OurHealth Richmond Aug/Sep 2013 Edition

THE ABC’S OF BACK TO SCHOOL HEALTH

INSIGHT ON MEMORY CARE

AUGUST

•

PROSTATE CANCER AWARENESS

SEPTEMBER 2013 | GREATER RICHMOND EDITION | OURHEALTHRICHMOND.COM

Bob Everton of Midlothian and other local seniors share why

they aren’t ready to ride off into the sunset just yet.

NUTRITION: THE HARVEST RECIPES

our health | BASIC

table of contents |august • september 2013

18

COVER STORY MEDI•CABU•LARY.....................10 Local experts define healthcare related terms

JUST ASK!..................................12

The New Face of Retirement: Retirement is no longer about resting on your laurels, and many local seniors can attest to it.

A variety of health questions answered by local professionals

THE LATEST...............................13 A listing of new physicians, providers, locations and upcoming events in the greater Richmond community

HEALTH AND FITNESS ON THE GO..................................17 Health-focused apps you can download to your smartphone or tablet. new physicians, providers, locations and upcoming events

* SPECIAL ADVERTORIAL SECTION *

RETIREMENT LIVING HIGHLIGHTS...............................26 MEMORY CARE...........................35 Caring for the Whole Person Fast Facts About Dementia from the Alzheimer’s Association

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47 COMFORT AND PEACE..............41 Bereavement Groups Truly Understand

BACK TO SCHOOL ABCs of Back-to-School Health

43

NUTRITION Healthy Eats: Preparing for the Harvest

MEDICAL EDUCATION ADVANCEMENTS IN RICHMOND..................................54 Richmond colleges and universities are helping answer the call for needed medical care

WOMEN’S HEALTH.....................61 The 2013 Pink Tie Gala: Cutting the Rug to Help Cure Breast Cancer

MEN’S HEALTH...........................64 Prostate Cancer-Screening is a Key to Long-Term Survival

www.ourhealthrichmond.com | 7

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OUR HEALTH RICHMOND MAGAZINE

august • september 2013

OUR HEALTH’S EXCLUSIVE MEDIA PARTNER PUBLISHER PRESIDENT/EDITOR-IN-CHIEF ASSOCIATE EDITOR VICE PRESIDENT OF PRODUCTION CLIENT LIAISON CHIEF DESIGNER ORIGINAL PHOTOGRAPHY WEBMASTER

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Timothy Bushman, MD

ON YOUR TABLET

Tara Dall Jan-Eric Esway, MD Tricia Foley, RD, MS Theodore Prokopsis Cleome Winters, MD CONTRIBUTING PROFESSIONAL WRITERS Sarah Cox Rich Ellis, Jr. Anika Imajo Laura Neff-Henderson Jennifer Romeo Edwin Schwartz ADVERTISING AND MARKETING Richard Berkowitz Senior Vice President, Business Development P: 804.539.4320 F: 540.387.6483 rick@ourhealthvirginia.com Kim Wood Vice President, Business Development P: 540.798.2504 F: 540.387.6483 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: 305 Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.355.3071 Information in all print editions of Our Health and on all Our Health’s websites (www.ourhealthrichmond.com and www.ourhealthvirginia.com) social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations.

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Copyright © 2013 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. The Our Health Southwest Virginia edition is published bi-monthly by McClintic Media, Inc. 305 Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthrichmond.com | www.ourhealthvirginia.com | Advertising rates upon request.

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our health | MEDI•CABU•LARY & JUST ASK

me d i • ca bu • l ar y

T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D

What are toe deformities?

Toe Deformities are a source of pain. They may be caused by injuries, disease and footwear.

Typically, they develop over time.

The most common deformities include hammertoes and overlapping toes. Toe deformities may be accompanied by pain and may lead to the development of corns and calluses, this is the appropriate time for surgical intervention.

Generally, surgical procedures aim at returning toes to normal positions. This requires the surgeon to realign bones and may call for re-adjusting tendons.

Sometimes, pins or screws are used to hold bones in place. The results of successful surgery can be enhanced, if, after the procedure, patients wear shoes that are comfortable and allow proper alignment.

Jan-Eric Esway, MD OrthoVirginia North Chesterfield | 804.320.1339

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What are signs and symptoms of impetigo?

What is myofascial pain syndrome?

Impetigo is a skin infection that occurs when bacteria is present around an area of skin injury such as a bug bite, scrape or cut. With warm weather, bike riding, and more playing outside, summer is a common time to see impetigo.

Red bumps are often seen first and these can progress to blisters and then to the classic honey colored or yellow crusty scabs. This skin infection is very common in kids and often presents on the face. It can spread to other parts of the body by scratching and is also contagious and can be spread from person to person by direct contact or by touching a surface that another child has touched.

Treatment involves keeping the area clean and using a topical antibiotic ointment and/or an oral antibiotic. Just another reason to listen to Mom and keep washing your hands!

Myofascial pain syndrome refers to pain in muscles and fascia.

Muscles are wrapped in fascia, a connective tissue that allows the muscles to slide on each other.

Those people that develop chronic pain in the muscles have trigger points. Trigger points are “knots” in the muscle that are tender when touched. These trigger points may also refer pain to a location distant from the area of the “knot”.

Many people with fibromyalgia also have myofascial pain. Trigger points and tender points are different. Trigger points refer pain, limit range of motion and give a feeling of weakness in the muscle.

Treatment by a physical therapist may include gentle exercises, manual treatments to the muscles and fascia, and trigger point dry needling. Treatment is targeted at the source of the pain for optimal results.

Cleome J. Winters, MD, FAAP The Pediatric Center Richmond | 804.741.4404

Tracey Adler, PT, DPT, OCS, CMTPT Orthopedic Physical Therapy, Inc Richmond | 804.285.0148

our health | MEDI•CABU•LARY & JUST ASK

ju st a sk!

T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D

Why is it important to maintain a routine schedule when caring for patients suffering from Alzheimer’s and dementia?

Having a general routine when providing both care and recreational activities helps give the person a sense of consistency and familiarity. A routine helps the person know what to expect next, even if they can’t quite voice it.

It’s very reassuring. Try to mimic lifelong preferences- such as a cup of coffee before breakfast, showering in the morning, familiar music during meals, a favorite snack in the evening. This can decrease anxiety and confusion when it “feels like” something is out of order, even if the person can’t voice what doesn’t seem right.

Theodore Prokopis Gayton Terrace Retirement Community Richmond 804.741.1011

What are factors for heart disease besides cholesterol?

What types of illnesses does a pediatric nephrologist treat?

Dr. Dall: Many people are aware that heart disease can be caused by diabetes, smoking, poor diet, inactivity and high cholesterol but there are lesser known factors that play an important role in preventing and reversing heart disease. For instance, having elevated Apo B particles or high levels of inflammation can lead to build-up within artery walls ultimately leading to heart attack or stroke. People with a lot of small Apo B particles can also be at risk for diabetes. Also new markers can measure levels of Omega 3 fatty acids which are also strong indicators for development of heart disease. Cholesterol may be a much less important player than we previously thought.

What types of illnesses does a pediatric nephrologist treat?

Tara Dall Health Diagnostic Labs Richmond | 804.343.2718

Children with kidney problems require continuous comprehensive care, from frequent lab work and clinic visits to multiple dialysis appointments each week. Pediatric nephrologists diagnose and treat all aspects of kidney disease including common conditions like kidney stones and urinary-tract infections – and more chronic conditions such as kidney failure, polycystic kidney disease, kidney malformations and transplant.

Treating children with kidney disease requires a multidisciplinary team approach including nephrologists and nurse practitioners to meet a child’s medical needs, nurse educators to help the family understand diagnosis and treatment, a social worker to meet school-related and support needs, and a dietitian to teach children and families about proper nutrition.

Timothy Bunchman, MD Children’s Hospital of Richmond at VCU Chief, Division of Nephrology Richmond | 804.628.7337

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THE LATEST | our health

the l atest

Allen Tsui, MD Bon Secours Tappahannock Primary Care Richmond | 804.443.5378

Shelly Smith, DNP, APRN, BC Bon Secours Powhatan Medical Associates Richmond | 804.285.6050

Anjail Shukla, MD Bon Secours Cure and Care Richmond | 804.288.1040

Rishi Bala, MD Bon Secours Patterson Avenue Family Practice Richmond | 804.741.6200

Christie Kuna, NP Bon Secours Patterson Avenue Family Practice Richmond | 804.741.6200

Howard Wiles,III, MD Richmond OB-GYN Midlothian | 804.320.2483

Tracy Hicks, MD Richmond OB-GYN Midlothian | 804.320.2483

Tamara Pringle, MD Richmond OB-GYN Midlothian | 804.320.2483

Flora Williams, MD Richmond OB-GYN Midlothian | 804.320.2483

HCA Virginia to break ground on new freestanding ER in Hanover

Malcolm Howell, MD Richmond OB-GYN Midlothian | 804.320.2483

New Leadership at HCA hospitals

On June 13th, HCA Virginia held a groundbreaking ceremony for Hanover Emergency Center – the first free-standing ER in Hanover County and HCA Virginia’s second in the Richmond area.

Developed by Charlotte, NC - based Crosland Southeast, the freestanding emergency center is scheduled to open in spring 2014. The facility will be comprised of 22,000 square feet including a full service emergency department and outpatient imaging center.

The ER will feature 12 treatment rooms staffed 24/7 by physicians and staff with special training in pediatric and adult emergency medicine. Advanced imaging services will include a 64-slice CT, ultrasound, digital x-ray, mammography, and bone density. Hanover Emergency Center also will offer outpatient lab services 24/7 with a doctor’s order.

David McKnight Controller HCA Capital Division

Suzanne Beauvoir Jackson New CEO of John Randolph Medical Center. She comes to JRMC with more than 11 years of healthcare leadership experience with HCA.

With a projected budget of $10 million, Hanover Emergency Center will be a department of Henrico Doctors’ Hospital, named one of the 100 Great Hospitals in America by Becker’s Hospital Review.

Jennifer Stanley New marketing director for HCA Virginia’s Chippenham and Jonhston-Willis Hospitals and John Randolph Medical Center.

www.ourhealthrichmond.com | 13

our health | THE LATEST

the l atest

N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S

Bon Secours St. Mary’s Hospital Opens In-Hospital Ronald McDonald House Family Rooms $75,000 given by Ronald McDonald House Charities to advance hospital’s pediatric care Leaders of Bon Secours Virginia Health System, Bon Secours St. Mary’s Hospital and Ronald McDonald House Charities of Richmond recently gathered at St. Mary’s Hospital for the dedication and blessing of three in-hospital rooms established for families of critically-ill pediatric patients.

The Ronald McDonald House Family Rooms are the result of a $75,000 gift from the Ronald McDonald House Charities of Richmond.

Located on the hospital’s fifth floor, the Ronald McDonald House Family Rooms include two dedicated sleeping rooms and a respite lounge for families of children in the Pediatric and Neonatal Intensive Care Units. The dedicated sleeping rooms include full-size beds, night stands, sofas and decorative upgrades including new wallpaper, new floors and upgraded private baths. The respite lounge offers a kitchenette with refreshments and a comfortable place for families to take a moment away to rest and recharge before returning to their children’s bedsides.

“Bon Secours understands that children heal better and faster with their family nearby, and we are proud to provide families with a quiet place to rest, steps away from their loved one’s bedside,” said Toni Ardabell, CEO, Bon Secours St. Mary’s Hospital. “We are extremely grateful to Ronald McDonald House Charities for their generous gift that will improve the lives of our pediatric patients and their families.”

