OurHealth Roanoke & New River Valleys Oct/Nov 2016 Edition

FREEZING THE PAIN

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PART 4: HOW TO IN HEALTHCARE

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THERE'S NO PLACE LIKE HOME

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TABLE OF CONTENTS OCTOBER • NOVEMBER 2016

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MEDI•CABU•LARY Local experts define health-related terms

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JUST ASK

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NEW & NOTEWORTHY

Healthcare questions answered by local professionals

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FIT BITS

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HOW TO IN HEALTHCARE SERIES PART 4 | TIME TO PUT THE SKILLS TO THE TEST

A listing of new physicians, providers, locations and upcoming events in the Roanoke and New River Valleys' communities

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HEALTH POINTS Interesting facts and tidbits about health

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HELLO, HEALTH

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THE BRIDGE TO BETTER HEALTH STARTS WITH PRIMARY CARE SERIES PART 5 | MEASURE YOUR CARE

FREEZING THE PAIN Follow the story of Diane Short and her journey of identifying and treating “frozen shoulder.”

THE DRIVE TO SURVIVE When breast cancer backed these five women into a corner, they found the drive to move forward with courage, determination and the power of positive thinking.

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The final in our series, part IV of OurHealth’s four-part series explores how to obtain a job in healthcare by creating an appealing, hire-worthy portfolio.

THE ANATOMY CHALLENGE Test your knowledge when it comes to the SHOULDER

NUTRITION Oliveto Artisan Olive Oils & Vinegars in Roanoke shares healthy fall recipes including Maple Balsamic Glazed Pork Medallions, Roasted Brussels Sprouts and Cinnamon Apple Sauté.

What is the Hype with HIIT | John Russell, BS, ACSM, a personal trainer at Green Ridge Recreation Center, shares the many training benefits of high intensity workouts.

Capturing the spirit of those working in healthcare and of people leading healthy lives through photos

This article, the fifth in a yearlong OurHealth series about primary care, focuses on how you can Measure Your Care.

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THERE'S NO PLACE LIKE HOME Generation Solutions unveils a referral service of qualified home maintenance experts, available to anyone at any age.

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CLOSER LOOK Images reflecting the landscape of healthcare in the Roanoke and New River Valleys * PLUS * a chance to win a free year's subscription to OurHealth!

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october • november 2016 PUBLISHER PRESIDENT/EDITOR-IN-CHIEF VICE PRESIDENT OF PRODUCTION VICE PRESIDENT OF BUSINESS DEVELOPMENT PROJECT COORDINATOR CHIEF DESIGNER GRAPHIC DESIGNER WEBMASTER ACCOUNTING MANAGER DIGITAL CONTENT MANAGER | EVENT SPECIALIST COPY EDITOR DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Hungate Kim Wood Deidre Wilkes Karrie Pridemore Tori Meador Heidi McClintic Laura Bower Heidi McClintic Bobbi Hoffman Dalton Holody Shawn Sprouse / www.sdsimages.com

CONTRIBUTING MEDICAL EXPERTS Daniel Bauer, MD Jolene Henshaw, MD Eduardo Lara-Torre, MD Scott Purcell, PhD, HCLD Adel Salama, MD Enrique Silberblatt, MD, FACS CONTRIBUTING PROFESSIONAL Geri Aston EXPERTS & WRITERS Susan Dubuque Tina Joyce Rick Piester Deidre Wilkes ADVERTISING AND MARKETING Kim Wood | P: 540.798.2504 kimwood@ourhealthvirginia.com SUBSCRIPTIONS To receive OurHealth via U.S. Mail, please contact Deidre Wilkes at deidre@ourhealthvirginia.com or at 540.387.6482

@ourhealthmag

COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions.

Copyright © 2016 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Roanoke and New River Valleys is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483.

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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 scar revision?

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Scar revision is the process by which a surgeon changes a scar, usually in the skin, to make it less visible or less likely to break open if it is fragile. In this process, the scar is cut out completely, and the wound is closed in two or more layers.

”

Scars can result from any wound, accidental or surgical, and are what the body uses to heal. Scar revision is the process by which a surgeon changes a scar, usually in the skin, to make it less visible or less likely to break open if it is fragile. In this process, the scar is cut out completely, and the wound is closed in two or more layers. The deep layers hold the tension so that the skin can heal with as narrow a scar as possible. Occasionally, the direction of the scar is changed so that it falls along the naturally occurring lines in the skin, where it is less visible. Most commonly, scar revision is used to improve the appearance of facial scars resulting from trauma such as motor vehicle accidents, falls, dog bites or knife wounds. Stitches from scar revisions are removed in five days, but the patient should protect the new wound for six months.

Enrique Silberblatt, MD, FACS Aesthetic Surgery of Virginia Roanoke | 540.994.7408 www.silberblatt.com

– Enrique Silberblatt, MD, FACS

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What is an ultrasoundguided breast biopsy?

What is embryo cryopreservation?

Ideally, we can find breast cancer when it is a small mass or abnormality on a mammogram or ultrasound. Smaller cancers are better, because they have a higher chance for being cured. If we can see an abnormality on either a mammogram or an ultrasound, we can use that image to find the lesion and perform a biopsy, or get a few small pieces of it, with a needle. The radiologist numbs the area by the lesion and makes a tiny incision, then inserts a large needle and takes several cores, or pieces, out of the lesion. This is not much tissue, but it is plenty to make a diagnosis of the lesion when it’s put under a microscope.

When an embryo is cryopreserved, it is being frozen for future use by the patient. This is typically done about five or six days after the eggs have been fertilized, when the embryo has reached the blastocyst stage; this means that the embryo has begun some cell differentiation, making it more stable than younger embryos.

In other instances, unfertilized eggs may be cryopreserved instead. An ultra-rapid freezing technique called vitrification is used that avoids the damaging formation of ice crystals.

The embryos are then stored in a cryopreservation tank inside a laboratory that is filled with liquid nitrogen and kept at -321ºF. Once frozen in this way, the embryos can be safely stored for many years if needed, and they have an almost 100-percent survival rate once thawed. The chances of pregnancy when using frozen/thawed embryos are high enough that, for a variety of reasons, many patients electively freeze all of their available embryos before returning for a uterine transfer.

A needle biopsy has several advantages, as it can provide details about a cancer before it is operated on so that physicians can make the best decisions about what type of surgery is needed. The needle biopsy can also rule out that the lesion is cancer and therefore help unnecessary surgery be avoided.

Jolene Henshaw, MD

LewisGale Physicians Montgomery Surgical Associates Blacksburg | 540.552.2726 www.lgphysicians.com

Scott Purcell, PhD, HCLD

Reproductive Medicine and Surgery Center of Virginia Charlottesville | 866.540.5190 www.rmscva.com

H E A LT H C A R E QUESTIONS ANSWERED

BY LOCAL PROFESSIONALS

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Bone density testing is recommended for women over the age of 65 and for younger women who have an increased risk of developing osteoporosis. With the results of bone density testing and knowledge of your risk factors, your healthcare provider can help determine whether your risk for osteoporotic fracture is high enough to warrant treatment with medication.

”

– Daniel Bauer, MD

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How does hospice handle pain management?

When a patient is in pain, it not only affects the patient, but also the family. When a patient elects to have hospice, one of the first steps is a comprehensive evaluation, which includes the hospice nurse identifying the causes and types of pain, among other key indicators.

Once the comprehensive pain assessment is complete, the nurse will consult with the patient's attending physician to determine the proper course of pain medications.

After the medications are started, the nurse works with the patient or family member to educate and manage any side effects that occur.

Medications are administered in the simplest form: the least frequency or smallest dose will be given to manage the pain effectively. It is possible that medications will be prescribed on a scheduled basis for chronic pain or to address 'breakthrough' pain, which is when the pain increases with movement or for other unknown reasons. The nurse assesses pain at every visit, but is also available 24/7 to adjust pain medications as directed by the physician.

What are some health risks related to premature menopause in women younger than 40?

Premature menopause (also known as premature ovarian failure or insufficiency) refers to patients whose ovaries lack the ability to consistently make estrogen.

Although not exclusively, premature menopause affects three main health areas.

The most commonly known of these areas is bone health. Patients who do not have estrogen may experience an increase in osteoporosis (weak bones). Cardiovascular health is also affected. Patients may experience an increase in heart disease, leading to a higher mortality compared to their peers. In some patients, the reason why the ovaries fail is because of an autoimmune disorder. In that case, the adrenal gland and thyroid may also be affected and should be evaluated.

The patient and caregiver will be instructed on tolerance and informed that there might be a need to periodically adjust the medications. They are also provided with education on the complications of unmanaged pain. The hospice team will also explore and initiate non-pharmacological interactions.

Therapies involving massage, pets, or music may also be used in an effort to manage pain as well as to enhance the patient’s quality of life.

Other, less common conditions associated with premature menopause include diabetes, pernicious anemia, myasthenia gravis (condition causing rapid muscle fatigue), rheumatoid arthritis, systemic lupus erythematosus (inflaming immune system disease) and dry eye syndrome; these should be considered based on the patient’s symptoms. Finally, all patients should be screened for Fragile X syndrome (a chromosome abnormality). Talk to your healthcare provider if you have concerns regarding early menopause.

Adel Salama, MD

Eduardo Lara-Torre, MD

Heartland Home Health and Hospice Roanoke | 540.725.7600 www.heartlandhomehealth.com

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

Carilion Clinic Roanoke | 540.985.9715 www.carilionclinic.org

Can genetics predispose a woman to low bone density and osteoporosis?

Yes, a woman can be genetically predisposed to develop low bone density and osteoporosis. Having a relative with osteoporosis can increase the chance of developing osteoporosis by a factor of two or more. While bone structure is largely determined by genetic factors, lifestyle choices can reduce the risk of low bone density fractures.

Experts recommend getting regular exercise, which may include walking, yoga or light weightlifting. A diet rich in calcium and vitamin D is also beneficial. Smoking and drinking alcohol in excess decreases bone density. Additionally, some medications such as prednisone as well as certain medical conditions decrease bone density.

Bone density testing is recommended for women over the age of 65 and for younger women who have an increased risk of developing osteoporosis. With the results of bone density testing and knowledge of your risk factors, your healthcare provider can help determine whether your risk for osteoporotic fracture is high enough to warrant treatment with medication.

Daniel Bauer, MD

Physician Associates of Virginia, PC Roanoke | 540.375.3790 www.pavclinics.com

NEW

NOTEWORTHY Don't Miss

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

LewisGale Hospital Montgomery First to Offer Genius® 3D Mammography™ in New River Valley LewisGale Hospital Montgomery is pleased to be the first to bring Genius® 3D Mammography™ to patients in the New River Valley, giving more women convenient access to this advanced technology closer to home. The Genius® 3D is the most accurate mammography system available in the healthcare industry.

3D mammography allows doctors to see masses and distortions associated with cancers significantly more clearly than conventional 2D mammography. Instead of viewing all of the complexities of breast tissue in a flat image, as with conventional 2D mammography, fine details are more visible and no longer hidden by the tissue above or below.

The ergonomic design of the Genius® 3D Mammography system has been shown to help deliver a more comfortable exam experience, while also offering the lowest possible patient dose of x-ray energy from its advanced detector technology.

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LewisGale Hospital Montgomery will hold an open house introducing this exciting technology to the public on Monday, October 24th from 4-6 p.m. at the Imaging Center located at 813 Davis Street in Blacksburg.

