downs Syndrome Community Organization to learn as much as she could about new techniques for working continues to meet in small groups and participates in events in with DS children so that she could provide her daughter with Richmond, like the Step Up for Down Syndrome 5K. They avenues to success. She started reaching out to other also host a major event for World Downs Syndrome families whose children also have DS, and several of Day on March 21 with music, food and a silent “There are many them began meeting regularly to hold potlucks auction. “The event allows community members of us who have built this and discuss the triumphs and obstacles of to come together and celebrate these kids group and we are all in raising a child with special needs. “Connecting who are thriving,” Ebelherr says. Their with one another helped us each in different organization also raises money to participate this together, finding ways,” she says. in conferences and provide social and workcomfort from being able to related opportunities for kids with DS. talk openly and share our Together they formed a solid group of families from Charlottesville to Waynesboro and Nelson Ebelherr, who also has 14- and 8-year-old journeys with one County and began working with the Down sons, has clearly made a difference in the another.” Syndrome Association of Greater Richmond. At Charlottesville community, but she is the first this point, at least ten families are involved. to say that she is just one of many. “There are many - Robyn Ebelherr of us who have built this group, and we are all in this Ebelherr and the other member families participate in together, finding comfort from being able to talk openly and programs like First Call. When a family gives birth to a DS child, share our journeys with one another.” one of them brings a gift basket and offers mentorship. They also provide support to families through local pediatrician’s offices. “That connection is so important,” Ebelherr says. “I remember having a ON THE WEB newborn and feeling a range of emotions.” More at OurHealthCharlottesville.com 20
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
VOLUNTEER Spotlight • Robyn Ebelherr and Friends Develop Charlottesville Down Syndrome Community Organization
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www.OurHealthCharlottesville.com
Questions. Answers. Knowledge.
HEMOGLOBIN A1C is a routine blood test done for
patients with diabetes and measures the exposure of red blood cells to high glucose over time.
Why are stroke survivors so tired after their stroke?
What is eAG related to diabetes?
What Is Myofascial Pain Syndrome?
Feeling lethargic following a stroke is common and may be due to a variety of reasons, and many of these causes may be easily treated. It is important that the underlying cause or causes be identified. A stroke itself may damage regions of the brain that help with alertness. For example, right hemispheric strokes can cause a person to appear sleepy, withdrawn or disinterested. This often improves over time. Generalized deconditioning from prolonged bed rest may also lead a person to easily fatigue following a stroke. The associated hemiplegia makes the work of each simple task much more challenging and taxing. Physical therapy (PT) and Occupational Therapy (OT) are necessary to prevent deconditioning, improve endurance and promote recovery. Poor nutrition, interrupted sleep and dehydration following stroke may also lead to extreme fatigue. Sleep apnea is common in stroke survivors and a frequent cause of daytime somnolence. Post stroke depression may also cause loss of energy and fatigue.
eAG is the estimated average glucose level that is measured in patients with diabetes. This cannot be checked directly, but is indirectly calculated using the results from a hemoglobin A1c test. Hemoglobin A1c is a routine blood test done for patients with diabetes and measures the exposure of red blood cells to high glucose over time. A formula is then used to estimate the eAG. The eAG equals 126 for patients with an A1c of 6 and 140 for patients with an A1c of 6.5. The eAG goal for patients with diabetes is under 140 for those on oral medication and under 154 for those on insulin.
Muscle comprises 40 percent of body tissues and is highly endowed with nerve, blood and lymphatic vessels. Myofascia is the composite of skeletal muscle and connective tissue (fascia) in which it is enclosed. Myofascial pain typically results from physical imbalances as muscles loose length from postural stressors, daily activities or sports, handedness patterns or following traumatic injury.
Medications should always be examined closely following a stroke. Those used to treat spasticity and pain following stroke can be particularly sedating. A thorough clinical evaluation should always be pursued in stroke survivors who appear excessively tired and deconditioned. Paul T. Diamond, MD, FAAPM&R
Director of Neurorehabilitation Department of Physical Medicine and Rehabilitation University of Virginia Health System UVA-HealthSouth Rehabilitation Hospital Charlottesville | 434.243.5622 www.uvahealth.com
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You can access the online eAG/A1C conversion calculator through the American Diabetes Association here: https://professional.diabetes.org/ diapro/glucose_calc. Meg Crook, MD
UVA Endocrinology Pantops Charlottesville | 434.293.7811 www.uvahealth.com
Free nerve endings that conduct pain signals to the brain are activated by physical, chemical or thermal stimuli. Shortened myofascia may evoke inflammatory chemical pain mediators and taken together result in tender points and zones within muscle and connective tissues. Myofascial pain "syndromes" are simply conditions with a consistent profile of symptoms and diagnostic indicators that can be readily identified and treated with a logical sequence of therapy intervention. Christopher Coslett, DC, ASCH Life Path Enterprises, LLC Charlottesville | 434.987.1423 www.lifepathenterprises.com
Q A ON HEALTH
Augusta Health Care for Women is proud to introduce Dana Porter, MD!
• Knowledge
Dana Porter, MD has specialized in Women's Health since 2003. In addition to general OB/GYN care, she has a special interest in high-risk obstetrics. Dr. Porter also enjoys adolescent health and infertility evaluation and treatment. Outside of the office, her hobbies include spending time with family, running, traveling, and cooking. Dr. Porter also has a love for animals, learning new things, and teaching others. Dr. Porter is currently accepting new patients. Dr. Dana Porter
39 Beam Lane
Fishersville
110 Houston St. Suite C
540.213.7750
Lexington
540.463.7751
Visit our website for more information: www.ahcfw.com
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Questions. Answers. Knowledge. What are the most common types of oral surgery procedures? The most common procedures performed by an oral and maxillofacial surgeon are: Dental extractions: the removal of
teeth for reasons of decay, cracks, fractures, or abnormal positions. Bone grafts: a technique performed
to preserve bone or to rebuild missing bone. Dental implants: replace individual
RISK FACTORS for
Barrett's esophagus include male gender, Caucasian race, chronic reflux, a hiatal hernia, tobacco use, obesity, family history and age.
or multiple teeth, or to anchor a prosthesis such as a denture. Removal of wisdom teeth:
performed at a wide range of ages for erupted or impacted third molars that may have pathology, symptoms (such as decay, pain, gum inflammation or infection) or to prevent damage/ disease to other teeth. Adjunctive orthodontics:
treatments that help with braces such as removal of teeth to create space, exposure (uncovering/ accessing) of impacted teeth or placement of anchors to help your orthodontist move teeth. Biopsies or removal of lesions:
taking samples of abnormal tissue to determine a diagnosis and treatment, or removing benign lesions of the teeth, gum tissue, or bone. Anesthesia: addresses pain
relief and comfort through local injections, sedation, or general anesthesia through intravenous (IV) medications. Corey C. Burgoyne, DMD
Blue Ridge Oral & Maxillofacial Surgery Fishersville and Lexington 540.886.2956 www.blueridgeoralsurgery.com
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What is Barrett’s esophagus?
What is the right age to get contact lenses?
Barrett’s esophagus is a condition in which the normal cell lining of the esophagus changes to a lining similar to that of the intestines. This process is called intestinal metaplasia and is thought to be the result of long standing acid reflux injury. There are no associated symptoms of Barrett’s esophagus, however it is clinically relevant as it increases the risk of esophageal cancer (specifically esophageal adenocarcinoma). In general, the risk of developing esophageal cancer from Barrett’s esophagus without dysplasia (pre-cancerous changes) is ~0.2-0.5% per year.
While there is no exact age to start contact lens wear, the decision to be fitted with contacts is one that must be weighed carefully. Doctors and patients must take into consideration an individual’s prescription, the patient’s ability to properly handle and care for their lenses, and then follow instructions for follow up care.
