INSIGHT ON CANCER CARE IN LYNCHBURG
SPOTLIGHT ON: LIFEWORKS REHAB ®
Special Pullout!
MEDICAL DESIGNATION RESOURCE GUIDE
APRIL • MAY 2013 | LYNCHBURG AND SOUTHSIDE EDITION | OURHEALTHVIRGINIA.COM
SENIORS: GET IN THE POOL
table of contents | april • may 2013 MEDI•CABU•LARY.....................10 Local experts define healthcare-related terms
JUST ASK!..................................12 A variety of health questions answered by local professionals
THE LATEST...............................14 A listing of new physicians, providers, locations and upcoming events in the Lynchburg and Southside community
IN THE COMMUNITY...................17 You CAN make a difference
HEALTH AND FITNESS ON THE GO..................................19 Health-focused apps you can download to your smartphone or tablet.
ALLERGIES.................................23 Misconceptions about allergies
26
SPOTLIGHT ON REHAB: LIFEWORKS REHAB®.................37 Getting back to life
MEDICAL DESIGNATION............50 Summary of common medical profession titles
PHYSICAL THERAPY..................43
SPECIAL PULLOUT! Medical designation resource guide
Physical therapy increasingly common for patients looking for pain relief
CANCER CARE............................53 Cancer update: Lynchburg
46
BLOOD SERVICES Baby can you spare a pint?
CELEBRATING THE HEALTHCARE WORKER NUTRITIONAL HEALTH..............58 Understanding nutritional values in foods
SENIOR LIVING...........................63 Get in the pool
READ THIS EDITION OF
OUR HEALTH LYNCHBURG AND SOUTHSIDE ON YOUR TABLET
april • may 2013
OUR HEALTH’S EXCLUSIVE MEDIA PARTNER PUBLISHER PRESIDENT/EDITOR-IN-CHIEF ASSOCIATE EDITOR PRODUCTION MANAGER CHIEF DESIGNER ACCOUNTING MANAGER WEBMASTER
McClintic Media, Inc. Stephen McClintic, Jr. | steve@ourhealthvirginia.com Angela Holmes Jennifer Hungate Karrie Pridemore Laura Scott Adapt Partners
CONTRIBUTING MEDICAL EXPERTS Jennifer Claiborne, DDS Ron Feinman, esq Shawn Hayes, MD Joseph Hutchison, MD Tricia Foley, RD, MS Dane McBride, MD Wayne Melancon Richard Ruble, CPO Jesse Stem, MD CONTRIBUTING PROFESSIONAL EXPERTS AND WRITERS Sarah Cox Rich Ellis Laura Neff-Henderson Tina Joyce Anika Imajo Edwin Schwartz ADVERTISING AND MARKETING Cynthia Trujillo P: 434.907.5255 cindy@ourhealthvirginia.com
OR SMART PHONE!
SUBSCRIPTIONS To receive Our Health via U.S. Mail, please contact Jennifer Hungate at jenny@ourhealthvirginia.com or at 540.387.6482
www.facebook.com/ourhealthvirginia
@ourhealthmag
SCAN THE CODE BELOW TO VISIT
www.ourhealthvirginia.com then click on the magazine cover to view the digital edition!
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: 305 Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.355.3071 Information in all print editions of Our Health and on all Our Health’s websites, including: www.ourhealthvirginia.com is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2013 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. The Our Health Lynchburg and Southside Virginia edition is published bi-monthly by McClintic Media, Inc. 305 Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthvirginia.com. Advertising rates upon request.
8 | www.ourhealthvirginia.com
our health | MEDI•CABU•LARY & JUST ASK
me d i • ca bu • l ar y
T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D
What is the practice of internal medicine? Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. At least three of their seven or more years of medical school and postgraduate training are dedicated to learning how to prevent, diagnose, and treat diseases that affect adults. Internists are sometimes referred to as the “doctor’s doctor,” because they are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems. Shawn Hayes, MD Lynchburg Internal Medicine Lynchburg | 434.200.3908
What are adenoids? The adenoids are lumpy clusters of spongy tissue that help protect kids from getting sick. They sit in the back of the nasal cavity and are above the roof of the mouth. Like tonsils, adenoids help keep your body healthy by trapping harmful bacteria and viruses that you breathe in or swallow. Adenoids also contain cells that make antibodies to help your body fight infections. Adenoids shrink as we age and by adulthood, they often practically disappear. Because adenoids trap germs that enter the body, adenoid tissue sometimes temporarily swells as it tries to fight off an infection. The swelling might go away on its own, but sometimes medical treatment is necessary. Adenoids can get so overcome by a bacterial invasion that they become infected themselves. Swollen or enlarged adenoids are common. Swollen or infected adenoids can make it tough to breathe and may cause a very stuffy nose, snoring and trouble getting a good night’s sleep, sore throat and trouble swallowing, swollen glands in the neck, ear infections or fluid. Joseph Hutchison, MD Blue Ridge Ear, Nose, Throat & Plastic Surgery Lynchburg | 434.947.3993
10 | www.ourhealthvirginia.com
What is degenerative disk disease? To a large degree, degenerative disc disease (DDD) refers to the natural aging process of the intervertebral disc. Our discs act as a cushion between the vertebrae. When we are young, our discs are soft and spongy, with a high water content. As we get older, the disc begins to dry out and settle; and provides less cushion. As this aging process occurs, the disc becomes less resilient and it may bulge or rupture. A bulging disc may put pressure on the spinal nerves. Also, as the disc provides less cushion, our body’s response is to produce bone spurs and calcium deposits to try to stabilize the disc. Often, these spurs become problematic as they may put pressure on the nerves within the spine. Jesse L. Stem, MD Orthopaedic Center of Central Virginia Lynchburg | 434.485.8500
What is elevated vacuum? Elevated vacuum is a term that describes a particular style suspension utilized in transtibial (below the knee) and transfemoral (above the knee) prosthetic sockets. An electric or mechanical pump is attached to the socket and provides a constant, monitored suction. This action pulls the liner and the patient’s residual limb towards the inner socket walls. Excessive motion is reduced thus preventing friction and shear forces from occurring. Circulation is improved which provides a healthier residuum. A silicone liner interface with a sleeve suspension is used in conjunction with the pump to complete the elevated vacuum system. This system has worked well with many patients and it allows for the option of a brimless design socket for transfemoral amputees. Brimless, meaning shorter trimlines, is to avoid pressure in the peroneal (groin) area, as well as allowing for better range of motion at the hip. All these factors that increase comfort for the amputee will allow the amputee to wear their leg longer and ultimately be more functional. Richard Ruble, CPO Excel Prosthetics and Orthotics Lynchburg | 434.528.3695
our health | MEDI•CABU•LARY & JUST ASK
ju st a sk!
T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D
What is the average cost of orthodontic treatment?
What are the health benefits of owning a pool?
Fees will vary depending on the treatment needed. The cost of orthodontic treatment will depend on many factors, including the severity of the problem, its complexity and length of treatment. Most orthodontists offer convenient payment plans, making treatment more affordable. Most orthodontists will work with you to find a plan that fits your family budget. Surprisingly, studies have shown that the relative cost of braces has not increased over the past twenty years nearly as much as other consumer products on a percentage basis. In addition, many patients have dental insurance that includes orthodontic benefits. Check with your employer’s human resources department to learn about your coverage. At your initial visit, the orthodontist and staff will be glad to discuss the cost of treatment and your financing options before treatment begins.