Supporting families of children receiving medical treatment away from home for decades, Ronald McDonald House Charities of Richmond also has supported St. Mary’s in advancing pediatric care, through an additional $175,000 establishing a pediatrics wing at the Bon Secours Reinhart Guest House, now under construction on the St. Mary’s campus. The wing

Doorway entrance to a family room. Pictured Left to Right: Sr. Anne Marie Mack, CBS; Toni Ardabell, St. Mary’s; Sue Durlak, President, Board of Directors of Ronald McDonald House Charities Richmond/McDonald’s Owner/Operator; Peter J. Bernard, Bon Secours

will provide three sleeping rooms and a playroom for visiting families of pediatric patients. Completion of the Bon Secours Reinhart Guest House is projected for May 2014.

“Bon Secours and Ronald McDonald House Charities both understand the importance of supporting families of sick patients, especially when they are traveling distances to be close to their loved ones,” said Ardabell. “The addition of the Ronald McDonald House Family Rooms to the St. Mary’s campus will help us provide the highest level of care possible for our patients.”

Through its financial commitments to the Ronald McDonald House Family Rooms and the Bon Secours Reinhart Guest House, Ronald McDonald House Charities of Richmond has dedicated $250,000 towards advancing pediatric care at St. Mary’s Hospital.

“Ronald McDonald House Charities has long recognized St. Mary’s Hospital as a vital partner in providing outstanding pediatric care in central Virginia,” said Kerry Blumberg, executive director, Ronald McDonald House Charities of Richmond. “We share similar values with Bon Secours, and we therefore are proud to collaborate with St. Mary’s in providing comfort and care to sick children and their families, at very stressful times of their lives.”

New Office Virginia Cardiovascular Specialists – Waterside Medical Center – with physicians Reza K. Omarzai, MD, FACC and Michael J. Bunda, MD, FACC.

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our health | THE LATEST

the l atest

New Doctor Darryn L. Appleton, MD, interventional cardiologist, Virginia Cardiovascular Specialists – seeing patients at Forest Medical Plaza and St. Mary’s Offices.

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N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S

HEALTH AND FITNESS ON THE GO | our health

Health and Fitness

On the Go

Having information at your fingertips; that’s what mobile apps are all about. Empowering users to effectively manage their healthcare and a healthy lifestyle is important to everyone.

In our new Health and Fitness on the Go section, we recommend a variety of health-focused apps you can download to your smartphone or tablet.

iTriage iTriage, founded by two emergency medicine physician, helps users answer the two most common medical questions: “What could be wrong?” and “Where can I go?”. iTriage helps you take charge of your health with simple tools to research problems, take action and live healthier.

Android

This app features loads of training tools to help you stay on track: »» »» »» »» »» »» »» »»

Check symptoms Learn about possible causes Research medications Determine appropriate action Locate and compare nearby care options Choose a medical provider Manage your personal health Free for iPhone and Android

iPhone

Noom Walk

SHARE YOUR FAVORITE HEALTH AND FITNESS APP!

Our new favorite pedometer! Noom Walk is better than your average pedometer. With this app, connect with your Noom friends and cheer each other along in your daily, weekly, or all-time step count! If you’re Android not wild about the social features, just use Noom Walk privately without uploading any information. Not only does it count all your steps, it does it without killing your battery! This is probably our favorite feature. Noom Walk uses less than 2% of your battery in a 24 hour period. You can leave it on all day! Challenge yourself to get a few more steps every day. »» Free for Android »» Not yet available on iphone, but coming soon

Share your favorite health and fitness app! Scan this QR code with your smartphone or tablet to visit and “Like” Our Health’s Facebook page, then post a “Comment” with your favorite health and fitness APP! www.ourhealthrichmond.com | 17

the new face of retirement

STICKING FOR

Barbara Gray

the NEW FACE of RETIREMENT | our health

Barbara Gray, of Midlothian, started running because she wanted to trick her mind and body into not being old. Two decades have passed since she completed her first five-mile race, and Gray is still running and still feeling young.

“I do enjoy running and started around age 50,” Gray recalls. “I had young teenagers and got interested in running because it was an activity I could do that didn’t need any specific training. I just needed a good pair of shoes. With my children’s being young teenagers, I wanted to be able to be active and healthy and stick around as long as I could. I also wanted to be young because I was about 10 years older than the other parents and you know how critical other children can be of other people’s parents. And, I wanted to keep up with my children’s schedules and was very busy with volunteer work. I didn’t want to act old, look old or be old, so I thought, ‘If I run, then I’m not old.’ It’s the mindset of tricking yourself into not being old.”

AROUND THE LONG RUN words | RICH ELLIS, JR.

Now in her 70s, Gray began her training with Sports Backers in Richmond and presently runs three races a year — a 10k, a half-marathon and the Race for the Cure.

“I’ve enjoyed the Sports Backers training program,” Gray says. “I train on my own, and I like Sports Backers because once a week on Saturday I get to run with a big group.”

She ran her first half-marathon in 2011 and in August will begin a formal training program with Sports Backers for the American Family Fitness half-marathon in Richmond in November. Gray has completed a half-marathon in a little over three hours but says she’s at a stage now where she doesn’t push herself.

“I have four goals for the half-marathon,” Gray explains. “First, get to the starting line.

Second, stay on my feet. Third is to finish. And fourth is to have a little fun along the way.”

When she isn’t running, Gray still has fun with the other activities that fill her life, some of which complement her running, including yoga and strength training. Until last year, Gray had a 22-year-long hobby of playing music as a music resource teacher at a local church preschool — a commitment that required as much energy at the beginning of the day as it did at the end.

Gray also likes to travel and says that takes a lot of energy, as does her yardwork and keeping up with her two-year-old granddaughter.

When it comes to staying active, Gray says to choose something that you’re interested in doing. “You really need to want to do it yourself,” she explains, “not because your friend does it. It’s something that only you can do for yourself.”

Gray has no plans to slow down anytime soon. “I have to stay physically fit because there are a lot of things riding on my still being around.”

www.ourhealthrichmond.com | 19

the new Bob Everton

MOTORCYCLE words | RICH ELLIS, JR.

MAN

face of retirement Bob Everton said if he had the money, he’d buy Montana.

Instead he bought a brand-new, cherry-red Harley-Davidson® Road King® motorcycle several months ago. The salesman said he’d never sold one to an 80-year-old man before. Everton replied, “That’s not the worst of it. I just signed a seven-year maintenance contract with you guys.”

Everton lives in Midlothian and, strangely enough, he used to hate motorcycles, thinking that anyone who rode one was crazy. He didn’t even start riding until he was 69.

“Once I did it, it opened up a whole new avenue to enjoy life,” Everton explains. “I think what happened is that after I retired from the Richmond Redevelopment and Housing Authority, I spent a lot of time at the Outer Banks. Then the Housing Authority wanted me to come back for a little while. While working there again, I began stopping by a local Harley dealer and looking.”

Just “looking” proved to be a slippery slope. On a whim, Everton took the state’s two-day beginner motorcycle course.

For the road portion of the class, they provide participants with a small motorcycle. “I don’t know why, but they passed me,” Everton said, and it was shortly thereafter that he purchased his first bike, a Suzuki 650cc.

“I was scared to death of the bike because I thought I had done so poorly in the class,” Everton recalls. “It was sitting out back and I said, ‘I’m going to ride that thing today or I’m not going to ride it.’ ” He rode it, and hasn’t stopped since.

Two years ago, when he was 78, an idea that had been in the back of Everton’s mind for a while could no longer be denied.

He wanted to ride until he didn’t want to ride anymore. So on July 3 he told his wife, “If I don’t go tomorrow, I’ll never go.”

With that, he loaded the bike with camping gear and set off on an epic adventure — a cross-country motorcycle ride by himself that would take him from Virginia to Alaska and back, covering more than 9,300 miles in six weeks.

“You meet so many people because there is something about a motorcycle that is instant communication,” Everton explains.

“You’re never alone because you’re always talking to people.”

Everton’s thirst for adventure is nothing new. As a young man, he decided he wanted to go to sea so he traveled to Boston, found a ship and proceeded to work as a merchant marine on the ship, traveling to Chile — a situation his mother wasn’t too pleased with. Upon his return, he attended the University of North Carolina. On another adventure, he and some friends took off in a ’47 coupe that had no windows on one side, no low gear and no spare tire, and headed to New Orleans to try to find another ship to work on. They didn’t find a ship, but they did find themselves in various places, including broken down in New Mexico and picking cherries in California.

“I don’t know why I’m so active,” Everton says. “My wife is a great cook and keeps me eating the things I should, but I honestly don’t know. I work out and try to eat halfway decent.

I want to feel good — my attitude is positive. The glass has always been half full to me. That’s the way I want it to be. I enjoy life and really do like people.”

Everton works out three or four times a week at the ACAC Fitness and Wellness Center in Midlothian and said he feels great and doesn’t have an ache or pain in the world.

“I had a triple bypass several years ago and think that an ingrown toenail hurts worse than that. I’ve also had colon surgery and prostate cancer. I’ve been very fortunate.”

In addition to working out and riding on two wheels, Everton said he loves watching sports on TV. He’s a diehard Tar Heels, Redskins and Nationals fan, enjoys reading and takes the dog to the park every day for exercise.

Everton plans to just keep going, and thinks that the motorcycling has a lot to do with that. “Every ride is different, even if you’ve traveled to the same place 50 times,” he explains.

“Different problems and pleasures, and just different from an automobile.”

That means the next time you see a cherry-red Harley Road King, take a closer look at who’s driving. It just might be Bob Everton, off on another adventure. www.ourhealthrichmond.com | 21

our health | the NEW FACE of RETIREMENT

words | RICH ELLIS, JR.

WHEN LADY LUCK SMILES

Bob Sugarman, of Richmond, is 92 and attributes his longevity and active lifestyle to a combination of luck, good physicians, consistent gym activity and reading.

First, the luck. “You have to be lucky,” Sugarman explains. “I was in World War II in the South Pacific. The landing craft I was supposed to be on was full so we were able to fly into Manila. The guys on the landing craft were shelled by the Japanese so I was lucky I didn’t go on that boat.”

Sugarman’s also been a very active sailor all his life and said that luck is involved in that arena too. “Many times you’re managing a boat in a storm and things always break because you’re sailing 24 hours a day. The luck and planning to make sure you’re properly equipped come into play. Other people might hit a storm at a different moment at sea and have a tragedy.”

Sugarman says the only sailing he does now is on “OPB” as he calls it — other people’s boats. “I’ve been healthy, but managing a sailboat — mine was 38 feet — takes a lot of time and energy,” he explains. Some of his past sailing accomplishments include crossing the Atlantic in a 35-foot sailboat; putting a crew together and sailing 1,000 miles from Deltaville, VA, to Nova Scotia, Canada; and spending nearly nine months on a sailboat on his honeymoon with his second wife, sailing to the Bahamas. Sugarman began sailing, and skiing, after the death of his first wife.

He’s always liked active sports, including golf and tennis, preferring them over the gym, until recently. Today he works out four or five times a week at the ACAC Fitness and Wellness Center in Midlothian.

“I have a routine,” Sugarman says. “They have a group of seven or eight machines and they put it together so I get some upper and lower body exercise. I use those every other day.

