OurHealth Roanoke & New River Valleys Apr/May 2013 Edition

CANCER CARE IN THE REGION

SPOTLIGHT ON: LIFEWORKS REHAB ®

Special Pullout!

MEDICAL DESIGNATION RESOURCE GUIDE

APRIL • MAY 2013 | SOUTHWEST VIRGINIA EDITION | OURHEALTHVIRGINIA.COM

CLINICAL TRIALS CORNER

table of contents |april • may 2013 MEDI•CABU•LARY.....................12

53

Local experts define healthcare related terms

JUST ASK!..................................14 A variety of health questions answered by local professionals

BLOOD SERVICES

THE LATEST...............................16 A listing of new physicians, providers, locations and upcoming events in greater Southwest Virginia

HEALTH AND FITNESS ON THE GO..................................21 Health-focused apps you can download to your smartphone or tablet.

ALLERGIES.................................25 Misconceptions about allergies

Baby can you spare a pint?

SPOTLIGHT ON REHAB: LIFEWORKS REHAB®.................39 Getting back to life

PHYSICAL THERAPY..................43 Physical therapy increasingly common for patients looking for pain relief

HEALTHY MILESTONES.............47

28

CELEBRATING THE HEALTHCARE WORKER

Embracing lessons

MEDICAL DESIGNATION............50 Summary of common medical profession titles SPECIAL PULLOUT! Medical designation resource guide

LOW VISION OPTOMETRY..........59 On the road again

CLINICAL TRIALS CORNER.......63 Global medical research innovations—close to home Cancer open trials

CANCER CARE............................71 Cancer: a regional outlook

NUTRITIONAL HEALTH..............76 Understanding nutritional values in foods

SENIOR LIVING...........................81 Green Ridge aquatic therapy

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

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

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our health | MEDI•CABU•LARY & JUST ASK

me d i • ca bu • l ar y

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

Are advanced medical directives and living wills the same thing?

Yes and no. Typically, in Virginia, an Advance Medical Directive contains a health care power of attorney and a living will. The health care power of attorney lists who will make your medical decisions if you are unable to make them. A living will is a declaration of your desires should you have a terminal condition and not be able to communicate your health care desires to your health care provider. So a living will does not contain a health care power of attorney, but an Advance Medical Directive contains both.

Ann Green, Esq Anderson, Desimone & Green, PC Roanoke | 540.776.6434

What are adenoids?

What is the Synergy S System?

What is elevated vacuum?

Adenoids are pharyngeal tonsils.

Most people know about the palatine tonsils because they can be easily seen in the back of the mouth and are the source of tonsillitis. The adenoids are situated at the junction of the nose and throat in an area known as the nasopharynx. This area is also where the middle ear connects to the throat through the Eustachian Tube. The adenoids are part of the immune system and respond to infections. The adenoids can also become enlarged and infected and contribute to ear infections, Eustachian Tube dysfunction, sinus infections, allergy, nasal obstruction, and sleep apnea. The tissue can be safely removed relieving many of these problems.

Synergy S is a very effective cancer-fighting tool. It can treat tumors as small as the tip of a pencil eraser and works well in confined areas where it’s necessary to deliver the highest dose of radiation to the tumor while reducing the dose to surrounding healthy tissue. With its 3D image guidance system, it can take into account organ motion and patient movement to ensure precise targeting of the tumor.

We can also use it for stereotactic radio-surgery for inoperable tumors – where the radiation beam operates like a scalpel. In certain situations, Synergy S can reduce the number of treatments for the patient and eliminate the need for more invasive procedures.

Elevated vacuum is a term that describes a particular style suspension utilized in transtibial (below the knee) and transfemoral (above the knee) prosthetic sockets. An electric or mechanical pump is attached to the socket and provides a constant, monitored suction. This action pulls the liner and the patient’s residual limb towards the inner socket walls.

Excessive motion is reduced thus preventing friction and shear forces from occurring. Circulation is improved which provides a healthier residuum. A silicone liner interface with a sleeve suspension is used in conjunction with the pump to complete the elevated vacuum system.

Paul Lenkowski, MD Jefferson Surgical Clinic Roanoke | 540.283.6000

John Rogers, MD Radiation Oncologist Blue Ridge Cancer Care at LewisGale Regional Cancer Center.

Salem | 540.776.4160

This system has worked well with many patients and it allows for the option of a brimless design socket for transfemoral amputees.

Brimless, meaning shorter trimlines, is to avoid pressure in the peroneal (groin) area, as well as allowing for better range of motion at the hip. All these factors that increase comfort for the amputee will allow the amputee to wear their leg longer and ultimately be more functional.

Richard Ruble, CPO Excel Prosthetics and Orthotics Lynchburg | 434.528.3695

12 | www.ourhealthvirginia.com

our health | MEDI•CABU•LARY & JUST ASK

ju st a sk!

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

Why is it important to maintain a routine schedule when caring for patients suffering from Alzheimer’s and dementia?

Establishing and maintaining a routine is especially important for people suffering from Alzheimer’s and dementia. A familiar pattern helps with the order of each day.

Because the disease affects shortterm memory, making a connection to past routines can also be helpful and calming. For example, if dinner was always at 5:00 at the kitchen table moving meals to the couch at 7:00 may feel out of place and cause problems. Another example is dressing. Clothes should be laid out in the order they go on. Creating a routine of dressing in the same order every day decreases the decisions that need to be made by the confused person. Order and routine can lead to a more peaceful interaction between the individual and his/her caregiver(s).

Heather Gearhart Director of Health and Wellness Services Warm Hearth Village Blacksburg | 540.552.9176

14 | www.ourhealthvirginia.com

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

Home medical equipment companies rent or sell durable medical equipment and require a physician’s prescription in two different scenarios. One, if the equipment or supply bears a “Federal Legend” it must be dispensed only with a physician’s prescription. Two, if Medicare or private insurance covers the item and the patient wants the item billed to their insurance plan, then a physician prescription is required.

Unless the item falls within these two scenarios, the item may be sold or rented without a physician’s prescription.

Melissa Cranwell Vice President Sun Medical Ltd. | 540.389.3800

How does thyroid hormone affect metabolism?

What are some non-surgical treatments for snoring?

Thyroid hormone, also called thyroxin, helps to closely regulate our body’s metabolism. I like to think of it as “controlling our body’s furnace,” as it influences all the chemical reactions that produce energy for our cells and tissues.

While having too much or too little thyroid hormone can negatively affect one’s health, present recommendations disagree as to whether screening someone who has no symptoms is useful. If one is concerned that their thyroid may not be functioning properly, it would be best to discuss this with their primary care physician.

Loud, disruptive snoring should be evaluated by your Doctor to rule out sleep disorders such as Obstructive Sleep Apnea. Nonsurgical ways to reduce snoring are sleeping on your side, weight loss, avoiding alcohol consumption or use of sedating medications, and using oral appliances that shift the jaw forward allowing more space in the airway. Nasal sprays, decongestants, and nose strips can reduce nasal congestion and eliminate snores caused by it. If these methods are ineffective, you may be able to use Continuous Positive Airway Pressure or CPAP, a non-surgical treatment for OSA as well as disrupted sleep due to loud, chronic snoring. CPAP is available by prescription for patients who qualify after an overnight sleep study.

Mark Greenawald, MD Carilion Clinic Family and Community Medicine Roanoke | 540.562.5700

Tina Clements, RST Sleep EZ Diagnostic Center Salem | 540.375.7735

THE LATEST | our health

the l atest

N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S

Richard Ruble, CPO has been named Branch Manager at Excel Prosthetics & Orthotics in Lynchburg.

Elizabeth Armstrong, FNP-C Family Medicine LewisGale Physicians 540.862.6357 | Low Moor

Paul Olson, MD Internal Medicine LewisGale Physicians 540.921.4343 | Pembroke

Pamela Olson, FNP Internal Medicine LewisGale Physicians 540.921.4343 | Pembroke

With rise of teen traffic deaths, new technology aims to end hand-held cell phones while driving ORIGO™ makes driving safer by preventing motorists from starting vehicles until phone is in docking station – curbing a deadly habit With a rise in teen-age driving fatalities and distracted driving continuing to be the leading killer on U.S. roads, a Roanoke company introduces a technology that can end hand-held cell phone use while driving, addressing a leading national public safety problem.

ORIGOSafe™ is a new ignition interlock system that requires drivers to secure their phone in a docking station before their vehicle can start. This prevents motorists from holding their phones to talk or text while behind the wheel.

“April is Distracted Driving Month and yet no matter how much people talk about the dangers of hand-held texting, especially among teens, driving isn’t getting any safer,” said Clay Skelton, ORIGO’s founder. “By taking the phone out of the driver’s hands – but not preventing making and receiving calls – ORIGO™ can reduce accidents, increase safety and improve the performance of drivers, particularly young drivers. It takes away the temptation to reach for the phone while driving.”

The statistics tell of a tragic problem: • Texting while driving causes 11 teen deaths every day, according to the Insurance Institute for Highway Safety.

• Motor vehicle crashes are the leading cause of death among teens in the United States, accounting for more than one in three deaths in this age group, according to the Centers for Disease Control and Prevention.

• 97 percent of teens surveyed by AT&T say texting while driving is highly dangerous, yet 75 percent of them say it’s common among their peers.

And it’s not just a young driver problem: • 100,000 crashes per year involve drivers who are texting, according to the National Safety Council.

• Texting takes drivers’ eyes off the road for an average of 4.6 seconds, according to the Virginia Tech Transportation Institute. At 55 mph, this is the same as driving the length of a football field blind-folded.

A study conducted by the Virginia Tech Transportation Institute found that “Talking or listening on a cell phone … did not statistically increase crash risk. Dialing, reaching, and other intensive visual-manual cell phone sub-

tasks did.” That’s why ORIGO™ allows drivers to stay connected hands-free through Bluetooth and other technologies, yet takes the phone completely out of the driver’s hands.

ORIGOSafe™ is easily installed in any type of vehicle, and is a fully integrated device that supports the top-selling smart phone models.

There’s no software to buy or maintain, and no need to wonder if it’s working. With ORIGOSafe™, parents are reassured knowing that their child is connected hands-free while behind the wheel.

Because the vehicle won’t start without an authorized phone in place, ORIGOSafe™ serves as an ideal theft deterrent. The ORIGOSafe™ also charges the phone while in the docking station, ensuring that the phone is always ready to be used when needed.

“ORIGOSafe™ was developed to give parents peace of mind, knowing that their loved ones are safe and focused while driving, and aren’t a danger to themselves or others while on the road,” Skelton said. “It’s clear that the concern for safety isn’t enough to stop such dangerous driving behavior.

There has to be an outside force to incite change.”

ORIGOSafe™ is available for purchase through the website www.DriveOrigo.com.

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our health | THE LATEST

the l atest

N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S

Capital Development Group and Elizabeth Medical Park, LLC announce the development of Salem’s first exclusive medical office condo park, Elizabeth Professional Park Building.

The single story condo park will feature over 35,000 square feet of medical office space. The medical condo park will be located on Knotbreak Road in East Salem off Texas Street. Medical space is available for purchase in a fee simple interest. For more information on the development, contact Dan Friesland 540.293.3496 or dfriesland@acspartners.us

Warm Hearth Village Celebrates Grand Opening of Village Center Residents at Warm Hearth Village celebrated the Grand Opening of the new 16,300 square foot Village Center that will promote the arts and the art of healthy aging for seniors in the New River Valley. More than three hundred guests from throughout the New River Valley attended the celebration that featured music, refreshments, a ribbon cutting and an allaccess tour of the new building.