The health benefits of owning a swimming pool are many. First and foremost, get in a vigorous cardio workout by doing laps or water aerobics. Swimming has the ability to work your body without harsh impact to your skeletal system making it the ideal exercise for both the young and old. The benefits of swimming include muscle strengthening for nearly every muscle in the body, increased flexibility, weight control, lowering cholesterol and the chance of getting diabetes. Physical therapists highly recommend swimming to patients as means of recovery.
Jennifer Claiborne, DDS Central Virginia Orthodontics Lynchburg | 540.385.GRIN (4746)
Additionally, being outside in the sun increases the body’s ability to produce Vitamin D naturally. Vitamin D is essential for strong bones because it helps the body use the calcium from our diets. However, be aware of the dangers of over exposure to the sun. Make sure you are wearing sunscreen with the appropriate SPF! Wayne Melancon Land Tech Group of Virginia Lynchburg | 434.386.5666
Will eating local honey help with my seasonal allergies? A review of medical literature shows a number of positive benefits of eating honey in modest amounts, but no scientific studies show that allergies are helped by eating honey, from either local or distant sources. The concept that it does help is based on a few personal stories, and upon the logical conclusion from the concept of desensitizing someone by giving progressively larger amounts of an allergenic substance, as is done by trained allergy specialists. There are two major errors in the claim, however, apart from the fact that there are no scientific studies to substantiate the claim. The first is that bees collect pollen mostly from flowering plants, not from non-flowering plants. But the pollens that cause allergic rhinitis and conjunctivitis (“hay fever”) are principally from the non-flowering plants, that rely on their pollens being airborne, rather than relying on insects to transfer the pollens. Bees collect very little grass or oak pollen, for example, so their honey would contain little if any of these pollens. Secondly, effective desensitization requires enough of the allergen to produce serious reactions, so the dose of this has to be built up gradually so as to not produce such reactions. If honey were to contain that much pollen, it would be dangerous. Fortunately, it does not, so unfortunately, it cannot desensitize a hay fever sufferer either. Dane McBride, MD Asthma and Allergy Center of Lynchburg Lynchburg | 434.846.2244
12 | www.ourhealthvirginia.com
I’m worried about running out of money if I (or my parents) have to go into a nursing home. Are there ways to protect our assets if that happens? This is a very real concern. Long term care nursing home expenses start around $6,500-$7,500 per month and go up from there. Medicare covers these costs for only 100 days, and only for 20 days in full. A long stay in a nursing home can easily wipe out a family’s resources. This is where a trained Elder Law attorney can provide real value. There are many planning techniques to help protect any family’s assets from all being spent on a nursing home, and qualified veterans or their widows may be entitled to separate benefits. As the rules are extremely complex, it’s best to seek a lawyer experienced in this area. While there are more opportunities the earlier you start, much can be done even if nursing home entry is imminent. The important thing is to start a plan as early as possible. Ron Feinman, Esq. Lynchburg | 434.528.0696
our health | THE LATEST
the l atest
N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S
The next Live Healthy Lynchburg challenge starts Monday April 1st and will run through May 31st. This 9-week program wants to motivate you to dedicate just 30 minutes of your day, 5 days a week, to being active! There are virtually no restrictions on eligible activity – if it gets you moving, raises your heartbeat and sparks your spirit, it counts! Organizations and individuals are welcome. So keep your eyes peeled and your shoes tied and get ready to join us for Strive for 5! Registration: Opens Wednesday, March 27, 2013 Start/End Dates: April 1– June 30, 2013 Participation: Participate individually, in groups and with your employer based on number of members/employees Strive for 5 is brought to you by Live Healthy Lynchburg in collaboration with Lynchburg Chamber of Commerce. Visit www.livehealthylynchburg.com to join.
Now Accepting Patients Ashley C. Veloso, OD St. Clair Eye Care Lynchburg | 434.239.2800 Accepting patients at both Timberlake and Langhorne Road locations.
14 | www.ourhealthvirginia.com
Richard Ruble, CPO has been named Branch Manager at Excel Prosthetics & Orthotics in Lynchburg.
IN THE COMMUNITY | our health
you CAN make a difference words | TINA JOYCE
Hunger impacts many people but can often go unnoticed. Many times families in our own communities skip meals in order to help pay a utility bill, pay rent, or help a loved one. Although there are many supportive agencies that work together to provide meals for individuals or families in need, transportation or other logistics may keep food from reaching those who need it most. A local leadership team, Lynchburg Leadership Class of 41-PALS, has taken on the challenge of hunger awareness in the greater Lynchburg Area in a unique initiative, as part of an annual educational program. Working as a team, PALS has researched and brought to Lynchburg an international program that addresses a growing health concern—hunger. Canstruction (a play on the word construction) is a nationally recognized charity that creatively raises food, funds, and awareness to help people struggling with hunger. The charity brings together architects, engineers, designers, contractors, students and others in the community to build artistic structures with canned food. All food and funds raised through the Lynchburg event will be generously donated to the Blue Ridge Area Food Bank. Seven teams of volunteers (lead by a professional mentor in the area of architecture, construction, or engineering) will begin building structures on Saturday, April 13th. All teams will compete to produce creative and unique artwork sculptures using www.ourhealthvirginia.com | 17
our health | IN THE COMMUNITY
canned food representing the theme “The Story of Our Toys”. The Blue Ridge Food Bank has provided the teams a preferred food list to ensure the health content of the food eventually being donated. The seven teams are sponsored by: Bank of the James, Genworth, Wiley Wilson, The City of Lynchburg, Babcock & Wilcox, Association of General Contractors of America AGCA), and Areva.
18 | www.ourhealthvirginia.com
The canstruction structures will be on display the week of April 14th-21st. In the following Lynchburg locations: Amazement Square, Bank of the James, Holiday Inn Select, City Hall, the Galleria, and the downtown YMCA. There will also be a number of local, non-profit organizations at each venue to provide additional information about hunger-relief efforts in the great Lynchburg area. For more information about the local event, email CanstructionLynchburg@gmail.com or view the international charity’s website www.canstruction.org.
HEALTH AND FITNESS ON THE GO | our health
Health and Fitness
On the Go
Ready to jump-start your fitness routine or find out if it may be time to get your hearing tested? In our new Health and Fitness on the Go section, we recommend a variety of health-focused apps you can download to your smartphone or tablet.
Couch-to-5k® from Active.com Follow this easy and fun training plan for beginning runners. Get off the couch and run a 5k in just 30 minutes a day, three days a week for nine weeks! This app features loads of training tools to help you stay on track: »» Track your route, distance and pace with GPS »» Access your own music playlist in-app »» Take advantage of your own “trainer” as they coach you through each workout »» Log your workouts in a journal »» Track your progress online »» Get support from the Couch-to-5k® community »» $1.99 for iPhone | $2.99 for Android
Android
iPhone
First Aid App by American Red Cross The official American Red Cross First Aid app puts expert advice for everyday emergencies in your hand. This First Aid app gives you instant access to the information you need to know to handle the most common first aid emergencies. With videos, interactive quizzes and simple step-by-step advice it’s never been easier to know first aid. This app features: »» Simple step-by-step instructions guide you through everyday first aid scenarios »» Fully integrated with 911 so you can call EMS from the app at any time. »» Videos and animations make learning first aid fun and easy. »» Safety tips for everything, from severe winter weather to hurricanes, earthquakes and tornadoes help you prepare for emergencies. »» Preloaded content means you have instant access to all safety information at anytime, even without reception or an Internet connection. »» Interactive quizzes allow you to earn badges that you can share with your friends and show off your lifesaving knowledge. »» Free for iPhone and Android
Android
iPhone
www.ourhealthvirginia.com | 19
HEALTH AND FITNESS ON THE GO | our health
uHear uHear is a hearing loss screening test which allows you to test your hearing to determine if it is within normal range, or if you have a potential hearing loss. It is a free, self-administered hearing test, along with tips and resources for preventing hearing loss. uHear lets you assess your hearing on any one or all three of these tests: »» Hearing Sensitivity is used to determine the quietest sounds you can hear »» Speech in Noise is a measurement of your ability to understand speech in the presence of noise »» Questionnaire is a series of twelve questions regarding your performance in common listening situations. »» Plus uHear can also help you locate a hearing healthcare provider in your area. After each test, you get your results along with helpful context and recommendations--and for the Hearing Sensitivity test, you also see results mapped out on a graph, showing performance charted across different levels of pitch for each ear. It’s a quick (and even kind of fun) way to see how well you hear. If you do suspect a hearing loss, please seek the advice of a professional. uHear was designed by Donald Hayes, Ph.D. Director of Audiology for Unitron Hearing. »» Cost: Free »» Device: iPhone (currently not available for Android) iPhone www.ourhealthvirginia.com | 21
our health | HEALTH AND FITNESS ON THE GO
SHARE YOUR FAVORITE HEALTH AND FITNESS APP!