It is therefore recommended that patients with non-dysplastic Barrett’s esophagus have an upper endoscopy (EGD) for cancer performed every three to five years. Risk factors for Barrett’s esophagus include male gender, Caucasian race, chronic reflux, a hiatal hernia, tobacco use, obesity, family history and age. National guidelines have suggested that patients with multiple risk factors also be screened for Barrett’s esophagus with an EGD. Eliot Smith, MD
Charlottesville Gastroenterology Charlottesville | 434.817.8484 www.cvillegi.com
Katherine Schlieper, OD
Primary Eyecare Charlottesville | 434.977.2020 www.cvilleeyecare.com
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words | JENNIFER LAMONT
Each new stage of a woman’s life brings new
a survival guide to women’s health in each decade
adventures, unique challenges and health concerns— made even more interesting by hormonal shifts, mood swings and the magical quest to find permanent youth and beauty. You don’t need your grandmother to tell you that your health changes as you grow older. But change it does. This guide to women’s health gives insight into some of the top health issues women are concerned with during each decade of life.
Forever 21! Ah, sorry. No. You’re in your 20s. Life is good. Your collagen hasn’t started to betray you yet and your skin glows no matter how many hours you spend partying. You can eat and eat, and then eat some more, with few consequences. It may not feel like it at times, but you have more energy than you will ever have. If only you could bottle it for later... The choices you make in your 20s shape your health and body during your later years. The younger you are, the less you tend to care about this fact. But if 55-Year-Old Future You could travel back to chat with 21-Year-Old You now, you don’t want her whining about her aching joints, age spots and expanding waistline the whole time, do you? Ugh, so not your problem.
Health A-Z
• INSIGHT
Taking care of your health seems like an idea best left for the ‘olds’ to worry about. You usually don’t have chronic health issues to face in your 20s, but there are two health issues that are especially concerning for women in your age group.
Love the Skin You’re In…Now After all, you live in it. Taking care of your skin at this age means more than washing your makeup off at night. (Which is a must, by the way.) While getting natural sunlight is important for your health, protecting yourself against sun damage helps prevent both aging and skin cancer. According to a 2015 report in the Journal of the American Academy of Dermatology, melanoma is the leading cause of cancer deaths among women in their 20s. The good news is that skin cancer is treatable when caught early. You should get a yearly skin screening by a physician, and perform self-checks, especially if you like to tan. Taking care of your skin keeps you safer—and younger-looking for longer. Girls in ancient Britain believed that carrying an acorn in their pocket kept them young because of the oak tree’s long lifespan. You don’t have to do that, unless you want to. There are other ways to effectively preserve your stores of collagen and elastin.
To get dermatologist-recommended skincare tips that will keep your skin beautiful, healthy and youngerlooking, visit ourhealthvirginia.com/va/women/ skincare-tips.
It Only Takes One Time
While getting
Your early 20’s is the time when your libido is raging and your brain’s risk-taking amygdala is still trying to run the show after your angsty teen years. That’s why taking care of your sexual health now lays the foundation for your long-term health.
natural sunlight is important for your health, PROTECTING
Of the 19 million new STD infections occurring each year, nearly half of them are in those ages 24 and younger, according to the Centers for Disease Control and Prevention (CDC). Doctors are saying that herpes, HPV (human papillomavirus) and chlamydia are rampant. HPV and chlamydia also have the added bonus of being asymptomatic, which means you or your partner can have it and not know it.
YOURSELF AGAINST SUN DAMAGE helps prevent both
AGING AND SKIN CANCER.
19 MILLION of the
NEW STD INFECTIONS occurring each year,
NEARLY HALF ARE AGES
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AND YOUNGER
Left untreated, sexually transmitted diseases can lead to pelvic inflammatory disease, infertility, cervical cancer, HIV and unwanted pregnancies—all of which affect your long-term health.
Visit ourhealthvirginia.com/va/women/sex-smart to get SEX-SMART TIPS and to find out which must-have tests you need in every decade, BUT ESPECIALLY IN YOUR 20S. As you roll in your 30s, your libido and other things may slow down a bit. The one you’ll care about the most is your metabolism. You could eat anything in your 20s. Now, not so much.
Women continued on page 30
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Health A-Z
• INSIGHT
19TH CENTURY
women resorted to
COMPLETELY ABSURD measures to lose weight.
Nothing Tastes as Good as Being Thin Feels… in Your 30s
Some of them
It becomes slightly harder to maintain a healthy weight in this decade as you juggle life and work responsibilities. It can feel impossible to shed the extra pounds that begin to creep up on you.
SWALLOWED ARSENIC to speed up their metabolism.
That’s probably why women in the 19th century resorted to completely absurd measures to lose weight. Some of them swallowed arsenic to speed up their metabolism. Even in tiny amounts, it wasn’t a safe practice. Others swallowed tapeworms in a capsule. Yes, tapeworms. The ‘theory’ was that the tapeworm cysts would reach maturity inside the intestines and absorb extra food. Blech. There are healthier and more effective ways to go about losing weight in your 30s which don’t involve ingesting poisons or parasites.
Visit ourhealthvirginia.com/va/women/weightloss-tips get research-backed tips for losing weight and THE SURPRISING LINK BETWEEN YOUR FRIENDS AND YOUR WEIGHT.
DID YOU KNOW?
After your roaring 20s and during the slowdown of your 30s when things are hopefully a bit more stable, your 40s are when things get a bit, well, crazy. That’s really the only way to describe the hormonal roller coaster that is perimenopause and menopause.
You’re on Fire! And Not in a Good Way! The Fiery 40s. 1 in 8 women will develop a thyroid condition in her lifetime
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You’re burning up, sweating and then freezing. And then the cycle repeats. This can happen a few times a week or multiple times a day. As cycles become irregular, women in their 40s suffer from hot flashes that can be mild or severe, lasting up to 10 infuriating minutes at a time. They can wake you up from a deep sleep and be triggered by stress, eating, caffeine, heat, spicy foods and… anything really.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Health A-Z • Women: These are the Decades of Our Lives
Extreme fluctuations in estrogen and progesterone create such an imbalance that estrogen levels in a perimenopausal woman can be higher than a younger woman’s levels. For many women, this is a rough time for trying to stay in balance. As estrogen also gradually declines, you lose bladder tone, natural lubrication and have increased urinary tract infections, night sweats and emotional symptoms. It’s a delicate balancing act to try and stabilize symptoms. Getting your hormones tested can help, but, because they fluctuate on an hourly basis, it can be hard to stabilize your hormones even with hormone replacement therapy (HRT). On the other hand, natural remedies may help, but the closer you get to actual menopause, the more severe your symptoms may become.
Visit ourhealthvirginia.com/va/ women/menopause to get expert lifestyle tips that will HELP YOU TRANSITION THROUGH THIS EXCEPTIONALLY HAIRY TIME. Getting your hormones tested can provide a snapshot of whether you may be approaching menopause. Your provider should test your thyroid hormones as well. Because hypothyroidism increases in frequency as women age into their 40s, researchers believe it may be connected to high levels of estrogen during this time. Research shows that too much estrogen can prevent the thyroid hormone from getting to where it needs to go and from converting to its active form. The American Thyroid Association estimates that one in eight women will develop a thyroid condition in her lifetime. Getting a comprehensive look at both thyroid and sex hormones will help you discover what is actually happening. Unfortunately, it could be both a thyroid problem and menopausal symptoms.
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Health A-Z
• INSIGHT
DIABETES and other symptoms of
METABOLIC SYNDROME —
LARGE WAIST, ELEVATED BLOOD PRESSURE AND TRIGLYCERIDES, HIGH BLOOD GLUCOSE LEVELS AND GLUCOSE INTOLERANCE
—
are the most important risk factors for heart attacks in women at an earlier age.
If you reach the other side of menopause with your sanity intact, your 50s can be downright freeing. They’re certainly calmer. No more menstrual cycle or fear of pregnancy. No more mood swings. And remember when 55-Year-Old You visited 21-Year-Old You? She’ll thank you for all the times you put down the donuts, went for a walk and ate avocado. Because her heart and blood sugar will be better for it.
