OurHealth Richmond Sept/Oct 2018

September • October 2018 ourhealthrichmond.com

These are the

Decades of our

Lives

What’s NEW in

HEALTH INSURANCE?

SERVING THE

GROWING

POPULATION OF

WOMEN VETERANS

THE FUTURE IS NOW FOR CANCER CARE

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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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SERVING THE GROWING POPULATION OF WOMEN VETERANS

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THE FUTURE IS NOW FOR CANCER CARE

Women veterans represent the fastest-growing veteran population and account for roughly ten percent of all veterans. Currently, however, only about half of women veterans receive their healthcare through VA medical centers.

Cancer care advancements in the Richmond area over the past few years have been remarkable. Patients who were required not long ago to drive out-of-state for treatments now have some of the most technologically sophisticated equipment and esteemed talent in the country at home.

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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 Richmond during September and October

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

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58 - 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 periods.

for your Mind, Body and Soul

62 - Beaumont Towers RUI University Keeps Residents Learning

Virginia Home for Boys and Girls to host the VHBG Youth Triathlon presented by Endorphin Fitness.

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65 - Listening to Your Body: It’s important to see your doctor if something just doesn’t feel right.

Volunteer Spotlight | Heroes. Champions. Community Minded.

Volunteer Cindy Lantz’s Experience with the Down Syndrome Association Helps New Parents.

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

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

48 - Helping Cancer Patients Navigate Non-Medical Issues: CancerLINC connects patients with local resources as they battle cancer.

Aging Well | Wisdom. Dignity. Support.

69 Food and Fitness | Nutrition. Exercise. Prevention.

Fresh & Fabulous Fall Produce: The fall harvest season brings a whole new assortment of delicious and heart-healthy fresh fruit and vegetables.

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Funny Bone | Spot the Seven Differences

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SEPTEMBER • OCTOBER 2018

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CONTRIBUTING RICHMOND MEDICAL EXPERTS Timothy Finkler, DDS Karen Galichon, MD Madison Kiley, RN

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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.

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The Pulse

INFORMATION • EVENTS • AWARENESS

Announcements Bon Secours St. Francis Opens First Cardiac Rehab Center in Chesterfield County Bon Secours Richmond Health System has opened a new Cardiopulmonary Rehabilitation Center at Bon Secours St. Francis Medical Center which marks the health system’s first Cardiac Rehab Center in Chesterfield County, expanding access to quality cardiac care for patients who have been diagnosed with heart disease or who are recovering from a heart attack or heart surgery.

“We are excited to open a new Cardiac Rehab Center that’s south of the James River to complement our two locations at Bon Secours St. Mary’s Hospital and Bon Secours Memorial Regional Medical Center,” says Ross Barber, director of cardiopulmonary rehabilitation at Bon Secours Virginia Health System. “We are proud that the multidisciplinary cardiac rehab team at St. Francis Medical Center brings more than 125 years of combined nursing experience to benefit our patients on their journey to recovery from heart disease.”

Upon referral to the Cardiac Rehab Center by a cardiologist, each patient meets with trained healthcare providers for a one-on-one evaluation and medical workup. The staff will create an individualized plan of cardiac rehabilitation lasting approximately 12-18 weeks. A cardiac rehab plan at Bon Secours includes a thoughtful flow of safe, supervised exercise conditioning and strength training that gradually increases in intensity, along with nutritional counseling and emotional support.

“Primary goals are to help patients maintain a healthy heart and enjoy an improved quality of life,” says Mark Doloresco, MD, a cardiologist

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OurHealth | The Resource for Healthy Living in Greater Richmond

(from left) Mark Doloresco, MD, cardiologist with Cardiovascular Associates of Virginia who practices at Bon Secours St. Francis Medical Center; Nancy Anderson, RN and Program Coordinator of the Cardiac Rehab Center at Bon Secours St. Francis Medical Center; Chris Accashian, CEO of Bon Secours St. Francis Medical Center; and Ross Barber, Director of Cardiopulmonary Rehabilitation at Bon Secours Virginia Health System.

with Cardiovascular Associates of Virginia who practices at Bon Secours St. Francis Medical Center. “Expected outcomes of effective cardiac rehabilitation are increased stamina and endurance, improved stress management skills, reduced need for hospital readmission and reduced length of stay if the patient is hospitalized. These wellness outcomes are hallmarks of the top caliber patient-centered care provided by all three Bon Secours Cardiac Rehab Centers serving the Richmond region.”

For more information: visit www.bonsecours.com/richmond

The Pulse • NEWS TO KNOW

Recognitions Henrico Doctors’ Hospital Recognized for Superior Performance in Labor and Delivery HCA Virginia’s Henrico Doctors’ Hospital has earned the 2018 Labor and Delivery Excellence Award™ from Healthgrades, the leading online resource for comprehensive information about physicians and hospitals.

This distinction places Henrico Doctors’ within the top 10 percent of all hospitals evaluated for the exceptional care of mothers during labor and delivery. In addition, Henrico Doctors’ is recognized as a 5-Star recipient for Vaginal Delivery in 2017 and 2018, and a 5-Star recipient for C-Section delivery for 2016, 2017 and 2018.

“Everything we do is about the safety, outcome and experience of the mothers who entrust their care to us,” says Amber Price, DNP, CNM, vice-president of Women’s and Children’s Services at The Women’s Hospital, Henrico Doctors’ Hospital. “Our rigorous processes allow for an optimal birth experience while maintaining the highest safety standards in maternal and newborn care, but our exceptional nursing and medical staff are the reason more women choose to have a baby here than at any other hospital in the region.”

To help consumers evaluate and compare hospital performance in labor and delivery, Healthgrades analyzed patient outcome data for virtually every hospital in the 15 states and the District of Columbia that provide all-payer state data for years 2014 through 2016.

Healthgrades found that the variation in hospital performance makes a significant difference in terms of clinical outcomes: hh From 2014 to 2016, if all hospitals included in the analysis performed similarly to those that received the Healthgrades Labor and Delivery Excellence Award, complications could have potentially been avoided for 101,543 patients.* hh From 2014 through 2016, patients treated in hospitals receiving the Labor and Delivery Excellence Award had, on average, a 36.8 percent lower risk of experiencing a complication while in the hospital than if they were treated in hospitals that did not receive the Labor and Delivery Excellence Award.

“Consumers value high-quality outcomes when selecting hospitals, especially with delivery of a child,” says Brad Bowman, MD, chief medical officer at Healthgrades. “Parents have many options when looking for the right providers, and the Healthgrades 2018 Labor and Delivery Excellence Award gives them important insight to find the top hospitals in their areas.”

For more information: View Healthgrades hospital quality methodologies. Learn more about how hospitals partner with Healthgrades at www.healthgrades.com/hospitals *Statistics are based on Healthgrades analysis of All-Payer data for years 2014 through 2016 and represent 3-year estimates for patients in 15 states and the District of Columbia for which all payer data was made available.

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The Pulse

• NEWS TO KNOW

Jason D. Adam, MD

Richmond Gastroenterology Associates Midlothian | 804.330.4021 www.RichmondGastro.com

Mugdha Agrawal, MD

Bon Secours Rheumatology Center Richmond | 804.217.9601 www.BonSecours.com

Kathryn Armstrong, NP

Nayef Chahin, MD

Bon Secours Heathsville Family Practice Heathsville | 804.580.7200 www.BonSecours.com

Children’s Hospital of Richmond at VCU Neonatology Downtown Richmond 804.828.9956 www.chrichmond.org

Caitlin Dillon, MD

Krista Edelman, MD

Jonathan Foote, MD

Joshua Freedman, MD

Edina J. Gorman, DDS

W. Gregory Hundley, MD

Nemer El Mouallem, MD

John Owens, DO

Charter Colony Family Practice Midlothian | 804.423.5050 www.BonSecours.com

Virginia Family Dentistry Mechanicsville 804.730.3400 www.vadentist.com

Richmond Gastroenterology Associates West Creek | 804.330.7840 www.RichmondGastro.com

VCU Health | Cardiology Richmond | 804.628.4327 www.vcuhealth.org

Commonwealth Gynecologic Oncology Richmond | 804.288.8900 www.BonSecours.com

VCU Health Oncology/Hematology Richmond | 804.828.5116 www.vcuhealth.org

Pediatric Lung Care Richmond | 804.281.8303 www.BonSecours.com

Cardiovascular Associates of Virginia Midlothian | 804.794.6400 www.BonSecours.com

PROUD SPONSOR OF

NEW PEOPLE 12

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The Pulse

Chippenham Hospital Named 5-Star Recipient in 2018 Healthgrades Women’s Care Awards Rachel Powell, MD

VCU Health General OB-GYN Richmond | 804.828.4409 www.vcuhealth.org

Parna Prajapati, MD

Children’s Hospital of Richmond at VCU Virginia Treatment Center for Children | Psychiatry Richmond | 804.828.3129 www.chrichmond.org

Rachel Sawyers, PA-C

Richmond Gastroenterology Associates Midlothian | 804.560.9852 www.RichmondGastro.com

HCA Virginia’s Chippenham Hospital has been named a 5-star recipient for vaginal delivery for three years in a row by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. This 5-star rating indicates that Chippenham’s clinical outcomes are statistically significantly better than expected when treating the condition or performing the procedure being evaluated. Chippenham Hospital is being recognized for its efforts in 2016, 2017 and 2018.

“We have a strong team in place and every staff member is genuinely dedicated to providing an exceptional birth experience for each of our patients,” says Karen Shirley, RN, director of women’s services at Chippenham Hospital. “Our patients remain our priority and they will continue to receive the most essential care that they deserve.”

Gordon Smith, MD

VCU Health Neurology Chair Richmond | 804.828.9350 www.vcuhealth.org

Eugena C. Waggoner, DDS

Virginia Family Dentistry Prince George 804.526.4822 www.vadentist.com

Brody Wehman, MD

Cardiac Surgery Specialists Richmond | 804.287.7840 www.BonSecours.com

Additional efforts at Chippenham have included a focus on the certified nurse midwife program; staying compliant with the March of Dimes’ 39 weeks education initiative, which aims to promote healthier babies and reducing early elective births; and developing strategies to lower C-section rates.

