OurHealth Lynchburg & Southside Feb/Mar 2016 Edition by OurHealth Media LLC

table of contents | february • march 2016

Heart Care:

How Far We Have Come

Although heart disease continues to be a leading killer, advancements in science and technology coupled with the expertise of various medical experts in the field have contributed to a significant decrease in heart disease and heart-related conditions.

MEDI•CABU•LARY.....................10 Local experts define health-related terms

JUST ASK!.......................................12 Healthcare questions answered by local professionals

NEW & NOTEWORTHY.............14 A listing of new physicians, providers, locations and upcoming events in the Lynchburg and Southside communities

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

THE ANATOMY CHALLENGE..................................19 Are you up for the challenge? In this issue, test your knowledge when it comes to the PATHWAY OF BLOOD THROUGH THE HEART.

OurHealth presents a new on-going series about the role primary care doctors play in preventative health, by emphasizing the importance of the relationship between a patient and their doctor.

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

New Kitchen, New Nutrition, New You!

In 2016, our New Kitchen, New Nutrition, New You series puts the focus on helping you get healthier in the kitchen — one ingredient at a time. Each edition of OurHealth will highlight small changes you can make in your food prep and shopping habits that can add up to a major positive impact on your nutrition and health.

hello, HEALTH!.............................. 42 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos

FIT BITS!........................................ 53 2016 FITNESS TREND ‘WATCH’ Deidre Wilkes, OurHealth's resident fitness specialist, shares how wearable technology is the fitness trend of the year.

Giving a Little Can SAVE A LOT of Lives

Words of gratitude can only begin to describe the emotion a small-town couple feels toward someone they have never met. Rebecca Tomlin and her husband, Mike, share their heartfelt story of receiving a lifesaving gift they didn’t know they needed.

NUTRITION.................................. 55 HEALTHY EATS: Check out OurHealth staff favorite recipes including Asian Broccoli and Black Bean Brownies!

CLOSER LOOK..............................66 Images reflecting the landscape of healthcare in Lynchburg and Southside * PLUS * a chance to win a free year's subscription to OurHealth!

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february • march 2016 PUBLISHER PRESIDENT/EDITOR-IN-CHIEF VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR ACCOUNTING MANAGER CHIEF GRAPHIC DESIGNER GRAPHIC DESIGNER PROJECT MANAGER | HR METRICS COPY EDITOR DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY ORIGINAL COVER ART WEBSITE

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CONTRIBUTING MEDICAL EXPERTS Chapman Brown, RPh Brad Lentz, DMD Clifford Phillips, OD Richard Spice, CPed, CFo Mark Townsend, MD CONTRIBUTING PROFESSIONAL Cynthia BeMent EXPERTS & WRITERS Jeanne Chitty Tricia Foley, RD Tina Joyce Stephen McClintic Jr. Heather Pippen Deidre Wilkes

ADVERTISING AND MARKETING Cynthia Trujillo | Senior Media Consultant P: 434.907.5255 | cindy@ourhealthvirginia.com

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SUBSCRIPTIONS To receive OurHealth Lynchburg and Southside via U.S. Mail, please contact Deidre Wilkes at deidre@ourhealthvirginia.com or at 540.387.6482

ourhealthLBSS.com then click on the magazine cover to view the digital edition! COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2016 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Lynchburg/Southside is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.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 Diabetic Retinopathy? Diabetic retinopathy is the most common diabetic eye disease, and it occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases new blood vessels grow on the surface of the retina.

“

Crowns are typically recommended when a tooth is prone to fracture, such as after root canal treatment, or when the tooth is too weak to retain a traditional filling.

”

- Brad Lentz, DMD

Background or nonproliferative diabetic retinopathy (NPDR) is the earliest stage of diabetic retinopathy. With this condition, damaged blood vessels in the retina begin to leak extra fluid and small amounts of blood into the eye. Many people with diabetes have mild NPDR, which usually does not affect their vision. In the early stages of NPDR, treatment should consist of a yearly eye exam, and keeping your blood sugar levels well-controlled. Diet and exercise can help control the progression of the disease.

Clifford Phillips, OD

St. Clair Eye Care Lynchburg | 434.845.6086 www.stclair-eye.com

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

What is Tetralogy of Fallot? Tetralogy of Fallot (TOF) is associated with low oxygen levels after birth and is the most common congenital heart defect. Historically, children born with severe versions of TOF do not fare well. People born with more severe cases often need several heart surgeries throughout their life, but are able to lead a full and active lifestyle. Those affected by TOF need lifelong care from pediatric and adult congenital cardiologists. Mark Townsend, MD

Pediatric Cardiologist Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252 tcg.centrahealth.com

What is the difference between a filling and a crown? A filling is material placed directly within or on the surface of a tooth. A filling replaces a defective tooth structure, usually from a cavity, and is completed in one office visit. The common types of filling material are white (bonded) and silver (amalgam). A crown is a type of restoration which encompasses the entire tooth, similar to a baseball hat on top of one’s head. A crown requires the tooth be trimmed (filed) around the outside and chewing surfaces so there is sufficient room to place the crown over the tooth, and then the crown will be bonded securely. Crowns are made from different materials such as gold and porcelain, with newer materials such as zirconia and lithium disilicate gaining popularity with dentists. Crowns are typically recommended when a tooth is prone to fracture, such as after root canal treatment, or when the tooth is too weak to retain a traditional filling. Crowns traditionally take two office appointments since the final crown is typically made at a dental laboratory.

Brad Lentz, DMD

Lynchburg Dental Center Lynchburg | 434.384.7611 www.lynchburgdentist.com

H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS

“

Antiviral drugs work best when taken within 48 hours of onset of flu symptoms, but they may still offer benefits when taken later. Seek treatment from your local healthcare provider as soon as flu symptoms appear, and be sure to get a flu vaccine each year for best protection against the flu.

”

Are antiviral drugs effective in treating the flu?

What role can orthotics play in treating diabetic foot problems?

Antiviral medications prescribed for treatment of influenza viruses are an important addition to vaccines in the control of the flu. Three antiviral medications currently approved by the Food and Drug Administration (FDA) are recommended for this year’s flu season. Oseltamivir (Tamiflu), Zanamivir (Relenza), and Peramivir (Rapivab) are the antivirals available by prescription for flu sufferers. Early treatment with these antiviral drugs can shorten the duration of fever and other flu symptoms.

Diabetes is a blood disease that can affect your circulation, especially in your feet. Not only is your circulation affected but your skin can become thinner over time. Your feet can lose their ability to alert you of issues and sometimes this combination of pressure and thinning of skin can lead to an ulcer. Based on Medicare studies, nearly 15 percent of the 29 million people in the U.S. that are diabetic will develop an ulcer. Medicare also states that nearly 80 percent of the foot ulcers that occur are preventable. By supporting and redistributing your body weight evenly over the surface area of the foot, you can prevent added pressure from developing under the heel or the ball of your feet, which are the most common places for ulcers to develop. Custom made foot orthotics, where your feet are casted by a certified medical professional, can play a big role in treating diabetic foot problems by preventing the pressure from developing in the first place.

Chapman Brown, RPh Gretna Drug Gretna | 434.656.1251 www.gretnadrug.com

- Chapman Brown, RPh

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

Richard Spice, CPed, CFo Excel Prosthetics and Orthotics Lynchburg | 434.528.3697 www.excel-prosthetics.com

What are some signs that it is time to move a loved one from independent living to an assisted living option? There are some very good clues that indicate when someone should move into assisted living. One of the main reasons is to receive help with medication management, according to the Assisted Living Federation of America. When there are signs your loved one is no longer safely and effectively managing their medications, this is a good indication a move is necessary. Other indications are that your loved one appears to need more help with activities of daily living, such as bathing and dressing. These also include assistance with other aspects of hygiene, incontinence management, and ambulation. Assisted living provides supervision and physical assistance with all of these, as well as meals, housekeeping and laundry services, and a full range of activities programming. If you’ve noticed your loved one is not getting nutritious meals, would benefit from interaction with others, or has difficulty managing other daily tasks, then it might be time for an assisted living option. Facilities offering assisted living will meet all of these needs, while providing support in a home-like environment.

Heather Pippen, Executive Director Heritage Green Assisted Living and Memory Care Lynchburg | 434.333.0503 www.heritagegreenlynchburg.com

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NEW

NOTEWORTHY Centra Foundation Receives Estate Gift of $6.5 Million

NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS

Audiology Hearing Aid Associates in Lynchburg and Danville

Centra Foundation is pleased to announce that it is the recipient of a bequest of $6.5 million from the estate of Alan B. Pearson. This gift was given by Mr. Pearson to support the programs and services of Centra’s Alan B. Pearson Regional Cancer Center. Mr. Pearson, who passed away in November was, according to Dr. Kathryn M. Pumphrey, Executive Vice President of the Centra Foundation, “passionate about helping individuals diagnosed with cancer. Alan loved our community and wanted to help people and make a difference in their lives.”

