OurHealth Richmond Aug/Sep 2015 Edition

AUGUST • SEPTEMBER 2015 | OURHEALTHRICHMOND.COM

The Resource for Healthy Living in Greater Richmond

also: One Man’s Positive

Journey with Prostate Cancer

table of contents | august • september 2015

28 MEDI•CABU•LARY.....................10 Local experts define health related terms

JUST ASK!.......................................12 Healthcare questions answered by local professionals

Back to School Health

To help you and your children start the school year with less stress and the right information, OurHealth asked parents what they most want to know before sending their children back to school.

NEW & NOTEWORTHY.............14 A listing of new physicians, providers, locations and upcoming events in greater Richmond

HEALTH POINTS.........................18 Interesting facts and tidbits about health

THE ANATOMY CHALLENGE..................................21 How much do you know about Our Anatomy?

In this issue, test your knowledge when it comes to the MOUTH.

THE ANATOMY ........................... 22 All About the Bite: examining how orthodontists care for your teeth and jaws.

hello, HEALTH!............................................38 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos

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OurHealth | The Resource for Healthy Living in Greater Richmond

The Resource for Healthy Living in Greater Richmond

40

One Man’s Positive Journey with Prostate Cancer: ‘I Like to Live’

Diagnosed with stage 4 prostate cancer in 2010, 53-year-old Chris Lee, from Colonial Heights could have just hung it up and given in.

52

A Special Place for Jami

Families with a special needs child have unique circumstances and challenges.

Although many pediatricians may be professionally equipped to assess children with special needs, their patient loads rarely allow for the extended time necessary to evaluate, treat and comfort families with a special needs child.

FIT BITS!........................................................................... 47 Couch to 5K training plan: The two most important things when training for a 5K are having a plan and a goal. This program gives you both!

NUTRITION........................................................... 49 HEALTHY EATS: Shop Seasonally for Better Flavor­and Extra Value Summer Beet Salad, Eggplant Marinara with Quinoa Spaghetti and Cranberry Orange Cupcakes

LOOKING BACK.............................................................. 66 Images reflecting the landscape of healthcare in Richmond *

A chance to win prizes!

PLUS *

THE THIRD ANNUAL

BEST B E D S I D E MANNE R AWARDS

WINNERS ANNOUNCED IN THE DECEMBER 2015 ISSUE www.OurHealthRichmond.com

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The Resource for Healthy Living in Greater Richmond

august • september 2015 OURHEALTH’S EXCLUSIVE MEDIA PARTNER

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CONTRIBUTING RICHMOND MEDICAL EXPERTS Erin G. Adams, MD

M. Taruj Ali, MD Alexis Bachrach, DO, FACOG

Ashley Cappel, RD Stephanie Crewe, MD

William O. Dahlke, Jr., DMD Joseph Dill, DDS, MBA

Vic Goradia, MD Peter S. Heyman, MD

Bryce Lothian, MD, FRCPC Baylor Rice, RPh, FIACP

Karen Rice, LCSW Thomas C. Robertson, MD

David R. Salley, MD Sara I. Sarraf, MD

Sarah Severs, AuD, CCC-A Chuck Shaffer, MD

H. Robert Tuten, MD Carol Williams MD, FAAP

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& WRITERS Suzanne Ramsey Edwin Schwartz Deidre Wilkes Diane York

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

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LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S

What is the Tdap vaccine?

Tdap vaccine can protect adolescents and adults from serious illness like tetanus, diphtheria and pertussis.

Tdap vaccine is also routinely given to pregnant mothers to protect their newborn baby and young children from pertussis (whooping cough).

Tdap is given to pre-teens at ages 11 or 12 as a booster vaccine. If anyone older than 13 years has not received Tdap, they should ask their healthcare provider and get it as soon as possible.

Stephanie Crewe, MD

Children’s Hospital of Richmond at VCU Adolescent Medicine Richmond | 804.828.CHOR www.chrichmond.org

What is MRT/LEAP sensitivity testing used for?

The mediator release test (MRT) is considered one of the most accurate and comprehensive blood tests available for food and food-chemical sensitivities. Unlike allergies, symptoms from food sensitivities take longer to arise and can therefore make it difficult to identify the foods and or chemicals one is sensitive to. If you are suffering from migraines, irritable bowel syndrome, eczema, acid reflux, joint pain or sinusitis you may have a food sensitivity.

Unlike elimination diets where you guess which foods are causing symptoms, MRT accurately identifies 150 problematic foods and food chemicals and allows the individual to focus on less-reactive safe foods to incorporate into their diet.

LEAP (Lifestyle Eating and Performance) therapy is also recommended. LEAP allows the registered dietitian to interpret each unique MRT result and provide dietary recommendations that will help minimize their symptoms and improve their overall health.

Chuck Shaffer, MD

The Weigh Station Glen Allen | 804.270.6000 www.weighstation.net

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OurHealth | The Resource for Healthy Living in Greater Richmond

What is asthma and how can I tell if my child has it?

Asthma is a disease of the airways, causing them to narrow because of swelling (inflammation) and muscle tightness (bronchoconstriction). The symptoms of asthma are caused by the difficulty of breathing through these narrowed airways.

The most common symptoms of asthma are wheezing, cough, or feelings of chest tightness or shortness of breath. Symptoms will worsen when someone with asthma is exposed to a ‘trigger’ that causes the airway narrowing. This could be an infection (e.g. a ‘cold’), an allergen (e.g. pollen) or an irritant (e.g. cigarette smoke).

A child with asthma may not be aware or be able to explain that he or she is having trouble breathing.

If you see that your child is having repeated episodes of asthma symptoms, they may have asthma.

A diagnosis of asthma can be made by your child’s primary care practitioner. Treatment is usually very effective by relieving the airway narrowing and alleviating symptoms.

Bryce Lothian, MD, FRCPC Pediatric Lung Care Bon Secours St. Mary’s Hospital Richmond | 804.285.2011 www.bonsecours.com

H E A LT H C A R E QUESTIONS ANSWERED

BY LOCAL PROFESSIONALS

When should I bring my daughter in for her first gynecologic exam?

What should I do if I miss a dose of my child’s antibiotic?

What is the best way to help my child prevent suffering an ACL tear?

This answer varies based on if she is having particular health problems. Bringing a teenager in for her first exam should allow her to feel comfortable with the idea of seeing a gynecologist on a yearly basis and to build a rapport so she trusts the provider to ask personal questions. She should be aware that there might not be a need for an internal exam or pap smear. She will be given the opportunity to be accompanied by a parent if she so chooses. Easy topics are typically discussed first, such as school and interests, before discussing more personal topics such as medical, social (smoking/alcohol/drug use), menstrual and sexual histories.

She will be given ample time to ask questions. A general physical exam is typically performed. If a pelvic exam is necessary, it will be explained in detail prior to being performed.

Recommendations are made based on the individual’s history and exam such as vaccinations, overall wellness and medications. She should be comfortable enough to continue care through her lifetime including annual exams and her reproductive health.

Antibiotics are usually taken between one and four times a day.

Doses should ideally be equally spaced throughout the day and taken at the same time every day.

This helps to maintain a constant level of medication in your child’s bloodstream.

Research shows that a training program that includes plyometrics, balance, strengthening and sports specific movements can reduce the risk of an ACL tear. The training needs to be performed more than once per week with a minimum duration of six weeks followed by a home maintenance program. There are several well-researched programs available and a typical session can last 45-75 minutes.

Alexis Bachrach, DO, FACOG Obstetrician/Gynecologist Virginia Physicians for Women Richmond | 804.282.8311 www.vpfw.com

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In most cases, you should NOT double the next dose if your child has missed one dose of antibiotics.

Give your child their missed dose as soon as you remember or, if it is nearly time for the next dose, SKIP their missed dose altogether. Giving a double dose of antibiotics may increase the risk of side effects.

As always, don’t hesitate to ask your pharmacist or healthcare provider for advice if you have any questions about your child’s medication, or if he/she has missed several doses of antibiotics or more than one day’s worth of treatment.

In the unfortunate circumstance that an ACL tear occurs, and surgery is needed, there have been several advances in the past five years that have produced improved surgical outcomes. The first was the recognition by surgeons and researchers that a more anatomically correct ACL reconstruction (i.e. replacement) could be performed.

The most recent advance is the ability to arthroscopically reattach the patient’s own ACL to the bone when a specific type of tear occurs.

This surgery is less invasive and can result in faster recovery and improved balance when returning to sports activities.

Baylor Rice, RPh, FIACP

Vic Goradia, MD

Even if your child is starting to feel better, always finish a course of antibiotics. If you don’t finish the course or if you miss several doses, the infection may return.