To help consumers evaluate and compare hospital performance, Healthgrades analyzed all-payer state data for 15 states and the District of Columbia for years 2014 through 2016. Healthgrades found that there is a significant variation in hospital quality between those that have received 5-stars and those that have not.

According to Healthgrades, from 2014 through 2016, patients having a vaginal delivery in hospitals with 5-stars have, a lower risk of experiencing a complication while in the hospital than if they were treated by hospitals with 1-star.*

Wendy Welch, MD

Children’s Hospital of Richmond at VCU Virginia Treatment Center for Children | Psychiatry Richmond | 804.828.3129 www.chrichmond.org

Caroline Wichman, NP Patterson Avenue Family Practice Richmond | 804.741.6200 www.BonSecours.com

Brandon C. Wong, DMD Virginia Family Dentistry Ashland | 804.550.3324 www.vadentist.com

“With more options than ever on where to receive care, consumers need to do their homework,” says Brad Bowman, MD, chief medical officer, Healthgrades. “Hospitals that have received a 5-star rating have shown dedication and expertise, resulting in high-quality outcomes for patients.”

“This recognition is a testament to the high level of care driven by our patient-centered focus and integrated approach, says Greg Lowe, chief executive officer of Chippenham & Johnston-Willis Hospitals. “ I am proud of Chippenham Hospital’s women’s health services for continuing to meet and exceed national standards.”

For More of The Pulse Visit: ourhealthrichmond.com

For more information: View Healthgrades hospital quality methodologies. Learn more about how hospitals partner with Healthgrades at www.hs.healthgrades.com/hospitals

Do you have health-related news to share for The Pulse? Send to Stephen McClintic Jr. via email

*Statistics are based on Healthgrades analysis of All-Payer data for years 2014 through 2016 and represent 3-year estimates for patients in 15 states and the District of Columbia for which all payer data was made available.

at steve@ourhealthvirginia.com.

www.OurHealthRichmond.com

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• NEWS TO KNOW

Recognitions

SEPTEMBER • OCTOBER

CALENDAR

INFORMATION • EVENTS • AWARENESS

9.9

9.9 Join us for this FREE Stand Up Paddleboard (SUP) class for recovering cancer survivors!

Escape on the water and maybe even find a new passion that can assist you on the path to health and wellness. Whether you are six months post treatment or five years into your survivorship, all cancer survivors are welcome.

FREE | 9 – 11 am | Riverside Outfitters 6834 Old Westham Road | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/events/SUP-recovery

9.22

ST. JUDE WALK/RUN

TO END CHILDHOOD CANCER Join St. Jude supporters across the nation by participating in the St. Jude Walk/Run to End Childhood Cancer, an inspiring, family-friendly event to raise money for the children of St. Jude.

September is Childhood Cancer Awareness Month, making it a perfect time to rally your family, friends and community in support of St. Jude Children’s Research Hospital. $10+ | 8 am - 12 noon Bon Secours Washington Redskins Training Center 2401 W. Leigh Street | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/events/ stjude-2018

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ROOFTOP YOGA Take your practice to the top, the ROOFTOP that is! Enjoy beautiful views of the city as you flow with the breeze under the sky. Register at www.omonyoga.com or thru the Om On Yoga App under Classes.

Please be sure to register early to save your spot! $12 Drop-in | $17 Drop-in and Beverage 10:30 – 11:30 am | Quirk Hotel 201 W. Broad Street | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/ events/yoga-quirk-9-9

9.23 CLIMB TO

CONQUER CANCER Join us for this fantastic road or trail race as we raise funds for cancer research! All routes take an easy tour around beautiful historic Church Hill before ascending the wellknown Libby Hill Cobble Climb where we’ll Climb to Conquer Cancer. For road cyclists, after the first Libby Hill ascent, you have the option of either a 26, 44, or 63-mile route through the flat country-side that surrounds Richmond. Or hop on your mountain bike or cross bike for a taste of trails, taking you 19 miles through Ancarrow’s Landing Park.

8:30 am | $20+ Start Line: Libby Hill 11 ½ N. 29th Street Richmond MORE INFORMATION: w www.ourhealthvirginia.com/ events/Libby2018

OurHealth | The Resource for Healthy Living in Greater Richmond

9.25

CANCER

LINC

SOCIAL SECURITY DISABILITY

BASICS

Join CancerLINC and attorney Susan Kennedy for a talk on qualifying for Social Security Disability Income (SSDI) and Supplemental Security Income (SSI) benefits. Learn what medical information is essential to include in order to qualify, as well as the procedures that will be used to determine eligibility.

CancerLINC is a Greater Richmond area non-profit that helps connect cancer patients and their families to a network of volunteer attorneys and financial consultants who provide pro bono assistance to qualified cancer patients.

FREE | 7 – 8:30 pm | Libby Mill County Public Library 2100 Libbie Lake East Street | Henrico MORE INFORMATION: w www.ourhealthvirginia.com/events/ cancerlinc-SSDI

Calendar

9.27 & 28

PAC CONSULTANT CERTIFICATION Do you currently or wish to counsel or advise families working with those living with dementia?

The PAC Independent Certified Consultant program is designed for professionals who counsel and advise families working through dementia related challenges. Professionals who may benefit from this training include geriatric care managers, executive directors, marketing directors, senior living advisors, marriage and family therapists, Stephens ministers and elder law attorneys.

8 am – 5 pm | Senior Helpers 9407 Kings Charter Drive | Mechanicsville MORE INFORMATION: w www.ourhealthvirginia.com/events/PACcert

HONEY BEES AND BEEKEEPING

Those contemplating beekeeping can join Jesse the Beekeeper with East Coast Honey to find out what it takes. Jesse surveys the importance of honey bee pollination to our food supply, how consumers can take personal action to protect honey bees and explains to aspiring beekeepers various aspects of beekeeping as a hobby and a business. He also touches on causes of Colony Collapse Disorder and what is involved in becoming a beekeeper.

Afterward, visit the Garden’s apiary (weather permitting). $32/$45 | 9 am – 12 noon Lewis Ginter Botanical Garden 1800 Lakeside Avenue | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/ events/beekeeping

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• SEPTEMBER • OCTOBER

ALL ABOUT

Calendar

• SEPTEMBER • OCTOBER

ANNUAL STEP UP

FOR DOWN SYNDROME 5K & FAMILY FESTIVAL

Join the Down Syndrome Association of Greater Richmond at the 12th Annual Step UP for Down Syndrome 5K & Family Festival. Whether you have Down Syndrome, know someone who does, or just want to show your support, take the first step and donate or register today! Fun activities for the entire family! $5 - $40 | 9 am – 1 pm (Rain or Shine) Acca Shrine Center 1712 Bellevue Avenue | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/events/stepup-2018

10.8

FORK UNION MILITARY ACADEMY OPEN HOUSE Visit the Fork Union Military Academy campus for one of several upcoming Open Houses. The college-prep boarding school is founded on Christian values and offers structure and discipline for boys in 7th grade – 12th grade and postgraduates.

FREE | All Day Event | Fork Union Military Academy 4744 James Madison Highway | Fork Union MORE INFORMATION: w www.ourhealthvirginia.com/events/forkunion-openhouse

10.11

GRANDPARENTS

CLASS

Being a grandparent is exciting, but is your knowledge of baby care and equipment up to date? Join us for a class on current baby trends and information. This class meets in one session. Registration is required.

FREE (registration required) | 7 – 9 pm Henrico Doctors Hospital The Williamsburg Room 1602 Skipwith Road | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/events/ grandparents-101

10.10 INVISALIGN SEMINAR WITH VIRGINIA FAMILY DENTISTRY

Join Virginia Family Dentistry orthodontists Dr. Melanie Spears and Dr. Allison Purcell for appetizers and refreshments as they answer all of your questions regarding Invisalign, the clear alternative to braces. They will be discussing who is a candidate for Invisalign treatment, possible treatment duration, and how the Invisalign process works, from initial consultation to the final appointment.

As a thank you, all attendees will be offered the opportunity to schedule a free orthodontic consultation with complimentary records (a $275 value).

FREE | 6 – 7:30 pm | Virginia Family Dentistry – Iron Bridge 6441 Iron Bridge Road | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/events/invisalign

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OurHealth | The Resource for Healthy Living in Greater Richmond

Calendar • SEPTEMBER • OCTOBER

10.13

SPIRIT OF THE HEART HEALTH

AND EDUCATION FAIR Screen actor and health advocate Lamman Rucker will be serving as the celebrity ambassador and local cardiologist Phillip Duncan, MD will be the host, in addition to other community leaders who will be empowering the Richmond community with healthy resources and information during this Health and Education Fair.

Free health screenings, consultation with physicians, nutrition and fitness experts, interactive family fun, a kid’s corner, food and door prizes and more will all be a part of this fantastic event!

FREE | 11 am – 3 pm Greater Richmond Convention Center – Exhibit Hall B 403 N. 3rd Street | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/events/ spirit-of-heart-health-and-educationfair/

10.27 HIKE

FOR KIDS 2018 Seventh Annual Hike for Kids event to support the youth of Blue Sky Fund.

Enjoy the challenge of our 3-mile (familyfriendly), 8-mile, or 14-mile loops, each starting and ending at the Virginia War Memorial. $10 - $30 | 9 am – 5 pm Virginia War Memorial 621 S. Belvidere Street | Richmond MORE INFORMATION: w www.ourhealthvirginia.com/events/ hike-for-kids-2018 www.OurHealthRichmond.com

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Health Scene HAPPENINGS • WHO’S WHO • TRENDING

CHILDREN TAKE ON TRIATHLON IN SUPPORT OF VIRGINIA HOME FOR BOYS AND GIRLS Triathlons are a great way to experience the benefits of a healthy lifestyle that requires daily exercise and good nutrition. On Saturday, August 18th, children ranging in ages from seven – 14 years old who competed in the 7th Annual Virginia Home for Boys and Girls (VHBG) Youth Triathlon proved you are never too young to start.

The Triathlon, which was sponsored by Endorphin Fitness and its Live Red Foundation, was founded out of a desire to help support VHBG and it’s mission to make a difference in the community. All of the proceeds raised from the Triathlon are used to support VHBG’s youth and community-related recreational activities to further support their social skills and emotional well-being. Since 1846, the VHBG has been serving children in crisis by providing stability within a teaching-family model. To learn more about VHBG, visit www.vhbg.org.