Appointments for Genius® 3D Mammography exams will be available beginning October 31, 2016.

Please call LewisGale Hospital Montgomery Central Scheduling at 540.953.5131 to schedule your appointment today.

For more information, visit www.lewisgale.com.

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

Abimbola Obafemi-Afolabi, MD

Michael Bailey, DO

Stetson Bickley, MD

MichaelCovelli,MD, FACS

LewisGale Hospital Alleghany Blue Ridge Cancer Care Carilion Clinic General Surgery Salem | 540.774.8660 Roanoke | 540.981.7000 Low Moor | 540.862.6710 www.blueridgecancercare.com www.carilionclinic.org www.lewisgale.com

Andrew Fintel, DO

Carilion Clinic Roanoke | 540.981.7000 www.carilionclinic.org

Patricia Lacy, PA-C

Katherine Liebesny, MD

Amy Neuhs, PA-C

Carilion Clinic Institute for Orthopaedics and Neurosciences Christiansburg 540.633.0523 www.carilionclinic.org

Carilion Clinic Institute of Orthopaedics and Neurosciences Christiansburg 540.731.2436 www.carilionclinic.org

Carilion Clinic Pearisburg | 540.921.6000 www.carilionclinic.org

Carilion Clinic Psychiatry Roanoke | 540.853.0900 www.carilionclinic.org

Milan Patel, DO

Carilion Clinic Physical Medicine and Rehabilitation Roanoke | 540.985.9992 www.carilionclinic.org

Richard Card, II, DO

Christopher Cline, DO

Fielding Fitzpatrick, DO Joshua Gazo, MD

Teresa Gibson, NP

Anita Jeyakumar, MD

Kimberly Matthews, DO

Kyle McCool, MD

Melanie Parks, NP

Carilion Clinic Roanoke | 540.981.7000 www.carilionclinic.org

Carilion Clinic Internal Medicine Roanoke | 540.224.5170 www.carilionclinic.org

Kyle Prickett, MD

Carilion Clinic Dermatology Roanoke | 540.581.0170 www.carilionclinic.org

Todd Brickman, MD Carilion Clinic Otolaryngology (ENT) Roanoke | 540.224.5170 www.carilionclinic.org

Carilion Clinic Psychiatry Christiansburg 540.731.7311 www.carilionclinic.org

Michael Quinn, DO

Carilion Clinic Roanoke | 540.981.7000 www.carilionclinic.org

LewisGale Hospital Pulaski Internal Medicine Pulaski | 540.980.8804 www.lewisgale.com

CarilionClinic Pearisburg | 540.921.6000 www.carilionclinic.org

Carilion Clinic Obstetrics and Gynecology Roanoke | 540.985.9862 www.carilionclinic.org

Carilion Clinic Otolaryngology (ENT) Roanoke | 540.224.5170 www.carilionclinic.org

Blue Ridge Cancer Care Pulaski | 540.994.8545 www.blueridgecancercare.com

Douglas Reeve, PA Carilion Clinic Urology Christiansburg 540.382.3440 www.carilionclinic.org

Carilion Clinic Psychiatry Roanoke | 540.981.8025 www.carilionclinic.org

Mark Witcher, MD, PhD Carilion Clinic Institute of Orthopaedics and Neurosciences Roanoke | 540.224.5170 www.carilionclinic.org

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NEW

NOTEWORTHY Don't Miss

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

With New Healthcare Coaching Institute, Virginia Tech Shapes Next Generation of Industry Leaders Virginia Tech will expand its footprint in downtown Roanoke in November when it opens its leadership coaching institute for the healthcare and life sciences industries.

The Healthcare Coaching Institute is a partnership of Virginia Tech’s Center for Organizational and Technological Advancement and the Pyramid Resource Group of Cary, North Carolina.

The institute opens at the same time a Health Science and Technology Innovation District is under development in Roanoke in partnership with Carilion Clinic and Virginia Tech.

The 125-hour program coaching certification program will serve professional coaches and is approved by the International Coach Federation.

“This is the first time we’ve offered something specifically related to healthcare and leadership coaching,” says Susan Short, associate vice president for engagement at Virginia Tech, part of Outreach and International Affairs. “Roanoke is a natural setting for the institute. We’re an easy connection for folks.”

The institute will offer in-person intensive sessions at the Hotel Roanoke and Conference Center along with instructor-led online courses. Participants are expected to be drawn from hospitals, provider networks, insurance companies, and entities related to the pharmaceutical and biotechnology fields.

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The institute is presented through Virginia Tech's Continuing and Professional Education, which provides professional training beyond the university’s traditional degree-based offerings.

Potential participants can find more information at www.cpe.vt.edu/hci.

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LewisGale Hospital Montgomery Begins $6 Million Capital Investment Project

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LewisGale Hospital Montgomery will spend $6 million over the next several months on hospital renovations and infrastructure, including over $1 million on its 9,000 square foot Emergency Room. Emphasis on ER renovations will be on the front end of the department, including an expanded triage area, where patients are first assessed upon their arrival. $850,000 will go towards renovations and enhancements to the hospital’s 11,000 square-foot Surgical Department which houses seven operating rooms. An additional $3 million investment will go toward the installation of a new energy management system that will control heating and air conditioning throughout the hospital much more efficiently.

The system will include alarms that trigger when temperature and humidity are out of range. “This is particularly important in the Operating Room area,” states Alan Fabian, CEO, LewisGale Hospital Montgomery.

Major renovations will also take place on the second floor Progressive Care Unit, where the majority of patients stay to be closely monitored for blood pressure and heart rhythm. The project also includes two new digital x-ray units, including one that will be used exclusively for ER patients, and additional security system enhancements.

The project is slated to be completed in early 2017. “During this time, we will work diligently to ensure that the construction project does not impact our patients and the care delivered by staff,” states Fabian.

For more information, visit 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

Replacing Just One Sugary Drink with Water Could Significantly Improve Health, Virginia Tech Researcher Finds Think one little sugary soda won’t make a difference on your waistline? Think again.

If people replace just one calorie-laden drink with water, they can reduce body weight and improve overall health, according to a Virginia Tech researcher.

“Regardless of how many servings of sugar-sweetened beverages you consume, replacing even just one serving can be of benefit,” says Kiyah J. Duffey, an adjunct faculty member of human nutrition, foods, and exercise in the College of Agriculture and Life Sciences and independent nutrition consultant.

Consuming additional calories from sugary beverages like soda, energy drinks, and sweetened coffee can increase risk of weight gain and obesity, as well as Type 2 diabetes and cardiovascular disease.

Duffey’s findings, which were recently published in Nutrients, an open access journal of human nutrition published monthly online, modeled the effect of replacing one 8-ounce sugar-sweetened beverage with an 8-ounce serving of water, based on the daily

dietary intake of U.S. adults aged 19 and older, retrieved from the 2007-2012 National Health and Nutrition Examination Surveys.

Duffey, along with co-author Jennifer Poti, an assistant professor of nutrition at the University of North Carolina at Chapel Hill, showed that this one-for-one drink swap can reduce daily calories and the prevalence of obesity in populations that consume sugary beverages.

The 2015 Dietary Guidelines for Americans recommend that no more than 10 percent of daily calories come from added sugar and that calorie-free drinks, particularly water, should be favored.

“We found that among U.S. adults who consume one serving of sugar-sweetened beverages per day, replacing that drink with water lowered the percent of calories coming from drinks from 17 to 11 percent,” Duffey says.

To find more on this study, visit www.vtnews.vt.edu.

Expectations for Employees to Check Email After Hours Can Cause Burnout, New Study Finds Employer expectations that emails will be monitored and responded to during nonwork hours are the main reason employees are unable to disconnect from the workplace, new research finds.

The emotional stress and exhaustion that may result from such expectations has a negative effect on the individual’s well-being and, ultimately, job performance.

William Becker, a Virginia Tech associate professor of management in the Pamplin College of Business and one of the study’s co-authors, says that just the expectation itself that emails will be tended to “creates anticipatory stress” in employees.

His study notes that “even during the times when there are no actual emails to act upon, the mere norm of availability and the actual anticipation of work create a constant stressor that precludes an employee from work detachment.”

Adds Becker: “Such expectations — whether real or imagined — cause more problems, including burnout and work-life balance problems, than the actual time it takes to read and respond to afterhours emails.”

The study finds that those who are hardest hit by such organizational expectations are employees who fervently wish to keep work and

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family separate — those with a “strong segmentation preference.”

Over time, however, the study adds, even employees who don’t care as much about the work-personal life separation will find the expectations problematic as well.

“An ‘always on’ culture with high expectations to monitor and respond to emails during nonwork time may prevent employees from ever fully disengaging from work, leading to chronic stress and emotional exhaustion,” according to the study.

The study is one of the first to show the critical role of email-related expectations in diminishing individual ability to mentally detach from work, through both the anticipatory stress and the actual time spent.

Becker, whose research interests include work emotion, turnover, organizational neuroscience, and leadership, is based at Virginia Tech’s National Capital Region campus in metro Washington, D.C. To find more on this study, visit www.vtnews.vt.edu.

Welcome

Daisy M. Edwards, FNP FAMILY NURSE PRACTITIONER

Services Provided: •

Adolescent and Adult Primary Care

•

Chronic and Acute Illness Management

•

Women’s Health

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Wellness Exams and Sports Physicals

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Certified to Perform Commercial Driver’s License Exams

“I am thrilled to be a part of the Blacksburg community, and happily look forward to providing the best possible care to you and your family.”

Medical Associates of Southwest Virginia 810 Hospital Drive Blacksburg | 540.951.1462 Hours: Monday - Friday from 8:30 am - 5:00 pm * Most insurances accepted

MedicalAssociatesSWVA.com Scan here for more information about our services and providers. www.OurHealthswva.com

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NEW

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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

Carilion Clinic Earns Most Wired Designation for Eighth Year in a Row For the eighth year in a row, Carilion Clinic has received Health Care’s Most Wired™ designation from the American Hospital Association’s Health Forum.

The designation is based on results from the 2016 Most Wired™ Survey, which is published annually by Hospitals & Health Networks magazine. Each year, the survey questions are updated to reflect increasing standards for technology within healthcare organizations.

For more information, visit www.carilionclinic.org.

Carilion New River Valley Medical Center Recognized for Lowering Hospital-Acquired Infections and a Culture of Patient Safety Carilion New River Valley Medical Center (CNRV) has received Virginia Health Quality Center’s (VHQC) 2015 Quality Innovation Award. VHQC’s is the Medicare Quality Innovation Network – Quality Improvement Organization for Maryland and Virginia.

The award recognizes seven hospitals that are achieving reductions in hospital-acquired infections (HAI) and creating a culture of patient safety.

Based on the 2015 calendar year performance, the top 10 percent of hospitals enrolled in the HAI Improvement Network in each state received this award. Virginia had just four hospitals earn this award.

To learn more about Carilion New River Valley Medical Center, visit www.carilionclinic.org/CRNV.

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Carilion Giles Community Hospital Dedicates New Compassion Room for End-ofLife Patients and their Families The Compassion Room at Carilion Giles Community Hospital (CGCH) helps end-of-life patients and their families spend time together in a more comfortable environment.

The new room was recently dedicated with a ceremony and reception for employees recognizing the CGCH Auxiliary, which funded the project for $10,000. The room provides as near a home-like experience as possible through incorporating personal touches into the design. Amenities for patients and families include: •

Sleeper couch

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Glider/rocking chair

•

Quilt on bed (goes home with family)

•

Mini refrigerator and coffee maker

•

In-room snacks

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CD player with soothing music

•

Outside window interests: bird feeder, flowers

To learn more, visit www.carilionclinic.org/CGCH.

