OurHealth Roanoke and New River Valleys Magazine: April/May 2019

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

April • May 2019 ourhealthroanokeNRV.com

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

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FEATURES

APRIL • MAY 2019

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2019 Roanoke and New River Valleys Healthcare Leaders

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

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Learn how 11 of the brightest members of the Roanoke and New River Valleys’ medical community are giving back, not because it’s a part of their job description, but because it is the right thing to do.

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

Spring Cleaning for Better Health: What You Shouldn’t Sweep Under the Rug No matter how tidy you are, some spots in your home always attract bacteria, fungus, mold, pet dander and more. These microorganisms and allergens can impact your breathing, sleep and overall health.

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DEPARTMENTS APRIL • MAY 2019

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The Pulse | People. Places. News to Know.

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

SFCS, a senior living, education and civic architecture, engineering, and interior design firm, held its 34th annual By Design Conference on February 21st and 22nd at the Hotel Roanoke and Conference Center.

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

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53 Kids Care | Inform. Educate. Grow

57 Specialty Spotlight Series | ENT Are People with Chronic Sinusitis More Prone to Developing Depression? Sinus infections are fairly common and anyone who has experienced one knows they can be unpleasant and uncomfortable. Frequent sinus infections can also affect quality of life to the point that chronic sufferers may experience increased anxiety and even depression.

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Specialty Spotlight Series | Gastroenterology Colonoscopies: Not So Strange and Scary After All: Patients worried about risks of colonoscopies or unsure what the procedure involves are less likely to get it done.

But when you strip away the myths surrounding colonoscopies, they’re a simple, life-saving procedure — not so strange or scary after all.

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

Protecting Young Athletes’ Eyes this Sports Season: By providing the protective eyewear available and designed specifically for children, and ensuring that the eyewear is worn consistently, parents can help children protect their eyes and establish healthy habits that will last a lifetime.

Specialty Spotlight Series | Allergy, Asthma and Immunology

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Healthy Observations | Educate. Eradicate. Victory.

75 - CHILD ABUSE PREVENTION MONTH | April 2019 Empowering Mothers to Overcome Substance Use Disorders: Mother Up is a project of Children’s Trust, an organization whose mission is to prevent and reduce the occurrence and trauma of child abuse and neglect.

78 - NATIONAL STROKE AWARENESS MONTH | May 2019 What Exactly Causes a Stroke? Strokes are very common in older Americans. In fact, the reason that two-thirds of people over 65 are hospitalized are because of a stroke 81 - BETTER HEARING AND SPEECH MONTH | May 2019 When Hearing Loss Stopped the Music: A condition that often leads to hearing loss cost Mark Skelton his ability to clearly hear the sweet sounds of music he so loves. But thanks to advancements in hearing aid technology, the beat is back on.

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april • may 2019

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

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The Pulse INFORMATION • EVENTS • AWARENESS

WARM HEARTH VILLAGE Celebrates 45th Anniversary

Owen W. Roberts, MD

Promotions, Additions, Openings and Changes LewisGale Physicians Opens Hematology and Medical Oncology Clinic in Galax LewisGale Physicians recently opened a new hematology and medical oncology clinic in Galax, located at 227 Hospital Drive. Owen W. Roberts, MD, board-certified in hematology and medical oncology, is providing new patient consultations and follow-up visits at the new office. Dr. Roberts is on the medical staff of both Twin County Regional Hospital for patients needing lab or imaging services, and LewisGale Regional Cancer Center in Pulaski for radiation and chemotherapy.

Dr. Roberts completed his medical degree at Uniformed Services, University of the Health Sciences in Bethesda, MD, a residency in Internal Medicine at Wilford Hall Medical Center at Lackland Air Force Base in Texas, and a fellowship in hematology/oncology at Uniformed Health Education Consortium in San Antonio, TX. He is welcoming patients at the new location, as well as at his Pulaski clinic, located at LewisGale Regional Cancer Center in Pulaski, by calling 540.994.8580.

Awards, Recognitions, Nominations and Celebrations Warm Hearth Village Celebrates 45th Anniversary On February 22, employees and residents of Warm Hearth Village in Blacksburg celebrated the organization’s 45th anniversary of its incorporation by paying homage to its founders, its unique history and its deep roots in the New River Valley community.

Wybe (Vee-ba) and Marietja (Mar-ee-cha) Kroontje (Croon-cha), Dutch immigrants from the Netherlands, were dissatisfied with the conditions they observed in “typical” nursing homes and were eager to give something back to the country that had given them so much during World War II. In 1974, they received the official stamp on their vision and many years of planning and hard work to build a nonprofit community with a variety of living options. This official milestone gave way to a flurry of activity that included the donation and purchase of land and the formation of what would become the 100-year plan for the development of Warm Hearth Village.

Leaders at Warm Hearth strive to keep the Kroontjes’ dreams moving forward by using the 100-year plan as a roadmap for the growth and development of the Village. In recent years, an active adult community, Village Center for community gathering and fitness opportunities, home health and home care services and a Carilion Clinic facility have all been added to the 220-acre campus to meet the increasing demands of seniors.

Warm Hearth Village is a nonprofit senior living community in Blacksburg that provides a full continuum of living options on its campus and in the home.

More Information: www.retire.org

More Information: www.lewisgale.com

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BESTBedside VOTING CATEGORIES INCLUDE: Allergy & Immunology Anesthesiology Audiology Cardiology Chiropractic Concierge Medicine Dentistry (Cosmetic) Dentistry (General) Dentistry (Pediatric) Dermatology Dietetics Emergency Medicine Endocrinology Family Practice Fertility Care Gastroenterology Geriatrics Hematology/Oncology Hospitalist Infectious Disease Internal Medicine Neonatology Nephrology Neurology Nurse Practitioner Obstetrics & Gynecology Occupation Medicine Ophthalmology Optometry Oral Surgery Orthodontics

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

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ROANOKE & NEW RIVER VALLEYS

The Pulse

• NEWS TO KNOW

Promotions, Additions, Openings and Changes Carilion Clinic Announces Several Key Appointments and Recognitions •

Jeanne Armentrout, Executive Vice President and Chief Administrative Officer: Jeanne Armentrout has joined the board of Corvesta, Inc., the parent holding company of Delta Dental of Virginia.

Armentrout currently serves on a number of Carilion Clinic boards, as well as the governor-appointed Virginia Board of Workforce Development. She brings more than 30 years of experience in healthcare, human resources management and consultation to her board role.

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Nicholas C. Conte, Executive Vice President and General Council: Nicholas C. Conte has been awarded “Lawyer of the Year” for 2019 by The Best Lawyers in America. Visit www.bestlawyers.com for more information.

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Tamera Howell, MD, Section Co-Chief, Obstetrics and Gynecology, Carilion New River Valley Medical Center: Tamera Howell, MD is one of 18 women from 16 health organizations selected to be part of the Carol Emmott Fellowship Class of 2019. Visit www.carolemmottfellowship.org for more information.

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Carilion Clinic Awarded Shared Governance Accreditation: Carilion Roanoke Memorial Hospital has been awarded shared governance accreditation by the internationally recognized Forum for Shared Governance. Visit www.sharedgovernance.org

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Carilion Clinic Achieves Stage 6 on the EMR Adoption ModelSM: The Healthcare Information and Management Systems Society (HIMSS) Analytics has announced that Carilion Clinic has achieved Stage 6 on the EMR Adoption ModelSM (EMRAM). HIMMS identifies hospitals on a scale of 0-7, with stage 7 being entirely paperless. Visit www.himssanalytics.org for more information.

David W. Hartman, MD, Addiction Psychiatry and Addiction Medicine: David W. Hartman, MD has been appointed to the Governor’s Advisory Commission on Opioids and Addiction. Visit www.governor.virginia.gov/media/ governorvirginiagov/executive-actions/EO-21-EstablishingThe-Governors-Advisory-Commission-On-Opioids-AndAddiction.pdf for more information.

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Carilion Roanoke Memorial Hospital Named ‘Most Wired’: The College of Healthcare Information Executives (CHIME) designated Carilion Roanoke Memorial Hospital ‘Most Wired’ for 2018 during a recognition ceremony held at the CHIME Fall CIO Forum in San Diego. Visit www.chimecentral.org for more information.

More Information: www.carilionclinic.org

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The Pulse

LewisGale Hospital Pulaski Breaks Ground on New Behavioral Health Unit LewisGale Hospital Pulaski has started construction on a new 16-bed Adult Inpatient Behavioral Health Unit at the hospital to support area residents experiencing mental health and addiction issues. The addition of Behavioral Health Care will result in 25 new jobs coming to the community.

Opening in late summer 2019, the new facility is a combination of new construction and renovation of existing space, resulting in 8,000-square feet devoted to patient health and treatment. The completed unit will feature individual therapy space, physician, nursing and staff offices, a dining area, as well as group and courtyard activity space.

“The new Behavioral Health Program at LewisGale Hospital Pulaski will enable our medical staff here to offer comprehensive behavioral health services for the first time,” explains Sean Pressman, CEO of LewisGale Hospital Pulaski. “There is a demonstrated and growing need for additional mental health services in our community, and throughout Southwest Virginia. This new facility will enable patients to receive treatment close to home and near the support of family and friends.”

The new unit will be separate and secure from the existing hospital, and will be accessed via a separate entrance adjacent to the main Hospital entrance. A team of physicians, nurses and mental health professionals – including social workers, recreational therapists and dietitians – will staff the unit and provide a wide range of treatment.

More Information: www.lewisgale.com

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• NEWS TO KNOW

Promotions, Additions, Openings and Changes

The Pulse

• NEWS TO KNOW

Promotions, Additions, Openings and Changes Community Health Center of the New River Valley Welcomes New Dentist The Community Health Center of the New River Valley (CHCNRV) announces the addition of Orlando Abreu, DDS, to its Giles and Radford/Pulaski Center locations. Dr. Abreu joins CHCNRV as a full-time dentist providing general dentistry to all ages. His 15-year career has included both practice and research in Venezuela, Puerto Rico and Virginia. He also serves on the Joint Commission on National Dental Examinations as a Test Constructor.

He has spent several years working specifically with children and he is multi-lingual.

“We are pleased to welcome Dr. Abreu to our Health Center family,” states Michelle Brauns, CEO. “Dr. Abreu’s wealth of experience – especially with children – and patientfirst attitude will benefit our patients and we are excited he is joining our team.”

The Community Health Center of the New River Valley provides affordable and high quality medical, dental, behavioral and preventative healthcare services to people of all ages, regardless of ability to pay.

Orlando Abreu, DDS

Appointments with Dr. Abreu can be made by calling 540.921.3502.

More Information: www.chcnrv.org

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The Pulse

• NEWS TO KNOW

Matthew Barr

Gregory Dehmer, MD

Sandeep Mittal, MD Chief

Laurie Beth Moyer, PA-C* Corinne LewisGale Physicians O’Shaughnessy, AuD

Carilion Clinic Neurosurgery Spine and Bone Health Daleville | 540.725.9771 Roanoke | 540.224.5170 www.lgphysicians.com www.carilionclinic.org

Carilion Clinic Otolaryngology Roanoke | 540.224.5170 www.carilionclinic.org

Travis Reeves, MD

Allyson Scruggs, NP

Aashit Shah, MD

Carilion Clinic Vice President of Accounting Roanoke www.carilionclinic.org

Carilion Clinic Otolaryngology Roanoke | 540.224.5170 www.carilionclinic.org

James Taylor, DO*

Carilion Clinic Cardiovascular Institute Director of Quality and Outcomes Roanoke | 540.982.8204 www.carilionclinic.org

Carilion Clinic Family Medicine Roanoke | 540.562.5700 www.carilionclinic.org

David Gregory, MD

John Harding, MD*

Carilion Clinic Family Medicine Roanoke | 540.562.5700 www.carilionclinic.org

LewisGale Physicians OBGYN Smith Mountain Lake 540.772.3680 www.lgphysicans.com

Cara Ravagli, PA

Carilion Clinic Geriatric Medicine Roanoke | 540.981.7653 www.carilionclinic.org

Carilion Clinic Section Chief of Neurology Roanoke | 540.224.5170 www.carilionclinic.org

Jeremy Smalley, MD* LewisGale Physicians Orthopedics Smith Mountain Lake 540.444.2020 www.lgphysicinas.com

Welcomes our New Healthcare Providers to the Community!