Scan this QR code with your smartphone or tablet to visit and “Like” Our Health’s Facebook page, then post a “Comment” with your favorite health and fitness APP!
22 | www.ourhealthvirginia.com
YMCA of Central Virginia The YMCA of Central Virginia now offers several apps for the community. These apps feature local information on the abundant activities and classes offered in the Lynchburg area YMCA’s. Offered are individual apps for Downtown & Y Express, Jamerson Family Y, and the Child Care app. The apps feature the following information: »» Class fitness schedules »» Family and lap pool schedules as well as water fitness class schedules »» Latest news events and program updates »» Instant notifications of closings or delays »» Cost: Free »» Device: Android and iPhone
Android
iPhone
ALLERGIES | our health
MISCONCEPTIONS ABOUT ALLERGIES words | EDWIN SCHWARTZ and STEVE McCLINTIC
Do I have allergies or do I have a cold or flu? Spring allergy season is here and with it comes some confusion. Part of the uncertainty lies in whether one is suffering from allergies or has caught a cold. Both allergies and colds share common symptoms of nasal congestion, sneezing and fatigue. Our Health spoke to local allergy experts to provide insight for our communities.
Fever points toward an infection, which indicates some sort of common cold or flu. Symptoms like itching in the nose, ears and eyes can point toward allergies. Also, symptoms lasting more than two weeks are most likely caused by allergies. With colds and flu, people usually start to feel better after a two-week period as the body’s defenses have fought it off. An additional factor to consider is if you were around anyone with a cold. This is because colds are contagious and allergies are not.
If pollen is on your car and you begin to itch, sneeze or get watery eyes, does this more than likely point to some sort of seasonal allergy? If this is something you’re concerned about, even in the non-pollen months, you can take an over-the-counter (OTC) antihistamine. Zyrtec, Claritin and Allegra are all medications that work pretty fast. If you take one, and in a couple of hours you feel better, this may be a sign you suffer from an allergy and not a cold. If you don’t feel better, you could have a cold or severe allergy. www.ourhealthvirginia.com | 23
our health | ALLERGIES
Are people who have allergies more sensitive to getting the flu? People with any sort of respiratory disease, such as asthma, have a higher chance of developing more severe symptoms after contracting the flu.
Regarding treatment of an allergic disease, there are three categories to consider – avoidance, medication and immunotherapy. What do these mean? With avoidance, you stay away from what you’re allergic to. Determining this may require some testing. If you know what you are allergic to, you know what to avoid. Concerning medications, there are many options with several kinds of prescription nasal sprays and OTC pills. Learning the very best combination takes time with trial and error while also accounting for your preference. The third treatment – immunotherapy – usually requires allergy shots. This involves taking the actual allergen – such as animal dander, mold or dust mites – sterilizing it and slowly increasing the amount a person receives. As the therapy continues, the body builds up a natural immunity to the allergen so the individual stops having allergic reactions. The advantages are two-fold, because it is the most effective treatment for decreasing symptoms and offers the greatest potential for cure.
Can allergies be treated with natural remedies? When the National Institute of Health investigated natural therapies as a means of treating allergic disease, it found many claims by manufacturers but very little data to back them up. Perhaps they do and perhaps they don’t. Just because something is natural doesn’t mean it’s necessarily good for you. After all, poison ivy is natural. If you feel you are experiencing any allergens, it’s really important to talk with your trusted medical provider to see if there’s any help you can get. Most importantly: Do what makes you feel better!
Celebrating the Healthcare Worker... Working in healthcare allows me to help people and that is our mission here at Lincare. Stephanie Stump Center Manager Langhorne Rd. location. 24 | www.ourhealthvirginia.com
ALLERGIES | our health
www.ourhealthvirginia.com | 25
As a physical therapists I enjoy working in the healthcare field because I can help people live a productive and pain free life. My physical therapy treatments not only include words | SARAH COX examination, diagnosis, and treatment of the immediate problem but education, prevention and ongoing home self-care to improve the patient’s long term quality of life. Harrison F. Hunt, PT, DPT Rehabilitation Associates of Central Virginia
I believe celebrating special observance days, exceptional projects and individual and organizational achievements is critical to the continued success of Centra. Everyone in our organization knows they have a hand in caring for others. We recognize that we all contribute and collaborate as a team. The camaraderie builds more success. That’s rewarding for everyone and our patients and community benefit. Patti McCue, Sc.D., R.N., MSN, NEA-BC senior vice president, Centra Patient Care Services
words | SARAH COX
The burnout factor in the healthcare industry is a viable concern. Hence the importance of recognizing the efforts of everyone who works in this field, from clinical to nonclinical employees. Patti McCue, Sc.D., R.N., MSN, NEA-BC, Senior Vice President of Centra
Patient Care Services, knows that everyone likes to be recognized. She says that in addition to a simple thank you, “shining a light on our employees’ contributions is not just a nice thing to do. It is so much more. I believe celebrating special observance days, exceptional projects, and individual and organizational achievements is critical to the continued success of Centra. Everyone in our organization knows they have a hand in caring for others. We recognize that we all contribute and collaborate as a team. The camaraderie builds more success. That’s rewarding for everyone and our patients and community benefit.” The Lynchburg Dental Center has approached showing appreciation in a unique way – soon it will be adding profit sharing to existing employee compensation and recognition initiatives, according to Marketing Consultant Tina Joyce. “Creating ownership in the practice and in daily patient care enhances every patient’s experience,’’ says Joyce. “We feel strongly that encouraging our staff to invest in their future through profit sharing is extremely valuable.”
our health | CELEBRATING THE HEALTHCARE WORKER
There is something magical about encountering a patient for the first time, having them express their needs and knowing I have the knowledge, resources and ability to create an orthosis or prosthesis to meet them right where they are at. Giving them hope and encouragement through increased function is such a rewarding gift to give someone. You will always find your job rewarding when you find a satisfying and interesting way of being of service to others. Sharidy McCord Practitioner, Virginia Prosthetics
Joyce says that Lynchburg Dental Center’s goal is to create a patient-focused atmosphere in which the team enjoys its day-to-day work. Bill Ashe, CEO of Medical Associates of Central Virginia, says that because they are a small business that sees a high volume of patients, the need for “motivated, enthusiastic healthcare staff that works well as a team and knows how to communicate with patients” is imperative. The business employs 180 people and has a variety of subspecialties including internal medicine, hospitalists, endocrinology, and infectious disease. Recognizing employees, Ashe says, directly impacts the patient experience. “We recognize them because we want our patients to have the best care possible. If our employees are happy when they are at work, that translates directly to patients, on the phone, taking care of them, and checking them in,” he explains. Employee recognition events take place three to four times each year. In September, the business holds an employee recognition week with events scheduled every day. “This allows us to celebrate them being with us,” says Ashe. Recognizing employees through this large annual event, which is planned for and publicized, keeps them focused on that event and how special they are.