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photos | NICK SEITZ

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OurHealth | The Resource for Healthy Living in Greater Richmond

Health Scene

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www.OurHealthRichmond.com

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VOLUNTEER

Spotlight HEROES • CHAMPIONS • COMMUNITY-MINDED

VOLUNTEER’S

EXPERIENCE WITH THE DOWN SYNDROME ASSOCIATION

HELPS NEW

PARENTS words | CATHERINE BROWN

Pictured above: Cynthia Lantz with daughter, Shelley

In 1989, soon after the birth of her daughter, Cynthia Lantz joined the Down Syndrome Association of Greater Richmond.

Shelley was born with Down syndrome (DS), and Lantz felt the desire to connect with others who also had children with DS. Now, as Chair of the First Call Program, Lantz provides that connection to new parents with a prenatal or postnatal diagnosis of DS.

but being on the front line is not easy for many reasons,” says Lantz.

“There are so many unknowns and questions, and you don’t know what your life will be.”

Lantz tries to be a mentor for families while also giving them space to figure out their new lives. She encourages them to get involved with the Down Syndrome Association so that they can connect with other families who have children with DS throughout every stage. “It’s a lifelong journey with a child with DS,” Lantz says. “The more involved you are, the better off you and your child are.

You can dig and find resources and give them the most opportunities possible.”

It took some time for Lantz to come full circle into that role.

She began participating in programs and events with the Down Syndrome Association after Shelley was born, but she did not participate in a leadership role until “Life is better and richer she joined the Board of Directors twenty years when we work together later. Then she served as the Board Vice President rather than being in our for two years and the Board President for two years before leading the First Call committee. little corner taking care

When she meets with new parents through the First Call Program, Lantz provides them the opportunity to meet Shelley. “She is an outstanding young lady,” Lantz says. “When I tell them all that she does and the contributions she of ourselves.”

As part of the First Call Program, Lantz visits makes, I hope that’s uplifting for them.” Throughout - Cynthia Lantz families whose baby has been born with DS to provide her life, Shelley has been very involved in her information and a care package. “It is an honor and a community through her job and activities, like Girl Scouts privilege to be invited into people’s homes,” Lantz says. “It’s a and swimming. She particularly enjoys participating in SPARC’s big deal that they trust me enough to come into their personal space annual LIVE ART program. and talk about something so personal.”

Lantz knows firsthand the challenges of raising a child with DS, and she knows the importance of having other families to connect with.

“Individuals with DS bring a dimension to life that is very valuable,

Lantz and her daughter have greatly benefited from their participation in the Down Syndrome Association, and Lantz hopes to help others make those important connections as well.

ON THE WEB

More at ourhealthrichmond.com

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VOLUNTEER Spotlight • Volunteer Shares Her Experiences with New Parents

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Questions. Answers.

Knowledge.

What are comorbidities?

A person who has more than one major diagnosis has comorbidities.

For example, a patient with coronary artery disease, diabetes, hypertension, hyperlipidemia, and obesity (a common finding in clinical practice) has multiple comorbidities.

In general, a person with multiple comorbidities, as compared to a person with only one major medical condition, will have lower quality of life, an increased risk for major events such as heart attack and stroke, and a shorter lifespan. He or she will likely spend more money on medications and more time visiting physicians.

A person with

MULTIPLE COMORBIDITIES as compared to a person with only one major medical condition WILL HAVE LOWER QUALITY OF LIFE, an increase risk for major medical

How can I determine if my parent’s home is able to be renovated to accommodate older seniors?

Because no two seniors have the same needs and no two homes are alike, the first thing needed is an in-home evaluation and inspection.

Most home improvement companies will offer an evaluation. At Harris Enterprises, we not only offer an evaluation, but we also offer a free 90-minute home inspection.

Following the home inspection, we are able to discuss thoroughly what needs are required to help keep your loved one in a safe and manageable environment.

Karen Galichon, MD

Primary Health Group at Henrico Doctors’ Hospital Parham Campus Richmond | 804.282.2580 www.phg-henrico.com

James Harris

Harris Enterprises of Virginia, Inc. Richmond | 804.405.9996 www.harrisenterpriseva.com

What is culinary medicine?

Culinary medicine is the practical application of a protocol, based on the research we have now, testing, in addition to using the knowledge of healing properties of plant medicine to enhance one’s eating regime. It is learning how to use what we can eat as opposed to what we cannot.

This is highly individualized. This knowledge can be taken into the kitchen to empower patients in their own healing journey. It could be introducing someone to vegetables and foods to enhance their immune system, or teaching someone who won’t eat vegetables new ways to cook and enjoy them. Combined partnership with practitioners and physicians results in the practical kitchen experience needed to complete a holistic approach to vibrant health.

Laurel Herman

The Blissed Out Chef Richmond www.theblissedoutchef.com

events, and a

SHORTER LIFE. CHECK OUT

OurHealthRichmond.com FOR EVEN MORE HEALTH RESOURCES!

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Q A ON HEALTH • Knowledge

www.OurHealthRichmond.com

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Questions. Answers.

Knowledge.

How does a root canal become infected?

What is a charitable bequest?

The simple answer to this question is, “bacteria“. If we did not have bacteria in this world then the tissue inside our teeth would never have inflammation or infection. So, with that relatively impermeable barrier made of dentin and enamel, how does the bacteria get inside?

A charitable bequest is a disposition in a will or estate plan, which is made to a charitable organization, such as a church. Leaving assets to a church can easily be accomplished by naming the church in one’s will.

By naming the church, one can make a major gift while using and preserving the assets during the remainder of one’s life. In addition, the charitable bequest may reduce an estate tax burden. The bequest may be a specific dollar amount, specific property, or a certain percentage of one’s estate assets.

The bequest may also provide that the church receive all or a stated percentage of one’s residual estate after payment of other bequests, debts, taxes and expenses. If one already has a will, a codicil may be created and attached to the will.

Bacteria can enter the tooth in several ways. The big three causes are a cavity, crack and trauma. The most common is a cavity.

Everywhere else on our body does an

AMAZING JOB FIGHTING BACTERIA.

Our teeth, on the other hand, have an amazingly

IMPENETRABLE

BARRIER

as protection but the tissue is not so good at fighting and healing when exposed.

With a cavity, the bacteria forms a hole in the tooth which gets progressively deeper and deeper until there is little to no more tooth structure between the bacteria and the tissue inside of the tooth.

The bacterial exposure causes inflammation and then necrosis.

Everywhere else on our body, we do an amazing job fighting bacteria.

Our teeth, on the other hand, have an amazingly impenetrable barrier as protection but the tissue is not so good at fighting and healing when exposed.

That is why dental pain from damaged root canal tissue has to be managed. Everywhere else on our bodies we are used to giving an achy area time and the discomfort usually passes. The only cure for that tooth pain which allows for the continued used of your tooth is root canal therapy.

Timothy Finkler, DDS

Commonwealth Endodontics Richmond | 804.501.0501 www.commonwealthendo.com

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What is the O-shot®?

The O-Shot® is a non-surgical, minimally invasive procedure to restore sexual desire and enhance the female orgasm in women as they age and experience a low libido. It is estimated that about 50 percent of all women deal with a lack of sexual desire. The O-Shot® uses plateletrich plasma injected into the vaginal wall to increase tissue growth and blood flow, which in turn improves feelings and desires.

Madison Kiley, RN

Renew Health & Wellness Richmond | 800.656.8386 www.renewmetoday.com

Ted Soto, COO

Virginia United Methodist Foundation and Development Company Richmond | 804.521.1150 www.vaumfoundation.org

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

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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

24

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 • Women: These are the Decades of Our Lives

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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.

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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.OurHealthRichmond.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.

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

ON THE WEB

More at ourhealthrichmond.com

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Health

A-Z

INSIGHT • AWARENESS • MINDFULNESS

SERVING THE

GROWING

POPULATION

WOMEN VETERANS OF

words CATHERINE BROWN

“The STAR Program has helped me reconnect and find camaraderie with other women who understand what I have been through and still go through. “It’s good to feel like you’re in a safe space and don’t necessarily have to guard what you say or filter your experience.”

- Beverly VanTull -

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According to Elizabeth Murphey, LCSW, Women Veterans Program Manager, Hunter Holmes McGuire VA Medical Center (Richmond VAMC), women veterans represent the fastest-growing veteran population and account for roughly ten percent of all veterans. Currently, however, only about half of women veterans receive their healthcare through VA medical centers.

Since the mid-1980s, the US Department of Veterans Affairs has worked to provide equal access to benefits for women veterans. Those efforts have benefited many older veterans, like Annie Walker, MBA, Director, Virginia Department of Veterans Services, who has, in her words, “received quality care for the past twenty years.” A 20-year disabled veteran who served as a drill sergeant, Walker has worked with her primary care physician to successfully manage her many conditions, including cancer and arthritis.

VA medical centers can do more, however. “We are participating in lots of new training,” says Murphey. “In particular, we are trying to change the culture at the VA to get rid of the assumption that the women in the waiting room are spouses.” That assumption has exacerbated a tendency among women veterans to not fully identify as veterans and thus not always access the services available to them. “These women have already had to prove themselves to gain respect from men in the military,” says Murphey. “We want to make sure they don’t have to prove themselves again.”

To meet the needs of women veterans, every VA medical center in the country, including Richmond VAMC, now has a Program Manager on staff who works to advocate for women veterans and coordinate services for primary and specialized care.

OurHealth | The Resource for Healthy Living in Greater Richmond

Providing gender-specific healthcare is important, as is meeting the mental and emotional health needs of women veterans. “Women veterans tend to feel pretty isolated in the community,” says Murphey. “They are hard-pressed to find other women who have been through what they have been through.” Recreational and individual therapy led by female veterans provides an opportunity for these women to connect and share their stories.

Serving the Growing Population of Women Veterans

Giving Women Veterans a Voice

•

Richmond VAMC is taking things a step further. “Sixty percent of women want care in a facility that is just for women,” says Murphey. “That is why we are in the design phase of developing a 12,000 square foot standalone facility just for women.” Staff at Richmond VAMC hope to break ground on the new facility next year.

