OurHealth Lynchburg and Southside Magazine

SPECIALTY SPOTLIGHT SERIES: Counting on Colonoscopies to Cure Cancer + Are Allergies Affecting Us More Than Ever?

April • May 2019 ourhealthlynchburg.com

LYNCHBURG AND SOUTHSIDE

How each is making medicine better just might surprise you.

Bringing Beauty Back to Your BODY, SKIN AND SMILE Before Bathing Suit Season

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WHO DO YOU think has the

BESTBedside VOTING CATEGORIES INCLUDE:

Manner

in Lynchburg and Southside?

POLLS OPEN MAY 1

ST

Visit www.ourhealthlynchburg.com and click on the 2019 Best Bedside Manner Awards voting button to submit your entries.

VOTING CLOSES JUNE 1, 2019, and winners will be featured in the December/January edition!

Questions? Email steve@ourhealthvirginia.com

LYNCHBURG & SOUTHSIDE

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FEATURES

APRIL • MAY 2019

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2019 Lynchburg and Southside Healthcare Leaders

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9 Cosmetic Procedures That Turn Back Time on Your Face, Body and Skin

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Spring Cleaning for Better Health: What You Shouldn’t Sweep Under the Rug

Learn how nine of the brightest members of the Lynchburg and Southside medical community are giving back, not because it’s a part of their job description, but because it is the right thing to do.

As plastic surgery becomes more affordable and technology advances, more people are electing to reshape themselves for added confidence, anti-aging benefits and enhanced physical health.

No matter how tidy you are, some spots in your home always attract bacteria, fungus, mold, pet dander and more. These microorganisms and allergens can impact your breathing, sleep and overall health.

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DEPARTMENTS APRIL • MAY 2019

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The Pulse | People. Places. News to Know.

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Health Scene | Happenings. Who’s Who. Trending.

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Specialty Spotlight Series | Cardiology

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Specialty Spotlight Series | Gastroenterology

Randolph College’s annual Science Festival allows the community to discover and celebrate the beauty of science and its connection to many aspects of life. The event, which offers activities for all ages, has grown significantly since its inception in 2009, and continues to add new attractions each year.

20 Q&A on Health | Questions. Answers. Knowledge.

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Specialty Spotlight Series | Allergy, Asthma and Immunology Are Allergies Affecting Us More Now Than Ever? There’s a good chance that you have allergies or know someone who does. In the U.S., more than 40 percent of children and 30 percent of adults now suffer from the condition, and it appears this trend is on the rise.

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Who’s Who on Your Heart Health Team? This guide to your heart health team includes many of the roles you’ll encounter when receiving care. But make no mistake about it—when it comes to the diagnosis, care, and management of heart disease, no two healthcare teams are alike. Each one is as complex and unique as your own heart.

Colonoscopies: Not So Strange and Scary After All Patients worried about risks of colonoscopies or unsure what the procedure involves are less likely to get it done. But when you strip away the myths surrounding colonoscopies, they’re a simple, life-saving procedure — not so strange or scary after all.

www.OurHealthLynchburg.com

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april • may 2019

PUBLISHER PRESIDENT/EDITOR-IN-CHIEF VICE PRESIDENT OF PRODUCTION ACCOUNTING MANAGER GRAPHIC DESIGNER

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Hungate Laura Bower Tori Meador

CONTRIBUTING MEDICAL EXPERTS

Kenneth Barron, MD Chapman Brown, III, RPh Saju Eapen, MD Kappa Peddy, MD James Stanley, DDS Stephanie Wright, LMA

CONTRIBUTING PROFESSIONAL

EXPERTS & WRITERS

Joe Butler Jeanne Grunert Jennifer Lamont Katherine Paljug

ADVERTISING AND MARKETING Cindy 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 © 2019 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.

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The Pulse

INFORMATION • EVENTS • AWARENESS

News and Notes Free Clinic of Central Virginia Receives Grant Ensuring Continuity of Care for 2,900 Patients The Free Clinic of Central Virginia has been awarded $120,000 from Sentara Healthcare and Optima Health. Made possible by the Virginia Association of Free and Charitable Clinics, this funding will support Medicaid expansion efforts in clinics across the Commonwealth of Virginia and comes at a critical time for the Free Clinic of Central Virginia as it works to become a “hybrid” provider, meaning it will accept Medicaid-enrolled patients while also treating low income, uninsured patients in the community.

Sentara is providing a total of $1.5 million to support free clinics throughout the Commonwealth as they transition to accepting Medicaid. Sentara owns Optima, which is one of the new Medicaid expansion insurance plans.

“Continuity of care is especially important for our patients with complex, chronic health conditions,” says Christina Delzingaro, CEO of the Free Clinic. “The Board wanted to ensure that our patients

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can continue to be served at both our Main Street and Holcombe Hurt Community Health Center locations, and that we preserve the important relationships our volunteer providers have with their patients. Medicaid expansion, however, does not mean that there is no longer a need for the Free Clinic or its volunteer medical, pharmacy and dental volunteers.”

“The issue,” says Delzingaro, “is that there are only a few medical practices in our region that are accepting new Medicaid patients. Virginia Medicaid payment rates are so low that they don’t cover the costs of providing the service. At about $40 a visit, the payment isn’t even enough to cover the Free Clinic’s costs, and we use volunteer providers. In a way, Medicaid care is charity care.”

The Free Clinic will continue to serve uninsured adult patients with incomes below 200 percent of the Federal Poverty Level. Patients with incomes between 138 percent and 200 percent of the Federal Poverty Level are not eligible for Medicaid under the expansion.

More Information: Visit www.freeclinicva.org.

Jamie Gray, NP

Erin Jones, PA

Alan Kauppi, MD

Hortense Russell, DO

Centra Medical Group – Bedford Bedford | 540.586.7273 www.centrahealth.com

Centra Medical Group Endocrinology Center Lynchburg | 434.200.3908 www.centrahealth.com

Centra Medical Group Surgical Specialists Lynchburg | 434.200.3901 www.centrahealth.com

Centra Urgent Care – Forest Forest | 434.200.7210 ww.centrahealth.com

Kisha Young, MD

Centra Medical Group Lynchburg Neurology Center Lynchburg | 434.200.3600 www.centrahealth.com

FOR EVEN MORE HEALTH RESOURCES, CHECK OUT

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The Pulse

• NEWS TO KNOW

News and Notes UVA Health Opens Advanced Diabetes Management Clinic to Improve Access to Devices and Supplies University of Virginia Health System has opened an expanded outpatient clinic to help individuals diagnosed with Type 1 diabetes and insulin-dependent type 2 diabetes more easily obtain appropriate technology to effectively manage their condition. The Advanced Diabetes Management Clinic, located at 183 Spotnap Road, Suite 2 in Charlottesville, is among just a handful of similar clinics in the U.S., and builds off UVA’s groundbreaking research that seeks to better manage this chronic disease.

Staffed by a team of five endocrinologists, a nurse practitioner, a certified diabetes educator and support staff, the Clinic is currently open Mondays from 8 am – noon (except first Ananda Basu, MD and third Mondays, when open 1 pm – 5 pm); Tuesdays and Wednesdays from 8 am – noon; and Thursdays from 1 pm – 5 pm, with additional times set aside for classes to educate patients on how to effectively use these diabetesmanagement devices.

“We’ll fit you with the right technology and work with your insurer to get all necessary devices or supplies approved expeditiously,” says Ananda Basu, MD, a UVA endocrinologist and the clinic’s director.

Nurse practitioner Mary Voelmle, FNP, CDE works closely with insurance providers to streamline the approval process for patients to receive diabetes management devices such as insulin pumps and continuous glucose monitors, with the goal of shortening the approval timeline from weeks or months to several days. “Our team works hard to educate patients and optimize the therapies available through these devices,” she says.

Mary Voelmle, FNP, CDE

UVA’s Center for Diabetes Technology has developed an artificial pancreas to automatically monitor and regulate blood-sugar levels in people with type 1 diabetes. The device is now undergoing its final round of clinical trials. If approved by the U.S. Food and Drug Administration, the artificial pancreas will also be available through UVA’s Advanced Diabetes Management Clinic.

Dr. Basu says that the clinic now serves adult patients, and is considering expanding its services to adolescents in the near future.

More Information: Call 434.293.7811 or visit www.uvahealth.com. www.OurHealthLynchburg.com

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The Pulse

• NEWS TO KNOW

New Locations, Ventures, Mergers and Acquisitions New Aesthetics Services in Lynchburg Lynchburg Aesthetics and Wellness, a new practice offering both surgical and nonsurgical aesthetic treatments, is now open. The practice, located at 101 Archway Court, Suite A in Lynchburg offers a full selection of facial and body contouring aesthetic services including Botox, fillers, laser skin resurfacing, brow and face lifts, and a host of other cutting-edge services for both women and men. Appointment hours in the new location are Monday, Tuesday, Thursday and Friday from 8 am to 5 pm.

More information or to schedule an appointment: Call 434.616.4986 or visit them on facebook at Lynchburg-Aesthetics-and-Health.

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Screenings and Events Centra and Local Dermatologists Teaming Up to Offer Free Skin Cancer Screenings Centra Alan B. Pearson Regional Cancer Center and local dermatologists from Dermatology Consultants, Seven Hills Dermatology and Ridgeview Dermatology will offer free skin cancer screenings to the community on Thursday, May 2, 2019 and Thursday, May 9, 2019 at the Cancer Center, located at 1701 Thomson Drive in Lynchburg.

Screenings will be conducted in private rooms by a dermatologist or other healthcare professional specially trained in detecting skin cancer.

This screening is available to anyone who does not have a dermatologist or who has not had a skin cancer screening in the last year. Space is limited.

Visit www.centrahealth.com/cancerscreenings to register and fill out the online form located on the page or call Molleigh Tomlin at 434.200.6093.

More Information: Visit www.centrahealth.com/ cancerscreenings.

The Pulse

News and Notes

Lynchburg Community Care Collaborative will hold its annual free health and resource day on Saturday April 13, 2019 at the Salvation Army from 8 am – 3 pm. Free health services to be offered include general medicine, dental, STD and pregnancy tests, mental health and vision screenings, podiatry, and women’s health referrals. The event will also link participants to continuing care as well as community resources, such as employment, housing, addiction/recovery, disability, food access, emergency, and social service providers, and is open to anyone in the community. Identification and insurance are not required.

The Salvation Army is located at 2215 Park Avenue, Lynchburg, across from Miller Park. Those seeking care are asked to park either in the Salvation Army parking lot or the Miller Park pool lot across the street.

Lynchburg Community Care Collaborative is a community coalition comprised of various medical, health, and resource providers who are dedicated to improving the health of Lynchburg area residents.

• NEWS TO KNOW

Lynchburg Community Care Collaborative Holding Free Health and Resource Day

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OurHealth Lynchburg & Southside ON YOUR TABLET OR SMARTPHONE

More Information: Visit www.liberty.edu/lucom/lccc or find on Facebook by searching “Community Care Collaborative Lynchburg.”

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Do you have health-related news to share for The Pulse?

Send to Stephen McClintic Jr. via email at steve@ourhealthvirginia.com.

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Health Scene HAPPENINGS • WHO’S WHO • TRENDING photography | JILL NANCE WAUGH/RANDOLPH COLLEGE words | JENNY HUNGATE

RANDOLPH COLLEGE SCIENCE FESTIVAL ATTRACTS ENTHUSIASTS FROM ALL GENERATIONS The Randolph College campus was full of local science enthusiasts of all ages the weekend of March 23rd during its popularly attended annual Science Festival, which allows the community to discover and celebrate the beauty of science and its connection to many aspects of life. The event has grown significantly since its inception in 2009, and continues to bring new attractions each year. Now spanning multiple days and with a large number of community sponsors, the Science Festival, led by the Randolph College Society of Physics Students, is one of the largest events held on campus.

The busy weekend features activities like races, remarks from key-note speakers, poetry competitions, a glow-stick party and more, but one of the most coveted events is Science Day, a free event for children in pre-school through 6th grade that routinely fills its registration early, and this year was no different! With hands-on activities and experiments, robots, lasers, lightening machines, a Non-Newtonian Fluid Pool and more, the event gives young minds an interesting and engaging scientific look at the world around them.

