CLOSER CONVERSATIONS. STRONGER RELATIONSHIPS. BETTER HEARING.
For Better Hearing, Consult an Audiologist Call us today for your appointment!
434.509.4662 Lynchburg 2321 Atherholt Rd
www.blueridgeENTPS.com
Douglas Cameron, Au.D. Tammy Garber, Au.D. Carole Read, M.Ed. In association with Dr. Timothy Courville Dr. Joseph Hutchison Dr. Sam Meshkinfam Dr. James Hengerer Andrea Adamczak, PA-C Christie Powers, PA-C Jennifer McCurley, PA-C
table of contents | august • september 2014
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School Times MEDI•CABU•LARY.....................10 Local experts define health related terms
Schools provide parents with a list of supplies needed for the new school year, but left off that list are steps to ensure a child’s good health. In this issue, OurHealth provides parents with a step-by-step resource full of valuable physical, emotional and social information to consider, as well as tips from local healthcare and healthcare-related providers from Richmond to help your children make healthy choices all year long.
JUST ASK!.......................................12 Healthcare questions answered by local professionals
NEW & NOTEWORTHY.............14 A listing of new physicians, providers, locations and upcoming events in Lynchburg & Southside
HEALTH POINTS.........................16 Interesting facts and tidbits about health
THE ANATOMY CHALLENGE..................................19 How much do you about our anatomy? In this issue, test your knowledge when it comes to the amazing EAR!
ANATOMY: The Aging Ear......... 20 Although grey thinning hair and deep wrinkles are two of the most commonly talked about signs of getting older, age-related hearing loss is a significant concern for many Americans.
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Blue Ridge Best of : Retirement Living Awards The results are in!
FIT BITS!........................................ 52 Health and Fitness On-the-Go: A Right to ‘Bare Arms’
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The Resource for Healthy Living in Lynchburg and Southside
54
[series]
Breaking the Silence: Alzheimer’s Disease
This series explores diseases that can be devastating to the individuals and families they affect—yet no one is talking about them—until now.
hello, HEALTH!.............................. 38 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos
NUTRITION.................................. 49 FEATURING HEALTHY, FRESH, LOCAL INGREDIENTS: Harvest Recipes—Brined Mesquite Turkey, Roasted Harvest Vegetables, Apple-Peach Oatmeal Crisp
76
Prostate Cancer Testing Remains Critically Important
64
Drug Recovery: Rene’s Story
Rene DuVal desperately called rehab center after rehab center to get help for the alcoholism she thought she had learned to control years earlier. LOOKING BACK........................... 82 Images reflecting the history of healthcare in Lynchburg and Southside * PLUS * a chance to win prizes!
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The Resource for Healthy Living in Lynchburg and Southside
august • september 2014
read this edition of
OurHealth Lynchburg and Southside
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PUBLISHER McClintic Media, Inc. PRESIDENT/EDITOR-IN-CHIEF Steve McClintic, Jr. | steve@ourhealthvirginia.com VICE PRESIDENT OF PRODUCTION Jennifer Hungate PROJECT COORDINATOR Deidre Wilkes CHIEF DESIGNER Karrie Pridemore ORIGINAL PHOTOGRAPHY Ed Ip Photography Sarah Mattozzi Lew Fraga WEBMASTER Next Generation Designs
CONTRIBUTING MEDICAL EXPERTS Eric Baugher, DMD, MS Harrison F. Hunt, PT, DPT Jessica Jara, MD Chal Nunn, MD Vickie Runk Jeffrey Widmeyer, MD, FACS
CONTRIBUTING PROFESSIONAL WRITERS Peter Betz, MD Susan DuBuque Rich Ellis Laura Neff-Henderson, APR Rick Piester Michelle Stephenson Deidre Wilkes
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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/Editor: 305 Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Information in all print editions of OurHealth and on all OurHealth’s websites (www.ourhealthvirginia.com and www.ourhealthrichmond.com) social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2014 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. The OurHealth Lynchburg/Southside 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 | www.ourhealthrichmond.com | Advertising rates upon request.
LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S
What is superficial venous reflux? Superficial venous reflux is a common condition that affects veins near the surface, usually in the legs. Normal veins carry blood back to the heart, and in the legs, this is done against the force of gravity. One-way valves keep blood from coming back down the leg. Valves sometimes fail, and let blood come back down the vein - this is called reflux. The veins below the failed valve can then become stretched and dilated, becoming what we see on the surface as a varicose vein. Jeffrey Widmeyer, MD, FACS Widmeyer Vein Center Vascular Surgery Lynchburg | 434.847.5347 www.veinhealing.com
What is hypotension? Hypotension is abnormally low blood pressure. Blood pressure is measured as systolic and diastolic pressures. “Systolic “ refers to blood pressure when the heart beats while pumping blood. “Diastolic” refers to blood pressure when the heart is at rest between beats. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. Normal blood pressure in adults is lower than 120/80 mmHg. Hypotension is blood pressure that’s lower than 90/60. Blood pressure doesn’t stay the same all the time. It lowers as you sleep. Most forms of hypotension happen because your body can’t bring blood pressure back to normal or can’t do it fast enough. For the most part hypotension is a medical concern only if it causes signs or symptoms or linked to a serious condition such as heart disease. Signs and symptoms may include tiredness, dizziness, blurred vision, cold and sweaty skin, feeling sick to your stomach or fainting. Jessica Jara, MD
Centra Health Internal Medicine/Cardiology Lynchburg | 434.200.5252 www.centrahealth.com
What is interceptive orthodontic treatment? Interceptive orthodontics refers to a phased approach to orthodontic treatment. The interceptive phase, or phase one, generally occurs between the ages of 7-11 in the transitional dentition, or when there is a mix of both primary and permanent teeth present. Treatment in this phase focuses on correcting a specific problem early to encourage normal skeletal growth and development or the eruption of permanent teeth. Some examples of problems that may require interceptive treatment include: severe crowding of teeth, uneven development of the upper and lower jaw, oral habits such as thumb-sucking or tongue thrust, severely protruding front teeth and crossbites. Early detection and correction of these problems in phase one should minimize the complexity and duration of treatment in phase two after all the permanent teeth have erupted. Most children will not need interceptive orthodontic treatment. The only way to know is to see your dentist regularly and to have a consultation with an orthodontist. The American Association of Orthodontists recommends that children have an orthodontic evaluation by age 7 so that any potential problems are detected early. Eric Baugher, DMD, MS
Central Virginia Orthodontics Lynchburg | 434.385.4746 www.bracesbycvo.com
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H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
What can be done to prevent exercise – related muscle cramps? Muscle cramping in athletes may be caused by skeletal muscle overload or fatigue, and / or by excessive sweat loss associated with a decreased level of electrolytes. Prevention is the key to most skeletal muscle spasm episodes. Just as athletes stretch and warm up before the game, non-athletes should warm up before heavy labor, such as yard work. Since cramps are associated with dehydration and electrolyte disturbances, it is important to keep the body well hydrated. Tips: • Stretch and cross train to help the muscles recover • Refrain from drinking caffeinated beverages • Have water available during workouts • Replenish lost fluid with up to 20 ounces of fluid for every pound of body weight lost • Drink sports drinks in sports that are endurance- based • Reduce risk of heat illness by reducing equipment worn during practice and by changing practice times If you suspect you have problems with muscle cramps during exercise, seek a consultation of a local sports injuries doctor for appropriate care. Harrison F. Hunt, PT, DPT
Rehabilitation Associates of Central Virginia Bedford | 540.586.1138 www.racav.com
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
How does gluten affect the gastrointestinal system? Gluten is a common ingredient in the food we eat. It is present in wheat and related grains such as barley and rye. Generally we all handle gluten very well and it does not cause problems. Gluten can cause adverse health issues ranging from bloating, gas, diarrhea and vomiting to migraine headaches and joint pain in those who suffer from gluten sensitivity, primarily as a result of celiac disease. It is estimated that 1% of the population may be affected. Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. In this condition the body is allergic to gluten and the allergic reaction is localized in the small bowel. The allergic reaction damages the lining of the small bowel and will “blunt” the villi or absorptive area of the small intestine and cause symptoms. Some can develop significant nutritional problems as a result. Most do not. A gluten free diet will cure the disease, but the underlying allergic sensitivity never goes away. Fortunately we now have many foods available for those that cannot tolerate gluten and most live normal unaffected lives. Chalmers Nunn, Jr., MD
Gastroenterology Associates of Central Virginia Lynchburg | 434.384.1862 www.gastrocentralva.com
What are some meaningful activities that can be done with people suffering from dementia? Activities play a significant role in the lives of those suffering from dementia. Pet therapy, is a valuable activity as it provides those struggling to communicate opportunities to still bond and form relationships without the stress or frustration that comes with being misunderstood. Allowing dementia patients to participate in the simple tasks associated with caring for pets offers them the chance to focus on the objectives that they can complete rather than dwelling on the ones they cannot. Gardening, on a small scale, can also be beneficial since it offers time outside and encourages physical activity. Simply planting a few flowers provides them responsibilities with which they were already familiar. Residents may recall music that was popular while they were growing up. Many can recall the words from songs they heard played countless times in church or within their homes while some prefer to dance along. Bringing activities that were once familiar into their, now often, unfamiliar world helps dementia patients better cope with their diagnosis. Vickie Runk
Runk & Pratt Senior Living Communities Lynchburg | 434.237.2268 www.runkandpratt.com
NEW
NOTEWORTHY
NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS
Danville Regional Medical Center Congratulates Local Physician, Medical Staff Member VCU Names Brian Zagol, MD, FACC, Interventional Cardiology Fellow of the Year Brian W. Zagol, MD, a local cardiologist currently practicing at Cardiology Consultants of Danville, Inc. with Drs. Gary Miller, David Kotlaba, and Kevin Lingle, recently completed an interventional cardiology fellowship at Virginia Commonwealth University (VCU) Medical Center (Richmond, VA), where he earned the great honor of being named Interventional Cardiology Fellow of the Year. The Interventional Cardiology Fellowship Program at VCU Medical Center is a comprehensive and rigorous year-long training program which provides fellows an exceptional learning experience in all aspects of interventional cardiology (non-surgical procedures such as angioplasty) used in treating cardiovascular (heart) disease.
In 2011, Dr. Zagol joined Cardiology Consultants of Danville, Inc and also became a member of the Medical Staff at Danville Regional. Prior to this, he served with the United States Air Force (USAF) as a staff cardiologist at Eglin Hospital, Eglin Air Force Base (Okaloosa, FL). During the time he served with the USAF, Dr. Zagol was also deployed to Balad, Iraq and Kandahar, Afghanistan, serving as the leader of a Critical Care Air Transport Team. About Danville Regional Medical Center Danville Regional is the leading medical center in the Dan River Region of Virginia and North Carolina providing open heart surgery, spinal surgery and advanced cancer treatment. Approximately 160 physicians are on the medical staff. The medical center employs approximately 1,300 people. For more information, visit www.DanvilleRegional.com.
Centra Finalizes Bedford Memorial Hospital Purchase In January of 2014, Centra announced its decision to solely own and operate Bedford Memorial Hospital by purchasing Carilion’s half of the organization. July 1st marked the first day of the new ownership. With the transaction complete, Centra will begin making investments in both facilities and staff at Centra Bedford Memorial Hospital. Centra will spend $1.5 million to $2 million in capital per year for the next three to five years to upgrade and grow the hospital. There will be updates to the emergency department as ambulatory care is ramped up, changes to long term care, modifications to the infrastructure of the buildings, more advanced medical equipment, improved technology and even cosmetic changes around the hospital. The recruitment of new physicians to the area is already underway with several new providers joining Centra this summer. Centra Bedford Memorial Hospital is a full-service 50-bed medical facility with special emphasis on outpatient surgery, emergency services, geriatrics, and 111- beds dedicated to rehabilitative services. The facility offers 24-hour emergency care, to more than 16,000 patients annually. For more information about Centra, please visit www.CentraHealth.com.
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
Brad Lentz, DMD
Blake Warren, PT, DPT Rehab Associates of Central Virginia Forest Office Forest | 434.525.4851 www.racva.com
Katie Shook, PT, DPT
Lynchburg Dental Center Lynchburg | 434.384.7611 www.lynchburgdentist.com
Matthew Nolen, PT, DPT
Samantha P. Foster, PT, DPT
Evan Ownby, MD
Rehab Associates of Central Virginia Clifton Street Office Lynchburg | 434.528.1848 www.racva.com
Rehab Associates of Central Virginia - Timberlake Office Lynchburg | 434.237.6812 www.racva.com
Rehab Associates of Central Virginia – Hurt Office Hurt | 434.324.9750 www.racva.com
Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252 www.centrahealth.com
www.OurHealthVirginia.com
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T I P S , T I D B I T S A ND MO R E TO IN F O R M A ND ENT ERTA I N YO U
TS BACKPACK FAC
shopping for school year includes w ne e th r fo ing ar Prep se, backpacks. supplies and of cour new clothes, shoes, nt way
for ideal and convenie an e ar s ck pa ck Ba llege – to carry rgarten through co de kin m fro – ts all studen backpacks that ver, her materials. Howe their books and ot at risk for erly can put a child op pr im rn wo or y are too heav nsider: me helpful tips to co injury. Below are so
e than ould weigh no mor sh ck pa ck ba ed ad A lo ght. ent’s total body wei 10 percent of a stud
from approximately pack should extend The height of a back slightly s to waist level or the shoulder blade low be s he inc o tw above the waist.
eight is be used to ensure w Both straps should o A waist belt can als distributed evenly. t more evenly across help distribute weigh the body.
dded backing not Backpacks with pa ed comfort, but only provide increas s n from sharp edge also offer protectio d an s pencils, ruler on objects such as notebooks.
ultiple Backpacks with m compartments can help distribute weight more Source: The American evenly. iatrics Academy of Ped
ON THE WEB
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September is National Childhood Obesity Childhood Obesity Facts Month and Figures* Obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of obese children
in the U.S. between the ages of six and eleven increased from 7% in 1980 to nearly 18% in 2012.