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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

Green Ridge Recreation Center Gets New Equipment Since opening its doors in January 2010, Roanoke County's Green Ridge Recreation Center has stayed at the forefront of the rapidly changing personal fitness industry.

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Green Ridge Recreational Center is introducing new, state-of-the-art pieces of exercise equipment, many of which are a first for Southwest Virginia. Highlights include dozens of new circuit machines from the Technogym personal selection line, featuring biomechanically correct curvilinear motion for more effective workout and fewer injuries. Several new Woodway treadmills are manually powered for greater fat burning potential and load bearing capacity. Cycling classes will get an upgrade with 27 new Keiser M3 bikes, featuring a live interactive television display allowing participants to race against each other in real time, and download statistics to a smart phone. Several top-quality weight racks have been custom designed for the facility. Finally, Green Ridge will offer the region’s first TRX Tactical Training Locker, filled with cutting-edge personal training field gear.

More information can be found at www.GreenRidgeRecreationCenter.com.

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

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

“If you think taking care of yourself is selfish, change your mind. If you don’t, you’re simply ducking your responsibilities.”

– Ann Richards, women and minorities advocate

DID YOU KNOW? Women are nearly twice as likely as men to experience depression, and although it can occur at any age, it is most common in women between the ages of 40 and 59. Your emotional health is as important as your physical health.

Talk to your healthcare team about being screened for depression.

BONES AND BARBELLS!

Studies show that strength training – not just walking or doing aerobics, but LIFTING weights – can help protect bones and prevent osteoporosis-related fractures!

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Source: Mayo Clinic

Get a call back after your last mammogram?

For every 1,000 women who have a screening mammogram, over 20 percent get a call from the doctor’s office!

100*

61 20* 19

will return for additional mammogram or ultrasound due to something seen in the initial mammogram

will have the additional imaging and find nothing is wrong will find what was seen in the imaging is likely not cancer and return in six months to keep watch on the finding

When breast cancer is found this way, the cure rate is very high!

will have a minimally invasive needle biopsy

5 will be diagnosed with breast cancer * Figures may be lower for women who have had prior mammograms and higher for women who are having their first mammogram.

Source: American College of Radiology

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

FASCINATING FACT

The tooth is the only part of the body that can’t repair itself.

Don’t forget to schedule regular dental exams!

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November is both

National Alzheimer’s Disease Awareness Month and National Family Caregivers Month If you are a caregiver of any kind, visit www.caregiveraction.org for tools and resources to help manage the care of your loved one.

More Than

Nearly

15 million 5 million family members, friends and neighbors care for a loved one with Alzheimer’s disease.

Americans are living with Alzheimer’s, and almost

60 Percent of Alzheimer’s and dementia caregivers are women.

Two-Thirds

of them are women.

Want to be part of the cure for Alzheimer’s ?

Sign up for TrialMatch, a free clinical matching service that connects individuals with Alzheimer’s, caregivers and healthy volunteers to current studies.

For more information visit www.alz.org/research.

JAM Out!

MOVE YOUR FEET so Others Can Eat!

November 4, 2016 | 6:00 p.m.

The Union Drumstick Dash will once again be held on Thanksgiving morning. Your participation provides food, shelter and clothing for the 350-plus men, women and children who seek services from the Rescue Mission Roanoke every day. The 5K route winds through downtown Roanoke, ending at the historic Roanoke City Market. Enjoy music of all types stationed throughout the route. A great start to the holiday!

Hotel Roanoke and Conference Center

Thursday, November 24, 2016 | 9:00 a.m.

110 Shenandoah Ave NE, Roanoke

Williamson and Franklin Roads, Roanoke

For more information, visit www.949starcountry.com.

For more information, visit www.drumstickdash.net.

Make it a girl’s night out! Pajama Jam 2016 is a dinner, concert, silent auction and raffle to raise funds and awareness for breast cancer. More than 900 women in their pajamas are expected to attend – fun!

One hundred percent of Pajama Jam’s proceeds will benefit Susan G. Komen Virginia Blue Ridge!

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the

Anatomy

CHALLENGE How much do you know about the

Shoulder? First, complete the

word search below. Next, match up the correct word with the part of the body in the illustration.

[ the Shoulder ]

WORD SEARCH acromion

glenoid socket

biceps muscle

humerus

bursa

rotator cuff

clavicle

scapula

deltoid muscle

For answers, visit OurHealth Roanoke and New River Valleys’ Facebook page at

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FREEZING THE

PAIN

Identifying and Treating “Frozen Shoulder” words | TINA JOYCE

Improving patients’ quality of life, increasing their range of motion, and striving to help their days be pain-free following a surgical procedure are goals of all healthcare professionals.

Receiving proactive care in the days and weeks following a lumpectomy or mastectomy may greatly reduce both acute and chronic pain as well as minimize a patient’s long-term limitations.

Diane Short, a patient who underwent a successful lumpectomy 18 months ago, found herself experiencing symptoms of adhesive capsulitis, or “frozen shoulder.” However, she had no previous knowledge that this condition existed and was treatable. This complication is not uncommon, but it can be misdiagnosed or ignored if a patient is not persistent with his or her post-surgery care provider. Often, a patient may feel that the pain or discomfort is normal following a lumpectomy and wait to disclose the severity or details of the symptoms, resulting in unneeded suffering for months or years.

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Diane explains, “No one ever called my symptoms ‘frozen shoulder,’ but my pectoral muscle was very sore, and I was unable to raise or straighten my right arm above my head. When I tried to raise it, I would have a sharp pain in my shoulder. I had a hard time reaching up in the cabinets or hanging or getting down items in a closet. I would shift my body and use my other arm or get a stepstool to get to what I needed. It seemed like I had no strength to lift or carry items. I finally asked my surgeon about physical therapy options a few months later. He set me up with a physical therapist.”

Audrey Ward, PT is the clinical manager at Professional Therapies Inc.’s Daleville location.

SIMPLE RANGE OF MOTION EXERCISES A physical therapist can teach patients range-ofmotion exercises to assist them in recovering their mobility. However, the degree to which patients are willing and able to commit to consistently performing the exercises, both in the office and at home, will affect their results.

It is important for patients to continually ask their doctors clarifying questions and communicate with them both before and after a procedure. Patients may have to be their own advocates and ask for options to alleviate their pain or improve their mobility.

Adhesive capsulitis is a pattern of restriction of the shoulder joint due to pain caused by an injury or surgery. A patient who experiences this, like Diane, will refrain from moving their arm and shoulder in order to avoid additional pain and discomfort. The joint then becomes “frozen” or stiff from lack of use and inflammation.

It is fairly common for patients to experience pain, joint restriction, and functional limitations after surgeries related to breast cancer, although it is also not uncommon after a stroke, rotator cuff injury, or other arm injuries. Muscle weakness, swelling, numbness, and a feeling of tingling may also persist. Typically, these symptoms are more prevalent after a mastectomy than a lumpectomy because more tissue is removed. Also, the complications may be more intense depending on whether or not any lymph nodes are removed.

“Many women don't develop a true adhesive capsulitis,

CROSS-BODY REACH

but instead have limited shoulder motion that comes from tightness from the scar tissue in the chest wall and shoulder area and sometimes from the swelling, or lymphedema, that can occur after mastectomy.

Treatment of true adhesive capsulitis involves stretching the muscles of the shoulder as well as joint mobilization, a type of Manual Therapy. Shoulder stiffness after

BEHIND BODY REACH

mastectomy might indeed include joint mobilization, but will also include mobilization of the scar tissue to make it more flexible and amenable to stretching of the shoulder joint muscles, management of any lymphedema (swelling in the arm after mastectomy) and, ultimately, strengthening exercises,” explains Audrey Ward, PT, the Clinic Manager of Professional Therapies, Inc.’s Daleville location.

FORWARD ARM EXTENSION (Continued on page 37...)

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(...continued from page 34)

Prompt, proactive care can greatly reduce the symptoms of “frozen shoulder.” Typically, a patient can begin physical therapy as early as two days post-surgery. According to Audrey Ward, PT, the Clinic Manager at the Professional Therapies, Inc.’s Daleville office, “Studies have shown that women who participate in physical therapy starting the second day after mastectomy have better shoulder joint mobility and function a year after surgery than those who don't participate in physical therapy.”

Therapists agree that early physical therapy significantly improves the patient’s joint mobility and overall recovery time and ultimately decreases the cost of healthcare associated with post-operative limitations. As the American Cancer Society explains, “It’s important to complete exercises [after breast cancer surgery] to get the arm and shoulder moving again. Exercises help to decrease side effects of surgery and help patients get back to usual activities.”

Diane reveals that she is doing much better today, 18 months after she had the procedure and 10 months after she began physical therapy, but she must continue to perform the exercises she learned.

“If I do too much,” she explains, “I will feel [pain] in the shoulder, especially if I haven't kept up with what I should be doing. The pectoral muscle is still sore, and it might be a while before that pain is no longer there.”

Ward expands, “Patients should also listen to their bodies so that they don't overdo on the stretches and exercises. It's crucial for them to communicate with the physical therapist about how they are tolerating treatment.”

The primary symptom of this condition is being unable to move your shoulder, either on your own or with the help of someone else. It develops in three stages:

FREEZING

STAGE 1

A physical therapist can teach patients range-of-motion exercises to assist them in recovering their mobility. However, the degree to which patients are willing and able to commit to consistently performing the exercises, both in the office and at home, will affect their results.

When a patient suffers from “frozen shoulder,” the shoulder capsule thickens and becomes tight. Stiff bands of tissue called adhesions develop. In many cases, there is less synovial fluid in the joint.

STAGE 2

Therapists also integrate functional training to develop the use of the painful area in order to improve the patient’s daily living or working activities. Additionally, manual therapy improves soft tissue, scar or joint restriction, while some therapists use modalities such as electrical stimulation to increase circulation and decrease pain.

THE STAGES OF FROZEN SHOULDER

STAGE 3

A thorough evaluation needs to be completed at a physical therapist’s office in order to discuss the patient’s medical history and assess their posture, range of motion, strength, balance, and functional level; this will allow the physical therapist to determine the best plan of care. During the following appointments, the focus shifts to teaching exercises and performing hands-on treatments targeting the joint as well as strength deficits that were found during the initial evaluation.

In the “freezing” stage, you slowly experience more and more pain. As the pain worsens, your shoulder looses range of motion. The freezing stage typically lasts from six weeks to nine months.

FROZEN The condition’s painful symptoms may actually improve during this stage, but the stiffness remains. During the four to six months of the “frozen” stage, performing normal daily activities may be very difficult.

THAWING Shoulder motion slowly improves during the “thawing” stage. A complete return to normal or close to normal strength and motion typically takes anywhere from six months to two years.

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read this edition of

on your tablet or smartphone

“Continue to inform your doctors how you are feeling or ask if there is a treatment that would help with any pain,” Diane advocates. “It's important that you continue to ask questions until you are satisfied.”

“Patients can learn about physical therapy treatments by calling a local physical therapy office, talking to their physician, or getting in touch with the American Physical Therapy Association,” shares Ward. “Another great source of information is other women who have undergone breast cancer surgeries or breast cancer support groups in the area.”

Physical therapy offers patients who are recovering from breast cancer surgeries an option to proactively enhance their speed and quality of recovery.

