OurHealth Magazine for Roanoke and New River Valleys: October/November 2019

Y O U R L O C A L H E A LT H R E S O U R C E

October | November 2019

COMPLIMENTARY COPY

OurHealthRoanokeNRV.com

LIVING WITH CHRONIC HEALTH CONDITIONS: LIVING WITH LEUKEMIA FOR 20 YEARS + WHAT YOU SHOULD KNOW ABOUT 7 CHRONIC CONDITIONS

HEART HEALTHY SOUPS AND STEWS PERFECT FOR THE FALL SEASON

BRADLEY FREE CLINIC

CELEBRATES 45 ANNIVERSARY

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WITH EXPANDED HOURS AND SERVICES

Ladies

Taking Time for Your Own Health SHOULD BE A

TOP PRIORITY

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FEATURES

OCTOBER • NOVEMBER 2019

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LIVING WITH CHRONIC HEALTH CONDITIONS: NOT JUST SURVIVING BUT THRIVING Amelia Morgan of Roanoke doesn't recall being diagnosed with leukemia at age 3, but after living with the disease for 20 years now, accepting it's her normal is what helps keep her moving forward.

PLUS: WHAT YOU SHOULD KNOW ABOUT SEVEN COMMON CHRONIC HEALTH CONDITIONS

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LADIES, TAKING TIME FOR YOUR OWN HEALTH SHOULD BE A TOP PRIORITY A recent survey showed almost 80 percent of women not only rank themselves last on their health to-do list, but will put off going to much-needed medical appointments because of their commitment to managing everyone else’s health, including their spouse/ significant other, children, elderly relatives, grandchildren and pets.

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DEPARTMENTS OCTOBER • NOVEMBER

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The Pulse | People. Places. News to Know.

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

65 – NOVEMBER 2019 | National Family Caregivers Month For Family Caregivers, It’s Important to Remember You’re Not Alone. With the increasing amount of seniors, the number of family caregivers who are responsible for those aging adults’ daily needs to grow as well.

On September 8th, more than 400 participants gathered at Explore Park for the 5th annual Hike for Hospice, raising nearly $24,000 to support Good Samaritan Hospice’s Bereavement Program.

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

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Answering the Call for Care | Volunteer. Services. Community.

Bradley Free Clinic Celebrates 45th Anniversary with Expanded Hours and Services. As part of Bradley Free Clinic’s mission to increase access to quality healthcare for low-income and underserved people in the Roanoke Valley and surrounding areas, it is now offering expanded hours during the week and serving patients with Medicaid or without insurance.

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73 – NOVEMBER 2019 | National Hospice and Palliative Care Month Choosing Hospice Doesn’t Mean You’re Giving Up on Life. It’s Means You’re Choosing How to Best Live It.

77 Food and Fitness | Nutrition. Exercise. Prevention.

Heart Healthy Soups and Stews Perfect for the Fall Season. This fall, warm up the cool, crisp season by having delicious – and heart healthy – soups and stews headline your meal plans.

Healthy Observations | Educate. Eradicate. Victory.

61 – OCTOBER 10, 2019 | National Depression Screening Day Spotting Signs of Depression in Seniors. Senior citizens often find themselves struggling to adjust to the changes that come with the aging process—and it’s easy for them to slip into depression.

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69 – NOVEMBER 2019 | National Home Care and Hospice A Commitment to Serve Those Who Are Older or Disabled.

Although you might hesitate or try to avoid facing the difficult truth of having an aging parent, eventually the reality sets in— it’s time for mom or dad to have in-home care.

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Funny Bone | Spot the Seven Differences

OCTOBER • NOVEMBER 2019

PUBLISHER PRESIDENT/EDITOR-IN-CHIEF VICE PRESIDENT OF PRODUCTION VICE PRESIDENT OF BUSINESS DEVELOPMENT GRAPHIC DESIGNER ACCOUNTING MANAGER

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Hungate Kim Wood Tori Meador Laura Bower

CONTRIBUTING MEDICAL EXPERTS

Heather Draeger, MD Jolene Henshaw, MD Chuan Loong Miao, MD, MPH Janet Miller, MA, CCC-SLP Michelle Mills, DDS Laura Smith, MD

CONTRIBUTING PROFESSIONAL

EXPERTS & WRITERS

Kelsey Casselbury Jennifer Lamont Todd Marcum Steve McClintic Jr. Dylan Roche

ADVERTISING AND MARKETING Kim Wood | P: 540.798.2504 kimwood@ourhealthvirginia.com

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

Copyright © 2019 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Roanoke and New River Valleys is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483.

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The Pulse INFORMATION • EVENTS • AWARENESS

Recognitions, Awards and Accreditations New Facilities and Relocations Carilion Clinic Leases 150,000 Square Feet at Tanglewood Mall for Carilion Children’s Outpatient Practices Carilion Clinic has announced that it is has leased 150,000 square feet of space at Tanglewood Mall in Roanoke County, which will become home to outpatient practices of Carilion Children's and may house other clinical services in the future as well.

After years of adding more and more specialized pediatric services for our community, we’re excited to have a new home for those services. More than a dozen pediatric and adolescent specialties are represented at Carilion now. This development will help us make access easier for our patients and their families.

Nancy Howell Agee, President and CEO of Carilion Clinic

According to Carilion Clinic, the Tanglewood Mall space was chosen because of its central location and ample parking. It will allow Carilion Children’s to consolidate outpatient specialty practices, thereby improving coordination of patient care among those practices.

“This is an exciting day for Carilion Children’s,” says Kimberly Dunsmore, MD, Chair of Pediatrics for Carilion Clinic. “This new facility will set the stage as pediatric care in our region continues to transform and grow. Our goal remains the same: to provide specialized care, close to home, for the children in our community who depend on it.”

Extensive renovation of the space will be required and is expected to begin this winter. Practices that will move to the new facility are still being determined.

The new Carilion Children’s location will be up and running in 18 to 24 months.

The leased space Carilion will fill was last occupied in 2018 by J.C. Penney and Miller Motte Technical College.

“Carilion is a valuable partner to Roanoke County,” says Phil North, Chairman of Roanoke County’s Board of Supervisors. “Their investment at Tanglewood Mall will serve as a catalyst for future development in the 419 corridor and will bring renewed energy to Tanglewood. It’s an exciting time to be living and working in this region.”

The Carilion Children’s renovation project at Tanglewood Mall is expected to cost more than $30 million. This is included in the estimated $1 billion Carilion plans to invest in capital projects across the communities Carilion serves during the next seven years, as announced in May 2019.

Carilion will request proposals from architects and general contractors for this project.

More Information: www.carilionclinic.org

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Community Health Center of the New River Valley Receives 2019 HRSA Quality Improvement Award The Community Health Center of the New River Valley has been awarded the Health Resources and Services Administration 2019 Quality Improvement Award.

The award recognizes the work that health centers across the U.S. do to address health priorities while providing quality, value-based community care.

Along with the designation, the Community Health Center of the New River Valley was awarded $64,000 to support quality improvement. The financial award was based on the community health center’s high performance in categories including: Improving Clinical Quality of Care, Increasing Access to Care, Using an Electronic Health Record to Track Quality and Achieving Patient-Centered Medical Home Recognition.

The Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services, is the primary federal agency responsible for improving healthcare for people who are geographically isolated, economically or medically vulnerable.

We are excited to receive this award recognizing our achievements in the areas of accessibility, quality, and patientcentered integrated healthcare services for our patients.

Michelle Brauns, CEO of the Community Health Center of the New River Valley.

The Community Health Center of the New River Valley provides affordable and quality medical, dental, behavioral and preventive healthcare services to people of all ages in Dublin, Christiansburg and Pearisburg, regardless of ability to pay.

More Information: www.hrsa.gov or www.chcnrv.org

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Recognitions, Awards and Accreditations Carilion Clinic Recognized as an Age-Friendly Health System Participant Carilion Clinic is one of 162 hospitals and healthcare practices in the U.S. to be formally recognized as an Age-Friendly Health System Participant by the Institute for Healthcare Improvement. Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and the Catholic Health Association of the United States. Age-friendly care focuses on four essential elements, called the 4Ms Framework, which include: what matters to older adults; medication, if needed, that is age friendly; attending to mentation, including delirium, depression and dementia; and mobility to maintain function.

Age-Friendly Health System Participants are hospitals and healthcare practices that have committed to putting the 4Ms into practice and have had the Institute for Healthcare Improvement review their plans. Hospitals and healthcare practices that have shown exemplary alignment with the elements of the 4Ms Framework by reporting the number of older adults reached with the 4Ms over at least a three-month period are recognized as Age-Friendly Health Systems – Committed to Care Excellence. Currently, 85 of the 162 recognized hospitals and healthcare practices have fulfilled the requirements to be designated as Age-Friendly Health Systems – Committed to Care Excellence. Additionally, more than 300 other hospitals and healthcare practices are taking steps to implement agefriendly care through participation in Action Communities or other collaborative programs offered by IHI and the initiative’s partners.

More Information: www.bit.ly/2OsuStK or www.carilionclinic.org www.OurHealthRoanokeNRV.com

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The Pulse

• NEWS TO KNOW

Representatives from RUI and Roanoke City gather to officially introduce Woodland Hills Community in Southwest Roanoke County with a ribbon cutting event.

New Facilities and Relocations Woodland Hills Community Celebrates Pre-Opening with Ribbon Cutting Event Retirement Unlimited, Inc. (RUI), a family-owned and Virginia based Senior Living Community management company, celebrated the pre-opening of Woodland Hills Community with a formal VIP and Ribbon Cutting Event on Thursday, August 29th. Several hundred attendees enjoyed tours of the community, live entertainment, and food prepared by the RUI Culinary Experience Team of Executive Chefs. The ribbon cutting included presentations by William Fralin, CEO of RUI; Doris-Ellie Sullivan, President of RUI; Mary-Katelyn Hovanic, Academic Administrator for RUI University; Roanoke City Mayor Sherman Lee and future resident Ms. Mary Slough-Picone.

“I look forward to move-in day,” says Mary Slough-Picone, while presenting with her friends and future residents. “In the very near future, not only will I be a resident of Woodland Hills, but so will several of my neighbor friends and a high school classmate as well.

This community provides a place for now and later down the road.

That translates as piece of mind, not only for me but for my family.”

RUI President Doris-Ellie Sullivan encouraged attendees to explore the community and talk with staff on the purposeful design elements, amenities, community offerings, and nursing care.

“We’re bringing a unique product to the Roanoke Valley,” says Fralin. “Woodland Hills is designed to be an interactive hub for our area offering space for meetings as well as programing through RUI University which is open and free to the community alongside our residents.”

RUI University was established in 2017 with the intent of providing semester-based courses through partnerships with universities, colleges, and museums. Courses are designed to provide intellectual engagement and social connection to residents and visitors while 14

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exploring the topics that they care most about in both an educational and entertaining manner.

“This is not about a building,” explains Fralin. “What we do is bring together someone who needs care with someone who is willing to provide it. It’s about the relationships and the incredible bonds that will be built inside this community.”

Woodland Hills is RUI’s ninth community in Virginia. The new community represents a $27 million investment in the Roanoke Valley, bringing 150 new job opportunities with health benefits, 401K, and relocation packages. In addition, the area will experience the economic impact of the spending power of 130 new residents.

The Woodland Hills Community will offer: • Independent Living, Assisted Living, and Memory Care, called Inspiritás • 98 elegantly designed studio, one- and two-bedroom units with granite countertops and stainless steel appliances • 24/7 On-site Licensed Nursing • Fine dining experience prepared by an Executive Chef • Life Enrichment calendar including entertainment and outings • RUI University programing for continuing education • Library, theater, bistro, and beautifully landscaped walking trails

Woodland Hills Independent Living, Assisted Living and Memory Care Community, located at 3365 Ogden Road in Roanoke, is scheduled to open later this fall.

More Information: www.rui.net/woodland-hills-update

Partnerships, Ventures and Acquisitions Warm Hearth Village and Virginia Tech Renew Partnership Providing Mental Health Counseling to Seniors Warm Hearth Village has announced it will continue its internship program with Virginia Tech’s School of Education that provides mental health counseling to independent living residents at no charge. The partnership, which was first offered this year, has benefited 35 residents at Warm Hearth who accessed the free counseling opportunities provided by mental health professionals seeking advanced degrees in the field from the university.

Paul Delaughter, who is pursuing his master’s degree in Counselor Education, and Connie Tomlin, a Licensed Professional Counselor and National Certified Counselor who is working toward her doctorate in Counselor Education and Supervision, will provide free individual and group counseling sessions as part of their clinical work at Virginia Tech.

“Aging comes with unique challenges,” says Tomlin. “I believe counseling can help seniors find meaning and joy in their journey.”

According to the World Health Organization, mental disorders affect approximately 15 percent of the population over the age of sixty, a number that is expected to increase substantially as the population ages, while the Centers for Disease Control and Prevention report that an estimated 20 percent of people 55 and older have some degree of mental health concern. Despite what the statistics state, it can be difficult to recognize mental health issues in seniors because of the unique age-related health and life challenges they traditionally face.

Symptoms can be very subtle or attributable to a variety of other health conditions (see infographic: 16 Common Conditions Affecting the Elderly) or life changes.

Delaughter says he is particularly interested in working with veterans and exploring the challenges they face as they age. “I want my work to have a direct impact on improving the quality of life for people around me,” he says. According to the Veterans Administration, less than 50 percent of veterans, many who are still suffering from post-traumatic stress disorder and major depression, receive mental health treatment.

Approximately 20 veterans die by suicide every day.