LewisGale Physicians Cardiothoracic & Vascular Surgery Blacksburg | 540.776.2020 www.lgphysicians.com

*Providers with home offices in Salem as well as the above listed satellite locations.

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Health Scene HAPPENINGS • WHO’S WHO • TRENDING words | JENNA LAZENBY

SFCS BY DESIGN CONFERENCE BRINGS TOGETHER EXPERTS TO HELP “INSPIRE THE FUTURE” FOR SENIOR LIVING SFCS, a senior living, education and civic architecture, engineering, and interior design firm, held its 34th annual By Design conference on February 21st and 22nd at the Hotel Roanoke and Conference Center. The conference brought together several hundred of the nation’s leading professionals and faculty in the field of senior living.

This year’s theme “Inspire the Future” delved into current trends and new directions for the senior living industry and explored how Life Plan communities offer opportunities and unique solutions for this complex market segment.

Speakers covered a wide range of topics, from overcoming staffing challenges to rethinking dining menus to repositioning communities to meet the changing needs of residents. The concept of senior living has come to be viewed in a much more contemporary way – it’s not “a home” but their home for the next stage of their lives, which is a part of the evolution many properties are incorporating into their decisions and design.

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Health Scene • HAPPENINGS www.OurHealthRoanokeNRV.com

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Questions. Answers.

Knowledge.

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

Adult acne and rosacea are common conditions that affect both men and women, but they are certainly more often seen in women. There are important differences that allow dermatologists to distinguish these diagnoses so that appropriate treatment can be given.

Scientists have observed

INCREASES IN ASTHMA

EXACERBATION COINCIDING WITH SEVERE THUNDERSTORMS. It is thought that pollen grains can absorb large quantities of moisture and then burst, releasing extremely small particles, which can then penetrate deep into the smaller airways of the lung.

- Saju Eapen, MD -

Rosacea is usually seen in the central portion of the face, especially the forehead, nose, and the mid cheek. Pustules (small bumps on the skin that contain fluid or pus) are commonly seen, as well as redness, and it is often associated with flushing and blushing, which is aggravated by exertion, heat and spicy foods. Closed pores (comedones) are not part of rosacea.

Adult acne typically does not concentrate in the central face, but rather around the jaw line and may be more widespread. Closed pores are often seen. Exaggerated flushing is not a part of typical acne.

Treatment results are excellent for both conditions, so it is important to seek dermatological care to get the help that is needed.

Gary Gross, MD

Dermatologist LewisGale Physicians Salem | 540.772.3421 www.lgphysicians.com

What does Photobiomodulation laser therapy for pain feel like and how long does it take?

Typically, a Photobiomodulation laser therapy session lasts 20 minutes. Clients need to allow one day in between visits to permit the body to detox fully.

During Photobiomodulation therapy, an individual lays in the NovoThor body pod and can listen to their own play list (or nothing at all) or listen to our selections of BrainFM tones of music. We offer four choices – relax, recharge, focus, and meditation.

Once clients are in the bed and the session has started, they can roll over in the bed, lay on their side, or stay on their back. It is a comfortable, warm environment and most clients say they come out feeling more refreshed or that they wish they could spend more time in the body pod. A good number of clients even fall asleep during their session! We have had great success with helping clients with pain, inflammation, and even athletes that want quicker muscle recovery.

Linda Bailey

Total You Health Roanoke | 540.404.8858 www.totalyouhealth.org

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

Is thunderstorm asthma a real thing?

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

Saju Eapen, MD

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

www.OurHealthRoanokeNRV.com

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Questions. Answers.

Knowledge.

What is spasmodic dysphonia?

There are actually two types of spasmodic dysphonia disorders: adductor and abductor spasmodic dysphonia. Adductor SD, the more common of the two, is the result of spasms in muscles that close vocal folds, interrupting speech and causing strained or strangled voice breaks. Diane Rehm, host of National Public Radio’s The Diane Rehm Show, was affected by the condition. After seeking treatment, she returned to the show, successfully hosting for another 18 years and became an outspoken advocate for education about the condition.

ADDING A PROTEIN AND

HEALTHY FAT WITH A FRUIT

such as natural peanut butter on an apple is a great way to curb appetite and offer a sweet snack at the same time.

- Tricia Foley, MS, RD, CHC, CLT -

Abductor SD is the result of spasms in muscles that open vocal folds, interrupting speech and causing breathy or soundless voice breaks. According to Clinical Voice Pathology: Theory and Management, symptom severity for both conditions vary among individuals ranging from mild interruptions in normal speech sounds to nearly voiceless by the severity of spasms.

A speech pathologist, neurologist and otolaryngologist (ENT) may all be a part of your diagnostic and care team.

My child’s ear tubes have not fallen out. Do we need to have them surgically removed?

What are some healthy alternatives to curb my sweet tooth?

Ear tubes typically last from six to 18 months before falling out on their own in the vast majority of cases. For the few cases where ear tubes do not fall out on their own, the general consensus among ENT providers is to observe the tubes until they have been in place for three years. Tubes that have been in place for three years or longer generally should be removed with a very brief outpatient surgery. Based on the appearance of the ear drum at the time, the ENT removing the tubes may recommend small patches be placed on the very small holes in the ear drums left from the tube removal.

Benjamin Cable, MD

Section Chief, Otolaryngology Carilion Clinic Roanoke | 540.224.5170 www.carilionclinic.org

This question comes up often.

Depending on your goals, some healthy alternatives include healthy smoothies made with plain Greek yogurt, frozen fruit and greens.

One of our favorites: blend one half of a banana, half cup of frozen blueberries and a handful of spinach with one cup plain Greek yogurt and ice.

Craving chocolate? Try a healthy hot chocolate using one cup unsweetened almond milk, one tablespoon cocoa powder and Stevia (or honey).

For low carb options, try cocoa powdered almonds for a yummy crunch or frozen berries drizzled with one to two tablespoons of heavy whipping cream for a delicious frozen treat. Adding a protein and healthy fat with a fruit such as natural peanut butter on an apple is a great way to curb appetite and offer a sweet snack at the same time.

Tricia Foley, MS, RD, CHC, CLT The Weigh Station Roanoke | 540.982.0250 Christiansburg | 540.381.2670 www.theweighstation.com

Melissa Patterson, MS, CCC-SLP Roanoke Valley Speech and Hearing Center Roanoke | 540.343.0165 www.rvshc.org

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LEADERS A

LOCAL HEALTHCARE

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

words | JOE BUTLER

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

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

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

In that spirit, we invite you to learn more about They could make sure an office, medical center or health 11 of the brightest members of our local exchange runs optimally; training and placing the right medical community who make up our list of people in the best position for them to prosper; ensuring 2019 Roanoke and New River Valleys Leaders in that employees enjoy where they work even when under Local Healthcare. stressful conditions; and establishing processes that are

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Beth Bankston

Nathaniel Bishop, DMin

Mitchell Davis

ROANOKE

ROANOKE

Chief Administrative Officer Jefferson Surgical Clinic www.jeffersonsurgical.com

President Jefferson College of Health Sciences www.jchs.edu

SOUTHWEST AND SOUTHSIDE VIRGINIA

American College of Healthcare Executives Member Medical Group Management Association Member

Jefferson Surgical Clinic opened its doors in 1956, and today, continues to offer a variety of health and wellness services in vascular surgery, urology and ENT to area residents at five area locations with the help of 13 physicians, nurse practitioners and physician assistants and an audiologist.

Bankston is the organization’s fourth administrator, and since her arrival a year ago, she has found multiple ways to seek improvements in its quality and reputation, ensuring the organization continues to remain a trusted healthcare leader. She has built upon the efforts of past clinic leaders to improve quality of care and quality of processes. These efforts go beyond medical skills, recruitment and compensation to facilities management, IT systems and financial oversight. Her previous leadership positions have included vice president of operations for Centra Medical Group and director of surgical practices for Carillon Clinic. Bankston also concentrates on building and maintaining relationships in the greater Roanoke area through her passion for healthcare and natural empathy for patients.

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Board of Visitors of the Divinity School of Duke University Board member emeritus Virginia Board for Community Colleges Member Virginia Tech Carilion School of Medicine Chair of Interprofessionalism

Nathaniel Bishop, DMin was hired as the president of Jefferson College of Health Sciences (JCHS) in 2010.

Since then, the college has seen high enrollment and a push for quality at all levels. It also is nearing the completion of a merger with Radford University, which is expected in summer 2019. A big part of the direction in education excellence is due Dr. Bishop’s efforts, and he has a good reputation of taking the time to encourage all students and staff, sometimes one individual at a time. Dr. Bishop has a long history of education and industry experience, including as the executive director of the Burrell Nursing Center, vice president and hospital director at Carilion Roanoke Community Hospital, and vice president of facility and guest services at Carilion Roanoke Memorial Hospital. He’s involved in various state education initiatives as well as other community and charitable endeavors, from local theater and churches to the local airport commission and United Way. Because of his efforts and longtime commitment to the region’s medical community, Dr. Bishop has received several commendations.

Many people say the environment of JCHS is like a family, and Dr. Bishop provides the role of a paternal and supportive personality who nurtures students and encourages them to always do their best.

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

Owner Interim Healthcare www.interimhealthcare.com Regional Vice President of Operations Saber Healthcare www.saberhealth.com Partner First Quality Rehabilitation www.thelandmarkgroupllc.com/first-quality-rehab Virginia Department of Health Professions – Virginia Board of Long-Term Care Administrators Chairperson – Governor appointed Roanoke Valley SPCA Board Member Former Commonwealth Council on Aging Board Member – Governor appointed Former Radford University Sports Foundation Member

As the franchise owner of seven Interim Healthcare home care agencies in Southwest and Southside Virginia, Mitchell Davis remains focused on supporting members of our community who could benefit most from home health services, especially seniors. He is active in maintaining and expanding the organization’s role in the community, and he has a reputation as someone who enjoys finding consensus among diverse populations. He has represented other Interim Healthcare franchise owners and providers from the eastern part of the U.S., and serves as a consultant for rehabilitation efforts. Davis also has extensive knowledge of state and national healthcare regulations and is active in several local and regional healthcare advisory committees. He has been appointed by the governor as Chairperson of the Virginia Department of Health Professions – Virginia Board of Long-Term Care Administrators. Prior to his current professional roles, Davis gained a solid perspective in several areas of community health, including as a certified case manager, nursing home administrator and licensed physical therapy assistant. In addition to seeking excellence in his role with Interim Healthcare, Davis is an active community volunteer, including current board member of the Roanoke Valley SPCA, past board member of the Salem Family YMCA, a volunteer youth coach for the City of Salem Parks and Recreation and Meals on Wheels.

William (Bill) Flattery, MPH ROANOKE Vice President Carilion Clinic Western Region Chief Executive Officer Carilion New River Valley Medical Center www.carilionclinic.org Colleagues of William Flattery like referring to his message that “it doesn’t matter what initials come after your name that makes you an effective leader.”

Instead, he suggests that the better leaders “are the ones who interact well with those around you, and the team you build.” Flattery has demonstrated this inspiring, humbling approach through his variety of healthcare administrative positions held throughout the U.S., including in the areas of operations, finance and management information technology. Flattery joined Carillon Clinic in 2007, and since then, he has focused on improving overall efficiency as well as accountability at the fiscal level, which ultimately can lead to better patient outcomes and better quality of care. This approach includes efforts to provide services closer to more patient’s homes and neighborhoods to make it easier to access quality care. Facilities that Flattery oversees have taken steps to improve communication and accountability, which has boosted unity and cohesion. He’s also been involved in current capital improvement efforts such as the opening of an infusion center that opened in the fall of 2018.