Residents of the Village have begun to filter into the Fitness Center for their orientation to the new swimming pool, cardio/strength training room and exercise studio. Penny Poehlmann was first to try out the new saltwater pool and says she’s looking forward to using the center which is a short walk from her home in WoodsEdge.

A variety of events are underway in the new building that include the VT CLASS continuing education for seniors through Virginia Tech, “Just Desserts,” a theatrical performance featuring cast from New River Stage and educational events for the community including a forum for families in partnership with The Alzheimer’s Association of Central and Southwest Virginia.

Warm Hearth is a non-profit senior living community that provides a full continuum of living options from active adult living to long-term nursing care in Blacksburg.

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THE LATEST | our health

LewisGale Medical Center Names Frist Humanitarian Award Winners LewisGale Medical Center provides patients with the highest levels of quality, compassionate care because of the dedicated and experienced medical professionals, employees and volunteers at the hospital. Recently, LewisGale recognized three of them with the 2012 Frist Humanitarian Awards – the highest honor one can receive at an HCA facility, the parent company for LewisGale Regional Health System.

The hospital presented Dr. Lucien Brailsford with the 2012 Frist Humanitarian Volunteer Award, Dr. Robert Williams with the 2012 Frist Humanitarian Physician Award, and Becky Asher with the 2012 Frist Humanitarian Employee Award.

“Our nominees’ compassion and energy, and the depth of their commitment, are inspiring,” said Victor E. Giovanetti, F.A.C.H.E., President, LewisGale Regional Health System. “It gives me great pleasure to nominate each of these award winners for the National HCA Frist Humanitarian Awards.”

The Frist Humanitarian Awards are named annually at HCA-affiliated hospitals to an employee, volunteer, and physician who demonstrate extraordinary concern for the welfare and happiness of patients and their communities. The winners from each hospital also have an opportunity to win the national Frist Humanitarian Award.

Dr. Brailsford dedicated his life to caring for others as a cardiothoracic surgeon. Upon his retirement in 2007, that dedication didn’t stop, rather it grew even stronger. For more than five years now, Dr. Brailsford has continued to give back to LewisGale Medical Center and to his community by serving as a volunteer at the hospital, as well as at other organizations in the Roanoke Valley, including the Rescue Mission’s medical clinic. The seminary also figures largely in Dr. Brailsford’s volunteer activities.

Both inside and outside the hospital, Dr. Williams is a tireless warrior in the fight against cancer, raising the term “patient advocate” to a new level. For more than 20 years, he’s treated LewisGale’s patients as his family, and at the same time, treated the patient, not just their disease. Dr. Williams’ commitment to improving other’s lives and health extends far beyond

Photo: (left to right) Victor Giovanetti, Becky Asher, Lucien Brailsford, MD, and Robert Williams, MD.

the hospital. In addition to the LewisGale committees on which he serves, Dr. Williams is a community leader. His efforts have been recognized locally and regionally by numerous publications and with countless commendations and citations.

For more than a decade, Becky Asher has served LewisGale Medical Center and her community, always putting others’ needs first and earning her peers’ respect as a hard worker, mentor and friend. As the Department Manager of the Pharmacy, she makes a lasting and important impact on countless patients’ lives and their outcomes. She’s served as team captain and co-chair for the Roanoke Chapter of Relay for Life, volunteered with the Bradley Free Clinic, and helped raise funds for brain cancer research by participating in the Race for Hope in Washington, D.C., three years in a row.

At the same time, she is one of the founding members of the Parrotheads of the Blue Ridge, Inc., – an organization through which she has helped many local charities by raising more than $30,000 last year alone.

“At LewisGale Medical Center and in their communities, these three award winners continue to make the world a better place, and we commend them both for their efforts and for their results,” Victor Giovanetti added.

Hospital Offers New Service to Help Patients with Substance Abuse Withdrawal LewisGale Hospital Alleghany, in partnership with SpecialCare Hospital Management Corporation, is pleased to introduce New Vision™, an inpatient medical stabilization service designed to help adults safely withdraw from drugs and/or alcohol.

The service is targeted to patients who are experiencing incapacitation due to substance use or abuse, or are experiencing acute withdrawal symptoms and other related health issues. Patients who are under the influence of chemical substances, and are considered medically unstable, will be closely observed and stabilized.

“We believe this service will give patients the medical help they need to begin to break the cycle of addiction in a safe and effective manner,” said Greg Madsen, CEO, LewisGale Hospital Alleghany. “With this service now available in our community more families will get the support they need when they need it most.”

The New Vision™ service utilizes a multi-disciplinary team approach in the individualized treatment of each patient. The inpatient stay typically lasts between three to five days and includes the following aspects: • • • •

Pre-Screening Assessment Admission Medical Stabilization

• Appropriate Discharge Planning New Vision™ Service at LewisGale Hospital Alleghany is accepting patients now. The service accepts most insurance, Medicaid and Medicare plans.

For additional information, please call 800.939.2273 or 540.862.6770.

www.ourhealthvirginia.com | 19

our health | THE LATEST

The Rehab Center at Richfield Now Open Short-term physical rehabilitation with quality patientcentered care and amenities in a new state-of-the art setting.

The Rehab Center at Richfield officially opened for patients and guests on March 10, 2013. The newly renovated facility was created out of an existing building on the Richfield campus.

Now, The Rehab Center at Richfield features 48 guest rooms in a stand-alone facility adjacent to Richfield Recovery & Care Center. It was developed to offer a different model for people with short-term rehabilitation needs following a hospital stay.

The new, comprehensive Rehab Center at Richfield brings an innovative level of capabilities and comfort to the Roanoke, Salem, and New River Valley communities with a focus on serving individuals in need of post-acute, short-term physical rehabilitation following joint replacement, illness, or injury. In addition to innovative rehabilitation programs, guests will also have a comfortable private room with a full bath for overnight stays, and amenities such as free Wi-Fi, a flat screen TV, madeto-order meals, and even concierge services—if a guest forgets a toothbrush or needs to have an errand run.

Photo: From left to right is Pete Larkin (Chief of Staff for Congressman Bob Goodlatte), Joseph “Butch” Church (Roanoke County Board of Supervisors Catawba Magisterial District), Ray Fisher (Richfield Chief Executive Officer), Stewart Bruce (Chairman of the Richfield Board of Directors), Charlotte A. Moore (Vice Chairman - Roanoke County Board of Supervisors), Angie Hall (Field Representative for Congressman Morgan Griffith), Mayor Byron “Randy” Foley (City of Salem Mayor).

“Our objective is to provide unparalleled therapy protocols, technology and amenities to our patients and to ensure their recovery is successful, complete, and enjoyable,” said Ray Fisher, Richfield’s CEO. “The Rehab Center will provide the highest quality recovery experience in the Mid-Atlantic region, fulfilling our commitment to provide optimal outcomes for our patients and their families.”

Prior to a patient’s scheduled surgery, The Rehab Center will arrange a tour of the facility where patients will have the opportunity to meet the therapists, nurses, and support staff to gain an understanding of what to expect during their stay. Accommodations can be reserved and paperwork can be completed at this time. It can ease a patient’s anxiety over surgery to know that his or her therapy will take place in a comfortable environment, with the latest physical/ occupational/speech therapy techniques designed to get patients back to a normal lifestyle quickly.

Richfield also offers an outpatient therapy program at The Rehab Center which will allow patients who are discharged from The Rehab Center to continue working with their existing therapist—someone who knows the patient and his/her progress well.

Approximately 700 residents call Richfield Retirement Community their home. Richfield employs approximately 550 individuals. For more information about Richfield, visit www.richfieldretirement.com.

20 | www.ourhealthvirginia.com

HEALTH AND FITNESS ON THE GO | our health

Health and Fitness

On the Go

Ready to jump-start your fitness routine or find out if it may be time to get your hearing tested? In our new Health and Fitness on the Go section, we recommend a variety of health-focused apps you can download to your smartphone or tablet.

Couch-to-5k® from Active.com Follow this easy and fun training plan for beginning runners. Get off the couch and run a 5k in just 30 minutes a day, three days a week for nine weeks!

This app features loads of training tools to help you stay on track: »» Track your route, distance and pace with GPS »» Access your own music playlist in-app »» Take advantage of your own “trainer” as they coach you through each workout »» Log your workouts in a journal »» Track your progress online »» Get support from the Couch-to-5k® community »» $1.99 for iPhone | $2.99 for Android

Android

iPhone

First Aid App by American Red Cross The official American Red Cross First Aid app puts expert advice for everyday emergencies in your hand. This First Aid app gives you instant access to the information you need to know to handle the most common first aid emergencies. With videos, interactive quizzes and simple step-by-step advice it’s never been easier to know first aid.

This app features: »» Simple step-by-step instructions guide you through everyday first aid scenarios »» Fully integrated with 911 so you can call EMS from the app at any time. »» Videos and animations make learning first aid fun and easy. »» Safety tips for everything, from severe winter weather to hurricanes, earthquakes and tornadoes help you prepare for emergencies. »» Preloaded content means you have instant access to all safety information at anytime, even without reception or an Internet connection. »» Interactive quizzes allow you to earn badges that you can share with your friends and show off your lifesaving knowledge. »» Free for iPhone and Android

Android

iPhone

www.ourhealthvirginia.com | 21

our health | HEALTH AND FITNESS ON THE GO

uHear uHear is a hearing loss screening test which allows you to test your hearing to determine if it is within normal range, or if you have a potential hearing loss.

It is a free, self-administered hearing test, along with tips and resources for preventing hearing loss. uHear lets you assess your hearing on any one or all three of these tests: »» Hearing Sensitivity is used to determine the quietest sounds you can hear »» Speech in Noise is a measurement of your ability to understand speech in the presence of noise »» Questionnaire is a series of twelve questions regarding your performance in common listening situations. »» Plus uHear can also help you locate a hearing healthcare provider in your area.

After each test, you get your results along with helpful context and recommendations-and for the Hearing Sensitivity test, you also see results mapped out on a graph, showing performance charted across different levels of pitch for each ear. It’s a quick (and even kind of fun) way to see how well you hear.

If you do suspect a hearing loss, please seek the advice of a professional. uHear was designed by Donald Hayes, Ph.D. Director of Audiology for Unitron Hearing. »» Cost: Free »» Device: iPhone (currently not available for Android)

22 | www.ourhealthrvirginia.com

iPhone

HEALTH AND FITNESS ON THE GO | our health

My Chart for Carilion Clinic My Chart is a new personal, online medical record app offered by Carilion Clinic. With this connection to your doctor’s office, you can: »» »» »» »»

Communicate with your doctor Access your test results Request prescription renewals View your recent clinic visits

You must first create an account through your healthcare provider in order to access your information through MyChart. If your healthcare provider is not listed, or if you require support accessing your existing account, contact them directly about accessing your account through the MyChart app. »» Cost: Free »» Device: Android and iPhone

Android

SHARE YOUR FAVORITE HEALTH AND FITNESS APP!

iPhone

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

www.ourhealthvirginia.com | 23

ALLERGIES | our health

MISCONCEPTIONS ABOUT ALLERGIES words | EDWIN SCHWARTZ and STEVE McCLINTIC JR

Do I have allergies or do I have a cold or flu?

Spring allergy season is here and with it comes some confusion. Part of the uncertainty lies in whether one is suffering from allergies or has caught a cold. Both allergies and colds share common symptoms of nasal congestion, sneezing and fatigue.

Our Health spoke to local allergy experts to provide insight for our communities.

Fever points toward an infection, which indicates some sort of common cold or flu.

Symptoms like itching in the nose, ears and eyes can point toward allergies. Also, symptoms lasting more than two weeks are most likely caused by allergies. With colds and flu, people usually start to feel better after a two-week period as the body’s defenses have fought it off. An additional factor to consider is if you were around anyone with a cold. This is because colds are contagious and allergies are not.

