table of contents | october • november 2015
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Exploring how the Lymphatic System keeps us Healthy
The lymphatic system plays a vital part in the body’s ability to fight disease. Its role is two-fold — refuse collector and police force.
MEDI•CABU•LARY.....................12 Local experts define health-related terms
JUST ASK!.......................................14 Healthcare questions answered by local professionals
NEW & NOTEWORTHY.............16 A listing of new physicians, providers, locations and upcoming events in the Lynchburg and Southside communities
HEALTH POINTS.........................18 Interesting facts and tidbits about health
THE ANATOMY CHALLENGE..................................21 Are you up for the challenge? In this issue, test your knowledge when it comes to the LYMPHATIC SYSTEM.
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The Faces of Breast Cancer
It’s a reunion. 26 women altogether. Some are young in age. Some young at heart. I see happiness. Some sadness. A bit of eagerness and anxiety. I see satisfaction. I see fear and doubt and certainty...
OurHealth | The Resource for Healthy Living in Lynchburg and Southside
The Resource for Healthy Living in Lynchburg and Southside
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Growing Emotionally
Healthy Children
What more could a parent ask for than a happy, well-adjusted child? We explore tips and techniques to help parents, grandparents and educators nurture the development of emotionally healthy and resilient children.
hello, HEALTH!.............................. 48 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos
FIT BITS!........................................ 51 Brave the Barre! This one-of-a-kind
workout is a continual, fat-burning series of exercises that tone the entire body in an
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effective yet safe way.
New Options in
Prenatal Care
Approaches to prenatal and postnatal care vary, but many agree that mother-to-mother support and encouragement are vital components in the pregnancy journey.
NUTRITION.................................. 53 HEALTHY EATS: Check out Tricia Foley's cancer fighting recipes including peach pumpkin oatmeal, kale salad, and quinoa crepes!
CLOSER LOOK..............................66 Images reflecting the landscape of healthcare in Lynchburg and Southside * PLUS * a chance to win prizes!
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The Resource for Healthy Living in Lynchburg and Southside
october • november 2015
PUBLISHER PRESIDENT/EDITOR-IN-CHIEF VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR ACCOUNTING MANAGER CHIEF GRAPHIC DESIGNER GRAPHIC DESIGNER ORIGINAL COVER ART WEBSITE SOCIAL MEDIA INTERN DIGITAL MEDIA SPECIALIST
McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Hungate Deidre Wilkes Laura Bower Karrie Pridemore Tori Meador Joe Palotas Next Generation Designs Jourdan Markey Dalton Holody
CONTRIBUTING MEDICAL EXPERTS & WRITERS Suzanne Bowser, MSN, RN Jay Cline, MD Patrick Curran, OD Joseph Dill, DDS, MBA Beth Mears, RN Cheryl Rakes, PT CONTRIBUTING PROFESSIONAL WRITERS Susan Dubuque Tricia Foley, RD Tina Joyce Stephen McClintic, Jr. Suzanne Ramsey Edwin Schwartz Deidre Wilkes
ADVERTISING AND MARKETING Cynthia Trujillo | Senior Media Consultant P: 434.907.5255 | cindy@ourhealthvirginia.com
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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 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 © 2015 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 ankylosing spondylitis?
What is Meniere's disease?
Ankylosing spondylitis (AS) comes from the Greek words ankyloxs crooked, spondylos vertebra and itis inflammation. The spine essentially fuses together and becomes less flexible. This causes what is commonly referred to as “hump back”. Complications can occur with inflammation from AS involving the eyes, heart and vertebral fractures, but the most common complications are the change in center of gravity (COG). COG is affected from the vertebral changes in the spine and can increase the risk of falls. The disease onset usually starts between the ages of 20 and 30 with low back pain and stiffness, limitations in movement of the spine, weight loss, fever and fatigue that continue to progress. A family doctor will typically make a referral to a rheumatologist for diagnosis and treatment. X-rays and MRIs are the best diagnostic tool. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDS) for pain and physical therapy. A physical therapist can prescribe stretching and core exercises to help improve and maintain flexibility in the joints and improve posture and general strength.
Meniere’s disease is a disorder of the inner ear that is characterized by episodic symptoms of vertigo (sensation of room spinning), tinnitus (ringing, roaring, or buzzing sound in the ear), ear fullness and hearing loss. The episodes typically last from 20 minutes to four hours and the symptoms usually go away when the episode is over. The cause of meniere’s disease is related to an abnormal amount of fluid in the inner ear. Most commonly it is single sided, but both ears can be involved in 10 to 15 percent of cases. The diagnosis is made based on history of the symptoms and a physical exam. Oftentimes, an audiogram (hearing test) and electronystagmogram (balance test) are used to aid in the diagnosis. The first line of treatment involves minimizing sodium and caffeine intake, and will often include blood pressure medication that helps to regulate the fluid within the inner ear. If symptoms persist, then medication can be injected through the eardrum and/or surgery can be utilized to alleviate symptoms.
Cheryl Rakes, PT
Interim Healthcare Danville | 434.836.4686 www.interimhealthcare.com
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
Jay Cline, MD
Blue Ridge Ear, Nose, Throat & Plastic Surgery, Inc. Lynchburg | 434.947.3993 www.blueridgeentps.com
What is amblyopia? Amblyopia is a term that describes a condition where one eye does not see as clearly as the other eye. The pathway between one eye ball and the brain is not working properly so the brain relies on the other eye for visual clarity. This can be due to a misalignment of the eye(s), a large difference in prescription between the two eyes or an opacification (clouding) of one eye due to a condition like cataracts or corneal scarring. This can cause lack of depth perception, trouble focusing and headaches due to eye strain. In some cases, amblyopia can be improved with visual therapy. Patrick Curran, OD
Johnson Curran Optometry Centers Lynchburg | 434.237.2100 www.johnsoncurran.com
H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
What are the symptoms of a concussion?
How often should my child have a dental ‘well visit’?
During the school year when children participate in PE and sports, bumps to the head often occur and may result in a concussion. Simply defined, a concussion is a brain injury which occurs when an individual experiences a disruption in normal brain function as a result of a blow to the head. The symptoms vary depending on the severity of the concussion but can include one or more of the following: loss of consciousness, difficulty thinking clearly or feeling “foggy”, difficulty concentrating, amnesia around the time of the event, headache, nausea or vomiting, blurred vision, hypersensitivity to light or noise, behavioral changes, or drowsiness. More severe symptoms such as continued loss of consciousness, unequal pupils, seizures, slurred speech, weakness or numbness, continued confusion, worsening headache, agitation, and repeated vomiting may indicate a more serious injury and the individual should be taken to the emergency department for immediate treatment. For any concussion symptoms, consult with your licensed healthcare provider for guidance.
The answer to this question has changed a bit over time. The recommendation used to be that every child should visit the dentist twice a year. The current recommendation is more specific to each child’s history of tooth decay or other dental problems, such as teeth crowding. If a child has a history of cavities, a dentist may recommend visits more than twice per year; however, if there is no history of tooth decay, once per year may be fine. There are other factors that can influence a dentist’s recommendations, so the first dental visit should take place as soon as a child’s first tooth appears.
Beth Mears, RN
Timberlake Christian Schools Lynchburg |434.237.5943 www.tcs4u.com
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
Joseph Dill, DDS, MBA
Vice President Professional Services Delta Dental of Virginia www.deltadentalva.com
What are some things to consider before deciding to have joint replacement surgery? When considering joint replacement it is important to start with a visit to your primary care physician to be sure you are in optimal health. If you are a smoker, you should quit prior to surgery as smoking prevents adequate healing. Talk with your family and your support system to make sure that you will have assistance with meals, transportation, and other activities after surgery. Prepare your home for your recovery by storing any throw rugs so it is easy to move around your home. Many insurance plans cover the necessary equipment that you will need after your surgery so it is important to talk with your doctor before making any equipment purchases. Many orthopedic physician offices offer pre-operative education for patients and their families to learn more about joint replacement.
Suzanne Bowser, MSN, RN
Unit Manager, Orthopaedics Centra Lynchburg General Hospital Lynchburg | 434.200.3000 www.lgh.centrahealth.com
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NEW
NOTEWORTHY
NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS
Piedmont Eye Center Announces Relocation
New Dental Practice in Lynchburg
Dr. Draper specializes in a variety of dental services including cosmetic dentistry and bonding, whitening, veneers and crowns. He also offers more routine dental procedures including fillings, root canals, extractions, dentures and implant dentures.
Piedmont Eye Center will soon have a new address in Lynchburg. The area’s largest multi-specialty ophthalmology practice is relocating this November to 116 Nationwide Drive. The new facility, spanning nearly 20,000 square feet, will provide the much needed space for state-of-the-art diagnostic equipment and treatment. The practice will also welcome it’s newest provider, James Pauuw, MD, who joins Elizenda Ceballos, MD in treating patients with glaucoma and cataracts.
To schedule your next dental appointment with Dr. Draper, call 434.832.7008 or connect with him via email at draper@lynchburgfamilydentistry.com.