With the cutting edge technology in the hearing aid industry today, it’s amazing that still only one in five people who need a hearing aid actually wear one, according to the National Institutes of Health. Today's hearing aids offer greater style and technology options - making them better-performing, better looking, and easier to wear. Audiology Hearing Aid Associates offers a wide selections of hearing aids and services for all ages. Visit Audiology Hearing Aid Associates today, in one of their two convenient locations, or call to schedule your next hearing appointment. For information on services, devices, and what to expect at your appointment, visit www.digitalhearing4u.com.

“This bequest, along with Mr. Pearson's previous contributions, makes his lifetime gift to the Centra Foundation the largest in the foundation’s history, over $10.8 million,” says Pumphrey.

Danville Office

It is because of Alan’s philanthropy that Centra opened the Alan B. Pearson Regional Cancer Center in 2008. His support of cancer care at Centra began in 1998 with generous donations to the Centra Foundation to sponsor free prostate screenings for men who could not afford them. He also supported nursing scholarships for students attending the Centra College of Nursing.

Lynchburg Office

743 Main Street Danville, VA 24541 434.799.6288

2104 Langhorne Road Lynchburg, VA 24501 434.528.4245

“We are extremely grateful to Mr. Pearson for his generosity,” says E.W. Tibbs Jr., President and CEO of Centra. “He has always held this medical community in high regard, and this contribution will make a lasting difference in the lives of the people we serve.” For more information about the Centra Alan B. Pearson Regional Cancer Center, visit www.cancer.centrahealth.com.

Joshua Alley, MD

Bariatric surgeon Centra Weight Loss Services Lynchburg | 434.200.3901 www.centraweightloss.com

Andrew Anderson, DO Central Virginia Family Physicians Lynchburg | 434.237.6471 www.cvfp.net

Joel Burroughs, MD

Central Virginia Family Physicians Rustburg | 434.332.7367 www.cvfp.net

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

Joshua Carapezza, PA-C Tracy Hall, NP Central Virginia Family Physicians Hurt | 434.324.9150 www.cvfp.net

Centra Medical Group Gretna | 434.656.1274 www.centramedicalgroup.com

Some information in the Best Bedside Manner Awards issue was incorrect. Below is the corrected information.

Optometry Honorable Mention R. Luke Wagoner, OD Wagoner Family Eye Care Lynchburg | 434.385.0213 www.wagonereye.com

Periodontics

Centra Weight Loss Services Now Offers Bariatric Surgery Centra Weight Loss Services is now offering bariatric weight loss surgery. Joshua Alley, MD, will handle general surgery cases through Centra Medical Group Surgical Specialists. As obesity trends continue to rise across the country, Dr. Alley brings another dimension to Centra’s comprehensive care. Dr. Alley specializes in the three most common, minimally invasive bariatric surgeries, including laparoscopic gastric bypass, laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric band. According to research, bariatric surgery benefits patients with type 2 diabetes and significantly reduces vascular events, sleep apnea, hypertension, joint disease and cholesterol. Studies also show that individuals with obesity live longer after having bariatric surgery. For more information on weight loss surgery and upcoming free seminars, visit www.centraweightloss.com or call 434.200.3901.

First Place Ryan Anderson, DDS

Periodontal Health Associates Lynchburg | 434.455.2444 www.periodontalhealthassociates.com “All too often healthcare professionals neglect interpersonal skills and forget that a good bedside manner is one of the main tools for diagnosis. Patients are more likely to open up and share with their doctor when they feel comfortable with them. Certain ailments are awkward to discuss with a stranger and by providing a positive demeanor in a relaxed atmosphere we are more likely to get the information needed to administer effective care.”

Pediatrics First Place

R. Skyler McCurley, MD

F. Read Hopkins Pediatric Associates, Inc. Lynchburg | 434.237.8886 www.hopkinspediatrics.com “The encounters that I have with families are meant to create long term relationships; I try to treat everyone like a neighbor, or a friend. I am honored to be recognized for building this kind of trust and openness.” www.OurHealthlbss.com

TI P S , T I D B I T S A ND MO R E TO I NF O R M A ND ENT ERTA I N YO U

Heart Trivia in Honor of American Heart Month

February is American Heart Month! Here are some fascinating facts about the human heart! See if you can ‘fill in the blanks’ (answers below):

The heart beats about ________times in one day. In an average lifetime, the human heart will beat more than 2.5 billion times.

The heart pumps about ________barrels of blood during an average lifetime – enough to fill more than 3 super tankers.

A kitchen faucet would need to be turned on all the way for at least ____ years to equal the amount of blood pumped by the heart in an average lifetime.

Because the heart has its own electrical impulse, it can continue to beat even when separated from the body, as long as it has an adequate supply of _________.

g n i t ina

Fasc

FACT:

e e area of th The surfac g is large human lun cover enough to fa one side o rt! tennis cou

For more information on heart disease and how to be heart healthy, schedule a check-up with your local family physician or visit the American Heart Association at www.heart.org. Answers:

A: 100,000

B: 1 million

C: 45

D: oxygen

March is National Nutrition Month! A healthy lifestyle includes nutrition – what we put in our body for fuel and protection from disease and illness. Here are some helpful tips to keep you on track:

Eat more whole foods

Avoid foods with more than five ingredients.

Plan healthy menus as a family

It really is the most important meal of the day.

the Lynchburg Community Market, open year-round on Saturdays from 7:00 am to 2:00 pm You can purchase fresh fruits, vegetables, produce and bakery items from local vendors. Visit their website at

Support your local farmer’s market

for more information and special events.

Work together to make healthy choices you will all enjoy.

Don’t skip breakfast

It is a great source for fresh fruits, vegetables and nuts. For additional resources on nutrition and healthy eating, visit the Academy of Nutrition and Dietetics at www.eatright.org.

Be sure to check out

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

www.lynchburgcommunitymarket.com

Beat the Winter Workout ‘Blues’

Finding the motivation to exercise during the week is already difficult for most people. During the cold, dark weather months, it can be nearly impossible for many to muster up the strength to get off the couch and into their workout gear. Here are a few tips to boost motivation and avoid a winter workout rut:

Find a winter activity you enjoy. The winter season is the perfect time to try a new winter sport like skiing, snowboarding, ice skating or snowshoeing.

Mix up your routine.

Did you know?

Every time you

step forward, you use

When you get the workout “blahs,” aim to challenge yourself by having a workout “adventure” once a week. Try a new group exercise class, sport, a different interval workout or running route.

Try interval training. Interval training alternates bouts of high and moderate activity. Another bonus of interval training is that the workout can be completed in a shorter period of time. Running outside is a great way to introduce interval training. Intervals can also be done on any indoor workout machine like the bike, treadmill, rower or elliptical.

Make working out a social activity – get a workout buddy or join a team. Whenever you need some extra motivation, make your workout a social activity. You are less likely to skip if your friends are waiting for you. Join a sports team or make dates with friends to go to exercises classes.

Invest in fun new winter active wear. Still trying to figure out what to use that Christmas gift card for? Treat yourself to a new pair of running shoes or a new outfit for inspiration!

Looking for more?

Scan here to check out the OurHealth calendar for more healthy activites in your area.

muscles!

No Runner

Left Behind Trail

Fun Run

Join the Blue Ridge Trail Runners in the far corner of the SnowFlex parking lot on Candlers Mountain for a Monday fun run. This run is usually 5 miles and while the route is not marked participants wait for everyone at each turn. DATE: TIME:

Weekly on Mondays 5:30 pm

LOCATION: SnowFlex 3998 Candlers Mountain Road Lynchburg, VA 24515 For additional information visit www.blueridgetrailrunners.com.

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the

Anatomy

CHALLENGE How much do you know about the

Pathway of Blood Through

the Heart? First, complete the word search below. Next, match up the correct word with the part of the body in the illustration.

[ the Heart ]

WORD SEARCH aorta

right atrium

aortic valve

right AV valve

inferior vena cava

right pulmonary artery

left atrium

right pulmonary veins

left AV valve

right ventricle

left pulmonary artery

superior vena cava

left pulmonary veins left ventricle pulmonary valve

_________________

1 _________________

_________________

_________________ _________________

_________________

_________________ _________________

_________________

For answers, visit OurHealth Lynchburg & Southsideâ&#x20AC;&#x2122;s Facebook page at

Follow the numbers to see the pathway of blood through the heart! www.OurHealthlbss.com

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

HEART CARE:

How Far We Have Come words | RICH ELLIS

The evolution of the subspecialty of cardiology is widely considered being responsible for the greatest prolongation of life in industrialized nations. Advancements in science and technology coupled with the expertise of various medical experts in the field have contributed to a significant decrease in heart disease and heart-related conditions. Although heart disease continues to be a leading killer, the death rate by age and impact to population per capita during the 21st century is markedly less than during the 20th century. To learn more about cardiovascular care, OurHealth turned to specialists from University of Virginia Health System.

