OurHealth Richmond May 2016 Edition by OurHealth Media LLC

Local Physicians Join Forces To Save Lives | Recognizing Healthcare Workers | Breaking The Silence: Domestic Violence

. . . e r A s r e n n i W e h t And

table of contents |may 2016

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

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

NEW & NOTEWORTHY.............14 A listing of new physicians, providers, locations and upcoming events in greater Richmond

HEALTH POINTS.........................18 Interesting facts and tidbits about health

THE ANATOMY CHALLENGE..................................21

[ women’s health ]

Local Physicians Join Forces to Save Lives Virginia Women’s Center and Radiology Associates of Fredericksburg offer breast cancer screening and diagnostic services under one roof to give patients access to cutting-edge technology.

How much do you know about Our Anatomy? In this issue, test your knowledge when it comes to the FEMALE BREAST

Recognizing Healthcare Workers This Month and All Year Long To help you keep track of the various healthcare and healthcare related recognition days throughout the year, OurHealth has organized a handy calendar of all 2016 observances.

OurHealth | The Resource for Healthy Living in Greater Richmond

FIT BITS!....................................................................................................... 45 What’s the deal with Kettlebells? You may have walked by them in the gym, and wondered ‘what the…?’ Those crazy-looking things are kettlebells, and they can add a whole new dimension to your workout!

hello, HEALTH!............................................................................................. 46 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos.

2016 Senior Living awards

are announced

[ special feature ]

Breaking the Silence:

DOMESTIC VIOLENCE An OurHealth special feature that explores medical and social issues that can be devastating to the individuals and families they affect. In each feature, we address topics no one wants to talk about. That is, until now. A CLOSER LOOK......................................................................................... 58 Images reflecting the landscape of healthcare in Richmond

* PLUS * A chance to win prizes!

www.OurHealthRichmond.com

may 2016

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click on the magazine cover to view the digital edition! COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2016 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Richmond is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 3420 Pump Road, #314 • Richmond, VA 23233 • P: 540.387.6482 F: 540.387.6483 MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.

LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S

What is an Antiviral? Viruses are disease-causing organisms that differ from bacteria. Unlike most bacteria, viruses need a living cell to cause disease. Common examples of viruses include rhinoviruses (i.e. the common cold), influenza (the flu), and HIV. Since viruses differ from bacteria, antibiotics do not work to treat them.

Typically, our bodies are very effective at curing most viruses when given enough time. — Sylvia Gonsahn-Bollie, MD

Antibiotics typically kill the bacteria itself whereas antivirals work by slowing down the virus activity in our cells so our immune system can effectively treat the virus. In some cases, the virus is never fully cleared from our body but just suppressed to very low levels with antiviral treatment. Some viruses that can benefit from antiviral treatment include influenza, hepatitis C, and HIV. Typically, our bodies are very effective at curing most viruses when given enough time. Vaccines have also helped improve our ability to fight certain viruses. Talk to your doctor or healthcare professional for more information on antivirals. Sylvia Gonsahn-Bollie, MD

Bon Secours West End Internal Medicine Richmond | 804.282.7857 www.bonsecours.com

What is Cervical Dysplasia?

What is High Fidelity Wraparound Framework?

Cervical dysplasia is a condition in which healthy cells on the cervix undergo abnormal changes. The changes are not cancer, but are considered precancerous. Cervical dysplasia is asymptomatic and most often discovered during routine PAP smears. When abnormal cells are detected, a test for the human papilloma virus or HPV or a cervical biopsy may be recommended.

High Fidelity Wraparound (HFW) is an integrated process, led by an Intensive Care Coordinator (ICC facilitator); where multiple systems (providers, natural supports and family members) come together with the youth and the family to create an individualized plan to address the youth’s complex emotional needs. This planning model helps to identify strengths, prioritize needs and engage formal and natural supports. The process facilitates care planning and coordination of services for youth with a myriad of complex emotional needs that are at risk of out-of-home placement or for youth who are preparing to return home to their communities.

HPV – which is spread through sexual contact – is strongly associated with cervical dysplasia. Some HPV strains are low-risk and cause genital warts while others are high-risk and can lead to cervical dysplasia and potentially cancer. Mild dysplasia may go away without treatment. Treatment options for moderate-to-severe dysplasia include cryosurgery to freeze affected areas, laser therapy to burn away abnormal tissue, LEEP which uses electricity to remove abnormal areas, and cone biopsies to surgically remove dysplasia. Rarely, a hysterectomy may be recommended. Today, patients can drastically decrease their odds of getting HPV and possibly cervical dysplasia, by getting the HPV vaccine. Keith Berkle, MD

Virginia Women’s Center Richmond | 804.288.4084 www.virginiawomenscenter.com

The care planning is driven by the needs of the youth and is done through the wraparound process. ICC provides a single point of contact for accountability by ensuring that all necessary services are accessed, coordinated, and delivered in a strength-based, individualized, family/youth-driven, ethical and cultural manner. The ICC planning process ensures that a care coordinator organizes and matches care across providers and child- serving systems to enable the youth to be served in their home and community. Terri Dorsey, MS, QMHP, QMRP Intensive Care Coordinator Virginia Home for Boys and Girls Henrico | 804.270.6566 www.vhbg.org

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

Physiatrists are medical doctors who have completed medical school, then complete specialty training in rehabilitative medicine, which covers a wide variety of medical conditions such as spinal cord injury, amputations, brain injuries, strokes, neuromuscular medicine, musculoskeletal medicine, pain management and cancer rehabilitation issues. — Bernice Stein, MD

What is the role of a physiatrist within the rehabilitation hospital setting? Inpatient rehabilitation hospitals combine specialized therapy and nursing care to improve and restore physical strength, mobility and cognition of patients after illness, injury or surgery. Patients who’ve had strokes, spinal cord injuries or cardiac surgery, for example, benefit greatly from participating in a program at the rehabilitation hospital level of care. This environment depends on an interdisciplinary team led by a physiatrist. The hospital team includes physical, occupational and speech therapists, nurses with specialized rehabilitation training, as well as physicians with expertise in internal medicine and specialties such as pulmonology or cardiology. A case manager coordinates with the doctor, patient and loved ones to ensure needs are met and questions are answered. Rehabilitation hospitals utilize this interdisciplinary approach to help a patient maximize his or her level of function and achieve the highest level of independence possible within an average one- to two-week timeframe. Bernice Stein, MD

Healthsouth Rehabilitation Hospital of Petersburg Petersburg | 804.894.4746 www.healthsouthpetersburg.com

OurHealth | The Resource for Healthy Living in Greater Richmond

What counseling and advice should I be looking for from a funeral director in dealing with the loss of a loved one? When a person experiences the loss of a loved one, they have to deal with the emotional loss of losing someone very dear to them and at same time make plans for the disposition of their loved ones remains. What should you look for in selecting a funeral home? The individual and firm assisting you should seek to listen to you and help create a life celebration ceremony that incorporates remembering the life lived and meeting the needs of those left behind. With this, all associated costs should be explained clearly and in a timely matter. Funerals are for the living, but they should not create an excessive financial hardship on those left behind. A true funeral “caregiver” can help you create a fitting farewell within your means. Finally, look for a firm that will help you with filing for insurance, survivor’s benefits, and other paperwork. Find a funeral home whose mission is to lessen the burden brought by the loss of a loved one. J. David Mullins, President Affinity Funeral Service Richmond | 804.299.4357 www.affinityfuneralservice.com

What are some early warning signs of Parkinson’s disease? Early warning signs of Parkinson’s disease may include problems with movement such as tremors, stiffness of the muscles, slowness of movement, or changes in one’s ability to walk normally. Posture may become hunched over, handwriting may get smaller, or the voice may get softer. Facial expressions may become less animated. Some people experience talking, shouting, thrashing around in their sleep, constipation, decreased sense of smell, or depression years before they develop the aforementioned problems with movement. Leslie Cloud, MD, MSc

Assistant Professor of Neurology VCU Parkinson’s and Movement Disorders Center Richmond | 804.662.5304 www.parkinsons.vcu.edu

NEW

NOTEWORTHY

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

New Emergency Care Center Opens in Chesterfield Chippenham Hospital Swift Creek ER, a department of Chippenham & Johnston-Willis Hospitals, located in the Hancock Village Shopping Center in Chesterfield is now open. The 11,500 square foot facility is staffed with board certified emergency room physicians and nurses 24 hours a day, 365 days a year.

for pediatrics and adults. Services offered at Swift Creek include full-service emergency care, a wide spectrum of pediatric care, advanced imaging with CT, portable ultrasound and diagnostic x-ray plus on-site lab testing and telemedicine capabilities with Chippenham and Johnston-Willis Hospitals.

Swift Creek is a full-service free standing Emergency Room, with separate entrances and waiting room areas

For more information about Swift Creek ER, visit www.swiftcreeker.com or call 804.327.7600.

Baylor Rice, RPh, FIACP Elected IACP Board of Directors President-Elect

Baylor Rice, RPh, FIACP, owner/pharmacist of South River Compounding Pharmacy in Richmond, has been elected President-elect to the 2016 International Academy of Compounding Pharmacists (IACP) Board of Directors by the IACP membership, and will serve in this role through January 2017. IACP is an association representing more than 4,000 pharmacists, technicians, students, and members of the compounding community who focus upon the specialty practice of pharmacy compounding. Pharmacy compounding is the long-established tradition in pharmacy practice that enables physicians to prescribe and patients to take medicines that are specially prepared by pharmacists to meet patients’ individual needs. In 1998, Mr. Rice and his wife opened South River Compounding Pharmacy, Inc. His vision of treating each patient based on their individual needs and using a team approach by working together with the patients’ practitioner has proved to be a success with positive outcomes for the patients. For all of your pharmaceutical and compounding needs visit South River Compounding in Midlothian or the West End. For more information visit www.southriverrx.com.

Virginia Family Dentistry Opens New Location in Richmond Area

Did your favorite provider win?

Virginia Family Dentistry, a multi-specialty dental practice founded in 1974 by W. Baxter Perkinson, Jr., DDS, recently opened its twelfth location at 8516 Patterson Avenue, Henrico, in the Beverly Hills Shopping Center.

Senior Living Awards

The new office offers dental care in a convenient location with two general dentists, Tyler Perkinson, DDS and Jamie Denoncourt, DDS. Both dentists are locals of the area, and are graduates of Virginia Commonwealth University’s School of Dentistry. The Patterson-Parham location offers brand new, state-of-the-art dental technology with four hygiene rooms and seven doctor operatories. The entire space has been completely renovated to provide patients with the most-up-to-date care possible. For more information or to make an appointment, call 804.364.7090 or visit www.vadentist.com.