Your 50s is Not for the Faint of Heart As you age, you lose some of your natural defenses against both heart disease and Type 2 diabetes. But you can prevent these conditions, even in your 50s. Both heart disease and diabetes are easily the most dangerous conditions facing women in this decade, but also the most preventable. They’re also intricately related. According to Harvard Medical School, diabetes and other symptoms of metabolic syndrome—large waist, elevated blood pressure and triglycerides, high blood glucose levels and glucose intolerance—are the most important risk factor for heart attacks in women at an earlier age. And your 50s is early. Heart disease may not abruptly present itself until later but it’s already starting now. During this decade, it’s extremely important to know your numbers. In a study conducted by the American Heart Association, half of the women knew that heart disease is the leading cause of death in women, but only 13 percent of them were worried about it. For younger women in their 50s, it’s dangerous to think it can’t happen to you.
DO YOU KNOW
YOUR
NUMBERS?
Because women in this age group tend to dismiss symptoms that aren’t easily recognized as heart attack symptoms, they die more than men of the same age who have typical pain and shortness of breath. Research shows women also die of diabetes more than men because it hits them harder during menopause.
Visit ourhealthvirginia.com/va/women/heart-healthy-numbers to FIND OUT WHAT YOUR HEART-HEALTHY NUMBERS SHOULD LOOK LIKE. 32
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Health A-Z •
Taking healthy steps—literally—will help prevent heart disease and diabetes. Walking and exercise, along with a healthy diet, are modest changes that have the most significant impact on reducing new cardiac and diabetes cases.
Women: These are the Decades of Our Lives
Keeping your blood sugar levels stable and eating a heart-healthy diet gives your body more of a fighting chance as you get older. Moving into your 60s and golden years doesn’t mean you have to lose your health. Seniors today are staying more active than ever, and it’s helping them stay sharp.
It’s Not the Years in Your Life, It’s the Life in Your Years While some of your ‘circuitry’ starts to burn out a little during this time, your brain continues to grow new cells well into your 60s. Even though it may not seem possible because you’re always forgetting why you walked into the kitchen, it’s a fabulous fact that you’re not done yet. Continued neurogenesis in our brain helps us with the capacity to learn new things. In our recent “Guide to Successful Aging Well Into Your 90s,” we talked about the importance of learning new, challenging skills and having fun socially while doing it. As an integral part of “successful aging,” keeping our minds active with more than crosswords is key to maintaining our cognitive abilities. While women have greater resilience to age-related cognitive impairment than men, according to research, a woman’s hormones can affect her cognition. But there are differences between age-related, normal memory loss and cognitive decline. If you can’t find your keys because you left them in the freezer by accident, that’s actually normal. If you continue to leave them in the freezer, that may be MCI (mild cognitive impairment), or the beginning of Alzheimer’s. Although many people in their 60s fear they’re getting Alzheimer’s Disease because they’re forgetful, many things are indicative of normal aging, and not dementia. Do you know the difference between normal forgetfulness and signs of dementia?
Is it normal forgetfulness or is there something more serious going on? Visit ourhealthvirginia.com/va/ women/forgetfulness to find out.
It’s Never Too Early… or Too Late Whether your 25, 45 or 65, you have unique health concerns depending on which decade you’re in. If you’re older, you’ve probably often reflected with a sigh, “If only I knew then what I www.OurHealthCharlottesville.com
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Health A-Z
• INSIGHT
know now…” And if you’re younger, you’re probably thinking you have all the time in the world. But each decade builds on the previous. You can mitigate the health concerns you do face by being proactive at every age. Know your numbers and the screenings you need in each decade of your life. Live a healthy lifestyle so you can transition smoothly from one decade to the next without wanting to go back and slap that 20-Year-Old.
Whether you’re 25, 45 or 65, you have UNIQUE HEALTH CONCERNS depending on which decade you’re in. You can mitigate the health concerns you do face by being PROACTIVE AT EVERY AGE.
ON THE WEB
More at ourhealthrichmond.com
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For a comprehensive list of the screenings you should get during each decade, visit ourhealthvirginia.com/va/women/screenings.
Sources hh hh hh hh hh hh hh
www.skincheck.org/Page1.php www.cdc.gov/std/stats/default.htm www.ncbi.nlm.nih.gov/pmc/articles/PMC3153870/ www.menopause.org/ www.health.harvard.edu/heart-health/gender-matters-heart-disease-risk-in-women www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/diabetes-hits-womenhard-at-menopause-beat-it-back www.nia.nih.gov/news/age-related-cognitive-decline-women-are-more-resilient-men
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ASK THE EXPERT
SARA KALTREIDER, MD
OCULOPLASTIC AND RECONSTRUCTIVE SURGEON EYELID & FACIAL AESTHETICS 630 Peter Jefferson Parkway, Suite 140 | Charlottesville c 434.244.8610 | w www.eyelidandfacialaesthetics.com
How Do I Reverse My Facial Aging? The natural aging changes of the face appear with varying signs, severity and speed. Some of us are bothered by evidence of aging more than others. Thanks to technology, advances in surgery and cosmeceuticals, we have many options to reverse some of these changes and maintain our rejuvenated appearance. Often a combination of treatments work far better than any one treatment alone. Consultation with an expert will provide the best options for you and guide you in choosing treatments with the “best bang for the beauty buck”.
What are Causes of Drooping Eyelids? Several factors may lead to drooping of the upper eyelids – such as: hereditary hooding, natural aging process, thinning and decreased elasticity of the skin, drooping of heavy brow tissue, loosening of the levator muscle, hard contact lens wear, past trauma or eye surgery, chronic eyelid rubbing, allergies with swelling and muscle deterioration. Treatment consists of repairing the anatomy by correcting the levator muscle position, removal of excessive hooding, and/or lifting the eyebrow position. Reduction or contouring of the fat pads provides additional aesthetic enhancement. Lower eyelid rejuvenation involves reducing or repositioning the fat pads and tightening the skin by removal or preferably the use of laser technology. Several approaches are used depending on the surgeon preference and patient anatomy. A transconjunctival approach avoids a visible incision and minimizes risk of retraction.
How Do I Rejuvenate My Aging Skin and Extend the Results oof Rejuvenating Procedures? There are many wonderful ways—both surgical and noninvasive—to rejuvenate facial and eyelid skin thanks to advances in technology. Once you have experienced your youthful facial and eyelid skin, you most likely want to preserve and extend your bright and lovely appearance. Your skin would appreciate the following care: gentle cleansing, hydration, nutrition and protection. Find products that you like and will use faithfully. Components of skin care products vary but you don’t always have to seek out the most expensive brands to find what you need. Look for certain key ingredients on the labels: antioxidants (Vitamin A-C-E, green tea polyphenols, Co-Q10, hyaluronic acid); humectants (hyaluronate, glycerin, sodium PCA, essential mineral complexes); and sunscreen (zinc oxide, antioxidants). The way to keep a youthful glow is to take care of your skin with gentle products, use sunscreen, don’t smoke and avoid traumatizing your skin by rubbing, particularly the eyelids. See your dermatologist for specific skin conditions and suggestions.
How Do I Find the Best Surgeon for My Aesthetic Goals? This is not always easy! You must have a certain level of trust and sometimes it comes down to a “gut feeling”. Start with these questions: What is the surgeon’s level of experience and training? What is the surgeon’s specific area of expertise for your goals? Do you have friends or family who have had similar procedures who you can ask about their experience? Can you access preliminary information on the internet or a physician website? Have you had complications from previous procedures and need someone who is experienced with revisions? Are you interested in possible surgical procedures as well as lasers? Much of this type of information may be found online. One great resource to check is www.RealSelf.com. It’s a forum for cosmetic patients and surgeons to exchange information on procedures, results, reviews and overall experience. Next you need to connect with your potential surgeon for a consultation. Learn about your options, risks and benefits, recovery, down time, expectations for results, accessibility of the surgeon if there are unexpected problems and any other questions that arise. Don’t leave without the satisfaction of having all your questions answered. Look out for red flags like feeling hurried, pressured or uneasy. It is less costly to go find another opinion than it is to have surgery and then be disappointed with your surgeon or the results.
