table of contents | august • september 2014
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School Times
MEDI•CABU•LARY.....................12 Local experts define health related terms
Schools provide parents with a list of supplies needed for the new school year, but left off that list are steps to ensure a child’s good health. In this issue, OurHealth provides parents with a step-by-step resource full of valuable physical, emotional and social information to consider, as well as tips from local healthcare and healthcare-related providers from Richmond to help your children make healthy choices all year long.
JUST ASK!.......................................14 Healthcare questions answered by local professionals
NEW & NOTEWORTHY.............16 A listing of new physicians, providers, locations and upcoming events in Southwest Virginia
HEALTH POINTS........................ 20 Interesting facts and tidbits about health
THE ANATOMY CHALLENGE................................. 23 How much do you about our anatomy? In this issue, test your knowledge when it comes to the amazing EAR!
ANATOMY: The Aging Ear......... 24 Although grey, thinning hair and deep wrinkles are two of the most commonly talked about signs of getting older, age-related hearing loss is a significant concern for many Americans
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Blue Ridge Best of : Retirement Living Awards The results are in!
NUTRITION.................................. 67 FEATURING HEALTHY, FRESH, LOCAL INGREDIENTS: Harvest Recipes—Brined Mesquite Turkey, Roasted Harvest Vegetables, Apple-Peach Oatmeal Crisp
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The Resource for Healthy Living in Southwest Virginia
FIT BITS!........................................ 72 Health and Fitness On-the-Go: A Right to ‘Bare Arms’
86 Prostate Cancer
Testing Remains Critically Important
hello, HEALTH!.............................. 74 Capturing the spirit of Southwest Virginian’s working in healthcare and of people leading healthy lives through photos
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[series]
Breaking the Silence: Pancreatic Cancer
This series explores diseases that can be devastating to the individuals and families they affect—yet no one is talking about them—until now.
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Drug Recovery: John’s Story
John grew up in a family heavily addicted to alcohol and drugs, becoming a heavy drinker and drug abuser himself, beginning at age 14.
LOOKING BACK........................... 98 Images reflecting the history of healthcare in Southwest Virginia * PLUS * a chance to win prizes!
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The Resource for Healthy Living in Southwest Virginia
august • september 2014
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CONTRIBUTING MEDICAL EXPERTS
Delmas Bolin, MD, PhD Caitlin Cheatham, Fitness Director Jay Easton, CRT David Killeen, DO, FCCP Frank Pupera, MD Amy Sullivan, MD
CONTRIBUTING PROFESSIONAL WRITERS
Susan Dubuque Rich Ellis Tricia Foley, RD Laura Neff-Henderson, APR Rick Piester Michelle Stephenson Deidre Wilkes
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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 305 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Information in all print editions of Our Health and on all Our Health’s websites (www.ourhealthvirginia.com and www.ourhealthrichmond.com) social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2014 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. The OurHealth Southwest Virginia edition is published seven times annually by McClintic Media, Inc. 305 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthvirginia.com | www.ourhealthrichmond.com | Advertising rates upon request.
LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S
What is a cluster headache?
What is a Transitional Care Hospital?
A cluster headache, although rare, is the most painful, primary headache disorder. Unlike migraine headaches, cluster headaches afflict men more often than women.
A Transitional Care Hospital (TCH), more commonly known as a Long Term Acute Care (LTAC) hospital, provides care for patients requiring an average length of stay of 2532 days. Traditional Acute Care Hospitals (ACH) typically have a 3-5 day length of stay. LTAC’s provide specialized, goal-directed care for medically complex patients needing extended recovery times.
Sufferers usually are restless and pace around due to the unbearable pain. The actual head pain is a unilateral, stabbing pain in the eye, and/or surrounding orbit, brow and forehead area, which may radiate to the back of the head and sometimes neck and shoulder. Typically, a cluster headache can last 45-90 minutes and can occur several times per day, for weeks or even months. They can also have a remission period that lasts for a period of months or years. Accompanying symptoms may include: tearing of the eyes, runny/ stuffy nose, droopy eyelids, small pupils and a sweaty forehead on the same side as the head pain. Night time attacks are common. Cluster headaches are more frequently present during the summer and winter solstices. Amy Sullivan, MD Carilion Clinic Neurology Roanoke | 540.224.5170 www.carilionclinic.org
Examples of services LTAC patients require are: dialysis, ventilator management and weaning, special monitoring, wound care, nutritional therapy, pain management and IV therapy. Jay Easton, CRT
Kissito Healthcare The Brian Center Botetourt Fincastle | 540.473.2288 www.kissito.org
What is Golfer’s Elbow? Golfer’s elbow, also known as medial epicondylitis, causes pain on the inside of the elbow. Golfer’s elbow develops when the muscles and tendons that control the wrist and fingers become damaged due to overuse or repetitive stresses. Despite the name, it’s not limited to people who play golf. Tennis players and other athletes who repeatedly flex and extend the wrists or grip with the hands can also develop this condition. The main symptoms include pain over the inside part of the elbow that may extend into the forearm, stiffness and pain when a fist is made, a sense of grip weakness, and occasionally, numbness and tingling that may radiate into the ring and little fingers. The pain may appear suddenly or come on gradually. Most people notice that the pain becomes worse when they swing a golf club or racquet, grip something, shake hands, turn a doorknob, or pick up objects with their palm down. Treatment typically includes specific stretches and exercises, which can be directed by a physical therapist, anti-inflammatories medications, rest from the offending activities, and icing the painful area. Usually, symptoms improve in two – three weeks. If symptoms last more than three weeks, it may be time to consult a sports medicine physician. Delmas Bolin, MD, PhD Performance Medicine of Southwestern Virginia Roanoke | 540.772.1890 www.pmswva.com
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H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
What causes someone to bruise easily? Most bruises form when a blow or injury causes the capillaries near the skin’s surface to break. As blood leaks out of the broken vessels a black-and-blue mark will form. The harder the blow, the larger the resulting bruise. Over time your body reabsorbs the blood, and the mark fades. Some people — especially women —bruise more easily than others. As you get older, your skin also becomes thinner and the protective fatty layer that helps cushion your blood vessels from injury decreases. Blood thinners (i.e. Aspirin or Warfarin) reduce the blood’s ability to clot. When taking these medications, bleeding from capillary damage might be prolonged, resulting in blood leakage and a bruise. Non- prescription blood thinning agents (i.e., fish oil and ginkgo) can also increase bruising. Corticosteroids have a thinning effect on the skin that leaves the capillaries more prone to breakage. Talk to your doctor if you think you have increased bruising and do not stop taking your medications unless your doctor advises you to make changes. Frank Pupera, MD
Cosmetic Vein Center of Virginia Vascular Surgery Blacksburg | 540.552.8346 www.cosmeticveincenterofvirginia.com
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What is the difference between elliptical vs. treadmill exercise? Though nothing is quite like hitting the pavement for a nice long run in the sunshine, a treadmill does have it’s advantages. With the capabilities to adjust incline and speed, you can also customize your own workouts. Treadmills also have far less impact on your body than running on pavement. In regard to the elliptical vs. treadmill question: A person uses more kinetic energy running on a treadmill, therefore burning more calories than on an elliptical. However, ellipticals may trump a treadmill if a person has lower back, hip, knee, or ankle pain. It is an even lower impact workout than running on a treadmill and because of the lower impact, there is less perceived exertion; thus the persuasion of someone possibly working out longer. Users can also adjust the incline and resistance levels of an elliptical to intensify their workout along with engaging their upper body by using the moveable arms. When it comes down to it, it is really all personal preference. Caitlin Cheatham, Fitness Director Sun Medical Ltd. Roanoke | 540.389.3800 www.sunmedical.com
What causes COPD? Chronic obstructive pulmonary disease (COPD) is caused by damage and inflammation to airways and the framework that holds the airways open. This can be caused by tobacco smoke, biofuels used in cooking, chronic or recurrent lung inflammation and some genetic diseases. COPD results in problems moving air out of the lungs. People can also have coughing and wheezing. People with COPD or emphysema with feel short of breath initially with exertion and as the disease progresses, will be short of breath at rest as well. Certain inhalers can help move air well and reduce the breathlessness and inflammation. Prevention by avoidance of tobacco and other smoke/irritants is the best way to avoid COPD. David Killeen, DO, FCCP
LewisGale Physicians Pulmonary Critical Care & Diseases Salem | 540.772.3540 www.lgphysicians.com
NEW
NOTEWORTHY
Virginia Tech Carilion Research Institute Scientists Make Surprising Discovery About a Common Virus
Scientific discoveries about the global virus, Rotavirus, which is responsible for nearly half a million deaths in children each year, enable researchers to take the next steps in research. The results of these studies are expected to provide an important scientific foundation for future vaccine design. •••••
Virginia Tech Carilion Research Institute Awarded Grant to Recruit Eminent Scholar in Cancer Biology
The Virginia Tech Carilion Research Institute recently received a $250,000 grant from the Commonwealth Research Commercialization Fund to recruit an eminent scholar to lead the institute’s cancer research center. The award went to the institute’s executive director, Michael Friedlander, who oversees the recruitment of high-level faculty team leaders. The grant contributes to the funds needed to recruit the ideal candidate and helps offset some of the costs associated with setting up a new research laboratory and operations at the institute. It also provides some funding for the selected researcher to recruit additional investigators. “The recruitment of a senior eminent scholar in cancer research will be a critical catalyst for maturing our cancer research program,” Friedlander said. “We’ve already assembled a group of cancer scientists working on breast, brain, and blood cancer therapeutic targets and strategies. This group has the potential to become a major force in cancer research.”
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NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS
Virginia Tech Carilion Research Institute Researchers to Study Mechanisms of Hard-to-Solve, Hereditary Breast Cancer to Find Treatment Options
Deborah Kelly and Zhi Sheng, assistant professors at the Virginia Tech Carilion Research Institute, recently received a grant from the Commonwealth Health Research Board to investigate hereditary breast cancer, an effort that may lead to new treatment approaches. This board funds research intended to benefit Virginia residents. The grant will fund a two-year project to study the mechanisms behind hereditary breast cancer related to the BRCA1 gene. This type of cancer often has a poor outcome, especially in Virginians compared to the national average. About 12 percent of women in the general population will develop breast cancer sometime during their lives, according to the National Cancer Institute, but 55 percent to 65 percent of women who inherit a harmful BRCA1 mutation will develop breast cancer by age 70. Once Kelly and Sheng gain better insight into the molecular basis of BRCA1 mutations, researchers may have the information to develop new specific treatments for hereditary forms of BRCA1-related cancers; improving the lives of women living with these mutations and improving their treatment options long term.
LewisGale Hospital Montgomery Recognized for Giving More Babies a Health Start in Life Scheduling a baby’s date of delivery without a medical reason, even just one to two weeks before their due date, can increase their risk for health problems. It’s the reason LewisGale Hospital Montgomery has been on a mission over the last two years to reduce the number of elective deliveries at its hospital before 39 weeks of pregnancy. The hospital was recently recognized by the March of Dimes and the Virginia Hospital & Healthcare Association as one of only 26 hospitals in the state who have successfully reduced preterm births. Worldwide, 15 million babies are born too soon each year and more than one million of those infants die as a result of their early births. Babies who survive an early birth often face the risk of lifelong health challenges, such as breathing problems, cerebral palsy, learning disabilities and others. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. Recent research by the March of Dimes, the National Institutes of Health and the U.S. Food and Drug Administration found that although the overall threat is small, the risk of death more than doubles for infants born at 37 weeks of pregnancy when compared to babies born at 40 weeks, for all races and ethnicities. You can find more information online at marchofdimes.com/39weeks or at www.lewisgale.com.
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NEW
NOTEWORTHY
NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS
Michele Keesling, RN Honored as Nurse of the Year for LewisGale Hospital Pulaski
Earlier this summer, LewisGale Hospital Pulaski named Michele Keesling, RN, as its 2014 nurse of the year for her commitment to excellence in nursing. Michele is a Registered Nurse with more than nine years of experience in the field. She currently works in the cancer center where she serves as the Oncology Nurse Navigator and Palliative Care Coordinator. Michele’s award was announced during LewisGale Hospital Pulaski’s celebration of National Nurse’s Week. She was recognized for her outstanding clinical skills and extreme compassion for patients. In addition to her nursing duties, Michele is the CoChair of the Nursing Professional Development Council and teaches CPR, Infusion skills and Certified Nursing Assistant skills to other nurses. She is also an Ordained Minister. Michele was nominated by her peers for this award. They had many words of praise for the care she gives patients every day and the example she sets for other nurses. “Service excellence is the main focus for Michele,” said Marsha Myers, Director, LewisGale Regional Cancer Center Pulaski. “She often sings and prays with patients and their families at their request. Whatever the family needs at the time Michele is there to help.”
Pictured left to right: Lori K. Caudill, BSN, RN, CMSRN; Debra S. Dishon, RN; Joyce F. Parsons, RN; Amanda B. Rorrer, BSN, RN; Michele Keesling, BSN, RN (Nurse of the Year); Linda M. Shepherd, MBAL, BSN, RN, CNO
Over the years, Michele has also been nominated for the hospital’s Service Excellence Award and the DAISY Award for Extraordinary Nurses. For more information see www.lewisgale.com.
Gail Arrington, NP
Lauren Baker, NP
Carol Felts, NP
Carilion Clinic General Surgery Carilion Clinic General Surgery Carilion Clinic Psychiatry and Westlake | 540.224.5170 Roanoke | 540.224.5170 Behavioral Medicine www.CarilionClinic.org www.CarilionClinic.org Radford | 540.731.7311 www.CarilionClinic.org
Victor Buckwalter, MD Matthew Carilion Clinic Family Medicine Schneider, PA Weyers Cave | 540.234.9241 www.CarilionClinic.org
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Jeffrey Wilson, MD
Carilion Clinic Child and Carilion Clinic Family Medicine Adolescent Psychiatry Roanoke | 540.853.0900 Blue Ridge | 540.977.1436 www.CarilionClinic.org www.CarilionClinic.org
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Molly Rutherford, MD, FACC Jefferson Surgical Clinic Cardiology Roanoke | 540.283.6000 www.jeffersonsurgical.com
Thomas Donohue, MD Carilion Clinic Pediatric Medicine Roanoke | 540.772.4714 www.CarilionClinic.org
T I P S , T I D B I T S A ND MO R E TO IN F O R M A ND ENT ERTA I N YO U
TS BACKPACK FAC
shopping for school year includes w ne e th r fo ing ar Prep se, backpacks. supplies and of cour new clothes, shoes, nt way
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from approximately pack should extend The height of a back slightly s to waist level or the shoulder blade low be s he inc o tw above the waist.