To learn more about the Science Festival, including the latest details about the 2020 event, search for “I Love Randolph Science” on Facebook or visit www.randolphscience.org.

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1 Students enjoy the planet painting station. 2 Measure twice, pour once! 3 The Randolph College Science Festival dinosaurs visit with guests at the Lynchburg Mini Makers Faire. 4 Spectators learn more about the force of air and movement. 5 Randolph College students introduce guests to the baby chickens from the organic garden. 6 Mixture and solution based science experimenting. 7 Students try out different instruments while learning about sound waves. 8 Randolph College students teach about the different bones in the body. 9 Guests of the Science Festival try to walk on a mixture of water and corn starch. 10 Students perform a science experiment in the college lab. 11 Students participated in various science experiments throughout the day.

12 Participants collaborate on a marshmallow and spaghetti STEM building project. 13 Students learn about air pressure and the science of flight. www.OurHealthLynchburg.com

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Questions. Answers.

Knowledge.

I thought I was suffering from adult acne, but could it be rosacea?

If you are experiencing acne-like breakouts that tend to come and go, have skin that is sensitive, burns and/or stings and/or have facial redness, you may have rosacea, which is also known as acne rosacea.

Other symptoms of acne rosacea include a tendency to flush and blush easily and/or having visible broken blood vessels on the face.

Skin can vary from being oily to dry, rough or scaly. Eye involvement, called ocular rosacea, can occur.

It is estimated that

MORE THAN

14 MILLION PEOPLE HAVE ROSACEA.

Women are more likely to get acne rosacea than men, but men tend to have more severe cases of rosacea.

Rosacea is common, and most who have it are between 30 – 50 years of age, fair-skinned and often have blond hair and blue eyes, but anyone with any skin type can develop the condition. Those who have a family history of rosacea and/or had acne as a teenager are commonly affected.

Is thunderstorm asthma a real thing?

Thunderstorms can trigger asthma attacks. Scientists have observed increases in asthma exacerbation coinciding with severe thunderstorms. It is thought that pollen grains can absorb large quantities of moisture and then burst, releasing extremely small particles, which can then penetrate deep into the smaller airways of the lung. It is important to note that not all thunderstorms will trigger asthma.

Saju Eapen, MD

Asthma & Allergy Center Roanoke | 540.343.7331 Salem | 540.343.7331 www.asthmaandallergycenter.net

A dermatologist can help assess other medical conditions that may appear as rosacea as well as discuss triggers such as spicy foods, alcohol and weather extremes, the importance of rosacea-friendly skin care and other necessary information as part of a patient’s tailored treatment.

Kappa Peddy, MD

Dermatology Consultants Lynchburg | 434.847.6132 www.lynchburgdermatology.com

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www.OurHealthLynchburg.com FOR EVEN MORE HEALTH RESOURCES!

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What is the biggest misconception about non-surgical body contouring treatments?

The biggest misconception about non-surgical body contouring treatments is they are the same as weight loss. Body contouring is ideal for minimizing fat in isolated areas that are resistant to traditional weight loss, but it is not effective for treating obesity, loose skin, visceral fat (fat under the muscle) or cellulite.

Another misconception about non-surgical body contouring is it’s ineffective or temporary. Nonsurgical procedures have undergone years of study to document their results. These treatments permanently destroy and eliminate fat cells. For long-term continual results, maintaining a healthy diet and exercise regimen are recommended.

The last misconception is that non-surgical body contouring treatments are painful. The fact is, these treatments are done with little to no pain or downtime, which is what makes them appealing.

Stephanie Wright, Licensed Medical Aesthetician

Wyndhurst Medical Aesthetics and Hormone Clinic Lynchburg | 434.386.8894 www.wyndhurstaesthetics.com

www.OurHealthLynchburg.com

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Questions. Answers.

Knowledge.

IF YOUR

PRESCRIPTION

MEDICATION IS RECALLED, DON’T PANIC.

Visit the FDA web site (www.fda.gov) to learn more about the recall and the steps you need to take.

Your pharmacist will also be readily available to offer instructions as well.

What do I do if my prescription medication has been recalled?

In the U.S., drugs are rigorously tested for safety and effectiveness before going to market, and they are continually evaluated by the Food and Drug Administration (FDA) after being made available to the public. A drug recall may occur when a prescription or over-the-counter medication is found to be defective or harmful, such as issues regarding packaging, contamination, or poor quality. If this happens don’t panic. Visit the FDA web site (www.fda.gov) to learn more about the recall and the steps you need to take. Your pharmacist will also be readily available to offer instructions as well. It may also be necessary to consult with your doctor or pharmacist about appropriate substitutions for your medication.

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

How is endometriosis diagnosed and treated?

What are signs that I might need a root canal?

Hormonal medications such as birth control can work well to reduce endometriosis symptoms for some women, but can have side effects.

However, these medications do not cure endometriosis. Laparoscopy with biopsy is the only accurate way to make a diagnosis. Ultrasound and MRI can identify ovarian cysts and pelvic nodules, but the majority of endometriosis cases cannot be seen with ultrasound or MRI.

The most common sign that a root canal may be needed is pain in the oral cavity, and the vast majority of the time, a tooth is the culprit of this pain. Symptoms may range from acute, sudden lingering pain to pain that comes and goes over a few days and normally becomes more localized and intense. Some of the precursors may be elevated lingering responses to cold or hot drinks or food, recent dental treatment and prolonged pain following the procedure; blunt trauma to teeth; and cracks that develop due to grinding or clinching the teeth. Also, there may be radiographic signs of infection, but not always.

Laparoscopic treatment of endometriosis is done by either ablating (vaporizing or burning) or excising (cutting out the disease).

Ablation is less invasive and less difficult but has a higher recurrence rate and cannot treat disease in all locations (such as on the bowel).

Excision requires more surgical expertise, but studies indicate longer pain relief and less chance of needing future additional surgery.

A surgeon with specialty training in endometriosis will be more skilled at identifying less obvious signs of endometriosis, ensuring that no disease is left behind at the time of surgery.

Kenneth Barron, MD

The Center for Advanced Gynecology Charlottesville | 434.234.4903 www.virginiagyn.com

Anything that breaks the enamel of a tooth, such as a crack, decay and/ or dental restoration, can possibly allow bacteria to make its way to the pulp inside the tooth and set up an infection and associated symptoms.

The good news is modern root canal therapy is safe, predictable and carries a great long-term prognosis while relieving pain.

James Stanley, DDS

Dr. James L. Stanley, DDS, PC Lynchburg | 434.385.0273 www.lynchburgendodontics.com

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LEADERS A

LOCAL HEALTHCARE

nthropologists tell us that the healer is one of the most important and revered roles of any culture. While the warriors, producers and merchants all have their uses and value, a functioning and thriving society always needs individuals with the proper training, wisdom and compassion to help their fellow men, women and children with any physical or mental condition, whether they practice in a tiny jungle hut or a cutting-edge medical clinic in a major modern city.

words | JOE BUTLER

patient-focused, efficient and fiscally sound. Others focus on making sure access to quality healthcare is available to all segments of our population, striving to leave no one behind.

OurHealth Lynchburg and Southside Magazine recently invited community members

to nominate online who they think best represents the area’s ideal healthcare leaders. We received many worthy suggestions, and we also learned that there’s a lot going on behind the scenes not everyone knows about. Colleagues shared “secret” details about afterhours activities some perform like helping Today’s healthcare providers and administrators kids at schools, coaching sports teams, shoulder the responsibility of continually volunteering at community clinics, advancing the quality of care made or going on church medical mission available in our communities all while Giving back trips to help others in need around overcoming more than their share of to their community the world. obstacles and challenges. Yet, many of not because it’s a part them extend themselves even further of their job description, We were encouraged to learn that to go above and beyond in an effort to all of these leaders are unified in but because it is the help us all become better humans. They thinking that giving back, performing right thing to do. research, they teach, they serve, and community service and building they look for other ways to give back to relationships all are the things they their professions and their communities to don’t just do because it’s a part of a job inspire future generations and future healers. description, but because they genuinely believe it’s the right thing to do.

Some leaders in the healthcare community don’t even have to work directly with patients to have vital roles.

In that spirit, we invite you to learn more about They could make sure an office, medical center or health nine of the brightest members of our local exchange runs optimally; training and placing the right medical community who make up our list people in the best position for them to prosper; ensuring of 2019 Lynchburg and Southside Leaders in that employees enjoy where they work even when under Local Healthcare. stressful conditions; and establishing processes that are

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OurHealth | The Resource for Healthy Living in Lynchburg and Southside

Shanna Akers, EdD, MSN/ MBA-HC, RN, CNE LYNCHBURG Dean Liberty University School of Nursing www.liberty.edu Carilion Nurse Residency Program Advisory Board Member Psi Delta Chapter, Sigma Theta Tau International Member Nursing BSN Honors Thesis Committee Member DNP Scholarly Project Committee Member

As dean of the School of Nursing at Liberty University, Shanna Akers, EdD, MSN/MBA-HC, RN, CNE has a vital role in making sure future nurses have proper skills to help a growing population that is going to require more healthcare in the future. She’s active in developing and strengthening partnerships with healthcare providers and others in the Lynchburg medical community and beyond. She also makes sure the school remains focused on teaching proper material, and that all accreditation remains current. She has been part of the Liberty faculty since 2009 and has focused on in-classroom and online programming as well. Akers has been called a transformational leader who is supportive of students, faculty and staff. She also is regularly involved in efforts to evaluate faculty and students at different credential levels, from RN to PhD. Akers has a role in encouraging people to consider various nursing fields and disciplines, from working at a summer camp to evaluating their thesis projects. Prior to her academic focus, Akers was a practicing nurse and a certified nursing educator. She’s involved in various local and national committees focusing on education and innovation.

John Barnard, Jr., MD

Shawn Crawford

LYNCHBURG

LYNCHBURG

Orthopedic Surgeon OrthoVirginia www.orthovirginia.com

Chief Executive Officer MD Resource, Collaborative Health Partners and CVFP Medical Group www.cvfp.net

OrthoVirginia President and Chairman of the Board Ex-officio member of Surgery Center of Lynchburg Board Fellow in the American Academy of Orthopaedic Surgery Virginia Orthopedic Society Member Lynchburg Academy of Medicine Member University of Lynchburg Physician Assistant Medicine Advisory Board Member

Some providers prefer to focus on the clinical side of medicine, leaving business and organizational details to others. Then there’s John Barnard, Jr., MD, who is able to do well in both worlds. While Dr. Barnard is an accomplished orthopedic surgeon and sports medicine physician, he is also heavily involved in the organizational side of Virginia’s medical community. He’s currently president and chairman of the board for the OrthoVirginia organization, and he had a lead role in merging the Orthopaedic Center of Central Virginia with OrthoVirginia, a multi-year effort that created what’s now considered the largest orthopaedic practice in the Commonwealth and one of the largest in the country. This move has improved efficiency and helped standardize orthopaedic care across the state. Dr. Barnard helped to open the Surgery Center of Lynchburg and develop it into one of the premier outpatient centers in Virginia. He’s also active in local, state, regional and national associations and medical societies, including the American Academy of Orthopaedic Surgeons and the OrthoForum.

Colleagues applaud his professionalism and interest in improving access to quality orthopaedic care throughout the region, and he has received glowing testimonials from patients who he has helped through knee and shoulder surgeries. Patients indicate their quality of life has improved and all are appreciative of his personality and healthcare skills.

During his 25 years of leadership experience in the healthcare industry, Shawn Crawford has served in a variety of settings, including private practice, hospital-based practices, outpatient diagnostic centers and Federally Qualified Health Centers. He helped to develop the first independent clinically integrated network in Virginia and the first network to develop a direct care program for employers. He and his team also helped lead CVFP Medical Group, a practice of over 50 physicians, to become a Level 3 Patient-Centered Medical Home and one of only two Patient Centered Connected Care Centers in Virginia. Crawford currently serves as the CEO for MD Resource, a management service organization providing services to more than 100 providers as well as CVFP Medical Group, a family medicine group of over 56 physicians with seven primary care locations, three immediate care locations, a university student health center, a diagnostic center and a central lab; and Collaborative Health Partners, a clinically integrated network of more than 100 participating providers with a focus on population health management.

