OurHealth Magazine for Roanoke and New River Valleys: June/July 2020 by OurHealth Media LLC

CONNECTING YOU TO

trustworthy CARE CLOSE TO HOME

| OurHealthRoanokeNRV.com

June | July 2020

Celebrating Local Nurses for making the True Difference inHealthcare.

June/July 40 Regular

HAVING A BETTER CONVERSATION WITH MEN ABOUT THEIR HEALTH

There is a tendency for men to be bad about taking charge of their health. It is through constructive conversation that men can be convinced to take their health more seriously.

DEPARTMENTS 12 15 20

The Pulse New People Q&A on Health

ON THE COVER

Celebrating Our

COMMUNITY OF NURSES

We are proud to honor the nurses in our local communities by name.

NON-SURGICAL COSMETIC SURGERY PROCEDURES MAKING THE CUT Many consider cosmetic surgery to address stubborn areas of fat, but there are many noninvasive fat-reduction options that can get you ready for swimsuit season.

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JUNE • JULY

Contents

MORE THAN MEETS THE EYE PART III | THYROID HEALTH

STEPPING UP OUR GAME IN THE FACE OF A PANDEMIC

What Can Our Eyesight Tell Us About Our Health? The ophthalmologists and optometrists at Blacksburg Eye Associates share what an eye exam can reveal about your thyroid health.

IS YOUR H 2 O HYDRATING OR OVERHYPED?

THE NEW NORMAL OF HEALTH: GOOD OR BAD?

With so many types of water available for consumption, it’s tough to determine what’s actually benefiting you and what’s simply a marketing ploy.

In addition to online activities, Green Ridge Recreation Center and the YMCA of Virginia’s Blue Ridge share about the innovations they have made during the COVID-19 pandemic.

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People have been careful to social distance, to disinfect, and to keep their hands clean. But if done improperly or taken to the extreme, these healthy practices can be potentially detrimental.

MoreThana Magazine

JUNE • JULY 2020

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CONTRIBUTING MEDICAL EXPERTS Olabode Agaja, DO

Steven Hosman, OD Gregory J. O’Shanick, MD Robert Swanson, MD, FACS Jim Wong, MD

CONTRIBUTING PROFESSIONAL Jennifer Lamont EXPERTS & WRITERS Steve McClintic, Jr.

Jonathan McNamara Rick Piester Dylan Roche

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The Pulse INFORMATION • EVENTS • AWARENESS

Recognitions,AwardsandAccreditations

Carilion Clinic’s Robert Trestman, MD Awarded 2020 NAMI Exemplary Psychiatrist Robert Trestman, MD, PhD, chair of Psychiatry and Behavioral Medicine at Carilion Clinic, has been selected to receive the 2020 National Alliance on Mental Illness (NAMI) Exemplary Psychiatrist Award. Dr. Trestman was nominated by Adrienne Kennedy, president of the NAMI board of directors. This year’s awards were given to psychiatrists noteworthy for going the extra mile and who have made substantial contributions to NAMI Affiliate, NAMI State Organization, or national NAMI activities. Award winners are recognized for their advocacy for access to care and research funding, community education programs or other NAMI priorities. Winners have also provided comprehensive treatment to people with mental illness including medical, rehabilitative, and social needs or have taken the time to educate people whose lives are affected by mental illness.

Robert Trestman, MD, PhD

Moreinformation: Visit www.nami.org.

SpecialAnnouncements:COVID-19Updates

Active Symptom Monitoring Won’t be Effective in Controlling Spread of COVID-19 Once World Returns to “New Normal,” Study Suggests As the number of new COVID-19 cases decreases and the world slowly resumes public activity in a controlled manner, a research study shows individual quarantines will be our best defense against future outbreaks of the virus.

strategy than active symptom monitoring due to the nature of the virus itself. “What was done to control the Ebola virus outbreak in 2014-2016 won’t work for COVID-19,” says Childs, referring to how active symptom monitoring was used to control Ebola spread as healthcare workers returned to the U.S. from the front lines of the outbreak in Africa.

Childs and coauthors from the Harvard T.H. Chan School of Public Health found that when a new case of COVID-19 is identified, if nine out of 10 of that person’s contacts are identified within half a day, and “There will be a point in this pandemic where we will want to switch our if nine out of 10 of them are then placed into near perfect isolation – resource allocation from social distancing towards early identification meaning zero contact with others – then transmission can effectively of cases, rapid and thorough contact tracing, and nearbe stopped 95 percent of the time. In comparison, active perfect isolation measures to effectively stop the chain symptom monitoring reduces transmission only 12 of transmission and mitigate a resurgence of this percent of the time. “Right now, social disease,” says Lauren Childs, Assistant Professor of distancing is our best “Right now, social distancing is our best option to Mathematics at Virginia Tech, who specializes in option to reduce spread reduce spread because community transmission understanding the spread of infectious diseases. remains widespread and we don’t have a good way because community Her remarks come on the heels of research, to monitor who’s infected,” Childs said. “The more transmission remains published in the May edition of SIAM we are able to reduce community transmission widespread and we News (Society for Industrial and Applied to very small pockets, the closer we will be to don’t have a good way to Mathematics), which indicates that of the two transitioning to more targeted interventions.” monitor who’s infected.” most common non-pharmaceutical interventions Childs is calling on regulators and health officials – Lauren Childs, Assistant Professor employed by governments and public health of Mathematics at Virginia Tech, who to consider the research – which is publicly available specializes in understanding the officials – individual quarantines and active symptom – to assist in developing frameworks for preventing spread of infectious diseases. monitoring – individual quarantine is more effective at transmission as the pandemic winds down and normal curbing COVID-19 spread. activities resume. One suggestion is to allocate more resources Applied as an intervention, active symptom monitoring means towards identifying and tracking infected individuals and ensuring people identified as coming into contact with the virus are allowed to individual quarantines are near-perfect, which would mean fully go about daily activity and are checked at regular intervals for signs isolating people in their homes, or if that isn’t possible, in hotel rooms of symptoms. They are only isolated after they become symptomatic. “We’re not there yet, but once we’re in a position where we can more Individual quarantine, on the other hand, requires all people known to readily keep track of infectious individuals and who they contact, with have been in contact with an infected person to be strictly quarantined the appropriate resources to track them and isolate them, individual for a period of 14 days. quarantine will be the best strategy to avoid a resurgence of this Researchers examined each strategy in the context of the novel virus pandemic,” Childs says. and found that although individual quarantine does impact a high Moreinformation: Visit www.siam.org. number of people who may never catch the virus, it remains a far better 12

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The Pulse

• NEWS TO KNOW

Recognitions,AwardsandAccreditations

NewLeadershipAnnouncements

Friendship Assisted Living Earns Three-Year License From Virginia Department of Social Services

Good Samaritan Hospice Welcomes New Chief Strategy Officer

Friendship, a local leader in senior living and rehabilitation, is proud to announce that Friendship Assisted Living (FAL) has earned a three-year license from the Virginia Department of Social Services (VDSS). According to the VDSS website, a three-year license is issued to a facility with activities, services, management and overall performance levels that routinely exceed the basic care, program and services required by the minimum standards. “Facilities earn multiple year licenses by consistently showing inspectors that they’re putting the residents first, and that all aspects of their operations are aimed at providing the highest level quality care that’s possible,” says Ben Higgins, Vice President of Healthcare Operations. “A three-year license is unheard of, especially in our region. These inspections include reviewing several years’ worth of survey history, ratings for potential risk and take into consideration the surveyors’ general trust in the leadership and team. Receiving this license is a huge endorsement for our community and highlights the tremendous effort our team puts forth daily for our residents,” says Higgins. Moreinformation: Visit www.friendship.us.

Good Samaritan Hospice, Roanoke and New River Valley’s only community-based, not-for-profit hospice, welcomes Karen Brubaker Miller to the team as Chief Strategy Officer. “As we begin to broaden our services to the community, Karen is going to be invaluable in developing programs that are on par with Good Sam’s reputation for excellence,” explains Aaron Housh, Good Sam’s CEO. “She brings a wealth of knowledge on advanced illness care and community partnerships.” Miller previously worked for United Hospice, based in Atlanta, Georgia, and served as Administrator, Regional Director and Director of Professional Services for several hospice branches in the southeast. In 2007, she was appointed as the Karen Brubaker Miller Chief Executive Officer of Hospice of the Golden Isles in southeast Georgia. In addition, she is the previous past President and Vice President of the Georgia Hospice and Palliative Care Organization (GHPCO). “We are very fortunate to have Karen at Good Sam,” explains Housh. “Her relocation to Roanoke to be with her husband and two children is a great opportunity for us. She is eager to connect with our community partners and will play a significant role in guiding Good Sam into the future.” Moreinformation: For more information on end-of-life care, call 540.776.0198 (Roanoke) or 540.381.3171 (NRV) or visit www.goodsamhospice.org.

NewTechnologiesandPrograms

Carilion Launches Drug Donation Program Carilion Clinic has launched a drug donation program to assist patients who are otherwise financially unable to afford prescription medication. The program, which is overseen by the Virginia Board of Pharmacy, allows individuals to donate unopened, non-refrigerated medications. All the medications are inspected once accepted and again before being dispensed. Currently, the Carilion Medical Center Pharmacy at 2001 Crystal Springs Ave SW, #110 in Roanoke is the only location accepting donations. As a reminder, all Carilion retail pharmacy sites offer safe drug disposal options for used and unused medications. Individuals interested in receiving medications through this program should contact the Carilion Medication Assistance Program office at 540.981.7647 to determine eligibility. Moreinformation: Visit www.carilionclinic.org/medication-assistance-programs.

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NEWPEOPLE

John Biery Jr., DO

Erin DeJesus, NP

Carilion Clinic Family Medicine – Wytheville Wytheville | 276.228.8686 www.CarilionClinic.org

Emma DeMorier, PA

VCOM Sports and Osteopathic Medicine Blacksburg | 540.232.8405 www.osteopathicsports.com

Karlie DiRuzza, PA

Darren Glass, MD

Donna O’Connell, PT Rehab Associates of Central Virginia Moneta | 540.296.3203 www.racva.com

Angelica Perry, DO

Bariatric Surgery LewisGale Physicians Salem | 540.772.3620 www.lgphysicians.com

Maria Phillips, FNP

Reginald Pinder, DO

Antonio Roman, MD

Rani Rosborough, MD

Olabode Agaja, DO

New Beginnings Pediatrics Blacksburg | 540.739.3623 www.newbeginningspediatrics.org

Carilion Clinic Orthopaedic Surgery Blacksburg and Christiansburg | 540.510.6200 www.CarilionClinic.org

Internal Medicine LewisGale Physicians Roanoke | 540.283.3760 www.lgphysicians.com

Sports Medicine Resident VCOM Sports and Osteopathic Medicine Blacksburg | 540.232.8405 www.osteopathicsports.com

Lin Shen, DO

Sports Medicine Resident VCOM Sports and Osteopathic Medicine Blacksburg | 540.232.8405 www.osteopathicsports.com

Carilion Clinic Family Medicine – Brambleton Roanoke | 540.725.7800 www.CarilionClinic.org

Daniel J. Torrent, MD

Carilion Clinic Aortic Center Roanoke | 540.853.0100 www.CarilionClinic.org

Carilion Clinic Neurology Roanoke | 540.224.5170 www.CarilionClinic.org

VCOM Sports and Osteopathic Medicine Blacksburg | 540.232.8405 www.osteopathicsports.com

Family Medicine LewisGale Physicians Radford | 540.731.1600 www.lgphysicians.com

Samuel Werner, DO

VCOM Sports and Osteopathic Medicine Blacksburg | 540.232.8405 www.osteopathicsports.com

Welcomes our New Healthcare Providers to the Community! www.OurHealthRoanokeNRV.com

The Pulse

• NEWS TO KNOW

Recognitions,Awardsand Accreditations

Carilion Clinic’s Heart Failure Team and Chest Pain Center Receive Accreditation Carilion Clinic’s Heart Failure Team has achieved Ventricular Assist Device Accreditation (VAD) by Det Norske Veritas and Germanischer Lloyd (DNV-GL). DNV-GL is part of a global organization (alternative or equivocal to Joint Commission). Also receiving accreditation from the American College of Cardiology is Carilion Clinic’s Chest Pain Center. Carilion was awarded Chest Pain Center Accreditation with Primary PCI (percutaneous coronary intervention) in April based on rigorous onsite evaluation of the staff’s ability to evaluate, diagnose and treat patients who may be experiencing a heart attack. Hospitals that have earned ACC Chest Pain Center with Primary PCI Accreditation have proven exceptional competency in treating patients with heart attack symptoms and have primary PCI available 24/7 every day of the year. Carilion Clinic is taking extra precautions and safety measures that exceed COVID-19 recommendations and guidelines are being practiced in emergency rooms, imaging services, family and pediatric practices, obstetrics and laboratories to keep patients safe throughout procedures.