28 | www.ourhealthvirginia.com
our health | CELEBRATING THE HEALTHCARE WORKER
In addition, there are several smaller events, such as ice cream treats, and other big events, such as a cookout. Throughout the year, employees may dress up on Halloween to interject some fun into the work place – something that the patients often enjoy. Medical Associates of Virginia also recognizes its employees through a Christmas party. “Healthcare is a challenging profession, and it’s easy to get burned out,” Ashe concludes. Shannon Barksdale, Marketing Director of Piedmont Eye Center, says that goal setting is a way to motivate and recognize the 65 employees in their two locations. These include seven physicians, certified ophthalmic assistants, staff, administrators, and managers. The goal setting, she says, is a way to measure progress with personal and practice goals. When they achieve them, they are recognized in many ways, such as company-wide emails. Additionally, Piedmont Eye Center holds lunches, monthly birthday celebrations, and extends benefits such as Sam’s Club memberships and gift cards for going above and beyond.
It is truly an honor to work at Women’s Health Services in such a positive environment with highly skilled physicians and nurses, and a great office staff that look forward to taking care of our patients and providing the best care possible. Laynee Jordan Administrator, Women’s Health Services 30 | www.ourhealthvirginia.com
www.ourhealthvirginia.com | 31
our health | CELEBRATING THE HEALTHCARE WORKER
At this stage of my career, my rewards come in helping others make a difference. I work with patient outcomes, teaching and training floor nurses evidence-based best practices to improve their patient outcomes. It takes longer to see my results than when I worked at the bedside, but it is rewarding to see our scores improve. Cheryl W. Gibson, RN, BSN Performance Improvement Abstractor, Centra Southside Community Hospital
“The medical field is a hard job. You’re dealing with people who are not seeing well and with patients who are elderly and maybe can’t hear well, and sometimes it’s not a job where you get a lot of thank you’s,” notes Barksdale. “In any job that you do, a job well done should be acknowledged. I do think that employees respond to a pat on the back. Our staff members get a lot of gratification from their job – while healthcare is tough, it is also rewarding because you see the difference you make in people’s lives. They know what kind of difference they are making.”
The reward is often the patient’s impact on me and the blessings that they bring forth in my life. It’s awesome to have a job where you meet so many different people. Susan Cheatham, BSN, RN, CAPA Ambulatory Surgery Centra Virginia Baptist Hospital
32 | www.ourhealthvirginia.com
Gretna Drug Company, Inc. Our Focus Prescriptions and home healthcare items
Our Mission The mission of Gretna Drug is to offer its patients the finest experience available in obtaining prescriptions and home health care items. Our experienced pharmacists and technicians are here and always available to answer questions and offer solutions to patient needs. Listening to our patients needs along with collaboration with other health care providers is how we best address the needs of our patients. With costs being a concern to all, our staff is acutely aware of ways to work with our patients to offer them the best value along with the best therapeutic outcome. We intend for everyone to be satisfied and feel that they have had a great experience dealing with Gretna Drug.
Our Involvement in the Community Gretna Drug has been a local, family-owned business since 1967. When Gretna Drug was purchased in 1967 it had already been in existence before 1900. Our owners and employees are local people who live and work in our community. Gretna Drug supports local efforts for schools, churches and many events that enhance our community. We are strongly committed to serving our community that supports us.
Our Motivation to provide the highest level of care Being a local, family-owned pharmacy, we have the opportunity to serve many who we know personally. Our reputation is always on the line and we work together to maintain a high standard for quality care in our community. It is our desire that our patients and healthcare providers feel that Gretna Drug is the logical choice.
Gretna Drug Company, Inc.
108 Vaden Drive | Gretna, VA 24557 | 434.656.1251 | www.gretnadrug.com
Excel Prosthetics Our Focus
Since being founded in 1978, Excel has expanded to seven offices located in Virginia, Tennessee, and West Virginia. The company has grown due to its innovative products and unwavering commitment to patient comfort and satisfaction. We have extensive experience with all levels of lower and upper extremity prosthetics and orthotics.
Our Mission
We understand that each patient has different circumstances, needs, goals, fears, and hopes. It’s our job to guide patients on this journey that they may have never expected. Our team of certified practitioners and technicians takes this responsibility very seriously. Patients can expect our team to take great care in analyzing specific needs and designing the appropriate prosthetic or orthotic. At Excel, experience and cutting-edge technology create a better quality of life for patients. Our industry-leading technologies are utilized by an experienced, professional team of certified practitioners and technicians. Excel Prosthetics & Orthotics is always working to bring the latest and most advanced technology to our patients. Technology is always changing and improving, and we owe it to our patients to seek out the knowledge of all options available. Digital scanning is an example of this technology that improves quality of prosthetic fitting and reduces the number of test fittings needed. Excel employs the use of elevated vacuum suction sockets, which help maintain a healthier residual limb and helps control volume changes. The use of microprocessor knee and ankle components are an important part of prosthetic design because they help reduce stress on the patient and increases energy efficiencies that allows for a longer duration of ambulation. Excel Prosthetics and Orthotics worked with the first patient to receive a BIOM ankle/foot system in our region. The BiOM replicates the action of the foot, ankle and calf muscles that work together to assist the individual’s forward motion when walking. While a traditional prosthesis can store energy and then return it, the BiOM actually replaces energy allowing amputees to walk as normally as possible over all terrain types. The BiOM is the only prosthetic system that can actually restore lost muscle function of the foot, ankle and calf for lower leg amputees. This allows patients to reduce their energy expenditures because this system actually assists during ambulation instead of being a passive device.
Our Motivation to Provide the Highest Level of Care
Our fully integrated facility ensures that patients receive the best care possible by employing enhanced scanning and digital mapping and on-site prosthetic engineering. During every initial evaluation, we capture the exact parameters of a patient’s residual limb through digital scanning. Computer aided machines are utilized to carve out an exact mold of the patient’s residuum allowing our engineers to develop and produce a socket that fits perfectly to the shape of the patient’s body. The result is a prosthetic that helps restore mobility and functionality, and more importantly, self-reliance. When the passion is rebuilding lives one step at a time, Excel Prosthetics is the Right Choice! Prosthetics
Excel Prosthetics
2255 Langhorne Road | Lynchburg, VA 24501 434.528.3695 | www.excelprosthetics.com
St. Clair Eye Care Our Focus: A full service, privately owned and professionally operated optometric facility.
Our Mission: Our mission statement is to respectfully meet and exceed our patients’ vision and eye health needs through: Honesty, Integrity, Quality, Dedication, Communication and Education. To ensure this, all of our doctors participate in yearly continuing education to keep abreast of the latest concepts and research in our field. We hold regular staff meetings to train our staff and hone their skills. Learning and education is an ongoing process at all our locations.
Our Involvement in the community: As much as possible, our practice tries to stay involved in our community. We are members of the Lynchburg and Appomattox Chambers’ of Commerce. Each year, we participate in various local health fairs. Members of our staff volunteer to assist some school nurses in performing student vision screenings. We assist several Lions Clubs in providing affordable exams and eyewear for area residents in need. We have sponsored several little league sports teams. Each year, Dr. Clifford Phillips travels to Jamaica with a local medical mission team to provide eye care to the indigent. He does upwards of 60 exams per day. Throughout the year, we graciously accept donated eyewear for Dr. Phillips to take on his trip.