Paul Delaughter is pursuing his master’s degree in Counselor Education, and Connie Tomlin, a Licensed Professional Counselor and National Certified Counselor is working toward her doctorate in Counselor Education and Supervision.

More Information: www.retire.org

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The Pulse

• NEWS TO KNOW

New Services, Programs and Technologies

Community Outreach

Hollins Communications Research Institute Unveils Pioneering Research Addressing Stuttering

Virginia Tech Carilion School of Medicine Lunch and Learn Series

Hollins Communications Research Institute (HCRI), based in Roanoke, recently completed a key research initiative in collaboration with the National Institutes of Health (NIH) in the first study to evaluate stuttering therapy outcomes among a group of stutterers who possess one of four mutant genes for stuttering in comparison to a group who do not carry the same mutant genes.

Findings revealed significant fluency outcomes for both groups following participation in HCRI’s 12-day stuttering therapy program. At the same time, results suggested stuttering is slightly more resistant to therapy in individuals who carry a stuttering gene mutation. While dysfluency measures after therapy were similar for both groups, personal perceptions of fluency among the carrier group were weaker.

For this research, HCRI President Ronald Webster, PhD and his team worked in collaboration with Dennis Drayna PhD of the NIH’s National Institute on Deafness and Other Communication Disorders (NIDCD). The two organizations have partnered for two decades on research to advance the scientific understanding of stuttering. HCRI was a member of the NIDCD team that discovered the genetic link to stuttering ten years ago.

HCRI stuttering therapy was used for the study because of the treatment’s quantitative, systematic methodology. In addition, HCRI clinicians have treated thousands of individuals who stutter with consistently positive results.

“At HCRI, we are in a strong position to facilitate genetics research because of our objective, physically based approach to therapy, as well as the large number of clients we have successfully treated,” Dr. Webster says.

HCRI’s research demonstrates that 93 percent of clients achieve normal levels of fluency by the end of their 12-day therapy. When evaluated two years post therapy, data indicates 75 percent maintain fluent speech. An additional 15 percent of individuals remain with improved fluency; however, they did not fall into the normal range.

Each group of stutterers was comprised of 51 individuals matched on age, gender and ethnicity. Speech samples before and after HCRI therapy were scored using detailed disfluency measures. Also, participants provided self-reported scores of their speech, based on perceived measures of struggle, avoidance and expectancy when speaking.

While therapy can be effective for mutant gene carriers, according to Dr. Webster, findings from this study provide a springboard for fine-tuning treatment when there is a genetic factor involved.

“We need to delve further into the physical details of speech, with emphasis on the carrier group,” Dr. Webster adds. “Additional research will enable us to more precisely define the effects of therapy and may set the stage for customizing treatment for those individuals who carry mutant genes. And, we are working on that at HCRI right now.”

Approximately 66 million people worldwide suffer from the effects of stuttering, with three million in the U.S, according to NIDCD. The condition is characterized by repeated or prolonged sounds, syllables, blocks and words that disrupt speech. Stuttering can impair social growth, hinder educational attainment, and limit career potential.

More Information: www.stuttering.org

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Virginia Tech Carilion School of Medicine offers a Diversity Lunch and Learn series that includes monthly sessions beginning in the Fall of each year. The sessions are free to participants, however, registration for each event is required.

Mark your calendars and register for these upcoming Lunch and Learn series’ sessions geared toward helping your body and mind!

GROW WHERE YOU ARE PLANTED For those seeking opportunities for growth and development, this Diversity Lunch and Learn series led

by Dr. Krista Crawford-Mathis, a professor with Virginia Tech’s Professional Masters in Business Administration program, discusses the importance of aligning your skills with the positions you are interested in, sharing your professional goals with your supervisor and networking and seeking references. You will also learn the importance of being your authentic self while recognizing the value you bring to any setting.

Cost: Free | Open To: Public Date: Tuesday, November 19, 2019 | Time: Noon – 2 pm Location: Virginia Tech Carilion School of Medicine, M 210, 2 Riverside Circle, Roanoke, VA 24016 Register: www.bit.ly/2oDYvxr

WELLNESS 101: ARE YOU THRIVING? Kick off your New Year on the right foot and join Virginia Tech’s Hokie Wellness team members Cathy Kropff, MD, CWWS, Well-Being and Student Affairs Program Administrator and Ana Agud, MPH, CWWS Manager, Work/Life Program, and develop a deeper understanding of wellness and how you can begin to thrive in the different areas of your life. Review behaviors related to the different dimensions of wellbeing and identify which areas you are excelling in and where you may be struggling while creating a personal action plan for realizing your happier, healthier self.

Cost: Free | Open To: Public Date: Tuesday, January 7, 2020 | Time: Noon – 2 pm Location: Virginia Tech Carilion School of Medicine, M 210, 2 Riverside Circle, Roanoke, VA 24016 Register: www.bit.ly/2naJ3Zd

More Information: www.medicine.vtc.vt.edu

Community Outreach YMCA at Virginia Tech To Hold its 50th Annual Craft Fair November 8th – 10th The YMCA at Virginia Tech is holding its 50th annual YMCA Craft Fair on Friday, November 8th from 1 pm – 7 pm, Saturday, November 9th from 10 am – 7 pm and Sunday, November 10th from noon – 4 pm. The event takes places at the Blacksburg Community Center, 724 Patrick Henry Drive, Blacksburg.

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The YMCA Craft Fair features over 50 juried artisans, including 13 new vendors this year. Arts and crafts categories include jewelry, metals, glass, woodworks, photography, stained glass, painting, sculpture, soaps and candles, furniture, pottery, textiles and more.

Additional activities include Storytime with Joelle, live music by American Roots, Simple Gifts of the Blue Ridge, as well as treats and beverages from Bollo’s Bakery & Café, Big Lick Ice Cream and Hethwood Market.

The money raised at the YMCA Craft Fair helps finance valuable programs and services while providing the opportunity for local, regional and national artisans to showcase and sell their products to the Blacksburg community just in time for the holidays.

More Information: Contact Laureen Blakemore via email at events@ymca.org or at 540.961.9622.

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The Pulse

• NEWS TO KNOW

Partnerships, Ventures and Acquisitions LAB Sports Performance and Carilion Clinic Partnering on Physical Therapy and Return to Sport Services LAB Sports Performance, a total body and functional movement training facility in Roanoke specializing in programs and motivational coaching designed to help increase individuals’ strength and/or speed abilities, prevent or rehabilitate from injuries, assist in weight loss and improve confidence, has entered into a partnership with Carilion Clinic.

LewisGale Medical Center's new helipad.

New Services, Programs and Technologies LewisGale Medical Center Debuts New Helipad to Expedite Access to Emergency Care LewisGale Medical Center recently unveiled a new helipad built on the roof of the medical facility that’s designed to decrease the time it takes for patients to receive treatment inside the hospital’s Emergency Department. The $3 million project that was granted final approval by the Federal Aviation Administration this past summer includes a three-story elevator shaft that provides direct access to the Emergency Department and Operating Room.

This November, Carilion Clinic Sports Performance and Rehabilitation will open in the nearly 14,000 square-foot LAB Sports Performance building located at 1824 9th Street in southeast Roanoke, where the health system’s sports medicine surgeons and physical therapy and rehabilitation experts will utilize treatment protocols specifically designed to help individuals of all ages and abilities safely return to their physical activity while pursuing their peak performance goals.

More Information: www.labsportsperformance.com or www.carilionclinic.org.

LewisGale’s rooftop helipad replaces the one that was constructed in 1972 along LewisGale’s Braburn Drive entrance path. With the former helipad, patients had to be placed in an ambulance after being unloaded from the helicopter and then transported to the Emergency Department’s entrance, according to Steve Pasternak, MD, Chief of Staff at LewisGale Regional Health System. Eliminating the ambulance transport step can help save precious seconds and minutes that can make a significant difference for patients with life threatening conditions.

“As we continue to expand our services at LewisGale Medical Center to accommodate those patients throughout Southwest Virginia with more severe medical needs, we are seeing increased helicopter traffic at LewisGale,” explains Lance Jones, CEO and Market President of LewisGale Regional Health System. Today, about 15-20 patients are transported via helicopter to the medical facility each month, a number that hospital officials say represents an increase over past years’ monthly use.

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Helicopter services that transport patients to LewisGale include Healthnet, Life-Guard, Wings Air Rescue, Air Evac Lifeteam, Pegasus, and Centra One.

Send to Stephen McClintic Jr. via email at steve@ourhealthvirginia.com.

More Information: www.lewisgale.com

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The Pulse

• NEWS TO KNOW

Shannon Armbruster, MD Anmol Bansal, MD Carilion Clinic Gynecological Oncology Roanoke | 540.581.0160 www.carilionclinic.org

Carilion Clinic Imaging Roanoke | 540.981.7122 www.carilionclinic.org

Amy Barker, NP

Elizabeth Barwick, DO

Briana Beach, DO

Michael Bergen, MD

Kate Burmaster, DO

Katherine Chafin, NP

Nicholas Clark, MD

Martha Cole, DO

Debbie Davis, PNP

Stephen Demma, NP

Jennifer Easterday, MD

Joshua Eikenberg, MD

Osa Emohare, MD

Leah Franks, PA-C

Braden Gregory, DO

Andrea Hanlon

Beth Hite, FNP-C

Brenna Keane, DO

Matthew Kelly, DO

Yousuf Khan, DO

Rebecca King-Mallory, MD Community Health Center of the New River Valley Dublin | 540.585.1310 www.chcnrv.org

Ashley Light, AuD

LewisGale Physicians Internal Medicine Salem | 540.444.2000 www.lgphysicians.com

Medical Director Good Samaritan Hospice Roanoke | 888.466.7809 www.goodsamhospice.org

LewisGale Physicians Endocrinology Roanoke | 540.772.3616 www.lgphysicians.com

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Carilion Clinic Gastroenterology Roanoke | 540.224.5170 www.carilionclinic.org

Carilion Clinic Dermatology & Mohs Surgery Roanoke | 540.224.5170 www.carilionclinic.org

Carilion Clinic Pediatric Medicine Roanoke | 540.484.0350 www.carilionclinic.org

Carilion Clinic Pediatric Pulmonology Roanoke | 540.985.9835 www.carilionclinic.org

Carilion Clinic Pain Management Roanoke | 540.224.5170 www.carilionclinic.org

Carilion Clinic Pain Management Roanoke | 540.224.5170 www.carilionclinic.org

LewisGale Physicians Family Medicine Roanoke www.lgphysicians.com

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

LewisGale Physicians OB/GYN Salem | 540.772.3580 www.lgphysicians.com

Carilion Clinic Family & Internal Medicine Martinsville | 276.670.3300 www.carilionclinic.org

LewisGale Physicians Urology Salem | 540.772.3702 www.lgphysicians.com

LewisGale Physicians Internal Medicine Salem | 540.444.2010 www.lgphysicians.com

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

LewisGale Physicians Pediatrics Salem | 540.772.3580 www.lgphysicians.com

Carilion Clinic Family Medicine Roanoke | 540.427.9200 www.carilionclinic.org

Carilion Clinic Interventional Radiology Roanoke | 540.981.7083 www.carilionclinic.org

LewisGale Physicians Cardiology Low Moor | 540.776.4000 www.lgphysicians.com

Gentle Shepherd Hospice Roanoke | 800.789.0856 www.gentleshepherdhospice.com

Carilion Clinic Otolaryngology Roanoke | 540.224.5170 www.carilionclinic.org

Todd Lowe

Director of Information Technology Friendship Retirement Community Roanoke | 540.265.2180 www.friendship.us

Nicholas Marko, MD, FAANS LewisGale Physicians Neurosurgery Salem | 540.444.1240 www.lgphysicians.com

Molly Nevitt, CPA, CGMA Susan Painter Chief Financial Officer Warm Hearth Village Blacksburg | 540.552.9176 www.retire.org

Director of Marketing and Admissions Salem Terrace at Harrogate Salem | 540.444.0343 www.salemterrace.com

Antonio Roman, MD

Dana Schenker, PA-C

Robert Swanson, MD, FACS Jefferson Surgical Clinic Roanoke | 540.283.6000 www.jeffersonsurgical.com

Jacob Winegardner, PA

Carilion Clinic Family & Internal Medicine Martinsville | 276.670.3300 www.carilionclinic.org

LewisGale Physicians Orthopedics Salem | 540.772.3530 www.lgphysicians.com

Carilion Clinic Orthopaedic Surgery Roanoke | 540.510.6200 www.carilionclinic.org

Denielle Morrison

Vivek Natarajan, MD

Jonas Rawlins, DO

Anita Register, DO

Club Friendship Manager Friendship Retirement Community Roanoke | 540.265.2056 www.friendship.us

LewisGale Physicians Internal Medicine Salem | 540.444.2010 www.lgphysicians.com

Carilion Clinic Orthopaedic Surgery Roanoke | 540.510.6200 www.carilionclinic.org

LewisGale Physicians OB/GYN Blacksburg | 540.443.0500 www.lgphysicians.com

Mohammed Siddiqui, DO Morgan Smith, RDH LewisGale Physicians Pediatrics Salem | 540.772.3580 www.lgphysicians.com

Mills and Shannon Dentistry Salem | 540.989.5700 www.millsandschnnon.com

Welcomes our New Healthcare Providers to the Community!