Moreinformation: Visit www.carilionclinic.org. For more on accreditation information, visit www.dnvgl.com or www.cvquality.acc.org.

SpecialAnnouncements:COVID-19Updates

Carilion Clinic Safety Restores Comprehensive Patient Services Throughout Western Virginia Carilion Clinic has resumed elective surgeries and same-day procedures under the strict, ongoing guidance of its Infection Prevention and Control team. Extra precautions and safety measures that exceed COVID-19 recommendations and guidelines are being practiced in emergency rooms, imaging services, family and pediatric practices, obstetrics and laboratories to keep patients safe throughout procedures. The latest guidelines and safety measures being followed include universal comprehensive coronavirus screenings for all entering patients (including caregivers and staff), pre-procedure coronavirus testing, more frequent cleaning and disinfecting of high-touch surfaces and common areas, providing face masks and other appropriate PPE for patients and designating social distance waiting and seating areas in common spaces. In addition, Carilion Clinic has enhanced its telemedicine options to help patients connect with their care team from the comfort of home by phone, video or MyChart. For visiting patients, a step-by-step guide has been developed to help understand the changes and new safety precautions that have been put in place. Every patient who is scheduled for an operation or procedure will be carefully evaluated using objective criteria that assesses their risk and readiness. Once scheduled, patients must selfisolate for two days before being tested for COVID-19 and must continue to self-isolate until their appointment or procedure. Only upon receiving a negative test will patients undergo their inpatient operation or outpatient procedure. All strict precautions introduced during the pandemic will remain for the foreseeable future. Moreinformation:Visit CarilionClinic.org/safe.

NewFacilities,Relocations, andServices

Nurse-Midwife Services Now Available in Floyd and Radford LewisGale Physicians announces the recent expansion of LewisGale Physicians NurseMidwives – the only practice locally catering to women who desire less medical intervention during low-risk pregnancy, labor, and delivery using a nurse-midwife in a safe, high-quality, hospital environment. Midwifery services have expanded and are now available in the Radford and Floyd communities. “A trend in maternity care nationwide – driven by patient demand – is for less medical intervention, which is what the nurse-midwives service offers, in addition to primary health care services for women from adolescence through menopause,” explains Kris Conrad, DNP, CNM, Director of the Nurse-midwives at LewisGale. Moreinformation: For midwifery services at LewisGale Physicians Nurse-Midwives, call 540.772.3650.

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• NEWS TO KNOW

Recognitions,Awardsand Accreditations

Carilion Clinic’s Chest Pain Center Receives Accreditation from American College of Cardiology The American College of Cardiology (ACC) has recognized Carilion Clinic for its demonstrated expertise and commitment in treating patients with chest pain. Carilion was awarded Chest Pain Center Accreditation with Primary PCI in April based on rigorous onsite evaluation of the staff’s ability to evaluate, diagnose and treat patients who may be experiencing a heart attack. Hospitals that have earned ACC Chest Pain Center with Primary PCI Accreditation have proven exceptional competency in treating patients with heart attack symptoms and have primary PCI available 24 hours per day and seven days per week, every day of the year. As required to meet the criteria of the accreditation designation, they have streamlined their systems from admission to evaluation to diagnosis and treatment all the way through to appropriate post-discharge care and recommendations and assistance in patient lifestyle changes. Moreinformation: Visit www.cvquality.acc.org.

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SpecialAnnouncements:COVID-19Updates

Virginia Department of Health Launches Data System to Help Alert People Exposed to COVID-19 The Virginia Department of Health (VDH) has implemented and is now using a COVID-19 Data Management System to report information related to efforts to notify people who may have been exposed to COVID-19. Information related to notification efforts — referred to as contact tracing — is available on the COVID-19 Data Insights webpage, located at www.vdh.virginia.gov/coronavirus/covid-19-data-insights/. The state-level data will be updated weekly on Fridays. The ability to report this information is the result of the new data management system. The data being reported includes the following:

» » » »

Percent of cases (individuals diagnosed with COVID-19) reached within 24 hours Number of contacts of cases who are undergoing public health monitoring Of contacts reached, percent contacted within 24 hours Percent of contacts that — after multiple attempts — were unable to be reached or have yet to be reached

A seven-day average will be provided in the “Percent of cases reached within 24 hours” category. Contact tracing involves finding people who may have been exposed to COVID-19 and providing guidance to prevent them from spreading it. Contact tracing is one of many trusted public health tools used to prevent further spread of contagious diseases. It has long been used for other contagious diseases like measles and tuberculosis (TB). Currently, contact tracing is one important part of how Virginia can slow the spread of COVID-19. As Virginia began to see increased numbers of COVID-19 cases, VDH expanded its staff of contact tracers and case investigators in its 35 health districts from a few hundred to more than 1,200 at the end of June. This number represents a suggested ratio of 15 contact tracers per 100,000 population. This contact tracing data is the latest publicly available COVID-19 data including the daily COVID-19 Cases in Virginia dashboard, Virginia’s Key Measures of COVID-19 Data and COVID-19 Case and Testing Data by ZIP Code. Moreinformation: For the latest information on the COVID-19 situation in Virginia, go to the VDH coronavirus webpage at www.vdh.virginia.gov/coronavirus/.

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Questions. Answers. Knowledge. How often should I replace my contact lens case? The American Optometric Association recommends replacing your contact lens case at least every three months. Failing to replace your contact lens case at the recommended interval increases the risk of complications.

Did you know? The American Optometric Association recommends

REPLACING YOUR CONTACT LENS CASE

AT LEAST EVERY

THREE MONTHS. You should avoid washing the case with tap water due to an increased risk of developing Acanthamoeba keratitis. This severe bacterial corneal infection can lead to permanent vision loss.

In between replacement, it’s essential to know how to clean your contact lens case properly. Optometrists traditionally recommended rinsing the case with fresh solution and air-drying it face down with the caps off. However, eye doctors now recommend rubbing the case with clean fingers before rinsing it with solution and air-drying. This extra step helps remove potential biofilm and bacteria better than rinsing alone. And you should avoid washing the case with tap water due to an increased risk of developing Acanthamoeba keratitis. This severe bacterial corneal infection can lead to permanent vision loss. Steven Hosman, OD

Vistar Eye Center Roanoke | 540.855.5100 www.vistareye.com

Can severe head trauma make you more susceptible to develop Alzheimer’s?

Can I donate blood if I’ve been exposed to COVID-19?

Studies show that severe traumatic brain injury (TBI) does increase the risk of developing dementia. Technically, any level of traumatic brain injury (mild, moderate or severe) is associated with an increased statistical lifetime risk.

While there have been no reported cases worldwide of any respiratory virus, including COVID-19, being transmitted through a blood transfusion, the Red Cross has implemented new blood donation deferrals out of an abundance of caution. The Red Cross has requested that individuals postpone their donation for 28 days following:

Think of your brain as if it were a bank account of brain cells. Throughout your lifetime, you take gradual withdrawals—and you can do that slowly or quickly, depending on your lifestyle. Maintaining a healthy lifestyle with regular exercise, controlling your blood pressure and getting plenty of sleep will prolong your ‘savings account’ of brain cells. Conversely, unhealthy habits like drug and alcohol abuse, uncontrolled high blood pressure, poor sleep habits and no exercise can cause a more rapid ‘withdrawal’ of those brain cells from our brain savings account. TBI also causes a withdrawal from that account. As we get older, we want our brain age to be as close to our real age as possible; otherwise, we will see more evidence of cognitive problems (dementia) at a younger age. So, the main message is that even if you have had an injury, living the healthiest life afterward is the best option to improve your overall brain function in your later years. Gregory J. O’Shanick, MD

Center for Neurorehabilitation Services, PC Richmond | 804.272.0114 www.cns-va.org

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» Travel to China and its special administrative regions, Hong Kong and Macau, as well as Iran, Italy and South Korea.

» A diagnosis of COVID-19 or contact with a person who has, or is, suspected to have the virus. Contact is defined as an individual who has cared for, lived with, or had direct contact with bodily fluids of a person with COVID-19 or someone suspected to have COVID-19. The deferral period often doubles the incubation period (average 14 days) out of an abundance of caution and to ensure the safety of the blood supply, as well as the safety of staff and donors. This 28day deferral period for COVID-19 aligns with recommendations from the American Association of Blood Banks Transfusion Transmitted Disease Committee and FDA considerations. Jonathan McNamara

Regional Communications Director American Red Cross of Virginia Richmond | 800.RED.CROSS www.redcross.org/local/virginia

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Questions. Answers. Knowledge. Not long after the COVID-19 outbreak, I began hearing the word “antigen” being used. What does it mean?

Did you know? ANTIGENS

CAN BE USED IN VACCINATIONS. A part of the organism can be injected into a human. After this exposure, that person will develop antibodies to the antigen and gain protection when he or she encounters the infective organism.

In the context of testing a particular infection, an antigen is a substance from an infective organism (chemicals, toxins, pollen, viruses, bacteria, fungi, or parasites) that causes your immune system to react. That substance (antigen) can be the outer coating, or any section, of the organism—and it is what we are trying to detect. The lab uses testing to recognize and attach to that specific antigen. For example, the lab will use antibodies (proteins created by our immune system to fight off the antigen) from a person or animal that had prior exposure to the infective organism. In that situation, a marker can be placed into the antibody for us to detect when it encounters the antigen. Another example of antigen use is vaccinations, where a part of the organism is injected into a human. After this exposure, that person will develop antibodies to the antigen and gain protection when he or she encounters the infective organism. Jim Wong, MD

Carilion Clinic Infectious Disease Roanoke | 540.981.7715 www.carilionclinic.og

Is it okay for my teenage son to lift weights with his dad? There is no minimum age requirement for participation in weight and strength training. However, a child or adolescent who intends to strength train should have the maturity to follow directions (usually around age seven or eight years old). If a child is capable of participating in an organized youth sport, then they are capable of participating in strength training to help their body increase muscular strength and endurance, as well as meet the demands of the sport itself. Strength training should begin with lighter weights and gradually progress to heavier weights. Injuries typically occur when a child does not have proper supervision, performs improper techniques, or lifts too much weight too soon. There is no ideal max weight for a child. If the child cannot maintain balance, control or proper technique with the load, it should be considered too heavy and should be reduced. It is essential to monitor complaints of discomfort and pain closely. Normal muscle soreness after exercise may be common; however, pain during an exercise means the activity should stop. Pain that persists longer than two days or acute pain should warrant medical evaluation. Olabode Agaja, DO

New Beginnings Pediatrics Blacksburg | 540.739.3623 www.newbeginningspeditrics.org

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What makes men more susceptible to hernia?   Males are naturally more susceptible to developing hernias in the lower abdomen due to the natural descent of the testes from the upper abdomen through the layers of the abdominal wall and into the scrotum during in utero development. Simply put, the testes must pass through a hole in the abdominal muscular wall to find its final resting place, the scrotum. This hole will usually heal on its own during the first year of life. However, if the hole doesn’t heal, a hernia will develop. Quite often, the hernia will become noticeable as a bulge in the left or right lower abdomen that enlarges over time. It is essential to notify your doctor if you have a new lump or bulge anywhere on your abdomen, as hernias can be quite dangerous if not appropriately treated. We now have minimally invasive and exceptionally durable repair options for abdominal wall hernias. Robert Swanson, MD, FACS Jefferson Surgical Clinic Roanoke | 540.283.6000 www.jeffersonsurgical.com

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CELEBRATING OUTSTANDING NURSES ROANOKE & NEW RIVER VALLEYS

Celebrating

OUR

COMMUNITYof

NURSES words | STEVE MCCLINTIC, JR.