More than 1/3 of children and adolescents are currently overweight or obese. Children and adolescents who are obese are likely to be obese as adults.
Healthy lifestyle habits, such as maintaining a proper diet and engaging in regular physical
activity, can lower the risk of
becoming obese and developing related conditions such as diabetes, high blood pressure and heart disease. *Source: www.cdc.com
CataractAwareness You Don’t Have to Live in a Fog
A cataract is a clouding of the normally clear lens of the eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window. Cataracts are diagnosed during an eye exam performed by an ophthalmologist or optometrist. Removal of cataracts is performed through an outpatient surgery procedure.
More than half of all Americans age 65 and older have cataracts.
Signs and Symptoms of Cataracts • Cloudy, fuzzy, foggy, or filmy vision • Variations in color appearance • Difficulty driving at night • Increased glare from lamps or the sun
Remember: schedule routine eye exams with an ophthalmologist or optometrist to stay on top of your eye health.
September is
Prostate Cancer Awareness Month
Ways to Reduce the Risk Although there is no proven prostate cancer prevention strategy, there are steps men can take to reduce their risk of developing the disease. Consider these healthy choices: • Maintain a low-fat diet • Increase the amount of fruits and vegetables consumed daily • Replace red meat with fish, chicken and other lean meats • Reduce intake of dairy products • Replace sodas with water and green tea • Incorporate soy into your diet • Limit consumption of alcohol • Maintain a healthy weight • Exercise most days of the week Age, gender and family history all play a role when it comes to prostate cancer. Maintaining regular appointments with a primary care physician and having necessary testing performed are important steps to take to ensure early diagnosis.
The
2014 Walk to
END Alzheimer’s® The Alzheimer’s Association Walk to End Alzheimer’s® is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. Held annually in more than 650 communities nationwide – including Richmond – this inspiring event calls on participants of all ages and abilities to reclaim the future for millions. Mark your calendars to participate in our area’s 2014 Walk to End Alzheimer’s® Event to help in the fight to end Alzheimer’s.
Martinsville Satellite Walk
For details on how to donate or register for the Martinsville or Danville event, visit http://tinyurl.com/k6xqrut For details on how to donate or register for the Lynchburg event, visit http://tinyurl.com/mkf4nqs
Danville Walk Information
For further information about any of these events, contact Jane Massie via email at jmassie@alz.org or at 434.845.8540.
Date: Saturday, September 20th Location: Jack Dalton Park Check-In: 8 am | Walk: 9 am Route Length: Two miles Date: Saturday, September 27th Location: Ballou Park Check-In: 8 am | Walk: 9 am Route Length: Two miles
Lynchburg Walk Information
Date: Saturday, October 11th Location: Wyndhurst (Tradewynd Drive) Registration: 8 am | Ceremony: 9 am Walk: 9:30 am | Route Length: Two miles
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
the
Anatomy
The Anatomy Challenge is proudly sponsored by
CHALLENGE
Here’s your chance to see how much you know about the amazing
EAR! First, find all the hidden words in the word search below. Next, match up the correct word with the part of the body in the illustration.
[ the amazing EAR ]
WORD SEARCH antihelix
earlobe
cartilage
eustachian tube temporal bone
cochlea
helix
cochlear nerve
incus
temporal muscle
concha
malleus
triangular fossa
ear canal
scapha
tympanic cavity
eardrum
semicircular canals
vestibular nerve
______________ ______________ ______________
stapes
______________ ______________
______________
______________
______________
______________
______________ ______________ ______________ ______________
______________ ______________
______________ ______________ ______________
______________ ______________
Lynchburg College | www.lynchburg.edu 1501 Lakeside Drive | Lynchburg, VA 24501 | 434.544.8100 facebook.com/lynchburgcollege
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aging the
words | LAURA NEFF-HENDERSON, APR
EAR
Experts with the Administration on Aging expect that, by 2030, there will be about 72.1 million persons 65 years or older, more than twice their number in 2000, accounting for more than 19 percent of the population and double the number of older Americans in 2000. Although grey thinning hair and deep wrinkles are two of the most commonly talked about signs of getting older, age-related hearing loss is a significant concern for many Americans. Age-related hearing loss, presbycusis, is one of the most common conditions affecting older and elderly adults. Approximately one in three people between the ages of 65 and 74 has hearing loss and nearly half of those older than 75 have difficulty hearing, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). There is no known single cause of age related hearing loss, according to the National Institutes of Health, and the damage is permanent. Having trouble hearing can make it hard to understand and follow a doctor’s advice, to respond to warnings, and to hear doorbells and alarms, says Danny W. Gnewikow, PhD, chief audiologist and founder of Audiology Hearing Aid Associates in Lynchburg and Danville.
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Hearing loss is also tied to depression and is linked to dementia. Research not only shows a connection between hearing loss and dementia, but a recent Johns Hopkins study of older adults found that hearing loss actually accelerates brain function decline, says Dr. Gnewikow.
Individuals, who think they may have a hearing problem, or answer yes to three or more of the following questions, should seek professional advice from an otolaryngologist or an audiologist.
Sam Meshkinfam, DO, with Blue Ridge Ear, Nose, and Throat in Lynchburg agrees. An increasing number of patients with dementia have hearing loss, he explains.
• Do you have trouble hearing when there is noise in the background?
Dr. Meshkinfam finds that many of his older patients report that they are embarrassed to ask others to repeat themselves and, as a result, many of them remove themselves from the world around them. “In the American culture, everything is done over dinner and people with hearing loss tend to shy away from going to dinner with family and friends because it’s an uncomfortable environment for them,” says Dr. Meshkinfam. “While everyone else is laughing at a joke, they didn’t hear and don’t understand. It sort of takes the joy out of life.”
Symptoms Early signs of hearing loss include difficulty understanding certain speech sounds when in the presence of background noise, consistently turning the television to a higher level than other people in the same listening environment, ringing or buzzing in the ear (tinnitus), and the tendency for an individual to ask people to repeat themselves often.
Causes The onset of age-related hearing loss begins to affect most people in their early 60’s, though it can be seen earlier, particularly if there is a genetic predisposition in the family. Many patients begin to seek medical treatment in their 40’s, says Dr. Meshkinfam. Individuals who listen to extremely loud music and/or work in certain professions where they are exposed to loud noise for prolong periods of time (factory workers, musicians, construction workers, farmers, chefs, musicians, airport workers, yard and tree care workers, and people in the armed forces) are especially susceptible for sensorineural hearing loss.
• Do you have a problem hearing on the phone?
• Is it hard to follow a conversation when more than one person is talking at the same time? • Do you have to strain to understand a conversation? • Do people seem to be mumbling when they talk to you? • Do you misunderstand what others are saying? • Do you ask people to repeat themselves often? • Do people complain that you turn the television volume up too high? Prolonged exposure to loud noise destroys nerve endings (hair cells), which results in permanent hearing loss. Hearing loss can also be caused by viral or bacterial infections, cardiovascular problems, head injuries, tumors, and certain medications. Other medical issues including diabetes, heart disease, and multiple sclerosis can also have a significant impact on hearing, explains Dr. Gnewikow.
Danny W. Gnewikow, PhD, is chief audiologist and founder of Audiology Hearing Aid Associates in Lynchburg and Danville.
More obvious cases of hearing loss include Sam Meshkinfam, DO, is a physician earwax buildup, an with Blue Ridge Ear, Nose, and Throat in Lynchburg. object in the ear, injury to the ear or head, ear infection, a ruptured eardrum, and other conditions that affect the middle or inner ear.
Getting Help As with most health conditions, early intervention is the key to a positive prognosis. In fact, it’s critical to slowing down the rate at which the patient is losing hearing, according to Dr. Meshkinfam. www.OurHealthVirginia.com
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“We all will lose our hearing as we age, but it’s the rate at which we lose our hearing that we can affect,” says Dr. Meshkinfam. “Reducing loud noise exposure and wearing hearing aids when we do have hearing loss – those are things you can definitely do to slow down the progression of hearing loss.”
The Experts Several different types of professionals are available to help with hearing loss. Each has a different type of training and expertise. A hearing instrument specialist is a state-licensed professional salesperson who is trained to perform hearing tests, take measurements of the ear canal, fit hearing aids, program hearing aids, and make routine repairs. The hearing instrument specialist is not licensed to diagnose or treat any medical illness, and is required by state law to recommend a medical examination by a physician prior to selling a hearing aid. An audiologist is a hearing professional who is trained not only to manage hearing aids but also to perform more detailed examinations of the hearing using sophisticated electronic equipment. The audiologist is also trained to evaluate and test the balance system. All audiologists have a college degree and at least a master’s degree plus one year of clinical training. Recent graduates now complete a four year doctoral program after college. An otolaryngologist, also known as an ear, nose, and throat specialist, is a medical doctor and surgeon trained to provide comprehensive care of the ears nose and throat, including the hearing. The otolaryngologist is the most highly trained physician for diagnosing and treating hearing loss and is the only physician trained to perform surgery in the ear. Many patients with ear complaints, hearing loss or ringing in the ears will be referred to an otolaryngologist for initial evaluation and treatment planning. Most otolaryngologists employ or collaborate with hearing instrument specialists or audiologists to provide the diagnostic testing and programming of hearing aids.
The Occupational Safety & Health Administration (OSHA) now requires employers to provide hearing exams and hearing protection to employees who work in environments with sustained high levels of noise. In addition to wearing ear protection in noisy environments, one of the most effective ways to mitigate the effects of hearing loss is the use of hearing aids. For most people, hearing aids are a good option, according to Dr. Meshkinfam. Medical professionals can tell pretty quickly via a simple hearing test, also known as an audiogram, whether that’s the case, he explains.
Treatment Options Because there is no cure for age related hearing loss caused by nerve damage, treatment is focused on improving everyday function, and reducing some of the risks associated with hearing loss. The first line of treatment for hearing loss should be a medical evaluation to determine whether or not the hearing impairment can be easily resolved through medical intervention, according to Dr. Gnewikow. One of the most common options for patients with hearing loss caused by nerve damage to the inner ear is hearing aids. In addition to making it hard to hear, sensorineural hearing loss frequently causes distortion of the sounds that the person does hear. Hearing aids can improve speech understanding by selectively amplifying the frequencies that have been damaged resulting in significantly improved speech quality. Today’s hearing aids which utilize directional microphones, multiple adjustable frequency bands, compression for unwanted loud sounds, Bluetooth connectivity, and other advances have improved the effectiveness of hearing aids in optimizing the useable hearing of patients with hearing impairment, explains Dr. Gnewikow. Additionally, advancements in telephone technology utilizing Bluetooth landline and cellphone adaptability to hearing aids have offered an improved approach to improving telephone communication for the hearing impaired. Many local specialists allow patients to evaluate the effectiveness of hearing aids through a trial period, before they actually purchase them. Patients have to be seen regularly for fittings and cleanings. In recent years, hearing aid technology
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has improved significantly and patients are now able to control a variety of settings that maximize hearing potential. The most basic models begin at about $1,000 for a pair, with the more advanced options topping out at $7,000. They do generally have to be replaced every three to five years; however, some patients are able to wear them for much longer before buying a new pair. While hearing aids are believed to be one of the most effective ways of treating age related hearing loss, there are other options available to people. For individuals with profound hearing loss, for whom hearing aids offer no significant benefit, cochlear implants are an option. Cochlear implants are small electronic devices surgically implanted in the inner ear.
• Inattentiveness
Warning Signs of Hearing Loss in Adults
• Buzzing or ringing in their ears • Failure to respond to spoken words • Persistent ear discomfort after exposure to loud noise (regular and constant listening to electronics at high volumes) • Muffled hearing • Constant frustration hearing speech and other sounds • Avoiding conversation • Social isolation • Depression
Dr. Meshkinfam warns though that the implantation surgery is the very beginning, and often the easiest part, of learning to live with, and maximize, cochlear implants. Patients often undergo years of programming sessions and therapy following the surgery. Assistive listening devices can also help those with hearing loss. Some of these devices include telephone and cell phone amplifiers, smart phones or tablet “apps,” and closed circuit systems in large venues, including places of worship, theaters, and auditoriums. Friends and family can also help by making minor accommodations to make the situation most ideal for the hearing impaired person. To help those with hearing loss, friends and family can speak louder, without shouting and should talk directly to the person with the hearing impairment. One of the most common ways that people cope with hearing loss is by learning to read lips and body movement to piece together pieces of the conversation they are unable to hear. It’s nearly impossible for a person with a hearing impairment of any level to understand what’s been said when the speaker talks as they are walking away. People should also be willing to repeat themselves instead of saying “never mind” when the person doesn’t hear them or understand. It’s also a good idea to turn off the television and/or radio and move away from any other background noise when possible. Avoid sitting near the kitchen at a restaurant or near a band www.OurHealthVirginia.com
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The Cardiovascular Connection
playing music at an event. Even without a hearing loss, background noise makes it hard to hear people talk.
Recent research reveals a strong connection between hearing loss and cardiovascular health. Studies have shown that a healthy cardiovascular system—a person’s heart, arteries, and veins—has a positive effect on hearing. Experts believe that because the inner ear is extremely sensitive to blood flow, it is sometimes the first area of the body to respond to abnormalities in the cardiovascular system. In one study published in “The Laryngoscope,” researchers found that patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered.