If pollen is on your car and you begin to itch, sneeze or get watery eyes, does this more than likely point to some sort of seasonal allergy?

If this is something you’re concerned about, even in the non-pollen months, you can take an over-the-counter (OTC) antihistamine. Zyrtec, Claritin and Allegra are all medications that work pretty fast. If you take one, and in a couple of hours you feel better, this may be a sign you suffer from an allergy and not a cold. If you don’t feel better, you could have a cold or severe allergy.

Are people who have allergies more sensitive to getting the flu?

People with any sort of respiratory disease, such as asthma, have a higher chance of developing more severe symptoms after contracting the flu. www.ourhealthvirginia.com | 25

our health | ALLERGIES

Celebrating the Healthcare Worker...

Being a nurse, means being an advocate! I get to fight everyday for what my patents are all deserving of-respect, dignity and a sense of being understood!

Lydia Border, RN Good Samaritan Hospice

Regarding treatment of an allergic disease, there are three categories to consider – avoidance, medication and immunotherapy. What do these mean?

With avoidance, you stay away from what you’re allergic to. Determining this may require some testing. If you know what you are allergic to, you know what to avoid.

Concerning medications, there are many options with several kinds of prescription nasal sprays and OTC pills. Learning the very best combination takes time with trial and error while also accounting for your preference.

The third treatment – immunotherapy – usually requires allergy shots. This involves taking the actual allergen – such as animal dander, mold or dust mites – sterilizing it and slowly increasing the amount a person receives. As the therapy continues, the body builds up a natural immunity to the allergen so the individual stops having allergic reactions. The advantages are two-fold, because it is the most effective treatment for decreasing symptoms and offers the greatest potential for cure.

Can allergies be treated with natural remedies?

When the National Institute of Health investigated natural therapies as a means of treating allergic disease, it found many claims by manufacturers but very little data to back them up. Perhaps they do and perhaps they don’t. Just because something is natural doesn’t mean it’s necessarily good for you. After all, poison ivy is natural.

If you feel you are experiencing any allergens, it’s really important to talk with your trusted medical provider to see if there’s any help you can get. Most importantly: Do what makes you feel better!

26 | www.ourhealthrvirginia.com

words | SARAH COX

To me, the healthcare profession offers the opportunity to help families and patients in their most stressful times find peace, comfort and hope.

It is a privilege and honor for those we serve to trust us in that position of responsibility and our duty to deliver the best possible care and experience for them and their loved ones.

John Piatkowski, MD Carilion Clinic Vice President and Carilion New River Valley Medical Center Chief Executive Officer words | SARAH COX

While May is traditionally the month that healthcare celebrates its employees, many hospitals, doctor’s offices, and clinics recognize their workers in many ways throughout the year.

At Carilion Clinic, which encompasses eight hospitals throughout Southwest Virginia, there is a lot of work done around recognition, says Human Resources Director for Organization Development Amy Hoots-Hendrix, and, she adds, “It is a privilege to be a part of that. Not only do we take care of our community, but we are a big employer.”

Hoots-Hendrix says there are studies that point to the correlation between patient satisfaction levels and employee engagement. “If they’re in their jobs and believe in what they’re doing, you have to believe that patients can feel that.”

To recognize healthcare workers at Carilion Clinic, events are planned such as picnics, an employee day at Mill Mountain Zoo, a night at a Salem baseball game, or a day at the Taubman Museum.

“If you recognize achievements and behaviors, they are most likely to be repeated,” says Hoots-Hendrix.

Charlotte Ramsey, Chief Nursing Officer of Carilion New River Valley Medical Center, says, “We are very, very clear that our employees are the backbone of our organization, and the work they do, day in and day out, actually significantly impacts our mission to the community.”

She says that the hospital’s healthcare workers—from environmental services to directors of the departments—play a role, everyone is a valued member, and everyone is impacting the experience. To recognize them, Ramsey says

Healthcare is a rewarding yet demanding profession that gives you a unique opportunity to impact lives in a meaningful way. You have a chance to experience all aspects of human life. Nothing is more fulfilling than helping someone heal and get back to enjoying their life.

Joseph Nelson III, MD Gastroenterologist, LewisGale Physicians

that the hospital plans formal events, such as annual reviews and recognition of receipt of credentials and degrees, but she feels that what makes the biggest impact are the informal ways of thanking people.

“If you see someone and thank them in the hall, that’s just as critical as the more formal things,” she notes.

Carilion has guidelines so that what works for the individual is used. A shy person may not want group recognition, but would be pleased with a note instead. Baby boomers, says Ramsey, are used to working and don’t want or need recognition, so “we have to find way to reward them. That’s why we need to take the individual approach.”

And sometimes, an ice cream social for the entire hospital simply lifts everyone’s day a bit higher. “It’s not the actual thing you’re giving them, but the fact that you’re taking the time to thank them for coming in on a holiday or under particular stress. They feel like you’ve really recognized them. People know you’ve really noticed.”

The Human Resources Director for LewisGale Hospital at Montgomery Kristie Walker points out that it takes everyone in the hospital working together, from the housekeepers to the doctors, to ensure that the patients get everything they need to get well.

“No one is more important than the other. Healthcare workers are givers by nature, putting others before themselves, and we feel it is important to take time to honor and appreciate and value them,” explains Walker.

She says that the hospital does this several times a year, but during hospital week in May, there is usually a week-long celebration of events. This is followed by a week for nursing recognition. The hospital workers week can include events such as a Snack Attack cart wheeled around by hospital administrators who go to every department three times a day; names drawn for prizes such as movie tickets; a barbecue with pulled pork, smoked chicken, and all the fixings in the parking lot; and breakfast biscuits brought in for those who work on weekends when there are limited cafeteria hours.

our health | CELEBRATING THE HEALTHCARE WORKER

“I think many studies have shown that people who are happy in the work that they do are more productive, and healthcare is one of those areas where patients come to you not feeling well, and when you’re not feeling well either, you’re not in the best mood,” says Walker. “It makes providing care more stressful, and we want to make sure that the patient gets well and is as comfortable as they can be. These events we do help to boost employee morale and help them to know how much their work is valued.”

But recognition of employees is also done year round, notes Walker. That employee can be the nurse who took the time, when a patient had multiple births that came quickly, to clean the patient’s car and install care seats. Or the social worker whose jewelry was admired by a patient, and she gave that piece of jewelry to her patient.

Karen Tuttle, CEO and Administrator of Jefferson Surgical Clinic, with five offices in Roanoke and over 100 employees, says that recognition of employees is “absolutely important, especially in the healthcare environment. Healthcare workers give so much of themselves emotionally and physically, so to give something to recognize them and say ‘thank you’—they need this and appreciate it.”

Healthcare is special because it allows us to put our God given talents and abilities to a higher use … truly helping others. I know it may sound like a cliché but helping others really does help bring a unique reward that only a handful of settings can provide.

Bill Caldwell, FACHE VP, Physician Practice Management LewisGale Physicians

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CELEBRATING THE HEALTHCARE WORKER | our health

Watching patients progress from major trauma back to their normal life is greatly rewarding.

Trevor Owen, MD Orthopaedic Trauma Surgeon, Carilion Clinic

While she says that the clinic’s employees are proud of their hard work and that this is its own reward, a nice gesture such as a trip to downtown’s Beeds Indeed or the Glazed Bisque It, a spa night, or gifts of logo items is a chance to celebrate healthcare workers’ “very humanitarian profession.”

“If you have ever been a patient, you know how it feels to receive care from someone who is not only skilled and experienced, but is also happy to be caring for you. Recognition and thanks help employees feel a little happier in their work, and, in turn, their patients benefit,” says Tuttle.

Roger Bohon, Practice Administrator at Asthma and Allergy Center, which has 45 employees, says that his workers are treated “like human beings. The doctors are very personable with the employees. The attitude is that the nurses and front office are watching each other’s backs. With all the regulations and changes taking place, we need to help each other out. We want to look over each other’s shoulders to reduce errors.”

Working together as a team reduces errors, explains Bohon. And that team stays together with recognition.

That may be in the form of flowers on birthdays, a holiday party for www.ourhealthvirginia.com | 33

our health | CELEBRATING THE HEALTHCARE WORKER

“As a physical therapist, I feel rewarded when I see someone do better today than they did yesterday. Small changes can make a big impact, and I have the skills and knowledge to make a positive influence in the mobility of each patient with whom I have the opportunity to work.”

Carole Robertson Home Care Physical Therapist, Carilion Clinic

employees and their families, and benefits for employees that are unusually generous for a practice of this size, such as life, health, and dental insurance plus a retirement plan.

R.J. Redstrom, Vice President of Human Resources for LewisGale Regional Health System, which includes LewisGale Medical Center, three campuses at Pulaski, Montgomery and Alleghany, its outpatient diagnostic sites, physician offices, and an ambulatory imaging center, says that particularly in healthcare, recognition impacts the quality of care patients receive.

“Patients are at the most vulnerable point in their lives, and happy employees make happy patients.

Healthcare is kind of unique—we have an annual hospital employee month and a week within that month, and every hospital makes a really big deal with activities, almost always a gift, and special treats such as ice cream sundaes and a special meal for the night folks.”

It’s always one of those things, says Redstrom. When you show how much you appreciate your employees, you rarely get negative feedback.

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Hypothetest, LLC Richard Eckert, MD Our Focus: Clinical trials and orthopaedic research

Our Mission: Our mission at HypotheTest is to gather high quality information about clinical trials of new drugs while respecting the dignity, comfort and safety of our participants who are kind enough to volunteer for these studies. In order to enhance the performance of our mission we are trained in the highest industry standards. Both our principal investigator and clinical coordinator are certified by the Association of Clinical Research Professionals.

Our Involvement in the community: HypotheTest is also involved in the community. Our volunteers come from diverse backgrounds, both from our patient-focused practice and our database of past enthusiastic volunteers. We actively seek volunteers through advertising and other communication methods.

All services that we offer, including physical examinations, labs and medications are free of charge to participants. We also cover the expenses of transportation for individuals.

We are active in various charitable organizations in the area.

Our Motivation to provide the highest level of care Because of the nature of clinical trials, our staff can spend as much time with a patient as necessary. Our personal, one-on-one care and our scrupulous tracking of laboratory and diagnostic studies assure the safety of our volunteers.

Our high degree of individual care leads to camaraderie between our staff and our volunteers. We get to know our volunteers and their families personally and there is a considerable social aspect to each visit. We are in constant contact with all of the volunteers by telephone in between their appointments in our office.

Dr. Eckert, Principal Investigator, is enthusiastic about maintaining cuttingedge familiarity with new drugs and their applications to ensure volunteers are completely aware of the conditions surrounding their pain and disease.

Hypothetest, LLC | Richard Eckert, MD 4370 Starkey Road | Roanoke, VA 24018 | 540.989.4100

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New River Periodontics and Dental Implant Center Our Focus: Conservative treatment of gum disease, cosmetic dental procedures, dental implants and oral pathology.

Our Mission: Dr. John Buyer, DDS, a third generation dentist who moved to the New River Valley in August 2009, applies traditional techniques and technological devices to provide a full range of comprehensive periodontal and dental implant therapies.

His expertise includes treating periodontal diseases, cosmetic periodontal surgery, gingival grafting, crown lengthening, correcting bone deformities with bone augmentations in preparation for implants and oral medicine.

Our Patient-Focused Care Patients often say they fear the surgical approach to treating periodontal disease.

Dr. Buyer first exhausts numerous non-surgical approaches before recommending surgery. “We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary. If surgery is absolutely required, then we can relieve anxiety with conscious sedation�, says Buyer. New River Periodontics has introduced the Laser Assisted New Attachment Procedure or LANAP, to the New River Valley area. This treatment offers an alternative to traditional periodontal surgical approaches.