Patients and providers who are looking to eliminate or minimize post-surgery “frozen shoulder” symptoms may begin treatment shortly after surgery, once a proper evaluation can be completed.

Expert Contributers Audrey Ward, PT with Professional Therapies Inc. in Daleville

Sources American Cancer Society www.cancer.org Frozen Shoulder American Academy of Orthopaedic Surgeons www.orthoinfo.aaos.org Rehab Associates of Central Virginia www.racva.com The Mayo Clinic www.mayoclinic.org

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words | SUSAN E. DUBUQUE

The stories of five women striving to cope with breast cancer with a drive to move forward.

Whether you are a man or a woman, an adult or a child, old or young, you have been touched by breast cancer. It may be your mother, aunt, sister or friend who has suffered, or perhaps you have been personally affected. Among the more than three million women in the U.S. who have breast cancer, many serve as inspirations to us all. There are women who demonstrate grace and dignity in the face of a life-threatening illness, there are those who transform a devastating medical condition into a positive, life-altering opportunity, and there are even those who selflessly extend a hand to others rather than focusing on their personal circumstances.

This article is a tribute to five of these amazing women. It is our hope that their stories will offer insight and inspiration to even more women who are facing the challenges of breast cancer now or must face them in the future.

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Lutheria Smith Lutheria with her husband, James.

LUTHERIA’S STORY Lutheria Smith spent several months teaching her adult Sunday school class a series of lessons on faith, courage and trust. Little did she realize that these lessons were really for her.

“When my daughter Jessica was 25 she had cancer of the lymph nodes. We talked about the whole mind-body system as being totally interwoven.

She tells me she developed a competitive spirit to not let a label define her by remembering past happy times and creating new future positive memories. The “what ifs” of “what if this happens... if I can’t...if I don’t get to...” were replaced by positivity and a new energy, booster shots, every day. For extra guidance try the phone apps: CALM, UPray, Mindfulness I and Mindfulness II.” JACKIE WILKERSON Psychological Health of Roanoke

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When Lutheria went in for her routine mammogram in April 2016, she had no clue what the findings would show. “My mother is a 14-year breast cancer survivor,” she says, “so I am vigilant about checking my breasts every month and having regular mammograms.” Thanks to a careful comparison of her current and prior studies, her radiologist discovered a tumor in the back quadrant of one of Lutheria’s breasts.

Lutheria had a double mastectomy, performed by surgeon Roxanne Davenport, MD with Carilion Clinic. Dr. Davenport and Lutheria’s oncologist, Suzan R. Merten, MD with Blue Ridge Cancer Care, determined that Lutheria would not benefit from chemotherapy. This was based on an Oncotype DX test, a genomic test that analyzed a sample of her tumor to determine how the cancer would respond to treatment. However, Lutheria will take Tamoxifen for five to 10 years in order to reduce the risk of her cancer recurring. In August 2016, she underwent reconstructive surgery with Kurtis Moyer, MD, a plastic surgeon with Carilion Clinic.

“From the moment I was diagnosed with cancer, I never thought I was going to die,” says Lutheria. “I believe that God has a plan or a purpose for everything that He allows to happen, and I knew my faith would get me through.”

Lutheria’s family provided tremendous support during this process. “My husband James and son Jamie (age 15) were a constant source of encouragement and (Continued on page 44...)

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FOUNDATIONS AND PROGRAMS Botetourt Breast Cancer Support Group Meets monthly at Fincastle United Methodist Church Family Life Center 137 South Church Street | Fincastle 540.863.8031

NU OUT1K

Breast Cancer Support Group Meets third Wednesday of each month at Montgomery Regional Hospital 3700 South Main Street | Blacksburg 540.443.3932 Carilion Clinic Breast Cancer Support Group Meets first and third Tuesday of each month Carilion Clinic Breast Care Center, Diagnostic Center 102 Highland Avenue | Roanoke 540.224.6939 Susan G. Komen Virginia Blue Ridge 4910 Valley View Boulevard NW Suite 212 | Roanoke 540.400.8222 www.komenvablueridge.org

MEDICAL FACILITIES AND IMAGING CENTERS BLUE RIDGE CANCER CARE www.blueridgecancercare.com Blue Ridge Cancer Care – Bedford 1710 Whitfield Drive | Bedford 540.586.5770 Blue Ridge Cancer Care – Blacksburg 2600 Research Center Drive, Suite A Blacksburg | 540.381.5291 Blue Ridge Cancer Care – Pulaski 2400 Lee Highway | Pulaski 540.994.8545 Blue Ridge Cancer Care – Roanoke 2013 South Jefferson Street | Roanoke 540.982.0237 Blue Ridge Cancer Care – Rocky Mount 390 South Main Street, Suite 103 Rocky Mount | 540.489.6522 Blue Ridge Cancer Care – Salem 1900 Electric Road | Salem 540.774.8660

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(...continued from page 42)

hope,” says Lutheria. “And my daughter Bradley (age 18) gave me a playlist of contemporary Christian songs. There was one song in particular that I liked, about going through a storm. I would listen to the music when I commuted to work or whenever I was feeling a little down.”

“My neighbors, friends, extended family and church family were all incredibly helpful,” Lutheria adds.

“They would stop by, send cards and notes, and keep me in their prayers. A neighbor gave me a beautiful clay cross that I kept with me the day of my surgery, and my friends created an online website to coordinate meals. For weeks following my surgery, dinners were delivered to our home.” Lutheria’s work colleagues participated in her recovery as well, generously donating time to her family through a vacation sharing program.

In order to reach out to her support network, furthermore, Lutheria set up a CaringBridge, an online journal that she used to provide updates and share her feelings and experiences about her cancer. “I posted notes at least once a week,” she says, “and my friends would reply with words of support and encouragement.”

Lutheria draws on her strong faith in many ways.

“Every day, I try to remember all the things I have to be grateful for and look to the future, thinking of all the things I have to look forward to,” she says. She does remind us, however, that we need to be careful what we ask for. “When you pray for something, it may not come in the form you expected. I wanted to work less and spend more time with my daughter the summer before she left for college, but spending that time with her while I was recovering from breast surgery wasn’t exactly what I had in mind.”

Lifted up by her faith and all of those who love her, Lutheria can now state unequivocally, “I am not defined by my cancer. In fact, I don’t have cancer. I am a cancer survivor.”

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Breanna Hall Breanna with her son Kyle.

BREANNA’S STORY Photo by Shawn Sprouse

There is nothing funny about breast cancer, but humor proved to be one of Breanna Hall’s greatest sources of strength as she dealt with her breast cancer diagnosis and treatment.

Breanna never gave breast cancer a thought. After all, at age 38, she was too young to worry about such things. Breast cancer only affects older women, right?

In June 2015, however, she was in for an unpleasant surprise. “I was putting on my bathing suit top when I noticed an indentation in my breast,” says Breanna.

Fortunately, she was aware and mindful of breast health since her gynecologist, Abby Smith, MD with LewisGale Physcicans, recommends baseline mammograms for all of her patients over age 35.

Breanna had it checked out immediately, and her test results revealed a 4-cm. breast tumor.

“I had a wonderful team of physicians caring for me,” says Breanna. “I decided to have chemotherapy first and then surgery.” William Fintel, MD with Blue Ridge Cancer Care, administered six rounds of chemotherapy before her surgery, Robert Williams, MD with Salem Surgincal (now retired), performed a bilateral (double) mastectomy in December 2016, and Barton Thomas, MD, completed her reconstructive surgery in March 2016.

“Losing my breasts was the toughest point in my whole ordeal. A part of me was gone, and I felt so exposed, but they’re just breasts. And look, I got new ones, and they are really perky,” says Breanna. It is that sense of humor and ability to find something positive in even the most devastating situation that helped Breanna throughout her breast cancer journey.

“I felt I had to be strong and upbeat for everyone around me,” says Breanna, “especially my son Kyle (Continued on page 48...)

MEDICAL FACILITIES AND IMAGING CENTERS CONTINUED...

Don’t forget to visit OurHealth’s calendar of events at www.OurHealthSWVA.com for special mammography events and healthy living activities throughout the community.

BLUE RIDGE CANCER CARE CONTINUED... www.blueridgecancercare.com Blue Ridge Cancer Care – Wytheville 590 West Ridge Road, Suite L Wytheville | 276.228.7665 CARILION CLINIC BREAST CARE CENTER SCREENING MAMMOGRAPHY LOCATIONS www.carilionclinic.org/womens/ breast-care Carilion Clinic Breast Care Center – Daleville 150 Market Ridge Lane | Daleville | 540.966.0454 Carilion Clinic Breast Care Center – Jefferson 1211 South Jefferson Street | Roanoke 540.985.9885 Carilion Clinic Breast Care Center – Peters Creek 6415 Peters Creek Road | Roanoke 540.265.5545 Carilion Clinic Imaging – Carilion Franklin Memorial Hospital 180 Floyd Avenue | Rocky Mount 540.484.8594 Carilion Clinic Imaging – Carilion Giles Community Hospital 159 Hartley Way | Pearisburg 540.922.4182 Carilion Clinic Imaging – Carilion New River Valley Medical Center 2900 Lamb Circle | Christiansburg 540.731.2720 Carilion Clinic Imaging – Carilion Tazewell Community Hospital 141 Ben Bolt Avenue | Tazewell 276.988.8730 LEWISGALE BREAST IMAGING LOCATIONS www.lewisgale.com/service/ lewisgale-breast-imaging-centers LewisGale Hospital Pulaski 2400 Lee Highway | Pulaski 540.994.8509

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(...continued from page 46)

(age 15). He was hit particularly hard by my illness.”

Breanna discovered that a little humor also goes a long way in making others feel more comfortable. “People don’t know what to say to you when you have cancer.

They may feel like they are walking on egg shells, but if you lighten the mood a little, it will put them at ease. They will realize you haven’t changed. You’re still you.”

Even though Breanna was able to smile and make jokes, she still dealt with the full range of emotions that accompanied her cancer. “I allowed myself to have a good cry once in a while, just let it all out,” Breanna recalls. “Then I would pick myself up and move on.”

Breanna not only has a positive attitude, she also wants to spread her good cheer. “I was in chemo one day and noticed another patient crying. I felt such an urge to go over and comfort her,” says Breanna.

“That experience made me realize that perhaps this was exactly what I was supposed to do: reach out to support other women who are coping with breast cancer.”

After finishing her treatment, Breanna completed training to become a breast cancer educator for Susan G. Komen Virginia Blue Ridge. She is now able to volunteer at health fairs and festivals, sharing information and resources on breast cancer.

Recently, she expanded her participation to include fundraising for cancer research and support services.

“The thought of my breast cancer reoccurring is scary, but a fellow survivor told me, ‘One day, you will wake up and cancer will not be the first thing on your mind.’ And she was right.

It’s important to stay active and stay positive,” advises Breanna.

There is one thing that Breanna is particularly positive about.

“December 9, 2016 will mark my one year of being cancer free. That will be a great day!”

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TRACIE’S STORY In August 2014, Tracie Duncan trained hard and completed the Draper Mile.

Later that month, she found herself in a race for her life — against breast cancer.

When a routine mammogram showed something suspicious, Tracie was a little alarmed. When the radiologist asked if she could come back for a biopsy the very next day, Tracie suspected that something was wrong. A few days later, when she received a phone call telling her that the results were cancer, though, Tracie was shocked. “It was surreal. I was driving home from work right after I got that call, and a Tim McGraw song came on the radio — ‘Live Like You Were Dying.’ I lost it,” recalls Tracie.