For more information on services provided at Piedmont Eye Center, visit www.piedmonteye.com.
Thomas Draper, DMD has recently taken over the Lynchburg dental practice previously owned by Michael Tyler, DDS. The dental practice, Lynchburg Family Dentistry, located at 22437 Timberlake Road, is now accepting patients and is able to accommodate most dental emergencies.
Joshua Alley, MD, FACS
Samantha King, MD
Michael Palmer, PT
Kate Strobel, NP
Bariatric Surgeon Centra Medical Group – Surgical Specialists Lynchburg |434.200.3901 www.centrahealth.com
Center for Industrial Rehab and Sports Medicine Memorial Hospital of Martinsville and Henry County Martinsville | 276.666.7590 www.martinsville hospital.com
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Richeson Drive Pediatrics Lynchburg | 434.385.7776 www.richesondrive pediatrics.com
Danielle Lewis, MD
Centra Medical Group Nationwide Lynchburg | 434.200.3908 www.centramedical group.com
Centra Medical Group – Stroobants Cardiovascular Center Lynchburg | 434.200.5252 www.stroobants cardiovascular.com
OurHealth | The Resource for Healthy Living in Lynchburg and Southside
Allison Maddy, NP
Centra Medical Group Altavista |434.309.1165 Brookneal | 434.376.2325 www.centramedical group.com
Samuel Omotoye, MD Centra Medical Group – Stroobants Cardiovascular Center Lynchburg | 434.200.5252 www.stroobants cardiovascular.com
Find us on social media. Follow us on Facebook, Twitter, LinkedIn and YouTube.
James Paauw, MD
Piedmont Eye Center Lynchburg | 434.947.3984 www.piedmonteye.com
Shedding New Light on Depression Researchers identify genetic clues to causes of clinical depression. Researchers from the Department of Psychiatry at Virginia Commonwealth University in Richmond, Va., working in collaboration with scientists from the University of Oxford and throughout China, have identified genetic clues to the underlying causes of clinical depression. VCU’s Virginia Institute for Psychiatric and Behavioral Genetics was a key participant in the research that successfully isolated specific changes in DNA that increase risk for major depression. This study was published online in the journal Nature in July of this year. Kenneth S. Kendler, MD, professor of psychiatry and human and molecular genetics at VCU School of Medicine—part of a team that is uncovering the genetic links to clinical depression.
“This type of genetic study is the first step in uncovering specific biological pathways to the illness. The findings could potentially lead to new ways to predict hereditary risk for depression and more effective treatments for the disease,” says Kenneth S. Kendler, MD, joint-senior author and professor of psychiatry and human and molecular genetics at VCU School of Medicine.
Check out this video about Dr. Kendler's genetic research on clinical depression.
Depression is no small problem. It affects approximately 19 million Americans and 350 million people worldwide. Studies show that rates of depression for Americans have risen dramatically in the past 50 years. In fact, the World Health Organization has classified depression as a worldwide epidemic. But thanks to this type of innovative research conducted by Dr. Kendler and his associates, one day we may even uncover the secret to preventing this devastating disease. To learn more, watch this video on the breakthrough research at www.VCUDepressionDiscovery.com or scan the QR code above.
Centra Psychiatric Emergency Center A Collaborative Effort Centra Mental Health Services announces the opening of Centra Psychiatric Emergency Center. The emergency center, developed in collaboration with Horizon Behavioral Health, Lynchburg Police Department and Centra Medical Group, will offer a safe, private and therapeutic 24 hour a day space, separate from Centra’s main emergency room. The center will provide one convenient and accessible location for area citizens experiencing a mental health or substance abuse crisis. The center is the only one of its kind in the region. Centra Psychiatric Emergency Center houses Centra and Horizon clinicians who provide psychiatric assessments, treatment and referral for clients transported to the center by Lynchburg-Central Virginia’s Crisis Intervention Team (CIT) and others who are voluntarily seeking help. The CIT is composed of specially trained police officers who are able to identify people in mental health crisis and divert them from incarceration into appropriate treatment. In addition to the initial assessment, collaborative care is provided by a team of professionals from all three partners and includes psychiatrists, psychiatric nurse practitioners, licensed clinicians, psychiatric nurses, mental health professionals, CIT trained officers, peer counselors and an intake team. Horizon has received $387,000 in grant funding from the Department of Behavioral Health and Developmental Services to provide CIT services at the emergency center, 24 hours a day, seven days a week. Last fiscal year, that service was only offered 12 hours a day. The center manages referrals to Horizon Behavioral Health and Centra’s mental health services including the acute inpatient programs for children and adolescents, adults and geriatric patients at Virginia Baptist Hospital, Piedmont Psychiatric Center and Centra’s Addiction & Recovery Services. “Mental illness is highly prevalent and fewer than half of people receive treatment, said Ted Stryker, Vice President of Centra Mental Health Services. “The psychiatric emergency center will remove one more barrier to people getting help.” The center will also use telepsych capabilities to provide mental health evaluations for patients in the Bedford, Farmville and Gretna emergency departments. For more information, please call the Centra Mental Health Intake & Resource Center at 434.200.4444 or Horizon Behavioral Health at 434.477.5000. www.OurHealthlbss.com
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T I P S , T I D B I T S A ND MO R E TO INF O R M A ND ENT ERTA I N YO U
OCTOBER
Breast Cancer Awareness Month »» Breast cancer is the second most common cancer diagnosed in women in the U.S., next to skin cancer. It is the second leading cause of death in U.S. women, after lung cancer.
But don’t be afraid, be proactive!
»» Be self-aware in your breast health. Know your risk. Get screened. Know what is normal for you. Make healthy lifestyle choices. »» For more information visit www.cancer.org. For answers to all your breast health questions, schedule an appointment with your local physician.
The chance of a woman having invasive breast cancer some time during her life is about 1 in 8. The chance of dying from breast cancer is about 1 in 37.
Source: www.cancer.org
NOVEMBER
American Diabetes Month
Diabetes can strike anyone, from any walk of life. And it does, in increasing numbers every year. Raising awareness of this ever-growing disease is one of the main efforts behind the mission of the American Diabetes Association (ADA). November is American Diabetes Month. This month and every month, encourage people to make healthy changes. Eat healthy, don’t smoke, increase physical activity and have regular check-ups with your local physician. »» Of the nearly 30 million people in the US with diabetes, 90-95 percent are type 2 diabetics. »» Another 86 million Americans have prediabetes and are at risk for developing type 2 diabetes. »» The ADA estimates that the total national cost of all diagnosed diabetes in the U.S. is $245 billion.
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»» There is hope. People who are at high risk for type 2 diabetes can lower their risk by more than half by making healthy changes. »» Are you at risk? Visit www.diabetes.org to take the ‘Ryan’s Challenge’ type 2 diabetes risk test or visit your local healthcare provider and ask about your risk for type 2 diabetes and heart disease.
29.1 MILLION people in the United States have diabetes. About
9.3%
of the population.
Source: www.diabetes.org OurHealth | The Resource for Healthy Living in Lynchburg and Southside
Enjoy the Fall Foliage and Crisp Autumn Air with Two Great Running Events!
Tempting Treats! Scared of Halloween candy? Don’t be! These Halloween treats are so low in calories that you’ll think you’re being tricked. In addition to calories, be mindful of both fat and sugar grams when selecting your special treat. calories
grams of fat
grams of sugar
10 Whoppers
100
4
14
2 Mini Size Snickers Bars
90
4
12
1 Piece of Taffy
55
0.5
12
1 Tootsie Roll Pop
60
0
10
2 Mini Size Reese’s Cups
80
5
10
7 Gummy Bears
70
0
11
1 Fun Size 3 Muskateers Bar
70
2
11
11 pieces of candy corn
70
0
14
1 Fun Size Package of M&M’s
100
4.5
13
1 Fun Size Almond Joy Bar
100
5
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Source: www.sparkpeople.com
National is October 24th
National Food Day is observed to remind us to make changes in our own diets and to take action to solve food-related problems at the local, state, and national level. The theme is Toward a Greener Diet. For more information about National Food Day and ways you can participate, visit www.foodday.org.
I AM Woman 5K Come out to Lynchburg’s one-of-a-kind WOMEN’S ONLY EVENT offering both a 5K run and walk. Proceeds benefit the Children’s Miracle Network. Date: Saturday, October 31st Time: 8:00 a.m. Location: Centra Alan B. Pearson Regional Cancer Center 1701 Thomson Drive Lynchburg, VA 24501 For more information, visit www.riversiderunners.com.
CASA Superhero 5k & Children’s Fun Run Because every child needs a hero, but abused children need superheroes! All proceeds benefit Court Appointed Special Advocates (CASA) of Central Virginia. The 5k race is open to all ages and abilities. The course is flat and fast as you go out and back along the paved, shady trail. The 1 mile children’s fun run is open to children 12 and under only. Parents are welcome to run with their small children without paying for a second registration (fun run only). The run will start at 10:00 a.m. Superheroes will chase the villains to the half way point, refuel, and run back to headquarters. This fun run will not be timed and all participants will receive a finisher’s medal. Dress as your favorite super hero. Costumes are encouraged, but not required. Date: Saturday, November 7th Time: 9:00 a.m. Location: Percival’s Island Trail (Downtown Lynchburg) For more information, visit www.lynchburgsuperherorun.com. www.OurHealthlbss.com
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
the
Anatomy
CHALLENGE How much do you know about the
Lymphatic System? First,
complete the word search below. Next, match up the correct word with the part of the body in the illustration.