Our Motivation to provide the highest level of care Our staff is a very loyal and caring group of people. They understand the importance of the precious gift of sight. Our doctors are dedicated to provide the highest quality eye care available. We use the latest equipment and technology to diagnose and treat certain ocular diseases and vision disorders. Our well-trained optical staff takes the time to help our patients select the best lens products to provide a precise and comfortable visual result. We offer a full line of designer frames and styles to fit any budget. Our contact lens staff offers the expertise and dedication to get the best fit for each patient’s personal needs.
St. Clair Eye Care
20838 Timberlake Road | Suite A | Lynchburg, VA 24502 | 434.239.2800 | www.stclair-eye.com 36 | www.ourhealthvirginia.com
SPOTLIGHT ON: LifeWorks Rehab® | our health
Getting Back to Life words | SARAH COX
With the LifeWorks Rehab® approach, Medical Facilities of America (MFA) delivers a customized rehabilitation program to each one of its patients throughout its 40 skilled nursing centers in Virginia and North Carolina. That is “one of the aspects of MFA’s recovery program that makes it stand out”, says Physical Therapist and Vice President of Rehabilitation Services Ron Selzler. The LifeWorks approach is a comprehensive program designed by a team of specialists to help patients set goals and treatments exclusive to their individualized community skill level. This means patients can recover and “return home as functional, safe and independent as possible”, Selzler explains. “LifeWorks is unique to MFA,” he says. “We have a high emphasis on setting goals and treatments specific to each patient’s skill level. Our therapy is in-house and is delivered by our in-house therapists.” Selzler goes on to explain that “Rehab is integrated into the fabric of the organization. It is delivered throughout the day, seven days a week, and it comes from a team approach. The key to the program is not simply getting patients home, but getting patients back to where they want and need to be in their community. An important component in each patient’s recovery plan is The Recovery Map®. This is a visual guide showing each stage of rehabilitation that integrates physical, occupational and other therapies to build strength, mobility and functional skills to enjoy life. “We are www.ourhealthvirginia.com | 37
SPOTLIGHT ON: LifeWorks Rehab® | our health
considered one of the premier rehab providers throughout Virginia,” says Selzler, “and we are the largest provider of skilled nursing services.” Therapies at LifeWorks Rehab® are intensive and the goal is the long-term success of each patient. Successful outcomes are measured with the exclusive Functional Independence Tool, or FIT. Each patient receives a FIT score upon admission to one of our Centers and then again at discharge. “For some, they were completely independent before the accident, illness or surgery that resulted in the stay with us. Others were at home with a caregiver. We must individualize each treatment plan to where each patient needs to be; to be safe,” says Selzler. “LifeWorks delivers an intensive therapy program is seven days a week and coordinates plans closely with the orthopaedic surgeon or attending physician to carry out specific protocols”, explains Selzler. Part of the plan is to visit the patient’s home prior to discharge and determine
www.ourhealthvirginia.com | 39
our health | SPOTLIGHT ON: LifeWorks Rehab®
what specific skills are needed to return to the patient’s unique environment. That may mean measuring the width of bathroom doors, the angle of the stairs, and the outdoor space. “In a healthcare environment such as ours, we are ADA accessible while homes are not,” Selzler points out. “To that end, experts look at uneven surfaces, stairs, and heights that may be challenging in getting back into the community. This community may include attending church and events that the patient had participated in prior to the accident, illness or surgery. Just as important as selecting an attending physician or orthopaedic surgeon is selecting a rehabilitation facility. “Patients should take the time to consider their choices for rehab, and they should ask questions such as how much therapy will they receive, is it available on weekends, and if their outcome will be measured,” he says. For more information on Medical Facilities of America and its LifeWorks program, see www.lifeworksrehab.com.
40 | www.ourhealthvirginia.com
PHYSICAL THERAPY | our health
PHYSICAL THERAPY increasingly common for patients looking
for PAIN RELIEF
words | LAURA NEFF-HENDERSON, APR
Americans are increasingly looking to physical therapists for help with pain, as a means of avoiding costly medications and surgeries. Often times, physical therapy can help patients heal faster. And, it’s less expensive than traditional medical care. Physical therapy helps relieve pain, promote healing, and restore function and movement. Physical therapists at Rehabilitation Associates of Central Virginia in the Bedford clinic report an increase in the number of individuals coming to them for help managing pain, according to Harrison F. Hunt, PT, DPT, co-owner of the company. She believes the increase is at least partially due to direct access, also called selfreferral, which allows patients who have not been under medical care for their ailment for at least 90 days to refer themselves to a physical therapist. Direct access is a provision of the Virginia Physical Therapy Practice Act. According to the World Federation for Physical Therapy (WFPT), patients who refer themselves to physical therapy take less time off work and are more likely to complete a course of treatment. The WFPT has also found that direct access saves money by reducing the costs associated with seeing other health professionals, including general practitioners and family physicians, prescription medications, secondary care, and costs to society caused when individuals take time off work. “Our goal is not only to decrease pain, but also to normalize function and provide a quick return to customary activities,” says Dr. Hunt. “We also strive to establish an ongoing injury prevention program once the patient is rehabilitated. Through strong partnerships with physicians, we are able to deliver a well-rounded program of rehabilitation, education, prevention and fitness to each patient.” One of the things Dr. Hunt and her colleagues enjoy most about their jobs is the opportunity they have to interact with patients of all ages who have a variety of ailments. A large number of their patients come in with sports injuries, but they also treat individuals who have been in motor vehicle accidents. Other individuals come in for assistance with back, neck, and shoulder pain resulting from every day stresses. People who work at computers day-in and day-out often seek treatment for neck, shoulder, and arm pain, says Dr. Hunt, while back pain is particularly common in individuals who have physically demanding jobs. Other individuals begin physical therapy to prepare for surgery, and then continue with physical therapy post-surgery. Those patients are required to have a referral since they have been under a doctor’s care for the ailment. “The better shape you are going into surgery, the better outcome you’ll have,” says Dr. Hunt. Those patients usually have limited range of motion and muscle inhibition or strength loss because of the swelling and pain caused by the injury. Patients who are diligent about physical therapy and at-home exercises, can sometimes avoid surgery altogether. That, says Dr. Hunt, can save the patient, and insurance companies money that would have been spent on expensive tests and www.ourhealthvirginia.com | 43
our health | PHYSICAL THERAPY
44 | www.ourhealthvirginia.com
PHYSICAL THERAPY | our health
surgeries. Physical therapy can also help patients avoid costly medications that are often hard on the stomach. Dr. Hunt advises individuals who think physical therapy may be an option for them to make an appointment. As part of the initial visit, the physical therapist will perform a complete evaluation to determine the best course of treatment. Treatment programs depend completely upon the nature and severity of the ailment and, but typically include twice weekly appointments for about eight to 12 weeks. When released from physical therapy, Dr. Hunt sends her patients home with exercises and an understanding of how they can prevent reoccurrence of the ailment. “Education is a huge part of what we do,” says Dr. Hunt, explaining that physical therapists spend a lot of time determine how the injury occurred, how they can reduce pain and regain mobility, and prevent reoccurrence.
Celebrating the Healthcare Worker... I love helping people with emergencies... they call, we get them in, and they leave smiling! A patient we saw the other day called and she was hurting. Dr. Wagoner doesn’t turn them away, even when he is really busy. She was so grateful! Dianne Bradley Optical Care Coordinator, Wagoner Family Eye Care www.ourhealthvirginia.com | 45
our health | BLOOD SERVICES
baby, can you spare a pint?
