OurHealth Lynchburg & Southside Feb/Mar 2014 Edition

FEBRUARY • MARCH 2014 | OURHEALTHVIRGINIA.COM

THE RESOURCE FOR HEALTHY LIVING IN LYNCHBURG AND SOUTHSIDE

table of contents | february • march 2014

JUST ASK!..................................10 The language of healthcare explained

THE LATEST...............................15 A listing of new physicians, providers, locations and upcoming events in Lynchburg and Southside

HEALTH POINTS.........................16 Interesting facts and tidbits about health

THE ANATOMY CHALLENGE.....19 How much do you about our anatomy? Test your knowledge for a chance to win great prizes!

HEALTH AND FITNESS ON THE GO..................................20 Health-focused apps you can download to your smartphone or tablet

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22

COVER STORY “ FINDING TREASURES” The Journey to Good Health: Embracing and Living a Healthy Physical, Emotional and Spiritual Life

The Resource for Healthy Living in Lynchburg and Southside

36

MEN, WOMEN AND THE TOTAL BODY Lynchburg couple Ashley and Sam Updike, discuss infertility challenges and how they were able to overcome them

66

PERIPHERAL ARTERY DISEASE Jimmy Moore’s tired legs a symptom of something more

NUTRITION.................................51 HEALTHY EATS: A healthy breakfast, lunch and dinner! Spicy apple oatmeal, artichoke chicken pitas and sweet potato chicken kebobs

HEART HEALTH MATTERS........56 :Lynchburg woman suffers heart attack despite healthy lifestyle

LOOKING BACK..........................74 Images reflecting the history of healthcare in Lynchburg * PLUS * a chance to win prizes!

www.ourhealthvirginia.com | 7

READ THIS EDITION OF

OUR HEALTH LYNCHBURG & SOUTHSIDE ON YOUR TABLET

The Resource for Healthy Living in Lynchburg and Southside

february • march 2014 OURHEALTH’S EXCLUSIVE MEDIA PARTNER PUBLISHER PRESIDENT/EDITOR-IN-CHIEF ASSOCIATE EDITOR VICE PRESIDENT OF PRODUCTION CHIEF DESIGNER WEBMASTER

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Susan Sheppard Jennifer Hungate Karrie Pridemore Adapt Partners

CONTRIBUTING MEDICAL EXPERTS Danny W. Gnewikow, PhD Kurt Jung, OD Ronetta Marhoover, NP Christine Marraccini, MD Joey Mason, BS, CRT Dane McBride, MD Ronald Morford, MD Robert O’Brien, MD Mark Rodammer, OD Lynnette Schindler, MD Jeffry Widmeyer, MD CONTRIBUTING PROFESSIONAL WRITERS Susan Dubuque Rich Ellis, Jr. Trisha Foley, MS, RD Tina Joyce Laura L. Neff-Henderson, APR Rick Piester Jennifer Romeo

OR SMART PHONE!

ADVERTISING AND MARKETING Cynthia Trujillo | P: 434.907.5255 F: 540.387.6483 | cindy@ourhealthvirginia.com SUBSCRIPTIONS To receive Our Health Richmond via U.S. Mail, please contact Jennifer Hungate at jenny@ourhealthvirginia.com or at 540.387.6482

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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 305 Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Information in all print editions of Our Health and on all Our Health’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 Our Health 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.

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OurHealth | JUST ASK!

ju st a sk!

T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D

Can watery eyes be a symptom of Dry Eye?

Does diet play a part in the development of heart disease?

It might seem counter intuitive to think that dry eyes may be watery but it is true. Dry eyes does not mean you do not tear, it means you do not produce good tears. The front of the eye (the cornea) is a very sensitive tissue and your tears provide a barrier against irritation.

If you do not have a thick, long lasting tear, you do not have a good barrier against irritation. If your eye is irritated, one of the results of irritation can be that you get a reflex tear, or in other words, it waters!

Diet can play a big role in our overall health, especially our heart health. Many people are familiar with watching their fat or cholesterol intake, but did you know that salt, or sodium, may cause you to hold onto fluid which can affect your heart? Extra fluid can cause swelling of the feet, legs, and abdomen, cause shortness of breath, and weight gain. These symptoms can increase your blood pressure and put more workload and strain on your heart. For patients with high blood pressure or a diagnosis of Congestive Heart Failure (CHF), a low sodium diet of 2 grams or 2000 mg a day is key to maintaining a healthy blood pressure and a strong heart.

One of the initial treatments for dry eyes is to use lubricant drops, or artificial tears, to supplement the tears you may inadvertently produce by yourself.

Mark Rodammer, OD St. Clair Eye Care Lynchburg | 434.239.2800 (Timberlake) Lynchburg | 434.845.6086 (Langhorne)

Ronetta Marhoover, NP Centra Stroobants Cardiovascular Center Lynchburg | 434.200.5252

How much of an impact does computer use have on a child’s vision?

Does overly dry air impact allergy symptoms in the winter?

Children can have the same symptoms as adults with computer use. Problems such as eye strain, discomfort, headaches and blurred vision can develop with the increased use of computers for education and entertainment. What is unique to children, compared to adults, is their inability to identify these as problems. Most children feel that everyone sees everything the same way they do.

Implementing a 20-20-20 rule will help with comfort as well. Every 20 minutes look at least 20 feet away for 20 seconds to relax the eyes.

For people with allergies, humidity is a two-edged sword.

A comprehensive examination with an eye care professional can help identify potential issues with children’s vision. Treating any underlying conditions, such as an uncorrected prescription for glasses (ie. astigmatism or focusing problems) or reducing glare can greatly reduce or eliminate these common symptoms in children.

Kurt Jung, OD Newman, Blackstock & Associates Lynchburg | 434.237.2100

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High humidity enables the growth of molds and tree and grass pollens. However, if humidity falls below 35%, our nasal and other respiratory membranes become dry, and we lose the protective moistness of a thin mucous blanket. Thus, we damage our first line of defense against viruses and other indoor allergens not dependent on humidity. When outdoor humidity drops in the winter, our indoor humidity can drop quite low. What to do?

The best solution is to use singleroom humidifiers with a humidity gauge so that the device can be turned off if humidity exceeds 5055% and turned on if it falls below 40%. Humidifiers must be cleaned regularly, however, so that they do not become sources of allergy and disease themselves.

Dane McBride, MD Asthma and Allergy Center Lynchburg | 434.846.2244

OurHealth | MEDI•CABU•LARY

me d i • ca bu • l ar y

What is the HeartSteps® program?

T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D

What is sclerotherapy?

• Patients will become more active, knowledgeable participants in their care

Sclerotherapy is a procedure done to close down unwanted veins.

The medicine (a “sclerosant”) is injected into the vein through a small needle, and causes irritation to the inside of the vein. This causes the vein to shrink down and harden. The body then dissolves and reabsorbs the vein. The blood that was being carried by the treated vein shifts into other normal veins. By the time the sclerosant medicine gets into the circulation, it is diluted enough that it has no effects on the rest of the body. Sclerotherapy can be done for a variety of conditions, including hemorrhoids and esophageal varices, but is most commonly done for varicose veins and spider veins on the legs.

• Patients will have a clear understanding when to call their physician

Jeffrey Widmeyer, MD Widmeyer Vein Center Lynchburg | 434.847.LEGS (5347)

HeartSteps is a multidisciplinary educational tool used to assist patients and physicians to effectively manage living with Congestive Heart Failure.

Lincare’s objectives are: • Increase intervals between hospital admissions for patients with CHF. • Improve patient compliance • Increase patients’ self management of CHF • Improve quality of life for CHF patients Our expected outcomes are:

• Number of hospital readmissions for CHF will decrease • Patients’ functional ability and quality of life will improve This service is administered in the home by our Board Certified Respiratory Therapist.

Joey Mason, BS, CRT Lincare Lynchburg | 434.237.3712

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What is Arthography and when is it used?