The world of hearing loss can be scary, especially because it typically comes on so gradually, according to Dr. Meshkinfam.
The Prognosis
He urges people who are suffering with hearing loss who may have gotten to a point where they feel there’s no hope to seek medical treatment. There are many good options for people who will see an almost immediate improvement in their quality of life by taking advantage of the medical advancements made in recent years.
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SCHOOL
TIMES
words |MICHELLE STEPHENSON
Thankfully, schools provide parents with a list of supplies needed for the new school year, but left off that list are steps to ensure a child’s good health. That’s where OurHealth comes in. This step-by-step resource provides parents with valuable physical, emotional and social information to consider, as well as tips from local healthcare and healthcare-related providers from Lynchburg and Southside to help your children make healthy choices all year long.
The First Alarm If you haven’t already done so, this is the perfect time to schedule your child’s check-up or sports physical. These appointments are a great way to ensure that your child is up-to-date on immunizations and is ready to start school. Also, if your child suffers from allergies, asthma, diabetes, or other chronic conditions, make sure to refill all medications so you can check them in with the school nurse before the first day. You may also want to schedule an eye exam so that new glasses and contacts can be ordered and delivered before the first day of school.
Reprints To order reprints of the original artwork featured on this issue’s cover, contact Jenny Hungate at 540.387.6482 or via email at jenny@ourhealthvirginia.com. To view additional work by our artist, Joe Palotas, visit www.salemartcenter.com
Pre-participation physicals are critical to detecting vulnerabilities whether cardiac, joint or otherwise which may need further evaluation prior to safe play.
Receiving immunizations is a simple way to protect yourself and loved ones from deadly diseases.
— Andrew Pieleck, DO, Centra Medical Group Orthopaedic, Rehabilitation & Sports Medicine Center, Bedford
— Kimberly DeVolld, MD, Centra Medical Group - Altavista
A week or two before the start of school is also a good time to encourage your children to move from their summer schedule, or lack thereof, to a more structured schedule. One of the most difficult transitions can be moving to an earlier bedtime. A commonly used way is to move children’s bedtime back 15 minutes each night or every other night until they are back on their school-year schedule. For younger children, it can be helpful to write down their morning routine and how long each task should take. They can even start practicing the morning routine before the first day. This helps children become more independent and can free up parents who are trying to get ready for work or get other children ready for school or daycare.
“Routine dental exams and attentive oral hygiene are important for children’s overall systemic health; consistent care improves their quality of life by increasing self esteem and decreasing missed days of school due to toothaches.” — Brad Lentz, DMD, Lynchburg Dental Center
Wake Up! The key to a successful and stress-free morning is to plan ahead. Check the weather on school nights and lay out appropriate clothes for the weather and temperature. Make sure children pack up their backpacks at night, and start thinking about breakfast. Possibly the single most important thing your child can do in the morning is to eat breakfast. Eating breakfast has been associated with better memory, test scores, and attention span, as well as decreased irritability, healthier body weights, and improved overall nutrition. Many families choose to skip breakfast because they don’t have time in the morning. Quick fixes include cereal or a bagel with low-fat cream cheese. Another solution is to make breakfast the night before. For example, hard boil eggs and cut up fruit are ideal options. If there is simply no time to eat breakfast at home, be sure to ask what breakfast options are available at your child’s school or daycare provider, or pack a breakfast for the bus or car ride to school. Good options include fresh fruit, high-fiber unsweetened cereal, nuts, reduced-fat cheese, peanut butter, bagels, pretzels, low-fat granola bars, dried fruit, rice cakes, whole-grain crackers, and cut veggies.
Brushing your teeth frequently and properly while in braces can be challenging, but it is extremely important to prevent permanent white spots from forming around the braces, as well as tooth decay and gum problems. — Dr. Keith Pyle, Orthodontist, Children’s Dentistry & Orthodontics of Lynchburg
Before leaving the house, make sure your child has a jacket and athletic shoes for physical education. But always make sure tat his or her backpack is not overstuffed. Many children suffer from back pain because they are lugging around too many books and supplies. Physicians and physical therapists recommend that backpacks should not be heavier than 10 percent of a child’s body weight. Also, make sure that your child wears the backpack with both straps in place, rather than over just one shoulder. Children who wear a backpack incorrectly typically lean to one side to offset the extra weight. This can cause back pain as well as shoulder and neck strain.
“By encouraging toothbrushing and flossing, and visiting the dentist routinely, at an early age, you will insure healthy habits for your child’s lifetime. — Summer A. Sawyer, DMD Children’s Dental Health of Lynchburg
Overstuffed backpacks are not the only cause of back pain in children. Poor posture is also a contributor, so encourage your children to sit or stand up straight. Establishing good posture during childhood may prevent back issues later in life.
Adolescents should protect the health of their back by ensuring their backpacks never weigh more than 10-15 percent of their body weight, and are properly fitted to rest f lat against the mid-back. — Jessica Holder, PT, DPT, OCS, Centra Rehabilitation Jamerson Family YMCA, Lynchburg
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Do You Know the Rules for Motorists & School Bus Safety? tt TWO LANE: When approaching a school bus with flashing signals and/or extended stop sign on a public or private road, vehicles traveling in both directions must stop
At the Bus Stop Even if your children have been riding the school bus for years, it’s a good idea to revisit bus safety every year before the start of school: • Wait for the bus to come to a complete stop before approaching it. • If there are seatbelts, buckle up. • Stay seated at all times to avoid injury if the driver has to stop or swerve suddenly.
tt MULTI-LANE Paved Across: When approaching a school bus with flashing signals and/or extended stop sign on a public or private road, vehicles traveling in both directions must stop
DIVIDED HIGHWAY unpaved space u (min 5ft.) OR any raised median/ physical barrier: When approaching a school bus with flashing signals and/or extended stop sign on a public or private road, vehicles behind bus MUST stop. Vehicles traveling in the opposite direction proceed with caution.
• If your child has to cross the street to enter or exit the bus, he or she should cross at least 10 feet in front of the bus and look both ways before crossing. Don’t just assume that all drivers will stop. If you have teenagers who are driving to school, remind them to wear their seatbelts, and when it comes to passengers, the fewer, the better. Virginia law says that teenagers who are under 18 and turned 17 after July 1, 2013 may only carry one passenger under age 21, unless accompanied by a licensed parent or other adult acting in place of a parent in the front passenger seat. However, if a teen has had his or her license for a year, he or she may carry up to three passengers under the age of 21 to and from a school-sponsored event. Encourage teens to minimize distractions: phones and other electronic devices, as well as eating and drinking, should not be allowed while driving.
The First Bell In addition to academics, children experience significant social-emotional learning opportunities at school, particularly in their classroom community. Through work and play, they will be building friendships for the school year and beyond. Talk with your children about the importance of being nice to others and developing strong bonds with classmates. Extra steps may be necessary to help quieter children foster connections. Encouraging them to join youth organizations or sports teams creates an opportunity for building friendships.
These friendships can be great buffers when bad things do happen at school. Responding appropriately to classroom challenges with friends and other peers is important. Talk to your children about the importance of reporting bullying to you and a trusted adult at school if it does occur. Learn the differences between bullying and other forms of aggression so you can help your children learn the differences and respond best to each. Some boys and girls both engage in bullying behaviors towards others and become the target of bullying behaviors. These children are at a much higher risk for disengaging in school and for other negative academic, social, mental, and physical health outcomes. Help your children learn appropriate ways to meet their needs and engage with other students effectively. Returning to school in the fall is for some teens exciting and for others
There are three types of bullying: • Physical: hitting, kicking, pushing, etc.
a transition from the sweet summer
• Verbal: threatening, taunting, name-calling
respite from educational and social
• Social: excluding peers from activities or starting rumors about them.
pressures to the returning torment
(Cyber bullying is often classified as verbal, social, or both verbal and social.)
of anxiety and bullying
— Karen Rice, LCSW, Clinical Supervisor, Outpatient Services at Virginia Home for Boys and Girls
If you find out that your child is engaging in bullying behavior, take it seriously. Get his or her perspective on the event, suggest alternative ways to have needs or desires met, and be clear that bullying behavior is never an acceptable strategy. Use logical consequences, linking the consequence to the aggression when possible. Use nonphysical discipline and remain consistent in your expectations. Model the behaviors you want your child to exhibit at home and at school.
Bullying behavior should never be tolerated; however, it’s important to separate the child from the behavior. Most children who display bullying behavior have been the target of bullying or other forms of abuse themselves.
— Mary-Lib Morgan, Bullying and Youth Violence Prevention Coordinator, Department of Prevention and Health Promotion, Virginia Department of Health
The Mid-Morning Stretch Physical education class is a very important part of a student’s schedule. With childhood obesity issues at an all-time high, physical activity, along with a balanced and nutritious diet, are essential to maintaining a healthy weight during the early stages of life. On days that your child has gym, make sure that he or she is wearing comfortable clothes and shoes that fit well and have good support. Physical activity is a key component of a healthy lifestyle and should begin in early childhood. In addition to the health benefits, it promotes psychological well-being, increases self-esteem and capacity for learning, and helps children and adolescents cope with stress. Higher-intensity physical activity generally provides more benefits than moderate-intensity physical activity, but any activity is better than none. The U.S. Department of Health and Human Services and the U.S. Department of Agriculture’s Dietary Guidelines for Americans recommends that children and adolescents engage in at least 60 minutes of moderate to vigorous physical activity on most days of the week, preferably daily. 32
OurHealth | The Resource for Healthy Living in Lynchburg and Southside
The Lunch Whistle If your child buys lunch at one of our local schools, there is typically a good variety of food offerings in appropriate portions. However, if your child usually brings a lunch from home, there are a few keys to making sure that he or she has a healthy lunch.
Childhood obesity continues to sky rocket in our nation. We can help prevent child hood obesity by getting children to exercise for at least an hour a day. The exercises should be fun for children like playing kick-ball and riding a bike etc. This generation tends to spends more time watching TV and playing video games. As parents we need to limit the TV time and set good examples by being active parents. — Kathy Thomas, Fitness Director, Downtown YMCA, Lynchburg
First, avoid caffeinated soda and energy drinks. Research has shown that caffeine increases blood pressure and decreases heart rate in people of all ages. The American Academy of Pediatrics maintains the position that stimulant-containing energy drinks have no place in the diets of children and adolescents. Additionally, make sure to pack a variety of healthy foods. Children between the ages of four and eight should eat/drink the following daily: • 1.5 cups of fruit • 4 to 5 ounces of grains • 2 cups of milk • 1.5 cups of vegetables
• 3 to 4 ounces of meat and beans
• 4 tsp of oils
Girls between the ages of nine and 13 should consume: • 1.5 cups of fruit • 5 ounces of grains • 3 cups of milk • 2 cups of vegetables
• 5 ounces of meat and beans
• 5 tsp of oils
Boys between the ages of nine and 13 should consume: • 1.5 cups of fruit • 6 ounces of grains • 3 cups of milk • 2.5 cups of vegetables
• 5 ounces of meat and beans
• 5 tsp of oils
Girls between the ages of 14 and 18 should consume: • 1.5 cups of fruit • 6 ounces of grains
• 3 cups of milk
• 2.5 cups of vegetables
• 5 tsp of oils
• 5 ounces of meat and beans
Boys between the ages of 14 and 18 should consume: • 2 cups of fruit • 7 ounces of grains
• 3 cups of milk
• 3 cups of vegetables
• 6 tsp of oils
• 6 ounces of meat and beans
This equates to 1,000 calories per day for children aged 2 to 3 years, 1,400 calories a day for children aged 4 to 8, 1,600 calories for girls aged 9 to 13, 1,800 calories for boys aged 9 to 13 and for girls aged 14 to 18, and 2,200 calories for boys aged 14 to 18. It is important to note that active children may require more calories. To keep caloric intake in check, encourage your child to eat slowly. People who eat quickly typically take longer to feel full, and they often have no idea how much they have actually eaten. Children need to eat slowly enough to give their brain the chance to recognize that they have eaten enough to no longer feel hungry. Slowing down and chewing food more thoroughly also makes food more enjoyable.
Pack a nutritional punch in your child’s school lunch with low fat proteins that will help keep your child full throughout the day.
— Ashley Cappel, RD, Healthy Lifestyles Center, Children's Hospital of Richmond
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
A healthy lunch can help your child perform at their highest level. — Beth Mears, RN, School Nurse, Timberlake Christian Schools
Children should be encouraged to drink plenty of water. Half of kids’ body weight is made up of water, so water is required to keep bodily systems functioning properly. It’s a good idea to offer water throughout the day and not just when they are thirsty. Children should be encouraged to drink more than usual when it’s hot or when they are taking part in physical activity. Fruits and vegetables are also excellent sources of water.
School’s out! Many Lynchburg and Southside families have two working parents, so after-school care can be a challenge. There is no hard and fast rule on when children are old enough to be left home alone after school, and children mature at very different rates, so parents need to make this call. One consideration may be how long the child will be home alone before a parent or older sibling arrives home. As a rule of thumb, most children are not able to handle stressful or emergency situations until they are about 11 or 12 years old. If you are considering leaving your child alone for a few hours after school, make sure that he or she is prepared for knocks on the door, emergency situations, and injuries. The YMCA of Central Virginia and the Danville Family YMCA offer babysitting courses that can help prepare children to stay home alone. How do you know if your child is ready? Consider the following: • A child who is home alone needs to know his or her full name, address, and phone number as well as how to reach you. You might consider having him or her call you once inside the house each day so that you will know that he or she has arrived home safely. Children also appreciate the security of knowing that they will be able to talk to you when they get home from school. • Establish a routine so that he or she knows what to do during the time he or she is alone. Do you expect that homework and/or chores will be done before you arrive home? • Make sure your child knows how to lock the door when he or she arrives home and that it should be kept locked. • Is there a neighbor nearby that he or she could check in with if needed?