Our Motivation to provide the highest level of care Dr. Buyer and the staff of New River Periodontics are extraordinarily proud of the work they provide to our communities. They work closely with their patients’ dentists. They also offer the option to schedule an appointment directly with them.

Providing high-quality results to patients and learning from each that results have met or exceeded expectations are what makes working for New River Periodontics so rewarding.

New River Periodontics and Dental Implant Center 2612 Sheffield Drive | Blacksburg, VA 24060 540.951.4848 | www.newriverperio.com

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Excel Prosthetics Our Focus Since being founded in 1978, Excel has expanded to seven offices located in Virginia, Tennessee, and West Virginia. The company has grown due to its innovative products and unwavering commitment to patient comfort and satisfaction. We have extensive experience with all levels of lower and upper extremity prosthetics and orthotics.

Our Mission We understand that each patient has different circumstances, needs, goals, fears, and hopes. It’s our job to guide patients on this journey that they may have never expected. Our team of certified practitioners and technicians takes this responsibility very seriously. Patients can expect our team to take great care in analyzing specific needs and designing the appropriate prosthetic or orthotic.

At Excel, experience and cutting-edge technology create a better quality of life for patients. Our industry-leading technologies are utilized by an experienced, professional team of certified practitioners and technicians. Excel Prosthetics & Orthotics is always working to bring the latest and most advanced technology to our patients. Technology is always changing and improving, and we owe it to our patients to seek out the knowledge of all options available. Digital scanning is an example of this technology that improves quality of prosthetic fitting and reduces the number of test fittings needed. Excel employs the use of elevated vacuum suction sockets, which help maintain a healthier residual limb and helps control volume changes.

The use of microprocessor knee and ankle components are an important part of prosthetic design because they help reduce stress on the patient and increases energy efficiencies that allows for a longer duration of ambulation. Excel Prosthetics and Orthotics worked with the first patient to receive a BIOM ankle/foot system in our region. The BiOM replicates the action of the foot, ankle and calf muscles that work together to assist the individual’s forward motion when walking. While a traditional prosthesis can store energy and then return it, the BiOM actually replaces energy allowing amputees to walk as normally as possible over all terrain types. The BiOM is the only prosthetic system that can actually restore lost muscle function of the foot, ankle and calf for lower leg amputees. This allows patients to reduce their energy expenditures because this system actually assists during ambulation instead of being a passive device.

Our Motivation to Provide the Highest Level of Care Our fully integrated facility ensures that patients receive the best care possible by employing enhanced scanning and digital mapping and on-site prosthetic engineering.

During every initial evaluation, we capture the exact parameters of a patient’s residual limb through digital scanning. Computer aided machines are utilized to carve out an exact mold of the patient’s residuum allowing our engineers to develop and produce a socket that fits perfectly to the shape of the patient’s body. The result is a prosthetic that helps restore mobility and functionality, and more importantly, self-reliance.

When the passion is rebuilding lives one step at a time, Excel Prosthetics is the Right Choice.

Excel Prosthetics 115 Albemarle Avenue | Roanoke, VA 24013 540.982.0205 | www.excelprosthetics.com

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Warm Hearth Village Our Focus Active adult, independent living, assisted living, memory care, skilled nursing care, long-term nursing care and Warm Hearth at Home

Our Mission The mission of Warm Hearth Village is to enrich the lives of seniors of all socioeconomic backgrounds through a wide range of choices in housing, services and care. On our campus Warm Hearth offers full-continuum of living options including independent living in three forms; subsidized apartments, town homes and free standing homes.

Health care options includes two levels of Assisted Living at Showalter Center or The Kroontje Center. The Kroontje Center also offers a memory support wing and both Skilled and Long-Term Nursing Home care. Additionally, Warm Hearth Village is now offering Warm Hearth at Home; a licensed Home Care provider for home based assistance. Tying the Village together is our newest project The Village Center. The state-of-the-art building hosts a wide variety of programing in the Tall Oaks Hall, offers quick dining options in the Huckleberry Cafe and will encourage health and wellness in the fitness center equipped with all the amenities including a saltwater pool.

Our Involvement in the Community Warm Hearth’s latest venture is Warm Hearth at Home. Warm Hearth at Home is a licensed Home Care Agency. The goal of Warm Hearth at Home is to foster independence for seniors in their own homes. Warm Hearth at Home can provide older adults with everything from medication set up by an registered nurse to companionship to a certified nursing assistant to help with activities of daily living. Each client is paired with a RN Care Manager that follows them with every need. Quarterly assessments ensure each need is met by our qualified and caring staff. Services are agreed upon between the client and his or her Care Manger and provided timely.

Our Motivation to provide the highest level of care Our residents and clients are all the motivation we need to offer and deliver the highest level of care. That, combined with our strong mission driven focus on quality as a nonprofit ensure that each person living at Warm Hearth Village or receiving services from Warm Hearth at Home receives the best care and services we have to offer them. Providing that service in such a beautiful environment is a joy.

Warm Hearth Village 2607 Warm Hearth Drive | Blacksburg, VA 24060 540.443.3448 | www.retire.org

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Getting Back to Life words | SARAH COX

With the LifeWorks Rehab® approach, Medical Facilities of America (MFA) delivers a customized rehabilitation program to each one of its patients throughout its 40 skilled nursing centers in Virginia and North Carolina. That is “one of the aspects of MFA’s recovery program that makes it stand out”, says Physical Therapist and Vice President of Rehabilitation Services Ron Selzler.

The LifeWorks approach is a comprehensive program designed by a team of specialists to help patients set goals and treatments exclusive to their individualized community skill level. This means patients can recover and “return home as functional, safe and independent as possible”, Selzler explains.

“LifeWorks is unique to MFA,” he says. “We have a high emphasis on setting goals and treatments specific to each patient’s skill level. Our therapy is in-house and is delivered by our in-house therapists.” Selzler goes on to explain that “Rehab is integrated into the fabric of the organization. It is delivered throughout the day, seven days a week, and it comes from a team approach. The key to the program is not simply getting patients home, but getting patients back to where they want and need to be in their community.

An important component in each patient’s recovery plan is The Recovery Map®. This is a visual guide showing each stage of rehabilitation that integrates physical, occupational and other therapies to build strength, mobility and functional skills to enjoy life. “We are considered one of the premier rehab providers throughout Virginia,” says Selzler, “and we are the largest provider of skilled nursing services.”

www.ourhealthvirginia.com | 39

SPOTLIGHT ON: LifeWorks Rehab® | our health

Therapies at LifeWorks Rehab® are intensive and the goal is the long-term success of each patient.

Successful outcomes are measured with the exclusive Functional Independence Tool, or FIT. Each patient receives a FIT score upon admission to one of our Centers and then again at discharge.

“For some, they were completely independent before the accident, illness or surgery that resulted in the stay with us. Others were at home with a caregiver. We must individualize each treatment plan to where each patient needs to be; to be safe,” says Selzler.

“LifeWorks delivers an intensive therapy program is seven days a week and coordinates plans closely with the orthopaedic surgeon or attending physician to carry out specific protocols”, explains Selzler. Part of the plan is to visit the patient’s home prior to discharge and determine what specific skills are needed to return to the patient’s unique environment. That may mean measuring the width of bathroom doors, the angle of the stairs, and the outdoor space.

Celebrating the Healthcare Worker...

Working in the healthcare field is rewarding because you get to touch the lives of someone in need. There is no greater compensation than knowing you have positively impacted someone’s life.

Leah Sowers, COTA/L Outpatient Therapy Manager, Friendship Retirement Community www.ourhealthvirginia.com | 41

our health | SPOTLIGHT ON: LifeWorks Rehab®

“In a healthcare environment such as ours, we are ADA accessible while homes are not,” Selzler points out.

“To that end, experts look at uneven surfaces, stairs, and heights that may be challenging in getting back into the community. This community may include attending church and events that the patient had participated in prior to the accident, illness or surgery.

Just as important as selecting an attending physician or orthopaedic surgeon is selecting a rehabilitation facility. “Patients should take the time to consider their choices for rehab, and they should ask questions such as how much therapy will they receive, is it available on weekends, and if their outcome will be measured,” he says.

For more information on Medical Facilities of America and its LifeWorks program, see www.lifeworksrehab.com.

42 | www.ourhealthvirginia.com

PHYSICAL THERAPY | our health

PHYSICAL THERAPY increasingly common for patients looking

for PAIN RELIEF

words | LAURA NEFF-HENDERSON, APR

Americans are increasingly looking to physical therapists for help with pain, as a means of avoiding costly medications and surgeries. Often times, physical therapy can help patients heal faster. And, it’s less expensive than traditional medical care. Physical therapy helps relieve pain, promote healing, and restore function and movement.

“Our philosophy is to provide the highest quality therapy through personalized care and education,” says Chris Rogers, MPT, director of the Blacksburg office of University Physical Therapy.

Like most physical therapists, Rogers and his colleagues treat patients of all ages, with a wide range of ailments resulting in chronic and acute pain.

In addition to individuals with injury related ailments, physical therapists also treat patients with pain resulting from every day stresses. They also see elderly patients who have balance and mobility issues to help minimize their risk of falling, avoiding future injuries.

Some of the most common chronic ailments that Cherrine Reed, a physical therapist with Lewis Gale Medical Center, treats patients for include lower back, hip, and shoulder pain.

Debbie Vaught, PT, CLT, with Carilion Clinic’s outpatient physical therapy department, has seen patients thrive in physical therapy. She has worked with many patients who have “gotten in such good shape [as a result of physical therapy]” that they are able been able to avoid surgery completely.

A lot of times, something as simple as losing weight can really make a difference for obese patients, explains Vaught.

There are times; however, when surgery is inevitable. In those cases physical therapists work with patients to increase strength, range of motion, and flexibility.

“If you go into surgery stronger, more flexible, with more range of motion, you’re going to come out of the surgery in much better shape, which should make rehab much easier,” says Rogers.

Physical therapy also helps patients reduce or eliminate the need for pain medication. www.ourhealthvirginia.com | 43

our health | PHYSICAL THERAPY

Celebrating the Healthcare Worker...

For all the stresses and strains across the spectrum of healthcare, I remember this one quote: “For any given worker on any given day, the world is a bit better off simply because we choose to get up and go to work.

Dr. John Heil, DA, FAASP, FAPA Licensed Clinical Psychologist Psychological Health Roanoke

“Pain medication may help the patient tolerate the pain, but it’s not going to fix what’s causing the pain. Our goal with therapy is to get to the root of the problem so we can get the patient off the pain medication and prevent this from returning and becoming an issue again down the road,” says Rogers.

Individuals with severe swelling can also find relief through physical therapy.

Vaught, who is a certified lymphedema therapist, works with her patients to reduce the skin tightness caused by pressure on the affected nerves and tissues that result from swelling.

By reducing the swelling, many patients are able to reduce or eliminate pain medication and get back to a “normal” life, explains Vaught.

“If you give yup and lay around, you’re definitely going to get weaker and life is going to get harder,” says Vaught.

“We see the gamut of people – from well-trained athletes to people in wheelchairs – so we are pretty good at tailoring customized programs.

Most patients who undergo surgery also have post-surgical physical therapy to help restore function during the healing process. In many hospitals, physical therapists work with patients who have had surgery before they are discharged from the hospital.

Rogers, Reed, and Vaught all advise individuals who think physical therapy may be an option for them to make an appointment.

Reed’s advice to anyone living with pain: “Be proactive. It’s not always the doctor that is going to suggest physical therapy in the first place. Go ahead and ask the doctor if they think physical therapy might help.”