An arthogram, or an arthrography, is the X-ray examination of a joint such as a shoulder, hip or wrist to help identify the source of your pain. Using a special form of X-ray called fluoroscopy, contrast material (dye) containing iodine is injected into the joint to highlight soft tissue structures so they are visible during an X-ray, MRI or CT. A board-certified, fellowship trained radiologist performs the procedure.

Robert O’Brien, MD Insight Imaging Roanoke | 540.581.0882

What is Ménière’s Syndrome In 1861, a French physician, Prosper Ménière, first described a condition in which episodes of vertigo (spinning sensation) and hearing loss coexisted. The syndrome is characterized by low frequency tinnitus (ear noise), a sensation of ear fullness, vertigo, and hearing loss which is fluctuant in nature. Current thinking links the disorder to increased pressure in the endolymph (the fluid that controls inner ear function). This increased pressure is thought to result in ruptures of the membrane that confines the fluid, causing damage to the delicate inner ear structures. The condition is best treated by ENT (Otolaryngology).

In cases where the hearing loss becomes permanent, an Audiologist can often help with hearing aids, depending on the degree of damage.

Danny W. Gnewikow, PhD Audiologist, CCC, FAAA Audiology Hearing Aid Associates Danville | 434.799.6288 Lynchburg | 434.528.4245

MEDI•CABU•LARY | OurHealth

www.ourhealthvirginia.com | 13

THE LATEST | OurHealth

the l atest

Eric Baugher, DMD Central Virginia Orthodontics Lynchburg 434.385.GRIN (4746)

N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S

Matthew Huffman, MD Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252

Ronetta Marhoover, NP Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252

Mike Petrikonis, NP Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252

Pavin K. Annamaraju, MD Medical Associates of Central Virginia Hospitalist Division Southside | 434.947.3944

Sally-Ann T. McIntosh, MD Medical Associates of Central Virginia Hospitalist Division Lynchburg | 434.947.3944

Patricia C. Richardson, MPH, MD Medical Associates of Central Virginia Internal Medicine Division Lynchburg | 434.947.3944

Kurt Jung, OD Drs. Newman, Blackstock & Associates Lynchburg | 434.237.2100

Anna Santos Marketing and Admissions Director Heritage Green Assisted Living & Daybreak at Lynchburg Lynchburg | 434.385.5102

Richard A. Bendall, Jr., MD Medical Associates of Central Virginia Hospitalist Division Lynchburg | 434.947.3944

Optometry Doctors of optometry are primary health care providers who examine, diagnose, treat, and manage diseases and disorders of the visual system and associated structures. They care for these conditions by prescribing eyeglasses, contact lenses and medications.

CORRECTION: In the Best Bedside Manner Awards section of the Dec/Jan issue, some information for the first place provider in Optometry was excluded. Here is the complete information.

{ first place } Gary St. Clair, OD St. Clair Eye Care | Lynchburg | 434.239.2800 | www.stclair-eye.com

I would like to thank all of my patients for showing their confidence and support in selecting me for “Best Bedside Manner” for the category of Optometrists. I feel it is extremely important to establish a relationship with each patient. The more comfortable a patient is with a doctor, the more likely they will abide by the doctor’s treatment plan and recommendations. It also gives the patient a reason to come back which is important for continuity of care. A patient may not remember everything you say or do, but they will always remember how you made them feel.

— Gary St. Clair, OD

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OurHealth | HEALTH POINTS

tips, tidbits and more to inform and entertain you

Chapstick® and

Lynchburg

About how

If you put all your

In Virginia,

long does

blood vessels end

it take for

children up

to end they would

to the age of

the heart to

stretch over

pump blood all through

made the first ChapStick® himself that resembled a small wickless candle wrapped in tin foil.

Fleet sold his recipe to fellow Lynchburg resident John Morton in 1912 for five dollars after failing to sell enough of the product to make it worth his continued efforts. John Morton along with his wife started production of the pink ChapStick® in their kitchen. Mrs. Morton melted and mixed the ingredients and then used brass tubes to mold the

the body?

That’s almost

services under

miles!

a. 10 seconds b. 30 seconds

access to oral health

2.5

the Affordable

times around the world!

Source: Delta Dental www.thatsthetrooth.com

c. 1 minute d. 3 minutes (Answer: b. 30 seconds)

Dr. C. D. Fleet, a physician from Lynchburg, invented ChapStick® or lip balm in the early 1880s. Fleet

90,000

19 will have

-D 3Movies andYour Eyes

3-D

Care Act.

Movies

require

3-D

Vision:

Traditional Theater 3-D Movies required two projectors to present the image that you view through the supplied frames.

Today’s newest technology presents the movie image from a single projector, which is believed to reduce eye fatigue and strain. To properly view a 3-D

Movie, you need to have good quality vision in each eye. Some

viewers may develop eye fatigue, headaches, or blurred vision after

sticks. The business was successful

watching a 3-D movie. If you or a relative, especially a child, experience any unusual

and the Morton Manufacturing Corporation was founded on the sales of ChapStick®.

symptoms following one of these movies, you may need to schedule an eye exam. Small inconsistencies in how well your eyes work together might lead to your symptoms. Often these inconsistencies can be corrected with glasses or a regimented therapy program to improve your visual ability and perception.

Source: www.newman-blackstock.com

Source: www.chapstick.com

DEPRESSION COSTS MORE in medical expenses and causes more sick days than DIABETES, BACK PROBLEMS or HYPERTENSION! Source: www.businesssolutionsinc.net 16 | www.ourhealthvirginia.com

HEALTH POINTS | OurHealth

Recommended Reading!

With so many books out there, new mom’s can become “over stimulated” with information. To narrow down that reading list (a little, anyway), visit the suggested reading list provided by The Pediatric Center (www. richmondpediatriccenter.com). One of our favorites for tackling that sleep schedule, Healthy Sleep Habits, Happy Child by Marc Weissbluth, MD. Rest is vital to your child’s health, growth, and development. Healthy Sleep Habits, Happy Child outlines proven strategies that ensure good, healthy sleep at every age.

FLU SHOTS

Just For Me – that’s the program that

are a good idea even for healthy adults, but they

are a must for: Pregnant women

Bedford Memorial Hospital Imaging Center is offering. The Just For Me Program is aimed at encouraging women 40 years old and older who have never had a mammogram to make an appointment. Women with inadequate or without insurance, will receive the mammogram free of charge.

Source: www.bedfordmemorial.org

Adults age 50+ Those with chronic health conditions Healthcare workers Teachers Source: www.centra.com

A new study from a recent medical journal announced that worldwide, nearly

30% of adults and

80% of children

aren’t

getting enough exercise. Researchers found the problem is worse for girls and women, who tend to be less active than boys and men.

Source: www.livehealthylynchburg.com

each year,

more than

130,000

people face the amputation of a limb.

More than 80 percent are done as a result of complications from diabetes and vascular disease.

Traumatic accidents account for the next largest group, largely due to automobile accidents and workplace incidents.

Source: www.excel-prosthetics.com

www.ourhealthvirginia.com | 17

THE ANATOMY CHALLENGE | OurHealth

words | STEPHEN MCCLINTIC, JR.

The human body is considered the most complicated machine in the world. We see with it, hear with it, breathe with it, walk and run with it, and sense pleasure with it. Its bones, muscles, arteries, veins and internal organs are organized with incredible design, and when we examine this design in detail we find even more amazing facts.

We are proud to introduce a new section of OurHealth called “The Anatomy Challenge”. In each issue, we will take a closer look at a part of the body. But did we get it right? Let us know for a chance to win great prizes!

aorta brachiocephalic trunk An artery that supplies blood to the right arm and the head and neck.