The following Monday, Tracie and her family met with her surgeon, Jolene B. Henshaw, MD with LewisGale Physcians. After considering all of the treatment options, Tracie elected to have a lumpectomy followed by radiation treatment.

In her position as a licensed physical therapy assistant for LewisGale Hospital Montgomery, Tracie has made a career of helping others get in motion, and she clearly practices what she preaches.

“Throughout my treatment, I just kept going. I had 40 radiation therapy sessions and only missed one day of work,” says Tracie. “Every time I met with my radiation oncologist, Dr. [Karanita] Ojomo with Blue Ridge Cancer Care, she would ask me if I was feeling tired or fatigued, which is common with radiation therapy. I just decided I wasn’t going to get tired. I had way too much to do.” Tracie stayed focused on the future, always keeping a new goal in sight. “I had my last radiation treatment on November 24, and three days later, on Thanksgiving Day, I completed the Drumstick Dash 5K with my husband, Don, my mother, and my niece. Even my dog Daisy got into the act.”

It didn’t stop there. In April 2015, Tracie and her mother walked the Susan G.

Tracie Duncan

Tracie threw the first pitch at "Pink in the Park" with the Pulaski Yankees.

TUFFF 1

Komen Race for the Cure. “When we crossed the finish line, I cried,” says Tracie. “After hearing all the statistics of women who have died from breast cancer, I realized I had so much to be grateful for. I am beating the odds.” Tracie has made the Susan G. Komen event a family affair, repeating the race in 2016 with a number of her family members.

There is hardly a sport that Tracie hasn’t used to celebrate her survivorship. At a Radford University women’s basketball game, Tracie and other breast cancer survivors were honored at a half-time ceremony. Also, Tracie was asked to throw out the first pitch at Pink in the Park, a special breast cancer event sponsored by the Pulaski Yankees. Tracie admits that she ‘throws like a girl.’ “My first pitch ended up behind me, and when they gave me second chance, I almost hit the umpire,” says Tracie. “The team loved it. They all high-fived me.”

In additional to her athletic activities, Tracie relied upon her deep faith in God and her family and friends to get her through the dark times. “My husband, parents, step-parents, sister, niece and all my friends — so many people have been there for me,” she recalls.

Tonia Hackett

“When you are diagnosed with cancer, your life as you know it will never be the same,” says Tracie, “but that doesn’t mean it can’t be better.” With an eye to the future, Tracie is now looking forward to next year’s Susan G. Komen race. “Only this time, I am going to run it.” There is little doubt that Tracie will achieve that goal and many more.

TONIA’S STORY Everyone knows that October is Breast Cancer Awareness Month, but to Tonia Hackett, that month has a deeply personal meaning. On September 30, 2008, she was told that she had simple breast cancer.

(Continued on page 52...)

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MEDICAL FACILITIES AND IMAGING CENTERS CONTINUED...

LEWISGALE BREAST IMAGING LOCATIONS CONTINUED... www.lewisgale.com/service/lewisgalebreast-imaging-centers

Check out OurHealth’s Facebook page throughout the month of October for weekly Pink Power giveaways! @OurHealthMagazine

LewisGale Imaging Center Brambleton 4330 Brambleton Ave | Roanoke 540.283.3700 LewisGale Imaging Center Daleville 65 Shenandoah Ave | Daleville 540.966.6620 LewisGale Imaging Center Montgomery 813 Davis Street | Blacksburg 540.953.5131 LewisGale Medical Center – LewisGale Breast Center 1802 Braeburn Drive | Salem 540.776.4983 LewisGale Women’s Center Alleghany 1 ARH Lane | Low Moor | 540.862.6357

OTHER RESOURCES Oftentimes, family and friends of those going through breast cancer treatments are overwhelmed and can begin to feel helpless. Here are some ways you can help and maybe put a smile on the face of someone who really needs it!

CaringBridge.com – CaringBridge helps family and friends create a free personal website to quickly share updates about loved ones and their health journey Sendameal.com – SendaMeal is an online service that allows family and friends to purchase gourmet prepared meals and gifts to be delivered to loved ones who may not have time to cook during times of treatment and hospital stays MealTrain.com – MealTrain is a free service that allows family and friends to organize home-cooked meals during specified time periods. People are invited to sign up for specific meals and dates that they would like to prepare and take to the home.

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(...continued from page 50)

One month later, her prognosis took a dramatic turn for the worse.

“I have no family history of breast cancer,” says Tonia, “and I didn’t notice any lumps in my breasts.”

However, a routine mammogram followed by a biopsy showed that Tonia had breast cancer.

“Initially, I was told that I had stage II breast cancer, and I opted to have a bilateral mastectomy to be safe. Then my doctor ordered additional tests and the whole picture changed. My breast cancer was actually stage IV and had metastasized to my liver.”

Tonia’s medical team offered chemotherapy, but did not recommend surgery to remove the cancer.

“My cancer was advanced, so my surgeon suggested that I go to Duke for a second opinion,” says Tonia.

“Here, I found hope. My treatment included a mastectomy, surgery to remove the cancer from my liver, chemotherapy and radiation. They attacked my cancer with every weapon available.” Two years later, Tonia had reconstructive surgery.

After that, Tonia had scans every three months, and she was cancer-free until one checkup in 2012, when her doctor discovered a scattering of lesions on her liver. Tonia’s cancer was back. Rather than panicking or sliding into depression, though, Tonia went into maintenance mode. “I take oral chemotherapy every day,” says Tonia, ‘and I manage my cancer as a chronic condition, just like a person with diabetes takes insulin.”

Tonia refuses to let her cancer define her life. “I can’t spend my life worrying about what might happen.

One day, cancer might get me. If not, then old age will get me, but I prefer to focus on living,” she says.

“Attitude is a choice, and I chose to be positive. I have so much to be grateful for. My faith, my family and my friends were all there to see me through the tough times, and now I want to pay it forward.”

As a volunteer for Susan G. Komen, Tonia has had many opportunities to reach out and help other women who are coping with breast cancer. “The first time I participated in the Race for the Cure, I was 52

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Jennifer McDonald Jennifer with children Allie and Dylan on a family trip to Colorado.

overwhelmed,” she recalls. “It was a sea of pink. I was with all these women who share this experience with me. It’s a wonderful cult, a real sense of community.”

Tonia is confident that a cure for breast cancer is on the horizon. “Research is making strides every day,” declares Tonia. “In fact, cancer no longer means an automatic death sentence. It’s a disease to be controlled and managed.” Tonia is living proof of this.

JENNIFER’S STORY When Jennifer McDonald was diagnosed with cancer, she wanted to shout out, “Hey God, are you up there?” Over time, though, she has discovered a sense of inner peace, strength and joy.

In 2011, Jennifer learned that she had inherited BRCA2, a gene mutation that greatly increases her chances of developing breast cancer. She took assertive action and chose to have a prophylactic (preventative) double mastectomy, assuming that it would eliminate her risk. Unfortunately, that was not the case.

“Two years later, I was stunned to discover a lump in my breast that turned out to be cancer. I felt angry and frustrated,” says Jennifer. “I had already made an incredible sacrifice to avoid this very thing.”

In her typical style, however, Jennifer went into action. She had a lumpectomy performed by surgeon Roxanne Davenport, MD with Carilion Clinic. Furthermore, after consulting with her oncologist, William Fintel, MD with Blue Ridge Cancer Care, she opted to complete four rounds of chemotherapy followed by Tamoxifen to reduce her cancer’s chance of recurrence.

Throughout her ordeal, Jennifer drew strength from many sources, starting with her family — her husband Michael, her son Dylan (age 12), and her daughter Allie (age 10). She also discovered a support group called Young Cancer Chicks of Southwest

“Positive thinking can help breast cancer patients handle situations better.

Patients need to focus on positive attitude along with positive action. Positive action can include changes in lifestyle such as healthy eating, exercise, and limiting alcohol consumption.

Making positive changes in lifestyle can bring about better physical and emotional wellbeing.”

PADMAJA MALLIDI, MD Blue Ridge Cancer Care

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“In our work at Komen Virginia Blue Ridge, we have the honor of meeting and working with many women as they journey through breast cancer. Just as each person’s breast cancer is different, so is the way they battle the disease. The one constant in each fighter and survivor is the power of positivity. I am amazed at how these women never say “poor me” or “why me,” they come to us to find out how to help other survivors, how they can give back and how we can find the cure.”

CATHERINE TURNER WARREN Executive Director Susan G. Komen Virginia Blue Ridge

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Virginia. Most of all, however, she tapped into an inner reserve of strength. “I’m kind of obsessed with fitness — running, doing triathlons and being conscious of my nutrition,” says Jennifer, “but now I’ve added yoga and meditation to give me a sense of peace, clarity and focus.”

Jennifer directs her energy and positive attitude toward helping others. “Since my diagnosis, I decided to change careers, and I’m now a personal trainer and Pilates instructor,” she reveals.

“I have two friends and several of my fitness clients who are coping with cancer. I hope I can give them support based on what I’ve learned through my own experience.”

“Really, surviving cancer takes more than medical treatment,” she adds. “It takes physical, emotional and spiritual strength.”

Jennifer is obviously the embodiment of all three of these as she prepares to take on her next challenge: completing another Half Ironman.

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HEALTHY EATS MAPLE BALSAMIC GLAZED PORK MEDALLIONS

INGREDIENTS

DIRECTIONS

1/3

cup Oliveto Maple Balsamic Vinegar

•

Wisk Dijon mustard and Maple Balsamic together.

2

teaspoons Dijon mustard

•

Heat olive oil in a non-stick skillet over medium high heat.

1

pork tenderloin, trimmed and sliced into 1 inch medallions, then pounded thin

•

Salt and pepper tenderloin medallions and place in skillet.

Sear about 4 minutes each side.

2

teaspoons Oliveto Milanese Gremolata Infused Olive Oil

•

Add Balsamic Vinegar and Dijon mixture.

•

Cook another minute or two, turning pork to coat evenly.

•

Plate and drizzle Balsamic mixture over top.

Oliveto Artisan Oils & Vinegars is located in Roanoke at The Shoppes at West Village. Open Monday – Saturday from 10 am to 6 pm.

540.725.1010 | www.OlivetoOliveOil.com www.OurHealthswva.com

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HEALTHY EATS ROASTED BRUSSELS SPROUTS INGREDIENTS 2

pounds brussels sprouts

1/3

cup Oliveto Lemon Olive Oil

½

cup Oliveto Pomegranate Balsamic Vinegar (Fig or Juniper Berry Balsamic Vinegar will also work)

1

tablespoon Cloister Wildflower Honey (available at Oliveto)

½

cup dried cranberries Salt and pepper

DIRECTIONS •

Preheat oven to 375 degrees.

•

Clean and cut in half Brussels sprouts.

•

Arrange on a baking sheet and toss with olive oil. Sprinkle with salt and pepper and roast in oven for 25 to 30 minutes, or until brown.

•

Combine balsamic vinegar and honey in a saucepan. Bring to a boil, then reduce heat to mediumlow and stir until very thick, about 15 to 20 minutes.

•

Drizzle the balsamic and honey reduction over the roasted sprouts and sprinkle with dried cranberries.

Oliveto Artisan Oils & Vinegars is located in Roanoke at The Shoppes at West Village. Open Monday – Saturday from 10 am to 6 pm.