Crawford recently completed his tenure as market president for Privia Health Southwest Virginia. Colleagues say Crawford constantly searches for ways to find success in an organization, but also makes sure this focus on quality is passed onto patients. As much as healthcare changes and evolves in new directions, Crawford makes sure to never lose focus on what patients need and want: compassionate service. www.OurHealthLynchburg.com

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Stephanie Ferguson, PhD, RN, FAAN, FNAP LYNCHBURG Professor College of Health Sciences at the University of Lynchburg www.lynchburg.edu Stephanie L. Ferguson & Associates, LLC Founder, CEO and President Bon Secours Mercy Health System Board Member Bon Secours Mercy Health System Strategy and Finance Committee Member National Academy of Medicine Elected Member White House Fellows Foundation and Association President-Elect and Governance and Finance Committee Chair National Academies of Practice, Elected Distinguished Practitioner and Fellow American Academy of Nursing Elected Fellow Bing Stanford in Washington Program for Stanford University Consulting Associate Professor

From local hospital rooms to university classrooms to the White House, Stephanie Ferguson, PhD, RN, FAAN, FNAP has acquired an impressive perspective of what’s important to people in their healthcare needs. As head of the PhD in Nursing program at University of Lynchburg, she makes sure future students have the skills and credentials they need to succeed. With a global mindset, she also advises domestic and international policymakers on ways to improve and deliver healthcare to growing populations, and she has worked in 100+ nations as a technical advisor, consultant and facilitator for the World Health Organization (WHO) and the International Council of Nurses (ICN). Dr. Ferguson began her medical career at age 13 as a volunteer at Centra Lynchburg General Hospital. She chose to remain in the area, but still gained the opportunity to grow her knowledge and advance her career. In 1996, President Bill Clinton appointed her as White House Fellow, and she still advises the White House on medical topics. She’s been elected to the National Academy of Medicine and has shared her perspective on global health and the role that the U.S. can have. Dr. Ferguson is Founder, CEO and President of Stephanie L. Ferguson & Associates, LLC, a global health consulting firm with more than 35 years of experience designing, implementing and evaluating health-related strategic plans and programs. She has received accolades from local patients and providers along with earning top nursing honors at national and international levels. Although we all are encouraged to think globally and be the change we want to see in the world, Dr. Ferguson is commended for truly putting these words into action.

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OurHealth | The Resource for Healthy Living in Lynchburg and Southside

Carl Hoegerl, DO

Christine Marraccini, MD, FACOG

GRETNA

LYNCHBURG

Neurologist and Professor Liberty University College of Osteopathic Medicine www.liberty.edu/lucom

Physician/Practice Partner Women’s Health Services of Central Virginia www.whscv.com

Lynchburg Academy of Medicine President

Women’s Health Services of Central Virginia Executive Committee Member

Virginia Osteopathic Medical Association Member

American Board of Obstetrics and Gynecology, Fellow

Medical Society of Virginia Member

American College of Osteopathic Neurology and Psychiatry Member

Lynchburg Academy of Medicine Member

Journal of the American Osteopathic Association Editorial Board Member

Emory-Grady Society of Gynecologists and Obstetricians Member

Carl Hoegerl, DO operates a small clinical practice in Gretna, but the bulk of his time is in the classrooms at Liberty University College of Osteopathic Medicine, where he’s the chair of the department of internal medicine and associate professor of neurology. His research focuses on the neurological factors involved in strokes and multiple sclerosis, and his knowledge is high in demand. Dr. Hoegerl has written 19 scholarly articles and a neurology textbook, and he speaks regularly about these topics. He also likes to teach medical students about current technologies and tools which can improve efficiencies and outcomes.

Dr. Hoegerl had a role in re-establishing the Multiple Sclerosis Center at Geisinger Medical Center in Pennsylvania where he served as a director and as a lead clinical researcher in multiple subject areas. He has taught at Temple University and Gannon University (Erie, PA), the latter which he attended; Gannon University declared Dr. Hoegerl Distinguished Young Alumni and presented him with its Medal of Honor and the Joe Luckey Award for Service. He even had a role in establishing a mobile free clinic in Danville and Martinsville to help those who lack insurance. Colleagues say Dr. Hoegerl is creative, organized and inspiring.

Claude Moore Physician Leadership Institute Fellow

As a board-certified OB/GYN, Christine Marraccini, MD enjoys working with patients before, during and after childbirth. She’s always happy to provide advice and recommendations for prenatal care and breastfeeding education options and helps diagnose and resolve reproductive challenges or related health conditions that patients might be experiencing. Dr. Marraccini also performs minimally invasive surgical procedures using the latest laparoscopic and robotic surgery techniques. Besides being innovative, these techniques also have a faster recovery time and less pain, since she knows it’s difficult for patients, especially women, to take too much time off from their personal or professional lives for extended surgical recovery. Through a medical mission trip in 2017, Dr. Marraccini was able to offer gynecological surgery care to women overseas. Her trip to Honduras allowed her to care for women who would have otherwise not been able to receive such care. On the local front, Dr. Marraccini knows that proper education and community resources during pregnancy are vital, so she has developed relationships with regional community organizations including Healthy Families of Central Virginia, which provides a supportive network for mothers with children up to age five; and The Motherhood Collective, which provides guidance for women who want to experience natural, unmedicated labor. Dr. Marraccini finds ways to help other community organizations that support women, including the Lynchburg Free Clinic and HumanKind and is active in preparing our next generation of healthcare providers in her role as a preceptor and instructor at Liberty University School of Osteopathic Medicine.

Mehgan McCrickard

Katie Morris, PT, DPT

LYNCHBURG

BROOKNEAL

Chief Operations Officer Johnson Health Center www.jhcvirginia.org

Site Director/Educational Lead Specialists Rehab Associates of Central Virginia Brookneal Clinic www.racva.com

Leadership Lynchburg Advisory Council Member Leadership Lynchburg Executive Leadership Forum

Johnson Health Center hired Mehgan McCrickard as a behavioral health clinician in 2009 and colleagues, supervisors, and even patients quickly became impressed with her personality, organizational abilities and leadership skills. Since then, she has been given additional responsibilities, and today is the facility’s Chief Operating Officer, a position that involves providing support for the entire organization. This role also includes searching for efficiencies in a wide variety of departments, including transportation, information technology, patient engagement and marketing.

McCrickard has been active in developing new programs and expanding services into the Greater Lynchburg area, including seven new service locations that offer comprehensive primary care, dental care and behavioral healthcare for everyone, whether or not they can afford it. This effort includes not only making sure all healthcare resources are in place but that the facilities and sites are ideal. McCrickard has been described as enthusiastic, humble, and passionate about the community served

by Johnson Health Center. She was part of Leadership Lynchburg’s Executive Leadership Forum and currently is a member of the Leadership Lynchburg Advisory Council. Because of her background and interest in everything from community outreach to behavioral health, McCrickard is able to work with many groups of people and help everyone see success.

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Virginia Chapter of the American Physical Therapy Association Treasurer

Katie Morris, PT, DPT began her medical training as a physical therapist and earned certification as a Geriatrics Certified Specialist, an effort which provided her with advanced clinical knowledge and skills working with geriatric patients. At Rehab Associates of Central Virginia, she currently holds two roles: the director of the Brookneal Clinic practice, where she provides operational oversight and clinical care for patients; and the educational lead specialist, where she manages clinical education for all newly hired licensed professionals in the company. Dr. Morris’ colleagues say she always focuses on everyone having the highest professional standards, matched by the highest attention to customer service. Along with being active in rehabilitative care, she enjoys community outreach, including promoting the clinic through the Brookneal Business chamber. Dr. Morris is a cancer survivor herself, which drives her high expectations for quality rehabilitative care. Within the region’s rehabilitative community, she’s also a leader, including treasurer of the Virginia Chapter of the American Physical Therapy Association, and her efforts have led to impressive recognition at local, national and international levels. Not only has Dr. Morris received international clinical outcome awards, the clinic in which she oversees is currently rated “world-class” through its Net Promoter Score, measuring patent satisfaction and experience. She is a leader in every sense of the word.

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

Verna Sellers, MD, MPH, CMD, AGSF LYNCHBURG Medical Director Centra PACE www.centrahealth.com Lynchburg Academy of Medicine Member Medical Society of Virginia Member Central Virginia Alliance for Community Living Member Virginia Medical Directors Association Founding Member

Verna Sellers, MD, came to the Lynchburg area in 2008 when she was asked to open PACE (Program of All-Inclusive Care for the Elderly) at Centra. The unique program is designed to allow and encourage adults over age 55 in local communities to stay in their homes, even if they may meet the criteria to move to a nursing facility. Participating seniors appreciate being able to remain independent, and they also appreciate Dr. Sellers’ expertise.

She has received numerous awards and recognition for her work in geriatric medicine as well as certification from the American Board of Internal Medicine in geriatric medicine, and from the Society of Post-Acute and Long-Term Care in hospice and palliative medicine. She has been interested in geriatric health most of her professional career, and even completed a two-year geriatric fellowship.

Along with providing care for Lynchburgarea residents in their homes and area assisted living facilities and nursing facilities, she is an active administrator and educator. She is a faculty member for the Society of Post-Acute and Long-Term Care Core Curriculum in Medical Direction and a preceptor for the Lynchburg Family Residency Geriatric Fellowship Program.

Dr. Sellers is also active in regional and national organizations, including being a founding member of the Virginia Medical Directors Association, and she is active in the Virginia Geriatric Society.

www.OurHealthLynchburg.com

31

Procedure Cosmetic Procedures

That Turn Back Time on Your Face, Body Skin

words | JENNIFER LAMONT

If you wish you could change something, or a few things, about your face, skin or body, you’re not alone.

As cosmetic and plastic surgery becomes more affordable and technology advances, more people are electing to reshape their face, body and skin for added confidence, anti-aging benefits and enhanced physical health.

Let’s be honest: most of us just want to look more like our filtered selfie pics.

The good news is that cosmetic enhancements are not such a big deal anymore. Thanks to social media, everyone it seems – including celebrities and your neighbor two doors down – is not only talking about what they’ve had “done,” they’re posting their videos and before-and-after pics online.

Americans have over 17 million surgical and minimally invasive cosmetic procedures each year, says the American Society of Plastic Surgeons – including a 28 percent jump since 2000 for men. Those numbers are increasing rapidly as lasers do more of the work, making cosmetic procedures not only safer, but also faster and less invasive.

The Most Popular Plastic Surgery Procedures Performed in the U.S. Of the millions of plastic surgeries performed each year, these are five of the 10 most popular in the U.S.:

A

BREAST AUGMENTATION (enlargement and reduction)

B

LIPOSUCTION (most popular procedure for men)

C

RHINOPLASTY (nose reshaping)

D

EYELID SURGERY (blepharoplasty of upper or lower lids, or both)

E “MOMMY MAKEOVER” (tummy tuck plus other procedures based on individual patient) CONTINUED ON PAGE 34

32

OurHealth | The Resource for Healthy Living in Lynchburg and Southside

www.OurHealthLynchburg.com

33

Community Care Connection For any type of medical procedure, you want a provider with the knowledge and skill to give you safe treatment and natural results. From plastic surgery to minimally invasive cosmetic treatments, residents in the greater Lynchburg area have access to some of the region’s best providers.

Who to Check Out for Surgical and Non-Invasive Facial Cosmetic Treatments

CONTINUED FROM PAGE 32

“Tweakments” Offer Improvements with Less Downtime “Tweakments” such as injectables, lasers and skin resurfacing are on the rise as more people are opting for less drastic options. These micro-adjustments can be done on your lunch hour with limited or no downtime.

The five most popular beauty tweaks are:

A BOTOX® COSMETIC (frown lines and crow’s feet treatment) B FILLERS/INJECTABLES (Juvederm, Elevess, Perlane and Restylane

are some of the brands. Injectables are not created equal and they focus on different areas of need)

William Carvajal, MD, FACS FACIAL SURGEON Central Virginia Oral & Facial Surgery 101 Archway Court | Lynchburg, VA 24502 434.832.8040 | www.cvofs.net Dr. Carvajal is board certified and a fellow of the American College of Surgeons, specializing in oral and maxillofacial surgeries. Founder of Central Virginia Oral & Facial Surgery, his practice offers cosmetic facial surgeries, as well as dental and orthodontic surgical treatments.