President and CEO South River Compounding Pharmacy Midlothian | 804.897.6447 www.southriverrx.com

Knee, Shoulder and Sports Medicine Specialist G2 Orthopedics and Sports Medicine Glen Allen |804.678.9000 www.G2orthopedics.com

NEW

NOTEWORTHY

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

Bon Secours acquires new da Vinci Xi Robot, further expands robotics program Bon Secours Richmond becomes the first health system in the region to offer next generation da Vinci Xi robot.

Bon Secours Richmond Health System is the first hospital system in the Central Virginia region to acquire the da Vinci® Xi Robotic Surgical System, providing surgeons with superior real-time visualization, greater dexterity, and precision during minimally invasive robotics procedures.

This next-generation robotic surgical system can be used across a wide spectrum of minimally invasive surgical procedures and has been optimized for highly complex, multi-quadrant surgeries in which instruments must be able to reach up and down and across large areas of the body, such as the abdomen or chest.

Bon Secours St. Mary’s Hospital in Henrico County and Bon Secours Memorial Regional Medical Center in Hanover County are the only locations in Richmond where the da Vinci Xi technology is available. After introducing the system in mid-

June, Andrew Vorenberg, MD, colon and rectal surgeon and past vice chairman of department of surgery at St. Mary’s Hospital, was the first surgeon in the Mid-Atlantic region to successfully perform a minimally invasive colorectal procedure with the daVinci Xi on June 23, 2015. Surgeons at Bon Secours are now using the robot to perform a number of procedures in the areas of cardiac, gynecology, urology, thoracic, bariatric, pediatric and general surgery.

Bon Secours has been using the da Vinci Surgical System for several years, which combines the latest in minimally invasive surgical and robotics technologies to perform successful complex and routine surgeries. These two new da Vinci Xi robots added to Bon Secours reserve brings the number of da Vinci systems across the Richmond Health System to six; three at St. Mary’s Hospital, two at Memorial Regional Medical Center and one at St. Francis Medical Center.

For more information, visit www.bonsecours.com.

Bon Secours St. Mary’s Hospital recognized in national ranking by U.S. News & World Report U.S. News & World Report, a premier ranking and analysis resource in the United States, has rated Bon Secours St. Mary’s Hospital among the nation’s best in five critical-care procedures and conditions. Out of more than 4,000 hospitals around the country that were evaluated for healthcare practices and outcomes in surgical procedures and chronic conditions, only 34 hospitals were designated as “High Performing” in all five of the following areas: heart bypass surgery, heart failure, hip replacement, knee replacement and chronic obstructive pulmonary disease (COPD). A rating of “High Performing” indicates that a hospital was significantly better than the national average in a given procedure or condition.

For more information on Bon Secours St. Mary’s Hospital, visit www.bonsecours.com.

Virginia Cardiovascular Specialists announces New staff and Changes Stephen Abramson, MD, FACC joins VCS after 29 years of private practice in Richmond. He will provide comprehensive cardiovascular services at the St. Mary’s office, located at 5875 Bremo Road ,Suite 505.

Stephen Abramson, MD, FACC

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Saumil Shah, MD,

Ashwani Kumar, MD, FACC

OurHealth | The Resource for Healthy Living in Greater Richmond

Saumil Shah, MD, electrophysiology, and Ashwani Kumar, MD, FACC, interventional cardiology have moved to the Forest Medical Plaza office at 7611 Forest Avenue, Suite 100 and 100A.

Continued Growth on HCA Virginia Campus’ Chippenham Hospital Opens New Child and Adolescent Treatment Center

HCA Virginia’s Tucker Pavilion at Chippenham Hospital has officially opened its new behavioral health Child and Adolescent Treatment Center.

Dagne Assefa, MD, FAAP

Zheni Avram, MD, FACP Susanne Colligon, NP

Bon Secours Palliative Medicine Midlothian | 804.288.2673 www.bonsecours.com

John Collins, MD

Bon Secours Pediatric Lung Care Richmond |804.281.8303 www.bonsecours.com

Virginia Physicians, Inc. Reynolds Primary Care Richmond | 804.346.1515 www.vaphysicians.com/ reynolds-primary-care

Katherine Dec, MD

Rachel Donaldson, DO

Supakunya Edmonson, DO

Mary Frayser, DNP, FNP-C

Jeff Oliver, PharmD, MHA

Brenda Radford, CNM Bon Secours

Children’s Hospital of Richmond at VCU Neurosurgery Downtown Richmond and Fredericksburg 804.828.CHOR www.chrichmond.org

The new 24-bed, 9,000 square foot treatment center will be dedicated to treating patients up to age 17 and will include outdoor areas and a gymnasium for therapeutic recreational activities.

John Randolph Medical Center opens new behavioral health adult inpatient unit HCA Virginia’s John Randolph Medical Center announces its new behavioral health adult inpatient unit.

VCU Medical Center Physical Medicine and Rehabilitation Downtown Richmond and West End | 804.828.0713 www.vcuhealth.org

Bon Secours Neurology Clinic at St. Mary’s Richmond | 804.893.8656 www.bonsecours.com

Bon Secours Neurology Clinic at St. Mary’s Richmond | 804.893.8656 www.bonsecours.com

Virginia Physicians, Inc. Ashland Medical Center Ashland | 804.798.8307 www.vaphysicians.com/ ashland-medical-center

The new 40-bed adult inpatient program will provide treatment for mental illness by delivering personalized inpatient care plans, and developing outpatient recovery plans to promote long-term mental wellness.

Chippenham & Johnston-Willis Hospitals to expand emergency care with new freestanding emergency room HCA Virginia’s Chippenham and JohnstonWillis Hospitals will soon begin construction on a new free-standing emergency department to be located in west Chesterfield on Hull Street/ Route 360.

The 10,000 square foot state-of-the-art Swift Creek Emergency Center is expected to open in early 2016 and will include 11 beds, a traditional adult ER, a dedicated pediatric ER with separate entrance and waiting, CT scanner, behavioral health capabilities and tele-medicine linkage to Chippenham and Johnston-Willis Hospitals.

Swift Creek Emergency Center will be open 24 hours a day, seven days a week.

For more information, visit www.hcavirginia.com.

Julie Julian, FNP-C

Virginia Physicians, Inc. Midlothian Family Practice Midlothian | 804.794.5598 www.vaphysicians.com/ midlothian-family-practicevillage

Nguyen Ngtam, MD Bon Secours Laburnum Medical Center Mechanicsville | 804.226.2444 www.bonsecours.com

Ida Vaclavik, NP

Bon Secours Virginia Breast Center Richmond|804.594.3130 www.bonsecours.com

Directory of Pharmacy Chippenham Hospital Richmond | 804.320.3911 www.hcavirginia.com

The Woman’s Center Midlothian | 804.423.8462 www.bonsecours.com

Philip Valmores, DO Bon Secours Lee Davis Pediatrics Mechanicsville 804.730.4690 www.bonsecours.com

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NEW

NOTEWORTHY

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

New non-surgical procedure for reducing double chins now available in Richmond In June of 2015 the FDA approved Kybella™ as the first and only non-surgical filler specifically for submental fat reduction.

Local cosmetic facial surgeon Joe Niamtu, lll, DMD is one of the first doctors in the area to offer Kybella™.

Dr. Niamtu is an official trainer for the product’s manufacturer, and teaches other surgeons on the procedure.

“Kybella represents a leap in the treatment of double chins,” says Dr. Niamtu. “It is an exciting breakthrough in non-surgical cosmetic facial rejuvenation.”

Kybella™ is a synthesized bile acid that is made naturally in the body and aids in digestion. It works by dissolving the cell wall of the fat cells and the body digests the fat and the drug is cleared for the body by natural processes.

Kybella™ is administered in the office with small needle injections (similar to Botox) and the actual treatment takes about fifteen minutes. The area can be numbed with local anesthesia, although many patients only need ice packs to numb the skin. After treatment, minor discomfort and swelling may occur and can last a few days.

For more Information on Kybella™, visit consumers.mykybella.com. More information on Dr. Niamtu can be found by visiting www.lovethaface.com.

Orange is the New Fit!

Orangetheory Fitness is coming to Richmond

Find us on social media. Follow us on Facebook, Twitter, Linked In and You Tube.

High Intensity Interval Fitness Franchise Continues Expansion with New Virginia Studio Orangetheory® Fitness, the energizing and fastgrowing fitness franchise, announces that the first Richmond, VA studio is coming soon. The studio will be in The Corner at Short Pump, located at the corner of Lauderdale Drive and West Broad Street. With three studios already open in Virginia and several more in development, the brand will continue to target the area for expansion, with as many as 11 additional locations statewide.

“We are passionate about health and wellness and are excited to bring Orangetheory Fitness to our community,” said Yedda Stancil, Growth Strategist for Orangetheory Fitness Richmond and local health and fitness expert and adjunct professor at VCU’s Department of Kinesiology and Health Science. “We can’t wait for Richmond residents to become part the Orangetheory family and start seeing results from this unique, high-energy workout.”