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dded backing not Backpacks with pa ed comfort, but only provide increas s n from sharp edge also offer protectio d an s pencils, ruler on objects such as notebooks.
ultiple Backpacks with m compartments can help distribute weight more Source: The American evenly. iatrics Academy of Ped
ON THE WEB
More at ourhealthvirginia.com 20
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September is National Childhood Obesity Childhood Obesity Facts Month and Figures* Obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of obese children
in the U.S. between the ages of six and eleven increased from 7% in 1980 to nearly 18% in 2012.
More than 1/3 of children and adolescents are currently overweight or obese. Children and adolescents who are obese are likely to be obese as adults.
Healthy lifestyle habits, such as maintaining a proper diet and engaging in regular physical
activity, can lower the risk of
becoming obese and developing related conditions such as diabetes, high blood pressure and heart disease. *Source: www.cdc.com
CataractAwareness You Don’t Have to Live in a Fog
A cataract is a clouding of the normally clear lens of the eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window. Cataracts are diagnosed during an eye exam performed by an ophthalmologist or optometrist. Removal of cataracts is performed through an outpatient surgery procedure.
More than half of all Americans age 65 and older have cataracts.
Signs and Symptoms of Cataracts • Cloudy, fuzzy, foggy, or filmy vision • Variations in color appearance • Difficulty driving at night • Increased glare from lamps or the sun
Remember: schedule routine eye exams with an ophthalmologist or optometrist to stay on top of your eye health.
September is
Prostate Cancer Awareness Month
Ways to Reduce the Risk Although there is no proven prostate cancer prevention strategy, there are steps men can take to reduce their risk of developing the disease. Consider these healthy choices: • Maintain a low-fat diet • Increase the amount of fruits and vegetables consumed daily • Replace red meat with fish, chicken and other lean meats • Reduce intake of dairy products • Replace sodas with water and green tea • Incorporate soy into your diet • Limit consumption of alcohol • Maintain a healthy weight • Exercise most days of the week Age, gender and family history all play a role when it comes to prostate cancer. Maintaining regular appointments with a primary care physician and having necessary testing performed are important steps to take to ensure early diagnosis.
The
2014 Walk to
END Alzheimer’s® The Alzheimer’s Association Walk to End Alzheimer’s® is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. Held annually in more than 650 communities nationwide – including Richmond – this inspiring event calls on participants of all ages and abilities to reclaim the future for millions. Mark your calendars to participate in our area’s 2014 Walk to End Alzheimer’s® Event to help in the fight to end Alzheimer’s.
Roanoke Valley Walk Information Date: Saturday, September 6th Location: Elmwood Park Registration: 8:00 am Ceremony: 9:00 am Walk: 9:30 am Route Length: Two miles
New River Valley Walk Information
For details on how to donate or register for the Roanoke Valley event, visit http:// tinyurl.com/lfgw4e4 For details on how to donate or register for the New River Valley event, visit http://tinyurl.com/mkquavv. For further information about either event, contact Suzanne Cresswell via email at scresswell@alz.org or at 540.345.7600.
Date: Saturday, October 10th Location: Main Street at Henderson Lawn Registration: TBD Ceremony: TBD Walk: TBD Route Length: Two miles
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the
Anatomy CHALLENGE
Here’s your chance to see how much you know about the amazing
EAR! First, find all the hidden words in the word search below. Next, match up the correct word with the part of the body in the illustration.
[ the amazing EAR ]
WORD SEARCH antihelix
earlobe
cartilage
eustachian tube temporal bone
cochlea
helix
cochlear nerve
incus
temporal muscle
concha
malleus
triangular fossa
ear canal
scapha
tympanic cavity
eardrum
semicircular canals
vestibular nerve
______________ ______________ ______________
stapes
______________ ______________
______________
______________ ______________
______________ ______________ ______________
______________ ______________ ______________
______________ ______________ ______________
______________
______________
______________ ______________ www.OurHealthVirginia.com
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aging the
words | LAURA NEFF-HENDERSON, APR
EAR
Experts with the Administration on Aging expect that, by 2030, there will be about 72.1 million persons 65 years or older, more than twice their number in 2000, accounting for more than 19 percent of the population and double the number of older Americans in 2000. Although grey thinning hair and deep wrinkles are two of the most commonly talked about signs of getting older, age-related hearing loss is a significant concern for many Americans. Age-related hearing loss, presbycusis, is one of the most common conditions affecting older and elderly adults. Approximately one in three people between the ages of 65 and 74 has hearing loss and nearly half of those older than 75 have difficulty hearing, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). There is no known single cause of age related hearing loss, according to the National Institutes of Health, and the damage is permanent. Having trouble hearing can make it hard to understand and follow a doctor’s advice, to respond to warnings, and to hear doorbells and alarms. It also makes the most basic interaction with friends and family difficult. Individuals with hearing loss tend to shy away from social activities, including going out to dinner with loved ones. They often report being embarrassed to ask others to repeat themselves and, as a result, remove themselves from the work around them because of it.
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Hearing loss is also tied to depression and is linked to dementia. Research not only shows a connection between hearing loss and dementia, but a recent Johns Hopkins study of older adults found that hearing loss actually accelerates brain function decline.
Individuals, who think they may have a hearing problem, or answer yes to three or more of the following questions, should seek professional advice from an otolaryngologist or an audiologist.
Symptoms
• Do you have trouble hearing when there is noise in the background?
Early signs of hearing loss include difficulty understanding certain speech sounds when in the presence of background noise, consistently turning the television to a higher level than other people in the same listening environment, ringing or buzzing in the ear (tinnitus), and the tendency for an individual to ask people to repeat themselves often. The symptoms come on gradually for most and, as a result, many people don’t realize the degree to which they are losing hearing, explains Michelle Ickes, PhD, CCC-A, director of audiology, at Roanoke Valley Speech and Hearing Center in Roanoke, Va. According to Dr. Ickes, many patients don’t come to her until a family member or friend, and most often a spouse, has repeatedly told them that they need to make an appointment to have their hearing checked. Janice Anderson, audiologist owner of Anderson Audiology in Dublin, Va. agrees. Her patients rarely know they have a hearing problem when they come in to see her, she explains.
Causes The onset of age-related hearing loss begins to affect most people in their early 60’s, though it can be seen earlier, particularly if there is a genetic predisposition in the family. Many patients begin to seek medical treatment in their 40’s, according to Anderson. Individuals who listen to extremely loud music and/or work in certain professions where they are exposed to loud noise for prolonged periods of time (factory workers, musicians, construction workers, farmers, chefs, musicians, airport workers, yard and tree care workers, and people in the armed forces) are especially susceptible for sensorineural hearing loss.
• Do you have a problem hearing on the phone?
• Is it hard to follow a conversation when more than one person is talking at the same time? • Do you have to strain to understand a conversation? • Do people seem to be mumbling when they talk to you? • Do you misunderstand what others are saying? • Do you ask people to repeat themselves often? • Do people complain that you turn the television volume up too high?
Prolonged exposure to loud noise destroys nerve endings (hair cells), which results in permanent hearing loss. The Occupational Safety & Health Administration (OSHA) now requires employers to provide hearing exams and hearing protection to employees who work in environments with sustained high levels of noise. Hearing loss can also be caused by viral or bacterial infections, cardiovascular problems, head injuries, tumors, and certain medications. Other medical issues including diabetes, heart disease, and multiple sclerosis can have a significant impact on hearing as well. More obvious causes of hearing loss include earwax buildup, an object in Janice Anderson, audiologist and the ear, injury to the ear owner of Anderson Audiology in Dublin, VA or head, ear infection, a ruptured eardrum, and other conditions that affect the middle or inner ear.
Michelle Ickes, PhD, CCC-A, is an audiologist at Roanoke Valley Speech and Hearing Center
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The Experts
Getting Help
Several different types of professionals are available to help with hearing loss. Each has a different type of training and expertise. A hearing instrument specialist is a state-licensed professional salesperson who is trained to perform hearing tests, take measurements of the ear canal, fit hearing aids, program hearing aids, and make routine repairs. The hearing instrument specialist is not licensed to diagnose or treat any medical illness, and is required by state law to recommend a medical examination by a physician prior to selling a hearing aid. An audiologist is a hearing professional who is trained not only to manage hearing aids but also to perform more detailed examinations of the hearing using sophisticated electronic equipment. The audiologist is also trained to evaluate and test the balance system. All audiologists have a college degree and at least a master’s degree plus one year of clinical training. Recent graduates now complete a four year doctoral program after college. An otolaryngologist, also known as an ear, nose, and throat specialist, is a medical doctor and surgeon trained to provide comprehensive care of the ears nose and throat, including the hearing. The otolaryngologist is the most highly trained physician for diagnosing and treating hearing loss and is the only physician trained to perform surgery in the ear. Many patients with ear complaints, hearing loss or ringing in the ears will be referred to an otolaryngologist for initial evaluation and treatment planning. Most otolaryngologists employ or collaborate with hearing instrument specialists or audiologists to provide the diagnostic testing and programming of hearing aids.
The Cardiovascular Connection
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As with most health conditions, early intervention is the key to a positive prognosis. In fact, it’s critical to slowing down the rate at which the patient is losing hearing, according to Dr. Ickes. In addition to wearing ear protection in noisy environments, one of the most effective ways to mitigate the effects of hearing loss is the use of hearing aids. Hearing aids can significantly impact a person’s quality of life. Medical professionals can tell pretty quickly via a simple hearing test, also known as an audiogram, whether that’s the case.
Treatment Options Because there is no cure for age related hearing loss caused by nerve damage, treatment is focused on improving everyday function, and reducing some of the risks associated with hearing loss. The first line of treatment for hearing loss should be a medical evaluation to determine whether or not the hearing impairment can easily be resolved through medical intervention, according to Dr. Anderson. One of the most common options for patients with hearing loss caused by nerve damage to the inner ear is hearing aids. In addition to making it hard to hear, sensorineural hearing loss frequently causes distortion of the sounds that the person does hear. Hearing aids can improve speech understanding by selectively amplifying the frequencies that have been damaged resulting in significantly improved speech quality. Today’s hearing aids which utilize directional microphones, multiple adjustable frequency bands, compression for unwanted loud sounds, Bluetooth connectivity, and other advances have improved the effectiveness of hearing aids in optimizing the useable hearing of patients with hearing impairment, explains Dr. Ickes. Additionally, advancements
Recent research reveals a strong connection between hearing loss and cardiovascular health. Studies have shown that a healthy cardiovascular system—a person’s heart, arteries, and veins—has a positive effect on hearing. Experts believe that because the inner ear is extremely sensitive to blood flow, it is sometimes the first area of the body to respond to abnormalities in the cardiovascular system. In one study published in “The Laryngoscope,” researchers found that patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered.
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in telephone technology utilizing Bluetooth landline and cellphone adaptability to hearing aids have offered an improved approach to improving telephone communication for the hearing impaired. Many local specialists allow patients to evaluate the effectiveness of hearing aids through a trial period, before they actually purchase them. Patients have to be seen regularly for fittings and cleanings. In recent years, hearing aid technology has improved significantly and patients are now able to control a variety of settings that maximize hearing potential. The most basic models begin at about $1,000 for a pair, with the more advanced options topping out at $7,000. They do generally have to be replaced every three to five years; however, some patients are able to wear them for much longer before buying a new pair.
• Inattentiveness
Warning Signs of Hearing Loss in Adults
While hearing aids are believed to be one of the most effective ways of treating age related hearing loss, there are other options available to people.
• Buzzing or ringing in their ears • Failure to respond to spoken words • Persistent ear discomfort after exposure to loud noise (regular and constant listening to electronics at high volumes) • Muffled hearing • Constant frustration hearing speech and other sounds • Avoiding conversation • Social isolation • Depression
For individuals with profound hearing loss, for whom hearing aids offer no significant benefit, cochlear implants are an option. Cochlear implants are small electronic devices surgically implanted in the inner ear. Dr. Ickes warns though that the implantation surgery is the very beginning, and often the easiest part, of learning to live with and maximize cochlear implants. Patients often undergo years of programming sessions and therapy following the surgery. Assistive listening devices can also help those with hearing loss. Some of these devices include telephone and cell phone amplifiers, smart phones or tablet “apps,” and closed circuit systems in large venues, including places of worship, theaters, and auditoriums. Friends and family can also help by making minor accommodations to make the situation most ideal for the hearing impaired person. To help those with hearing loss, friends and family can speak louder, without shouting and should talk directly to the person with the hearing impairment. One of the most common ways that people cope with hearing loss is by learning to read lips and body movement to piece together pieces of the conversation they are unable to hear. It’s nearly impossible for a person with a hearing impairment of any level to understand what’s been said when the speaker talks as they are walking away. www.OurHealthVirginia.com
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People should also be willing to repeat themselves instead of saying “never mind” when the person doesn’t hear them or understand. It’s also a good idea to turn off the television and/or radio and move away from any other background noise when possible. Avoid sitting near the kitchen at a restaurant or near a band playing music at an event. Even without a hearing loss, background noise makes it hard to hear people talk.
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“Family and friends can make life so much easier for the person with a hearing loss if they would just give them the same consideration they would give a blind person,” says Anderson.
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“Vaccines are not an obligation to be avoided or suffered; they are a gift for health.” — David Berry, D.O., Ph.D., MS, FAAP, FACOP, LewisGale Physicians
SCHOOL
TIMES
words |MICHELLE STEPHENSON
Thankfully, schools provide parents with a list of supplies needed for the new school year. But left off that list are steps to ensure a child’s good health. That’s where OurHealth comes in. This step-by-step resource provides parents with valuable physical, emotional and social information to consider, as well as tips from local healthcare and healthcare-related providers throughout Southwest Virginia to help your children make healthy choices all year long.
The First Alarm If you haven’t already done so, this is the perfect time to schedule your child’s check-up or sports physical. These appointments are a great way to ensure that your child is up-to-date on immunizations and is ready to start school. Also, if your child suffers from allergies, asthma, diabetes, or other chronic conditions, make sure to refill all medications so you can check them in with the school nurse before the first day. You may also want to schedule an eye exam so that new glasses and contacts can be ordered and delivered before the first day of school.
Reprints To order reprints of the original artwork featured on this issue’s cover, contact Jenny Hungate at 540.387.6482 or via email at jenny@ourhealthvirginia.com. To view additional work by our artist, Joe Palotas, visit www.salemartcenter.com
Kids entering kindergarten, middle school and college probably are due for vaccines and for those that don’t need them, annual visits are important to assure that kids are growing and developing at the correct rate while also making sure there aren’t problems waiting to surface. — Amy Kryder, M.D., Carilion Clinic Pediatric Medicine
The purpose of the pre-participation medical history and physical examination is not to disqualify or exclude an athlete from competition, but to ensure that an athlete has recovered from any prior injuries, evaluate existing injuries, and detect pre-participation conditions that may put the athlete at increased risk so they may practice and participate in sports safely.