[ the Lymphatic System ]
WORD SEARCH appendix
spleen
axillary lymph nodes
subclavian vein
cervical lymph nodes
thoracic duct
inguinal lymph nodes
tonsil
popliteal lymph nodes
thymus gland
red bone marrow
____________________
sponsored by
____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________
Jeffrey Widmeyer, MD
Widmeyer Vein Center 7626 Timberlake Road Lynchburg 434.847.LEGS (5347) www.veinhealing.com
____________________
For answers, visit
____________________
OurHealth Lynchburg & Southside’s
____________________
Facebook page at
www.OurHealthlbss.com
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Exploring how the
LYMPHATIC SYSTEM keeps us
Healthy words | EDWIN SCHWARTZ
The lymphatic system plays a vital part in the body’s ability to fight disease. Its role is two-fold — refuse collector and police force. To learn more about how the lymphatic system protects us from the spread of infection and cancer, OurHealth decided to examine its design and most common disorders.
Defining the lymphatic system As part of the body’s defense network, the lymphatic system collects fluid, waste material and organisms (such as bacterial viruses) in the body’s tissues and rids them of damaged cells. The system is mostly composed of lymph vessels and lymph nodes. Lymph vessels are similar to the veins that carry blood throughout the body, but instead of blood, lymph vessels carry a fluid called lymph. Lymph nodes are located throughout the lymphatic system. They filter the lymph fluid of foreign substances such as bacteria, viruses or cancer cells. These organisms are then destroyed by special white blood cells called lymphocytes.
The purpose of the lymphatic system The lymphatic system serves two primary functions. First, in its role as refuse collector, the lymphatic system drains about 15 percent of the plasma (the liquid part of blood) that accumulates in the tissue between blood
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What is lymph? Lymph is a clear, watery fluid that circulates in the lymphatic system. In addition to carrying lymphocytes, it also contains cellular debris gathered from either dead cells within the body or bacteria from within the lymphatic system.
cells — called interstitial tissue — back into the circulatory system. The circulatory system moves blood throughout the body; it comprises the heart, arteries, capillaries and veins. Second, the lymphatic system functions as the primary defense network of the immune system. The lymphatic vessels are connected by hundreds of lymph nodes that contain lymphocytes, which help fight infection and cancer cells. In this policing function, the lymphatic system can be seen as a network that scans the blood plasma for enemies, both foreign (infection) and domestic (cancer).
Other parts of the body that work with the lymphatic system The network of lymph vessels reaches the entire body. These vessels become larger as they meet at the center of the body and drain into two ducts near the heart. All the lymph fluid that drains from the body circulates through the lymph nodes several times before returning to the general blood circulation of the heart. The spleen (in the left upper abdomen) and the thymus (in the upper chest) are connected to the lymphatic system. They regulate the white blood cells that combat disease and infection.
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OurHealth | The Resource for Healthy Living in Lynchburg and Southside
Diseases and conditions that affect the lymphatic system Swelling of the lymph nodes can result from any disease that involves infection, injury or cancer. This occurs as the lymph nodes try to filter abnormal cells that have entered the system. Some lymphatic diseases result from the blocking of lymph drainage. When the lymph channels are blocked or cut, the lymph fluid can’t flow out of the tissue. Subsequently, the tissue swells with this fluid, causing a condition called lymphedema. In most cases, lymphedema affects the extremities. In the United States, the primary disease that affects the lymphatic system is cancer. This can originate in the lymphatic system in the form of lymphoma, which is caused by cancerous lymph nodes or cancer lymphocytes that reside in those nodes. Cancer can enter the lymph nodes in two ways: It can originate there, or it can start somewhere else and spread to the lymph nodes. In fact, most cancers spread to other parts of the body through the lymphatic system. Cancer in the lymph nodes has a dual significance. First, it means the body’s immune system has failed to contain or destroy the cancer. And it indicates that the cancer cells are able to live away from their primary site.
What are lymph nodes? Lymph nodes are small, bean-shaped organs that filter harmful substances within the lymphatic system. They are located throughout the lymphatic network and can form junctions where damaged cells, infectious organisms (e.g., bacteria or virus) and cancer cells are filtered and destroyed. If multiple infectious organisms or cancer cells are present, the lymph nodes typically become swollen.
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Little known facts about
LYMPHATIC SYSTEM Did you know the human body has approximately 500 lymph nodes? Typically they can’t be felt until they become swollen. In addition to the lymphatic vessels and lymph nodes, the lymphatic system includes the spleen, thymus, tonsils and adenoids. These organs also protect our bodies from invading pathogens that can cause disease.
For example, breast cancer cells were originally normal cells that were only able to live in the breast. Once cancer cells are able to live away from ” home,” it becomes more difficult to destroy them. Metastasis — the process by which cancer spreads from its primary site to distant locations in the body — is often an indicator of advanced disease.
Treatment options for lymphatic system diseases If the lymph nodes are swollen due to an infectious condition, antibiotics can be used for treatment. If cancer has invaded the lymph nodes, treatment is based on the stage of the cancer. Treatment for lymph node involvement may include surgery, chemotherapy, biological therapy and/or radiation therapy, depending on the situation. In cases of lymphedema (insufficient drainage of lymph fluid), treatment usually involves increasing the pressure on the tissue to push the lymph fluid out and back into circulation. This can usually be accomplished with a compressive extremity garment and physical therapy. Because lymphedema is irreversible and effective therapy is limited, cancer surgery now focuses on removing as few lymph nodes as possible. This is because when cancerous lymph nodes are removed, lymph channels are cut. If the ends of the channels can’t heal with each other, lymphedema can result. 26
OurHealth | The Resource for Healthy Living in Lynchburg and Southside
How can we care for our lymphatic system? The lymphatic system draws little attention when it is working properly. However, most people have at one time felt a small nodule along their neck or under their jaw. This is normal, because whenever lymph nodes are fighting infection or handling excess fluid, they become enlarged. The swelling should subside over time.
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Lynchburg & Southside on your tablet or smartphone
Patients should mention this and any similar findings to their physicians, especially if these nodules persist in size and appear in multiple locations. Since there is no specific screening tool for cancers that begin in the lymph nodes (as with lymphoma), the best way to prevent cancer in the lymphatic system is to practice good health maintenance and screening. Good health maintenance means sustaining an appropriate weight for one’s height, along with regular exercise. Prevention should include colonoscopies and annual mammograms, especially for people with a family history of cancer.
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Reprints To order reprints of the original artwork featured on this issue’s cover, contact Deidre Wilkes at 540.387.6482 or via email at deidre@ourhealthvirginia.com. To view additional work by our artist, Joe Palotas, visit www.salemartcenter.com
I see pretty ladies painted in pink. Breast cancer must be the connection. But as I look closer, look deeper, I see more. Notice more. I want to understand… more. It’s a reunion.
words | STEPHEN C. McCLINTIC, JR. original art | JOE PALOTAS
26 women altogether. Some are young in age. Some young at
heart. I see happiness. Some sadness. A bit of eagerness and anxiety. I see satisfaction. I see fear and doubt and certainty. I see
Autumn. Autumn will turn 40 in October. She is very excited about her big
day. And what’s her first order of business? A trip to her doctor for a mammogram. This is especially important to Autumn. It was on her birthday three years before that she lost her mother to breast cancer. www.OurHealthlbss.com
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Foundations and Programs Lynchburg Awareness Garden Foundation 1700 Langhorne Road Lynchburg | 434.384.6740 www.awarenessgarden.org
Breast Cancer Support on Eagles Wings American Cancer Society Lynchburg Office 1701 Thomson Drive Lynchburg | 434.200.5127 www.cancer.centrahealth.com
MAAM (Mammography Annually A Must) an Associate of Centra Health Foundation 1920 Atherholt Road Lynchburg | 434.200.4790 www.foundation.centrahealth.com/maam
Every Woman’s Life – A Virginia Department of Health Program Central Virginia Health District
116 Kabler Lane Rustburg | 434.592.9550 ext. 121 www.foundation.centrahealth.com/maam
It’s hard not to see, um, I mean, not hear,
Belle. Belle is really excited.
She just hit a huge milestone: five months cancer free! And she loves to shout her excitement from the highest towers. Rightfully so. Because for Belle, celebrating every second she is cancer free is worth doing. I see
Christina’s passion. It’s helping people, notably those with breast
cancer. As a patient advocate, she connects women with resources they need and otherwise may not have access to, such as medical care, counseling and even a pillow to lay their head on. Christina is a true godsend. In
Dawn, I see someone with a sunny disposition who loves being
a night owl. Dawn’s day starts at the stroke of every midnight. She’s an oncology nurse at the hospital where she works the late shift. Dawn believes her patients’ nights need brightened up while being treated, and she’s the perfect person for the job. I see
Eve waiting. Tomorrow is a big day for her and she doesn’t know what
to expect. Will it hurt? Will it help? Eve begins radiation in the morning. I hope tonight is not too tough on her. I can’t see
Faith, but I know she’s there. Faith fought breast cancer
for five years. And while her fourth bout with the disease may have taken her life, it didn’t take her spirit. Faith’s legacy of strength and courage is as present as ever.