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Brian Gross MD, FACS

Cynda Ann Johnson, MD, MBA

Michelle Narramore

SALEM

ROANOKE

BLACKSBURG

Otolaryngologist (ENT) LewisGale Physicians www.lgphysicians.com

Former Dean Virginia Tech Carilion School of Medicine www.medicine.vtc.vt.edu

Administrator Warm Hearth Village www.retire.org

AAMC Group on Student Affairs Steering Committee Member

Girls on the Run Member/Treasurer

Physician Excellence Committee Member Surgical Governance Committee Member Surgical Quality Committee Member

A successful medical organization requires the right amount of synergy between administration, staff, physicians and other specialists. But it’s also easy for this balance to be disrupted unless regular effort goes into maintaining it.

That’s part of the role of Brian Gross, MD, FACS, who in addition to treating patients in outpatient and inpatient settings, is part of key committees designed to improve communication, accessibility and overall well-being.

Dr. Gross was a founder of the Surgical Governance Committee, which has a goal of improving perioperative services including accountability. He’s also a founding member of the Physician Excellence Committee, which focuses on improving collaboration and support with administration, and the Surgical Quality Committee that discusses quality of care. All of these efforts and attention to processes by Dr. Gross and other physicians have had positive results, not just in patient outcomes but in overall morale, community support and improved physician recruitment.

Dr. Gross has also received recognition for his efforts over the years, including Preceptor of the Year in 2016 and 2018, Roanoker Magazine’s Top Doc award and OurHealth Roanoke and New River Valleys Magazine’s award for best bedside manner. Colleagues and patients say Dr. Gross is an exceptional physician, friend and colleague, willing to push for improvement and think in innovative ways.

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Commonwealth Health Research Board Member AMA Section on Medical Schools Governing Council Member

Cynda Ann Johnson, MD, MBA recently retired from the role she founded – dean of Virginia Tech Carilion School of Medicine. But she’s far from done using her clinical medicine and academic experience to mentor and inspire future medical leaders at a regional and national level, especially women.

Dr. Johnson is now involved in a variety of medical education advisory boards, boards of medicine, and even economic and civic organizations. She began her academic career at Stanford and completed medical school at UCLA. She was a founding dean of the Brody School of Medicine at East Carolina University and later served as senior associate vice-chancellor for clinical and translational research. Her efforts have led to a wide variety of recognition, from the “Salute to Service” from the Medical Society of Virginia to Citizen of the Year from the NAACP. Dr. Johnson is still considered an inspirational figure to many of the Virginia Tech Carilion School of Medicine graduates as they continue in their careers.

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

LeadingAge Dementia Care Cabinet Member Alzheimer’s Advocacy Team for Representative Morgan Griffith Member

Warm Hearth at Home offers home health and home care services, and Michelle Narramore makes sure all residents and clients receive the help they need and all procedures are properly followed, including regular supervision and evaluation of the staff.

She also is responsible for keeping track of financial information and always looks for ways to improve overall efficiency.

Prior to joining Warm Hearth, Narramore worked in the administrative offices of Functional Pathways, a therapy group. This position helped her develop expertise in managing procedural and regulatory information. Today, at Warm Hearth, she puts effort into nurturing staff, clients and the surrounding community. She’s also been asked to join U.S. Representative Morgan Griffith’s Alzheimer’s Advocacy Team and has visited with the state’s other Congressional leaders. Narramore also considers volunteer activity to be vital, and is involved in several charitable endeavors, including the Salvation Army.

She has volunteered with Memory Walk, which raises money for Alzheimer’s disease; and Color Run, which raises money for other charities. She recently joined the board of Girls on the Run, providing them with transportation, gear and training.

Jennifer Pressman SALEM Administrator Salem Health and Rehabilitation Center www.mfa.net For the last 11 years, Jennifer Pressman has led the team at Salem Health and Rehabilitation Center to higher levels of patient satisfaction and employee retention. This effort starts with always looking for ways to create a positive work environment, which leads to a focus on quality, and ultimately to better patient experiences. Her goal for the organization is to identify opportunities to improve operations, especially if it will help enhance a patient’s experience.

Customer satisfaction scores are an impressive 93 percent, and Salem Health and Rehabilitation Center has been named Center of the Year by its parent company Medical Facilities of America (MFA). Pressman has made sure Salem Health and Rehabilitation Center always remains active in the community, including being part of the City of Salem’s Christmas parade. She seeks ways to encourage students to pursue medical and nursing careers, and supports Roanoke Valley Nurse Aide, a local CNA program, as well as serves as a clinical site for training with Roanoke County Schools. Co-workers describe Jennifer as someone who is genuinely happy and welcoming to all patients, staff and families.

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Mike Shannon, CPA

Michael Simpson, DO, CAQSM

Dixie Tooke-Rawlins, DO, FACOF

ROANOKE

DUBLIN

BLACKSBURG

Chief Financial Officer Friendship Retirement Community www.friendship.us

Family Medicine/Sports Medicine Physician LewisGale Physicians www.lgphysicians.com

President and Provost Virginia College of Osteopathic Medicine www.vcom.edu

American Academy of Family Physicians Fellow

Commission of Osteopathic College Accreditation Team Chair/inspector

Better Business Bureau Member

Although retirement communities like to promote their welcoming atmosphere, interactive social activities and amenities, and general ambience, behind the scenes there needs to be strong financial management. That’s part of the strength of Mike Shannon, who has extensive experience in postacute care as well as accounting and financial best practices.

Shannon oversees all aspects of billing, payroll, information technology, accounting and finance, as well as the institutional and retail pharmacy at Friendship Retirement Community. He’s always making the effort to learn new strategies that can improve fiscal management as well as quality of life for residents.

Shannon also researches practices at similar retirement communities to stay abreast of trends in the industry, and he is able to identify effective ways to reduce spending and make processes more efficient without compromising quality and care. He has worked within several different types of retirement communities for nearly 30 years and has also held public accounting positions, noting that both perspectives have been invaluable to his role at Friendship. Part of his strength is that he has remained an important part of the leadership team at Friendship for years, and has been a stable figure for the administration and residents.

ON THE WEB

More at OurHealthRoanokeNRV.com

Edward Via College of Osteopathic Medicine Faculty Member

Some of the highest praise a healthcare provider can give another is being told they consistently put patients first. That’s how Michael Simpson, DO has been described: he is an educator, he runs a family medicine practice, and he helps area athletes with sports medicine needs.

This assistance includes volunteering with the Pulaski County School system to offer physicals to students. During high school football season, Dr. Simpson can often be seen on the sidelines ready to offer his skills to athletes if needed.

He has received additional training in concussion assessment, management, and treatment. He’s the only ImPACT consultant in the area, a medical credential demonstrating extensive research in concussions.

Patients appreciate Dr. Simpson’s dedication, passion and willingness to work hard, regardless of whether it’s the weekend or the weekday, or during or after traditional office hours. Peers, parents and students also like his attention to detail, expertise and focus on overall good health. He also oversees the training of family medicine residents through Roanoke’s Graduate Medical Education program. Even though much of modern medicine is based on paperwork and related billing, Dr. Simpson regularly leads by example as far as making sure patient needs are always met.

Virginia Governor’s Task Force on Prescription Drug Abuse Research Advisory Council for Auburn University’s Board of Directors Member Southwest Virginia Health Authority Member American Osteopathic Board of Family Physicians Fellow

Dixie Tooke-Rawlins, DO, FACOF has received local and national acclaim as an educator, administrator and a healthcare provider. As president of Virginia College of Osteopathic Medicine, she works to provide superior instruction for future doctors. Since the 1970s, she’s practiced medicine and helped others around the world, including in the U.S. and Central America. She’s been asked by Virginia’s governors to be part of several task forces looking at community health topics, including prescription drug abuse, healthcare reform and healthcare workforce development. Along with an interest in osteopathic medicine, Dr. TookeRawlins has looked for ways to improve rural access and delivery of healthcare services.

Her duties at VCOM include staffing and accreditation to recruitment and building relationships in Virginia’s medical communities. The school also has three campuses in the U.S. and three international locations. Prior to working in Virginia, Dr. Tooke-Rawlins practiced in Missouri where she was an advocate for community health and rural health programs, with a focus on education. For her efforts, she’s been presented with impressive recognition, including a Lifetime Achievement Award from the American College of Osteopathy Family Physicians; National Minority Access Role Model; Mentor Hall of Fame and the National Educator of the Year.

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Procedure Cosmetic Procedures

That Turn Back Time on Your Face, Body Skin

words | JENNIFER LAMONT

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

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

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

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

Americans have over 17 million surgical and minimally invasive cosmetic procedures each year, says the American Society of Plastic Surgeons – including a 28 percent jump since 2000 for men. Those numbers are increasing rapidly as lasers do more of the work, making cosmetic procedures safer, faster and less invasive.

Of the millions of plastic surgeries performed each year, these are five of the 10 most popular:

A

BREAST AUGMENTATION (enlargement and reduction)

B

LIPOSUCTION (most popular procedure for men)

C

RHINOPLASTY (nose reshaping)

D

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

E

“MOMMY MAKEOVER” (tummy tuck plus other procedures based on individual patient) CONTINUED ON PAGE 36

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35

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

Who to Check Out for “Tried and True” Cosmetic Surgery: Steven G. Harris, MD Jefferson Surgical Clinic Plastic Surgery 1924 Braeburn Circle | Salem 540.283.4962 www.jeffersonsurgical.com/services/ plastic-surgery Dr. Harris relies on time-tested techniques and says that satisfaction comes from having a practice that is half cosmetic and half reconstructive, which makes patients happy in two different ways.

Who to Check Out When You Want the Most Sought-After Procedure: Kurtis E. Moyer, MD, FACS Professor of Surgery, Virginia Tech Carilion School of Medicine Chief of Plastic Surgery, Carilion Clinic 2107 Rosalind Avenue | Roanoke 540.853.0510 www.carilioncosmetic.com Breast augmentation is far and away the most popular cosmetic procedure and has been for over a decade. It’s the number one procedure Dr. Moyer performs at the Carilion Clinic Cosmetic Center.

Who to Check Out for Non-Invasive Anti-Aging: Jane Gilley, NP Inspire MedSpa 1995 S. Main Street | Suite 903 Blacksburg | 540.739.3214 www.inspiremedspava.com Jane Gilley, NP, a nurse practitioner and owner of Inspire MedSpa in Blacksburg, says that anti-aging medicine focuses on staying healthy and biologically efficient throughout life. “Most of us work hard all our lives, It is a pleasure to be able to help patients enjoy the years of life we worked so hard to get to.”

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

The five most popular beauty tweaks are:

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

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

C D

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

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

Wondering if you’re a good candidate for liposuction?

Or, whether you should consider a breast lift instead of the enlargement you’ve been wanting forever? Here are the ins and outs for 9 of the most popular procedures in the Roanoke and New River Valleys to help you refresh your face, skin and body.

Most Popular Surgeries

The

to Improve Your Body Shape 1. Liposuction WHY IT’S POPULAR:

Slims down chin, thighs, stomach, waist, hips, calves, buttocks, back, arms, face and breasts

HOW IT’S DONE: •

Local or general anesthesia, or IV sedation

•

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

BEST CANDIDATES: •

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

•

People with firm, elastic skin and more muscle tone

WORST CANDIDATES: •

People who want to use it for weight loss or treatment for obesity

•

Those who are trying to treat cellulite

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

AVERAGE COST:

$3,374*

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Spotlight On: Steven G. Harris, MD BOARD-CERTIFIED PLASTIC SURGEON

Jefferson Surgical Clinic

Focusing on both cosmetic and reconstructive surgeries, Dr. Harris is a board-certified plastic surgeon with Jefferson Surgical Clinic’s Plastic Surgery Center in Salem. Whether cosmetic or reconstructive, Dr. Harris says his field offers the opportunity to help restore people to a way they once were, which is a greatly satisfying way of taking care of patients.

The two most popular cosmetic procedures Dr. Harris performs are the mini-facelift and tummy-tuck (abdominoplasty).

The mini-facelift differs from a full facelift in that it doesn’t address the lowest part of the neck near the collarbones, says Dr. Harris. But, it does address the jowls, jawline and immediate neck area underneath the jaw.

Because it’s less complex and invasive than a full facelift, the mini version “costs about half as much, the patient doesn’t have to go to sleep for it and there are no drains,” he explains.