Screening physicals are an important part of every athletes pre-season preparation. These exams can identify potential health risks allowing for early treatment preventing serious injury. — James M. Farmer M.D., LewisGale Physicians
— Thomas K. Miller, M.D., Carilion Clinic Orthopaedics
A week or two before the start of school is also a good time to encourage your children to move from their summer schedule, or lack thereof, to a more structured schedule. One of the most difficult transitions can be moving to an earlier bedtime. A commonly used method is to move children’s bedtime back 15 minutes each night or every other night until they are back on their school-year schedule. For younger children, it can be helpful to write down their morning routine and how long each task should take. They can even start practicing the morning routine before the first day. This helps children become more independent, and can free up parents who are trying to get ready for work or get other children ready for school or daycare. Experts estimate 80% of learning is done through the visual system, and studies show that vision screenings miss 73% of vision problems - schedule your child a comprehensive eye exam to ensure they have the best chance to succeed. — John M Dovie, OD, FAAO, Blacksburg Eye Associates
Wake Up! The key to a successful and stress-free morning is to plan ahead. Check the weather on school nights and lay out appropriate clothes for the weather and temperature. Make sure children pack their backpacks at night, and start thinking about breakfast. Possibly, the single most important thing your child can do in the morning is to eat breakfast. Eating breakfast has been associated with better memory, test scores, and attention span, as well as decreased irritability, healthier body weights, and improved overall nutrition. Many families choose to skip breakfast because they don’t have time in the morning. Quick fixes include cereal or a bagel with low-fat cream cheese. Another solution is to make breakfast the night before. For example, hard boiled eggs and cut up fruit are ideal options.
Pack smart by packing only what you need and putting the heaviest items closest to your back. -Caleb Behrend, MD, Orthopaedic Spinal Surgeon, Carilion Clinic Orthopaedics - Spine Center
If there is simply no time to eat breakfast at home, be sure to ask what breakfast options are available at your child’s school or daycare provider, or pack a breakfast for the bus or car ride to school. Good options include fresh fruit, high-fiber unsweetened cereal, nuts, reduced-fat cheese, peanut butter, bagels, pretzels, low-fat granola bars, dried fruit, rice cakes, whole-grain crackers, and cut veggies.
“Getting the day off to a healthy start can recharge the brain and body, providing what we need to efficiently perform our daily activities.” — Don Mankie, RD, Carilion Clinic Children’s Hospital, Pediatric Gastroenterology and Nutrition
Before leaving the house, make sure your child has a jacket and athletic shoes for physical education. But always make sure that his or her backpack is not overstuffed. Many children suffer from back pain because they are lugging around too many books and supplies. Physicians and physical therapists recommend that backpacks should not be heavier than 10 percent of a child’s body weight. Also, make sure that your child wears the backpack with both straps in place, rather than over just one shoulder. Children who wear a backpack incorrectly typically lean to one side to offset the extra weight. This can cause back pain as well as shoulder and neck strain.
You’re never too young to take care of your spine. Posture is importantdon’t slouch! Also, lighten your backpack. Rule of thumb is no more than 10% of your body weight. — James M. Leipzig, M.D., FACS, LewisGale Physicians
Overstuffed backpacks are not the only cause of back pain in children. Poor posture is also a contributor, so encourage your children to sit or stand up straight. Establishing good posture during childhood may prevent back issues later in life.
www.OurHealthVirginia.com
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Do You Know the Rules for Motorists & School Bus Safety? tt TWO LANE: When approaching a school bus with flashing signals and/or extended stop sign on a public or private road, vehicles traveling in both directions must stop
tt MULTI-LANE Paved Across: When approaching a school bus with flashing signals and/or extended stop sign on a public or private road, vehicles traveling in both directions must stop
DIVIDED HIGHWAY unpaved space u (min 5ft.) OR any raised median/ physical barrier: When approaching a school bus with flashing signals and/or extended stop sign on a public or private road, vehicles behind bus MUST stop. Vehicles traveling in the opposite direction proceed with caution.
At the Bus Stop Even if your children have been riding the school bus for years, it’s a good idea to revisit bus safety every year before the start of school: »» Wait for the bus to come to a complete stop before approaching it. »» If there are seatbelts, buckle up. »» Stay seated at all times to avoid injury if the driver has to stop or swerve suddenly. »» If your child has to cross the street to enter or exit the bus, he or she should cross at least 10 feet in front of the bus and look both ways before crossing. Don’t just assume that all drivers will stop. If you have teenagers who are driving to school, remind them to wear their seatbelts, and when it comes to passengers, the fewer, the better. Virginia law says that teenagers who are under 18 and turned 17 after July 1, 2013 may only carry one passenger under age 21, unless accompanied by a licensed parent or other adult acting in place of a parent in the front passenger seat. However, if a teen has had his or her license for a year, he or she may carry up to three passengers under the age of 21 to and from a schoolsponsored event. Encourage teens to minimize distractions: phones and other electronic devices, as well as eating and drinking, should not be allowed while driving.
The First Bell In addition to academics, children experience significant social-emotional learning opportunities at school, particularly in their classroom community. Through work and play, they will be building friendships for the school year and beyond. Talk with your children about the importance of being nice to others and developing strong bonds with classmates. Extra steps may be necessary to help quieter children foster connections. Encouraging them to join
youth organizations or sports teams creates an opportunity for building friendships. These friendships can be great buffers when bad things do happen at school. Responding appropriately to classroom challenges with friends and other peers is important. Talk to your children about the importance of reporting bullying to you and a trusted adult at school if it does occur. Learn the differences between bullying and other forms of aggression so you can help your children learn the differences and respond best to each. Some boys and girls both engage in bullying behaviors towards others and become the target of bullying behaviors. These children are at a much higher risk for disengaging in school and for other negative academic, social, mental, and physical health outcomes. Help your children learn appropriate ways to meet their needs and engage with other students effectively.
Returning to school in the fall is for some teens exciting and for others a transition from the sweet summer respite from educational and social pressures to the returning torment of anxiety and bullying
— Karen Rice, LCSW, Clinical Supervisor, Outpatient Services at Virginia Home for Boys and Girls
There are three types of bullying: »» Physical: hitting, kicking, pushing, etc. »» Verbal: threatening, taunting, name-calling »» Social: excluding peers from activities or starting rumors about them. (Cyber bullying is often classified as verbal, social, or both verbal and social.) If you find out that your child is engaging in bullying behavior, take it seriously. Get his or her perspective on the event, suggest alternative ways to have needs or desires met, and be clear that bullying behavior is never an acceptable strategy. Use logical consequences, linking the consequence to the aggression when possible. Use nonphysical discipline and remain consistent in your expectations. Model the behaviors you want your child to exhibit at home and at school.
Bullying behavior should never be tolerated; however, it’s important to separate the child from the behavior. Most children who display bullying behavior have been the target of bullying or other forms of abuse themselves.
— Mary-Lib Morgan, Bullying and Youth Violence Prevention Coordinator, Department of Prevention and Health Promotion, Virginia Department of Health
The Mid-Morning Stretch Physical education class is a very important part of a student’s schedule. With childhood obesity issues at an all-time high, physical activity, along with a balanced and nutritious diet, are essential to maintaining a healthy weight during the early stages of life. On days that your child has gym, make sure that he or she is wearing comfortable clothes and shoes that fit well and have good support. Physical activity is a key component of a healthy lifestyle and should begin in early childhood. In addition to the health benefits, it promotes psychological well-being; increases self-esteem and capacity for learning, and helps children and adolescents cope with stress. Higher-intensity physical activity generally provides more benefits than moderate-intensity physical activity, but any activity is better than none. The U.S. Department of Health and Human Services and the U.S. Department of Agriculture’s Dietary Guidelines for Americans recommends that children and adolescents engage in at least 60 minutes of moderate to vigorous physical activity on most days of the week, preferably daily. 36
OurHealth | The Resource for Healthy Living in Lynchburg Southwest Virginia and Southside
The Lunch Whistle If your child buys lunch at one of our local schools, there is typically a good variety of food offerings in appropriate portions. However, if your child usually brings a lunch from home, there are a few keys to making sure that he or she has a healthy lunch.
Children that stay physically active can expect to enjoy better physical health, stronger immune systems, more energy, stronger self-esteem, better memory, more confidence, and enhanced emotional well-being. — Chelsea Arner, NASM, Wellness Supervisor, Green Ridge Recreation Center
First, avoid caffeinated soda and energy drinks. Research has shown that caffeine increases blood pressure and decreases heart rate in people of all ages. The American Academy of Pediatrics maintains the position that stimulant-containing energy drinks have no place in the diets of children and adolescents. Additionally, make sure to pack a variety of healthy foods. Children between the ages of four and eight should eat/drink the following daily: »» 1.5 cups of fruit »» 4 to 5 ounces of grains »» 2 cups of milk »» 1.5 cups of vegetables
»» 3 to 4 ounces of meat and beans
»» 4 tsp of oils
Girls between the ages of nine and 13 should consume: »» 1.5 cups of fruit »» 5 ounces of grains »» 3 cups of milk »» 2 cups of vegetables
»» 5 ounces of meat and beans
»» 5 tsp of oils
Boys between the ages of nine and 13 should consume: »» 1.5 cups of fruit »» 6 ounces of grains »» 3 cups of milk »» 2.5 cups of vegetables
»» 5 ounces of meat and beans
»» 5 tsp of oils
Girls between the ages of 14 and 18 should consume: »» 1.5 cups of fruit »» 6 ounces of grains
»» 3 cups of milk
»» 2.5 cups of vegetables
»» 5 tsp of oils
»» 5 ounces of meat and beans
Boys between the ages of 14 and 18 should consume: »» 2 cups of fruit »» 7 ounces of grains
»» 3 cups of milk
»» 3 cups of vegetables
»» 6 tsp of oils
»» 6 ounces of meat and beans
This equates to 1,000 calories per day for children aged 2 to 3 years, 1,400 calories a day for children aged 4 to 8, 1,600 calories for girls aged 9 to 13, 1,800 calories for boys aged 9 to 13 and for girls aged 14 to 18, and 2,200 calories for boys aged 14 to 18. It is important to note that active children may require more calories. To keep caloric intake in check, encourage your child to eat slowly. People who eat quickly typically take longer to feel full, and they often have no idea how much they have actually eaten. Children need to eat slowly enough to give their brain the chance to recognize that they have eaten enough to no longer feel hungry. Slowing down and chewing food more thoroughly also makes food more enjoyable.
Pack a nutritional punch in your child’s school lunch with low fat proteins that will help keep your child full throughout the day.
— Ashley Cappel, RD, Healthy Lifestyles Center, Children's Hospital of Richmond
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OurHealth | The Resource for Healthy Living in Southwest Virginia
The key to healthy lunches is preparing the meal the night before or bringing a supply of healthy options to school on Monday morning. — Don Mankie, RD, Carilion Clinic Children’s Hospital, Pediatric Gastroenterology and Nutrition
Children should be encouraged to drink plenty of water. Half of kids’ body weight is made up of water, and water is required to keep bodily systems functioning properly. It’s a good idea to offer water throughout the day and not just when they are thirsty. Children should be encouraged to drink more than usual when it’s hot or when they are taking part in physical activity. Fruits and vegetables are also excellent sources of water.
School’s out! Many Southwest Virginia families have two working parents, so after-school care can be a challenge. There is no hard and fast rule on when children are old enough to be left home alone after school, and children mature at very different rates, so parents need to make this call. One consideration may be how long the child will be home alone before a parent or older sibling arrives home. As a rule of thumb, most children are not able to handle stressful or emergency situations until they are about 11 or 12 years old. If you are considering leaving your child alone for a few hours after school, make sure that he or she is prepared for knocks on the door, emergency situations, and injuries. The YMCA of the Roanoke Valley offers babysitting courses that can help prepare children to stay home alone. How do you know if your child is ready? Consider the following: »» A child who is home alone needs to know his or her full name, address, and phone number as well as how to reach you. You might consider having him or her call you once inside the house each day so that you will know that he or she has arrived home safely. Children also appreciate the security of knowing that they will be able to talk to you when they get home from school. »» Establish a routine so that he or she knows what to do during the time he or she is alone. Do you expect that homework and/or chores will be done before you arrive home? »» Make sure your child knows how to lock the door when he or she arrives home, and that it should be kept locked. »» Is there a neighbor nearby that he or she could check in with if needed?
Children today have so many barriers to physical activity, so as part of our Ridge Kids after school program we provide daily active time where the kids get that opportunity to run, play, have fun and be kids. —Jim Basham, Recreation Programs Supervisor, Green Ridge Recreation Center
»» Does your child know never to enter your home if a door or window is open or broken? »» Explain what to do if someone knocks on the door (tell the person knocking that you are busy and are unable to come to the door, not that you are not home). Whether or not a parent is home or not, make sure to have healthy snacks on hand in the afternoon, and make sure your child has a designated homework space. This space should be quiet and distraction-free with comfortable seating and good lighting.
Family Time Time with family allows children and parents the opportunity to
talk about stress that comes from the start of a new school year.
— Wesley Brusseau, LCSW, Clinical Social Worker, Psychological Health Roanoke
Family time on school nights typically revolves around preparing and eating dinner, although many families are unable to have meals as a family due to children’s extracurricular activities or parents’ job schedules. Even though it can be challenging, try to have as many meals together as a family as possible. During family meals, turn the TV off, and don’t allow electronics at the table. In addition to the relationship benefits of family meals, research has shown children eat more fruits and vegetables and fewer fried foods and sugary drinks when they eat with the entire family.
Wind Down While some children focus best on homework right after school, other children are better able to focus after dinner. Some parents choose a specific time for children to start homework (by 4 pm), while others give guidelines (no video games or TV watching until homework is complete). After dinner is also a great time for families to read together. This can further nurture your child’s love of reading and help him or her wind down for bedtime. The importance of sleep cannot be overstated. Well-rested children are more focused, and poor sleep habits can also increase the risk of obesity. According to the Centers for Disease Control and Prevention, school-aged children require at least 10 hours of sleep each night, and teens require 9 to 10 hours a night.