UNRAVELING THE
CANCER RIDDLE
words | NANETTE LEVIN
photos | COURTESY OF AUGUSTA HEALTH CANCER CENTER AND SENTARA MARTHA JEFFERSON HOSPITAL
Charlottesville hospitals are making discoveries and using technologies to solve some of the mysteries that have plagued cancer researchers and doctors for decades. Breakthroughs within the past five years have been remarkable. Area resources are playing a role in the future of cancer care. Population figures don’t put Charlottesville on the largest urban areas map. With a Metropolitan Statistical Area of just over 230,000, which ranks it as 195th in the United States, it’s not a bustling metropolis. Yet, the medical institutions that call this city home are contributing to discoveries that are changing the reality for cancer patients around the world. They’re also implementing some of the latest technologies. From landmark clinical trials to employing innovations in immunotherapy, prostate cancer treatment and precise brain tumor procedures, the doctors who serve the population are accessing some of latest knowledge and tools available for fighting the disease.
Big strides in understanding cancer “It’s fair to say that the progress in cancer treatment has been truly dramatic over the past five to 10 years,” says Michael Williams, MD, ScM with the University of Virginia Cancer Center. “The pace is accelerating year over year in many areas of cancer treatment.” He cites UVA’s commitment to patient care and clinical research as helping to contribute to this progress. “We now can control the disease and improve the survival for many patients with immunotherapeutic agents and with oral drugs that target tumor cells directly,” he states. Sometimes these discoveries are used in combination with traditional chemotherapy, radiation therapy and surgery, but often are replacing such treatments, he notes. “The changes in medical therapy are dramatic in the last few years,” says Kelvin B. Raybon, MD, FACP and Medical Director of Oncology and Infusion Services at Augusta Health Cancer Center. “The reason is we understand the human genome. In 2000 we sequenced the entire human DNA. We’re beginning to understand the mutations that cause cancer to grow... to become dangerous. We’re getting better at developing drugs that target the mutation. We’ve finally learned how to get the body’s own immune system to help recognize the cancer.”
“We’re beginning to understand the mutations that cause cancer to grow . . . to become dangerous. We’re getting better at developing drugs that target the mutation. We’ve finally learned how to get the body’s own immune system to help recognize the cancer.” Kelvin B. Raybon, MD, FACP Medical Director of Oncology and Infusion Services at Augusta Health Cancer Center
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Health A-Z • The Future is Now for Cancer Care
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Health Kelvin Raybon, MD, Medical Director of Oncology and Infusion Services and Sheryl Search, MSN, RN, OCN, discuss the daily schedule in medical oncology (chemotherapy). Photo provided by Augusta Health Cancer Center Margaret, in the foreground, is a breast cancer patient. Behind her are all the staff and physicians who worked with her during her journey. Those standing behind her include her radiation and medical oncologist, radiation technologists, the Augusta cancer fitness coordinator, oncology nurses, social work pharmacy personal, surgeons, the cancer dietician, breast cancer nurse navigator, mammographers, support staff and the valet parking attendant.
“The Calypso Beacons (see page 43) have just been FDA approved for the lung,” says Sylvia Hendrix, MD, Medical Director of Oncology for Sentara Martha Jefferson Hospital. “We treat a lot of lung cancer patients that can’t go to the OR. The Calypso Beacons are a great way for us to track where those lung cancers are. That program is just getting rolled out here at Martha Jefferson. There are only 10 centers in the country that it’s been released to.”
Clinical studies seeking discoveries One of many examples of immunotherapy breakthroughs at the UVA Cancer Center is the use of a chemotherapy-free, oral combination of Ibrutinib plus Venetoclax to treat relapsed mantle cell lymphoma, according to Dr. Williams. This study, the first in the US, was developed and is being led by Craig Portell, MD, a hemotologist and oncologist with UVA. Three other major cancer centers participating in this study are in Atlanta, St. Louis and Los Angeles. “The initial results have been very promising for this difficult type of lymphoma,” Dr. Williams says. “We expect enrollment to conclude within the next year, having accrued about 30 patients treated thus far among the four centers,” he explains. The ALCEMIST (Adjuvant Lung Cancer Enrichment Market Identification and Sequencing Trials) is an NCI funded study that’s sponsored by most of the large cancer organizations across the county and one Augusta Health Cancer Center is participating in, according to Dr. Raybon. “It’s a complicated trial because lung cancers are not all the same,” he says. “There are some cancer’s that are caused by certain mutations which we have developed drugs for. If we have removed the cancer from the body, we are worried that it will come back and if you have a certain type of mutation can we give you the targeted treatment for that mutation and keep it from coming back in the future?” ALCEMIST is trying to answer this for a variety of cancers.
Sylvia Hendrix, MD Medical Director of Oncology for Sentara Martha Jefferson Hospital
Michael Williams, MD, ScM University of Virginia Cancer Center
Dr. Raybon indicates Augusta Health has 20 current trials open, up from nine when he arrived in 2017. These include studies focused on breast cancer, bladder cancer, blood diseases and colon cancer. “We’re excited to open new trials,” he says. “The greatest accomplishment is that we’ve more than doubled our research capabilities in the last ten months.” www.OurHealthCharlottesville.com
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Health A-Z
• INSIGHT
Attacking prostate cancer with more precision September is prostate cancer awareness month. According to the American Cancer Society, prostate cancer ranks only behind skin cancer as the most prevalent in American men, with one in nine being diagnosed with this disease. Sentara Martha Jefferson Hospital has implemented tools and technology that enables precise targeting of radiation therapy to improve the outcomes and reduce the side effects for their prostate cancer patients. The facility has also adopted other advances to aggressively combat the disease. From a new space separator that moves the rectum away from the prostate to machines that calculate ideal radiation arcs through a robotic patient positioning table, and technology that tells a surgeon when the prostate is moving in real time, innovations are abound. Dr. Hendrix says that generally speaking, 20-25 percent of her patients are men with prostate cancer. Earlier this year she started using the SpaceOAR for brachytherapy (see sidebar on next page) and other procedures. “We have several programs which specifically benefit prostate cancer patients including intensity modulated radiation with dose escalation using volumetric arc therapy, Calypso Beacon implantation, 6 degree of freedom treatment tables, Brachytherapy and Xofigo,” she says (see sidebar on page 43). She describes intensity modulated radiation therapy (IMRT) with dose escalation using volumetric arc therapy. “Let’s say that you have a golf ball and that’s your target, that’s your prostate cancer. It’s a sphere. You’re going to take a bunch of flashlights and the flashing light is going to be the beam of radiation. Say there are four – front, back, left, right. The machine rotates around the patient. The patient stays in one place.” Radiation goes through areas around the prostate such as the rectum, bladder, sexual function This linear accelerator machine is used for prostate treatment with or without SpaceOAR.
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Health A-Z •
Brachytherapy & SpaceOar
Unraveling the Cancer Riddle
One of the accelerators used for radiation oncology at Augusta Health Cancer Center. The facility has two. Photo provided by Augusta Health Cancer Center.
nerves, and hip, then determines angles to offer the least chance of hurting beneficial body cells. She describes the radiation beam as akin to the pixels on an old TV. The intensity of the beam can be modulated square by square with intensity changes microscopically. “This was impossible to do before fast processing computers.” It’s 3-dimensional mapping of dose deliveries in real time. Dr. Hendrix states the targets aren’t squares or spheres, but random. She indicates it’s common with prostate cancer to treat other areas including seminal vesicles and lymph nodes in the pelvis. These technology tools allow the physician to target not only the location of doses with pinpoint accuracy, but also control the radiation amount, which can be different for every spot. “Most people don’t know this but in a man’s body the prostate moves all during the day,” she says. Gas puts it toward the front, a full bladder moves it down. Targets need to be within a millimeter. X-rays or CT scans find the prostate. The 6 degrees of separation table moves so the patient’s prostate is in the same place every day. “What that means for me is I don’t have to add a lot of additional margin around the prostate,” Dr. Hendrix explains. “You can have really tight edges when you do this type of radiation if you have the right imaging because it gives you a lot of confidence that you’re going to be treating the right area precisely every day.” A typical patient receives 42 treatments over an eight and a half week period with IMRT, so it’s important to know where the prostate is and when it moves.