Cardiologists versus Cardiovascular Surgeons Patients often confuse the roles of cardiologists and cardiovascular surgeons, mistakenly believing that there are no discernable differences in the types of services they provide, the conditions they treat or the procedures they perform. It’s a popular misconception and understandably so because both focus on caring for, diagnosing and treating conditions related to the heart and vascular system — but that’s where the similarities end. Cardiologists and cardiovascular surgeons work closely together, and the lines are becoming more blurred, says Ravi Ghanta, MD, assistant professor of surgery and a cardiovascular surgeon with the University of Virginia Health System, but there are distinct differences between the two specialties.

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Cardiologists manage cardiovascular diseases of the heart and blood vessels in terms of their diagnostics and medical treatment, Dr. Ghanta explains, and although they are not performing surgery, some cardiologists perform catheter-based procedures, the most common of which is stenting coronary arteries. Cardiovascular surgeons, on the other hand, manage the decision as to whether heart or vascular surgery is necessary; when it is, they perform it. Examples include coronary artery bypass grafts and heart valve procedures, all of which affect the flow of blood to the heart.

“There have been a lot of exciting changes in the last five years in the management of valvular heart disease,” Dr. Ghanta explains. “In the past, the only way to manage it was through open surgery, but now there are new devices and technologies that allow us to treat some valvular disease with catheter techniques. Those are procedures that are performed by a multidisciplinary team of cardiac surgeons and interventional cardiologists.” Using coronary artery disease — blockage of the heart arteries — as an example because it’s one of the most common conditions, Dr. Ghanta says that typically a cardiologist would be involved in identifying the presence of the disease and optimizing medicines and medical management to prevent the disease from progressing. The cardiologist would also perform and interpret diagnostic tests, such as an ultrasound of the heart and cardiac catheterization, to determine the disease’s extent. If the disease can be managed with a coronary stent, a cardiologist would perform that procedure as well. If, however, the disease is extensive and the cardiologist felt that the patient 22

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needed to have cardiac surgery, the patient would be sent to a cardiovascular surgeon for evaluation.

Every 25 seconds an American will have a coronary event. “The cardiovascular surgeon would evaluate the patient and whether or not we can perform a bypass operation on them,” Dr. Ghanta explains. “If we can, then we would do the bypass surgery, take care of the patient during and after surgery, and when they’ve recovered from the surgery, they would go back to their cardiologist to resume care. “We’re very closely allied, and we work closely together,” Dr. Ghanta says. “We just have different areas of focus.”

Continuing Improvement with LVAD’s One of those areas of focus for Leora Yarboro, MD, a cardiovascular surgeon and an assistant professor of cardiac surgery with the University of Virginia Health System, is a device called an LVAD — left ventricle assist device. These implantable, mechanical devices don’t replace the heart but rather help a weakened heart pump blood. “Heart failure is a big problem in the U.S. and in our region in particular,” Dr. Yarboro explains. “It brings people into the hospital frequently with readmissions and is a significant cause of mortality, so there is a lot of interest in heart failure medicine, which is what cardiologists do, and there’s also a new interest in heart failure surgeries, which is what I do.” LVADs are the gold standard for patients with advanced heart failure who aren’t responding to medication, Dr. Yarboro says. Many of these patients need a heart transplant, but there aren’t enough donor hearts available. That’s where the LVAD can come into play. For patients who are candidates for a heart transplant, an LVAD can improve their quality of life because it enables them to live outside the hospital until a donor www.OurHealthlbss.com

heart becomes available. It’s a similar situation for older patients whose hearts aren’t pumping with enough force but who aren’t candidates for a heart transplant. Many of those patients can use the LVAD to assist their weakened heart for as long as they live, improving their quality of life too. Today’s LVADs are much smaller than the original ones that were about the size of a grapefruit; they were implanted into the abdomen and were unsuitable for use in women because of the device’s size. With the new version's reduced size, it can be implanted in both men and women next to the heart where it serves as a pump. The LVAD is frequently used to assist the heart’s left side — the side that most often needs assistance because it’s the heart’s workhorse, Dr. Yarboro explains. The LVAD can also be used to take over the full pumping function for that side of the heart if needed. LVADs are powered by a driveline that’s connected 24/7 to rechargeable batteries the patient carries in a package small enough that it usually goes unnoticed. “Some of the newer advancements that we’re hoping to achieve in the next couple of years are fully implantable devices where there’s nothing outside the body at all,” Dr. Yarboro says. “That’s the future of these devices — to become smaller and fully implantable.” Newer pumps should also be able to sense when the patient’s activity level increases and adjust the pumping rate accordingly, something that today’s LVADs can’t do.

Evolving Treatment of Aortic Aneurysms In addition to performing heart surgery, cardiovascular surgeons also perform surgery on the vascular system. For Dr. Ghanta, that often means treating aortic aneurysms. “Aortic aneurysms are common conditions that occur when the aorta — which is the main blood vessel in the body that sends blood away from the heart to the rest of the body — enlarges to greater than 1 1/2 times its normal size,” Dr. Ghanta explains. “This 24

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

dilation can be caused by multiple factors but most commonly by high blood pressure and sometimes by having a connective tissue disorder, of which Marfan syndrome is the most common.” “Most aneurysms are asymptomatic, so most people don’t know they have them, and they are frequently picked up on imaging tests done for other reasons,” says Dr. Ghanta. However, depending on the aneurysm’s location, some patients may complain of chest, back or stomach pain or — if the aneurysm is located in the chest — shortness of breath. Aneurysm treatment has evolved over the last several years, Dr. Ghanta says. The traditional way to treat an aneurysm is through open surgery. Depending on where the aneurysm is located, that surgery is performed through the breast bone, between the rib or in the abdomen, and it sometimes requires the use of a heart-lung machine. The surgery involves removing the aneurysm and replacing it with a fabric tube that’s sewn into place. While it is a major surgery, it’s also a very common one that has had great success and is very safe; its risks have decreased significantly over time.

“What’s developed over the last several years is catheter-based technology to treat aneurysms,” Dr. Ghanta explains. “This allows us to put a fabric tube or stent inside the blood vessel to exclude the place where the aneurysm is located. Instead of making an incision and performing open surgery, we go in with a catheter and deploy this stent to cover the area where the aneurysm is, eliminating the need for open surgery.” This type of procedure was initially used to treat aneurysms in the abdomen and is now being used for ones located in the chest. Not every aneurysm can be treated with this procedure, particularly when the www.OurHealthlbss.com

aneurysm is in a complicated location such as where there are branches off the aorta leading to major organs. Those types of aneurysms are more difficult to treat with stent therapy because the blood vessel leading to the organ can’t be covered up with a stent. In those situations, open surgery is still the standard treatment, but there are some new technologies and techniques being developed that could allow for stent-based therapies to be employed in those areas as well.

Ravi Ghanta, MD is a surgeon and assistant professor of surgery with the University of Virginia Health System. He is certified by the American Board of Surgery and the American Board of Thoracic Surgery.

Additionally, Dr. Ghanta points to advancements that are being made in learning how and why aneurysms form and the development of medical therapies to reduce their size.

Leora Yarboro, MD is a surgeon and assistant professor of surgery at the University of Virginia Heart and Vascular Center. She is certified by the American Board of Surgery and the American Board of Thoracic Surgery.

“Sometimes patients have aneurysms, but we don’t feel they’re big enough to warrant surgery,” Dr. Ghanta says. “Instead we’ll use aneurysm surveillance and periodically use imaging to see if it’s growing in size or if any concerns have developed. If they have, then we will take the patient for a procedure. There are a large number of patients who have aneurysms who don’t end up having surgical procedures.”

Be Heart Smart Avoiding cardiac and vascular disease through diet, exercise and preventive care and by avoiding tobacco use should be every patient’s goal. But when that isn’t possible because of genetics or the presence of disease or other conditions, a patient’s primary care physician can refer them to a cardiologist as the next step in the diagnosis and treatment sequence. Contributing Medical Experts: Ravi Ghanta, MD, surgeon and assistant professor of surgery with the University of Virginia Health System. Leora Yarboro, MD, surgeon and assistant professor of cardiac surgery with the University of Virginia Health System.

Sources: American Heart Association – www.heart.org

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the 2016 OurHealth Lynchburg and Southside Primary Care Series: an issue-by-issue overview

+++ february

| march

KNOW YOUR CARE: understanding your health and how to maintain it

+++ words | JEANNE CHITTY and STEPHEN McCLINTIC, JR.

know

YOUR

care

An apple a day keeps the doctor away. This age-old proverb

Understanding your health and how to maintain it

certainly carries its share of credibility. People around the world live by it and keep their crispers crammed with the tasty treat. And it has spawned several studies by researchers about the health benefits of apples. No doubt about it, loyalty to apples is long-lived because this proverb professes how good they are for us.

