OurHealth Lynchburg & Southside Jun/Jul 2013 Edition

LYNCHBURG HILLCATS PITCHER

SUMMER SKIN CARE MORE

why sports are good for kids

JUNE

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J U LY 2 0 1 3

discuss men’s health, her cancer scare and teaching their children

living a balanced life the importance of

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THE 40-YEAR-OLD CHECK UP: IT MATTERS

LY N C H B U R G A N D S O U T H S I D E V I R G I N I A E D I T I O N

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THE CHANGING ROLES OF HOSPITALS IN LYNCHBURG

OURHEALTHVIRGINIA.COM

table of contents |june • july 2013

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COVER STORY MEDI•CABU•LARY.....................10 Local experts define healthcare related terms

JUST ASK!..................................12

Governor Bob McDonnell and First Lady Maureen McDonnell discuss men’s health, her cancer scare and teaching their children the importance of living a balanced life

A variety of health questions answered by local professionals

THE LATEST...............................14 A listing of new physicians, providers, locations and upcoming events in the Lynchburg and Southside community

HEALTH AND FITNESS ON THE GO..................................17 Health-focused apps you can download to your smartphone or tablet

HEALTHY AT 40..........................19 Turning 40 can be confusing, frustrating and an emotional burden. Our Health shares local experts’ opinions on why it doesn’t have to be

HOSPITAL CHANGES.................35 In sickness and in health: the changing role of hospitals

NUTRITION.................................41 Healthy Eats: seasonal recipes

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46 SKIN

Beware of the sun this summer!

52

KIDS CARE Pitching to success

D-DAY..........................................58 Taps for Evelyn Kowalchuk, RN: Angel of Mercy for D-Day injured

SENIOR LIVING...........................63 Having a great traveling experience

www.ourhealthvirginia.com | 7

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june • july 2013

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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: 305 Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.355.3071 Information in all print editions of Our Health and on all Our Health’s websites, including: www.ourhealthvirginia.com is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions.

Copyright © 2013 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. The Our Health Lynchburg and Southside Virginia edition is published bi-monthly by McClintic Media, Inc. 305 Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthvirginia.com. Advertising rates upon request.

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our health | MEDI•CABU•LARY & JUST ASK

me d i • ca bu • l ar y

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

What is a tympanogram?

Tympanic membrane is the fancy name for eardrum. When a doctor wants to find out how your eardrum is working, he or she may get a tympanogram. In this test, a doctor uses a special machine that is small enough to be inserted into your ear. It makes a quiet noise that should get your eardrum moving. The result of this test is known as a tympanogram.

It can help the doctor know if there is fluid inside the ear or if the pressure is not normal.

Joe Hutchison, MD Blue Ridge Ear, Nose, Throat & Plastic Surgery Lynchburg | 434.947.3993

What is the Activities in Motion program at LifeWorks Health and Rehab centers?

The Activities In Motion program at LifeWorks Health and Rehab centers is a company exclusive activities program designed to motivate both the mind and the body through dynamic groups.

Integrated with LifeWorks Rehab, Activities In Motion maximizes the patient’s potential to attain the best possible quality of life outcomes.

Each series of therapeutic activities in the program complements the patient’s clinical rehabilitation goals, cultivates good physical health and mental well-being, and continues life-long interests and routines.

The Exercise Series promotes physical health and focuses on energy and movement for strength, endurance, balance, coordination, and flexibility. The Recreation Series focuses on fostering independence, social-interaction, and community living and emphasizes lifelong enrichment, increased activity levels, and personal satisfaction.

The Imagination Series focuses on mental exercise and inspires creativity, individuality, and resourcefulness. This distinctive combination of exercise, recreation, and imagination is part of a complete provision for patient wellness.

Joe Grooten, MS Medical Facilities of America Roanoke | 540.776.7568

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What is Stargardt’s disease?

Stargardt’s disease is the most common juvenile macular dystrophy.

Macular dystrophy is a group of inherited diseases causing light-sensitive cells in the back of the eye (retina) to deteriorate, particularly in the central area of the macula where fine focusing occurs.

Stargardt’s disease affects approximately one in 10,000 people and is characterized by central vision loss early in life. Peripheral vision often stays intact. Symptoms typically develop by twenty years of age. Visual acuity may range from 20/50 to 20/200 in these patients.

Stargardt’s is an inherited disease passed along to children when both parents carry mutations of a gene associated with vitamin A processing in the eye. Parents can carry recessive genetic traits without having the disease themselves.

There are currently no medical treatments available for this condition. However, early detection is important as low vision referral can be quite helpful.

Golnaz Javey, MD Piedmont Eye Center Lynchburg | 434.947.3984

What are signs of sleep deprivation in children?

Sleep is vital to the health of children. Some 15 million US children and teens do not get enough sleep.

Infants require 14-16 hours of sleep; pre-schoolers 10-12 hours; school kids 10-11 hours and teens 8-9 hours.

Kids who do not get enough sleep demonstrate daytime sleepiness, decreased mental alertness, decreased school performance, emotional lability and impulsive behavior. Sleep deprived teens are at increased risk of driving accidents.

Good “sleep hygiene” is important.

Establish a bedtime routine.

Remove distractions from the bedroom. Turn the lights out. Keep the bedroom cool. Make sure the bed and bedding are comfortable.

If you have tried everything and your child is still showing signs of inadequate sleep then contact your health care provider to discuss sleep issues. If your child has loud snoring, very restless sleep or pauses in breathing during sleep contact your health care provider about an evaluation for sleep apnea.

Katherine Nichols, MD F. Read Hopkins Pediatric Associates Lynchburg | 434.237.8886

our health | MEDI•CABU•LARY & JUST ASK

ju st a sk!

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

Is orthodontic treatment effective for adults?

Yes, healthy teeth can be moved at any age. You’re never too old to benefit from orthodontic treatment and many orthodontic problems can be corrected as easily for adults as for children.

Orthodontic forces move teeth in the same way for both adults and children. Today, adults make up about one in every five orthodontic patients. Orthodontic treatment can help correct crooked teeth or spaces that you have been self-conscious about for years. It can give you the confidence and pride that come with straight teeth and a great smile. If you have a history of gum disease, your orthodontist will consult with your dentist and/ or periodontist about the health of your gums before starting treatment and if you are a candidate for orthodontic treatment, you will continue regular supervision with your dentist or periodontist.

Furthermore, new techniques and materials today have made wearing braces more comfortable and less noticeable.

Bruce Bentley, DDS Central Virginia Orthodontics Lynchburg | 434.385.GRIN (4746)

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What can I do for my leaking when I cough, sneeze or exercise?

Is there really a difference between generic and brand name drugs?

Stress incontinence is caused by a weakness of the support around the urethra, the tube coming out of the bladder. Treatment options include Kegel exercises, pelvic floor physical therapy, and surgery. There are outpatient surgical options available including the tension-free vaginal tape procedure. This is a very effective incision-less outpatient procedure that will produce immediate results for most women with stress incontinence.