As part of the initial visit, the physical therapists perform a complete evaluation to determine the best course of treatment. Treatment programs depend completely upon the nature and severity of the ailment and, but typically

44 | www.ourhealthvirginia.com

include twice weekly appointments for about eight to 12 weeks.

When released from physical therapy, many physical therapists send their patients home with techniques to help them continue improving, as well as a firm understanding of how they can prevent reoccurrence.

Sometimes those techniques involve exercises. Other time they involve modality treatments, things like hot or cold compresses and electrical stimulation.

After they’ve gotten better and reduced or eliminated the pain, it’s vital that patients understand how to prevent a reoccurrence.

“Teaching people how to use their bodies correctly is huge,” says Reed. She works with her patients to help them identify the bad habits they’ve developed that can lead to chronic issues over time. “I try to look at the person and identify those habits and help them find better ways to hold the phone, for example.”

The basic tenets of body mechanics are vitally important to maintaining good health, according to Vaught. While many people know how to pick up a heavy box taking care not to bend at the week and put stress on the back, people don’t tend to think about how they bend over to pick a pencil up off the floor.

Both acts are just as important, says Vaught.

“Just learning how to do the everyday things just a little bit differently can make a huge difference,” says Vaught.

Vaught’s advice to individuals living with pain: “Do not give up.

Keep trying. Seek help.” Rogers, Reed, and Caught all agree – the sooner the physical therapist can get involved, the better.

www.ourhealthvirginia.com | 45

EMBRACING

LESSONS words | TINA JOYCE • photography | BRON DUNCAN archive photos courtesy of Northside High School

Win more. Lose Less.

words | SARAH COX

In organized sports, this is the measuring stick of

success.

When it comes to winning games, Billy Pope, the head boys’ basketball coach at Northside High School in Roanoke County, knows how to make it happen. In fact, he and his teams have done so more than 400 times during his coaching career.

Yes, Coach Pope teaches players how to win on the court. But it’s off the court where he hopes his lessons make a difference.

I believe that you find out just how good your team is ten years

down the road. If the young men you coached are doing well in life then,

that’s the greatest victory.

- Billy Pope

The score clock ticks down to zero on another high school basketball season in the Roanoke Valley. The bitter-sweet ending of another season means a team, as we know it, concludes a journey that will impact each player the rest of their lives in some way. Young studentathletes come together for a time to build relationships, improve physical health, and persevere through challenges—both physically and emotionally. Although a season is about much more than wins and losses, this year’s record revealed a milestone number and a memorable day for one local coach.

our health | HEALTHY MILESTONES

This past January, Coach Billy Pope, head boys’ basketball coach at Northside High School, celebrated his 400th win. When asked about his initial thoughts on the noteworthy win, he simply stated with a smile, “It must mean I have been coaching a long time.”

Not only has Pope been coaching the game for many years, he is privileged to have coached with two of his three assistants, Ed Culicerto and Jim Wolfe, for all 400 wins.

Many people often don’t realize the long hours and mental evaluation put in by coaches, both during the season and in the off-season. It is more than just gameday. There are hours of preparation that go into each practice, every game, and into off-season opportunities, such as camps and summer leagues.

Reaching 400 wins in the coaching profession is monumental and worth celebrating. However, more importantly than wins is what comes with such tenure: the opportunity to teach life lessons along the way.

Coach Pope has been teaching student-athletes through the game of basketball for 33 years. He explains, “We all have a part to play in getting kids ready for adulthood.

We teach them to be on time, the value of working hard, and that jobs often require teamwork. I teach my players in practice, then coach them in games. Fans see the results of preparation play out in games, but many of the lessons learned by athletes begin before they ever step on the court.”

Athletics allow an avenue for the three aspects of health to be addressed and further developed in students: mental, physical, and social. “Sports encourage students to get in really good shape physically, but there is also a lot of work and dedication required of them as well,” shares Coach Pope. “Many of my former players come back and talk about the challenges they could or couldn’t overcome—rarely does anyone talk about the minutes they played.”

Pushing student-athletes mentally and physically creates a natural adversity they have to conquer to improve. “It is important to realize that getting into great physical shape is a two-way street. I’ve learned over the years that students either resist or embrace hard work. Real change happens in their lives when they accept the challenges and realize they don’t have to, but get to be part of something bigger than themselves,” explains Coach Pope.

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HEALTHY MILESTONES | our health

Coaching philosophies are rooted in establishing principles, and more importantly standing firm on these principles. However, Coach Pope has learned to adjust his style based on the strength of his players and team each year. “Every team is special to me, even the ones that struggled,” shares Coach Pope. “Clearly some teams have done well because they were motivated and driven.” Winning games is a process. It is important to realize that even the most successful teams have to work through challenges. Coach Pope realizes there are life lessons to be taught along the way.

“Sports really can mirror life itself. You don’t always get what you want in life and sometimes you have to make adjustments. Team sports are hard. Sometimes you have to watch others get the credit, whether or not they deserve it, ” explains Coach Pope.

Billy Pope’s wife of nearly 32 years, Patty, shares an appreciation for the game as well as an even greater affinity for the mentoring that takes place from her husband.

He has never missed a game in his 33 years of coaching (27 as the head coach of Northside) and his wife has been to nearly all of his games. They have four daughters who also support their father’s passion for basketball.

“You cannot be in this profession without the support of your family. Coaches tend to get out of balance fairly easy. My wife is generous, caring, and always brings me back into balance,” Coach Pope proudly and humbly admits.

Mental exhaustion from the constant thinking about players, practice times, effectiveness of drills, games situations, and strategies to improve can easily lead to stress of one’s physical health. “You learn that there are things you can control, and things you can’t. I teach my players that basketball is just one aspect of your life,” shares Coach Pope.

Coach Pope feels that striving for balance and helping youth find that same healthy structure has contributed to his 400 wins. “It’s hard to see the bigger picture when you are young. Win or loose, it is not the end. You just move on to the next thing,” he explains. As part of the structure and balance he seeks to teach and model, he likes to start every day with a quote. ‘Don’t let tomorrow take up too much of today,’ is one of my favorites,” says Coach Pope.

In the end, Coach Pope wants his student-athletes to enjoy the game, embrace moments, and learn a few valuable things along the way. As he celebrated his 400th win, he too did just that. www.ourhealthvirginia.com | 49

A Summary of Common Medical Professional Titles words | SARAH COX

Have you ever tried to decipher the differences between a DO and an MD, or tried to figure out what an EMT is? Below is a list of abbreviations and what they mean. Each of the titles below requires a certain standard of education and passing certification exams. There are six basic types of credentials you may possess that can be used after your name.

The first is your degree (e.g., BS, MS, JD, PhD, EdD). These credentials are awarded based on the completion of a particular educational program.

The second is licensure. These credentials are awarded based on the completion of a specified educational program and the successful passing of a national licensure exam.

Then there’s the state designation or requirement. These credentials are similar to licensure, but they are usually beyond basic licensure and designate authority and recognition to practice at a more advanced level in that state.

Additionally, there is national certification. These credentials are awarded by a nationally recognized, usually accredited, certifying body.

To give some examples, a DO is a doctor of osteopathy, and an MD is a doctor of medicine. The main difference is that a DO, who will have the same rigorous training as an MD, is that D.O.s have been specially trained to perform osteopathic manipulations on patients. They view the patient as a “total person” and focus on preventative care.

An MD attends an allopathic school, whereas a DO attends an osteopathic school; both teach the same basic science curricula necessary to becoming a fully qualified doctor.

An EMT, or emergency medical technician, is required to pass a state exam to be certified to practice in that state.

A “fellow” designation, such as a Fellow American College of Physicians, designates the period of medical training that a physician or dentist may undertake after completing a specialty training program (residency). During this time (usually more than one year), the physician is known as a fellow. Fellows can act as an attending physician or consultant physician while they are in specialty training, and after completion of their fellowship, the physician is permitted to practice without direct supervision by other physicians in that sub-specialty, such as cardiology or oncology.

There are also several designations for nurses, from NPs, or nurse practitioners, to RN, or registered nurses, each signifying differences in licensure, certification and education.

baby, can you spare a pint?

A little blood, unlike time and money, is something that most of us can easily spare. And at some time or another, almost all of us will witness blood donations at work.

“Odds are, at some point in your life, you’re going to encounter someone who has needed a blood product,” says Joshua Smith, communications manager at Virginia Blood Services (VBS). “It could be someone that’s very close to you. It could be you.”

words | ANIKA IMAJO

Bridging the gap between eligible donors and the scores of patients in need, organizations such as VBS and the American Red Cross receive, process, and distribute the precious commodity that helps save lives— from premature babies to trauma victims—every day.

“97% of us will either need blood or know someone who needs blood,” says Kristen Hatfield, marketing program manager for the American Red Cross’ MidAtlantic Blood Services Region.

Blood products commonly play a critical role in surgeries -cardiac, orthopedic, obstetric and gynecological—as well as treatments for cancer and blood disorders such as sickle cell disease, according to Chelsea Sheppard, MD, medical director of VBS. VBS is a member of America’s Blood Centers (ABC), a network of North American non-profits that collectively amass more than eight million units of whole blood annually, more than half the donor supply for the US and Quebec, according to the ABC website. With nine locations (three in the Greater Richmond area) supplying local health care systems throughout the commonwealth, VBS requires a daily minimum of 400 donations in order to meet Virginia’s average demand.

Then there are the urgent situations, the accidents and even large-scale disasters, which require an immediate supply of prepared blood products, sometimes in large quantities.

VBS delivers blood products to three level one trauma centers in Virginia, including the Virginia Commonwealth University Health System. www.ourhealthvirginia.com | 53

our health | BLOOD SERVICES

“Distribution to hospitals varies from standard to STAT order,” Dr. Sheppard explains. “Because traumas can happen at any time, at any volume, it’s important that we have the supply to meet local patients’ needs.”

For a current update on which blood types are most needed in our area, please visit www.vablood.org or use your smart phone or tablet to scan this QR code.

Through the Red Cross’ nationwide blood system, your donation here in Virginia may support life-saving efforts in other parts of the country. The regional center satisfies needs close to home first, supplying blood products to more than 50 Virginia hospitals. But Hatfield points out that its inventory may also be routed to disaster-struck areas -- such as the Northeast following its recent colossal snowstorm -- where demand is high and conditions may stall local blood drive efforts.

“Clearly no one’s coming out in two feet of snow to donate or collect blood,” she remarks. “And we always say, ‘The need for blood never gets a day off.’

The ongoing need for a ready supply of blood products demands an efficient and safe system of delivery from the donor’s vein to health care facilities.

Blood can be collected as whole blood donations, to be separated into various components in a centrifuge.

“That one donation can actually help save three lives,” Smith emphasizes, “because we make the products out of one unit – plasma, platelets, and red blood cells.”

But current technology also permits collection of isolated components from the source. Once blood is drawn from the donor, the desired component may be

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removed and the remaining parts returned to the donor, explains Dr. Sheppard, whose background includes a fellowship in transfusion medicine at Emory University.

Double red cell donation, through which donors can safely give two units of red blood cells at once, is also now possible. Such donations yield more units of blood without taxing the donor.

“Because platelets and plasma are returned to donors, in addition to saline, fluid levels are maintained and some donors report feeling more hydrated after their completed donation,” Dr. Sheppard says.

A 115-day waiting period is required between double red cell donations from a single donor, she adds, explaining that the body needs that time in order to restore blood cells.

Blood donations must also undergo a process of testing for both bacteria and disease, according to Dr. Sheppard, who says HIV, hepatitis B and C, syphilis, and West Nile virus are among the infections they test for in screening donations.

Because blood products don’t keep indefinitely in storage, a steady influx of fresh donations is critical.