And, because the incisions are smaller, the healing time is

much quicker. “You get about two-thirds of the value of a facelift for half the price and way less than half the recovery,” says Dr. Harris.

Sticking to the tried and true methods that work well, Dr. Harris also uses newer closing techniques, such as skin adhesives in addition to sutures. Using both, as opposed to only sutures, creates better-looking scars that aren’t as obvious. He adds that restoring people in both reconstructive and cosmetic ways helps him “make patients happy in two different ways, but both are important for helping people feel better about themselves.”

Steven G. Harris, MD A board-certified plastic surgeon with Jefferson Surgical Clinic’s Plastic Surgery Center in Salem.

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Spotlight On: Kurtis E. Moyer, MD, FACS BOARD-CERTIFIED PLASTIC SURGEON

CONTINUED FROM PAGE 36

2. Breast Augmentation Enlargement and/or Lift

Carilion Clinic

HOW IT’S DONE: •

General or local anesthesia

As part of the cosmetic team of specialists at Carilion Clinic, Dr. Moyer helps to educate patients so they’re fully informed and empowered to make the right aesthetic choices. The Carilion Clinic Cosmetic Center performs both surgical and non-surgical treatments for all areas of the body.

•

Implants – silicone or saline

•

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

Dr. Moyer’s most popular surgical procedure is breast augmentation. He says the best candidate for the procedure is “a healthy patient who has reasonable expectations that are achievable safely.” Health is of utmost concern when undergoing any surgery and plastic surgery is no different. People who have major health conditions aren’t considered good candidates.

Carilion’s Cosmetic Center is well-equipped to handle all types of invasive and non-invasive procedures. “The Carilion Clinic Cosmetic Center is a unique environment. We are a cosmetic surgery center that can perform surgery on site under general anesthesia with a board-certified anesthesiologist. This is in addition to having two master aestheticians, a nurse practitioner and four board certified plastic surgeons all performing cosmetic-related procedures,” says Dr. Moyer.

“I personally enjoy the opportunity to assist each patient on their unique journey. Cosmetic surgery is not one size fits all. In order to meet and exceed a patient’s expectations, open communication and education about each procedure is essential.

These are the aspects of cosmetic surgery that I truly enjoy the most,” he adds.

Kurtis E. Moyer, MD, FACS Professor of Surgery, Virginia Tech Carilion School of Medicine and Chief of Plastic Surgery, Carilion Clinic in Roanoke.

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

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

WORST CANDIDATES: •

Those with severely sagging breasts. A breast lift may have to be done at the same time as an enlargement to correct severe situations.

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

AVERAGE COST: Implants –

$3,718*

| Lift – $4,672*

3. Tummy Tuck WHY IT’S POPULAR: •

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

•

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

HOW IT’S DONE: •

General anesthesia (most often) or IV sedation

•

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

BEST CANDIDATES: •

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

•

Finished with childbearing

•

Close to ideal body weight

WORST CANDIDATES: •

Those who may get pregnant again in the future

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

AVERAGE COST:

$3,000*

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

HOW IT’S DONE: •

General anesthesia or IV sedation

•

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

BEST CANDIDATES: •

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

•

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

WORST CANDIDATES: •

Those who are overweight

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

AVERAGE COST:

$7,448*

2. Non-Surgical “Tweakments”

Laser Skin Resurfacing, Fillers and Microdermabrasion WHY THEY’RE POPULAR:

Myth vs.

Reality?

Cosmetic Surgery and Plastic Surgery are the Same.

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

WITHOUT HIGHLY INVASIVE SURGERY, THEY MINIMIZE PROBLEM AREAS: • Fine lines and wrinkles around or under eyes, forehead and mouth •

Sun-damaged skin and dark spots

•

Acne or chickenpox scars

•

Birthmarks and freckles

•

Thin lips and hollow cheeks

•

Large pores

•

Skin irregularities and pre-cancerous growths

HOW IT’S DONE:

A

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

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Spotlight On: Jane Gilley, NP Inspire MedSpa

B

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

C

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

Helping patients through medical weight loss, body contouring, injectables and other antiaging procedures, Gilley says her two most popular procedure types are body contouring and the O-Shot (a non-surgical shot that is said to treat sexual dysfunction and improve orgasms in women).

People who make the best candidates for the kind of non-invasive procedures Inspire MedSpa offers are those who are concerned with their health and appearance, and also know there are no quick fixes without putting in any effort in maintaining their health and looks. “I can do any procedure, but it requires some effort in the maintenance,” says Gilley.

She’s also beginning to do more Platelet Rich Plasma procedures. “This therapy can be used aesthetically as well as for physical ailments. It is a multifaceted approach toward health and healing. It is autologous, which minimizes risks and improves outcomes,” she says.

In treating her patients, Gilley gets the most satisfaction from seeing the pleasure people get after they see results or tell her they feel better about who they are. “It is important to treat the whole person and not just a snapshot of the patient. We must feel good internally or whatever we do externally will not have the best outcome,” says Gilley.

BEST CANDIDATES:

People who want to rejuvenate their face, look younger and aren’t ready yet to “go under the knife.”

•

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

WORST CANDIDATES: •

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

•

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

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

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

AVERAGE COST:

Ablative Laser Therapy – $2,124*

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

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

Microdermabrasion – $1,170*

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

HOW IT’S DONE: •

Local anesthetic

•

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

Bone is sometimes removed if necessary.

BEST CANDIDATES: •

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

•

People with asymmetric, uneven gums

WORST CANDIDATES:

Jane Gilley, NP With Inspire MedSpa in Blacksburg.

•

•

Those with poor oral hygiene and periodontal disease

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

AVERAGE COST: $300 –

$3,000

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

Did you know?

You can acquire new dimples in about 30 minutes?

If you think you’d be cuter with dimples, you may be right. Performed as an outpatient procedure, a “dimpleplasty” costs between $2,000 and $5,000. And, when done right, it makes you undeniably adorable.

40

The

Treatments that Help Your

Skin & Hair Glow

1. Cellulite Treatment – Cellfina WHY IT’S POPULAR: Smooths out dimpling on thighs and buttocks up to an amazing three years

CONTINUED ON PAGE 42

ASK THE EXPERT

BANA HOSSEINIAN, DDS, MDS MOUNTAIN VIEW ORTHODONTICS 221 S. Maple Street | Vinton, VA 24179 |

c 540.342.9876 | w www.orthomv.com

As a child, I had braces, but I haven’t worn my retainer regularly, causing my teeth to shift. What are the best options for me as an adult to have my teeth straightened?

There are several options for patients who have had previous orthodontic treatments earlier in life and have then encountered what’s called relapse of crowding and rotations of their teeth. An orthodontic professional can diagnose and recommend a certain type of treatment during a consultation, based on how severe the relapse is and the type of bite the patient may be displaying or experiencing.

BEFORE

Some options for patients in this situation can include: •

Radiance clear braces: Radiance clear braces are a type of brace that’s comfortable and difficult to see. These clear and sturdy brackets are actually made out of sapphire, which can be especially appealing to people who may have sensitivities or allergies to certain types of metals.

•

Empower: Empower are brackets with lighter wire on a slide mechanism.

This type of bracket uses lower friction to move teeth, which means a faster treatment time for the patient. These types of brackets are also easier to keep clean than traditional braces.

•

Aligner therapy, such as Invisalign®: With Aligner therapy, patients are fitted with clear, customized removable appliances called aligners that don’t require wires or brackets. The orthodontist designs the prescription for the aligners in such a way that they will move the teeth and correct any relapses. Different size aligners are exchanged on a regular schedule during the treatment process, usually between 12 and 48 sets. They can also be easily taken out to eat, brush or floss, another advantage from traditional braces that are unable to come off during the treatment process. We like to call this therapy the ‘wireless’ treatment.

AFTER

These options are all low-profile and particularly suitable for adult patients who may be concerned about their appearance and how much the braces could be visible in public, or if they work in a profession where they need to consider how being seen with braces could appear.

There are other treatment options available for people who have relapsed in their orthodontic treatment. For instance, different kinds of spring retainers can be designed which can move the mild crowding and rotations of the teeth.

The cost of each treatment has a wide range as each patient’s needs are different. The occlusion, the severity of relapse, and the condition of the gums and tissues can all be contributing factors when selecting the type of treatment options.

BANA HOSSEINIAN, DDS, MDS

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CONTINUED FROM PAGE 40

HOW IT’S DONE: •

Local anesthesia and minimally invasive

•

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

BEST CANDIDATES: •

People who are a healthy weight but want to reduce cellulite

•

Those who know treatments won’t completely eliminate cellulite

WORST CANDIDATES: •

Those who are significantly overweight

•

Those who are trying to eliminate fat, not cellulite

•

Those who have excessive varicose veins or other veinrelated illnesses

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

AVERAGE COST: $3,500 –

$6,500*

depending on the size and number of dimples

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

HOW IT’S DONE: •

Local anesthesia for minimally invasive procedures

•

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

BEST CANDIDATES: •

People of any age

•

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

WORST CANDIDATES: •

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

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

AVERAGE COST:

$500 – $3,000*

depending on the size and complexity of the procedure

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

HOW IT’S DONE: •

Local anesthesia with sedation

•

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

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Community Care Connection

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BEST CANDIDATES:

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

The American Board of Plastic Surgery (ABPS) is part of the American Board of Medical Specialties (ABMS). www.abplasticsurgery.org The American Society of Plastic Surgeons (ASPS) members are certified by the American Board of Plastic Surgery and is a terrific resource for consumer information. www.plasticsurgery.org The American Board of Cosmetic Surgery (ABCS) offers a helpful checklist to consumers to vet cosmetic surgeons. www.americanboardcosmeticsurgery.org

Did you know?

The issue is in the connective tissue of fibrous strands (collagen septae) under the skin. If the septae isn’t strong or tightly woven, fat cells bulge between the strands and get trapped in the dermal layer, creating the dreaded orange peel effect. The septae in men is thicker, stronger and more closely knit than in women. Genetics, thinner skin, diminishing estrogen levels and hormonal imbalances also play a role.

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

•

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

WORST CANDIDATES: •

Those who are completely bald

•

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

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

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

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

A B C D

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

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

Where Should You Start?

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

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

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

•

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

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

•

Use a physician with extensive knowledge of facial anatomy and structure when having even non-invasive procedures done. For instance, you may know you want a filler, but do you know the best kind to get? They’re all different and not created equal. Know your stuff before they put it in your face.

The real reason you have cellulite: Cellulite is not “normal” fat. As most women are keenly aware, it’s a formidable opponent that doesn’t respond to diet or exercise. Appearing on nearly 90 percent of women and 10 percent of men, cellulite forms on both thin and overweight people alike.

•

Arming yourself with knowledge will give you the safest, most optimal (a.k.a. natural) results. With laser advancements, new techniques and the boom in effective anti-aging procedures, cosmetic procedures are safer, quicker and more effective than ever before. * 2017 costs published by the American Association of Plastic Surgery EXPERT CONTRIBUTORS Jane Gilley, NP with Inspire MedSpa in Blacksburg Steven G. Harris, MD with Jefferson Surgical Clinic Plastic Surgery in Salem Kurtis E Moyer MD FACS with Professor of Surgery, Virginia Tech Carilion School of Medicine and Chief of Plastic Surgery, Carilion Clinic in Roanoke

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Spring Cleaning Better Health WHAT YOU SHOULDN’T

SWEEP UNDER THE RUG words | KATHARINE PALJUG

No matter how tidy you are, spots in your home

always attract bacteria, fungus, mold, pet dander and more. These microorganisms and allergens can impact your breathing, sleep and overall health. The start of spring is the ideal time for a thorough cleaning of areas in and around your home and other places that you may not always have on your “To-Do” list.

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BATHROOM TOWELS:

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

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

Christina Abraham, MD An allergist with Allergy and Asthma Associates, Inc. in Roanoke.

TOOTHBRUSH HOLDER:

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

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

How to Clean: Wash toothbrush holders weekly, either in the dishwasher or with soap and hot water.