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Health Scene HAPPENINGS • WHO’S WHO • TRENDING words | STEVE MCCLINTIC, JR. photos courtesy of | GOOD SAMARITAN HOSPICE

5TH ANNUAL HIKE FOR HOSPICE RAISES NEARLY $24,000 On Sunday, September 8th, more than 400 participants of all ages gathered at Explore Park on the Blue Ridge Parkway during the 5th Annual Hike for Hospice, raising nearly $24,000 to support Good Samaritan Hospice’s Bereavement Program, which serves Roanoke Valley residents who are coping with loss and grief.

A BBQ lunch, complete with vegan jackfruit options was made available, while live bluegrass music, a special Grandparents Day booth with complimentary family photos and optional group excursion hikes throughout the park were just a few of the many activities those in attendance enjoyed.

Good Sam’s Bereavement Program annually serves approximately 700 individuals, hosts 100+ grief counseling classes and groups in the community that are free and open to the public and follows each patient’s family for 13 months after they pass to offer support and reassurance. The Program is considered uncompensated care and is totally sustained by funds raised from our community. Good Sam is committed to not only providing the very best care for its patients, but also supporting the families and loved ones who must process the grief and reconcile with the loss. To learn more about Good Sam and its programs, visit www.goodsamhospice.org.

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Health Scene • HAPPENINGS

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Questions. Answers.

Knowledge.

When is the best time to have breast reconstruction surgery?

Did you know?

October is

BREAST CANCER

The best time to undergo breast reconstructive surgery is at the same time as when having a mastectomy.

This is called immediate reconstruction. It has the advantage of being able to preserve more of the skin of the breast and possibly the nipples (depending on the cancer and breast shape). It also combines two surgeries, so patients have one less surgery to schedule, and usually has a better cosmetic outcome than later reconstruction. However, if for some reason reconstruction must be delayed, plastic surgeons still have many great options to offer patients who have delayed reconstruction.

Jolene Henshaw, MD

LewisGale Physicians General and Breast Surgery Blacksburg | 540.961.1590 www.lgphysicians.com

AWARENESS MONTH For more information about how you can spread awareness, visit www.cancer.org.

What is the most common gastrointestinal condition facing people as they age?

Older people very frequently experience constipation, which can be considered chronic when symptoms include less than having three or less bowel movements per week, hard stools, needing to strain to have a bowel movement or a feeling of incomplete emptying.

Medications that slow down the bowel, inactivity and insufficient water intake can also contribute to developing constipation.

Chronic constipation can lead to hemorrhoids, anal fissure, fecal impaction and rectal prolapse.

Testing for causes of chronic constipation may include thyroid function and electrolytes tests and an X-ray of the abdomen. A colonoscopy may be needed to rule out tumor causing blockage.

Treatment usually begins with making diet and lifestyle changes such as increasing fiber and fluid intake and getting regular exercise.

If these changes don't help, over the counter medications such as fiber supplements, stimulants (bisacodyl and Senokot), osmotics (MiraLax or Milk of magnesia) can be used first, or your doctor may recommend one the many of the prescription medications available. Don’t suffer from constipation. Seek help.

Chuan Loong Miao, MD, MPH

LewisGale Physicians – Gastroenterology Salem | 540.772.5970 www.lgphysicians.com

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What is the leading cause of infertility in women?

Infertility in women can be caused by several factors, including agerelated decreases in egg supply, problems with ovulation, fallopian tube blockage, endometriosis, and uterine factors such as fibroids. The testing that infertility specialists recommend is intended to evaluate each of these variables to determine if they are playing a role in a patient’s difficulty conceiving.

In almost one third of patients, however, female testing results are normal. If the patient has a male partner and his semen analysis is also normal, then this is called unexplained infertility. There is not one single cause of infertility for all women, so if it is taking longer than you expected for you to conceive, then you should seek an evaluation.

Laura Smith, MD

Reproductive Medicine and Surgery Center of Virginia, PLC Charlottesville | 434.654.8520 www.rmscva.com

www.OurHealthRoanokeNRV.com

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Questions. Answers.

Knowledge.

Did you know?

October is

DENTAL HYGIENE AWARENESS MONTH

Using fluoride toothpaste helps prevent tooth decay, so it plays an important role in your child’s oral hygiene habits.

My child dislikes using toothpaste. Is using it really necessary?

What are the benefits of cord blood banking/donation?

Can high blood pressure cause speech problems?

Toothpaste is not absolutely necessary to remove the plaque and debris from teeth. A soft toothbrush and water with a good brushing technique can be adequate.

Once your child is old enough to spit the toothpaste out, I highly recommend using a fluoridated toothpaste. Fluoride is the most important ingredient. It helps teeth resist cavities and helps remineralize incipient (early) cavities.

Toothpastes also have abrasives to help scrub off the stains. The abrasives, such as silica, are gentle in toothpastes and safe for teeth.

Some people try to use homemade toothpastes and those mixtures can be too abrasive for the enamel.

Cord blood banking is the collection of blood remaining in the umbilical cord after clamping the cord following birth. The stem cells in the cord blood can be used to treat some leukemias and lymphomas and genetic disorders of the blood and immune system, among others.

Yes, the two can be associated, by increasing your risk of having a stroke or later-life cognitive decline. High blood pressure causes thickening of the walls of blood vessels, making the onset of hardening of the arteries (atherosclerosis) more likely. People with thickened blood vessel walls and atherosclerosis are at a higher risk of stroke.

Typically, children dislike the taste of mint or cinnamon toothpaste.

If this is the reason your child refuses to use it, then try to look for different kid-friendly flavors, trying a few different options until finding one he or she prefers. The most popular flavors for little ones are bubble gum and berry. It is very important to check the toothpastes to make sure they contain fluoride.

Remember to brush twice a day.

Brushing before bedtime is very important! Flossing once a day should start as soon as children have teeth that touch; a toothbrush cannot remove the food in between teeth. Children need help from a parent brushing and flossing typically until age seven or eight.

Good luck keeping those smiles shiny and clean!

Michelle Mills, DDS

Mills and Shannon Dentistry Salem | 540.989.5700 www.millsandshannon.com

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Cord blood may be stored in either a public or a private cord blood bank.

Public cord blood banking is free, where available, and makes stem cells available to anyone who needs them. The blood from public cord blood banks is being used for stem cell transplants, immune therapies and pediatric neurological disorders such as cerebral palsy and traumatic brain injury.

Private cord blood banking allows you to reserve use of your child’s stem cells for use when a family member is known to have a malignant or genetic condition that may be able to benefit from a stem cell transplant in the future.

However, the chance of privately banked cord blood being used by your child is extremely low; by age 20, only three in 5,000 (0.06 percent) children will need a stem cell transplant. Collection and storage costs at private cord blood banks can be very expensive.

Ask your physician for more information.

Two possible disorders of communication from stroke are aphasia which can affect your ability to speak, write, and understand language, both verbal and written, or dysarthria. Dysarthria is characterized by slurred or slowed speech that can be difficult to understand. Also, there’s general agreement that high blood pressure in middle age is a risk factor for later-life cognitive decline, including overall cognition, memory, and processing speed.

Janet Miller, MA, CCC-SLP Roanoke Valley Speech and Hearing Center Roanoke | 540.343.0165 www.rvshc.org

Heather Draeger, MD

Physicians to Women Roanoke | 540.982.8881 www.ptow.com

READ THIS EDITION OF

OurHealth Roanoke & New River Valleys ON YOUR TABLET OR SMARTPHONE

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Living with

CHRONIC HEALTH CONDITIONS: NOT JUST SURVIVING

but Thriving

words | STEVE MCCLINTIC, JR. AND KELSEY CASSELBURY

Chronic health conditions, such as cancer, heart disease, lung disease and arthritis, to name a few, have traditionally led to a very poor quality of life and even premature death for those affected by them.

Broadly defined, chronic diseases are conditions that last a year or longer, require ongoing medical attention and can limit activities of daily living or both. But thanks to advancements in technology, medicine and services, and the expertise of health experts available today, including here in Roanoke and the New River Valleys, people are able to slow the progression of chronic illnesses and even realize improvements in their health and vitality. But don’t just take our word for it. At age three, Amelia Morgan was diagnosed with leukemia. Now at age 23, Morgan is learning how to thrive, despite lingering medical concerns.

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age 3 , n a g r o M Amelia

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CHRONIC CONDITION: Leukemia

A Parent's Worst

NIGHTMARE: When a Child is Diagnosed WITH CANCER

AT AGE THREE, AMELIA MORGAN OF ROANOKE WAS DIAGNOSED WITH LEUKEMIA. TWENTY YEARS LATER, SHE CONTINUES TO MANAGE THE DISEASE THROUGH HER COMMITMENT TO THRIVE THE BEST WAY SHE CAN. words | KELSEY CASSELBURY

When Amelia Morgan was just three-years-old, her parents experienced the horror of their child being diagnosed and treated for acute lymphocytic leukemia (ALL), a type of aggressive cancer that starts in the bone marrow and quickly spreads to the blood cells.

“It was devastating,” recalls Amelia’s father, John Morgan. “We still don’t know how the medicine she’s been taking will affect her; what the aftermath of all of it will do to her body.”

Now 23, Amelia has been in remission for 15 years. But it turns out that childhood leukemia isn’t always something you can recover from fully, even when your body is free from cancer cells. Chemotherapy, as well as other treatments, has had a long-term effect on her physical and mental health, and she still struggles to cope with daily life. Thanks to her family’s support, as well as her faith in God, though, Amelia still tries her best to live a fulfilling life.

A Childhood Battle Acute lymphocytic leukemia is named as such because it’s a disease that affects a specific type of white blood cell (lymphocytic), progresses rapidly (acute) and, compared to chronic lymphocytic leukemia, is a slow-growing condition. It’s the most common type of childhood cancer, and, thankfully, one of the most likely to be cured in juveniles.

Amelia is one of those lucky individuals who entered remission two years after diagnosis, but that wasn’t always a sure thing. “They didn’t think I was going to make it because the type of chemotherapy that they give to kids wasn’t working,” she shares. “They had to give me adult chemo and larger doses of it because nothing was working at all for me.”

“THEY DIDN’T THINK I WAS GOING TO MAKE IT BECAUSE THE TYPE OF CHEMO THAT THEY GIVE TO KIDS WASN’T WORKING. THEY HAD TO GIVE ME ADULT CHEMO, BIGGER DOSES BECAUSE NOTHING WAS WORKING AT ALL FOR ME.” – AMELIA MORGAN

Amelia was first diagnosed with leukemia as a preschooler, but treatment meant that while other kids were learning their ABCs and how to share toys, she was in and out of the hospital through her pre-kindergarten and kindergarten years. “I wasn’t able to go to school like everyone else,” she recalls. “I had to wear a mask while I was taking chemotherapy because of the germs.” Although Amelia was able to partially attend first grade, her attendance was sporadic because of illnesses. Even when she did attend, Amelia couldn’t do the same sort of fun activities as the other kids – she simply got worn out due to the effects of treatment.

The vast majority of children with acute lymphocytic leukemia enter remission after just one month of treatment, though the whole process typically lasts two to three years. While Amelia didn’t go into remission – which means that leukemia cells no longer show up in bone marrow samples – as quickly as others do, she did finally do so around age five. However,

Left photo: Amelia Morgan in 1999, age 3. Just before being diagnosed with acute lymphocytic leukemia.

Photo above: Amelia Morgan elementary school picture. www.OurHealthRoanokeNRV.com

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Amelia credits her supportive and close family and friends for keeping her positive, including her grandparents, sister, young nephew and her father, John Morgan.

her childhood battle wasn’t over, and in 2007, she developed a brain abscess that required brain surgery. Once again, she had to spend a significant amount of time in the hospital. She continues to get MRIs performed to this day to monitor the condition.

An Ongoing Struggle Amelia missed out on a normal childhood, a trend that has continued with her missing out on a lot today in what’s typical for an early 20s lifestyle. Rather than starting a career like so many others, she gets by on disability pay. Her immune system is weak, and she tires easily.

The chemotherapy annihilated her memory, as well as her concentration skills. “Some days, I don’t feel well. Some days, I feel amazing. Some days, I don’t want to do anything,” she says.

Every day, Morgan takes 12 different medications. She goes to regular check-ups to make sure that the leukemia hasn’t crept its way back in. Oftentimes, her check-ups require a spinal tap be performed, a procedure also known as a lumbar puncture, that allows a healthcare professional to examine the fluid surrounding the spinal cord. “It’s messed up my back,” Amelia says. “That affects my life every day, the back pain.” Her next spinal tap is scheduled in spring 2020, and she hopes it might be the last one.

“I TRY TO LEAVE IT IN GOD’S HANDS,” SHE SHARES. “IF THE CANCER EVER DID COME BACK, I WOULD LEAVE IT WITH GOD.”

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Finding Strength to Thrive Life isn’t easy for Amelia. “I get emotional sometimes,” she admits. “I still think that something might happen.” Six months ago, she was diagnosed with lupus, an autoimmune disorder that occurs when the body’s immune system attacks its own tissues and organs, causing inflammation, fatigue and joint pain, among other symptoms. “Sometimes, my body doesn’t want to go,” she says. “But I fight through it, and get myself up and ready.”

Amelia had become accustomed to living a sedentary lifestyle, but now she tries to exercise because she knows it can keep symptoms at bay. She also loves to travel and going on road trips, especially to Amelia Island in Florida.

While she tries to be strong for herself everyday, Amelia credits her family for keeping her going. She’s close to her sister, Hailey, and eight-year-old nephew, with whom she spends nearly every day. She’s also found purpose in taking care of her grandfather, who’s currently battling prostate cancer, and her grandmother, who has Alzheimer’s disease. “You know that

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

movie, ‘50 First Dates’? It’s just like that,” Morgan says. “She’ll know something one day, and then the next day she won’t.”