Programs and Support Groups Danville City, Pittsylvania and Henry Counties
I love how I see
Grace. Make-up’s a mess. Hair’s frazzled. Filth’s beneath
her fingernails. But Grace feels amazing today. No nausea. No tiredness. No pain. Grace is the picture of gratefulness. I see
Harmony hard at it. She’s a mother of five. A wife. Works full-time.
Harmony balances baseball games and bagged lunches and board meetings Virginia Breast Cancer Foundation Cancer Support Group United Way of Danville – Pittsylvania County 1225 West Main Street Danville | 434.791.3277 www.vbcf.org
Every Woman’s Life – A Virginia Department of Health Program Pittsylvania-Danville Health District 1200 HG McGhee Drive Chatham | 434.432.7232 ext. 236
West Piedmont Health District
295 Commonwealth Blvd. Martinsville | 276.638.2311 ext. 136
and bedtime stories, all in perfect union. She never misses a beat. Not even with Stage 3 breast cancer. In
Iris, I see a woman who is focused. Iris is near the end of this life. Her
body is beaten, but her will remains unworn. She is determined to see her son graduate from high school in two weeks. I believe she will. I can see it in her eyes. I see one side of
Jade. She sees two: one she loves and embraces and
the other she detests. Jade works at an insurance company where she is responsible for letting clients know if their claim is approved or declined. She knows she’s just the messenger, but makes it her mission to help people any way she can. Sometimes, she can’t. This is the side of herself that
30
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she dislikes. I see Jade trying. I see Jade hoping. I see Jade
be there for the little ones. And she’s making good on it
being a shining beacon and doing bigger and better things in
with gusto.
the future. I see total selflessness in
Kara. It’s evident in her motto:
‘Give First’. Kara’s always putting the needs of others before
I see
Olive reaching out for peace. It’s already been two days,
and she’s holding on by a limb. How can she possibly find out sooner? Could her doctor fast track the results? Olive is waiting
her own. Always willing to offer her assistance at a moment’s notice. I can’t imagine her working anywhere else than in her job at the hospice center. She embodies the meaning of compassion and care. In
Liberty, I see justice. Or, justice
as she sees it. Liberty made the decision to beat breast cancer at its own game by killing its chances of ever killing her. She had a double mastectomy. Case closed. Let freedom ring. I see someone deserving in After
her
doctor’s
Mea.
appointment
yesterday, Mea made her way over to the mall and had a massage and makeover. Why not? Anyone fighting breast cancer deserves a little “me” time. Including Mea. I see a lot of energy in
Nana. A
LOT. And Nana needs it. She has 14 grandchildren and four greatgrandchildren. Every Sunday, the whole brood – children, grandchildren and great-greatchildren – come over after church for a home cooked dinner. But as evening approaches and the crowd dwindles, Nana’s day is not done. That’s because she’s raising her great-granddaughter’s
three
girls.
You see, Nana’s daughter passed away from breast cancer. So did her granddaughter. Nana made a promise to both of them that she would always www.OurHealthlbss.com
31
Medical Facilities & Imaging Centers Bedford Blue Ridge Cancer Care – Bedford
on the results from her biopsy. She promises she will never delay getting her mammogram again. She promises she will do self-breast exams regularly. She promises she will take better care of herself. She promises to do anything, just to get good news this one time. I see someone who never throws caution to the wind in
Prudence.
That’s why this is a markedly difficult time for her. Prudence does everything
1710 Whitfield Drive | Bedford | 540.586.5770 www.blueridgecancercare.com/locations/detail/bedford/
by the book. Dots every ‘i’ and crosses every ‘t’. Her mantra in life is to never
Centra Bedford Memorial Hospital
a genetic testing, despite having routine mammograms, despite doing self
1613 Oakwood Street | Bedford | 540.587.7806 www.bedfordmemorial.org/medical-services/ imaging-center
Danville Center for Radiation Oncology
188 S Main Street | Danville | 434.799.4592
Danville Diagnostic Imaging Center
125 Executive Drive, Suite D | Danville | 434.799.9729 www.danvilleregional.com
Danville Regional Medical Center 142 South Main Street | Danville www.danvilleregional.com
OBGYN Associates of Danville
101 Holbrook Street | Danville | 434.792.7765 www.obgyndanville.com
be caught by surprise. So finding out she had breast cancer – despite having breast exams EVERY DAY, despite exercising and eating healthy and taking her vitamins and balancing her work and life – was the shock of her life. How will Prudence handle the unexpected? I see true beauty in
Queena. She knows it and owns it. And she should.
Yet, Queena doesn’t put herself on a throne. She’s humble and kind and spirited and happy. Her beauty is her positive attitude. It starts from within and powers her belief that good can help overcome anything, including her breast cancer. I see a sharp person in
Rose. Rose has her soft side, but be careful how you
handle her. Rose has been a breast surgeon for nearly 18 years. Her mission in life is to beat the disease, one patient at a time. She will do anything for her patients and each will tell you they owe their lives to her. One thing to remember about Rose: never, ever get in her way of trying to find a cure.
Lynchburg Centra Alan B. Pearson Regional Cancer Center and Centra Mobile Mammography Van 1701 Thomson Drive | Lynchburg | 434.200.4048 www.cancer.centrahealth.com
Centra Mammography Center Tate Springs
1900 Tate Springs Road, Suite 1 | Lynchburg | 434.200.7764 www.centrahealth.com/the-mammography-centers
Timberlake
20293 Timberlake Road | Lynchburg | 434.200.7890 www.centrahealth.com/the-mammography-centers
Centra Virginia Baptist Hospital Mammography Services
3300 Rivermont Avenue | Lynchburg | 434.200.4048 vbh.centrahealth.com/services/mammography
Women’s Health Services of Central Virginia 114 Nationwide Drive | Lynchburg www.whscv.com
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I no longer see
Scarlett wearing the burden of the big ‘C’. Scarlett
didn’t deserve to get breast cancer. No one does. But that’s not how she saw it. As Scarlett tells it, she lived a fast life for most of her early years. Like many do. She didn’t take care of her body. Like many don’t. She didn’t go to the doctor regularly. Like many should. But she wasn’t being punished by getting breast cancer. It took Scarlett some time, but she now knows she won’t be defined by guilt. She will be defined by victory. When I see
Temple, I can’t help but look up to her. She commands a
presence like no one else. People flock to her for guidance. For support. For hope. Although Temple is only 21 years old, she has more wisdom and life experience than most women twice her age. Having breast cancer before your 19th birthday has a way of making you grow up fast. Oh,
Unni. What a down to earth person I see. I only wish Unni knew
what it meant to celebrate your own accomplishments. She takes the word ‘modesty’ to a whole other level. Overcoming breast cancer for the third time? It was all because of the doctors, according to Unni. Overcoming depression?
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It was all because of the counselors. Unni is so much stronger than she realizes. She was the leader in her fight and the reason she won. Modesty is magnificent. So is celebration. I can see
Venus coming from a,
well, you know. Venus knows she’s
in charge. No one’s messing with her. She’ll let you know if she needs your help. But just in case breast cancer rears its ugly head, watch out. Venus is a good one to have in your corner. I see a whimsical wave from
Willow. Quiet and reserved. She’s always been well taken care of. Never had a care in the world. I don’t believe Willow has ever been challenged in life like she is being challenged now. And it is now that she needs more support than ever. With open arms. That’s how I see
Xena. She’ll prepare a place for
anyone. Anytime. Anywhere. Comfort food cures all woes, she believes. A handmade quilt and a hot cup of cocoa refuels the tired and weary. Xena’s a good soul to know. I see a warrior in
Yaawar. She’s
battle tested. A keen strategist. A true motivator. If your down, she’ll pick you up. Yaawar wears many wounds with pride and dignity. One trip through her boot camp and you will be quickly reminded what you’re fighting for. Lastly, it’s
Zora
I see. Is
it
coincidental that Zora’s name means alive? Zora is special. She is not just alive. She comes alive when we need www.OurHealthlbss.com
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Medical Facilities & Imaging Centers Southside Centra Southside Community Hospital Mammography Services 800 Oak Street | Farmville | 434.392.8811 www.sch.centrahealth.com
her most. I not only see her individually, but I see her in every one of these women. And I see her in all women who fight breast cancer. All men who fight breast cancer. All men, women and children who fight any cancer. Family, friends, doctors, nurses, caregivers‌ everyone who offers support to those in the fight against cancer. Remembering Zora when cancer is first diagnosed is the most important time to do so. It is then when we must come alive. Be alive. Be prepared to fight. Be prepared to win. Be prepared to live. I
love
these
women
and
they symbolize.