For school aged children, getting an adequate amount of quality sleep each night is important to optimize growth, health and learning. — William Elias, M.D., Carilion Clinic Pulmonary & Sleep Medicine
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OurHealth | The Resource for Healthy Living in Southwest Virginia
A good night's sleep is important for everything — emotional health and improved learning. Patients who do not sleep well tend to feel miserable. We know now that patients with sleep apnea even have increased risk for heart attack stroke and worsened diabetes.. — Bruce N. Stewart, M.D., FAASM, FACP, FCCP, LewisGale Physicians
24/7 Be Aware In addition to bullying, children can also be introduced to drugs, alcohol, violence, and sex at school. Southwest Virginia schools, while safer than most, are unfortunately no exception. Most parents of teenagers are concerned about the use of tobacco, alcohol, and drugs in this student population, because there is tremendous peer pressure to experiment with these substances during high school, and even middle school. Parents should take steps to ensure that teens are aware of the dangers involved with their use. For example, smoking often becomes more than a high school habit. In fact, it can turn into a lifelong addiction that can be extremely difficult to break. When talking to your teen about smoking, emphasize the more undesirable effects, including bad breath, stained teeth, wrinkles, a long-term cough, and decreased athletic performance. Other forms of tobacco, such as chew or snuff, can also lead to nicotine addiction and cause the same health problems as smoking cigarettes, with the addition of mouth sores. Alcohol is the most socially accepted drug in our society, and even small amounts can impair judgment and provoke risky and violent behavior. Drinking can also slow reaction time, and many teenagers are unaware that alcohol use can have deadly consequences. Inform your teen that alcohol-related car crashes are the leading cause of death for those aged 15 to 24 years. www.OurHealthVirginia.com
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A new school year can cause you and your child stress, good and bad, so it’s important for you to spend time together to provide support and encouragement. Parents often forget they can be the number-one supporter for their children. — Wesley Brusseau, LCSW, Clinical Social Worker, Psychological Health Roanoke
Another concern of parents is teenage sex. Even more concerning is unprotected teenage sex. Encourage abstinence, and encourage your teen to avoid situations that can lead to sexual activity. Choosing not to use alcohol or drugs can help your teen make clearer choices about sex. If you know that your teen is having sex, it is important for him or her to know the facts about birth control and sexually transmitted diseases. Encourage the use of condoms; however, remind them that only abstinence is 100% effective in preventing disease and pregnancy. Although Southwest Virginia elementary, middle- and highschools have not seen a major act of violence, such as a deadly school shooting, students have occasionally been known to fight and to bring weapons to school. While it is difficult to pinpoint exactly which children will engage in violence at school, there are some risk factors: »» A prior history of violence »» Drug and/or alcohol abuse »» Association with delinquent peers »» Poor family functioning »» Poor grades in school »» Poverty in the community. The keys to a successful school year are encouraging your children to make healthy choices and maintaining open communication with them. A little planning can ease the transition back and can provide a stress-free first day for kids and parents alike.
Sources: www.aap.org www.cdc.gov www.dmv.virginia.gov www.healthychildren.org www.kidshealth.org www.pediatriccareonline.org
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the results are in
Retirement Living Awards BLUE RIDGE
BEST OF:
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1001 Franklin Road SW | Roanoke | 540.982.1001 1330 East Main Street | Salem | 540.389.9208
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BARBER
BRONZE
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BEAUTY SALON
OurHealth | The Resource for Healthy Living in Southwest Virginia
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Locations in Roanoke, Blacksburg, Salem and Daleville 540.389.7549
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GERIATRIC CARE (PHYSICIAN)
SILVER
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Interim Healthcare
4395 Electric Rd | Roanoke, VA 24018 540.774.8686 | www.interimhealthcare.com SILVER
Friendship Retirement Community
327 Hershberger Road | Roanoke, VA 24012 540.265.2230 | www.friendship.us BRONZE
Carilion Home Care Service
1615 Franklin Road SW | Roanoke, VA 24016 540.224.4800 | www.carilionclinic.org
HOSPICE GOLD
Good Samaritan Hospice
2408 Electric Rd | Roanoke, VA 24018 540.776.0198 | www.goodsamhospice.com SILVER
Gentle Shepherd Hospice
6045 Peters Creek Road | Roanoke, VA 24019 540.989.6265 | www.gentleshepherdhospice.com BRONZE
Southern Care Hospice
5330 Peters Creek Road | Roanoke, VA 24019 540.366.0927 | www.southerncareinc.com
INDEPENDENT LIVING GOLD
Friendship Retirement Community
SILVER (TIE)
Warm Hearth Village
2603 Warm Hearth Drive | Blacksburg, VA 24060 540.552.9176 | www.retire.org
Brandon Oaks Nursing and Rehabilitation Center 3804 Brandon Avenue | Roanoke, VA 24018 540.776.2600 | www.brandonoaks.net BRONZE
Richfield Retirement Community
3615 W. Main Street | Salem, VA 24153 540.380.2986 | www.richfieldliving.com HONORABLE MENTION
The Village on Pheasant Ridge
3328 Pheasant Ridge Road | Roanoke, VA 24014 540.400.6482 | www.villageonpheasantridge.com
INSURANCE AGENT GOLD
Debbie Mitchell Insurance
4712 Brambleton Avenue | Roanoke, VA 24018 540.774.6864 SILVER
Becky Pollard – Business Solutions
303 E. Burwell Street | Salem, VA 24153 540.444.4000 | www.businesssolutionsinc.net BRONZE
Lynn Atkinson – Humana
3800 Electric Road, Suite 406 | Roanoke, VA 540.520.8414 | www.humana.com
JEWELRY
Salem Terrace at Harrogate
1851 Harrogate Drive | Salem, Virginia 24153 540.444.0343 | www.salemterrace.com
327 Hershberger Road | Roanoke, VA 24012 540.265.2230 | www.friendship.us
GOLD
Fink’s Jewelers
3545 Electric Road | 540.342.2991
4802 Valley View Boulevard NW | Roanoke, VA Valley View Mall | 540.362.3779
16960 Forest Road | Forest, VA 24551 | 434.237.6301 www.finks.com
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SILVER
RM Johnson and Sons
10 S College Avenue | Salem, VA 24153 540.389.4783 | www.rmjohnson.com BRONZE
AmRhein’s
2740 Ogden Road | Roanoke VA | 540.989.7100
1101 West Main Street | Salem VA | 540.387.3816 www.amrheins.com
LAWN CARE SERVICES GOLD
GLC Landscaping and Lawn Care
Christiansburg, VA | 540.980.2676 SILVER
Prestige Lawn Care
Salem, VA | 540.380.3159 BRONZE
Lawncare Solutions
540.387.0015 | 540.580.9040 www.lawncaresolutionssalem.com
SILVER
Advanced Home Care
72 Saint Johns Place Road | Salem, VA 24153 540.389.8121 | www.advhomecare.org BRONZE
Commonwealth Home Health
1900 Apperson Drive | Salem, VA 24153 540.380.3383 | www.commonwealthcare.com
MEMORY CARE GOLD
The Dogwood Memory Care Center at Salem Terrace 1851 Harrogate Drive | Salem, Virginia 24153 540.444.0343 | www.salemterrace.com SILVER
Emeritus at Roanoke
3585 Brambleton Ave | Roanoke, VA 24018 540.772.7181
Pulaski Health and Rehabilitation Center
2401 Lee Highway | Pulaski, Virginia 24301-2329 540.980.3111 | www.pulaskihealthrehab.com
PALLIATIVE CARE GOLD
Carilion Clinic
1615 Franklin Rd SW | Roanoke 540.224.4753 | www.carilionclinic.org SILVER
LewisGale Medical Center
1900 Electric Road | Salem, VA 24153 540.776.4000 | www.lewisgale.com BRONZE
Friendship Retirement Community
327 Hershberger Rd | Roanoke, VA 24012 540.265.2100 | www.friendship.us
1127 Persinger Road, SW | Roanoke, VA 24015 540.343.4900 | www.emeritus.com BRONZE
Friendship Retirement Community
327 Hershberger Road | Roanoke, VA 24012 540.265.2230 | www.friendship.us HONORABLE MENTION
Woodhaven Nursing Home
Rt. 460, Montvale, VA 24122 | 540.947.2207 www.woodhavennursinghome.com
Richfield Retirement Community
3615 W. Main Street | Salem, VA 24153 540.380.2986 | www.richfieldliving.com
LOCAL PHARMACY (DELIVERY ) GOLD
Valley Apothecary
1802 Braeburn Dr. | Salem, VA 24153 540.772.3788 | www.valleyapothecary.com SILVER
Friendship Pharmacy and Emporium
327 Hershberger Rd | Roanoke, VA 24012 | 540.265.2152 BRONZE
West Pharmacy
2012 Electric Rd | Roanoke, VA 24018 | 540.774.5500
MEDICAL EQUIPMENT GOLD
Sun Medical
1807 Murry Rd SW | Roanoke, VA 24018 540.389.3800 | www.sunmedical.com
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NURSING HOME GOLD
Berkshire Health and Rehabilitation Center
705 Clearview Dr. | Vinton, VA 24179 540.982.6691 | www.berkshirehealthrehab.com SILVER
Friendship Retirement Community
327 Hershberger Road | Roanoke, VA 24012 540.265.2230 | www.friendship.us
PLACES OF WORSHIP GOLD
Bonsack Baptist Church
4845 Cloverdale Road | Roanke, VA 24019 540.977.0485 | www.bonsackbaptist.org SILVER
Second Presbyterian Church
214 Mountain Avenue SW | Roanoke, VA 24016 540.343.3659 | www.spres.org BRONZE
Restoration Church
P.O. Box 902 | Salem, VA 24153 540.384.1601 | www.restorationsalem.org
BRONZE
Brandon Oaks Nursing and Rehabilitation Center 3804 Brandon Avenue | Roanoke, VA 24018 540.776.2600 | www.brandonoaks.net HONORABLE MENTION
Raleigh Court Health and Rehabilitation Center 1527 Grandin Rd SW | Roanoke, VA 24015 540.342.9525 | www.raleighcthealthrehab.com
OurHealth | The Resource for Healthy Living in Southwest Virginia
P OST-ACUTE REHABILITATION SERVICES GOLD
Pulaski Health and Rehabilitation Center
2401 Lee Highway | Pulaski, Virginia 24301-2329 540.980.3111 | www.pulaskihealthrehab.com
REAL ESTATE SERVICES GOLD
Long and Foster Realtors
BRONZE
Happy Housekeepers
5145 Starkey Road | Roanoke, VA 24018 540.774.4299 | www.thehappyhousekeepers.com
3906 Electric Road | Roanoke, VA 24018 540.989.0863 | www.roanokevalley-longandfoster.com SILVER
MKB
3801 Electric Road | Roanoke, VA 24018 540.989.4555 | www.mkbrealtors.com BRONZE
SILVER
Salem Health and Rehabilitation Center
1945 Roanoke Blvd | Salem, VA 24153 540.345.3894 | www.salemhealthrehab.com BRONZE (TIE)
Friendship Retirement Community
327 Hershberger Road | Roanoke, VA 24012 540.265.2230 | www.friendship.us
Richfield Retirement Community
3615 W. Main Street | Salem, VA 24153 540.380.2986 | www.richfieldliving.com
Thomas and Wall Real Estate
120 Wilson Street | Floyd, VA 24091 www.thomaswallre.com
RESIDENTIAL CLEANING GOLD
Helpful Hands Homecare Service
2302 Colonial Ave. SW, Suite D | Roanoke, VA 24015 540.342.3434 | www.helpfulhands.net SILVER
Molly Maid of the Roanoke Valley
1417 Peters Creek Road | Roanoke, VA 24017 540.562.0002 | www.mollymaid.com
RESTAURANTS GOLD
The Roanoker Restaurant
2522 Colonial Ave SW | Roanoke, VA 24015 540.344.7746 | www.theroanokerrestaurant.com SILVER (TIE)
Montano’s International Restaurant
3733 Franklin Road SW | Roanoke, VA 24014 540.344.8960
Carlos Brazilian International Cuisine
4167 Electric Road | Roanoke, VA 24018 540.776.1117 | www.carlosbrazilian.com BRONZE
K&W Cafeteria
609 Hershberger Rd NW | Roanoke, VA 24012 540.563.4977 4242 Electric Rd | Roanoke, VA 24018 540.989.3369 | www.kwcafeterias.com
SENIOR COMMUNITY CENTERS GOLD
Christiansburg Recreation Center Christiansburg, VA | 540.382.2349 www.christiansburg.org
SILVER
Brambleton Recreation Center (Roanoke County) 3738 Brambleton Ave | Roanoke, VA 24018 540.772.7529 | www.roanokecountyparks.com BRONZE
Anchor of Hope Community Center (Roanoke)
2302 Florida Ave NW | Roanoke, VA 24017 540.627.5067 | www.anchorofhopecommunitycenter.com
SENIOR RELOCATION/ MOVING SERVICES GOLD
Crowning Touch
6704 Williamson Rd | Roanoke, VA 24019 540. 982.5800 | www.crowningtouchusa.com SILVER
Virginia Varsity Transfer
2087 Apperson Dr. | Salem, VA 24153 540.982.2202 | www.virginiavarsity.com BRONZE
Smooth Transitions of the Blue Ridge
2231 Woodcliff Road | Roanoke, VA 24014 540.797.2354 | www.smoothtransitionsroanoke.com
SENIOR TRANSP ORTATION GOLD
LOA Area Agency on Aging, Inc.
706 Campbell Avenue SW | Roanoke, VA 24040 540.345.0451 | www.loaa.org SILVER
RADAR
P.O. Box 13825 | Roanoke, VA 24037 540.343.1721 | www.radartransit.org BRONZE
New River Valley Community Services 2B Corporate Drive | Radford, VA 24141 540.831.5911 | www.nrvcs.org
SKILLED NURSING FACILITIES GOLD
Friendship Health and Rehab Center
327 Hershberger Road | Roanoke, VA 24012 540.265.2100 | www.friendship.us SILVER (TIE)
Carrington Place at Botetourt
290 Commons Parkway | Daleville, VA 24083 540.966.0056 | www.carringtonplaces.com
Pulaski Health and Rehabilitation Center
2401 Lee Highway | Pulaski, VA 24301-2329 540.980.3111 | www.pulaskihealthrehab.com BRONZE
Brandon Oaks Nursing and Rehabilitation Center 3804 Brandon Avenue | Roanoke, VA 24018 540.776.2600 | www.brandonoaks.net
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SPAS GOLD
Pure Spa
3555 Electric Road, Suite H | Roanoke, VA 24018 540.904.5900 | www.puresparoanoke.com SILVER
Brighter Image Day Spa
5720 Williamson Road | Roanoke, VA 24012 540.265.7887 BRONZE
Les Cheveux Salon and Day Spa
306 McClanahan St SW | Roanoke, VA 24014 540. 343.7211 | www.lescheveauxsaloninc.com
SPEECH THERAPY GOLD
Pulaski Health and Rehabilitation Center
2401 Lee Highway | Pulaski, Virginia 24301-2329 540.980.3111 | www.pulaskihealthrehab.com SILVER
Roanoke Valley Speech and Hearing Center 2030 Colonial Ave | Roanoke, VA 24015 540.343.0165 | www.rvshc.com BRONZE (TIE)
Friendship Outpatient Therapy Clinic
327 Hershberger Road | Roanoke, VA 24012 540.265.2230 | www.friendship.us
Salem Health and Rehabilitation Center
1945 Roanoke Blvd | Salem, VA 24153 540.345.3894 | www.salemhealthrehab.com
ON THE WEB
More at ourhealthvirginia.com
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BRANDON OAKS
A LifeCare community offering a continuum of care
At Brandon Oaks, the people and the lifestyle draw residents in from all over the state and country. As the only true LifeCare community in Roanoke, Brandon Oaks serves as an industry leader in the field of luxury independent living, while offering a full continuum of health care including assisted living and skilled nursing. Brandon Oaks is a not-forprofit community sponsored by Virginia Lutheran Homes. However, people of all faiths and denominations are accepted and welcomed. Brandon Oaks offers a wide range of lifestyle options. A variety of apartment types and cottages are available. Residents take comfort in knowing that award-winning care is readily available should the need arise. In 2014, publications such as The Roanoker, OurHealth, SwoCo, Virginia Living and the national publication US News and World Report awarded Brandon Oaks and its various services for excellence in senior living. In addition, the American Health Care Association and National Center for Assisted Living awarded Brandon Oaks’ Assisted Living the Bronze Quality Award for excellence in quality and improvement measures.