Know what else is good for us? Going to a primary care doctor. Not keeping him or her away. Yes, doctors can help heal us when we’re sick, but they can also help us stay healthy, empower us with preparedness and beat the bugs before they have a chance to bother us. Primary care doctors promise to be our health’s greatest advocate, our partner in prevention, our companion in care. OurHealth Lynchburg and Southside is pleased to introduce a yearlong series focusing on the role of primary care. In each issue throughout 2016, we will take a detailed look into the specialty, providing information that expands on some of what we might already know and much about what we might not. We will deliver insight from local doctors and other healthcare providers and share personal stories of people living in our communities. We will confirm what is correct and dispel what is not.

april

| may

DO YOUR CARE: taking action with your health

+++ june

| july

SHARE YOUR CARE: setting good examples for others to learn and live by

+++ august

| september

INSPIRE YOUR CARE: keeping creative with fresh care ideas

+++ october

| november

MEASURE YOUR CARE:

tracking your efforts to ensure you’re on the right path

+++ december

| january

CELEBRATE YOUR CARE:

rejoicing the rewards realized from taking good care of yourself

Our commitment to you — our readers in the Lynchburg and Southside communities — is this: We will help close the gap between your knowledge and your desire to learn more about primary care with the hope that you and your loved ones can cross the bridge toward a healthier life.

Angie’s Lesson on

the Importance of Primary Care That was Angie’s* way of thinking. And why not? From the looks of her, she was more than the picture of good health — she was the poster child. A weekend and weekday warrior. We’re talking 5 miles at the track every morning before most people tap the snooze button. Daily diet? Dynamite. Body fat? Best it could be. Aches and pains? Free and clear. Sneezes and sniffles? Forget about it.

“I’m not going to a doctor unless I’m sick.”

It’s safe to say that Angie was fanatical about staying fit. She felt fantastic, looked fantastic. Her formula was foolproof. This lady was in control of her life, and she knew it.

Fast forward four months. Angie still looks and feels as fabulous as ever. But her life has a taken a different direction. It started over the course of a couple of weeks this past October. “All of a sudden, I was just completely and utterly exhausted, so much so that I could hardly keep my eyes open on the drive home from work,” says Angie. “I found myself falling asleep at 7 in the evening and waking up at 5 in the morning, and I would still feel like I hadn’t slept for days.” Angie’s lethargy lingered for several days. Next came nausea, followed by the start of a sore throat. While she hated to admit it, Angie says she felt like she had the flu. “I hadn’t been sick since sixth grade,” Angie shouts. She consulted her best friend, Evan, a nurse, to get some care advice. He told her to do exactly what she already knew. “WelI, I always believed you only go to the doctor when you’re sick,” says Angie. “I couldn’t argue with myself, I supposed.” Evan helped Angie get an appointment the next day with the doctor he works for in Lynchburg. “Evan had been on me for years to get a checkup,” admits Angie. “I think he was a little excited I was sick so that I would finally go!” So at age 28, and for the first time since she was in middle school, Angie walked through the doors of a doctors office. Following a thorough physical exam complete with a battery of blood tests, Angie learned that pregnancy was the cause of her constant fatigue. “Ecstatic, overjoyed and still tired” is how Angie says she felt after finding out her good news. “Honestly, after I got to the doctor’s office, it kind of crossed my mind that I might be pregnant. My husband and I had been trying to start a family. I wasn’t completely surprised, but I was super excited!” She learned something else, however, that did completely surprise her. 30

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“My lab results came back showing that my cholesterol was through the roof,” she says. “At first, I thought it must have been a mistake. I mean, how could I have high cholesterol? I did everything the right way.” Turns out that some things are out of our control, even if you’re a super woman like Angie. Additional testing revealed that Angie has a condition called “familial hypercholesterolemia,” an inherited genetic abnormality that can raise cholesterol levels despite a carefully managed diet and ample exercise. Left untreated, the condition can lead to serious heart disease and even death. Familial hypercholesterolemia affects about 1 in 500 people and is considered the most common type of inherited high cholesterol. It is treated with lifestyle changes and medication. “I spent a lot of time discussing my family’s health history with the doctor, and after finding out some facts from my parents, I learned that heart disease is what killed my grandfather, aunt and cousin,” Angie explains. “I also found out that my dad has been on cholesterol medicine since he was 29 and his sister since she was 22. None of us knew this hereditary condition was in our family until I was tested. It bothers me so much that it’s too late for those we’ve lost.” Learning she has familial hypercholesterolemia when she did was incredibly timely for Angie. During pregnancy, a woman’s cholesterol levels can increase by 25 to 50 percent, and most cholesterol-lowering medications are not recommended during this time. For women with familial hypercholesterolemia, it’s especially important to have their cholesterol levels closely monitored throughout pregnancy. Angie’s wake-up call has not only given her a new lease on life, it has also taught her one of the most important lessons in her life. Continue on page 34

PRIMARY CARE FOR BABIES AND CHILDREN WHERE DO YOU PLACE YOUR PERSONAL CARE? Going to the doctor for an annual check-up seems like a stretch for so many people. It really isn’t though. A check-up is the best way to measure health and make adjustments if needed. Surprisingly, most people are more structured about properly maintaining items they own than they are about themselves. This measuring stick shows just a few examples. Shouldn’t your personal health be measured as well?

x|year

AUTO OIL CHANGE: Every year, vehicles are taken to a professional for state inspection. They are entrusted to an expert who ensures they are safe for the road. Oil changes every 3000 miles. Another check-up, another preventative step. On average, a car’s oil is changed five times a year to keep it running for the long term.

CAR TIRE ROTATION: Tires need preventative care too. To maximize their life, they get balanced and rotated by professionals every 5000 miles, or an average of three times a year.

LAWNS:

x|year

4 x|year

3 x|year

x|year

The grass is greener and more weed-free than on the other side of the fence because it is entrusted to a lawn service professional to keep it that way through regular treatments. On average, lawns are serviced four times a year to remain picture perfect.

PETS: Annual shots and check-ups ups for the family dog, cat and other critters are the norm to keep them healthy and active.

A pediatrician is your child’s primary care provider. Primary care for your child begins at birth. “Infants are thoroughly examined at birth and again prior to leaving the hospital with the new parents,” says Dr. Anderson. Almost immediately, well-child visits with the child’s primary care provider (pediatrician) begin. “In addition to making sure the baby is healthy and gaining weight, the doctor will help guide parents on infant health,” he says. As the child ages, they have annual checkups until their teens. “Not only is physical health monitored with tracking growth and development and immunizations, the provider also discusses social issues that surround a teen’s emotional health, such as relationships, school, sports and driving,” says Dr. Anderson.

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Continued from page 32

What are the different types of primary care providers? The National Institutes of Health and the U.S. National Library of Medicine have designated these different types of primary care providers:

“Knowing what I do now, I am actually a little ashamed that I was being so shortsighted about the importance of having a relationship with a doctor,” Angie shares. “I looked at going to one as a weakness, as a result of me not taking care of myself. It was such an inaccurate way of thinking. I get it now, though, and fortunately before it was too late. Going to the doctor is a part of a healthy routine. A physical gives you a baseline, an understanding of where you are in your health and where you need to be. It’s the most important information you need to know. I am so happy I learned such a valuable lesson that I can pass on to my child.”

» Internal Medicine physicians: Board-certified or board-eligible doctors who have completed a residency in internal medicine. They provide care for adults of all ages with numerous medical conditions. » Family Practice Physicians: Board-certified or board-eligible doctors who have completed a family practice residency. Their patients include children and adults of various age groups. They may also practice minor surgery and obstetrics. » Pediatricians: Board-certified or board-eligible doctors who have completed a pediatric residency. Their patients include newborns, infants, children, and adolescents.

THE PRIMARY CARE PROVIDER CIRCLE OF HEALTH

» Obstetricians/gynecologists: Board-certified or board-eligible doctors of this specialty may serve as a primary care physician for women. » Geriatricians: Board-certified doctors who have completed a residency in either internal medicine or family practice. They may serve as primary care physicians for elderly adults with complicated problems related to the aging. » Nurse practitioners (NPs) and physician assistants (PAs): These skilled health professionals go through different training and certification procedures than physicians do, but they are qualified to manage many of your health issues.

PRIMARY PREVENTION [pri mar y pre ven tion] noun: keeping patients healthy by preventing disease.

SECONDARY PREVENTION [sec on dary pre ven tion] noun: identifying diseases early to prevent complications.