Generic drugs are copies of brand name drugs with the same pharmacological effects of the branded counterpart.

Many wonder since generics are offered at a fraction of the cost of branded drugs if they are as effective. The FDA (Food and Drug Administration) requires generics to be as safe and effective as branded drugs. Generics are less expensive since they have not had to incur the expense of developing and marketing a new drug. When multiple manufacturers make a generic drug that also drives down the price due to competition.

The FDA applies the same strict standards to both generic and branded drug manufacturers. In fact the FDA estimates 50% of generic drugs are made by brand name companies and generics are required to work as fast and as effectively as a branded product.

Matthew J. Tompkins, MD Lynchburg Gynecology Lynchburg | 434.385.7818

Chapman Brown, III, RPh Gretna Drug Gretna | 434.656.1251

Do I need a referral from a doctor to use the services of a home medical supply company?

It depends on the equipment needed and if any insurance is to be billed. Services such as oxygen, nebulizers, medications, sleep products (CPAP, BiPAP and supplies) require a prescription regardless of billing insurances.

This is a requirement by the Commonwealth of Virginia and the Board of Pharmacy. But, regular wheelchairs, walkers, beds and bedside commodes can be purchased without a doctor’s prescription. However, if you expect your insurance company to pay for any of this equipment, it will require a doctor’s authorization.

Joey Mason Lincare Area Manager Western VA 434.338.1997

our health | THE LATEST

the l atest

James Warner, MD, EdD, FACC Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252

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

Edward Bonyak, MD, FACC Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252

Kai Ihnken, MD, FACS Centra Cardiothoracic Surgery Lynchburg | 434.200.3100

Brian Mandeville, MD Medical Associates of Central Virginia Lynchburg | 434.947.3944

E.W.Tibbs Jr. named as Centra president and CEO Centra executive E.W. Tibbs Jr. has been named as president and CEO of the Lynchburg-based healthcare system by the full Centra Board of Director. His appointment was recommended by the executive committee following the resignation of Michael Bryant, who served in that post since October 2011.

Tibbs was Centra senior vice president for operations and president and CEO of Centra Southside Community Hospital in Farmville. He joined Centra in 2006, having previously served as president and CEO of Bedford Memorial Hospital. He is a registered nurse and holds a Bachelor of Science degree in nursing as well as a master’s degree in business administration.

“E.W. brings a wealth of leadership expertise in both the clinical and financial side of healthcare systems,” said Kenneth S. White, Centra Board Chairman. “We are very fortunate to have someone of his talents and expertise in the organization, and now recommended for the helm.”

“This is an exciting time for Centra,” White said. “We have strong partnerships with the physicians, institutions and people in the communities we serve. We are in the midst of a 10-year master facilities plan, a process that includes looking at what facilities we will need and how they will be used over the next decade. We are studying patient volume projections, identifying trends in healthcare, including the projected shifts from inpatient to outpatient care, fee-for-service to accountable care, population health and wellness.

“We are well positioned as we move forward. We are committed to remaining a locally governed, nonprofit, integrated healthcare system providing a comprehensive range of healthcare services for our region.”

Brent Riley, DDS Riley Dental Associates of Central Virginia Lynchburg | 434.385.7707

Three Centra leaders were recently promoted at Centra Lynchburg General Hospital.

They are Beth Bankston, Carl Cline and Wren Roberts.

Beth Bankston Vice President of Orthopaedics and Neurosciences

Carl Cline Service Line Director for Neurosciences

Bryant said, “I have enjoyed my time with Centra, and have confidence in the management team I am leaving behind and Centra’s strategic direction.”

“We are disappointed that Michael has chosen a different path and we extend every good wish to him in his future endeavors,” said White. “Michael has a deep understanding of the challenges the healthcare industry is facing across the country. He brought this knowledge to Centra, from the standpoint of both how he perceives healthcare will be delivered in the future and the changing methodology of healthcare funding.

“Under his leadership, we have made significant progress in strategically positioning Centra to meet these challenges and we thank him for that.”

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Wren Roberts Managing Director for Support Services

THE LATEST | our health

For the Fourth Time, Centra Cardiovascular Services Receives Highest National Heart Surgery Rating The Society of Thoracic Surgeons (STS) has awarded Centra a three-star rating for the fourth time. Centra, therefore continues to be among the nation’s highest possible tier of hospitals providing heart surgery.

This three-star rating, which only 12 percent of heart centers hold, reflects above average, quality performance. David Frantz, MD, cardiothoracic surgeon states, “The standards of the Society of Thoracic Surgeons have been a very useful yardstick to measure our quality against heart surgery programs all over the country. The STS database continues to be a wonderful tool to help all of us improve. We are honored to receive the top rating from the Society for the 4th time. This award is a testament to the excellence of our heart center and our cardiothoracic surgery team. Centra’s patients can be assured they are receiving the highest quality care available.”

For more information about the Centra Stroobants Heart Center, please call 877.

MDLINK1 or visit us online at CentraHealth.com.

Alan Pearson donates $1 million to Centra At this past Friday evening’s Night of Hope, an annual fundraising event for Centra’s Patient Support Fund, Alan B. Pearson surprised all in attendance by announcing a $1 million donation to the Alan B. Pearson Regional Cancer Center. With this gift, his combined donations make it one of the largest personal gifts ever made to the Centra Foundation, now exceeding $4 million. Additionally, he has contributed over $100,000 to the Centra College of Nursing scholarships.

“It is clear that we have touched Mr. Pearson’s heart with our work, and he touches ours with his gift,” says E.W. Tibbs, President and CEO of Centra. “I am overwhelmed and humbled by Mr. Pearson’s generosity, and excited by the impact this donation will have on the future of cancer care in central Virginia.”

“At this stage in my life, if I see anyone sick, I want to help them,” said Alan B. Pearson. “Central Virginia is just a nice place to live, and with everyone pulling together it’s just getting nicer.”

“The gift will have an immediate and lasting effect on the health of individuals in the region and will allow Centra to continue growing their nationally recognized cancer program,” said Dr. Kathryn Pumphrey, Vice President of the Centra Foundation. “The funds will support cancer services and education in the community.”

Additional proceeds from Friday night’s event will go towards the cancer patient support fund and the Rosemary & George Dawson Inn. Both funds serve to relieve the burden and stress patients and families face during difficult medical times.

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Vote for your favorite physicians and/or providers in more than 50 medical specialties by visiting

Vo t i n g i s O p e n June

1s t ~ J u l y 1 0 t h 2 0 1 3

Winners announced in the December 2013/January 2014 edition of

Our Health

HEALTH AND FITNESS ON THE GO | our health

Health and Fitness

On the Go

Heading out the door and wondering if you should grab sunscreen, tissues, or both?! In our new Health and Fitness on the Go section, we recommend a variety of health-focused apps you can download to your smartphone or tablet.