“Mold exposure can be reduced in the home by keeping the humidity low,” explains Christina Abraham, MD, of Allergy and Asthma Associates, Inc. in Roanoke. Running your bathroom fan after baths and showers will keep your bathroom drier.

KITCHEN COFFEE MAKER:

Nearly half of coffee makers have yeast and mold in them, which can make you sick if you ingest them, especially if you have other health problems. “People with immunodeficiency or obstructive lung disorders can get serious lungs infections when exposed to mold,” says Dr. Abraham.

How to Clean: Once a week, put all the removable parts of your coffee maker in the dishwasher. Anything that can’t go in the dishwasher should be wiped down with soap and hot water.

»

SPONGES:

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

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

»

BONUS TIP: Every time you flush the toilet, contaminants such as fecal matter and bacteria fly out. Close the lid before flushing to keep those germs contained.

REFRIGERATOR DRAWERS:

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

How to Clean: Clean refrigerator drawers once a month, either in the dishwasher or by hand with soap and hot water. Wipe with white vinegar to kill bacteria, mold and yeast.

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

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LIVING ROOM REMOTES:

Everyone touches the TV remotes, covering them in food, bacteria and other particles. Many remotes have yeast, mold and Staphylococcus bacteria on them.

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

RUGS AND CARPETS:

“Dust mites are present in carpet and upholstered furniture,” says Dr. Abraham. Rugs and carpets can also trap mold, mud, fungus, pet dander and food.

These exacerbate allergies and breathing problems, cause poor air quality and expose you to germs.

How to Clean: Vacuum rugs and carpets at least once a week. They should also be cleaned yearly with a professional-grade steam cleaner. If you can, keep floors bare to avoid trapping allergens and dirt.

COMPUTERS:

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

Computers also collect dust, pollen and animal dander.

How to Clean: Dust your computer weekly using antibacterial wipes or a damp cleaning cloth with white vinegar to kill bacteria.

Vacuum keyboards regularly.

»

BONUS TIP: Take shoes off before coming inside!

You’ll avoid tracking in mud, pollen, animal feces, and other particles.

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BEDROOM MATTRESSES:

“With dust mites, it doesn’t matter how good of a housekeeper you are, they get in your bedding because their diet it human skin,” explains Aneysa Sane, MD, an allergist at Carilion’s Allergy and Immunology Clinic in Daleville. Mites can be especially irritating if you have allergies, asthma or breathing difficulties like COPD.

How to Clean: Vacuum both

sides of your mattress at least twice a year. Pay special attention to edges and crevices, where dust and dead skin get trapped.

Aneysa Sane, MD

An allergist with Carilion’s Allergy and Immunology Clinic in Daleville.

PILLOWS:

You shed skin, saliva and bacteria every night, and these get trapped in your pillows, along with dust, pollen, pet dander, fungi and mites.

How to Clean: Launder

pillows at least twice a year at 140° F to kill bacteria and mites. As with your mattress, use machine-washable pillow protectors. “Keeping the air dry is important because mold and dust mites love it wet,” says Dr. Sane. She recommends not running humidifiers in the bedroom every night.

“You can get zip covers to enclose your mattress and improve your breathing,” suggests Dr. Sane. These covers zip shut around the whole mattress, box spring or pillows. They should be washed with your sheets.

Christina Abraham, MD is an allergist with Allergy and Asthma Associates, Inc. in Roanoke.

Aneysa Sane, MD is an allergist with Carilion’s Allergy and Immunology Clinic in Daleville.

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How to Clean:

Stuffed animals should be laundered at least once a month and after every illness.

To kill more bacteria and viruses, add white vinegar to the rinse cycle.

»

Expert Contributors

More at OurHealthRoanokeNRV.com

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

BONUS TIP: “Contrary to marketing, there is no such thing as a hypoallergenic pet,” says Dr. Abraham.

Keep animals out of the bedroom, especially if you have allergies or trouble breathing while you sleep.

“It’s always better to practice avoidance of irritants than to take medication,” says Dr. Sane.

If you’re experiencing chronic discomfort or allergies that impact your sleep, breathing or general well-being, start by cleaning your home environment. And if your symptoms persist, talk to your doctor to find out what’s really going on.

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Kids Care INFORM • EDUCATE • GROW

Protecting Young

ATHLETES’

EYES this

Sports Season words | RICK PIESTER

No one needs to be reminded that our vision is precious.

But it’s a frightening prospect that something so precious can be severely damaged — or lost entirely — in an instant.

An estimated 100,000 people suffer eye injuries while playing sports every year, and 13,500 result in blindness. Experts say that 90 percent of all eye injuries can be prevented by the use of proper protective eyewear.

Eye injuries are the leading cause of blindness in kids. When it comes to young people, the American Academy of Ophthalmology says that the most sports-related eye injuries in the U.S. affecting kids ranging in age from 5 to 14 happen while they are playing baseball.

John M. Dovie, OD, an optometrist with Blacksburg Eye Associates, notes that specialized protective eyewear “can prevent 90 percent of sports-related eye injuries, of which more than 10 percent end in permanent damage to vision.”

With baseball season and many other forms of warm-weather sports upon us, Dr. Dovie says that every athlete deserves clear, comfortable vision and safe eyes. “I really think there needs to be a better job done teaching safety and the importance of prevention in our youth sports,” explains Dr. Dovie. “Safety sports eyewear should be standard gear, like a batting helmet.”

What Should a Parent Think About When Looking for Protective Eyewear for a Young Person?

Dr. Dovie says that parents should not be overly concerned that children will be singled out or picked on by wearing protective eyewear. “Many times,” he says, “parents are more concerned about looks than the child is. Protective eyewear for sports is much cooler than it used to be.”

In fact, he says, a quick web search for star athletes wearing sports glasses will show all kinds of famous athletes – Kareem Abdul-Jabbar, Von Miller, and Horace Grant among them. A sports-specific search will bring up many current athletes in baseball, basketball, and golf who wear protective eyewear when playing sports.

Eye injuries are the leading cause of blindness in kids.

When it comes to young people, the American Academy of Ophthalmology says that the most sportsrelated eye injuries in the U.S. affecting kids ranging in age from 5 to 14 happen while they are playing baseball.

90% “Specialized protective eyewear can prevent 90 percent of sports-related eye injuries, of which more than 10 percent end in permanent damage to vision.”

John M. Dovie, OD An optometrist with Blacksburg Eye Associates in Blacksburg

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GROW

Most important, Dr. Dovie says, is to consult with and buy from a reputable seller and buy in person. Make sure the frame fits well, as a frame that is too big or too small may not protect as well.

Blacksburg Eye Associates offers a wide selection of eyewear to fit every need, including an inventory of ANSI-rated safety eyewear, and they offer prescription sports eyewear protection that range from swim goggles to sports glasses for the baseball field. Visit www.blacksburgeye.com/services/optical/our-brands for a catalog of the lines they feature.

8 Tips to Protect Children’s Eyes While Playing Sports

A

All children need protective eyewear regardless of whether or not they wear glasses or contacts.

B

All sports protective eyewear should meet the impact standards of the American Standards for Testing and Materials (ASTM).

C

A wide range of polycarbonate facemasks and guards can be attached to helmets or be worn by themselves.

D

Everyday fashion eyewear is not held to the same protective standards as eye wear products labeled as protective eye wear for sport use.

E

Lenses should be made from polycarbonate materials because they provide the highest level of impact protection and are available in both eyeglasses and sunglasses.

F

Just because a sport requires a helmet or face guard, it doesn’t mean that children’s eyes are protected from injuries.

G

Protective eyewear can be purchased at sporting goods stores as well as eye care providers’ offices.

H

Be sure that sports safety glasses that will be used outdoors also protect the eyes from UV rays.

When selecting protective eyewear, make sure both the frame and the lenses are labeled as safe for sports use – many brand name sports sunglasses can come with impact resistant ‘safety’ lenses, but the frames themselves may not be rated for sports use.

The frames of eye protection for sports should be padded or cushioned along the brow and bridge of the nose. Padding will prevent the eye guards from cutting the skin. And the lenses themselves should be tested and certified for high-impact use, to keep young athletes safe and playing for many seasons to come.

By providing the protective eyewear available and designed specifically for children, and ensuring that the eyewear is worn consistently, parents can help children protect their eyes and establish healthy habits that will last a lifetime. To learn more about choosing the right eyewear to protect your child while playing sports, including choosing prescription protective eyewear, speak with your eye doctor or contact Blacksburg Eye Associates at 540.953.2020 or visit www.blacksburgeye.com.

EXPERT CONTRIBUTOR John M. Dovie, OD is an optometrist with Blacksburg Eye Associates in Blacksburg.

SOURCE The Vision Counsel - www.thevisioncouncil.org

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Specialty Spotlight Series

EAR, NOSE AND THROAT (ENT)

words | JOE BUTLER

Sinus infections are fairly common and anyone who has experienced one knows they can be unpleasant and uncomfortable. Frequent sinus infections can also affect quality of life to the point that chronic sufferers may experience increased anxiety and even depression.

Chronic sinusitis, also known as chronic rhinosinusitis, is a relatively common condition involving recurrent episodes of inflammation of the sinuses, which are the cavities located between your eyes and below your brain. Inflamed sinuses can cause blockages, pressure in your nasal cavity, trouble breathing and general inflammation. As a result, those suffering with chronic sinusitis may feel lethargic, uncomfortable and find the condition difficult to overcome. OurHealth Roanoke and New River Valleys Magazine recently spoke with Gregory Zachmann, MD of Jefferson Surgical Clinic and Paul Lenkowski, MD, PhD of Roanoke Valley ENT and Allergy to learn more.

What are some possible causes of sinusitis?

A concrete way to approach sinus disease is to think about anatomy and inflammation. Anatomy refers to the structure of your sinuses, your sinonasal anatomy. Anatomic abnormalities can contribute to sinonasal symptoms.

Narrow openings, abnormal structures, scarring and polyps are all examples of these symptoms.

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EAR, NOSE AND THROAT (ENT)

Inflammation, which can be caused by your body’s response to your environment, can result from many causes, perhaps chronic bacterial or fungal infections. Allergic inflammation, or allergies, also can play a big role in sinonasal symptoms.

What are some possible risk factors of chronic sinusitis?

Cases can vary from person to person, but if you are uncomfortable or bothered by your symptoms, it’s time to see an expert. Common environmental and physical conditions may cause recurrent sinusitis, such as allergens or nasal abnormalities including polyps.

Paul Lenkowski, MD, PhD An ENT specialist with Roanoke Valley ENT and Allergy.

Speaking with a doctor about your symptoms is your best option. He or she can provide a comprehensive evaluation of all conditions that may contribute to your sinus problems.

CAN ENVIRONMENT PLAY A ROLE? Pollution, smoking and infections contribute to sinus disease. Chronic infections can be caused by pathogens (viruses, bacteria and fungus), an ineffective immune system or both. Genetics play a big role and can predispose people to sinus problems.

Gregory Zachmann, MD An ENT specialist with Jefferson Surgical Clinic.

What are other possible causes of chronic sinusitis?

Another cause could be allergies, including pollen and pet dander. Year-round exposure to allergens such as dust, molds or other elements in our environment should also be assessed. When sinusitis symptoms persist and physical blockages or polyps are not the underlying cause, allergy testing is called for.

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Is sinusitis connected to depression?

A recent study published by the Journal of American Medical Association, or JAMA Network, found increased incidences of depression and anxiety associated with chronic rhinosinusitis and patients with nasal polyps.

When you consider the impact sinusitis has on quality of life, it may not surprise you that this condition has the potential to impact lives similarly to chronic pain and other major disorders.

Patients who constantly battle blocked nasal passages, colds and infections cannot breathe effectively and are prone to losing sleep. The misery of sinus disease certainly does not improve our mood. While it is true that chronic sinusitis and depression and anxiety are related, this does not mean that sinusitis causes depression or vice versa.

Can treating sinusitis help depression?

If treated properly, relief from chronic sinusitis may help alleviate symptoms of depression or anxiety associated with this condition. Treatment will improve your quality of life and this can improve mood and outlook. Many patients feel that sinus therapy can give them a new lease on life. Be sure to tell your sinus surgeon how your sinus problems impact your quality of life.