THE IMPORTANCE OF HAVING A PRIMARY CARE PROVIDER WHO KNOWS YOU AND YOUR HEALTH Think about having to go to a physician or healthcare provider who knows nothing about you when you’re feeling more tired than usual. That provider might not think it’s anything urgent, but your regular doctor would be more likely to see that your thyroid medication needs adjusting. Similarly, your primary care provider can reassure you in the event that you’re concerned about the freckles on your nose because they haven’t changed in the past several years. This kind of attentive relationship can make a big impact on the quality of your health because it establishes a continuity of care. Being able to deliver an accurate diagnosis and an appropriate treatment becomes much easier for a primary care provider who has thorough information about a patient. Having adequate data also eliminates the need for unnecessary tests and procedures. If the patient’s condition requires a consultation with a specialist, the

primary care provider will be able to coordinate cost-effective healthcare services for patients. Primary care providers promote health and prevention and strive to develop a sustained partnership with their patients. They are highly educated in the treatment of common medical conditions and offer long-term management of chronic conditions, which is important for patients whose conditions affect multiple organs, such as diabetes, hypertension and cancer. They also provide appropriate medical tests and screenings to develop a baseline of your health. Using their findings, they can recommend further testing, changes in medication, therapy, healthy diet and lifestyle choices and safe health behavior. If additional tests and treatments are needed, primary care providers are skilled in assessing the severity of your medical conditions and can refer their patients to consulting specialists.

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There are numerous studies in medical journals that support the notion that having a primary care physician is beneficial to long-term health. A particular research

What are your needs and wants in a primary care provider? » Would you feel more comfortable with a provider of the same or different sex as you? » Do you prefer someone older or younger?

paper in the International Journal of Health Services indicates that U.S. states with more primary care providers per capita have better health outcomes, including fewer deaths from cancer, heart disease or stroke.

» Would you like your primary care provider to use alternative medicine? » How easily accessible should your primary care provider’s office be? » How convenient should their office hours be for your schedule?

The Primary Care Partnership:

it’s all about trust between you and your provider

As in any partnership, there should be open communication between patient and healthcare provider. When you first meet your primary care provider, he or she is going to need to know a lot of information about you, including your past and current health history, your family history, current and past lifestyle habits and medications. It is important to be open and honest with the doctor, no matter how private or embarrassing the information might be. While certain tests and labs can provide a lot of details, the information a patient’s head is the most important for a doctor to know. Without honest and open dialogue, a treatment plan might not be as effective as possible. Remember: You can trust your doctor or provider with your personal information. It remains confidential and only shared with any consulting specialist who is involved in your care.

» Does the doctor fall within your health insurer's “in-network” providers?

By law, your health information cannot be disclosed to anyone else without your signed consent. Along with regular checkups and screening tests, this data will provide a foundation upon which a continuity of care can be established.

Finding a Primary Care Provider who is right for you Once you have analyzed your wants and needs, you have several ways in which to select a primary care provider. The easiest is to ask your friends and family for their suggestions, as well as other doctors. Most insurance companies offer an online database of local in-network and out-of-network providers. You can also find providers who have been voted on by the community, such as in OurHealth’s Best Bedside Manner Awards edition that comes out every December. Scan the QR code provided for the complete list

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PARTNER WITH YOUR PRIMARY CARE PROVIDER If you happen to require a consultation with an outside specialist for a new or chronic condition, your primary care physician or provider has access to a vast network of highly qualified specialists who can give you a second opinion and the benefit of their expertise. Having your primary care provider handle the referral is very beneficial because he or she will likely have a relationship with the consulting specialists. “Our nursing staff calls the specialty office with all necessary clinical information so that an appointment can be made,” says Betsy Smith, administrative assistant at Access Healthcare in Forest. Remember, you always have a choice in determining your doctor based on your insurance, location and personal preferences. “The patient is responsible for contacting their insurance company to determine if the specialist participates with the insurer,” says Smith. Once the specialist appointment is complete, the specialist sends the results to the primary care physician. Your primary care physician will make sure that you are promptly informed of your test results. The specialist typically communicates the findings to the primary care provider within two to seven days of the visit. “Specialists are good about making themselves available to the primary care doctor to discuss a patient’s case,” says Andrew Anderson, DO, a family physician with Central Virginia Family Physicians in Lynchburg. Once the primary care provider is able to review the specialist's findings, an open line of communication is formed for discussion about care and treatment. Betsy Smith is the Administrative Assistant with Access Healthcare in Forest.

In the event the patient is hospitalized, the specialist will continue to send all medical notes to the primary care provider during the hospitalization and will follow up after the patient is discharged. Thus, the chain of communication is strengthened by a group of health professionals dedicated to supporting your health.

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What are some screenings that may be performed during a check-up to establish a patient’s baseline of care? » Blood pressure screening » Cholesterol screening (for adults of certain ages or higher risk) » Colorectal cancer screening (adults over age 50) » Depression screening » Diabetes (Type 2) screening (for adults with high blood pressure) » Lung cancer screening (for adults 55-80 at high risk for lung cancer) » Obesity screening

Additional screening, testing or labs may include: »

Complete blood count (may identify conditions such as anemia, infection, and other disorders)

Comprehensive metabolic profile (a broad screening test used to check for conditions such as diabetes, and liver or kidney disease and provide an overall picture of your body’s metabolism and chemical balance)

Thyroid studies

WHAT YOU SHOULD EXPECT DURING A TYPICAL FIRST VISIT WITH YOUR PRIMARY CARE PROVIDER Most doctors will ask you to bring in the bottles for any medications you take (including herbs or supplements), in addition to asking you about medical conditions, procedures, surgeries and hospitalizations you have had. In order to gain a better understanding of your lifestyle, they will question you about your use of drugs, alcohol and tobacco; your sexual preferences; and your exercise, diet and sleep habits. Your provider will listen to your specific concerns and conduct a thorough physical exam. According to Andrew Anderson, DO with Central Virginia Family Physicians, “there are certain conditions for which testing on the first or second visit may be considered.” This initial testing “does more than establish a baseline; they screen for bigger problems down the road,” says Dr. Anderson. The tests, ranging from a simple blood pressure reading to more detailed blood labs, screen for preventable conditions. “Because conditions like heart disease and diabetes are so prevalent in the U.S., we look at these preventative screening tests early on because an ounce of prevention is worth much more when there is no cure,” he says. “The tests typically screen kidney function, liver function, cholesterol, blood sugar levels and white and red blood cell levels. These are usually considered preventative care measures by health insurance companies and are covered,” says Dr. Anderson. “But check with your insurer just to be sure.”

Andrew Anderson, DO with Central Virginia Family Physicians see patients at the Timberlake Road location in Lynchburg.

Years ago, it was considered customary to have a yearly physical and to undergo a series of standardized tests. But the current thought is that because each person is unique and has different health requirements, it is not cost-effective, affordable or sensible to have every patient see a physician or provider at the same time each year and take the same tests on the same schedule. Your physician or provider will now tailor your checkup and subsequent tests and/or treatments based exclusively on the factors that define your life.

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What can you do to best prepare in advance of your first visit to a primary care provider? Your primary care provider will need the following information to best develop your care plan. Going to your doctor with this information already in hand is a good way to be ahead of the curve. » A list of all prescribed and over-the counter (OTC) medications and supplements you are currently taking. Bring the bottles of medications and supplements with you so the doctor can note all information needed, such as the number of milligrams for each, how often each is taken, etc. » A list of your family’s health history – parents, grandparents and other immediate family members — who have or had conditions such as heart disease, cancer, arthritis, depression, etc. This can require you to do some research. Asking your family members is the best way to start gathering this information. » A list of all known medical conditions, as well as procedures you have had, such as surgeries and hospitalizations and their dates.

Build your bridge to better health with

OurHealth’s Primary Care Series The bridge to better health starts with Knowing Your Care and the options available to you. The information and resources available in this article should help you start your journey. Throughout this series, we will provide additional information on each series’ topic on our website, www.ourhealthcville.com. If you have questions that you would like to see highlighted in this series, please reach out to us anytime by email at steve@ ourhealthvirginia.com. We are proud to be a resource in your plan for better health.

* Names and location have been changed for the privacy of the patient.

Expert Contributors: Andrew Anderson, DO with Central Virginia Family Physicians Betsy Smith with Access Healthcare in Forest

Sources: National Institutes of Health – www.nih.gov

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The 6th Annual Bowlathon, hosted recently by United Way of Central Virginia at AMF Bowling Center, saw over 300 bowlers aptly attired for this yearâ&#x20AC;&#x2122;s theme - The United Way Strikes Back. The event, sponsored by BWXT Technologies brought in a little over $20,000 this year. Bowlers got to experience an intergalactic event complete with Storm Troopers, Princess Leia and R2D2! United Way of Central Virginia raises funds that stay local and support over 40 different programs between 28 non-profit agencies; including The Red Cross, The Salvation Army, Humankind and many more. For a complete list of partner agencies and to learn more about United Way's new Education Readiness Initiative, visit www.unitedwaycv.org.