A little blood, unlike time and money, is something that most of us can easily spare. And at some time or another, almost all of us will witness blood donations at work.
“Odds are, at some point in your life, you’re going to encounter someone who has needed a blood product,” says Joshua Smith, communications manager at Virginia Blood Services (VBS). “It could be someone that’s very close to you. It could be you.”
words | ANIKA IMAJO
Bridging the gap between eligible donors and the scores of patients in need, organizations such as VBS and the American Red Cross receive, process, and distribute the precious commodity that helps save lives— from premature babies to trauma victims—every day. “97% of us will either need blood or know someone who needs blood,” says Kristen Hatfield, marketing program manager for the American Red Cross’ Mid-Atlantic Blood Services Region. Blood products commonly play a critical role in surgeries—cardiac, orthopedic, obstetric and gynecological—as well as treatments for cancer and blood disorders such as sickle cell disease, according to Chelsea Sheppard, MD, medical director of VBS. VBS is a member of America’s Blood Centers (ABC), a network of North American non-profits that collectively amass more than eight million units of whole blood annually, more than half the donor supply for the US and Quebec, according to the ABC website. With nine locations (three in the Greater Richmond area) supplying local health care systems throughout the commonwealth, VBS requires a daily minimum of 400 donations in order to meet Virginia’s average demand. Then there are the urgent situations, the accidents and even large-scale disasters, which require an immediate supply of prepared blood products, sometimes in large quantities. VBS delivers blood products to three level one trauma centers in Virginia, including the Virginia Commonwealth University Health System. “Distribution to hospitals varies from standard to STAT
46 | www.ourhealthvirginia.com
BLOOD SERVICES | our health
order,” Dr. Sheppard explains. “Because traumas can happen at any time, at any volume, it’s important that we have the supply to meet local patients’ needs.” Through the Red Cross’ nationwide blood system, your donation here in Virginia may support life-saving efforts in other parts of the country. The regional center satisfies needs close to home first, supplying blood products to more than 50 Virginia hospitals. But Hatfield points out that its inventory may also be routed to disasterstruck areas—such as the Northeast following its recent colossal snowstorm— where demand is high and conditions may stall local blood drive efforts. “Clearly no one’s coming out in two feet of snow to donate or collect blood,” she remarks. “And we always say, ‘The need for blood never gets a day off.’
Donating blood at Virginia Blood Services.
The ongoing need for a ready supply of blood products demands an efficient and safe system of delivery from the donor’s vein to health care facilities. Blood can be collected as whole blood donations, to be separated into various components in a centrifuge. “That one donation can actually help save three lives,” Smith emphasizes, “because we make the products out of one unit—plasma, platelets, and red blood cells.” But current technology also permits collection of isolated components from the source. Once blood is drawn from the donor, the desired component may be removed and the remaining parts returned to the donor, explains Dr. Sheppard, whose background includes a fellowship in transfusion medicine at Emory University.
www.ourhealthvirginia.com | 47
our health | BASIC
Double red cell donation, through which donors can safely give two units of red blood cells at once, is also now possible. Such donations yield more units of blood without taxing the donor. “Because platelets and plasma are returned to donors, in addition to saline, fluid levels are maintained and some donors report feeling more hydrated after their completed donation,” Dr. Sheppard says. A 115-day waiting period is required between double red cell donations from a single donor, she adds, explaining that the body needs that time in order to restore blood cells. Blood donations must also undergo a process of testing for both bacteria and disease, according to Dr. Sheppard, who says HIV, hepatitis B and C, syphilis, and West Nile virus are among the infections they test for in screening donations. Because blood products don’t keep indefinitely in storage, a steady influx of fresh donations is critical. Packed blood cells have life spans commonly ranging from 35-42 days, depending on the preservative added, according to Dr. Sheppard. While plasma and cryoprecipitate, or the frozen product derived from plasma, may last frozen for one year, Dr. Sheppard explains, “Platelets must be stored at room temperature for their utility and thus must be used within five days in order to avoid bacterial growth.” This especially brief shelf life makes platelet donations — which may be made by a single donor every two weeks— of particular importance to the blood supply. Blood must, of course, be matched by type between donor and recipient. According to Dr. Sheppard, blood types are determined by inherited antigens—or proteins and sugars on the surface of red blood cells. “The most common antigens that people hear about are A,B, and O (which is actually the lack of A or B),” she explains. The types in this group of antigens are further distinguished as positive or negative, depending on the presence or absence of the D antigen, which belongs to the group known as the Rh system. Type O negative is the universal donor, meaning it can be transfused into patients who have any of the eight major blood types, but contributions of all blood types are valuable. Meeting an unyielding demand on a continuous basis means raising awareness of the need for blood donations. 48 | www.ourhealthvirginia.com
BLOOD SERVICES | our health
“The number one reason people don’t donate blood is because they just haven’t been asked to donate blood,” observes Smith, adding, “We’ve got 37% of the entire population that can donate blood. Less than 10% of that 37% actually does.” As the eligibility criteria for blood donations are subject to change based on FDA guidelines, both organizations encourage potential donors to undergo the screening process to find out if their blood can make a critical difference to others. As Hatfield put it, “Blood donors are heroes!” If you have a tattoo, have lived in certain parts of the world, or have been deferred as a donor in the past, don’t count yourself out as a candidate to give blood. And those who find they can’t donate blood can still make a significant contribution to the effort, Smith says, by helping to get the word out about the importance of blood donations. “If you can’t donate, advocate.” To learn more or to get involved, please contact Virginia Blood Services (http://Vablood.org) at 1-800-989-4438 or the American Red Cross (redcrossblood. org) at 1-800-RED CROSS.
For a current update on which blood types are most needed in our area, please visit www.vablood.org or use your smart phone or tablet to scan this QR code.
Chelsea Sheppard, MD, medical director of VBS
www.ourhealthvirginia.com | 49
A Summary of Common Medical Professional Titles Have you ever tried to decipher the differences between a DO and an MD, or tried to figure out what an EMT is? Below is a list of abbreviations and what they mean. Each of the titles below requires a certain standard of education and passing certification exams. There are six basic types of credentials you may possess that can be used after your name. The first is your degree (e.g., BS, MS, JD, PhD, EdD). These credentials are awarded based on the completion of a particular educational program. The second is licensure. These credentials are awarded based on the completion of a specified educational program and the successful passing of a national licensure exam. Then there’s the state designation or requirement. These credentials are similar to licensure, but they are usually beyond basic licensure and designate authority and recognition to practice at a more advanced level in that state. Additionally, there is national certification. These credentials are awarded by a nationally recognized, usually accredited, certifying body. To give some examples, a DO is a doctor of osteopathy, and an MD is a doctor of medicine. The main difference is that a DO, who will have the same rigorous training as an MD, is that D.O.s have been specially trained to perform osteopathic manipulations on patients. They view the patient as a “total person” and focus on preventative care. An MD attends an allopathic school, whereas a DO attends an osteopathic school; both teach the same basic science curricula necessary to becoming a fully qualified doctor. An EMT, or emergency medical technician, is required to pass a state exam to be certified to practice in that state. A “fellow” designation, such as a Fellow American College of Physicians, designates the period of medical training that a physician or dentist may undertake after completing a specialty training program (residency). During this time (usually more than one year), the physician is known as a fellow. Fellows can act as an attending physician or consultant physician while they are in specialty training, and after completion of their fellowship, the physician is permitted to practice without direct supervision by other physicians in that sub-specialty, such as cardiology or oncology. There are also several designations for nurses, from NPs, or nurse practitioners, to RN, or registered nurses, each signifying differences in licensure, certification and education.