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Seth Corey, MD

Children’s Hospital of Richmond at VCU Hematology and Oncology Downtown Richmond 804-828-CHOR www.chrichmond.org

Susan Jones, MD

Children’s Hospital of Richmond at VCU Psychiatry Downtown Richmond 804.828-CHOR www.chrichmond.org

Nikisha Richards, MD VCU Health Ophthalmology Nelson Clinic and Stony Point | 804.828.9315 www.eye.vcu.edu

Shweta Joshi, MD

Richmond Gastroenterology Associates Richmond | 804.673.2806 www.richmondgastro.com

Jeffrey Taylor, MD

VCU Health Internal Medicine Richmond | 804.957.6287 www.vcuhealth.org

Tejas Patel, MD

VCU Health Orthopaedic Surgery Richmond | 804.828.7069 www.vcuhealth.org

Jessica Tsukanov, DO VCU Health Family Medicine and Population Health Nelson Clinic 804.828.5883 www.vcuhealth.org

Cherish Van Schaik, NP

Christine Paul, MD

Hayes E. Willis Health Center Family Medicine & Population Health Richmond | 804.230.7777 www.vcuhealth.org

Bon Secours Blackstone Family Practice Center Blackstone | 434.292.7261 www.bonsecours.com

Linda Pinsky, OD

VCU Health Ophthalmology Nelson Clinic and Stony Point | 804.828.9315 www.eye.vcu.edu

Cheryl Wood, NP

Bon Secours Neurology Clinic at Memorial Regional Mechanicsville 804.325.8720 www.bonsecours.com

Healthgrades Recognizes Two Bon Secours Hospitals with Distinguished Hospital Award for Clinical Excellence Bon Secours St. Mary’s and Memorial Regional are the only Central Virginia hospitals to receive the award. Bon Secours St. Mary’s Hospital and Bon Secours Memorial Regional Medical Center have received Healthgrades’ 2016 Distinguished Hospital Award for Clinical Excellence. The facilities are two among 260 recipients nationwide to receive this prestigious honor, placing them in the top five percent of hospitals that deliver high-quality care in the nation across at least 21 of 32 common inpatient conditions and procedures, as evaluated by Healthgrades. Bon Secours St. Mary’s Hospital and Bon Secours Memorial Regional Medical Center are the only hospitals in Central Virginia named to the list. During the 2016 study period (inpatient stays from 2012–2014), Healthgrades

Distinguished Hospitals for Clinical Excellence, as a group, had a 26.5 percent lower risk adjusted in-hospital mortality rate across 19 procedures and conditions where mortality was the clinical outcome, compared to all other hospitals. During this same period, if all other hospitals performed at the level of Distinguished Hospitals for Clinical Excellence across these 19 procedures and conditions, 158,858 lives could potentially have been saved. For example, patients treated at a hospital that achieved the Distinguished Hospital for Clinical Excellence Award had, on average, a 32 percent lower risk of dying from heart failure than if treated at a hospital that did not receive this distinction. To learn more about how Healthgrades determines Distinguished Hospital Award for Clinical Excellence recipients, please visit www.healthgrades.com/quality.

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NEW

NOTEWORTHY

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

Bon Secours Memorial Regional

Renovation and Expanded Services Renovation aims to enhance birthing experience, while programmatic offerings expand lowintervention birthing options. Bon Secours Memorial Regional Medical Center recently completed a 1,300-square-foot renovation of the labor and delivery area of the hospital. Three postpartum rooms have been added for delivered mothers and babies, all with showers and new furniture. In addition to the facility enhancements, Bon Secours Memorial Regional Medical Center offers a variety of low-intervention options for today’s expectant mothers, many of whom have birth plans and want less intervention than previous generations of women. These options include: • Nitrous oxide – A blend of 50 percent nitrous/50 percent oxygen, nitrous is inhaled as needed, when in labor, to take the edge off of pain so that labor can progress on its own. Women using nitrous report they are able to stay awake and in control throughout labor. Bon Secours was the first health system in Virginia to offer nitrous oxide as a pain management option during labor. • Wireless fetal monitors – Lightweight and cordless, the monitor can be carried like a shoulder purse or it can hang from the IV pole, resulting in an increased range of motion for women in labor. Patients can stroll the unit’s hallway, allowing labor to continue naturally while the baby’s heartbeat and the mother’s contraction pattern are being carefully monitored.

FEATURE story: BREAKING THE SILENCE

DOMESTIC VIOLENCE

• Hydrotherapy/birthing tubs – The use of water as a nonpharmacologic pain relief technique is extremely desirable for many women in labor. The comfortable jetted tubs at Memorial Regional can be a great tool to help women relax during and between contractions. For infants requiring comprehensive critical care, Memorial Regional offers a Neonatal Intensive Care Unit (NICU) that is staffed around the clock by specially trained physicians and nurses, along with experienced professionals in pediatric practice areas such as respiratory therapy, cardiology and radiology, among others. Raymonda Ryce, MD, Dominion Women’s Health at Memorial Regional, says, “In addition to low intervention offerings, Memorial Regional provides many other advantages to area mothers, including international board-certified lactation consultants and doula-trained labor nurses. Doulas working with Bon Secours-affiliated providers and with patients are welcome at Memorial Regional, as well as at all Bon Secours hospitals.” Bon Secours invites anyone expecting a baby to sign up for a tour through the Love and Learn program, and see the newly refurbished unit. The goal is to help women create a memorable and successful birth experience at Memorial Regional. To sign up for a tour, call 804.340.2229 or visit www.va.bonsecours.com/love-and-learn.

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Accountable Care Collaboration to Enhance How the Health System Cares for Patients

Virginia Care Partners (VCP) and UnitedHealthcare have launched an accountable care program to improve people’s health and their satisfaction with their healthcare experience.

VCP was formed in 2012 by physicians committed to improving their patients’ health outcomes by applying best treatment practices across all care settings – in physician offices, hospitals and outpatient-care settings.

The new accountable care program will dedicate more resources to care coordination and make it easier to share important health information. More than 18,000 people enrolled in UnitedHealthcare’s employer-sponsored health plans are eligible to benefit from this collaboration.

The primary care doctors and specialists who comprise the physician-led network work with the VCP Transitions of Care clinical team, which includes nurse care managers and a licensed clinical social worker, clinical pharmacist and registered dietitian, to assist patients in transitioning from hospital to home.

Many people who have gone to the doctor or hospital – particularly those with complex or chronic illnesses – have found they often have to connect information from each of their doctor’s visits themselves, and have sometimes received duplicative tests or care that isn’t coordinated. Through this collaboration, UnitedHealthcare and VCP will work together to better coordinate patients’ care, using shared technology, timely data and information about emergency room visits and hospital admissions. This partnership will also provide services to help patients manage their chronic health conditions by enhancing relationships with their personal physicians and encouraging healthy lifestyles.

The nurse care managers visit patients in the hospital before they are discharged to ensure that they understand their diagnosis and discharge orders and to help them schedule follow-up appointments. They notify the patient’s primary care physician and send discharge summary, orders and medication lists to the practice. They follow up with patients once they are home to answer questions, help them better understand their health care issues and needs, and alert care providers about any complications or issues. When needed, they work with the primary care physician to integrate behavioral health services. For more information about UnitedHealthcare’s full spectrum of value-based initiatives, visit www.UHC.com/valuebasedcare and for a complete list of participating providers, visit Virginia Care Partners at www.virginiacarepartners.com.

Find OurHealth’s

Favorite Spring Recipes for May online.

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

feeling

STRESSED OUT? Stress is a physical, mental, or emotional response to events that cause bodily or mental tension.

Looking for a unique way to combat stress? Try this latest trend

in stress relief: COLORING Here are just a few reasons why you should pick up those colored pencils. • Focusing your energy on a single task, temporarily takes your mind off worries or concerns. • Release creative energy without having to create something from scratch. Coloring books provide guidance while also allowing for creativity to flow. • Coloring is a quiet, calming activity that can be done alone in a relaxed environment. • Coloring is FUN! It may bring back nostalgic childhood memories and a simpler, less hectic life. Scan the QR code for a FREE downloadable coloring sheet, compliments of OurHealth Richmond!

Trivia Time!

Take the trivia challenge to see how much you know about these ‘little known’ health facts, and impress your friends at your next dinner party! 1. No matter how flexible you are, you can’t kiss your elbow:

 True

 False

2. What does the symbol Rx mean on prescriptions? 3. One in every 2,000 babies is born with a tooth already in place

 True

 False

4. What is the purpose of goose bumps? 5. In an average lifetime, does a person have more breaths or heartbeats? 6. On average, who has more hair?

 Blondes  Brunettes  Red heads

7. How many muscles do you use to take a single step forward?

 50

 200

 450

8. How often do we shed and re-grow our outer skin cells?

 Every 8 days  Every 27 days  Every 4.5 months

Find the answers at www.OurHealthRichmond.com or on our Facebook page

OurHealth | The Resource for Healthy Living in Greater Richmond

The Benefits of

Lifelong Learning for Adults 50+ The pursuit of knowledge through lifelong learning—the process of keeping your mind and body engaged at any age whether it’s learning how to dance, speak a foreign language, write a blog, improve your golf swing, or repair your car—has wonderful benefits for adults 50 and up. • Keeps your mind sharp • Improves memory • Increases self-confidence • Offers an inexpensive way to try something new • Saves money as you learn to “do it yourself” • Gives you a feeling of accomplishment • Helps you meet people who share your interests • Builds on skills you already have • Offers an opportunity to learn a new skill or trade and increase your income • Gives you a new interest that you can share with family and friends

Local colleges, parks and recreation departments, senior centers and libraries are all great resources to discover what learning experiences are available. Find something you are passionate about, or want to explore – and have fun learning!

The Virginia Memorial Day 12K & 5K Run, Walk or Roll

Give Back to Those Who Gave…

Hosted by The Race Before Us, a non-profit organization devoted to supporting spirituality, health and fitness in our community and sponsored by the YMCA of Greater Richmond and Race Team RVA Running Club. The Virginia Memorial Day 12k & 5k race has designated the Families of the Wounded Fund, Inc. as the charity that will benefit from this race.

Kids helping kids! Children’s Hospital of Richmond at VCU Power Kids Triathlon – Presented by Allergy Partners of Richmond Recognized as the best and biggest triathlon in Virginia for kids ages 5-14! This event benefits the Shady Grove YMCA Summer Kids Camp Programs. By donating to the ‘campership’ program through this event, you are helping send children to camp even if their parents cannot pay the full fee. Your generosity now will mean more happy children in September! Date: Saturday, May 21, 2016 Time: 8 a.m. Location: Shady Grove Family YMCA 11255 Nuckols Road Glen Allen | 804.270.3866 Race Details: Ages 5-8 Indoor 50 meter swim 1.8 mile bike 0.6 mile run

Ages 9-14 Indoor 100 meter swim 4.8 mile bike 1.2 mile run

F or more information and to register, visit www.richmondmultisports.com.