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OurHealth | The Resource for Healthy Living in Greater Richmond

“Orangetheory classes are led by highly qualified motivational fitness trainers,” says Brooks Stone, a premier group training expert and community leader in Richmond. Stone has partnered with Orangetheory Fitness to deliver this scientifically proven and technology based concept. One Orangetheory Fitness workout is designed to burn up to nine times the amount of fat calories you typically burn in a normal day. This is accomplished by each participant wearing a heart rate monitor and working at their individual “Orange Zone” during a group training session where all participants receive aggregate workout summaries via email to track progress and results.

The new studio will celebrate its’ grand opening in late September.

For more information on Orangetheory Fitness and membership packages, contact Brooks Stone at 804.823.7530 or visit www.orangetheoryfitness.com.

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

SNACK TIME! Snacks are an important part of a child’s diet as they may not get sufficient nutrients from breakfast, lunch and dinner. It’s important to ensure that kids have nutritious healthy snacks available in their lunchbox to get them through the school day and provide the extra energy and nutrients they need.

Avoid the trap of filling your child’s lunchbox with items such as chips, cookies, chocolate bars and soft drinks that are high in saturated fat, salt and sugar and offer little nutritional value. These foods are known as ‘extra’ or ‘occasional’ foods and while they can be included in a healthy diet they should not be eaten on a daily basis.

A few tips for healthy lunchbox snacks: Keep it small – there should be just enough to get kids through until their next meal, not a meal themselves.

Make it nutrient rich – use this opportunity to get extra nutrients into your child’s diet, such as calcium, vitamins, minerals and fiber.

Think like a kid – choose snacks that kids can eat easily without too much fuss, that way they are more likely to eat them!

Need some ideas? Here are just a few healthy, simple and fun-to-eat-snacks: • Fruit and cheese ‘kabobs’ (on a skewer, alternate cheese cubes or shapes with various varieties of fruit)

BACK TO SCHOOL & CONCUSSIONS With back to school time right around the corner, comes the increased risk of concussion— through school activities and sports. If you suspect your child has suffered a concussion, you should seek immediate medical attention. Watch out for some of these danger signs: • One pupil (the black part in the middle of the eye) larger than the other • Drowsiness or cannot be awakened • A headache that gets worse and does not go away • Weakness, numbness, or decreased coordination • Repeated vomiting or nausea

• Pretzel rods and cream cheese

• Slurred speech

• Carrots and ranch dressing

• Convulsions or seizures

• Avocado spread on whole wheat toast • Watermelon cubes mixed with feta cheese • Plain yogurt with frozen berries • Ants on a log (celery, *peanut butter, and raisins) *for school lunchboxes, substitute cream cheese or cottage cheese for peanut butter

• Difficulty recognizing people or places • Increasing confusion, restlessness, or agitation • Unusual behavior • Loss of consciousness (even a brief loss of consciousness should be taken seriously) Source: www.cdc.gov

Prostate Cancer by the numbers:

prostate cancer is the most common cancer in American men.

Other than skin cancer,

The American Cancer Society’s

estimates for prostate cancer in the United States for 2015 are:

220,800 new cases of prostate cancer

and

27,540 deaths

from prostate cancer About one in seven men will be diagnosed with prostate cancer during his lifetime.

Prostate cancer is the

second leading cause of cancer death in American men, behind only lung cancer.

Approximately

one

in

38 men will die of

prostate cancer.

Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.9 million men in the U.S. who have been diagnosed with prostate cancer at some point are still alive today.

Source: American Cancer Society, www.cancer.org

August is National

Immunization Awareness Month!

August is National Immunization Awareness Month—and, it’s also ‘Back-to-School’ month for many students. Did you know that in 2006, the Virginia General Assembly passed a law which requires ALL 6th grade students to have a Tdap booster prior to entry into school, unless there is documentation of receipt of a dose of Tdap booster after age seven?

***** Looking for a new ‘smoothie’ recipe? Check out this app—

SIMPLY SMOOTHIES— available for $.99 on iTunes.

The Simply Smoothies App allows you to be the chef and helps you create custom smoothie recipes.

Select the liquid base, types of fruit and/or veggies, the protein source and any fun add-ins, and it does the work. It also calculates the perfect amount of each ingredient, plus the nutritional info for your creation and voila, you have the perfect smoothie!

*****

Fig Tree 5K

Fig Tree Therapy is a group of mental health clinicians dedicated to ministering to the mental health needs of individuals and families. This year, they are holding their first 5K in support of Richmond Autism Integrated Network. R.A.I.N. is an organization that offers fun, skilled-based activities to give children with autism the tools they needs to better understand and navigate the often confusing and inconsistent world around them.

Date: Saturday, September 19, 2015 Time: 8:00 a.m.

Location: 4901 Lake Brook Drive Glen Allen, VA 23060 To register, visit the Richmond Road Runners Club at www.rrc.org. www.OurHealthRichmond.com

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The Anatomy Challenge is

the

proudly sponsored by

Anatomy

CHALLENGE How much do you know about the

Mouth? First, complete the

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

[ the Amazing Mouth ]

WORD SEARCH Central Incisor

Top Lip

Right Tonsil

Lateral Incisor

Hard Palate

Left Tonsil

Canine

Orapharynx

Tongue

Premolars

Soft Palate

Bottom Lip

Molars

Uvula

For answers, visit OurHealth

____________________

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Richmond's Facebook page at

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With more than 10 locations in Greater Richmond to serve you.

Huguenot-Bon Air • 794.9789 | West End-Staples Mill • 672.4900 | Atlee-Ashland Midlothian-288 • 379-1011 | Tri-Cities • 526.4822 | Ironbridge-Courthouse Powhatan • 598.3000 | Short Pump • 364-7010 | Mechanicsville-Hanover Brandermill-Woodlake • 739.6500 | Chester-Rt. 1/Rt. 10

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550.3324 743.8166 730.3400 751.0300 www.OurHealthRichmond.com

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ALL

words | EDWIN SCHWARTZ

ABOUT the BITE Examining how orthodontists

care for your teeth and jaws

Misaligned teeth is a condition orthodontists call malocclusion.

Left untreated, it can cause periodontal disease and create unusual amounts of stress on teeth and jaws. To learn more about the types of malocclusion conditions, OurHealth spoke with the experts at Virginia Family Dentistry.

Malocclusion, or misaligned teeth, is the most common condition treated by orthodontists. These professionals receive an additional two to three years of specialized training beyond dental school to learn how to align and straighten teeth.

Malocclusion may impact periodontal health because plaque is more difficult to remove when teeth are not aligned. If left untreated, it may cause periodontal (gum) disease and premature wear of teeth. Periodontal disease may also increase the risk for hardening of the arteries.

According to Rick Marcus, DDS, an orthodontist with Virginia Family Dentistry, all orthodontic problems are skeletal (jaw-related) or dental (teeth-related) in nature.

Most are a combination of the two.

Treatment plans are individualized and vary according to the patient’s age, the severity of the condition and the cause of the misalignment.

Typical malocclusion conditions include overbite, underbite, crossbite, open bite, misplaced midline, spacing and crowding.

Overbite

Richard Marcus, DDS, MS is an orthodontist at Virginia Family Dentistry. He serves patients in both the Atlee and West End locations of Virginia Family Dentistry.

This term, not to be confused with an overjet, describes the condition where the lower teeth are far behind the upper teeth. An excessive overbite can promote wear of the front teeth, and, in severe cases, it may damage the gum tissue behind the upper teeth.

With an overbite, or deep bite, the lower teeth often remain unseen due to the overlapping upper teeth. The lower front teeth may also experience premature wear and chipping.

Treatments may include braces, tooth extraction, Invisalign™ or a growth modification device. Orthodontists use growth modification devices (appliances) to change the shape, position, length or width of the jawbone. An example is the Herbst appliance, which attaches to the upper and lower molars to correct overbite caused by a small lower jaw.

The benefits of correcting orthodontic problems Well-aligned teeth have significant oral health benefits because they are easier to clean, function better, are less likely to decay and are less susceptible to chipping and wear.

And the cosmetic changes can be beneficial as well.

“Improving one’s smile can give a big boost to self-confidence and self-esteem and can have a positive life-long impact on one’s emotional well-being,” says Allison Purcell, DDS, also an orthodontist with Virginia Family Dentistry.

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How Invisalign™ Works Invisalign™ is an orthodontic device that uses transparent, incremental aligners to straighten teeth.

Simple, nearly invisible plastic aligner trays are worn over the teeth as they are gradually moved into position.

A new set of aligners—slightly different from the last— is provided every two weeks until the treatment is complete.

“Invisalign™ can create results with the same quality of braces—and often faster,” says Dr. Marcus.

Underbite An underbite occurs when the lower teeth are in front of the upper teeth. An underbite is usually caused by undergrowth of the upper jaw, overgrowth of the lower jaw or a combination of the two. Left untreated, an underbite can cause chewing problems and uneven wear of the teeth.