Who to Check Out for Medical Aesthetics Kristen Kuk, MD AESTHETICS DIRECTOR Ridgeview Dermatology 101 Candlewood Court | Lynchburg, VA 24502 434.363.4190 | www.ridgeviewdermatology.com After moving to Lynchburg and taking a break from clinical practice to stay home with her young family, Kristen Kuk, MD decided to return to medicine in the field of medical aesthetics. She has maintained an active medical license and has focused her CME on aesthetics, including training in laser and injectables.

Who to Check Out for Innovative Aesthetics

C D

CHEMICAL PEEL (light, medium or deep) LASER HAIR REMOVAL (sometimes requiring repeat treatments, this isn’t totally painless)

E MICRODERMABRASION (“sanding” or abrasion of the skin’s surface)

Which Procedures are Trending in Lynchburg and Southside?

Wondering if you’re a good candidate for liposuction? Or, whether you should consider a breast lift instead of the enlargement you’ve been wanting forever? Here are the ins and outs for nine of the most popular procedures in the Lynchburg and Southside areas and beyond to help you refresh your face, skin and body.

Most Popular Surgeries

The

to Improve Your Body Shape

Ashley Chieppa, PA-C Dermatology Consultants 1330 Oak Lane, Suite 101 | Lynchburg, VA 24153 434.847.6132 | www.lynchburgdermatology.com

1. Liposuction

Dermatology Consultants uses several new technologies, including IPL (intense pulsed light) and the BLU-U illuminator (non-invasive, blue light photodynamic therapy to treat acne and other conditions). Ashley Chieppa, PA-C educates patients and helps them customize their own treatment plan.

Liposuction slims down the chin, thighs, stomach, waist, hips, calves, buttocks, back, arms, face and breasts.

Who to Check Out for Medical Aesthetics and Hormone Treatments Stephanie Wright LICENSED MASTER AESTHETICIAN Wyndhurst Medical Aesthetics and Hormone Clinic 200 Archway Court | Lynchburg, VA 24502 434.386.8894 | www.wyndhurstaesthetics.com Wyndhurst Medical Aesthetics and Hormone Clinic offers a variety of aesthetic treatments including laser treatments, fillers and body contouring, including CoolSculpting®. They also offer medical weight loss and hormone replacement therapy. Stephanie Wright, master aesthetician at Wyndhurst, says there’s nothing better than educating her patients and giving them confidence in their own skin.

34

WHY IT’S POPULAR:

HOW IT’S DONE: •

Local or general anesthesia, or IV sedation

•

Areas of fat are removed from directly beneath the skin by using a vacuumsuction canula, a tube-shaped instrument. Ultrasound or laser (SmartLipo) may also be used to break up fat deposits prior to removal.

BEST CANDIDATES: •

People who are within 30 percent of their ideal body weight with pockets of fat that don’t respond to diet or exercise.

•

Those with firm, elastic skin and more muscle tone.

WORST CANDIDATES: •

People who want to use it for weight loss or treatment for obesity and those wishing to get rid of cellulite.

TYPE OF PROVIDER TO LOOK FOR: Board-certified cosmetic, plastic or dermatologic surgeon

AVERAGE COST:

$3,374*

CONTINUED ON PAGE 36

Spotlight On: William Carvajal, MD, FACS FACIAL SURGEON

Central Virginia Oral & Facial Surgery Lynchburg: 434.832.8040 Farmville: 534.394.2329 www.cvofs.net “The eyes are the window to the soul,” says William Carvajal, MD, FACS, a board-certified oral and maxillofacial surgeon and founder of Central Virginia Oral & Facial Surgery in Lynchburg and Farmville. He should know. His most popular surgical procedure is blepharoplasty, which rejuvenates the eyes by removing excess eyelid skin or fat to correct sagging, drooping or puffiness.

The procedure can take years off the face. Because eyelid skin is thinner than other areas on the face, it often shows aging first. “The best candidates are patients with excess skin or hooding of the upper eyelids and puffy, baggy lower eyelids. Patients with low brows often require additional treatment for brow position,” says Dr. Carvajal.

Although his office treats patients with cosmetic and reconstructive surgeries on the face, jaw and teeth, it also performs non-surgical treatments, like fillers, body contouring and sculpting. With minimum to no downtime, fillers and body contouring treatments are increasingly popular. “We can change a person’s entire face with fillers through a liquid facelift, cheek lifts, tear trough correction, and lip augmentation,” he says.

“The thing I enjoy most about cosmetic surgery,” says Dr. Carvajal, “is helping people correct areas they are very self-conscious about. Helping to restore a person’s self-confidence is extremely rewarding.”

William Carvajal, MD, FACS A facial surgeon with Central Virginia Oral & Facial Surgery in Lynchburg.

Did you know?

You Can Acquire New Dimples in About 30 Minutes.

If you think you’d be cuter with dimples, you may be right.

Performed as an outpatient procedure, a “dimpleplasty” costs between $2,000 and $5,000. And, when done correctly, it makes you undeniably adorable. www.OurHealthLynchburg.com

35

Spotlight On: Kristen Kuk, MD

CONTINUED FROM PAGE 34

2. Breast Augmentation Enlargement and/or Lift

AESTHETICS DIRECTOR

Ridgeview Dermatology Lynchburg: 434.363.4190 Forest: 434.333.7370 Smith Mountain Lake: 540.759.7500 Farmville: 434.315.5389 www.ridgeviewdermatology.com

HOW IT’S DONE: •

Under general or local anesthesia

•

Implants: silicone or saline

•

Fat transfer enlargement: using liposuction to take fat from other parts of your body and inject into your breasts has the benefit of being safer but without as much volume as silicone implants.

BEST CANDIDATES: • ENLARGEMENT: those who have fully developed breasts, but are bothered by the feeling they’re too small.

Ridgeview Dermatology specializes in adult, pediatric and surgical dermatology, as well as non-invasive aesthetic treatments. Kristen Kuk, MD is uniquely qualified in the field of medical aesthetics.

• LIFT: women who are dissatisfied with breast shape after pregnancy, weight loss or aging, and have a good amount of breast tissue left.

The most popular procedures that she performs are BOTOX injections and dermal fillers. “Injectables are a good option as the results are quick and the treatments are well-tolerated,” says Dr. Kuk. Treating both men and women in a wide range of ages, she aims to achieve a subtle improvement that “restores a youthful appearance without making drastic changes.”

Dr. Kuk’s most popular non-invasive treatment is CoolSculpting®. Completely non-surgical, CoolSculpting® reduces fat using a technology called cryolipolysis. “We use temperature to induce cell death in fat cells in targeted areas of the body. This treatment has become increasingly popular nationwide, as very few people are not candidates and there are a wide range of body areas that can be treated, including under the chin, abdomen, back, thighs and upper arms,” says Dr. Kuk. She adds, “I like minimally invasive cosmetic procedures because they often give patients a boost to their confidence without having to endure a major surgery or a lengthy recovery. I also enjoy the artistic nature of some of the procedures, particularly dermal filler. Every patient’s face is different and there are a wide range of options in terms of how and where filler can be injected to achieve a patient’s goals.”

Kristen Kuk, MD Aesthetics Director with Ridgeview Dermatology in Lynchburg.

WORST CANDIDATES: •

ANYONE UNDER THE AGE OF 18: The breasts of teenage girls can continue to develop well into the 20s. The breasts should be fully developed before augmentation is considered. Trying to perform the surgery before full development can cause the enhanced breasts to become deformed as growth continues.

•

ANYONE WITH UNREALISTIC EXPECTATIONS FOR THE OUTCOME: Cosmetic surgery can initiate major changes in a patient’s life. You should not undergo the procedure if you are doing it for any reason other than to feel confident about your body. Going through the procedure with unrealistic expectations can have permanent consequences for mental and psychological health.

TYPE OF PROVIDER TO LOOK FOR: Board-certified cosmetic or plastic surgeon

AVERAGE COST: Implants –

$3,718*

3. Tummy Tuck WHY IT’S POPULAR: •

Gives you a flatter, contoured abdomen that’s more proportionate with your body type and weight.

•

Sometimes part of a “mommy makeover” to restore a woman’s body after childbearing. Mommy makeovers involve multiple sites depending on the patient’s circumstances. Possible procedures alongside a tummy tuck are breast augmentation, breast lift, buttock augmentation, vaginal rejuvenation and liposuction.

HOW IT’S DONE: •

General anesthesia (most often) or IV sedation

•

The skin over the lower abdominal area is removed and the remaining skin is tightened.

BEST CANDIDATES: •

Those who aren’t carrying too much excess fat in the abdomen, but have loose skin after pregnancy or after losing a large amount of weight.

•

Finished with childbearing

•

Close to ideal body weight

WORST CANDIDATES: •

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OurHealth

Lynchburg & Southside ON YOUR TABLET OR SMARTPHONE

36

| Lift – $4,672*

Those who may get pregnant again in the future.

TYPE OF PROVIDER TO LOOK FOR: Board-certified cosmetic or plastic surgeon

AVERAGE COST:

$3,000*

The Most Effective Ways to Take Years Off Your Face 1. Facelift (Rhytidectomy) WHY IT’S POPULAR: Smooths wrinkles and sagging skin all over the face – on the forehead, eyes, cheeks, jowls and chin. Often performed with a forehead lift and eyelid reshaping (blepharoplasty) for better, more youthful results.

HOW IT’S DONE: •

General anesthesia or IV sedation

•

Tissue is lifted and repositioned through small incisions just behind the hairline. Excess skin is removed, while deep folds are smoothed out and skin is tightened.

BEST CANDIDATES: •

People who want to rejuvenate their face and feel they look older than they are.

•

Those who still have supple, elastic skin and a well-defined bone structure.

Myth vs.

Reality?

Cosmetic Surgery and Plastic Surgery are the Same.

Although we tend to use the terms interchangeably, cosmetic surgery is not the same as plastic surgery. Cosmetic surgery can be performed by several different types of doctors who may not have training in plastic surgery. Plastic surgeons are trained in reconstruction and in cosmetic surgery.

WORST CANDIDATES: •

Those who are overweight

TYPE OF PROVIDER TO LOOK FOR: Board-certified cosmetic or plastic surgeon AVERAGE COST:

$7,448*

2. Non-Surgical “Tweakments”

Laser Skin Resurfacing, Fillers and Microdermabrasion WHY THEY’RE POPULAR: WITHOUT SURGERY, THEY MINIMIZE PROBLEM AREAS SUCH AS: • Fine lines and wrinkles around or under eyes, forehead and mouth •

Join us

ON SOCIAL MEDIA #OurHealthLynchburg

Sun-damaged skin and dark spots

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37

Spotlight On:

•

Acne or chickenpox scars

•

Birthmarks and freckles

•

Thin lips and hollow cheeks

•

Large pores

PHYSICIAN ASSISTANT

•

Skin irregularities and pre-cancerous growths

Dermatology Consultants

HOW IT’S DONE:

Ashley N. Chieppa, PA-C, MPAS

Lynchburg: 434.847.6132 www.lynchburgdermatology.com The most popular cosmetic treatments performed at Dermatology Consultants are intense pulsed light (IPL), micro-needling and injectables.

The practice implements new technologies and innovative treatments, as well as offers a medicalgrade skincare line that includes multiple awardwinning products, according to Ashley Chieppa, PA-C, a certified physician’s assistant with Dermatology Consultants.

“We have recently introduced a new procedure called Broad Band Light (BBL) that will help to rejuvenate skin and treat discoloration, rosacea, acne, and hair reduction. Interestingly, this is the only device that has been shown to increase the expression of genes associated with more youthful skin, which is a very exciting finding,” says Chieppa. “The BBL also affords a drug-free alternative to treat acne, if the patient prefers,” she adds.

Dermatology Consultants’ medical-grade skincare line has been studied in peri- and post-menopausal women who are known to be estrogen-deficient.

“During the first five years of menopause, low estrogen levels lead to a loss of up to 30 percent of skin collagen, which steadily declines thereafter.

The new product has been studied and found to improve skin dryness and dullness, thickens the skin and improves fine lines as well as tightens the appearance of the skin,” Chieppa explains.