A portion of the race proceeds will be donated directly to the Families of the Wounded Fund, Inc. You can also donate directly to this cause and learn more about their mission by visiting www.fotwf.org. Date: Monday, May 30, 2016 Time: 8 a.m. Location: Striker West Creek Field (in West Creek Business Park) 12575 West Creek Parkway Richmond To register: Visit www.rvaraces.com www.OurHealthRichmond.com

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Anatomy

The Anatomy Challenge is proudly sponsored by:

the

CHALLENGE How much do you know about the

anatomy of the female

breast? Complete the word search below. Next, match the correct word with the part of the body in the illustration.

[ the female breast ]

WORD SEARCH areola

pectoralis major muscle

chest wall

pectoralis minor muscle

lactiferous sinus

rib

mammary gland lobes

skin

nipple

subcutaneous fat pad

pectoral fat pad For answers, visit OurHealth Richmond's

Facebook page at

____________________ ____________________ With seven locations to serve you: St. Maryâ&#x20AC;&#x2122;s Hospital Office Building South Virginia 5875 Bremo Road | Suite 400 Richmond | 804-288-4084 Henrico Doctorsâ&#x20AC;&#x2122; Forest Medical Plaza 7611 Forest Avenue | Suite 200 Richmond | 804-288-4084

____________________ ____________________

Mechanicsville 7515 Right Flank Road Mechanicsville | 804-288-4084

____________________

St. Francis Medical Pavilion 13801 St. Francis Boulevard | Suite 100 Midlothian | 804-288-4084

____________________

John Rolfe Commons 2240 John Rolfe Parkway Richmond | 804-288-4084 Kilmarnock 102 DMV Drive Kilmarnock | 804-436-8038 Tappahannock 658 Hospital Road | Suite 304 Tappahannock | 804-288-4084

____________________ ____________________ ____________________ ____________________ www.OurHealthRichmond.com

â&#x20AC;&#x153;Getting a yearly mammogram beginning at 40 years old is the best way to combat breast cancer,â&#x20AC;? says Dr. Talukdar. 22

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Local Physicians

words | LAURA NEFF-HENDERSON, APR

JOIN FORCES

Save Lives

Virginia Women’s Center and Radiology Associates of Fredericksburg offer breast cancer screening and diagnostic services under one roof to give patients access to cutting-edge technology. Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer, according to the American Cancer Society. And those numbers are on the rise. Researchers at the U.S. National Cancer Institute predict that in 2030, roughly 441,000 U.S. women will be diagnosed with breast cancer, up from 283,000 in 2011 — the most recent year for which numbers are available. Physicians at the Virginia Women’s Center and Radiologic Associates of Fredericksburg have teamed up to do their best to make sure this predicted increase in the incidence of breast cancer doesn’t hold true locally.

Through a new breast health program, radiologists from Radiologic Associates of Fredericksburg are now on-site at Virginia Women’s Center offices. This partnership allows patients to undergo routine screening and follow-up diagnostic testing in surroundings familiar to them. By making the screening process as easy as possible for patients, they hope to see more women getting annual screenings. Additionally, Virginia Women’s Center patients now have access to 3-D mammography — the biggest advancement in breast imaging in the last 10 years, according to radiologist Roni Talukdar, MD, with Radiologic Associates of Fredericksburg.

www.OurHealthRichmond.com

Nationally, less than 50 percent of women get a yearly mammogram, according to the Susan G. Komen breast cancer organization. “That’s not acceptable,” says Kristin Schraa, MD, a gynecologist with Virginia Women’s Center. “We know that annual screening mammography saves lives.” Early detection, physicians agree, is the key to survival. Women who find the cancer early — either through breast self-exams or annual screenings — are much more likely to survive.

Breast cancer signs and symptoms According to the American Cancer Society, the most common symptom of breast cancer is a new lump or mass on the breast: “A mass that’s painless, hard and has irregular edges is more likely to be cancer, but breast cancers can be tender, soft or rounded. They can even be painful.” There’s not a one-size-fits-all symptomatology. For this reason, it’s important to have any new breast mass, lump or change checked by a healthcare provider experienced in diagnosing breast diseases. Other possible symptoms of breast cancer include • Swelling of all or part of a breast. Kristin Schraa, MD, is a gynecologist with Virginia Women’s Center in Richmond. Dr. Schraa is certified by the American Board of Obstetrics and Gynecology.

• Skin irritation or dimpling. • Breast or nipple pain. • Nipple retraction (turning inward). • Redness, scaliness or thickening of the nipple or breast skin. • A nipple discharge other than breast milk.

Decreasing the risk Women can help reduce their risk of developing breast cancer by • Maintaining a healthy weight. • Exercising regularly (at least four hours a week). • Getting plenty of sleep. • Avoiding alcohol. Roni Talukdar, MD is a diagnostic radiologist with Radiologic Associates of Fredericksburg and offers services at Virginia Women’s Center in Richmond. Dr. Talukdar is certified by the American Board of Radiology.

• Avoiding exposure to carcinogens (chemicals that are known to cause cancer, like nicotine). • Breastfeeding their babies when possible. Women with a family history of breast cancer or inherited changes in their genetic makeup could have a higher risk of developing breast cancer. They should talk with their physician about medications that block or decrease estrogen as well as possible preventative surgeries to remove breast tissue and/or the ovaries and fallopian tubes.

Early detection The goal of screening tests for breast cancer is to find the cancer before it causes symptoms. Drs. Schraa and Talukdar both recommend that women begin having yearly mammograms at age 40, or earlier if they’re at high risk. While breast cancer screenings cannot prevent breast cancer, cancer found during screening exams is more likely to be smaller and confined to the breast. The size of 24

OurHealth | The Resource for Healthy Living in Greater Richmond

a breast cancer and how far it has spread are some of the most important factors in predicting a woman’s survival. “Finding breast cancer early reduces a woman’s risk of dying from the disease by 25 to 30 percent or more,” according to www.breastcancer.org.

The new collaboration between Virginia

Mammography

Women’s Center and

During a mammogram, each breast is briefly compressed between two plates attached to the mammogram machine. The top plate is plastic and adjustable, while the bottom plate is a fixed metal X-ray plate. The bottom plate holds the X-ray film that records the image. Compressing the breasts between the plates reduces breast movement and makes the layer of breast tissue as thin as possible. While each image takes just seconds to record, this part of the procedure is critical to producing highquality images that are viewed by a radiologist.

Radiologic Associates of

Mammograms are read, or interpreted, by radiologists — doctors who specialize in diagnosing and treating diseases and injuries using medical imaging techniques such as X-rays. When reviewing a mammogram, radiologists are looking for calcifications — tiny mineral deposits within the breast tissue that can be the earliest sign of cancer — as well as solid and cystic masses.

additional tests, it will

The main challenge with mammograms is that they aren’t perfect. Normal breast tissue can hide a breast cancer so that it doesn’t show up on the mammogram. This is called a “false negative.” When a screening mammogram shows an abnormal area that looks like a cancer but turns out to be normal, it’s called a “false positive.” Ultimately the news is good: no breast cancer. But the suspicious area usually requires followup with more than one doctor, along with extra tests and procedures, including a possible biopsy.

Fredericksburg means that when women get called back for those be back to their doctor’s office — a place they are already familiar with and a doctor they already know.

Besides worrying about being diagnosed with breast cancer, the additional tests and followup visits required by a false-positive mammogram result can cause even more stress. Virginia Women’s Center is now able to offer mammography for patients with breast implants, diagnostic mammography, breast biopsies and breast ultrasounds in its offices.

3-D mammography Nationally, about 8 to 10 percent of women who have 2-D mammograms are called back to undergo additional testing. While this can happen for many reasons, one of the most common reasons is because traditional 2-D images are not clear enough for the radiologist to interpret accurately. On the other hand, 3-D mammography — also called “digital tomosynthesis” — creates a three-dimensional picture of the breast using X-rays. The procedure complements the standard 2-D mammogram and is performed at the same time with

1 in 8 women in the US will develop invasive breast cancer over the course of her lifetime. www.OurHealthRichmond.com

40 years of age and older should Women

receive mammography screenings on an annual basis.

Women at high risk (those with a family

history of breast cancer) are generally recommended to

start screenings at age 30, unless otherwise recommended by their doctor.

the same system. There is no additional compression required, and it takes only a few additional seconds.

“One of the best things about 3-D mammography is that the study is much more conclusive. Fewer people have the frightening experience of needing to come back for more images,” says Dr. Schraa.

During the 3-D part of the exam, the X-ray arm takes several low-dose images from different angles around the breast that are used to create the 3-D picture. The images are then converted into a stack of very thin layers. The radiologist is able to review the reconstruction, one thin slice at a time, making it easier to see if there’s anything to be concerned about. Because of the quality of the images, radiologists are also able to more easily identify cancer that could be hiding behind overlapping tissue. A 2013 study, “Increased Risk of Developing Breast Cancer After a False-Positive Screening Mammogram” (Henderson et al. 2015), found that 3-D mammography identified more breast cancers and led to fewer callbacks compared to conventional 2-D mammography. Women who are concerned about radiation exposure don’t need to worry about any increased risk with the 3-D technology, says Dr. Talukdar. The exposure is well below the limit set by the Federal Drug Administration, and the risk of breast cancer far outweighs the risk of radiation exposure from the procedure. “If the clearer images prevent a patient from having to come back for more images, they are actually being exposed to less radiation,” explains Dr. Schraa. Studies on 3-D mammography show a 40 percent improvement in early detection and a 40 percent decrease in unnecessary callbacks and biopsies. “All of the data we’ve seen and my own personal experience have shown that this has incredible promise in helping us save lives,” says Dr. Talukdar. “I’ve already detected cancers that I don’t think I would have seen on 2-D mammography.” With Medicare and Medicaid now covering the 3-D portion of the procedure, Dr. Schraa is hopeful that other insurance companies will quickly follow suit. In the meantime, the Virginia Women’s Center only charges a small fee to cover the cost of the improved technology to those patients whose insurance won’t cover 3-D screenings.

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“We feel so strongly that it’s such a better option. We are encouraging all of our patients to choose 3-D screening,” says Dr. Schraa. “It’s what we are doing for ourselves and what we recommend for our patients.”