New breakthroughs in immunotherapy UVA is also developing cutting edge cellular therapies for solid tumors and blood cancers. This includes CAR T-cell therapy for ALL (acute lymphoblastic leukemia) in children and young adults. With this approach, a patient’s immune T-cells are collected from the bloodstream and genetically redirected to activate the reprogrammed cells to destroy leukemic cells. Using the same
BRACHYTHERAPY is the treatment of cancer, especially prostate cancer, by the insertion of radioactive implants directly into the tissue. When dealing with prostate cancer, doctors often identify multiple sites for the placement of these radioactive implants with the aim of eradicating the cancer. With today’s technology, physicians can identify the best areas to target with great precision. The SPACEOAR is a liquid that’s placed into the space behind the prostate. It forms a pad to push the rectum away from the prostate. This makes it easier for the physician to administer focused radiation. Clinical trials have shown this device can eliminate rectal scarring and long-term side effects such as rectal bleeding, chronic diarrhea and pain. It lasts for three months and then is absorbed by the body.
“We are recommending SpaceOAR for all patients with prostate cancer being treated primarily with radiation, external beam and/or brachytherapy. It is not used in patients that receive radiation after surgical removal of the prostate.” – Dr. Hendrix www.OurHealthCharlottesville.com
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Health A-Z
• INSIGHT
Charlottesville hospitals are using some of the most advanced and precise technology available for treating brain tumors and other cancers with radiation, including this linear accelerator.
approach, patients with relapsed, aggressive forms of nonHodgkin lymphoma can be treated in a clinical trial or via one of the FDA-approved CAR-T-cell therapies. The UVA School of Medicine and the Medical Center continue to expand Stem Cell Transplantation facilities and programs, with the recruitment of Karen Ballen, MD, from Harvard University and the Massachusetts General Hospital as Director of Adult SCT Programs and Daniel Lee, MD, from the National Cancer Institute as Director of Pediatric SCT. A state-of-the-art facility for the production of cellular therapeutics will open in December 2018 to further improve and develop novel approaches to cancer immunotherapy. “This effort currently focuses on BATs (bispecific antibody armed T-cells), a novel form of cellular therapy directed toward pancreatic cancer, among the most difficult cancers to treat. Findings borne from this initiative will have future applications for breast cancer, other solid tumors as well as leukemia and lymphoma,” Dr. Williams states.
Building for the future of cancer care “I came on board as a medical director in 2017, so I haven’t been here quite a year yet, but it’s clear that the hospital has a commitment to build an outstanding community cancer center,” says Dr. Raybon of Augusta Health Cancer Center. He indicates staff is now stable with high quality expertise following a period of challenges. The facility is in the process changing the name to Augusta Health Center for Cancer and Blood Diseases. “Patients who need radiation and chemotherapy have a onestop-shop here simultaneously,” he says. “We have a new thoracic surgeon, Miguel Aguinaga, MD, who didn’t come here to do heart bypasses.” Instead, he’s focused on lung cancer surgery, which is a rare focus find for someone with this kind of expertise, Dr. Raybon asserts. 42
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Health A-Z •
The 6 degrees of freedom table, also called the perfect pitch couch.
Over the next 18-24 months, UVA will open a new inpatient hospital tower, expand the Emily Couric Clinical Cancer Center, and expand capacity in community-based clinics in Charlottesville, Culpeper and Fishersville. “Our goal is to make our cancer expertise more available to patients throughout central Virginia,” says Dr. Williams. Dr. Hendrix of Sentara notes the hospital’s TrueBeam Linear Accelerator and 6 degrees of freedom tables as exceptional technology. She says patients benefit from the array of therapies available including “Surgery, radiation, medications including hormonal therapy, chemo; a whole service line that is directed toward prostate cancer patients to help support them.”
Fighting brain tumors Augusta Health added tactic radiation treatments to its services within the last year for brain tumors and localized tumors within the body. “This often takes one or only a few treatments to literally eradicate a tumor. That’s not something that has been here long. We are actively treating brains,” Dr. Raybon says. “The radiation doctors are also able to vary the radiation when giving it to breasts or lungs based on the patient’s breath,” he explains. This ensures the heart, lungs and other normal structures are avoided to maximize effectiveness and minimize collateral damage through respiratory gaited radiation. “In other words, the machine is watching your breath or measuring your breath and giving you radiation only during certain times of your breathing... delivering radiation at the precise time in your breathing cycle so it knows where everything is.” “For many years, if you had cancer spread to the brain, we’d just zap your whole brain with radiation,” Dr. Raybon explains. “That took care of the cancer but it’s not good for your brain.” With more precise targeting, patients don’t lose thinking capabilities from treatments.
Unraveling the Cancer Riddle
Intensity-modulated radiation therapy (IMRT) is an advanced type of radiation therapy used to treat cancer and noncancerous tumors. Volumetric Arc Therapy (VMAT) or RapidArc Radiotherapy Technology is an advanced form of IMRT that delivers a preciselysculpted 3D dose distribution with a 360-degree rotation of the gantry in a single or multi-arc treatment. Unlike conventional IMRT treatments, during which the machine must rotate several times around the patient or make repeated stops and starts to treat the tumor from a number of different angles, VMAT/ RapidArc can deliver the dose to the entire tumor in a 360-degree rotation, typically in less than two minutes. Calypso Beacon is a machine that tells a doctor where the prostate is, how it’s tilted and announces with a radio signal when the prostate is no longer in alignment due to coughs or wiggles during treatment. It’s been available for at least the past five years. Xofigo is an intravenous radium for bone metastases.
www.OurHealthCharlottesville.com
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Health A-Z
• INSIGHT
Putting a team behind the patient Augusta Health also has a pain management team. Much of their work involves placing catheters into bones, particularly the spine, and administering heat within the tumor to destroy it. Bones can also be reinforced with a product that acts like cement, hardening to make the bones strong and healthier. “That is a new technology that we just started with our pain management doctors here,” Dr. Raybon says, noting tumors in the spine are painful and bones with cancer are susceptible to fracture. On-site services at Augusta Health include nutritionists, nurse navigators, nurses, support groups and an onsite pharmacy. “We really have the full complement of oncology and hemotologic support services under one roof,” he says.
Expert Contributors hh hh hh
Sylvia Hendrix MD with Sentara Martha Jefferson Hospital Kelvin B. Raybon, MD, FACP with Augusta Health Cancer Center Michael E. Williams, MD, ScM with University of Virginia Cancer Center
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
ASK THE EXPERT
JEAN BRICKWEDDE
AESTHETIC HAIR CONSULTANT ALTERNATIVE HAIR SOLUTIONS, LLC 716 Rio Road West | Charlottesville c 434.964.0865 | w www.charlottesvillewigs.com
What Features Make a Wig More or Less Detectable? Wigs can be virtually undetectable provided the color, density and placement is accurate. Too much hair or too much thickness never looks natural. Correct placement of a wig is essential to ensure it best reflects your natural hairline. A wig placed too far forward will cover your hairline and "close in" your face while one that is placed too far back will expose your hairline, preventing it from following your face’s natural contour.
Does My Wig Need to Match My Natural Hair Color? Depending on the look you wish to achieve, a wig does not necessarily need to be your natural color. After all, women change their hair color all the time. What’s most important is choosing a color that’s most flattering to you. COLOR TIP DURING CHEMOTHERAPY: If you are undergoing chemotherapy, it’s helpful to go a shade lighter than your natural color.
What Type of Hair Style Is Best for Me? A hair style with a "fringe" or bangs in the front can help reduce detectability. If a fringe suits you, keep it a little lighter and wispy. If you wear your hair off your face, then a lace front (a fine mesh with hair knotted into it) is the only option. A lace front eliminates the solid material of the cap allowing an invisible hairline. Even though a lace front is not necessary if you are wearing a bang, it allows a natural look if the wind blows the hair away from your face.