The largest and longest artery in the body that carries oxygen-rich blood from the left ventricle of the heart to the body.

left atrium The upper chamber of the heart that receives oxygen-rich blood from the lungs via the pulmonary vein.

right atrium The right atrium receives blood from the veins and pumps it to the right ventricle.

coronary arteries The coronary arteries run along the surface of the heart and provide oxygen-rich blood to the heart muscle.

left ventricle The lower left chamber of the heart that pumps blood through the aortic valve into the aorta.

Want to win a $25 gift card inferior vena cava right ventricle The right lower chamber of the heart that pumps blood to the pulmonary (lung) artery.

A large vein carrying oxygen-poor blood to the right atrium from the lower half of the body.

to Fresh Market?

Identify at least ten errors and send your responses to steve@ourhealthvirginia.com by 3/10/14. The winner will be announced on OurHealth’s Facebook page 3/15/14.

www.ourhealthrichmond.com | 19

OurHealth | HEALTH AND FITNESS ON THE GO

Health and Fitness

On the Go Having information at your fingertips; that’s what mobile apps are all about. Empowering users to effectively manage their healthcare and a healthy lifestyle is important to everyone.

In our Health and Fitness on the Go section, we recommend a variety of health-focused apps you can download to your smartphone or tablet.

Glow First

SHARE YOUR FAVORITE HEALTH AND FITNESS APP!

Share your favorite health and fitness app!

Scan this QR code with your smartphone or tablet to visit and “Like” OurHealth’s Facebook page, then post a “Comment” with your favorite health and fitness APP! 20 | www.ourhealthvirginia.com

Glow First is for couples who are sure they want to have a baby as soon as possible. If, for some reason, you do not get pregnant using the Glow app, Glow First provides you with the ability to get a much cheaper infertility screening to see if something is wrong. It’s a way to share the risk of infertility with other couples that are going through the process of trying to start families. You contribute money each month to Glow First. At the end of 10 months the entire fund (plus possible matching contributions) will be split amongst those who are not pregnant. If you get pregnant within 10 months then your money goes towards those who were not so fortunate. Apply to participate in Glow First by downloading the App through iTunes. Currently only available for iPhone or iPad. Cost: free

iPhone OR iPad

HEALTH AND FITNESS ON THE GO | OurHealth

Gazelle GazelleÂŽ, a mobile health app from Quest Diagnostics, empowers you to see, store, and share your vital health information, and take control of your health anytime, anywhere. Get Quest Diagnostics lab test results sent directly to your mobile device, quickly view your medical records in an emergency, conveniently access your prescription names and doses whenever you need them, share your health information via email or fax and more! Gazelle also allows you to store your doctor, insurance and emergency details, allergies, problem list, vital statistics, prescriptions, lab results and medical and immunization histories.

Available for iPhone, Android and Blackberry.

Cost: free

www.ourhealthvirginia.com | 21

THE JOURNEY TO GOOD HEALTH | OurHealth

FINDING

TREASURES words | Tina Joyce

The Hollins Mill Tunnel is a popular part of the James River Heritage

Trail in Lynchburg. Carved out of the canyon wall, this more than 500 foot tunnel covers a beaten path that leads to the Point of Honor Trail. In talking with people in the community, many indicate that the Tunnel symbolizes a place where they have realized a renewed direction in life, physically, emotionally and spiritually. Entering the darkness of the Tunnel symbolizes fear, the cracked path symbolizes the unsteadiness life sometimes brings and the increased lightness as the tunnels ends symbolizes victory achieved through struggle.

A cheerful smile and a sassy haircut may at first give outsiders the impression of a year filled with success and triumph, possibly even fun, for Michelline Hall. But on a closer look, her smile seems to reveal a joy that can come only from deep within. It doesn’t appear to be based on circumstances or professional accolades, but from perspective.

Behind her sparkling brown eyes, there’s clearly a journey waiting to be shared.

Her journey is one of family, education, health and faith. Her story is shared with no regrets, but with a recognition of lessons learned through the seasons of her life and the process of finding her deepest strength amid some of life’s greatest challenges.

She loves to talk and is open to sharing her story so that others might find similar joy. However, she admits to facing struggles from her past

Reprints To order reprints of the original artwork featured on this issue’s cover, please send an email to: info@ourhealthvirginia.com To view additional work by our artist, Joe Palotas, visit www.salemartcenter.com

that she’s only recently begun to tackle.

Michelline is confident, strong and well organized. These qualities serve

www.ourhealthvirginia.com | 23

OurHealth | THE JOURNEY TO GOOD HEALTH

her well as a former art teacher and now freelance photographer. She seems to have always had a plan.

Her plan.

Growing up in Lynchburg with a single mother, Michelline says her mother always provided a hard-working example and held high expectations for Michelline and her two sisters. School was always taken very seriously in her home. “So much of my having confidence is because of the time my mom invested in me early,” Michelline recognizes.

Also, a supportive family surrounded her and gave her direction and advice—words, as a teenager, she was sometimes reluctant to hear. “When I was about 15, I learned something very valuable from my Uncle Charlie. He could see me going through fairly normal teenage junk and dealing with a lot of emotions. He took me aside and said ‘Michelline, sometimes you have to let yourself cry. It’s how you feel.’ ” Little did she, now 31, know she would be reminded of his wisdom.

Michelline speaks highly of her husband of seven years, Jawansa “Jay” Hall, a graphic and website designer, who, she says, is the best husband in the world. “I’ll never forget the day he first asked me for my [phone] number,” she says with a flirty grin.

“We were juniors at E.C. Glass High School. I heard his footsteps running down the tile hallway. But he was very calm and smooth when he rounded the corner to say ‘hi,’ ” she remembers. They had known each other about a year before they started dating.

She was a hard-working student and the college preparatory courses she took in high school had prepared her well for college. She was accepted at both Virginia Commonwealth University (VCU) and Virginia Intermont College (VI), which she and Jay later both attended.

Michelline had a plan. She took a year off from school to work and live on her own prior to attending college. “It was probably the best thing I could have done,” she explains. During that year she learned the value of working and saving money. She also gained a greater respect for her mother, a nurse, who raised three girls with a deep desire for faith. “I don’t remember a Sunday we didn’t go to church.”

24 | www.ourhealthvirginia.com

THE JOURNEY TO GOOD HEALTH | OurHealth

Michelline continued sticking to her plan. She wanted to major in photography and did not want to wait until her junior year of college to be able to take those courses. Her decision to attend VI was both strategic and intentional, as was her continuing courtship with Jay. “We had a lot of fun. Jay is hilarious! He is my best friend. For us, college was both the best of times and the worst. Dating can be difficult,” she acknowledges. They dated eight years before getting married after they graduated from college. “I had in my mind that once you get married, you couldn’t rely on your family anymore,” she remembers erroneously thinking.

Insightfully, Michelline also shares, “The longer you are together, the more patient you become, but the less tolerant you are of some things.”

A year after graduating from college, Michelline and Jay were married. Their long courtship and the support from family and friends gave them a strong foundation, critical for an enduring marriage. In no time, many were asking when they were planning to start a family.

www.ourhealthvirginia.com | 25

OurHealth | THE JOURNEY TO GOOD HEALTH

Michelline and Jay always knew they wanted children, but they were in no hurry.

The plan was to wait. “We wanted to be more secure before we had kids,” she says. “We both had resources available to us that our grandparents didn’t. We are blessed to be in a better situation, partially because both of our parents have college degrees.” As a result, Jay and Michelline planned to be deliberate about when they had children.

Early in their marriage, both Jay and Michelline realized they needed to begin taking better care of their physical health.

She admits to somewhat neglecting her body in college by not eating well. They began attending a church that addressed and emphasized the purposeful care of both their

physical

and

their

spiritual health. They began making more healthful food choices and quickly began to reap the benefits of a healthier lifestyle.

“When I was about 27, I really had an epiphany. I realized my [spiritual] heart wasn’t right,” shares Michelline. She began to recognize that she had been living much of her life according to her own plan, rather than being aware of a much bigger picture. There were many things she could simply not control.