All in all, Amelia says, it’s her faith that keeps her going. “I try to leave it in God’s hands,” she shares. “If the cancer ever did come back, I would leave it with God.” That’s a sentiment that’s no surprise to Amelia’s father, who specifically remembers one moment from when his daughter was a sick child in the hospital. “She woke up one morning and said that an angel has visited her,” he says. “The angel basically told her not to worry, and that everything would be OK. It was very uplifting.”

Living with a chronic disease like leukemia presents a tremendous amount of challenges, many of which those affected by it are reminded of on a daily basis. While advancements in medicine and technology continue to improve the way people like Amelia can live and thrive, maintaining a positive attitude can often be the biggest difference maker. Amelia understands that ‘normal’ for her is different than for others her age, but she also knows it could be a lot worse. Keeping this in mind, along with relying on her faith, family and friends, are just a few of the ways that she is able to continue finding joy in so many different ways of life. www.OurHealthRoanokeNRV.com

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What you should

KNOW ABOUT

SEVEN COMMON CHRONIC HEALTH CONDITIONS words | STEVE MCCLINTIC, JR.

According to the Centers for Disease Control and Prevention (CDC), six in 10 adults in the U.S. suffer from one chronic disease, and four in 10 U.S. adults are affected by two or more. While advancements in medicine continue to improve the lives of those limited by these incurable conditions, the best course of care anyone can prescribe to is still prevention, and it starts with changing our behaviors.

60% ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), SIX IN 10 ADULTS IN THE U.S. SUFFER FROM A CHRONIC DISEASE.

Chronic diseases are defined broadly as conditions that last one year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the U.S. Following is a list of the most common chronic conditions affecting our health today according to the CDC.

Heart Disease Heart disease describes a range of conditions that affect your heart. Diseases under the heart disease umbrella include blood vessel diseases, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you're born with (congenital heart defects), among others.

The term “heart disease” is often used interchangeably with the term “cardiovascular disease.”

Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease.

SEEK EMERGENCY MEDICAL CARE IF YOU HAVE THESE HEART DISEASE SYMPTOMS: A Chest pain

B Shortness of breath

C Fainting

Heart disease is easier to treat when detected early, so talk to your doctor about your concerns regarding your heart health. If you're concerned about developing heart disease, talk to your 34

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doctor about steps you can take to reduce your heart disease risk. This is especially important if you have a family history of heart disease.

Cancer Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues. Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors. Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors. Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.

Unlike malignant tumors, benign tumors do not spread into, or invade, nearby tissues.

Benign tumors can sometimes be quite large, however. When removed, they usually don’t grow back, whereas malignant tumors sometimes do. Unlike most benign tumors elsewhere in the body, benign brain tumors can be life threatening.

Did You Know?

There are more than 100 types of cancer. Types of cancer

IN ALL TYPES OF CANCER, SOME OF THE BODY’S CELLS BEGIN TO DIVIDE WITHOUT STOPPING AND SPREAD INTO SURROUNDING TISSUES. CANCER CAN START ALMOST ANYWHERE IN THE HUMAN BODY, WHICH IS MADE UP OF TRILLIONS OF CELLS.

are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in cells of the lung, and brain cancer starts in cells of the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

To learn about specific types of cancer based on the location in the body, visit www.cancer.gov/types.

Chronic Lung Disease Chronic Lung Disease (CLD) refers to the type of disorders that affect the lungs and other parts of the respiratory system. It usually develops slowly and may get worse over time.

Chronic lung disease may be caused by smoking tobacco or by breathing in secondhand tobacco smoke, chemical fumes, dust, or other forms of air pollution. Types of chronic lung disease include asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, asbestosis, pneumonitis, and other lung conditions. Altogether, lung diseases accounted for more than one million deaths in the U.S. in 2010, according to the National Heart, Lung and Blood Institute.

Stroke A stroke occurs when a blood clot blocks the blood supply to the brain or when a blood vessel in the brain bursts. Anyone can have a stroke, including children, and some risk factors are beyond your control such as age, sex and ethnicity. Stroke risk varies by race and ethnicity and is the fourth leading cause of death for Americans. Risk of having a first stroke is nearly twice as high for African-Americans than for Caucasians and African-Americans are more likely to die following a stroke than are Caucasians. Falling between the two is risk for Hispanics. American Indians, Alaska Natives, and African-Americans are more likely to have had a stroke than any other groups.

Stroke risk increases with age, but stroke can, and does, occur at any age. In 2009, 34 percent of people hospitalized for stroke were younger than 65 years. The prevalence of stroke between men and women is pretty much the same except between the ages of 20 – 39 and 60 – 79 when a slightly higher percentage of women were afflicted from 2007 – 2010 according to the American Heart Association. www.OurHealthRoanokeNRV.com

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Alzheimer’s Disease Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. In most people with the disease—those with the late-onset type—symptoms first appear in their mid60s. Early-onset Alzheimer’s occurs between a person’s 30s and mid-60s and is very rare.

Alzheimer’s disease is the most common cause of dementia among older adults.

Estimates vary, but experts suggest that as many as 5.5 million Americans age 65 and older may have Alzheimer’s. Many more under age 65 also have the disease. Unless Alzheimer's can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimer’s disease.

Diabetes Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough – or any – insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells.

OVER TIME, HAVING TOO MUCH GLUCOSE IN YOUR BLOOD CAN CAUSE HEALTH PROBLEMS, SUCH AS: A Heart Disease

D Eye Problems

B Stroke

E Dental Disease

C Kidney Disease

F Nerve Damage

G Foot Problems

THE MOST COMMON TYPES OF DIABETES ARE TYPE 1, TYPE 2, AND GESTATIONAL DIABETES. TYPE 1 DIABETES: If you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age.

People with type 1 diabetes need to take insulin every day to stay alive.

TYPE 2 DIABETES: If you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Type 2 is the most common type of diabetes.

GESTATIONAL DIABETES: Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a greater chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.

Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.

Chronic Kidney Disease Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

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SIGNS AND SYMPTOMS OF CHRONIC KIDNEY DISEASE DEVELOP OVER TIME IF KIDNEY DAMAGE PROGRESSES SLOWLY. SIGNS AND SYMPTOMS OF KIDNEY DISEASE MAY INCLUDE:

» Changes in how much you urinate

» Nausea » Vomiting » Loss of appetite » Fatigue and weakness » Sleep problems

» Chest pain, if fluid builds up around the lining of the heart » Shortness of breath, if fluid builds up in the lungs

» Persistent itching » Decreased mental sharpness » Muscle twitches and cramps » Swelling of feet and ankles

» High blood pressure (hypertension) that's difficult to control

Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

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ASK THE EXPERT

ANN MCGEE GREEN

ANDERSON, DESIMONE AND GREEN, P.C. 4923 Colonial Avenue | c 540.776.6434 | w www.andersondesimone.com

What Kind of Care Would You Want if Unable to Express Your Wishes?

What is the difference between a living will and an advanced health care directive?

An advanced health care directive in Virginia has two parts: First, the living will, which explains what measures you would want taken in the event that you have a terminal condition.

The second part is the healthcare power of attorney, which takes effect when the person who signs it is unable to make his or her own medical decisions. It’s known as “springing power,” which means it “springs to life” upon an event, such as a disability.

Who should I appoint to serve as my power of attorney?

It’s important to choose someone who is honest, has integrity, will maintain thorough records and is a good communicator. It’s also wise to choose someone who is financially savvy – you don’t want to give power of attorney to your son who just went through a bankruptcy and is desperate for money; it’s too much of a temptation. This is not their money; they’re a steward of someone else’s money.

What is a power of attorney?

There are many types of power of attorney, including a power of attorney for medical decisions and a power of attorney for financial decisions. When people talk about a power of attorney, they’re often thinking about a durable power of attorney for financial purposes. “Durable” means it endures your disability, so you want some language that says it endures past your disability. This document enables the appointed individual to do whatever the document says – if your power of attorney doesn’t mention the ability to change the beneficiary designations or doesn’t mention power to manage your retirement account, then the designated person may not be able to handle those actions on your behalf.

How should a power of attorney be appointed if I have multiple children?

If you are considering assigning power of attorney to one of your children, don't assume it has to be your oldest. Who is the most organized? Who is the most responsible? Who is best at managing important matters? Choosing a child who would be angry if you didn’t gives me pause. Unfortunately, the most likely people in this day and age to financially abuse someone is a relative, often a child, while using a power of attorney he or she has been given.

If you have multiple children, an option is to name one child as a power of attorney, but have him or her account to the other children for any actions taken. Alternatively, you may want to consider naming someone outside your family, taking into account that individual’s experience, age and position in life.

Lastly, always name an alternate. The saddest thing is when someone names his or her spouse as power of attorney, for example, and the spouse passes away or become incapacitated due to an injury or illness, preventing him or her from being able to act on your behalf.

If I don’t have these documents, what will happen if I become unable to communicate my desires personally?

Depending on the situation, it’s very possible for decisions regarding your affairs to enter the legal system, where guardianship may be assigned to a person to make your medical decisions and a conservatorship assigned to someone to make your financial decisions. This is a court proceeding that costs thousands of dollars. Sometimes, however, this is the best option if you don’t have anyone close who’s trustworthy.

If I change my mind about who or what is named in these documents, can I modify them?

Absolutely – at any time, as long as you have the capacity.

About Ann M. Green ANDERSON, DESIMONE AND GREEN, PC Ann M. Green is an attorney with Anderson, Desimone & Green, PC, a law firm devoting 100 percent of its practice to estate planning (wills, living wills, trusts, powers of attorney and probate) and Elder Law (guardianships, asset protection and Medicaid planning) to clients throughout Southwest Virginia.

ASK THE EXPERT

ROBERT O’BRIEN, MD INSIGHT IMAGING

2923 Franklin Road SW | Roanoke | c 540.581.0882 | w myInsightImaging.com | f f f f Hours: Monday through Friday 6 am - 10 pm | Saturday & Sunday 8 am - 4:30 pm

Can Part of Our Blood Really Be Used to Treat Pain and Promote Healing?

What is platelet rich plasma (PRP), and where does it come from?

Platelets are small cells found in your blood. By taking a small amount of blood from your arm and placing it into a centrifuge machine, we are able to separate red blood cells and other components from the platelet rich plasma. Then, just the platelet portion (platelet rich plasma) is injected into the injured site.

What kind of conditions benefit the best from PRP injections?

PRP injections can be effective throughout the musculoskeletal system, which includes the shoulders, elbows, wrists, hands, hips/pelvis, knees, ankles and feet, and spine for a variety of injuries, such as: » Chronic tendonitis or tendon sprain

How do PRP injections help facilitate healing and manage pain?

» Muscle strain or tear

Immediately following the injection to the injured site, the PRP releases cellular growth factors that trigger the body’s natural healing response. In the months that follow, inflammation and pain will decrease and tissue repair will occur. As the tissue matures, it will strengthen the tendons, ligaments, discs or joints of the site. Pain and inflammation will typically continue to decrease as this occurs.

» Joint pain

Does the process of withdrawing the platelets or injecting them back into the patient hurt at any point?

Like any procedure, the process is not pain-free.

However, pain is usually mild – it’s comparable to a blood draw and a vaccination shot.

Are there any side effects or downtime after the procedure has been completed?

The side effects are typically minimal. Following the procedure, we suggest limiting your activity in the joint or site on your body that you had treated, much like you might limit activity after a sprain. The physician will provide specific instructions depending on the site you had treated, so you go home knowing how to care for yourself.

» Ligament sprain, strain or tear » Osteoarthritis » Cartilage loss This minimally invasive approach is ideal for those with damaged joints who are not ready for joint replacement or spinal surgery.

About Robert O’Brien, MD INSIGHT IMAGING Robert O’Brien, MD is a board-certified interventional and vascular radiologist with Image Guided Pain Management, PC. Dr. O’Brien provides professional physician services at Insight Imaging in Roanoke. For more information, visit myInsightImaging.com or call 540.581.0882.

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Ladies,

Taking Time for Your Own Health SHOULD BE A

TOP PRIORITY words | JENNIFER LAMONT

I was waiting in my doctor’s office recently, half-listening for my name to be called. Hunched over my phone, swiping and typing, I was returning work emails, making a grocery list, texting and looking up superhero party ideas for my grandson’s third birthday. After several minutes, the nurse opened the door and ushered me down the hall.

I took a deep breath as I followed her to the exam room. I wasn’t nervous about seeing the doctor.

This quarterly visit was part of my routine over the last three years to monitor my Hashimoto’s thyroid disease and fibromyalgia symptoms. I just needed more air. I had been holding my breath much of the time I was sitting there trying to get things done with the few minutes I had to ‘spare.’ Like many people, my breathing becomes shallow when I’m unconsciously stressed.

And I’m stressed a lot. Just like every other woman I know. As a mother, daughter, grandmother, friend, co-worker and full-time caretaker to a 91-year-old grandparent, my plate is beyond full. I often need to remind myself to stop and breathe for a minute. Of course, I’m not alone. Roles Eighty percent may be blurring, but family health needs, nurturing and caretaking of women not only continues to fall mostly on women. Naturally, or by necessity, women rank themselves last become the family’s nutritionist, health researcher, care advocate on their health to-do list, and appointment scheduler – but for everyone else. but will put off going to

Ladies, Do You Take Better Care of your Pet Than Yourself?

much-needed doctor’s appointments because they’re too busy.