Start the school year off right by establishing a consistent routine after school for homework. — Beth Mears, RN, School Nurse, Timberlake Christian Schools
Lunchtime offers an important opportunity for your child to eat nutrition-packed-foods that will help get them through the day, when your child will need energy to concentrate and focus on their school curriculum. — Nickie Lang, RD, Clinical Dietitian, Centra
• Does your child know never to enter your home if a door or window is open or broken? • Explain what to do if someone knocks on the door (tell the person knocking that you are busy and are unable to come to the door, not that you are not home). Whether a parent is home or not, make sure to have healthy snacks on hand in the afternoon, and make sure your child has a designated homework space. This space should be quiet and distraction-free with comfortable seating and good lighting.
Family Time Family time on school nights typically revolves around preparing and eating dinner, although many families are unable to have meals as a family due to children’s extracurricular activities or parents’ job schedules. Even though it can be challenging, try to have as many meals together as a family as possible. During family meals, turn the TV off, and don’t allow electronics at the table. In addition to the relationship benefits of family meals, research has shown children eat more fruits and vegetables and fewer fried foods and sugary drinks when they eat with the entire family. For tips on healthy eating and family meal planning, visit Live Healthy Lynchburg at www.livehealthylynchburg.com
Wind Down While some children focus best on homework right after school, other children are better able to focus after dinner. Some parents choose a specific time for children to start homework (by 4 pm), while others give guidelines (no video games or TV watching until homework is complete). After dinner is also a great time for families to read together. This can further nurture your child’s love of reading and help him or her wind down for bedtime. The importance of sleep cannot be overstated. Well-rested children are more focused, and poor sleep habits can also increase the risk of obesity. According to the Centers for Disease Control and Prevention, school-aged children require
Children between the ages of 2 and 11 need a minimum of 10 hours of sleep in order to be able to learn effectively in school. The proper amount of good quality sleep is so crucial for growing children. — George Morcom, RPSGT, RST, CRT, Sleep Center Manager, Centra Sleep Disorders Center, Virginia Baptist Hospital
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
Keep your retainers somewhere visible either by your toothbrush or beside your bed so you will remember to wear them at night. — Eric Baugher, DMD, MS, Central Virginia Orthodontics
at least 10 hours of sleep each night, and teens require 9 to 10 hours a night.
24/7 Be Aware In addition to bullying, children can also be introduced to drugs, alcohol, violence, and sex at school. Unfortunately, although safer than most, Lynchburg and Southside schools are no exception. Most parents of teenagers are concerned about the use of tobacco, alcohol, and drugs in this student population, because there is tremendous peer pressure to experiment with these substances during high school, and even middle school. Parents should take steps to ensure that teens are aware of the dangers involved with their use. For example, smoking often becomes more than a high school habit. In fact, it can turn into a lifelong addiction that can be extremely difficult to break. When talking to your teen about smoking, emphasize the more undesirable effects, including bad breath, stained teeth, wrinkles, a longterm cough, and decreased athletic performance. Other forms of tobacco, such as chew or snuff, can also lead to nicotine addiction and cause the same health problems as smoking cigarettes, with the addition of mouth sores. Alcohol is the most socially accepted drug in our society, and even small amounts can impair judgment and provoke risky and violent behavior. Drinking can also slow reaction time, and many teenagers are unaware that alcohol use can have deadly consequences. Inform your teen that alcohol-related car crashes are the leading cause of death for those aged 15 to 24 years. www.OurHealthVirginia.com
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“Research shows that alcohol and drugs are primary risk factors that can lead to truancy and other school performance issues, as well as crime. The Partnership for the Prevention of Substance Abuse works to teach children and teens the necessary skills to build a better future.” For more information on this and other programs in the Lynchburg area, visit Presbyterian Homes and Family Services at www.phfs.org
Another concern of parents is teenage sex. Even more concerning is unprotected teenage sex. Encourage abstinence, and encourage your teen to avoid situations that can lead to sexual activity. Choosing not to use alcohol or drugs can help your teen make clearer choices about sex. If you know that your teen is having sex, it is important for him or her to know the facts about birth control and sexually transmitted diseases. Encourage the use of condoms; however, remind them that only abstinence is 100% effective in preventing disease and pregnancy. Although Lynchburg and Southside elementary, middle- and high- schools have not seen a major act of violence, such as a deadly school shooting, students have occasionally been known to fight and to bring weapons to school. While it is difficult to pinpoint exactly which children will engage in violence at school, there are some risk factors: • A prior history of violence • Drug and/or alcohol abuse • Association with delinquent peers • Poor family functioning • Poor grades in school • Poverty in the community. The keys to a successful school year are encouraging your children to make healthy choices and maintaining open communication with them. A little planning can ease the transition back and can provide a stress-free first day for kids and parents alike.
Sources: www.aap.org www.cdc.gov www.dmv.virginia.gov www.healthychildren.org www.kidshealth.org www.pediatriccareonline.org
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AFTER LIFE SERVICES
COMPREHENSIVE REHAB (INPATIENT)
GOLD
Tharp Funeral Home
GOLD
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The Summit Health & Rehabilitation Center 1300 Enterprise Drive | Lynchburg, VA 24502 434.845.6045 | www.centrahealth.com
SILVER
Diuguid Funeral Service & Crematory
SILVER
811 Wiggington Road | Lynchburg, VA 24502 434.385.8900 | www.diuguidfuneralservice.com
Westminster Canterbury
501 VES Road | Lynchburg, VA 24503 800.962.3520 | www.wclynchburg.org
BRONZE
Norris Funeral Services and Crematory
3995 Franklin Turnpike | Danville, VA 24540 434.822.0550 | www.norrisfuneral.com
ASSISTED LIVING GOLD
Heritage Green Assisted Living Communities 200 Lillian Lane | Lynchburg, VA 24502 800.362.1763 | www.heritagegreenal.com SILVER
Valley View Retirement Community
1213 Long Meadows Drive | Lynchburg, VA 24502 434.237.3009 | www.valleyviewretirement.com BRONZE (TIE)
BEAUTY SALON GOLD
Future Images by Sharon
18013 Forest Road | Forest, VA 24551 434.385.4247 SILVER
London Hair Company
3412 Waterlick Road, Suite H | Lynchburg, VA 24502 434.237.1166 BRONZE
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701 Church Street | Lynchburg, VA 24504 434.846.2232 | www.anthonyandcompanysalon.com
The Summit Assisted Living
1400 Enterprise Drive | Lynchburg, VA 24502 434.582.1500 | www.summitlynchburg.com
Bentley Commons at Lynchburg
1604 Graves Mill Road | Lynchburg, VA 24502 434.485.0482 | www.kapdev.com
BARBER GOLD
Strands Salon
101 Northwynd Circle | Lynchburg, VA 24502 434.455.2160 SILVER
Timberlake Barber Shop
3311 Waterlick Road | Lynchburg, VA 24502 434.237.2112 BRONZE
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2225 Lakeside Drive | Lynchburg, VA 24501 434.385.5110
COFFEE HOUSE GOLD
Father’s Table Bakery and Café
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The Muse Coffee Company
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Lynchburg Health & Rehab
5615 Seminole Avenue | Lynchburg, VA 24502 434.239.2657 | www.lynchburghealthrehab.com
COMPREHENSIVE REHAB (OUTPATIENT) GOLD
Rehab Associates of Central Virginia
44 Clifton Street | Lynchburg, VA 24502 434.528.1848 | www.racv.hostcentric.com SILVER
Orthopedic Center of Central Virginia
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Danville Orthopedic & Athletic Rehab 174 Executive Drive | Danville, VA 24541 434.797.1504 | www.doarpt.com
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COMPANION CARE GOLD
Home Instead Senior Care
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Generation Solutions
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Heavenly Hands
1607 Wards Ferry Road | Lynchburg, VA 24502 434.851.3367
42
BRONZE (TIE)
Medical Care Center
OurHealth | The Resource for Healthy Living in Lynchburg and Southside
COUNTRY CLUB GOLD
Boonsboro County Club
1709 Boonsboro Country Club Drive Lynchburg, VA 24503 | 434.384.2111 www.boonsborocountryclub.com SILVER
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701 Golf Club Road | Danville, VA 24540 434.724.1387 | www.tuscaroracountryclub.net BRONZE
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3409 Rivermount Avenue | Lynchburg, VA 24503 434.384.8181 | www.oakwoodcc.net
ELDER LAW GOLD
Ron Feinman, Esq.
801 Main Street, Suite 702 | Lynchburg, VA 24504 434.528.0696 | www.ronfeinman.com
GERIATRIC CARE GOLD
Joel T. Hodges, MD
2216 Landover Place | Lynchburg, VA 24501 434.947.3944
SILVER
John Olmsted III, MD
Centra – Rehabilitation and Geriatric Specialists 3300 Rivermont Avenue | Lynchburg, VA 24503 434.384.1581 BRONZE
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SILVER
Susan Oliver
502 Wyndhurst Drive | Lynchburg, VA 24502 434.832.1332
3300 Rivermont Avenue | Lynchburg, VA 24503 434.947.5999
BRONZE
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The Estate and Elder Law Center of Southside Virginia, PLLC 641 Main Street | Danville, VA 24541 855.503.5337 | www.vaelderlaw.com
FITNESS CENTERS GOLD
Jamerson Family YMCA
801 Wyndhurst Drive | Lynchburg, VA 24502 434.582.1900 | www.lynchburgymca.org SILVER
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Curves
20722 Timberlake Road and 2842 Linkhorne Drive Lynchburg, VA 24503 | 434.237.7907 | www.curves.com
FLORIST GOLD
Arthur’s Flower Cart
8125 Timberlake Road | Lynchburg, VA 24502 434.239.2629 | www.arthursflowercartoflynchburg.com SILVER
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2134 Langhorne Road | Lynchburg, VA 24501 434.846.6581 | www.doylesflorist.com BRONZE
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3261 Fort Avenue | Lynchburg, VA 24501 434.846.6494 | www.kathrynsflowerandgiftshop.com www.OurHealthVirginia.com
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GOLF COURSE GOLD
Boonsboro County Club
1709 BCC Drive | Lynchburg, VA 24503 434.384.2111 | www.boonsborocountryclub.com SILVER
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1148 Ivy Hill Drive | Forest, VA 24551 434.525.2680 | www.ivyhillgc.com
GROCERY STORE GOLD
Kroger
4 locations in Lynchburg | Visit www.kroger.com for addresses and phone numbers SILVER
Fresh Market
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7 Chambers Street | Danville, VA 24541 434.793.8211
HOME HEALTH GOLD
Interim Healthcare
517 Leesville Road | Lynchburg, VA 24502 434.832.7460 | www.interimhealthcare.com SILVER
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2808 Old Forest Road | Lynchburg, VA 24501 434.384.2800 | www.firstcare.biz BRONZE (TIE)
Generation Solutions
1032 Claymont Drive | Lynchburg, VA 24502 434.455.6500 | www.generationsolutions.net
Centra Home Health
1920 Atherholt Road | Lynchburg, VA 24501 434.200.4111 | www.centrahealth.com
HOSPICE GOLD
Gentle Shepherd Hospice
22667 Timberlake Road | Lynchburg, VA 24502 434.237.7669 | www.gentleshepherdhospice.com SILVER
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SILVER
Fink’s Jewelers
Thomas Jefferson Crossing | 16960 Forest Road Forest, VA 24551 | 434.237.6301 | www.finks.com BRONZE
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111 North Bridge Street | Bedford, VA 24523 540.586.8034 | www.arthursjewelry.com
2250 Murrell Road, Building B, Unit 2 Lynchburg, VA 24501 | 434.847.6400 www.sevenhillshh.com
LAWN CARE GOLD
BRONZE
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2097 Langhorne Road | Lynchburg, VA 24501 434.200.3204 | www.centrahealth.com/hospice
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2707 Mayflower Drive | Lynchburg, VA 24501 434.525.7801 | www.apluslawncare.com SILVER
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Valley View Retirement Community
1213 Long Meadows Drive | Lynchburg, VA 24502 434.237.3009 | www.valleyviewretirement.com SILVER
The Summit
1400 Enterprise Drive | Lynchburg, VA 24502 434.582.1500 | www.summitlynchburg.com BRONZE
Heritage Green Assisted Living Communities 200 Lillian Lane | Lynchburg, VA 24502 434.385.5102 | www.heritagegreenal.com
Southern Landscape Group
192 Miles Lane | Evington, VA 24550 434.821.6004 | www.soscapes.com BRONZE
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434.444.4279 www.andersonandandersonlandscaping.com
MEDICAL EQUIPMENT GOLD
GME Medical Supply
2300 Bedford Avenue | Lynchburg, VA 24503 434.528.3765 | www.gmemedical.com SILVER
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Andy Matthews Agency
4069 Waterlick Road | Forest, VA 24551 434.534.9004 | www.andymathewsagency.com SILVER
Lincare
1200 Fenwick Drive | Lynchburg, VA 24502 434.237.3712 | www.lincare.com BRONZE
Commonwealth Home Healthcare 479 Piney Forest Road | Danville, VA 434.797.2332
Allen Dukes – AXA Advisors
121 Goldenrod Place | Lynchburg, VA 24502 434.832.0012 | www.goldenrod.myaxa-advisors.com
MEDICAL SUPPLIES GOLD
BRONZE
Lincare
State Farm
Francisco Mayo | 3813 Wards Road, suite F Lynchburg, VA 24502 | 434.847.1249 www.franciscomayo.com
1200 Fenwick Drive | Lynchburg, VA 24502 434.237.3712 | www.lincare.com SILVER
Roberts Home Medical
JEWELER GOLD
Bowen Jewelry Company
829 Main Street | Lynchburg, VA 24504 434.845.3495 | www.bowenjewelry.com