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Photos courtesy of Butch Bryant.

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New Kitchen New Nutrition New You! In 2016, our New Kitchen, New Nutrition, New You series puts the focus on helping you get healthier in the kitchen — one ingredient at a time. Each edition of OurHealth will highlight small changes you can make in your food prep and shopping habits that can add up to a major positive impact on your nutrition and health. Our goal is to present you with suggestions you can use and build on that will help you create a healthier kitchen — and life — by year's end.

words | CYNTHIA BEMENT and TRICIA FOLEY, MS, RD

Winter invites us to burrow under blankets, linger by the fire and enjoy warm, wonderful comfort food at every opportunity. Casseroles and soups spring to mind — the bigger the flavor, the better. However, these homey dishes can call for ingredients that — while meant to boost flavor and save prep time — might not be the best choices for your health. You can have it all, though, with dishes like the tasty One-Pan Taco Casserole, made healthier with a few tweaks. Read on to see how we've removed the nutritional pitfalls in this recipe and substituted healthier ingredients, and learn why making these changes (in this recipe and others) will create instant improvements in your wintertime nutrition. www.OurHealthlbss.com

Casserole

WATCH

It's that time of year again, casserole season! Assessing the following key ingredients can reveal the impact your favorite casserole recipe can have on your health.

Sodium

Ditch the Canned Goods & Invest in Spices

A lot of casseroles recipes are very high in sodium because they call for canned goods. To lower sodium content, opt for the fresh or frozen alternatives to canned ingredients. Another sodium trap can be premade spice packets. You can decrease sodium while adding lots of flavor by using herbs and spices.

Saturated Fat

Leaner Meat & Less Cheese

Most casserole recipes containing meat (specifically ground beef) and cheese are high in saturated fat. The leaner the meat you can buy the better. Also, cut back on the amount of cheese called for and use 2 percent instead of full-fat cheese.

Sugar

Reduce Sugar Whenever Possible

Casserole recipes are often very high in sugar. Watch premade tomato-based products such as ketchup and tomato sauce. Look for the ingredient listing on a product. 46

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A recipe for success: Scrutinize ingredients Whenever you try out a new (or reinstate an old) casserole recipe, assessing its key ingredients can reveal the true measure of the dish’s impact on your health. One of those ingredients is sodium. “A lot of casserole recipes are very high in sodium because they call for canned goods,” says Tricia Foley, a registered dietitian and board member of the Southwest Virginia Academy of Nutrition and Dietetics. “For example, a cup of tomato sauce has 1,284 milligrams of sodium, and Americans only need about 1,500 milligrams a day according to the American Heart Association, so that's almost the full amount in that one cup.” To lower sodium content, opt for fresh or frozen alternatives to canned ingredients whenever possible, such as dicing your own fresh tomatoes or using frozen instead of canned green beans. Another sodium trap can be premade spice packets, such as taco seasoning, used here in our pretweaked, original recipe. Instead, Foley suggests investing in individual spices as alternative seasonings in your recipes. “People can decrease their sodium and still have lots of flavor by using herbs and spices. And unlike baking, cooking isn't a scientific thing. You can play around, and it probably won't be a disaster.” Next on the offender list is saturated fat. Meats — ground beef in our recipe — and cheeses can be big culprits, so study nutritional labels for these ingredients to make sure they’re not taking your dish into the danger zone. For ground beef, Foley suggests going as lean as possible. “Even 85-percent lean is very fatty. You want to limit your saturated fat to about 5 to 6 percent of your daily caloric intake. Buying 95-percent-lean ground beef and draining it after browning helps to reduce saturated fat.” Cheese is often over-loaded in casserole recipes, according to Foley. She suggests cutting back on the amount of cheese called for and using 2-percent fat instead of full-fat cheese, which will cut saturated fat and allow other flavors to shine through. Sour cream is another common high-fat ingredient. Swapping it for plain or Greek yogurt lowers saturated fat while adding protein, she says. The third big nutritional downfall of many casserole recipes, which may be surprising, is sugar. One frequently used ingredient category to analyze is

WATCH FOR IT IN OUR NEXT ISSUE premade tomato-based products like ketchup and tomato sauce. “Look for tomato sauce with less than 3 grams of added sugar per serving,” Foley suggests, and buy reduced-sugar versions when possible. Also look at the ingredient list on the product to make sure it does not contain high fructose corn syrup. Premixed seasoning packets can also contain high amounts of sugar.

Celebrating Spring with Healthier Salads

One last healthy swap that’s beneficial to any recipe, especially casseroles, is bringing in a higher-fiber alternative to pasta. In the updated One-Pan Taco Casserole, we’ve replaced white rotini pasta with black beans, which, according to Foley, will add more fiber as well as vitamin B, magnesium and folate. Substituting whole-wheat pasta for white pasta is also a good move if it’s accompanied by an overall reduction in the amount of pasta called for (example, reduce 1 cup of regular, white pasta to 1/3 cup whole-wheat pasta). One last healthy swap that’s beneficial to any recipe, especially casseroles, is bringing in a higher-fiber alternative to pasta. Here, we’ve replaced white rotini pasta with black beans, which according to Foley will add more fiber, as well as vitamin B, magnesium and folate. Substituting whole-wheat pasta for white pasta is also a good move if it’s accompanied by an overall reduction in the amount of pasta called for (example: reduce 1 cup of regular, white pasta to 1/3 cup whole wheat).

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Get label-literate Even with all the information currently available on food packaging, making sense of it is still an issue for most of us. In order to successfully make healthy changes in your cooking and food shopping habits, being able to understand food labels will serve you well, says Foley. “Take the time to check the ingredients list, not just the nutrition label,” she says. Ingredients are listed by weight, most to least, so pay close attention to the first five ingredients, while also looking for those ending with “-ose,” which are what Foley calls “sugar words,” such as sucrose, fructose and dextrose. On the label portion, it can be tough to conceptualize the amount of each nutritional component listed. Foley’s trick: think visually. “Everything is in grams, and our brains don't think in grams,” she says, citing sugar as an example. “Four grams of sugar is equal to 1 teaspoon of sugar. That's an easy way to convert it in your mind and give yourself a visual.” Taking time to analyze each recipe in your current casserole repertoire as well as any new recipe you consider trying takes practice and attention to detail. “It’s multifactorial,” says Foley, “you have to look at the whole recipe and each ingredient in it.” Start incorporating these healthy swaps into your comfort mainstays now, and by next winter, you’ll be making the healthiest, most delicious casseroles at any potluck — not to mention at your own table.

Continues with the Healthy SWAP recipe on page 50...

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Tricia Foley’s

ONE-PAN TACO DISH Tricia Foley is OurHealth Magazine’s resident nutritionist.

Looking for more? For more healthy recipes with similar ingredients, scan here or visit our website at www.OurHealthlbss.com! 50

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Healthy Regular Ingredients

SWAP

Healthier Ingredients

1.5

pounds ground beef

1.5

pounds 95% LEAN ground beef or turkey

tablespoon canola oil

tablespoon olive oil

of a large white onion, diced

ounces uncooked rotini pasta (8 ounces = 2.5 cups)

15.5 ounce can of black beans

tablespoons low sodium chicken broth

cups low sodium chicken broth

15 ounce can of diced tomatoes

8 ounce can tomato sauce

heaping tablespoons plain Greek yogurt

heaping tablespoons of sour cream

teaspoon garlic powder

package of taco seasoning

teaspoon chili powder

1.5

teaspoon salt

teaspoon paprika

cups shredded Colby-jack cheese

teaspoon cumin

ground pepper to taste

salt and ground pepper to taste

cup shredded 2% Colby-jack cheese

Toppings

Avocado

Toppings

Green onions

Avocado

Black olives

Green onions

Hot sauce

Black olives

Colby-jack cheese

Hot sauce

2% Colby-jack cheese

Instructions: Sauté onions in oil over medium heat, just until softened.

Instructions:

Add ground beef to pan and brown, breaking up meat as it

Sauté onions in oil over medium heat, just until softened. Add

cooks. Season meat with one packet of taco seasoning (follow

ground beef to pan and brown, breaking up meat as it cooks.

directions on back of package). Once beef is cooked, add

Once beef is cooked, add tomatoes (un-drained), tomato sauce,

tomatoes (un-drained), tomato sauce, chicken broth, dried pasta,

chicken broth, black beans, and spices as well as salt and pepper

and seasoning as well as an additional ½ teaspoon salt. Bring

to taste as needed. Bring to a simmer, cover and reduce heat to

to a simmer, cover and reduce heat to low. Cook 12-15 minutes,

low. Cook an additional 1-2 minutes. Meanwhile, prep toppings

or until pasta is tender. Meanwhile, prep toppings by shredding

by shredding cheese, dicing tomatoes, green onion and avocado.

cheese, dicing tomatoes, green onion and avocado. Once pasta is

Remove contents from heat and stir in two heaping tablespoons

tender, remove from heat and stir in two heaping tablespoons of

of Greek Yogurt and one cup of cheese. Add toppings (tomatoes,

sour cream and one cup of cheese. Top with additional cheese,

avocado and green onion and sprinkle additional cheese on top

and cover to allow cheese to melt. Once melted, add toppings

as desired).