Allergy Alert (from Pollen.com)

Plan your day, or even week, with this easy to follow allergy app.

Allergy Alert provides index levels for four different conditions: Allergy (pollen), Asthma, Cold & Cough, and UV Sensitivity. You can also get an idea of what which pollens may affect you the most. You’ll always know when to grab the tissues and sunscreen!

Android

This app features loads of training tools to help you stay on track: »» Today’s allergy forecast »» 4-day extended forecast »» Which pollens are predominant right now »» Allergy and UV index levels

iPhone

»» Free for iPhone and Android

LoveMySkin

SHARE YOUR FAVORITE HEALTH AND FITNESS APP!

LoveMySkin app helps you map your moles for skin cancer prevention! This app makes is easy to track suspicious moles or lesions. Just tag a mole on the figure and edit details to monitor growth and change. Use the ABCD guide (Asymmetry, Border, Color, and Diameter) pictures to shoe the differences between benign and malignant moles. The best part, this app gives you the tools to perform self-skin exams and be more aware of changes to your skin that could indicate the early warning signs of skin cancer. »» $0.99 for iPhone »» Not yet available on Android

iPhone

Share your favorite health and fitness app! Scan this QR code with your smartphone or tablet to visit and “Like” Our Health’s Facebook page, then post a “Comment” with your favorite health and fitness APP!

www.ourhealthvirginia.com | 17

turning can be confusing words | ANIKA IMAJO

It’s an age when we’re young enough to remember thinking 40-year-olds were on the express train to decrepitude, but we’re old enough to accept that time does pass quickly. At this point in life, we may be embarking on monumental new endeavors, while questioning whether our bodies can forgive us for the misdeeds of our youth.

Talking to a primary care physician about the fears and physical challenges that commonly emerge in our 40s can be reassuring.

Joseph Baum, MD, a regionally based family practice physician, advises against fixating on age when it comes to health. Instead, he encourages a sound approach to wellness at all phases of life. www.ourhealthvirginia.com | 19

our health | HEALTHY AT 40

“I do think people need to constantly be aware of what it takes to stay healthy and not rely on doctors and operations and pills. They need to rely on good common sense about their weight, their nutrition, their sleep patterns, and their peace of mind.”

In our 40s we may start detecting physical changes that are natural signs of getting older. Jumping to conclusions about the significance of these developments, he notes, isn’t helpful.

“At 40 a lot of women start having issues with their periods, guys start having issues with their sexuality and sometimes their strength and energy. They come to me with those complaints that are related to age,” he says, observing that patients are often concerned simply because their bodies are behaving in ways that are new to them.

“So it’s important for people to discuss these things with their doctor.

But both the doctor and the patient need to keep an open mind – the doctor not to assume it’s aging, and the patient not to assume they have cancer or something worse.”

At age 40, patients are commonly introduced to some new screening procedures. Women are advised to start getting regular mammograms, and men may be encouraged to begin discussing prostate health.

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HEALTHY AT 40 | our health

Depending on inherited predispositions and the age at which conditions were diagnosed in affected family members, physicians may take additional steps to screen for certain cancers and heart-related conditions.

“Of course, we look at diabetes and cholesterol problems that take on new importance.

When a person ages, the heart ages and blood pressure may go up. So it’s really important that we monitor a little more closely everything that would go along with changes that could be detrimental.”

Weight control, which may become more challenging after age 40, can be useful in staving off or managing such conditions.

“I do think obesity sneaks up on people and it’s really important not to let that keep building up,” says Dr. Baum, who cautions against overindulging and eating to boost energy.

Many of the popular dietary options for fast fuel – potato chips, rice, pasta, sugary drinks – should be limited or avoided.

“People have to understand that foods like potatoes and bread are nothing but pure

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our health | HEALTHY AT 40

sugar in carbohydrate form,” he points out. “A lot of these foods are nothing but empty calories that have little or no nutritional value.”

Eating more vegetables is also a good idea, and Dr. Baum recommends canned or frozen vegetables – whose nutrients are generally well preserved when they’re packed – as well as farmer’s market produce when possible. Supermarket produce, he explains, may lose much of its nutritional value throughout its journey to the store and while it languishes on the grocer’s shelf.

Exercise, as well, is beneficial for not only body conditioning and weight control, but also – in the form of physical therapy – for alleviating aches and pains.

Dr. Baum recommends making time each day for some form of range of motion exercise to maintain physical function and prevent stiffness. Although he encourages including some form of cardiovascular activity in your routine, he does advise taking some precautions first.

“You really need to see a physician to make sure you’re healthy enough to do it. Also try to find somebody who knows what they’re doing to give you the right kind of exercise, because the wrong exercises can do harm to the body.”

Beyond physical measures we might take to keep our bodies fit, how we cope with the demands of life – which may be particularly taxing in our 40s – will also determine our overall wellness. Stress may lead to sleep problems, overeating, irritability, and strain on relationships.

Dr. Baum recommends getting to the root of these problems, rather than seeking quick fixes.

“I think it’s important that people who feel like they’re stressed out don’t go to 22 | www.ourhealthvirginia.com

the doctor for a pill to cover up their stress,” he says, arguing that getting professional help and lifestyle modifications will yield healthier, more lasting results.

“The Greeks understood a long time ago that peace of mind and health of the body go together. And I think it’s important that everybody understands that, whether they’re 20, 40, or 60.”

Joseph Baum, MD, a regionally based family practice physician,

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Interview | Stephen McClintic, Jr. photography | Governor’s Photo Michaele White Children in the Garden Kathy Scott

GOVERNOR

Bob McDonnell and FIRST LADY

Maureen McDonnell discuss men’s health, her cancer scare and teaching children the importance of

living a balanced life.

OH: Men tend to lead less healthy lifestyles than women. They are more apt to smoke and drink and more likely to be overweight.

Consequently, the average life expectancy for males in the United States is five years less than for females. In your opinion, how do you feel we can address the men’s health problem?

You are correct that, according to the Centers for Disease Control, (CDC) life expectancy for men both nationally and in Virginia is almost five years less than that for women.

Of course, there are many reasons for that since, throughout the world, males generally have a higher mortality rate than females at every age – including the first year of life.

You mentioned smoking and obesity, which are two of the lifestyle issues that are closely connected to chronic diseases such as heart disease, cancer, emphysema, diabetes, and many more.

[ continued on page 26 ]

our health | GOVERNOR McDONNELL ON HEALTHCARE IN VIRGINIA

Above and at right on pages : Students from St. Joseph’s Villa spent time at Virginia’s Executive Mansion planting several varieties of vegetables (donated by Southern States) and herbs (donated by Robbins Family Farms).

This is one of many activities that highlight Maureen McDonnell’s Health and Wellness initiative.