The highlights of Chieppa’s day, she says, are seeing her follow-up patients who are excited by the improvement in their condition. “I tend to guide my patients towards procedures that will rejuvenate their skin, but still look natural. Thankfully, with the advent of lasers, neuromodulators such as BOTOX, micro-needling, and medical-grade skincare, facial rejuvenation can now be done noninvasively,” concludes Chieppa.

A

LASER SKIN RESURFACING – short, concentrated beams of light pulsate against the area of damaged skin to remove one layer at a time. Collagen growth is stimulated to improve the skin’s elasticity.

B

DERMAL FILLERS – often made from Hyaluronic Acid (HA) which is naturally occurring in the body and moisture-rich, fillers plump lips, cheeks and add definition to the jawline. Brands include Juvederm, Restylane, Radiesse and Voluma.

C

MICRODERMABRASION – a special tool “sands down” the top layer of skin, essentially refinishing it to give a smooth appearance.

BEST CANDIDATES: •

People who want to rejuvenate their face, look younger and aren’t ready to “go under the knife” for a more involve procedure.

•

Those who know non-surgical options are temporary, requiring repeat treatments.

WORST CANDIDATES: •

LASER THERAPY – those with acne, deep wrinkles, excessive skin or very dark skin.

•

DERMAL FILLERS – those who may be allergic to any of the components in the fillers, or if pregnant or breastfeeding.

• MICRODERMABRASION – people who develop rashes or suffer from cold sores, or have acne or very dark skin.

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic, cosmetic or dermatologic surgeon, or nurse practitioner

AVERAGE COST:

Ablative Laser Therapy – $2,124*

Dermal Fillers – $450 – $750* per syringe.

(Some procedures only need one syringe but most patients need several.)

Microdermabrasion – $1,170*

3. Gingival Contouring The “Gummy” Smile Fix WHY IT’S POPULAR: Enhances the smile, shows more teeth and makes the mouth more proportionate and comfortable.

HOW IT’S DONE: •

Local anesthetic

•

Using a laser (most often) or cutting tool, excess gum tissue is removed and sculpted to lengthen the crown of the tooth and expose more of the enamel.

Bone is sometimes removed if necessary.

BEST CANDIDATES: •

Those with thick, puffy gums or smiles that show more gum than teeth.

•

People with asymmetric, uneven gums.

WORST CANDIDATES: •

Those with poor oral hygiene and periodontal disease.

TYPE OF PROVIDER TO LOOK FOR: Cosmetic dentist, periodontist or oral surgeon

Ashley N. Chieppa, PA-C With Dermatology Consultants in Lynchburg.

AVERAGE COST: $300 –

CONTINUED ON PAGE 40

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$3,000

(depending on how many much gum tissue needs to be contoured)

Community Care Connection Who to Check Out for Cosmetic and Reconstructive Surgery Simon Hatin, MD PLASTIC SURGEON Centra Medical Group Plastic Surgery Center 1330 Oak Lane, Suite 100 | Lynchburg, VA 24503 434.200.4350 | www.centrahealth.com/ facilities/cmg-plastic-surgery-center Dr. Hatin has more than 20 years of surgical experience in plastic surgery. He is board certified by the American Board of Plastic Surgery.

Keith Pitzer, MD PLASTIC SURGEON Centra Medical Group Plastic Surgery Center 1330 Oak Lane, Suite 100 | Lynchburg, VA 24503 434.200.4350 | www.centrahealth.com/facilities/ cmg-plastic-surgery-center Dr. Pitzer is a cosmetic and reconstructive surgeon, board certified by the American Board of Plastic Surgery. He is well-skilled in reconstructive and aesthetic techniques in all areas including face, eyelids, breast and body. Dr. Pitzer blends surgical techniques with less invasive treatments, including fat grafting and stem cell placement, to achieve optimum results. His goal is to produce a lasting change that is natural in both form and function.

Henry Wilson, MD, FACS PLASTIC SURGEON Centra Medical Group Plastic Surgery Center 1330 Oak Lane, Suite 100 | Lynchburg, VA 24503 434.200.4350 | www.centrahealth.com/ facilities/cmg-plastic-surgery-center Dr. Wilson has practiced plastic surgery since 2004.

He is double board-certified: in plastic surgery by the American Board of Plastic Surgery; and in general surgery by the American Board of Surgery. Dr. Wilson completed an additional year of fellowship in breast and cosmetic surgery.

How to Find a Surgeon Choosing a surgeon and a facility is one of the most important decisions to make if you’re considering cosmetic surgery. Go beyond Google reviews and even HealthGrades to really vet your doctors. Look for board certifications and accredited hospitals.

The American Board of Plastic Surgery (ABPS) is part of the American Board of Medical Specialties (ABMS).

www.abplasticsurgery.org The American Society of Plastic Surgeons (ASPS) members are certified by the American Board of Plastic Surgery and is a terrific resource for consumer information.

www.plasticsurgery.org The American Board of Cosmetic Surgery (ABCS) offers a helpful checklist to consumers to vet cosmetic surgeons.

www.americanboardcosmeticsurgery.org www.OurHealthLynchburg.com

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CONTINUED FROM PAGE 38

The

Treatments that Help Your

Skin & Hair Glow

1. Cellulite Treatment – Cellfina® The Cellfina® System treats the primary structural cause of cellulite – the connective bands woven throughout fat in the thighs and buttocks. These tight bands pull down the skin, creating the puckering you see on the surface of the skin. Similar to a rubber band under tension, once released, the treated skin bounces back to smooth itself out in as little as three days. This one-time cellulite treatment is performed at a doctor’s office in less than an hour.

WHY IT’S POPULAR: Smooths out dimpling on thighs and buttocks while lasting up to three years.

HOW IT’S DONE: •

Local anesthesia and minimally invasive

•

A small, needle-size incision under the skin releases the tight bands of connective tissue that are trapping the bulging fat cells. Once released from this tension, the skin appears smooth.

BEST CANDIDATES: •

People who are a healthy weight, but want to reduce cellulite.

•

Those who know treatments won’t completely eliminate cellulite.

WORST CANDIDATES: •

Those who are significantly overweight.

•

Those who are trying to eliminate fat, not cellulite.

•

Those who have excessive varicose veins or other vein-related illnesses.

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic, cosmetic or dermatologic surgeon, or a licensed physician working under the supervision of a board-certified plastic surgeon.

AVERAGE COST: $3,500 –

$6,500* (depending on the size and number of dimples)

2. Scar Revision WHY IT’S POPULAR: Although no revision technique can completely erase scars, revision minimizes scars anywhere on the body where they are conspicuous, bothersome or disfiguring.

HOW IT’S DONE: •

Local anesthesia for minimally invasive procedures

•

General anesthesia for surgical revision requiring advanced wound closure techniques. No revision technique can completely erase the scar.

BEST CANDIDATES: •

People of any age

•

Those with scars that are painful, itchy or preventing a joint from moving properly.

WORST CANDIDATES: •

Those who have acne or other infections in the area to be treated.

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic, cosmetic or dermatologic surgeon

$500 – $3,000* (depending on the size and complexity of the procedure) AVERAGE COST:

3. Hair Restoration WHY IT’S POPULAR: Restores a balding or thinning scalp with transplanted hair from an area of thick growth and becomes permanent. This procedure helps the two-thirds of all men and one-fifth of all women suffering from hair loss to bypass the hereditary and/or hormonal factors that cause it.

CONTINUED ON PAGE 42

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www.OurHealthLynchburg.com

41

Spotlight On:

CONTINUED FROM PAGE 40

Stephanie Wright

HOW IT’S DONE:

LICENSED MASTER AESTHETICIAN

•

Local anesthesia with sedation

Wyndhurst Medical Aesthetics and Hormone Clinic

•

Small pieces of hair-bearing scalp are removed from a donor site and grafted to a bald or thinning area of the scalp.

BEST CANDIDATES:

Lynchburg: 434.386.8894 www.wyndhurstaesthetics.com Wyndhurst Medical Aesthetics and Hormone Clinic focuses on educating clients on maintaining overall health, wellness and beauty, while treating and preventing the signs of aging.

•

Candidates with a healthy growth of hair at the back and sides of the head to serve as ‘donor areas.’

•

People who know that sometimes two or more techniques are used together, or treatments repeated, to achieve the best result.

WORST CANDIDATES: •

Those who are completely bald.

•

People who take medicines or have medical illnesses that cause hair loss.

According to Stephanie Wright, a licensed master aesthetician at Wyndhurst Medical Aesthetics and Hormone Clinic, their two most popular procedures are CoolSculpting® and HydraFacial®.

“CoolSculpting® permanently destroys fat cells to target problem areas that diet and exercise cannot reach. It’s non-invasive with absolutely no downtime. Almost everyone is a good candidate. We say, ‘If we can squeeze it, we can freeze it!’

Any pocket of fat from the chin to the knees can be treated.

However, any area of the body that stores fat under the muscle and cannot be ‘squeezed’ is not treatable,” she says.

TYPE OF PROVIDER TO LOOK FOR:

Wright adds that everyone is a good candidate for HydraFacial®, which is another non-invasive treatment. It delivers hydrating moisturizing serums to the skin while extracting impurities, Wyndhurst Medical Aesthetics is also implementing new techniques for treating hyperpigmentation (uneven skin tone and freckles).

Cosmetic surgeries and minimally invasive treatments are medical procedures that carry risks, and they’re also an art form. Know who’s a DaVinci and who’s a Picasso during his Surrealism phase: •

The provider you choose should have plenty of ‘before-and-after’ photos.

Start there and don’t be afraid to ask for more. Because results are everything, you’ll want a skilled physician who consistently produces many quality results.

“I grew up with terrible acne and felt unable to leave the house without makeup. It was my first experience with an aesthetician who taught me how to treat my skin and get my acne under control,” says Wright. “Now I wear makeup because it’s fun, not because I have to. That’s the exact feeling I try to give all my patients. It’s fun to have makeup and keep up with beauty trends, but there is nothing more beautiful than healthy skin.”

•

Do extensive research on any treatment and doctor you are considering.

Confirm whether your surgeon is board-certified by searching on the American Society of Plastic Surgeons (ASPS) website.

•

Use a physician with extensive knowledge of facial anatomy and structure when having even non-invasive procedures done. For instance, you may know you want a filler, but do you know the best kind to get?

They’re all different and not created equal. Know your stuff before they put it in your face.

Stephanie Wright Master Aesthetician with Wyndhurst Medical Aesthetics and Hormone Clinic in Lynchburg.

Board-certified plastic, cosmetic or dermatologic surgeon

$6,000 – $15,000* (depending on how many grafts are placed) AVERAGE COST:

With these and any other cosmetic procedure, it’s important to be as healthy as possible when undergoing treatment. People who have the best outcomes share the following factors:

A B C D

As close to ideal weight as possible Non-smoker (Smoking causes spasms of the small blood vessels needed for normal blood circulation and healing afterward.)

Free of illnesses that can impair healing Positive outlook with stable mental health and realistic expectations

Where Should You Start?

Arming yourself with knowledge will give you the safest, most optimal (a.k.a. natural) results. With laser advancements, new techniques and the boom in effective anti-aging procedures, cosmetic procedures are safer, quicker and more effective than ever before. * 2017 costs published by the American Association of Plastic Surgeons

ON THE WEB EXPERT CONTRIBUTORS William Carvajal, MD, FACS, Facial Surgeon, Central Virginia Oral & Facial Surgery, Lynchburg Ashley N. Chieppa, PA-C, Dermatology Consultants, Lynchburg Kristen Kuk, MD, Aesthetics Director, Ridgeview Dermatology, Lynchburg

42 Wright, Master Aesthetician, Wyndhurst Medical Aesthetics and Hormone Clinic, Lynchburg Stephanie

More at OurHealthLynchburg.com

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ASK THE EXPERT

BEN B. ROSS, DMD, FACP Board Certified Prosthodontist

PANTOPS PROSTHODONTICS 404 People Place, Suite 301 | Charlottesville | w www.pantops.org | f f f g f

c 434.977.9836

What can patients do to keep their own teeth, natural or prosthetic, healthy as long as possible?