Then I have my routine where I use some other stretching machines on those odd days — primarily the stationary bike and treadmill.”

Travel, on land, also keeps Sugarman busy. He and his wife, Julie, have five greatgrandchildren and they spend time visiting family who are spread up and down the East Coast. Last winter he drove back and forth from Virginia to St. Augustine, FL, — he does all the driving and loves it — and traveled to Hartford and Boston.

Sugarman also attributes his longevity and activity to his physicians. “You need a group of doctors who are talented and willing to spend their time and energy seeing that you are in good shape,” he explains. “I listened to them and do what they want me to. I also think the activity in the gym, consistently, is awfully important, and we read a lot.”

Sugarman said that at one point he even put together a men’s group that met regularly to discuss current affairs. He also still subscribes to the newspaper and is active on his computer and other electronic devices.

With a little luck, Sugarman plans to remain active and pursuing what he enjoys.

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Bob Sugarman

the new face of retirement

the new face of retirement

Dewey Reynolds jokes that he can finally afford to drive a school bus. The retired real estate broker lives in Henrico County and has been driving a bus for Hanover County Schools for three years, approximately four hours a day, in the morning and afternoon.

Reynolds is also an avid runner, and has been since he started running in 1977. “I was at a point in my real estate career where I needed exercise that I could do on my own schedule and not have to put too much expense into it,” Reynolds recalls. Fast-forward 36 years and you’ll find Reynolds now involved with the Sports Backers marathon training program in Richmond. He’s presently running, on average, 25 miles a week and will work up to about 40 or 45 miles per week as he prepares to run the Richmond Marathon — again — this November.

“Running is great exercise,” Reynolds says when asked why he does it. “I just enjoy getting out and running. At this age (74), not too many people are running. I don’t have too many aches and pains because I have concentrated over the years on not running injured and that has served me very well. Another key is to make sure I stretch and warm up.” As part of his training, he tries to run on the track once a week, hill work once a week and the roads at other times.

THE RUNNING

MAN

words | RICH ELLIS, JR.

Reynolds is no stranger to running marathons. In March, he completed the Shamrock Marathon in Virginia Beach, where he posted his worst marathon time ever — six hours and 20 minutes. However, it was 40 degrees and raining, with 30 mph headwinds. “I’ve had much better success in other marathons,” Reynolds explains. That is an understatement.

He’s run the prestigious Boston Marathon six times — one of which was to celebrate his 70th birthday — and in 1983 finished the marathon in a personal best of 3:01:40. Lately, Reynolds has found a new running partner — his 26-year-old daughter. She ran her first race with him — Richmond’s Monument Avenue 10k — and now appears to have also been bitten by the running bug, since she plans on running a half-marathon in November.

Reynolds has five other children, six grandchildren and two great-grandchildren.

Staying active isn’t just about running, however. Reynolds also plays a little golf and is very active in credit union legislative activities, which he says can be traced back to his real estate years when he was involved in real estate legislative action. “I have a keen interest in the legislative arena and am very active in the political scene,” Reynolds says.

Reynolds is also active with his church and loves to sing, especially with his gospel group.

Even then, however, running probably isn’t too far from his thoughts.

Dewey Reynolds

Dunlop House

Assisted Living & Specialized Memory Care The Personal Choice Dunlop House is a vibrant, energetic community focused on the individual needs and desires of every person who chooses our worry-free lifestyle. Having personalized support allows our residents to embrace what they truly love, unburdened from daily chores and concerns. We believe that choosing an assisted living community is choosing independence from the things in life that are holding you back.

The Choice is Yours Dunlop House not only offers a beautiful community center, lovely landscaped gardens, fabulous dining options, and floor plans ranging from large two-bedroom apartments to cozy studios, but also an engaging social calendar. We believe that enjoying life nurtures the soul. And where that enjoyment is found is personal for everyone. Here the choice is yours - from games and bridge to shopping trips and excursions, reading by the fireplace or joining one of our many clubs, there is something for everyone. “During the first few weeks of moving here, we became involved with the exercise program, games, and musical entertainment. Plus we have made so many new friends,” says Nat and Laura C., residents since 2011.

The Choice for Wellness and Wellbeing After you have unburdened yourself from the chores of daily living and reconnected to the people and things you love, let us nurture your body as well. Our team of professionals will customize a wellness program based on your personal dietary needs and fitness level. Our on-site physical, speech and occupational therapies, 24-hour licensed nurses, and a variety of visiting medical professionals will monitor and support your physical wellbeing.

Our Neighborhood – The Choice for Memory Care We believe that life is measured in moments. And by creating moments that matter every one of us will experience snap shots of wonder and happiness. A smile. A laugh. A warm embrace. A sweet piece of cake. The smell of bread baking. These are just a few things that touch our senses. For our loved ones who are experiencing memory loss through dementia or Alzheimer’s disease, those moments can be inspirational. In the safe setting of “Our Neighborhood,” each resident has a personalized plan that focuses on the social, emotional, physical, spiritual and cognitive needs that will renew their individual sense of purpose and independence. Caregivers specialized training in managing and supporting all types of memory loss assist with the needs of daily living and the overall wellbeing of each resident.

A member of the Colonial Heights community since 1999, Dunlop House blends a rewarding and vibrant lifestyle with a wide range of services, living options, luxuries, amenities and convenience. Dunlop House is simply the choice for senior living in the area.

DUNLOP HOUSE 235 Dunlop Farms Boulevard | Colonial Heights, VA 23834 | 804.520.0050 | www.dunlophouse.com

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St. Mary’s Woods retirement community Exceptional Living Without Exception Discover for yourself the lifestyle found at St. Mary’s Woods. Meet our exceptional residents and caring professionals. Stay engaged with our exceptional events, programs and excursions, while you embrace the freedom from home maintenance and mundane chores. Experience our exceptional dining service and homemade, culinary delights. At St. Mary’s Woods life is lived, enjoyed, experienced, embraced and most of all Exceptional, without exception. St. Mary’s Woods is a nonprofit, nondenominational senior living community sponsored by the Catholic Diocese of Richmond. Our reputation of providing innovative resident care and programming has established us as a leader in Richmond for seniors and their families since 1988.

Exceptional Engagement The many excursions, activities, and entertainment offered at St. Mary’s Woods keep our residents busy. If making new friends, exploring new places and learning new things sounds good to you, don’t miss our complimentary minibus departing soon for area museums, historical sites, restaurants, shopping, and more. The fun is also found right here at St. Mary’s Woods - concerts, movie nights, seminars, and guest speakers, card games, a variety of club activities offer something for everyone.

Exceptional Living Quiet and convenient. When it comes to location, you will find the best of both worlds at St. Mary’s Woods. Located off of Gaskins Road, just minutes from I-64, we are close to shopping centers, grocery stores, pharmacies, doctor’s offices, and more. Although the attractions of the West End are at your fingertips, our community is nestled against a peaceful, wooded area complete walking paths.

Enjoy views of nature from our spacious, maintenance-free apartments that feature full kitchens, oversized bathrooms, large closets, and individuallycontrolled heating and air conditioning. Personal patios are available in some apartments, and all residents and visitors are welcome to enjoy our popular new front porch, chapel and activity center. Furthermore, a new, full-community generator has recently been installed to provide an extra level of safety, security, and peace of mind for residents and their families.

With no buy-in and reasonable market-rate monthly payments, customized care, and other a la carte services from which to choose, you will be able to preserve your nest egg for the future.

Exceptional Personalized Care Supporting your independence and personal wellness is not only your goal, but also the goal of our caring nursing team. A licensed or registered nursing professional is on-site around-the-clock to provide peace of mind, while monitoring your overall health and well-being.

OUR LADY OF HOPE 13700 North Gayton Road | Richmond, VA 23233 | 804.360.1960 | www.ourladyofhope.com

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Spring Arbor of Richmond and of Salisbury

At Spring Arbor, the community’s team of skilled and experienced staff members nurture independence while promoting professional, compassionate care. The staff firmly believes residents should not have to choose between dignity and care — assistance is always offered and never imposed, and the full-service amenities offer residents, family and friends a range of healthcare and lifestyle options.

Residents at Spring Arbor receive care from licensed healthcare professionals, who provide personalized treatment and wellness plans, medication administration assistance, and access to any follow-up therapy needs along with 24-hour care.

Each care plan is based on the resident’s individual needs. Basic assisted living services are a part of the standard service package each resident receives, and because each resident’s care needs are unique, Spring Arbor works in conjunction with family and physicians to customize personal senior care plans for every resident for continued support.

While residents receive professional and caring attention, they can rest even easier knowing meals, transportation and housekeeping services are taken care of.

At Spring Arbor, residents enjoy three nutritionally balanced and delicious homecooked meals designed by a registered dietitian each day and can select from a variety of entrée and snack options. A full-time activity coordinator creates a varied social calendar each month, and exercise programs are available onsite. When transportation is needed, Spring Arbor provides van rides to doctor’s appointments or fun outings around the local community.

With Spring Arbor’s two locations in the Richmond area, each resident is sure to find accommodations to suit his or her needs. Convenient neighborhood locations ensure residents spend their retirement close to their lifelong friends, churches, social activities, families and shopping.

Located in the beautiful West End and Southside, Spring Arbor of Richmond and Spring Arbor of Salisbury feature a variety of assisted living, Alzheimer’s and dementia care services. This continuum of care ensures residents can transition seamlessly to higher levels of care should the need arise.

Each facility offers spacious studio and one- and two-bedroom suites, offering a unique combination of neighborly warmth and personal privacy.

Spring Arbor prides itself on promoting a family atmosphere and looks forward to lending a helping hand while residents enjoy new friends, new experiences and new smiles.

Spring Arbor Richmond

Spring Arbor of Richmond 9991 Ridgefield Parkway | Henrico, VA 23233 804.592.1948 | www.springarborliving.com/richmond-va.htm

Spring Arbor of Salisbury 14001 Turnberry Lane | Midlothian, VA 23113 | 804.601.0910 www.springarborliving.com/locations/midlothian-va.htm Spring Arbor Salisbury

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Our Lady of Hope Our Lady of Hope is a senior living community dedicated to possibilities. A special place that embodies the definition and realization of “hope” is what you will find here. Hope is the “feeling that what is wanted can be had” or the “feeling that something desired may happen.” Our team of caring professionals is focused on personal well-being of all of the residents at Our Lady of Hope. Everything we do is to create possibilities for renewed and continual personal growth. From the life enrichment programs, delicious cuisine, and friendly neighbors, to the caring team members we are a community that inspires hope of the individual spirit.

Our Lady of Hope is a nonprofit, nondenominational senior living community sponsored by the Catholic Diocese of Richmond. Since 1995, we’ve provided affordable assisted living, memory care, long-term nursing care, and rehabilitation services. And, with a registered or licensed nurse on site 24 hours each day, residents and their families have confidence knowing assistance is always available.

Floor plans feature kitchenettes, oversized bathrooms, several large closets, nurse call systems, and individually controlled heating and air conditioning. Each is designed for privacy and personalized support. A new, full-community generator has recently been installed to provide an extra level of safety, security, and peace of mind for residents and their families.

The social calendar is full of possibilities. Join in a game of corn-hole, or get ready for a competitive card game of poker or bridge. The many concerts, cultural outings, shopping trips, educational programs, exercise classes, worship services, will give you plenty of options to be entertained and engaged. If you have a green thumb we also have several gardens that are inspired by our residents-the St. Francis Garden and the Garden of Hope.