(tomatoes, avocado and green onion).

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FITBITS words | DEIDRE WILKES

H EA LT H A ND F I T NES S O N THE GO

2016 Fitness Trend â&#x20AC;&#x2DC;Watchâ&#x20AC;&#x2122;

Are you wearing it?

Are you tracking steps, running mileage, calories burned or average heart rate using a wearable device? If so, you are part of the top trend in fitness for 2016. According to the American College of Sports Medicine (ACSM), who recently published its annual fitness trend forecast, for the first time, exercise pros say wearable technology will be the top fitness trend this year. Wearable technology includes fitness trackers, smart watches, heart rate monitors and GPS tracking devices. With technology taking hold of our daily lives, it has also changed the way we plan and manage workouts. Wearable devices also provide immediate feedback that can make one more aware of their activity level as well as provide motivation to achieve health and fitness goals. Whether tracking steps, run times or calories, wearable devices provide ways to monitor and analyze data either through the device itself or on apps that can be downloaded on a computer, tablet or phone. Some apps even offer interactive communities or blogs where information can be shared between members. To read the complete Worldwide Survey of Fitness Trends for 2016: 10th Anniversary Edition, visit www.acsm.org.

V I S I T TH I S LO CA L RE TA I L E R O R S CA N H E RE TO VISIT

Deidre Wilkes, AFAA, ACSM Certified Personal Trainer Deidre is the resident fitness specialist for OurHealth Lynchburg and Southside.

T H E I R W E B S I TE F O R M O RE I N F O RM AT I O N A B O UT W E A RA B L E TE CH N O LO GY O P TI O N S :

Riverside Runners 2 4 8 0 R I V ER MO NT AV ENUE

LYNCH B URG, VA | 4 3 4 . 8 4 6 . 7 4 4 9 W W W. R I V ER S I D ER UNNER S . CO M

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HealthyEats

OurHealth Staff Favorites

ASIAN BROCCOLI Broccoli, known as one of several "super veggies", contains more protein than most other vegetables.

Ingredients:

Sauce Ingredients:

Directions:

cups of bulgur fine or medium

½ cup sesame oil

cups broccoli flowerets

1 teaspoon ginger

tablespoon toasted sesame seeds

1 teaspoon garlic

Blanch broccoli and chill with ice bath. Then simply mix all ingredients together. Easy!

½ cup roasted cashews

¼ cup orange juice

½ cup thinly sliced red pepper

3 tablespoon rice wine vinegar

1½ teaspoons orange zest

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HealthyEats

OurHealth Staff Favorites VEGAN GLUTEN FREE

BLACK BEAN BROWNIES Black beans are high in folic acid and magnesium and a good source of potassium and iron, all of which are essential nutrients your body needs to function properly.

Ingredients:

Directions:

15 ounce can black beans, drained and rinsed

heaping tablespoons flax mixed with 6 tablespoons water (egg replacer)

tablespoons coconut oil, melted

Preheat oven to 350 degrees. Grease muffin tin (12 standard). Prepare flax egg in food processor and let sit for five minutes.

¾ cup cocoa powder ¼ teaspoon salt 1

teaspoon vanilla

cup sugar

1½ teaspoons baking powder Walnuts for topping

Add all dry ingredients then the beans. Pour coconut oil over beans. Pulse in processor a few times then puree for three minutes. Scrape the sides and puree again until the batter is smooth. Scoop into tin. Top with walnuts. Bake about 30 minutes or until brownies pull away from side of tin. Make sure to let completely cool before removing from pan. Healthy, easy, delicious!!

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Giving a little can

SAVE A LOT of Lives words | TINA JOYCE photography | REGAN JOYCE

Words of gratitude can only begin to describe the emotion a Big Island couple feels toward someone they have never met. Rebecca Tomlin, and her husband, Mike, share their heartfelt story of receiving a lifesaving gift they didn’t know they needed. It was early one day last September and Rebecca didn’t feel quite right. She had been unusually tired for weeks but dismissed her fatigue as simply being busy. She works diligently at H & H Market and Café in the heart of Big Island and has served the local convenience store and mom and pop restaurant for more than 20 years. This particular morning was different. Rebecca, or “Becky” as her family and coworkers refer to her, went to work at 9:00 am as usual, but by noon she was extremely exhausted and began to feel nauseated. She went home. Within a short time, her family called 9-1-1 and her husband was accompanying her to Centra Lynchburg General Hospital via ambulance. Her physician’s team became concerned when they received the results from a standard blood work-up in the emergency room. She was sent directly to the Centra Alan B. Pearson Regional Cancer Center for further testing. The medical professionals there immediately requested a bone marrow biopsy be performed. Within a short time, Emaculate Tebit, MD, an oncologist with Centra Lynchburg Hematology and Oncology Clinic, came in and shared the unfathomable news, “You have tested positive for leukemia,” explained Dr. Tebit. Within five hours, Tomlin found herself being transported via ambulance to the University of Virginia Medical Center. Time was of the essence. “Dr. Tebit acted quickly. She had previously worked at the University of Virginia Medical Center and spoke highly of the team I was about to be transferred to,” explains Tomlin. “It all happened so fast, but we had confidence in Dr. Tebit and her recommendations.”

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Mike and Rebecca Tomlin with their grandchildren, Anna and Luke, at H&H Market and cafe in Big Island, VA.

A diagnosis of acute myeloid leukemia (AML) led physicians to begin chemotherapy treatment immediately for Tomlin. AML is a quickly progressing form of leukemia - cancer of the blood and bone marrow - and can be fatal within a few months if untreated. Because AML begins in the bone marrow, Rebecca’s early bone biopsy helped secure a rapid diagnosis and facilitate aggressive treatment.

The National Cancer Institute explains leukemia as follows:

“The blood bank has been a savior to us. Becky wouldn’t be here without it,” Mike shares. “I sure would like to meet him or her and say thank you. My wife wouldn’t be alive today without his or her donation. We are very grateful.”

In a person with leukemia, the bone marrow produces abnormal white blood cells that are called leukemia cells and leukemic blast cells. The abnormal cells can’t produce normal white blood cells. Leukemia cells divide to produce copies of themselves. The copies divide again and again, producing more and more leukemia cells. Unlike normal blood cells, leukemia cells don’t die when they become old or damaged. Because they don’t die, leukemia cells can build up and crowd out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to the tissues, control bleeding, or fight infections. Also, leukemia cells can spread to other organs, such as the lymph nodes, spleen, and brain, publishes the National Cancer Institute. Treatment for patients diagnosed with AML often involves two rounds of chemotherapy. Due to the rapid onset of the disease, treatments begin immediately after diagnosis to reduce the chances of the disease spreading to vital organs. The goal of the first round of chemotherapy is to destroy the leukemia cells, but it often destroys the normal bone marrow cells in the process. As a result, patients can develop extremely low blood counts and require lifesaving antibiotics and blood transfusions in order to replace unhealthy cells with healthy blood cells from a donor. This was true for Tomlin. Her blood count dropped significantly, putting her at grave risk both during her first and second rounds of chemotherapy. Blood transfusions are provided based on a patient’s physical and laboratory evaluations. Tomlin received 30 red cell units and 32 units of platelets during her first hospital stay and 37 red blood cell units and multiple units of platelets during her second stay. A typical transfusion is approximately three units of blood. “The blood bank has been a savior to us. She wouldn’t be here without it,” recounts her husband Mike Tomlin.

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A blood bank or blood center is a facility, sometimes located within a hospital where the blood is processed. The donor’s blood type is determined and then the donated blood is separated into components, stored, and prepared for transport to medical facilities to be used for patient transfusions, such as Tomlin’s. Collection of blood from donors may occur at permanent donation centers or mobile drives. However, she quickly faced another challenge. Not only was Tomlin fighting cancer and undergoing chemotherapy treatments, but her body was also producing antibodies that attacked the new, healthy donor platelets she received during the transfusions. This rejection of platelets made it more difficult to control her bleeding, requiring more platelets. Unlike red blood cells, which carry oxygen to all areas of the body, and white cells, which help fight infection, platelets are responsible for slowing or stopping bleeding. Bleeding was an ongoing risk for Tomlin due to her low platelet count. Physicians, staff, and laboratory professionals at University of Virginia Health System’s Blood Bank and Transfusions Services and at Virginia Blood Services worked to find the exact platelet match Tomlin needed to avoid rejection. However, an initial search at blood banks throughout the region ended without success. The life span of platelets is relatively short (about five days), so regular donations are imperative to keep an adequate supply available. After continuous communication and an extensive investigation, a matching donor was found in Texas!