540.725.1010 | www.OlivetoOliveOil.com www.OurHealthswva.com

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HEALTHY EATS WARM CINNAMON APPLE SAUTÉ

INGREDIENTS 3

tablespoons Oliveto Butter Olive Oil

4

large apples (cored, peeled and sliced)

¼

cup brown sugar

1

tablespoon lemon juice

1

tablespoon Oliveto Cinnamon Pear Balsamic Vinegar

¼

teaspoon cinnamon

¼

teaspoon nutmeg

½

cup dried cranberries

DIRECTIONS •

Add Butter Olive Oil to skillet and heat.

•

Add apple slices and sauté 6 to 8 minutes.

•

Add brown sugar, lemon juice, Cinnamon Pear Balsamic Vinegar, cinnamon, nutmeg and dried cranberries and cook for 2 minutes more.

•

Pour over ice cream or pound cake and serve.

Oliveto Artisan Oils & Vinegars is located in Roanoke at The Shoppes at West Village. Open Monday – Saturday from 10 am to 6 pm.

540.725.1010 | www.OlivetoOliveOil.com www.OurHealthswva.com

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

John Russell, BS, ACSM

S T I B FIT

AND H E A LT H ON F IT N E S S

John holds a BS degree in Exercise and Sports Science and is an ACSM certified personal trainer at Green Ridge Recreation Center.

THE GO

WHAT’S THE HYPE W

ITH HIIT?

HIIT – no, it’s not a typo, and there isn’t any actual hitting involved – stands for High-Intensity Interval Training. It is a training technique that involves one hundred percent effort through quick, intense bursts of exercise, followed by short, sometimes active, recovery periods.

A High-Intensity workout increases the body’s need for oxygen during the effort and creates an oxygen shortage, causing the body to ask for more oxygen during recovery.

This after burn effect is referred to as excess post-exercise oxygen consumption (EPOC) and is the reason why intense exercise will help burn more calories in less time than aerobic and steady-state workouts. An additional benefit from EPOC is the metabolism boost that will last for up to 48 hours after a complete HIIT workout!

“My suggestion is to gauge your ability level and choose a HIIT program that fits your needs and level. Beginners should start off at one low impact HIIT session 1-2 times a week. A good example would be using the stationary bike: set resistance to a moderate level, then pedal for 20 seconds as fast as possible immediately followed by 40 seconds slow pedaling. Repeat for 8-12 rounds.”

John Russell, BS, ACSM Personal Trainer at Green Ridge Recreation Center

Ready for a challenge?

Try your hand (or full body, rather) at Green Ridge Recreation Center where they offer several classes that incorporate the HIIT principle, as well as personal trainers who can train individuals or small groups!

GREEN RIDGE RECREATION CENTER 7415 WOOD HAVEN ROAD ROANOKE, VA 24019 | 540.777.6300 WWW.GREENRIDGERECREATIONCENTER.COM

SCAN HERE TO VISIT THE GREEN RIDGE RECREATION CENTER WEBSITE WORKOUT STATS: HIGH INTENSITY LOW

STRENGTH

MODERATE

ENDURANCE

HIGH

CARDIO

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

the

2016

OurHealth Roanoke and New River Valleys

RT PA

HOW TO IN HEALTHCARE SERIES:

IV

an issue-by-issue overview

TIME TO

PUT THE SKILLS TO

THE TEST words | TINA JOYCE

OurHealth Roanoke and New River Valleys magazine's series “How-to in Healthcare” is a step-by-step guide to pursuing a career in healthcare.

In Part I, OurHealth offered insights into the fascinating world of healthcare education. Anyone with a passion for serving others, a love of science or a fascination with the way the body works is a prime candidate for a career in healthcare. These traits often develop in childhood, which is why we began our expert advice with tips for the families of students interested in healthcare opportunities in college.

In Part II, college and university professionals gave advice on certificate and degree programs for students transitioning into healthcare professions after completing two- or four-year degrees.

In Part III, we began outlining the steps for entering graduate and medical school programs and exploring the best options for individual students.

Now, in our fourth and final article, we seek to open the doors to employment.

Even when students are diligently focused on completing their educational requirements, they can easily lose sight of the details of creating an appealing, hire-worthy portfolio.

BE PROACTIVE Education plus experience should equal employment. Why, then, are so many graduates moving back in with their parents to pay off their college debt?

PART FOUR

Insight on how to find the right job in your field of specialty.

October | November

According to the Association of American Medical Colleges,1 78 percent of medical school graduates have $180,000 in debt upon graduation. This certainly isn’t the

www.OurHealthswva.com

QUESTIONS STUDENTS SHOULD ASK HEALTHCARE PROFESSIONALS:

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•

What was your path through education?

•

What would you do differently?

•

What was the best advice you received in school?

•

What was your greatest professional struggle?

•

What was your greatest professional reward?

•

What was your first job in the field?

•

What’s the most important thing I can do to prepare for my first interview?

•

What stands out the most to you in a résumé or CV?

•

What healthcare associations do you belong to, and which do you benefit from the most?

•

What have you learned the most about from your patients?

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

figure their parents will boast about in the next Christmas letter. But if medical students and graduate students seek careers proactively, beginning early in the educational process, they can lighten these financial burdens and broaden their future opportunities.

Of course, not everyone seeking a career in healthcare has to complete four years of undergraduate work and medical school. But training for any healthcare profession takes time and financial commitment. These are valuable commodities and should be used wisely.

Students should seek wisdom, education and experience. One of the best ways to gain wisdom is to ask the wise. By gathering information from people working in or retired from the healthcare professions, you create opportunities to learn from others—both from their successes and from their mistakes.

As early as high school, students can start preparing their professional portfolios to include pertinent work experience and positive references. Building relationships is crucial. You might admire a particular educator or medical professional you meet through study, practicums or residencies. If you want their help, simply ask.

By the time a student is in the final stages of education, a career path will hopefully have become clear, and the student can focus on landing the job or career of their choice. It is important to be flexible, persistent, and patient.

Whether you can choose a particular location for work depends on several factors. Can you relocate, and are you willing to? What connections do you have at a particular facility? (Do you know someone who works there now or has in the past?) Does your educational institution offer career placement services? What credentials (academic or experiential) does the facility require for employment?

Students completing residency programs are often approached by recruiters. Drug companies and staffing companies that focus on healthcare recruitment might contact residents or graduating students about opportunities. It is vitally important to examine every employment offer with discernment. Proceed cautiously and do your research.

It is especially advantageous to get to know someone at the facility you’d like to work in. Volunteering and working

“I encourage prospective employees to identify what they like in a patient care setting and foster networks with those who match their preferences. Many of our employees come to us after doing a clinical rotation in one of our centers while they are in school. Others seek us out based on our reputation or insight they have gained from a family member or friend. At Medical Facilities of America, our positions are advertised on our company websites and on www.

Indeed.com. To learn more, just go to www.mfa.net/careers.”

TODD PUTNEY

Vice President of Human Resources Medical Facilities of America

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“Take every opportunity possible to research specific details about the job you are interested in. Most employers want something specific; a certain skill set, certifications/licensure, years of experience, a certain schedule or flexible scheduling, etc. Without researching all details of the position, a potential candidate would find it difficult to make a well-informed decision on whether a particular job or the company seeking to hire for that job, is a good fit. It is much better to spend time with a recruiter asking specific questions about a position and learning about the company’s requirements and expectations, than to find out later on that the job isn’t a good fit for the candidate, the company or possibly both. Most recruiters are very happy to share this type of information with candidates, as it makes their interview time and scheduling more efficient, and gives them a better understanding of what the candidate is looking for in a job and if that fits with what the company also needs.”

CHRIS MARLIN, PHR

Vice President, Human Resources LewisGale Regional Health System

“Start researching healthcare facilities and opportunities in locations where you would like to live 12-18 months before completing your education or training. This will give you plenty of time to consider all of your options and hopefully take some of the stress out the process.”

DEBRA LOVELACE

Human Resources Senior Director Carilion Clinic

part time are great ways to gain insight into an organization before applying for permanent employment. If you earn the respect of employees, board members, or supervisors, your chances of being asked to submit a resume and of gaining an interview increase drastically.

BUILDING YOUR

RÉSUMÉ OR CV Students should consider several factors when building a résumé or a curriculum vitae. First, the difference between them is important. A résumé simply and concisely presents your skills and your qualifications for a particular position or career. It should be one or two pages long. A CV includes a more complete history of your academic credentials. CVs are used by students seeking fellowships, grants, postdoctoral positions and teaching and research positions at postsecondary colleges and universities. The length can vary a lot.2 A résumé or CV cannot be built overnight. Compiling accolades and experience takes time, and if you wait until graduation to start, then by industry standards you are far too late. Many key components of a résumé can be acquired only through volunteer work, hours of commitment to a job or residency program or rigorous academic training.

Regardless of age or year of school, students should always be thinking about building a résumé. It takes far more work than checking a box to indicate “done” on an application. Volunteer work and work experience should reflect not only your values but your passion.

Employers are always seeking the “best fit” employees for their organizations. Students should also seek the “best fit” employers to help them fulfill their goals and purposes.

CREATING A NETWORK Forbes magazine published a “top ten” list of contacts you should have in your network. “The trick,” the article says, “is to make sure you are building a diverse network by adding people from different industries, backgrounds, age groups, ethnic groups, etc. that fit into different roles. Building a deep network by only including people from your current profession or business focus leaves too many stones unturned, limiting potential opportunities.”

An active network naturally encourages dialog about new employment opportunities. Lunch with an association president or local hospital board member can lead to insights about upcoming job openings. Regardless of whether you are pursuing a new job or planning to change jobs in the (Continued on page 71...)

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

A TYPICAL RÉSUMÉ

INCLUDES THE FOLLOWING INFORMATION: •

•

•

•

•

A TYPICAL CV INCLUDES THE FOLLOWING INFORMATION: •

NAME AND CONTACT INFORMATION: Contact information at your current institution or place of employment might work best.

•

AREAS OF INTEREST: List your varied academic interests.

•

EDUCATION: Specify your degrees, earned or in progress, institutions and years of graduation. You might include the title of your dissertation or thesis here.

•

EDUCATION: List your degrees and certifications and the educational institutions and programs you attended.

GRANTS, HONORS, AND AWARDS: List any grants you have received, honors bestowed on you for your work and awards for your teaching or service.

•

WORK EXPERIENCE: List the companies or organizations you have worked for, the location of each, the dates you worked for them and your job titles and duties.

PUBLICATIONS AND PRESENTATIONS: Give a list of your published articles and books and presentations you have given at conferences. If there are a lot, you might make one section for publications and another for presentations.

•

EMPLOYMENT AND EXPERIENCE: This section can include separate lists for teaching experience, laboratory work, field work, volunteering, leadership and other relevant experiences.

•

SCHOLARLY OR PROFESSIONAL MEMBERSHIPS: Here you list the professional organizations you belong to. If you have held an office or position in one of them, you can say so here or in the Experience section.

•

REFERENCES: This is a list of people willing to write letters of recommendation for you, including their contact information.3

COVER LETTER: This provides a permanent written record of the submission of the resume. It says what is being sent, to whom and by whom.

NAME AND CONTACT INFORMATION: Your residential address might be the most appropriate.