Reference Henderson, L. M., R. A. Hubbard, B. L. Sprague, W. Zhu, and K. Kerlikowske. 2015. “Increased Risk of Developing Breast Cancer After a False-Positive Screening Mammogram.” Cancer Epidemiology, Biomarkers & Prevention 24:1882-89.

Expert Contributors • Roni Talukdar, MD, with Radiologic Associates of Fredericksburg. • Kristin Schraa, MD, is a gynecologist with Virginia Women’s Center.

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91%

survival rate if breast cancer is detected in Stages 0-III

22%

survival rate if breast cancer is detected in Stage IV Sidebar statistics sourced from the American Cancer Society (www.cancer.org)

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RECOGNIZING

HEALTHCARE WORKERS THIS MONTH AND ALL YEAR LONG words | RICH ELLIS

Caring for people is a never-ending commitment. Illness and accidents never take a day off, they don’t recognize national holidays or weekends, they occur around the clock, and they affect everyone at some time or another. And even as these individual healthcare crises unfold and are managed, attention and work elsewhere is focused simultaneously on promoting and protecting patients’ good health through education and prevention, and on medical research. Simply put – healthcare never stops, because it can’t. Delivering it is a heavy responsibility, and one that falls squarely on the shoulders of a select group of people – healthcare professionals. These committed individuals – knowing full well the challenges, risks, hours, sacrifices, highs and lows inherent in caring for others – still choose to perform this work so that others have a chance to live a better life through improved health. To try and begin to thank and recognize these professionals for their dedication, sacrifices and commitment, many national recognition days have been established over the years to honor specific healthcare professions – from National IV Nurse Day to National Dental Assistants Recognition Week to National Doctors’ Day. While one day isn’t enough to say “thank you,” it’s a start. So to help you keep track of all the various healthcare-related recognition days and weeks that occur throughout the year so you can recognize the professionals in your life, OurHealth put together this healthcare appreciation calendar listing all the various observances.

USE IT WELL, AND THANK A HEALTHCARE PROFESSIONAL EVERY DAY.

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MAY Month of

MAY

Critical Care Awareness and Recognition Month

The Society of Critical Care Medicine (SCCM), along with the American Association of Critical-Care Nurses (AACN), American College of Chest Physicians (CHEST), American Thoracic Society (ATS), and the American Association for Respiratory Care (AARC), honors critical care professionals this month for their speedy and dedicated work. For more information, visit the Society of Critical Care Medicine at www.sccm.org.

Month of

MAY

Oncology Nursing Month

Oncology nurses throughout the country are honored this month for not only their clinical and technical expertise, but for helping people through some of the most trying times of their lives. For more information, visit the Oncology Nursing Society at www.ons.org.

MAY 6-12

Nurses Week

Held annually since 1820, National Nurses Week celebrates the role nurses play in delivering high quality care to patients around the world. For more information, visit the American Nurses Association at www.nursingworld.org/nationalnursesweek.

MAY 8-14

Hospital Week

MAY 8-14

Skilled nursing, post-acute, and other care settings use National Nursing Home Week as a time to recognize staff for their dedication to caring for seniors and persons with disabilities. For more information, visit the American Health Care Association at www.nnhw.org.

MAY

School Nurse Day

On National School Nurse Day we celebrate our local school nurses! The National Association of School Nurses (NASN) applauds the contributions school nurses make every day to improve the safety, health, and academic success of our students. For more information, visit NASN at www.nasn.org.

MAY 15-21

Medical Transcriptionist Week

JUNE JUN

For more information, visit the Association for Healthcare Documentation Integrity at www.ahdionline.org.

MAY 15-21

Neuroscience Nurses Week

Neuroscience Nurses Week celebrates the work of neuroscience nurses everywhere. For more information, visit the American Association of Neuroscience Nurses (AANN) at www.aann.org.

For more information, visit the American Hospital Association at www.aha.org/hospitalweek.

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Healthcare Recruiter Recognition Day

National Healthcare Recruiter Recognition Day, which always falls on the first Tuesday in June celebrates the contribution healthcare recruiters make to their organizations every day. For more information visit the National Associations for Health Care Recruitment at www.nahcr.com.

JUN 9-16

Nursing Assistants Week

Nursing Assistants Week begins on Career Nursing Assistants Day, June 9, to recognize nursing assistants and other direct-care workers who provide daily care in nursing homes, home care, and other long-term care settings. For more information visit the Career Nursing Assistants website at www.cna-network.org

National Medical Transcriptionist Week is a week-long event to recognize the contributions healthcare documentation specialists make in helping to ensure complete and accurate patient health records.

National Hospital Week, the nationâ&#x20AC;&#x2122;s largest healthcare event, celebrates hospitals and health systems and the men and women who support the health of their communities.

Nursing Home Week

JULY Month of

JULY

UV Safety Awareness Month

In support of UV Safety Month this July, the American Academy of Ophthalmology reminds the public of the importance of shielding eyes from the sunâ&#x20AC;&#x2122;s harmful rays with 100 percent UV-blocking sunglasses and broad-brimmed hats. Make a point to recognize your eye care provider this month. For more information, visit the American Academy of Ophthalmology at www.aao.org.

AUGUST AUG 14-20

Health Center Week

This week in August, we recognize the service and contributions of community, migrant, homeless, and public housing health centers in providing access to affordable, high-quality, cost effective healthcare to medically vulnerable and underserved people. For more information, visit the National Association of Community Health Centers at www.healthcenterweek.org.

AUG

Health Unit Coordinator Day

SEP 11-17

Vascular Nurses Week

Vascular Nursing Week celebrates vascular nurses who focus on the care of persons living with vascular disease. For more information, visit the Society for Vascular Nursing at www.svnnet.org.

SEP

Neonatal Nurses Day

SEP 18-24

Nursing Professional Development Week

Nursing Professional Development Week celebrates nursing professional development specialists and their profession of engaging nurses in the lifelong learning and development of their healthcare career goals. For more information, the Association for Nursing Professional Development at www.anpd.org.

National Neonatal Nurses Day is celebrated every September 15 by honoring the members of the neonatal community and their care for the littlest of patients. For more information, visit the National Association of Neonatal Nurses at www.nann.org.

August 23 we celebrate health unit coordinators who serve as the hub of activity in critical care units, emergency departments, inpatient units and outpatient services. For more information, visit the National Association of Health Unit Coordinators (NAHUC) at www.nahuc.org.

SEPTEMBER SEP 11-17

Healthcare Environmental Services and Housekeeping Week

This week is designed to recognize and elevate healthcare environmental services staff for the critical and often unrecognized role of environmental services in quality outcomes. For more information, visit the Association for the Healthcare Environment (AHE) at www.ahe.org.

SEP 11-17

Nephrology Nurses Week

Nephrology Nurses Week honors the dedicated nephrology nurses who care for patients with kidney disease. For more information, visit the American Nephrology Nursesâ&#x20AC;&#x2122; Association at www.annanurse.org.

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SEP 18-24

Surgical Technologist Week

The Association of Surgical Technologists (AST) offers national recognition through National Surgical Technologist Week, a week that has been designated to celebrate and honor the professions.

OCT 2-8

Gerontological Nursing Week

This week honors the specialty practice of gerontological nursing dedicated to the clinical care of older adults across diverse care settings. For more information, visit the National Gerontological Nursing Association at www.ngna.org.

For more information, visit AST at www.ast.org.

OCT

OCTOBER Month of

OCTOBER

Medical Librarians Month

The Medical Library Association (MLA) created the National Medical Librarians Month observance to raise awareness of the important role of the health sciences information professional. For more information, visit the MLA at www.mlanet.org.

Month of

OCTOBER

Pharmacists Month

For more information, visit the American Pharmacists Association at www.pharmacist.com.

OCTOBER

This week, we recognize the integral role of foodservice staff in helping employees and patients of healthcare facilities stay well-nourished and healthy. This week is an excellent opportunity to recognize and thank the dedicated individuals who provide food and nutrition services in healthcare. For more information, visit the Association for Healthcare Foodservice at www.healthcarefoodservice.org.

OCT 2-8

American Pharmacists Month is a time to recognize pharmacists for the vital contributions they make as medication experts and as an integral part of the healthcare team.

Month of

2-8

Physical Therapy Month

National Physical Therapy Month is hosted by the American Physical Therapy Association (APTA) each October to recognize how physical therapists and physical therapist assistants can transform people’s lives by restoring and improving motion. For more information, visit APTA at www.moveforwardpt.com.

Healthcare Foodservice Workers Week

Midwifery Week

National Midwifery Week is a time to celebrate midwives’ contributions to women’s healthcare, including pregnancy, childbirth, and gynecologic and reproductive health. For more information, visit the American College of Nurse-Midwives at www.midwife.com.

9-15

OCT 2-8

Nuclear Medicine and Molecular Imaging Week

Celebrated during the first full week of October, Nuclear Medicine and Molecular Imaging Week encourages recognition of those members of the nuclear medicine specialty for their hard work. For more information, visit the Society of Nuclear Medicine and Molecular Imaging at www.snmmi.org.

OCT 6-12

Physician Assistants Week

For more information, visit the American Academy of Physician Assistants at www.aapa.org. OurHealth | The Resource for Healthy Living in Greater Richmond

Case Management Week

National Case Management Week, held annually during the second full week of October, is an opportunity to recognize the contributions and value of case management within the healthcare delivery system. For more information, visit the American Case Management Association at www.acmaweb.org.

OCT 9-15

Central Service Week

With the dedication of central service professionals, healthcare customers can count on clean and sterile instruments being delivered consistently and on time. For more information, visit the International Association of Healthcare Central Service Material Management at www.iahcsmm.org.

OCT 9-15

Healthcare Security and Safety Week

Emergency Nurses Week is a national celebration of the dedicated nursing professionals who stand ready to care for those people most in need. For more information, visit the Emergency Nurses Association at www.ena.org.

OCT 10-15

National Physician Assistants Week is intended to celebrate and recognize over 100,000 certified physician assistants in the United States.

OCT

Dialysis Technician Recognition Week

In conjunction with Healthcare Security and Safety Officer Appreciation Day on October 12, this week celebrate the role of security and safety professionals that provide healthcare facilities, personnel, patients, and visitors a secure environment. For more information, visit the International Association for Healthcare Security and Safety at www.iahss.org.

OCT 9-15

Emergency Nurses Week

This week-long event is celebrated to increase awareness of nephrology professionals involved in patient care, dialyzer reuse, equipment maintenance, kidney transplantation, and administrative areas. The celebration recognizes the contributions dialysis professionals make to the healthcare field and to their patients’ quality of life. For more information, visit the National Association of Nephrology Technicians/Technologists at www.dialysistech.net.