Great Variety for Active Adult Living Of course, the beautiful backdrop of the Blue Ridge Mountains and convenient location within the Roanoke Valley (close to cultural and shopping destinations) are a few additional perks. The vibrant community of residents enjoy the freedom and opportunity to pursue things in life that are important to them - whether it be education, culture, fitness or travel. With a calendar full of activities including overnight trips to exciting destinations on the East Coast, numerous educational opportunities and exercise classes right at their fingertips, residents find themselves busier now than before they came to Brandon Oaks. At the center of all the activity around campus is the Health and Vitality Center at Brandon Oaks. Amenities include a fully equipped fitness center, aerobics room, hair and nail salon, heated pool, massage parlor, chapel, casual bistro, formal dining room, library, full service bank and much more. Residents are able to maximize their independence while enjoying the benefit of security and peace of mind for the future. Brandon Oaks is the premier retirement community in the Roanoke Valley.
Brandon Oaks 3804 Brandon Avenue, S.W., Roanoke, VA 24018 | 540.776.2600 | www.brandonoaks.net
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A Home and Community based alternative to a nursing facility
Kissito PACE
Program of All-Inclusive Care for the Elderly
Staying independent and remaining at home is important for the community’s seniors. Safety and proper care are serious concerns. Kissito PACE understands this and helps seniors to stay healthy and living at home for as long as possible. Seniors in the Kissito PACE program benefit from a wide range of coordinated healthcare services provided in the PACE Centers, at home, and in other appropriate settings; 24 hours a day, 7 days a week, 365 days a year.
Services Participants receive all their healthcare services from Kissito PACE and its healthcare provider network.
Kissito PACE services include: »» Kissito PACE Center access up to 5 days a week
»» Support for caregivers and family members
»» Primary medical and specialty care, including physicians specializing in geriatrics
»» Chronic disease self-management education
»» Nursing care
»» Dental care, including dentures
»» Social activities »» Social services »» Recreational services »» Drug coverage »» Wheel chair accessible transportation to and from the PACE Center and other medical appointments »» Medical equipment and supplies »» Dietary services »» Occupational and physical therapy »» Speech therapy
»» Home and personal care »» Vision care, including glasses »» Hearing care, including hearing aides »» Podiatry »» Mental health services »» End-of-life care »» Hospital and nursing facility stays »» Services such as lab work, x-rays, and surgery »» 24-hour, 7-days a week, 365 days a year access to an interdisciplinary team »» The Interdisciplinary Team Approach
All care and services are coordinated through the Kissito PACE Interdisciplinary Team which consists of a primary care physician, social services director, program manager, registered nurse, physical and occupational therapist, registered dietitian, activity coordinator, personal care attendant, transportation coordinator, and a home care coordinator.
Kissito PACE
5251 Concourse Drive | Roanoke, VA 24019 | 540.904.2817 | www.KissitoPACE.org
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Commonwealth Assisted Living At Commonwealth Assisted Living, the dedicated and specially trained staff get to know the needs and preferences of each resident and are committed to making life easier for both the resident and his/her family.
Memory Care Commonwealth Assisted Living in Christiansburg and Radford are two of nine assisted living communities in Virginia currently offering a specialized Alzheimer’s/Dementia program, Sweet Memories. This program is staffed with compassionate, 24-hour caregivers, specially trained to offer those experiencing memory loss, Alzheimer’s or Dementia the attention they need, as well as the safety and security they require. Sweet Memories provides healthy dining options, personal care services and activities that stimulate mind and body.
Commonwealth Assisted Living at Christiansburg
Whether it’s in the assisted living community, or the Sweet Memories community, services are provided for all residents that help them keep up with the activities of daily living. Those can include help with bathing, dressing, meals and exercise or any other daily need. Therapy programs and outside home care are also available on request.
Commonwealth Assisted Living at Christiansburg Commonwealth Assisted Living at Christiansburg is a unique Assisted Living community that offers living choices for seniors with a wide range of needs and lifestyle preferences. Residents can choose a spacious room in a modern two-story facility, complete with an indoor pool and exercise area. For those interested in a higher level of independent living, Commonwealth Assisted Living at Christiansburg also features a number of cottages that are available for purchase by residents. Commonwealth Assisted Living at Christiansburg is known for its well-appointed rooms, welcoming common areas and abundance of activity choices for all residents. Meals at Christiansburg are carefully prepared by an experienced staff, carefully designed to meet nutritional needs, while delighting the taste buds. Residents gather together for meals in an elegant dining room.
Commonwealth Assisted Living at Radford Situated in a bustling commercial neighborhood just across the New River from Radford University, Commonwealth Assisted Living at Radford offers seniors the additional care they need to maintain a quality lifestyle. Conveniently located close to Carilion New River Valley Community Hospital and many specialty medical offices, make this property an excellent choice. For residents who want an additional level of independence, with the added support of daily lifestyle services, Commonwealth Assisted Living at Radford also offers senior apartments in an adjacent building. Residents throughout Commonwealth Assisted Living at Radford get the caring and respectful assistance they need to carry out the activities of daily living. The well-trained and sensitive staff can help with bathing, dressing, meals and exercise. Therapy programs and outside home care are also available. Meals and snacks are carefully and nutritionally prepared by a veteran staff, and served in an elegant dining room where residents can mingle and share.
Commonwealth Assisted Living at Christiansburg 201 Wheatland Court / Christiansburg, Virginia 24073 / 540.382.5200 / www.commonwealthal.com
Commonwealth Assisted Living at Radford 7486 Lee Highway / Radford, Virginia 24141 / 540.639.2411 / www.commonwealthal.com
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Commonwealth Assisted Living at Radford
Virginia Veterans Care Center The Virginia Veterans Care Center (VVCC) in Roanoke is deeply committed to serving the veterans of our armed forces who so bravely spent a part of their lives serving us. On Veterans’ Day in 1992, then-Governor Doug Wilder made a trip west from Richmond to participate in the opening ceremonies for a brand-new assisted living and nursing home facility. Much time and effort had gone into building this facility, including considerations for top-level healthcare, as well as on-campus services and activities such as nature trails, library, chapel, barber shop and billiard room. While many of the area’s retirement living centers offered similar services, there was still something unique about the Center Governor Wilder was visiting. What’s the difference? This Center was opening specifically for our honorably discharged armed forces veterans who lived or who had enlisted in Virginia. Today, the VVCC still remains a state-of-the-art model for long-term healthcare and one of only two state homes for veterans in the Commonwealth of Virginia. Housing 240 beds, which includes a 60-bed assisted living area and a 60-bed Alzheimer’s Care unit, VVCC continues to provide comprehensive, high quality care with on-site, x-rays, physical therapy, podiatry care, and many other ancillary healthcare services. As well, nearly all residents of VVCC receive some level of financial assistance that subsidizes their living expenses, making it a much more affordable retirement option. These services and resources certainly play a role in the quality of life veterans’ living at VVCC have, but according to residents and staff alike, it’s the people that make the biggest difference. “I have been here for more than 14 years, and I can say it’s been the most rewarding job in my career,” explains Patti Smith, VVCC’s Director of Admissions and Public Relations. “The people who work here do so with the purpose to give thanks to our veterans, to show appreciation for their efforts and to make their lives as enjoyable and fulfilling as possible.” Smith says the camaraderie between residents at VVCC is what’s so special. “They have so much to share and so much in common, but believe it not, it’s not just about the bond they share from being in the armed forces,” maintains Smith. “They’re like brothers and sisters – it’s such an unconditional friendship among everyone.” Smith says that VVCC also houses the area’s only “Wander Garden” for Alzheimer’s patients. The “Wander Garden” is an enclosed, outside area where Alzheimer’s patients can visit unsupervised 24-hours a day without the threat of getting hurt or unknowingly leaving the campus. Plus, the entire area of the “Wander Garden” has been safety-checked to prevent accidental injuries. Even the plants in the area are safe and non-toxic. “It’s a wonderful place for our residents because it allows them freedom in a safe environment - something many Alzheimer’s and dementia patients rarely enjoy,” says Smith. The VVCC is heavily supported by the American Legion, the Veterans of Foreign Wars (VFW), AMVETS, Disabled American Veterans (DAV) and community groups. Each of the organizations lend a hand whenever called upon to help out the veterans at VVCC. “I believe the VVCC stands for many great things, but above all else, the VVCC is a way to show our veterans we care and appreciate them and all they have done,” concludes Smith. “Everything we do here is our way of saying “thank you” to our veterans. It’s a great feeling.” They were there for us when we needed them, and now we will be there for them.
Virginia Veteran’s Care Center 4550 Shenandoah Ave. | Roanoke, VA 24107 | 540.982.2860 | 800.220.VETS
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Virginia Veteran’s Care Center
The Landmark Group Highland Ridge Rehab Center - Dublin
Highland Ridge Rehab Center, a progressive skilled nursing facility, has 132-beds with semi-private and private rooms. The Center provides short-term skilled nursing and a specialized rehabilitation program. A professional team works with physicians to design and implement a care plan to meet each person’s specific needs. Each resident’s team may include a Physical Therapist, Occupational Therapist, Speech Pathologist, Dietician, Discharge Planner, and an Activity Director. The new rehab addition includes dedicated rehabilitation areas, as well as an activity room for arts, crafts, games, movies, and more. With an emphasis on increasing independence, both in mobility and in the ability to provide self care, individuals will have the choice to decide which plan of care best suits their goals. Each person’s mobility will be advanced at a pace tailored to his or her individual needs. Skilled nursing and health services include 24-hour RNs and LPNs with support from Certified Nursing Assistants, Continuity of Care Services, Physical Therapy, Interdisciplinary healthcare teams, pain management, IV Therapy, Restorative Nursing Services and Occupational Therapy. In addition to skilled nursing services, Highland Ridge Rehab Center offers Aqua Therapy programs. Aquatic Therapy incorporates Physical and Occupational Therapy performed in water. By using the resistance of water instead of weights it becomes very effective after an injury. It balances the amount of weight placed on the joints by exercise outside of water, and its benefits are continuous. Aquatic therapy focuses on circulation, endurance, flexibility, range of motion, balance, and coordination. Aqua Therapy programs are therapeutic and have shown to benefit those with conditions such as Arthritis, Athletic Injury, Balance and Coordination difficulties, Chronic Pain, Fibromyalgia, Joint Replacement, Orthopedic and/or Neurologic Impairment, and Osteoporosis.
Highland Ridge Rehab Center
5872 Hanks Avenue | Dublin, VA 24084 | 540.674.5193 | www.thelandmarkgroupll.com
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SALEM TERRACE
at Harrogate
A New Look for Senior Living! Salem Terrace features stunning mountain views, delicious cuisine, award-winning care, and a wealth of exciting events and amenities. Residents live in luxury and style while enjoying the full retirement experience. Salem Terrace offers care tailored to residents from independent living to assisted living. Specialized Alzheimer’s and dementia care is also available in the secure Dogwood Memory Care Center, offering peace of mind for residents, family and friends. When it comes to retirement, it’s all about the lifestyle. Spacious apartments, first-class dining, and fun activities are just a few of the many lifestyle choices that make Salem Terrace stand out from any other community in Southwest Virginia.
Independent Living Options For the active senior who yearns to retire in comfort and style, independent living is the clear choice. Independent residents are those individuals who seek security, luxury and choice, but do not need daily care assistance. These residents are afforded all of the amenities of the community, such as three chef-prepared meals daily, housekeeping, activities and social events, and maintenance-free living, just to name a few.
Assisted Living Options Salem Terrace offers four levels of assisted living care for residents in need of extra help with activities of daily living. A wide variety of assisted living care services, ranging from help with medications to mobility assistance, is offered to suit each individual’s unique care needs. Care levels are based on a personalized assessment to determine the appropriate amount of support required. As always, licensed nurses and certified nursing assistants are on duty 24 hours a day, seven days a week.
Memory Care Options Managing the 24-hour a day responsibility of caring for a loved one with Alzheimer’s or dementia can overwhelm even the most dedicated caregiver. The Dogwood Memory Care Center at Salem Terrace at Harrogate offers a comforting option. More than just a place to reside, the Dogwood Center provides an individualized plan of care to help each resident get more out of life. The memory care program promotes health, nutrition, hygiene, activity and socialization. A secured walking garden provides a sense of independence and an opportunity for physical exercise, and appropriate activities are integrated into daily life.
Salem Terrace at Harrogate 1851 Harrogate Drive | Salem, Virginia 24153 | 540.444.0343| www.salemterrace.com
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HERMITAGE
IN ROANOKE
From the moment you pass through the grand gates of Hermitage in Roanoke, a lifestyle of peaceful luxury comes to mind. Since 1964, Hermitage in Roanoke has been a community offering Independent Living, Assisted Living, and Nursing Care lifestyles for seniors 62 years of age and over. A part of Virginia United Methodist Homes, Inc., a not-for-profit corporation, Hermitage in Roanoke is committed to providing an independent lifestyle as well as security throughout the continuum of care. On its “Bed and Breakfast� like grounds, Hermitage in Roanoke offers a choice of accommodations. Both independent living apartments and assisted living apartments are available. Should the need arise, nursing care, rehab therapy, and respite care services are just down the corridor. Residents enter the continuum of care based on the need for services. If and when changes occur, residents will continue to receive the care they need. This is especially important for couples when one requires more services than the other. Keeping husbands and wives together, regardless of where they are on the aging spectrum, is a priority of the customized care offered at Hermitage in Roanoke. Besides the quality living accommodations, the community at Hermitage in Roanoke also offers an abundance of social activities to enhance residents’ well-being and allow them to continue their active lifestyle. Community features include a large library, walking paths, exercise room, billiards room, chapel, and wood working shop, just to name a few. From weekly outings, to on-site seasonal celebrations, there is always something to do at Hermitage in Roanoke.