Most women will take the family’s beagle to the vet before they take themselves to the doctor. A recent survey showed almost 80 percent of women not only rank themselves last on their health to-do list, but will put off going to a much-needed doctor’s appointments because they’re too busy taking children, elderly parents, spouses and pets to their appointments.

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Whether it’s societal conditioning or genes, we tend to take better care of others than we do ourselves. To be honest, I had rescheduled this appointment with my primary doctor twice before when other responsibilities came up. But delaying this visit indefinitely isn’t an option.

“My doctor relies on my exam and lab results to keep my thyroid levels in optimal ranges.

Without regular visits, I don’t receive my prescriptions, so that makes it easier for me to keep the appointment. But other appointments, like specialists, dentists or diagnostic tests, can sometimes feel more optional.” – JENNIFER LAMONT As a working caregiver, I’ve learned the hard way that putting off a doctor’s appointment can turn a cough into pneumonia with a three-day hospital stay, and a shoulder injury into a full-blown torn rotator cuff. The few hours I would have spent going in for initial treatment was far less than the several weeks I needed to recover from both of those health issues. More than losing time from work, I was not able to care for anyone, let alone myself.

So, I know that making time for my regular doctor visits, like this, is a priority. But even while the nurse was taking my blood pressure in the exam room, I was wondering if I’d make it out of there in time to stop by the grocery store, pick up my grandmother’s prescription and have her dinner on the table by 5:30. To make my appointment productive, I did a few things to maximize my time. These tips not only help my doctor get the most out of our visit, they also help me better manage my health overall:

How to Help Your Doctor Help You: 4 Tips A

Write down any questions or concerns before the appointment on paper or a note-taking app on your phone.

B

Keep a list of all the medications with dosages and supplements you’re taking. I do this for everyone I help take care of, including myself. Keeping a list of medications, allergies and important dates right on my phone makes filling out medical forms and answering questions faster and easier.

C

If you think of a question during the visit, ask it. If there is something you don’t understand, get clarification.

D

Be honest about any symptoms or issues you’re having.

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RELATING EXPERTS

Ladies, You’re Not Alone: A Female Medical Expert Relates To How Tough Finding Time for Her Health Can Be words | CHRISTIN CLARK, MSN-FNP

Many may believe that it just comes naturally – and more easily – for women who work in the medical field to stay on top of their own health. But the truth is that even those who are empowered with healthcare expertise and knowledge can struggle finding time to apply their own advice. Christin Clark, a nurse practitioner with Jefferson Surgical Clinic in Roanoke, shares that she too has to be mindful when it comes to making her own health a priority, and that providing a little education about how the body works is not only smart way for her patients to start developing a better understanding of their own health needs, but also a great reminder to herself.

Women’s plates are full. As a nurse practitioner, I am dedicated to the care of others and yet, I experience the same struggles as other women with prioritizing my own health. I juggle patient care, my daughters’ travel sports, church events and volunteering at health screening events as I can. When I am constantly focused on helping others realize their best health, it can be easy to put myself on the back burner.

Stay on Top of Important Screenings But, there are always new healthcare advances making it easier to be diligent about maintaining and improving my physical and mental well-being. I always make time for regular checkups, annual pelvic exams, mammograms and routine lab work. Being proactive by getting screened regularly for things like heart disease, vascular diseases and cancer risks helps me better understand my health risks so that I am much better prepared to take ownership as an advocate for my own health.

My specialty is vascular diseases, which can be any abnormal condition affecting our arteries and veins, but I embrace the reality that the human body is a complex system, something fully shared by the multi-disciplinary team at Jefferson Surgical Clinic. We have to treat our health with the recognition that, just like in life, our well-being is intricately tied to the well-being of everything we count upon, and to those who count upon us. Finding a healthcare practice that is equipped to treat multiple diseases and systems of the body, including Cardiology, Urology, Colon-Rectal, ENT and Plastics, helps provide full support for immediate assessment and care when needed, and also ongoing support necessary to keep you healthy.

One of the reasons I love what I do at Jefferson Surgical is the opportunity to change lives by gifting my patients with healthcare knowledge. Too often, patients come to me with health issues that could have been prevented with just a little education – becoming educated about your health risks and how your body works is the best step you can take to achieve and maintain a healthy lifestyle.

Be Self Aware of How You Feel I’m not perfect and I can’t say that there aren’t days when self-care gets put on the back burner. But, I do maintain a strong awareness of how I feel when I make time for my own health, and over time, that selfawareness has made it easier to make and keep new habits.

“My own healthcare routine consists of a series of small, yet intentional, actions that keep my body healthy and my mind active. My morning devotional is often the catalyst that helps me take on a challenging day – especially when the day doesn’t turn out as planned. A great way to be successful in our efforts to maintain healthy habits is to recognize that not every day needs to look the same. I always find a way to make time for exercise, even if the only time I have is to take laps around the softball field while I cheer my daughter on from the sidelines. Meal planning at the start of each week ensures I always have healthy food options available.

Being flexible while choosing to make healthy choices helps me feel empowered.” – Christin Clark, MSN-FNP

Physical and Mental Breaks: Gifts You Can Give Yourself I encourage my patients to reframe their thinking when it comes to taking care of their own health because taking on too much, with an already overloaded lifestyle, can seem daunting at best. Being intentional about making balanced eating choices (never skip a meal!), enjoying moderate exercise and giving ourselves physical and mental breaks are not tasks to be done; they’re gifts we give ourselves.

It’s time we embrace making our health a priority, empowering us to continue pursuing our passions, caring for others and taking life’s challenges head on.

About Christian Clark, MSN-FNP Christin Clark is a nurse practitioner at Jefferson Surgical Clinic in the Vascular Clinic in Roanoke. When she’s not assisting patients, Clark can normally be found spending time with her husband and two children. Together they enjoy outdoor activities, hockey and volunteering as a family. To learn more about Clark and the services she specializes in, visit www. jeffersonsurgical.com or call 540.283.6000.

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CONTINUED FROM PAGE 44

The exam went smoothly, and I left my doctor’s office that day with no changes in my lab results, which was a good thing. It’s after I walk out of her office and in between these appointments that making my health a priority is easier said than done. Finding a good balance between taking care of myself and others can be difficult while trying to get things accomplished each day. Managing my time effectively helps.

It’s Time to Be Your Own Caretaker

“To really find that balance, I need to be ‘selfish’ at times. Meaning, I need to make myself a priority for at least some small part of each day.

You know that safety demonstration you watch before every flight that tells you to put on your own oxygen mask before you apply your child’s mask? It seems counterintuitive as a parent, but you must help yourself first so you can help others. You’re no good to anyone if you run out of air.”

Making yourself a priority will not only will improve your health and happiness, but you owe it to yourself and the ones you love. There are many ways to treat yourself with the same love, respect and care you give to others.

They’re some of the very same things you’d want your best friend, spouse or child to do. Here are nine of my favorite ways to stay balanced, productive, happy and healthy:

1

Include Whole Foods While Meal Prepping.

2

Keep Yourself Strong.

3 4 5 6

– JENNIFER LAMONT

Nothing zaps your energy and health more than processed and fast foods. Spend a couple hours one day each week to cook up nutritious meals for the next seven days. Each Sunday, I cook up a few different recipes so my grandmother and I have healthy meals during the week. This saves us both time, money and frustration, while helping us eat a healthy diet most of the time.

Lifting weights is not only beneficial for women of all ages, it’s proven to reduce stress and boost self-esteem, while preventing aging and illnesses. It also helps you function better in your daily activities, making injuries less likely. Combine with walking or your favorite type of cardio to burn fat, get lean and increase those feel-good endorphins. Get outside to exercise whenever possible, but go to the gym if that’s what you prefer.

Keep Organized with To-Do Lists and a Calendar Schedule.

To-do lists allow you not only set priorities and stay focused, but they help motivate you when you cross off completed items. Having a central calendar in the kitchen, as well as on my phone, helps me keep track of everyone’s appointments, including mine.

Take Time to Enjoy Your Friends.

Studies show the healthiest people in the world are those who have a strong support system. People who have fun on a regular basis with others – those who they like to be around – live longer and feel more purpose in life as they age. Even better, do a physical activity with your favorite friends and you get even more benefits.

Keep Your Dentist and Doctor appointments.

Studies show that while women go to the doctor more frequently than men, they are just as likely to suffer from chronic conditions without getting treatment.

That’s why regular checkups are so vital. You may not feel sick or be experiencing any issues, but it doesn’t always mean you are healthy.

Join a Support Group if You’re a Caregiver.

There are working caregivers everywhere. In fact, over 40 million unpaid caregivers in the U.S. are taking care of at least one family member over the age of 65 right now.

Support groups for caregivers are especially important because they understand your situation. Friends can support you, but they can’t relate or give you proper emotional support like other caregivers can.

I know that sometimes

PUTTING MY NEEDS FIRST IS NOT SELFISH; it’s essential.

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7

Increase the Gratitude and Positivity in Your Life.

8

Ask For Help and Then Take a Nap.

9

Do Nothing.

Keep a gratitude journal, even if you only write one line a day. Find the humor and positivity in situations and people. Surround yourself with those people who bring happiness, positivity and hope into your life.

Hire a cleaning service when you need it. Ask your kids, spouse or other family members to help with chores or errands. Get enough sleep at night so you can function at your best level during the day.

Sometimes you need a break from everything and everyone. It’s okay to say “no” to everything once in a while, and just be present with yourself. But it doesn’t count if you’re on your phone.

Sometimes, I find myself ‘in-between’ errands, family, working and projects where I realize I suddenly have a few minutes to myself. Here are some quick ways I de-stress and recalibrate:

Six Ways to Take Care of Yourself When You Only Have 5 Minutes: A

Breathe deeply, inhaling for 4 seconds and exhaling for 4 seconds. Set a timer for 5 minutes.

B

Do 20 wall push-ups, 20 squats or lunges, and 20 jumping jacks.

C D E

Stretch your legs, ankles, shoulders and neck.

F

Read a few lines from an actual book you hold in your hand, not an e-book on your phone.

Walk outside.

Find a quiet corner to meditate, pray or think about something for which you’re grateful.

As a woman in the unique position of being able to take care of two young grandsons and her grandmother, I know that sometimes putting my needs first is not selfish; it’s essential.

The quality of care they get from me is dependent on my own health and happiness. Putting myself first doesn’t mean I’m putting them last. It just enables me to give them the best version of myself.

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Commonly Overlooked CONDITIONS

Who Can You Turn to in Roanoke & New River Valleys For Help?

POLYCYSTIC OVARY SYNDROME affects seven to 10 percent of women

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Polycystic Ovary Syndrome (PCOS)

What is PCOS?

What are the symptoms of PCOS?

Polycystic Ovary Syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens (male sex hormones) that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. PCOS affects seven to 10 percent of women of childbearing age and is the most common cause of infertility. In the U.S., an estimated five to six million women have the condition. PCOS is the most common hormonal disorder among women of reproductive age, but many women don’t know they have it.

Because there is such a wide range of symptoms, PCOS is defined as a syndrome, not a disease. The most common symptoms are irregular menstrual cycles, acne, weight problems, such as weight gain or upper body obesity, and abnormal hair growth. Many women also experience infertility or pregnancy loss. The ovaries often become enlarged and may contain one or more abnormal cysts. Enlarged ovaries are easily detected by transvaginal ultrasound. Many symptoms occur either early in the condition or develop gradually.

Women with PCOS, especially overweight women, may have insulin resistance and have an increased risk for diabetes and high lipids.

of childbearing age and is the most common cause of infertility.

Where in Roanoke & New River Valleys Can I Get Help? *

How is PCOS diagnosed?

Jill Devlin, DO

There is no single test to diagnose PCOS. It is diagnosed in women who have irregular menstrual cycles when blood tests or physical symptoms suggest they may have elevated levels of male hormones, hirsutism (abnormal growth of hair on a person’s face and body, especially on a woman), or the typical PCOS pattern noted on ultrasound. Many women are diagnosed with PCOS after being evaluated for miscarriages and infertility.

Carilion Clinic Obstetrics and Gynecology Blacksburg | 540.961.1058 Christiansburg | 540.731.4578 Giles | 540.961.1058 www.carilionclinic.org

According to the American Society of Reproductive Medicine (ASRM), the criteria to diagnose this condition includes having two of the following three findings: • High androgen levels • Irregular menstrual cycles • Polycystic appearing ovaries on ultrasound

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Where in Roanoke & New River Valleys Can I Get Help? * Blue Ridge Pain Management Associates Salem | 540.216.0376 Christiansburg | 540.291.7200 Roanoke | 540.291.7203 www.blueridgepm.com

Carilion Clinic Pain Management Roanoke | 540.224.5170 www.carilionclinic.org

Murray E. Joiner, Jr., MD Murray E. Joiner and Associates Roanoke, Lynchburg, Covington, Wytheville | 540.772.4448 www.virginiapain.org

Virginia Interventional Pain and Spine Center Chheany Ung, MD Roanoke | 540.777.0090 Christiansburg | 540.251.3472 www.vapainsc.com

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Fibromyalgia

What is fibromyalgia?

What are the symptoms of fibromyalgia?

For decades, medical providers misdiagnosed fibromyalgia, a condition indicated by widespread, general pain and fatigue, or simply refused to diagnose patients at all. Thankfully, physicians are more frequently – but not always – recognizing fibromyalgia for the difficult and very real issue that it is.

Around five million adults, of which 80 to 90 percent are women, suffer from fibromyalgia, which affects a person’s soft tissue. The cause is unknown, but factors could include infections, physical or emotional trauma, long-term stress and genetics.