Packed blood cells have life spans commonly ranging from 35-42 days, depending on the preservative added, according to Dr. Sheppard.

While plasma and cryoprecipitate, or the frozen product derived from plasma, may last frozen for one year, Dr. Sheppard explains, “Platelets must be stored at room temperature for their utility and thus must be used within five days in order to avoid bacterial growth.”

This especially brief shelf life makes platelet donations -which may be made by a single donor every two weeks -- of particular importance to the blood supply.

Blood must, of course, be matched by type between donor and recipient. According to Dr. Sheppard, blood types are determined by inherited antigens – or proteins and sugars on the surface of red blood cells.

“The most common antigens that people hear about are A,B, and O (which is actually the lack of A or B),” she explains. The types in this group of antigens are further distinguished as positive or negative, depending on the presence or absence of the D antigen, which belongs to the group known as the Rh system.

Type O negative is the universal donor, meaning it can be transfused into patients who have any of the eight major blood types, but contributions of all blood types are valuable. www.ourhealthvirginia.com | 55

our health | BLOOD SERVICES

Meeting an unyielding demand on a continuous basis means raising awareness of the need for blood donations.

“The number one reason people don’t donate blood is because they just haven’t been asked to donate blood,” observes Smith, adding, “We’ve got 37% of the entire population that can donate blood. Less than 10% of that 37% actually does.”

As the eligibility criteria for blood donations are subject to change based on FDA guidelines, both organizations encourage potential donors to undergo the screening process to find out if their blood can make a critical difference to others.

As Hatfield put it, “Blood donors are heroes!”

If you have a tattoo, have lived in certain parts of the world, or have been deferred as a donor in the past, don’t count yourself out as a candidate to give blood.

And those who find they can’t donate blood can still make a significant contribution to the effort, Smith says, by helping to get the word out about the importance of blood donations.

“If you can’t donate, advocate.”

To learn more or to get involved, please contact Virginia Blood Services at 800.989.4438 or online by visiting www.vablood.org or the American Red Cross at 800.RED CROSS on online at www.redcrossblood.org.

Above: American Red Cross blood drive participants.

Celebrating the Healthcare Worker...

In healthcare, everyone comes to see you when they need help or advice. So whether I’m in surgery or greeting a patient in the elevator, I find it rewarding to know that I’ve made an impact, no matter how small the interaction may have been.

Emilie Biddle Practice Manager, Carilion Clinic 56 | www.ourhealthvirginia.com

Chelsea Sheppard, MD, medical director of VBS

LOW VISION OPTOMETRY | our health

on the road

again

Advancements in low vision treatment options are giving people like Clyde Sarver of New Castle the ability to do things that were once considered impossible. In Clyde’s case, this means getting behind the wheel and back on the road again.

words | SARAH COX

Four years ago, Clyde Sarver woke up and discovered that he had suffered severe vision loss in his left eye. The New Castle man had experienced a broken blood vessel in that eye. Soon after that Mr. Sarver began to notice that his vision in the right eye was becoming blurred. He was then diagnosed with macular degeneration. Although he is receiving treatment from his retinal specialist, his blurred vision continues to bother him.

Recently the 77-year -old man visited Dr. David L. Armstrong, a Roanoke optometrist, who often helps patients whose vision has been damaged by disease or injury. Dr. Armstrong is one of a few optometrists nationally who care for patients with low vision.

Dr. Armstrong prescribed three different types of low vision glasses for Mr. Sarver, each for a different purpose. For driving and other distance vision, bioptic telescopic glasses were prescribed. Clear Image microscopic glasses were prescribed to help with reading. Mr. Sarver states that with them he is able to read as well as he did when he was a much younger man. A new type of glasses, called E-Scoop are for general use. Developed in The Netherlands, the E-Scoops magnify, improve contrast and divert the image away from the damaged macula. Mr. Sarver told Dr. Armstrong that he really likes that pair and takes them everywhere.

Lighthouse International, an organization dedicated to helping people with reduced vision, defines low vision as a partial vision loss that cannot be corrected. A person with low vision has severely reduced visual acuity and often has difficulty recognizing a familiar face and difficulty reading or seeing objects such as steps, curbs, uneven surfaces or furniture.

Dr. Armstrong has helped many people return to a more normal, enjoyable life by prescribing appropriate low vision glasses. “I see this part of my practice as a ministry” he says. www.ourhealthvirginia.com | 59

our health | LOW VISION OPTOMETRY

One of his recent patients, a young mother from northern Virginia, who suffers from Stargardt’s Disease had been declared legally blind by her eye doctor. With the telescopic glasses that Dr. Armstrong prescribed she is now able to watch her son play sports.

A southwest Virginia woman had not been able to see well enough to read. She cried as she read the Bible for the first time in two years. The microscopic glasses that Dr. Armstrong prescribed allow her to return to something very important to her, reading her Bible.

Although people with low vision cannot be helped with conventional eyeglasses, low vision optometrists are often able to prescribe special glasses, like Mr. Sarver’s, which help. There is no cure for macular degeneration, diabetic retinopathy, Stargardt’s Disease and other sight damaging diseases but appropriately prescribed low vision glasses often improve a person’s quality of life.

With his special new glasses Clyde Sarver is able to enjoy watching University of Virginia games on television, play solitaire on his computer and see better for outdoor activities. Now that he can see the print better he is getting back to reading. Being able to read has helped him maintain his interests. “I like to read absolutely everything that’s printed and now I can.”

Before getting his new low vision glasses, Mr. Sarver says “I plodded along, and tried to use magnifying glasses, but none worked well. These new glasses give me a little bit of freedom. I can go to town if I want.”

Dr. Armstrong always speaks with low vision patients by phone to determine if he can help them before scheduling an appointment. To learn more about low vision and Dr. David L. Armstrong visit www.VirginiaLowVision.com.

Celebrating the Healthcare Worker...

Dentistry is a challenging career in many ways. It’s meeting the patients, helping them overcome fears, sharing a joke, relieving pain and giving people smile makeovers that is rewarding. I wouldn’t want any other job!

Dr. Michele Mills, Dentist Mills & Shannon Dentistry 60 | www.ourhealthvirginia.com

CLINICAL TRIALS CORNER | our health

GLOBAL MEDICAL RESEARCH INNOVATIONS — CLOSE TO HOME words | RICH ELLIS

Cleveland Clinic. Mayo Clinic. Duke. Memorial Sloan. Johns Hopkins. When “groundbreaking medical research” is mentioned, these leading medical institutions often come to mind, and with good reason. They’ve established themselves as global healthcare leaders through both their medical research and best-in-class treatment. What many people probably don’t realize, however, is that this type of game-changing medical research also happens a lot closer to home, and at healthcare organizations that might consist of just a handful of medical professionals. And despite their lack of mainstream media coverage or top-ofmind awareness among consumers, the research and treatment innovations these local healthcare leaders discover and deliver are just as important to patients worldwide as those delivered by larger and better-known organizations.

In our own backyard, one doesn’t have to travel any further than Walnut Avenue in Roanoke to find such an example of local medical research with global treatment implications. For example, there are less than a dozen surgeons in the world that have been trained and are using the latest Total Ankle Joint replacement technology with a unique lateral approach from the Zimmer Orthopedics. One of them is right here in Roanoke.

Charles Zelen, DPM is that surgeon. He practices at Foot and Ankle Associates of Southwest Virginia. Dr. Zelen has over 13 years of experience in total ankle replacement. In addition, he is medical director of The Professional Education and Research Institute (PERI) on Walnut Avenue in Roanoke.

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PERI is a private research organization that was established in 2005 to educate surgeons in lower extremity surgery and in performing clinical research in foot and ankle surgery and diabetic limb salvage.

At the same time, PERI specializes in clinical trials on wound healing — specifically on healing diabetic wounds — and trials involving orthopedics.

The Professional Education and Research Institute has specialized treatment rooms for patients enrolled in the more complex clinical trials.

“Our mission is to improve foot and ankle care through physician education and clinical research,’” Dr. Zelen says.

PERI’s work on healing diabetic wounds —which are notoriously difficult to heal because of neurological and circulation issues that often afflict diabetics— usually involves skin grafting materials and wound dressings.

The Professional Education and Research Institute offers a multimedia classroom for group presentations and lectures.

“The advantage to patients and a benefit to the community [of the clinical trials] is that they get to try new treatment modalities at no cost to them,” Dr. Zelen explains. “Over the past eight years, we have participated in FDA phase II, phase III and post-market trials involving wound gels, dressings and skin grafting products. In addition, we have participated in genetic research, looking at growth factors to help re-establish foot circulation in patients who can’t undergo bypass or endovascular surgery. That participation has made an impact on developing new ways to help save diabetics’ limbs.”

A clinical trial presently underway at PERI studies the effectiveness of human amniotic membrane on diabetic ulcers. Dr. Zelen serves as the principal investigator.

“Human amniotic membrane has been used in wound care for many years,” Dr. Zelen explains. “The product being studied is well known to have a number of growth factors imbedded in it that help diabetic wounds heal.”

This is the second trial PERI has conducted using amniotic membrane. The first trial met with great success and was presented at the Symposium on Wound Care’s national wound healing conference last year, as well as later that year at the Clinical Symposium on Advances in Skin and Wound Care in Las Vegas.

The Professional Education and Research Institute has a fully functioning seven station cadaveric and biomechanics lab. From simply extremity labs to complex total joint and spine labs, all are possible in the facility that can accommodate up to 20 surgeons and faculty.

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In podiatry and in orthopedics for the foot and ankle, PERI participates in both retrospective and prospective studies. The retrospective studies look at clinical results in tendon repairs and bunion surgery, and examine ankle and rear-foot fusions.

PERI’s medical professionals also perform cadaver studies in the Institute’s cadaver and biomechanical lab. Presentations of their research and findings have been accepted at the American Orthopedic Foot and Ankle Society.

CLINICAL TRIALS CORNER | our health

In 2011 their study examining cadaver skin in Achilles tendon repair was accepted for poster presentation, as was a 2012 study comparing the use of cadaver skin to porcine and bovine skin in Achilles tendon repair.

In addition to Dr. Zelen, PERI’s clinical research staff includes Deborah Morrison, RN, Clinical Research Nurse, and Morgan Stepanek, BS, Clinical Study Coordinator.

“As far as current prospective clinical trials in orthopaedics, we are participating in a study examining the effectiveness of injectable human amniotic membrane in the treatment of plantar fasciitis—also known as heel spurs,” Dr. Zelen explains. “Human amniotic membrane has been used in orthopedic applications too—just as it has in wound care—for many years with a bulk of the research in spine surgery.”

The clinical trials and medical research being performed at PERI hold the promise of improving and saving lives right here as well as around the world, with an added benefit for trial participants of receiving treatment close to home, where they’re most comfortable.

Additional information about PERI, including about participation in clinical trials or for medical professionals or companies interested in renting the facility for training, can be obtained by contacting the lab coordinator at 540.797.2726.

Any patient with a history of plantar fasciitis for at least two months, who meets certain health criteria, and who hasn’t had success with previous treatment may be a candidate to participate in the trial.

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CLINICAL TRIALS CORNER | our health

CLINICAL TRIALS: Clinical trials are conducted to determine what works and what doesn’t work when it comes to new medical approaches or products.

In each edition of Our Health, we provide a listing of clinical trials offered locally. Below is a listing of trials offered through Blue Ridge Cancer Care. To learn more or to find out if you are candidate, please call 540.982.0237.