Throughout each day, residents enjoy delicious and nutritious meals prepared by the chef and culinary team. Restaurant-style dining for three meals a day offers residents the opportunity to socialize with friends and neighbors.

Convenience, privacy, and fun are all features of life at Our Lady of Hope. Although we are conveniently located off of North Gayton Road, near Short Pump Mall and all of the shops, restaurants and entertainment venues, we are close to neighborhoods and schools. Our campus backs up to a meadow and features walking paths, gardens and courtyards. From your own apartment, to a comfortable chair by one of the fireplaces, the library, the chapel, or one of the shady gazebos, finding a quiet retreat is easy to do. Here you will find the best of both worlds.

OUR LADY OF HOPE 13700 North Gayton Road | Richmond, VA 23233 | 804.360.1960 | www.ourladyofhope.com

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The Village at ManorCare

The Village at ManorCare is located in Henrico’s Lakeside area, known to have a rich historic heritage as one of Richmond’s first “suburbs,” with Lewis Ginter Botanical Gardens and Joseph Bryan Park only minutes away.

The Village, Assisted Living Center, helps individuals maintain control over their lives and encourages independence while providing assistance. With a welcoming, home like environment, The Village enhances life through wellness programs, activities, socialization and personal care services with warm, caring and knowledgeable staff.

We understand the importance of making services as accessible and affordable as possible. Managing one’s expenses can be a lot to worry about, especially when it comes to long term-care. Imagine the convenience of paying one all inclusive monthly bill. Rates are determined and established up front by choosing between the wide selection of accommodations that meet individual desires and needs.

There are no confusing levels of care charges or move-in fees. That is what you can expect at The Village at ManorCare.

The full-time programming staff is dedicated to providing a variety of programs.

Informative guest speakers, movies, craft classes, social hours, musicals…the list goes on and on. Join in on an excursion for shopping, visiting museums, picnics, sightseeing field trips and much more! No matter what your interests or hobbies may be you can be assured you’ll find it at The Village!

The Village shares its campus with ManorCare Health Services – Richmond, a comprehensive rehabilitation and skilled nursing facility, providing access to advanced therapy services and skilled nursing should the need arise. The surrounding area also hosts multiple hospitals and physicians’ offices, helping each resident receive continued care from his or her favorite local healthcare providers. With so many healthcare services available on campus and nearby, The Village positions residents well for both current and future needs.

The Village has an innovative approach to caring for their residents and resident families. With The Village at ManorCare’s expertise and commitment to quality care, family and friends can expect loved ones to enjoy each amenity comfortably.

The Village at ManorCare 2125 Hilliard Road | Richmond, VA 23228 |804.266.9666 www.hcr-manorcare.com/ManorCare/villageatstratfordhall.aspx

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our health | MEMORY CARE

34 | www.ourhealthrichmond.com

MEMORY CARE | our health

Caring for the Whole Person words | SARAH COX

The approach toward caring for patients with memory issues, whether that is mild cognitive impairment (MCI) or the late stages of Alzheimer’s, is more holistic now than it has ever been. Juliet Holt Klinger, who has a master’s in social work and in gerontology, and is the director of Dementia Care and Programs at Brookdale Senior Living Solutions, has witnessed this change over the 25 years she has been in the business.

“The big evolution for us has been the true development of person-centered care,” Holt Klinger explains. “The expectation now should certainly be that. We have moved beyond bingo and salsa and work with the individual, which honors them more and is more efficient care, as well.”

Holt Klinger says that through this person-centered approach has come a recognition and embracing that the person with dementia (and there are many different types of dementia) has a lot of living yet to do. The attitude has changed from considering folks with dementia to be suffering, or victims, to “how can we create an optimum life” for them?

According to the Alzheimer’s Association, dementia is defined as “a general term for loss of memory and other mental abilities severe enough to interfere with daily life. It is caused by physical changes in the brain.”

Brookdale, which has 650 facilities in 38 different states, with 270 of those facilities devoted to dementia care, has recognized that there is a rise in dementia among Americans. Part of this, explains Holt Klinger, is due to the “silver tsunami” as she phrases it, or the rise in our aging population. No longer are people being shut away or drugged up. At Brookdale, for instance, their lives include “fun, joy, growth opportunities, outings, and all kinds of things that 20 years ago we didn’t trust folks with dementia to do,” says Holt Klinger.

One of the most successful programs Brookdale has put into place is the use of computers and a software program called “It’s Never Too Late.” This operates with a 23-inch touch screen that is prefilled with content such as puzzles, games, geography webcams, email and voicemail capabilities. And Skype.

One lady in her late 90s skypes every day with her sister, who is also in her 90s and lives in another state.

“I think that 20 years ago, let along 10, no one would have believed that persons with dementia could be webcamming. This opens up a whole new world of engagement for them, and pushes us to think of persons with dementia in another way,” says Holt Klinger.

And that is exactly what she wants Brookdale programs to do — “not just take care of someone with dementia, but to really maximize their living with the disease,” she adds.

FOR A COMPLETE LISTING OF MEMORY CARE FACILITIES IN THE RICHMOND AREA, PLEASE SCAN THE QR CODE BELOW TO VISIT WWW.OURHEALTHRICHMOND.COM, THEN CLICK ON THE MEMORY CARE LISTINGS IMAGE.

She says that her facilities go about treating dementia in a different way because of their philosophical belief: “A person with dementia should live as full a life as possible. We really try to honor our residents with respect to using their remaining ability. We start looking at that, instead of the decline.”

Holt Klinger says that Brookdale is introducing a new early-stage program in some states — not in Virginia yet — called Crossing. This is geared toward those in their early memoryloss stages, and she says she believes that is where the world is headed. She says that early intervention is the key, and that while staving off the disease is not possible, slowing www.ourhealthrichmond.com | 35

our health | MEMORY CARE

it down with robust mental workouts is important.

James Bennett, MD, chair of the neurology department at Virginia Commonwealth University School of Medicine, is of a similar mind. He is also director of the VCU Parkinson’s and Movement Disorders Center, and says that while there is a lot of passion and anecdote about dementia, there is not a lot of good science. First of all, he says, there are not drugs that have any meaningful impact on memory. Some have a positive temporary effect, but none as of yet have a long-lasting effect on memory.

However, there are three main areas that can affect the preservation of memory. They are diet, exercise and vitamin B intake.

The Mediterranean diet, he says, is not a cookbook but a philosophy of eating. It is very rich in fresh fruit and vegetables, is low in saturated fat and emphasizes vegetable oils, whole nuts, lentils and dried beans.

“People who have the highest Mediterranean diet, compared to the lowest, will reduce their risk of developing mild cognitive impairment, or MCI. For people with MCI, eating a very high Mediterranean diet can reduce the risk of converting to Alzheimer’s disease by almost 50 percent, so basically this diet can have a major impact on developing memory problems,” says Dr. Bennett.

Americans, on the other hand, would rather have a single pill, says Dr. Bennett. Some people have tried to “subfactor” the Mediterranean diet into particular components that are beneficial, but, he says, he’s not convinced that there is a single thing that one can take in a pill.

“It is very likely the addition of things that are good for you, and the removal of things that are bad for you. It also reduces the risk of stroke, heart attack, diabetes and cancer,” he says.

There have been two Parkinson’s studies, one done in Japan where the diet is heavy in fish, seaweed and mushrooms, and one done in Manhattan, that have similar results.

“One can reduce getting Parkinson’s disease by almost 40 percent, just by diet,” Dr. Bennett says of the results of the aforementioned studies.

The second important factor is vitamin B intake — specifically B1, B6 and B12. This lowers the level of homocysteine, which is a “common amino acid (one of the building blocks that make up proteins) found in the blood,” according to www.WebMD.com. If it forms in excess in our bodies, we increase our risk of dementia and stroke. However, in a study where people took vitamin B, they had no significant brain atrophy, says Dr. Bennett, as opposed to those who were placed on a placebo.

The third component is exercise. Bennett says there are a lot of studies that indicate that consistent exercise is good for you, and that can be anything from walking several times a week to a graded or gradual uptick.

“It has been found that those who did regular walking prevented atrophy in the part of the brain associated with memory — the hippocampus — and those who did not walk had slow atrophy. So … if you move around and do something, you’re better off,” he concludes.

Mental games? He says the jury is still out on that approach. The pharmacological approach — drugs such as the widely used Aricept — may slow down memory loss temporarily, but he calls them pharmacological bandages.

36 | www.ourhealthrichmond.com

MEMORY CARE | our health

“I just wish it were easier. I tell people, you are in charge of this, not me, and this is your life and your lifestyle, and you can do this, or not. This is simply a matter of planning and making it a priority,” says Dr. Bennett.

Sarah Lageman, PhD, a neuropsychologist specializing in behavioral techniques to cope with thinking changes, also works at Virginia Commonwealth University, at the Parkinson’s and Movement Disorders Center. Her research is focused on developing memory compensation plans and strategies to help people stay independent longer. Her patient population is those who have early-stage Alzheimer’s. In Alzheimer’s, she says, the memory loss is such that the cells start dying. In Parkinson’s, patients still have the memory but have trouble finding it — they can’t access it when they need to.

Her research, part of which is funded by the Michael J. Fox Foundation, looks at problem-solving strategies. She works with patients one hour a week for eight weeks to get them to form memory-intervention habits. One such strategy is a calendar that helps people take notes and track things in their daily lives.

James Bennett, MD, Neurology department chair at VCU School of Medicine

Sarah Lageman, PhD, is a neuropsychologist at VCU

“I would say that memory supports are behavioral and most effective in those with mild levels of change,” says Lageman.

She has modified this strategy to determine if there are new ways they can tackle tasks before they give them up out of frustration. If they come upon a challenge that they can’t do, such as exercising, reading the newspaper or gardening, before they give it up she and the patient try to figure out other ways of doing the task.

She, too, says the empirical evidence regarding the effectiveness of pharmaceuticals is not overwhelming, and that if people don’t have the money, or have side effects from it, it’s simply not worth it.

The Lynmoore at Richmond West End, with both assisted living and memory care units, offers a holistic approach in what Director of Marketing Daphne Marshall calls “a homelike atmosphere to reduce the anxiety, social withdrawal and agitation” that comes with dementia. The atmosphere gives a significant nod to what residents remember of their own homes — the sights, smells and sounds of living.

“Sensory elements like decorations from their era, iconic images from their past, and personal memorabilia are peppered throughout,” points out Marshall. “The greatest loss oftentimes is not only their words, but the landscape. Our memory care is designed to help with the feeling of being lost.”

She says the focus of Lynmoore is not just on recreation but also about creating daily moments of success and keeping the residents engaged. She says that their “arms” also extend to family, “who are faced with watching their loved ones slowly unwind to the reality of who they once were, in every capacity.”

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MEMORY CARE | our health

FAST FACTS! ABOUT DEMENTIA FROM THE ALZHEIMER’S ASSOCIATION

»» According to the Alzheimer’s Association’s 2013 “Alzheimer’s Disease Facts and Figures” guide, Alzheimer’s disease is the most common type of dementia. Dementia is a general term used to describe a variety of diseases and conditions that result when brain nerve cells die or no longer function correctly. When this happens, changes to memory, behavior and clear thinking occur.