Re-call, Re-care, Re-check! Regular and frequent visits to the prosthodontist is the best advice we can give to our patients who have prosthetic teeth. These patients need to see the prosthodontist more often than average patients to be ahead of any changes that are constantly occurring in our mouths and bodies. For natural teeth, I see the biggest threat today coming from the acidity levels in our diet and the number of medications that cause xerostomia, or dry mouth. It’s the high acidity levels that cause cavities, still the number one cause of tooth loss.

BEN B. ROSS, DMD, FACP

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What can patients expect when they visit a prosthodontist?

Most people haven’t heard of a prosthodontist and what they can do for them. A prosthodontist is a specialist who has three years of training beyond dental school that deals with reconstructive, aesthetic, and functional dentistry.

This includes implants, cosmetic makeovers, full mouth rehabilitations, single and multiple crowns and bridges, as well as removable teeth, tooth grinding/clenching problems, and sleep apnea appliances. Prosthodontists are the experts when it comes to looking at the whole mouth, the jaw and facial muscles, the temporomandibular joints, and the teeth. Once these are all in balance, then and only then can a harmonious relationship exist that functions great and looks even better!

It’s even been said that we are known as the dentist’s dentist.

With all this in mind, patients can expect the most thorough exam and detailed diagnosis.

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words | KATHARINE PALJUG

No matter how tidy you are, some spots in your home always

attract bacteria, fungus, mold, pet dander and more. These microorganisms and allergens can impact your breathing, sleep and overall health.

“The most common allergies we see are environmental, like pollen, pet dander and mold,” says Robert Sullivan, MD, an allergist with Allergy Partners of Lynchburg.

Even people without allergies can be affected by mold, dust and allergens in the home, especially if they are ingested or inhaled. And anyone can be affected by bacteria and other germs.

Luckily, most of these irritants can be cleaned away once you know where they’re hiding. And even if it takes a little extra time, it’s definitely worth it, says Dr. Sullivan. “Some things are unavoidable,” he says, giving pollen as an example.

“You can’t stay away from pollen, but you can keep your windows shut and clean frequently to stay healthier.”

The start of spring is the ideal time for a thorough cleaning of areas in and around your home and other places that you may not always have on your “To-Do” list. www.OurHealthLynchburg.com

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BATHROOM TOWELS:

Towels are often home for Staphylococcus bacteria, which causes staph infections. Bathroom humidity keeps towels damp, breeding mold and fungus that can exacerbate allergies, asthma and COPD. Shared towels, such as hand towels, get especially dirty.

How to Clean: Wash every three to seven days, and add bleach or white vinegar to kill even more bacteria.

Terry Cralle, RN

A certified professional in healthcare quality and sleep educator in Farmville.

TOOTHBRUSH HOLDER:

Toothbrushes transfer saliva and bacteria from your mouth, hands and bathroom surfaces.

(On more than a quarter of toothbrush holders, this includes Salmonella and E. coli bacteria.) Damp holders grow mold and fungus, which end up on your toothbrush, hands and mouth.

How to Clean: Put toothbrush holders in the dishwasher every week, or scrub by hand and rinse with hot water.

“Dust mites and mold thrive in a humid environment,” says Terry Cralle, RN, a certified professional in healthcare quality and sleep educator in Farmville. “Use bathroom exhaust fans and dehumidifiers to keep dampness at a minimum.”

KITCHEN COFFEE MAKER:

Nearly half of coffee makers have yeast and mold in them. “These allergens can to lead nasal congestion, sneezing and coughing,” says Cralle. They can also cause skin irritation, along with exacerbating allergies and asthma.

How to Clean: Once a week, put all the removable parts of your coffee maker in the dishwasher.

Anything that can’t go in the dishwasher should be wiped down with soap and hot water.

»

SPONGES:

Bacteria and mold grow on sponges, especially if they get reused frequently.

How to Clean: Instead of a sponge, use cleaning cloths that you wash after every use. If you use a sponge, replace with a new one every week. (This applies to kitchen sponges too!)

»

BONUS TIP: Every time you flush the toilet, containinmants such as fecal matter and bacteria fly out.

Close the lid before flushing to keep those germs contained.

REFRIGERATOR DRAWERS:

Mold, yeast, Salmonella and E. coli often live in refrigerator drawers. Food packaging, raw meats and vegetables from grocery store bins transfer these allergens and germs to your home, where they multiply in the humid interior of a refrigerator.

How to Clean: Clean refrigerator drawers once a month with soap and hot water. Wipe with white vinegar to kill bacteria, mold and yeast.

BONUS TIP: Instead of throwing away baking soda away when it’s finished its 30-day stint in your fridge, dump it down the garbage disposal with running water. It will keep your disposal fresh too!

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BEDROOM MATTRESSES:

“You spend one third of your life in your bedroom,” Dr. Sullivan points out, and that’s where many particles and allergens lurk as a result. “The biggest irritants are dust mites in the bedding and pet dander.” This can be especially irritating if you have allergies, asthma or breathing difficulties like COPD.

How to Clean: Vacuum both sides

of your mattress at least twice a year, including edges and crevices where dust and dead skin get trapped. “To protect against dust mites, you can use mattress covers,” adds Dr. Sullivan. These covers zip shut around the whole mattress, box spring or pillows. They should be washed with your sheets.

PILLOWS:

“People constantly shed skin, saliva and hair,” says Cralle. These get trapped in your pillows, along with dust, pollen, pet dander, fungi and mites, “causing stuffy noses and aggravating asthma, which will interfere with sleep.”

How to Clean: Launder pillows at least

twice a year in water that is at least 140° F to kill bacteria and mites. As with your mattress, use machine-washable pillow protectors.

STUFFED ANIMALS:

Well-loved stuffed animals attract dust, mites and bacteria, especially when kids are sick.

How to Clean: Stuffed animals should

be laundered at least once a month and after every illness. To kill more bacteria and viruses, add white vinegar to the rinse cycle.

»

BONUS TIP: Pets carry dust, bacteria and dirt around, along with shedding dander. “Consider keeping pets off of the bed or out of the bedroom entirely,” says Cralle, especially if you have allergies or trouble sleeping. www.OurHealthLynchburg.com

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LIVING ROOM REMOTES:

Everyone touches the TV remotes, covering them in food, bacteria and other particles.

Many remotes have yeast, mold and Staphylococcus bacteria on them.

How to Clean: Use a light cleaner and cloth to wipe them down weekly, or daily if anyone is sick.

RUGS AND CARPETS:

Rugs and carpets can trap mold, mites, dust, mud, fungus, pet dander and food. These exacerbate allergies and breathing problems, cause poor air quality and expose you to germs.

How to Clean: Vacuum at least once a week. Shake rugs outside every season. Rugs and carpets should be cleaned yearly with a professional-grade steam cleaner.

Robert Sullivan, MD

COMPUTERS:

The average desktop computer has 400 times more bacteria than a toilet seat. These are transferred from your hands, usually after you touch your nose or mouth, or from eating while using the computer. Computers also collect dust, pollen and animal dander.

How to Clean: Dust computers every week using antibacterial wipes or a damp cleaning cloth with white vinegar to kill bacteria. Vacuum keyboard surfaces weekly or monthly; vacuum inside if the keyboard opens.

An allergist at Allergy Partners of Lynchburg.

» BONUS TIP:

“Things like air filters are also helpful for pollen and mold spores,” adds Robert Sullivan, MD, an allergist at Allergy Partners of Lynchburg.

Take shoes off before coming inside! You’ll avoid tracking in mud, pollen, animal feces, and other particles.

Expert Contributors Terry Cralle, RN is a certified professional in healthcare quality and sleep educator in Farmville.

Robert Sullivan, MD is an allergist with Allergy Partners of Lynchburg.

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Specialty Spotlight Series ALLERGY, ASTHMA AND IMMUNOLOGY

Are Allergies Affecting Us More Now Than Ever? words | KATHARINE PALJUG

There’s a good chance that you have allergies or know someone who does.

In the U.S., more than 40 percent of children and 30 percent of adults now suffer from the condition, and it appears this trend is on the rise.

“The most common allergies we see are environmental,” says Robert Sullivan, MD, an allergist with Allergy Partners of Lynchburg. “We’re seeing more food allergies than doctors used to, however.” Medical experts can’t point to exactly why this is the case, but some potential causes may be attributed to excessive hygiene and early antibiotic use. Called “The Hygiene Hypothesis,” it’s when the immune system is not exposed to many infectious agents, and thus doesn’t have the chance to build up an immunity. It looks for something else to do, and allergies may result.

Potential causes of this increase in allergies range from early antibiotic use to not getting enough vitamin D. But while research continues, there’s good news: most environmental allergies can be managed with environmental control, medication and desensitization with allergy shots.

FOOD ALLERGIES Any food can trigger an allergic reaction, but the more common ones are peanuts, tree nuts, eggs, dairy, soy, wheat, “fin” fish and shellfish.

Doctors have also seen new food allergies develop. “One allergy that we’re starting to see is the alpha-gal, which is an allergy to mammalian meat due to tick bites,” says Luis Matos, MD, MBA with Allergy and Asthma of Virginia, located in Forest, Danville and Roanoke. “It commonly starts with abdominal pain, IBS or upset stomach but it doesn’t catch attention until they get hives and not realize it’s from meat that they ate three to six hours earlier.”

Food Allergy Symptoms

Nausea, vomiting, diarrhea, constipation, eczema, and hives or swelling in areas of the skin that touch the food.

“Swelling around the eyes, lips, hands and feet – a condition called angioedema – may be a sign of an allergic reaction,” explains Dr. Matos. In more severe cases, the swelling can involve the tongue, back of the throat (causing trouble swallowing) or the larynx (cutting off breathing). This can progress to anaphylaxis where there is also a shock-like state with a rapid heartbeat and low blood pressure.

“These more severe reactions are considered medical emergencies and should be treated immediately in the emergency room, then followed up with a visit to an allergist.”

Luis Matos, MD, MBA

An allergist with Allergy and Asthma of Virginia in Forest, Danville and Roanoke.

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ALLERGY, ASTHMA AND IMMUNOLOGY

Diagnosing Food Allergies

What’s the Hygiene Hypothesis?

The Hygiene Hypothesis is when the immune system is not exposed to many infectious agents, and thus doesn’t have the chance to build up an immunity. It looks for something else to do, and allergies may result.

Food allergies are assessed with a careful history of the patient followed by skin tests.

If some of the skin tests are positive for allergies, a blood test is sometimes ordered afterwards to check for food-specific IgE, or allergic antibodies to foods. Your doctor may also recommend an elimination diet, in which foods are removed from the diet and reintroduced one by one.

Managing Food Allergies The best way to manage a food allergy is by cutting the food that triggers it out of your diet. Sometimes, if the diagnosis of food allergy is questionable, an allergist may recommend a food challenge in the office where a food is given to the patient in very small amounts and increasing the amount every 15 minutes under careful supervision, making sure epinephrine and antihistamines are readily available. This can sometimes allow the patient to safely re-introduce that food into their diet. If you have a severe food allergy, especially if there is any angioedema, you should also carry an epinephrine device, such as an EpiPen or an Auvi-Q, in case of an anaphylactic reaction.

The sequence of treatment for an acute allergic reaction should be done in this order:

A Administer epinephrine B Call 9-1-1 C Take Benadryl

The American Academy of Pediatrics (AAP) advises introducing new foods to babies one at a time and watching for allergic reactions. Though the AAP used to recommend delayed introduction of highly allergenic foods, such as peanuts, new guidelines recommend early exposure to reduce food allergies, but talk to your doctor first, suggests Dr. Sullivan. “If kids have severe eczema or a history of allergic reactions, we usually recommend seeing an allergist before we introduce those foods.”

If you need to take epinephrine, you should always go the emergency room.

Don’t take Benadryl first as it takes about 30 minutes to start working. You need epinephrine that works in immediately if you can’t breathe.

“Another thing that’s been recognized more recently is oral allergy syndrome, or pollen food allergy syndrome,” adds Dr. Sullivan. “There are shared proteins between pollens and certain foods, so when you eat those foods it will cause tingling in the throat or lips.” Fruits are a common cause of this allergy. Most people with this type of allergy can eat the allergic foods without reacting if they’re cooked and don’t need to carry an EpiPen.