26 | www.ourhealthvirginia.com

THE JOURNEY TO GOOD HEALTH | OurHealth

Baby talk began to enter the conversation once Michelline and Jay were in their

Michelline Hall during one of her recent photo shoots at McBride Blackburn Opticians.

30s. Michelline was with her sisters when she found out she was pregnant. “I was so excited!” she reflects. Soon after the great news was shared, they began standard, routine doctor appointments.

As with all expecting mothers, she remembers first seeing the baby, a boy they named Judah, during an ultrasound. “The first time we got to see Judah, I was so amazed!” she says with joyful excitement. Besides their wedding day, this is the moment so many young women look forward to, leading to both the anticipation

“Say how you really feel and cry when you need to cry.”

These words of

and uncertainty that accompanies such moments.

advice from Uncle

Michelline’s eyes shift as she continues her story. She looks down and her smile

Charlie more than a

fades. As she searches for the right words and pauses before continuing, stillness fills the air.

decade ago hold true

Her joy, as a newly expecting mother, was soon coupled with extreme exhaustion.

today as much as

Not uncommon for mothers in their first trimester, low energy often accompanies morning sickness and cravings. However, Michelline’s fatigue worried family and

they did then.

friends because of its severity and duration.

She began struggling to perform her daily duties as an art teacher at Desmond T. www.ourhealthvirginia.com | 27

THE JOURNEY TO GOOD HEALTH | OurHealth

Doss School and was gaining weight rapidly, too rapidly for the comfort of her doctors. She then began developing fibroid tumors, which she later learned she has a family history of.

Fibroid tumors are solid tumors made of fibrous tissue, hence the name “fibroid.” These growths are found most often in the uterus of women in their 30s and 40s and are typically benign (noncancerous).

Clearly,

however,

even

benign

tumors can elevate the stress level for an expectant mother.

Soon after the fibroid masses were detected,

Michelline

developed

pneumonia and had to be admitted to the hospital; her stay extended three weeks due to complications.

“I was so scared, but the baby was always fine,” she states with optimism.

At the end of her hospital stay, a pulmonary specialist confirmed the fluid was gone in her lungs. However, new tests revealed fluid was now accumulating around her heart, causing significant pain. Due to the fibroids and increasing pain, her body was having difficulty keeping food down. The doctor suspected lupus,

a

chronic

autoimmune

disease that attacks healthy tissue and causes inflammation, pain and damage.

Additionally, Michelline’s weight continued to increase at an unhealthy rate from fluid retention, making everything—including breathing—more difficult. “The pain was pretty intense, but I made myself get up and move for Judah. He kept me going.” www.ourhealthvirginia.com | 29

OurHealth | THE JOURNEY TO GOOD HEALTH

The severe pain, exhaustion and more repeated hospital visits were beginning to take a toll on Michelline. Next, she had to quit the job she loved at the school. Her plan seemed to be unraveling.

Although baby Judah was developing normally, Michelline’s health presented risks that could easily trigger premature labor. In her mind she had already calculated the safest date for labor to begin when Judah’s chances of survival would significantly increase.

When her water broke prematurely, she was obviously worried but remained curiously calm. She asked Jay to call the paramedics. “I was at peace because the

“Our church family and my school family have been amazing through this past year of struggle,” shares Michelline. She realizes that family can create an invaluable, emotional network of support— even after you are married.

baby had always been okay,” she explains.

Amid the stress surrounding the circumstances, Michelline delivered baby Judah in the ambulance on the way to the hospital. Shortly after, both were whisked into the hospital to meet with the obstetrics medical team.

Next, the unimaginable occurred and would change Jay’s and her lives forever.

The doctor was about to share the news no parent is ever prepared to hear. “The doctors came in [the room] and said, ‘the baby didn’t make it.’ I was ready to die.

I felt like I was dying the whole pregnancy [because of the pain], but I imagined it was going to be worth it because I was gonna have our baby,” she says quietly.

Michelline sits quietly for a moment. She breathes deep and says, “I didn’t cry— until they let me hold him.”

The moment all mother’s dream about, combined with an unimaginable experience no one can prepare for, created an intimate and emotional memory only tears can articulate.

“At that moment, you either have faith or you don’t,” she explains. “Because of my faith, as sad as I can get, I only know I will see our son again.”

Despite dealing with the loss of a loved one, arrangements still must be made, suddenly and without adequate preparation. Thankfully, family came together to organize a funeral. “We felt like we needed to have a funeral because he was a real baby. I felt him move; we loved him; he was our child,” explains Michelline.

They relied heavily on family and friends. “They were all amazing,” she shares, referencing their help.

She also treasured their sustaining support the more sick she became. As if the loss of their baby wasn’t enough, Michelline and Jay were still battling her continuing health concerns. In fact, after the loss of Judah, Michelline was officially diagnosed with lupus. She was once again admitted to the hospital; this

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THE JOURNEY TO GOOD HEALTH | OurHealth

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OurHealth | THE JOURNEY TO GOOD HEALTH

time a seizure landed her in the intensive care unit (ICU). “Because I was so sick, my husband had to start calling all the shots. It’s a lot of pressure to be the point person,” she admits.

The next time she woke up, she was in the ICU at the University of Virginia Health System. She had had an allergic reaction to the lupus medication and the fluid kept building around her heart. “Draining the fluid around my heart was the most painful experience, outside of labor, that I have ever experienced,” Michelline explains.

On the heels of emotional and physical distress from a challenging pregnancy and the loss of their baby, Michelline next had to undergo six months of chemotherapy to treat the lupus.

By this time, the young couple, with their well-planned timeline of security and family, was depleted financially and emotionally. “My husband and I were mentally, physically and spiritually drained.

I had to pray to have joy for our friends expecting babies at the same time as Judah was due,” she humbly admits.

Thankfully, through the next six months, Michelline has gradually improved, and today, as she reflects over the past year, she reveals she has learned much about herself, her relationships and her faith.

She treasures the short time she was able to hold baby Judah. She embraces and celebrates the fact that their marriage has been strong 32 | www.ourhealthvirginia.com

enough to persevere through such hurt. She is also grateful they made a lifestyle choice to improve their diet several years ago. “Had we not changed our diet seven years ago, I would not have survived this far,” she emphatically states.

There are so many people who contributed to their strength. “Our church family and my school family have been amazing through this past year of struggle,” shares Michelline.

She realizes that family can create an invaluable, emotional network of support—even after you are married.

Summarizing her most memorable and appreciated support, she shares that the amount of cards given to them was such a blessing because there were times they just couldn’t talk on the phone anymore. The cards with kind, thoughtful words allowed them to really absorb the messages from family and friends. She also found tremendous value in the practical things people offered: food, money, cleaning their house or offering to pick up a prescription.

Most importantly, Michelline shares, “Prayer. It really sets the tone in sickness and the darkest hours.” She still smiles, but talks slower and more reflectively. She glances at Jay to see if he agrees.

He sensitively smiles as he listens to a story his heart knows too well, yet his expression is neither of hurt nor frustration, but of gratitude; he has his wife back. He acknowledges he almost lost her too.

“The most difficult thing for me was not having her at her best. She is such a

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motivator. There is such a void when you only have a component of your spouse and not knowing if this will be your new normal,” he shares.

Jay explains how grateful he is to have his wife today. Despite losing their son, at times he had to consider the possibility of losing them both within two months.

The experience has led him to treasure each day with his wife.

Reflecting over the past several months he explains how he greatly appreciated having a point person designated to handle correspondence and arrangements and to answer calls and questions. After such a difficult time, such as the loss of a loved one, “having someone help you after the dust settles is really important,” shares Jay. Reality hit even harder when the decision needed to be made, during Michelline’s chemotherapy treatments, about what to do with her long hair. The treatments were making her hair fall out in chunks. Once an artistic, vibrant woman full of energy, she now appeared more visibly sick to her concerned husband.

They had to make a choice. It was time to start new, all new.