Health A-Z

Richmond VAMC sees many more young female patients than it has in past years. Staff have responded by increasing the number of gynecologists and other specialists on staff and implementing services like same-day radiation for mammograms. When services are unavailable onsite, Program Managers refer patients to other VA medical centers or community providers.

“Women veterans tend to feel pretty isolated in the community. They are hard-pressed to find other women who have been through what they have been through.”

- Elizabeth Murphey, LCSW -

Beverly VanTull, Military Medic and Corpsmen (MMAC) Program Manager, is a fifteen-year army veteran who served in Iraq. She has benefited from her participation in Richmond VMAC’s Servicemember Transitional Advanced Rehabilitation (STAR) Program, which provides recreational and behavioral therapy. “The STAR Program has helped me reconnect and find camaraderie with other women who understand what I have been through and still go through,” says VanTull. “It’s good to feel like you’re in a safe space and don’t necessarily have to guard what you say or filter your experience.” For some women, that group is the only place they feel comfortable.

Enhanced mental health offerings and new initiatives help spotlight the experiences of women veterans. For instance, the Center for Women Veterans puts together an exhibit of art by female veterans that tours the country each year. In conjunction with that exhibit, Richmond VAMC displays art by women veterans in the local community. The STAR program also hosts a showcase to give women veterans the chance to perform, whether through dance, poetry or song.

When women veterans can share their experiences, they can more strongly identify as veterans. The women who strongly identify with their veteran experience may in turn be more likely to access the services available to them.

“Women veterans deserve the best care they can get,” says Murphey, and the staff at Richmond VAMC are striving to provide that optimal care.

Expert Contributors hh

hh hh

Elizabeth Murphey, LCSW, Women Veterans Program Manager, Clinical Command Center Consultant, Department of Chief of Staff, Hunter Holmes McGuire – Richmond VAMC Annie Walker, MBA, Director, Veterans Education, Transition and Employment, Virginia Department of Veterans Services Beverly VanTull, Military Medics and Corpsmen Program (MMAC) Program Manager, Veterans Education, Transition and Employment, Virginia Department of Veterans Services

Annie Walker, MBA Veterans Portrait Project photo by Stacy L. Pearsall. www.OurHealthRichmond.com

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THE

FUTURE NOW

IS FOR CANCER CARE words | NANETTE LEVIN

Cancer care advancements in the Richmond area over the past few years have been remarkable. Patients who were required not long ago to drive out-of-state for treatments now have some of the most technologically sophisticated equipment and esteemed talent in the country at home.

From the Sarah Cannon Cancer Institute at Henrico’s Doctors’ Hospital’s TrueBeam Linear Accelerator to VCU’s leap into CAR T-cell therapy, Richmond stands out as a leader in innovation.

Clinical trials are creating landmark breakthroughs resulting in customized treatments for a cancer patient’s particular issues. Richmond played a big role in TAILORx, with findings that now allow doctors to determine which breast cancer patients will benefit from chemotherapy.

This year, an expected 500 people will be trained to support VCU’s CAR T-cells initiative.

While the current focus is on a narrow range of blood cancers, there are potential applications in the future for a wide variety of other cancers.

Focus is also being put on patient-centric initiatives to encourage better experiences and extended support. Screenings are becoming more precise. Insurance is covering more aimed at early diagnosis for better outcomes. The big future issues are cost and access. Doctors in Richmond are working on that too.

Modeling for better cancer treatment “When we talk about cutting edge or where we should be going with cancer, there are four big topics we should focus on,” says William J. Irvin, Jr, MD, Medical Director of Medical Oncology and the Director of Clinical Research for the Bon Secours Cancer Institute. “One is a commitment to research, a commitment to clinical trials.” Another is the practical application of findings. “How do we use the mountains of data that are now becoming available to us to benefit our patients?” asks Dr. Irvin. Lowering costs is critical, he adds.

“Probably the most important is how we can be more patient-centric. With all these new tools and these strategies and these trials, making sure the patient is still in the center and their needs are taken care of and we’re not just focusing on the markers.”

“How do we use the mountains of data that are now becoming available to us to benefit our patients?”

William J. Irvin, Jr, MD Medical Director, Medical Oncology and the Director of Clinical Research for the Bon Secours Cancer Institute/Bon Secours Virginia Health System

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Health A-Z

• INSIGHT

Removing stem cells from storage is part of the CAR T-cell treatment process. Photo Credit John Wallace, VCU Massey Cancer Center.

A technician at VCU Massey Cancer Center removes biological samples from storage. Photo credit John Wallace, VCU Massey Cancer Center.

At Bon Secours Virginia Health System, Dr. Irvin and others have adopted a CMS (Centers for Medicare and Medicaid Services) Model. They’re one of 195 facilities across the country participating in this initiative designed to improve care and lower costs through comparative outcome assessment. Research done by each is shared with all.

This includes looking at everything from nutrition, financial counseling, palliative care, rehab, family needs and other issues affecting the patient’s quality of life. The process puts systems in place so the patient is at the center of all healthcare providers’ conversations.

“Transplant has always been part of cellular therapy. We’ve been always looking at how do we use medications or how do we biologically trick the immune system into recognizing something it overlooked?

How do we, if you will, give it a better pair of glasses?”

John McCarty, MD Director of the Cellular Immunotherapies and Transplantation program at VCU Massey Cancer Center

“As a treatment society, we’re going to have to figure out how to either get this cost down or how to manage the toxicity of the costs to the patient. Cancer doesn’t discriminate.

We shouldn’t be discriminating in treatment either. And so, figuring how we can balance the cost of exciting novel therapies with making these cutting edge therapies available to everyone, that has not been addressed yet. It’s not going to do a person any good if we cure their cancer but bankrupt them for several generations,” Dr. Irvin states.

Breakthrough plug and receptor genomic approaches VCU Massey Cancer Center is the first in Virginia to offer FDA-approved CAR T-cell therapy.

John McCarty, MD with VCU explains, “CAR T-cells are literally genetically reprogrammed immune system cells from a patient’s own body that are reprogrammed to fight cancer.”

“The initial studies that got these approved were in people we were sending to hospice,” he admits.

“For a T-cell to recognize a cancer, get turned on and say ‘you’re bad’, ‘you’re going away’, it has to plug into a cancer cell the way you plug in an appliance. It needs to be grounded or it won’t turn on,” Dr. McCarty says. “CAR T-cells have created the prongs so we are able to reprogram those cells into expressing the specific prongs and the plug that we want it to have so it will recognize the cancer we’re trying to treat.”

The process sends patients’ blood to a lab where T-cells are separated then subjected to viral reprogramming to re-educate the cells to fight a specific cancer. They’re expanded, frozen, then sent back to the patient location. Chemotherapy is administered to “give the T-cells some elbow room.”

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Health A-Z • The Future is Now for Cancer Care

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Health A-Z • The Future is Now for Cancer Care

Harry Bear, MD, PhD, left, collaborates with colleagues in medical and radiation oncology.

Dr. Bear led the TAILORx clinical trial at Massey.

This TrueBeam linear accelerator with Hyperarc high-definition radiotherapy (HDRT) located at Sarah Cannon Cancer Institute at Henrico Doctors’ Hospital is the East Coasts’ first. This HyperArc HDRT is designed to improve radiotherapy and radiosurgery treatments, delivering a new era of precision, reduced side effects, and tumor control for patients.

While this is a commercially available procedure now, the agents for one dose is $400,000 to $500,000. According to Dr. McCarty, care and continued intervention can be as much as three times that cost. But for kids up to age 25 with ALL (acute lymphoblastic leukemia), this has a 90 percent remission rate. ”Some have been through as many as 11 different therapies with no effect,” Dr. McCarty notes. “We need more time to follow the patients that have been treated thus far to understand how durable, and long lasting these responses might be.”

“Our bone marrow transplant program is now renaming itself as the Cellular Immunotherapy and Transplantation Program. Our national professional society is also changing its name to reflect that we are now doing cellular therapy. So that’s how much of a game changer, that we are actually changing the name of our organization,” say Dr. McCarty. He credits his bone marrow transplant team, VCU Massey Cancer Center, VCU Health, Children’s Hospital of Richmond and Virginia Commonwealth University for collaborating to make the CAR T-cell initiative possible in Richmond.

“Anything we can do to cut out variables and add more certainty to benefit is much better for patients. Now we give the chemo to the right people who really benefit. It’s much more satisfying and better for patients.”

Charles Geyer, MD Director of Clinical Research at VCU Massey Cancer Center

Removing the chemotherapy question in breast cancer patients Charles Geyer, MD also with VCU, was co-author of the TAILORx clinical trials. This involved over 10,000 women. “This test was one of the first genomically driven assays that was approved, looking at 10 or more [factors] and in looking at that information, how would that alter our treatments?” he asks.

Cancer Care continued on page 45 www.OurHealthRichmond.com

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Unlocking the keys for customized cancer care “Clinical trials and research, that is the only way we improve the lives of people with cancer. The folks that participate in clinical trials are truly heroes because the information we get from a trial may not help them but it’s going to help the next person.”

- Dr. Irwin, Bon Secours

“We’re not just taking someone else’s recipe for how to treat cancer but we’re also writing and innovating new recipes that others can use as well. Right now, technically, we could, in theory, create the appropriate target plugs for any cancer, but there has to be specificity. We have to find a target that’s present only on the cancer cells and not cells we need for normal bodily function.”

– Dr. McCarty, VCU

“We now have many, many drugs, some only on the market for months at this point, that target specific mutations. It’s pretty amazing because new drugs for different mutations are FDA approved almost monthly at this point. What that means for patients is not only are they getting a treatment which is very specific for their diagnosis, but patients also have fewer side effects than traditional chemotherapy.”

- Dr. Cuttino, HCA

“We have expanded our hours and are open on Saturdays now so the patient does not need to go to the emergency room. We are constantly changing the dimension of what we are doing. We want to provide a one-stop shop where a patient comes in here, gets a diagnosis, gets treatment, gets all CT scans, gets all medications in one place. We have five different locations here in Richmond and the suburbs and we’re constantly looking into expanding more and more.”

– Dr. Choudhary, VCI

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Health A-Z

Cancer Care continued from page 43

•

What the trials determined is a large number of women over age 50 who are diagnosed with breast cancer don’t need chemotherapy.