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Local Surgical Innovation REDUCES INFECTIONS
words |SUZANNE RAMSEY
Henry Wilson, MD, of Centra Medical Group Plastic Surgery Center, has implemented a no-touch surgical technique that has drastically reduced infection rates for patients undergoing breast reconstruction surgery. “Breast reconstruction with implants, although a very safe surgery, has a fairly high infection rate that is quoted between 3 percent and 24 percent, depending on which study you look at,” Dr. Wilson says. “There are several reasons for this. The skin has been opened for hours during surgery, prosthetic devices are used, there are two surgical teams involved and there are many staff rotations that occur. To me, this was an opportunity to find some way to improve our technique and lower infection risk.” The new procedure uses what Dr. Wilson describes as a “self-retaining retractor” to hold the wound open and the plastic surgical drape in place. “By holding everything open, it minimizes how much you have to have an assistant putting retractors in and out of the wound all the time,” says Dr. Wilson. “Every time you move things or touch things, you have the potential for contamination or for disrupting the drapes. The retractor holds everything there.” Self-retaining retractors are not new to surgery in general, but Dr. Wilson says the equipment in use didn’t quite work for breast surgery. “It needed some modification in order to work. The diameter was too small for the existing ones. I worked with a company and got them to make a larger diameter version of the retractor system,” Dr. Wilson explains. According to Dr. Wilson, who recently traveled to Bogota, Colombia, to talk about his work, using the new technique adds only five to 10 minutes to surgery and only $100 to $200 to the total cost. “It's well worth it to prevent a single infection, which can cost tens of thousands of dollars,” he says. With 40 to 50 surgeries behind him, Dr. Wilson says the results have been dramatic. “Comparing a snapshot of two similar groups of patients — in 2012 without the technique to 2014 after beginning no-touch — the rate of infection dropped from about 11 percent, an acceptable amount, to zero, which is obviously much better!”
Henry Wilson, MD of Centra Medical Group Plastic Surgery Center 36
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The Resource for Healthy Living in Lynchburg and Southside
Local health. Anywhere you go. OurHealth magazine is Central Virginia’s only resource entirely dedicated to delivering information about local healthcare services and healthy living topics. Pick up our print edition at more than 900 locations throughout the area or get the digital edition by visiting
ourhealthlbss.com .
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Growing Emotionally Healthy Children words | SUSAN DUBUQUE
What more could a parent ask for than a happy, well-adjusted child? Today, health and family magazines abound with valuable information on children’s mental health issues — from attention deficit hyperactivity disorder and autism spectrum disorder to bipolar disorder and youth suicide. But let’s approach the subject from a different perspective. We will explore tips and techniques to help parents, grandparents and educators nurture the development of emotionally healthy and resilient children. At the foundation of emotional health you will find the combined effects of our genes and environment—nature and nurture. We can’t control our genetic makeup, but there are many ways we can influence a child’s state of emotional well-being through our behaviors, interactions, communications and the environment we create at home, at school and in our communities.
Look in the mirror Children tend to reflect the emotional status of their parents, and it goes beyond the hereditary implications. Make an honest assessment of your own emotional status. Are you generally happy, stable and able to cope with the trials and tribulations of everyday life? Or are you depressed, anxious, angry or struggling with some other form of mental distress? In any case, you serve as an emotional role model for your child. When you gaze into the emotional looking glass, if you don’t like what you see, get help. If you had diabetes, cancer or the flu, you wouldn’t hesitate to seek medical attention so you could be there for your family. Only if you are mentally healthy can you truly be available to your child. And your child will learn an important lesson too — that it is OK to ask for help when life becomes emotionally overwhelming.
Focus on the whole child “A child’s physical and emotional health are intertwined. In fact, they are really one in the same,” says Aradhana “Bela” Sood, MD, a pediatric psychiatrist with the VCU Medical Center's Virginia Treatment Center for Children. So let’s start with the basics — the things your grandmother would have endorsed. www.OurHealthlbss.com
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Nutrition The relationship between a balanced diet and emotional well-being has been recognized for a number of years. The literature is filled with articles on the consequences of inadequate nutrition, including social withdrawal, decreased concentration, sleep disturbances, irritability, apathy and depression. According to national nutritional expert and registered dietitian Eileen Meyers, “Perhaps the best rules to follow regarding your child’s nutrition are driven by common sense.”
Eileen Myers, MPH, RDN is Vice President, Affiliations and Patient Centered Strategies with The Little Clinic. The Little Clinic is a retail health clinic company operating inside select Kroger stores in central Virginia.
Tips for avoiding the bedtime drama include:
Provide three well-balanced meals a day. That may sound too fundamental to even bother mentioning, but it's essential to make this point in light of the busy schedules that many families maintain.
•
Allow some sugar and fats, but not in excess or in place of a wholesome diet.
•
Watch out for caffeine, sodium and chemical additives, which are abundant in kids' favorite snack foods. But don’t be a fanatic — an occasional Twinkie is really all right.
•
Serve as a role model for good eating habits.
•
Stock your refrigerator and cupboards with healthy, fun treats like fresh fruit, yogurt, carrot sticks and fruit juice.
•
Don’t use food as a means of nurturing your child. Rather than rewarding your child with a cookie, give him a hug. Instead of a piece of cake, take a walk together.
•
Most importantly, don’t allow food to become a source of stress in your child’s life. Mealtime should be relaxed and enjoyable. This is a time for sharing the day’s events, not fighting over uneaten Brussels sprouts.
Forty winks Inadequate and poor sleep can lead to mood swings and behavioral problems, as well as difficulty concentrating and poor performance at school. But how much sleep is enough? (see box below)
•
Encourage your baby to fall asleep independently and to become a ” self-soother.”
•
Allow toddlers and young children to use a security object such as a blanket or stuffed toy.
While every child is different, the National Sleep Foundation offers the following guidelines:
•
Develop regular daytime and bedtime schedules.
•
Newborns (0 to 3 months) – Up to 18 hours around the clock on an irregular schedule
•
Create a consistent and enjoyable bedtime routine, such as reading a book or sharing a story.
•
Infants (4 to 11 months) – 9-12 hours at night and 30 minute to two-hour naps, one to four times a day, fewer as the child reaches age 1
•
Establish a sleep-friendly environment — cool, quiet and dark.
Toddlers (ages 1-2) – 11-14 hours of sleep in a 24-hour period; when the child reaches about 18 months of age, naps will decrease to once a day, lasting about one hour
•
Keep TVs and computers out of the bedroom.
Preschoolers (ages 3-5) – 11-13 hours per night; most children do not nap after 5 years of age
•
School-age children (ages 6-13) – 9-11 hours per night
•
Teens (ages 14-17) – 8-10 hours per night
•
• • 40
•
Avoid caffeine.
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Just do it Provide your child with plenty of opportunities for exercise. Physical exertion releases natural endorphins that have an emotionally uplifting effect. And there are lots of other benefits from specific activities, so find one that meets your child’s needs. “Without mental health, there is no health,” says Dr. Sood. Perhaps this should be our new mantra.
Express yourself Help your child develop a “feeling vocabulary” so she can express what’s really going on inside. Otherwise she is may resort to throwing a temper tantrum, acting out, sulking or just holding it all inside and feeling miserable. Feelings are neither good nor bad, they just are. Acknowledge and accept your child’s feelings even when she is sad, angry, hurt, jealous, insecure, lonely, afraid — whatever. Build a safe place where your child is free to openly express her full range of emotions. While all feelings are OK, the behaviors that follow may or may not be. Let your child know that while she is entitled to be angry when her little brother breaks her favorite toy, it is not OK to retaliate by hitting him or breaking his toys. As a parent, you are entitled to your feelings too. If you are sad, it is fine to share that with your child. In fact, it gives you the perfect opportunity to demonstrate the best way to deal with negative feelings. For example you could share, “I am very disappointed that we didn’t get to go to the beach today because it rained. But let’s see what else we can do that’s fun. Why don’t we bake some cookies or make a dress for your doll.” Show your child how to look for plan B — a great tool to build resiliency. While it is important for your child to understand and express his own feelings, it is equally important that he learn to interpret other people’s feelings. In the aftermath of a dispute between your child and a sibling or friend, take a moment for a little lesson in empathy. Ask your child, “How do you think that made Billy feel when you called him a fatty pants? How does it make you feel when someone calls you a name?” There are excellent books, posters, games and even flashcards devoted to decoding other’s feelings. Children will adopt the family’s attitudes toward other people. Be aware of disparaging comments — even when made in jest — regarding others. Show respect for people who may be different than your family, and your child will acquire a sense of acceptance and openness.
Some other benefits of specific activities include: •
Martial arts can help children gain confidence as well as self-control and discipline.
•
Soccer, softball and baseball are great sports that children of any age, size and physique can play. There are plenty of youth leagues that emphasize skill development, fitness, teamwork and sportsmanship.
•
Weightlifting can help teens who aren’t particularly competitive build self-esteem while they build muscles.
•
Running and walking are activities that can be done pretty much anywhere, anytime.