Fibromyalgia presents much like arthritis, but doesn’t cause the same sort of joint and muscle inflammation and damage as that particular condition. In addition to widespread pain and fatigue, fibromyalgia symptoms include headaches, irritable bowel syndrome, painful menstrual periods, sensitivity to heat and cold, concentration and memory issues (often referred to as “fibro-fog”) and tingling and numbness in the hands and feet.

Support Group: Finding Ease in Dis-ease Susan Boyes, LPC Meets every Wednesday from 6:30 pm – 8:30 pm 3635 Manassas Drive, Roanoke Session cost: $30 – $40 540.491.4263 susanboyes@susanboyes.com www.susanboyes.com

Where in Roanoke & New River Valleys Can I Get Help? * Michael Arthur, MD The Center for Ultra Health, LLC Roanoke | 540.989.9800 www.thecenterforultrahealth.com

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How is fibromyalgia diagnosed?

At one time, physicians diagnosed fibromyalgia by checking known trigger points and pressing on certain areas of the body to determine if they were painful. Those points included the back of the head, upper chest, knees and elbows. While painful trigger points are still standard for fibromyalgia, they’re no longer the primary way to diagnose. Instead, a doctor might determine a patient has fibromyalgia if they’ve experienced general, widespread pain for at least three months and have no other diagnosable medical condition to explain it.

Chronic Fatigue Syndrome

What is Chronic Fatigue Syndrome?

When it comes to invisible diseases, chronic fatigue syndrome (CFS) might be the most invisible of all. Little is known about the disorder, which was only recently recognized to be a legitimate condition. CFS could be the result of a viral infection such as Epstein-Barr, but researchers have yet to find a definitive link. Healthcare professionals also point to immune system problems and hormonal imbalances as potential culprits. Life with CFS can be isolating, leading to complications such as depression, increased work absences – and, as a result, difficulty climbing the career ladder – and a restriction on daily activities that can keep a person healthy and happy.

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What are the symptoms of CFS? As the name suggests, severe fatigue is the main indicator of CFS. It gets worse after physical or mental activity, but the exhaustion doesn’t get better after rest. This form of fatigue isn’t just feeling tired, but rather an all-consuming exhaustion that has lasted six month or longer. People with CFS often experience problems with thinking and memory, as well as dizziness or weakness while standing or sitting up. They might also feel muscle or joint pain and headaches, although those aren’t symptoms experienced by everyone with the condition.

How is CFS diagnosed?

Diagnosing CFS isn’t easy – for the patient or the physician.

There isn’t a test that can plainly tell if a person has CFS, so it’s mostly a diagnosis of elimination by testing for and ruling out other diseases, such as sleep disorders, hypothyroidism and mental health issues. However, even if CFS is diagnosed, there’s no true treatment—and there’s certainly no cure. Instead, the focus is on relieving symptoms through medications such as antidepressants, cognitive therapy and a few minutes of movement a day that’s gradually increased to help reduce hypersensitivity to exercise.

Those with

IRRITABLE BOWEL SYNDROME suffer with upset stomach, cramping and diarrhea

at least three days every month.

4

Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome?

The fact that irritable bowel syndrome is often overlooked in women is ironic; the condition, also known as spastic colon, affects more females than males. Although everyone deals with an upset stomach, cramping and diarrhea on occasion, those with IBS suffer from it at least three days every month (and, for the most part, much more often than that). Although the two conditions sound similar, IBS isn’t the same as inflammatory bowel disease, which is much more serious and has drastic complications.

What are the symptoms of IBS? Irritable bowel syndrome often starts with cramping and abdominal pain, then progresses to bloating, gas, and episodes of both constipation and diarrhea. The pain will likely go away after a bowel movement, but will inevitably return. Women often have more symptoms around the time of their periods, and some say IBS gets worse during pregnancy.

A change in diet to avoid “trigger” foods – including cruciferous vegetables like broccoli, kale and cauliflower, and legumes such as beans and lentils – often successfully manages the worst IBS symptoms.

How is IBS diagnosed?

Many doctors will diagnose irritable bowel syndrome based on symptoms, but some might want to do a few additional tests to rule out other potential conditions. For example, the symptoms could be caused by an infection or another disorder such as celiac disease, so the patient might need to provide a stool sample or undergo a blood test.

If a doctor suspects the symptoms are being caused by a more severe disease, such as colitis, Crohn’s disease or cancer, they might perform a colonoscopy. Over the past five years, blood tests to help diagnose IBS have appeared on the market. However, it only has the potential to diagnose forms of IBS in which diarrhea is the prominent symptom, rather than constipation, so it’s not a catch-all for helping everyone who suffers from the condition.

Where in Roanoke & New River Valleys Can I Get Help? * Carilion Clinic Gastroenterology Roanoke | 540.224.5170 www.carilionclinic.org

Gastroenterology Consultants of Southwest Virginia, Inc. Roanoke | 540.345.4900 www.colonoscopyroanoke.com

LewisGale Physicians Gastroenterology Salem | 540.772.3580 Blacksburg | 540.552.3670 www.lgphysicians.com

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Where in Roanoke & New River Valleys Can I Get Help? * Carilion Clinic Rheumatology (arthritis and lupus) Roanoke | 540.224.5170 Dermatology (psoriasis) Roanoke | 540.981.1439 Gastroenterology (Celiac disease) Roanoke | 540.224.5170 www.carilionclinic.org

Endocrinology Associates, Inc. (thyroid conditions and Grave’s disease) Roanoke | 540.344.3276 www.endocrinologymed.com

LewisGale Physicians Rheumatology (arthritis) Salem | 540.772.3707 Dermatology (psoriasis) Salem | 540.772.3421 Roanoke | 540.265.1604 Gastroenterology (Celiac disease) Salem | 540.772.3580 Blacksburg | 540.552.3670 www.lgphysicians.com

Gastroenterology Consultants of Southwest Virginia, Inc. (Celiac disease) Roanoke | 540.345.4900 www.colonoscopyroanoke.com

River Ridge Dermatology (psoriasis) Blacksburg, Roanoke and Giles 540.951.3376 www.riverridgederm.com

Roanoke Area MS Center (multiple sclerosis) Jill Cramer, MD Blue Ridge Associates in Neurology Salem | 540.381.6211 www.swvabrain.com

Support Group: Making Lupus Look Good Founded by Ayshia Merchant Roanoke makinglupuslookgood@gmail.com Visit f MakingLupusLookGood for updates on current events and support groups planned.

Women develop

AUTOIMMUNE DISEASES at a rate of 2:1 compared to men, with the condition typically appearing during her childbearing years.

5

Autoimmune Disorders

What are Autoimmune Disorders?

Rather than just one disease, autoimmune disorders are a cluster of individual conditions that occur when the immune system attacks the body’s own tissues rather than fighting infections from outside invaders. Women develop autoimmune diseases at a rate of 2:1 compared to men, with the condition typically appearing during her childbearing years.

There are more than 80 known autoimmune disorders, but common conditions include: • Rheumatoid arthritis

Support Group: GBS|CIDP Foundation International

• ●Lupus

(Guillain-Barre Syndrome) Roanoke Chapter Meeting Saturday, November 2, 2019 2 pm – 4 pm Carilion Clinic Outpatient Therapy 207 South Jefferson Street | Roanoke Visit https://bit.ly/2oTr6Pv to reserve your free seat. www.gbs-cidp.org

• ●Guillain-Barre

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• ●Multiple sclerosis • ●Hashimoto’s thyroiditis • ●Grave’s disease • ●Celiac disease

What are the Symptoms of Autoimmune Disorders?

Although autoimmune disorders aren’t just one disease, early symptoms are often similar. These include achy muscles, fatigue, swelling and redness, hair loss, numbness and tingling in the hands and feet, rashes and trouble concentrating. Some autoimmune diseases, particularly rheumatoid arthritis and psoriasis, have symptoms that come and go. These periods of time are known as “flare-ups;” when the symptoms go away, it’s known as “remission.”

How are Autoimmune Disorders Diagnosed?

No matter which autoimmune disease a person is suffering from, diagnosis typically starts with an antinuclear antibody test. If the test comes back positive, it means a person might have an autoimmune condition, but it won’t indicate exactly which one. From there, a doctor will likely take symptoms into account to diagnose the specific disorder. Because symptoms are so generalized and often come and go, some doctors might not take a person’s complaints seriously. Reaching out to a specialist that has experience dealing with specific symptoms—for example, a gastroenterologist if constipation and diarrhea are a major issue—can often help increase the chance for a diagnosis.

*The medical practices and providers listed in the Community Care Connection do not necessarily represent a comprehensive listing of professionals in the Roanoke and New River Valleys communities that specialize in the related conditions.

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ANSWERING THE

CALL FOR CARE

VOLUNTEER • SERVICE • COMMUNITY

words | TODD MARCUM

As part of Bradley Free Clinic’s mission to increase access to quality healthcare for low-income and underserved people in the Roanoke Valley and surrounding areas, it is now offering expanded hours during the week and serving patients with Medicaid or without insurance. Volunteer medical providers continue to see patients on Tuesdays and Thursdays evenings beginning at 5 pm and on Friday mornings.

Since 1974, Bradley Free Clinic has provided free medical, dental and pharmacy care to the Roanoke Valley’s working uninsured, temporarily unemployed and their families through its team of volunteer healthcare professionals, many of whom are among the most respected in the field throughout the region. During the past 45 years, a lot has changed about the landscape of healthcare in our area, including the needs of people who require access to it, and Bradley Free Clinic has been diligent in adapting how it provides care to help answer the call.

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Bradley Free Clinic has long depended on many selfless medical professionals in the community who donate their time to provide patient care on Tuesday and Thursday evenings and Friday mornings – an invaluable contribution of service that will continue. To help address the increasing need for care, Bradley Free Clinic is now accepting Medicaid and is open Monday through Friday from 9 am to 5 pm, in addition to evening hours on Tuesday and Thursdays, and on Friday mornings. The clinic has also added a full-time nurse practitioner – Susan Blick – to its team of clinical staff, who sees patients on every week day from 9 am to 5 pm. Blick is a certified family nurse practitioner and registered nurse with more than 30 years of experience providing direct care to patients with complex needs. Her position is funded by a grant by the Virginia Health Care Foundation (www.vhcf.org).

Janine Underwood, Executive Director of Bradley Free Clinic, notes that the philosophy of Bradley Free Clinic has not changed and that it is still a volunteer-driven free clinic that functions through the generosity of its volunteers and donors.

Susan Blick, NP

Bradley Free Clinic’s new full-time certified family nurse practitioner.

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“As healthcare needs [have] changed in our community, Bradley Free Clinic is [doing its part] by responding [with] increased access to care and expanded services [available] to the lowincome and underserved,” says Underwood. “In the ever-changing world of healthcare delivery, we are delighted that we can provide an additional service option for our patient population.”

Bradley Free Clinic has always—and continues—to rely on local medical providers who donate their time to provide access to care to low income and uninsured people in the community.

Volunteer medical providers, many of whom have full- or parttime jobs with various organizations in the area, include primary care physicians, specialists, dentists, pharmacists and nurses— as well as community volunteers with complementing skills and talents—all play an important role in operating the clinic. Bradley Free Clinic offers comprehensive services focused on women’s health, behavioral health, Hepatitis C and diabetes management.

Bradley Free Clinic’s expansion of services means it can now meet the needs of all medically underserved patients in the Roanoke area, whether uninsured or covered by Medicaid.

“The expansion of Medicaid in Virginia has been an excellent step forward, providing coverage to more people,” says Randy Rhea, MD, a family medicine physician with Carilion Clinic and Bradley Free Clinic’s Board President. “Yet, many new Medicaid recipients have found it difficult to find a permanent medical home with providers who will accept their insurance or [who] can see them promptly. Many of Bradley Free Clinic’s patients benefited from Medicaid expansion and because of their longstanding relationship with our quality providers, they wanted to remain as Bradley patients. The expansion of services will allow our Medicaid-eligible patients to remain with the Clinic and the providers who [they know and who] know them.”

Without access to a medical home such as Bradley Free Clinic, Dr. Rhea notes that many uninsured and underinsured people can often face difficult financial choices that can turn a minor medical condition into one that requires emergency room treatment or hospitalization. When conditions that could be easily corrected if treated early in a clinic setting become potentially life-threatening and require costly emergency treatment to address, it puts stress on limited healthcare resources and creates bottlenecks in the healthcare delivery system.

Bradley Free Clinic’s expansion of services means it CAN NOW MEET THE

NEEDS OF ALL MEDICALLY UNDERSERVED PATIENTS IN THE ROANOKE AREA, whether uninsured or covered by Medicaid.

John Burton, MD, Director of Carilion Clinic’s Emergency Department, states that he supports the expansion of services at Bradley Free Clinic so that low income, underserved people in the Roanoke Valley who have non-life threatening conditions will have options for routine and followup care other than the local emergency rooms*. Crowding in emergency www.OurHealthRoanokeNRV.com

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departments, which is determined when the identified need for emergency services is greater than the emergency resources that available, has long been a challenge in the U.S. Experts say crowding contributes to extended wait times, delays in treatment, and decreased satisfaction, among other issues. Providing access to avenues of care where patients with non-life threatening health conditions can be effectively treated is believed to be part of the solution.

“The funding mechanisms for healthcare are constantly changing, but we are focused on the needs of the underserved,” says Dr. Rhea. “Our expanded hours and scope have a real impact on the people in our community who need help. We feel this step will make a real impact on healthcare in our community and continue Bradley Free Clinic’s legacy of caring for people in need and supporting the health care infrastructure for the region.”