2010 Tate Springs Road | Lynchburg, VA 24501 434.846.5381 | www.robertshomemedical.com BRONZE
GME Medical Supply
2300 Bedford Avenue | Lynchburg, VA 24503 434.528.3765 | www.gmemedical.com
PHARMACY
MEMORY CARE GOLD
Heritage Green
200 Lillian Lane | Lynchburg, VA 24502 434.385.5102 | www.heritagegreenal.com SILVER
Runk and Pratt of Forest
GOLD
Kroger Pharmacy
4 locations in Lynchburg | Visit www.kroger.com/ pharmacy for addresses and phone numbers
SILVER
Gretna Drug
108 Vaden Drive | Gretna, VA 24557 434.656.1251 | www.gretnadrug.com BRONZE
Rustburg Family Pharmacy
925 Village Highway | Rustburg, VA 24588 434.332.1730 | www.rustburgpharmacy.com
208 Gristmill Drive | Forest, VA 24551 434.385.8506 | www.runkandpratt.com/facilities/forest BRONZE
Carriage Hill
1203 Roundtree Drive | Bedford, VA 24523 540.586.5982 | www.carriagehillretirement.com
NURSING HOME GOLD
Westminster Canterbury
501 VES Road | Lynchburg, VA 24503 800.962.3520 | www.wclynchburg.org SILVER
The Summit Health & Rehabilitation Center 1300 Enterprise Drive | Lynchburg, VA 24502 434.845.6045 | www.centrahealth.com BRONZE (TIE)
Avante at Lynchburg
2081 Langhorne Road | Lynchburg, VA 24501 434.846.8437 | www.avantecenters.com
Lynchburg Health & Rehab
5615 Seminole Avenue | Lynchburg, VA 24502 434.239.2657 | www.lynchburghealthrehab.com
PALLIATIVE CARE GOLD
Gentle Shepherd Hospice
22667 Timberlake Road | Lynchburg, VA 24502 434.846.6270 | www.gentleshepherdhospice.com SILVER
Centra Health
1920 Atherholt Road | Lynchburg, VA 24501 434.200.6085 | www.centrahealth.com BRONZE
Seven Hills Home Health
2250 Murrell Road, Building B, Unit 2 Lynchburg, VA 24501 | 434.847.6400 www.sevenhillshh.com
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PLACE OF WORSHIP GOLD
Thomas Road Baptist Church
1 Mountain View Road | Lynchburg, VA 24502 434.239.9281 | www.trbc.org SILVER
Brentwood Church
1971 English Tavern Road | Lynchburg, VA 24501 434.821.3044 | www.brentwoodchurch.org BRONZE
Heritage Baptist Church
219 Breezewood Drive | Lynchburg, VA 24502 434.237.6505 | www.hbclynchburg.com
POST ACUTE REHABILITATION SERVICES GOLD
Medical Care Center
2200 Landover Place | Lynchburg, VA 24501 434. 846.4626 | www.heartland-manorcare.com SILVER
Lynchburg Health & Rehab
5615 Seminole Avenue | Lynchburg, VA 24502 434.239.2657 | www.lynchburghealthrehab.com BRONZE
Stanleytown Health & Rehabilitation Center 240 Riverside Drive | Bassett, VA 24055 276.629.1772 | www.stanleytownrehab.com
RESTAURANTS GOLD
The Neighbors Place
104 Paulette Circle | Lynchburg, VA 24502 434.455.4300 | www.theneighborsplace.com
SILVER
4327 Boonsboro Road | Lynchburg, VA 24503 434.384.3400 | www.milanosoflynchburg.com BRONZE
Country Kitchen
2326 Lakeside Drive | Lynchburg, VA 24501 434.385.5032 | www.countrykitchenrestaurants.com
SENIOR CENTERS GOLD
Templeton Senior Center
225 Wiggington Road | Lynchburg, VA 24502 434.455.4000 | www.lynchburgva.gov SILVER
Centra PACE
1901 Tate Springs Road | Lynchburg, VA 24501 434.200.3000 | www.centrahealth.com BRONZE
Templeton Senior Center
225 Wiggington Road | Lynchburg, VA 24502 434.455.4115
SKILLED NURSING FACILITIES GOLD
Lynchburg Health & Rehab
5615 Seminole Avenue | Lynchburg, VA 24502 434.239.2657 | www.lynchburghealthrehab.com
GOLD
Spa 4109
4109 Boonsboro Road | Lynchburg, VA 24503 434.384.9338 | www.spa4109.com SILVER
DL Nails and Spa
13955 Wards Road | Lynchburg, VA 24501 434.237.7901 BRONZE
Future Images by Sharon
18013 Forest Road | Forest, VA 24551 434.385.4247
SPEECH THERAPY GOLD
Lynchburg Health & Rehab
5615 Seminole Avenue | Lynchburg, VA 24502 434.239.2657 | www.lynchburghealthrehab.com SILVER
Stanleytown Health & Rehabilitation Center 240 Riverside Drive | Bassett, VA 24055 276.629.1772 | www.stanleytownrehab.com BRONZE
Lynchburg Speech Therapy
1049 Claymont Drive | Lynchburg, VA 24502 434.845.6355 | www.lynchburgspeechtherapy.com
SILVER
Medical Care Center
2200 Landover Place | Lynchburg, VA 24501 434. 846.4626 | www.heartland-manorcare.com BRONZE
Westminster Canterbury
501 VES Road | Lynchburg, VA 24503 800.962.3520 | www.wclynchburg.org
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SPAS
Milano’s Italian Restaurant
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ON THE WEB
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Valley View
retirement community
For 26 years, seniors from the Lynchburg community and across the country have delighted in Valley View Retirement Community’s gracious amenities and joyful home like atmosphere. Valley View provides a unique blend of independent and assisted living, offering each resident the flexibility to make each living arrangement feel like home. Across Valley View’s community, residents enjoy luscious, mature trees, walking trails, and raised gardening beds, and each apartment offers a private balcony, allowing residents to further enjoy the natural beauty surrounding each home. In this quiet, park-like community, Valley View also offers dining, housekeeping, and a wellness center, each maintained by an outstanding, experienced staff. With two full-time activity coordinators, Valley View looks forward to entertaining residents with a variety of social events. Valley View prides itself on hosting a rich calendar of social activities, including fitness classes, outdoors activities, crafts, outings, games, volunteer opportunities, and more. In addition, the community’s free transportation service provides each resident with access to his or her favorite medical facilities, shopping, and entertainment in the Lynchburg area. Because the community is fully staffed and can provide residents with extra help, even assisted-living residents can take part in community life. When residents would like to introduce guests to this rich experience, Valley View encourages family, friends, and even pets to visit. There are no restrictions on overnight or other visits, and Valley View offers access to private dining rooms and catering for residents’ special occasions. While residents can look forward to experiencing the independence and freedom they want, family and friends are put at ease knowing the campus is staffed by 24-hour personnel, and monthly rental fees include emergency pull cord and response system services for an added level of security. Because Valley View offers both independent and assisted living care, residents can stay on site as needs change; residents interested in moving to a higher level of care can do so without losing contact with the staff and fellow residents they have come to know well and value as family. Month-to-month leases are available for flexibility, and Valley View offers these amenities and others without long-term commitment, entrance fee, and buy-in expense, providing excellent senior living value.
Valley View Retirement Community 1213 Long Meadows Drive | Lynchburg, VA 24502 | 434.237.3009 | www.valleyviewretirement.com
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A Commitment to Excellence for Over 64 Years
The Williams Home
Lynchburg’s Gracious Retirement Living for Ladies
Our Mission Statement:
The Williams Home, Inc. is a non-profit organization providing Independent, Residential and Assisted Living to meet the needs of its female residents in a caring environment. The Williams Home provides Three (3) Levels of Care: Independent, Residential and Assisted Living. We are nestled on 6 acres in one of the finest neighborhoods of Lynchburg, Virginia. We are a community of gracious ladies who enjoy daily activities, comfort, security and friendships both with staff and other residents. The Williams Home may be the solution you have been looking for. The stately columned entrance to the beautiful lobby, relaxing sitting areas, elegant dining room, comfortable resident’s rooms and peaceful gardens are waiting to be seen by you.
Our History:
If you want to understand what makes the Williams Home unique in Central Virginia it is important to know about our founding and how we have arrived at where we are today. The Williams Home was founded in 1941 by Mr. James Luther Williams. He had been the Secretary of the Lynchburg Coca-Cola Bottling Works and then the president of the Depositors Industrial Loan Bank. In his Will he provided for the construction and maintaining of a non-profit home for women 55 years of age and older. The land was purchased in 1944 but because of WWII the building was not completed until 1950 when the doors opened in March. At that time the capacity was just 11 residents. Since then there have been several expansions in our facilities as well as our services. In 1970 the Annex building was added that allowed for all rooms to be private with private baths and it increased our Residential Living residents to 28. The Annex also contained the full kitchen and dining room for the residents. In most ways our mission is the same. We continue to provide a warm and caring environment at an affordable rate to ladies of Virginia.
What Sets Us Apart:
We are Lynchburg’s only retirement home for ladies. We will be celebrating our 65th year in March of 2015. We have LPN’s and licensed staff on duty 24/7. We strive to keep a homelike environment and are unique with our one-to-one personal care. Our residents play an essential role in creating a sense of belonging at the Home. With only 38 residents, you are sure to benefit from our intimate family atmosphere and friendly personalized service.
The Williams Home, Inc.
1201 Langhorne Rd. | Lynchburg, VA 24503 | 434.384.8282 x5 | www.thewilliamshome.org | williamshomeinc@aol.com
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Heritage Green assisted
living communities
The Lynchburg area is home to two Heritage Green Assisted Living Communities. Located in the foothills of the Blue Ridge Mountains, Heritage Green offers both assisted living and memory care accommodations. Heritage Green Assisted Living Community caters to seniors who require assistance with the activities of daily living, ranging from a variety of needs from very independent to againg in place with hospice care. The 48-unit, community encourages residents to maintain maximum independence by providing a unique mix of support services and privacy. With both private and semi-private accommodations, Heritage Green offers 24-hour personal care assistance managed by a Clinical Care Director with an onsite Medical Director. Heritage Green shares its campus with DayBreak, which offers programs for residents with Alzheimer’s and other dementias. For those who desire memory care, DayBreak offers a 32-unit, fully secured community that caters to seniors with various degrees of memory impairment. The unique facility features self-contained neighborhoods, each with a living room, dining room, and outside courtyard. The staff is highly trained to assist in all activities of daily living, including bathing, dressing, and managing health and wellness. A consulting Geriatric Psychiatrist and monthly Alzheimer’s Support Group attend to the resident’s and families’ needs. DayBreak’s memory care program, overseen by a Clinical Care Director and a Life Enrichment Director, incorporates clinical, personal, and social needs into an individualized yet interactive approach by promoting sensory activities, reminiscence techniques, physical exercises, motor skills therapy, and social engagement. Residents of both communities look forward to three delicious meals per day and nutritious snacks. Meals prepared in consultation with a nutritionist are cooked from scratch, and menus are adjusted seasonally to meet the preferences of each resident. In the elegant dining room, holidays and special events are particularly festive. Heritage Green encourages residents to invite family and friends to experience special events, as well. At Heritage Green Assisted Living Communities residents enjoy the benefits of weekly laundry and housekeeping services, therapeutic and social activities, safety features, care assessment, ongoing case management, and wellness programs. Staff members delight in providing respect, care, and compassion to residents, family, and guests, alike. We are Growing a Tradition of Care at Heritage Green Assisted Living and Memory Care!
HERITAGE GREEN ASSISTED LIVING COMMUNITIES 200 Lillian Lane | Lynchburg, VA 24502 | 434.385.5102 | www.heritagegreenal.com
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The Landmark Group Blue Ridge Therapy Connection—Stuart A progressive nursing facility, Blue Ridge Therapy Connection has 190-beds with semi-private or private rooms. They provide multi-faceted nursing services including skilled short-term and long-term services, specialized care for Alzheimer’s and Dementia, and access to an adjacent Assisted Living campus. If more complex care is required, these services along with telemedicine, rehab, pain management, and post surgical care are provided. In addition to our nursing services, Blue Ridge Therapy Connection offers physical, occupational, and speech therapies with a transitional care model to provide the full continuum of care. Therapy Connection features a separate community entrance, private rooms, and a family gazebo picnic area. Our in-patient rehabilitation rooms are all private suites with TV, Cable, WI-FI, and phone. This program is ideal for post operative care or traditional strength and endurance training. We promote support and encouragement from families for a smooth and quick transition back home!
Blue Ridge Therapy Connection 105 Landmark Drive | Stuart, VA 24171 | 276.694.7161 | www.thelandmarkgroupllc.com
The Landmark Center—Stuart The Landmark Center is the Assisted-Living Facility of the Landmark Group, and is located adjacent to the campus of Blue Ridge Nursing Center. Opened in 1996, The Landmark Center has 75-beds, and provides the freedom of lifestyle and care for wellness. The variety of activities and time spent with friends gives the peace of mind that comes from knowing that someone is always there. Some of the many services provided at The Landmark Center include both assisted and independent community living, respite care for short and long-term stays, inpatient and outpatient rehabilitation, wellness and chiropractic services, and on-site licensed rehab and medical services. The Landmark Center also provides both on and off-site catering services, with restaurant-style meals served daily, as well as a variety of social, educational and recreational programs.