WHEN SHOULD I SEE AN ENT SPECIALIST FOR SINUSITIS? A primary care doctor may recommend simple treatments or prescribe antibiotics. However, if these procedures have no effect, it may be time to make an appointment with an ear, nose and throat (ENT) specialist who can provide physical relief with surgery or symptomatic relief via identification and treatment of allergies.

What happens at an ENT visit?

Your first visit with an ENT should involve a thorough review of your symptoms to identify when sinusitis symptoms flare up to try and narrow the cause of the condition.

How is sinusitis diagnosed?

A diagnosis can be made through a physical examination, review of history and other testing. One procedure is a nasal endoscopy, which involves looking inside the nose with a tiny camera to look for abnormalities. If we identify polyps or badly blocked sinuses, and you have not responded to medicine or treatments, we can also use a special X-ray called a CT scan to see inside the sinuses CONTINUED ON PAGE 62

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ASK THE EXPERT

GREGORY C. ZACHMANN, MD JEFFERSON SURGICAL CLINIC 1234 Franklin Road | Roanoke, VA 24016 |

c 540.283.6000 | w www.jeffersonsurgical.com

How do I know whether my symptoms are related to chronic sinusitis or are caused from allergies?

Chronic sinusitis is a relatively common condition involving recurrent episodes of inflammation of the sinuses (the cavities around your nasal passages.)

Inflamed sinuses can cause blockages, pressure in your nasal cavity and trouble breathing.

Cases vary from person to person, but if you are uncomfortable or bothered by your symptoms, it’s time to see an expert. Some cases are related to lingering infections due to a patient’s unique nasal anatomy, while others could be caused by allergies.

In either case, speaking with a doctor about your symptoms is your best option. Your family doctor may recommend simple treatments or prescribe antibiotics. However, if these procedures have no effect, it may be time to make an appointment with an ear, nose and throat (ENT) specialist. An ENT can provide physical relief with surgery or symptomatic relief via identification and treatment of allergies.

Your first visit with an ENT should involve a thorough review of your symptoms to identify when sinusitis symptoms flare up to try and narrow the cause of the condition.

Following this review, your ENT may physically examine the nose passages with a scope.

If we identify polyps or badly blocked sinuses, and you have not responded to medicine or treatments, we may need a CT or CAT scan to produce a 3D model of your sinus compartments for further clarity. If the scan results appear significant and you need surgery, we’ll then use the 3D model from the CAT scan and an image guidance computer to navigate to the precise location of the blocked nasal cavities during endoscopic sinus surgery.

When sinusitis symptoms persist and physical blockages or polyps are not the underlying cause, allergy testing is called for. Common allergies including pollen and pet dander may be factors, however, year-round exposures such as dust, molds or other elements in our environment should also be assessed. Allergy treatments involve exposing a patient to their allergens to condition the body, boost tolerance and reduce symptoms. Often, these are delivered via injections, however, I was the first in the region to introduce Sublingual Immunotherapy (SLIT). SLIT eliminates the need for injections by delivering small doses of allergens via a spray under the tongue and can be administered by patients in their homes.

Every patient has a unique cause for their sinusitis, therefore the solutions used are tailored to the individual patient. The good news is that the majority of patients we treat can get better. I have a particular interest and passion for treating chronic sinusitis and have made it a focus of my practice. Why? Because I’m interested medically, but personally, I enjoy seeing patients find relief and improve their overall quality of life.

GREGORY C. ZACHMANN, MD

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EAR, NOSE AND THROAT (ENT)

CONTINUED FROM PAGE 60

and to look for structures that might contribute to sinus disease. Then we review this with patients showing them their anatomy and what may be causing their symptoms and where it’s located. People find this very enlightening. Make sure your sinus surgeon shows you the images of your CT scan so you too can see your own sinuses.

WHAT ARE SOME TREATMENT OPTIONS? Initially, chronic rhinosinusitis is treated with medical therapy. This can include nasal therapies, nasal lavage, antibiotics and treatment of underlying allergies and other contributing conditions. When a person continues to have symptoms despite medical therapy, or if they cannot or will not tolerate medical therapy, other procedures can be considered, including Functional Endosocopic Sinus Surgery, or FESS.

What is Functional Endosocopic Sinus Surgery?

This is a commonly performed procedure which can be performed to improve ventilation of the sinuses and remove nasal polyps if present. The nasal airway can be improved as well.

Be sure to inquire about medical and other therapies before considering surgery. Your sinus surgeon should be able to treat all aspects that contribute to your sinus problems.

What are some of the popular myths and misconceptions about sinusitis?

SINUS SURGERY IS HARD ON PATIENTS. This was once true. Today, specialists can

perform sinus procedures in an office much like visiting your dentist. The technology available to ENT specialists has developed rapidly and allows for minimally invasive surgeries that can be nearly painless and effective.

SINUS SURGERY IS ONLY DONE IN HOSPITAL OPERATING ROOMS. Today, most sinus

surgeries can be safely performed in an office as an outpatient procedure, which results in lower costs, faster recovery time and less downtime from work and other activities. Often, minimally invasive techniques can relieve sinus symptoms in a single afternoon.

SINUS PROBLEMS ARE NOTHING TO WORRY ABOUT. This is especially not true:

chronic sinusitis can significantly impact your quality of sleep, your physical activity ability and many other day-to-day activities that otherwise promote a healthy quality of life.

Patients who constantly battle blocked nasal passages, colds and infections cannot breathe effectively and are prone to losing sleep. The misery of sinus disease certainly does not improve our mood. While it is true that chronic sinusitis and depression and anxiety are related, this does not mean that sinusitis causes depression or vice versa.

There is no benefit to “coping”. If someone is bothered by sinusitis, they should talk with their primary care provider and determine if seeing an ENT is required. Putting off treatment only belabors an already draining condition.

Any other advice for those who may be suffering from chronic sinusitis?

Every patient has a unique cause for their sinusitis, and solutions should be tailored to the individual. The good news is that the majority of patients can get better. New technology and treatment solutions provide increased success for patients in their recovery.

EXPERT CONTRIBUTORS Paul Lenkowski, MD, PhD, Roanoke Valley ENT and Allergy.

Gregory C. Zachmann, MD, Jefferson Surgical Clinic.

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Specialty Spotlight Series

ALLERGY, ASTHMA AND IMMUNOLOGY

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

There’s a good chance that you have allergies or know someone who does. In the U.S., more than 40 percent of children and 30 percent of adults now suffer from the condition, and it appears this trend is on the rise.

“Allergies in general are increasing,” says Saju Eapen, MD, who practices at Asthma and Allergy Center in Roanoke. “And both food and environmental allergies in adults are increasing.” Medical experts can’t point to exactly why this is the case, but some potential causes may be attributed to excessive hygiene and early antibiotic use. Called “The Hygiene Hypothesis,” it’s when the immune system is not exposed to many infectious agents, and thus doesn’t have the chance to build up an immunity. It looks for something else to do, and allergies may result.

While research continues, there’s good news: most environmental allergies can be managed with environmental control, medication and desensitization with allergy shots.

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

“Food allergy has increased the past few decades,” says Christina Abraham, MD, of Allergy and Asthma Associates, Inc. in Roanoke. “A decade ago, alpha-gal red meat allergy was unheard of. Now it is very prevalent.” This allergy is caused by tick and possibly chigger bites, and it creates a delayed allergic reaction after eating beef, pork, or lamb meat.

Food Allergy Symptoms

Nausea, vomiting, diarrhea, constipation, and hives or swelling are common symptoms.

Hives, as well as swelling around the eyes, lips, hands and feet – a condition called angioedema – may be a sign of an allergic reaction. In more severe cases, the swelling can involve the tongue, back of the throat (causing trouble swallowing) or the larynx (cutting off breathing). This can progress to anaphylaxis where there is also a shock-like state with a rapid heartbeat and low blood pressure. These more severe reactions are considered medical emergencies and should be treated immediately in the emergency room, then followed up with a visit to an allergist.

Saju Eapen, MD

An allergist with Asthma and Allergy Center in Roanoke.

“In the under age five group, eczema is often caused by food allergies,” adds Dr. Eapen. “When we see children with chronic eczema, it’s really important to do food allergy testing.” www.OurHealthRoanokeNRV.com

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ALLERGY, ASTHMA AND IMMUNOLOGY

Diagnosing Food Allergies

What’s the Hygiene Hypothesis?

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

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

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

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

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

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

The American Academy of Pediatrics (AAP) advises introducing new foods to babies one at a time and watching for allergic reactions.

Though the AAP used to recommend delayed introduction of highly allergenic foods, such as peanuts, new guidelines recommend early exposure to reduce food allergies.

“If you need to take epinephrine, you should always go the emergency room,” affirms Dr. Eapen. “Don’t take Benadryl first as it takes about 30 minutes to start working. You need epinephrine that works in immediately if you can’t breathe.”

ENVIRONMENTAL ALLERGIES “For environmental allergies, we are seeing a lot more people,” Dr. Abraham says. These allergies include pollen, dust mites, mold and animal dander. Synthetic air fresheners and cleaning sprays can also sometimes cause reactions as some contain harsh chemicals that irritate the eyes, throat and nasal passages, however this is due to an irritant response and not an allergic response.

Environmental Allergy Symptoms Runny nose, itchy eyes, throat or ears, sneezing, coughing, wheezing or asthma can all be symptoms of environmental allergies.

Diagnosing Environmental Allergies Allergists use skin tests to check up to 40 allergens at once. Your doctor will prick areas of the skin with different substances and watch for a reaction, which appears in 15-20 minutes and looks like a hive. These are sometimes followed by intradermal tests to double-check prick test negatives.

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

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People who have dust mite or mold allergies need to go the extra mile when it comes to cleaning. Vacuum frequently, clean or replace air filters monthly and wash sheets and towels at least once a week in very hot 130-degree water. You’ll also need to protect your bed from dust mites with a pillow protector, full mattress encasement and box spring encasement – ones that are made with fabric of a very tight weave, as three dust mites are small enough to fit end-to-end across the eye of a fly. It is also helpful to keep humidity levels between 37 percent and 50 percent as molds and dust mites thrive in humid conditions.

Cleaning for Dust Mites and Mold Allergies:

VACUUM FREQUENTLY

When Should You See an Allergist?

For children, Dr. Eapen recommends that parents watch how their child breathes. “A lot of times kids, when they’re two or three, they’ve always felt that way and don’t know how to say something’s wrong,” he explains. “If a child always has to breathe through their mouth at night, that’s a sign of chronic nasal congestion, which is usually due to allergies.”

You should always see a doctor quickly if you experience trouble breathing or angioedema.

ALLERGY, ASTHMA AND IMMUNOLOGY

“When OTC medications, such as antihistamines or nasal steroids, are not working then I recommend you see a specialist,” Dr. Abraham says. “Also, when allergies are starting to interfere with work or school.” Your doctor also may prescribe stronger antihistamines, an inhaler, or allergy shots, which train your immune system to stop responding to allergens.”

CLEAN OR REPLACE AIR FILTERS MONTHLY

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

MEDICATION ALLERGIES “Medication allergies are more common in the elderly because they’re on more chronic medication,” says Dr. Eapen. In children, the most common allergy is to penicillin and related antibiotics, including amoxicillin. However, many adults outgrow allergies to antibiotics that they have not been exposed to for a long time.

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

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

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

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

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

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

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

What is an Intradermal Test?

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

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ALLERGY, ASTHMA AND IMMUNOLOGY

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

Asthma and Eczema Symptoms

“The risk of developing asthma is higher in children with eczema.”

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

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

Managing Asthma and Eczema Christina Abraham, MD An allergist who practices at Allergy and Asthma Associates, Inc. in Roanoke.

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

Asthma is treated with an inhaler or nebulizer. Most patients with asthma need inhaled corticosteroids or inhalers that combine corticosteroids with bronchodilators. These should be administered every day as a preventative measure for all asthma patients that have asthma episodes more than two times per week during the day or more than two times per month during the night. Those who have only mild intermittent asthma can be treated with an as needed albuterol inhaler. There are asthma controllers, which are usually inhaled corticosteroids or Singulair, and asthma relievers – usually albuterol, a bronchodilator. “Both are necessary,” says Dr. Eapen. “The relievers or “rescue inhalers” are for acute asthma which is not being controlled by the preventative medication.”