Since mid-March, nearly every measure of consistency that once framed our lives has been replaced with one word we never imagined would define our hope for a better tomorrow: uncertainty. Yet, as used as we have become to this unknown, there has never been a time in which we were left in doubt of who remains present and accounted for and who still stands strong, steady and prepared to answer our call for care whenever we need it: the men and women who represent the frontline of our healthcare system. Traditionally, this is the time of year when we feature several of the healthcare workers who represent a significant segment of our frontline of healthcare – our nurses – in our annual Celebrating Outstanding Nurses recognition program. This year however, it only seems fitting that we do something different, something we feel shows how much we value every man and woman serving our communities as nurses. In partnership with the Virginia Board of Nursing – Department of Health Professions and its partnering agency, Virginia Interactive*, OurHealth Magazine for Roanoke & New River Valleys is pleased to recognize all nurses serving the Roanoke & New River Valleys community by name and certification in the following pages. From Certified Registered Nurse Anesthetists (CRNA), Nurse Practitioners (NP), Clinical Nurse Specialists (CNS) and Certified Nurse Midwives (CNM)/Certified Professional Midwives (CPM) to Registered Nurses (RN), Licensed Practical Nurses (LPN) and Certified Nurse Aides/Assistants (CNA), these are the people you entrust your health and wellbeing to, and who we are proud to collectively honor and celebrate, and most importantly, give our deepest, heartfelt thank you.

“

These are the people you ENTRUST YOUR HEALTH and WELLBEING to, and who WE ARE PROUD TO COLLECTIVELY HONOR AND CELEBRATE, and most importantly, give our deepest, HEARTFELT THANK YOU.

”

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ROANOKE & NRV – CERTIFIED REGISTERED NURSE ANESTHETISTS: AND | REGISTERED NURSES: ATK

Certified Registered Nurse Anesthetists Certified Registered Nurse Anesthetists (CRNA) are Advanced Practice Registered Nurses (APRNs) who administer anesthesia and other medications. They also monitor patients who are receiving and later recovering from anesthesia.

Nurse Practitioners Nurse Practitioners (NP) are Advanced Practice Registered Nurses (APRN) who have earned either a Master’s of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), as well as completed additional training and certification. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe treatment plans.

Clinical Nurse Specialists Clinical Nurse Specialists (CNS) are Advanced Practice Registered Nurses (APRN) with graduate education at the master’s or doctoral level as a CNS. They are clinical experts in evidence-based nursing practice within a specialty area, treating and managing the health concerns of patients and populations.

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Certified Nurse Midwives &Certified Professional Midwives Certified Nurse Midwives (CNM) are Advanced Nurse Practitioners (ANP) who provide healthcare and wellness care to women, which may include family planning, gynecological checkups and prenatal care. Certified Professional Midwives (CPM) are trained and credentialed to offer expert care, education, counseling and support to women for pregnancy, birth and the postpartum period.

Registered Nurses Registered Nurses (RN) are individuals who have graduated from a stateapproved school of nursing and have been licensed by a state authority after passing qualifying examinations for registration. RNs roles range from direct patient care and case management to establishing nursing practice standards, developing quality assurance procedures, directing complex nursing care systems, conducting clinical research and teaching in nursing programs, as well as practicing in many other invigorating settings.

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Licensed Practical Nurses Licensed Practical Nurses (LPN) are individuals who complete an accredited practical nursing certificate program and have been licensed by a state authority after passing qualifying examinations for registration. LPNs are directly involved in providing basic patient care and ensuring that patients are comfortable and well cared for. LPNs may also administer certain medications and perform other duties such as taking blood pressure, inserting catheters and recording other vital signs.

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Certified Nurse Aides/Assistants Certified Nurse Aides/Assistants (CNA) are individuals who have completed a state-approved education program and are trained and often certified to assist nurses (as in a hospital or nursing home) in providing basic patient care and services (such as bathing, feeding, or measuring vital signs of patients).

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COVER FEATURE INSIGHT • AWARENESS • MINDFULNESS

HOW CAN WE have a BETTER CONVERSATION with Men About

THEIR HEALTH? words | DYLAN ROCHE

Many a TV sitcom or newspaper cartoon has shown us an oh-so-negative trope: a nagging wife berating her clueless husband about his high cholesterol, his beer consumption, his back pain or some other aspect of his health. Nobody wants to be that couple, right? But the struggle not to be that husband and wife is real. All gender stereotyping aside, there’s still a tendency for men to be bad about taking charge of their health. According to a January 2018 study published by the peer-reviewed World Journal of Men’s Health, men have a lower life expectancy around the world, and this receives little national, regional or global attention from policymakers or health care providers who could push for change. According to the Centers for Disease Control and Prevention, the average life expectancy for women is 81.2 years while for men, it’s five years less at 76.2. This problem can be further exacerbated by the tendency of women to try to take care of their husbands’ health situations for them. As Althea Dent, MA, LPC, with Total Life Counseling in Roanoke explains, this is a pretty common gender dynamic. “Women are typically the nurturers,” she says. “Even if you’re a career woman, we are conditioned to be caretakers, to be nurturing for the family.”

Why Don’t Men Go See Their Doctor? National organizations like the American Psychological Association, the AARP and the Family Caregiver Alliance agree that women are more likely than men to be the family caregiver — not only when it comes to looking after sick, injured or disabled relatives but also when it comes to addressing the health needs of the immediate family. Mom is the one who schedules doctor appointments for the kids, who plans nutritious meals for lunch and dinner, and who enforces safety rules so nobody gets hurt. Meanwhile, in some families, Dad can just be another kid she has to take care of. There’s plenty of theories on why. Men are traditionally the breadwinner of the family, so they work demanding jobs that make them less available for a doctor’s appointment. Society has dictated they be tough and fearless, so they tend to take more risks and fewer precautions. Society has also dictated that things like healthy eating and weight consciousness are traditionally feminine — it’s way manlier to chow down on a burger and bulk up instead of eating a salad. 40

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Did you Know? Research reports that there is a

FIVE YEAR

GENDER GAP when it comes to life expectancy. On average, MEN live to

76.2 On average, WOMEN live to

81.2

What can I say to get you to care about your health?!

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Somephrasesyoucouldtry,

“

I’m so excited about our relationship and I want us to have a long life together.

”

“

We want to be healthy enough to travel in retirement. And we want to enjoy many years playing with our grandchildren.

”

“

I want to know you’re taking care of yourself so that it doesn’t get any worse.

”

“

I’m scared of this and it would give me a lot of comfort to know you’re taking care of yourself.

”

“

I know it’s a hassle for you to research the right cardiologist, so I tried to help you out by finding a good one. You have an appointment for next Tuesday at 5:00 pm.

”

“

Here’s why it’s still important you take care of your health.

”

Althea Dent, MA, LPC Total Life Counseling in Roanoke

The other part of this is that a doctor’s visit is something women are introduced to at a young age — they often see an OB-GYN as soon as they start menstruating. Men might see a doctor for a physical every year throughout adolescence, but it’s easy for them to fall out of this practice once they become adults. “Women tend to go to the doctor more often and develop a relationship,” Dent explains. “Men don’t go as often. If you’re healthy, you can skate through life pretty well up until about 40.” And by the time they reach 40, it’s commonplace for men to have it in their heads that they know what’s best for them and that listening to a doctor’s advice is akin to having someone mess with their routine. They don’t want to hear how they should be cutting back on their consumption of chips and beer. And they’re a little unnerved at the thought of a prostate exam even if it means early detection of cancer. That’s not the only problem, however. A review published by the World Journal of Men’s Health emphasizes that men don’t often have health information readily available to them or have outreach programs that are tailored to their needs. Even worse is the fact that male-specific conditions — such as erectile dysfunction or premature ejaculation — are not taken seriously or perceived as priorities, even though they could be indicative of other problems. Most men aren’t aware, for example, that erectile dysfunction is linked to cardiovascular disease. For the women taking on the role of family caretaker, all these social aspects are stacked against her when she tries to open up the conversation about why her husband should adopt healthier lifestyle practices or go to the doctor more often. Her husband might be resistant or dismissive. Worse still, it could be a point of resentment. So…what’sthebestwaytoopen suchaconversation?

Broaching the Topic of Health: Ways to Make Your Point Discussing health is just like any other conversation in a relationship — it needs to be constructive and respectful, and it requires listening as much as it does talking. FocusonthePositive:When there’s problem behavior, such as neglecting one’s health, it’s easy to focus on the negative. Instead of being critical, it’sbestto beencouraging and emphasize why improvement is a positive option.

Dent suggests women could frame it along the lines of “I’m so excited about our relationship and I want us to have a long life together.” Women can help their husbands be more receptive to health promotion by presenting their reasons as ways they can improve in important areas of their life. For example, taking care of their health will make them stronger. Having more energy and vitality will mean they are able to be more productive and successful in the office and more effective parents in the home. Dent takes it one step further and suggests using future-based ideology in the long term rather than focusing on the here and now. In other words, what does he have to gain in the years to come rather than what inconvenience will he face now? “We want to be healthy enough to travel in retirement,” you might say. “And we want to enjoy many years playing with our grandchildren.” Whenit’snegative,behonest abouthowitaffectsyou: These conversations can be stressful, and it’s easy to get wrapped up in how you feel yourself. If you find that you’re focused on the negative, be honest about why. Making yourself vulnerable can be difficult, but it shows that your intentions are not to be a control freak. Be willing to say, “I’m scared of this and it would give me a lot of comfort to know you’re taking care of yourself.” Continued on page 44...

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Before Starting a Conversation, ConsidertheFollowing:

1 Focus on the Positive:

When there’s problem behavior, such as neglecting one’s health, it’s easy to focus on the negative. Instead of being critical, it’s best to be encouraging and emphasize why improvement is a positive option.

2 When it’s negative, be honest about how it affects you: These conversations can be stressful, and it’s easy to get wrapped up in how you feel yourself. If you find that you’re focused on the negative, be honest about why. Making yourself vulnerable can be difficult, but it shows that your intentions are not to be a control freak. Be willing to say, “I’m scared of this and it would give me a lot of comfort to know you’re taking care of yourself.”

Forexample,youmightsay,

“

Honey, I know it’s inconvenient to get to the doctor, but I’m concerned about your health. You’re getting close to 40, and you don’t have as much energy as you used to. You should schedule a checkup just to make sure everything is 100 percent right.

”

3 Don’t make assumptions or expect certain reactions from him: Some men will need

more persuasion, but others might simply need to hear you make the recommendation that he go see a doctor. Don’t head into the conversation with the mindset that it’s going to be a struggle. Clearly assert your reasons for thinking the way that you do.

4 Be respectful: Don’t resort to

words that patronize or put him down. Saying things like “selfish,” “oblivious” or “irresponsible” just make the situation worse.

5 Make it a team effort:

Remember that it’s not you versus him – it’s you and him together versus the problem of his health. Work toward a solution that you both feel comfortable with. In some cases, that might be simply going for a checkup to establish a relationship with a general practitioner.

Continued from page 42...

In many situations, these especially negative conversations can happen when he’s exhibiting symptoms or has received a diagnosis. If you witness that your husband has trouble sleeping, shows signs of depression, feels frequent fatigue or headaches, or simply walks in a way that indicates injury, let him know that these signs concern you. “I want to know you’re taking care of yourself so that it doesn’t get any worse,” you might say. When a person receives a difficult diagnosis, it will require support from the non-affected spouse. If your man hears from his doctor that he’s at risk for diabetes but he’s still eating too many refined carbs, your first inclination is to tell him he can’t do that. Instead, remind him that these instructions came from his doctor. If it helps, have your doctor prioritize

the lifestyle changes your husband needs to make — that way, you both are

on the same page about which ones can’t be compromised and which ones could potentially be relaxed occasionally.

Don’tmakeassumptions orexpectcertainreactions fromhim: Some men will need more persuasion, but others might simply need to hear you make the recommendation that he go see a doctor. Don’t headintothe conversationwiththemindset thatit’sgoingtobeastruggle. Clearly assert your reasons for thinking the way that you do.

For example, you might say, “Honey, I know it’s inconvenient to get to the doctor, but I’m concerned about your health. You’re getting close to 40, and you don’t have as much energy as you used to. You should schedule a checkup just to make sure everything is 100 percent right.” He might be receptive to your suggestion but unwilling to make it a priority. “That sounds great, dear,” he might say. “As soon as I have the time, I’ll make an appointment.” By the next day, he’s forgotten. In these situations, you could try helping him out by researching the right doctor and making his appointment for him (as long as you know days and times that are convenient for him). Continued on page 46...