[ continued from page 24 ]

I think that we have to begin addressing men’s health early by focusing on the health of infants, children, and adolescents. We need to help parents and individuals by promoting healthy communities that provide increased opportunities for healthy food choices and physical activity while striving to prevent the initiation of tobacco use or underage and binge drinking. In addition, health problems can be addressed by developing and reinforcing programs in a variety of settings, including faith based organizations, worksites, as well as traditional healthcare systems. Healthcare providers can also help by screening for risk factors such as obesity, limited physical activity, and/or excessive alcohol use and promoting behavior change.

OH: What advice would you give to men that may help jump start their healthier lifestyle?

I think that the common sense advice to eat a healthy diet, get enough exercise, and eliminate tobacco use and binge drinking remain the most effective means of obtaining and maintaining a healthy lifestyle. These things are both simple though, for many people, incredibly difficult. However, a man who is striving for a healthier way of life can start with small steps – eat more fruits and vegetables and less red meat as well as drink fewer sugary drinks. Go for a 26 | www.ourhealthvirginia.com

walk or take time to participate in a sport that he enjoys. For men who smoke, call the Virginia Tobacco Quitline at 1-800 QUIT NOW (1.800.784.8669) for counseling, information, and self-help materials, and limit alcohol to no more than two drinks per day. Some men may use food, tobacco, or alcohol in a belief that it helps reduce stress while, in fact, a poor diet, tobacco and binge drinking will increase the physical stress in the body.

In addition, it is important for men to see their physician for regular checkups and to follow their physician’s instructions. Men should know their health numbers: blood glucose, blood pressure, cholesterol, and weight. For the man that has already developed a chronic disease, he really needs to consult with his healthcare professional to ensure proper medical care and for assistance with lifestyle changes.

OH: Women tend to be the person in the family who orchestrates the “family health calendar” to ensure both children and adults maintain regular visits to the doctor and stay up to date on immunizations and screenings. While it is terrific to have someone help support you and guide you toward a healthy lifestyle, should it really be the responsibility

www.ourhealthvirginia.com | 27

of a spouse or partner to make sure an adult man is keeping up with medical appointments and screenings and other healthrelated needs?

Good health begins with each of us.

I do all that I can, despite all of the travel and meals away from home required of my job, to eat well and exercise when I can. We are all responsible for our own health as no one can be with us every day to remind us of healthy choices.

I’ve been fortunate that my wife has always been an advocate for preventive healthcare and wellness efforts in our home. She’s made the issue one of her key focus areas as First Lady, as well. Several times a year she welcomes underserved children from the community to the Executive Mansion to help plant and tend herbs and vegetables.

The kids have the opportunity to cook their harvest in the kitchen and further discuss maintaining a healthy lifestyle through proper nutrition and exercise. We hope to demonstrate to these kids that eating healthy can start at home and in their own neighborhoods.

OH: Healthy living should begin at an early age. Many young men think they are invincible, especially through their 20s and 30s. How have you and the First Lady encouraged your children to live a healthy lifestyle early in life?

We’ve 28 | www.ourhealthvirginia.com

always

encouraged

our

children to be active in sports, including swimming, cross-country, cheerleading, soccer and more. In addition, we’ve raised them to make good decisions when it comes to snacking reaching for an apple, for example, rather than a bag of chips. Maureen and I believe if you develop good habits when you are young, it’s significantly easier to continue them for your entire life.

OH: Have you ever had that “gut check” scare - a time when you thought you might be facing a serious health condition which made you take a different direction in the way you take care of yourself?

When my wife was 17, she learned she had a breast tumor. It was the same year her aunt underwent a complete mastectomy. Going into surgery, Maureen had to sign a consent form

www.ourhealthvirginia.com | 29

our health | GOVERNOR McDONNELL ON HEALTHCARE IN VIRGINIA

allowing doctors to proceed with a complete mastectomy if the onthe-spot biopsy proved malignant.

Fortunately, the tumor was benign, but the doctors informed Maureen that she was pre-disposed to breast cancer. That event has helped frame our outlook on health, nutrition and exercise - pushing Maureen and I to do all that we can proactively to lead healthy lives. Prevention is often the most important and reliable disease-fighting tool that exists today.

OH: As the Governor for the Commonwealth of Virginia, your schedule clearly stays full. How do you find time to eat well, exercise, maintain regular visits to the doctor, stay emotionally balanced, etc.?

It all comes down to everyday living and the healthy choices we make in our daily diets, exercise programs, annual check-ups, and other tests that are so important. I admit it’s not easy - I have an extremely busy schedule - I don’t go on runs as often as I’d like, but maintaining a commitment to living a balanced life is vitally important.

OH: When it comes to diet and exercise, what’s your favorite healthy meal and what type of exercise do you like to do that helps you physically and mentally?

There are few things I find more enjoyable than throwing the football or playing a round of golf with my two sons. Combining family time 30 | www.ourhealthvirginia.com

GOVERNOR McDONNELL ON HEALTHCARE IN VIRGINIA | our health

with physical activities is a great way to build memories with loved ones and stay in shape at the same time. When time allows I greatly enjoy a run around Virginia’s beautiful Capitol Square, which features the capitol building designed

by Thomas Jefferson. But a treadmill gets the job done, as well.

When looking for a good, healthy meal thankfully you don’t have to look far. We are blessed to live in a state with so many incredible agriculture producers who provide an abundance of fresh products for Virginians, from Virginia apples to fresh seafood. We try to take advantage of the many healthy food options we have available right here in the commonwealth.

OH: In thinking about your positive health habits, what message do you hope will most resonate with your children as they grow older?

I believe that we have to do all that we can to help our children learn to take responsibility for their own health. I hope that the principles we’ve instilled in our five children will be carried on to the next generation now that they are grown and starting adult lives of their own.

www.ourhealthvirginia.com | 33

our health | THE CHANGING ROLE OF HOSPITALS

34 | www.ourhealthvirginia.com

THE CHANGING ROLE OF HOSPITALS | our health

In Sickness and In Health:

Centra Lynchburg General Hospital

The Changing Role of Hospitals words | SUSAN DUBUQUE

On March 23, 2010, U.S. President Barack Obama signed the Patient Protection and Affordable Care Act into law and healthcare reform became a reality.

In the wake of all this change, healthcare organizations from across the country are making significant course adjustments and proclaiming, “We are no longer just dedicated to treating you when you’re sick or injured. We are also committed to improving your health—and keeping you out of the hospital.” The healthcare systems throughout Virginia—and right here in our community—are leading the charge— driven by their missions, community needs, strategic plans and above all, the need to control burgeoning healthcare costs.

Before we delve into what’s happening in the commonwealth, let’s pause for a moment to explore what wellness is and—of equal importance—what it is not.