•
When your child is feeling stressed or anxious, suggest a five-minute “power break.” Jumping rope, running around the block or bouncing a ball 100 times can provide a needed bit of relief, especially during a demanding homework session.
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Be an active listener “Busy parents are often half-hearted listeners. Take a few minutes to really connect with your child,” says Dr. Sood. Here are the components of active listening:
Instead of praising your child for his accomplishments and achievement, you can also emphasize: •
•
•
Intrinsic goodness. Your child’s goodness comes from within and is not attached to any external measure of success. Reinforce positive attributes like kindness, patience, gentleness and humor. Give love unconditionally. Like Mr. Rogers used to say, “I like you just the way you are.” Effort. Praise your child for trying something new or sticking with a tough assignment, regardless of the outcome. Intentions. Your daughter drops and breaks a dozen eggs along with your favorite serving dish. OK, so you want to scream. Before sending her to her room, take a deep breath and ask what she was doing. Her answer: She wanted to make breakfast for Mrs. Smith next door who is sick in bed. There isn’t a plate in the world worth more than that act of kindness. Give her a hug and work together to clean up the mess and make Mrs. Smith’s breakfast.
•
Eye contact. Look at your child, not the TV, your phone or the morning newspaper.
•
Attentive body language. Lean toward your child. Sit close. Nod your head to let him know you're listening.
•
Be quiet. Resist the temptation to offer an immediate solution. Ask your child if she would like a suggestion or if she just wants you to be a sounding board.
•
Verbal following. Make little “I’m listening” sounds, like “oh,” “really?” or “hmm.” Or restate what you heard your child say, like, “It made you feel really sad when Becca didn’t invite you to her party.” Simply paraphrase, rather than getting into deep interpretations. This lets your child know you are really hearing her and allows her to clear up any miscommunications.
•
Make sharing time a priority. Set aside time to talk with your child on a regular basis — not just when something’s wrong. It may only be 15 minutes every Saturday morning over a cup of hot chocolate, but make sure that time is sacred. Even if you child isn’t in the mood to talk, let her know that time is reserved just for her.
Look for the positives How will your child know what good behavior looks like if you only tell him when he is being bad? “Make it a point to catch your child in the act of being good,” says Dr. Sood. “Reinforce the behaviors you would like to see with praise. Thank your child for not interrupting you while you were on the phone or remark how nice it was to see him share with a friend.” When your child does slip, as all kids will, provide opportunities to turn things around. Give him a chance to succeed. Help your child find activities or talents where she can succeed and shine. If your daughter has two left feet, don’t insist that she continue with the ballet classes that she dreads. Instead, find something that will help her build her sense of accomplishment and self-confidence.
A routine matter Children find comfort in knowing what to expect. “Routines help children thrive and stay grounded. Self-control is learned in part by the routines we use when growing up,” says Melody Ailsworth, DO, a pediatrician with Richeson Drive Pediatrics in Lynchburg. Establish clear and consistent rules and routines with preset consequences, such as bedtime, and then stick to them. “Routines can be used for many reasons, but a few of the most important are ensuring children's health, social skills and safety, and helping children learn positive, responsible behavior,” says Dr. Ailsworth. “Making routines fun makes transitions easier for the whole family,” shares Dr. Ailsworth. “A great bed time routine includes the 4B’s; Bath, Brush (teeth), Book and Bed.” “Teens also benefit from routines,” she continues. “Having family meals together
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three times a week or more has shown to be protective in preventing drug exploration, sexual activity at a young age, fewer school suspensions and reducing the risk of suicidal thoughts.”
Establish family traditions “Family traditions are the cornerstone for establishing what values are significant to a family unit,” says Deirdre Edwards, licensed professional counselor with Centra Bridges Treatment Center. “Holidays, birthdays, family dinners, honoring accomplishments, vacations, community involvement and spirituality are the most common areas where traditions are formulated. They mark what it means to be ‘part of’ this family.” Traditions don’t have to be anything elaborate, just something that is unique to your family. Perhaps at dinner time you each tell a joke or every Saturday morning you visit the farmers’ market and stop for an ice cream cone on the way home. Invite your children to help determine what your traditions should be. These small moments make your family special and help create warm memories for your child.
All together now “Being a member of any group requires an individual to have responsibilities for being a part of that group. This is not any different when the group is a family,” says Edwards. “Chores or responsibilities foster independence, a sense of accomplishment as well as a sense of belonging to the family.” Children can contribute to the household in an age-appropriate way, from picking up their toys when they are toddlers, to mowing the grass as teens. Even very young children can learn to complete their “work” before playtime. As children get a little older, they can also be encouraged to contribute to their community. A child can recycle, donate money to a charity or volunteer to work for a worthy cause. These are wonderful ways to foster giving, build empathy and help children to be less self-centered. www.OurHealthlbss.com
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Natural consequences Your child is late for dinner for the fifth night in a row, and you’re tired of being treated like a short-order cook. First, you lecture him for 15 minutes about being inconsiderate. Next, you take away a privilege or ground him after school. Then you cook dinner — all while continuing the verbal assault. Finally, you swear this will be the last time you will ever prepare a second meal if he is late. Sound familiar? Next time this happens, allow natural consequences to prevail. If your child misses dinner, either he doesn’t eat or he prepares his own meal and cleans up afterward. He made the choice; let him live with the consequences. It is a far less combative approach. It puts your child in control of the outcome and removes you from being ” the enforcer.”
Maybe yes, maybe no “We all hate the word ‘no’— but limits are important to establishing boundaries and expectations,” says Edwards. “As parents we can explore what words we use. Sometimes ‘no’ can be formulated as a choice. Being able to choose is empowering for a child — it will foster independence and problem-solving skills. Just be sure that you provide options that you can live with when presenting your child with choices.” Help your child build a tolerance for hearing ‘no’. “Allow him to experience small frustrations so his fuse can grow, and he will be able to deal with larger frustrations and disappointment as he gets older,” says Edwrads. In her book, ”Stop Struggling With Your Child,” Evonne Weinhaus offers a simple suggestion for parents who are tired of arguing with their children over every little thing — just say “yes.” Instead of saying, “No, you can’t have a cookie because we will be eating dinner in 15 minutes,” say, “Yes, you can have a cookie — right after dinner.” At the mere mention of the word “no,” your child is suddenly prepared for battle. But there isn’t a lot to argue with when you say “yes.” 44
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Limit screen time Let’s face it. We’re living in a digital age, surrounded by gadgets. We even refer to our children as “digital natives.” But what are the effects of spending hours each day in front of a computer or television? And how much screen time is too much? Samantha King, MD, a pediatrician with Richeson Drive Pediatrics, offers guidance from the American Academy of Pediatrics on this important subject. “Children under age 2 should have no screen time at all. Older children should be limited to less than two hours a day of non-educational screen time.” This includes computers, video games, phones and, of course, TV. In a recent study conducted at UCLA, results indicate a relationship between screen time and social skill development in children. When screen time was limited, the children’s ability to read other peoples’ emotions improved. Other studies suggest that screen time can have a variety of negative effects on kids, including childhood obesity, irregular sleep patterns and behavioral problems. In an effort to decrease screen time, “enforce a no screen time policy during meals and keep televisions and computers out of children’s bedrooms,” says Dr. King. “Replace screen time with other activities such as board games, reading, puzzles or playing outside,” she offers. “Finding other healthy options to spending time in front of a screen improves children's physical and emotional wellbeing.”
Deirdre Edwards, MEd, LPC, LMFT, Residentail Services Director with Centra Bridges Treatment Center.
Cut your losses Even a happy, well-adjusted child can face a very real and devastating loss such as the death of a beloved grandparent or family pet. Or it may be less obvious, such as the loss of self-esteem when your daughter does not make the cheering squad. You can help your child through the grieving process by: •
Letting her know that losing someone or something special hurts. Give her permission to grieve.
•
Encouraging your child to talk about her full range of feelings, such as anger, sadness, denial, guilt, jealously and fear.
•
Holding on to the good feelings. Help your child create a memory box or memory book. Give him photos of his grandfather and memorabilia like a class ring or medals from military service. Help him capture and preserve the warm loving feelings he had for his loved one.
•
Taking on the positive characteristics of a loved one. Let’s say a close friend or relative dies or moves away. Or perhaps your child is feeling the loss of a favorite teacher when it's time to move to the next grade. Ask your child what he liked or admired most about that person. Then encourage him to adopt that trait. Your child can keep the memory alive by being as nice as grandma, as funny as Jason or as courageous as Mr. Jones.
•
Samantha King, MD is a pediatrician with Richeson Drive Pediatrics in Lynchburg. Dr. King is certified by the American Board of Pediatrics.
Letting go. If your daughter is deeply saddened that she didn’t make the basketball team, help her let go of those feelings and move on. Rather than dwelling on the loss, encourage her to focus her energies on a new activity. While it is important to recognize the pain your child is feeling, it is equally important to help her learn coping mechanisms and regain her sense of control.