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Men’s Health QUIZzes:

Applying What We’ve Learn in Real Life

It’s one thing to grasp the ideals of how to have conversations about health with men, but it’s another matter to actually apply them. Take a look at the following scenarios and quizzes see if you can identify the best way to broach the topic of health with men.

Primary Care and More: A Primary Care Provider Is On Your Side and Who You Can Depend On and Trust

Managing Stress: Speaking with an Expert Who Can Provide Solid Advice is a Good Thing

He’s not getting an annual physical. Why? The common response among a lot of men is it doesn’t make sense going to the doctor when nothing is wrong. Telling him that something might be wrong that he may not know about because symptoms aren’t always obvious can be counterproductive. Instead, focus on the importance of having a primary care provider to establish a baseline of health and who he can get to know and trust and feel comfortable confiding in, as well as allow him quicker access to healthcare services if ever needed.

He’s landed a senior management position and is working 60-hour weeks. On top of that, he has four teenage children who need his guidance and direction. It’s clear he’s under a lot of stress.

What should she say? a

How the heck do you not have a relationship with a primary care provider? What’s the matter with you?

You’re supposed to be going for an annual physical. You need to schedule one, like, yesterday!

Getting to know a doctor now who you can trust and confide makes for one less thing you need to worry about doing should you need to see one. You already know my primary care doctor, who I’ve seen for years. Well, he also accepts male patients. Why don’t I make you an appointment with him? I know you’re averse to seeing a doctor. Get over yourself. You can have a heart attack like anyone else.

AnswerC: Focus on the benefits

of having a primary care doctor – someone with whom he can confide, trust and depend on as opposed to being the bearer of bad news. Don’t assume his mindset or shame him for his negligence.

Find a Primary Care Provider Right for You at Carilion Clinic Family and Internal Medicine Carilion Clinic offers physicians, physician assistants and nurse practitioners providing primary care at its more than 40 locations conveniently located in and around the Roanoke and New River Valleys. They also offer the option of telemedicine appointments if needed. Visit www.carilionclinic. org/specialties/familymedicine for contact information of a practice closest to you.

What should she say? a

We all have stress and we all have to deal with, all right? Get over yourself.

I really can’t stand the way you’ve been acting lately. You need to go get some help.

If you don’t get your stress under control, then you’re going to give yourself a heart attack. And you’re going to drive the kids to resent you! I know you put a lot of pressure on yourself to provide for our family and to teach the kids as best you can, but we both know too much stress isn’t a good thing. My friend told me her husband has been talking to someone who specializes in stress management who has really helped him learn how to better manage his life, and she says he feels so much better now than he ever thought.

AnswerD: Acknowledge why he’s stressed and do so without adding to his stressful burden by making him feel guilty or by resorting to threats, ultimatums or shaming. Offer suggestions for help in a way he may better relate to and respond.

Psychological Health Roanoke: A Little Help Can Go a Long Way When Managing Stress When the stressors of life seem overwhelming, turning to someone who has expertise to help you manage it is not only a good choice, but a responsible one. Psychological Health Roanoke can help you set and achieve personal goals, work through challenges, and pursue and realize positive changes for you and your family. Visit www.psychhealthroanoke.com or call 540.772.5140 to learn more and set up your first appointment.

Aging Well: Becoming Older Doesn’t Diminish the Importance of Being Proactive with Your Health He’s been complaining about his knee for years. He does everything possible to avoid stairs at any cost and walking for more than a few minutes is causing more pain than he can stand. He knows it’s time for knee-replacement surgery, but he is dreading the recovery time.

Skin Care Check: Yearly Skin Exams Help Set a Baseline And Can Be Life Saving He knows skin cancer runs in his family. And while he’s pretty good at using sunscreen now, he admits that years went by when he was not as diligent. He thinks his moles are fine, probably.

What should she say? a

I know it seems like a lot to keep up with. But having a baseline for a yearly skin exam can help us catch any changes sooner. I can help keep an eye on those moles on your back too.

Why are you such a child? Can’t you just make some commonsense decisions that are good for you?

I hate that you won’t even go have that spot checked! Do you even know if it has changed any? You never pay attention to anything.

Don’t you know that skin cancer is the most common form of all cancers? And skin cancer deaths in men are on the rise!

What should she say? a

I don’t care if you’re in bed for weeks – you can’t continue like this. It’s surgery or else. Why are you such a child? Can’t you just make some commonsense decisions that are good for you? I know the recovery may be difficult. But with guidance from your doctor, I am here to support and help you take each step, one at a time. I hate that you won’t even try to better your quality of life, even though the doctor said you need this surgery.

AnswerC: Show him empathy for

what he has experienced and explain that you are here to help and support him in following a plan outlined by his doctor. Suggest manageable options or constructive solutions instead of simply trying to control what he does.

Getting you home through accelerated recovery is what LifeWorks Rehab™ is all about. Staffed with a skilled interdisciplinary team of physical, occupational and speech therapists, nurses and dietitians, the goal of the LifeWorks Rehab™ program is to get patients to regain function and return home safely and as quickly as their recovery allows. The LifeWorks Rehab™ program offers a personalized recovery map, seven-days-a-week therapy, and a state-of-the-art recovery gym to get you back to living your normal life as completely and quickly as possible. Visit www.lifeworksrehab.com to connect to one of six health and rehabilitation centers offering the LifeWorks Rehab™ Program in the greater Lynchburg area.

AnswerA: Show him empathy for

what he has experienced and explain that you are here to help and support him in following a plan outlined by his dermatologist. Suggest manageable options or constructive solutions instead of simply trying to control what he does.

Learn About Skin Cancer Screenings and Skin Health at River Ridge Dermatology Staffed with compassionate, board certified dermatologists, and experienced physician assistants and nurse practitioner, River Ridge Dermatology helps coordinate all aspects of your skin care needs, including medical, surgical, and cosmetic. Men (and women) who have a family history of skin cancer, have had blistering sun burns in the past, or have tanned significantly throughout their life should see a dermatologist for a thorough head to toe skin exam at least once a year. Your provider will make notes of any spots that may need monitoring and instruct you on what to look for when checking your skin between appointments.

Men’s Health Quizzes:

Applying What We’ve Learn in Real Life Preventative Tests: Prostate Cancer Screenings are Life Saving and May Be Necessary at an Early Age.

Physical Fitness and Nutrition: Life’s Obligations Can Make Keeping Healthy and in Shape a Challenge

He knows prostate cancer runs in his family. But because it didn’t affect his father until he was in his late 60s and his grandfather until he was in his late 70s, he doesn’t see the urgency or need in his early 50s.

Between chasing the big promotion at work and helping raise the kids at home, adult life has gotten pretty busy. He hasn’t stuck to a workout routine or healthy diet in years, and it’s starting to show in his weight and lack of energy.

What should she say?

I know the thought of finding out something could be wrong is scary. But even if there’s a small chance that you do have prostate cancer, finding out early is best. The information from your doctor says it’s just a simple blood test. And finding out everything is OK is better than worrying about something that may not be worth worrying about at all, right? I promise I will be right be your side.

You’re not Superman, buddy. You could have prostate cancer now and be totally oblivious to it.

Are you telling me you don’t think being around for your family is important enough to go get a little test done?

How would it make you feel if you had to tell your children you waited to be tested after it was too late – when it is certain to kill you?

AnswerA: Discuss with a compassionate and empathic tone and reinforce with trustworthy facts that dispel myths associated with testing procedures. Demonstrate that knowing more about his health will make life less stressful and scary than not knowing, which removes one less burden that he needs to carry. Reinforce you are by his side throughout the process.

Learn About Prostate Cancer Screenings and Other Men’s Wellness Topics at Virginia Urology According to urologists at Virginia Urology, central Virginia’s largest urology practice, prostate cancer screening is commonly performed through a physical exam and prostate specific antigen (PSA) test that measures the level of PSA in the blood. PSA is a substance made by the prostate. Men with a higher risk of should consider screening at age 40 or 45. Your doctor can discuss other types of tests and information that will help you become more informed and less anxious about it. Virginia Urology also offers the convenience of telemedicine appointments so you can learn more about prostate cancer and other men’s wellness topics from the convenience of your home. To learn more, visit www.uro.com or call 804.330.9105.

You probably don’t care about how you look, but you should at least care about your health. You need to start working out again and eating better. I remember how much you used to enjoy hitting the gym. How about we get back into the routine together, starting with taking a walk on the gym track in the evening. I’ve also found some pretty tasty and healthy recipes we can make at home and try together. Don’t take this the wrong way, but you’re getting fat. If you don’t take care of yourself, you’re going to have a heart attack by the time you’re 50. Remember how I told you a month ago it was time to get back to the gym? I guess I’ll just have to let out these trousers of yours — again!

AnswerB:Even if you’re already engaged in a fitness and nutrition plan, involve him and make it a team effort. It’s a lot easier to make a change with a supportive and caring partner. Don’t be negative or focused on the way he looks.

Make Your Fitness Goals a Family Affair at Green Ridge Recreation Center and YMCA of Virginia’s Blue Ridge Whether you’re a seasoned fitness guru or starting out with a goal in mind, both YMCA of Virginia’s Blue Ridge and the Green Ridge Recreation Center have what you need. Online and inperson classes, aquatics, community programs, and state-of-the-art equipment make either of these fitness and wellness centers the perfect place to reacquaint with your fit self. Visit www.ymcavbr.org or call 540.342.9622 for more information on programs at the YMCA’s four local centers. Visit www.greenridgerecreationcenter.com or call 540.777.6300 for more information on Green Ridge programs and membership.

Continued from page 44...

And just as you should be making assumptions or pretending as if you can read his mind, don’t expect him to be able to read your mind either. Explain everything, including your intentions: “I know it’s a hassle for you to research the right cardiologist, so I tried to help you out by finding a good one,” for example. “You have an appointment for next Tuesday at 5:00 pm.” Be respectful: Don’t resort to words that patronize or put him down. Saying things like “selfish,” “oblivious” or “irresponsible” just make the situation worse.

It’s also important to remember that though you have your concerns, he may have concerns of his own as well. Allow him to assert them without interruption and demonstrate that you are listening to him. “I see your point,” you can say before rephrasing what he just expressed to you. “Here’s why it’s still important you take care of your health.” Makeitateameffort: Remember that it’s not you versus him – it’s you and him together versus the problem of his health. Worktowarda solutionthatyoubothfeel comfortablewith. In some cases, that might be simply going for a checkup to establish a relationship with a general practitioner.

You could offer support by planning appointments together if you are both able to see the same GP. Make it fun by planning an outing afterward that you’ll enjoy together, such as antiquing or lunch. This way, the doctor visit just becomes part of a fun day.

It’s Up to Him You can have constructive conversations over and over again. You can lead by example, making your own appointments and diligently following the expert advice that your doctor gives you. And you can promote healthy practices for your family, such as nutritious dinners and regular exercise. There will still be times when your husband might neglect his health. Ultimately, remember that this is his choice – and respect that. “A good relationship needs to have freedom,” Dent explains. “People need to be separate people. They need to be able to say no and hear no."

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Community Care Connection

BEAUTIFUL BODY SELF-CARE • EXPRESSION • CONFIDENCE

Nonsurgical

Fat Reduction Procedures

Help Remove Unwanted Fat

Minus the Long Recovery By all accounts, it fits the description of a contradiction, but nonsurgical cosmetic surgery is exactly what it is. Nonsurgical fat-reduction procedures have come a long way over the years, a viable alternative to the more commonly known surgical cosmetic procedure, liposuction. But with five FDA-approved options available in Charlottesville & Shenandoah Valley, there’s even more reason to trust and consider these than ever before. words | DYLAN ROCHE

ummer is finally in full swing. With Memorial Day serving as the unofficial opening weekend of the season, we pack away our sweaters and excitedly dust off the beach bag in anticipation of brighter, fun-filled days ahead. The summer season also brings with it women and men who have a renewed interest in shaping up their body for the celebrated season of bathing suits, shorts and tank tops. For some men and women, standing in the way of their ideal warm weather bodies are pesky pockets of fat that just don’t seem to respond to any amount of diet and exercise. Today, it’s much more common to consider cosmetic surgery to address these stubborn areas of fat. But fat-reducing surgical options like liposuction or a tummy tuck (abdominoplasty) not only require a more lengthy recovery period to allow incisions to heal properly and appear less visible – they can also cost significantly more than nonsurgical alternatives. Traditionally, surgical cosmetic procedures are scheduled in the winter or early spring, allowing plenty of time to recover from incisions and show off your new body in advance of the swimsuit season. But if you were hoping to get liposuction or a tummy tuck in 2020, you might have missed your chance — at least if you want to be ready for summer. That doesn’t mean you’re necessarily out of options though. In some cases, a noninvasive fat-reduction procedure could be a viable option.