If you are conjuring up images of Richard Simmons in way-too-short shorts and a headband, making loud whooping sounds, banish the thought. Seriously, banish it forever. Wellness is not just about healthy eating and going to the gym. It is not a destination or a static state of being. Wellness is a process designed to help you www.ourhealthvirginia.com | 35

our health | THE CHANGING ROLE OF HOSPITALS

The Wellness Spectrum: As demonstrated by this model, wellness is not just for the well. It is for everyone.

And it has a place throughout the continuum of care.

achieve your optimal level of health and well-being. But it is a fluid process, subject to change over time and as you age and your health circumstances evolve. (see Wellness Spectrum on page 33) So what is Centra doing to incorporate wellness and health promotion into their operations right here in the Central Virginia? The answer: a lot!

Kathryn Pumphrey EdD, CFRE is the Executive Vice President of the Centra Foundation.

Caring for the Community “Community health education is one of the missions of the Centra Foundation,” said Kathryn M. Pumphrey, EdD, executive vice president of the foundation. And the organization fulfills its mission in many significant ways.

Physicians, nurse practitioners, nurse educators and other healthcare providers offer free programs to civic and social clubs, churches, senior centers and other community groups on a wide array of topics—from diabetes and heart disease to cancer prevention and weight management.

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our health | THE CHANGING ROLE OF HOSPITALS

“Our healthcare professionals have an abundance of knowledge and expertise that they are willing to share— help people with the information to make good decisions and stay healthy,” said Amanda Posid, marketing specialist for Centra Health.

Who says there’s no free lunch? Centra hosts a free Lunch & Learn Wellness Series—with heart-healthy topics presented by an RN and exercise physiologist. For smokers who are committed to quitting, there is a class called Be Tobacco Free!

You don’t even have to leave the comfort of your home to access valuable health information. HeartAware is a free online tool that identifies risk factors for heart attack and heart disease.

Savvy employers have come to appreciate the benefits of a healthier workforce—with an eye to productivity, profitability, fewer workers’ comp claims and lowered healthcare costs. Centra supports all these goals with onsite corporate health fairs.

Each event is customized for the particular employer, and may include a variety of health screenings, an online health risk assessment and informational booths. “Last year, we conducted 31 health fairs, reaching more than 6,000 individuals,” said Pumphrey.

Health fairs are also offered to large not-for-profit organizations like the YMCA. “Centra makes a substantial investment in the health of our community,” said Pumphrey, “including numerous health screenings that save lives.”

A special committee of the foundation—called M.A.A.M. (Mammograms Annually A Must)—helps to fund and organize free mammography screening days for the community and supports media campaigns to 38 | www.ourhealthvirginia.com

THE CHANGING ROLE OF HOSPITALS | our health

build awareness about mammography. Since M.A.A.M.’s inception, more than 2000 local women have received free mammograms. In addition, Centra also provides screenings for prostate, cholesterol, blood pressure and bone density.

You’ll Feel Right at Home This month, Centra opened its first Patient-Centered Medical Home. A medical home uses a team approach in coordinating care and establishing long-term healing relationships—particularly helpful for patients with chronic medical conditions such as diabetes, pulmonary disease and congestive heart failure. Primary care physicians, nurse practitioners, physician assistants and care managers ensure that individuals receive the preventative care, education and support needed to manage their health and well-being.

“Our first practice to adopt this model of care is the Lynchburg Family Medicine Center—comprised of 28 physicians who care for more than 5000 children and adults,” said Jennifer Horton, senior project manager for Centra Medical Group.

“A care manager will evaluate the specific needs of every patient in the practice—determining if additional support might help that individual achieve an optimal level of health,” said Horton. That support can range from health education and transportation assistance, to help with medications and referrals to specialists. Special attention is given to patients who have diabetes, asthma or a history of smoking, as well as those who recently used the emergency department or were hospitalized.

Access to care is what really sets the medical home apart from a traditional primary care practice. “Same-day appointments are available for both routine and sick visits, and one evening a week we have extended office hours,” said Horton. “This means that patients have access to their healthcare providers right away, before a small problem turns into a crisis.”

Centra has 14 primary practices in Farmville, Lynchburg and Danville and will be converting all sites to medical homes in the coming months. The full complement of services and staff will be customized to meet the particular needs of the patients in that group.

Note: Centra’s Patient-Centered Medical Home is recognized by the National Committee for Quality Assurance (NCQA). www.ourhealthvirginia.com | 39

our health | THE CHANGING ROLE OF HOSPITALS

Susan Dubuque is principal and co-founder of Neathawk Dubuque & Packett, a marketing and advertising firm based in Richmond, VA, that has a special group dedicated to healthcare and wellness. A nationally recognized speaker, Susan has published more than 100 articles on healthcare and service marketing, and has assisted more than 200 hospitals and healthcare organizations with marketing and branding initiatives. Author of two books, A Parent’s Survival Guide to Childhood Depression and Kid Power Tactics for Dealing with Depression, she launched a national campaign to increase public awareness of childhood depression.

NCQA is a non-profit organization dedicated to improving health care quality.

While there are far too many wellness programs to mention them all, there is one activity that is sure to make you smile. This September will mark the 40th anniversary of the Virginia 10 Miler in Lynchburg. In addition to Centra’s sponsoring the race, hundreds of Centra associates will be out there running or walking—for their own health’s sake— and to set a positive example of good health for the whole community.

So come on, everyone. Time to put down that bowl of chips and get off the sofa.

Wellness isn’t a fad. It’s a mindset that tells us all that our health and well-being are in our own hands. We are responsible for the choices we make each and every day. But we’re not alone. Centra is here to care for us when we’re ill—and if you take advantage of the opportunities they offer, they’ll help you move a little further along in your journey to a longer, healthier life.

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HealthyEats RILLING G R E M SUM

Grass Fed Beef on the Grill: Ingredients: 1-2 tablespoons coarse sea salt 1-2 teaspoons ground black pepper 1-2 cloves garlic, minced 1

16 ounce tenderloin (filet mignon) steak at least 1 ¼ - 1 ½ inches thick.

Note: The amount of seasoning you will use depends on the size of your steak. If it is close to one pound, use less. If it is closer to two pounds, use more.

2. Start the grill, and allow it to get hot. If you’re using a gas grill, turn off all but one of the burners after it has gotten up to temperature. If you’re using charcoal, rake all the coals to one side. When you can’t hold your hand three to four inches above the metal for more than three seconds, you know the temperature is hot enough.

4. Sear the steaks for two to three minutes on each side directly over the flame, with the lid down. Then, move the steaks to the part of the grill that’s not lit. Set the lid in place and allow the steaks to cook, without flipping them, until they reach 120-135 degrees, about ten to twenty minutes, depending on the size of the steak.

3. Cut a sixteen ounce steak into four different steaks.

5. Remove the steaks to a platter, and allow them to rest a few minutes before serving.

Directions:

1. Combine the salt, pepper, and garlic in a small bowl. Rub the mixture into both sides of the steak, and then allow the meat to come to room temperature while you prepare the grill.