“You know the blood bank is important, but after something happens to you, you really begin to understand how wonderful it is. I wouldn’t be here without the donors and doctors working together,” Becky shares. “I thank the Lord and everyone who helped me through this process.”

Tomlin explains, “I sure would like to meet him or her and say thank you. My wife wouldn’t be alive today without his or her donation. We are very grateful.”

According to the American Society of Hematology, about 106 million people in the U.S. are eligible to donate blood, but only 10 percent donates. With approximately 5 million people receiving blood transfusions every year, donors are in constant demand. www.OurHealthlbss.com

“We have some patients [like Tomlin] with complex blood needs that require extensive laboratory testing to determine the best blood component match,” says Gay Wehrli, MD, associate medical director and fellowship director, Blood Bank and Transfusion Medicine Services at UVA Health System. “The Blood Bank and Transfusion Medicine Services works closely with its blood supplier, Virginia Blood Services, to ensure a safe and sufficient blood supply. We have patients who require nationwide searches to find the best match, possibly a rare donor. Thus, our community of blood donors is both local and nationwide.”

Chelsea Sheppard, MD is the medical director for Virginia Blood Services. Dr. Sheppard is certified by the American Board of Pathology with a subspecialty in Blood Banking and Transfusion Medicine.

Tomlin was at University of Virginia Medical Center for five weeks during her first round of chemotherapy treatment and four weeks during the second round. Her stays were prolonged partially due to bleeding, complicated by the challenge of finding compatible donor platelets. “You know the blood bank is important, but after something happens to you, you really begin to understand how wonderful it is. I wouldn’t be here without the donors and doctors working together,” Tomlin shares. “I thank the Lord and everyone who helped me through this process.” According to Chelsea Sheppard, MD, medical director of Virginia Blood Services, blood banks consider two things when seeking a blood donor: whether the person is healthy enough to donate and whether his or her blood is safe enough to donate. The American Association of Blood Banks Donor History Task Force developed a uniform donor history questionnaire - approved by the FDA for use and is required for licensed facilities - that is given to donor prospects to assist early in the screening process.

Once the initial screening takes place and the donor’s eligibility is confirmed, the process of whole blood donation can be completed in about 30 minutes. Gay Wehrli, MD, MBA, MSEd is an assistant professor of pathology at University of Virginia Health System. She is certified by the American Board of Pathology with a subspecialty in blood banking and transfusion medicine.

1. Schedule an appointment or find a blood drive at www.vablood.org. 2. Undergo a mini-physical that includes checking temperature, pulse, blood pressure, and hemoglobin levels. 3. Recline for eight to 10 minutes (longer times for specific donations) with trained staff from the organization drawing blood intravenously. 4. Enjoy light refreshments for 10 to 15 minutes in a reception area until your body returns to normal. Once a donor’s blood is collected, it undergoes a thorough screening process and is tested for numerous viruses and diseases until it is determined safe. “It is vitally important the public understands that donating blood should not be used as a way to test for viruses,” cautions Dr. Wehrli. Local health departments offer testing as well as primary physicians. Many towns also offer free testing clinics for those without insurance.

Emaculate Tebit, MD with Centra Lynchburg Hematology & Oncology Clinic is certified by the American Board of Internal Medicine with a subspecialty in Hematology and in Medical Oncology.

“We want to ensure a safe and sufficient blood supply today, tomorrow, and every day in the future,” says Dr. Wehrli. “To do this, we depend on the altruism of our communities through blood donation. Each day patients need transfusions, whether for ongoing chronic disease treatment, acute disease treatment, or for saving the life of trauma victims.”

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One donation can help support the lives of up to three patients, according to Virginia Blood Services. “We have no artificial substitute, so we require blood donors in order to procure this valuable resource for people in need,” says Dr. Sheppard. Mike and Rebecca Tomlin now understand the value of the renewable resource of blood donation. Tomlin is now resting and recovering comfortably in her own home. Their only son, Allen, and his wife, Jessica, live next door. This allows for close support and daily visits from their two grandchildren, Anna (12) and Luke (6). “It is nice to have her home,” says a smiling Anna. Becoming a blood donor can save the lives of people of all ages. Donors can feel confident knowing that each time they donate blood, they are helping to improve or save a life. To learn more about becoming a lifesaving hero by donating blood, visit www.redcrossblood.org or www.vablood.org.

Contributing Medical Experts: Chelsea Sheppard, MD, Medical Director of the Virginia Blood Services. Emaculate Tebit, MD with Centra Lynchburg Hematology & Oncology Clinic is certified by the American Board of Internal Medicine with a subspecialty in Hematology and in Medical Oncology. Gay Wehrli, MD, MBA, MSEd, Associate Medical Director and Fellowship Director, Blood Bank and Transfusion Medicine Services (BBTMS) and Associate Chief Medical Information Officer University of Virginia Health System.

Sources: National Cancer Institute - www.cancer.gov American Society of Hematology www.hematology.org

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OurHealth asked Chelsea Sheppard, MD of Virginia Blood Services and Gay Wehrli, MD of the University of Virginia Health System to share their insights on commonly asked questions about blood transfusions.

Q &A A

What types of procedures typically require a blood transfusion?

Procedures do not dictate blood transfusions, physical exams and laboratory results do. However, some procedures commonly require blood transfusions, such as complex heart surgery, bone marrow and other types of transplants, orthopedic surgeries and complications of pregnancy. Blood transfusions are both life-sparing and lifesaving. We depend on our communities for blood donations to support our family and friends who need transfusions. There are patients with chronic diseases and those undergoing acute treatments that require ongoing transfusions, such as sickle cell anemia and cancer chemotherapy, respectively. There are also trauma victims (for example, car accident victims) who require lifesaving, immediate transfusions. Blood transfusions are needed throughout life, from the in-utero fetus through the elderly. Nationwide, about 15 million blood components are transfused annually. About half of the blood components transfused are for patients on general medicine services plus surgery services, for example, general surgery, orthopaedic surgery and cardiac surgery). University of Virginia Health System transfuses more than 100 blood components per day. This means we depend on 100 community members to donate each day. There are no weekends or holidays for our patients in need of transfusions. Patient blood management efforts continue to reduce the need for transfusions. Blood center and hospital transfusion service physicians and staff reach out to educate physicians and patients. We strive to ensure appropriate transfusion decisions. This means using the right patient evaluation to include laboratory testing and physical exams to establish the right time or indication and the right blood component for the optimal transfusion outcome.

Q &A A

How often do we face blood shortages?

We face a decrease in donations during holidays, such as in December, and in summer when schools are out. Businesses are not doing drives and people are out of town or busy. This is when the number of donations decrease the most. Perhaps families can start a new tradition by taking family and friends to your local community blood center and give the gift of blood. Whole blood donors can donate every two months, and platelet donors can donate every two weeks.

Q &A A

What are the most difficult blood types to match?

We always need blood group O, the universal red blood cell donor. We always need platelets, and these units are very special because they usually go to cancer patients who require them to keep them from bleeding while they are undergoing treatment. Blood type D makes up about 15 percent of the population. This is the “negative” or “positive” that we speak of when we say A+ or B-. The positive or negative indicates the presence or absence of the D antigen. In addition, group AB - which means that the person has both an A antigen and B antigen, makes up 4 percent of the population, but this type is the universal donor for plasma, which means their plasma can be given to anyone. Therefore, in a trauma situation, before we know the blood type of the patient, we frequently use type O red blood cells and AB plasma. But since AB donors only make up about 4 percent of the donor population, it can be difficult to produce enough AB plasma to meet the demands of an active trauma center at times.

Q &A A

What complications are most commonly experienced during a blood transfusion?

Transfusions on the whole are quite safe. Reactions are not common; however, mild reactions occur 1 to 3 percent of the time. The most common reactions - fever, chills, and skin changes such as hives – are usually treated easily, often with overthe-counter medications. More serious reactions can occur, including lung injury and cardiac overload (getting too much blood too fast and the heart has trouble pumping it quickly enough). Infections are rare, and the risk of getting an infectious disease from a blood unit is extremely low due to thorough screenings performed at blood centers and transfusion services before the blood is released. Newer testing methodologies for donor blood samples have dramatically reduced the transfusion transmission of viruses (such as HIV), so these cases are exceedingly rare. Regardless, each patient is monitored closely throughout a transfusion by a team of nurses, physicians and laboratory professionals ready to respond quickly. Comparably all donors are monitored closely throughout the donation process and over time for returning donors. Donating blood is very safe.

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