OCT 17-21

Medical Assistants Recognition Week

Medical Assistants Recognition Day falls on October 19, but celebrate these professionals and their vital role, contributions, and efforts in healthcare all week long. For more information, visit the American Association of Medical Assistants at www.aama-ntl.org.

OCT

23-29

Healthcare Facility and Engineering Week

This week recognize the important role that the healthcare facility team plays in ensuring safe and functional environments for patients, visitors, and staff. For more information, visit the American Society for Healthcare Engineering at www.ashe.org.

OCT

23-29

Pastoral Care Week

Pastoral Care Week gives us the opportunity to recognize the pastoral and spiritual care given through professional chaplaincy and pastoral counseling. Regardless of spiritual, religious, or cultural background, Pastoral Care Week celebrates those who provide spiritual support to others. For more information, visit Pastoral Care Week at www.pastoralcareweek.org.

NOVEMBER Month of

NOVEMBER

Family Caregivers Month

Caregiver Action Network (CAN) formerly known as National Family Caregivers Association, set aside a week of the year to promote appreciation for family caregivers. Because of the massive interest in family caregivers, National Family Caregivers Week turned into a month-long event celebrated every November. For more information, visit the Caregiver Action Network at www.caregiveraction.org.

Month of

NOVEMBER

Home Care and Hospice Month

During November the home care and hospice community honor the millions of nurses, home care aides, therapists, and social workers who make a difference for the patients and families they serve. For more information, visit the National Association for Home Care &Hospice at www.nahc.org.

NOV 1-7

Medical-Surgical Nurses Week

This week honors the medical-surgical nurses who make a difference in the lives of patients every day. Take time during this week to recognize the amazing nurses who practice in this specialty. For more information, visit the Academy of Medical Surgical Nurses at www.amsn.org.

NOV

NOV 1-7

Urology Nurses and Associates Week

Urology Nurses and Associates Week celebrates urologic healthcare professionals and their care for patients through guidance and treatment for a variety of urologic diseases and concerns. For more information, visit the Society of Urologic Nurses and Associates at www.suna.org.

NOV 6-12

Allied Health Professions Week

Allied Health Professions Week honors the three million healthcare providers working in more than 80 allied health professions. Allied health practitioners greatly influence healthcare delivery by supporting, facilitating, and complementing the roles of physicians and other healthcare specialists. For more information, visit the Association of Schools of Allied Health Professions at www.asahp.org.

NOV 6-12

Medical Staff Services Awareness Week

The National Association of Medical Staff Services (NAMSS) has partnered with hospitals, managed care organizations, doctors’ offices, university health systems, and government agencies to honor medical services professionals. For more information, visit the NAMSS at www.namss.org.

NOV 6-12

Radiologic Technology Week

The National Association of Healthcare Transportation Management (NAHTM) members recognize that the key to timely and caring patient transportation is the staff that provides patient transportation.

National Radiologic Technology Week is celebrated annually to recognize the vital work of medical imaging and radiation therapy professionals across the nation. The celebration takes place each November to commemorate the anniversary of Wilhelm Conrad Roentgen’s discovery of the x-ray on November 8, 1895.

For more information, visit NAHTM at www.nahtm.org.

For more information, visit the American Society of Radiologic Technologists at www.asrt.org.

1-7

Patient Transportation Week

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2017

DECEMBER DEC 4-10

Flu Vaccination Week

This week we recognize all of our flu vaccination partners and highlight the importance of continuing flu vaccination through the holiday season and beyond. For more information, visit the Center for Disease Control and Prevention at www.cdc.gov.

2017

JANUARY JAN

IV Nurse Day

Every year since 1981, National IV Nurse Day has honored the commitment shown and the outstanding patient care practiced by infusion nurse professionals. For more information, visit the Infusion Nurses Society at www.ins1.org.

2017

FEBRUARY FEB 6-12

PeriAnesthesia Nurse Awareness Week

This week recognizes and celebrates our nation’s 60,000+ perianesthesia nurses who work in preanesthesia and postanesthesia care, outpatient surgery, and pain management settings, and care for patients before and after surgery. For more information, visit the American Society for PeriAnesthesia Nurses at www.aspan.org.

FEB 12-18

Cardiovascular Professionals Week

This week celebrates the work of cardiovascular professionals and the support they provide to improve patient care.

MARCH Month of

MARCH

Recognizing all athletic trainers— healthcare professionals specializing in the prevention, diagnosis, treatment, and rehabilitation of injuries and sport-related illnesses. For more information, visit the National Athletic Trainers’ Association at www.nata.org.

Month of

MARCH

Professional Social Work Month

This month celebrates medical and public health social workers who provide psychosocial support. They also advise caregivers and help plan for patients’ needs after discharge from hospitals. Social workers may work for hospitals, nursing and personal care facilities, individual and family services agencies, or local governments. For more information, visit the National Association of Social Workers at www.socialworkers.org.

MAR 5-11

Dental Assistants Recognition Week

Dental Assistants Recognition Week recognizes this versatile, multi-talented member of the dental team, who contributes to quality dental care.

11-18

MAR

Registered Dietitian Nutritionist Day

Registered Dietitian Nutritionist Day recognizes registered dietitian nutritionists as the indispensable providers of food and nutrition services and their commitment to helping people enjoy healthy lives. For more information, visit the Academy of Nutrition and Dietetics at www.eatright.org.

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Health Care HR Week

Health Care HR Week recognizes human resources professionals in hospitals and other organizations across the nation for their efforts in workforce compensation and benefits, employee relations, healthcare reform, and wellness. For more information, visit the American Society for Healthcare Human Resources Administration at www.ashhra.org.

MAR

Certified Nurses Day

Certified Nurses Day honors nurses who contribute to better patient outcomes through national board certification. Today we recognize nurses who earn and maintain the highest credentials in their specialty. For more information, visit the American Nurses Credentialing Center at www.certifiednursesday.org.

MAR

Doctors' Day

On this national day of celebration, we recognize the essential role that physicians serve in all of our daily lives and thank them for their contribution to our public health. For more information, visit the American Board of Physician Specialties at www.abpsus.org.

For more information, visit the American Dental Assistants Association at www.adaausa.org.

For more information, visit the Alliance of Cardiovascular Professionals at www.acp-online.org.

Athletic Training Month

MAR

2017

APRIL Month of

APRIL

Humor Month

Throughout the month of April, we honor those who make us laugh. Therapeutic humor promotes health and wellness by stimulating a playful discovery, expression or appreciation of the absurdity or incongruity of life’s situations. For more information, visit Association for Applied and Therapeutic Humor at www.aath.org or National Humor Month at www.humormonth.com.

APR 9-15

Volunteer Week

Established by President Richard Nixon, National Volunteer Week recognizes and celebrates the efforts of volunteers. Every April, charities, hospitals, and communities recognize volunteers and foster a culture of service. For more information, visit the Association for Healthcare Volunteer Resources Professionals at www.ahvrp.org.

APR

10-14

Cancer Registrars Week

National Cancer Registrars Week was established as an annual celebration to promote the work of cancer registry professionals. Founded by the (NCRA), it is celebrated the second week in April. For more information, visit the National Cancer Registrars Association at www.ncra-usa.org.

APR

Radiologic and Imaging Nurses Day

This day recognizes the work of those working in the specialty practice of radiologic and imaging nursing. For more information, visit the Association for Radiologic & Imaging Nursing at www.arinursing.org.

APR 16-22

Neurodiagnostic Week

Neurodiagnostic Week, honors and celebrates the contributions of neurodiagnostic professionals throughout the country. For more information, visit ASET â&#x20AC;&#x201C; The Neurodiagnostic Society at www.aset.org.

APR

Transplant Nurses Day

The International Transplant Nurses Society (ITNS) is committed to creating opportunities to celebrate the thoughtful and compassionate care of transplant nurses and the ways they impact patientsâ&#x20AC;&#x2122; lives. For more information, visit ITNS at www.itns.org.

APR 23-29

Medical Laboratory Professionals Week

National Medical Laboratory Professionals Week celebrates medical laboratory professionals and pathologists working behind the scenes. This week we honor these medical laboratory professionals around the country who perform and interpret more than 10 billion laboratory tests in the United States each year. For more information, visit the American Society for Clinical Laboratory Science at www.ascls.org.

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Bliley’s

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Greater Richmond Area | 800.473.0022 www.careadvantageinc.com

We believe the most valuable thing we own cannot be seen or touched - it is the goodwill of people we have served and their recommendation of us to family and friends. That’s why we are Richmond’s most preferred family-owned funeral and cremation provider.

Come and see what being voted number one in Assisted Living is all about. Experience the difference a community with quality care, spacious apartments, beautiful grounds, lively activities and compassionate staff can make in the life of your loved one. Call us for a tour and lunch today!

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Commonwealth Assisted Living at Chesterfield

Home Instead Senior Care

Chester | 804.748.2500 Dinwiddie | 804.479.8881 Hopewell | 804.458.8516 Petersburg | 804.733.8511 www.jtmorriss.com THIRD

North Chesterfield | 804.554.3588 www.commonwealthal.com THIRD

THIRD

St. Mary’s Woods

Encompass Home Health

Richmond | 804.741.8624 www.stmaryswoods.com

Woody Funeral Homes Mechanicsville | 804.730.0035 Richmond | 804.288.3013 Midlothian | 804.794.1000 www.dignitymemorial.com

HONORABLE MENTION

The Hermitage Richmond | 804.474.1800 www.hermitage-vumh.com

Spring Arbor of Salisbury Midlothian | 804.601.0910 www.springarborliving.com

Greater Richmond Area | 804.527.1100 www.HomeInsteadRichmond.com

OurHealth | The Resource for Healthy Living in Greater Richmond

Richmond | 804.562.4252 Bon Air | 804.377.1188 Colonial Heights | 804.541.6224 www.ehhi.com HONORABLE MENTION

Covenant Home Care Richmond | 804.569.6104 www.covenanthome.care

Hospice Care

Independent Living Community

FIRST

Crater Community Hospice

Cedarfield Richmond | 804.474.8800 www.hermitage-cedarfield.com

Petersburg | 804.526.4300 www.cratercommunityhospice.org Crater Community Hospice (CCH) was formed 20 years ago by and for the Crater District as a nonprofit organization. In addition to hospice care we are a resource for education, guidance and support to anyone in the community with need. Through collaboration with many partners we maximize the use of all resources to improve the overall quality of life in this community.