Tricia Foley’s

GRILLED STEAK Tricia Foley is Our Health Magazine’s resident nutritionist.

our health | NUTRITION HEALTH

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HealthyEats RILLING G R E M SUM

Vegetable Medley: Makes 4 servings

Ingredients: 2 red bell peppers, seeded and halved 2 yellow squash, sliced lengthwise into 1/2-inch-thick rectangles 2 zucchini (about 12 ounces total), sliced lengthwise into 1/2-inch-thick rectangles 1 bunch (1-pound) asparagus, trimmed 10 green onions, roots cut off 3 tablespoons olive oil, plus 2 additional tablespoons

Salt and freshly ground black pepper

3 tablespoons balsamic vinegar 2 garlic cloves, minced 1 teaspoon chopped fresh basil leaves 1/2 teaspoon finely chopped fresh rosemary

Directions:

1. Place a grill pan over medium-high heat or prepare the barbecue (medium-high heat).

2. Brush the vegetables with three tablespoons of the oil to coat lightly.

Sprinkle the vegetables with salt and pepper.

4. Arrange the vegetables on a platter. The key to getting those great grill marks is to not shift the vegetables too frequently once they’ve been placed on the hot grill.

3. Working in batches, grill the vegetables until tender and lightly charred all over – about eight to ten minutes for the bell peppers, seven minutes for the yellow squash and zucchini, four minutes for the asparagus and green onions.

5. Whisk the remaining two tablespoons of oil, balsamic vinegar, garlic, basil, and rosemary in a small bowl to blend.

6. Add salt and pepper to taste. Drizzle the herb mixture over the vegetables.

7. Serve the vegetables, warm or at room temperature.

Tricia Foley’s

SUMMER VEGGIES Tricia Foley is Our Health Magazine’s resident nutritionist.

HealthyEats RILLING G R E M SUM

Grilled Peaches: Makes 4 servings

Ingredients: 1/4 stick unsalted organic (grass-fed) butter, at room temperature 1 teaspoon cinnamon 2 tablespoons Stevia

Pinch salt

4 ripe peaches, halved and pitted

Mint leaves, for garnish

Directions:

1. In a small bowl, add the butter and stir until smooth. Add the cinnamon, Stevia, and salt and mix until combined.

2. Heat grill to high. Brush peaches with butter and grill until golden brown and just cooked through. Garnish with mint leaves.

Tricia Foley’s

FRUIT ON THE GRILL Tricia Foley is Our Health Magazine’s resident nutritionist.

BEWARE OF THE SUN words | SARAH COX

First thing: Anyone can get skin cancer, and they get it from the UV, or ultraviolet rays of the sun as well as sun lamps and tanning booths. Light-skinned, fair-haired and light-eyed people do have a greater risk, but dark-skinned people get it as well. The National Cancer Institute estimates that 76,690 men and women (45,060 men and 31,630 women) will be diagnosed with and 9,480 men and women will die of melanoma of the skin, the most serious type of skin cancer, in 2013. More than 3.5 million cases of basal and squamous cell skin cancer are diagnosed in this country each year.

our health | SKIN

Cancers are caused by a combination of both environmental and genetic factors, but with skin cancer, environment makes the more significant impact. So those with a history of skin cancer in their family should be extra diligent when preventing exposure to the sun. Did you know that about 10 percent of all patients with melanoma have family members that also have had the disease?

There are several types of skin cancers, according to the National Cancer Institute. All form in the tissues of the skin.

Melanoma is cancer that forms in the melanocytes, or skin cells that make up our pigment. Basal cell carcinoma forms in the lower part of the epidermis, which is the outer layer of the skin. Squamous cell carcinoma forms in squamous cells, and neuroendocrine carcinoma is formed in the neuroendocrine cells.

While most skin cancers are detected after the age of 50, the damage begins far earlier, and that is why everyone should be aggressive in their prevention of exposure to the sun’s UV rays.

Some tips to protect one self are as follows: • Research your sunscreen. The SPF, or sun protection factor, of a sunscreen does not indicate how strong it is, but rather how long it will keep you protected. It is calculated by how many minutes it takes a person to burn, multiplied by the number that tells you how long it should last. So if you burn in 10 minutes, multiply that by SPF 30 and that will keep you protected for 300 48 | www.ourhealthvirginia.com

SKIN | our health

minutes – theoretically. So, if you burn in 10 minutes of sun exposure without any protection, SPF 30 will keep you protected for 300 minutes (in theory!).

• Apply one ounce generously to all exposed skin, and reapply often every few hours, or more often. It is suggested that one reapply every two hours, even on cloudy days, and after swimming or sweating, as sunburns significantly increase one’s lifetime risk of developing skin cancer, especially for children.

• Be careful about what is in your sunscreen. Some chemicals are allergens and potential hormone disrupters. Watch for a PABA-free, (one that has no paraaminobenzoic acid) brand. It can cause allergic reactions.

• Additionally, avoid sunscreens that contain Vitamin A (retinyl palmitate), which the FDA has found may make your skin photocarcinogenic, or at greater risk of turning cancerous when exposed to sunlight.

• And avoid sunscreens with added insect repellent. Choose a sunscreen because it protects you from the sun.

• Wear protective clothing in addition to putting on sunscreen. Light layers of clothing are suggested, as light colors reflect heat. To remain comfortable in the heat, try wearing a tank top, and then a light camp shirt open over that. Natural fibers like cotton are coolest. However, be aware that an ordinary t-shirt is only the equivalent of SPF 5. An alternative is to buy clothing designed to block sun, even up to SPF 50.

• Do not use tanning beds. The UV radiation from tanning beds and the sun causes skin cancer and wrinkling.

• If your family has a history of cancer, moles, or is fair skinned and fair haired, be more diligent about sun protection. www.ourhealthvirginia.com | 49

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• Drink plenty of water, but if one is exercising vigorously, a sports drink can replace electrolytes. Don’t drink too much, and avoid sugary drinks and alcohol, which can dehydrate you.

Jason Givan, MD is a board-certified dermatologist with Dermatology & Mohs Surgery Consultants.

• Wear sunglasses. They will protect your eyes from UV rays, the tender skin around your eyes, and reduce the risk of cataracts. Look for those that block both UVA and UVB rays, and consider wrap-around sunglasses.

Jason Givan, MD, board-certified in dermatology, fellowship trained Mohs surgery, and cutaneous oncologist, is associated with Dermatology & Mohs Surgery Consultants. He says that people are just not as aware of the dangers of the sun as they should be, and while the knowledge is much greater than in the past, there are still dangerous misconceptions.

“The biggest is that people have a sense of security in feeling that they are protected when it’s not warm and bright and sunny outside, when in fact some of the most damaging rays come through year round, despite the weather. Another misconception is that a tan is healthy or it’s a sign of health, when in fact a suntan is the skin’s reaction to previous sun damage, and the suntan is the skin’s way of developing a defense to protect against future damage,” he explains.