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Pull together, even when you’re apart When parents separate or divorce, children suffer. “If you and your spouse have made the decision to end your marriage, do not drag your child into the battleground. Allow him to maintain a close and loving relationship with both parents,” advises Dr. Sood. A child’s self-image is in large part a reflection of both parents. If you tell a child that Mommy is bad, he will think he is bad. If you tell him that Dad is a creep, he will assume he is one too. “Your child is a miracle that you both created,” says Dr. Sood, “so set aside your differences and put the needs of your child first.” Here are some ways to be good co-parents:
Bela Sood, MD, FAACAP is a psychiatrist with Virginia Treatment Center for Children in Richmond. She is certified by the American Board of Psychiatry with a subspeciality in Child and Adolescent Psychiatry.
•
Refrain from making disparaging comments about each other.
•
Avoid blaming and finger-pointing.
•
Give your child free access to the other parent.
•
Try to maintain consistency in parenting styles and household rules.
•
Make major decisions about your child as a team.
The concept of positive co-parenting is not limited to parents who live apart; they also apply to intact families. Even moms and dads who live together can unknowingly pull and tug at their child’s emotions.
Bullying Bullying in any form — physical, verbal, emotional or relational — can be deeply hurtful to a child, leaving her feeling frightened, angry, helpless, embarrassed and even guilty that the bullying is somehow her fault. “Bullying should not be accepted as normal childhood or teenage behavior,” says Dr. Ailsworth. “It is estimated that over 100,000 children miss school every day because of verbal, social, physical or cyberbullying.” Encourage a child who is being bullied to:
Melody Ailsworth, DO is a pediatrician with Richeson Drive Pediatrics in Lynchburg.
•
Understand bullying. Explain that bullies are really unhappy, frustrated and insecure people. They try to make themselves feel better by controlling other people and making them feel lousy.
•
Walk away. Bullies want to know they have control over your emotions, so don’t react with anger or retaliate with physical force. If you walk away, ignore them or calmly and assertively tell them you’re not interested in what they have to say, you’re demonstrating that they don’t have control.
•
Find the humor. If you relax and comment on the bullying situation with humor, you’ll likely no longer be an interesting target for a bully.
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Control what you can. Many things in life are beyond our control, including the behavior of other people, so focus on the things you can control such as the way you choose to react to bullies.
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Report the bullying to a trusted adult. Unless bullies are reported and stopped, they may become even more aggressive.
“Being involved with your child in school, socially and during after school activities helps protect her from exposure to bullying,” says Dr. Ailsworth. “Make sure your 46
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children know to talk to adults and share with you the concerns they have with friends and classmates. If you have any concerns your child is being bullied, talk with officials at school, guidance counselors and your pediatrician to learn how to protect your child.” If your child is not able to resolve the bullying on her own, get involved. Tell the teacher, contact the bully’s parents, and if you have to, call the police. Your child must feel confident that you will step in to protect her.
“There is no simple recipe for raising an emotionally healthy child,” says Dr. Sood. “The best advice I can offer is to love and accept your child unconditionally. Focus on your child’s strengths and positive attributes. Keep your sense of humor. And, finally, remember: Before you blink, your child will be grown. So enjoy every moment of the toughest job you will ever love.”
MEDICAL EXPERTS Melody Ailsworth, DO, pediatrician with Richeson Drive Pediatrics in Lynchburg Deirdre Edwards, MEd, LPC, LMFT, Residential Services Director, Centra Bridges Treatment Center Samantha King, MD, pediatrician with Richeson Drive Pediatrics in Lynchburg Eileen Myers, MPH, RD, LDN, FADA, national expert on nutrition and eating disorders Aradhana “Bela” Sood MD, MSHA, Senior Professor of Child Mental Health Policy, Professor of Psychiatry and Pediatrics, Virginia Treatment Center for Children at VCU Health
RESOURCES Stop Struggling with Your Child by Evonne Weinhaus Stop Struggling with Your Teen by Evonne Weinhaus and Karen Friedman The Optimistic Child: A Proven Program to Safeguard Children Against Depression and Build Lifelong Resilience by Martin Seligman Transforming Teen Behavior: Parent – Teen Protocols for Psychosocial Skills Training by Mary Nord Cook SOS: Help for Parents by Lynn Clark 1-2-3 Magic: Effective Discipline for Children 2–12 by Thomas Phelan Magic Years: Understanding and Handling the Problems of Early Childhood by Selma Fraiberg
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Young Athletes Autumn Classic Young Athletes Autumn Classic OurHealth’s staff photographer, KG Thienemann, spent a recent Saturday morning capturing some great moments at the second annual Young Athletes Autumn Classic hosted by Lynchburg College's Doctor of Physical Therapy Program and Special Olympics Virginia in the Wake Field House at Lynchburg College. The event, for children ages 3-11 of all ability levels, featured an exciting day of sporting events including basketball, volleyball, track, bowling, and weightlifting. With the help of numerous faculty and student volunteers, children and families participated in a fun-filled day promoting respect, unity, and inclusion. Young Athletes™ is a unique sport and play program for children ages 2 to 7 with intellectual disabilities. Its focus is on fun activities that are important to mental and physical growth. The goal of the Young Athletes Autumn Classic is to bring together children with and without disabilities to promote more inclusive school environments. For more information on Special Olympics Virginia and the Young Athletes™ program, visit www.specialolympicsva.org.
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Original photography by KG Thienemann
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FIT BITS BRAVE THE BARRE
Deidre is our resident fitness specialist for OurHealth Lynchburch & Southside.
TRY A BARRE CLASS
Iron and Grace
Downtown Y
Lynchburg | 434.944.8633 www.ironandgraceva.com
Lynchburg | 434.847.5597 www.ymcacva.org
Peakland Pilates
NG ST
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BO D & D M IN
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MODERATE INTENSITY
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IB ILT
IY
Lynchburg | 434.384.5354 www.peaklandpilates.com
EX
Barre training is designed to use the body's own mass and very light weights as resistance. This one-of-a-kind workout is a continual, fat-burning series of exercises that tone the entire body in an effective yet safe way. Most barre-based classes use a combination of postures inspired by ballet and other disciplines like yoga and pilates, which also provide a mind-body connection. The barre is used as a prop to balance while doing exercises that focus on isometric strength training (holding the body still while contracting a specific set of muscles) combined with high reps of small range-of-motion movements. Utilizing the barre while contracting the abdominals provides the low back and spine with the stability needed to complete safe movements. It also allows smaller muscle groups to be isolated and sculpted while major muscle groups are simultaneously worked. This technique provides an intense, yet low-impact workout that garners quick, dramatic, and lasting results.
AFAA, ACSM
Certified Personal Trainer
FL
Have your friends been talking about going to 'barre', and you're wondering what new hotspot you're missing out on? When you finally realize they're not drinking cocktails, but rather working their tails, you're even more intrigued. So, what's the barre craze all about?
Deidre Wilkes,
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HealthyEats Fresh Peaches from:
Gross’ Orchard Gross’ Orchard 6817 Wheats Valley Road Bedford | 540.586.2436 Gross' Orchard is family owned and has been in business since before the turn of the century. They specialize in mountain grown peaches and apples. They also offer wagon rides from 12 noon to 5 p.m. daily. Open year round!
Peach Pumpkin Oatmeal (Makes 2-3 servings)
Ingredients: ½ cup unsweetened pumpkin puree ½ cup unsweetened coconut milk 1 cup fresh peaches, peeled and chopped ¼ teaspoon ginger ½ teaspoon cinnamon ¼ teaspoon nutmeg ¼ teaspoon sea salt 1 cup steel cut oatmeal ¼ cup chopped walnuts
Directions: 1. In a medium saucepan, whisk together the pumpkin puree, unsweetened coconut milk, peaches, spices and salt until smooth. 2. Bring to a boil. 3. Add the oatmeal, and then turn down the heat to a simmer. 4. Stir occasionally, until the oats are tender, about 25-30 minutes.
Tricia Foley’s Cancer Fighting
PEACH PUMPKIN OATMEAL Tricia Foley is OurHealth Magazine’s resident nutritionist. www.OurHealthlbss.com
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HealthyEats Local Kale from:
Kale Salad
Ginger Tahini Dressing
(Makes 2 servings)
(Makes 2 servings)
1825 Taro Road Cullen | 434.542.5202 www.facebook.com/GoldmanFarm
Ingredients:
Ingredients:
2 cups of kale leaves
¼ cup olive oil
Goldman Farm is a six generation family owned farm located in Cullen. They offer produce in several of the local farmers markets including the Forest Farmers Market and Lynchburg Community Market.
1 medium carrot, julienned
1/3 cup apple cider vinegar
¼ of a medium purple onion, diced
2 tablespoons tahini
2 tablespoons sesame seeds, for sprinkling
1 ½ teaspoons fresh ginger
Directions:
sea salt & pepper to taste
1. Wash kale leaves in a colander under cool water, and allow water to drain.
1 small garlic clove, diced
2. Let kale air dry while you rinse the carrot, cut off ends and julienne. Set aside.
1. Combine all ingredients in a high-speed blender or food processor.
3. Remove skin from onion, cut in half, and dice into small pieces.
2. Once well mixed, pour into a covered glass jar (for storing easily in the fridge).
Goldman Farm
4. Combine kale, julienned carrots and diced onions in a bowl. 5.
Toss together. Refrigerate until ready to serve. Sesame seeds will be added after dressing.