She shaved her hair and made the decision right then to begin putting their life back together. Her health is improving and the physical and emotional healing is an ongoing process.

They both feel like the struggles have strengthened their bond with one another. “There is no judgment, no pep talk… we are just here for each other,” shares Michelline as she also remembers the wisdom from her uncle. “Say how you really feel and cry when you need to cry.” These words of advice from Uncle Charlie more than a decade ago hold true today as much as they did then.

There is no question Michelline is resilient and Jay is steadfast in his support. The lessons they are learning are far more valuable than any selfscripted plan. They are learning to embrace life— whether for only a few minutes, or for years.

There are treasures found in times of great loss and discouragement that wouldn’t have otherwise been revealed.

In the midst of sorrow and pain Michelline and Jay continue to find joy in the memories made through this season of life and continue to anchor their journey in faith.

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MEN, WOMEN AND THE TOTAL BODY | OurHealth

words | SUSAN DUBUQUE

INFERTILITY: Why Can’t We Get Pregnant?

Ella came into the world June 30, 2013, pink and wailing. She weighed a robust seven pounds two ounces and was 21 inches long.

Her arrival did not follow the typical 38-week gestational period.

Rather, she was born in the wake of a two-and-a-half-year journey that was marked by incredible periods of joy and frustration.

Ashley and Sam Updike, Lynchburg, had been married for about a year when they decided the time was right to start a family. They envisioned having several children, and since both were young and in excellent health, they never anticipated any problems fulfilling their dreams.

But Mother Nature had other ideas. Six months later—they still weren’t pregnant.

“Every month was an emotional roller coaster,” says Ashley. “We’d be excited that it was time to try again, and then we’d have a huge letdown when my period came, and I would have a week of being mad.”

After a year of trying, the Updikes made an appointment for a fertility assessment, but before they could see the specialist, Ashley discovered that she was already pregnant. The couple was overjoyed—but the happiness was short-lived when only two weeks later, Ashley miscarried.

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OurHealth | MEN, WOMEN AND THE TOTAL BODY

When she returned to work following her miscarriage, Ashley had to struggle with her own loss, while smiling and congratulating three of her coworkers who had announced during her absence that they were pregnant.

After six more months of trying, Ashley and Sam once again pursued fertility testing—only to find that the results were normal for both of them. “I actually hoped that something would show up on the tests,” recounts Ashley. “Then we would know the cause and we could try to do something about it.”

Secretly, Ashley hoped that if a problem did exist, that it wasn’t with her husband. “I just wasn’t sure how Sam would handle it,” recalls Ashley. Although she admits to asking herself, “Why me? Am I a real woman?”

Throughout this whole ordeal, Ashley says, “We really relied upon our faith to see us through.”

Although there was no identified cause for the infertility, Lynnette Schindler, MD, OB-GYN with Women’s Health Services of Central Virginia, was prepared to take action to support the Updikes’ desire for a baby.

“My doctor prescribed medication to ensure I was ovulating and then we tried a procedure called intrauterine insemination,” says Ashley, “and we got pregnant Lynette Schindler, MD is a board certified OB/GYN practicing with Women’s Health Services of Central Virginia

38 | www.ourhealthvirginia.com

the first try. I also had my hormone levels tested to make sure everything was in order for a successful pregnancy.”

MEN, WOMEN AND THE TOTAL BODY | OurHealth

Interim Health care full page

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stay

TUNED.

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While Ashley and Sam feel blessed to have Ella, the hurt and disappointment that they encountered during the prior two years is still raw and close to the surface. “My heart breaks for anyone who is struggling to have a baby. Through it all, Sam and I felt very alone,” shares Ashley. “I would encourage others to just take it one step at a time and to seek support from people who really understand what you are going through.”

Ashley reflects on Mother’s Day: “Year one, I was really trying to get pregnant. Year two, I had miscarried. Finally, the third year I was thankful to be pregnant. But this year—with Ella in our lives—will be the best of all!”

••••• Ashley and Sam definitely are not alone and their story is not unique. Infertility is no small matter in terms of the number of people affected, the complexity of the problem or the emotional toll it takes. In the United States, about 11 percent of women of childbearing age—that’s 6.7 million women—are coping with the physical and psychological pains associated with infertility.

Let’s explore the subject of infertility in greater depth—how it is defined, the most common causes, the latest treatment options and, most of all, the outlook for individuals who are desperately seeking to have a baby.

Infertility: Defined While the medical literature uses terms like “impaired fecundity,” most simply stated, infertility means that a woman has not been able to get pregnant after one year of trying, or six months if she is over the age of 35. Infertility can also apply to women who can get pregnant but are unable to carry the baby to full term.

Christine Marraccini, MD, OB-GYN with Women’s Health Services of Central Virginia, describes infertility as “an equal opportunity disorder.” About one-third of the cases are caused by factors that affect the woman, one-third by factors that affect the man. For the remaining one-third, the cause may be a combination of problems in both partners or it may be unknown.

Christine Marraccini, MD is a board certified OB/GYN practicing with Women’s Health Services of Central Virginia

Dr. Marraccini says, “In some ways, our ability to treat infertility has surpassed our ability to accurately diagnose it. And for many couples, not knowing is the hardest part.” www.ourhealthvirginia.com | 41

OurHealth | MEN, WOMEN AND THE TOTAL BODY

Childbirth truly is miraculous when you consider the intricacy of the process and all the things that could go wrong. To have a baby: »» A woman’s body must ovulate—release an egg from the ovaries »» The egg must travel through the fallopian tubes »» Along the way, the egg must be fertilized by a man’s sperm »» The fertilized egg must then attach—or implant—in the uterus »» The hormonal and nutritional environment must be able to support the pregnancy to full term »» Infertility can happen if a problem occurs in any of these vital steps.

Seeking the Cause “Many cases of female infertility are caused by a problem with ovulation, like polycystic ovary syndrome (PCOS),” indicates Dr. Marraccini. PCOS is a hormonal imbalance that interferes with normal ovulation. The ovaries may be enlarged with many small cysts—or fluid-filled sacs with microscopic eggs called follicles— that are visible on ultrasound.” Women with PCOS may have irregular, infrequent menstrual cycles, excessive hair growth or acne. Obesity is an added problem found in about 50 percent of women with PCOS. “But on a positive note,” says Dr. Marraccini, “diet and exercise that result in weight loss are likely to improve the frequency of ovulation and enhance a woman’s ability to get pregnant.”

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Other causes of infertility in women are blocked fallopian tubes, which may be due to pelvic inflammatory disease; endometriosis; or surgery for an ectopic pregnancy. Physical problems with the structure of the uterus and uterine fibroids are associated with repeated miscarriages.

“Male infertility may result from the absence of sperm or a low sperm count,” reports Dr. Marraccini. Or the shape of the sperm can affect the movement—or motility—and the ability of the sperm to fertilize the egg. Physical injury or other damage to the reproductive system may block the sperm. In rare cases infertility in men is due to a genetic disease such as cystic fibrosis.

Societal changes have affected fertility rates in our country as more women choose to wait until their late 30s or 40s before starting a family. In fact, roughly 20 percent of women in the United States now have their first child after age 35.

Age contributes to infertility in women in a variety of ways: older women have fewer eggs, their eggs are not as healthy and their ovaries are less able to release eggs. Adding insult to injury, women over the age of 35 are also more likely to have miscarriages. With all these factors combined, about one-third of couples in which the woman is age 35 or older have fertility problems.

Dr. Marraccini acknowledges that “determining the cause of infertility can be an arduous process—beginning with complete physical exams as well as medical and sexual histories of both partners. If no cause is identified, we may recommend additional tests.”

For men, this involves evaluating the number, shape and movement of the sperm. For women, testing may include analyzing body temperature and ovulation, x-raying dye flow through the fallopian tubes and a laparoscopy—a minor surgical procedure allowing the doctor to see inside the abdomen and examine the reproductive organs. Scarring and endometriosis can be detected through laparoscopy.