The Future is Now for Cancer Care

“The uncertainty has really largely been taken care of by this study,” he says. “Before, when we couldn’t find who these women were, we had to have this difficult discussion where if you just do your hormone therapy [will the cancer come back]?” What was discovered is younger women seemed to benefit from chemotherapy with a 15 score (out of 100), but older women didn’t until their score reached 25.

“A diagnosis of breast cancer is devastating, so unsettling,” says Dr. Geyer. “Anything we can do to cut out variables and add more certainty to benefit is much better for patients.

Now we give the chemo to the right people who really benefit. It’s much more satisfying and better for patients.”

Patient-centered strategies Yuvraj Choudhary, MD with Virginia Cancer Institute (VCI) cites immunotherapy discoveries in recent years as having an incredible impact on cancer care. He explains it as a way to “Rev up your own immune system to stop cancer cells.”

“We’re using this for melanoma; we’re now seeing these for lung cancers, renal cell cancers; it’s really changed the way we treat bladder cancer,” he says. Dr. Choudhary believes we’ll be seeing this applied to many other cancers soon.

“One of the newer drugs for breast cancer has been the cyclin B1 inhibitors. These drugs were just approved a couple of years back and they changed the way we treat metastatic hormone positive breast cancer,” Dr. Choudhary explains. At VCI, in addition to the TAILORx clinical trial findings, they’re also using a PAM50 test, which he says looks at 50 genes to determine whether chemotherapy is necessary in a patient. Wait time for an answer on whether chemotherapy will be necessary is now an average of five days versus the prior two-three weeks.

Like Bon Secours, VCI participates in the CMS Model, but they expand on this. “Every patient from VCI is presented at tumor board,” Dr. Choudhary explains. “A tumor board basically is where you have surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, nutrition specialists, social workers, psychologists – there’s about 40 people sitting in a room. It’s not limited to one disease. All are at one place. So, rather than sending a patient to six, seven places, we sit there and see what’s best for a patient. We take that very seriously.”

“The future of cancer care, this is what keeps me excited. The reason why people like me chose to do oncology is the constant research that is happening and the changes in treatment.

What I was doing five years ago is totally different than what I’m doing today.”

Yuvraj Choudhary, MD Virginia Cancer Institute (VCI)

Dr. Choudhary, who has been at VCI for the past three years, started medical school when he was 17 and has been practicing medicine for 20 years. “The future of cancer care, this is what keeps me excited. The reason why people like me chose to do oncology was the constant research that is happening and the changes in treatment. What I was doing five years ago is totally different than what I’m doing today.”

He’s passionate about fostering a new generation of doctors. Dr. Choudhary cites recent shadows from a medical student from the Czech Republic and a high school student from Texas, an upcoming one from Pakistan and a Northern Virginia high school female who amazes him with her young clarity of purpose as a future specialist in pancreatic cancer.

“Unless we invest in the coming generation then our existence is pointless.”

Targeting tumors and biopsies with more precision “PSA blood tests have been available in any medical office for years, but multiparametric pelvic MRIs to help guide biopsies and direct treatment have only been available for a couple www.OurHealthRichmond.com

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• INSIGHT

of years,” says Laurie Cuttino, MD. HCA, Bon Secours and VCU have equipment on site to do this. “CT lung screenings and navigational bronchoscopy are available in all health systems in town,” she says.

“Henrico Doctors’ Forest Campus is the only hospital in the region to offer intra-operative MRI for brain tumor surgery,” Dr. Cuttino states.

“The Da Vinci robot has revolutionized cancer surgeries, allowing more precise operations with faster recovery and fewer complications.”

Laurie Cuttino, MD Radiation Oncologist, Medical Director of radiation oncology at Sarah Cannon Cancer Institute at Henrico Doctors’ Hospital; Associate Professor of Radiation Oncology at Virginia Commonwealth University.

“The Sarah Cannon Cancer Network is also unique in that we offer the most tumor sitespecific, multi-disciplinary conferences in town,” she says. Conferences are dedicated to breast, lung, GI, gynecology, liver/pancreas, and neuro-oncology. “During these meetings, doctors from all different specialties review patient cases together and devise the best treatment plan.”

Dr. Cuttino applauds advances available in robotic surgery using the Da Vinci robot. “This device has revolutionized cancer surgeries, allowing more precise operations with faster recovery and fewer complications.”

The Sarah Cannon Cancer Institute at Henrico Doctors’ Hospital has one of only two TrueBeam Linear Accelerators with Hyperarc high-definition radiotherapy (HDRT). It adds pinpoint precision, reduced side effects, and better tumor control for patients. Because of the extreme accuracy of new techniques, patients can now get big doses of radiation that would have damaged surrounding structures in the past. “We’re doing that in a wide variety of cancers all over people’s bodies,” Dr. Cuttino says.

Screenings are saving lives “Richmond is a great place for healthcare. There’s virtually nothing we don’t have here,” continues Dr. Cuttino. She notes 3-D mammograms, low dose CT screenings for lung cancer, prostate MRIs and changed screening guidelines on colon cancer. “When I started training 20 years ago, you never saw colon cancer under 50. I just started treating a 36-year-old,” she says.

“The most diagnosed form of cancer in Virginia is lung cancer. People don’t know that there is a screening test for lung cancer that’s been proven to save lives,” says Dr. Cuttino. “I’m seeing an epidemic in lung cancer in patients who have never smoked,” she states.

JOIN THE OurHealth Community ON Social Media!

Write us, tweet us, or tag us today! #OurHealthRichmond

“Ask your primary care physician what you should be screened for. There is nothing to fear about cancer screenings because the old adage, ‘The earlier we catch it the better our odds for cure’ remains true.” Dr. Cuttino adds “Stage 1 breast cancer has a 99 percent cure rate.

Get that mammogram.”

Expert Contributors hh hh hh hh hh

Yuvraj Choudhary, MD with Virginia Cancer Institute (VCI) Laurie Cuttino, MD with Sarah Cannon Cancer Institute at Henrico Doctors’ Hospital Charles Geyer, MD with VCU Massey Cancer Center William J. Irvin, Jr, MD with Bon Secours Cancer Institute/Bon Secours Virginia Health System John McCarty, MD with VCU Massey Cancer Center

ON THE WEB

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Health A-Z • The Future is Now for Cancer Care

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www.OurHealthRichmond.com

Health

A-Z

INSIGHT • AWARENESS • MINDFULNESS

HELPING

CANCER PATIENTS

NAVIGATE NON-MEDICAL ISSUES

CancerLINC connects patients with local resources as they battle cancer words | BRANDY CENTOLANZA

Michael Onsel of Richmond and Beth

There are a lot of RESOURCES THAT ASSIST CANCER PATIENTS WITH NONMEDICAL ISSUES, but finding an organization that is reputable and credible is important as there are places that have been known to prey on those who are desperate and can be taken advantage of.

Devastation. Anguish. Hopelessness. These words only begin to describe the way people feel after learning they have cancer. Finding the strength to prepare for the long road of treatment that lies ahead while trying to hold onto the hope for recovery is more than anyone battling the disease should be expected to handle. But many are forced to carry the added burden of insurance, employment and financial challenges that cancer can cause, leaving them feeling further defeated, alone and unsure of where to turn for help.

CancerLINC, originally known as the Legal Information Network for Cancer, provides patients in the greater Richmond area and their families with assistance, education, and referrals to legal, financial, and other resources at little or no charge. The organization was founded in 1996 by two local attorneys, both cancer survivors.

“CancerLINC eases the burden of cancer for patients and their families,” explains Chris Williams, executive director. “In a nutshell, we connect local cancer patients with volunteer attorneys, financial professionals, and others, whose services are provided in most cases free of charge to help patients address the problems they face. It could be as simple as helping to create a will to issues such as eviction, bankruptcy, insurance denials, employment matters, and financial security.”

Since its inception, CancerLINC has helped more than 10,000 cancer patients during their time of need. Last year, the organization assisted 398 patients and their families. Its core services involve assessing non-medical issues and connecting patients with one of more than 200 CancerLINC legal and financial professionals, who all volunteer their time and services.

CancerLINC’s outreach services include counseling and referrals through a partnership at VCU Massey Cancer Center; connections to end-of-life services such as wills and powers of attorney for cancer patients in area hospices through The Cycle of Life program; monthly workshops to aid with legal documents including wills, advance medical directives, and powers of attorney; educational seminars related to the financial issues that may befall cancer patients; and guest speakers who educate patients about CancerLINC’s mission and services.

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OurHealth | The Resource for Healthy Living in Greater Richmond

Health A-Z Helping Cancer Patients Navigate Non-Medical Issues

“It was the first time I’ve really had to face a major health issue,” Onsel says. “I was blessed to have the immediate support of family and friends, which really bolstered me through the initial shock. The determined and attentive care of my girlfriend especially provided me with the strength and love to heal and live.”

•

Michael Onsel turned to CancerLINC last year after being diagnosed with squamous cell carcinoma of his left tonsil.

CANCER

LINC

A close friend suggested Onsel reach out to CancerLINC for assistance with estate documents and medical directives.

“Being well informed greatly increases your ability to focus your precious energies on finding solutions to the challenges you’ll face,” Onsel says. “CancerLINC helps you do just that. It goes without saying that the invaluable legal and other services CancerLINC made possible Pro Bono, or at a minimal cost, greatly reduced my stress, both emotional and financial.

I simply could not have afforded or even navigated these processes without CancerLINC’s assistance.”

TOP CancerLINC CLIENT ISSUES • AMD/POA/Trust/Will

29%

• Financial Assistance

16%

Barbara Whitaker first turned to CancerLINC for support back in 2002 thanks to a recommendation from her cousin. Whitaker has been having ongoing residual health issues related to a brain tumor and sought legal assistance from CancerLINC after her insurance tried to drop her disability coverage. An attorney took on Whitaker’s case and won an appeal.

• Social Security

8%

• Financial Planning

7%

• Employment Issues

7%

“When I first heard they were going to take me off of disability, I thought “Oh, my goodness.

Now what am I supposed to do?’” Whitaker says. “I am so grateful to all the people who helped me at CancerLINC. They are the sincerest group of people I’ve ever met. Without their help, I would not have made it through this. They saved me.”