Treatment may include growth modification of the jaws at an early age, tooth extraction or surgical jaw correction.

Crossbite Crossbite occurs when the upper teeth fit inside the lower teeth in the back. A narrow or V-shaped upper jaw causes this skeletal condition. A crossbite can cause premature wear of teeth, asymmetrical jaw growth and difficulty chewing.

If the patient is still growing (typically 8 to 12 years old), a crossbite can be corrected with a painless expander. If growth has ended, surgery is required to alter the upper jaw width and correct the misalignment.

Open bite Allison Purcell, DDS is an orthodontist at Virginia Family Dentistry. She serves patients in both the Irongate and Mechanicsville locations of Virginia Family Dentistry.

This occurs when the teeth do not overlap in the front, or the front teeth do not meet the bottom teeth. Certain jaw growth patterns and thumb or finger sucking may be the cause.

An open bite may produce wear on the teeth that do not meet, speech problems, tongue thrusting habits and eating problems. For example, it may be impossible to bite into pizza or tear lettuce.

Recommended treatment depends on multiple factors and can include growth modification using braces, tooth extraction, Invisalign™ or surgical jaw correction.

Misplaced midlines The midline is an imaginary vertical line that divides the left and right sides of the mouth. A misplaced midline occurs when the upper midline and lower midline do 24

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How overjet differs from overbite An overjet and an overbite are often confused with one another, but they are different types of malocclusion. With an overbite, the upper front teeth reach too far down over the lower front teeth.

An overjet occurs when the upper front teeth are pushed outward, often called buck teeth.

This can be caused by an improper alignment of the molars, a protrusive upper jaw and deficient lower jaw, flared upper incisors or a combination of all three.

An excessive overjet can prevent proper functioning of the front teeth, keep the mouth from closing properly and leave the upper teeth more susceptible to trauma.

Treatment may include growth modification using a functional appliance, tooth extraction or jaw surgery.

not align and can be dental or skeletal in nature. Dental causes are relatively easy to correct, but skeletal ones can be more difficult.

Dental causes may include crowding, excessive spacing or missing teeth, which would require braces or Invisalign™ to correct. A misplaced midline caused by asymmetric jaw growth could require jaw surgery.

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Spacing What makes Virginia Family Dentistry unique “Because we have general dentists and other specialties in-house, it makes the referral process easier and more streamlined,” says Dr. Marcus. “For example, I can simply walk down the hall to find out what the dentist needs from me instead of making the patient run all over town.”

“To ensure the best treatment, we consult each other to provide a multidisciplinary approach to our patients’ orthodontic and dental care,” says Dr. Purcell. “Also, having four other orthodontists to discuss orthodontic patient cases when needed is an invaluable resource.”

Spacing is an excess of space, or gaps, between a patient’s teeth.

This condition usually occurs when the teeth are smaller than the available space. These gaps may be reduced with braces or Invisalign™.

If an orthodontist does not want to close a space, a dentist will use an implant (or bridge) to replace a missing tooth. The orthodontist then makes sure the space is appropriate in size and space for the dentist to do the job properly.

Crowding This condition occurs when there is not enough space for the teeth to fit properly within the jaws or when the teeth are larger than the available space. Crowding can make it difficult to adequately clean teeth surfaces and can increase the risk of gum disease and tooth loss.

Treatment includes braces or Invisalign™. Extractions are only necessary in severe cases or if teeth protrude.

Orthodontists treat patients of all ages The American Association of Orthodontists recommends that 7-year-olds have an orthodontic evaluation. This is designed to determine when to begin treatment and to identify any conditions to be addressed before all permanent teeth are in.

“Bring your child to an orthodontist to determine the best time to begin treatment,” advises Dr. Purcell. “The evaluation can give you peace of mind that orthodontic treatment can wait and can help you plan for the future if it is needed.”

But it is never too late to consider orthodontic treatment. Both Dr. Marcus and Dr. Purcell have treated patients in their 70s and 80s.

Expert contributors: • Richard Marcus, DDS, MS, with Virginia Family Dentistry • Allison Purcell, DDS, with Virginia Family Dentistry

Steel Horse Harley-Davidson • 11501 Hull Street Road • Midlothian, VA 23112

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words | DIANE YORK

Back to school means meeting new teachers, new classmates, school supplies, clothes, choosing sports and so much more!

This time of year can generate a lot of anxiety in parents and kids. While all of these things are important, perhaps the most important element is your child’s health. Parents have so many questions about their children’s health and the return to school.

Will my child need shots? What’s the difference between a physical exam and a sports exam? How do I tell if he is too sick to go to school? Might she have a vision or hearing problem?

There’s just so much to deal with.

Reprints To order reprints of the original artwork featured on this issue’s cover, contact Deidre Wilkes at 540.387.6482 or via email at

To help you and your children start the school year with less stress and the right information, OurHealth asked parents what they most want to know before sending their children back to school. Then they asked the experts for feedback. Local doctors, counselors, nurses, and other professionals have provided answers to some of the most important questions you may have at this time of year.

deidre@ourhealthvirginia.com.

To view additional work by our artist, Joe Palotas, visit www.salemartcenter.com

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My son was diagnosed with a growth plate fracture after a football injury. What does that mean?

H. Robert Tuten, MD

Pediatric Orthopaedics Tuckahoe Orthopaedic Associates Richmond | 804.285.2300 www.tuckahoeortho.com

At the ends of our bones, we have growth plates. These allow the bones to grow normally over time. The level of concern with a growth plate fracture is directly related to the location of the fracture. Some growth plate fractures do very well in certain locations, others do not. If your son or daughter has a growth plate fracture, it should be evaluated by a pediatric orthopedic surgeon who has extensive knowledge in how to treat these and what the future may hold for these fractures. Some growth plate fractures need close follow up over time to make sure the limb does not grow crooked or short. Children tend to be resilient after injuries but fractures near the elbow, knee and ankle are especially notorious for causing problems after a growth plate fracture.

What is the HPV vaccine, and should I consider it for my teenage daughter who is not yet sexually active?

Human papillomavirus (HPV) is a common virus that is mainly spread through sexual contact. Often, HPV has no symptoms so many people don’t know they have it. Certain high-risk types of HPV are associated with an increased risk for developing cervical cancer. Other so-called low-risk types can cause genital warts. In females, the newest version of the HPV vaccine— Gardasil 9—helps protect against the nine strains of HPV that can cause 90 percent of cervical cancers and 90 percent of genital warts cases.

Sara I. Sarraf, MD

Virginia Women’s Center Midlothian |804.288.4084 www.VirginiaWomensCenter.com

Gardasil 9 is recommended for girls and young women ages 9-26 and boys ages 9-15.

Because the vaccine is most effective in individuals before they become sexually active, I highly recommend it for your daughter, even if she is years away from sexual activity. We’re very fortunate to have a vaccine that can actually help prevent cancer.

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My teen is listening to music with ear buds for long periods of time, should I be concerned?

According to the CDC, approximately 12.5 percent of children and adolescents aged 6-19 years have noise induced hearing loss (NIHL). NIHL is caused by exposure to loud sounds (either sudden or long term) that damage the inner ear’s sensory hair cells. Once damage is done, it cannot be reversed and results in permanent hearing loss.

NIHL is 100 percent preventable.

The first step is limiting exposure to loud or uncomfortable sounds. If you are around noise, hearing protection is essential. For teens in bands or that attend concerts, custom-molded musician’s plugs can protect hearing while allowing them to safely enjoy the music.

If they regularly use music players and earbuds, and you can hear their music, it’s too loud. According to the American Academy of Audiology, the maximum volume level on players is 100 decibels; which exceeds the 85 decibel threshold for safety.

Kidzsafe™ volume limiting earbuds are a good alternative way to enjoyably listen to music.

Sarah Severs, AuD, CCC-A Virginia Ear Nose & Throat Richmond | 804.484.3700 www.virginia-ent.com

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My daughter has been diagnosed with strep throat four times in the past year. Should we consider having her tonsils removed?

David R. Salley, MD

Virginia Ear Nose & Throat Richmond | 804.484.3700 www.virginia-ent.com

There is no doubt that dealing with strep four times in a year is trying. The doctor visits, antibiotics, and discomfort can be extremely difficult and it may be tempting to think it is time for a surgical consultation to discuss tonsillectomy. However, the textbook recommendation for tonsillectomy requires seven cases in a year, five a year for two years, or three a year for three years. If a child has four episodes in six months, we may consider surgery as well. The reason for this is that recovery from tonsillectomy is quite difficult and lasts for two weeks. There is a small risk of bleeding that could result in a trip back to the operating room. There is need for a soft diet for the entire time and narcotics are sometimes necessary for pain control.

In short, don’t be too quick to want an operation with a very difficult recovery for a problem which will sometimes resolve on its own.