Surgery Versus Nonsurgical Procedures: How Do They Compare? While it’s true that some noninvasive fatreduction procedures take weeks or even months for you to see optimum results just as surgery does, they don’t require the same downtime for recovery. That’s because cosmetic surgery – which can include not only liposuction, but also body sculpting procedures like a tummy tuck, breast lift or buttock lift – are often a one-time procedure for a major body change. These surgeries require anesthesia and sometimes an overnight stay at the hospital. And then there are some unpleasant surprises during recovery. You might need to wear a compression garment for six to eight weeks, and you may need to use surgical drains to remove the excess fluid and blood that collect at the surgical site. Furthermore, you won’t see results right away. According to the American Society of Plastic Surgeons, liposuction might take out 10 pounds of fat, but the fluid retention and swelling you experience immediately after your procedure could have you looking and feeling as if you’ve gained weight. This swelling could even take several months before it fully dissipates. While you recover, you might deal with incision wounds, stitches, and dressings and bandages. You might need to avoid bending, straining or lifting.

Roanoke and New River Valleys Medical Providers Certified to Perform FDAApproved, Non-surgical Fat Reduction Procedures Before undergoing any medical procedure, always verify the medical provider has received certification from a reputable board. Board certification ensures the provider has received optimal training and has a demonstrated record of safely and effectively performing the procedure. The following medical providers practicing in and around the Greater Roanoke and New River Valley areas are certified to perform FDAapproved, non-surgical fat reduction procedures. The following is a partial list. For a complete list of all local, certified providers offering non-invasive fat reduction procedures, visit www.coolsculpting.com, www.sculpsure.com, www.mykybella.com, www.myultraslim.com, and/or www.bodybybtl.com.

CoolSculpting® Aesthetic Surgery of Virginia Enrique Silberblatt, MD Roanoke | 540.776.1600 www.silberblatt.com Performing every procedure himself, Enrique Silberblatt, MD offers private consultation time to develop a comprehensive body contouring treatment plan tailored to each patient. In addition to CoolSculpting®, Dr. Silberblatt offers additional body sculpting services to accentuate and define the muscle and skin, complimenting the results of CoolSculpting®.

Check Out CoolSculpting® River Ridge Dermatology Blacksburg | Roanoke | Narrows 540.951.DERM (3376) www.riverridgederm.com River Ridge Dermatology, a Coolsculpting® certified provider, can help patients eliminate stubborn fat that resists all efforts through diet and exercise. The practice offers three effective services, including Coolsculpting®, to help patients achieve fast results with little downtime. River Ridge Dermatology also continues to offer telemedicine appointments and consultations as well as in-office appointments while maintaining safe social distancing protocol. Call to schedule a consultation for your customized treatment plan.

New River Aesthetics Blacksburg | 540.953.2210 Radford | 540.731.6892 Wytheville | 276.335.2112 www.newriverdermatology.com New River Aesthetics, a division of New River Dermatology, is currently offering $200 off Coolsculpting® Packages through the end of July 2020. To get notified about upcoming events, specials and packages, visit the practice’s Facebook page @NewRiverDerm. Continued on page 51... www.OurHealthRoanokeNRV.com

If you’re still holding out hope this year for that beach body that stubborn, hard to lose fat deposits are standing in the way of, you’re not alone. With FDA-approved, nonsurgical fat reduction procedures, the look you’ve been trying to achieve is possible – minus the extra downtime, recovery, scarring, drainage or other unpleasant side effects.

BeRealisticinYourExpectations Non-surgical fat reduction, according to the American Board of Cosmetic Surgery, is intended for patients who are near their ideal bodyweight but are trying to rid themselves of bodyfat that they can’t seem to lose with diet and exercise. As with surgery, some of these procedures can take several weeks or even months to see optimum results; however, you can go about your routine as usual in that time. If you opt for a procedure in May, there’s nothing to stop you from going to the beach in June or July. You could even see optimum results by August, when there’s plenty of summer weather left to be enjoyed.

Keep in Mind:

If FDA-Approved, Nonsurgical Fat Reduction Procedures Sound Appealing, Consider These Options

Noninvasive fatreduction procedures won’t make an overweight person magically become a healthy weight and the results need to be maintained with diet and exercise.

Here are some of the noninvasive fat-reduction procedures you might consider: Note that most of them refer to some kind of lipolysis, the formal term for the breakdown of fat.

The American Society of Plastic Surgeons defines nonsurgical fatreduction procedures as any that use heat, cooling or injected medications to reduce fat cells. They won’t make an overweight person magically become a healthy weight, and the results need to be maintained with diet and exercise. But for people who are trying to lose stubborn areas of body fat, particularly people who cannot or do not want to undergo invasive surgery, they are potential options.

CoolSculpting®

SculpSure®

Kybella®

UltraSlim®

CoolSculpting® what’s known as cryo-lipolysis technology. A device is placed on your skin, where it transmits cold temperatures that freeze the fat cells without hurting your skin or other tissue. The fat is then eliminated through your lymphatic system.

SculpSure® uses what’s known as laser lipolysis. The SculpSure applicator emits laser energy, sending wavelengths through your skin to heat up your fat cells and disrupt them without harming other cells in the process.

Kybella® uses injection lipolysis, in which a chemical called deoxycholic acid, which is naturally produced by the body to break down fat for digestion, is injected into the body, where it disrupts and kills fat cells.

UltraSlim® uses photonic lipolysis, also known as red light therapy. A specialized lamp is used to deliver wavelengths of light through the skin. The wavelengths then trigger selected fat cells to reduce them in size.

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5 BTL Vanquish ME™ BTL Vanquish ME™ uses radiofrequency lipolysis. Radiofrequency is emitted from an instrument or applicator that doesn’t even need to make physical contact with the skin — it’s held from about 1 centimeter away, and its heat kills fat cells without harm to skin or other cells.

Itemsto Consider

Before Making an Appointment

Continued from page 49...

Community Care Connection SculpSure® Allura MD Laser Aesthetics Salem | 540.444.0448 www.alluramd.com

Surgeon Certification

Quick Tip: Be sure to discuss your concerns and

Seek out surgeons that are certified by the American Board of Cosmetic Surgery.

ask questions with your surgeon — and not just about their training and years of experience but also about whether you are a good candidate for the procedure.

What Should You Consider Before Making an Appointment? Although a noninvasive procedure doesn’t come with the same risks and side effects that you would have with surgery, there are still a few important factors to consider. Most importantly, you want to make sure you’re scheduling an appointment with a doctor who is certified to perform the procedure. As the American Board of Cosmetic Surgery explains, an inexperienced or unqualified surgeon means you could end up not getting the results you want, which is a waste of your time and money, plus it sets you up for disappointment. And with the American Society of Plastic Surgeons reporting the average cost of nonsurgical fat-reduction as $1,417, you don’t want to be disappointed in the results.

The American Board of Cosmetic Surgery encourages patients to seek out surgeons that are certified by its board, which ensures those doctors are knowledgeable and trainedintheirfield, have undergone in-depth training, have completed fellowships, and work in accredited hospitals and surgical centers.

It can also be helpful for you to look at before and after photos so you get a sense of what the procedure will accomplish. This can help you determine which option and doctor is best for you, and it will help you manage your expectations. If possible, look at people with body shapes that are similar to yours. Finally, be sure to discuss your concerns and ask questions with your surgeon — and not just about their training and years of experience but also about whether you are a good candidate for the procedure and what you will need to do to see the best results in the months following. Remember, no fat-reduction procedure is a replacement for a healthy lifestyle, and to see long-lasting results from these procedures, you will need to maintain a healthy diet and exercise routine. But if you’re looking to make a subtle change this swimsuit season? Well, one of these procedures could give you the boost of confidence you need.

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Consider the Cost The average nonsurgical fat reduction is $1,417.

Do Your Research Look at before and after photos so you get a sense of what the procedure will accomplish.

Allura MD Laser Aesthetics, a certified SculpSure® provider, offers two special programs that include discount pricing and no-interest payments on treatments. Visit the practice’s website to learn more about these programs and other medical spa services available.

Starkey Medical Esthetics Salem | 540.389.0909 www.starkeymedical.com Starkey Medical Esthetics offers a VIP Program for members only that provides discounts, offers, and incentives. The program begins in October and runs throughout the year. Starkey Medical Esthetics also offers monthly specials on all of their skincare services, including SculpSure®. Visit the practice’s website to view monthly updates and new promotions.

Kybella® The Medi Spa at Ridgewood Hill Roanoke | 540.444.4343 www.medispava.com Carol Wray, MD, and her team of certified skincare professionals offer a variety of non-surgical and skin spa procedures, including Kybella® and CoolSculpting®. In addition to monthly specials found on the practice’s website, they also offer an exclusive VIP Program that includes yearround pricing discounts. Membership dues for the VIP Program are $99 per year.

The Art and Science of Dermatology Roanoke | 540.725.7546 www.theartandscienceofdermatology.com In addition to the practice’s cosmetic dermatology services, including Kybella®, the practice also offers an annual Star Membership program that includes yearround discounts and special pricing on services like fillers and injectables. Visit www.theartandscienceofdermatology.com/ specials for details.

UltraSlim® Talk to Your Surgeon Ask questions with your surgeon to see if you would be a good candidate for the procedure.

New Day Body Sculpting and Aesthetics Winchester | 540.401.5802 www.newdaybodysculptingandaesthetics.com New Day Body Sculpting and Aesthetics offers free complimentary consultations. You can also find the award-winning Skinbetter Science® skincare line at their location.

BTL Vanquish ME™ Charlottesville Skin and Laser Center Charlottesville | 434.984.4491 www.cvilleskinandlaser.com

Don’t Forget No fat-reduction procedure is a replacement for a healthy lifestyle.

Along with body sculpting services, the practice offers specials on services like facials, hair removal, and injectables. Visit www.cvilleskinandlaser.com/specials for details and to learn about upcoming deals.

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CoolSculpting

Guide to

Non-Surgical Body Contouring

ComparingNoninvasiveFat-ReductionProcedures

LENGTHOFPROCEDURE: 30 minutes, performed in-office SIDEEFFECTS/RISKS: Mild discomfort from intense cold feeling. Less than 1 percent see paradoxical hyperplasia (unexpected increase in number of fat cells) FDAAPPROVED: FDA approved for abdomen, flanks, thighs, bra fat, back fat, banana roll, and most recently the upper arms WHO’SNOTACANDIDATE: Patients with sensitivity to cold-related conditions (e.g. cryoglobulinemia, cold urticaris and paroxysmal cold hemoglobulinuria) NUMBEROFPROCEDURESREQUIRED:Typically two treatments HOWLONGBEFOREREALIZINGRESULTS: Two to four months

Under the Chin Kybella

Upper Arms CoolSculpting

SIDEEFFECTS/RISKS: Temporary redness, tenderness or swelling

Back

FDAAPPROVED: FDA approved for abdomen, flanks, back, inner thighs, outer thighs and submental area

Waist

WHO’SNOTACANDIDATE: Patients with loose skin or fat deep inside the abdomen

Abdomen

CoolSculpting, SculpSure UltraSlim and BTL Vanquish ME™

Flanks

(Love Handles)

CoolSculpting, SculpSure UltraSlim and BTL Vanquish ME™

Hips

UltraSlim

Buttocks UltraSlim

Under the Buttocks CoolSculpting

Inner and Outer Thighs

CoolSculpting, SculpSure UltraSlim and BTL Vanquish ME™

Quick Facts about Non-Surgical Body Contouring Options to reduce fat, smooth cellulite, tighten skin, rejuvenate sagging tissues & more Less dramatic results than surgery, but little to no downtown Most treatments are done in-office in 90 minutes or less Gradual onset of results; typically results are final in 2 to 3 months

When is Cosmetic Surgery a Better Option? » You desire more dramatic body sculpting » You have significant loose or sagging skin » You prefer to undergo a procedure only once to achieve your final results » Your cosmetic surgeon agrees that surgery will better achieve your desired changes » You would like to enhance, rather than reduce, the size of an area 52

LENGTHOFPROCEDURE: 25 minutes, performed in-office

CoolSculpting and SculpSure

UltraSlim

» » » »