Melanoma can develop at any age, and in fact very young children can develop it, according to Dr. Givan, but it’s rare. As one ages and increases their lifetime sun exposure, the risks go up. One of the most significant risk factors for melanoma is severe sun damage and sunburns as a young age, and in particular the amount of high intensity, acute sun exposure one gets.

“Blistering sun burns before age 18, with an increasing number of those kinds of sun burns, increases your risk of melanoma,” he says.

Another myth is that dark-skinned races can’t get skin cancer, when in fact anyone can. African Americans do get melanoma and are most likely to get acral lentiginous (a melanoma that develops on hands and feet, typically under fingernails or toe nails).

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SKIN | our health

While dark-skinned patients don’t just get this type of melanoma, they are less likely to get other types. But all types can be fatal.

Yes, says Dr. Givan, a diagnosis of melanoma is very upsetting, but if detected early it can be treated. To do so, he suggests regular self-examinations to be aware of what’s normal about your skin. That way, you can detect what is abnormal, if a mile is new, changing or growing.

The acral lentiginous type of melanoma appears in an unusual place, so it is often left undetected.

Another factor is genetics. Having a first degree relative (the closer the relative, the higher the risk, so first degree is a patient’s parents, siblings or children) puts one at risk for melanoma, just by virtue of being closely related.

Beyond the genetic factor, Dr. Given says to protect yourself with wide-brimmed hats, UV protective clothing, sunscreen worn daily, and do outdoor activities more in morning and evening. He recommends at least SPF 30 for sunscreen, and make sure the sunscreen is broad spectrum or UVA/UVB coverage. Even infants should be wearing sunscreen, and one can look for sunscreens that are not chemical based and not irritating to skin.

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PITCHING TO SUCCESS words | SARAH COX

Jarett Miller, a right-hand starting pitcher with the minor league Lynchburg Hillcats baseball team, has been playing his sport since tee-ball. Playing through coach-pitch, then through high school, on to a D-2 school, then to junior college, and then drafted out of UNC Greensboro, Miller has been with the Hillcats for one season. He knows that a strong combination of eating right and exercising correctly is the ticket to being fit.

our health | KIDS’ CARE

“You can have a great workout, but eat poorly, and the workout was pointless.

Having a good diet at an early age up to now has helped both on and off the field,” he says.

According to Miller, that healthy diet started in middle school for him. He does not count calories, being 6’1” and 195 pounds, but he knows what to do and what not to do: do not eat heavily before going to bed; eat a good breakfast; and depending on the day, eat a heavy or a light lunch. The breakfast he ticks off can consist of egg whites, yogurt, and a healthy (not sugary) cereal. Lunch can be chicken salad, fruits, and vegetables.

Dinner has protein. “As an athlete, I don’t want to lose weight. If I need a snack, it has to be an apple or peanut butter and bread,” he says.

While his weight fluctuates between seasons, he is stringent about maintaining his weight in season. It’s his responsibility to his team.

He has learned that beyond eating, a routine of weightlifting and cardio is important to make sure, he says, that “I have the same energy starting the season as I do finishing it. There is no getting tired in between.”

Weightlifting helps with that. As does running. He explains that if he pitches one day, the next he does a 25-minute jog and heavy leg lifting. When he’s in the bullpen, he throws for upper body. It’s a different but set routine every day.

As a pitcher, he has to have considerable stamina on the mound because, he says, “I want to make sure that my fast ball is the same the first inning or the sixth. I feel that running helps a lot, as do breathing techniques on the mound.”

It goes without saying that as a pitcher, he holds a lot of the cards in his hand, which makes him conscientious of his behavior as far as eating and exercising. “Baseball is a 54 | www.ourhealthvirginia.com

KIDS’ CARE | our health

team sport. If one person doesn’t do his job, it doesn’t matter if another person does.

You can’t win as an individual. Individuals always win the stats, but a series is not won by an individual,” he states.

To that end, being part of a team has made Miller a more well-rounded person. He has learned to get along with a lot of different kinds of players, whether from Venezuela, the Dominican Republic, or the United States. “I have to learn to play with different ethnicities,” he says.

Miller explains that in high school, sports became an outlet for stress and a way to stay organized. In college, it became even more stressful, trying to juggle schoolwork, exams, and away games. “I would get off the bus at 4 a.m. and then have an exam.

This is the most stressful, but once you get done with school, baseball gets a lot more fun because you can focus.”

Now, it’s his job at a whopping $800 per month, working 10-hour days. “You go broke before you make the big league money,” he says.

But no matter. He’s in it for the love of the game. He knows that work ethic is a large part of this game. First of all, he says, you have to respect your coach. “They are the authority figure. You have to do as you’re told. You’re not always going to have things

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our health | KIDS’ CARE

go your way or be done your way. I had three different college coaches, and everyone has a different coaching style. I never back talked, just transferred schools, and did it professionally.”

Today, his work ethic has paid off. It’s a matter of mindset. “This is a work ethic you won’t develop anywhere else,” he says of baseball. “Baseball is the hardest sport to play. It has the longest season, the longest game, and hitting the baseball is the hardest thing to do in any sport. The hitter has less than one-tenth of a second to decide if he’s going to swing,” Miller points out.

He says that if you can teach a kid work ethic, you’ve done a great deal. “You can have all the talent in the world, but you get what you work for. My parents instilled this ethic in me from a young age,” he says.

That translates beautifully to life in general. In an article written for Indy Smallbiz, driver Deseri Garcia points out, “It has been said that words alone don’t teach but experiences do … sports provide a training ground to practice and cultivate leadership abilities. They provide the opportunity to play with integrity; edify your teammates; create a culture that people want to be a part of; inspire others to a common vision; motivate others to perform beyond their limiting beliefs; fuel passion; be a life-long learner and team player.”

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our health | D-DAY

Evelyn “Chappy” Kowalchuk, RN

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D-DAY | our health

Taps for

Evelyn Kowalchuk, rn

Angel of Mercy for D-Day Injured words | RICK PIESTER photography | NATIONAL D-DAY MEMORIAL MUSEUM

Most people who work in healthcare are heroes in their own right, but some exhibit a special kind of heroism.

Some practice their craft under horrid circumstances, even under the threat of gunfire from an armed enemy army, and a few of those are honored for their bravery.

One of those few was Evelyn “Chappy� Kowalchuk, RN, one of 25 flight nurses to brave the hell of Omaha Beach three days after the initial D-Day invasion. Her mission was to rescue and evacuate wounded soldiers, often under fire from German forces, and keep them alive until they could be transported to safety and further care.

This year marks the 69th anniversary of the D-Day invasion.

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Evelyn and her husband Andrew became Bedford County residents in 1988, moving to Huddleston after her retirement from a lifelong career in nursing.