The Landmark Center 227 Landmark Drive | Stuart, VA 24171 | 276.694.3050 | www.thelandmarkgroupllc.com
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FITBITS
H EA LT H A ND F I T NES S O N T H E G O
A Right to 'Bare Arms'
Get ready to show off your shapely and toned arms! Here are three exercises that will target the muscles of the upper arms and shoulders to give you that well-defined look! For optimum results, perform three sets of 8-12 repetitions of the following exercises three - five times per week.
#1. Bicep Curl 1. Stand in an upright position with your knees slightly bent. Contract your abdominal muscles to support your back and relax your shoulders. 2. Grasp the dumbbells with an underhand grip, palms facing up. Fully extend your arms, keeping them tight against your sides. Your elbows must be loose and not locked. 3. Lift the weights slowly until your hands reach your shoulders. Your arms should be the only muscles working during the exercise. At the top of the motion, contract your bicep muscles. Keep your abdominals tight and shoulders relaxed during the exercise. 4. Lower the dumbbells back to your starting position, arms extended and elbows loose. Repeat the exercise for a desired number of repetitions and sets.
#2. Tricep Kickback 1. Grab a dumbbell in one hand and put the other hand on your knee. 2. Point your elbow as high as you can towards the ceiling while leaving the dumbbell hanging by your side. 3. Slowly extend your arm until it is as straight as it will go. (DO NOT change the position of your elbow!) 4. Pause for a second, then lower back to starting position. 5. Repeat steps 3 and 4 for desired reps 6. Your upper arm and elbow should not move at all during the entire set. This is very important in order to target the tricep muscle.
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#3. Upright Shoulder Row with Fitness Tubing 1. Step on the tube with both feet, holding one handle in each hand. 2. Cross the tubing to form an X shape. Palms should face your legs. 3. Raise your elbows toward the ceiling, pulling on the tube. 4. Keeping your wrists in a neutral position and raise to shoulder height. 5. Slowly lower to starting position and repeat for desired number of repetitions.
Deidre Wilkes, AFAA, ACSM, Certified Personal Trainer Deidre is a certified personal trainer with more than 15 years experience in the health and fitness industry. She is the resident fitness specialist for OurHealth.
www.OurHealthVirginia.com
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Breaking the Silence
Alzheimer’s Disease words | SUSAN DUBUQUE
This series explores diseases that can be devastating to the individuals and families they affect—yet no one is talking about them. That is, until now. In each edition of OurHealth, we bring these diseases into the light—and dedicate these stories to the courageous patients and families living with them and the providers and researchers who commit their lives to treating and seeking cures for these silent killers.
He was a strong and vibrant man—74 years old and still working full time as a regional sales executive. The changes started slowly, with small things. A forgotten name. A bit of confusion. A little difficulty following conversations. But gradually, Jerry Villano’s memory loss became more apparent and more alarming.
“The tipping point occurred the day we had our carpets cleaned,” recalls Jerry’s wife, Becky Barney-Villano. “Before he left the house to run some errands, Jerry had a very pleasant 20-minute conversation with the carpet cleaner. When he came home later in the day, Jerry asked me if the carpet man had come yet. I was dumbstruck. But most of all I was scared to death.”
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"...we are very grateful for every day we share, for every memory we create and hold dear" says Becky, with husband Jerry.
What is dementia? Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer’s is the most common type of dementia.
Becky immediately made an appointment for her husband to see his personal physician. And on January 9, 2009, based on a mini-mental status exam, the doctor diagnosed Jerry with mild dementia. Jerry’s doctor prescribed Aricept ®, a medication used to improve memory and cognitive function associated with Alzheimer’s disease. “The doctor also suggested that Jerry do brain exercises to keep his mind alert. We were heartsick,” says Becky, “but determined to fight this in every way we could.” Becky and Jerry began attending an Alzheimer’s support group—seeking information, guidance and, most of all, the comfort and solace of other families coping with the same issues. It was through these contacts that they realized that Jerry had not received a thorough evaluation. In fact, his diagnosis was based entirely on a 30-question screening tool. So, the next stop in their journey was further testing. Jerry was given a comprehensive evaluation by a team of specialists. This included a complete physical, blood work, an MRI, a neurological examination and in-depth interviews with Becky and Jerry. “The most startling part of the evaluation was the brain scan,” says Becky. “I could see it right there on the screen—part of the brain was atrophied. It suddenly became crystal clear—Jerry’s really not doing these things to annoy me. There is an organic reason for his behavior.” As a result of the assessment, Jerry’s diagnosis was revised to mild cognitive impairment (MCI). “This new diagnosis gave us some hope,” recalls Becky. “We were told that MCI can increase Jerry’s risk of later progressing into Alzheimer’s disease. But some people never get worse, and a few eventually get better.” Becky and Jerry are determined to be among the group that “gets better” and they are making progress in that direction. Jerry continues taking medication—including two classes of drugs used for Alzheimer’s disease. Becky encourages him to exercise, and Jerry now plays golf once a week and works out with a personal trainer twice a week. He engages regularly in activities to stimulate his brain. And through the support group, the couple enjoys socializing with many close friends.
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“It’s wonderful to spend time with people who understand what we’re going through and never judge,” says Becky. Becky offers the following advice to other families facing this challenge: • At the very first sign of memory or cognitive problems, get help. Have a complete evaluation by a highly trained specialist. • Alzheimer’s is not a simple disease—and you have to tackle it from many directions—medication, physical and mental exercise, diet and a strong social network. • If you are the caregiver, don’t forget to take care of yourself. When you are caring for an Alzheimer’s patient, everything in your life changes. Ask for help. Take time for yourself. Renew and refresh. You can’t take care of anyone if you are sick or exhausted. “Alzheimer’s is a cruel disease,” reflects Becky. “It robs you of your past, your present and your hope for the future. Jerry and I feel blessed that he has stabilized and even improved, thanks to all the right interventions. And we are very grateful for every day we share. For every memory we create and hold dear.”
It’s time to stop whispering about Alzheimer’s disease. Let’s have a frank and open conversation about this disorder—the nature of the disease, risk factors, current treatments and what the future holds.
What is Mild Cognitive Impairment? Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It
Understanding Alzheimer’s Disease We’ll start with the most basic question: What is Alzheimer’s disease? Alzheimer’s is an irreversible, progressive brain disease that results in loss of memory, language, intellectual functioning, judgment and complex motor skills, as well as behavioral, mood and personality changes. The symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. An estimated 5.1 million Americans are afflicted with this disease, including about a half million who are under the age of 65 (called early onset).
can involve problems with memory, language, thinking and judgment that are greater than normal agerelated changes.
Alzheimer’s disease is the most common cause of dementia among people age 65 and older and accounts for about 60 percent of all dementias. Dementia is not a specific disease—rather it describes a group of symptoms that are associated with decline in mental ability. According to Peter Betz, MD, Medical Director of Centra Piedmont Psychiatry Center, “There are various forms of dementia including vascular dementia, alcoholism dementia, dementia from repeated head trauma, dementia with Lewy bodies and front temporal dementia, among others. Alzheimer’s-type symptoms can be caused by various medical conditions from thyroid disorders and vitamin deficiencies to medication reactions. Most people with Parkinson’s disease will develop dementia as a late-stage complication.” “It is still not clear how the Alzheimer’s disease process begins, but it is likely that damage to the brain starts a decade or more before symptoms become apparent,” says Dr. Betz. During this preclinical phase, toxic changes are taking place in the brain. “Sticky clumps of protein called beta-amyloid plaques begin to form outside and around the brain’s nerve cells. And twisted fibers called neurofibrillary www.OurHealthVirginia.com
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tangles—composed largely of the protein tau—build up inside nerve cells.” Although tangles and plaques are hallmarks of the disease, researchers are unsure if they cause it or are a byproduct of it. Scientists have known about plaques and tangles since 1906, when a German physician, Dr. Alois Alzheimer, identified these abnormalities in the brain tissue of a 51-year-old woman who died from an unusual mental illness that involved memory loss, language problems and unpredictable behavior. As Alzheimer’s disease progresses, nerve cells—called neurons—in several areas of the brain shrink and die, including cells that normally produce neurotransmitters, the chemical messengers that relay brain signals from one neuron to another. Acetylcholine is a neurotransmitter that is deficient in people with Alzheimer’s. As nerve cells continue to die, the brain itself shrinks and the wrinkles along its surface become smoother.
Risk Factors and Causes of Alzheimer’s Disease Like all types of dementia, Alzheimer’s disease is caused by brain cell death. “But the exact cause is still unknown,” observes Dr. Betz. “The disease may be triggered by a variety of factors including age, genetics, serious head injury, brain inflammation, environmental factors and damage to neurons from overproduction of toxic free radicals.” Alzheimer’s is not a normal part of growing older; however the greatest risk factor for the disease is increasing age. The risk of Alzheimer’s doubles every five years after age 65, and reaches nearly 50 percent after age 85. Family history is another Alzheimer’s risk factor. Research has shown that individuals who have a parent, sibling or child with Alzheimer’s disease are more likely to develop the disease and the risk increases if more than one family member has the illness. Alzheimer’s disease that clearly runs in families is called Familial Alzheimer’s disease (FAD), and accounts for less than five percent of all cases. FAD usually occurs between the ages of 30 and 60. In recent years, scientists have zeroed in on 58
OurHealth | The Resource for Healthy Living in Lynchburg and Southside
three gene mutations that cause early-onset Alzheimer’s. Other studies suggest that specific genes may increase an individual’s risk for developing late-onset Alzheimer’s, but do not definitely signal that the person will develop the disease.
Warning Signs of Alzheimer’s Disease Alzheimer’s disease appears differently in every case, but there are a number of common warning signs that prompt patients and family members to seek medical assessment. The most prominent complaint is memory loss, particularly the inability to recall names, recent events, new information and the placement of objects. Here are other indications that may indicate Alzheimer’s disease: • Confusion about time and place • Struggling to complete familiar actions such as brushing teeth, getting dressed and other daily activities • Trouble finding appropriate words, completing sentences, following directions and conversations • Poor judgment when making decisions • Changes in mood and personality, such as increased suspicion, rapid and persistent mood swings, withdrawal and disinterest in usual activities • Difficulty with complex mental tasks, such as balancing a checkbook Source: Alzheimer’s Foundation of America
How is Alzheimer’s Disease Diagnosed? There is no simple screening test for Alzheimer’s disease and a number of medical conditions can cause dementia—some of which are temporary or reversible with proper treatment. Therefore, it is important to have clinical evaluation by a highly trained physician in order to arrive at an accurate diagnosis. A comprehensive evaluation for Alzheimer’s disease when performed by an experienced clinician is about 90 percent accurate and typically includes the following: • A detailed medical and social history. Past medical records and information provided by the patient or a family member will help identify or rule out other possible causes for symptoms. The physician will ask about the patient’s ability to carry out daily activities and any changes in behavior or personality. Family history of Alzheimer’s disease will be considered and special attention will be paid to the onset of the patient’s symptoms. The symptoms of Alzheimer’s disease typically appear gradually and become more persistent over time.
Becky offers the following advice to other families facing this challenge: • At the very first sign of memory or cognitive problems, get help. Have a complete evaluation by a highly trained specialist. • Alzheimer’s is not a simple disease—and you have to tackle it from many directions—medication, physical and mental exercise, diet and a strong social network. • If you are the caregiver, don’t forget to take care of yourself. When you are caring for an Alzheimer’s patient, everything in your life changes. Ask for help. Take time for yourself. Renew and refresh. You can’t take care of anyone if you are sick or exhausted.
• A medication inventory. A complete list of prescription and over-thecounter medications will be reviewed to determine if a particular drug or drug interaction may be causing dementia. A urine screen may be used to detect the presence of some drugs. • A history of substance abuse or misuse. Chronic drug or alcohol abuse can cause cognitive and memory impairment. www.OurHealthVirginia.com
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• A complete physical examination. A thorough physical examination is essential since disease in many organ systems may lead to dementia. Special emphasis and attention is given to the neurological evaluation. • A mental status examination. Mental status includes an evaluation of attention, orientation, short- and long-term memory, language ability, thought processes, judgment and more. • Laboratory tests and screenings. A variety of tests may be ordered including a complete blood cell count, electrolyte panel, screening metabolic panel, thyroid gland function tests, vitamin B-12 and folate levels, urinalysis and tests for syphilis. Depending on the patient’s history, tests may be requested for human immunodeficiency antibodies, an electrocardiogram (ECG), chest x-ray, brain MRI scan and an electroencephalogram (EEG). A lumbar puncture may also be performed.
The
2014 Walk to
END Alzheimer’s® The Alzheimer’s Association Walk to End Alzheimer’s® is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. Held annually in more than 650 communities nationwide – including Richmond – this inspiring event calls on participants of all ages and abilities to reclaim the future for millions. Mark your calendars to participate in Richmond’s 2014 Walk to End Alzheimer’s® Event to help in the fight.
Richmond Walk Date: Saturday, October 18th For additional details see healthPoints on Page 17.
• Psychiatric assessment. The effects of emotional problems must also be taken into account when evaluating a patient for Alzheimer’s disease. Stress, depression or anxiety—as well as adjusting to a major life change such as the death of a spouse—can cause confusion and forgetfulness that may be mistaken for dementia. To further confound matters, depression may be present with Alzheimer’s disease and other forms of dementia. NOTE: Criteria for evaluation established by the National Institute of Neurological and Communicative Disorders and the Alzheimer’s Disease and Related Disorders Association Work Group.