SculpSure

NUMBEROFPROCEDURESREQUIRED:One or more, depending on treatment area HOWLONGBEFOREREALIZINGRESULTS: Six to 12 weeks

Kybella LENGTHOFPROCEDURE: 20 minutes, performed in-office SIDEEFFECTS/RISKS: Temporary mild swelling, numbness, redness, bruising, risk of facial weakness or prolonged numbness (rare) FDAAPPROVED: FDA approved for treatment of the area under the chin (double chin) WHO’SNOTACANDIDATE: Not for patients with loose skin or poor tone NUMBEROFPROCEDURESREQUIRED:Often two are needed, but a patient can have up to six HOWLONGBEFOREREALIZINGRESULTS: Eight weeks

UltraSlim LENGTHOFPROCEDURE: About 30 minutes, performed in-office SIDEEFFECTS/RISKS: None FDAAPPROVED: FDA approved for nonsurgical fat reduction WHO’SNOTACANDIDATE: Not for patients who are pregnant or have reduced liver function NUMBEROFPROCEDURESREQUIRED:Yes, usually three or more HOWLONGBEFOREREALIZINGRESULTS: Results seen in as little as a few hours

BTL Vanquish ME™ LENGTHOFPROCEDURE: About 30 minutes, performed in-office SIDEEFFECTS/RISKS: Mild erythema FDAAPPROVED: FDA approved for deep tissue heating WHO’SNOTACANDIDATE: Not for patients with loose skin or poor tone NUMBEROFPROCEDURESREQUIRED:Typically once per week for four weeks HOWLONGBEFOREREALIZINGRESULTS: Two weeks from fourth procedure

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MORE THAN

MEETS THE EYE III Eye Health and Thyroid Disease In part III of our series, The optometrists at Blacksburg Eye Associates take us on a journey with B.E. SPEC (Blacksburg Eye sidekick Specialist) who shares his insight on the surprising ways your eyes reflect your thyroid health. words | JENNIFER LAMONT

In the first two parts of our “More Than Meets the Eye” series, we learned how the optometrists at Blacksburg Eye Associates can not only see if your vision has changed but can also detect heart disease, immune disorders and other conditions during an eye exam. In fact, an eye exam can be as effective as a physical in determining your overall health. It’s also where patients may be surprised to learn they have a problem with their thyroid. Like many diseases, thyroid disease often shows up in the eyes first. The eye doctor has a front-row seat into how your thyroid is behaving because of changes to your vision, muscles and other tissues of the eye. Many of these changes aren’t something you may notice—and some are telltale signs of thyroid disease. In this issue, “Your Eyes and the Thyroid,” Blacksburg Eye Associates specialist, B.E. SPEC, is back again to show you how it all works. A little sort of fellow, you may remember SPEC from our ongoing eye health series. He gives you an inside look into that little butterfly-shaped gland in your neck, your thyroid, and how it impacts your vision and eye appearance overall. We’ll tell you the reasons why it’s so important to get a comprehensive eye exam every two years, even if you don’t think you have a problem with your eyesight or notice a change in your vision.

Hi, I’m SPEC!

I’m here to help you preserve your vision. If your immune system is unbalanced, your eyes can give clues to the docs at Blacksburg Eye—even if you don’t notice any vision problems.

Put Your Knowledge to the Test

| page 60

As you follow SPEC along the illustrative map on page 60, you can test your ‘Eye(Q)’ knowledge with our fun, interactive quizzes. On your way to the finish line, watch out for B. Lind Spot, who likes to throw obstacles in your way that can damage your vision.

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1 IN 8

WOMEN According to the American Thyroid Association, one woman in eight will develop a thyroid disorder during her lifetime.

60%

Up to 60 percent of those are unaware of their condition. But, once discovered, most types of thyroid conditions can easily be treated.

Is Your Thyroid Really That Important?

Did You Know?

Hashimoto’s thyroiditis is a type of autoimmune thyroid disorder where the body’s immune system attacks the thyroid gland as if it was foreign tissue, causing it to be inflamed and malfunction.

Studies now show that Hashimoto’s disease is more common in people who work more than the typical 40 hours a week.

Yes, it is. And here’s why: Your thyroid regulates your body and brain in surprising ways. As a master gland, it secretes a steady stream of hormones into your bloodstream from where it sits at the lower front part of your neck. Thyroid hormones are carried to every cell of your body, so the gland needs to stay balanced. Your heart, muscles, brain and other organs depend on a steady, balanced supply of these hormones to function properly. When out of balance, the thyroid can secrete too little regulating hormone (hypothyroid), or too much (hyperthyroid). Both conditions result in symptoms that can look like other conditions. While certain symptoms are common to each type of thyroid problem, it’s not unheard of to experience the same types of symptoms regardless of whether you’re hypo or hyper, such as hair loss and muscle aches. Here are some of the more usual symptoms common to each type:

Hypothyroid (UNDERACTIVE)

Weight gain » Rough, dry skin or hair loss » Depression, anxiety or » memory loss Brain fog, fatigue or feeling » run down Muscles aches and weakness » Cold intolerance » Puffy or dark circles under » the eyes Increased cholesterol and » risk of co-morbid conditions like heart disease and type 2 diabetes

DID YOU MISS PART TWO OF THE

More Than Meets the Eye Series? CHECK IT OUT ONLINE AT www.OurHealthRoanokeNRV.com

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Hyperthyroid (OVERACTIVE)

Weight loss, even with high calorie » intake Rough, dry skin or hair loss » Anxiety or memory loss » Brain fog or feeling run down » Nervousness, tremors and insomnia » Muscle aches and weakness » Heat intolerance, excessive sweating » Puffy or bulging eyes » Facial swelling » Increased cholesterol and risk of co» morbid conditions like heart disease and type 2 diabetes

Many of these symptoms are often incorrectly attributed to aging, especially in women. According to the American Thyroid Association, one woman in eight will develop a thyroid disorder during her lifetime and up to 60 percent of those are unaware of their condition. But, once discovered, most types of thyroid conditions can easily be treated.

How Thyroid Disease Shows Up in Your Eyes While a disordered thyroid can cause many symptoms throughout your body, thyroid disease can also affect your eyes due to inflammation. That inflammation can lead to damaged eye tissues and vision loss. Whether your thyroid is making too little or too much hormone, it can affect your eyes in distinct ways. Most people are aware of what happens when someone has an overactive thyroid, usually caused by Grave’s disease, and the characteristic bulging eyes, retracted eyelids and muscle damage that can occur.

Grave’s ophthalmopathy, or thyroid eye disease (TED):

This autoimmune condition occurs as often as glaucoma. The body mistakenly attacks the eyes and surrounding tissues as a ‘foreign object’ in the same way it attacks the thyroid gland itself. It’s this attack that causes muscle and fatty tissue enlargement in the eyes, extra pressure, difficulty closing the eyelids and sensitivity to light, just to name a few symptoms.

Patients who are at the opposite end of the spectrum with an underactive thyroid, however, can also develop thyroid eye disease—although not nearly as frequently. In either case, if your eyes often feel gritty, watery, dry, red or inflamed, these may be more subtle signs of thyroid eye disease that call for additional medical testing. If your eyelids are especially puffy and the hair on the outer halves of your eyebrows no longer grows or is thinning, that can also be a sign of thyroid disease. While an overactive thyroid has more outwardly visible and severe eye symptoms, an underactive thyroid is a much more common condition in adults and can still damage the eyes without the visible symptoms.

Did You Know? If you know you have thyroid disease already, regular, comprehensive eye exams are crucial.

Thyroid eye disease symptoms can occur in patients who are hypothyroid, hyperthyroid and in a small percentage of patients who are secreting normal amounts of thyroid hormones.

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Did You Know?

Your eye doctor can pick up changes in your vision that aren’t obvious to you, even if you feel like your eyesight has not changed. They can also detect clues to how your thyroid is behaving by testing your optic nerves, vision, visual field and taking eye pressure readings.

When is it time to schedule an appointment? Schedule an eye exam immediately if you experience sudden changes in your vision, including:

Blurring or double vision in one or both eyes

» »

Floaters or spots

» » »

Bright flashes or blind spots

A diagnosis of any kind that may affect your vision (diabetes, autoimmune disorders)

Dimmed vision, even if it lasts only a few seconds Distorted objects Frequent headaches or sensitivity to light

“

Ocular manifestations of thyroid disease can be obvious, or not so obvious, and only a comprehensive eye exam can correctly diagnose whether this type of autoimmune condition has damaged the tissues of the eyes or eyesight. Patients are often surprised to hear that dry eyes, watery eyes, double vision, and pressure or swelling around the eyes can indicate a serious condition, including thyroid disease. And if a patient already knows they have a thyroid condition, eye exams are especially important to their overall health and management of the disease. – Dr. John Dovie, OD, FAAO, Blacksburg Eye Associates.

”

Because thyroid eye disease impacts women more frequently as they get older, many of these symptoms can be mistaken for menopausal signs or just aging. Overall symptoms throughout your body, as well as eye issues, are sometimes so subtle the disease can often get overlooked during a regular physical. Thyroid eye disease affects middle-aged women more than any other group, but it can occur at any age. When it develops in men, the disease is harder to treat and can progress more rapidly and intensely than it does in women. The most serious eye condition that can develop in thyroid eye disease is vision loss, which can occur when the optic nerve gets compressed. So, a comprehensive eye exam is essential for making a correct diagnosis. Because eye doctors are often the first to find undiagnosed, and sometimes surprising, health issues, a comprehensive eye exam can help boost your overall health and help you see clearly throughout your lifetime.

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John Dovie, OD, FAAO An optometrist with Blacksburg Eye Associates.

Colleen Mitchell, OD, FAAO An optometrist with Blacksburg Eye Associates.

Adrianna Hempelmann, OD An optometrist with Blacksburg Eye Associates.

If you have questions related to any of the topics covered in this series and/or you wish to schedule an appointment with an eye care specialist, call Blacksburg Eye Associates at 540.953.2020 or visit www.blacksburgeye.com for additional information.

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JOIN SPEC TO

Test Your EyeQ

As you follow SPEC along the path to good health, test your knowledge with our fun, interactive quizzes. On your way to the finish line, watch out for B. Lind Spot, who likes to throw road blocks in the way that can damage your vision.

Your thyroid absorbs needed iodine from foods. Which foods do NOT have iodine in them? Way to go!

A – Seafood B – Turkey C – Yogurt D – Himalayan Salt

Continue down the path to good health.

IF YOU PICKED ANSWER D:

While it has trace amounts of minerals that are good for you, Himalayan salt has very little naturally occurring iodine in it.

YOU ARE CORRECT AND CAN CONTINUE DOWN THE PATH OF GOOD HEALTH!

ROAD BLOCK BUT, IF YOU PICKED ANSWERS A, B, OR C:

In terms of iodine and salt, regular iodized table salt meets your daily requirements better than the pink stuff.

YOU HIT ONE OF B. LIND. SPOT’S ROAD BLOCKS! Quick, learn the correct answer to continue down the path of good health.

DETOUR AHEAD You did it!

Continue down the path to good health.

Smoking doesn’t affect your thyroid. IF YOU PICKED ANSWER B:

A – True B – False

YOU ARE CORRECT AND CAN CONTINUE DOWN THE PATH OF GOOD HEALTH!

ROAD BLOCK

BUT, IF YOU PICKED ANSWERS A:

YOU HIT ONE OF B. LIND. SPOT’S ROAD BLOCKS!

Smoking is one of the biggest risk factors for thyroid disease. It increases your risk by eight times and reduces the effectiveness of medicines and treatments.

Quick, learn the correct answer to continue down the path of good health.

DETOUR AHEAD Great work today friends! In the August/September 2020 edition of OurHealth for Roanoke and New River Valleys, we will continue our More Than Meets the Eye Series with a look at how eye health can have an impact on the kidneys.

Great work!

Continue down the path to good health.

Weight gain, fatigue, hair loss, dry skin and decreased concentration are all signs of which type of thyroid disorder? A – Hypothyroid B – Hyperthyroid C – Both A and B IF YOU PICKED ANSWER C:

YOU ARE CORRECT AND CAN CONTINUE DOWN THE PATH OF GOOD HEALTH!

GOT YOU!

ROAD BLOCK

BUT, IF YOU PICKED ANSWERS A OR B:

YOU HIT ONE OF B. LIND. SPOT’S ROAD BLOCKS! Quick, learn the correct answer to continue down the path of good health.