In fiscal year 2017-18, Bradley Free Clinic provided more than $5.4 million in free services. In addition to its medical and dental clinics, Bradley Free Clinic offers comprehensive services focused on women’s health, behavioral health, Hepatitis C and diabetes management. The Roanoke Valley HOPE Initiative (RVHI), a program designed to assist individuals suffering from substance abuse disorders (SUD) in any form who are seeking resources for treatment and recovery.

Randall Rhea, MD During a recent news conference, Randall Rhea, MD, Board President of Bradley Free Clinic, discusses Bradley Free Clinic’s newly offered services, which include its expanded hours, a full-time nurse practitioner and accepting Medicaid in addition to offering care to qualifying uninsured patients in need.

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Bradley Free Clinic continues to depend on the support of dedicated and committed donors in the community. To learn more about the services offered and how you can help support their efforts, visit www.bradleyfreeclinic.com. *If you are experiencing a life-threatening condition, call 9-1-1 and/or visit the nearest emergency room as soon as possible.

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Spotting Signs of Depression in Seniors words | DYLAN ROCHE

From mourning the death of friends or a spouse to leaving the home where they’ve lived for decades and adjusting to a less independent lifestyle, senior citizens often find themselves struggling to adjust with the changes that come with the aging process— and it’s easy for them to slip into depression.

Annually, October 10th is recognized as National Depression Screening Day to help bring awareness and encourage screening to be performed in those who may be at risk.

Even though depression can be common in seniors, it’s not something that should be dismissed as a natural part of aging, says Stacey Corbitt, Director of Community Outreach with Hermitage, a continuing care retirement community in Roanoke. Those with a senior loved one should take the time to look for the symptoms of depression, which can include noticing that the person is sleeping too much or too little, grumpiness or irritability, confusion or attention problems or a loss of interest in activities that they used to enjoy.

Addressing Senior Depression Vigilance is the first step to addressing the problem. “At Hermitage, we focus on spending time and really getting to know our residents, so we can recognize signs of depression that may not be obvious,” Corbitt says, adding that the end goal is to provide the seniors a new sense of purpose and belonging.

Healthy Observations • OCTOBER 10

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| National Depression Screening Day

If a senior is struggling with depression, it’s important that they have the opportunity to stay busy and engaged. Whether they’re involved in recreation on their campus or going on “field trips” for dinner and shopping, residents are more likely to avoid experiencing the symptoms of depression if they find themselves part of a community.

At Hermitage, “We focus on spending time and really getting to know our residents, so we can recognize signs of depression that may not be obvious,” Corbitt says, adding that the end goal is to provide the seniors a new sense of purpose and belonging.

STACEY CORBITT

Director of Community Outreach with Hermitage, a continuing care retirement community in Roanoke.

“Participating in different programs gives our residents a sense of involvement and accomplishment that can help combat depression, not just in the activity itself, but in building relationships amongst each other and team members,” Corbitt says. Hermitage’s numerous activities for residents include movie nights, social hours, dance exercise classes, Bible study, theater and much more.

Aging comes with both physical and emotional struggles, and having problems with mobility and memory can feel like a barrier to participating in stimulating activities.

Sometimes, however, all it takes to push past that barrier is for someone to check in and offer help. “We go to our residents’ room before every program to see if they would like to attend,” Corbitt shares, “and offer assistance if needed to get to and from.”

Even those who are taking care of a senior at home can follow the example set by the team at Hermitage. To assess your own emotional health or the health of a loved one, you can take an anonymous screening at www.helpyourselfhelpothers.org.

A Partner in Care If you suspect something is wrong with an aging loved one, don’t hesitate to step in – sometimes this makes all the difference. “When a resident hasn’t been coming to a program that they normally enjoy, their friends notice and will check on them or send a team member to,” Corbitt says. “If someone who normally likes to eat in the dining room hasn’t been coming, our team takes notice and we will visit, talk with him or her and listen to what is going on. Building relationships is important to have a sense of belonging.”

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AT A GLANCE

Hermitage Roanoke 1009 Old Country Club Road | Roanoke | 540.449.0071 | www.hermitageroanoke.org

Specialties/Services Independent assisted living, nursing care, rehab therapy, respite care 62 OurHealthliving, | The Resource for Healthy Living in Roanoke and New River Valleys

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It’s Important to Remember

YOU’RE NOT ALONE words | KELSEY CASSELBURY

‘Take care of one another’. It’s a mantra that most families’ bedrock principles are built upon. Still, for the more than 90 million Americans who care for loved ones with chronic conditions, disabilities, disease or the frailties of old age, it’s not always easy serving the role of selfless caregiver on top of managing their many other responsibilities. And knowing where to turn to for help when needed is very important for everyone’s interest.

November is designated as National Family Caregivers Month to help raise awareness of family caregiver issues, celebrate their efforts, educate family caregivers about selfidentification and increase support.

A caregiver – sometimes referred to as an informal caregiver is an unpaid individual such as spouse, partner, family member or friend involved in assisting others with activities of daily living and/or medical tasks. While those cared for can range in age from young children to the elderly, the average age is 69.4. According to the Virginia Public Access Project, almost 19 percent of Virginians will be over age 65 next year in 2020, and, by 2040, nearly one in five Virginians will be of senior citizen age. The Roanoke Valley outpaces the commonwealth’s numbers, with estimates that nearly 23 percent of citizens will be over 65 beginning in the coming new year.

Of course, plenty of seniors live active, healthy and independent lives without the need for a family caregiver – but what about the

ones who can’t? With the amount of seniors in need increasing, the number of family caregivers who are responsible for aging loved ones’ daily needs grows too, adding to the caregiver’s already challenging and full plate of responsibilities that includes work, family and social responsibilities.

The Unrecognized Epidemic For some families, home health care providers or assisted living facilities are among popular options available to help provide needed care for aging family members. For others, though, that’s simply not an option, whether it’s due to financial constraints or personal preference. And unfortunately, the selflessness of these millions of unpaid caregivers can come with a price, with their own physical and mental health often suffering due to the intense demands of the added responsibility.

40-70%

In fact, research estimates that between 40 and 70 percent of caregivers show significant symptoms of depression, as well as experience higher levels of stress than non-caregivers and suffer from a higher rate of physical issues, such as headaches, pain and acid reflux.

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Healthy Observations • NOVEMBER | National Family Caregivers Month

Finding a Middle Ground Even if full-time care isn’t an option, a caregiver often benefits by finding some sort of compromise, such as an adult day care program – also called respite care – where a caregiver can enroll a loved one who can’t be left home alone on their own. The Feinour Center Adult Medical Day Care at Friendship in Roanoke is one such program, which serves approximately 20 to 25 people each day.

“Our program benefits the caregiver by providing that much-needed respite, which allows them time for themselves,” notes Erin Layell, Director of Home and Community-Based Services for Friendship. It also benefits the patients, she adds, by offering socialization and engagement opportunities that offset the isolation that so many aging and disabled adults can experience when they’re at home, as well as providing a daily structure and routine that allows the participants to both eat and sleep better.

It’s common for family caregivers to experience guilt when first enrolling their loved one in an adult day care program such as the one at Friendship – after all, no one wants to feel like they’re abandoning the person they care for. Consider starting by enrolling just one to two days a week to see how everyone adjusts to a new schedule and activities.

Daily activities offered at The Feinour Center Adult Medical Day Care at Friendship can include yoga, painting lessons, pet therapy, live music, community service projects and outings.

After a few weeks, both the caregiver and patient might be ready to start attending full-time, if finances allow. “The benefits realized by everyone become a welcomed part of everyone’s new routine,” Layell says. “Knowing their loved one is in a safe, pleasant environment that they enjoy can help provide the balance caregivers need and deserve.”

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AT A GLANCE

Specialties/Services

The Feinour Center Adult Medical Day Care at Friendship

The Feinour Center provides a safe, nurturing, and healthy environment that promotes overall wellness for individuals through activities that are tailored to their interests and meeting social, physical, and cognitive needs, such as:

324 Hershberger Road | Roanoke | 540.385.8720

www.friendship.us Program Options

» Flexible schedule options from hourly to all-day participation

» Transportation assistance program available for

those who qualify Most major insurance plans and Medicaid accepted

»

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» Art and creative expression » Tai chi and full body exercises » Games for memory stimulation » Learning and guest lectures » Snacks and a nutritious lunch

» Music » Group outings » Faith-based programs » Cooking

The Feinhour Center staff includes recreation therapists, nurses and nursing assistants providing: Comprehensive Medication management individualized plan of care Memory stimulation Health and wellness activities Nutritious prepared meals Post-hospitalization recovery Monthly health assessments Physical, occupational, and Daily health monitoring speech therapy services Dementia care

» » » » » » » Assistance with daily care needs

» » » »

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A Commitment to Serve

Those Who Are Older or Disabled Professional home care providers play a central role in our healthcare system and in homes across the nation, serving as skilled nurses, therapists, nursing aides and companions – a key part of ‘aging in place’ safely and successfully. words | KELSEY CASSELBURY

For decades, your mom or dad has lived a healthy, independent life.

Although you help out every once in a while, such as driving him or her to a doctor’s appointment or making a delicious dinner, both you and your parents have felt confident in their ability to reside in their own home without needing medical care or assistance with daily tasks – and thank goodness for that, given your significant obligations to work and the family you’re raising.

But then, you start to notice an odd occurrence here and there. Mom’s house doesn’t seem quite as clean as it once did. Dad has some bruises on his arms and legs that don’t have an explanation. Mom is losing weight, and her refrigerator is stocked with much at all. Although you might hesitate or try to avoid facing the difficult truth of having an aging parent, eventually the reality sets in that additional help is needed.

“We have patients who will notice a change in their function or ability to perform certain tasks in their daily lives just as much as we have family who may have noticed these same things.”

Home Care: A Key Part of The ‘Aging in Place’ Movement

Elaine Smith

Not long ago, the natural transition for the elderly in need of more formal assistance with daily activities and care was to move into a retirement facility. But being completely uprooted from their familiar surroundings – their home – may not be what every person wants or truly needs

Outreach Coordinator for Warm Hearth at Home

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Healthy Observations • NOVEMBER | National Home Care and Hospice Month at that point in time. Adapting homes to be more “senior friendly” in terms of accessibility and safety and offering experts who come into the home to provide care and assistance – home care professionals – are all part of a growing trend called ‘aging in place’. ‘Aging in place’ provides the elderly with safe and dependable options that make remaining in their homes longer into their golden years an option they can choose – and one their family can feel confident about.

but rather simply help with housework, meal preparation, driving and other non-medical needs. Next, there’s the option of certified nursing aides for people who need help with getting dressed and other hands-on tasks. Lastly, there’s home health care, designed for those who need more skilled nursing care and/or physical therapy, occupational therapy or speech therapy, either in short- or long-term.

Home Care Fast Facts

November is National Home Care and Hospice Month, during

which time the home care and hospice community honor the millions of nurses, home care aides, therapists and social workers who make a difference for the patients and families they serve.

Seniors Often Seek Out Home Care Services Themselves

In 2018, U.S. home care providers

TRAVELED EIGHT BILLION MILES to deliver care to patients in their homes.

NINETY PERCENT OF AMERICANS

want to age in place, and home care is the preferred method of health care delivery among the disabled, elderly, and chronically ill.

“When a potential patient or family member calls to inquire, our staff can help them navigate the options and help them find services that best fit their needs,” Smith notes, a process that lays the foundation of a partnership among the patient, the family and the care provider.

Building an Alliance When someone is taking care of your loved one at home, you want to make sure they are the right person for the job and that they respect the needs and desires of your family. Smith says that it’s important to ask plenty of questions of the agency with which you’re working, as well as of the person who is placed with your family. Questions might include if the person has had a background check, if they’re comfortable with the needs of the patient and what their past experiences as a caregiver have been like. The goal is to work as a team with anyone involved in the patient’s care, Smith continues.

It’s not always the child who realizes the need for care. “We find that those directly in need of our services – patients – contact us equally as often,” says Elaine Home care provides Smith, Outreach Coordinator for Warm high-quality, compassionate care to Hearth at Home, a home care provider in Blacksburg that’s part of Warm Hearth Village, which offers a continuum of living options that range from independent living to long-term nursing home care.

However, there are times when a match “We have patients who will notice a doesn’t work out. If you don’t think that change in their function or ability to the provider is the right fit, that’s OK – perform certain tasks in their daily lives just as much as we have reach out to the agency to talk about what’s going on. “When that family who may have noticed these same things.” situation arises, we simply need to be made aware that the caregiver Even when they know it’s right, a son or daughter might struggle isn’t ideal, and we will place a different caregiver with the patient,” with guilt for hiring a home care provider instead of taking on the Smith says. “Our caregivers are all unique. Our goal is to identify the responsibility of caring for a parent on their own. Finding the right right caregiver who is ideal for the patient’s personality.” level of care, as well as the right provider – and then creating a trusting, strong relationship with that caregiver – can go a long way ON THE WEB More at OurHealthRoanokeNRV.com in soothing concerns.

MORE THAN FIVE MILLION AMERICANS ANNUALLY.

Warm Hearth at Home offers three levels of care: The first level – companion care – is for people who don’t need hands-on assistance

AT A GLANCE

Warm Hearth at Home 1901 South Main Street, Suite 7 | Blacksburg | 540.443.3428 | www.whvathome.org

Specialties/Services Home health, including skilled nursing, rehabilitative therapies and home health aides, as well as home care, including care management, medication management, companion care and70personal care.

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Choosing Hospice Doesn’t Mean You’re Giving Up on Life.

It’s Means You’re Choosing How to Best Live It.