Cedarfield exclusively offers a quiet setting on 90 private acres in Richmond’s West End, yet only minutes from Short Pump’s upscale shopping and fabulous restaurants. The expanse of the property, combined with endless amenities, gives Cedarfield the atmosphere of a resort with the spirit of an intimate community. — Cedarfield

— Crater Community Hospice

SECOND

SECOND (TIE)

Hospice Community Care

Covenant Woods

Glen Allen | 804.292.2944 THIRD

Mechanicsville | 804.569.8716 | www.covenantwoods.com

Westminister Canterbury Richmond Richmond | 804.264.6000 | www.wcrichmond.org

AseraCare Hospice Richmond | 804.282.4364 www.aseracare.com/richmond-va HONORABLE MENTION

THIRD

Brandermill Woods Midlothian | 804.744.1173 www.brandermillwoods.com

Hospice of Virginia Richmond | 804.281.0451 www.americanhospice.com/virginia

HONORABLE MENTION

Crossings at Bon Air Richmond | 804.560.1440 |www.thecrossingsatbonair.com

Heritage Oaks Richmond | 804.477.1914 |www.holidaytouch.com

Lakewood Henrico | 804.740.2900 |www.lakewoodmanor.org

Medical Equipment Provider

Memory Care

FIRST

FIRST The Memory Center Midlothian | 804.378.5100 www.thememorycenter.com

West Home Health Care, Inc. Richmond | 800.494.9378 www.whhci.com West Home Health Care, a family owned durable medical equipment business, has been serving Central and Southside Virginia since 1986. Built around customer satisfaction, it is our goal to provide the best service and home medical products available. Our experienced and friendly consultants and delivery personnel will assist you in regaining your independence and making your daily living more manageable. West Home Health Care, Inc.

Nursing Home Care

The Memory Center Richmond is uniquely designed around an innovative “town center and neighborhood’ concept for the memory impaired. The community centers around ‘main street’ and features a movie theater, library, general store, tavern, ice cream stand and salon. The philosophy is to offer residents the freedom to enjoy areas of interests and to promote stimulation, freedom and movement. The services offered emphasize quality of care with a 4-to-1 staff ratio to include the nursing team.

FIRST

The Laurels of Bon Air Richmond | 804.521.9980 www.laurelsofbonair.com At The Laurels of Bon Air, guests receive around-the-clock nursing care, nutritious and appetizing meals, and a broad variety of recreation and leisure opportunities. Our goal is for guests to achieve the highest possible level of independence and quality of life within a comfortable living environment. We refer to this as the Laurel Way of Caring. — The Laurels of Bon Air

— The Memory Center

SECOND

Clay Home Medical

The Christopher Center at Our Lady of Hope

Lucy Corr Village

Petersburg | 800.300.5888 www.clayhomemedical.com

Richmond | 804.360.1960 www.ourladyofhope.com

Chesterfield | 804.748.1511 www.lucycorrvillage.com

THIRD

THIRD (TIE)

Buford Road Pharmacy

Brookdale West End Richmond

Beth Sholom Healthcare Center

Richmond | 804.272.1423 www.bufordrx.com

Richmond | 840.214.7013 www.brookdale.com

HONORABLE MENTION

Capital Medical Supply

Chestnut Grove

Richmond | 804.353.0707 www.capitalmedicalsupply.com

Richmond | 804.262.7333 | www.chestnutgroveliving.com

Dunlop House Colonial Heights | 804.520.0050 | www.dunlophouse.com

Heritage Green Assisted Living and Memory Care Mechanicsville | 804.723.6538 www.heritagegreenhanover.com

OurHealth | The Resource for Healthy Living in Greater Richmond

Richmond | 804.750.2183 | www.bslcc.org

Our Lady of Hope Richmond | 804.360.1960 | www.ourladyofhope.com HONORABLE MENTION

Autumn Care Nursing and Rehab Mechanicsville | 804.730.0009 www.autumncorp.com

Colonial Heights Health and Rehabilitation Colonial Heights | 804.526.6851 www.care-virginia.com

co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s co ng r at ulation s

www.OurHealthRichmond.com

Palliative Care

Post-Acute Rehab Services

Rehab Inpatient

FIRST

VCU Massey Cancer Center

Parham Healthcare and Rehabilitation Center

Healthsouth Rehabilitation Hospital of Virginia

Richmond | 804.264.9185 www.parhamhealthrehab.com

Richmond | 804.288.5700 www.healthsouthrichmond.com

Richmond | 804.828.0450 www.massey.vcu.edu “As a national leader in palliative care, VCU Massey Cancer Center has worked diligently to integrate this important form of care into mainstream medicine through clinical practice, education and research. This positive feedback from our community helps fuel us to continue improving the quality of life of patients with serious illnesses in Richmond and beyond.”

“LifeWorks Rehab is an exclusive program designed to get patients home quicker, stronger and healthier than ever.” — Aaron Roop, Administrator Parham Healthcare and Rehabilitation Center

“At HealthSouth Rehabilitation Hospital of Virginia, we understand that getting your life back is your single goal. It’s our life’s work.” —David Cashwell, MHA FACHE Chief Executive Officer

— Egidio Del Fabbro, MD Palliative Care Program Director

SECOND

Bon Secours Palliative Medicine

Vibra Hospital of Richmond

Sheltering Arms Physical Rehabilitation Centers

Richmond | 804.288.COPE (2673) www.bonsecours.com

Richmond | 804.678.7000 www.vhrichmond.com

Greater Richmond Area | 804.764.1000 www.shelteringarms.com

THIRD

AseraCare Hospice

Healthsouth Rehabilitation Hospital of Virginia

Parham Healthcare and Rehabilitation Center

Richmond | 804.282.4364 www.aseracare.com/richmond-va

Richmond | 804.288.5700 www.healthsouthrichmond.com HONORABLE MENTION

HONORABLE MENTION

Glenburnie Rehabilitation and Nursing Center

Westport Rehabilitation and Nursing Center

Richmond | 804.281.3500 www.carevirginia.com

Sheltering Arms Physical Rehabilitation Centers Greater Richmond Area | 804.764.1000 www.shelteringarms.com

Richmond | 804.264.9185 www.parhamhealthrehab.com

OurHealth | The Resource for Healthy Living in Greater Richmond

Richmond | 804.288.3152 www.wetsportrehab.com

Hanover Health and Rehabilitation Center Mechanicsville | 804.559.5030 www.hanoverhealthrehab.com

Rehab Outpatient FIRST

Sheltering Arms Physical Rehabilitation Centers Greater Richmond Area | 804.764.1001 www.shelteringarms.com “Thank you to the readers of OurHealth Richmond for voting Sheltering Arms first place in outpatient rehabilitation! Our physicians, therapists, medical psychologists and rehab nurses are committed to helping patients meet their unique recovery goals, whether that involves learning to walk again, or finding relief from aches and pains.” — Mary Zweifel Interim Chief Executive Officer

SECOND

Tidewater Physical Therapy Greater Richmond Area | 804.323.7874 www.tpti.com THIRD

Bon Secours Physical Therapy Midlothian | 804.325.8822 www.bonsecoursphysicaltherapy.com HONORABLE MENTION

Lawrence Rehabilitation Specialists The Gait Center Richmond | 804.523.2653 www.gaitcenter.com

www.OurHealthRichmond.com

Skilled Nursing Care

Speech Therapy

Stroke Care

FIRST

The Laurels of Willow Creek

All About Care by Care Advantage

Midlothian | 804.379.4771 www.laurelsofwillowcreek.com

Greater Richmond Area | 800.473.0022 www.careadvantageinc.com

HCA Johnston Willis Hospital Stroke Center

The Laurels of Willow Creek is a 120-bed skilled nursing and rehabilitation center located in the heart of Midlothian, Virginia. The Laurels of Willow Creek specializes in providing short-term rehabilitation services. We enjoy the reputation of returning many of our guests to successful community living.

Thank you for voting All About Care as your therapy company! As one of the only locally owned companies left, we treat you like family. —Debbie Johnston, RN CEO and Founder

— The Laurels of Willow Creek

Richmond | 804.330.2000 www.hcavirginia.com You can rely on us for the fast response and effective treatment you need to save your brain and safeguard your quality of life during a stroke. Designed with your treatment and well-being in mind, our specialized HCA Virginia neuroscience intensive care units (NSICUs) with transitional step-down facilities set the standard in the region for quality stroke care. — HCA Johnston Willis Hospital - Stroke Center

SECOND

Brandermill Woods - The Haven

Rehab Management

Sheltering Arms Physical Rehabilitation Centers

Midlothian | 804.379.7100 www.brandermillwoods.com

Midlothian | 800.969.9265 www.rehabmanagement.com

Greater Richmond Area | 804.764.1000 www.shelteringarms.com

THIRD

Tylers Retreat at Iron Bridge

Sheltering Arms Physical Rehabilitation Centers

Healthsouth Rehabilitation Hospital of Virginia

Chester | 804.413.6508 www.saberhealth.com

Greater Richmond Area | 804.764.1000 www.shelteringarms.com

Richmond | 804.288.5700 www.healthsouthrichmond.com

HONORABLE MENTION

All About Care by Care Advantage

Hanover Health and Rehabilitation Center

Greater Richmond Area | 800.473.0022 www.careadvantageinc.com

Lexington Court Rehabilitation and Healthcare Richmond | 804.740.6174 www.lexingtoncourt.net

Parham Healthcare and Rehabilitation Center Richmond | 804.264.9185 www.parhamhealthrehab.com

OurHealth | The Resource for Healthy Living in Greater Richmond

Mechanicsville | 804.559.5030 www.hanoverhealthrehab.com

S T I B T I

words | DEIDRE

WILKE

WHAT

ND TH A HEAL N SS O FITNE O THE G

’S THE

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

DEAL W

ITH KE

You may have walked by them in the gym, and wondered ‘what

TTLEBE

LLS?

the…?’ They look like ‘cannonballs with handles’, and often come in bright colors and different sizes. You ignore them, and continue on to the more familiar looking dumbbells in shapes and sizes you are familiar with. Those crazy-looking things are kettlebells, and they can add a whole new dimension to your workout!

Believe it or not, the kettlebell was developed in Russia in the 1700s, and was used to measure grains and in downtime, show off strength among men, which started the very early development of kettlebell exercises. While there is a competitive component to the kettlebell sport (Girevoy Sport), it has more recently become popular in health and fitness centers – in weight rooms as well as group exercise classes.

WHAT MAKES TRAINING WITH KETTLEBELLS UNIQUE? •

The asymmetrical design of the weight makes it uneven and harder to handle. The core muscles (abdominals and lower back) are engaged during the exercises.

•

The idea is to complete total body, functional movements useful for everyday activities. These movements teach the body to work as one unit, improving balance and coordination, along with strength and endurance.

•

Kettlebell exercises burn more calories in less time, since multiple muscle groups are working at the same time.