New Options, New Hope Medical science is no less amazing than the wonder of childbirth. The advances in reproductive medicine in the past 30 years are astounding, bringing new hope to couples who are struggling to get pregnant—with treatment options ranging from medication and surgery to artificial insemination and assisted reproductive technology. www.ourhealthvirginia.com | 43

OurHealth | MEN, WOMEN AND THE TOTAL BODY

Various medications may be used to stimulate ovulation. Dr. Marraccini notes, “We often prescribe Clomiphene citrate—called Clomid—for women who have PCOS. This medication is taken orally. For women who are resistant to other medications, a group of medications known as gonadotropins, which are injections, can be used to get most women who have ovulation problems to ovulate.” These are only two of a whole suite of medications that can help women achieve pregnancy.

In some cases, when a structural problem

exists,

surgery

can

increase the chances of natural conception.

Men

may

have

a

vasectomy reversed. Women may benefit from laparoscopic surgery for endometriosis, a myomectomy for uterine fibroids or surgery to repair the fallopian tubes.

“Most fertility cases—85 to 90 percent—are treated with medication or surgery,” says Dr. Marraccini, “and we are fully equipped to treat these patients in our practice and right here at Centra.” But when basic measures fail to result in pregnancy, couples may need more aggressive treatment options. “Then, we are happy to make a referral to a fertility specialist in Charlottesville or Richmond.”

Sometimes nature just needs a little help. One example is intrauterine insemination

(IUI)—often

called

artificial insemination. With IUI, the woman is injected with specially prepared sperm. She may also be treated with medication to stimulate ovulation. IUI is often used to treat mild male infertility or couples with unexplained infertility.

Assisted reproductive technology (ART) refers to a whole class of 44 | www.ourhealthvirginia.com

OurHealth | MEN, WOMEN AND THE TOTAL BODY

fertility treatments that involves removing the eggs from a woman’s body, mixing them with sperm to create an embryo and then transferring the embryos back into the woman’s body.

•••••

On July 25, 1978, at 11:47 p.m., a five-pound 12-ounce baby girl was born named Louise Joy Brown. She had blue eyes and blonde hair and was perfectly healthy.

The process was a success and the first “test tube baby” was born. Today, thanks to the perseverance and pioneering work of Dr. Patrick Steptoe and Dr. Robert Edwards, in vitro fertilization (IVF) is considered commonplace and utilized by infertile couples around the world.

••••• “There are several variations of ART that are similar to in vitro fertilization,” says Dr. Marraccini, “including intracytoplasmic sperm injection—or ICSI. This procedure may be used for couples who have experienced the disappointment of failed IVF attempts or where there is a serious problem with the sperm.

Here, a single sperm is injected into a mature egg and the fertilized egg is then transferred into the fallopian tube or uterus.”

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eggs, sperm or embryos that were donated by others—allowing a woman to experience pregnancy and birth, even though the baby may not be her biological child.

Women with ovaries but no uterus, or those who should not become pregnant due to health issues, may be able to use a surrogate or gestational carrier. Here, the mother’s egg is fertilized by the father’s sperm and the embryo is placed in the gestational carrier’s uterus. The baby is given to the parents after birth.

In the past, fertility treatments were associated with multiple births—twins, triplets, quadruplets and more. Fertility specialists today consider a single birth to be the true mark of success. According to Dr. Marraccini, “Multiple births add significant risks to both the mother and the newborns. I tell my patients they can have as many babies as they want—just one at a time.”

Beyond the Physical Infertility can cause a world of hurt that goes far beyond physical pain. The dream of the perfect family is shattered. The chance to carry on a name and legacy is gone. For many, the sense of loss is palpable. “Women and men coping with the inability to have children can experience a spectrum of feelings from shame and

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OurHealth | MEN, WOMEN AND THE TOTAL BODY

embarrassment to disappointment, grief and even personal failure,” says Dr. Marraccini.

The overwhelming emotions resulting from infertility are compounded even further by the financial pressures. Even with health insurance, the out-of-pocket expenses associated with infertility can be astounding. Some policies will cover the diagnostic workup; most do not cover the actual treatments. The bills can reach tens of thousands of dollars—beyond the reach of many couples who wish to add to their families. Some fertility clinics now offer financing options that include a money-back guarantee if a successful pregnancy is not achieved.

What Does the Future Hold?

The last three decades have led to exciting advances in reproductive medicine, but the future holds even more promise for effective, new fertility treatments.

Preimplantation genetic diagnosis (PGD) is an innovative spin on in vitro fertilization that can help couples who have serious genetic disorders—such as cystic fibrosis and Tay-Sachs disease—avoid passing them on to their children. PGD allows doctors to remove a single cell from an embryo to determine whether it has a

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genetic abnormality before transferring it into a patient.

For women suffering from PCOS, an insulin-promoting drug called metformin offers an encouraging new development.

Many women with PCOS who are not responsive to Clomid may respond better after treatment with metformin.

“As more and more women opt to delay childbearing, egg freezing may offer a solution to the rapid decline in fertility women experience after the age of 35,” says Dr. Marraccini.

“A woman can have her eggs frozen at age 30, and saved for the future. Then, if she wants to start a family at age 42, she can have her frozen eggs fertilized and the embryos transferred back into her body at a time when she would have been likely to run out of fertile eggs. As far as her fertility is concerned, she will be only 30 years old.”

Today, freezing eggs is common practice to preserve fertility, but experimental procedures—like freezing ovarian tissue, in vitro egg maturation and stem cell research to reverse ovarian failure or poor egg numbers—offer a glimpse into the fertility innovations of tomorrow.

For many, the desire to bear a child is as profound and essential as the desire to breathe. Thankfully, advances in medicine like these will allow more couples—like Ashley and Sam— to experience the joy of true Mother’s Day celebrations.

Sources: • Centers for Disease Control and Prevention, National Center for Health Statistics • Society for Reproductive Endocrinology and Infertility • U.S. Department of Health and Human Services, Office on Women’s Health • American Congress of Obstetricians and Gynecologists

Expert Contributor: • Christine Marraccini, MD, OB-GYN, Women’s Health Services of Central Virginia, practicing at Centra, Lynchburg, VA, www.WC.CentraHealth.com Resources: • RESOLVE National Infertility Association – www.resolve.org • American Society for Reproductive Medicine – www.asrm.org

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HealthyEats AH

BREA Y H T EAL

KFAST

Crockpot Apple Oatmeal Ingredients: 2 sliced apples

Directions: 1.

Add 2 sliced apples, 1/3 cup Stevia, and 1 tsp cinnamon in the bottom of the crock pot.

2.

Pour 2 cups of oatmeal and 4 cups of water on top. Do NOT stir.

3.

Cook overnight for 8 - 9 hours on low.

1/3 cup Stevia 1 teaspoon cinnamon 2 cups Steel cut oats 4 cups water

Tricia Foley’s

SPICY APPLE OATMEAL Tricia Foley is OurHealth Magazine’s resident nutritionist.

HealthyEats AH

LUNCH Y H T L EA

Artichoke Chicken Pitas Ingredients: 4 100% whole wheat pitas 16 ounces cooked chicken, sliced 3 tablespoons olive oil

Directions: 1.

Brush both sides of pita bread lightly with some of the oil. For a charcoal grill, place the pita on the rack of an uncovered grill directly over medium coals for 2 minutes or until golden. (For a gas grill, preheat grill. Reduce heat to medium. Add pita to grill rack. Cover and grill as above.)

1/4 teaspoon pepper

2.

Remove from heat.

3.

Top the grilled side of each pita with 4 ounces cooked chicken breast, spinach, cheese, artichoke hearts, garlic and tomato.

4.

Sprinkle with salt and pepper.

5.

Return to grill rack and grill about 2 minutes more until bottoms are browned and toppings are heated through.

6.

Top with pizza seasoning. Serves 4.