ENVIRONMENTAL ALLERGIES Environmental allergies are caused by pollen, dust mites, mold and animal dander. “These can be affected by irritant odors like perfumes, smoke, air fresheners and cleaning sprays,” says Dr. Matos. “They contain harsh chemicals that irritate eyes, nose and lungs, making allergies worse.”

Environmental Allergy Symptoms Runny nose, itchy eyes, throat or ears, sneezing, or hay fever. Less common are hives, rashes or other skin irritation.

Diagnosing Environmental Allergies Allergists use skin tests to check up to 40 allergens at once. Your doctor will prick areas of the skin with different substances and watch for a reaction, which appears in 15-20 54

minutes and looks like a hive. These are sometimes followed by intradermal tests to double-check prick test negatives.

Cleaning for Dust Mites and Mold Allergies:

Managing Environmental Allergies Environmental allergies are managed by limiting exposure and taking over-the-counter (OTC) medications such as nasal sprays or antihistamines. It’s also recommended to keep windows closed, live somewhere with hardwood floors, rather than carpets or rugs, which can trap allergens, and it’s best to avoid using blinds and heavy curtains.

“If over-the-counter medications aren’t working anymore, or people want to know exactly what they’re allergic to, they’ll come in for skin testing,” says Dr. Sullivan. Your doctor may prescribe stronger antihistamines, an inhaler, or allergy shots, which train your immune system to stop responding to certain allergens.

You should always see a doctor quickly if your allergies cause wheezing, trouble breathing or angioedema.

MEDICATION ALLERGIES

VACUUM FREQUENTLY

ALLERGY, ASTHMA AND IMMUNOLOGY

“People who have dust mite or mold allergies need to go the extra mile when it comes to cleaning,” recommends Dr. Matos. Vacuum frequently, clean air filters and wash sheets and towels at least once a week. You’ll also need to protect your bed from dust mites and mold. “If you are a chronic allergy sufferer, go for a pillow protector, full mattress encasement and box spring encasement,” Dr. Matos notes.

CLEAN OR REPLACE AIR FILTERS MONTHLY

WASH SHEETS AND TOWELS AT LEAST ONCE A WEEK in very hot 130-degree water.

Allergies to medication can be diagnosed at any age, but many people don’t discover them until they are older and take multiple prescriptions for the first time.

One common medication allergy in children is penicillin and related antibiotics, including amoxicillin. However, some adults outgrow childhood antibiotic allergies. “When we see a patient for penicillin allergy, after we talk about their history, we can set them up for testing and hopefully prove they’re not allergic anymore,” Dr. Sullivan explains.

PROTECT YOUR BED FROM DUST MITES with a pillow protector, full mattress encasement and box spring encasement.

Medication Allergy Symptoms Rashes, hives, swelling or gastrointestinal discomfort can be the result of an allergy to a medication. Less common are difficulty breathing or anaphylaxis.

Reactions to medication usually happen quickly, so doctors can pinpoint the cause based on what you are taking. If you are using multiple medications, you may need skin tests or challenge tests.

Managing Medication Allergies Doctors won’t prescribe medication to which you are allergic, but if you are seeing a medical provider for the first time, always make sure you disclose your known medication allergies. It is helpful to bring a list of your current medications as well as your medication allergies every time you see a doctor. People who are severely allergic to medications often wear an alert bracelet or carry a card that lists their medication allergies at all times.

Always consult a doctor if you believe you are reacting to a medication.

If you experience trouble breathing, throat tightness, wheezing, hives or angioedema, go to an emergency room immediately.

KEEP HUMIDITY LEVELS BETWEEN 37 PERCENT AND 50 PERCENT as molds and dust mites thrive in humid conditions.

What is an Intradermal Test?

Intradermal allergy testing is another method of skin testing to help determine whether an individual is allergic to a specific allergen, often used in follow-up after a negative prick test. The test involves injection of a small amount of the suspected allergen in the very top layer of the skin called the dermis.

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ALLERGY, ASTHMA AND IMMUNOLOGY

ASTHMA AND ECZEMA Some reactions are caused by an overactive immune system but not in response to a specific allergen. Two common ones are asthma and eczema.

Asthma and Eczema Symptoms

“If you’re not allergic to something and you’ve been avoiding it, once you find out you’re not allergic, it can be a game changer for your everyday life.”

“Asthma makes the airways in your lungs tighten, causing wheezing, coughing and trouble breathing,” says Dr. Matos. Eczema affects your skin, causing itching, dryness, dark patches, peeling, bleeding and swelling.

Diagnosing Asthma and Eczema Doctors can usually diagnose eczema by examining your skin. Asthma is assessed with a lung function test to see how much and how fast you can expel air out, and is often followed by an inhaler treatment with a bronchodilator if abnormal and then followed by another lung function test to see if the bronchodilator has helped.

Managing Asthma and Eczema Robert Sullivan, Jr., MD An allergist with Allergy Partners of Lynchburg.

Even mothers who exclusively breast feed their infant child should be advised they can possibly cause their child’s eczema to worsen if the infant is allergic to certain foods that the mother has consumed, as food proteins can sometimes transfer into the breast milk.

Asthma is treated with an inhaler or nebulizer. Most patients with asthma need inhaled corticosteroids or inhalers that combine corticosteroids with bronchodilators. These should be administered every day as a preventative measure for all asthma patients that have asthma episodes more than two times per week during the day or more than two times per month during the night. Those who have only mild intermittent asthma can be treated with an as needed albuterol inhaler. There are asthma controllers, which are usually inhaled corticosteroids or Singulair, and asthma relievers – usually albuterol, a bronchodilator, and both are necessary.

Eczema is treated topically, including daily soaking baths in lukewarm water to let the moisture soak into the skin and applying prescription corticosteroid creams and moisturization, which is a process called the Soak and Seal Method that was developed at Duke. Anti-itch medication, such as antihistamines are also essential to keep the patient from scratching. Eczema is known as the “itch that rashes,” not the “rash that itches.” It is also important to test for food allergies as they can exacerbate the rash and eliminating these foods from the diet can improve the eczema.

No matter the cause of your allergy symptoms, visiting your doctor is the first step towards managing them. “Some allergies, like food allergies, can be life-threatening, and it’s really important to know if you have one of these,” says Dr. Sullivan. Other times, he adds, finding out exactly what they’re reacting to can be liberating for patients. “If you’re not allergic to something and you’ve been avoiding it, once you find out you’re not allergic, it can be a game changer for your everyday life.”

Expert Contributors Luis Matos, MD, MBA is an allergist with Allergy and Asthma of Virginia in Forest, Danville and Roanoke.

Robert Sullivan, Jr., MD is an allergist with Allergy Partners of Lynchburg.

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ASK THE EXPERT

LUIS MATOS, MD, MBA, FAAAAI, FACAAI ALLERGY AND ASTHMA OF VIRGINIA

LYNCHBURG OFFICE | 1019 Vista Park Drive, Suite A | Forest, VA 24551 |

c 434.515.0419

ROANOKE OFFICE | 1315 2nd Street | Roanoke, VA 24016 |

c 540.384.1797 DANVILLE OFFICE | 4500 Riverside Drive | Suite B | Danville, VA | c 434.251.0026

w www.va-allergy.com Why should I see a board-certified allergist?

Certification by a medical specialty board is a highly reliable indicator that a physician is extremely skilled, very knowledgeable, and has dedicated herself or himself to meeting the very highest standards in the practice of medicine.

Board-certified physicians have taken that extra step to reach and maintain the pinnacle of their specialty.

For allergists, the path to board certification begins with completing a four-year undergraduate degree and four years of medical school followed by a threeyear residency program in either pediatrics or internal medicine. If a physician intends to become an allergist, he or she pursues fellowship training, a two-year handson experience in a teaching hospital, doing research, writing papers and treating allergy, asthma and immunological disorders in both children and adults.

Immunology (college.acaai.org) – the two leading organizations representing only allergists and immunologists who are board certified. Both provide a “Find an Allergist” tool to assist in the search.

But even after a person has identified a board certified allergist and scheduled an appointment, he or she should wait until after one or more appointments before deciding if the physician is best for his or her needs. Taking note of how thorough the physician is during the evaluation, such as whether or not he or she asks detailed questions while performing a thorough, unrushed examination using advanced techniques and state-of-the-art diagnostic tests to develop a personalized treatment plan that ultimately works goes a long way in establishing trust and assurance that the patient has made the best decision for his or her health.

After successfully completing the required education and residency and fellowship training, the physician then sits for a very thorough exam in either pediatrics or internal medicine, as well as a second rigorous exam in allergy and immunology. If he or she passes, it leads to board certification.

In the area of asthma treatment, for example, there are specialists other than allergists who can treat the symptoms of this condition. But the difference is that allergists are trained to find the root cause, or “trigger,” of the asthma. About 75 percent of people with asthma have at least one environmental allergy — to dust, mold, pollen, animal dander, and the like. So allergists are intent on finding and dealing with the cause of asthma, a much more thorough approach and treatment.

So how does someone find an allergist who is board certified? The first step I recommend is to conduct research. For most, this means going online, which can be reliable as long as she or he uses a credible, third party resource such as the American Academy of Asthma, Allergy and Immunology (www.aaaai.org) or the American College of Asthma, Allergy, and

LUIS MATOS, MD, MBA, FAAAAI, FACAAI

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Specialty Spotlight Series CARDIOLOGY

Who’s Who ON YOUR

Heart Health Team? words | JEANNE GRUNERT

Cardiology, or the branch of medicine that focuses on diseases and abnormalities of the heart, includes multiple specialty areas. This guide to your heart health team includes many of the roles you’ll encounter on the average heart care team. But make no mistake about it – when it comes to the diagnosis, care, and management of heart disease, no two healthcare teams are alike. Each one is as complex and unique as your own heart.

Your First Point of Contact:

Primary Care Provider Your first point of contact in the healthcare system is your primary care provider. He or she may be an internal medicine, family practice or pediatric physician or nonphysician provider, such as a nurse practitioner (NP) or physician assistant (PA). These medical experts act as trusted medical advisors, and they diagnose problems and refer patients to specialty providers.

Your primary care provider may refer you to a specialist or recommend laboratory tests or imaging scans. It’s important to follow through with their recommendations. Go for the scans, get the bloodwork done, and meet with your provider to review the results.

Rather than try to decide for yourself which person on a

cardiac care team to see first, make an appointment with your primary care provider, or, if symptoms are sudden, head to the emergency room if you feel anything unusual such as chest pain, shortness of breath, or a tightness in your chest.

CARDIOLOGY

From your primary care provider’s office, depending on the results, you’ll most likely be referred to a cardiologist.

“When it comes to the heart, early action is key,” says John Haas, MD, a non-invasive cardiologist with Centra Lynchburg General Hospital.

John Haas, MD

A cardiologist at Centra Lynchburg General Hospital.

What’s the Difference Between a Cardiologist and Cardiothoracic Surgeon?

“You know your body the best. If something is "off" or just a little different from normal, tell a medical professional. Let us sort through whether or not that change is important. Utilize your primary care, urgent care, or the emergency department if you ever have concerns about a change with your heart or lungs. They will contact us if they need our help.”

People often confuse these two terms. Both cardiologists and cardiothoracic surgeons are medical doctors with extensive education in disease and abnormalities of the cardiovascular system.

A cardiothoracic surgeon specializes in surgical procedures of the heart, lungs, esophagus, and organs of the chest. Stroobants Cardiovascular Center has two cardiothoracic surgeons serving the local area: Kenneth Saum, MD and Hournan Tavaf, MD.

And that’s the next stop on our virtual meet and greet with your heart health team: your cardiologist.

Centra Named A Top 50 Cardiovascular Hospital in the Nation Centra was recently recognized as a Top 50 Cardiovascular Hospital in the nation

by IBM Watson Health for the eighth time, more than any other hospital in Virginia.

When compared with other U.S. acute care hospitals providing cardiovascular care that were included in the study, the Watson Health 50 Top Cardiovascular Hospitals consistently outperformed on clinical outcomes, efficiency, and 30-day readmissions, providing higher quality care at a lower cost.

Visit www.100tophospitals.com for more information.

“Each of our Advanced Practice Providers has a solid general cardiology foundation and can treat many common cardiovascular conditions."

William R. Price, IV, MBA, MSN, NP-C

The the Managing Director of Operations and Cardiovascular Imaging Services at Stroobants Cardiovascular Center.