Treatments for Alzheimer’s Disease At this time there is no cure for Alzheimer’s disease but researchers are continually testing various new treatments and combinations of drug therapies to control symptoms, slow the progression of the disease and improve the quality of life. The U.S. Food and Drug Administration (FDA) has approved a number of medications that offer some relief to patients with varying degrees of impairment. “The prescription medications used treat Alzheimer’s symptoms in early to moderate stages are a class of drugs called cholinesterase inhibitors—which treat symptoms related to memory, thinking, language, judgment and other thought processes,” explains Dr. Betz. “These medications work by preventing the breakdown of acetylcholine—the neurotransmitter or chemical messenger important for learning and memory.” They delay the worsening of symptoms for six to 12 months for about half the people who take them. A second type of medication called memantine is used to treat moderate to severe Alzheimer’s. Memantine is prescribed to improve memory, attention, reason, language and the ability to perform simple tasks by regulating the activity of glutamate, a different messenger chemical involved in learning and memory. Some patients also benefit from psychiatric care—including treatment for depression, paranoia and hallucinations—and behavioral management interventions. “Alzheimer’s disease and other forms of dementia affect more than just the patient,” observes Dr. Betz. “Education, counseling, support and respite care are vital to family members and caregivers.”
Prognosis of Alzheimer’s Disease Not every Alzheimer’s patient experiences the same symptoms or at the same rate, but the disease tends to advance through the following general stages:
During the mild stage of Alzheimer’s disease, memory loss worsens and changes in other cognitive abilities become apparent. Typical problems include getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, using poor judgment, and some mood and personality changes. People often are diagnosed in this stage.
As the disease advances to a moderate stage, damage occurs in areas of the brain that control language, reasoning, sensory processing and conscious thought. Memory loss and confusion grow worse, and people begin to have problems recognizing family and friends and may have difficulty carrying out tasks that involve multiple steps such as getting dressed. They may experience hallucinations, delusions and paranoia and may behave impulsively.
By the final severe stage, plaques
and tangles have spread throughout the brain and brain tissue has shrunk significantly. Individuals need help with even the most basic tasks including eating or using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up. In the later stages, Alzheimer’s disease damages parts of the brain that control breathing, swallowing and the ability of the body to fight off infections—the majority of Alzheimer’s disease-related deaths are due to infections such as pneumonia. The average life expectancy for someone with Alzheimer’s is eight to 10 years after the onset of symptoms. However, individuals with Alzheimer’s have been known to live up to 20 years after the first signs appear.
Implications In light of the aging population, Alzheimer’s disease will impact a greater percentage of Americans. This is truly a public health crisis in the making. By the year 2050, the number of people age 65 and older will more than double to 88.5 million—and those 85 and older will increase three-fold to 19 million. Right now, we’re spending $220 billion a year for medical treatment and care for dementia patients. In 20 years, we expect that number to increase to $550 billion— exceeding our nation’s defense budget. www.OurHealthVirginia.com
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The critical importance of conquering Alzheimer’s disease is widely recognized. In May 2012, the U.S. Department of Health and Human Services released the National Plan to Address Alzheimer’s Disease, which calls for preventing and effective treatment of Alzheimer’s disease by 2025.
What Does the Future Hold? In the past, a definitive diagnosis of Alzheimer’s disease— seeing the tangles, plaques and deterioration of nerve cells— was only possible through examination of the brain after death. “Now, brain imaging studies offer promise for more accurate diagnosis and the early detection of Alzheimer’s disease,” remarks Dr. Betz. Here are a few examples: • A positron emission tomography with fluorodeoxyglucose (FDG-PET)—involves injecting the patient with a radioactive tracer and then using a PET scan to determine how glucose— or sugar—is being metabolized in the brain. The brain uses sugar as fuel and when certain areas of the brain are not able to utilize glucose, this is consistent with Alzheimer’s disease. • PET scanning can be used with a tracer that reveals amyloid plaques. This tracer was developed by two researchers from the University of Pittsburgh and is commonly called Pittsburgh compound. The FDA has approved other amyloid imaging agents for PET scans. • An MRI can show evidence of brain atrophy associated with Alzheimer’s disease and additional causes of dementia, such as disease of small blood vessels in the brain. • Studies presented at the Alzheimer’s Association International Conference suggest that earlier signs of Alzheimer’s disease may be evident in the eyes and nose. The beta-amyloid plaques that accumulate in the brain of Alzheimer’s patients also can build up in the eye and can been seen in the retina when the plaque is “stained” with curcumin, a component of the spice turmeric. A laser can also be used to detect the betaamyloid in the lens of the eye. Other studies are evaluating the possibility of using a smell test for Alzheimer’s. There are many innovative research efforts related to Alzheimer’s disease and dementia taking place around the country and around the world. One study taking place is identifying certain proteins in the spinal fluid of Alzheimer’s patients that are present 15 to 20 years before symptoms appear. Another is looking at specific lipid levels—or fats—that are elevated in the blood of Alzheimer’s patients. This type of research will lead to earlier diagnoses, more effective treatments and, dare we hope, ultimately a means of curing and preventing Alzheimer’s disease.
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Alzheimer’s Disease:
Arm Yourself with Knowledge words | SUSAN DUBUQUE
Take Charge: Protect Your Brain The best way to prevent most lifethreatening diseases is to pick your parents carefully. Unfortunately, only a fraction of Alzheimer’s disease cases have direct genetic causes. But there are lifestyle changes—choices you can make—to reduce your risk for Alzheimer’s disease and help you maintain mental acuity. And every one of them is grandmother approved. The same things you should do to reduce your risk of heart disease, cancer and diabetes also offers a degree of protection from Alzheimer’s disease and dementia. Eat a healthy diet. “There is a growing body of research that shows the value of the Mediterranean diet in reducing risk for Alzheimer’s disease and maintaining cognitive performance,” says Dr. Betz. The Mediterranean diet is based on eating plenty of vegetables, fruits, legumes, fish and cereals; high intake of unsaturated fats (specifically olive oil) and low intake of saturated fats; and moderate amounts of dairy, meat and poultry. Even making simple changes to your diet can have a positive effect. Here are a few ideas: • Reduce the packaged, processed and “fast” foods you eat • Shop around the outer aisles of the grocery store—this is where you will find the fresh produce, meats, fish, eggs and dairy • Try out your local farmer’s market • Stay away from “white” foods—such as white bread, pasta, sugar and potatoes
Maintain your weight. Some researchers actually refer to Alzheimer’s disease as “type 3 diabetes” because of its strong link to obesity, which elevates brain proteins that are linked to the development of the disease. Further, brain imaging has shown that people with obesity have smaller brain volumes, which increases the risk for Alzheimer’s. Exercise your body. “Moderate exercise clearly has a positive impact on cognitive function and memory among older adults,” states Dr. Betz. “It actually increases the size of the parts of the brain that shrink with age. So find something you enjoy doing—biking, running, swimming, tennis, brisk walking—and do it regularly.” Get that heart beat up and your blood pumping. The benefits of movement are cumulative throughout the day—so take the stairs and park your car at the far end of the lot and walk a little farther. And it’s never too late. A Finnish study found that Alzheimer’s disease patients who engaged in 30 minutes of exercise three times a week experienced a slower rate of cognitive decline than those who did not. Exercise your brain. Increasing evidence suggests brain workouts play a role in maintaining cognitive health. “While mental exercise won’t prevent Alzheimer’s disease,” clarifies Dr. Betz, “it can delay its onset.” So flex those neurons by reading, Sudoku, word games. Stretch those brain cells by learning something new—like a foreign language or musical instrument. Do math in your head. Stimulate your taste buds by using new herbs and spices. Refine your hand-eye abilities with knitting, drawing, painting and assembling puzzles. Engage your senses by taking in the world around you. As a side benefit, all these things will make you a more interesting person to be around—and social contact has
also been found to support good cognitive health and lowered rates of depression. Manage your health. Work with your healthcare provider to keep your blood pressure, cholesterol and glucose under control. And consider taking a daily vitamin B—which has been shown to reduce brain shrinkage associated with Alzheimer’s disease by lowering levels of the amino acid homocysteine. But always check with your physician before taking any supplements.
Expert Contributors: • Peter Betz, MD, Medical Director of Geriatric Psychiatry, Centra Piedmont Psychiatry Center
Sources: • Alzheimer’s Association • Alzheimer’s Foundation of America • National Academy of Sciences • National Institute on Aging • National Institutes of Health • National Institute of Neurological Disorders and Stroke
Peter Betz, MD is the Medical Director of Centra Piedmont Psychiatry Center.
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rene's
words | RICK PIESTER
Rene DuVal was on the phone calling rehab center after rehab center, desperate to get help for the alcoholism she thought she had learned to control years earlier. Life had dealt Rene a series of blows in recent years. Her mother—who was also her best friend and closest co-worker—died unexpectedly at the age of 63. Her death imperiled the family real estate development business that the mother held together almost single-handedly. Eventually, the business failed. And Rene went back to drinking. That was about eight years ago, but Rene was hardly a newcomer to alcohol and drugs. She remembers her first taste of alcohol—as a fourth grader at a family party, a sip of a Grasshopper— the sweet, green, mint-flavored after dinner drink that gained most of its popularity in the 1960s and 1970s. “Alcohol was an everyday part of my life since the day I was born,” she remembers. “My father and mother would come home from work and first thing mix a gin and tonic.” In reality, it was not that much different from many American families, then or now. Rene describes her family as having a “social drinking home,” although she now recognizes one of her grandfathers as an alcoholic, though not acknowledged as one at the time. In high school in Richmond, she drank heavily on the weekend, to the point where she would black out and not remember what she had been doing. She also experimented with marijuana in middle school through high school. In college at the Shenandoah Conservatory (now Shenandoah University) in Winchester, Rene turned to cocaine and “ecstasy,” the street name (along with “Mollies”) for MDMA, named and known for its ability to produce a sense of
euphoria in users. She became addicted, and like many users, the quest to always get more of the drugs became dominant in Rene’s life. Her drug use in college resulted in a run-in with the police. Her court case was heard by a judge who Rene says lost a daughter, killed by a drunk driver. The judge, or so the story goes, sentenced anyone with a drug or alcohol offense to a minimum of three days in jail.
Gwen Wheeler is a mental health and substance abuse counselor Pathways Treatment Center
Rene clearly loves her late mother, but she also recognizes her mother’s weaknesses. “She spent her life pretty much enabling my father,” she says, “and she enabled me. When I went to jail, it was all the judge’s fault as far as my mother was concerned. Not mine. The way my mother saw it, I was just doing what any other college kid was doing.” Rene served the time in jail, but it wasn’t the last time, and it wasn’t the most serious offense. Driven to get her hands on more money for more drugs, she started stealing money from her family, and she embezzled funds from the family real estate business. “My embezzlement was reported to the authorities in Virginia,” she says, “and I panicked. I ran. I tried to hide by running to the West Coast.” Convicted of possession of cocaine in California, she spent just over a year in jail there. She then returned to Virginia and spent four more months in jail on the embezzlement charges. She emerged from her jail time clean and sober, and she stayed that way for a dozen years. She married, had two children, returned to work in the family business, and by
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all appearances had conquered alcohol. “If you asked my kids at the time, they would have said that their Mom doesn’t drink. I had kids now, and I knew where my drinking had gotten me in the past and I didn’t want to go back there.” But that seemed to change in October 2006, when Rene’s mother, in the hospital for a somewhat routine heart procedure, suffered what would be the first of two heart attacks and died after spending 11 days in a coma. “She was only 63,” Rene says. “She was very healthy, an avid fisherman, she had been fishing only the week before. It put me into severe depression.” Day by day, little by little, she went back to drinking. She’d start with a screwdriver in the morning, when she was getting her children ready for school. She would nurse the screwdrivers until 1 or 2 in the afternoon, she says, when she would switch to white wine. “I would end up numb, which, after all, was what I wanted.” This went on for three years, until she says she realized that she had surrendered her life to drinking. That’s when she got on the computer and started looking for rehabilitation centers. And then she started calling rehab centers. None of them called her back. But, in the odd way that seemingly routine and random events can result in major life changes, one rehab center did call back. It was the Pathways Treatment Center, a unit of Centra Health located at Centra’s Virginia Baptist Hospital in Lynchburg. “When I talked to Pathways, the Pathways computers were down for some reason. But they said to pack up a couple days’ worth of clothes, get in the car and get to Lynchburg. They said we would straighten out the insurance coverage later.”
September is National Recovery Month:
Blackberry Ridge Launches Substance Abuse Treatment Program words | RICK PIESTER
Amherst-based Blackberry Ridge has established an outpatient treatment program for people who want to recover from alcohol or drug abuse. The rehabilitation center, located on a mountaintop in Amherst County with an expansive view of the Blue Ridge Mountains, has also opened an outpatient office off Old Forest Road in Lynchburg. “What that means to the average person struggling with drug or alcohol abuse is that we can help you to lead a substance free life” states Dr. Christopher von Elten, MD, medical director for Blackberry Ridge. “We have medications we can use to help slowly taper patients off of prescription drugs, illicit drugs such as heroin, as well as alcohol. These medications—combined with counseling, education, and communitybased support programs—can help people break the cycle of addiction and rebuild their lives.” Blackberry Ridge is a state licensed drug and alcohol treatment program that currently provides residential treatment for those struggling with substance abuse addiction or dependency. The new office is private and confidential, yet conveniently located. Blackberry Ridge services are affordable and insurance is accepted.