• Insurance

4%

• Housing/Eviction

4%

• Debt Issues

3%

• Bankruptcy

3%

• Medicare/Medicaid

2%

• Estate Planning

2%

• Mortgage Issues

1%

• Custody/Guardianship

1%

It is predicaments like Whitaker’s that are at the heart of CancerLINC. “To me, CancerLINC represents the true definition of philanthropy,” Williams says. “Area legal and financial professionals make time in their busy schedules to provide free services for local residents who are in need. There is no expectation of payment or tangible reward. In fact, these services are provided when they could be working for a paying client.”

Another benefit of CancerLINC is that volunteers meet cancer patients where they are, eliminating the burden of traveling to the organization’s office when patients are seriously ill and emotionally spent.

Life remains a daily struggle for Whitaker, who is no longer able to work due to her condition.

“It all can be overwhelming, but don’t be afraid to ask for help,” she says. “The important thing is not to give up.”

Onsel agrees.

“Do not try to fight alone,” he says. “Muster up any and all of the positive energy and assistance you can from friends and family. And contact CancerLINC. Often, the service providers they put you in contact with have been touched personally by cancer and are dedicated to helping you. Their staff are friendly, patient, and dedicated to helping you find your way through the maze of challenges that cancer creates.”

For more information about CancerLINC, visit www.cancerlinc.org ON THE WEB

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at

R

O M N H D IC HEART Life is Why RICHMOND SPONSORS

about

American Heart Association

VOLUNTEERS Improving health and wellness in RVA

of people who experience an out-of-hospital cardiac arrest die, BUT THEY DON’T HAVE TO.

“That’s why WE ARE OUT IN THE COMMUNITY teaching Hands-Only CPR. CPR, especially if started immediately, can triple a cardiac arrest victim’s chance of survival.”

MICHELLE GOSSIP, MSN, RN AHA VOLUNTEER CPR INSTRUCTOR ARCTIC PROGRAM COORDINATOR VCU HEALTH SYSTEM

The American Heart Association (AHA) in Richmond is led by passionate community volunteers dedicated to creating a world of longer, healthier lives—a world where everyone can achieve their best possible health—but we cannot do it alone. With the help of local partners and experts, we seek to solve complex issues that affect this generation and generations to come, right here in our community.

I lost my father at age three to a heart attack. Years later, I also lost my mom to a heart attack, which she thought was a bad case of heartburn. I work with the AHA to spread awareness about the warning signs and the importance of making your health a priority so that families can spend more precious time together.

NIKI CURCI SCOTT AHA RICHMOND BOARD MEMBER EVP, SUNTRUST MORTGAGE

NIKI CURCI SCOTT

Stay connected with us yearround by visiting our website at www.heart.org/Richmond and following us on social media: RichmondAHA AmericanHeartVA RichmondAHA

Our children are the first generation expected to live shorter lives than their parents. The AHA’s youth programs are teaching our kids the importance of developing heart-healthy habits, and that being physically active can be fun!

COREY COTMAN PE TEACHER JB WATKINS ELEMENTARY SCHOOL

TOGETHER we CAN

IMPROVE

quality of life,

“Nearly half of deaths from heart disease, diabetes and stroke are tied to poor nutrition.

We are teaching area residents how to cook affordable, healthy meals using the AHA’s science-based nutrition guidelines and recipes.”

CHEF GORDON AND CHERYL RUSSELL AHA MISSION COMMITTEE MEMBERS; OWNERS, C.H.E.T.S.

By working within clinical settings to implement blood pressure control programs, we’re helping the over 200,000 Richmond area adults with high blood pressure reduce their risks for stroke, heart attack and diabetes.”

DR. STACEY EPPS AHA RICHMOND BOARD PRESIDENT NEUROLOGIST, BON SECOURS HEALTH SYSTEM

ENSURE

healthy environments,

ELEVATE

CARE and

CHANGE POLICY for

ALL people

in the Richmond area.

in richmond

Where we work, play, live, learn and pray should help our health, not harm it.

Our Hard Hats for Hearts initiative is bringing sciencebased, workplace wellness resources to the construction industry, which has the highest use of tobacco, a major risk factor for cardiovascular diseases and stroke.

MITCH HADDON AHA RICHMOND BOARD CHAIR PRESIDENT, COLONIALWEBB

“Working together with advocates and congenital heart disease families, the AHA passed legislation in Virginia that requires a simple pulse oximetry test for newborns before they leave the hospital, allowing earlier diagnosis and treatment of deadly heart defects and saving lives.”

JODI LEMACKS AHA VOLUNTEER ADVOCATE NATIONAL PROGRAM DIRECTOR, MENDED LITTLE HEARTS

40

%

of the population, including nearly

49,000

children, lives in a food desert or area with limited access to nutritious foods.

“We are working on community initiatives with partners like the The Market at 25th Street grocery store in Richmond’s East End, to improve access to healthy, affordable foods for everyone.”

SHERYL GARLAND AHA RICHMOND BOARD, PRESIDENT-ELECT CHIEF OF HEALTH IMPACT, VCU HEALTH

SEPTEMBER 2018

DECEMBER 2018

ACTION: Make a plan to keep your family healthy year-round using our recipes, food and beverage toolkit and suggested ways to work physical activity into your busy schedule. heart.org/recipe

ACTION: Give a personal gift to the AHA in honor of someone you love, or in memory of someone you have lost to heart disease or stroke. heart.org/donate

OCTOBER 2018

To learn about events and engagement activities being held throughout the year, visit our website at heart.org/Richmond and follow us on social media:

RichmondAHA | RichmondAHA

AmericanHeartVA

ACTION: Knit a hat for infants born in the month of February as part of our Little Hats, Big Hearts campaign. Hats received at our office in Glen Allen will be sent to local hospitals to encourage new families to think about their health.

WORLD STROKE DAY Monday, October 29, 2018

WHY WE WALK? Thousands of walkers from the city and surrounding counties lace up their sneakers and come out to the Heart Walk for a variety of reasons. Some are raising money and awareness for research and programs, survivors are celebrating another year of living a full life, and others are paying tribute to loved ones lost to this devastating disease.

“My family and I are walking in memory of my husband, Jerry Grossman,” says Estelle Grossman. “This would have been his 20th Heart Walk.

Jerry was a dedicated volunteer for the AHA, Mended Hearts and a founding member of Mended Little Hearts in Richmond which provides hope and support to children, families and caregivers impacted by congenital heart defects. We are so proud of the work and difference he has made in the community.”

Jerry Grossman at the Walk.

Stroke is a leading cause of death and disability around the world. Learn and share the warning signs of stroke and the importance of calling 9-1-1 immediately if you notice them in yourself or someone else. strokeassociation.org

NOVEMBER 2018 EAT SMART MONTH

ACTION: For recipes and other practical information to help you eat smart during the holidays and year-round, join Healthy For Good at heart.org/HealthyForGood

GIVING TUESDAY

JANUARY 2019 ACTION: Kick off the new year by setting wellness goals for yourself and encouraging loved ones to do the same.

FEBRUARY 2019 AMERICAN HEART MONTH

ACTION: Celebrate American Heart Month all throughout February by attending events, raising awareness and scheduling an appointment with your doctor to know your numbers.

WEAR RED DAY Friday, February 1, 2019 Support the fight against heart disease in women by wearing red or organizing an awareness event with your employees or colleagues.

Share your photos with us on social media with the hashtag #GoRedRVA

GO RED FOR WOMEN CASTING CALL

Tuesday, November 27, 2018

Saturday, February 2, 2019

Support the AHA by giving a personal gift on the International Day of Giving.

Have cardiovascular diseases or stroke affected your life?

If so, we are excited to meet you at our casting call where we will be selecting local survivors to share their stories and serve as ambassadors for the cause.

ACTION: Sign up for You’re the Cure, our grassroots network that is impacting legislation being passed at the state and federal level. yourethecure.org

HEART WALK Saturday, October 6, 2018 Get your heart pumping at this family-friendly fall event where we will raise money together to support the AHA’s mission.

2018 Chair: Melinda Hancock, Chief Financial Officer, VCU Health For more information visit: www.richmondvaheartwalk.org

GET

INVOLVED. GO RED FOR WOMEN LUNCHEON Friday, February 22, 2019 The Go Red For Women Luncheon celebrates our yearround efforts, and includes a survivor speaker, silent auction and a heart-healthy lunch.

2019 Chair: Leigh Sewell, Bon Secours Virginia Health System Learn more at RichmondVaGoRedLuncheon.heart.org

MARCH 2019

NATIONAL NUTRITION MONTH ACTION: Throughout the month of March, we encourage all Americans to focus on adopting healthy eating habits to reduce risk of heart disease and stroke.

APRIL 2019

MOVE MORE MONTH ACTION: Thanks to science and research funded by the AHA, you can find out the seven simple steps that will allow everyone to live longer, healthier lives. Take Life's Simple 7® on our website to motivate yourself to move more throughout April.

MOVE MORE DAY Wednesday, April 3, 2019 Kick off a month-long celebration of physical activity and wellness on Move More Day. Share your favorite ways to move on social media using the hashtag #MoveMoreRVA.

MAY 2019

NATIONAL STROKE AWARENESS MONTH BLOOD PRESSURE AWARENESS MONTH ACTION: Encourage your faithbased organization to host a Power Sunday by downloading our toolkit online. Our toolkit will provide you with the necessary information to raise awareness and discuss common risk factors of stroke throughout the month of May.

WORLD HYPERTENSION DAY Friday, May 17, 2019 More than 1.13 billion Americans have high blood pressure. The AHA encourages you to schedule an appointment with your doctor to check your blood pressure in honor of World Hypertension Day.

BE

WELL. RAISE AWARENESS

ALL YEAR LONG.

6TH ANNUAL POWER TO END STROKE™ JAZZ NIGHT May 2019 (TBD) This free community event provides stroke education to the community about this largely preventable and treatable disease. Attendees are invited to participate in wellness-focused workshops, line dancing and enjoy a hearthealthy dinner.

JUNE 2019 CPR/AED AWARENESS WEEK June 1-7, 2019 Your hands have the power to save a life! Visit our website during CPR/AED Awareness Week to find a class near you or watch our 90-second instructional video on hands-only CPR.

HEART BALL Saturday, April 27, 2019 Encourage your company to sponsor our annual Heart Ball – a celebration of the year-round efforts of our donors and volunteers to advance our mission.