Alzheimer’s disease is ultimately fatal. »» Other types of dementia include vascular dementia and Parkinson’s disease dementia. Vascular dementia is a decline in thinking skills caused by conditions that block or reduce blood flow to the brain, thus depriving brain cells of necessary oxygen and nutrients. Parkinson’s disease dementia is impairment in thinking and reasoning that eventually affects many people with Parkinson’s disease. »» As of 2011, diagnostic criteria for Alzheimer’s, proposed by the National Institute on Aging and the Alzheimer’s Association, include the three stages of Alzheimer’s — preclinical Alzheimer’s disease, mild cognitive disease and dementia due to Alzheimer’s disease. An indepth explanation of the symptoms for each stage is available on the Alzheimer’s Association website, www.alz.org

OCTO BER

5

MARK YOUR CALENDARS NOW !

The Greater Richmond Chapter’s Walk to End Alzheimer’s is October 5, 2013.

»» The Greater Richmond Chapter will hold its Walk to End Alzheimer’s on Saturday, October 5, 2013 at INNSBROOK, (Markel Plaza), 4600 Cox Road, Glen Allen, VA 23060 »» There will be a one or three mile course (dogs and strollers welcomed). »» Check in time is 9 am and the opening ceremony begins at 10 am.

»» The two main treatments of Alzheimer’s disease are divided into pharmacologic (treatment with medication) and non-pharmacologic »» Contact Sandy Grady by phone at 804.967.2580 or (treatment without medication) therapy. While there are no drugs that 804.467.5734 or by can slow or stop the death or malfunction of brain neurons, there email at sgrady1@alz.org or visit www.alz.org/grva are some that may reduce symptoms. Non-pharmacologic treatment for more information and to register. goals are to improve the quality of life and reduce symptoms such as depression, apathy, wandering, sleep disturbance, agitation and aggression. Because both pharmacologic and non-pharmacologic treatment options can often change, it’s important to speak to a physician to learn more information about the latest. »» About 5.2 million Americans have Alzheimer’s disease, and five million of those are people ages 65 and older. By 2030, an estimated 72 million Americans 65 and older will make up 20 percent of the total population, which will be up from 13 percent in 2010. »» Alzheimer’s disease is the sixth leading cause of death in the United States. »» Annually, more than 15 million Americans provide unpaid care for people with Alzheimer’s disease and other dementias. In 2012, these unpaid caregivers provided an estimated 17.5 billion hours of unpaid care, which is valued at more than $216 million. »» The Alzheimer’s Association provides a 24/7 helpline (800.272.3900), support groups, education for family and professional caregivers, care consultation and safety programs.

www.ourhealthrichmond.com | 39

COMFORT AND PEACE | our health

Bereavement Groups Truly Understand words | EDWIN SCHWARTZ

The loss of a spouse is one of life’s most stressful events, especially for seniors. But in recent years research has recognized older adults’ adjustment to widowhood varies considerably. The nature of the relationship, cause of death and available social support are all factors that can account for the range in recovery ability.

Although spousal loss can occur at any age, widowhood in the United States is mostly experienced by those 65 and older. Nearly threequarters of the 900,000 people who become widowed annually in the United States fall in this category. Today life expectancy at birth for men is 76, compared to 80 for women. So women are much more likely to outlive their spouse.

Joan Rexinger of Richmond lost her husband, Daniel, on December 21, 2011. In 1988, on his fiftieth birthday, Daniel was in a head-on collision. “The accident sped up any preexisting condition he may have had,” says Rexinger. “I was his caregiver for 25 years as he eventually had 20 major surgeries and died of vascular disease.”

“He was my hero. We both depended on each other,” says Rexinger.

“Dan traveled a lot for 26 years. He depended on me to run the household, write the checks, rear the kids and balance the checkbooks so he could concentrate on being an executive for Circuit City.”

“You become very independent with a traveling husband,” adds Rexinger. “But I was dependent on him for his love, companionship and faithfulness. We were married 51 very happy, happy years.”

Dr. Elisabeth Kübler-Ross, a renowned psychiatrist who specialized in near-death studies, identified the five common stages of grief as denial, anger, bargaining, depression and acceptance. While not everyone experiences every stage, others may endure one or more several times or enter multiple stages simultaneously. But however a person grieves, Kübler-Ross believed most individuals experience at least two of these stages.

“The void in my life was the most difficult adjustment,” says Rexinger. “I had been his caregiver for so many years, and it became a full-time job. I couldn’t leave him alone.”

“One of the hardest things is going back to church,” she adds. “Holidays are awful.

And weekends are the hardest. You have to try to plan something. Getting back into playing bridge has saved my mind.”

Rexinger owes a great deal of gratitude to her Bon Secours bereavement group for her recovery. “I met so many different people who had the same problem I had,” she says. “Initially, I thought these people couldn’t have loved their husbands as much as I loved mine. But I learned they loved those they had lost as much as I did.” www.ourhealthrichmond.com | 41

our health | COMFORT AND PEACE

“Bon Secours was wonderful,” Rexinger adds. “Everybody had a story. Everybody told it and cried their eyes out. There was no shame or embarrassment. The group held a memorial service where we held candles and said whom you represented. Everybody was given a rose.”

“Another lesson I learned is you can’t talk about your true feelings with those who haven’t gone through it,” says Rexinger. “I tried to talk with people. But only those who have lost a spouse understand. My identical twin sister, Jean Hayes, was my rock. I leaned on her as she understood what I was going through.”

Spousal loss will happen to nearly all married seniors. And many may experience symptoms of grief, loneliness, anxiety and distress. However, no two individuals grieve the exact same way.

One of the most significant lessons came when Rexinger was properly diagnosed as grieving and not depressed. She had lost 25 pounds and was not able to eat. “Grieving is so different from depression,” she says.

“I was told the grief was making me sick.

Once you figure it out, you can get the right medication.”

“If you can’t handle it, get professional help,” advises Rexinger. “I was a mess. I was losing weight and couldn’t stop shaking. Finding the right doctor who recognized I wasn’t depressed made all the difference. I was told I was grieving and it’s coming out in my stomach. The right medication calmed me down and made me a different person in one day.”

Distinguishing between grief and clinical depression is difficult, because they share many symptoms. But there are ways to tell the difference. Grief is a roller coaster and involves a wide range of emotions. It is a mix of good and bad days. Even while grieving one can have moments of pleasure or happiness.

With depression, the feelings of emptiness and despair are constant. If the grieving doesn’t let up over time or extinguishes all signs of joy such as laughing or smiling, the person may be experiencing depression.

For anyone grieving the loss of a loved one, Rexinger says, “Join a bereavement group.

There you will come together for six weeks and form a lasting bond, even if you never see each other again. Because they will understand.”

42 | www.ourhealthrichmond.com

HealthyEats AR P E PR

OR THE F G N I

HARVEST

Corn and Tomato Salsa: Makes 4 servings

Ingredients: One of the best things about summer is the fresh produce you can enjoy from your garden! If your garden is anything like mine

2 ears of fresh corn

Directions: 1.

Season the corn with olive oil, salt and pepper.

2.

Place the corn over a grill and cook for about one to two minutes on all sides.

Drizzle of olive oil

Sea salt to taste

3.

Remove and cool.

Freshly ground black pepper to taste

4.

Remove the kernels from the cob.

5.

Combine the corn, tomatoes, onions, peppers, cilantro, lime juice and lemon juice. Mix well.

6.

Season the salsa with salt and pepper.

during these dog days of summer, you are

4 ripe tomatoes, sliced and then diced

often left with a surplus of produce that

¼ cup minced red onions

you are unsure how to use. Here are some

1 teaspoon minced jalapeno peppers

delicious recipes, full of flavor, that are sure

2 tablespoons chopped fresh cilantro

to satisfy any palate.

Juice from 1 freshly squeezed lime

Juice from 1 freshly squeezed lemon

Tricia Foley’s

CORN & TOMATO SALSA Tricia Foley is Our Health Magazine’s resident nutritionist.

HealthyEats P

FOR TH G N I AR R EP

E HARVEST

Zucchini “Pasta” and Fresh Tomato Sauce:

4.

Using a spatula, push the zucchini to the side so a portion of the bottom of the pan is clear. Add the garlic, and cook for 15 to 30 seconds. Mix the garlic into the zucchini.

5.

Stir in the tomatoes, lemon zest, salt, pepper and Parmesan cheese. Cook until softened, about two minutes.

6.

Add ground turkey to mixture and divide into four servings.

Makes 4 servings

Ingredients: 16 ounces lean ground turkey

Directions:

¼ cup grated Parmesan cheese

1.

In a large skillet, coat with cooking spray and then brown turkey until no longer pink (about 10 minutes). Set aside.

2.

In another large skillet, heat the olive oil over medium-high heat.

3.

Add the zucchini and cook just until wilted, flipping them over occasionally with a spatula. (The zucchini will be soft and somewhat see-through.)

1 teaspoon grated lemon zest ¼ teaspoon sea salt ¼ teaspoon ground black pepper 1 tablespoon olive oil 6 medium (8-ounce) zucchini, peeled with potato peeler 2 garlic cloves, thinly sliced ½ pint grape or cherry tomatoes, halved lengthwise

Tricia Foley’s

ZUCCHINI “PASTA” Tricia Foley is Our Health Magazine’s resident nutritionist.

HealthyEats P

FOR TH G N I AR R EP

E HARVEST

Watermelon Spritzer: Makes 6 servings

Ingredients: 8 cups cubed seeded watermelon (about 6 pounds with the rind), divided 1 cup water, divided 1/3 cup stevia, divided 1/4 cup fresh lime juice 1 sparkling water (such as LaCroix, So Clear or Perrier), well chilled

Lime slices, for garnish

Directions: 1.

Combine half the watermelon, half the water and half the stevia in a blender; puree.

2.

Pour through a coarse strainer into a large container.

3.

Repeat with the remaining watermelon, water and stevia.

4.

Stir in lime juice.

5.

Refrigerate until well chilled, about four hours.

6.

To serve, stir in sparkling water and garnish with lime.

Tricia Foley’s

WATERMELON SPRITZER Tricia Foley is Our Health Magazine’s resident nutritionist.

BACK TO SCHOOL | our health

of Back-to-School Health words | LAURA NEFF-HENDERSON, APR

It’s long been known that classrooms are meccas for germs. According to WebMD a 2005 study of germs in schools found that classroom water fountain spigots and plastic cafeteria trays were the germiest spots in school. While toilet seats get cleaned regularly, trays and water fountains do not.

So it’s no surprise that, for many children and their parents, as well as their teachers, backto-school often means spending more than a handful of weekends on the couch with a box of tissues and cough drops.

Learn more about some of the most common childhood illnesses:

Asthma and Allergies An estimated five million children have asthma, making it the most common chronic disease of childhood, according to the Asthma and Allergy Foundation of America. Asthma is a chronic (long-term) illness in which the airways become blocked or narrowed, causing shortness of breath, trouble breathing and other symptoms. Allergies, also a prevalent childhood illness, occur when the immune system overreacts to a substance that’s harmless to most people. This overreaction can leave children coughing and sneezing, with itchy eyes, a runny nose and a scratchy throat. In severe cases it can also result in rashes, hives, lower blood pressure, difficulty breathing, asthma attacks and even death. Although allergies have no cure, they can be managed with proper prevention and treatment.

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Bronchitis Children who suffer from repeated lung infections often develop bronchitis, an inflammation of the lining of the bronchial tubes, the airways that connect the trachea (windpipe) to the lungs. Children who have bronchitis often have a difficult time breathing when air passes in and out of the lungs. The most common symptom is usually a cough.