Study Name: NK-102 vs Phys Choice Locally Adv or MBC A Phase III Open-Label, Randomized, Multicenter Study Of NKTR-102 Versus Treatment Of Physician’s Choice (TPC) in Patients with Locally Recurrent or Metastatic Breast Cancer Previously Treated with an Anthracycline, a Taxane, and Capecitabine. Indication: Breast Cancer

Study Name: Rd Dbl Blind Paclitaxel+\-Bev HER2- BrCa A Phase III, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate the Efficacy and Safety of Bevacizumab, and Associated Biomarkers, in Combination with Paclitaxel Compared with Paclitaxel Plus Placebo as First-Line Treatment of Patients with HER2-Negative Metastatic Breast Cancer. Indication: Breast Cancer

Study Name: TC vs Anthracycline HER2- Adj Br Ca-B49 A Phase III Clinical Trial Comparing the Combination of Docetaxel Plus Cyclophosphamide to Anthracycline-Based Chemotherapy Regimens for Women with Node-Positive or HighRisk Node-Negative, HER2-Negative Breast Cancer. Indication: Breast Cancer

Study Name: PX-866 +/- Docetaxel Phase II Study of Docetaxel +/- PX-866 for Patients Who Have Received at Least One Prior Regimen for Locally Advanced, Recurrent, or Metastatic Head and Neck Cancer. Indication: Head and Neck Cancer

Study Name: PX-866 +/- Cetuximab Phase II Study of Cetuximab +/- PX-866 for Patients with Incurable Squamous Cell Head and Neck Cancer with a History of Progression or Recurrence following at Least One Prior Platinum Based Chemotherapy. Indication: Head and Neck Cancer

Study Name: SGN-35 CD30+ Non-Lymphoma Malignancies A Phase II, Open-Label Study of Brentuximab Vedotin in Patients with CD30-Positive Nonlymphomatous Malignancies. Indication: Leukemia

Study Name: GS 1101 + Rituximab > 1st ln CLL A Phase III, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Efficacy and Safety of GS 1101 (CAL-101) in Combination with Rituximab for Previously Treated Chronic Lymphocytic Leukemia. Indication: Leukemia

Study Name: IMC-1121B + Plat vs. Plat 1st Ln NSCLC An Open-Label, Multicenter, Randomized, Phase II Study of a Recombinant Human Anti-VEGFR-2 Monoclonal Antibody, IMC-1121B in Combination with Platinum-Based Chemotherapy versus Platinum-Based Chemotherapy Alone as First-Line Treatment of Patients with Recurrent or Advanced Non-small Cell Lung Cancer. Indication: Lung Cancer

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Pixantrone+Ritux vs Gem+Ritux RR NHL A Randomized Multicenter Study Comparing Pixantrone + Rituximab with Gemcitabine + Rituximab in Patients with Aggressive B-cell Non-Hodgkin Lymphoma Who Have Relapsed after Therapy with CHOP-R or an Equivalent Regimen and are Ineligible for Stem Cell Transplant.

Indication: Lymphomas

DCDT2980S/DCDS4501A+ Ritux R/R BCell NHL A Randomized Open-Label Multicenter, Phase II Trial Evaluating the Safety and Activity of DCDT2980S in Combination with Rituximab or DCDS4501A in Combination with Rituximab in Patients with Relapsed or Refractory B-Cell Non Hodgkin’s Lymphoma. Indication: Lymphomas

SGN-35 CD30+ Non-Lymphoma Malignancies A Phase II, Open-Label Study of Brentuximab Vedotin in Patients with CD30-Positive Nonlymphomatous Malignancies.

Indication: Myeloma

SGN-35 CD30+ Non-Lymphoma Malignancies A Phase II, Open-Label Study of Brentuximab Vedotin in Patients with CD30-Positive Nonlymphomatous Malignancies.

Indication: Solid Tumors

Imprime PGG® + Cetuximab in KRAS wildtype mCRC A Phase III Open-Label, Randomized, Multicenter Study of Imprime PGG® in Combination with Cetuximab (Erbitux®) in Subjects with Recurrent or Progressive KRAS Wild Type Colorectal Cancer. Indication: Colon Cancer

RAD001 Or Placebo in DLBCL A double-blind placebo controlled phase III study of RAD001 adjuvant therapy in poor risk patients with Diffuse Large B-Cell Lymphoma versus matching placebo after patients have achieved complete response with first-line Rituxan.

Indication: Lymphomas

Denosumab campared with Zometa in Multiple Myeloma A randomized, double-blind, multi-center study of Denosumab compared with Zoledronic Acid (Zometa) in the treatment of bone disease in subjects with newly diagnosed Multiple Myeloma. Indication: Myeloma

Brentuximab Vedotin in older patients with Hodgkins Lymphoma A phase 2 single-arm, open-label study of single-agent Brentuximab Vedotin for front-line therapy of Hodgkins lymphoma (HL) in adults age 60 and above. Indication: Lymphomas

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our health | CLINICAL TRIALS CORNER

Volunteers Needed.

Clinical research studies for osteoarthritis of the knee or hip and low back pain.

Qualified participants will receive at no cost: study medication, study related exams, and travel compensation.

Call 540.989.4100 for more information. HypotheTest, LLC Dr. Richard Eckert

GDC-0941/Carboplatin/Taxol or GDC-0941/ Carboplatin/Taxol/Avastin in 1st line NSCLC A phase II randomized study evaluating the safety and efficacy of Carboplatin/Taxol and Carboplatin/Taxol/Avastin with and without GDC-0941 in patients previously untreated advanced or recurrent NSCLC. Indication: Lung Cancer

Ipilimumab or Placebo with Carboplatin/Taxol in patients with recurrent/Stage IV NSCLC. A phase III randomized study comparing the efficacy of Ipilimumab/Placebo in addition to Taxol and Carboplatin in patients with Stage IV/Recurrent NSCLC. Indication: Lung Cancer

Erlotinib + MetMAb/Placebo for Met+ NSCLC A randomized, phase 3, multicenter, double-blind, placebocontrolled study evaluating the efficacy and safety of MetMab in combination with Tarceva (Erlotinib) in patients with met diagnostic-positive non-small cell lung cancer (NSCLC) who have received standard chemotherapy for advanced or metastatic disease. Indication: Lung Cancer

Afatinib versus Erlotinib in 2nd line Squamous Lung Cancer

A randomized, open-label Phase III trial of Afatinib versus Erlotinib in patients with advanced squamous cell carcinoma of the lung as second-line therapy following first-line platinum-based chemotherapy. Indication: Lung Cancer

Standard of Care +/- Continuous Bevacizumab beyond progression in patients with NSCLC An open-label, randomized, Phase IIIb trial evaluating the efficacy and safety of standard of care +/- continuous Bevacizumab treatment beyond progression of disease in patients with advanced non-squamous Non-Small Cell Lung Cancer after first-line treatment with Bevacizumab plus a platinum doublet-containing chemotherapy. Indication: Lung Cancer

Fulvestrant +/- BKM120 in patients with metastatic Breast Cancer A Phase III randomized, double blind placebo controlled study of BKM120 with Fulvestrant, in postmenopausal women with hormone receptor-positive HER2-negative locally advanced or metastatic breast cancer which progressed on or after aromatase inhibitor treatment.

Indication: Breast Cancer

Celebrating the Healthcare Worker...

Working in the field of nutrition allows me to help others improve not only their diet, but their overall health and quality of life. There is nothing more rewarding than helping someone regain their since of wellbeing.

Tricia Foley, MS, RD The Weigh Station 70 | www.ourhealthrvirginia.com

CANCER CARE | our health

cancer:

A REGIONAL OUTLOOK words | SARAH COX

From a multi-team disciplinary approach and advancements in chemotherapy to technology that precisely targets tumors and dedicated oncology dieticians, the field of cancer care in Southwest Virginia continues to advance.

According to David Buck, MD, a radiation oncologist with Blue Ridge Cancer Care and Medical Director for the Department of Radiation Oncology for Carilion Clinic, one of the strengths of these two entities working together is the multidisciplinary teams that meet on a weekly basis to discuss individual cases.

“We have multiple tumor boards that meet every week that include oncologists, pulmonologists, pathologists, and radiologists, and we are able to talk about individualized care, coming at it from a team approach,” says Dr. Buck. This, he notes, gives the patient the advantage of having “the best minds coming together, and this is the best way to advance their specific case and treatment.” www.ourhealthvirginia.com | 71

CANCER CARE | our health

Another advantage of having critical mass – the large patient population in Southwest Virginia coming to the Roanoke and New River areas for treatment – is that clinical trials are regularly conducted to advance cancer treatment.

The patient population is also responsible for the investment that Carilion Clinic has made with new technologies such as 3D imaging in the form of image guided radiation and the cyber knife, which is a form of stereotactic radiosurgery. “It’s essentially a miniaturized machine placed on a robotic arm,” explains Dr. Buck, who elaborates that this allows him to deliver “hundreds of tiny beamlets to give high dosages very precisely.”

This enables them to compress what would normally be six or seven weeks of radiation into three to five sessions. “In my 15 years in practice, to watch these advancements is rewarding, and then to have Carilion make these investments has been outstanding,” says Dr. Buck.

Padmaja Mallidi, MD, an oncologist with Blue Ridge Cancer Care and Medical Director for Medical Oncology with Carilion Clinic, says that targeted therapies, most specifically biological agents, are being used to successfully treat cancer and, at the same time, cut down on the side effects. Blue Ridge Cancer Care has an outpatient facility, while Carilion Roanoke Memorial Hospital has a dedicated oncology unit, staffed with oncology nurses and dieticians.

Dr. Mallidi says that targeted therapies reduce recovery time, shorten the length of side effects, and sometimes can be given in oral tablet form, thus cutting down on the necessity of coming into the office to receive infusions.

Celebrating the Healthcare Worker...

One of Dr. Mallidi’s special interests is in holistic medicine. She spent two years earning a fellowship in integrated medicine and has been applying techniques here in Roanoke. Some of those techniques concentrate on helping patients cope with the social and emotional stress of having cancer.

“We are doing a journaling project, and we are looking into acupuncture to help with nausea, fatigue, and neuropathy,” says Dr. Mallidi. She says that the multidisciplinary team approach discussed by Dr. Buck is “very important to cancer care.

They go through each case and figure out what’s best for the patient. We are learning every single day about new treatments.”

She says that while cancer rates are increasing quite rapidly, deaths are lessening. To that end, she says Carilion Clinic plans on focusing on preventive medicine in the near future – sending a nutritionist and doctor into the community to discuss diet, exercise, and stress relief.

Tricia Kingery, Senior Director of Oncology/Palliative Care Services for Carilion Clinic, points out that Carilion Clinic’s Breast Care Center is advancing cancer care through pre-treatment planning conferences where “malignant and benign cases are reviewed prior to treatment, so when they do the wire localization procedure combined with breast MRI and the pre-treatment planning conference, this assures performing a more exact surgery.”

“As healthcare workers, we are tasked with supporting both the wellness needs and education for our patients, as well as comforting them during life events which are so often unexpected. It is a privilege to be part of providing these services and see the real-time impact we make in improving the quality of life for so many of the members of our community.”

Melanie Morris Director, Carilion Clinic Transfer and Communications Center

Additionally, Kingery points out that the reexicision rates – or second surgeries – are below the national average at Carilion Clinic. Part of the hospital’s success is due to specialized treatments. “Patients with ovarian cancer really need a specialist and should be offered treatments such as intra-peritoneal chemotherapy,” says Kingery. www.ourhealthvirginia.com | 73

our health | CANCER CARE

She notes Carilion Clinic’s specialties, such as breast and gynecologic oncology, “sets us aside.” For instance, the Carilion Infusion Center is focused about 50 percent on gynecologic cancer. On the oncology unit, 100 percent of the nurses are trained according to the Oncology Nursing Society’s chemotherapy course, and at least 40 percent of those nurses are certified in oncology nursing. Carilion Clinic is also accredited under the American College of Surgeons Commission on Cancer.