6 cups fresh spinach leaves 6 ounces feta cheese, crumbled 1 clove garlic, minced 26 ounce jar marinated artichoke hearts, drained and chopped 1 medium tomato, chopped 1/2 teaspoon salt Pizza seasoning (optional)

Tricia Foley’s

ARTICHOKE CHICKEN PITAS Tricia Foley is OurHealth Magazine’s resident nutritionist.

[ www.ourhealthlbss.com ]

sta y

TUNED.

HealthyEats A

Y DIN H T L HEA

N ER

Grilled Coconut Sweet Potato Kabobs Ingredients: 2–3 sweet potatoes, peeled and cut into 1-2 inch pieces

Unsweetened, coconut flakes (to taste)

1 one-pint container of plain Greek yogurt 1 tablespoon coconut oil

4.

Roll the entire skewer gently on a plate liberally sprinkled with the coconut flakes. Season with salt if desired.

5.

Pair with side salad and protein of choice. Serves 4-6.

Directions: 1.

Pre-heat grill to medium-high.

2.

Steam sweet potato chunks in a small amount of water, stovetop, for 10 minutes. Allow to cool.

3.

Place the sweet potato chunks on skewers, baste with plain Greek yogurt, and drizzle with coconut oil, then grill until lightly browned and crispy on the surface (about four minutes on each side).

Tricia Foley’s

SWEET POTATO KEBOBS Tricia Foley is OurHealth Magazine’s resident nutritionist.

OurHealth | HEART HEALTH MATTERS

words | LAURA L. NEFF-HENDERSON, APR

Heart attack strikes Lynchburg woman despite active, healthy lifestyle Much the same way she remembers the day she married her sweetheart and the day she gave birth to her daughter, Lynchburg resident Jessie Vogt remembers the day she had a massive heart attack. A date, and experience, permanently etched in her mind – and one that forever changed her life.

Until that day, Vogt had been the picture of health.

At 5’5 tall, Vogt is a trim woman who has never been overweight and takes pride in her passion to cook healthy meals for her family. She and her husband, Ed, work out together at least five days a week, often using the treadmill, recumbent bicycle, and weights in their basement. She works six hour shifts at a local book story during the work week and spends a lot of time at church each week, where her husband is the pastor.

The Vogts have always been active. Their daughter is 30-years-old, married, and has two children.

Vogt moved to Lynchburg in 2009 after retiring from a 27-year career as an interpreter for deaf and hard of hearing students in her native North Carolina.

The heart attack couldn’t have come as more of a surprise. In fact, just three weeks earlier, Vogt passed her annual check-up with flying colors and says her primary care physician was thrilled with her health.

56 | www.ourhealthvirginia.com

There was one thing though that would play a huge role in her heart health – a strong family history of heart disease.

Vogt’s mom suffered a heart attack at 43-years-old and her father underwent a quintuple bypass in his early 50s.

“That’s why we ate healthy and I stayed active - because I knew it ran so strongly on both sides of my family,” says Vogt. And, it’s why they raised their daughter to do the same, she explains.

•••••

September 22, 2012 – that’s the day everything changed for Vogt. She was just 53-years-old when she had a massive heart attack.

By all accounts, that Saturday morning was completely normal – in every way. Vogt and her husband had just returned from a week-long trip to Myrtle Beach, South Carolina, where they enjoyed a vacation with their daughter and her family building sand castles and playing in the surf.

They also enjoyed spending time feeding the ducks and playing at a local park and played a few rounds of miniature golf. And, a trip to Myrtle Beach wouldn’t be complete without doing a little outlet shopping as well.

Vogt spent the morning unpacking and took a trip to the grocery store to restock the empty refrigerator. She had plans later that day to visit a local orchard to buy apples for the apple butter she wanted to make that evening.

When she started to do some light household cleaning, she began to feel an intense pressure in her chest and knew pretty quickly that something was wrong – very wrong.

“I hadn’t had any symptoms leading up to this,” says Vogt. “Nothing.”

She managed to get her husband off the lawn mower and take aspirin before he drove her straight to Centra Lynchburg General Hospital.

Vogt didn’t make it more than a few feet into the lobby of the emergency room 58 | www.ourhealthvirginia.com

HEART HEALTH MATTERS | OurHealth

before she collapsed. And, that’s the extent of what she remembers until more than 48 hours later.

With help from her husband and the excellent nurses and doctors at the Centra Stroobants Heart Center, she’s pieced together the story and now knows that when she collapsed, a nurse she knows as Courtney, rushed to her side and began CPR. Several more nurses came running to help, a “Code Blue” was called, and, a defibrillator was used to deliver a therapeutic dose of electrical energy to her three times. She was subsequently intubated.

“Code Blue” is used in hospitals as an alert for when someone is in grave danger of dying. It usually means the person requires resuscitation.

“Patients presenting with chest pain who collapse can suffer from ventricular fibrillation and require emergent electrical cardioversion,” says Chad A. Hoyt, MD, medical director of the Stroobants Cardiovascular Center. “They can even present in severe shock and require placement of a venous catheter to cool the body and protect the brain.”

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HEART HEALTH MATTERS | OurHealth

“Within 38 minutes, I was in the Cardiac Catheterization Lab and they had begun the stent procedure,” says Vogt.

“Cardiologist Carl Moore, MD, placed two stents in the left descending artery, opening it back up so blood could flow again.”

Know the Five Signs of Heart Attack If you have any of the signs of a heart attack, acting fast can improve your chances for recovery and survival.

Call 911 immediately if you or a loved one experiences any of these common signs of a heart attack: »» PRESSURE or squeezing in the center of the chest. »» SHOOTING PAIN that spreads to shoulders, arms, neck or jaw.

“When a patient is in cardiac arrest,

»» NAUSEA, dizziness, fainting or sudden abnormal sweating.

every second counts,” says Dr. Hoyt.

»» SHORTNESS of BREATH

“The decision of a patient to seek

»» HEARTBURN or INDIGESTION-like pain

medical

attention

immediately

provides significant benefit. The longer

Women may also experience abdominal pain and weakness. To learn more, visit: www.knowthefive.com.

a patient waits, the more heart muscle is damaged.”

“I firmly believe that this immediate and timely treatment saved my life,” says Vogt.

and recover from the heart attack.

The nurses and doctors not only took care of me, they also

Vogt woke up in the Cardiac Intensive Care Unit a day later.

took care of my family,” says Vogt. “Dr. Moore is top notch

She didn’t know where she was, or what had happened,

and very caring and compassionate.”

and she was unable to open her eyes for a while.

By then, her family had all stared to arrive because doctors hadn’t been sure of whether or not she would live through the day. Luckily, her daughter was in the room and was

She also credits the constant prayer of friends and family with recovery.

•••••

able to understand Vogt’s signs that the intubation tube

Three days later, Vogt was released from the hospital.

was hurting her and needed to be moved.

memory,” says Dr. Hoyt.

Those first few months were hard; harder than she had expected. They were also plagued with the fear that she could do something, anything, that might cause another heart attack.

It turns out her healthy and active lifestyle played a role

Within a few weeks, she began cardiac rehabilitation at

in saving her life too. The heart attack, according to Vogt,

The Stroobants Heart Center, located at The Cardiovascular

was caused by a piece of plaque that dislodged and ended

Group. The purpose of the three-month program is to

up blocking the artery. The fact that she was otherwise

monitor and improve the recovery process, increase fitness

perfectly helped, allowed her to survive the stent procedure

and reduce the risk of future heart problems.

“When a patient suffers a traumatic situation, their body can enter a state of shock, and could result in lack of

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HEART HEALTH MATTERS | OurHealth

The program, says Vogt, was a wonderful resource, and

rehabilitation program with helping her let go of some of

a tool she came to rely on in her recovery. The medical

the fears that came with such a traumatic experience.

professionals she worked with, and the other cardiac patients

In February 2013, Vogt returned to Stroobants Heart Center

she met, left such a positive impression on her heart that she

for a cardiac catheterization, a procedure this allows

now volunteers at the center twice a week.

doctors to view the chambers, valves, and coronary arteries

“They were so helpful to me and I want to pay that forward,” says Vogt.

in the heart to determine if there are blockages or other

It took her about six months, she says, to start feeling almost normal again.