Ready to give it a try? Check out these local facilities that offer kettlebell classes and training:

Richmond Kettlebell Club | 401 N. Ridge Road | Richmond | 804.741.1902

www.richmondkettlebellclub.com

Girya Garage | 2319 W. Main Street #1 | Richmond | 804.615.9987 | www.giryagarage.com www.OurHealthRichmond.com

5th Annual Westchester Shamrock 5K & Kids 1K Fun Run On a chilly but perfect running day, the 5th Annual Westchester Shamrock 5K & Kids 1K Fun Run took off through the streets of Westchester Commons. Five hundred 5K runners and over 125 1K runners participated to benefit the event’s new charity, the Bon Secours Hospice House. Over 1,200 people, many dressed in their best St. Patrick’s Day green, enjoyed the Bon Secours Health & Fitness Zone, vendor booths, green cupcakes, inflatables and the upbeat sounds of music during the event.

Did you miss it? No worries - mark your calendars now for next year’s Shamrock 5K taking place on March 18, 2017! 46

OurHealth | The Resource for Healthy Living in Greater Richmond

photos courtesy of Heaton Johnson

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breaking the silence

words | SUSAN DUBUQUE

DOMESTIC

VIOLENCE Breaking the Silence, an OurHealth special feature, explores medical and social issues that can be devastating to the individuals and families they affect. In each feature, we address topics no one wants to talk about. That is, until now. We bring these conditions into the light and dedicate the stories to the courageous patients and families living with them and the healthcare providers and researchers who commit their lives to treating and seeking solutions to these enigmatic problems. ××××× STAR’S HUSBAND SANG “EENY, MEENY, MINY, MO” AS HE AIMED THE GUN AT HER AND THEIR TWO YOUNG DAUGHTERS, ONE AFTER ANOTHER. THEN SLOWLY, SLOWLY, HE LOWERED THE GUN. This scene is real — not the stuff of made-for-TV movies. And it is only one example of the horrendous abuse Star Myles suffered at the hands of her husband for nearly 15 years, culminating in a night of terror when he knocked Star unconscious and shot her in the head. Here is Star’s story. ××××× At first, it was flattering. “He was one of the most popular boys in school, and he was interested in me. He was a senior, and I was just a freshman.” That’s how Star Myles begins her saga of years of living with fear and abuse. He was attentive and affectionate, and soon they became a couple. “I was the envy of all the other girls at school,” says Star. If only they knew the real story.

‹… Star Myles of Richmond with daughters (from left) Tamia, Briana and Jayla www.OurHealthRichmond.com

Her new boyfriend expected — demanded — that she spend every spare minute with him. Without realizing what was happening, Star gradually became cut off from her friends. No more giggling in the halls between classes or trips to the mall with her girlfriends. Within the first year of dating, his attention turned into possessiveness, and affection grew into jealousy. Star remembers several vivid examples. “One day, my boyfriend walked into my classroom at school and demanded that I come with him. I was so horrified that I picked up my books and papers and practically crawled out the door.” And it didn’t stop there. “When I was still in school, I had a part-time job at Krispy Kreme. Every day, he would sit in his car in the parking lot where he could see me while I worked. He would stay there for my entire shift.” It wasn’t long before the control and emotional abuse turned physical. “He would push me, hit me and choke me,” recalls Star. “One time he dragged me down to the James River and threatened to drown me. Star, looking forward to high school graduation.

“I was a good girl and a good student,” she says. “I always earned A’s and B’s in school. I wanted to go to college and become a registered nurse.” It’s not surprising that Star’s grades started to slip. She then became pregnant and delivered her first baby at age 17. After the birth of the baby, the abuse continued. By this time, Star was completely isolated from her friends and even her family. “It seems astonishing that I would put up with this treatment, but I was so ashamed and embarrassed. I didn’t want anyone to know how bad things were,” she says. “In 2000, when I was 18, we moved in together,” says Star. “I was determined to provide my daughter with a family — to create a home for her.” Star had a second child four years later, and five months after that she and the father of her children married. But being a father did nothing to mollify him. The abuse intensified. Now fearing for her children, Star tried to leave. “I took my two girls and went to my grandmother’s house, but my husband showed up and starting beating me right in front of my grandmother,” she says. Feeling completely helpless and without anywhere else to go, Star returned home.

Every 9 seconds

in the U.S., a woman is assaulted or beaten.

Star was a hard worker and for eight years she held a responsible job with a financial company. But her husband’s domination even extended to the workplace. “He bought me a cell phone and insisted that I stay connected with him on the phone throughout my work day.” Star was the primary breadwinner for the family. “My husband worked as a security guard, but he spent all his money on alcohol, cigarettes and going out with his friends. I wasn’t allowed to spend any money on myself. I couldn’t buy clothes for work or have my hair done, or my husband would accuse me of trying to ‘look good’ for other men.” On several instances, neighbors called the police when they heard shouting and fighting coming from the couple’s apartment. Finally, in January 2011, Star had had enough. She called the police herself. She had recently given birth to her third baby, and the final straw was when her husband tried to shove her down the stairs while she was holding the newborn. It took every bit of strength she had, but Star signed a restraining order.

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The court date was Feb. 14. “Since my husband had no record, the judge just fined him $200 and told him he had to take an anger management class. It’s amazing, but he actually got mad at the judge and stomped out of the courtroom,” says Star. Out of the blue, just a few days after Valentine’s Day, Star’s husband sent her flowers at work. That was the first and only time in all the years the couple was together that he sent her flowers.

Above Left: Star’s children from left: Briana Austin (12), Jayla Austin (6), Star and Tamia Austin (17). Above Right: Star with her two oldest daughters in 2008.

That gesture of warmth and kindness was short-lived. On Feb. 22, Star was at home studying for her state boards to become a licensed practical nurse. Through all the turmoil at home and while working a full-time job and caring for her children, Star had continued her studies. She completed all the course work and just had to sit for the exam. Soon she would be on her way, completing the first step toward her goal to eventually becoming an RN. The thought of Star advancing professionally was more than her husband could bear. He picked a fight and became even more aggravated when Star ignored his sniping and continued studying. He lashed out and spit in her face. “I tried to defend myself, and I knocked his glasses off his face,” recounts Star. “That really set him off.” As the argument escalated, Star entered her oldest daughter’s bedroom while holding her 1-year-old baby in her arms. “I thought that in the presence of the girls, my husband would get himself under control and just leave,” she says. But nothing could be further from the truth. In a fit of rage, he struck Star in the head with the butt of his gun — a .40-caliber Glock — and then shot her in the head. The baby dropped from her arms, and Star collapsed on top of her.

Caitlin Shiflett, MSW, Victim Advocate and Project Empower Coordinator for the Injury and Violence Prevention Program, VCU Health.

Star’s oldest daughter, age 11, called 911 and carefully followed the dispatcher’s instructions until the emergency squad arrived, saving her mother’s life. Star was rushed to VCU Medical Center’s trauma center, where she remained in intensive care on a ventilator for more than a week. She has endured 15 surgeries since the shooting and spent many months recovering from her massive injuries that included a traumatic brain injury, the loss of an eye and a shattered jaw. www.OurHealthRichmond.com

1 in 4

The number of women who will experience domestic violence during their lifetime.

The road to recovery has been long and arduous. Star was unable to care for herself or her children for more than a year. She stayed at her grandmother’s home, and her mother — who was unemployed at the time — became her caregiver. Star’s husband’s aunt stepped forward and cared for Star’s three daughters while she healed. It has been five years since “the incident,” as Star refers to the shooting, and the entire family has come a long way. “I genuinely believe that God saved me for a reason,” says Star. “It wasn’t my time. I still had a lot of work to do.” “First, I had to forgive my husband. There’s no time to waste dwelling on anger or hatred.” Then she arranged counseling for her children. “They experienced so much. I want to make sure they can move past this and not carry the scars throughout their lives.” Star’s husband is now serving 50 years in prison without chance of parole. Star credits Sgt. Carol Adams, a Richmond police officer, with her emotional recovery. Sgt. Adams witnessed the murder of her own mother as a teenager, and in 2014 she established the Carol Adams Foundation to provide emotional and financial support to victims of domestic violence. The foundation provides shelter and transportation to individuals trying to escape from a dangerous spouse or relationship. Star and her three daughters, now ages 6, 12 and 17, are living in a house owned by the foundation. “I have been on disability since the shooting,” says Star. “Being able to live in this home gives our family stability and has allowed me to get back on my feet financially.” According to Star, her blessings don’t stop there. A group of volunteers came to the house to build a deck. Among them was Robert Irving, the assistant commissioner of field operations for the Virginia Department of Motor Vehicles. Irving quickly recognized Star’s drive and determination, and he encouraged her to apply for a parttime position at the DMV to help ease her back into the workplace.

1 in 7

The number of men who will be victims of severe violence by an intimate partner in their lifetime.

Despite years of living in terror and being subjected to unbelievable abuse, Star maintains a positive attitude and giving spirit. “I was so filled with embarrassment and shame. And I felt trapped. Now, I am committed to helping others who are in a similar situation.” Star lives her mission by serving as a volunteer with VCU Medical Center’s chapter of the Trauma Survivors Network. “When a patient who has suffered a violent injury comes into the hospital, I go visit them. I let them know that they are not alone and that there is help out there. I want to help others find the strength and courage to escape from violent relationships.” When it comes to strength and courage, there is little doubt that Star Myles has plenty to share. ××××× It’s time to stop whispering about domestic violence. Let’s have a frank and open conversation about this issue — exploring the prevalence, warning signs and resources available to help those in need. If you think domestic violence rarely occurs, think again. If you see domestic violence as physical injury, take a closer look. If you believe domestic violence could never happen in your neighborhood, check the facts. Domestic violence — also called intimate partner violence — is a repetitive pattern of behaviors to maintain power and control over a spouse or romantic partner. The behaviors can include physical, verbal, emotional or psychological abuse; sexual violence; threats; intimidation or economic deprivation. Domestic violence can

OurHealth | The Resource for Healthy Living in Greater Richmond

18.5 million

The number mental health visits every year are due to intimate partner violence.