½ teaspoon lemon juice
Directions:
3. Makes just over a cup worth of dressing (2 tbsp/serving). 4. Reserve extra dressing for future use.
To Serve: 1. Pour dressing onto the kale salad, and toss with the tongs until everything is evenly coated. 2. Sprinkle with sesame seeds.
Tricia Foley’s Cancer Fighting
KALE SALAD
Tricia Foley is OurHealth Magazine’s resident nutritionist. www.OurHealthlbss.com
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HealthyEats Local Apples from:
Crews Family Orchards
Quinoa Crepes (Makes 6 servings)
Ingredients:
3760 Old Mine Rd Gretna | 434.656.6965 www.facebook.com/pages/CrewsFamily-Orchard
1 1/2 cups quinoa flour
With more than one thousand peach, nectarine and apple trees there is no shortage of delicious fruit to choose from. In addition the farm grows tomatoes, watermelons, cantaloupes, peppers, corn and other fresh vegetables! Open 8 a.m. to 8 p.m. Monday to Saturday and on Sunday from 1 p.m. to 8 p.m. mid-June thru November.
1 teaspoon cinnamon
1/2 cup wheat flour 1 teaspoon baking soda 2 cups carbonated or soda water 3 tablespoons olive oil 3 apples, sliced
Directions: 1. In a medium bowl, mix together quinoa flour, whole wheat flour, baking soda, and cinnamon. 2. Add carbonated water and oil and whisk until well combined. Preheat a large nonstick skillet over medium heat. 3. Add a few drops of olive oil. 4. For first crepe, pour about 1/3 cup of batter into skillet, rotating skillet quickly until bottom is evenly coated. 5. Cook crepe on medium high heat until bottom is light brown. Flip over and briefly cook other side. 6. Repeat previous step until batter is gone. 7. Serve with sliced apples.
Tricia Foley’s Cancer Fighting
QUINOA CREPES
Tricia Foley is OurHealth Magazine’s resident nutritionist. www.OurHealthlbss.com
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NEW OPTIONS IN PRENATAL CARE words | TINA JOYCE photography provided by | KG THIENEMANN
Approaches to prenatal and postnatal care vary, but many agree that mother-to-mother support and encouragement are vital components in the pregnancy journey. OurHealth takes a closer look at a program offering these benefits that has recently returned to the Lynchburg area. Choosing the right prenatal care can make a significant impact on the pregnancy experience. Many classes are available, and their formats differ between providers. It is important to choose a program that best fits the needs of the expectant parents. Centra Medical Group Women’s Center in Forest (formerly Forest Women’s Center) has reintroduced a popular program for expectant parents. The CenteringPregnancy prenatal care program combines private check-ups with group discussions about topics such as nutrition, exercise, breastfeeding, and preparing for childbirth. Each group is made up of eight to 12 women at the same stage of pregnancy, and fathers are encouraged to attend. The two-hour monthly appointments begin with routine examinations, blood pressure testing, weighing, and measurements. Then mothers, and often fathers, gather for facilitated discussion and education.
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Participants at a recent 'Centering' appointment at Central Medical Group Women's Center.
Parents who choose the CenteringPregnancy option benefit from a more relaxed, interactive approach to prenatal care. Rather than the standard 15 minutes of consultation time with a midwife or five to 10 minutes with a physician, centering patients find they have more than an hour to ask questions and share experiences. They feel less rushed and more at ease when leaving their appointments. “Centering really normalizes pregnancy for women. They are able to learn from other women and share their concerns. The agenda is primarily patient-led and women soon realize they have an innate wisdom,” explains Lucie Bautista, a certified nurse-midwife at Centra Medical Group Women’s Center. Patients meet monthly until week 30 of gestation, and then appointments are held every other week until the 36th week. During the last month of pregnancy, patients meet every week, alternating between group sessions and private medical appointments.
Centering Pregnancy Defined The National Library of Medicine defines centering pregnancy as “an innovative model of prenatal care that emphasizes risk assessment, education, and support within a group setting.” Centering programs, in place throughout the country, expand the benefits offered by traditional care, making appointments more personal and patient-focused.
Lucie Bautista, CNM is a certified nurse midwife with Centra Medical Group Women’s Center in Forest.
According to the Centering Healthcare Institute, the term “centering” comes from the belief that healthcare should be focused on individuals participating in the care experience at any given time. That starts with the individual patient and extends to the whole group, including clinical care providers. The centering model of care brings people together who share common goals, but their personal preferences and values make each group unique. When groups of people come together with a common purpose of health and well-being to share information and learn together, a transformation happens at the personal and collective level that brings about self-confidence, better understanding, and greater engagement. And that translates into personal decisions and actions that are supported by the group and leads to better health outcomes.
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CENTRA MEDICAL GROUP WOMEN'S CENTER Centra Medical Group Women’s Center offers prenatal, labor, and delivery care for women with low-risk pregnancies and patients deliver at Centra Virginia Baptist Hospital. They also have a consultative and collaborative relationship with Women’s Health Services of Central Virginia, which provides comprehensive surgical and non-surgical gynecological and obstetrical services, as well as bone density testing, fitness and dietary and nutrition counseling. To learn more about Women’s Health Services of Central Virginia, visit www.whscv.com. 2007 GRAVES MILL ROAD | FOREST, VA 24551 | 434.385.8948
Kim Price, is the Director of Women and Children’s Services with Centra Health.
More than Pleased with CenteringPregnancy “I think the centering program is amazing,” says Amanda Page of Forest. Amanda and Mike Page are expecting their third child in October and are overjoyed the program has made a comeback. They participated in CenteringPregnancy when their first child was born six years ago and were very pleased with the care, education, and encouragement the format presented. “When we were first pregnant, I was scared to death. It was great to be able to ask so many questions and learn from others as well,” says Amanda Page. The Pages had a more traditional prenatal experience with their second child, when the CenteringPregnancy program was temporarily suspended for a time due to funding issues. “The care was still good; the appointments just felt less personal and more rushed,” admits Amanda Page. They are pleased that CenteringPregnancy is an option again with their third pregnancy. “I think it is a great program. I highly recommend it. You get so much more out of the experience than just attending a traditional appointment,” says Amanda Page. The two-hour appointments spent with medical professionals and other expectant parents are the most obvious difference in a centering program. “At first it might seem awkward,” says Bautista. “But once the first www.OurHealthlbss.com
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Photo to the left: Current class of expectant moms all due late this year. Photo below: Mike and Amanda Page of Lynchburg.
appointment takes place, parents come together and share. We even hold a reunion after the babies are born, and mothers can tell their birth stories. I know of groups that become so close they continue to have gatherings after their children are born and growing.” Fathers can often feel isolated and unsure of how to properly show support throughout a pregnancy. Being connected with others in a group setting can help men learn what “normal” means for both parents and capitalize on the experiences of veteran parents. “The class helps me too. I know more what to expect. Plus when you have group care, you have the whole group to help you think of questions to ask,” says Mike Page.
“I would encourage anyone to try it [CenteringPregnancy]. There are not always textbook answers in pregnancy. When you come together as a group, you get a whole different perspective. In a sense, you get to define your ‘normal’.”
Peggy Karpenske, RN is the manager of Centra Medical Group Women’s Center in Forest.
-Amanda Page, CenteringPregnancy Program participant According to Peggy Karpenske, perinatology manager for Centra Medical Group Women’s Center, the program is gaining in popularity. An evening session was recently added to reach more expectant parents. Participation in the CenteringPregnancy program is covered by most major insurances and is billed accordingly. Patients make initial appointments with the Women’s Center and can inquire about the www.OurHealthlbss.com
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” We at Centra Health support the initiative to include a CenteringPregnancy program for our patients, through CMG Women's Center, because we feel Centering patients are well prepared for childbirth. The mothers form a special bond with each other during this time and learn from their midwives and each other. This model of care has been shown to improve birth outcomes and we are fortunate to offer this model of prenatal care in our community!” -Kim Price, MSN, MBA, RN NEA-BC and Director Women and Children's Services program at their first appointments to determine if the program is right for them. “At Centra Medical Group Women’s Center, we have seven midwives, all with different personalities. We all share a common goal. We want our patients to feel like they received good care, but also that we cared about them as individuals. I think the program is so rich and wonderful,” says Bautista. For additional information on the centering model, visit centeringhealthcare.org; for more information on the CenteringPregnancy program at Centra Medical Group Women’s Center, visit forestwomen.centrahealth.com. MEDICAL EXPERTS Lucie Bautista, CNM with Centra Medical Group Women’s Center in Forest. Peggy Karpenske, RN with Centra Medical Group Women’s Center in Forest. Kim Price, with Centra Health in Lynchburg.
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closer LOOK
Can you identify which local practice the image belongs to?
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h s t b l u a S e H r ne! u O To agazi M
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