Are All Wigs Custom Made? Not all wigs are custom made. A custom wig is made exactly according to specific measurements, including density, color and length. It can take anywhere from 12-16 weeks to make a custom wig. "Stock" or standard wig cap sizes usually fit, but when necessary, depending on the construction of the cap, a wig can be altered, the same as altering any other wearable garment.
What If My Hair Is Thinning or If I Suffer From Female Pattern Baldness? Integration hairpieces, also known as a pull through system or integration system, may be the solution you are looking for if you have thinning hair or are experiencing Female Pattern Baldness. This option involves integrating your own hair into a hairpiece that is constructed of a material similar to "fishnet" with varying sizes of openings to
pull your natural hair through, enhancing your coverage, body and length. Integration hairpieces are held in place with either clips or by hand-knotting it with your natural hair. When ordering an integration hairpiece, be mindful of the density you choose because unlike a wig or hair topper that provides total head coverage, an integration hairpiece provides an extra amount of volume to your existing hair.
Synthetic Fiber Wig vs. Real Human Hair Wig: Which is Better? The decision between a real human hair wig and synthetic one depends on your lifestyle, budget and reason for needing one. If hair loss is the result of chemotherapy, I suggest a synthetic wig as the situation is temporary and most insurance companies will cover at least part of the cost. If your hair loss is permanent, then I suggest a wig made of human hair because it will better stand the test of time. However, if a human hair wig is beyond your budget, there are some very good synthetic/ human blends that can be a good compromise.
PROS of Real Human Hair Wigs • Last longer • Can be styled any way desired
CONS of Real Human Hair Wigs • More expensive • Needs to be styled after shampooing just as natural hair does • Limited color selection due to a desire to do as little processing to the hair as possible, although some coloring may be done to achieve the right color for you • Most human hair wigs are ordered according to length, then cut into the desired style.
PROS of Synthetic Wigs • Less expensive • Require little to no maintenance • Always maintains its style • Extensive color selection and styles
CONS of Synthetic Wigs • Do not wear as well or last as long • Cannot change the style unless it’s made of heat defiant fiber • Cannot use any direct intense heat (curling iron, blower, etc.) unless made of heat defiant fiber
Health A-Z
• INSIGHT
words | TIM WENDEL
Ways to Maximize Family Time During Cancer Treatment A diagnosis of cancer can be devastating to any family. Still, when my brother contracted acute lymphoblastic leukemia (ALL) in the mid-1960s, my parents did a remarkable job of making sure we lived life to fullest. Such an approach can benefit families today. HONEST TALK: It wasn’t that long ago that some people wouldn’t even say the word “cancer” aloud. Instead it was the “C-word” or not even mentioned at all. Adults and even older siblings need to be more open and ready to answer younger ones’ questions, too. STAY ACTIVE AND INVOLVED: Despite Eric’s eight-year battle against ALL, he played ice hockey, touch football and sandlot softball. He sometimes was away from our family, being treated at Roswell Park, one of the top cancer research centers in the country. But when Eric rejoined us, my parents urged him to pick up where he had left off. Tim Wendel is a Charlottesville-based journalist and the author of “Cancer Crossings: A Brother, His Doctors and the Quest to Cure Childhood Leukemia.”
DON’T BE AFRAID TO LAUGH: My brother briefly wore a wig after losing his hair due to chemotherapy treatments. That lasted until the first family swimming outing when it kept coming off in the swimming pool. When he opted to go without the wig, we applauded his decision. STAY IN THE MOMENT: Concerns about the past and certainly the future can overshadow everything else when a loved one has cancer. That said, try to stay in the moment. Squeeze as much as you can into every single day that you’re together. FIND A COMMON ACTIVITY: In my family’s case, we all learned to sail. I didn’t realize until years later that this was my father’s response to having a son diagnosed with ALL. Under his guidance, we became expert enough to travel across miles of open water on Lake Ontario, repeatedly to the Canadian side. We haven’t sailed as a family in some time, but those crossings and those adventures rank among our favorite times together.
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Health
A-Z
INSIGHT • AWARENESS • MINDFULNESS
WHAT’S
NEW
IN
HEALTH
INSURANCE? words | BRANDY CENTOLANZA
Be in the know when it comes to choosing healthcare coverage for you and your family during the upcoming open enrollment periods.
10 ESSENTIAL HEALTH BENEFITS • ambulatory patient services • emergency services • hospitalization • maternity and newborn care • mental health and substance use issues • prescription drugs • rehabilitative services and devices • laboratory services • preventive services as well as chronic disease management • pediatric services, including pediatric dental and vision care
We all want to be assured we have the best healthcare coverage in the event of an accident or illness. Here’s the latest in what you should know about healthcare insurance.
Why is health insurance important? Chances are you or a family member will need to see a doctor or visit a hospital at some point in your life. Those medical bills could be costly without health insurance coverage. But which healthcare insurance plan should you choose and how do you enroll? The website Enroll Virginia (www.enrollva.org), launched in 2013, provides answers to questions involving healthcare coverage basics. Enroll Virginia works to educate all Virginians about the latest in the health insurance marketplace as well as provides free, unbiased assistance with the application and enrollment process.
What does health insurance cover? The federal Affordable Care Act requires that all health insurance plans share certain common characteristics. All health plans must provide coverage in what is known as Essential Health Benefits. These benefits fall under ten categories and include ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use issues; prescription drugs; rehabilitative services and devices; laboratory services; preventive services as well as chronic disease management; and pediatric services, including pediatric dental and vision care.
How does health insurance work? Those with health insurance pay certain costs for care while their health insurance carrier pays the remainder of the bill. A PREMIUM is the set amount you pay to your health insurance company each month, even if you don’t use medical care during that month. A DEDUCTIBLE is the amount you pay for care before your health insurance company picks up its share. Once you meet your deductible, the insurance company begins to cover some costs for your care. Deductibles can range from as low as $250 to as high as www.OurHealthCharlottesville.com
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Health A-Z
• INSIGHT
HEALTHCARE INSURANCE TERMS YOU NEED TO KNOW. • PREMIUM is the set amount you pay to your health insurance company each month. • DEDUCTIBLE is the amount you pay for care before your health insurance company picks up its share. • COPAYMENT is the fixed amount you pay for medical care after you’ve met your deductible. • COINSURANCE is similar to copayment except you pay a percentage of the health care costs instead of a fixed amount.
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$2,000. A COPAYMENT is the fixed amount you pay for medical care after you’ve met your deductible. A visit to a physician’s office, for example, may cost $25 in copayment as opposed to $150 without a health insurance plan. Meanwhile, COINSURANCE is similar to copayment except you pay a percentage of the health care costs instead of a fixed amount.
What are the health insurance options? Government Health Plans are those created and mandated by the Affordable Care Act. You cannot be denied coverage even if you have preexisting medical conditions. Likewise, someone cannot be dropped from coverage if they have a major illness and it becomes too costly to insure. The website www.governmenthealthinsurance.com allows you to compare health insurance plans. Top health insurance companies in Virginia include Aetna; United Health One; Anthem; Optima Health; and Celtic. The Bureau of Insurance at the Virginia State Corporation Commission (www.scc.virginia.gov/boi/) must review and approve rates. Early reports indicate that some Virginia insurance companies want to raise premiums for 2019 health insurance plans by an average of 13 percent.
What else is new for 2019? New changes to the Affordable Care Act in 2019 include the elimination of the individual mandate penalty. The U.S. Congress recently passed and the president signed the Tax Cuts and Jobs Act, which now states that there is no financial penalty for those individuals who do not have health insurance.
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Health A-Z •
ONLINE RESOURCES:
What’s New in Health Insurance?