More information can be found at www.blackberryridge.org, or by calling 434.946.7070.
From the moment she arrived at Pathways on a Friday and each day that weekend, she saw a counselor. “That was important to me,” she says. “I know a lot of people who www.OurHealthVirginia.com
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have been to different treatment centers, and it was as long as two weeks before they saw a counselor.” On Monday, she met Gwen Wheeler, the Pathways mental health and substance abuse counselor with whom she would work for years to come. She also met with a physician, who did a physical evaluation before beginning a medical detoxification program to clean her body of the effects of alcohol. Rene spent a total of about four weeks at Pathways before returning home to Richmond to continue with her recovery program. “Rene is really the model client for us,” Gwen says. “She has stayed highly invested in her sobriety. Even when she had a relapse, she did not stay out of treatment for long at all. She’s worked very hard on staying sober. That’s a very important thing we look for in people who come for treatment.” The relapse Gwen mentions came in August of 2013. “I learned that in truth had I never really dealt with the grief issues surrounding my Mom’s death,” Rene says. In addition, her husband (now ex-husband) was himself an alcoholic, which runs counter to one of the basic tenets of recovery, that recovering alcoholics not associate with people who are abusing alcohol or drugs.
“It is a lot of work,” Rene agrees. “There are times when you just don’t want to deal with recovery. You just want to go back. But then you realize that going back would just make everything worse, not better. You have to realize that all you have to deal with is today. It’s a journey, a path. And you have to stay on it.”
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OurHealth’s KG Thienemann recently visited the
Lynchburg Community Market
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Lynchburg Community Market The Lynchburg Community Market offers the best of locally produced fruit, vegetables, cheese, meat, baked goods, and specialty items. Farmers sell their products on Wednesdays and Saturdays year-round. Located inside the Market, the Heritage Crafters Gallery and Artist’s Alley complement the two permanent shops, four locally-owned restaurants, and a bakery and cheese shop that also operate year-round.
See more at: www.lynchburgva.gov/community-market
At the Lynchburg Community Market... 1. 2. 3. 4. 5. 6. 7. 8. 9.
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Sarah East and daughter, Vail East Jack Criswell, Owner of A Pip Printing Store, Fort Avenue Walter Erwin, Lynchburg City Attorney Dr. Linda Thienemann Will Henderson Sarah East Carol Anderson Hungry Hill Farm Booth Lynchburg Community Market patron chooses from a selection of fresh beets
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Healthy Eats
harvest recipes
Entrée: Brined Mesquite Turkey Serves: several
Turkey Ingredients: 1 6-8 pound boneless turkey breast Coconut oil Salt and pepper to taste
Brine Ingredients: 1 3 3 5 ½
tbsp black peppercorns sprigs fresh thyme bay leaves garlic cloves, sliced cup sea salt
Directions:
2. Place the turkey in a sealable plastic bag and pour the brine over the turkey. 3. Seal the bag and allow brining for 12 hours. 4. Remove the brine and pat the turkey dry with a paper towel. 5. Pre-heat the oven to 350ºF. 6. Rub the skin of the turkey with coconut oil and season with salt and pepper to taste. 7. Place the turkey on a roasting rack in a baking pan and roast, uncovered until the internal temperature reaches 165ºF. (Approximately 40 minutes per pound). 8. Allow the turkey to rest 15 minutes before slicing and serving.
Local Turkey from: Auburn Leaf Farms
5500 Mollies Creek Road | Gladys, VA 24554 www.auburnleafarms.com | 434.283.8109 farmfresh@auburnleafarms.com Located in Gladys, Virginia Auburn Leaf Farms prides themselves on treating their animals humanely providing them with plenty of sunshine, fresh water and ample grazing. All turkeys are raised on pasture land and are moved daily to fresh grasses.
1. Combine all ingredients for the brine until the salt is dissolved.
Tricia Foley says
SOURCE LOCAL TURKEY Tricia Foley is OurHealth Magazine’s resident nutritionist.
Healthy Eats
harvest recipes
Side Dish: Roasted Harvest Veggies Ingredients: ½ butternut squash, peeled, cubed and seeds removed (1.5 cups) ½ acorn squash, sliced in ½ inch thick rounds and seeds removed 1 small sweet potato, cubed 1.5 cup raw Brussels sprouts, stems removed and sliced in half 2 tbsp olive oil 1 tsp chili powder ¼ tsp cayenne 2 tbsp maple syrup Salt and pepper to taste ½ cup pecans ¼ cup dried figs, chopped
Directions: 1. Preheat the oven to 425º F. 2. In a small bowl combine the olive oil, chili powder, cayenne, maple syrup and a pinch of salt and pepper. 3. Spread the veggies out on one or two baking sheets so they are not overlapping. 4. Drizzle the olive oil mixture over the veggies and toss to coat. 5. Roast in oven until vegetables are tender and starting to brown, about forty minutes. 6. Stir the veggies halfway through. 7. When there are fifteen minutes remaining, add the pecans and figs, toss to coat.
Local Sweet Potatoes and Apples from: Dickie Brothers Orchard 2685 Dickie Road | Roseland, VA 22967 434.277.5516 | info@dickiebros.com www.dickiebros.com
The Dickie Family has been farming for two hundred and sixty three years! Today they grow fifteen different varieties of apples. In addition they grow peaches, plums, blackberries, sweet potatoes, pumpkins and much more! They encourage their customers to come pick their own fruit all season long!
Tricia Foley uses
A VARIETY OF VEGGIES Tricia Foley is OurHealth Magazine’s resident nutritionist.
Healthy Eats
harvest recipes
Local Peaches from: Critzer Family Farms
9388 Critzer Shop Road | Afton, VA 22920 Contact: Whitney and Rosemary Critzer 540.456.4772 | w.critzer@yahoo.com One time primarily a beef cow and orchard farm, today, the farm is totally focused on providing fresh local fruits and vegetables. You can visit the farm and pick your own produce starting the first weekend in May.
Topping Ingredients:
Dessert: Apple-Peach Oatmeal Crisp Filling Ingredients: 2 apples, sliced 3 firm peaches, sliced 1 tbsp Stevia 1.5 tsp ground cinnamon 1 tsp ground nutmeg 1 tbsp lemon juice ½ cup water
1 1/3 3/4 1 1/4 6
cup oats cup whole wheat flour cup Stevia tsp cinnamon tsp salt tbsp Ghee butter, melted
Directions: 1. Preheat oven to 375°F. 2. To create the filling, place the fruit slices in the bottom of a greased 9-inch dish. 3. Drizzle with lemon juice. 4. Sprinkle Stevia, ground cinnamon, ground nutmeg, and water on the fruit. 5. In a separate bowl, combine the dry ingredients for the topping. 6. Add melted Ghee and mix until crumbly. 7. Spread the crumb mixture evenly on top of the fruit. 8. Bake for fifty to sixty minutes, so the top is lightly brown and the fruit is bubbly. 9. Serve warm and enjoy!
Tricia Foley’s
APPLE-PEACH TREAT Tricia Foley is OurHealth Magazine’s resident nutritionist.
PROSTATE
words | RICH ELLIS photography | LEW FRAGA
C NCER Testing Remains Critically Important Three retirements and two bouts with cancer didn’t slow this Lynchburg resident down. He beat both lung cancer and prostate cancer and is still moving forward today, working with treasured items from the past – his antiques.
An early screening—by mistake—
and the result is cancer Warren Craghead doesn’t have time for retirement—having tried it three times already—or cancer for that matter. The 76-year-old Lynchburg resident recovered from lung cancer more than 20 years ago—cancer he attributes to having been a smoker—and prostate cancer in 2009. In addition to being a cancer fighter and survivor, Warren also was an officer in the U.S. Air Force, a government oceanographer, a NASA computer contractor, dabbled in real estate, and today he’s in the antiques business. Warren’s prostate cancer was discovered quite by accident, although he’s confident it would have been discovered six months after the original diagnosis regardless. “I was going to my regular doctor and they did a PSA test every year,” Warren explains. “It [the PSA level] was always very low. They gave me a PSA test at six months by mistake, and that number had gone up. Because it jumped up, my doctor thought I should get it checked out.” Warren’s physician referred him to K. Finnie Green, MD, a urologistist with Centra Seven Hills Urology.
According to Dr. Green, PSA test results assess a probability or risk for underlying prostate cancer, depending on a man’s PSA pattern. Because the PSA test is presently the subject of much discussion within the medical field and media, Dr. Green emphasizes the importance of having a discussion about prostate cancer and PSA testing with a urologistist. Dr. Green decided, in part, that because the number had increased, they would need to do a biopsy, Warren explains. That’s when they found cancer. Prostate cancer, Dr. Green explains, is just as it sounds – a malignant growth of the prostate that must first be distinguished from the more prevalent benign, non-cancerous growth of the prostate. A symptom frequently associated with prostate enlargement, regardless if the growth is benign or cancerous, is a slow or weak urine stream, difficulty urinating, frequent urination throughout the day and night, and a feeling that the bladder hasn’t emptied completely. “The bladder doesn’t really care whether it’s cancerous or the more common non-cancerous growth,” Dr. Green explains. “What does matter to the bladder is that the flow of urine is being blocked [by the enlarged prostate].”
Diagnosing Prostate Cancer When it comes to the prostate, waiting for symptoms to appear, however, is a bad idea because oftentimes, they don’t. Instead, Dr. Green explains, a PSA test and physical exam are used to indicate prostate-related problems. The PSA test measures the level of prostate-specific antigen (PSA) in the blood. A spike in that level during an annual test can be a warning flag of a prostate abnormality, while the physical exam consists of a digital rectal exam (DRE) to feel for any abnormalities on the prostate itself. Neither test, however, indicates whether growth is malignant or benign. For that, a biopsy is needed.
“The biopsy was a cross between uncomfortable and painful,” Warren says, describing the procedure as “being awake and upside down – with my pants off.” In addition to the biopsy, Dr. Green says that they also will obtain images of the prostate using ultrasound. “A lot of times you can see cancer on the prostate as it has a particular characteristic finding,” he explains. “Many times, however, we don’t see any obvious tumor, but because of how high that PSA has risen, we also perform a biopsy.” The two procedures are performed during the same visit, in the urologist’s office, and typically takes 30 minutes or less.
Treatment Options The biopsy results, Dr. Green explains, help determine the next course of action. “If it’s negative, we’re going to watch the PSA very, very closely because the PSA level changing is what brought us here in the first place,” he says. “In the patient with a positive biopsy, we have identified prostate cancer. Now we have to sit and discuss options for treatment.”
Prostate cancer is not typically seen in men under 50. It’s more common to find it in men in their mid-50s, with peak incidence occurring between the mid-60’s to early-70’s.
Those treatment options are guided by a variety of factors, and rely in part on nomagrams – mathematical tables that look at independent variables and provide a predictive probability of the event in question, based on aggregating multiple variables, Dr. Green explains. Those variables include the PSA level, the prostate biopsy and cancer’s appearance, and what the prostate felt like during the rectal exam. “Put all factors in the nomogram and it gives a probability that they have localized disease, that it has not spread, or it gives you a probability that it has spread,” Dr. Green says. “All treatments hinge on whether the disease is localized to the prostate or whether it has spread, because the treatments for localized disease are completely different as compared to if we think it has spread.” If the cancer is confined to the prostate, one treatment option is minimally-invasive robotic surgery to remove the prostate, known as a prostatectomy. Radiation, typically an implant of radioactive seeds or possibly external beam radiation – is another treatment option. For Warren, treatment included six weeks of external beam radiation to the prostate because it appeared as though some of the cancer may have spread beyond the prostate. “The radiation was a piece of cake,” he says. “Since I had lung cancer in ’87, it [prostate cancer] didn’t scare me quite as bad as it would have if I hadn’t already had cancer.” A third treatment option—used if the cancer has spread beyond the prostate— is hormonal therapy, Dr. Green explains. Delivered via a shot, the therapy blocks production of the male hormone testosterone, which, as Dr. Green describes, “is a fuel that the prostate cancer burns to live.” The hormone therapy may also be combined with radiation therapy. Dr. Green explains that the treatment options are highly individualized, and as a result, require a 45-minute discussion with the patient and his family to discuss the disease and treatment options.
Kinloch Nelson, MD is a physician at Virginia Urology. Dr. Nelson specializes in general urology and urologic oncology, robotic surgery. www.OurHealthVirginia.com
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The current American Urologistical Association recommendations are to screen with a PSA test beginning at age 60 and continuing on an annual basis to age 75. If, however, you have a positive family history for prostate cancer, particularly on the paternal side, screening should begin at age 55.
“Treatment options are best discussed between the urologist and patient in detail to help you make the proper decision,” Dr. Green explains. Based on his individual results, Warren is happy with the decisions he made, and with the happy accident of a six-months-early PSA test that helped discover his prostate cancer.
Additional information For more information or to schedule an appointment with a physician/provider at any of Centra Seven Hills Urology’s locations, call 434.200.5297 (toll-free 800.894.3787) or visit http://urology.centrahealth.com/our-physicians Centra Seven Hills Urology Locations • 2542 Langhorne Road | Lynchburg, VA 24501 • 1330 Oak Lane, Suite 203 | Lynchburg, VA 24503 • 1039 Mayberry Crossing Drive, Suite C | Moneta, VA 24121 • 173 Executive Drive | Danville, VA 24541
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where and when is this? Post the correct answer on our Facebook page by September 7, 2014.
You could win some great food from The Fresh Market! Cool, right?
The winner will be announced
on our Facebook page September 14, 2014. ON THE WEB
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