our health | CANCER CARE
52 | www.ourhealthvirginia.com
CANCER CARE | our health
cancer update: LYNCHBURG words | SARAH COX
Lung cancer is the number one killer of men and women, with a higher mortality rate than breast, colon and pancreatic cancers combined, says Charles Mulligan, Jr., MD, board-certified in general and thoracic surgery with Centra Thoracic Surgery. Dr. Mulligan says that one of the significant advancements in the treatment of cancer is a multidisciplinary approach. While he can step in to evaluate patients with abnormalities found that may require biopsies, and deliver the diagnosis, staging and treatment of the disease, he also works with a larger team consisting of pulmonologists, GI doctors, a medical oncologist, a radiation oncologist, and other services such as a nutritionist and a rehab specialist. “We go over all the cases every other week and try to make the best treatment plans based on a patient’s overall tolerance,” he explains. This is personalized medicine, and he hopes that soon it can be delivered in one site, where a patient can be seen by various specialists who then meet to discuss the case. While the news about lung cancer is still dim—there are about 220,000 new cases a year, with a 16 percent cure rate—early detection through screening has been found to impact survival rates in high risk patients by 20 percent. A screening program, offered through Central Virginia Imaging, part of Radiology Consults of Lynchburg, is available to the high-risk population of those who are 55 and older, with a history of smoking about 30 packs per year but have quit for longer than 15 years.
www.ourhealthvirginia.com | 53
our health | CANCER CARE
Another advancement in the treatment of lung cancer is the video-assisted thoracic surgery, or VATS, which is a type of surgery that “enables doctors to view the inside of the chest cavity after making only very small incisions. It allows surgeons to remove masses close to the outside edges of the lung and to test them for cancer using a much smaller surgery than doctors needed to use in the past,” according to Harvard Medical School’s Harvard Health Publications. This minimally-invasive approach helps the patient recover quicker and back to baseline breathing faster. Baseline breathing, according to Dr. Mulligan, is how a patient is breathing prior to surgery. Dr. Mulligan says that it is also very important to go through rehab after lung surgery. “When you cut a section of the lung out, the remaining section gets hyper expanded. It takes a period to get back to baseline, and the key is aggressive exercise. Most people I am operating on have some other issues, like COPD, so their breathing is not normal to begin with. Then, after putting someone to sleep, their lungs get aggravated.” Then, surgery further “insults the body,” he says. While the patient will have a sensation of breathlessness for weeks after surgery, someone with bad lungs may take a couple of months to recover. The key, he says, is “aggressive ambulation.” Another key advancement in oncology is through the research that is pinpointing the molecular characters, or markers. “We are going to find more and more of these niches to better treat individual patients with medicines,” he says. Research is a vital part of cancer treatment, and at the Lynchburg Hematology/ Oncology Clinic, a part of the Centra Health Pearson Regional Cancer Center, approximately 800 patients are pre-screened for cancer trials each year. In 2012, this translated to 103 patients who consented to clinical trials. According to Donna J. Washburn, Clinical Nurse Specialist and Oncology Clinical Trials Research Coordinator, this represented an increase of 27 patients more than 2011 totals. According to the Coalition of Cancer Cooperative Groups, “… clinical trials contribute
54 | www.ourhealthvirginia.com
our health | CANCER CARE
to the overall knowledge and progress against cancer. Many of today’s standard treatments for cancer began in clinical trials. Many people treated for cancer are now living longer thanks to the knowledge gained through clinical trials.� Currently, Centra has about 120 individual patient volunteers who are currently being treated and/or actively followed on clinical cancer trials in Lynchburg. About 410 volunteers have enrolled in oncology trials since the inception of the program in 2003. Washburn says that clinical trials conducted through Centra have made a difference. For instance, in a past trial comparing chemotherapy regimens for women with positive lymph nodes, the conclusion was reached that the addition of a fourth chemotherapy drug did not improve
56 | www.ourhealthvirginia.com
CANCER CARE | our health
outcomes. “This saves thousands of women from suffering the added risks and side effects and costs of an additional chemotherapy drug,” Washburn points out. Some trials have helped with the development of “personalized medicine,” says Washburn, “to find new tests that analyze a patient’s genes to help determine what treatment is probably best.” An example of this is the TAILORx trial, which represented a major step forward into the era of personalized medicine for breast cancer. Prior to this research, any woman with a tumor over 1 centimeter that was hormone sensitive, HER2 negative, was given chemotherapy along with surgery, radiation if needed and hormone therapy. “However, for a majority of those women (80 – 85%), the added chemotherapy does not improve survival and may result in overtreatment,” says Washburn. The trial opened in Lynchburg in 2006, when 34 women volunteered; about 25 are still being followed for disease-free survival. Nationally, the trial enrolled over 10,000. Centra also has clinical trials for supportive therapy and care. For instance, a study of Pegfilgrastim (Neulasta), which helps increase white blood cell count, was given to volunteers with locally-advanced or metastatic colorectal cancer to help prevent serious infection. Another study, the VCU Day/ Night Study, was a project designed to help understand how lifestyle enhances cancer survivorship. Washburn points out that Centra only does trials that provide the best-known care available for the patient. “For example, we would never give someone a choice of getting standard treatment or the clinical trial,” she says. Patients are always given the best treatment possible. “Even a trial outcome that is not favorable for the intended purpose can be useful to researchers in later studies, or can prevent a drug coming to market that is inferior.” Washburn says that anyone interested in volunteering for a clinical trial should contact her at 434.200.1495, or donna.washburn@centrahealth.com.
www.ourhealthvirginia.com | 57
our health | NUTRITION HEALTH
UNDERSTANDING NUTRITIONAL VALUES IN FOODS words | TRICIA FOLEY, RD, MS
There is a lot of misinformation when it comes to nutrition, which can sometimes make products seem healthier than they really are. To ensure you are making the healthiest choices possible, below are some nutritional explanations to help keep you on track.