My child suffers from frequent ear infections. Should I be concerned about possible hearing loss, and how often should I have his hearing screened?

While there have been reports of permanent hearing loss after a bout of otitis media, in reality that risk is very low. The main hearing loss that comes from middle ear infections is due to the fluid behind the ear drum. This hearing loss is transient and will resolve once the infection is treated and the fluid clears.

Thomas C. Robertson, MD

Virginia Ear Nose & Throat Richmond | 804.484.3700 www.virginia-ent.com

The academy of otolaryngology recommends putting tubes in the eardrums if a child has more than four infections within six months. Usually if a child has had that number of infections, your ear, nose, and throat surgeon will do a hearing test prior to surgery. These tubes stay in the eardrum for a year or so and will decrease the number of infections during the time they are in. If a child does have an infection, it usually makes treating the infections easier since they can be treated with topical antibiotic drops.

Is it necessary to bring my child in for a ‘well-visit’ check-up every year, if she is in overall good health?

The Academy of Pediatrics recommends 11 well visits within the first two years of life, coordinated with the primary childhood immunization schedule. Those recommended visits are suggested at birth, two weeks, one, two, four, six, nine,12, 15, 18 and 24 months of age, respectively. Most parents are aware of these requirements and are consistent with fulfilling each visit. It is also recommended, however, that children complete well visits with each annual year until the age of 18-21. Annual examinations help to establish each patient’s baseline physical findings, and the interviews help to determine if there are ‘red flags’ in their behaviors. Each annual visit allows parents and young patients an opportunity to discuss their health concerns with a nonemotionally attached expert. Trusting relationships can be created and maintained, fulfilling the goals of great preventive care.

My teen has acne, what the best way to lessen the effects?

Acne is common in teens. Puberty hormones play havoc on skin. A few steps can lessen the effects of teen acne. hh Wash gently twice a day with warm water and mild soap.

hh Exfoliate no more than weekly.

Erin G. Adams, MD

Dominion Dermatology, PC Glen Allen | 804.262.6060 www.dominiondermatology.org

hh Look for noncomedogenic, sunscreen containing moisturizer. hh Makeup should be oil-free and noncomedogenic. Never sleep in makeup.

hh Wash hair at least every other day, and avoid greasy/oily hair products. hh Avoid touching your face with phones or hands. hh Wash pillowcases often.

hh Limit high glycemic index foods like chocolate, white bread and pasta and instead incorporate fruits, vegetables and whole grains into your diet. Drink about eight glasses of water per day. hh Minimize stress with adequate sleep and exercise.

For more severe acne, medicated washes, antibiotics and other topical products may be prescribed by a dermatologist. It is important to treat acne early to avoid scarring and its negative effect on self-esteem.

Carol Williams MD, FAAP Bon Secours Hanover Pediatrics Richmond | 804.559.7280 www.richmond.bonsecours.com

What are some good food ideas to include in my child’s lunch box that won’t spoil and are not heavy in sodium and preservatives?

Making meals fun and interesting is a great opportunity for kids to try new and healthy foods. hh Sick of the same old sandwich? Try a whole wheat quesadilla with cheese, chicken and veggies or make an english muffin pizza. Mock “sushi” rolls are also a great way to present healthy food in a fun way. Other packable proteins include hummus, pistachios, deviled eggs and edamame.

Ashley Cappel, RD

Children’s Hospital of Richmond at VCU Richmond | 804.828.2467 www.chrichmond.org

hh For side items, toss the sugar and sodium filled processed foods and try more filling and nutritious options like snow peas with guacamole or bean dip. Make your own “chips” by tossing kale or thinly sliced sweet potatoes in olive oil before baking them. hh If you’re worried about fruit spoiling or getting smashed, try packing a nutritional punch with a homemade frozen smoothie that will thaw by lunch time.

Should I have my child fitted for a custom-made mouth guard to wear during gym class or when participating in sports?

Sports-related dental injuries and trauma are unfortunately a frequent occurrence.

Although some sports-related dental injuries are unavoidable, most can be prevented. The use of a mouth guard William O. Dahlke, Jr., DMD has repeatedly been shown to reduce Children’s Hospital of the incidence of orofacial and Richmond at VCU dental injuries. The very best Richmond | 804.828.9095 option is a customwww.chrichmond.org made mouth guard fitted by a dentist.

Boil and bite mouth guards are available at sporting goods stores and can sometimes be an acceptable and less expensive alternative. Generally, we do not recommend stock style mouth guards because they are held in place by clenching the teeth, but for some children with orthodontic appliances, this may be the only option available.

Parents should speak to their child’s dentist to learn about the most appropriate option for their child.

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Is it still possible for my child to get chicken pox, even if he has been vaccinated?

The chicken pox vaccine is approximately 85 percent effective after one dose, and 98 percent effective after receiving the second dose. This protection is long lasting, and studies have shown great protection at least 10 years after series completion. The vaccine is quite effective, though it is still possible to see chicken pox in vaccinated individuals (about 2 percent). Those that do get chicken pox, tend to have very mild cases with few complications. Also, those receiving chicken pox vaccine are less likely to get shingles (a reactivation of chicken pox virus). Chicken pox vaccine is a great example of an effective vaccine that has significantly decreased the incidence, morbidity and mortality associated with what was once a common disease.

Peter Heyman, MD

RVA Pediatrics, PC Midlothian | 804.379.5437 www.rvapediatrics.com

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During the summer, my kids don’t follow any type of bedtime schedule or routine and often stay up late. What’s the best way to get back to a bedtime schedule that will prepare them for the start of the school year and ensure they are getting enough sleep?

Insufficient sleep is fairly common in children particularly among adolescents.

Adolescents have a natural night-owl tendency that is often exaggerated during the summer break.

The use of electronic gadgets with bright screens has a significant negative impact on our sleep pattern. Adolescents have a heightened response to circadian phase delaying effects of night time light exposure and this can further delay their sleep phase.

M. Taruj Ali, MD

Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com

Caffeine intake is another factor that may impact adolescent sleep pattern.

The following measures might help: hh Establish a bedtime routine; warm shower, reading, relaxing or listening to soft music hh Institute an earlier bedtime gradually starting a few days before start of the school year hh Turn off all electronic devices at least 1 hour before bedtime hh Avoid caffeine intake after lunchtime

hh Avoid heavy exercise just before bedtime

hh Keep a consistent sleep schedule and avoid naps. If you must nap limit it to 30 minutes or less

How often should my child have a dental ‘well visit’?

The answer to this question has changed a bit over time. We used to say every child should visit the dentist twice a year.

The current thought is more specific to your child’s history of tooth decay or other dental problems, such as teeth crowding. If your child has a history of cavities, your dentist may recommend more than twice a year; however, if your child has no history of tooth decay, once a year may be fine. There are other factors that can influence your dentist’s recommendations, so be sure to bring your child in as soon as their first tooth appears and have the discussion with your dentist.

Joseph Dill, DDS, MBA

Vice President Professional Services Delta Dental of Virginia www.deltadentalva.com

My child always tells me everything is “fine” when I ask about his day at school or daycare. How do I get more out of him?

Think about how often you answer that question the same way. Perhaps you answer absent-mindedly, not wanting to truly review your day, or perhaps you just don’t take the question seriously. Our children also respond in similar ways. Your strategy as a savvy parent is to ask the same question in other ways, ways which solicit more direct information. You may say, “Tell me about your teacher,” “Who do you sit with at lunch?”, or “How was your day on a scale of 1-10?” and, “Why?” Accompanying comments such as “I like hearing about your day,” and follow up comments from your child’s answers to the previous day’s questions help, too. You just may learn some things about your child, even give him a forum for any worries or concerns he may not know how to introduce himself. Show your child, by your example, how to connect through conversation.

Karen Rice, LCSW

Virginia Home for Boys and Girls Henrico | 804.270.6566 www.vhbg.org

While this information may have answered many of your questions, you may want to schedule a back to school physical to give you (and your child) the opportunity to get more answers from your pediatrician or other medical professional. The American Academy of Pediatrics recommends that every child have a yearly physical exam and suggests that just prior to the return to school is a good time for that exam. Many studies show that your child’s health will affect his ability to learn.

A back to school physical can help identify and treat problems such as: hyperactivity, sleep disorders, vision or hearing problems, swings in blood sugar from prediabetes, diabetes or hypoglycemia (low blood sugar) and other disorders. For teens especially, adolescence is a time when important changes are taking place physically and mentally. Back to school physicals can help identify and treat physical or mental health problems and can be the most important part of your plan to help your child ensure academic success. Knowing that you have done the best you can to improve your child’s health will help both of you relax and enjoy the new school year!

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ADA

GARDEN PARTY

American Diabetes Association The Central Virginia American Diabetes Association held its Garden Party Diamond Gala on May 29 at the historic John Marshall ballroom in downtown Richmond. The event celebrated the Association’s 75th year as the leader in discovery, innovation and progress to improve the lives of people with diabetes through research, education and advocacy.