2019 Chair: Mark Hourigan, CEO, Hourigan | Visit richmondvaheartball.heart.org for details.

OUR

IMPACT IN THE

WE DID THAT!

We are improving

and saving lives in Central Virginia through many endeavors, from funding life-saving heart and stroke research to advocating for policies that are improving and protecting the health of our community. While our impact has been great, heart disease and stroke continue to be

RVA

COMMUNITY.

the #1 killer of our friends and neighbors. We need your help and support more than ever to continue the progress we’ve made!

CPR TRAINING AS A REQUIREMENT FOR OUR TEACHERS AND HIGH SCHOOL STUDENTS BEFORE GRADUATION.

OUR VOLUNTEERS AT

NEED: This law adds more than 365,000 life-savers to our community annually, but still only 11% of Richmonders survive from cardiac arrest outside the hospital. We’re working to train more people in our community in Hands-Only CPR, especially highrisk populations, so we can save more lives.

THE STATE CAPITAL ADVOCATING FOR POLICY

EXPANDED HEALTHCARE COVERAGE FOR UP TO 400,000 VIRGINIANS. NEED: While access to medical care will help heart disease and stroke patients live longer, fuller lives, we still have a huge gap in life expectancy based on which neighborhood you live in. The life expectancy in Richmond's Gilpin Court is 20 years less than someone who lives five miles away in Westover Hills. We want everyone to have opportunities to live a healthy life no matter where they live.

RICHMOND, VIRGINIA

FOLLOW THE DISCUSSION

#CloseHealthGaps

Short Distances to Large Gaps in Health 70 YRS TRACT 107

77 YRS

VIRGINIA UNION UNIVERSITY

TRACT 407

BROOKLAND PARK

63 YRS TRACT 301

MUSEUM DISTRICT

GILPEN COURT

WINDSOR FARMS

83 YRS TRACT 106

CHURCH HILL

MANCHESTER

WESTOVER HILLS

69 YRS TRACT 604

SWANSBORO

Life expectancy at birth (years) SHORTER

LONGER

NEED: Yet, smoking related illnesses cost Virginia $3.11 billion in healthcare costs annually. Over 26% of Richmond adults smoke, the highest percentage in Virginia and higher than the national average, and nearly 27% of Richmond high schoolers have tried smoking. We need your support in advocating for an increase in the cigarette tax, because it is scientifically proven to be one of the most effective ways to prevent children from using tobacco products and helping adults quit.

WE’VE FUNDED RESEARCH that has led to the development of the artificial heart valve, implantable pacemakers, cholesterol inhibitors, micro-surgery and drug-coated stents.

NEED: Thanks to these advancements lives have been saved and patient outcomes are better, yet there still is no cure for coronary heart disease (CHD).

That’s why we continue to raise funds for projects that look at what triggers CHD long before symptoms and fatal events occur.

HEALTHIER SCHOOL LUNCHES FOR OUR CHILDREN. By working with food and beverage companies, we guided the development and adoption of strong federal nutrition standards for school meals and snacks.

NEED: While kids have less opportunity to consume sugarsweetened beverages and unhealthy foods in school, 30% of children in Virginia are overweight or obese. This presents a great opportunity for us to fund programs that instill healthy eating habits and physical activity in our youth.

FAIRMOUNT

VIRGINIA STATE CAPITOL

1 MILE

copyright 2015 Robert Wood Johnson Foundation

SMOKE-FREE WORK PLACES, BARS AND RESTAURANTS IN VIRGINIA. Research shows that heart attack rates drop immediately following implementation of a smoke-free law, resulting in a 17% reduction after one year and about a 36% reduction after three years.

67 YRS TRACT 203

VIRGINIA COMMONWEALTH UNIVERSITY

www.OurHealthRichmond.com

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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

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.

• emergency services • hospitalization • maternity and newborn care • mental health and substance use issues • prescription drugs

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.

• rehabilitative services and devices • laboratory services • preventive services as well as chronic disease management • pediatric services, including pediatric dental and vision care

58

How does health insurance work?

OurHealth | The Resource for Healthy Living in Greater Richmond

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.

ONLINE RESOURCES:

What’s New in Health Insurance?

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 are the health insurance options?

Health A-Z

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 $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.

Where should I go for more information?

Multiple websites offer helpful information about Open Enrollment.

Here are a few sites you might find useful.

www.healthcare.gov

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.

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.

www.vahp.org

Virginia Association of Health Plans

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.

www.enrollva.org Enroll Virginia

ON THE WEB

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POST-TRAUMATIC HEADACHE

A Pain in the Brain?

NATHAN D. ZASLER, MD, DABPMR, FAAPMR, FACRM, BIM-C, FIAIME, DAIPM, CBIST

Headache and neck pain are the most common physical complaints following a concussion (mild brain injury), experienced early after injury by over 70 percent of concussed individuals. Headaches can also occur after more severe brain injury.

In those cases, the pain disorder is more likely to be associated with underlying surgical causes.

Often, injured persons will seek medical care following a concussion and/or cervical whiplash injury, only to be diagnosed with “post-traumatic headache” (PTHA). PTHA is a term that neither identifies the cause of the headache nor guides treatment — but this doesn’t mean you should accept it as a final diagnosis.

EVALUATION

PTHA may be quite persistent, but it cannot be positively correlated with the severity of a head injury. It also isn’t a pain in the brain matter itself, per se.

There are multiple sources of head and neck pain both inside and outside the head that need to be considered when evaluating anyone who is experiencing post-traumatic headache. These types of headaches are often treated as migraine headaches, when the great majority of them are actually caused by other post-traumatic headache pain generators. It therefore isn’t surprising that people treated for migraines following a trauma event often don’t get better, as migraine may not be the real cause of the headache disorder.

MECHANISMS

When examining a patient who is suffering from persistent headaches, it is important for the clinician to keep the different factors of these types of headaches in mind and understand the importance of taking a thorough headache history. Genetic loading risk variables and preinjury headache history are a significant part of this assessment, as is understanding the injury that resulted in the headache condition itself.

There are three main mechanisms by which trauma can trigger headaches, and they may occur individually or in combination: hh Brain or cerebral injury hh Cranial injury (damage to the head or structures in the head, but outside the brain) hh Cervical whiplash injury (injury that occurs when the head moves forward and back quickly) One of the major clues about the headache’s origin should come from a clinician

establishing the symptom profile for that particular headache. The major questions relative to the headache profile that need to be asked are expressed in the pneumonic “C.O.L.D.E.R”: Character, Onset, Location, Duration, Exacerbation, and Relief. Other important descriptors include the headache’s frequency, severity, associated symptoms, and presence/absence of aura. Also, the clinician must find out the degree of functional disability that the headache causes and the time of day that it usually appears.

TYPES OF HEADACHES

The major types of headaches seen following trauma are musculoskeletal headache (including jaw/TMJ disorders), neuroma and neuralgic (nerve) headache, tension type headache, and migraine headache.

There are also less common headache disorders with which evaluating clinicians need to be familiar. In this clinician’s experience, the most common cause of head pain (headache) after trauma is cervical injury with pain that is referred to the head.

Clinicians and patients must also be adequately educated about headaches caused by medications or medication overuse.

SUCCESSFUL TREATMENT

With the appropriate time taken in acquiring an adequate pre-injury and postinjury history and headache description as well as conducting a focused clinical evaluation and ordering appropriate diagnostic testing, the clinician should be able to determine the condition’s underlying cause. Once the appropriate diagnosis is made, treatment should be instituted in a holistic fashion with a sensitivity to maximizing the benefits of any particular intervention, making sure that the treatment can be optimally followed, and educating the patient and family regarding the disorder.

Multiple studies have demonstrated that ongoing litigation has little to no effect on the persistence of headache complaints. A small number of patients will develop intractable post-traumatic headache. In this clinician’s experience, when properly treated, most PTHA is not permanent and/or disabling over the long term. In order to begin to treat each patient, however, prognosis must be based on understanding the cause of the headache rather than on a nonspecific diagnosis such as PTHA. Understanding the diversity of possible pain generators and taking the time to conduct a good interview and an appropriately focused physical assessment will lead to the best outcomes.

Readers interested in more information about Traumatic Brain Injury (TBI) and community resources should contact:

Brain Injury Association of Virginia (BIAV) 1506 Willow Lawn Drive | Suite 212, Richmond, VA | P: 804.355.5748 | F: 804.355.6381 | Free Helpline ~ 1.800.444.6443 | https://www.biav.net

Aging Well WISDOM • DIGNITY • SUPPORT

Beaumont Tower’s

RUI UNIVERSITY KEEPS RESIDENTS

LEARNING

words | CATHERINE BROWN

When Deacon Charlie Voss was younger, his dad used to tell him, “A day you don’t learn something new is a day wasted.” The now 71-year-old took that to heart and committed to his education, earning a bachelor’s degree in accounting as well as graduate degrees in history and theology.

Now, as a resident of The Towers Retirement Community, Voss continues to learn, thanks to RUI University, a program that provides lifelong learning opportunities to its many residents.

Through the program, The Towers offers residents both a chance to stimulate their intellect and to connect with others who share similar interests.

“We want the residents to always continue to grow and expand their minds.”

- Samantha GuckertLife Enrichmen Director at the Towers

The Towers offers residents both a chance to stimulate their intellect and TO CONNECT WITH OTHERS WHO SHARE SIMILAR INTERESTS.

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The Towers is a retirement community in suburban Richmond that offers Independent Living, Assisted Living, and a Memory Care Program to over 150 residents. Voss moved to The Towers in September of 2017 and is part of the independent living community there.

Residents of The Towers can enjoy many different activities each day, from fitness classes to sports games to artmaking and daily devotions.

RUI University is a relatively new addition to The Towers’ roster of activities. It was launched just last year by The Towers’ parent company, Retirement Unlimited Incorporated.

The program’s founders developed RUI University to enable residents in seven of their communities to participate in continuing education. “We want the residents to always continue to grow and expand their minds,” says Samantha Guckert, Life Enrichment Director at The Towers.

To pique the interests of a variety of residents, Guckert brings in community members who can share their expertise. Some of the teachers are retired professors, students, doctors or therapists. Courses cover many different subjects, including arts, history, finances, the weather, and health and wellness. Many of the residents particularly appreciate courses taught by local health professionals about health issues that affect them, like pelvic health and balance.