Hermitage in Roanoke 1009 Old Country Club Road | Roanoke, VA 24017 | 540.767.6800| www.hermitageinroanoke.org
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WARM HEARTH VILLAGE Celebrating 40 Years of Quality, Stability, and Dedication to Residents
Located within view of Virginia Tech, Warm Hearth Village is just minutes away from shopping, cultural events, recreational activities, restaurants, professional services, sporting events, and LewisGale Hospital at Montgomery. Warm Hearth is a nonprofit community with a mission to serve seniors from all socioeconomic backgrounds. The 220 acre woodland campus offers a full continuum of living options, from active adult/independent living to long-term nursing care. Rehabilitative and skilled care and care management in your home, round out the comprehensive list of offerings.
The Village Center
At the heart of Warm Hearth is the Village Center. As the hub of activity, the Village Center brings together residents from across the campus and enhances both physical and social wellness. Here, residents and the community can utilize the welcome center, fitness center, cafĂŠ, and community gathering spaces. The fitness center promotes healthy aging and is staffed by trained professionals who assist in developing personal exercise and nutrition plans. Featuring an indoor, saltwater pool and a cardio and strength training room, the fitness center provides a range of personalized assistance and group exercise classes. In addition, the fitness center includes treatment rooms for massage, chiropractic care, and acupuncture therapy. The new Huckleberry CafĂŠ features a unique variety of fresh, locally sourced food and drink options for residents. In partnership with local farms and artisans, the CafĂŠ is able to offer fresh fruits and vegetables, herbs, pasture-raised meats, free-range eggs, farm cheeses, and freshly baked goods. Menu options regularly change with the season.
Staying Active
At Warm Hearth, there are many opportunities to be engaged and active. A variety of events and programs that cater to a wide range of interests and activity levels are offered throughout the community. They include music, theater, arts, fine dining, games, and continuing education programs with Virginia Tech and Radford University.
Care and Service
Residents of Warm Hearth receive priority admission to the next level of care should the need arise. This list of services and amenities available to residents is abundant and includes home and grounds maintenance; transportation, on-site dining; 24-hour emergency response; evening security; physical, occupational, and speech therapies; and home care to name a few.
Warm Hearth Village 2603 Warm Hearth Drive | Blacksburg, VA 24060 | 540.552.9176 | www.retire.org
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Click here to download the three-page PDF highlighting Friendship Retirement Community Services!
Healthy Eats
harvest recipes
Entrée: Brined Mesquite Turkey Serves: several
Turkey Ingredients: 1 6-8 pound boneless turkey breast Coconut oil Salt and pepper to taste
Brine Ingredients: 1 3 3 5 ½
tbsp black peppercorns sprigs fresh thyme bay leaves garlic cloves, sliced cup sea salt
Directions:
2. Place the turkey in a sealable plastic bag and pour the brine over the turkey. 3. Seal the bag and allow brining for 12 hours. 4. Remove the brine and pat the turkey dry with a paper towel. 5. Pre-heat the oven to 350ºF. 6. Rub the skin of the turkey with coconut oil and season with salt and pepper to taste. 7. Place the turkey on a roasting rack in a baking pan and roast, uncovered until the internal temperature reaches 165ºF. (Approximately 40 minutes per pound). 8. Allow the turkey to rest 15 minutes before slicing and serving.
Local Turkey from: Auburn Leaf Farms
5500 Mollies Creek Road | Gladys, VA 24554 www.auburnleafarms.com | 434.283.8109 farmfresh@auburnleafarms.com Located in Gladys, Virginia Auburn Leaf Farms prides themselves on treating their animals humanely providing them with plenty of sunshine, fresh water and ample grazing. All turkeys are raised on pasture land and are moved daily to fresh grasses.
1. Combine all ingredients for the brine until the salt is dissolved.
Tricia Foley says
SOURCE LOCAL TURKEY Tricia Foley is OurHealth Magazine’s resident nutritionist.
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Healthy Eats
harvest recipes
Side Dish: Roasted Harvest Veggies Ingredients: ½ butternut squash, peeled, cubed and seeds removed (1.5 cups) ½ acorn squash, sliced in ½ inch thick rounds and seeds removed 1 small sweet potato, cubed 1.5 cup raw Brussels sprouts, stems removed and sliced in half 2 tbsp olive oil 1 tsp chili powder ¼ tsp cayenne 2 tbsp maple syrup Salt and pepper to taste ½ cup pecans ¼ cup dried figs, chopped
Directions: 1. Preheat the oven to 425º F. 2. In a small bowl combine the olive oil, chili powder, cayenne, maple syrup and a pinch of salt and pepper. 3. Spread the veggies out on one or two baking sheets so they are not overlapping. 4. Drizzle the olive oil mixture over the veggies and toss to coat. 5. Roast in oven until vegetables are tender and starting to brown, about forty minutes. 6. Stir the veggies halfway through. 7. When there are fifteen minutes remaining, add the pecans and figs, toss to coat.
Local Sweet Potatoes and Apples from: Dickie Brothers Orchard 2685 Dickie Road | Roseland, VA 22967 434.277.5516 | info@dickiebros.com www.dickiebros.com
The Dickie Family has been farming for two hundred and sixty three years! Today they grow fifteen different varieties of apples. In addition they grow peaches, plums, blackberries, sweet potatoes, pumpkins and much more! They encourage their customers to come pick their own fruit all season long!
Tricia Foley uses
A VARIETY OF VEGGIES Tricia Foley is OurHealth Magazine’s resident nutritionist.
Healthy Eats
harvest recipes
Local Peaches from: Critzer Family Farms
9388 Critzer Shop Road | Afton, VA 22920 Contact: Whitney and Rosemary Critzer 540.456.4772 | w.critzer@yahoo.com One time primarily a beef cow and orchard farm, today, the farm is totally focused on providing fresh local fruits and vegetables. You can visit the farm and pick your own produce starting the first weekend in May.
Topping Ingredients:
Dessert: Apple-Peach Oatmeal Crisp Filling Ingredients: 2 apples, sliced 3 firm peaches, sliced 1 tbsp Stevia 1.5 tsp ground cinnamon 1 tsp ground nutmeg 1 tbsp lemon juice ½ cup water
1 1/3 3/4 1 1/4 6
cup oats cup whole wheat flour cup Stevia tsp cinnamon tsp salt tbsp Ghee butter, melted
Directions: 1. Preheat oven to 375°F. 2. To create the filling, place the fruit slices in the bottom of a greased 9-inch dish. 3. Drizzle with lemon juice. 4. Sprinkle Stevia, ground cinnamon, ground nutmeg, and water on the fruit. 5. In a separate bowl, combine the dry ingredients for the topping. 6. Add melted Ghee and mix until crumbly. 7. Spread the crumb mixture evenly on top of the fruit. 8. Bake for fifty to sixty minutes, so the top is lightly brown and the fruit is bubbly. 9. Serve warm and enjoy!
Tricia Foley’s
APPLE-PEACH TREAT Tricia Foley is OurHealth Magazine’s resident nutritionist.
FITBITS
H EA LT H A ND F I T NES S O N T H E G O
A Right to 'Bare Arms'
Get ready to show off your shapely and toned arms! Here are three exercises that will target the muscles of the upper arms and shoulders to give you that well-defined look! For optimum results, perform three sets of 8-12 repetitions of the following exercises three - five times per week.
#1. Bicep Curl 1. Stand in an upright position with your knees slightly bent. Contract your abdominal muscles to support your back and relax your shoulders. 2. Grasp the dumbbells with an underhand grip, palms facing up. Fully extend your arms, keeping them tight against your sides. Your elbows must be loose and not locked. 3. Lift the weights slowly until your hands reach your shoulders. Your arms should be the only muscles working during the exercise. At the top of the motion, contract your bicep muscles. Keep your abdominals tight and shoulders relaxed during the exercise. 4. Lower the dumbbells back to your starting position, arms extended and elbows loose. Repeat the exercise for a desired number of repetitions and sets.
#2. Tricep Kickback 1. Grab a dumbbell in one hand and put the other hand on your knee. 2. Point your elbow as high as you can towards the ceiling while leaving the dumbbell hanging by your side. 3. Slowly extend your arm until it is as straight as it will go. (DO NOT change the position of your elbow!) 4. Pause for a second, then lower back to starting position. 5. Repeat steps 3 and 4 for desired reps 6. Your upper arm and elbow should not move at all during the entire set. This is very important in order to target the tricep muscle.
Hand weights and resistance bands courtesy of Sun Medical in Salem. Sun Medical now carries residential and commercial fitness equipment, visit www.sunmedical.com for details.
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#3. Upright Shoulder Row with Fitness Tubing 1. Step on the tube with both feet, holding one handle in each hand. 2. Cross the tubing to form an X shape. Palms should face your legs. 3. Raise your elbows toward the ceiling, pulling on the tube. 4. Keeping your wrists in a neutral position and raise to shoulder height. 5. Slowly lower to starting position and repeat for desired number of repetitions.
Deidre Wilkes, AFAA, ACSM, Certified Personal Trainer Deidre is a certified personal trainer with more than 15 years experience in the health and fitness industry. She is the resident fitness specialist for OurHealth Southwest Virginia
www.OurHealthVirginia.com
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OurHealth’s staff photographer, Deidre Wilkes, captures generous donors at the blood drive for Virginia
Blood Services at Kissito PACE in Roanoke.
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Virginia Blood Services holds blood drive at Kissito Pace in Roanoke Earlier this summer Virginia Blood Services held a blood drive at Kissito Pace in Roaonke. Virginia Blood Services (VBS) is a local, nonprofit provider of blood products to area hospitals. When donors give blood with VBS, it stays local to help patients right here in our community. For more information on VBS services, or to schedule a blood drive, visit: www.vbs.org Kissito PACE, a community alternative to nursing home care, helps seniors stay healthy and living at home. Seniors in the Kissito PACE program benefit from a wide range of healthcare services provided in the PACE Center and at home. Kissito PACE relieves the burden on family caregivers by providing wheelchair-accessible transportation, care coordination, and complete access to healthcare services for participants. For more information on Kissito PACE visit: www.kissitopace.org
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1. Virginia Blood Services Van 2. April Jones and Jimmy Hines 3. Ronda Hart and Wensday Tumulak 4. Kissito PACE Entrance 5. Wensday Tumulak and April Jones 6. Rhonda Price and Wensday Tumulak 7. April Jones and Jimmy Hines 8. Wensday Tumulak 9. Eric Thompson 10. Kissito PACE
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Save local lives.
August Blood Drives August 18
9:00 a.m. – 1:00 p.m. Christiansburg Recreation Center 1600 North Franklin Street Christiansburg, VA 24073
August 25
August 29
Skyline College 5234 Airport Road Roanoke, VA 24012
Virginia Tech Graduate Life Center 31H Graduate Life Center Blacksburg, VA 24060
12:00 p.m. – 4:00 p.m.
11:00 a.m. – 5:00 p.m.
Give blood local. Keep it local. 7
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Breaking the Silence
Pancreatic Cancer
words | SUSAN DUBUQUE photography | SHAWN SPROUSE
This series explores diseases that can be devastating to the individuals and families they affect—yet no one is talking about them. That is, until now. We will bring these “orphan” diseases into the light—and dedicate these stories to the courageous patients and families living with them and the providers and researchers who commit their lives to treating and seeking cures for these silent killers.
For seven years, Carol Mauceri loved her job as an oncology nurse for Blue Ridge Cancer Care in Roanoke and nine years at LewisGale in Salem. She felt humbled by the strength and dignity her patients showed as they faced treatments for lifethreatening cancers. But little did she know that in July 2012, she would be the one fighting for her life. “Several nights after dinner, I experienced a sense of fullness,” recalls Carol. After a week, she called her primary care physician, Chetna Jha, MD, LewisGale Physicians. “Dr. Jha thought it was my gall bladder and ordered an ultrasound. She also told me to go to the ER if I had problems over the weekend.” By Sunday, Carol’s pain had migrated to her left side. “I wanted some quicker answers, and decided to go to the emergency department. I thought I might have had an ulcer.” The next two weeks were a whirlwind. A CT scan, lab work and an MRI. More blood tests to reassess pancreatic enzyme levels that were through the roof. Next came an endoscopic biopsy.
“The following Friday, I heard the words that would transform my life,” says Carol. “I was told that I had a tumor at the head of my pancreas that was obstructing the pancreatic duct.” Carol turned to William A. Fintel, MD, medical oncologist at Blue Ridge Cancer Care where she used to work. “Dr. Fintel used the ‘c’ word that I wanted to hear—he said we could ‘cure’ my pancreatic cancer if we caught it early,” recounts Carol. “But he made it clear that we would have to go after my cancer from every direction— starting with a Whipple surgery, then 12 weeks of chemotherapy and six weeks of radiation therapy.”
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the fears of her 11-year-old grandson, Josiah, who lives with Carol and her husband, Frank. “Josiah lost his mother when he was six years old and he is a very sensitive, compassionate child. He naturally worried about me when I got sick, and asked repeatedly if I was going to die,” says Carol. “We did everything possible to make him feel safe and secure and to assure him that ‘Poppy’ and ‘Nana’ were going to be here for him for a very long time.”
The road to recovery was long and arduous. “I tolerated chemo pretty well, but radiation really knocked me down,” says Carol. “I lost so much weight and became so weak, that I ended up in the hospital for 10 days.”
Bolstered by an outpouring of love and support from her family and friends and fortified by her faith, Carol gradually regained her strength and sense of vitality. “I was blessed to have my husband Frank’s daily love, support and care,” says Carol. “He stayed with me 24/7 following my surgery and then continued caring for me and Josiah during the long weeks of my treatment.”
Throughout this ordeal, Carol didn’t have the luxury of focusing solely on her own recovery. She also had to attend to the needs and soothe
Carol’s initial response to having cancer was to ask “Why me?” But today, she has a whole new attitude about life—replete with empathy and gratitude.
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“I’ve walked the walk,” reflects Carol. “I really think I could offer tremendous support to newly diagnosed cancer patients.” She is deeply thankful for the doctors who cared for her, the boundless love of her family and friends and the blessing of renewed health. “God has a plan for each of our lives and I want to enjoy every precious moment.”