Coming to terms with our own mortality, or that of a loved one, is a challenge we all must face. While we know that dying is inevitable, the reality of it is simply not a conversation most want to embrace. So, when a prognosis indicates a shorter life span, end-of-life services – like hospice care – become a focus and the difficult dialogue becomes important.

November is designated as National Hospice and Palliative Care Month to help bring awareness to a sensitive topic that remains misunderstood on many levels.

If the notion that “we fear most what we know the least about” is widely accepted, then perhaps it’s time to take a closer look at medical services like hospice care. Good Samaritan Hospice, the only community-based, not-for-profit hospice serving the Roanoke and New River Valleys, recognizes that there are a multitude of misconceptions about hospice and strives to dispel the long-held myths about this specialized care. More than 5500 hospices in the U.S. provide aggressive symptom management for patients, as well as emotional and spiritual support. In addition, hospice considers the family/caregivers as their patient and offers care and resources for them as well. The goal is to bring comfort and compassion to this sacred chapter of life. Educating on what hospice “is” and what hospice “is not” is the first step toward that goal. www.OurHealthRoanokeNRV.com

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AT-A-GLANCE

Good Samaritan Hospice www.goodsamhospice.org f GoodSamHospice | t GoodSamHospice

DISPELLING THE MYTHS A BOUT

Hospice Care

m info@goodsamhospice.org Roanoke Office

2408 Electric Road Roanoke | 540.776.019

Christiansburg Office

1160 Moose Drive Christiansburg | 540.381.3171

About Good Samaritan Hospice

Good Samaritan Hospice was established in 1992 as a community-based, non-for-profit hospice. It is a member of the National Partnership for Hospice Innovation, Virginia Association for Hospices and the Palliative Care Partnership of the Roanoke and New River Valleys.

Good Sam seeks to affirm life in the midst of illness and grief by providing quality patient care, family support, community education, and counseling services through an interdisciplinary team of caregiving professionals and trained volunteers.

Myth: Hospice means giving up.

Fact: Hospice means intentionally and aggressively pursuing what matters most to each patient and family.

It ensures that choice, compassion, comfort, dignity and respect are priority.

Myth: Hospice patients only have days remaining to live.

Fact: Medicare and Medicaid do not limit the length of the hospice benefit. Patients may enroll when the physician believes that the patient has an expected prognosis of living six months or less if the disease runs its normal course.

Hospice will continue as long as the patient meets eligibility requirements. Hospice care is never ended due to the length of time a patient has been under care. Because prognosis is difficult, that time may extend well beyond six months.

Myth: Hospice patients must live in a private residence.

Fact: Many patients reside in a nursing or assisted living facility. Medicare and Medicaid consider long-term care facilities to be the patient’s place of residence. The services are the same as those living in a private residence, including bereavement follow-up for the family. Hospice provides care wherever someone considers home.

Myth: Once electing the hospice benefit, there is no turning back.

Fact: Medicare and Medicaid do not limit the number of times a patient chooses to enroll in hospice. Sometimes, individuals in hospice care choose to suspend their hospice benefit and try a new treatment. Later, they may choose to discontinue curative measures and start hospice again. The options are not limited. In addition, sometimes people “graduate” from hospice when their condition stabilizes or improves over a period of time. If their condition worsens later, they can choose to re-enter hospice.

Myth: Only a physician can call for a hospice consult.

Fact: Anyone can call for a

Myth: Hospice services end when a patient dies.

hospice consult. A physician will have to order the full clinical assessment, but anyone can request a visit from a hospice representative to learn more about the services available and have their individual questions answered. There is no obligation or expectation with this free service.

alongside families up to one year following the death of their loved one. Patients often are comforted knowing that hospice will continue to be there for their families/caregivers. In addition, ongoing grief support is available through a variety of programs made available through a hospice’s bereavement program.

Fact: Hospice remains

No one hopes to enter hospice care, but if you or a loved one should need it, you can be comforted knowing it’s about living fully and completely. For more information, call Good Sam Hospice or visit www.goodsamhospice.org.

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Food Fitness NUTRITION • EXERCISE • PREVENTION

Heart Healthy

Soups &Stews Perfect for the Fall Season words | OURHEALTH STAFF WRITER

This fall, warm up the cool, crisp season by having delicious – and heart healthy – soups and stews headline your meal plans.

No doubt about it, backyard barbeques and burgers are the benchmarks of a scrumptious summer food season. While putting a wrap on warm weather might not mean the end of outdoor cooking for the diehard grill masters among us, it does signal the start of when savory soups and stews made with nutritious fall harvest foods can take center stage on the menu, whether it’s at your next tailgate party or quick family dinner. And with so many heart healthy and flavorful ways to prepare these hearty bowls of goodness, you can be assured of pleasing even the pickiest person’s palate on your team.

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Kale and Red Quinoa Soup This protein-packed soup is an ideal dinner for busy days. Herbes de Provence lend a flavor of the French Riviera and the smoked paprika harmonizes nicely with the pepperiness of the kale.

Nutritional Information Calories: 245 | Total Fat: 6 g Saturated Fat: .5 g | Trans Fat: 0 g Polyunsaturated Fat: 1 g Monounsaturated Fat: 3 g Cholesterol: 0 mg | Sodium: 294 mg Total Carbohydrates: 40 g Dietary Fiber: 10 g | Sugars: 6 g Protein: 10 g

Slow Cooker Size/Shape: 3 to 4 ½ quart; round or oval Slow Cooking Time: 6 to 8 hours on low; 2 to 3 hours on high Ingredients | Makes 4 servings (1 1/2 cups) • • • • • • • • • • • • • • •

1 14.5-ounce can no-salt-added whole tomatoes, undrained 1 14.5-ounce can no-salt-added Great Northern beans, rinsed and drained 4 cups coarsely chopped kale (1/2 of a 5-ounce bunch), any large stems discarded 2 cups fat-free vegetable broth (low-sodium) 1/2 cup red quinoa, rinsed and drained in a fine-mesh sieve 1 medium carrot, cut into 1/2-inch slices (about 1/2 cup) 1 medium rib of celery, cut into 1/2-inch slices (about 1/2 cup) 1/2 cup chopped red onion 1 tablespoon olive oil 2 medium minced garlic cloves 3/4 teaspoon dried herbes de Provence or dried thyme, crumbled 1/2 teaspoon crushed red pepper flakes 1/2 teaspoon smoked paprika (sweet or hot) 1/4 teaspoon salt 1/4 teaspoon pepper

Directions Put all the ingredients in the slow cooker. Cook, covered, on low for 6 to 8 hours or on high for 2 to 3 hours, or until the vegetables and quinoa are tender.

Recipes courtesy of American Heart Association, Copyright © 2019

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FARMERS MARKETS:

Black Bean Soup You will love this Simple Cooking with Heart Mexican recipe because it’s simple to make, it’s heart healthy and budget friendly.

Ingredients | Makes 4 servings • nonstick cooking spray • 1 medium onion (diced) • 1 tablespoon garlic (jarred, minced) • 2 teaspoon ground cumin • 1 jalapeño (chopped) • 2 16-oz canned, low-sodium black beans (undrained) • 1 15-oz canned, no-salt-added, diced tomatoes (undrained) • 1 cup low-sodium chicken broth • Chopped, fresh cilantro (optional)

SHOP LOCAL, SUPPORT LOCAL Freshly picked foods like kale, onions and carrots, and even herbs, as well as locally raised meats are plentiful during the fall season and can be found at many farmers markets in and around the Roanoke and New River Valleys.

Blacksburg Farmers Market Where: Corner of Roanoke Street and Draper Road, Blacksburg When: Wednesdays from noon – 6 pm and Saturdays from 8 am – 2 pm (April – October); (Saturday hours from 9 am – 2 pm during November and December); Saturdays only, 10 am – 2 pm (January – March) More Information: w www.blacksburgfarmersmarket.com

Catawba Valley Farmers Market Where: 4965 Catawba Creek Road, Catawba When: Thursdays from 3:30 pm – 7 pm (Mid-May – midOctober); Holiday Market held Saturday, November 23rd from 9 am – 3 pm (inside the Catawba Community Center) More Information: w www.catawbafarmersmarket.com

City of Salem Farmers Market Where: 3 E. Main Street, Salem When: Monday – Saturday, from 7 am – 4 pm (April – December); Saturday only, from 9 am – noon (January – March) More Information: w market.salemva.gov

Directions A

Spray large pot with cooking spray, over mediumhigh heat add onion and cook until translucent (Five minutes).

Grandin Village Farmers Market Where: 2080 Westover Avenue, SW, Roanoke (through November 6th); Winter Market: 1327 Grandin Road, SW, Roanoke (inside the Grandin CoLab) (December through March)

B

When: Saturdays from 8 am – noon (Mid-April to November 6th); Winter Market: every third Saturday from 10 am – 1 pm

C

More Information: w www.leapforlocalfood.org/markets/grandin

Add garlic, cumin and jalapeño and cook one minute more.

Add beans to pot and lightly mash with a potato masher or fork.

D

Add tomatoes and broth – bring to a boil and reduce to medium heat, cover and simmer for 15 minutes.

E

Serve topped with chopped fresh cilantro (optional).

Historic Roanoke City Market Where: 32 Market Square, SE, Roanoke When: Daily, year-round, from 8 am – 5 pm (Closed Christmas Day and New Year’s Day More Information: w www.downtownroanoke.org/explore/farmers-market

Radford Farmers Market Where: 1122 E. Main Street, Radford When: Saturdays from 8 am – 1 pm (May – October)

Nutritional Information Calories: 245 | Total Fat: .5 g Saturated Fat: 0 g | Trans Fat: 0 g Polyunsaturated Fat: 0 g Monounsaturated Fat: 0 g Cholesterol: 0 mg | Sodium: 34 mg Total Carbohydrates: 45 g Dietary Fiber: 12.9 g | Sugars: 6 g Added Sugars: 0 g Protein: 15 g

More Information: w www.radfordva.gov/498/farmers-market

Vinton Farmers Market Where: 204 W. Lee Avenue, Vinton

Quick Tip Serve this black bean soup as a side to a meal or warm in microwave and use as a filling for tacos!

When: Open year-round, Monday – Saturday, from 8 am – 6 pm More Information: f VintonFarmersMarket

West End Farmers Market Where: 1210 Patterson Avenue, SW, Roanoke (Located in the covered pavilion behind Freedom First Credit Union) When: Tuesdays, year-round, 3 pm – 6 pm More Information: w www.leapforlocalfood.org/markets/westend

Turkey Chili Warm up with this Classic American staple turkey chili that’s both savory and satisfying.

Ingredients | Makes 6 servings • Cooking spray • 1 1/2 tablespoon. canola or corn oil • 1 medium or large onion, chopped • 20 oz. ground, skinless turkey breast • 2 large garlic cloves (minced) OR • 1/2 teaspoon garlic powder • 2 teaspoon chili powder • 1/2 teaspoon pepper • 1/2 teaspoon ground cumin • 15.5 oz. canned, no-salt-added pinto beans (rinsed, drained) • 15.5 oz. canned, no-salt-added black beans (rinsed, drained) • 14.5 oz. canned, no-salt-added, diced tomatoes (undrained) • 1 3/4 cups fat-free, low-sodium chicken broth • 1 cup frozen whole kernel corn • 6 oz. canned, no-salt-added tomato paste • 4 medium green onions (green part only, sliced)

Directions A Lightly spray a Dutch oven with cooking spray. Add the oil and heat over medium-high heat, swirling to coat the bottom. Cook the onion for three (3) minutes, or until soft, stirring occasionally.

B Reduce the heat to medium. Stir in the turkey. Cook for five (5) minutes, or until browned, stirring frequently to turn and break up the turkey.

Nutritional Information Calories: 347 | Total Fat: 5 g Saturated Fat: .5 g | Trans Fat: 0 g Polyunsaturated Fat: 1.5 g Monounsaturated Fat: 2.5 g Cholesterol: 64 mg | Sodium: 129 mg Total Carbohydrates: 42 g Dietary Fiber: 10 g | Sugars: 34 g Protein: 34 g

C Stir in the garlic, chili powder, pepper, and cumin. Stir in the remaining ingredients except the green onions. Cook for five (5) to seven (7) minutes, or until heated through, stirring frequently. Just before serving, sprinkle with the green onions.

ON THE WEB More at OurHealthRoanokeNRV.com

Recipes courtesy of American Heart Association, Copyright © 2019

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Funny BONE HUMOR • SEARCH • CHECK

CONGRATULATIONS

BECKY BURTON-WISE of Salem

Can you spot the SEVEN differences between the two cartoons?

Becky Burton-Wise of Salem was the first person to email the correct seven differences in last issue’s Funny Bone.

Be the first reader to email us describing what the seven differences are and you will earn the satisfaction (and bragging rights) of having your name in print in the next edition. OK, START YOUR SEARCH!

For the full list of answers visit our facebook page @OurHealthRoanokeNRV.

Email info@ourhealthvirginia.com with the subject line Funny Bone Roanoke and NRV.

Visit www.OurHealthRoanokeNRV.com or our Facebook page @OurHealthRoanokeNRV and sign up for our e-newsletter for more fun games, quizzes and contests to win great prizes!

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83 Medical Facilities of America

11 Richfield Living

37 The Woodland Place 68 VCOM 27 Virginia Prosthetics & Orthotics 67 Virginia Veterans Care Center 84 Vistar Eye Center 69-70 Warm Hearth Village 41 YMCA of Virginia’s Blue Ridge

www.OurHealthRoanokeNRV.com

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