Courses are offered on a semester basis and meet once a week for about thirty to forty-five minutes in a newly renovated room in The Towers. All residents are encouraged to attend the free courses; all they need to do is sign up. “In the near future,” says Guckert, “we plan to also offer the classes to community members who are not residents here.” Courses typically have eight to twelve participants, but for hands-on courses, like an art-making class, staff like to keep enrollments lower.

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Aging Well • A Guide to Successful Aging into Your 90s and Beyond

The Towers resident, Deacon Charlie Voss with friends.

As a Vietnam War veteran and history buff, Voss enjoys the history courses that are offered. “Over the past twenty-five to thirty years, we have been forgetting our history,” Voss says, “and we’re starting to repeat the mistakes we have made.” Voss has always studied history, so he particularly enjoyed the course he took about the Buffalo Soldiers, African American soldiers who served in the western frontier following the Civil War. “I could have talked to them for hours,” Voss says. One of the instructors was a World War II veteran, so that connection was meaningful for him.

The topic also interested Voss because it was relatively new to him. “I had never learned much about the Buffalo Soldiers, and with this course I learned so much,” Afterward Voss went online to the History Channel website to continue to learn more.

“The more I learn, the more I know,” says Voss. “The more I know, the more I want to learn.”

- Deacon Charlie Voss -

Voss’ response to the RUI courses is exactly what The Towers likes to see. “This program has blossomed into something amazing,” Guckert says. “We hope to also provide the opportunity to enable residents to share their expertise with one another.” The opportunity for residents to continue learning and hone their interests keeps them engaged both mentally and emotionally.

“You have to keep your brain active, or it will go stagnant,” Voss says. “Besides, this gives me another reason to get up besides doing my laundry.”

Expert Contributors: hh

Samantha Guckert, Life Enrichment Director, The Towers

hh

Deacon Charlie Voss, Resident, The Towers

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Aging Well

Aging Well WISDOM • DIGNITY • SUPPORT

• Listening to Your Body

LISTENING

TO YOUR

BODY

It’s important to see your doctor if something just doesn’t feel right

words | BRANDY CENTOLANZA

For years, Sherita Dorman, 53, suffered from irregular vaginal bleeding.

Sometimes, the bleeding was so severe it would soak through her clothing and hinder her ability to work as a nurse.

“It lasted for about six or seven years,” Dorman says. “It was very heavy. I just tried to deal with it.”

At the time, Dorman was considered perimenopausal. Perimenopausal is the timeframe for women when their bodies begin the natural transition to menopause and thus the end of their reproductive years. Irregular periods are often one of the first signs of approaching menopause and can last any where from three to 10 years before menstruation stops completely.

“I always tell my patients that they are their best

Women experience perimenopause—also called the menopausal transition—at different ages, some as young as their mid-thirties or their forties. Symptoms include irregular periods, vaginal dryness, hot flashes, problems with sleeping, mood swings, and weight gain.

Dorman made multiple trips to the Emergency Department and her general care practitioner when the bleeding became insufferable and was told each time that what she was experiencing was normal. In the fall of 2017, Dorman sought another opinion from Shruthi Sambamoorthy, MD, a physician who specializes in internal medicine and works at JenCare Senior Medical Center’s Shockoe Bottom location.

“What she had was irregular and abnormal bleeding,” Dr. Sambamoorthy says. “I just didn’t like how it sounded. What she was experiencing was a red flag for me.”

advocates. You know your body well and you know when something is not right.”

SHRUTHI SAMBAMOORTHY, MD Internal Medicine Physician with JenCare Senior Medical Center

Dr. Sambamoorthy sent Dorman to a gynecologist. Following a transvaginal ultrasound and biopsy, Dorman was diagnosed with endometrial adenocarcinoma, a type of uterine cancer. Symptoms of this type of cancer are heavier or more frequent periods or bleeding between periods, pelvic pain or swelling or lumps in the pelvic area, and weight loss. The only symptom Dorman experienced was the abnormal bleeding.

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Aging Well

• INSIGHT

“I couldn’t believe it,” Dorman says. “I just started praying and praying.”

Dorman soon underwent a full hysterectomy, and since the disease was caught early, no other cancer treatments like chemotherapy were necessary.

“I’m so glad,” says Dorman. “I am feeling so much better. I am so blessed.”

Dr. Sambamoorthy credits Dorman for the positive outcome, citing her determination in finding answers from medical professionals regarding her condition.

“Her cancer was in Stage 1,” Sambamoorthy says. “If she had waited any longer, it could have been much worse.”

“I always tell my patients that they are their best advocates,” Dr. Sambamoorthy says. “You know your body well and you know when something isn’t right. Never pass something off if it happens only once or twice. If you notice something is abnormal, call your doctor.”

TOP HEALTH CONCERNS FOR SENIOR CITIZENS • Poor Diet • Obesity and Falls • Hypertension • Congestive Heart Failure • Cancer • Diabetes • Mental Health Issues Including Depression • Arthritis and Joint Problems • Alzheimer’s Disease and Dementia • Osteoporosis • Respiratory Problems such as Chronic Obstructive Pulmonary Disease (Copd)

Dorman agrees. Following her surgery, she was bed-ridden for a month and sore from the operation but now she’s fully recovered. Her mother, Jasmine, and her grandchildren looked after her while she healed.

“My mom is my best friend,” Dorman says. “She was very supportive and came over every day to make sure I was okay. The cancer has gone away. I encourage anyone to get things checked out. You never know what it might be, and you don’t want to go through what I went through.”

Preventative Medicine and Seniors JenCare Senior Medical Center provides affordable VIP care to senior citizens typically over 55 who have Medicare Advantage insurance. Dr. Sambamoorthy joined JenCare last year.

“I really enjoy working with the senior population because they always have the most interesting stories to tell,” Dr. Sambamoorthy says. “Working with them is very rewarding, and I feel like I can make a difference by promoting a happy, healthy lifestyle for them.”

Dr. Sambamoorthy sees her patients on a monthly basis as a way to get to know them and better diagnose and treat any conditions they have.

“I want that connection and relationship with my patients,” she says.

Dr. Sambamoorthy’s patients also can be assured that she and the team of healthcare professionals she works with in her practice are there for them long after they leave the office.

“We are accessible 24 hours a day, seven days a week,” Dr. Sambamoorthy says. “They can call us any time with questions. We are always here for them.”

As seniors age, Dr. Sambamoorthy suggests they focus on their general health, which includes getting enough sleep, socialization, and physical activity, as well as maintaining a healthy, nutritious diet.

Of course, patients always should schedule a visit with a physician for any unusual problem or concern no matter how small, and at JenCare, patients are encouraged to take advantage of walk-in appointments.

“Preventative medicine is so important,” Dr. Sambamoorthy says. “It’s important to keep up with your screening tests like mammograms and Pap smears, colonoscopies, and vaccinations.”

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At the end of the day, seniors need to be proactive about their own health.

“You know your body best,” Dr. Sambamoorthy says. “It is important to listen to it.”

Expert Contributor hh

Listening to Your Body

“What is not normal is seeing someone who looks like they’ve stopped taking care of themselves, or if they show signs of losing weight,” says Dr. Sambamoorthy. “Look out for changes in mood, memory or attention span. Difficulty breathing could be a sign of an underlying respiratory problem. Trouble with walking or having a hard time keeping a steady posture could lead to problems with falling.”

LIGHT BLEEDING OR SPOTTING is normal during perimenopause and menopause.

•

Friends and family members, or caretakers, should be on the look out for any warning signs.

Aging Well

Seniors also may be susceptible to a variety of health challenges as they age. Top concerns for senior citizens are poor diet, obesity and falls; hypertension; congestive heart failure; cancer; diabetes; mental health issues including depression; arthritis and joint problems; Alzheimer’s disease and dementia; osteoporosis; and respiratory problems such as chronic obstructive pulmonary disease (COPD).

IF BLEEDING IS HEAVY or if women experience weight loss, lethargy, or pelvic pain or cramps, they should contact their health care professional.

Shruthi Sambamoorthy, MD with JenCare Senior Medical Center

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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

Colors of Fall

color contain vitamins, minerals,

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.

fiber and phytochemicals that have different disease-fighting elements. These compounds may be important in reducing

Fruits, Vegetables and Your Weight

the risk of many conditions,

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.

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

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.

healthy lifestyle that can lower

Other Fresh-food Benefits

your risk for these diseases.

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.

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.OurHealthRichmond.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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Food Fitness

BROCCOLI

•

SALAD

How to Eat Healthiest During the Busy Summer Season

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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APPLE BREAD

PUDDING Whole grain bread, apples and cinnamon make a sweet dessert that is healthy too. Serve warm and enjoy with a glass of skim or low-fat milk.

DIRECTIONS SERVING SIZE: 3” x 4” piece. Makes about 4 Servings.

INGREDIENTS

Cooking spray

1

whole egg

1

egg white

1

cup skim milk

2

Tbsp brown sugar blend

1

tsp vanilla extract

1

tsp cinnamon

1/2 tsp cloves or allspice

A Pre-heat oven to 350 degrees.

B Spray 9x9 baking dish with cooking spray.

C In large bowl, whisk together egg, egg white, milk, sugar blend, vanilla, cinnamon, and cloves.

D E

Add bread and apple cubes. Add fruit or nuts if desired. Mix well.

Pour mixture in to prepared baking dish and bake in preheated oven for 40-45 minutes.

NUTRITION FACTS

Calories: 131; Total Fat: 1.2 g; Saturated Fat: 0.3 g; Trans Fat: 0.0 g; Polyunsaturated Fat: 0.2 g; Monounsaturated Fat: 0.3 g; Cholesterol: 32 mg; Sodium: 154 mg; Total Carbohydrate: 26 g; Dietary Fiber: 5 g; Sugars: 16 g; Protein: 5 g

6

slices light, whole-grain or multigrain bread, cubed

Dietary Exchanges: 1 fruit, 1/2 starch

3

medium apples (cored, cut into 1/2-inch cubes)

Recipe copyright © 2016 American Heart Association.

1/2 cup of any one of the following: raisins, dried cranberries, fresh or dried blueberries, chopped walnuts, pecans or almonds (optional)

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Funny BONE HUMOR • SEARCH • CHECK

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