It’s time to get this conversation started. Let’s talk frankly and openly about pancreatic cancer—the nature of the disease, risk factors, current treatments and what the future holds. The pancreas—it’s one of those organs that we all know we have, but its purpose is a little muddled. So let’s begin with the most fundamental questions—what is the pancreas and what does it do? The pancreas is an organ in the abdomen that sits in front of the spine above the level of the bottom of the breast bone. It performs two main functions. First, it makes insulin, a hormone that regulates blood sugar levels. Second, it makes enzymes that help break down proteins so they can be more easily absorbed by the body and used for energy. Enzymes leave the pancreas through a system of tubes called “ducts” that connect the pancreas to the intestines. The pancreas is close to many important structures like the small intestine (called the duodenum), the bile ducts, blood vessels and nerves.
Understanding Pancreatic Cancer Pancreatic cancer makes up only three percent of all cancers, yet it is the fourth leading cause of cancer-related deaths among both men and women in the United States. According to Sanjoy Saha, MD, a surgical oncologist at LewisGale Medical Center, “Pancreatic cancer receives far less attention than other forms of cancer for several reasons—the occurrence is rare, the outcome is poor and there are few survivors to champion the cause. As a result, there is less funding for research.” Cancers of the pancreas fall into two major categories—endocrine and exocrine. Cancers of
the endocrine pancreas—the part that makes insulin and other hormones—are called “islet cell” or “pancreatic neuroendocrine” cancers. Islet cell cancers are rare and typically grow slowly. These tumors often release hormones into the bloodstream including insulin, glucagon and gastrin.
Carol Mauceri at home in Roanoke with husband, Frank, and grandson, Josiah
Cancers of the exocrine pancreas—the part that makes enzymes—develop from the cells that line the ducts that deliver enzymes to the small intestine. These cancers—called pancreatic adenocarcinomas—comprise 95 percent of all pancreatic ductal cancers and will be the focus of this article.
Causes and Risk Factors There are more than 46,000 new cases of pancreatic cancer diagnosed each year in this country alone. But, according to Paul Yeaton, MD, Carilion Clinic Gastroenterology, “Most people who develop the disease have no known risk factors. There are cases that run in families, but these are rare.” Perhaps the biggest risk factor is increasing age, as the majority of cases occur in individuals over the age of 60. African Americans may be at slightly greater risk as well as individuals with close family members who have been diagnosed with the disease. These factors are all beyond our control. “But there are some behaviors that increase the risk of developing pancreatic cancer,” notes Dr. Saha, “including smoking, obesity, a sedentary lifestyle and a fatty diet.” www.OurHealthVirginia.com
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Other factors associated with the disease are diabetes, chronic inflammation of the pancreas (called pancreatitis), stomach surgery and chronic infections such as hepatitis B. Despite these identified risks, there is no specific cause found in most people who develop pancreatic cancer.
Symptoms of Pancreatic Cancer
For patients with locally advanced or metastatic pancreatic cancer—which represents about 80 percent of the cases—survival is even shorter and is typically measured in months.
“The pancreas lies deep in the belly—and a cancer can grow silently for years before it is discovered,” says Dr. Yeaton. Symptoms may appear only once the tumor grows large enough to press on other nearby structures such as nerves (which causes pain), the intestines (which affects appetite and causes nausea and weight loss) or the bile ducts (which results in jaundice or a yellowing of the skin, loss of appetite and itching). Different symptoms may occur if the pancreatic cancer metastasizes or spreads through the blood and lymph systems. Pancreatic cancer most commonly spreads to the liver, lymph nodes and lining of the abdomen. “There is no simple screening test for pancreatic cancer and since the symptoms are often vague, most pancreatic cancers are found when the disease is in an advanced stage and has spread to other organs,” notes Dr. Yeaton.
How is Pancreatic Cancer Diagnosed? Some people with pancreatic cancer first see their primary care physician complaining about digestive problems, weight loss or back pain. These complaints may be further evaluated with a physical examination, blood tests and, sometimes, x-rays and an ultrasound. When pancreatic cancer is present, an ultrasound will reveal an abnormality in the pancreas about 75 percent of the time. The next step in the process is likely to be a computed tomography (CT) scan. If a pancreatic mass is identified and cancer is suspected, a biopsy is performed to make a definitive diagnosis. “An endoscopic ultrasound is the most sensitive way to detect pancreatic cancer,” reports Dr. Yeaton. A blood test for CA 19-9 can show abnormally high levels in people with pancreatic cancer.
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Unfortunately, this test is not specific for pancreatic cancer—and it’s not perfect. Other cancers as well as some benign conditions can cause the CA 19-9 to be elevated, and about 10 percent of the time the CA 19-9 will be at normal levels in the blood despite a confirmed diagnosis of pancreatic cancer. However, tracking the rise and fall of CA 19-9 during the course of the illness may be useful in guiding treatment.
Treatments for Pancreatic Cancer Treatment options for pancreatic cancer vary depending upon the stage of the disease when it is diagnosed. Pancreatic cancer is broken into four stages—stage I being the earliest stage and stage IV being the most advanced. The four stages are categorized into three groups.
Local, Resectable Cancer (Stage I and II) Patients with stage I and II cancers are classified as having “local” or “resectable” cancers. These are cancers that are contained in the pancreas and can be completely removed with surgery—the only treatment today that can cure pancreatic cancer. The type of surgery typically performed to remove a pancreatic cancer is called a pancreatoduodenectomy—but more commonly referred to as a “Whipple”— named after Dr. Allen O. Whipple, who first performed this procedure in 1935. “A Whipple involves removing a portion of the stomach, duodenum (the first part of the small intestine), pancreas, bile ducts, lymph nodes and gallbladder,” says Dr. Saha. This is a major surgical procedure that should be performed only by a surgeon with significant experience. “Ensuring a better outcome for patients with ‘curable’ pancreatic cancer,” says Dr. Fintel, “is a three-step process: surgery to remove the cancer, chemotherapy to kill any free-floating cells and radiation therapy to get at the ‘root’ of the cancer.” Unfortunately, only about 20 percent of the patients diagnosed with pancreatic cancer have tumors that can be treated surgically. The rest have tumors that are too advanced to be completely removed or have metastasized at the time of diagnosis.
Locally Advanced, Unresectable/ Marginally Resectable Cancer (Stage III) If pancreatic cancer is diagnosed when the tumor has expanded to nearby major blood vessels or nerves but not spread to distant sites, this is described as “locally advanced” pancreatic cancer (stage III). At this point, the tumor cannot safely be removed with surgery and is therefore considered “unresectable.” Pancreatic cancer is an aggressive disease, and fortunately the specialists in this field are embracing treatment protocols that are just as aggressive. “We can offer a glimmer of hope to some stage III pancreatic cancer patients by classifying them as ‘marginally resectable,’ says Dr. Yeaton. “Chemotherapy and radiation treatments are used to reduce the tumor. Then, the patient is re-staged to determine if the tumor is now ‘resectable’—and can be removed surgically.”
Metastatic Cancers (Stage IV) Once a pancreatic cancer has metastasized or spread beyond the pancreas to other organs it is classified as stage IV. At this point chemotherapy is used to fight the disease “systemically.” Chemotherapy travels through the bloodstream and can therefore attack a cancer that has spread wherever it is found in the body. In metastatic pancreatic cancer, chemotherapy is used to extend and improve the quality of life. Unfortunately, the overall benefit is modest and chemotherapy prolongs life for the average patient by only a few months. Side effects of treatment for pancreatic cancer vary depending on the type of treatment. Radiation therapy tends to cause fatigue, nausea and diarrhea. Chemotherapy side effects may include fatigue, loss of appetite, changes in taste, hair loss and lowering of the immune system that can increase the risk of infections. Today, much better supportive medications are available to help patients manage side effects. But the discomfort of treatment is usually considered minor when compared to the risks of uncontrolled pancreatic cancer.
Prognosis of Pancreatic Cancer Pancreatic cancer is a harsh disease. Even for tumors that are discovered at an early stage and can be treated surgically, the risk of cancer recurrence is high. About 20 percent of patients who have curable pancreatic cancer—stage I and II—live five years. For patients with locally advanced or metastatic pancreatic cancer—which represents about 80 percent of the cases— survival is even shorter and is typically measured in months.
What Does the Future Hold? Doctors and researchers across the nation and around the world are collaborating on the development of better treatments for pancreatic www.OurHealthVirginia.com
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“I’ve walked the walk,” reflects Carol. “I really think I could offer tremendous support to newly diagnosed cancer patients.”
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cancer. Progress over the past quarter century has been slow, but there are promising developments on the horizon. Here are a few: New chemotherapy agents are now available and clinical trials are evaluating different combinations of these drugs for treating pancreatic cancer. Other studies are testing the best ways to combine chemotherapy with radiation therapy. “Targeted cancer therapies” get at the core of what drives pancreatic cancer. Many of these treatments focus on proteins in the cells that are involved in “signaling pathways.” By blocking signals that tell cancer cells to grow and divide uncontrollably, targeted cancer therapies can help stop cancer progression and may cause cancer cell death, called apoptosis. Other targeted therapies can cause
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cancer cell death by stimulating the immune system to recognize and destroy cancer cells or by delivering toxic substances directly to the cancer cells. This January, findings related to a vaccine therapy for the treatment of metastatic pancreatic cancer were presented at the 2014 Gastrointestinal Cancers Symposium held in San Francisco, CA.
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GAME ON: Debbie Ryan’s Story words | SUSAN DUBUQUE photography | UNIVERSITY OF VIRGINIA
She’s a formidable athlete of national and international acclaim, with a career spanning 34 years and 736 victories. Architect of the University of Virginia’s women’s basketball program. Inductee into the Women’s Basketball Hall of Fame. Yet not one of these accomplishments can come close to the most significant victory of her life—beating pancreatic cancer. In late 1999, Debbie Ryan was already a coaching legend—by now taking her team to the NCAA tournament was SOP. But a nagging stomachache prompted her to seek medical attention. “The problem kept coming and going,” recalls Debbie. “Initial imaging tests didn’t show anything abnormal.” In August 2000, as Debbie was coming home from a recruiting trip, a particularly severe episode sent her reeling. She saw Dr. Yeaton, who performed an endoscopy. The results were devastating—a tumor in the duct.
But she wasn’t fighting alone. Virginia State Senator Emily Couric was diagnosed with pancreatic cancer just three weeks before Debbie. “We went through our treatment together,” says Debbie. Joined by this common experience, Debbie and Emily spent their time in chemotherapy plotting and planning. “We distracted ourselves from the fear and pain of cancer treatment by designing a new cancer center. We thought about every little detail of the experience—from the meditation garden and exercise facilities, right down to the robes.” Sadly, Emily’s cancer was inoperable. The new cancer center became a reality and now bears the name Emily Couric Clinical Cancer Center. Although Debbie Ryan retired from coaching in 2011, her role as an inspirational leader continues. She is on a new mission—to create awareness of pancreatic cancer and help raise money for research.
“I knew the odds. I had done my research,” says Debbie. “Everyone dies.” But Debbie did defy the odds. And 14 years later she is considered cured.
“Only four percent of pancreatic cancer patients survive more than five years, so there is no one left to carry the flag,” remarks Debbie.
This was no easy battle. “Imagine something as personal as struggling with cancer being waged on the front page of USA Today,” recalls Debbie. “And other coaches tried to use my health issues against me. I was battling for my career and my life.”
“This cause clearly has a bold new champion,” says Dr. Yeaton. “If there were a Hall of Fame for cancer survivors, surely Debbie Ryan would be its first inductee.”
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Pancreatic Cancer:
Arm Yourself with Knowledge words | SUSAN DUBUQUE
Pancreatic Cancer Snapshot »» Pancreatic cancer is the fourth leading cause of cancer-related death among both men and women in the United States, yet it makes up only 3 percent of all cancers »» In 2014, an estimated 46,400 people will be diagnosed with pancreatic cancer in this country and more than 38,000 will die of this disease »» Because pancreatic cancer usually is diagnosed at an advanced stage, the survival rate is extremely low compared with those of many other cancer types »» The incidence rate of pancreatic cancer has increased since 1999 and the mortality rate also has increased slightly since 2000 »» More than $2 billion is spent annually in the United States for pancreatic cancer treatment
Risk Factors While there is no known cause of pancreatic cancer, there are factors that are associated with the increased risk for the disease. They include: »» Gender – men are 30 percent more likely to get pancreatic cancer than women »» Ethnicity – African-Americans are at greater risk for pancreatic cancer than Caucasians or other racial/ethnic groups »» Age – most cases occur after age 60, while cases before age 40 are uncommon »» Cigarette smoking – accounts for approximately 20 percent of cases »» Family history – 5-10 percent of pancreatic cancer patients have a family history of the disease »» Diabetes 84
»» Inflammation of the pancreas »» Obesity »» Fatty diet – high consumption of sugar and red meat, low consumption of fruits and vegetables »» Prior history of stomach surgery »» Chronic infections such as hepatitis B
Signs and Symptoms Early pancreatic cancer often does not cause symptoms, and the later symptoms may be nonspecific and varied. For that reason, pancreatic cancer is often not diagnosed until it is advanced. Common symptoms include: »» Pain in the upper abdomen that radiates to the back »» Heartburn - acid stomach »» Poor appetite or nausea and vomiting »» Diarrhea »» Significant weight loss »» Diabetes »» Jaundice - yellow tint to skin and whites of the eyes »» Itching »» Blood clots
Seeking Support for Pancreatic Cancer Many hospitals provide special services for patients and families battling pancreatic cancer. The American Cancer Society and Pancreatic Cancer Action Network (PANCAN) both provide information and support for people living with this disease. The American Society of Clinical Oncology website contains a wealth of information for patients, families and professionals interested in learning more about pancreatic cancer. »» American Cancer Society - cancer.org »» PANCAN - pancan.org
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»» American Society of Clinical Oncology - cancer.net or asco.org
Local Resources The Roanoke area has advanced medical services for patients coping with pancreatic cancer. Here is a summary of what each of the major health systems has to offer. Carilion Clinic Cancer Center, in collaboration with Blue Ridge Cancer Care, provides a full range of pancreatic cancer treatments, including chemotherapy and radiation, on both an in-patient and outpatient basis. Carilion’s cancer treatment program emphasizes a multidisciplinary approach to care, allowing every patient to benefit from the collaborative expertise of specialists who meet regularly to discuss each patient’s care and progress. Additionally, Carilion Clinic is among a select few hospital systems statewide to offer innovative treatments such as SIR-Spheres and CyberKnife, along with targeted radiation technologies and access to the most recent clinical trials. Carilion Roanoke Memorial Hospital also has a new inpatient oncology unit, allowing patients to recuperate with the help of physician specialists and nurses dedicated to caring for cancer patients. For more information, visit carilionclinic. org/cancer/oncology-care-virginia LewisGale Regional Health System is known for its high-quality cancer care, patient safety and health outcomes. Through its two regional cancer centers and multidisciplinary clinics, patients have access to a vast network of specialists, clinical trials, genetic testing and some of the most advanced treatment options available. For pancreatic cancer that includes the Whipple procedure, Synergy S stereotactic radiosurgery and Intensity-Modulated Radiation Therapy (IMRT) for precise tumor targeting. LewisGale is also the first
in Southwest Virginia to offer the HIPEC procedure or Hyperthermic Intraperitoneal Chemotherapy. This highly specialized therapy is used to treat advanced abdominal cancer that has either originated or spread to the abdomen. During the treatment the cancer is removed and a hot chemo bath is used inside the abdominal cavity to kill remaining cancer cells. For more on LewisGale’s cancer services, visit lewisgale.com.