More than 3 women are murdered

by their husbands or intimate partners every day in the U.S.

happen to anyone regardless of age, race, sexual orientation, religion, education or income level. It can occur with couples that are married, living together or dating. Both men and women can be victims, and both can be abusers. The statistics are staggering. Nearly 48 million women in the U.S. experience physical violence by an intimate partner every year. Fortunately, our community has an abundance of support services. Bonnie Price, director of forensic nursing, leads a team of 10 forensic nurses who provide 24/7 coverage at all Bon Secours Richmond hospitals. “Our team is trained to intervene in cases of domestic, sexual, child or elder abuse, as well as human trafficking,” says Price. “Our team serves 23 counties and cities across Central Virginia. “Our referrals come from a variety of sources,” Price notes. “We may receive a call from the police or EMS squad telling us that a suspected victim of abuse is on the way to the hospital. The emergency department or inpatient staff may alert us. And sometimes the patient may ask for help directly.” The signs of abuse can be subtle or overt. “But there are some indicators that alert our team to go into action,” says Price. Here are a few: • The injury doesn’t match the story, such as a black eye that is supposedly caused by “running into the door.” • The partner does the talking for the patient and is unwilling to leave the patient alone with the healthcare professional. • The patient has injuries in various stages of healing. • The patient has a history of suspicious injuries. “Sometimes the bruises and injuries are on parts of the body that don’t readily show — we call this the ‘bathing suit area,’ ” says Price. And not all abuse is physical. “Domestic violence is about control. That may be controlling the money or limiting where the victim goes and who the victim is ‘permitted’ to associate with. Sometimes just threatening physical harm — or worse yet, threatening to harm the children — is enough to maintain control over the victim.” The forensic nurses, working in tandem with a member of the Regional Hospital Accompaniment Response Team, visit identified patients. RHART is a collaboration of organizations including Bon Secours Richmond Health System, VCU Medical Center, YWCA of Richmond, Safe Harbor, Hanover Safe Place and other domestic violence and rape crisis programs from throughout the area. During this initial visit, the nurse

Bonnie Price, DNP, RN, SANE-A, SANE-P, AFN-BC, Director, Forensic Nurse Program, Bon Secours Richmond.

$$$

The cost of intimate partner violence in the U.S. exceeds

$5.8 billion per year nearly $4.1 billion in direct medical expenses and

$1.8 billion

in lost productivity.

www.OurHealthRichmond.com

Up to 10

million children

are exposed to domestic abuse in their homes every year.

and RHART volunteer conduct a “danger assessment” to evaluate the frequency and severity of the abuse and whether the pattern of abuse is escalating. Other factors considered are if there is a presence of alcohol and drugs, if the perpetrator has ever threatened to kill the victim and if there is a weapon in the home. This care team offers support, information and guidance. “If the patient is willing to report the assault to the police or initiate an order of protection, we will guide them through that process,” says Price. “If the individual is ready to leave the violent situation, we will connect them with vital resources in the community.”

But why do they stay? “If you live in a safe and relatively happy home, you may be quick to judge and wonder why individuals living in dangerous and threatening environments just don’t leave,” says Caitlin Shiflett, victim advocate for VCU Medical Center. “There are many reasons why someone would remain in a frightening and abusive relationship, but perhaps the most pervasive is fear.” Abusers might repeatedly threaten to hurt the victim, their children, a pet, friend, family member or even themselves if the partner leaves. “Emotions other than fear can serve as powerful barriers to leaving,” adds Shiflett. “An abuser may call the victim names, put them down and play mind games. As a result, the victim may have low self-esteem and at some level even feel to blame or that they deserve the mistreatment. They may also feel ashamed of their situation and embarrassed to ask for help.” Financial control is a very real part of an abusive pattern. Victims might be dependent on their abusers for financial support and worry about taking care of themselves and their children on their own. Victims might also feel compelled to stay with an abusive partner for the sake of their children. “A victim may not want to break up the family, or perhaps they fear that the partner will take the children away or hurt the children if he or she is not there to protect them,” says Shiflett. Sometimes friends and family are not supportive of a victim leaving. “They may not understand or believe the seriousness of the situation,” observes Shiflett. “They may feel angry that the victim has left before and gone back. Or they may fear for their own safety if the victim comes to stay with them.” Sadly, lack of knowledge of where to turn could be the most common reason why victims remain. “Abusers are likely to cut off their partner from family and friends in an effort to exert more control. The victim might feel that there is no one to turn to and nowhere to go,” says Shiflett. “They may not be aware of the many resources available in the community to help abuse victims escape.”

21 percent of female victims AND 6 percent of male victims disclose abuse to a medical professional at some point in their lifetimes.

ONLY

OurHealth | The Resource for Healthy Living in Greater Richmond

Women are at greatest risk when attempting to break free from an abusive relationship, and they might make repeated attempts before successfully escaping. “At this point, the abuser is losing control and may become irrational,” says Bonnie Price. “It is imperative that the victim have a plan to leave safely, such as identifying a place to go, assembling important papers and stashing away a little money. We work with the regional hotline to help locate shelter beds, arrange transportation and assist the victim in successfully separating from a dangerous home and relationship.”

Breaking the cycle of domestic violence The effects of domestic violence are deep, far-reaching and long-term. Research clearly indicates that children who live in a home marked by domestic violence are far more likely to become abusers or victims of abusers themselves as adults. The Centers for Disease Control and Prevention conducted the Adverse Childhood Experiences Study — one of the largest investigations ever carried out to assess associations between childhood maltreatment and later-life health and well-being. The study findings revealed that children who personally experience or witness violence are at far greater risk for suffering from a variety of mental health problems, drug and alcohol abuse and chronic diseases, including heart disease, diabetes, cancer and the like. “Most people perceive intimate partner violence as a relationship issue between two people. In fact, it is a public health issue affecting all society,” says Kellie Carlyle, PhD, an associate professor in VCU’s Department of Health Behavior and Policy. “Laws can offer some protection, but what is really needed to break the cycle is a fundamental shift in values and in how we talk about sex and violence. We must all be mindful of how we talk about relationships, especially to children. A common example is to not teach a little girl that a boy hitting her

Recognize the signs of domestic violence Domestic violence can take many forms, and the abuse can be physical, emotional, sexual, psychological or economic. The first step in helping a friend or family member in trouble is to recognize what domestic violence looks like. Not all the signs will be present in every abusive relationship, but if you notice a pattern of behaviors, there could be a problem. People who abuse their partners might hh Blame others for problems or feelings.

hh Downplay or deny their partner’s feelings or concerns.

hh Criticize or put down their partner, especially in front of others.

hh Blow up over things that seem minor.

hh Be very jealous.

hh Use verbal abuse such as namecalling, cursing or yelling. Use nonverbal threats such as “the look.” hh Control all the money in the relationship.

People who are being abused might

hh Have injuries and give explanations that don’t make sense.

hh Wear inappropriate clothing to hide bruises and scars (e.g., long sleeves in summer). hh Not be allowed to visit with friends or family. hh Not have access to car keys.

hh Rarely be seen in public without their partner.

hh Abuse alcohol or drugs. hh Break objects. hh Abuse pets.

hh Use physical violence, such as hitting, shoving and choking. hh Force or demand sex.

hh Often “check in” with their partner.

hh Go along with anything their partner says or does. hh Be afraid of their partner’s temper. hh Abuse alcohol or drugs.

hh Have low self-esteem, even if he or she was once a very confident person. hh Be depressed or suicidal.

hh Frequently be absent from work, school or social events.

Source: Virginia Department of Social Services Office of Family Violence

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means he likes her. The accumulation of these messages creates a context that allows intimate partner violence to happen and aggression in intimate relationships to be normalized.” Here are some additional keys to social change when it comes to preventing intimate partner violence: • Education. Learning about healthy relationships must begin early. One positive example is a program sponsored by the CDC called Dating Matters — a comprehensive teen dating violence prevention initiative that focuses on 11- to 14-year-olds in high-risk urban communities. The program includes preventive strategies for individuals, peers, families, schools and neighborhoods. Kellie Carlyle, PhD, MPH, Associate Professor, Department of Health Behavior and Policy and Affiliate Faculty, Institute for Women’s Health, VCU Health School of Medicine

• Know the signs. Abusers and victims of domestic violence can go to great lengths to cover up their dysfunctional and dangerous relationships. To further complicate matters, every relationship is unique. But there are common signs that can indicate an unhealthy and potentially abusive relationship. • Speak out. “You don’t have to be a healthcare professional to ask a relative, friend or co-worker if they feel respected in their relationship,” says Dr. Carlyle. “That simple question opens the door to conversation. It lets the individual know that they deserve to feel respected and that someone is concerned about them. Don’t worry — it isn’t your responsibility to know how to solve the problem if an abusive relationship is disclosed. Just look the other person in the eyes, let them know that they are worth something and guide them to a hotline.” • Get involved. Our community has many wonderful programs that support abuse victims, enabling them to break free and regain control of their lives. Reach out and get involved. Learn what you can do to break the cycle of domestic violence. It’s everyone’s problem, and we can all play a role in the solution.

Expert Contributors • Kellie Carlyle, PhD, MPH, Associate Professor, Department of Health Behavior and Policy and Affiliate Faculty, Institute for Women’s Health, VCU Health School of Medicine • Bonnie Price, DNP, RN, SANE-A, SANE-P, AFN-BC, Director, Forensic Nurse Program, Bon Secours Richmond • Caitlin Shiflett, MSW, Victim Advocate and Project Empower Coordinator for the Injury and Violence Prevention Program, VCU Health

MEN who as children witnessed their parents’ domestic violence are

2 times as likely to abuse their own partners as men raised in nonviolent homes. 56

OurHealth | The Resource for Healthy Living in Greater Richmond

Women who are victims of domestic violence are

8 times more likely to be killed by their partners if there is a firearm in the home.

Resources • Carol Adams Foundation www.thecaroladamsfoundation.org | 804.218.2866 • Hanover Safe Place www.hanoversafeplace.com | 629 N Washington Hwy | Ashland, VA 804.752.2702 • The James House www.thejameshouse.org | 6610 Commons Drive, Suite C | Prince George, VA 804.458.2840 (24/7 crisis line) • LGBTQ Partner Abuse and Sexual Assault Helpline 866.356.6998 (available Monday-Friday, 8 a.m.-8 p.m.; 24/7 after July 1) • National Domestic Violence Hotline www.ndvh.org | 800.799.SAFE (7233) or 800.787.3224 TTY (24-hour hotline) • Safe Harbor www.safeharborshelter.com | 2006 Bremo Road, #201 | Richmond, VA 804.249.9470 • Virginia Domestic and Sexual Violence Action Alliance www.vsdvalliance.org | 5008 Monument Ave. | Richmond, VA 804.377.0335 • Virginia Family Violence & Sexual Assault Hotline 800.838.8238 (24-hour hotline) • Virginia Home for Boys and Girls www.vhbg.org

70 times more likely to be murdered A woman is

in the few weeks after leaving her abusive partner than at any other time in the relationship.

• Therapeutic Resources 804.270.6566, ext. 159 | (available 8:30 a.m. - 4:30 p.m.) • YWCA of Richmond www.ywcarichmond.org | 6 N 5th St, Richmond, VA 23219 | 804.612.6126 (Greater Richmond Regional Hotline)

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