The nearly 200 participants and volunteers found a number of gems at the Gala’s Silent and Live Auctions. Kat Simons, the Music and Public Affairs Director at Lite 98, kept the evening’s events moving along. The Association’s Corporate Leadership Award was given to the Bon Secours Richmond Health System and was accepted by Peter J. Bernard, CEO of Bon Secours Virginia. The Distinguished Health Professional Award was presented to Jay S. Schukman, MD, MSc, the Regional Vice President and Medical Director of Anthem Blue Cross and Blue Shield, Virginia and past President of the Association’s Community Leadership Board.

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Photos courtesy of the American Diabetes Association

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One man’s

POSITIVE JOURNEY with prostate cancer

‘I like to live’ words | SUZANNE RAMSEY

Chris Lee could make a good case for being unhappy. Diagnosed with stage 4 prostate cancer in 2010—news he received on his 20th wedding anniversary, no less—the 53-year-old from Colonial Heights could have just hung it up and given in.

But that’s just not Lee and not how he lives with prostate cancer.

“Attitude is just so important, being optimistic,” says Lee, operations manager for a local furniture store. “You can’t let things weigh you down. You can give in to it, or you can stand up and fight and tell [cancer] you’re going to win. You must have a good attitude and believe that everything’s going to be OK. I really think that if I didn’t, I’d be dead right now.”

In February 2010, Lee made an appointment with his primary care physician.

He’d been having what he describes as “body aches” and says his left thigh was hurting and wouldn’t stop.

Attributing the pain to a cholesterol medication he’d been taking for a couple of months, Lee hoped his physician would just change up his meds and send him on his way. Instead, the doctor wanted to check Lee’s prostate specific antigen, commonly known as PSA. Lee says that when the results came back, the number was extremely high.

More testing followed, and on May 5, 2010, when he was just 48 years old, Lee received a devastating diagnosis.

“A lot of things back then are a blur to me,” says Lee. “I just remember [the urologist] basically telling me I had metastasized—stage 4 prostate cancer, and there was no cure.”

Lee eventually learned that the cancer had spread from his prostate to his spine and throughout his body. Tumors were found on three vertebrae, which deeply troubled his physicians.

“They were worried that my spine was literally going to collapse like a stack of boxes,” Lee says. “One at the bottom falls, and the rest of them fall. That’s basically where I was.”

Christopher is thankful to be able to see his oldest daughter off to her prom, and graduate high school.

(From left) Daughter Taylor, Martha, oldest daughter Laura Beth, and Christopher.

Lee and his wife of 25 years, Martha Lee, met with an oncologist to discuss their options. In the end, they opted for an “extremely aggressive” plan. He had radiation treatments—14 over three weeks—to shrink the tumors on his vertebrae.

He also began hormone therapy.

Staying the Course Five years later, Lee is in clinical remission, meaning his cancer is undetectable.

What is prostate cancer?

Prostate cancer is a cancer that occurs in a man’s prostate—a small, walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm.

Source: WebMD

“Personally, I feel better than most people I know,” he says. “I don’t have aches and pains. My feet hurt a bit, but I’m in retail, I understand that. Other than being chemically castrated, but that’s nothing compared to not living. I don’t have the endurance I used to have, and I’m not nearly as strong as I used to be, but I’m still very active. During this whole process, other than going to the doctor, I’ve missed a day and a half of work.”

When asked what he likes to do these days when he’s not working, Chris says, without sarcasm or bitterness, He’s active in his church, Swift Creek Baptist in Colonial Heights, where he teaches the young adult Sunday school class and sings in the choir.

“I like to live.”

Lee also spends a lot of time with his wife, Martha Lee, who calls her husband “my best friend.” She has accompanied him to every medical appointment. In fact, they’ve spent so much time together since their first date 26 years ago that Lee says he feels “weird” if she’s not around.

“It’s so nice,” he says. “I hear other people talking about their spouses or not wanting to go home, and I just don’t get that. We have a really good, very strong marriage. The absolute easiest thing I’ve ever done is to be married to my wife.”

Apparently the feeling is mutual. “I just want to say, I thank God every day for him,” Martha Lee says.

The Lee’s two daughters have also been a great source of support, telling Lee on the worst of days, “Dad, you’re going to be alright. This is going to be OK.” Timothy J. Wallace, MD, PhD, is a radiation oncologist with Radiation Oncology Associates, a Division of Virginia Urology, and treats patients at Bon Secours Cancer Institute at Reynolds Crossing. He is certified by the American Board of Radiology.

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Over the past five years, friends from church have mowed the grass and tackled home maintenance projects with an enthusiasm that took a little getting used to at first.

“My church has been utterly phenomenal with support,” Lee says. “The entire time, it’s been, ‘How can we help you? What do you need?’ The hard part on our side was

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learning to let people do things for us. We realized if they don’t get to help you, they miss out on the blessings of helping you.”

Perhaps more than anything, Lee credits his faith with helping him cope with having cancer.

“I have a very strong faith. I really do,” he says. “I don’t know how people make it through the day without having the hope that the Lord gives us. My faith was strong before this. It’s even stronger now. This gives you a totally new perspective on life.”

As part of that faith, Lee clings to Bible verses with positive messages, such as Romans 8:28, which states, “And we know that all things work together for good to them that love God, to them who are the called according to his purpose.”

“Somehow, some way, it’s going to be for the good,” Lee says.

He also believes in miracles.

Looking back at the day he was diagnosed, Lee admits he was stunned and “in disbelief” but says, “I never have and still don’t believe it’s going to take me away from here. I believe in miracles, and I believe I am one.”

What is metastatic cancer?

Metastatic cancer is a cancer that has spread from the part of the body where it started (the primary site) to other parts of the body. When cancer cells break away from a tumor, they can travel to other areas of the body through the bloodstream or the lymph system (which contains a collection of vessels that carry fluid and immune system cells).

Source: American Cancer Society

The Power of the Positive Physicians agree that having a good attitude goes a long way when dealing with a chronic or life-threatening illness.

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What are symptoms of prostate cancer?

Early prostate cancer usually causes no symptoms, but more advanced prostate cancers can sometimes cause symptoms such as • Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night.

• Blood in the urine.

• Trouble getting an erection (erectile dysfunction).

• Pain in the hips, back (spine), chest (ribs), or other areas from cancer spread to bones.

• Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord.

Source: American Cancer Society

“It’s absolutely vital for many reasons,” says Timothy J. Wallace, MD, PhD, medical director of Radiation Oncology Associates in Richmond. “For one, an attitude like that is contagious. If you have a positive attitude, your caregivers are going to play off that. You will see caregivers and families with positive attitudes, and you’re going to feed off that. It’s a healthy approach to terminal cancer.”

The reality, however, is that having cancer is depressing. Even if it doesn’t change the outcome, Dr. Wallace sees value in what Norman Vincent Peale called, “The Power of Positive Thinking.”

“In my experience, it makes a difference,” Dr. Wallace says, adding, “It’s not going to cure your cancer, but it will certainly make the day to day more rewarding, in my opinion.”

With regard to the importance of religion or faith in this kind of situation, Dr. Wallace says believing in something seems to make a difference.

“Personally, I think faith is all part of that positive attitude,” he says. “I think faith is vitally important, but that’s a very personal part of that journey. People who are religious, many people, would say it’s the most important thing. Their faith is more important than anything in getting them through this.

“People who aren’t necessarily religious I think in some way find something,” Dr. Wallace continues. “If it’s not God, it’s faith in something else. Everybody put in this situation tries to have faith, wants to have faith, even needs to have faith. I think it’s very important, whether or not you’re religious. Faith and spirituality play a part in any life-altering illness.”

Who’s at Risk?

According to the American Cancer Society, “other than skin cancer, prostate cancer is the most common cancer in American men.” The organization also estimates that in 2015 approximately 220,800 U.S. men will be diagnosed with prostate cancer and about 27,540 will die from the disease. The ACS says 1 in 7 men will be diagnosed with prostate cancer at some point in his life.

African Americans are at even greater risk. The Prostate Cancer Foundation says that “African American men are more likely to develop prostate cancer compared with Caucasian men and are nearly 2.4 times as likely to die from the disease.”

Funded by a two-year grant from the National Institutes of Health, Dr. Wallace is studying that issue.

“It’s a different disease,” he says. “It tends to affect African Americans at a younger age and more aggressively. We’re looking at the tumor-mediated immune responses— how your body reacts and attacks the cancer—postulating that African American men’s immune system responses are different than their Caucasian counterparts.”

Physicians say heredity also plays a role in prostate cancer. Lee’s father died 22 years ago—at age 63—from prostate cancer. Lee was diagnosed in his late 40s. That he was diagnosed at such a young age is notable and seems to be in keeping with the hereditary link.