Kingery is working with the journaling project as well as other integrative therapies to help patients and their families cope with the emotional side of cancer.

At LewisGale Regional Health System, Vice President of Oncology Services Mike Abbott says their two main goals are staying on top of the most advanced therapies and keeping patients in their community for support.

LewisGale Regional Health System has completely replaced its mammography equipment with digital equipment and has also introduced low-dose CT lung cancer screening as early detection has been shown to reduce mortality rates. A “super dimension system” or electromagnetic navigation bronchoscopy, Abbott says, is like a GPS for the lungs. It takes a CT image, and surgeons are able to use this imaging to guide them to the cancer. This results in a minimally invasive approach and uses the airways, so it lets doctors “get to nodules we couldn’t get to before,” explains Abbott.

Additionally, breast-specific gamma imaging, or BSGI, is an alternative to conventional mammography for those with dense breast tissue or hard-to-interpret mammograms. A low-dose CT scan is used to screen the lungs, and, according to

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CANCER CARE | our health

Abbott, early detection has been found to increase a person’s chances of survival with lung cancer by 20 percent. “It’s all about finding it early. It’s still the number one cancer that people die from, but when you find it early and surgery is an option, the survival rate is so much better,” says Abbott.

One of the most significant advancements at LewisGale Regional Health System is not the equipment, but the hands that use it – specifically, Sanjoy Saha, MD, who is a fellowship-trained surgical oncologist that recently joined the health system. One of the procedures he can offer that patients formerly had to go out of the area for is hyperthermic interperitoneal chemotherapy. “Certain cancers in the abdomen start out in the appendix. The procedure for this is cytoreductive surgery to cut out the cancer and then using the profusion machine to heat up the abdominal area and run chemotherapy through it,” says Abbott.

The availability of this option allows patients to stay in their localities, as does the new medical oncologist and infusion system at LewisGale Hospital at Pulaski and the new Blue Ridge Cancer Care building in Blacksburg that will have infusion suites as well as space for subspecialists to see patients.

William Fintel, MD, President of Blue Ridge Cancer Care, notes he’s been saying for years that oncology is soon to be “the queen of the medical sciences.” Why? “Literally every cancer patient I see has a genetic illness. It is either inheritable or mutable. All of the tumors that we are facing have some degree of genetic miscommunication,” says Dr. Fintel.

Padmaja Mallidi, MD, an oncologist with Blue Ridge Cancer Care and Medical Director for Medical Oncology with Carilion Clinic

David Buck, MD, a radiation oncologist with Blue Ridge Cancer Care and Medical Director for the Department of Radiation Oncology for the Carilion Clinic

William Fintel, MD, President of Blue Ridge Cancer Care

But with research, oncologists are seeing breakthroughs and understanding cancer better. Dr. Fintel notes, “We are now able to look at the inside matrix of the genetic cell and turn off these genes with medications. It is amazing that we now know how genes work; every gene makes a protein, and there are molecules that inhibit some replication steps. We just stop that protein production in its tracks.”

It is not a cure, explains Dr. Fintel, but it is opening up a path that they have never seen before. Dr. Fintel, who has been an oncologist for 25 years, says that “oncology picks you, you don’t pick it.” He explains that the willingness of his patients to undergo research, which is a brave move, is one of the reasons he appreciates this field and most especially, his patients.

Tricia Kingery, Senior Director of Oncology/ Palliative Care Services for Carilion Clinic

“When you are 74 years old, having all these toxicities, that is flat-out bravery,” he says of one of his patients who has willingly undergone a clinical trial. The research aspect of cancer in the Roanoke Valley has taken off, he says, and one of the results is that targeted agents are getting easier to administer and safer for the patient.

Celebrating the Healthcare Worker...

Hospice embraces a person’s physical, emotional and spiritual comfort.

With that being said, I feel that it is both a privilege and a blessing to be a part of a person’s end of life journey.

Lisa Myers, RN RN Case Manager, Good Samaritan Hospice www.ourhealthvirginia.com | 75

our health | NUTRITION HEALTH

UNDERSTANDING NUTRITIONAL VALUES IN FOODS words | TRICIA FOLEY, RD, MS

There is a lot of misinformation when it comes to nutrition, which can sometimes make products seem healthier than they really are. To ensure you are making the healthiest choices possible, below are some nutritional explanations to help keep you on track.

Have you ever wondered what enriched fiber really means? It sounds healthy, but unfortunately, it means that many of the good nutrients that were originally in the food have been stripped out through refinement and then some of these components have been added back in an unnatural way. Since our bodies do not know how to process these foods as well as whole, unprocessed foods, they should be avoided.

The term fortified is equally confusing. Eating fortified foods means that companies have artificially added vitamins or minerals. A good example is orange juice. It is often fortified with calcium. Although not harmful, getting calcium from naturally occurring calcium rich foods is always preferable over getting calcium from fortified foods.

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NUTRITION HEALTH | our health

A few additional misleading tag lines include “no sugar added,” “trans fat free,” and “net carbs.” Please don’t confuse “no added sugar” with not having any sugar. It simply means that no additional sugar, on top of the naturally occurring sugars already in the food, has been added. Depending on the food, there may be plenty of sugar already in it.

Trans fat is made by adding hydrogen to vegetable oil through a process called hydrogenation, making it last longer on the shelves. For this reason, it’s also seen on the ingredients label as hydrogenated oil. When the label claims the food is “trans fat free,” take time to check the ingredients list. You may be surprised to still find it there.

Products containing trans fat can label them “trans fat free” if there is less

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our health | NUTRITION HEALTH

than half of a gram per serving. The problem here is many people consume more than an actual serving. If a serving is one tablespoon, but someone is using more than that, he is going to consume more trans fat than he bargained for. In fact, the 2010 dietary guidelines suggest keeping trans fat as low as possible.

Eating more than a few grams on a regular basis can result in increased heart disease risk.

Also popular on the food labels are net carbs. These are the carbohydrates left over once the fiber and sugar alcohols have been subtracted from the total carbohydrates on the label. The thought is that fiber and sugar alcohols are not fully absorbed, so they do not need to be counted. This isn’t a perfect science.

The true absorption rate varies depending on the type of fiber and sugar alcohol used. Many products keep their net carbs down by adding artificial sweeteners, which increase the number of sugar alcohols, thereby reducing the net carbs. Be careful with high levels of sugar alcohols because they are hard for the body to process and are not real food. Net carbs may be helpful in guiding you in the right direction since low net carbs normally means the product has more fiber.

However, net carbs should not solely be used in determining whether or not the food is healthy.

Why is fiber important in the first place? Fiber can help with a number of things.

It can enhance satiety, improve texture, reduce calorie absorption, slow the absorption of sugar into the bloodstream, improve cholesterol, encourage the growth of friendly bacteria in the gut, and reduce colon exposure to potential carcinogens (cancer causing agents). Soluble fibers are known for their ability to lower cholesterol and slow the movement of food through the small intestine.

Examples of soluble fiber include oats, peas, beans, apples, citrus fruits, carrots, and barley. Insoluble fibers are known to be protective against colon cancer since they help to increase stool bulk and relieve 78 | www.ourhealthvirginia.com

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constipation. Examples of insoluble fiber include nuts, beans, and vegetables such as cauliflower, green beans, and potatoes. Aim for at least twenty five to thirty grams of fiber per day, ideally from whole foods. Check the nutrition facts to see how many grams per serving your foods contain.

How many calories should you eat daily? This number will be different for everyone. Calorie needs are very much dependent on sex, age, activity level, and goals (are you trying to lose, gain or maintain your weight). Depending on these factors you may need more or less than the “average� person. For a complete chart of calorie recommendations, please visit: http://www.webmd.com/diet/calories-chart.

There are formulas that can be used to help calculate your estimated calorie needs. The most commonly used is the Harris Benedict equation. Keep in mind though that these are still estimates and do have room for error. Knowing your estimated calorie intake is helpful to ensure you’re giving your body what it needs. Of course, not all calories are created equal. Remember, 100 calories of broccoli will provide you with much more nutritional value than 100 calories of potato chips.

Since calories are not created equal, what foods are the best for getting the nutrients you need? The answer is simple, fresh, unprocessed, local whole foods. Some examples include organic fruits, especially those with thin skin like blueberries, apples, and plums. These fruits are packed with even more nutrients (antioxidants, vitamins, and minerals) than their thick peel cousins (bananas, oranges, etc). Buying organic is also important since eating fruits laden with pesticides may undo some of the health benefits. Non-starchy vegetables such as broccoli, peppers, and mushrooms are also going to provide more nutrition per calorie than starchy vegetables like potatoes and corn. Beans and lentils are great starch choices providing a healthy dose of fiber, iron, and even protein. Looking for fresh produce and products that have labels and taking time to read the ingredients will keep you from falling for nutritional misinformation.

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A Q U AT I C S

A RT H RI T I S Roanoke County’s Green Ridge Recreation Center offers a variety of programs designed to help improve the health of people in our communities - including one designed for those living with arthritis.

words | CAMERON MAY

Arthritis affects more than 50 million people in the United States, including many who live right here in Southwest Virginia. While exercise is recommended as a way to help increase strength and flexibility, reduce joint pain, and combat fatigue for those with the condition, high impact activity can often be too painful to tolerate.

The Arthritis Foundation Aquatic Program offered at Green Ridge Recreation Center may be the answer for those looking for a low impact way to exercise.

“Aquatic therapy has been medically documented as being a beneficial way to increase physical activity for those who can’t perform traditional, high impact exercise,” explains Paige Hickey, an aquatic instructor at Green Ridge. “The improvement in quality of life is huge. Plus, it’s so much fun that most people have a hard time believing it’s actually exercise!”

The buoyancy of the warm water provides an unloading of the weight bearing joints of the spine, knee, and hips. This is helpful for those who can’t tolerate exercising on land due to joint pain. Water also provides assistance and resistance while exercising so that progress through various levels of activity can be achieved while increasing strength.

Arthritis is a condition of many forms and stages. Different coping methods are more appropriate than others. When the disease advances to more disabling levels, what used to be a viable exercise routine can become seemingly impossible. This creates a crossroad for the body between balancing pain and the need for physical activity. www.ourhealthvirginia.com | 81

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Another great advantages of aquatic therapy is that the entire body gets a workout, which is important for those with arthritis.

“Every part of the body benefits from the routines,” explains Hickey. “This is an all-natural method of dealing with arthritis without the risks of adding another medication.”

The medical and physical benefits aren’t the only ones that the Arthritis Foundation Aquatics Program offers in spades. Like every activity at Green Ridge Recreation Center, there is a huge opportunity for social interaction and growth.

“When I come in and see the people in the program interacting with other, especially those whom are elderly and probably don’t have that much outside interaction, it’s incredibly satisfying for me,” shares Hickey.

Hickey says groups often meets for pot luck suppers and other activities outside of Green Ridge.

“Seeing people in the water together - laughing, talking, and having a good time - makes me realize that what we’re offering is much more than just physical therapy.”

The Arthritis Foundation Aquatics Program is only one course in a large arsenal that Green Ridge’s Aquatics Program boasts. Some of the other programs are more intense and fitness based and able members are encouraged to branch out to those as well.

Celebrating the Healthcare Worker...

I have found healthcare to be a rewarding career with many exciting opportunities. I have worked in many settings including Behavioral Health, ER, Home Health and School Nursing. There is truly no limit to the variety of opportunities.

Kay Kostura, RN, BSN Behavioral Health, LewisGale Medical Center 82 | www.ourhealthvirginia.com

A list and description of Green Ridge Recreation Center programs can be found online at www.roanokecountyva.gov or by calling 540.777.6300.