Chickenpox Caused by the varicella-zoster virus (VZV), chickenpox used to be a common illness among kids in the United States, particularly among those under 12 years old. The telltale sign of the virus is the itchy rash of spots that look like blisters and can appear all over the body.

The rash is extremely contagious and is generally accompanied by flulike symptoms. The Centers for Disease Control and Prevention (CDC) recommends that children receive the chickenpox vaccine at between 12 and 15 months old and between four and six years old.

The vaccination is 98 percent effective at preventing chickenpox.

Diabetes Type 1 diabetes, often called juvenile diabetes, develops when the pancreas can’t make the insulin that the body needs to break down glucose/sugar necessary to have energy.

Without insulin, too much sugar stays in the blood. Type 2 diabetes used to be called adultonset diabetes, but is increasingly common in children and teens as a result of obesity.

Children with type 1 diabetes may need to take insulin, while those with type 2 diabetes manage their illness with diet and exercise, medication and/or insulin.

Ear Infection In children, the signs of an ear infection often include ear pain, especially when lying down; tugging or pulling at the ear(s); difficulty sleeping; fussiness; difficulty hearing or responding to sounds; loss of balance; and a fever. For adults, the symptoms usually include ear pain, drainage of fluid from the ear, diminished hearing and a sore throat.

Flu Flu is highly contagious, particularly when people share close quarters, like children do in school classrooms. Flu is spread among children when a child either inhales infected droplets in the air or when the child comes in direct contact with an infected person’s secretions. This happens most often when children share utensils and cups. The symptoms usually start abruptly and cause kids to feel the worst during the first two or three days. The symptoms typically include a highgrade fever; chills; exhaustion; headache and body aches; a dry, hacking cough; a sore throat; vomiting; and belly pain. The number one way to prevent flu is to get an annual influenza vaccination.

Gastroesphageal Reflux Disease/GERD Like in adults with the condition, gastroesophageal reflux — GERD, for short — is the upward movement of stomach contents into the esophagus and sometimes into or out of the mouth. It is usually the result of an immature digestive system and most infants with the condition outgrow it by the time they are one year old. In older children, obesity, overeating, constipation, and certain foods, beverages, and medications can be the cause of the condition. The most common symptoms of reflux in kids are frequent or recurrent vomiting, frequent or persistent cough, refusing to eat or difficulty eating (choking or gagging with feeding), and heartburn, gas, or abdominal pain.

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Hand, Foot and Mouth Disease The Hand, foot and mouth disease most often occurs in children under 10 years old and is characterized by a rash of small blisterlike sores on the palms of the hands and soles of the feet and in the mouth. Symptoms include fever, sore throat and headache. The disease is spread from person to person through saliva, fluid from blisters or the feces of an infected person. Outbreaks occur most often in the summer and early fall in classroom settings, where large groups of children congregate. The illness typically lasts for about a week.

Impetigo Impetigo, one of the most common skin infections among kids, usually produces blisters or sores on the face, neck, hands and diaper area. This contagious, superficial skin infection usually affects preschool and school-age children. The infected areas appear in plaques ranging from dime to quarter size, starting as tiny blisters that break and expose moist, red skin. After a few days, the infected area is covered with a grainy, golden crust that gradually spreads at the edges.

Juvenile Idiopathic Arthritis Nearly 300,000 children in the United States have some sort of arthritis, an inflammation of the joints. The most prevalent form of juvenile arthritis is juvenile idiopathic arthritis, also known as juvenile rheumatoid arthritis. It affects about 50,000 U.S. kids and is very different from adult rheumatoid arthritis. Arthritis can be short-term — lasting for just a few weeks or months, then going away forever — or it can be chronic and last for months or years. Symptoms include joint pain, swelling and stiffness, leading to irritability, refusal to walk or protecting or guarding of a joint. Children who suffer from this condition may have periods with no symptoms in between flare-ups.

Kawasaki Disease Kawasaki disease is an illness that involves the skin, mouth and lymph nodes, and most often affects kids under the age of five. Kawasaki disease occurs in 19 out of every 100,000 kids in the United States. It is most common among children of Japanese and Korean descent, but can affect all ethnic groups. The cause is unknown, but if the symptoms (a fever lasting at least five days, red eyes, a body rash, swollen, red cracked lips and tongue, swollen, red feet and hands and/or swollen lymph nodes in the neck are recognized early, kids with Kawasaki disease can fully recover within a few days.

Untreated, it can lead to serious complications that can affect the heart.

Lice Lice aren’t dangerous and they don’t spread disease, but they are contagious. Itching, the most common symptom of all types of lice infestation, is caused by an allergic reaction.

Lice bite the skin to feed on a person’s blood. The saliva from these bites causes the allergic reaction and itching. Lice are a very common problem, especially for kids between the ages of three and 12 and are more common in girls than boys. Itching may occur right away in some people that are very sensitive to lice bites. Others build up a tolerance to the bites and have little or no itching, even with repeated infestations.

Mononucleosis Known to teenagers all over the country as the “kissing disease,” mononucleosis is caused by the Epstein-Barr virus (EBV), a type of herpes virus. Most people who get mono are between the ages of 15 and 25, but younger kids can get it too. The mono virus affects the lymph nodes, throat, salivary glands, liver, www.ourhealthrichmond.com | 49

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spleen and blood. Symptoms include extreme tiredness and an achy body, as well as a decrease in appetite.

Otitis Externa (Swimmer’s Ear) Otitis externa, also known as swimmer’s ear, is an inflammation and infection of the ear canal. It occurs when the protective film that covers the ear canal is removed.

Swimmer’s ear often develops when excess water enters the ear canal. But other conditions can cause swimmer’s ear, including allergies, forceful ear cleaning and skin problems. Symptoms can include itching, pain and a feeling of fullness in the ear.

Pinkeye (Conjunctivitis) Pinkeye (also called conjunctivitis) is the most common problem children have. Symptoms include itching, inflammation or swelling and a clear, white, yellow or greenish gooey liquid collecting in the eyes. Adults, especially parents and teachers who spend a lot of time with kids, can get conjunctivitis too. The condition usually lasts about a week or less, and then goes away by itself or after treatment.

Query Fever Q fever, or Query fever, is an infectious disease transmitted from animals to humans that can affect the heart, lungs and other body parts and cause flulike symptoms. Although rare, it can affect children and adults who drinking raw, infected, unpasteurized milk; come into contact with infected animals; or are bitten by ticks. In some people Q fever may not cause any symptoms. Symptoms that may appear include fever, headache, cough, joint and muscle pain, nausea, vomiting and diarrhea. In rare cases, symptoms can last for longer than six months. This form of the disease (chronic Q fever) can lead to serious complications if it goes untreated.

Reye Syndrome Reye syndrome is an extremely rare but serious illness that can affect the brain and liver. It occurs most commonly in children recovering from a viral infection and predominantly affects children between the ages of four and 14 years old. Common symptoms include frequent vomiting, lethargy or sleepiness, and irritability or aggressive behavior. Other symptoms include changes in vision, difficulty hearing and abnormal speech.

Strep Throat Strep throat is one of the most common childhood illnesses. It’s contagious and painful, and typically happens during the school year when children are in close contact with one another. A strep infection can be spread through sneezing, coughing and shaking hands. Symptoms include a severe and sudden sore throat without coughing, sneezing or other cold symptoms, pain or difficulty swallowing, a fever above 101 degrees F, swollen lymph nodes in the neck, white or yellow spots or coating on the throat or tonsils and/or a bright red throat or dark red spots on the roof of the mouth at the back near the throat.

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Tonsillitis Tonsillitis is an inflammation of the tonsils, tissue that sits on both sides of the back of the throat. They help in the immune system to protect the body from infections that may enter the body through the mouth. When the tonsils become infected they become enlarged and red and have a yellow or white coating. Tonsil infections may be contagious and can spread from person to person by contact with the mouth, throat or mucous of someone who is infected.

Tonsillitis symptoms include a sore throat, fever, swollen glands in the neck and trouble swallowing.

Urinary Tract Infection Urinary tract infections (UTIs) are common in kids, especially girls and uncircumcised boys. According to ww.kidshealth.org, about 8 percent of girls and 2 percent of boys have had at least one UTI before their fifth birthday. These infections occur when the kidneys, ureters, bladder or urethra become infected.

Symptoms include pain when urinating; changes in frequency, appearance or smell of urine; fever; chills; loss of appetite; nausea; vomiting; lower abdominal pain; and lower back pain or discomfort.

Viral Pneumonia Pneumonia is a general term that refers to an infection of the lungs, which is most often caused by a virus. Often, pneumonia begins after a person has had an upper respiratory tract infection (an infection of the nose and throat). Symptoms vary depending on the age of the child and the cause of the pneumonia, but the most common include fever, chills, cough, nasal congestion and difficulty breathing, as well as vomiting, chest pain, abdominal pain and lethargy.

Whooping Cough (Pertussis) Whooping cough is a bacterial infection of the respiratory system, characterized by severe coughing spells, which can sometimes end in a “whooping” sound when the person breathes in. It primarily affects infants younger than six months old before they’re adequately protected by immunizations, and kids 11 to 18 years old whose immunity has started to fade. The first symptoms of whooping cough are similar to those of a common cold, including a runny nose, sneezing, mild cough and low-grade fever. After a few weeks, the dry, irritating cough evolves into coughing spells that can last for more than a minute and leave the child red or purple in color. At the end of a spell, the child may make a characteristic whooping sound when breathing in or may vomit.

Xerophthalmia (Dry Eyes) Xerophthalmia, also known as dry eyes, is a medical condition that occurs when the eye fails to produce tears. It is caused by a vitamin A deficiency and is common in developing countries around the world. Symptoms include dry, itchy, painful eyes.

Yeast Infection Yeast infections usually occur in warm, moist parts of the body, such as the mouth and moist areas of skin. Vaginal yeast infections are particularly common in girls and boys during the summer months, when children spend an increased amount of time wearing wet bathing suits. Also, recent use of prescription antibiotics or steroid medication can cause yeast infections to develop in children. Infants and toddlers who use an infected www.ourhealthrichmond.com | 51

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pacifier or bottle nipple can develop a yeast infection. Symptoms vary wildly depending on the location of the infection.

Zoonotic Disease Zoonotic diseases are those that can be transmitted from animals to humans. These diseases are caused by bacteria, viruses, parasites, and fungi that are carried by animals and insects. Examples are anthrax, dengue, Ebola hemorrhagic fever, Escherichia coli infection, Lyme disease, malaria, Plague, Rocky Mountain spotted fever, salmonellosis, and West Nile virus infection. People can get zoonotic diseases from contact with infected live poultry, rodents, reptiles, amphibians, insects, and other domestic and wild animals.

A common way for these diseases to spread is through the bite of a mosquito or tick.

People can get diseases in most places where they might have contact with infected animals and insects, including: animal displays, petting zoos, pet stores, nature parks, wooded and bushy areas, farms, county or state fairs and/or childcare facilities and schools. To help prevent zoonotic diseases, wash hands thoroughly and frequently, avoid direct contact with certain animals and their environment, closely supervise children to ensure they wash their hands properly and avoid hand– to–mouth activities (thumb–sucking, eating, and use of pacifiers) after animal contact, use EPA–registered insect repellents that contain 20% or more DEET (N, N–diethyl–m– toluamide) on the exposed skin for protection that lasts up to several hours, use products that contain repellents (such as permethrin) on clothing (treat clothing and gear, such as boots, pants, socks and tents), look for and remove ticks from the body and limit the number of places around your home for mosquitoes to breed by getting rid of items that hold water.