REFERENCES (POSSIBLY) : This is a list of people willing to write letters of recommendation for you, including their contact information

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FIVE TIPS TO BUILD

AND EXPAND YOUR PROFESSIONAL NETWORK To assist in exploring employment opportunities, the following five tips may build and expand a professional network according to the Harris Casel Institute.5

STEP #1: MAINTAIN AN ACTIVE LINKEDIN PROFILE

This vast professional platform is a great way to network with others if you stay active. Create a profile and market your experience for free. On LinkedIn, you can stay up-to-date on healthcare news and advances. Actively optimize your profile with keywords that relate to your specific healthcare profession.

Here are some ways you should use LinkedIn: •

Start conversations: Comment, share, and start

•

Endorse colleagues: On LinkedIn, you can endorse

•

conversations with other healthcare professionals. You can get your name out there by asking crucial questions or asking others to keep you in mind when they give updates.

Commenting on other blog posts regularly could help you become a part of a wider conversation. Remember to give positive feedback on other professionals’ blog posts to build your online presence. others as a friendly gesture. If you endorse others, there’s more of a chance they will endorse you back.

Endorsements look good to potential employers.

Include a picture: A profile picture can increase your chances of endorsements and consideration from employers. It also helps personalize your profile. A picture helps put a name to a face and will help others notice you when you’re at events.

STEP #2: GET INVOLVED IN

HEALTHCARE ORGANIZATIONS Getting involved is a crucial part of networking. You may want to search for associations, societies, and groups that revolve around a particular healthcare specialty of your expertise or interest. If you’re interested in Medical Assisting and its many aspects, you may want to join the American Association of Medical Assistants. If you become a member of an organization, you could learn new developments in your field and take part in all the benefits of being part of a local or national healthcare community.

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

STEP #3: EVENTS Keep your eye out for healthcare events. You can search through forums, LinkedIn, and healthcare websites to see if there are any events in your area where you can network with healthcare professionals. Events are a great way to network with others. If you show up to events frequently, people may start to recognize you.

STEP #4: VOLUNTEER You can show your passion for your healthcare profession by volunteering at a local healthcare facility or organization.

Volunteering will not only look good on your résumé and benefit the community, but you can meet others who are just as passionate about improving the health of others. Volunteering gives you the opportunity to expand your network and learn new developments about the healthcare world.

STEP #5: BUILD YOUR

PROFESSIONAL PRESENCE It’s always positive to differentiate yourself from the rest of your competition. Make sure your online presence and interpersonal skills stand out. Highlight personality traits that are seen as good or unique. For example, you could become recognized for your passion on a specific healthcare subject. If you build upon a certain trait, you may become known for it, which could help you to stand out from the crowd.

With dedication and a positive attitude, you could start to make strong professional relationships with others in your healthcare field. You may expand your knowledge and professional horizons, which could lead you to advance your career and build upon your technical skills.

SOURCE: www.harriscasel.com

(...continued on page 68)

medical community, you should remain active and involved in organizations that fit your personal and professional interests.4

PREPARING FOR

AN INTERVIEW Once you’ve made contact with a potential employer or have an interview scheduled, there are steps you can take to ensure it’s a positive interview. First, conduct more in-depth research.

Before seeking an interview, a student should ideally have done research and applied only to organizations that share their mission or goal. It would be a waste of time, and misleading to an employer, to take an interview for a job you have no intention of accepting.

Learn about the organization, its history and its vision. Learn who the key stakeholders are and who makes the final hiring decisions. Then ponder interview questions and prepare appropriate, honest answers.

According to the Integrity Training Institute, “Most managers hire for skills, but fire for character. Because of the

“Treat everyone you meet as a possible employer and every assignment you complete as part of an interview. You never know what is out there for you, especially if you do not allow every possible opportunity to come your way.”

SARAH BOSWELL

Assistant Director of Admissions Jefferson College of Health Sciences

“Take time to research your top organizations, get to know their reputation and culture. Are they award winning, supportive of the community, invest in their employees and technology?

Highlight what you like in introductions. Be sure to check out www.Glassdoor.com and other industry websites.”

ANDREA HENSON

Director, Professional Recruitment and Onboarding Carilion Clinic

www.OurHealthswva.com

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TOP QUESTIONS FOR INTERVIEWING HEALTHCARE EMPLOYEES •

Tell me about your last performance review.

What was mentioned about how you could improve? Any re-occurring themes?

•

What situations kept you from fulfilling your job duties or from coming to work on time at your last job?

•

Tell me about the most recent problem you had with a co-worker. Listen and then ask, how did you handle it?

•

What about your character makes you a good candidate for this job?

•

Priorities often change suddenly throughout the day. If you are asked to quickly do another task, how does that affect your mood? What if it's the third time before noon?

•

What do you feel is an acceptable amount of days to be absent in a calendar year?

•

How do you handle situations that could cause you to be tardy or absent?

•

How did you fill downtime at your last job?

•

How have you responded in the past when you found another employee was stealing?

•

How have you responded in the past when your replacement calls in sick and a substitute will take over an hour to come in?

•

24/7 operations are like relay races where you take the baton, run with it and then pass it on smoothly. How do you make seamless transitions on shift changes?

•

During the last year, when your replacement hasn’t shown up and your manager asked you to stay late, what percentage of the time have you stayed late?

• •

72

Think about the last time your manager critiqued your work. How did you respond?

Give an example of when you did something without being asked. Can you give me another example?

•

Describe a recent problem you had with one of your manager's decisions. Listen and then ask, how did you handle it?

•

Tell me about your most frustrating experience as a __________(job title). How did you handle it?

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

overwhelming problems associated with hiring employees who lack required character traits, more and more healthcare managers are asking character-discerning questions when interviewing employees.”6 Being a sought-after employee or student should be a goal.

Joining business associations or healthcare organizations can also add to a student’s résumé. However, nothing can replace focus, hard work and strong relationships.

Students should acquire academic integrity and valuable experience and build reputable references in the healthcare field.

In Part I, OurHealth gave parents and students direction for finding a course load suited to entering a healthcare profession.

Parts II, III and IV of the series showed how students should begin with academic focus, work hard to earn stellar grades and then build connections with people in their educational institutions and professions. As individuals progress and mature, by asking key questions and seeking wise counsel they can ensure they are guided down a path to success, not toward fear of graduation.

SOURCES: 1 The American Association of Medical Colleges. www.aamc.org 2 The University of California at Davis. www.icc.ucdavis.edu/materials/resume/resumecv.htm 3 The University of North Carolina at Chapel Hill. www.writingcenter.unc.edu/ handouts/curricula-vitae-cvs-versus-resumes 4 How to Build a Powerful Professional Network. www.forbes.com/job-search 5

www.harriscasel.com/networking-tips-for-budding-professionals

The Integrity Institute. www.characterbasedleadership.com/health1.html 6

ON THE WEB

More at ourhealthswva.com

www.OurHealthswva.com

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Photography by Shawn Sprouse

Robert Williams, MD a longtime local physician with Salem Surgical and a pillar in the community, was recently honored with a retirement reception that was held at the Education Center at LewisGale Medical Center.

Dr. Williams exclusively focused his surgical practice to the treatment of breast cancer. He has made it a personal mission to help eradicate this disease through medical treatment and breast cancer awareness efforts, including leading the drive to bring the Susan G. Komen Virginia Blue Ridge Chapter to the area. While our community will dearly miss Dr. Williams in practice, his advocacy in the fight of this disease will always be present.

OurHealth staff photographer, Shawn Sprouse was on-hand to capture the hundreds of people – both professionally and personally – who Dr. Williams has had such a profound effect on during his career.

We wish Dr. Williams well-being and happiness in this next chapter of his life.

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

ON THE WEB

More at ourhealthswva.com

www.OurHealthswva.com

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the 2016 OurHealth Roanoke and New River Valleys Primary Care Series: an issue-by-issue overview

PART

+++

5

february

| march

KNOW YOUR CARE: understanding your health and how to maintain it

+++

| may

april

DO YOUR CARE: taking action with your health

+++ june

MEASURE YOUR

care words | GERI ASTON

Improving your health requires lasting lifestyle changes that affect the way you eat, your activity level, your mindset and your interactions with your doctor.

Tracking Your Efforts to Ensure You’re on the Right Path!

Oftentimes the plan includes losing weight because overweight and obesity play a major role in many chronic conditions — high blood pressure, heart disease, diabetes, arthritis and sleep disorders, for example. The temptation is to measure your success by your weight. But the scale is just one measuring tool, and it doesn’t capture the full impact of the lifestyle changes you’ve made.

This article, the fifth in a yearlong OurHealth series about primary care, examines other ways to keep tabs on your progress toward better health.

| july

SHARE YOUR CARE: setting good examples for others to learn and live by

+++ august

| september

INSPIRE YOUR CARE:

keeping creative with fresh care ideas

+++ october

| november

MEASURE YOUR CARE:

tracking your efforts to ensure you’re on the right path

+++ december

| january

CELEBRATE YOUR CARE:

rejoicing the rewards realized from taking good care of yourself

www.OurHealthswva.com

“Raid” the Fridge Storm your fridge and pantry — not to grab a snack, but to check their contents.

STOCK THE FRIDGE with Fresh Foods •

Load up on the fruits and vegetables

•

Shop for simple foods with real ingredients

•

Start reading the labels of the foods in your pantry, the fewer the ingredients, the better

•

Avoid foods with unrecognizable ingredients

•

Avoid high doses of salt, saturated fat and/or trans-fat

Primary care providers we have interviewed for this OurHealth series have recommended that people move away from foods made in a factory, sweets, sugary beverages and junk food. Instead, they have suggested that people eat more fresh foods, especially vegetables and fruit. If money is tight, frozen vegetables and fruits can be good, less-expensive alternatives.

Is your fridge stocked with fresh items? Are there plenty of vegetables and fruits? If so, you’re on the right track.

If not, it’s time to re-evaluate your buying choices.

Doctors have also recommend that people shop for simple foods with real ingredients.

Read the labels on the food in your cupboard or pantry.

Do the items have just one or only a few ingredients that you don’t recognize? Are they low in sugar, salt and (Continued on page 80...)

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

GETTING YOUR ZZZZ’S Getting a good night's sleep does more than keep you feeling refreshed. According to the National Heart, Lung, and Blood Institute, it plays an important role in your physical and mental health.

In the extreme, the damage from not getting enough sleep can occur in an instant, such as a car crash, the National Institutes of Health notes. Meanwhile, the National Highway Traffic Safety Administration estimates that 83,000 crashes annually between 2005 and 2009 were related to drowsy driving.

Over time, the lack of sleep can hurt your health in a number of ways, NHLBI says. Sleep is involved in the healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure and stroke.

Sleep helps maintain a healthy balance of important hormones, including the ones that make you feel hungry or full. Lack of sleep makes you feel hungrier and increases your risk for obesity. Sleep also affects the hormone that controls your blood glucose (sugar) level. Sleep deficiency results in a higher than normal blood sugar level, which over time can increase the risk for diabetes.

Your immune system relies on sleep to stay healthy. Ongoing sleep deficiency can change the way your immune system responds, for example, by making it more difficult to fight common infections.

Sleep also helps your brain work properly, NHLBI says. During sleep your brain is preparing for the next day — it's when your brain forms new pathways to help you learn and remember information. If you don’t get enough sleep, you may have trouble making decisions, solving problems, controlling your emotions and behavior and coping with change. Sleep deficiency also has been linked to depression and suicide.

Sleep also helps your brain work properly.

During sleep your brain is preparing for the next day — it's when your brain forms new pathways to help you learn and remember information. If you don’t get enough sleep, you may have trouble making decisions, solving problems, controlling your emotions and behavior and coping with change.