Expert Contributors Thanks to the following medical experts who shared their time and knowledge to provide the technical information for this article—and especially for their tireless dedication to pursuing more effective ways to treat—and ultimately cure— pancreatic cancer.
»» William Fintel, MD, Medical Oncology, Blue Ridge Cancer Care, practicing at LewisGale Medical Center »» Sanjoy Saha, MD, Surgical Oncology/General Surgery, LewisGale Medical Center »» Paul Yeaton, MD, Gastroenterology, Carilion Clinic
Paul Yeaton, MD, Gastroenterology, Carilion Clinic
Additional References »» American Cancer Society »» National Cancer Institute, General Information about Pancreatic Cancer
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Sanjoy Saha, MD, Surgical Oncology/General Surgery, LewisGale Medical Center
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William Fintel, MD, Medical Oncology, Blue Ridge Cancer Care, practicing at LewisGale Medical Center
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words | RICH ELLIS photography | SHAWN SPROUSE
suddenly diagnosed with
PROSTATE
CANCER No one told Mike Unroe that 45 was too young to worry about prostate cancer, or that he should wait until age 55 to have a PSA screening. He’s glad they didn’t.
Screening is the Best Way to Detect Prostate Cancer If you’re a man without risk factors that heighten your probability for contracting prostate cancer – such as a family history of the disease – the American Urological Association (AUA) recommends an annual Prostate Specific Antigen (PSA) screening to aid in the early detection of prostate cancer between the ages of 55 and 69.
SEPTEM IS PRO BER STATE CANCE AWARE R NE MONTH SS
Fortunately for Blue Ridge resident and Roanoke County firefighter Mike Unroe—whose case is somewhat unique—his annual county physical automatically included a PSA screening every year after age 40. “At my 44-year physical, my PSA was 2.7,” Unroe explains. “The next year it was 3.9 or 4. Although it wasn’t technically high, it was flagged due to the rate of increase.”
There are 230,000 new cases of prostate cancer annually, Roanoke County firefighter, Mike Unroe, was one of those.
A departure from the baseline in a patient’s annual PSA test results is a red flag for possible prostate cancer. Based on Unroe’s PSA test results, his physician referred him to a urologist who placed him on two weeks of an antibiotic to see if perhaps the prostate was inflamed due to an infection that was causing the spike in PSA levels. Two weeks later, the PSA level was tested again and this time it measured 4.7. At this point, it was decided the best course of action was a biopsy of the prostate to determine if cancer was present. The biopsy results indicated Unroe did indeed have prostate cancer. And, even though his prostate cancer appeared at an earlier age than is typical, Unroe certainly wasn’t alone. Technically, Dr. Daniel says, the AUA guidelines recommend that men between the ages of 55 and 69 discuss screening with their physician, particularly if there is a family history of prostate cancer. Unroe had just such a family history—which could help explain his prostate cancer at 45—as his maternal uncle was also diagnosed previously with the disease.
Diagnosing Prostate Cancer “Prostate cancer is diagnosed through the PSA test, a digital rectal exam, and prostate biopsy,” Dr. Daniel explains. “You start out with the PSA and digital rectal exam, and if those are abnormal, we do a prostate biopsy which is a 15-minute procedure performed in the office.” Only about 15 percent of patients with prostate cancer present with symptoms, Dr. Daniel says, and when they do, it’s usually because the cancer is at a more advanced stage, which makes early detection through screening critically important in terms of recovery rates. Prostate cancer, Dr. Daniel explains, tends to be a slow-growing cancer, which is one of the reasons that the screening guidelines have changed. The school of thought now is that some men were being over-treated for prostate cancer. For example, for a man in his 70’s with a non-aggressive prostate cancer, treatment might not be necessary because statistics show that he will probably die of something else other than the prostate cancer. “By looking at men age 55 to 69, they’re trying to identify prostate cancers that are clinically significant and treat those men,” Dr. Daniel explains. Following his diagnosis, Unroe said he talked with a number of medical professionals about his prostate cancer before deciding that treatment was his best option. “Basically everyone I talked to said that at my age and given my [good] health, I should go ahead and get it [the prostate] taken out, even though there was a chance of side effects. I’ve got my opinion about it too, and it was to go on and get it out and not worry about it.”
There are 230,000 new cases of prostate cancer annually,” explains Charles Daniel, MD, a urologist at Jefferson Surgical Clinic in Roanoke, VA. “And it’s the second most common cause of cancer death in men. Unroe’s Treatment Unroe said his discussions with physicians and urologists about treatment options ranged from the implantation of radioactive seeds to external radiation to surgery, including the minimally-invasive DaVinci robotic surgery to remove the prostate gland through a procedure known as a prostatectomy. “It just so happened, I also heard a commercial on the radio talking about the DaVinci surgery in Lynchburg,” Unroe explains. “I liked the idea of that because I’m still pretty active, so I started looking locally and found that the only one performing DaVinci around here [Roanoke] then was Dr. Daniel.” “Even if you’re diagnosed with prostate cancer, it doesn’t mean you’re automatically going to go into radical treatment,” Dr. Daniel explains. “For example, we commonly perform active surveillance protocols. What’s important to understand is that if prostate cancer is diagnosed, there are numerous treatment options available.” One such option, Dr. Daniel explained, is the minimally-invasive robotic prostatectomy that Unroe underwent. Radiation is also a treatment option, as is the shift toward active surveillance. “Active surveillance doesn’t mean we ignore it,” Dr. Daniel says. “It means we check your PSA and perform a digital rectal exam and sometimes repeat the prostate biopsy down the line so that we only treat disease that we think is medically significant.” And there are some newer tests out now that help identify which of those prostate cancers are more likely to be www.OurHealthVirginia.com
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medically significant, Dr. Daniel explains. Once the diagnosis is made, the cancer’s aggressiveness and the patient’s overall health are evaluated and a decision formed as to whether they will require treatment. There’s no question in Unroe’s mind that he and Dr. Daniel made the right decision in having his prostate cancer treated with a prostatectomy. Five years later, he’s cancer free and back to doing everything he did before the cancer was diagnosed. “Other than the normal discomfort of having gone through surgery and having a catheter for a week, it was great and I can’t complain,” Unroe says. “I didn’t have any side effects, but I also made sure I was in good shape before I did it.”
Additional Information For more information or to schedule an appointment with a physician/provider at Jefferson Surgical Clinic, call 540.283.6000 or visit www.jeffersonsurgical.com.
Jefferson Surgical Clinic Locations »» Jefferson Surgical Clinic – Roanoke 1234 Franklin Road, S.W. Roanoke, VA 24016 »» Jefferson Surgical Clinic – Salem 1900 Electric Road Lewis-Gale Medical Center Medical Office Building Salem, VA 24153
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john's
words | RICK PIESTER
“I have to devote my life to recovery.” That’s how John Mullarkey sums up the path before him if he ever hopes to remain free of the alcohol and drugs that controlled him for most of his life. John grew up in a family heavily addicted to alcohol and drugs. A heavy drinker and drug abuser himself, beginning at age 14. As a high school sophomore, he chose alcohol and drugs over his first serious girlfriend. He was in and out of rehab at least six times before he turned 27. But May 7, 2013, is a holiday of sorts for John Mullarkey. That’s the day after he checked into Mount Regis Center, the alcohol and rehabilitation center in Salem. John was 26 years old. He’s been clean and sober since then and, talking to John, you quickly get the feeling that if he can overcome addiction, just about anyone can. John’s story begins in Pittsburgh, PA. He grew up in the inner city, never feeling that he fit in with others at school and in his neighborhood. John and his mother moved to the suburbs when John was in the third grade. He entered his new school after the school year had started, and by that time friendships had already been made, cliques had already been formed, and he felt further excluded. He was bullied by others. He always felt like an outsider.
Like many alcoholics, he drank at first to “belong.” “I started drinking at age 14 or 15 with some buddies
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Mount Regis Center, alcohol and rehabilitation center in Salem
from high school,” he says. “We would buy a bottle or two of hard liquor and down that throughout the weekend. I really enjoyed drinking. I enjoyed the feeling. Then drinking moved from the weekend to weeknights. I drank as much as I could as many times as I could.” “Then one night when I was 15, one of my buddies told me he was meeting up with some of his friends to smoke pot. It was one in the morning. I was not sure I should do it because I knew that members of my family had issues with drugs. But I went anyway.” He tried it, and he loved it. “It pretty much turned my thinking on drugs,” he says. “The drug made me comfortable with myself and around other people. I never felt I had friends that I could rely on until I started using. It progressed really fast for me. Drugs and alcohol became my life, my solution to everything.” At about the same time, John had his first serious girlfriend. By his sophomore year of high school, the girlfriend gave him a choice: drugs or me. He chose drugs and alcohol. ”I really did love her, but not as much as I loved drinking and drugs. So I chose drinking and drugs. Hands down.” Bonnie Stewart, clinical director at Mount Regis
“We truly believe that anyone who wants to recover can do it,” notes Bonnie Stewart, clinical director at Mount Regis.
It was a busy time for John. He dabbled in the hydrocodone-based painkillers Vicodin and Percocet, which contain the narcotic pain reliever oxycodone. He remembers a “huge fight” with his stepfather, a man he always resented, never wanting him in his life. John had what he says was “a mound” of Vicodin that his stepfather mistook for heroin. He felt that the man was always “after” him, and this time he reported John to the police, further widening the breach between them. John knew that his stepfather was a recovering addict, but ignored his warnings. He had contracted the liver disease Hepatitis C from sharing needles while addicted to heroin. “He had a liver transplant in Pittsburgh in 2002,” John says now. “He lived until his liver failed in 2011. He knew what addiction was like. He was 20 years clean.” John started selling drugs, eventually becoming one of the major marijuana dealers in his high school. Inspired by someone in his social studies class, he started snorting cocaine. Again, he was unsure because he had heard about cocaine and heroin being the most addictive drugs, “but I took a line and loved it. The depression I was feeling was gone in an instant. Nothing put me up on cloud nine like that first line did. So I was looking for cocaine all the time. Nothing else mattered” John took his first trip to rehab at age 16: “Really, I went just to get my parents off my back. I was thinking that maybe I had a little bit of an issue, maybe I used drugs a little too often, but deep down, even then, I think I knew that drugs were starting to ruin my life.”
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As soon as he got out of rehab, he started feeling that same uneasiness that had plagued him for so long. But now he had a new drug. In rehab, he learned about “ecstasy,” the street name (along with “Mollies”) for MDMA, named and known for its ability to produce a sense of euphoria in users. “I jumped right on that train.” Incredibly, John graduated from high school with honors. He cobbled together a bunch of student loans and entered nearby Duquesne University, planning on a career in nursing. But his drug use, he says, “doubled and quadrupled. Drugs were always available; I was at college, away from home, away from family. I didn’t have to hide anything.” He partied all the time, missing his sophomore year final exams and repeating his sophomore year. He had run-ins with Duquesne campus police and the local police force and spent some time in jail. He managed to complete his junior year in college, but flunked out during his senior year. “It was all a direct result of my drinking and using,” he says. At 21, he started using heroin, which by then had become available as a powder that was so powerful it could be snorted. No longer did people have to use needles. And it was much cheaper than the prescription painkillers. He also started smoking crack cocaine: “I was always looking for something harder.” Years went by, and he finally had had enough of looking up at the world from his bathroom floor. “I finally took a look at my life,” he says. “I realized that I was killing everyone around me, that I was sucking the life out of them. I had experienced what my life would be like inside a jail cell or in a psychiatric ward, or dead. Almost every addict knows people who have died from drug abuse. Even in high school, people I knew died.” By then, he had gotten to know a Pittsburgh therapist recognized in the area for her expertise in addiction and family therapy. He asked her for advice, and she recommended Mount Regis. And by then, somehow, he had gained what every drug or alcohol counselor will tell you is indispensible for recovery — the willpower to stop and the determination to stick it out. “We truly believe that anyone who wants to recover can do it,” notes Bonnie Stewart, clinical director at Mount Regis. “It’s so important to recognize that alcoholism, or addiction to drugs, is a disease that people can learn to control if you can learn the life skills to resist, if you can understand why you started using in the first place. And if you keep working at it.” After a medically-assisted detoxification period to rid his body of drugs and alcohol without many of the horrible sensations of unassisted withdrawal, John started working at it. He started, and still continues, to go to group meetings almost every day, and working the Twelve Steps.
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Lounge and Group Meeting Room at Mount Regis
The Twelve Steps has been a staple of Alcoholics Anonymous since the late 1930s. It has found its way into many other forms of rehabilitation. It’s a set of principles that guides and outlines the course of action for recovery from addiction. The process involves admitting that a person cannot control his or her use of alcohol or drugs, recognizing a higher power as a source of strength, examining past mistakes with the help of a more experienced person who is usually referred to as a “sponsor,” making amends for past errors, learning to live a new life under a new code of behavior, and helping others who suffer from the same addiction. “The people at Mount Regis were amazing,” he says, “and I saw so many signs that God wanted me up and on my feet.” At Mount Regis, John befriended another young man who hailed from Pittsburgh, and who was headed to Florida. “I knew that if I went back to Pittsburgh,” he says, “and back to the same environment, I would start using again, go back to my old life. So I followed my buddy to Florida.” John Mullarkey will turn 28 soon. And he’s in Florida, where he works at a 120-person residential halfway house facility. It wasn’t an easy path for him. He started work as a handyman and landscaper when he arrived in Florida. Eventually, he was hired by the halfway house and has gone on to become a manager. “I know I’ll make it,” he says. “As long as I keep working at it, and applying the Twelve Steps, and staying honest.” He’s helping others, and he plans to go back to school to finally get his degree in nursing. He’ll then be the second nurse in his household. His girlfriend, a graduate of Georgetown University and a nurse practitioner, moved to Florida to be with him in July. “Now,” John says, “I feel like I can do whatever I want to do.”
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guess where & when... Where is this? And approximately what year was this image taken? Post the correct answer on our Facebook page by September 7, 2014.
...and you could win!
You could win a prize pack for 4 from
Chick-fil-A. Cool, right? The winner will be announced on our Facebook page September 14, 2014.
Redeemable at these Roanoke locations: Chick-fil-A Valley View and Chick-fl-A on 220 South next to the Home Depot