- Sources: Centers for Disease Control, the World Health Organization and WebMD

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In 2004 Governor Mark Warner’s administration launched the Healthy Virginians initiative. The program’s mission is to promote healthy lifestyles in state government offices, in Virginia schools and among families who receive healthcare through Medicaid.

Healthy Virginians was created in part to allow schools to address the epidemic of childhood obesity. Over the past 20 years, the number of overweight children nationwide has almost doubled, while the number of overweight teens has tripled. Each year in Virginia more than one in three people diagnosed as obese are children.

Other alarming trends have developed as well. More than a third of young people in grades 9–12 do not regularly engage in vigorous physical activity. Chronic diseases such as hypertension and Type 2 diabetes now appear in children as young as eight years old. And overweight children now have a 70% chance of being overweight as adults.

Healthy Virginians addresses these issues with two initiatives to create better nutritional and physical environments for students — the Governor’s Nutrition and Physical Activity Award program and the School Breakfast Program.

Under the Governor’s Nutrition and Physical Activity Award program, Virginia’s public schools can earn a bronze, silver or gold award for best practices that promote healthy lifestyles. These practices include providing a daily minimum of 30 minutes of physical activity; encouraging students to design individualized exercise plans; selling only 100% fruit juice, low-fat milk or water; creating Fitness or Nutrition Nights; and during the school day providing or selling only foods that meet minimum nutritional standards. Data for the most recent school year show 278 awards have been earned — 35 gold, 123 silver and 120 bronze.

The Department of Education administers this program, which includes an interactive, webbased scorecard that allows schools to measure their progress and receive recognition for meeting their goals. Schools may also compete locally and statewide as they earn points to see which is healthiest.

“More than 900 public schools in 114 school divisions in Virginia have participated in the Governor’s Award program,” says Joe Hilbert, director of Governmental and Regulatory Affairs at the Virginia Department of Health. “The scorecard for the award serves as a resource for best practices in physical activity and nutrition for schools. And school divisions have used it to assist in the development and implementation of their local wellness policy.”

“The best practice standards for nutrition will be revised in the near future to incorporate new research and regulations,” says Hilbert, “including the recently released federal ‘Smart Snacks in Schools’ standards and the revisions to the state regulations for the sale of à la carte foods.”

The School Breakfast Program was designed to help improve academic performance, quality of nutrition and attendance. In 2003–2004, less than 28 million breakfasts were served, while that number increased to more than 44 million in 2011–2012. Since the Healthy Virginians breakfast incentive funding began, the number of public schools that offer breakfast and lunch has increased by nearly 11%.

Since 2004 the Healthy Virginians has also allowed for collaborative activities among numerous state government agencies, local school divisions and community organizations.

“In addition to the Governor’s Nutrition and Physical Activity Award Program administered by the Department of Education, the Virginia Foundation for Healthy Youth (VFHY) and the Virginia Department of Health (VDH) have both engaged in extensive programmatic efforts,” says Hilbert.

“The mission of VFHY is to lead statewide efforts to reduce and prevent youth tobacco

The new home of the VCU School of Medicine

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Students of John Tyler Community college’s nursing program in Richmond.

Richmond colleges and universities are helping answer the call for needed medical care words | ANIKA IMAJO

FOR A COMPLETE LISTING OF MEDICAL EDUCATION PROGRAMS OFFERED THROUGH LOCAL COLLEGES AND UNIVERSITIES IN THE RICHMOND COMMUNITY, PLEASE SCAN THE QR CODE BELOW TO VISIT WWW.OURHEALTHRICHMOND.COM, THEN CLICK ON THE MEDICAL COLLEGES IMAGE

As pressure mounts on the nation’s thinly stretched healthcare workforce, Richmond’s schools — both emerging and established — are rallying in response to the escalating needs.

Challenges at the intersection of a growing aging population, a shortage of primary care physicians and increased required access to health services as a result of legislative reform demand a well-trained corps of professionals prepared to function in a dynamic healthcare climate.

Advancing in pace with evolving circumstances, Virginia Commonwealth University (VCU) School of Medicine has introduced a number of initiatives to produce future generations of effective providers.

Its new Family Medicine Scholars Training and Admissions Track (fmSTAT) program — whose inaugural class will enter its second year this fall — is the culmination of extensive brainstorming within the Department of Family Medicine about how they might attract and cultivate students committed to primary care, according to Carolyn Peel, MD, fmSTAT medical director.

“This particular program is something that we have toyed around with in our minds.

‘What if we could get these people who are really predisposed to family medicine early on? And what if we could really give them a great experience?’ ” Students who enter medical school with an interest in primary care, she explains, often lose sight of their initial objectives when exposed to an educational environment in which tertiary care tends to dominate.

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identifies candidates whose values and professional goals indicate an inclination toward family medicine.

Orleans working for the Teach for America program before she decided to apply to medical school.

“I had never really been interested in medicine at all until after I graduated from college,” recalls Shaheen Ali, an fmSTAT student who double-majored in English and philosophy in undergraduate school. Deferring her admission to a PhD program in English literature, she spent two years in New

“While I was there I realized that as much as I love books and reading and writing and the narrative of human lives, the thing that made it really wonderful for me was that they were human lives, and I love being around human beings.”

Family medicine was the best way she could think of to fulfill her goal of serving other people in a meaningful way, says Ali, who grew up in Chesterfield County.

Once accepted, the program’s participants become part of a small community within the broader medical school class, exposed to an additional curriculum that highlights and explores material most relevant to their calling.

“The way that we deliver that is through a number of experiences,” says Judy Gary, assistant director for medical student education at VCU, explaining that seminars and off-campus retreats are among the activities designed to both immerse fmSTAT students in family medicine and encourage cohesiveness within the group.

The ongoing support that fmSTAT students are offered from their moment of arrival includes a oneon-one mentorship program with community family practitioners, many of whom have contributed to the education of VCU School of Medicine students for many years, Dr. Peel points out.

“I often feel very spoiled because we have personal mentors who really are there for us whenever we need them,” notes Ali, who says she actually regards the entire Family Medicine Department as a group of mentors. This support system, she says, reinforces her personal aspirations.

“The Family Medicine Department

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and the fmSTAT program are really good reminders of why I am doing this, why I as an individual find value in medicine and find value in helping other people through medicine.”

The fmSTAT program, still in its infancy, is one of 17 Family Medicine Interest Groups to receive the American Academy of Family Physicians’s 2013 Program of Excellence Award for its efforts toward engendering interest in the field.

Beyond this innovative program, VCU School of Medicine is undergoing a radical overhaul of both its physical space and its educational approach.

“It was just the perfect time for developing a new curriculum and then having the actual structure in place that would allow us to deliver it correctly,” observes Ike Wood, MD, senior associate dean for medical education and student affairs at VCU School of Medicine.

Relying heavily upon lectures, the traditional curriculum offered by VCU and most other U.S. medical schools wasn’t the best method for imparting relevant skills and knowledge, say Dr. Wood, explaining that students more readily absorb information that is integrated into the practice of medicine and discovered through collaborative team efforts.

Several students and staff from the inagural VCU fmSTAT class. From left: Shaheen Ali, Andaleeb Rahman, Augustine Lewis, MD, Judy Gary, Lydia Lee and Carolyn Peel, MD

“When we looked at the literature on how adults learn, a large group lecture is extremely ineffective as far as adults’ being able to retain information, to problem solve, to apply the information to a novel situation or to become self-directed learners. These are all characteristics that you want to see in physicians.”

As the new curriculum required a new space — in which lecture halls are replaced by learning studios and collaboration tables that allow students to engage directly with the material — the James W. and Frances G. McGlothlin Medical Education Center was built.

In its two floors of simulation space, students practice treatment on actors who provide feedback about bedside manner and thoroughness of exams. High-fidelity, interactive manikins stand in for live patients as students hone their treatment skills under a range of simulated circumstances.

And the new curriculum, Dr. Wood says, also places a strong emphasis on interprofessionalism, an integral part of VCU’s educational program formalized through the recent establishment of its Center for Interprofessional Education on the Health Sciences Campus.

“When you finish medical school and you get into the real world, that’s just the nature of how you take care of patients,” Dr. Wood remarks. “It’s multidisciplinary teams, and everybody brings strengths to the table.”

As the need for professionals in a host of healthcare fields increases, other schools throughout Greater Richmond are likewise expanding their offerings.

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highest in demand, fastest-growing positions in the Richmond area,” says Troy Ralston, campus president of South University, Richmond (SU), which opened in 2009.

According to Ralston, demand for skilled personal care aides, home health aides, physical therapist assistants, occupational therapist assistants and physician assistants is steadily rising.

SU, he says, is in the initial accreditation stages for a physician assistants’ master’s program and for a degree program for occupational therapy assistants, which may be available in January of 2015.

SU’s physical therapy assistants’ program, whose inaugural class will begin this summer, was created in direct response to healthcare trends in Richmond and beyond.

“Whether individuals are ‘aging in place,’ moving to continuing care retirement communities, assisted living facilities or skilled nursing facilities, there is increasing need for professionals who address mobility deficits,” explains Tawny Chamberlain, PT, program director of the physical therapist assistant school.

Physical therapy (PT) teams can make a notable impact by providing noninvasive preventative measures and even aiding patients in the management of some chronic diseases, she explains.

“When patients present with limitations, PT can intervene to reduce or eliminate issues, thereby assisting in reduction of healthcare costs. These measures may also serve to reduce the need for surgery or other medical management. In Virginia, patients can directly access PT services without a physician’s referral, further reducing healthcare costs.”

Making their career studies certificate courses more accessible to students whose schedules or locations present obstacles, J. Sargeant Reynolds Community College (JSRCC) offers 25 programs — 20 in healthcare fields — available online, and boasts one of only six accredited online programs in the nation for polysomnography or sleep technology, according to Susan Hunter, PhD, dean of the School of Nursing and Allied Health.

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Evolving accreditation and professional standards must also be accommodated by professional training programs, she adds.

For example JSRCC is now partnering with an area healthcare employer to train radiation technicians, now required to hold an associate’s degree.

JSRCC’s nursing program has also added three full-time faculty members to its current roster of 75 adjunct professors in the past two years, responding to a professional demand that schools throughout the Greater Richmond area are rallying to address.

VCU and other four-year schools to facilitate its graduates’ transition to advanced nursing degree programs.

“We’re looking at how we’re graduating people to meet the changing landscape. We’ve always done a really good job of graduating qualified and prepared people, but it’s just not enough to be ready to go to work. We’re preparing people for lifelong learning in any health profession, because it’s changing so quickly.”

Sharon Broscious, RN, director of SU’s nursing program, anticipates that the aging population, increased access to healthcare coverage and shortages of physicians will all necessitate a greater need for nurses able to provide a broad range of services.

“Nurses will certainly still be needed in the acute care setting,” notes Broscious, who says that her program has significantly increased its admissions.

“But more nurses may be needed in the community, where the focus would be prevention and screening.”

SU’s nursing school, which offers a bachelor of science degree program in nursing, introduced a family nurse practitioner program last fall.

Aside from expanding their scope, nursing programs must also adapt their focus and methods in preparing graduates to address current issues.