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

You should always see a doctor if you have trouble breathing or a rash that won’t clear up. Once you do, your doctor may refer you to an allergist for additional testing, because many people who have one of these conditions also have allergies.

No matter the cause of your symptoms, seeing a doctor is the first step towards managing them and finding relief. With the treatment options available today, no one should feel they must live in discomfort. Break free from the burden allergies, asthma or eczema may be causing you, and start feeling better than you ever imagined you could.

Expert Contributors Christina Abraham, MD is an allergist who practices at Allergy and Asthma Associates, Inc. in Roanoke.

Saju Eapen, MD is an allergist who practices at the Asthma and Allergy Center in Roanoke.

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ASK THE EXPERT

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

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

c 434.515.0419

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

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

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

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

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

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

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

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

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

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

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

LUIS MATOS, MD, MBA, FAAAAI, FACAAI

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Specialty Spotlight Series

GASTROENTEROLOGY

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

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

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

“People hear about possible complications or side effects of the bowel preparation, or they’re afraid to be put to sleep, or they don’t like the idea of the procedure,” says Christopher Mertes, MD, a primary care doctor at Carilion Clinic Family Medicine in Blacksburg. He frequently discusses concerns about colon health with his patients, and in many cases, he’s the doctor who first brings up scheduling a colonoscopy. “For people who aren’t exposed to the medical system every day, it feels very invasive.”

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

Myth #1

You’ll Have Diarrhea the Entire Day Before

The prep for a colonoscopy is easier than you might imagine. To clear the bowels, doctors give you two doses of a laxative, which are consumed in two different stages. Patients having a morning procedure can prep the night before, then consume only liquids until the colonoscopy is done. For an afternoon procedure, many people have a normal morning, then start preparing before lunch.

“I encourage everyone to have a colonoscopy. I had one myself recently, which I think is the best advertisement for getting one done.”

Dario Sorrentino, MD A gastroenterologist with Carilion Clinic in Roanoke.

“During the bowel prep, you have to be home because you have to be close to a toilet,” explains Dario Sorrentino, MD, a gastroenterologist with Carilion Clinic who performs colonoscopies at multiple locations in the Roanoke region, including Carilion’s Riverside gastroenterology facility. But that doesn’t mean you spend all night in the bathroom. Most patients are able to get a good night’s sleep, then take their second dose in the morning.

Myth #2

It’s Going to be Awkward and Uncomfortable

Getting a colonoscopy is no more awkward than a visit to the dentist – and for many people, less uncomfortable than having their teeth cleaned. On the day of your colonoscopy, you’ll meet your medical team, including the anesthesiologist and www.OurHealthRoanokeNRV.com

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GASTROENTEROLOGY

nurses, and will be provided a private space to change into a gown. Only necessary medical staff will be in the room during the procedure.

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

Afterwards, you’ll be taken to a recovery room while you wake up from the anesthesia.

Once you’re awake and dressed, your doctor will sit down with you to discuss any findings and follow-up steps.

“In general it is very safe and comfortable,” Dr. Sorrentino says.

Myth #3

You Don’t Have Time To Get One

A colonoscopy takes 20 to 30 minutes, and most patients need another 15 to 30 minutes to wake up from sedation. Even with time to talk with the doctor afterwards, most patients are out of the office in under four hours.

“Usually a few hours after the procedure is done, you are feeling good. But we do recommend as a matter of precaution that the patient takes the day off, that you stay home and relax,” says Dr. Sorrentino. You’ll need to avoid driving or drinking alcohol for 24 hours after anesthesia, but you will be able to go back to eating a normal diet right away.

“Once you wake up from the procedure, most people feel wonderful,” Dr. Sorrentino adds. “Very rested, very relaxed.”

“The thing about colon cancer is that many, many people are completely asymptomatic until it’s become a life-threatening cancer. And for the majority of colon cancers, if we catch them early enough, potentially before it even becomes cancer, we can add so many years onto your life.”

Myth #4

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

A few people react to the sedation, either during the procedure or with some sickness afterwards. But that’s uncommon. If the doctor removes a precancerous growth, called a polyp, there’s a risk of bleeding afterwards. This tends to be minimal and ends quickly. The most serious risk is a perforation in the colon from the procedure itself, which can cause pain and further complications. “It’s rare that people have perforations, especially if they’re healthy,” explains Dr. Mertes.

In fact, you’re more likely to develop colon cancer as a result of not having a colonoscopy than to experience complications from having one.

“Colon cancer is a very frequent disease in Western societies,” says Dr. Sorrentino. “Each one of us has a lifetime risk of nearly six percent, which is very high.” That’s just over one out of every 20 adults. The risk of significant complications from a colonoscopy, by contrast, is closer to one out of 1000.

Myth #5 Christopher Mertes, MD A primary care doctor at Carilion Clinic Family Medicine in Blacksburg.

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It’s Too Risky

You don’t need one if you feel fine

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

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

“The thing about colon cancer is that many, many people are completely asymptomatic until it’s become a life-threatening cancer,” Dr. Mertes explains. “And for the majority of colon cancers, if we catch them early enough, potentially before it even becomes cancer, we can add so many years onto your life.”

Current healthcare guidelines recommend that most patients get colonoscopies by age 50, though some groups with higher risk levels should have them earlier. African Americans and anyone with inflammatory bowel disease should talk to their doctor by age 40 about when to get a colonoscopy.

READ THIS EDITION OF

“You also want to screen earlier if someone has a primary relative who has had colon cancer,” says Dr. Mertes. “Either 10 years before the age that they had cancer or by 40.”

OurHealth Roanoke & New River Valleys ON YOUR TABLET OR SMARTPHONE

If getting a colonoscopy is difficult due to your location or work schedule, there are tests that can use stool samples to screen for signs of colon cancer. These are done at home, then mailed to a lab for diagnosis. But while it is better to do a home screening than none at all, colonoscopy is considered the gold standard.

“I encourage everyone to have a colonoscopy,” Dr. Sorrentino adds. “I had one myself recently, which I think is the best advertisement for getting one done.”

ON THE WEB

Expert Contributors Christopher Mertes, MD is a primary care doctor at Carilion Clinic Family Medicine in Blacksburg.

Dario Sorrentino, MD is a gastroenterologist with Carilion Clinic in Roanoke.

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HEALTHY OBSERVATIONS APRIL | NATIONAL CHILD ABUSE PREVENTION MONTH

EMPOWERING MOTHERS TO

OVERCOME Substance Use Disorders words | JEREMY BUTTERFIELD photography | AMY PEARMAN, BOYD PEARMAN PHOTOGRAPHY

This is a real story. And there are many like it.

Lost and afraid, when Stephanie*, from Roanoke, discovered she was pregnant with her third child, she was living in a car and suffering from crippling depression over her substance use disorder and the loss of her other two kids to foster care.

Terrified to make a change for fear of the unknown, Stephanie credits her third child with being the catalyst that reunited her family. “She saved my life and she brought my other two children back home. If it wasn’t for her, I would have never gotten clean. It’s hard, but it’s worth it.”

With the help of Project LINK, Stephanie found a group of diverse women sharing stories of common struggles. She found a community and a newfound resolve to seek treatment. Now, more than one year sober, Stephanie takes pleasure in the small things. Bath time. School pickups. Even temper tantrums. “That’s the life I love having. I don’t miss anything about my old life. This is where I need to be. This is where I belong.”

Stephanie’s story is not unique. Thousands of mothers throughout the nation experience substance abuse disorders. But no matter their location or situation, there is one commonality that unites them all. Motherhood. Mothers are strong. Mothers are resilient. Mothers care deeply and love naturally. They make the hard choices for the good of the little lives in their care.

Mother Up is a project of Children’s Trust, an organization whose mission is to prevent and reduce the occurrence and trauma of child abuse and neglect. With support from Carilion Clinic, Virginia Department of Social Services, and Community Based Child Abuse Prevention Program, www.Mother-Up.org launched on April 1, 2019 to provide mothers overcoming substance use disorders an online resource for treatment and counseling options in our region. The goal; facilitate recovery by ensuring area mothers know they are not alone.

Cases of Neonatal Abstinence Syndrome in Southwest Virginia Increased 31% in 2017

What is Project LINK? Project LINK provides intensive case management and home visiting services to pregnant and parenting women who are “at risk” or are currently abusing substances. The Department of Behavioral Health and Developmental Services (DBHDS) funds eight Project LINK sites in Virginia. Each site is affiliated with at least one community service board and provides services to pregnant and parenting women and their families that live within the community served by that community service board.

SCAN THE QR CODE PROVIDED to visit www.dbhds.virginia.gov/ library/substance%20abuse%20 services/project-linkcontacts-february2017doc.pdf for listings and contact information.

Neonatal Abstinence Syndrome (NAS) occurs in a newborn who was exposed to opiate drugs while in the mother’s womb and is now facing withdrawal symptoms. Although NAS www.OurHealthRoanokeNRV.com

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APRIL | NATIONAL CHILD ABUSE PREVENTION MONTH

is associated the most with opiate drugs, babies exposed to alcohol and other drugs can also have symptoms of withdrawal. According to the Virginia Hospital & Healthcare Association, the total number of NAS hospitalizations in Virginia increased from 741 in 2016 to 819 in 2017, a nearly 11 percent increase in one year. In Southwest Virginia, NAS cases increased 31 percent in 2017.

Mother-Up.org launched on April 1, 2019, the first day of National Child Abuse Prevention Month

child abuse and neglect, while promoting the social and emotional well-being of children and families.

If you are pregnant and have an addiction, you can have a healthy pregnancy and strong baby. When it is managed with medication and counseling, you gain the ability to focus on recovery for you and the proper care for your baby. Mothers don’t have to take this journey alone. There are people in our community who are ready to be your advocate and guide.

Seeking help can be confusing, uncomfortable and sometimes scary.

But the benefits of treatment outweigh the risks. “Mother Up means taking responsibility for your life and being the great mother you know you can be for your children,” explains Stephanie. “Do it for yourself, but do it for your children because those little lives need you. I think mothers just need to know there is help out there.

There is support.”

Recognizing the need to address this increase and curb its upward trend, Mother Up creators organized a series of focus groups and calls with area providers, substance abuse counselors, medical professionals and mothers in recovery. What they found Scan the QR Code Provided to Visit was a missing link in the road to recovery. www.Mother-Up.org Treatment and counseling programs were available, but there needed to be one central clearing house for these Stephanie is ONE TOUGH MOTHER. resources to facilitate mothers experiencing an alcohol or drug problem to find the treatment that was right for them and take the next step. there are many more just like her.

Mother-Up.org launched on April 1, 2019, the first day of National ON THE WEB Child Abuse Prevention Month. The monthlong focus highlights the More at OurHealthRoanokeNRV.com importance of families and communities working together to prevent

And

Resources for Mothers

For more information about Mother Up, visit www.mother-up.org or contact any of the available local resources listed below.

Project LINK at Blue Ridge Behavioral Healthcare

ARCH Bethany Hall

Project LINK is a program for pregnant women and women with children under five who seek help. Call 540.266.9200 and ask to be connected with Susan Shirley (ext. 3275) or Patricia Spangler (ext.3223).

In operation for the last 45 years, Bethany Hall is a residential substance abuse treatment program in Roanoke for women, pregnant/postpartum women, and child welfare involved women in recovery from drugs and alcohol offering a holistic approach to recovery, while providing a supportive and healing treatment environment.

www.brbh.org/adult

Avenues to Wellness

www.avewell.com/services/ substance-abuse-counseling Avenues offers substance abuse assessment and counseling to adolescents, adults and their families.

Children’s Trust: Healthy Families

www.roact.org/programs/ healthy-families Healthy Families Roanoke Home Visiting Program helps parents with the changes in their lives that come along with pregnancy and the birth of a child.