“One first-degree relative, father or brother, with prostate cancer increases your risk two fold,” Dr. Wallace says. “If you have two first-degree relatives, father and brother, it increases your risk five fold. Three first-degree relatives increase your risk 11 fold.

There’s a direct link. That’s really the key.

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What is hormone therapy?

Hormone therapy for prostate cancer is treatment to stop the male hormone testosterone from reaching prostate cancer cells. Hormone therapy for prostate cancer is also called androgen deprivation therapy.

Most prostate cancer cells rely on testosterone to help them grow. Hormone therapy (which can be given in the form of an injection) for prostate cancer cuts off the supply of testosterone or stops testosterone from reaching the cancer cells, causing cancer cells to die or to grow more slowly.

Source: Mayo Clinic

“It means a lot more to me, as a physician and as a prostate cancer specialist, when someone comes to me and says, ‘My brother was diagnosed when he was 40,’ as opposed to, ‘My father and grandfather were both diagnosed in their 80s.’ Age has something to do with it for sure. The more-hereditary prostate cancers tend to hit people at a younger age.”

Early prostate cancer symptoms are often non-existent or might be explained away as something else, particularly benign prostatic hyperplasia.

“As it progresses, that’s when it really becomes symptomatic: bone pain, blood in the urine, pain in ejaculation,” Dr. Wallace says. “When prostate cancer becomes symptomatic, it’s in all likelihood spread or become locally advanced.”

Screening for prostate cancer is easy—a digital rectal exam and a simple blood test—but early detection appears to be key to survival. According to the American Cancer Society, the fiveyear survival rate for patients with prostate cancer that has not spread beyond the prostate, or that has only spread to what it describes as “nearby areas,” is nearly 100 percent.

For those with “distant stage” cancers, meaning the cancer has spread beyond the prostate to lymph nodes, bones or other organs, that number drops to 28 percent.

Unfortunately, prostate cancer screening also is controversial, with some researchers claiming it does more overall harm than good.

For example, the U.S. Preventative Services Task Force, which describes itself as “an independent, volunteer panel of national experts in prevention and evidence-based medicine,” concluded in 2012, “there is moderate certainty that the benefits of www.OurHealthRichmond.com

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What is benign prostatic hyperplasia?

Prostate gland enlargement, also called benign prostatic hyperplasia, is common as men get older. It can cause bothersome urinary symptoms.

Untreated, prostate gland enlargement can block the flow of urine from the bladder and cause bladder, urinary tract or kidney problems.

Source: Mayo Clinic

PSA-based screening for prostate cancer do not outweigh the harms.”

While he acknowledges the controversy, Dr. Wallace says he generally recommends that men start talking with their physicians about the pros and cons of prostate cancer screening at age 50.

“It’s important that men have discussions at the age of 50, but not necessarily have the screening,” he says. “Generally, 50 for Caucasian men with the annual digital exam and PSA. For African American men, we recommend that they start having discussions at age 45, or earlier if there are risk factors.”

Expert contributor: • Timothy J. Wallace, MD, PhD, with Bon Secours Cancer institute at Reynolds Crossing

Sources: • Mayo Clinic – www.mayoclinic.org • American Cancer Society – www.cancer.org • WebMD – www.webmd.com

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FITBITS

H EA LT H A ND F I T NES S O N THE GO

Couch to 5K

Have you ever dreamed about running in a 5K, but didn’t know where to start? The two most important things when training for a 5K are having a plan and a goal. The following chart gives you both!

This 10-week program culminates with the Great Pumpkin 5K in Glen Allen on Saturday, October 24, 2015.

The plan starts out with a lot of walking, and just short bouts of jogging. As you progress, there is more jogging, and less walking, until the final weeks when you’ll be done with walking altogether. Your final reward is completing the Great Pumpkin 5K! Invite family or friends to join you—this is great for accountability and camaraderie—as well as safety when running as a group.

For more motivation, go online at www.rrrc.org/events and register today for the race! Most races offer some type of ‘swag’ to registrants—t-shirts, goody bags, etc. Be sure to check for group pricing too, sometimes, there are discounts if you register as a group. *Consult with your physician/provider before beginning any new fitness program

Deidre Wilkes, AFAA, ACSM, Certified Personal Trainer Deidre is a certified personal trainer with more than 15 years experience in the health and fitness industry. She is the resident fitness specialist for OurHealth Greater Richmond

week

day 1

day 2

day 3

day 4

day 5

day 6

day 7

week 1

5 min walk 2 min jog 5 min walk

rest

5 min walk 2 min jog 5 min walk

rest

5 min walk 3 min jog 5 min walk

rest

rest

week 2

5 min walk 3 min jog 5 min walk

rest

5 min walk 4 min jog 5 min walk

rest

5 min walk 5 min jog 5 min walk

rest

rest

week 3

5 min walk 6 min jog 5 min walk

rest

4 min jog 5 min walk 4 min jog 5 min walk

rest

5 min walk 7 min jog 5 min walk

rest

rest

week 4

5 min walk 7 min jog 5 min walk

rest

5 min walk 8 min jog 5 min walk

rest

5 min walk 9 min jog 5 min walk

rest

rest

week 5

5 min walk 9 min jog 5 min walk

rest

6 min jog 5 min walk 6 min jog 5 min walk

rest

5 min walk 10 min jog 5 min walk

rest

5 min walk 11 min jog 5 min walk

week 6

5 min walk 11 min jog 5 min walk

rest

13 min jog 5 min walk

rest

15 min jog 5 min walk

rest

rest

week 7

15 min jog 5 min walk

rest

8 min jog 5 min walk 8 min jog 5 min walk

rest

16 min jog 5 min walk

rest

17 min jog 5 min walk

week 8

17 min jog 5 min walk

rest

18 min jog 5 min walk

rest

20 min jog 5 min walk

rest

rest

week 9

20 min jog

rest

12 min jog 5 min walk 12 min jog

rest

24 min jog

rest

25 min jog

week 10

25 min jog

rest

25 min jog

rest

30 min jog

race day!

celebrate! you did it!

HealthyEats

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Summer Beet Salad Serves: 2 Ingredients: 2 large handfuls Spring mix 1 cup cubed roasted beets tossed

in olive oil ¼ cup red onion 1/8 cup slivered yellow pepper ¼ cup feta 1/8 cup toasted almonds ¼ sliced cucumber

Dressing Ingredients: 1/3 cup Balsamic Vinegar 2/3 cup olive oil 1 tablespoon honey 1 teaspoon dill

Salt to taste

½ teaspoon garlic

Directions: 1. Put bed of greens on plate and assemble salad with beets on bottom.

2. Dribble with dressing. Enjoy!

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HealthyEats

proudly sponsored by

Good Foods Grocery

Eggplant Marinara with Quinoa Spaghetti Ingredients:

2

1

1 cup eggplant

1lb box of quinoa spaghetti

8 ounce cans of crushed tomatoes

½ cup olive oil (divided)

½ cup red pepper

2 cups minced onions

½ cup yellow pepper

1 tablespoon garlic

3 tablespoons fresh parsley 1 teaspoon oregano 1 teaspoon basil

Directions: 1. Cook quinoa spaghetti according to box directions and set aside 2. Sauté onions and garlic in 2 tablespoons of olive oil until onions are tender 3. Add 8 oz cans of crushed tomatoes to sauté pan and let simmer for an hour 4. Cube eggplant, red pepper and yellow pepper and toss with olive oil then roast at 375º for 14 minutes 5. Add roasted eggplant and peppers to the sauce along with parsley, oregano and basil 6. Simmer sauce another five minutes then put on top of pasta

Good Foods Grocery’s

EGGPLANT MARINARA

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HealthyEats

proudly sponsored by

Good Foods Grocery

Cranberry Orange Cupcakes (pink icing) Cupcake Ingredients:

Cupcake Directions:

1 cup turbinado sugar

1. Combine sugar, baking powder, salt, oat flour, all purpose flour and orange zest. Set aside.

1/3 teaspoon baking powder ½ teaspoon salt ½ cup oat flour 1¼ cups all purpose

Good Foods flour 1 tablespoon zest of orange ¼ cup egg replacer 1 tablespoon + ½ teaspoon ground flax meal 1

cup hot water

2. Combine egg replacer, ground flax meal, hot water and vanilla extract in a separate bowl. Set aside.

4. Combine all three mixes from steps 1-3 together.

Mix well.