Weight gain, fatigue, hair loss, dry skin and decreased concentration are signs of both hypothyroid and hyperthyroid, although more common in hypothyroid patients. Because your thyroid regulates essential processes like breathing, metabolism and heart rate, an underactive thyroid doesn’t secrete enough hormone to keep these processes going at the proper speed. But a person can experience these hypothyroid symptoms when they’re actually hyperthyroid, and vice versa.

DETOUR AHEAD

What is the most common early symptom of thyroid disease that affects the eyes?

While dry eyes can be attributed to a number of conditions, if you are experiencing other thyroid symptoms, like thinning hair, difficulty swallowing or fatigue, you should schedule both a physical and a comprehensive eye exam.

A – Vision loss B – Dry eyes C – Puffy eyelids D – All of the above

IF YOU PICKED ANSWER B:

YOU ARE CORRECT AND CAN CONTINUE DOWN THE PATH OF GOOD HEALTH!

ROAD BLOCK BUT, IF YOU PICKED ANSWERS A, C, OR D:

YOU HIT ONE OF B. LIND. SPOT’S ROAD BLOCKS! Quick, learn the correct answer to continue down the path of good health.

DETOUR AHEAD www.OurHealthRoanokeNRV.com

Stepping Up Our Game

in the Face of a Pandemic Fitnesscentersfindnewhopecoming outofthepandemic. words | RICK PIESTER

For so many businesses across Virginiaâ&#x20AC;&#x201D;like those throughout Americaâ&#x20AC;&#x201D; mid-March marked the beginning of the end. As COVID-19 took over our state and the nation most industries were forced to close or drastically curtail their operations to limit the spread of the runaway pandemic. But some organizations saw the shutdown as a way to become creative, finding ways to serve their clientele and preserving what they could of their missions, talents, employees, and their income. Fitness centers, in particular, found ways not only to endure but thrive. COVID-19 may have eliminated the traditional methods clients got their exercise, but fitness centers did not merely go away. Flurries of last-minute, intense meetings produced innovations that not only buoyed the centers and their members during the multi-level shutdowns but also provided fodder for future activities.

Social Media Steps In Nationally, fitness is a $34 billion industry, and estimates are that 20 percent of Americans have memberships in some type of fitness organization, according to the International Health, Racquet and Sportsclub Association. 62

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When workout spaces were forced to shut their doors, fitness club members turned to their cell phones, tablets and laptops. In the Roanoke Valley, many fitness organizations had already become comfortable with presenting fitness activities online with live-streaming or recorded sessions through Facebook, YouTube, or even Zoom for small groups. And they used various messaging techniques to steer their members online. At the five-location YMCA of Virginia’s Blue Ridge, changes were launched on some particularly broad fronts, according to Regional Director, Tricia Reynolds. “We stepped up a lot of our offerings on Facebook and our YouTube channel,” she noted, adding that members responded well. Some clients, she says, worked out in real-time along with instructors from the Y’s studio. Others recorded the sessions and went to them later.

“

of the personal connections that members and guests have with our instructors,” he says.

Stepping Up On-Site Distance and Services Following the state-mandated 10 feet of separation between workout room users meant each organization had to take a different approach. The Green Ridge Center has a substantial footprint, so staff there were able to accomplish separation requirements by placing grill covers over every other piece of exercise equipment.

Exercise is a great antidote for stress and isolation.

“We also did a lot of at-home calls to our members and donors,” she says, “and we learned that a lot of people were stressed during the shutdown period. They felt isolated, and exercise is a great antidote for stress and isolation. We encouraged people to go to Facebook or take our virtual classes.” Indeed, the COVID-19 pandemic had very much elevated the value of working out. Poor cardiovascular health is one of the significant risk factors for severe illness or death as a result of the virus. Roanoke County’s Green Ridge Recreation Center also made heavy use of online activities. “We closed on March 18,” says Scott Ramsburg with Roanoke County Parks, Recreation and Tourism, “thinking that perhaps we’d be closed for only a few weeks. And as time went on, we realized we didn’t really know when we would reopen.” So, the Green Ridge Center started the first of what would eventually evolve into approximately 75 different online video workouts, using local instructors. There is plenty of “one-size-fits-all” material available from national sources, but Ramsburg feels that using local instructors helped with membership retention. “It really underlines the importance

The YMCA needed to do things a little differently to observe the 10-feet rule. “In our wellness centers, we moved the equipment throughout the entire facility at each location,” notes Reynolds. They moved equipment into gymnasium spaces and even into hallways. “That way,” she says, “we maximized the space available to us so that more people could work out, while at the same time feeling safe and comfortable when Phase 3 was implemented.” (In most of Virginia, Phase 3 was ushered in on July 1.)

”

Embracing Change Every Step of the Way In addition to online activities and physical space modifications, fitness centers made further innovations to include outdoor fitness classes. Outdoor classes, allowed during Phase 2, were a popular choice for many members—and a godsend for others who felt particularly isolated during the shutdown. Helping their clientele to keep fit has led to nonfitness innovations as well. Both the YMCA and Green Ridge Recreation Centers have responded to demands for childcare services. When many childcare centers closed in mid-March, locals turned to these organizations for help with daycare. Both facilities now offer daycare services for working families. They are finding these services help cement connections between their organizations and area families, offering promise for increased memberships once the pandemic— hopefully—is behind us all.

Green Ridge Recreation Center 540.387.6078 7415 Wood Haven Road Roanoke, VA 24019 greenridgerecreationcenter.com

f GreenRidgeRecreationCenter f Roanoke County Parks

YMCA of Virginia’s Blue Ridge f YMCAVBR f YMCA of Virginia’s Blue Ridge ymcavbr.org

Kirk Family YMCA 540.342.9622 520 Church Avenue SW Roanoke, VA 24016

Salem Family YMCA 540.387.9622 1126 Kime Lane Salem, VA 24153

YMCA Express at Gainsboro 540.344.9622 108 Orange Avenue NW Roanoke, VA 24016

Rockbridge Area YMCA 540.464.9622 790 North Lee Highway Lexington, VA 24450

Botetourt Family YMCA 540.966.9622 115 Shenandoah Avenue Daleville, VA 24083

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NUTRITION

Most prominent among water’s benefits are the ways it regulates body temperature, lubricates your joints, and removes waste through urination, perspiration and bowel movements. Water helps your body absorb certain vitamins and minerals, improves blood flow, and even boosts your cognitive function.

INSIGHT • AWARENESS • PREVENTION

Most people need to DRINK SIX TO

EIGHT GLASSES of water everyday,

Is Your H2O Hydrating

or Overhyped? With so many types of water available for consumption, it’s tough to determine what’s actually benefitting you and what’s simply a marketing ploy. words | DYLAN ROCHE

Water, water everywhere, but which type should you drink? And how much? And when? If you find yourself looking at shelves of bottled water in the grocery store and trying to determine the best type, you’re not alone. The task of finding the right bottle of H2O is steeped in a little bit of misconception (and sometimes even marketing gimmicks). That’s not to say water isn’t important for your overall wellness — any doctor or healthcare expert will tell you that it absolutely is. But most of the time, just drinking the plain ol’ stuff straight from the tap is just as good for you, or even better for you, than the expensive bottle with the trendy health claim you get from the store.

Health Benefits of Hydration There’s no one single benefit to drinking plenty of water — it’s vital for overall health. Everything in your body depends on water if it’s going to function the way it should: Every cell, tissue, organ and system in the human body requires water.

but this rule isn’t hard and fast for everyone.

Benefits of Water 1 Lubricates Your Joints

2 Removes Waste

3 Helps Body Absorb Vitamins and Minerals

4 Improves Blood Flow

5 Boosts Cognitive Function

(8 ounces per glass)

Somepeopleneedmore whileotherpeopleneed less. As the Centers for Disease Control and Prevention notes, you get some fluids through the foods that you eat, such as fruits and vegetables with high water content (think celery, tomatoes, melons, apples, and berries). If you eat a lot of water-densefoods, you might not need to drink a full eight glasses of water.

On the other hand, some people have an increased need for water because they’re at a higher risk of dehydration. Athletes undergoing intense training, for example, need to drink more water to replace what they lose through sweat — this is especially true if they’re exercising outside in hot weather. The same goes for people who work physically demanding outdoor jobs, such as landscaping or construction. Certain health conditions will also increase your hydration needs. If you’re running a fever or if you’re losing a lot of fluids through diarrhea and vomiting, you need more water than normal. Additionally, people who have certain medical conditions, such as kidney stones or bladder infections, might hear from their doctor to drink extra fluids. www.OurHealthRoanokeNRV.com

Drinking plenty of water, but your pee looks like highlighter ink? It mightbe thevitaminB complex you’re taking. Vitamin B supplements, or a multivitamin with a high dose of B vitamins, will often turn your urine bright yellow. Don’tbealarmed

— this is normal and not a sign of dehydration.

The Problem with Being Parched If you’re worried you aren’t drinking as much water as you should be, your body will tell you. The easiest way to find out is to check the color of your urine. A hydrated person’s urine will usually be colorless or light yellow, but people who are dehydrated will often urinate a dark yellow or even an amber color. If you’re dehydrated, you might notice other symptoms beyond the color of your urine. Dehydration can also cause fatigue, headaches, lightheadedness, dry mouth and extreme thirst. Instead of waiting for symptoms, you should actively prevent dehydration by consuming plenty of water throughout the day. It’s also important to increase your fluid intake if you consume a lot of caffeine, which is a diuretic and will make you urinate more frequently. Keep your caffeine intake to no more than 200 to 300 milligrams per day.

What Are You Drinking? When it comes to staying hydrated, water is your best bet instead of fluids like juice or soft drinks, because water does the job without any added calories or sugars. But what type of water is the best for you? According to the Mayo Clinic, tap water and bottled water are similar in terms of safety, so whether you choose to drink water straight from the tap or buy a bottled product mostly comes down to personal preference. 66

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While tap water is generally safe, some people with

CERTAIN HEALTH CONDITIONS COULD BE VULNERABLE to

getting sick from contaminants in water — chemo patients, people with HIV/AIDS, transplant recipients, pregnant women, seniors and children could all be at risk, according to the Mayo Clinic. Yourdoctorcanadvise youonwhatprecautions youshouldtake, whether you should boil your tap water, or whether you should opt exclusively for bottled water.

The Food and Drug Administration (FDA) regulates the many different types of bottled water on the market, holding them to what’s known as a “standard of quality.” These standards dictate the maximum level of contaminants that bottled water can have, including chemical, physical, microbial and radiological contaminants. The FDA’s current good manufacturing practice regulations (commonly called CGMP) dictate that bottled water must be produced, held and transported under sanitary conditions. In addition to enforcing good manufacturing practices on manufacturers of bottled water, the FDA maintains standards for identifying specific types of bottled water and requires those types be identified on the label. In other words, when you pick up two bottles in the grocery store and one says “spring water” and the other says “distilled water,” those identifiers are actually defined and regulated by the FDA. So, in that case, what’s actually the difference between spring water and distilled water? Let’s break down the different options you have as a consumer when it comes to staying hydrated.

Tap Water: This is probably the most readily available type of water for the average American household. Tap water is the water that comes straight from your kitchen sink, and yes, it’s safe to drink. The water that flows into your home comes from a municipal source that is regulated by the Environmental Protection Agency, and the Centers for Disease Control and Prevention even states the U.S. drinking supply is one of the safest in the world. The water is processed and treated to meet drinking water standards, even though, according to the International Bottled Water Association, less than 1 percent of municipal water is actually used for drinking. Municipal water is primarily used for activities like cleaning, cooking, showering, watering the lawn or garden, and flushing the toilet. In rare circumstances, sources of public water can become contaminated either at the source or during the distribution system, according to the CDC. This can cause adverse health problems. If this situation occurs, your household will receive notification from local authorities, such as your local department of health or department of public works.

Mineral Water: Per the FDA’s definition, mineral water is that which has come from an underground source and contains minerals (such as sodium or calcium) or trace elements that are naturally part of the underground water source — they haven’t been dissolved into the water by the bottling company. The water must contain at least 250 parts per million total dissolved solids according to the FDA’s definition.

Spring or Glacier Water: These terms mean the water has been taken from an underground formation where the water flows naturally to the surface. In some cases, the water will be collected through a borehole that taps into the underground formation feeding the spring, but the FDA requires that this water must have the same composition and quality as it would have when it flows naturally to the surface.