“The whole concept of nursing education is changing, so we spent the last couple of years really advancing our simulations, advancing our electronic technology,” explains Deborah Ulmer, RN, PhD, dean of the Division of Health Sciences at John Tyler Community College (JTCC).

According to Dr. Ulmer, JTCC is also placing more emphasis on developing skills to care for the aging and providing students with training in community settings, rather than just in hospitals.

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2012 honary Doctor, Rashmi Vaidya, MD and her dance instructor/partner Angel Rodriquez doing the foxtrot.

The 2013 Pink Tie Gala: Cutting the Rug to Help Cure Breast Cancer words | ANIKA IMAJO photography | JENNIE WOOD OF PINK PHOTOGRAPHY

“Just live life to its fullest, take a chance where you’ve never taken a chance before and do what you can do while you can do it.”

Emboldened by this philosophy, Karen Ledgerwood will muster the moxie to make her performance debut at the seventh annual Pink Tie Gala, where the novice dancer will showcase her waltz moves before a crowd of hundreds.

Ledgerwood and the eight other breast cancer survivors composing the 2013 Celebration of Life Dance Team embody the spirit of the occasion, having demonstrated their courage and grace under far more trying circumstances.

“I’m a little nervous,” admits Ledgerwood, who was diagnosed with breast cancer in March of 2011. In February of 2012, she learned the cancer — now stage 4 — had metastasized to her brain.

“I want to do well. I’d like to show other women — not necessarily cancer survivors, but all women — we can do anything we try, even if it’s something we’re not used to doing.”

Representing the human faces and individual stories at the heart of the event, each year’s dance team members — paired with professional partners and trained to perform ballroom dance routines especially for the gala — play a large role in making the breast cancer benefit a resounding success.

The history of this annual affair, now ranked among Richmond’s most beloved charity functions, is likewise a lesson in overcoming obstacles.

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“I was thinking, ‘Why is nobody coming to this?’ I was so mad because people were not as passionate about it as I was, and we couldn’t get any sponsors because we weren’t a charity ourselves.”

But this initial disappointment illuminated the path toward subsequent triumphs.

Using her vacation funds, Groves established a nonprofit organization, River City Charities.

She rallied sponsors, created the dance team and saw the first year’s paltry attendance of 87 rise to 250 in the second year.

“And we’ve grown 100 people a year since then,” says Groves, who anticipates that this year’s gala — to be held on October 19 at the Greater Richmond Convention Center ballroom — will draw 600 to 700 attendees.

“It’s the premier breast cancer event in the city of Richmond,” notes Sherry Fox, PhD, RN, vice president of Bon Secours Cancer Institute (BSCI), which has been the event’s presenting sponsor since 2010. “It really focuses on and highlights the strides we’ve made in helping women survive breast cancer.”

Linda Tiller, executive director of the Central Virginia Affiliate of Susan G. Komen for the Cure, says the benefit is popular largely because it guarantees everyone a great time. The public’s enthusiastic response to it, she adds, is also bolstered by Groves’s commitment to inclusivity.

“The ticket price allows a much larger segment of the local population to attend a gala and feel the joy of making a difference.”

And the community recognizes that the Gala’s impact extends far beyond the excitement of the big night. Delivering 100 percent of its proceeds to Susan G. Komen for the Cure, with

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And the community recognizes that the Gala’s impact extends far beyond the excitement of the big night. Delivering 100 percent of its proceeds to Susan G. Komen for the Cure, with 76 percent going toward grant programs in Richmond and 24 percent devoted to funding research at the national level, this all-volunteer effort inspires confidence among sponsors and guests that their support will be invested fully into the fight against breast cancer at home and beyond.

“That’s one thing that makes the Pink Tie special to us,” explains Dr. Fox. “So many organizations have high overhead and lots of the money they raise goes to national efforts. And Bon Secours is all about reaching out and serving the community.”

Pink Tie proceeds help finance such local resources as the Every Woman’s Life Program, a service that provides access to breast and cervical cancer screenings for uninsured, low-income women in Richmond.

“We at Komen Central Virginia are so very fortunate that Susan Groves is committed to this cause and willing to work every year to make her event bigger and better than ever — not for the recognition, but truly just because she wants to raise more money to fight breast cancer,” Tiller observes.

2012 survivor dancer Mary Baker and her dance instructor/partner Ken Yorgey.

But it’s more than dollars that the gala seeks to raise. Raising awareness is a yearlong endeavor that culminates annually on a festive evening in October, says Groves, whose dedication to the cause arose from her own exposure to Komen literature about breast cancer’s staggering statistics.

At the time, she recalls, she had no personal connection to the disease. But contemplating the threat it posed to her teenage daughter triggered a mother’s instinct to take action.

“As a parent, if your child is at risk, you do whatever you can. And I’m the type of person who doesn’t know how to do anything halfway.”

Understanding the scope of the problem and feeling empowered to confront it will go a long way toward positively changing breast cancer’s course, remarks dance team member Joanne Snook. Snook, a past volunteer who will take to the dance floor with the Texas Two Step this year, values the gala as an opportunity for breast cancer survivors to share their stories and deliver a heartening message.

The Pink Tie Gala will be held again this year at the Greater Richmond Convention Center Ballroom.

“When I think about it, when I was first diagnosed, I just knew that I was going to be a survivor. I put it into perspective so I could go out there and let everybody know that we can beat this.”

The Celebration of Life Dance Team will no doubt inspire the crowd at this year’s Pink Tie Gala, serving as corporeal reminders to embrace the joy of the moment, conquer fear and truly celebrate life.

“I’m going to put my heart into it and try to do my best,” says Ledgerwood, sharing what she’s learned about venturing into unfamiliar territory. “If it’s something out of your comfort zone, you’re going to take a deep breath, hang on and just give it a whirl and see what happens.” www.ourhealthrichmond.com | 63

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Prostate Cancer-Screening is a Key to Long-Term Survival

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Prostate cancer is the most common form of cancer in men and the third-leading cause of men’s cancer deaths, with nearly 239,000 men diagnosed with it in 2013, according to the American Urological Association. But when prostate cancer is detected early, the prognosis for long-term survival is excellent. The key is an early diagnosis, making screening for prostate cancer extremely important because there typically aren’t any symptoms in the disease’s early stages.

“Prostate cancer is usually asymptomatic until it’s pretty far advanced,” explains Timothy J. Bradford, MD, a urologist at Virginia Urology, which has eight locations throughout Central Virginia. “The vast majority of prostate cancer that we detect now is early-stage, localized prostate cancer. Basically it’s just confined to the prostate and there’s no sign of cancer outside the prostate. The prognosis is excellent for localized prostate cancer. Depending on your particular pathology, the cure rate varies, but for many men we’re talking about a 90 to 95 percent cure rate.”

Screening Dr. Bradford notes that while there is not a consensus today pertaining to when a man should undergo a prostate exam, in general the current AUA recommendations are for men to undergo a prostate screening beginning at age 50 to 55 and continuing every one to two years thereafter. For men deemed to be at high risk for prostate cancer — including African American men or men with a first-degree relative who’s had prostate cancer — screening should begin at age 40.

Screening for prostate cancers includes a test to measure the amount of prostate specific antigen (PSA) in the bloodstream and a digital rectal exam (DRE) to feel the prostate for any abnormalities. While there is also a good deal of controversy recently surrounding PSA levels, what they mean and the recommended course of action in light of some recent studies and recommendations, Dr. Bradford explains that if you have either a suspicious rectal exam or a significantly elevated PSA, then you may elect to undergo a prostate biopsy. This outpatient procedure involves tissue samples being taken from the prostate and examined under a microscope to determine prostate cancer’s presence.

Stages Prostate cancer, like other cancers, is measured in four stages, with stage one representing the cancer’s early stage. At this stage, the cancer is confined to the prostate, Dr. Bradford explains. In stage two, while the cancer is still confined to the prostate, the cancer has progressed within the prostate. Stage three represents the cancer’s progression from being contained strictly in the prostate to now moving outside the prostate capsule. And stage four represents the cancer having metastasized, spreading from the prostate to other parts of the body.

“When it spreads elsewhere in the body, it generally spreads to the bones,” Dr. Bradford explains. “That’s the most common site. Regional lymph nodes and lymph nodes around the prostate are also common areas for it to spread.”

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As mentioned earlier, the prognosis for early-stage prostate cancer is excellent. However, at the other end of the spectrum, there is no cure for stage four prostate cancer because the cancer has metastasized.

“There are medications that can prolong your life and that can ease your symptoms, but there is no cure for metastatic disease, which is why it’s so important to catch it in the localized stage,” Dr. Bradford explains.

Treatments Treating prostate cancer depends on a wide variety of factors unique to each patient. Generally speaking, however, stage one might not involve any treatment.

“Active surveillance is an appropriate treatment option for low-risk prostate cancers,” Dr. Bradford says. “Basically what that means is following along, making sure your PSA level doesn’t rise significantly and it’s kind of a wait and see. The natural history of prostate cancer — especially low-risk prostate cancer — is that it’s prolonged. Many prostate cancers may not cause you any harm in the first 10 to 15 years after diagnosis. However, you have to stratify prostate cancers into low risk, intermediate risk and high risk.”

Dr. Bradford uses the example of a 75-year-old male who has other illnesses in addition to being diagnosed with low-risk prostate cancer.

“The prostate cancer is probably not going to be the thing that takes

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takes his life. You probably don’t need treatment for that. We’re finding more and more men who are willing to consider active surveillance as an option.”

The two most common types of treatment are surgery to remove the prostate, called a prostatectomy, or radiation, which comes in several different forms, Dr. Bradford explains. There is external radiation and there is brachytherapy, also called radioactive seed implantation, in which radioactive pellets are inserted into the prostate. The latter is used mostly for low and intermediate risk cancers. Surgery and external radiation are used for all risk categories of localized prostate cancer.

Both radiation and surgery are effective in terms of cancer control and there aren’t significant differences between them in terms of cancer control. However, there are significant differences in terms of side effects, Dr. Bradford says, some of which are temporary.

“When it comes to the treatment of prostate cancer, a lot of the decision tree comes down to side effects,” Dr. Bradford says.

“The most common side effects for surgery are temporary incontinence and problems with erectile dysfunction. The most common side effects with radiation would be urinary symptoms — urinary frequency, burning with urination, difficulty urinating, blood in the urine; it can also cause diarrhea, blood in the stools and problems with erections.”

Generally speaking, Dr. Bradford says that younger men tend to lean toward surgery and older men toward radiation, but that the decision ultimately comes down to the patient and his physician deciding which treatment option is best for him.

“There are a couple of other treatment options that are a little bit newer and not quite as proven,” Dr. Bradford explains. “One of them is called cryotherapy, which is freezing the prostate.

The other one is called HIFU, which stands for high intensity focused ultrasound.” That procedure is being used in Europe and Canada but isn’t FDA approved here yet. Two other treatment options include androgen deprivation therapy to lower a man’s testosterone and immunotherapy to direct the body’s own immune system to target cancer cells. Newer chemotherapy drugs also exist.

Prostate cancer’s diagnosis and treatment do not, admittedly, provide a clear-cut path to one decision that’s either right or wrong, particularly in light of the recent differences in opinions regarding PSA levels and treatment. What is clear, however, is the undeniable importance of regular screening for prostate cancer, particularly for men in a high-risk category.

Timothy J. Bradford, MD urologist at Virginia Urology 66 | www.ourhealthrichmond.com