Icing Ingredients: 1

cup Earth Balance buttery spread

5. Scoop cupcake batter into greased muffin tin. Fill muffin cups up two-thirds of the way.

1

cup powdered sugar

6. Bake at 350 degrees for 40 minutes.

¼ cup cranberry relish jelly

1½ teaspoons vanilla ¼ teaspoon salt

Icing Directions:

3. Combine safflower oil, almond milk and cranberry relish jelly.

1. Beat all ingredients in mixer until smooth.

2. Apply icing liberally to cooled cupcakes in any style you prefer.

½ teaspoon vanilla extract ¼ cup safflower oil

3. Top with a small dollop of cranberry relish jelly.

¼ cup almond milk ¼ cup cranberry

relish jelly

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words | TINA JOYCE

a special place

Nothing exposes deep emotion faster than an ultrasound during pregnancy. The unfamiliar initial static followed by the sound of tiny heartbeat rhythms fills a mother’s heart with anticipation and is remembered for a lifetime … ba-bump, babump, ba-bump. With similar intensity, a faint heartbeat, or a search for a missing one, can quickly evoke anxiety and fear.

Pregnancy is a 40-week physical and emotional journey. It’s a winding, hilly road filled with excitement and uncertainty for the parents-to-be.

Expectant mothers, even those with previous pregnancies, have different experiences with each child.

Jule Alston’s journey was no exception. Caring for two children and pregnant with her third, Alston’s pregnancy was progressing normally until about 24 to 25 weeks. An ultrasound revealed the baby wasn’t growing at a rate consistent with this stage of gestation. At first, there was no serious concern, but Alston’s physician ordered in utero testing to help determine a probable cause. Doctors tested for toxoplasmosis and fifth disease among other possibilities, but each test came back negative.

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www.OurHealthRichmond.com

53

Jule and Thomas Alston in their Henrico County home with children, Jamisen Monet Alston (age 3), Jada (13), and Tyler (8).

The pregnancy progressed until Alston’s 33rd week, when a faint fetal heartbeat sent her into the operating room at Bon Secours St. Mary’s Hospital in Richmond for an emergency cesarean section. Weighing only three pounds, Jamisen Monet Alston made her way into the world while her dad and siblings waited apprehensively.

“She is small, but she looks great,” doctors reassured the Alstons. Baby Jamisen was admitted to the neonatal intensive care unit at Bon Secours where she remained for 2 1/2 weeks. She underwent immediate testing to determine the cause of her slow development and low birth weight. Her biggest challenges appeared to be maintaining a constant body temperature—common for premature babies—and an apparent hearing loss.

Soon, however, blood and urine tests revealed that Jamisen had contracted the cytomegalovirus (CMV) in utero, causing her slow weight gain. CMV is a common virus (similar to chicken pox) that can affect anyone, but its symptoms are intensified when a fetus is infected. Unfortunately, CMV in utero can cause significant harm to an unborn child, with long-term health consequences that appear over time.

Valerie Bowman, MD, is a pediatrician with Bon Secours Developmental and Special Needs Pediatrics. She is certified by the American Board of Pediatrics.

Valerie Bowman, MD, a board-certified pediatrician with Bon Secours Medical Group, was assigned to care for Jamisen as soon as she was diagnosed with CMV. Dr. Bowman evaluated her shortly after birth and then periodically alongside Jamisen’s primary care pediatrician.

After the fourth week, the virus was no longer active in the baby’s tiny body, and she appeared to be progressing normally. However, as weeks passed, doctors began to see that Jamisen, now known as “Jami,” was facing additional challenges.

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“My advice to other families with similar challenges ... just take one diagnosis at a time,” Jule Alston recommends.

CMV caused calcification in her brain during development in addition to macular scarring. Jami was diagnosed with cerebral palsy that affects her left side and impacts both fine and gross motor skills. And she is completely deaf. The passing of time will likely reveal other long-term complications of the virus.

Once a secure CMV diagnosis was made, evaluations and assessments became routine. Physician recommendations began to overwhelm Alston and her husband, Thomas—physical therapy, occupational therapy, and future speech therapy—all in addition to routine wellchild checks. Jami’s health and long-term progress required constant attention.

“At one point, our regular pediatrician was honest with us and said we might want to find a specialist because he didn’t have experience with challenges as complex as Jami’s,” says Alston.

The Alstons found themselves with the burden of making life-altering medical decisions for their child while still meeting the daily needs of their other children and the demands of financially supporting their family.

Scheduling therapy appointments and seeing medical professionals at different locations became daunting.

Alston, who originally planned to return to work after a few months, found herself with a new full-time job— caring for a child with special needs.

“My husband’s job was flexible, but he is also in school, so trying to manage transportation for our other children, lengthy doctors appointments and follow-up appointments made it too demanding for me to return to work,” says Alston. www.OurHealthRichmond.com

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What is Cytomegalovirus?

Cytomegalovirus is a common virus that can infect anyone.

It typically remains dormant, and many people don’t realize they have the virus because it rarely causes symptoms.

People with weakened immune systems and pregnant women are at greatest risk for the virus to become active and produce symptoms.

• Infants with congenital CMV commonly have hearing loss and may have the following symptoms: • Yellow skin and eyes ( jaundice).

• Purple skin splotches, a rash or both.

• Small size at birth (or low birth weight).

• Enlarged spleen.

• Enlarged and poorly functioning liver.

• Pneumonia.

• Seizures.

So the Alstons were thrilled to learn that Dr. Bowman, in collaboration with Bon Secours, was planning to open a pediatric clinic designed to meet the needs of highrisk, medically complex children.

“When I found out Dr. Bowman was opening a clinic for children with special needs, I could have hugged her. She was exactly what we needed,” Alston says. “I can call her at any time. I don’t know what I would do without her.”

Bon Secours Developmental and Special Needs Pediatrics opened in January 2015. It focuses on providing easier accessibility, longer appointment times and specialized care (both acute and preventive) in one location.

Dr. Bowman is now the primary pediatrician at the clinic. Previously, she spent almost eight years in a Richmond pediatric emergency room, followed by 10 years in her own practice. When Dr. Bowman’s third child was born with special needs, she closed her practice to focus on her family’s needs and went to work for Bon Secours.

“I feel like when I call Dr. Bowman in a panic, she understands as a parent why I am worried, but as a professional, she knows what steps to take and when Jami needs to be seen. She is wonderful!”

The Need Is Great Primary care physicians manage many patients with a broad variety of needs. Families with a special needs child have unique circumstances and challenges. Although many pediatricians may be professionally equipped to assess children with special needs, their patient loads rarely allow for the extended time necessary to evaluate, treat and comfort families with a special needs child.

Bon Secours Developmental and Special Needs Pediatrics has committed to providing attention exclusively to high-risk children in a way that is unique to health care yet beneficial to special needs patients. This innovative approach to treating and serving special needs children and their families may operate as a model for other health care entities.

The need is great for high-risk specialty care. High-risk children may include those with medically complex needs, social complications, and/or financial challenges. “This care model allows health care providers to spend more time with each patient. Also, preventive care is done differently. There is a collaborative effort between a social worker, a nurse navigator, and the care coordinator in one facility, providing a family with a substantial support system,” explains Dr. Bowman. “Accessibility is key.”

In addition to resources available through Bon Secours, a psychologist will soon join the team of professionals at the clinic to help ensure patients receive collaborative medical care, in addition to providing lifestyle resources as needed, in one convenient location. According to Dr. Bowman, the team works to ensure that the special needs child receives individualized care that focuses on the complete wellness of the child, which includes the child’s medical, developmental/educational, psychological, and social needs.

What the Future Holds Advancements in technology and medicine occur daily. It’s vital for medical teams to work together to communicate options to patients as they become available. For example, Jami, now 3 years old, has been fitted with bilateral cochlear implants for hearing. “The implants help her tremendously,” says Alston.

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Bon Secours Developmental and Special Needs Clinic,

located inside Bon Secours St. Mary’s Hospital, offers a unique approach to pediatrics.

Its lead pediatrician, Valerie Bowman, MD, focuses exclusively on coordinating care for high-risk or medically complex children and their developmental needs. The clinic’s focus is to provide a support system with a social worker, nurse navigator, and psychologist collaborating on the best care for children.

Typical families may go through financial hardships, adjustments with employment, or lack of family support at times. However, families with a special needs child have an increased risk of financial instability, social isolation or family disruption.

According to Alston, her biggest challenge can be remembering to take care of herself. “Our other children, Jada, age 13, and Tyler, age 8, are really helpful, and I am so thankful for their kindness. Our son seems to be able to understand her the best,” she says.

“Jami can’t walk yet and doesn’t really speak. She can communicate, but it can be extremely exhausting trying to engage her in the right way. Plus, with her many therapy appointments, it’s hard not to feel isolated. It’s exhausting, but she’s worth it.”

Note: Primary care physicians and pediatricians can recommend patients to Developmental and Special Needs Pediatrics. For more information about the clinic and the patients who may benefit from its approach to health care, call 804.287.7463 or visit the Bon Secours website at www.richmond. bonsecours.com.

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Photo courtesy of VCU Libraries.

This photo of

VCU Senior Pharmacy Students was taken in what year ?

Post the correct answer on our Facebook page by September 10, 2015.

You could win some great food from Good Foods Grocery! Cool, right?

The winner will be announced on our Facebook page

September 17, 2015.

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