Where should I go for more information? Multiple websites offer helpful information about Open Enrollment. Here are a few sites you might find useful.
healthcare.gov Healthcare.gov
www.vahp.org
Virginia Association of Health Plans
www.enrollva.org Enroll Virginia
What questions should you ask your employer? If you don’t understand something about your health insurance benefits through your employer or need more information, don’t hesitate to ask human resources. Questions to ask include whether your insurance is an HMO or PPO; if dental and vision are covered under your plan; what the waiting period is before your health insurance plan kicks in; if there are geographical limitations; if your health insurance plan also covers your partner if you aren’t married; and what the timeframe is for the open enrollment period.
Where can I go for more information? In addition to Enroll Virginia and The Bureau of Insurance at the Virginia State Corporation Commission, the Virginia Association of Health Plans (www.vahp.org) can provide guidance when it comes to health insurance. The goal of the association is to improve the health of all Virginians by expanding access to high quality, affordable health care coverage.
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ASK THE EXPERT
TEAGUE FUNERAL HOME SAM SHORT, MANAGER
FUNERAL AND CREMATION SERVICES 2260 Ivy Road | Charlottesville | c 434.977.0005 | w www.teaguefuneralhome.com Q: What is the cost of cremation versus a traditional funeral service with burial?
Q: When selecting a funeral home, how can I feel confident in choosing the right one?
A: There are a number of options available for those who wish to be cremated and prices vary depending on what services a family chooses.
A: The best way to feel comfortable making any funeral arrangement is to do so well in advance. That way you can make important decisions with a clear head and not be influenced by grief. When selecting a funeral home, you should consider the reputation of the firm and how long they have served the community. At Teague Funeral Home, we have served the greater Charlottesville area for over 81 years, we offer a 100% service guarantee, bereavement travel services, aftercare support for families and our staff is required to complete ongoing training and professional development.
Like burial or entombment, cremation is just another form of final disposition. It does not have to preclude having the deceased prepared for a private or public viewing and visitation. Many families who choose cremation have that gathering time and then have the casket present for a funeral ceremony.
However, cremation can be a more economical choice if a family requests no embalming and preparation and does not select a casket. Additionally, cemetery costs are less for an urn than for a casket.
Q: What is the process of cremation? I signed so many papers and had to initial here and there so many times to have my father cremated. Why is that? A: Cremation is a high heat process that reduces the body to bone fragments which are then usually processed into a finer particulate. Most people commonly refer to cremated remains as ashes. Because cremation is such a final and irreversible process, there are laws that govern it and many safeguards in place to protect both the family and funeral director. We require positive identification and appropriate authorization forms to be signed before we schedule any cremation. Q: Do all funeral homes provide the same services? A: All funeral homes are not the same. Because of our affiliation with the Dignity Memorial network, Teague Funeral Home offers many valuable services at no cost to the family that other funeral homes simply do not have available. A few examples include: • National transferability. Life changes constantly and you need a provider who is as flexible as you are. If you move more than 75 miles from where your original arrangements were made, your prearranged funeral services are fully transferable and will be honored at any of the more than 2,000 Dignity Memorial providers throughout North America. • Bereavement travel assistance. When you are grieving a loss, the last thing you want to do is keep up with travel details. Dignity Memorial providers offer travel assistance for family and friends traveling to a funeral from out of town. • 24-hour Compassion Helpline®. When you are coping with the loss of a loved one, it often helps to talk to someone—and we understand that. All of the families we serve and the guests attending the service are invited to use our complimentary 24-hour phone service to seek assistance from professionals trained in grief counseling.
As we have become more of a consumer oriented society, most people seek the best value for money spent. Fortunately for the consumer, the funeral profession is highly regulated and pricing information is readily available. One final note about shopping around for the best price, is: “you get what you pay for”. Or the converse: “you don’t get what you don’t pay for”. Price alone is never the best way to shop for a funeral home. Be sure to ask a lot of questions so you can make an informed decision on a funeral home that will best serve your family.
Q: Would someone from your funeral home help me plan my funeral today with the understanding that it will not be paid until I pass away? A: YES. Our preplanning staff is trained in guiding you through that, all important conversation, where your wishes are documented and kept on file at our funeral home. We also offer a free “Personal Planning Guide” that allows you to document your end of life decisions and valuable estate information in one convenient book. Q: If I choose to pay for my funeral today, will my survivors have to pay more at the time of my death due to inflation? A: NO. You may choose from a wide variety of prepayment options and all prices for services and merchandise are guaranteed to never increase over time due to inflation. Since the mid-1970’s, the cost of funerals has increased between 8-12% annually. By creating a payment plan, you and your family can rest assured no additional money will be required at the time of your passing for services and merchandise. Q: Why are so many people making these plans today? A: Most people understand that planning ahead is considered prudent and responsible behavior and they make their plans because they love their family. The single worst time for a family to have to come into a funeral home to make arrangements is immediately following the death of a loved one. If we die without advance funeral plans, the last thing we do on earth is leave our loved ones with an emotional burden and a financial debt. Planning ahead establishes a sense of peace of mind.
Aging Well WISDOM • DIGNITY • SUPPORT
Individualized Fast-Track Ortho Program GIVES PATIENTS
PEACE OF MIND words |CATHERINE BROWN
At Charlottesville Health and Rehabilitation Center, Medical Facilities of America offers an innovative Fast-Track Ortho Program to help patients recover from knee or hip replacement surgery or a lower body fracture. Developed with orthopedic surgeons, the highly individualized program incorporates intensive daily therapies to enable patients to return to their normal activities more quickly than with other inpatient therapies.
FAST TRACK ORTHO IS DESIGNED SPECIFICALLY FOR PATIENTS WHO HAVE HAD: Knee Replacement Surgery Hip Replacement Surgery Lower Body Fracture
Therapist Patty Lankford explains, “The Fast-Track Ortho program was developed as a bridge for patients who have had a procedure done but are not quite ready to return home.”
What is involved with Fast-Track Ortho? When participating in Fast-Track Ortho, patients stay at the facility for an average of 13 days following a procedure or injury. The stay begins with an initial meeting. “We first evaluate the individual and see what their deficits and goals are. Then we develop focused treatment plans on those goals based on their deficits.” - Patty Lankford, MPT, Rehab Director with Medical Facilities of America
Two main components of the program include strength and balance. Regardless of the procedure done, therapists work with patients to help them rebuild their strength and refine balance to perform daily tasks. Therapists also work with patients to ensure they are aware of any precautions to consider; for instance, they help them use adaptive equipment to avoid bending the knee too far after a knee replacement. While participating in the program, patients can also be involved in a variety of activities, from movie nights to church services and musical groups. “With all of our activities, including coffee and conversation, bingo and pet therapy,” says Lankford, “the patients have the opportunity to interact and socialize with one another.” www.OurHealthCharlottesville.com
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Aging Well
• INSIGHT
INDIVIDUALIZED FAST-TRACK ORTHO
PROGRAM BREAKDOWN
Orthopedic surgeons developed a highly individualized program that incorporates intensive daily therapies to enable patients to return to their normal activities more quickly than with other inpatient therapies. Patients stay at the facility an average of 13 days following a procedure or injury.
Initial Meeting A team of therapists start by evaluating the individual to see what their deficits and goals are.
Develop Treatment Plan The team then develops an individualized treatment plan according to the patients deficits and goals.
Implement the Plan The patient then participates in physical and occupational therapy three hours a day, seven days a week.
Care Meetings Throughout the Program, there are regular care meetings to update the patient and family members about progress and goals moving forward.
Returning Home Therapists provide a workbook with extensive information about daily exercise for the patient when they return home.
Who should participate in the Fast-Track Ortho Program? The orthopedists, nurses, hospital case managers and Fast-Track Ortho admissions department have developed criteria for determining who would succeed in the Program. “It’s a fast-paced, intense program,” says Lankford, “so patients need to have the cognitive ability to understand everything, and they need to be able to handle the therapy and aggressive goals.”