She became a fixture as a volunteer for many community activities. One of her involvements included escorting then President George W. Bush to the dedication of the National D-Day Memorial on June 6, 2001, 12 years ago this year. And on Memorial Day, 2012, she was part of the program dedicating a new narrative plaque at the D-Day Memorial commemorating the role of flight nurses during World War II. Bedford County and the country lost Evelyn on April 7, 2013 at the age of 93. Predeceased by her husband and their son Ivan, her family is planning her burial at Arlington National Cemetery. Another son, Peter Andrew, survives.

A New Jersey native born as Evelyn Chaychuk, she earned her RN degree from Newark Memorial Hospital in 1941 and enlisted in the U.S. Army the following year.

After entering the Army, she told the Bedford Bulletin, she saw a notice on a bulletin board in the military hospital where she was working.

The Army was looking for nurses to volunteer as flight nurses. Kowalchuk and some others asked the head nurse what flight nurses were. “I have no idea,� the head nurse replied.

But she volunteered anyway, and found herself riding in C-46 and C-47 cargo planes flying across the English Channel to land on improvised runways on the Normandy beachhead in the days following D-Day. The planes ferried badly wounded men to hospitals in Great Britain. It was the job of the flight nurses to take care of the 24 wounded soldiers as 60 | www.ourhealthvirginia.com

D-DAY | our health

Memorial Arch: Located in Bedford, Virginia— the town suffering the highest per capita D-Day losses in the nation. The National D-Day Memorial honors the Allied forces that participated in the invasion of Normandy on June 6, 1944 during World War II.

they were transported to hospitals.

The men were missing arms, missing legs and had head and chest wounds.

“My C-47 landed on Omaha Beach,” Kowalchuk told the Bulletin.

“Although a number of planes were shot down, that particular danger was not very worrisome at the time.

Our real concern was to get the wounded boys on the planes and to a hospital.”

“When we got those boys on the plane,” she continued “we had the worst shock. We had nurses that were training in New York and California.

They had never, never seen the injuries and the blood and the pain these boys were going through.”

Invasion Pool located at the National D-Day Memorial in Bedford.

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Flight nurses served in all embattled theaters during World War II, and they did so with distinction. It is a testament to their training and dedication that of the 1,176,048 patients air evacuated during the war, only 46 died en route.

Seventeen flight nurses were killed during the war.

After her military service, Evelyn continued her nursing career, first as a school nurse in the Newark Board of Education and Health, then becoming the first female school nurse at Newark Academy in Livingston, NJ. She finished her nursing career in the Irvington, NJ, Board of Education.

Moving to Bedford County, she became active as a volunteer with community organizations and made numerous speaking engagements about her military and nursing experiences. She was also recognized for many more accomplishments and achievements, but most of all was known for her sense of humor, her courageous ambitions, her remarkable smile and loving nature, all of which served her well as a pioneer flight nurse who took care of so many.

Editor’s note: stories such as Evelyn Kowalchuk’s and many more are included in Volume III of the History of Healthcare in Lynchburg. Look for free copies of the history at many locations in the summer.

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SENIOR LIVING | our health

Having a great

TRAVELING

Experience

words | SARAH COX

Johanna Brown, MD, board certified in infectious diseases and a physician with Medical Associates of Central Virginia, says there are a few precautions to take when seniors travel overseas. Most of these are common sense, and much of the information can be obtained from the Centers for Disease Control and Prevention website (www.cdc.gov).

On the site’s opening page, a section called “Travelers’ Health” provides valuable information including health information for over 200 countries, vaccinations needed, diseases common in certain areas (such as malaria and yellow fever), how to find a travel clinic, and precautions to take before traveling. Additionally, notices of recent problems are posted, such as the outbreak of malaria in Greece (April 26 post date) or cholera in Haiti and the Dominican Republic (April 10), that will give travelers a heads-up and allow them time to get the necessary vaccinations. www.ourhealthvirginia.com | 63

our health | SENIOR LIVING

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Dr. Brown says that travelers should be up to date on all their immunizations, including tetanus, influenza, and pneumovax (for pneumonia). One of the first questions she asks patients is if they are planning a Caribbean cruise, since influenza is prevalent there year-round.

Additionally, she advises travelers to be cautious about getting prescription refills in certain countries. “You don’t know what you are going to get in many places, especially the developing world, and they may not contain all the ingredients,” she states.

Take a 30-day supply, carry on all prescriptions, and carry a letter of explanation from a doctor for any insulin needles that you need to take with you on the airplane.

If you’re traveling to the tropics, she recommends additional vaccinations including Hepatitis A, typhoid, and yellow fever. “Last, if you need to go to a malaria-endemic area, take medication,” she says.

According to the Centers for Disease Control and Prevention (CDC.gov), “Every year, millions of US residents travel to countries where malaria is present. About 1,500 cases of malaria are diagnosed in the United States annually, mostly in returned travelers.”

Prescription pills to prevent malaria are taken beginning at least one to two days ahead of travel, according to the CDC. For areas that have dengue fever, a viral illness transmitted by mosquitoes, according to Dr. Brown, travelers should bring mosquito repellent with lots of DEET. “It is not rocket science,” notes Dr. Brown. “If you have a destination, plan ahead and check with your doctor for additional immunizations.”

She says that DEET is extremely safe and EPA-approved, but you need to know how to use it and its duration. “You need at least 23 percent to protect for about four hours. In the jungle, mosquitoes will go after you after four hours,” she explains. www.ourhealthvirginia.com | 65

our health | SENIOR LIVING

DEET is safe for children, if they are older than six months. Pair this with permethrin, a spray you can buy at camping stores to spray on clothing. But, says Dr. Brown, “spray on the clothes, not the body, and if you have cotton clothes, this spray will hold up to six washes. It’s really nice for jungle expeditions – but you must spray it outside of the house.”

Practical approaches are often advisable. For instance, don’t eat food from street vendors, notes Dr. Brown. In developing countries, eating fruits with peels is safe, but street vendors will often cut the fruit for easy eating. Do not eat this, she says. “Mangoes may not be the way to go because they are cut up already. They are delicious, but that’s how people get sick. You also can’t eat salads. Better to have everything cooked. Sometimes, you have to go to those extremes to avoid traveler’s diarrhea.”

If you contract diarrhea, you will want to have antibiotics with you in case it doesn’t stop. According to the CDC, “Travelers’ diarrhea (TD) is the most common illness affecting travelers. Each year between 20%-50% of international travelers, an estimated 10 million persons, develop diarrhea.” Ways to prevent getting it are, again, commonsense. Avoid eating foods and drinking beverages from street vendors; avoid eating raw or undercooked meats and seafood; and avoid eating raw fruits and vegetables. And something as simple as Pepto-Bismol can help reduce the symptoms. Additionally, have a vial of antibiotics on hand if the diarrhea persists.

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