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The Cardiologist:

Your Heart Is in Their Hands A cardiologist specializes in the diagnosis and treatment of abnormalities in the cardiovascular system. Cardiologists are medical doctors with advanced training in diseases and problems of the cardiovascular system as a whole. This includes your heart, of course, as well as the vascular system.

At Stroobants Cardiovascular Center, part of Centra Medical Group, there are seven specialty areas: rhythm, vein/vascular, congenital/pediatrics, structural, preventative cardiology, congestive heart failure, and cardiothoracic surgery. Each of these areas includes cardiologists as well as other care team members such as nurses, certified nurse practitioners, physicians assistants, and more.

Your cardiologist will perform a physical examination, review notes and test results sent from your primary care provider, and speak with you regarding your symptoms. He or she may order additional tests to gather more information. Cardiologists may recommend you to other physicians in the Stroobants Cardiovascular Center, such as a specialist in vascular diseases if your diagnosis includes problems with the veins or vascular system, or over to the physicians at the heart failure clinic. Conditions such as coronary artery disease, which is blockages of the arteries in heart that require surgery, are treated by cardiothoracic surgeons.

Cardiothoracic surgeons who operate on the heart and blood vessels to repair damage caused by diseases or disorders of the cardiovascular system.

It may seem as if you see a lot of doctors, but each one has spent many years studying, learning, and practicing medicine their chosen specialty area. The result is a physician who understands the complexities and nuances of each aspect of the cardiovascular system, how their heart disease interacts with other medical conditions, and the impact on the overall person.

Advanced Practice Providers:

Heart Health Experts Who Play a Big Role in Your Heart Health Advanced Practice Providers (APP) are Master or Doctoral prepared clinicians who are able to diagnose and treat many medical conditions. At Stroobants Cardiovascular Center, these nurse practitioners (NP) and physician assistants (PA) play a crucial role in the delivery of cardiovascular care to the local patient population.

“Stroobants Cardiovascular Center has highly trained APPs who specialize in care for the spectrum of disorders in a patient with cardiovascular disease,” says William R. Price, IV, MBA, MSN, NP-C, the Managing Director of Operations and Cardiovascular Imaging

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Services at Stroobants. “Each of our APPs has a solid general cardiology foundation and can treat many common cardiovascular conditions.”

Stroobants Cardiovascular Center also have many APPs who have sub-specialized in caring for patients with specific cardiovascular disease states such as rhythm problems, congestive heart failure, valvular disorders, vascular or vein issues and congenital heart disease. APP’s are an important element of the care team within the Stroobants Cardiovascular Center and play a big role in the quality of care the heart center delivers.

Cardiac Nurses:

Cardiac nurses explain test results, provide treatment plans, and answer patient questions.

Amber Mawyer, RN is a Nurse Navigator for the vein and vascular specialists at Stroobants Cardiovascular Center. She explains that a specialty cardiac nurse is trained in a very specific field. “The Stroobants Cardiovascular Center has many different sub-specialties and specialty has a trained nurse or nurses that are involved in devising a very specific plan for each patient.

For example, my specialty is in vein and vascular disease.”

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Caregivers, Educators

“The Stroobants Cardiovascular Center has many different subspecialties and specialty has a trained nurse or nurses that are involved in devising a very specific plan for each patient.

For example, my specialty is in vein and vascular disease”

Amber Mawyer, RN

Nurse Navigator for the vein and vascular specialists at Stroobants Cardiovascular Center.

Mawyer spends a great deal of her time working directly with patients as well as educating the public about vein and vascular diseases.

“I work with four different providers that treat diseases specific to veins and arteries in the legs,” says Mawyer. “I work closely with patients from the time of their initial consult and follow their care to the end of their treatment plan. My role consists of explaining test results, educating patients on procedure details, scheduling and assisting the physicians during the procedures, triaging patient phone calls, and coordinating clinic days.”

Getting Well:

Cardiopulmonary Rehabilitation Last on the list of who’s who in cardiac care is the cardiopulmonary rehabilitation team.

Rehabilitation includes not just exercise, but proper nutrition and lifestyle management to help people recover and prevent future heart problems.

“Cardiopulmonary rehabilitation is just as important as taking your medication to help you along the recovery process,” says Lauren Martin MPH, BSN, RN, the Cardiopulmonary Unit Manager for the Stroobants Cardiovascular Center.

“Anyone who attends cardiopulmonary rehab can expect a detailed exercise program tailored to the individual patient, that is completed under the supervision of registered nurses and exercise physiologist.”

Lauren Martin MPH, BSN, RN

Cardiopulmonary Unit Manager for Centra Stroobants.

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“Patients comes two to three times a week for exercises, and a case manager follows them closely and can communicate any concerns directly to the doctor,” says Martin. “During the program, patients may attend free education classes on healthy lifestyles and how to manage chronic illnesses. They receive top-notch care from a team of healthcare professionals trained in the specialty of rehabilitation after cardiovascular and pulmonary events.”

An Ounce of Prevention If heart disease runs in your family, an ounce of prevention may be worth a pound of cure. Nearly all medical experts agree that the two best things you can do to improve your heart health are to put down the cigarettes and get up off the couch, or stop smoking and start moving.

As anyone who has quit smoking or taken up an exercise program will tell you, it's easy to start any self-improvement project, but challenging to continue. That's why Centra offers a free prevention website that includes resources such as HeartAware, an online heart health assessment tool as well as details about smoking cessation, nutrition and weight management classes. Visit www.centrahealth.com/Prevention to learn more about these tools and programs designed to help you realize your health goals.

Knowing who’s who on your heart healthcare team is just the first step towards a healthier, better you. Remember, start with your primary care provider, or, if you’re experiencing any sudden Central Medical Group offers a shortness of breath or chest pain, FREE prevention website: head to the emergency room. www.centrahealth.com/Prevention From there, your heart health team will guide you to the next step to a healthier you.

Expert Contributors John Haas, MD is a non-invasive cardiologist with Centra Lynchburg General Hospital.

Lauren Martin MPH, BSN, RN is the Cardiopulmonary Unit Manager for Stroobants Cardiovascular Center.

Amber Mawyer, RN is a Nurse Navigator for the vein and vascular specialists at Stroobants Cardiovascular Center.

William R. Price, IV, MBA, MSN, NP-C is the Managing Director of Operations and Cardiovascular Imaging Services at Stroobants Cardiovascular Center.

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Specialty Spotlight Series GASTROENTEROLOGY

COLONOSCOPIES: Not So Strange and Scary After All words | KATHARINE PALJUG

If you’re over 50, your doctor likely has mentioned a colonoscopy. But have you followed through and scheduled one?

A colonoscopy screens the rectum and large intestine, or colon, for abnormal growths. It’s a standard procedure that doctors recommend, but many adults still hesitate to get one.

“I think patients are most concerned about preparing for a colonoscopy,” says Ralph Wisniewski, II, MD, a gastroenterologist with Gastroenterology Associates of Central Virginia in Lynchburg. “Some people don’t like the thought of it; it’s embarrassing for some patients.”

“The biggest fear is that of the unknown, namely what if something bad is found, and another concern is pain,” explains Bhushan Pandya, MD, a gastroenterologist with Danville Gastroenterology Center. “A medical checkup is a difficult concept for many of us, particularly when it’s related to our bowels.”

Patients worried about risks of colonoscopies or unsure what the procedure involves are less likely to get a it done. But when you strip away the myths surrounding colonoscopies, they’re a simple, life-saving procedure — not so strange or scary after all.

Myth #1 “The overall risk of having a significant complication is probably around three in 1000. The average risk of colon cancer is around five percent, or one in 20. The risk of colon cancer is actually higher.”

Ralph Wisniewski, MD A gastroenterologist with Gastroenterology Associates of Central Virginia.

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You’ll Have Diarrhea the Day Before

The prep for a colonoscopy is easier than you might imagine. To clear the bowels, doctors give you two doses of a laxative, one to take the evening before the procedure, one to take the next morning.

The prep causes you to have bowel movements, but that doesn’t mean you spend hours in the bathroom. “Usually within four hours or so, it subsides,” Dr. Wisniewski explains. “In the morning, you wake up and take a second dose.”

Patients having a morning procedure can prep the night before, along with drinking only liquids until the colonoscopy is done. For an afternoon procedure, you can start preparing before lunch.

Myth #2

It’s Going to be Awkward and Uncomfortable

Getting a colonoscopy is no more awkward than a visit to the dentist — and for many people, less uncomfortable than having their teeth cleaned.

After checking in, you can expect to meet the team who will be taking care of you, including your anesthesiologist and nurses. You’ll have a private space to change into a gown, and only necessary medical staff will be in the room during the procedure.

You’ll be sedated for the colonoscopy, which should eliminate discomfort or awkwardness. During the actual exam, the scope is carefully slid all the way through your colon to check for anything abnormal. If doctors do find anything, they will typically remove it right away so you don’t have to come in for a second procedure.

“With deep sedation, people tend to go to sleep quicker and wake up quicker, about 5-10 minutes after the procedure,” Dr. Wisniewski says. “The team will make sure you’re not feeling any side effects of the anesthesia, then your doctor will discuss your results and any follow-up steps.”

Myth #3

You Don’t Have Time To Get One

A colonoscopy takes about 20 minutes, and most patients need another 15 to 20 minutes to recover from sedation. Even with time to talk with the doctor afterwards, you’ll probably be out of the office in less than three hours.

“Patients are observed for about 30 to 60 mins after the procedure, and they walk out with their family or friends,” says Dr. Pandya. “Patients are advised not to drive or operate machinery for 24 hours after sedation, but they can eat and resume their normal activities otherwise.”

In general, getting a colonoscopy rarely requires more than a day out of your normal schedule.

“For most people, we would recommend taking the day off and going back to work the next day,” says Dr. Wisniewski.

Myth #4

It’s Too Risky

Every medical procedure comes with risks, but the risks during a colonoscopy are low.

A few people react to the sedation, either during the procedure or with some sickness afterwards. But that’s uncommon. If the doctor removes a precancerous growth, called a polyp, there’s a risk of bleeding afterwards. This tends to be minimal and to end quickly. The most serious risk is a perforation in the colon from the procedure itself, which can cause pain and further complications. “These occur in a very small number of patients,” says Dr. Pandya.

You’re more likely to develop colon cancer as a result of not having a colonoscopy than to experience complications from having one. “The overall risk of having a significant complication is probably around three in 1000,” says Dr. Wisniewski. “The average risk of colon cancer is around five percent, or one in 20. The risk of colon cancer is actually higher.”

Myth #5

“People with colon cancer in their immediate family should start getting a colonoscopy 10 years before their relatives had colon cancer.”

You Don’t Need a Colonoscopy if You Feel Fine

During many screening tests, doctors are looking for tumors. But colonoscopies find and remove polyps before they develop into cancer. This means that the best time to get a colonoscopy is when you feel perfectly fine — and hopefully, getting one will mean that you continue to stay healthy and free from colon cancer.

Bhushan H. Pandya, MD A gastroenterologist with Danville Gastroenterology Center.

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“Colonoscopies prevent colon cancer, which is the second most common cancer in the U.S.,” Dr. Pandya explains. “It is found in more than 150,000 people every year. It is probably the only cancer that can be stopped from happening.”

Current healthcare guidelines recommend that most patients get colonoscopies by age 50, though some groups with higher risk levels should have one earlier. African Americans and anyone with inflammatory bowel disease should talk to their doctor by age 40 about when to get a colonoscopy. “People with colon cancer in their immediate family should start getting a colonoscopy 10 years before their relatives had colon cancer,” advises Dr. Pandya.

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While a colonoscopy is considered the gold standard, there are tests

that can use stool samples to screen for signs of colon cancer. If you are hesitant about getting a colonoscopy, talk to your doctor about the possibility of one of these tests instead.

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“The preferred test is a colonoscopy, but if someone doesn’t want or can’t do that, they should still get one of these non-invasive tests,” concludes Dr. Wisniewski. “The worst thing you can do is not get screened at all.”

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Bhushan Pandya, MD is a gastroenterologist with Danville Gastroenterology Center.

Ralph Wisniewski, II, MD is a gastroenterologist with Gastroenterology Associates of Central Virginia in Lynchburg.

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