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www.archservices.org/ treatment.html

Carilion Clinic Psychiatry & Behavioral Medicine

www.carilionclinic.org/locations/ carilion-clinic-psychiatrybehavioral-medicine-roanoke Carilion’s team of psychiatrists, therapists and behavioral specialists help patients with mental health and chemical dependency issues by offering adults and adolescents both outpatient and inpatient care at specialized facilities in Southwest Virginia.

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HEALTHY OBSERVATIONS MAY | NATIONAL STROKE AWARENESS MONTH

What Exactly Causes a

Stroke? words | RICK PIESTER

In a way, there is no such single thing as “a stroke.”

That’s because strokes are infinite in their variety, in their causes, in their severity, and in the amount of damage they cause.

But there are some constants: Strokes are very common in older Americans. In fact, the reason that two-thirds of people over 65 are hospitalized are because of a stroke. Strokes are a major cause of death and long-term disability among elderly people; they are the leading cause of disability and the third leading cause of death.

Strokes themselves fall into two broad categories:

Many stroke survivors can return to self-sufficiency over time, but 25 percent are left with a minor disability and 40 percent experience moderate-tosevere disabilities.

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A

Ischemic Stroke: Ischemic strokes involve the blood clotting in a dangerous way

B

Hemorrhagic Stroke: Hemorrhagic strokes are caused by the sudden and violent

that blocks arteries and halts the flow of blood to the vital organs, including the brain. These type of strokes are the result of a buildup of fatty material or cholesterol in the blood vessels. The clots break away and starve the brain of blood.

breaking of a blood vessel near the brain, called a hemorrhage. High blood pressure and aneurysms (weak spots along the walls of a blood vessel) are among some of the known causes of this type of stroke.

People who suffer an ischemic stroke have a higher survival rate, compared to those who have a hemorrhagic stroke. But older people who survive a hemorrhagic stroke have a higher rate of regaining normal function over time.

Medical Attention Immediately Following a Stroke is Essential Two overwhelmingly important factors in stroke survivability are how soon a person suffering a stroke gets medical attention, and how quickly the person begins a program of rehabilitation designed for the type and severity of the stroke he or she has suffered.

And a third important factor in stroke survivability is a person’s physical condition pre-stroke, according to Taressa Gibson-Hurd, OTR/L, a Roanoke Valley occupational therapist.

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Know the Signs of Stroke Taressa, a member of the skilled rehabilitation staff at Our Lady of the Valley retirement community in Roanoke, notes that seniors who walk regularly, work around the house, take care of themselves, and try to stay healthy in general have a much higher chance of surviving a stroke without major long-term disabilities.

Taressa also notes that a notable difference lies in the way that older patients respond emotionally to a stroke, particularly older people who face a long, and sometimes painful, rehabilitation.

In her work with younger patients who have sustained brain injuries, Taressa says that a long, slow period of recovery can produce feelings of depression, even suicide. But in older patients, a long, frustrating slow recovery can lead to tendencies to simply “give up,” or to decide to stop their rehabilitation, thinking “I’ve had a long life, what’s the point of all this work and effort if I’m old anyway?”

Rehabilitation experts agree that the best approach in this case is to help the patients express their feelings of frustration, making sure the older patient eats healthy food, and encouraging them to stick with their work on the road to recovery.

ON THE WEB

About 93 percent of people who responded to one respected survey recognized that numbness on one side of a person’s body could signal a stroke. But in the same survey, only 38 percent of respondents could recognize all major stroke symptoms, and knew to call for medical help (9-1-1) when someone was having a stroke.

That’s why the American Heart Association and the American Stroke Association encourage everyone to remember the acronym F.A.S.T. (Facial weakness, Arms, Speech and Time). Paralysis of the face, an inability to keep one’s arms level and slurred speech are all telltale signs that a person is having or is about to have a stroke. The last point – time – is perhaps the most important; a delayed response for medical attention could lead to permanent disability.

Many strokes give no warning signs. For more detailed information, here are signs and symptoms of an oncoming or ongoing stroke: Numbness, weakness or tingling in the face, arm or leg–specifically on one side of the body

Dizziness and loss of balance

Changes in vision, including double vision, blurred vision or loss of vision in one or both eyes

Loss of coordination or consciousness

Difficulty with speech or inability understand when being spoken to

Drowsiness or lack of energy

Confusion; Problems with judgment, memory, spatial orientation or perception

Visible mood swings

Severe, sudden headache, paired with pain between the eyes, in the face or a stiff neck, and vomiting or altered consciousness

Difficulty swallowing

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Our Lady of the Valley Rehabilitation Services 650 North Jefferson Street | Roanoke | 540.345.5111 | www.ourladyofthevalley.com/rehab SULLIVAN CENTER AT OUR LADY OF THE VALLEY: SKILLED REHABILITATION The Sullivan Center at Our Lady of the Valley offers short-term care and rehabilitation services, whether due to an injury or surgery. Their physical, occupational, and speech therapists and around-the-clock nurses help individuals get back to 100 percent as quickly as possible. Individuals receiving inpatient care have access to all that Our Lady of the Valley has to offer including three daily meals in the Sullivan Center dining room, friendly social interaction, planned activities and comfortable surroundings. Residents at Our Lady of the Valley also receive priority admission to the Sullivan Center if they should require recovery assistance before returning to their apartment.

HEALTH & WELLNESS THERAPY CENTER: The on-site Health & Wellness Therapy Center at Our Lady of the Valley was upgraded in a recent expansion project to provide additional space and therapy equipment to better serve the residents and rehabilitation guests. The expert team of Genesis Rehab Services – their on-site therapy provider – helps get residents back on their feet, whether they need physical, occupational or speech therapy.

Lauren Ware, Community Relations Coordinator | Karen Jones, Marketing and Admission Director | Michele Crigger, Director of Admissions & Resident Relations

HEALTHY OBSERVATIONS

PICTURED BELOW: Mark Skelton of Roanoke

MAY | BETTER HEARING AND SPEECH MONTH

When

HEARING LOSS Stopped the MUSIC words | RICK PIESTER

A condition that often leads to hearing loss cost Mark Skelton his ability to clearly hear the sweet sounds of music he so loves. But thanks to advancements in hearing aid technology, the beat is back on.

Some 25 years ago, Mark Skelton of Roanoke was diagnosed with Meniere’s disease, a disorder of the inner ear that often leads to hearing loss.

Now 58, the Roanoke-based clinical engineering manager had always been an avid music fan — jazz, some blues, and 60s rock among his favorites.

But when his hearing loss progressed to the point that he needed hearing aids, Skelton was disappointed in the way he heard his beloved music. “The hearing aids didn’t allow me to experience the full frequency response of music,” he says. “I couldn’t hear the lower frequencies (the bass notes) in the music. I could pick up a speaker and feel the bass, but I couldn’t hear it.”

That’s because music reproduction has always been a knotty problem for those who work with people who have suffered hearing loss — audiologists and manufacturers of hearing aids — notes Roanoke audiologist Michelle Ickes, PhD. Dr. Ickes, director of audiology at the nonprofit Roanoke Valley Speech and Hearing Center in Roanoke, says that for many years, hearing aid users and manufacturers alike have considered the ability to hear speech as their top priority.

Michelle Ickes, PhD

An audiologist with Roanoke Valley Speech and Hearing Center in Roanoke

There’s a Difference Between Speech and Music

If it were plotted on a piano keyboard, we would hear speech at sound frequencies beginning at about “middle C” and running above. Much of music, by contrast, runs beginning at “middle C” and below, in the lower frequencies of soundwaves. So speech and music are different creatures audiologically speaking, and music hasn’t always been part of the process of hearing aid design.

Music and speech are each processed in different parts of the brain, Dr. Ickes says, and a onesize-fits-all approach simply did not suit.

During the past decade, however, hearing aid manufacturers —Widex and Starkey among them — have responded to demands by musicians and music lovers by conducting research and designing hearing aids that would reproduce speech as well as give hearing aids users a true-to-life music listening experience.

Roanoke Valley Speech and Hearing Center 2030 Colonial Avenue 540.343.0165 | Roanoke www.rvshc.org OFFICE HOURS: Monday – Thursday, 8 am – 5:30 pm and Fridays from 8 am – noon.

SPECIALTIES/SERVICES: Speech langue pathologists who evaluate, identify and treat individuals of all ages with communication disorders, delays and disabilities ASHA certified and state licensed audiologists who provide diagnostic hearing testing, hearing aid dispensing, hear aid trouble shooting and auditory processing disorder testing for individuals of all ages.

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MAY | BETTER HEARING AND SPEECH MONTH

A beneficiary of those efforts, Dr. Ickes recently fit Skelton with a new set of Widex hearing aids that includes a separate setting for music. They’ve opened up a new aural world for him.

“I was amazed at what I was missing in music,” he says now. “I was missing that bass and the full scope of music. Now that I have these new hearing aids, I’m anxious to hear artists I’ve never tried listening to before.”

Wi dex Pro

Hearin g Aid

Do I Have a Hearing Problem?

Some Telltale Signs

As many as one in every five Americans have some level of hearing loss. Roanoke audiologist Michelle Ickes, Ph.D., says there are a few giveaways. “One way to tell,” she says, “is when someone cranks up the volume, the bass or the treble on the car radio, or on an audio equalizer at home. A fairly ‘flat’ response should be all that anyone needs. Another way is if someone is always asking others what they said, or thinks that those around him or her are always mumbling. Another telltale sign is reporting a constant high-pitched ringing sound or hissing in the ears. Any of those things should send you for professional help.

Other signs to look for,

according to the Hearing Loss Association of America, would be if you: Have difficulty on the phone Have trouble following the conversation in groups Frequently turn up the volume on the TV or car radio Oversleep because you didn’t hear your alarm clock Have difficulty hearing or understanding speech at the movies

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Avoid going to noisy parties and restaurants

His particular type of hearing loss enables him to now wear behind-the-ear hearing aids that hook over the top of his ear, with a wire that connects the hearing aid to a custom-made earpiece containing the loudspeaker that fits into his ear canal. Two small microphones in the piece behind his ear collect and digitize sound, adjusting the sound based on Mark’s needs, and feeds the sound to speakers in his ear canal.

Mark is also anxious to return to live musical performances, and, he says, he feels his family is noticing his improved hearing in general, in addition to his greatly enhanced joy from music.

Cochlear Implants Have Become More Music Friendly Too

Newer on the scene are refinements in cochlear implants specifically for music lovers and musicians. This involves surgery to implant a receiver under the skin behind the ear, connected to electrodes in the cochlea, a spiral-shaped tube in the inner ear that contains thousands of nerve endings whose job it is to carry sound to the brain. When the surgery has healed, the receiver is connected to an external microphone/processor that feeds the sound to the implant.

Cochlear implants (“CI” for short) were a gamechanger with regard to allowing people with hearing impairments to decipher speech. But they left a lot to be desired when it came to music.

“I was amazed at what I was missing in music.

I was missing that bass and the full scope of music. Now that I have these new hearing aids, I’m anxious to hear artists I’ve never tried listening to before.”

Dr. Ickes notes that CIs contain only 22 tiny electrodes to transfer sound, compared to the thousands of nerve endings in the healthy ear, excellent for speech, but way below par for music. Listen to a simulation of music through a cochlear implant from several years ago, and - Mark Skelton it will sound something like a very dull bell, wrapped in muffling material, without pitch or timbre. Not at all musical, underlining the truth that music is a much more complex proposition that human speech.

The past few years have seen vast improvement. Audiologists, sound engineers, and other scientists have been busily refining the way that the implants respond to music, working with improved computer software that makes musical tones much clearer for the implant user.

Still, CIs are not by any means an instant cure-all. Not all people who have hearing impairment or who are deaf are good candidates for CIs. There are certain types of hearing loss that are immune from help by implants. And post-surgery, implant users still have sometimes lengthy learning curves in “teaching” their brains to interpret what they then hear as sound and speech.

But there is progress. And there is hope. And in many ways, it is music that keeps hope alive.

EXPERT CONTRIBUTOR Michelle Ickes, PhD, an audiologist with Roanoke Valley Speech and Hearing Center in Roanoke

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