Sleep deficiency also has been linked to depression and suicide.

Source: National Heart, Lung, and Blood Institute

How do you know if you’re getting enough sleep? Last year, the National Sleep Foundation came out with the following recommendations for healthy amounts of sleep.

Age Young Adults (18-25)

Adults (26-64)

Older Adults (65+)

Recommended

May be appropriate

Not recommended

7 - 9 hours

6 hours; 10 - 11 hours

< 6 hours or > 11 hours

7 - 9 hours

6 hours; 10 hours

< 6 hours or > 10 hours

7 - 8 hours

5 to 6 hours; 9 hours

< 5 hours or > 9 hours

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(... continued from page 78)

saturated fat and contain no trans fat? If you answered “yes,” it’s a sign you’re eating right.

Or is your pantry full of chips, sweets and other products with long lists of unrecognizable ingredients and high doses of sugar, salt, and saturated or trans fat? If you answered “yes,” you need to shop healthier.

The Lowdown on CHECKUPS FOR ADULTS Regular checkups are important even for people who feel well. They give your doctor a chance to screen for diseases, determine if you’re at risk for future medical problems and update vaccinations. Checkups also help you maintain a relationship with your doctor so he or she can better help you when you are ill.

Put Pep in Your Step Keeping physically active is part of a healthy lifestyle. The health improvement plan you developed with your doctor likely includes some goals for being more active.

But how often do you need a checkup?

Here are some recommendations.

Eye Exam 18 to 39: Every 2 years if you have a vision problem, more often if recommended by your eye doctor.

40 to 54: Every 2 - 4 years 55 to 64: Every 1 - 3 years 65 and older: Every 1 - 2 years

Dental Exam Adults should go to the dentist once or twice a year for an exam and cleaning. Your dentist will decide if you need more frequent visits.

Physical/Wellness Visit There’s no rule of thumb about when to get a physical. It depends on how healthy you are in addition to your age.

Under 30: If you’re healthy — don’t smoke, have no disease risk factors (including being overweight) and don’t take prescription medications — get a checkup every 2-3 years.

Others should ask their doctors how often they need a physical.

30-40: Healthy individuals should get a physical every other year.

50 and over: Annual physicals are recommended.

One way to measure success is to monitor how much physical activity you weave into your day or week. The Centers for Disease Control and Prevention says typical adults should get two and a half hours of moderate activity a week and perform muscle strengthening activities two or more days a week.

Moderate activity means exercise you could do while carrying on a conversation without getting out of breath, like brisk walking.

Tracking the amount of activity you get is just one measure, though. It’s also helpful to evaluate the effect your activity has had on the way you feel and on your endurance.

If your goal was to improve your fitness by walking, are you feeling more energetic?

Are you able to walk farther than before? Do you breathe easier while you walk? The same measures apply to jogging.

Maybe your increased activity level has given you the ability to do something you weren’t in shape to do before, like taking an aerobics class, walking the golf course instead of riding a cart or chasing after your grandchildren in the park.

These would all be positive signs of a healthier you.

Minding your Mind Improving your health isn’t a neck-down endeavor.

Positive mental health is part of the whole picture.

Research shows that exercise can help reduce anxiety and improve mood. Sunshine and exercise boost the level

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of serotonin, a chemical your body produces that is important for healthy brain function. Exercising with friends or family is good for your physical and mental health because socializing eases anxiety and depression.

If you’re nine months into your health improvement plan, it’s time to take stock of its impact on your mental health. Are you feeling more motivated, happier or less stressed now than you were before?

Sometimes a mental health problem can block efforts to improve your physical health.

Depression can make a person unmotivated to exercise, eat right or take their medications.

That can lead to a chronic illness or worsen an existing one. An underlying mental health issue could be the reason for a physical problem such as obesity.

When mental health symptoms affect your ability to work or to enjoy relationships or your life, doctors recommend getting help from a mental health professional. If that’s the case with you, have you made an appointment yet? If you have, are you continuing to keep your appointments? If you were prescribed mental health medications, are they working? (Many medicines for mental health don’t take full effect for several weeks or months.)

Preventative Care Well/Sick Visits Minor Injuries Disease Management Including Patient Education Plans Serving VA Premier Members of All Ages

If you answered “yes” to these questions, it’s a good indication that you’re on the way toward better mental health. If you answered “no,” it’s time to check in with your doctor to figure out what’s going on so you can come up with solutions.

Better Labs and Less Medicine People with chronic diseases often need to get regular lab tests. The results help you and your doctor measure whether your lifestyle changes and medication are working.

At nine months into your health improvement plan, have your lab results improved? If you’re diabetic, is your blood sugar in better control? If you’ve got high blood pressure or high cholesterol, are those numbers coming down?

If so, keep up the good work. If not, it’s time to contact your physician. Primary care physicians interviewed for this series urge their patients to call their office when they’re having trouble sticking with a health improvement plan. More often than not, doctors can suggest solutions. But doctors can’t help if they don’t know there is a problem. www.OurHealthswva.com

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MEASURING

MENTAL HEALTH When mental health symptoms affect your ability to work or to enjoy relationships or your life, doctors recommend getting help from a mental health professional.

YES NO

Have you made an appointment yet?

YES NO Are you continuing to keep your

appointments?

It’s also important to keep follow-up appointments and get the lab tests your doctor suggests. Life is busy, but you have to make time for your health.

A reduction in the amount of medication you need to take can also serve as a measure of your success. Maybe because you’re eating better and exercising, you’ve gotten healthy enough for your doctor to lower the dose of your blood pressure medicine. Or perhaps your healthier lifestyle means you’re reaching less often for the pain relievers in your medicine cabinet.

Positive results like these count whether you’ve lost weight or not.

YES NO If you were prescribed mental health

medications, are the they working?

If you answered YES to these questions, it’s a good measure that you’re on the way toward better mental health. If you answered NO, it’s time to check in with your doctor to figure out what’s going on and come up with solutions.

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Don’t Give Up What if you don’t see the results you hoped for when you started on your health improvement plan? Doctors say you shouldn’t give up or beat yourself up over it.

Talk to your physician about your concerns to get advice on how to achieve the change you want.

If any of your results are negative, you can use them as motivation to improve. Everyday is a new day to make good health choices.

Next in Our Series Part VI of OurHealth magazine's six-part series, “The Bridge to Better Health Starts With Primary Care,” examines ways you can celebrate the rewards realized from taking good care of yourself. Be on the lookout for Part VI in the December/January issue!

Sources “How Much Sleep Do We Really Need,” National Sleep Foundation, www.sleepfoundation.org.

“Physical Exam Frequency,” MedLinePlus, National Institutes of Health, National Library of Medicine, www.medlineplus.gov.

“Research on Drowsy Driving,” National Highway Traffic Safety Administration, www.nhtsa.gov.

“Should you get an annual physical?” DukeHealth, www.dukehealth.org.

“Why Is Sleep Important?” National Heart, Lung, and Blood Institute, www.nhlbi.nih.gov.

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THERE’S NO

PLACE LIKE

HOME words | RICK PIESTER

Generation Solutions unveils a referral service of qualified home maintenance experts, available to anyone at any age.

To many older people, nothing is more important than spending their years in their own homes. The urge to age at home is so powerful that less than five percent of Americans age 65 and over live in some sort of a group home like a nursing home or a continuing care retirement community. As time goes on, that percentage is declining. Within the next few decades, furthermore, the number of older Americans will double. People who work in senior care often refer to this as the coming “silver tsunami.”

The challenges of staying at home throughout retirement tend to grow as one ages. Steep stairs can create an interest in single-floor living, and slippery showers pose dangers that can be countered by revamped bathrooms with nonskid floors and grab bars. Few conventional homes are set up for occupants in wheelchairs, however.

For older people, additionally, even “routine” home maintenance can become troublesome. Most people’s physical strength and dexterity decline as they age, along with what might once have been a strong interest in do-it-yourself projects. Also, many older Americans are at risk of receiving poor quality work, being overcharged, or being victimized by dishonest “contractors” who collect a sizable down payment on an overpriced project, then simply disappear. www.OurHealthswva.com

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To take advantage of the service, all you need to do is to call Generation Solutions.

From there, you’ll be connected with a staffer whose full-time job includes responding to inquiries for contractors.

After discussing your project, the staffer will offer you several contractors to

for Lynchburg

Bothered by the near-constant stories of home construction scams that reached him from the family members, friends, and neighbors of Generation Solution clients, the company’s founder and CEO, P. Tulane Patterson, started brainstorming ways to combat the problem. His approach: to develop an in-house, vetted directory of experts and reliable choices in a variety of home maintenance and construction specialties.

540.776.3622

The timing on this project couldn’t have been better, since the CEO’s daughter, Catherine Patterson, was on a summer break

choose from and then contact whatever contractor you choose or let you contact them directly.

434.455.6500

for Roanoke

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Home improvement scams are a national disgrace that has caught the attention of the leadership of Generation Solutions, the 20-year-old company that provides an array of services to help people spend their retirement years at home. The company itself was founded on the widespread desire of older Americans and their families for seniors to live comfortably and safely in their own homes. It’s grown to be an award-winning agency dedicated to doing whatever is necessary to help aging clients remain independent and healthy.

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

(Continued on page 88...)

FREE E-BOOK To get a better idea of the top modifications for making a home safe for seniors, Generation Solutions is offering a free download of its digital booklet “How to Make a Home Senior-Friendly.”

To receive this guide, go to the Generation Solutions website (www.generationsolutions.net), look for the “Services” tab and click on the “Home Modifications” link. Next, find the booklet cover and follow the downloading instructions. This website is secure and safe.

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Contractor Alliance Services Include: Painting Electrical Gutter Cleaning & Repair Roofing Driveway Maintenance Tree Service Lawn Care Snow Removal Plumbing Heating & Cooling Home Modification

(...continued from page 86)

from her college studies and was available to team up with Generation Solutions’ home care consultant Treena Koroneos to bring this service to life.

As such, October will see the launch of the Generation Solutions Contractor Alliance, with the company ready to make referrals — from separate lists in the Roanoke and Lynchburg areas — of reliable contractors from nearly a dozen specialties in home construction and maintenance, including plumbing, electrical, heating and cooling, home modification, tree service, painting, driveway maintenance, gutter cleaning and repair, lawn care, and snow removal.

“We spent a great deal of time developing these lists,” notes Catherine Patterson. “We researched contractors in each area, talked with them, and did additional research with the Better Business Bureau, the State Corporation Commission, the courts, and more and narrowed the lists down to companies that want to give seniors quality work and who fit our company’s mission of keeping seniors safe.

Our aim was to wind up with two to three possibilities in each specialty area.”

Better yet, anyone of any age, regardless of being a Generation Solutions client or not, will be able to get referrals to specialists in whatever area of work they need.

There’s absolutely no fee for this service.

To take advantage of the service, all you need to do is to call Generation Solutions at 434.455.6500 for Lynchburg and the surrounding counties or at 540.776.3622 for Roanoke and the nearby areas. From there, you’ll be connected with a staffer whose full-time job includes responding to inquiries for contractors. After discussing your project, the staffer will offer you several contractors to choose from and then contact whatever contractor you choose or let you contact them directly. The work itself and payment for it remains strictly between you and the contractor, and Generation Solutions will follow up to make sure your initial contact was satisfactory.

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closer LOOK

Can you identify which local practice the image belongs to?

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a prize Pack For 4 from

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