By then, she’d been able to build her strength back up and return to an active lifestyle, though she admits things are different now.

problems.

“Thank God there was no damage! I am a walking miracle thanks to the Lord, Dr. Moore, and the wonderful staff at Centra’s cardiac unit I am alive today,” says Vogt.

“Had I been back in North Carolina, I would not be alive today because they don’t have that kind of cardiac team there,” says Vogt. Her nephew, who manages the cardiac

“I do get tired more quickly. When that happens, I take a

rehab program at the hospital in her hometown, agrees,

break and get right back to it.”

according to Vogt. In the year since Vogt’s heart attack, she

She also credits the medical professionals in the cardiac

has undergone extensive cardiac rehab. Although a slow, gradual progress, she has regained her physical strength www.ourhealthvirginia.com | 63

OurHealth | HEART HEALTH MATTERS

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HEART HEALTH MATTERS | OurHealth

and is back to her active lifestyle.

reduce the risk of future cardiac problems.

Vogt’s advice to people who may not make the best lifestyle choices, regardless of whether they have a family history of heart disease, is that now is the time to start eating right and exercising.

She continues to work, garden, and cook and is actively

“That may not have stopped my heart attack, but if I had not

involved in her church as well as her knitting club and her

done those things, there would have been no pulling through

volunteer work.

this for me,” she says.

In addition to maintaining her diet and exercise regime, Vogt is on a daily dose of several different medications to help

www.ourhealthvirginia.com | 65

Jimmy Moore’s tired legs a symptom of something more Jimmy Moore’s legs hurt, but he didn’t know that his life was in danger. After all, he was 72 and had spent a lifetime on his feet. It only seemed natural that his legs would be tired.

The Forest resident had stood on concrete for years as a machinist for Babcock & Wilcox and Framatome. He had played football at E.C. Glass High School and marched in the U.S. Army in Korea. He had remodeled basements, built decks and helped frame houses.

OurHealth | PERIPHERAL ARTERY DISEASE (PAD)

Until last year, he had taken care of the soccer and lacrosse fields at Forest Youth Athletic Association Park. For 10 years, he tirelessly tended to the family vegetable garden.

A few years after he retired, he was diagnosed with chronic bronchitis, caused by an early-in-life smoking habit. But that didn’t turn him into a couch potato. He enrolled in Centra’s pulmonary rehabilitation program at the Jamerson Family YMCA. Up at 4 a.m., by 5 o’clock he was pulling out of his driveway to work out at the Y. Although he stayed active, the pain in his legs was growing worse. It hurt to climb stairs. He couldn’t walk to his mailbox 50 yards from his house without stopping.

He would wait five minutes. The pain would go away, and he could walk again. At the Y, after five to seven minutes of his workout, he would have to stop because the pain in his legs was so intense.

“It was as if someone was putting a knife in my calves,” Moore said.

“I had never felt anything like it. That pain put a normal cramp to shame. But the pain would go away and then it would come back. By March, the pain was excruciating. I told my wife I didn’t know how I was going to continue exercising.”

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PERIPHERAL ARTERY DISEASE (PAD) | OurHealth

Then Moore discovered an open crack in his heel while he was crewing for his daughter, who was trail-running. His wife bandaged the sore, but it didn’t heal. “My podiatrist looked at the crack and felt my feet. He said, ‘Jimmy, you have very little pulse in your feet. It won’t heal unless you have some circulation.’”

Moore

was

referred

to

the

Centra Medical Group Stroobants Cardiovascular Center. He was the last patient that Thursday afternoon to see Ronald Morford, MD, boardcertified cardiologist with the center.

The next morning, Moore was in the hospital. Dr. Morford cleared three blockages in the arteries of his right leg by balloon angioplasty and placed a tiny balloon behind Moore’s right knee to restore his circulation.

Three months later, Dr. Morford placed two stents in arteries above Moore’s left knee.

Without these minimally invasive procedures, Moore might have lost his foot, his leg or his life.

Peripheral Artery Disease Moore’s leg pain wasn’t the result of standing on concrete, marching in the military, building houses, taking

care

of

athletic

fields,

exercising, gardening or a natural part of aging. It was the result of peripheral artery disease (PAD), a progressive condition that results from the narrowing of the vessels that supply oxygen-rich blood to the legs, abdomen, pelvis arms or neck. The disease affects 8 to 12 million people in the United States, especially those over age 50. www.ourhealthvirginia.com | 69

OurHealth | PERIPHERAL ARTERY DISEASE (PAD)

Peripheral vascular disease is similar to another silent killer—high blood pressure—because of the lack of symptoms in its earliest stages. A person may have blockages in the arteries of the legs, but in PAD’s early stages, the blockages are not significant enough to cause pain. But as time goes by, the blockages worsen, causing many of the symptoms experienced by Moore, including: »» Aching, tiredness or pain in the legs during walking or exercising, which disappears after a few minutes of rest »» Numbness and tingling in the lower legs and feet »» Coldness in the lower legs and feet »» Ulcers or sores on the legs or feet that don’t heel PAD is similar to coronary artery disease and carotid artery disease—all three of the conditions are caused by narrowing or blockages of the arteries, also known as artherosclerosis, or the buildup of plaque in the arteries. When the muscles in the legs are not fed adequately with blood, they respond with cramping because they are being starved of oxygen. People with PAD are at a high risk for heart attack and stroke, and advanced PAD can result in amputation.

A simple test, called the Ankle-Brachial Index (ABI), in which blood pressure is measured in the arm and foot, is used to diagnose PAD. Blood pressure should be the same everywhere; if it is lower in a patient’s foot than in the patient’s arm, there is a blockage somewhere in 70 | www.ourhealthvirginia.com

PERIPHERAL ARTERY DISEASE (PAD) | OurHealth

between. ABI can be performed in a doctor’s office or at national screenings called Legs for Life, which are coordinated by the Society of Interventional Radiologists.

In its earliest stages, when a patient does not feel any pain, PAD can be modified or even reversed through lifestyle changes, including, »» Exercise—walking 30 minutes a day cuts the risk of PAD in half »» Daily aspirin or similar medicine »» Smoking cessation »» A healthy diet »» Cholesterol management. Statin medications have been found to be effective regardless of the cholesterol levels »» Blood pressure control

Ronald Morford, MD, board-certified cardiologist with the center.

»» Diabetes management

Back to the life he loves The day after Moore underwent balloon angioplasty in his right leg, he walked to his mailbox without stopping. “My leg didn’t hurt me one bit,” he said. “It was if

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OurHealth | PERIPHERAL ARTERY DISEASE (PAD)

someone had gone to a light switch and turned it on. I had no idea you could go through a procedure like this and completely change your lifestyle.”

Moore added that after the procedure the crack in his heel healed in a very short time.

He is back to long hours tending his vegetable garden and early morning workouts at the Jamerson Family YMCA — all without pain.

“I can’t say enough good things about Centra,” he said. “The care is just fantastic. I can’t begin to bring the words together to say how great Centra is. Dr. Morford changed my life overnight.”

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IMAGE COURTESY OF LYNCHBURG HISTORY

OurHealth | LOOKING BACK

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Looking Back

How well do you know your healthcare history in Southwest Virginia? If you recognize this structure from the past, post

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your answer on the OurHealth Facebook page by March 5, 2014 for a chance to win this issue’s Looking Back contest! Scan the QR code to go to our Facebook page or visit www.facebook.com/ourhealthmagazine.

Individuals posting correct answers by March 13, 2014 will be entered to

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2000

$25 gift card to Fresh Market!

The winner will be announced on OurHealth’s Facebook page March 20, 2014.

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