Sparkling Water: Sparkling water is technically not considered a type of bottled water under FDA regulations — it’s actually a soft drink. Sparkling water, which is sometimes called club soda or soda water, is water that has been carbonated, a process in which it is infused with carbon dioxide gas. This carbonation gives sparkling water its distinctive bubbly effervescence. As long as there are no added sugars or artificial flavors, sparkling water is just as good for you as other types of water. It’s just as hydrating, and despite popular misconception, the carbonation does not pose any threat to your bones or teeth. However, people with sensitive stomachs could feel gassy or bloated from the carbonation. www.OurHealthRoanokeNRV.com

Purified Water:

Alkaline Water:

Purified water comes from municipal sources just like tap water, but it is treated with a purification process before it is bottled up and distributed. One common type of purified water is distilledwater, which is vaporized, leaving behind any minerals it contains, and then the vapors are condensed into water again.

There’s an idea out there that by consuming foods and drinks that are alkaline (that is, they have a higher pH level compared with acidic foods), you can lower the acidity of your blood and help protect yourself against diseases.

Other ways of purifying water include reverseosmosis, where the water is forced through membranes to remove minerals, or ozonation, where ozone gas, an antimicrobial agent, is used to disinfect the water instead of chlorine, which can leave an unpleasant taste and odor.

14 13 12 11 10 9 8 7 6 5 4 3 2 1 0

Flavored or Infused Water: As the name suggests, flavored or infused water is water that has been flavored or infused to give it a distinct taste. In some cases, this is a good thing — it might have natural flavors and no added sugars, so you’re ostensibly drinking plain water with a more appealing taste. But check the ingredient list and nutrition facts first. Artificial flavors, artificial colors, added sugars, artificial sweeteners, caffeine or other ingredients might be a turn-off depending on your health concerns.

Flavored water can be a great option for people who are used to drinking a lot of soda or fruit punch and are bored by the taste of plain water. You can even make your own flavored water at home by dressing it up with slices of lemon, limes, oranges, cucumbers or strawberries. 68

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As such, people consume alkaline water — which often has a pH of 8 or 9 — with

THE HOPES THAT IT WILL NEUTRALIZE THE ACIDS IN THEIR BLOOD BETTER than

traditional water, which has a pH of 7, making it neutral and neither alkaline nor acidic.

Unfortunately, this believe is a myth and not a fact.

Electrolytes Water: Electrolytes — including sodium, potassium, calcium and magnesium — are minerals that carry an electric charge when they’re dissolved in water, and they’re vital for many important bodily functions, including

fluid balance. People lose electrolytes through sweat, so athletes and other individuals who perspire profusely need to be diligent about replenishing their electrolytes along with their fluids; however, this is often easy enough to do with a balanced diet.

THERE’S NO NEED TO CONSUME DRINKS THAT ARE SUPPLEMENTED WITH ELECTROLYTES, such as Gatorade, which are often high in sugar and calories.

Well Water: Some properties source their tap water from a private well rather than from a municipal source regulated by the EPA. Well water is taken from a hole drilled into the ground to tap what’s known as an aquifer — a layer of rock, sand or earth containing water.

Because the EPA does not regulate private wells, people in households onwellwatershouldgettheir watertestedforcontaminants annually.

What’s the Verdict? When it comes to water, opt for bottled water if it’s more convenient (for example, you’re on a road trip and need a healthy, hydrating beverage from the gas station), but it’s generally no healthier or safer for you than tap water from a municipal source. Avoid any sort of gimmicky health claims, such as those about alkalinity or electrolytes, and always be sure to read the label to make sure there aren’t any added sugars or other ingredients.

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Test Your Knowledge: Think you have a solid understanding of what makes a good bottle of water? TRUEor FALSE: Bottled water is better for you than tap water. ANSWERFALSE: Although bottled water might be convenient in some

circumstances, tap water is just as hydrating.

TRUEor FALSE: The carbonation in sparkling water dehydrates you and depletes your body of calcium. ANSWERFALSE: This is a common misconception. Sparkling water is just as

hydrating as regular water.

Which of the following is a circumstance that might warrant drinking more than the recommended six to eight glasses of water a day? A Intense physical activity in the heat B Vomiting and diarrhea

C D

A bladder infection All of the above

ANSWERD: Any of these three reasons would warrant drinking more water.

www.OurHealthRoanokeNRV.com

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THE LAST STITCH LOCAL • TOGETHER • COMMUNITY

Good:We’re respecting personal space. The Centers for Disease Control and Prevention has been encouraging people to keep six feet of distance between themselves and others, as this will lessen the risk of transmission. Thanks to this guideline, many are now paying conscious attention to the personal space of others and reducing the risk of exhaling germy respiratory droplets on somebody else or having somebody else’s germy respiratory droplets on them.

The New Normal of Health: Good or Bad? words | DYLAN ROCHE

Life has definitely been different for the past few months. Throughout the COVID-19 pandemic, people across the country and around the globe have had to change the way they work, shop, attend school, exercise, worship and socialize. But it’s not merely restrictions and closures that have altered people’s ways of life. COVID-19 has altered the way people think about their health and hygiene — people who until recently might not have thought twice about how easily germs and viruses can be transmitted have But done now found themselves hypervigilant, whether for their improperly or own safety or for the safety of those around them.

“

taken to the extreme, these healthy practices have the potential to be detrimental.

”

In many ways, that’s a good thing. People are careful to respect the personal space of others, to disinfect the surfaces in their homes and places of business, and even keep their hands clean to the best of their ability. Who could argue with these practices?

But done improperly or taken to the extreme, these healthy practices have the potential to be detrimental. Let’s take a look at these habits that many of us are developing during the spread of COVID-19 and consider how we can keep safe and healthy, either now or in the long term after the pandemic ends.

Bad:Being physically close to people can be good for us. While most people are not in the habit of making physical contact with strangers, the fear of getting too physically close has meant limited interaction with friends, neighbors, and even extended family. This is detrimental because physical closeness and touch is an important part of our physical and mental wellbeing. According to Penn Medicine, our bodies produce the hormone oxytocin when we make physical contact with somebody else, and oxytocin stimulates feelings of trust, bonding and connection, all of which are good for our mental health. Oxytocin can also improve physical health by improving appetite control, enabling better sleep, and improving our mood. In fact, the National Institutes of Health explains that people who are social and frequently have physical interaction with others tend to live longer lives, and they are even less likely to develop colds even when they are exposed to viruses.

OUR TAKE: Personal space is great, and let’s continue to respect it. But once the pandemic is over, let’s go back to hugs and handshakes (as long as we and the other person can both be presumed healthy).

www.OurHealthRoanokeNRV.com

Did You Know?

Long-term use of antibacterial soap can cause more harm than good by killing the healthy bacteria on your skin. The Cleveland Clinic advises consumers to avoid antibacterial hand soap, as long-term exposure to the chemicals in these soaps could kill the healthy bacteria on your skin and could even cause hormonal effects. Instead, opt for soap without antibacterial chemicals, which does just fine when combined with water to loosen dirt and germs and remove them from your skin.

COMMON MISUSE OF HOUSEHOLD CLEANERS:

Using more of a product than directed on the label.

Good: We’re doing a better job of disinfecting. Because the research isn’t yet clear how long coronavirus can live on certain surfaces, more people are taking extra precautions to disinfect often-touched surfaces that ordinarily wouldn’t get the clean treatment the way they should — that includes the obvious places like the kitchen counter, as well as less obvious spots like doorknobs, light switches, and elevator buttons.

Bad: Some people aren’t using disinfectant carefully — and it’s making them sick. The Centers for Disease Control and Prevention notes that as the use of cleaners and disinfectants increased, so too did the possibility of improper use, and the number of cases of people exposed to toxic products saw a sharp increase in March 2020. Among the common ways people misuse household cleaners are using more of a product than directed on the label, mixing chemical 72

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Mixing chemical products together.

Applying in areas with bad ventilation.

Using chemical products without proper protective gear, such as rubber gloves.

Storing cleaning products in a place that is accessible to small children.

products together, applying in areas with bad ventilation, and using chemical products without proper protective gear, such as rubber gloves. Additionally, people should never store cleaning products in a place that is accessible to small children. Disinfectant misuse spiked even further following a comment by President Donald Trump during a coronavirus task force briefing, in which he suggested injecting cleaners into the body as a way of killing the virus (President Trump later claimed this suggestion was made sarcastically). In the 18 hours following the President’s comment, the New York City Department of Health and Mental Hygiene saw approximately 30 cases of misuse reported to its poison control department. Reckitt Benckiser, the company that manufactures Lysol and other popular cleaning products, put out a statement saying, “As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route).” The company also said, “As with all products, our disinfectant and hygiene products should only be used as intended and in line with usage guidelines. Please read the label and safety information.”

OUR TAKE: Disinfecting is great, and we should stick with doing it regularly — and doing it to all surfaces. But if we’re going to keep cleaners around the house, we need to be careful that we’re following instructions, using them properly, and storing them away from children.

Good: People are keeping their hands clean. In the early weeks of the coronavirus pandemic, grocery stores and pharmacies across the country couldn’t keep their shelves stocked with enough hand soap and hand sanitizer. Keeping clean hands had become a major priority for the population. That’s a good thing, as the CDC calls hand washing the most effective way of stopping the spread of germs, thus reducing the risk of getting yourself sick or getting others sick.

Bad: Don’t overdo it. Unfortunately, there are some healthy practices you can do to an unhealthy extent. More importantly, you shouldn’t assume they make you invincible. As the CDC explains, alcohol-based hand sanitizers should never take the place of a good hand washing with soap and water; what’s more, people are more likely to contract a virus by breathing in respiratory droplets than by having germs on their hands.

Quick Tip: According to the CDC,

Alcohol-based hand sanitizers should never take the place of a good hand washing with soap and water.

People talk about how the coronavirus requires us to adopt a “new normal.” And our take on that? Well, that’s not a bad thing if this new normal is better for our own health and the health of those around us!

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The Cleveland Clinic advises consumers to avoid antibacterial hand soap, as long-term exposure to the chemicals in these soaps could kill the healthy bacteria on your skin and could even cause hormonal effects. Instead, opt for soap without antibacterial chemicals, which does just fine when combined with water to loosen dirt and germs and remove them from your skin. People can also face problems if they wash or sanitize their hands too frequently, as this can cause their skin to dry out, crack and get easily infected. If you are in a situation where you have to wash your hands frequently — for example, you are a caretaker for an elderly or immunocompromised person — be sure to keep your hands moisturized with lotion.

OUR TAKE: Washing your hands is good, and in some situations (such as a pandemic), we might need to do it more frequently than is comfortable. When the pandemic is over, let’s continue to keep our hands clean — but let’s not do it more than is necessary. www.OurHealthRoanokeNRV.com

Who Do You

THINK HAS THE

BEST

BEDSIDE MANNER IN Roanoke & New River Valleys?

A DV E R T I S E R D I R EC TORY 11 Alzheimer’s Association 19 American Heart Association 15 American National Bank & Trust 33 Anderson Desimone & Green, P.C. 6 Asthma & Allergy Center 57 Blacksburg Eye Associates 27 Brandon Oaks 3, 39 Carilion Clinic 69 Center for Neurorehabilitation Services 38 Crowning Touch 54, 64 Green Ridge Recreation Center 73 Humana, Lynn Atkinson 4 Interim Healthcare 75 Medical Facilities of America 9 Mills and Shannon Dentistry 21 Mountain View Orthodontics 31 New Beginnings Pediatrics 13

New River Periodontics

35 Our Lady of the Valley 23 Paul C. Kaiser, Ltd. Orthodontics 13 Pheasant Ridge Assisted Living & Memory Care 53 Physicians to Women, Inc. 18 Rader Funeral Home

2020

69 Radford Health and Rehab Center 17 Reproductive Medicine and Surgery Center of Virginia, PLC

2020

53 River Ridge Dermatology

BEST BEDSIDE MANNER AWARDS

COMING SOON!

14 Annual Best Bedside Manner Awards Don’tmiss the

59 Richfield Living

in the December/JanuaryEdition of

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14 Roanoke Oral Surgery 59 Roanoke Valley Speech and Hearing Center, Inc. 5 Susan G. Komen Virginia Blue Ridge 2 VCOM 47 Virginia Urology 54 Virginia Veteran Care Center 76 Vistar Eye Center 17 Warm Hearth Village 70 YMCA of Virginia’s Blue Ridge