Have you ever wondered what enriched fiber really means? It sounds healthy, but unfortunately, it means that many of the good nutrients that were originally in the food have been stripped out through refinement and then some of these components have been added back in an unnatural way. Since our bodies do not know how to process these foods as well as whole, unprocessed foods, they should be avoided. The term fortified is equally confusing. Eating fortified foods means that companies have artificially added vitamins or minerals. A good example is orange juice. It is often fortified with calcium. Although not harmful, getting calcium from naturally occurring calcium rich foods is always preferable over getting calcium from fortified foods. A few additional misleading tag lines include “no sugar added,” “trans fat free,” and “net carbs.” Please don’t confuse “no added sugar” with not having any sugar. It simply
58 | www.ourhealthvirginia.com
NUTRITION HEALTH | our health
means that no additional sugar, on top of the naturally occurring sugars already in the food, has been added. Depending on the food, there may be plenty of sugar already in it. Trans fat is made by adding hydrogen to vegetable oil through a process called hydrogenation, making it last longer on the shelves. For this reason, it’s also seen on the ingredients label as hydrogenated oil. When the label claims the food is “trans fat free,” take time to check the ingredients list. You may be surprised to still find it there. Products containing trans fat can label them “trans fat free” if there is less than half of a gram per serving. The problem here is many people consume more than an actual serving. If a serving is one tablespoon, but someone is using more than that, he is going to consume more trans fat than he bargained for. In fact, the 2010 dietary guidelines suggest keeping trans fat as low as possible. Eating more than a few grams on a regular basis can result in increased heart disease risk. Also popular on the food labels are net carbs. These are the carbohydrates left over once the fiber and sugar alcohols have been subtracted from the total carbohydrates on the label. The thought is that fiber and sugar alcohols are not fully absorbed, so they do not need to be counted. This isn’t a perfect science. The true absorption rate varies depending on the type of fiber and sugar alcohol used. Many products keep their net carbs down by adding artificial sweeteners, which increase the number of sugar alcohols, thereby reducing the net carbs. Be careful with high levels of sugar alcohols because they are hard for the body to process and are not real food. Net carbs may be helpful in guiding you in the right direction since low net carbs normally means the product has more fiber. However, net carbs should not solely be used in determining whether or not the food is healthy. www.ourhealthvirginia.com | 59
our health | NUTRITION HEALTH
Why is fiber important in the first place? Fiber can help with a number of things. It can enhance satiety, improve texture, reduce calorie absorption, slow the absorption of sugar into the bloodstream, improve cholesterol, encourage the growth of friendly bacteria in the gut, and reduce colon exposure to potential carcinogens (cancer causing agents). Soluble fibers are known for their ability to lower cholesterol and slow the movement of food through the small intestine. Examples of soluble fiber include oats, peas, beans, apples, citrus fruits, carrots, and barley. Insoluble fibers are known to be protective against colon cancer since they help to increase stool bulk and relieve constipation. Examples of insoluble fiber include nuts, beans, and vegetables such as cauliflower, green beans, and potatoes. Aim for at least twenty five to thirty grams of fiber per day, ideally from whole foods. Check the nutrition facts to see how many grams per serving your foods contain. How many calories should you eat daily? This number will be different for everyone. Calorie needs are very much dependent on sex, age, activity level, and goals (are you trying to
60 | www.ourhealthvirginia.com
lose, gain or maintain your weight). Depending on these factors you may need more or less than the “average� person. For a complete chart of calorie recommendations, please visit: http://www.webmd.com/diet/calories-chart. There are formulas that can be used to help calculate your estimated calorie needs. The most commonly used is the Harris Benedict equation. Keep in mind though that these are still estimates and do have room for error. Knowing your estimated calorie intake is helpful to ensure you’re giving your body what it needs. Of course, not all calories are created equal. Remember, 100 calories of broccoli will provide you with much more nutritional value than 100 calories of potato chips. Since calories are not created equal, what foods are the best for getting the nutrients you need? The answer is simple, fresh, unprocessed, local whole foods. Some examples include organic fruits, especially those with thin skin like blueberries, apples, and plums. These fruits are packed with even more nutrients (antioxidants, vitamins, and minerals) than their thick peel cousins (bananas, oranges, etc). Buying organic is also important since eating fruits laden with pesticides may undo some of the health benefits. Non-starchy vegetables such as broccoli, peppers, and mushrooms are also going to provide more nutrition per calorie than starchy vegetables like potatoes and corn. Beans and lentils are great starch choices providing a healthy dose of fiber, iron, and even protein. Looking for fresh produce and products that have labels and taking time to read the ingredients will keep you from falling for nutritional misinformation.
www.ourhealthvirginia.com | 61
SENIOR LIVING | our health
words | RICH ELLIS
Get in the Pool
People suffering from a variety of joint conditions, including arthritis, benefit from water-based exercise. For many people with arthritis, the very thought of going up and down steps, taking a long walk, or participating in weight training might make them cringe, knowing the pain level they’ll experience with each of those seemingly routine activities. As it turns out, movement might just be the best treatment for arthritis and other forms of joint pain, particularly if that movement occurs initially in a near weightless environment. And achieving weightlessness doesn’t even require a trip beyond earth’s atmosphere. Instead, a visit to the local pool can be just what the doctor ordered. “Being in the water, depending on how deep you go, actually decreases your body weight,” explains Jennifer Harvey, a licensed physical therapist assistant with Centra Health. “It also decreases stress on the joints, as well as on the spine. So, for patients who have a lot of pain issues that may be preventing them from doing exercise on land, we’re able to do more with them in the water because the pain is less and the stress on the body is less. But at the same time, the water gives us the advantage of adding resistance on its own.” Jennifer works at Lynchburg’s Jamerson YMCA of Central Virginia three days a week, splitting her time between treating YMCA patients and aquatics patients. Centra and the Y work together to share the pool, helping a wide range of patients – not just those suffering from arthritis – benefit from aquatics therapy. Aquatics therapy is essentially exercise in the water, using the properties of water to help patients exercise more effectively, and with reduced pain. At any one time, www.ourhealthvirginia.com | 63
SENIOR LIVING | our health
Jennifer’s aquatics therapy patients might include those who recently underwent a joint replacement, back injury patients suffering from acute or chronic pain or disc injuries, or patients who recovering from an operation. The aquatics exercise program often begins with walking in different directions as a warm up and then transitions to lower body exercises and some kicks, and progresses to the addition of ankle and arm weights to add additional resistance, Jennifer explains. Deep water exercises using flotation devices can also be included to help patients by decompressing joints and the spine. “Ultimately, strength training is most effective for combatting arthritis,” Jennifer explains. “The very nature of arthritis is that it’s painful, so by treating patients with that in the water, they’re able to move more than they would be able to on land, but yet we’re still getting resistance and some nice strengthening exercises accomplished in the water so we find their outcomes are much better.” Mary Peterson, the Jamerson YMCA’s Aquatics Coordinator, works with patients in the Y’s aquatics therapy program and said the improvements she’s seen in patients is nothing short of unbelievable. “I have had people tell me that in three weeks’ time, they’ve noticed their balance is better, that they have lost five to seven pounds, and that they’ve been able to reduce their medication levels,” Peterson explains. “The ability for patients to go from water and translate what they’ve been doing in the water to land – making that transition is hugely beneficial. “ Patients who have participated in water exercises prior to having hip- or kneereplacement surgery tend to recover faster, Mary adds. Even if the patient wasn’t really that physically fit prior to surgery, the fact that they were in the water exercising helps with their fitness and strengthens the muscles around the hip and knee. Strengthening the joint muscles is important for arthritic patients as well, but often it can’t be accomplished on land simply because of the pain levels arthritis patients experience when exercising. “Once arthritis is there, we can’t really undo it, but what we can do is strengthen the muscles surrounding the joints that are arthritic to help support them. That www.ourhealthvirginia.com | 65
our health | SENIOR LIVING
usually gives the patient much more function,” Jennifer Harvey explains. “I’ve seen several patients that have osteoarthritis of the knee. They get very debilitated because it hurts so they don’t move and they get very weak. Once they’re in the water, we’re able to do a lot of strengthening exercises.” Jennifer said that patients see an almost immediate improvement in their pain level and the ease of doing specific movements, such as going up and down a step. Functional changes can occur in as soon as two weeks where patients notice that they’re getting around much better. The improvements, however, can be short-lived unless patients make water-based exercise a habit, even after their therapy is finished. In order to maintain the gains reached in therapy, Jennifer says some patients transition to water aerobics or make swimming on their own a regular part of their exercise routine. Water-based therapy isn’t new, but there is a wealth of new scientific research underway examining the benefits patients receive from aquatic exercise, including one study that looks at placing knee and hip-replacement patients in the water as soon as their incision has healed to help improve recovery times. Whether you’re suffering from a joint-related injury, illness or pain, recovering from one, or trying to prevent a condition from occurring, getting in the water might be a good first step on the road to improvement. For more information about aquatics therapy, contact the Jamerson YMCA at 434.5821900 or Centra Health Rehab at 434.237.8160.
66 | www.ourhealthvirginia.com