What makes Fast-Track different? The major difference with the Fast-Track Ortho Program is the speed and intensity with which the patients progress through skill sets. “Patients typically participate in physical therapy and occupational therapy three hours a day, seven days a week,” says Lankford. The physical therapy portion involves working on tasks like moving up and down stairs and getting “Patients typically in and out of bed, while the occupational therapy participate in physical portion involves preparing to return to daily living therapy and occupational activities, like taking a shower and keeping up therapy three hours a with housekeeping.
day, seven days a week.”
Throughout the Program, there are regular care meetings to update the patient and family members about progress and goals moving forward. A Recovery Map in each room also tracks the patient’s progress as the patient moves through the Program.
What happens when the program ends? Before patients leave the program, therapists provide a workbook with extensive information about exercises they should continue when they return home. The workbook also includes education about symptoms to look out for and a review of medications. “It helps patients when they have all of that information in one place,” explains Lankford, “and we start working through that book while they are in the Program to help them transition home.” Most importantly, patients leave the Fast-Track Program with confidence that they can return to their normal daily living activities. “The short burst of intense therapy ensures they are safe and can get back home to what they enjoy doing,” says Lankford. EXPERT CONTRIBUTORS Patty Lankford, MPT, Rehab Director with Medical Facilities of America
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Aging Well • Individualized Fast-Track Ortho Program
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Food Fitness NUTRITION • EXERCISE • PREVENTION
FRESH &
FABULOUS FALL PRODUCE
words | MICHELLE MCLEES, AMERICAN HEART ASSOCIATION
The fall harvest season brings a whole new assortment of delicious and hearthealthy fresh fruit and vegetables. Apples, pears, broccoli and Brussels sprouts are fresh in the market – or in your garden. Autumn is a time to shift from the seed fruit that we eat in the summer to all the nutrition-rich goodies, like the grapes and persimmons we get in the fall. These fresh foods are not only tasty, but can help you feel better, get healthier and may protect against heart disease and stroke. Fruits and vegetables with color contain vitamins, minerals, fiber and phytochemicals that have different disease-fighting elements. These compounds may be important in reducing the risk of many conditions, including cardiovascular disease. The American Heart Association recommends at least 4-5 servings per day of fruits and vegetables based on a 2000-calorie diet as part of a healthy lifestyle that can lower your risk for these diseases.
Colors of Fall Fall brings its own color wheel of seasonal fruits and vegetables. Deep colors like oranges, reds, and purples are especially prominent in the cooler months. However, it’s important to strive for variety with your fall favorites. Don’t just have a green salad; add all different colors into the salad. More colors usually means there is good nutritional value in your meal.
Fruits, Vegetables and Your Weight The autumn months bring additional health and nutritional challenges. The shorter, cooler days can make it harder to get physical activity outdoors. And there are the looming (and caloriepacked) temptations of football party snacks, Halloween sweets and Thanksgiving buffets. However, one good way to avoid those extra seasonal pounds is to keep eating plenty of fresh fruit and vegetables. For example, apples are thought to have a unique source of fiber that is excellent for weight control. They are especially crisp and delicious during the fall because this is when they are harvested.
Other Fresh-food Benefits While grocery stores will carry an assortment of fruits and vegetables throughout the year, buying seasonal produce can take some of the strain off your wallet. When foods are in season locally, they are usually more abundant and affordable.
More Recipes Also don't miss these and other WEB EXCLUSIVE recipes at OurHealthCharlottesville.com/ recipes
Buying seasonal produce may also add zest and flavor to your meals. Fruits and vegetables that are in season are typically fresher and more flavorful. However, some canned or frozen fruits and vegetables can be just as healthy and satisfying. Some people think frozen or canned vegetables lack nutritional value, but they are usually processed at the peak of harvest, so they can provide nutritional value, which is similar to fresh produce. Consider selecting fruit canned in its own juices and canned vegetables labeled “no” or “reduced” sodium. www.OurHealthCharlottesville.com
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ROASTED SUNDRIED TOMATO
BEEF TRI-TIP
WITH PEPPERS
& SWEET
POTATOES This beef tri-tip roast is served with red peppers and sweet potatoes.
DIRECTIONS SERVING SIZE: About ½ cup beef (3 ounces cooked beef); ½ cup cooked vegetables. Makes about 8 servings.
INGREDIENTS 1
beef Tri-Tip Roast (1-1/2 to 2 pounds)
1/2 cup reduced-fat Italian salad dressing 1/4 cup drained sun-dried tomatoes (oilpacked) 1/4 cup water 1 1/2 lbs sweet potatoes (cut into 2-inch pieces) 2
red bell peppers (cut into 2-inch pieces)
1
teaspoon salt
2
tablespoons grated Parmesan cheese
Fresh, chopped parsley (optional)
A
Preheat oven to 425°F. Place dressing, tomatoes and water in blender or food processor container. Cover; process until smooth. Divide mixture into thirds.
B
Combine sweet potatoes, peppers and 1/3 tomato mixture in large bowl; toss to coat. Place vegetables on parchment-lined shallowrimmed baking pan. Set aside.
C
Season beef Tri-Tip Roast, as desired. Spread 1/3 tomato mixture evenly onto all surfaces of beef roast. Place roast on prepared vegetables. Insert ovenproof meat thermometer so tip is centered in thickest part of beef, not resting in fat. Do not add water or cover. Roast in 425°F oven 30 to 40 minutes for medium rare; 40 to 50 minutes for medium doneness.
NUTRITION FACTS
Calories: 265; Total Fat: 9.1 g; Saturated Fat: 3.1 g; Trans Fat: 0.01 g; Polyunsaturated Fat: 0.8 g; Monounsaturated Fat: 4.2 g; Cholesterol: 67 mg; Sodium: 551 mg; Total Carbohydrate: 21 g; Dietary Fiber: 3 g; Sugars: 6 g; Protein: 25 g; Dietary Exchanges: 1 starch, 1/2 vegetable, 3 lean meat, 1/2 fat This Heart-Check Certified recipe is brought to you by National Cattlemen’s Beef Association, a contractor to the Beef Checkoff.
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BROCCOLI
SALAD WITH WATER
CHESTNUTS &
DRIED
CRANBERRIES
The acid in the red wine vinegar breaks down the broccoli, softening it so there's no need to cook it.
DIRECTIONS
A
SERVING SIZE: 2 cups. Makes about 4 servings.
INGREDIENTS 7
cups chopped broccoli florets (from about 2 heads broccoli)
1
cup grated broccoli stem (also from those same 2 heads broccoli)
2
(5-ounce) cans sliced water chestnuts (drained)
1/3 cup dried, unsweetened cranberries 3
Tbsp canola oil
3
Tbsp red wine vinegar
1/2 tsp garlic powder 1/4 tsp salt 1/4 tsp ground black pepper
Remove and reserve the stalks from the broccoli. Chop broccoli florets into bite-size pieces. Add into a large zip-top bag with water chestnuts and dried cranberries.
B Place a box grater inside a small bowl. Grate the stalks to get around 1 cup of grated broccoli stem (or more depending on how big the stalks are). Add into the bag.
C.
In a small bowl, add oil, vinegar, garlic powder, salt, and pepper. Whisk with a fork to combine. Add dressing into the zip-top bag. Seal the bag and gently toss to combine. Refrigerate for at least an hour and up to 24 hours to let the broccoli marinate in the dressing. Serve.
NUTRITION FACTS
Calories: 182; Total Fat: 11 g; Saturated Fat: 0.9 g; Trans Fat: 0.0 g; Polyunsaturated Fat: 3.2 g; Monounsaturated Fat: 6.7 g; Cholesterol: 0 mg; Sodium: 192 mg; Total Carbohydrate: 20 g; Dietary Fiber: 9 g; Sugars: 2 g; Protein: 5 g; Dietary Exchanges: 3 vegetable, 1/2 fruit, 2 fat Recipe copyright © 2016 American Heart Association.
COOKING TIP:
Since the broccoli florets are “cooking” in the acidic dressing, cut the florets as small as possible so the acid makes the broccoli soften quicker. Don’t have red wine vinegar? Just substitute lemon juice.
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