table of contents | december 2015
26 MEDI•CABU•LARY.....................10 Local experts define health related terms
Third Annual Best Bedside Manner Awards
JUST ASK!.......................................12 Healthcare questions answered by local professionals
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 THYROID.
THE ANATOMY ........................... 22 Examining the Thyroid: Learn about the thyroid, how it works and its most common ailments.
FIT BITS!........................................................................... 53 Pickle-what? Pickleball! Pickleball started as a children’s backyard game, but is popular with adults as a fun game for players of all levels!
hello, HEALTH!................................................................. 54 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos
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The Resource for Healthy Living in Greater Richmond
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Breaking the Silence: Stroke
This series explores diseases that can be devastating to the individuals and families they affect—yet no one is talking about them—until now.
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YMCA’s Diabetes Prevention Program: ‘It’s Working!’
The Y’s yearlong educational course aims to help adults who have been diagnosed with prediabetes or are at risk for Type 2 diabetes make lifestyle changes that can help them avoid or delay onset of the disease.
NUTRITION..................................................................... 65 HEALTHY EATS: Shop Seasonally for Better Flavorand Extra Value: Try your hand at these “Clean Eating” Recipes: Slow Cooked French Toast Casserole, Sweet Potato & Cauliflower Mash and Pumpkin Ice Cream!
CLOSER LOOK................................................................ 74 Images reflecting the landscape of healthcare in Richmond *
A chance to win prizes!
PLUS *
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The Resource for Healthy Living in Greater Richmond
december 2015 OURHEALTH’S EXCLUSIVE MEDIA PARTNER
PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT ACCOUNTING MANAGER CHIEF DESIGNER COPY EDITOR ORIGINAL COVER ART WORK ORIGINAL PHOTOGRAPHY SOCIAL MEDIA INTERN
McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Deidre Wilkes Laura Bower Karrie Pridemore Bobbi Hoffman Joseph Palotas Tyler Darden/www.tylerdardenphotography.com Jourdan Markey
CONTRIBUTING RICHMOND MEDICAL EXPERTS Donna Brown, MD, FAC Sharon Camden, MD, PhD Vic Goradia, MD Rajanya Petersson, MD Robert Sealand, MD CONTRIBUTING PROFESSIONAL Susan Dubuque EXPERTS & WRITERS Tricia Foley, RD Arthur Olivarez Suzanne Ramsey Mark Reinke Edwin Schwartz Deidre Wilkes ADVERTISING AND MARKETING Richard Berkowitz Senior Vice President, Business Development P: 804.539.4320 F: 540.387.6483 rick@ourhealthvirginia.com SUBSCRIPTIONS To receive OurHealth Richmond via U.S. Mail, please contact Deidre Wilkes via email at deidre@ourhealthvirginia.com or at 540.387.6482
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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2015 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Lynchburg/Southside is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.
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 Dry Eye Syndrome?
What is Anaerobic Exercise?
Dry eye syndrome is a very common condition. Approximately 30 percent of people over the age of 50 suffer from this disease process.
Anaerobic exercise refers to exercising in such a way that the body’s energy demands are met through metabolic processes that do not depend on oxygen. This is opposed to aerobic exercise, which does require oxygen for energy production.
There are three tear film layers in the eyes, and they all need to be healthy for the eyes to be comfortable and to insure stable and normal vision. People who suffer from dry eye syndrome may notice the feeling of a foreign body sensation or burning of the eyes. In addition, vision may be affected with variability throughout the day with changes in environmental conditions. Fortunately, this condition is treatable. There are many ongoing research efforts providing new therapies that offer help for those suffering from dry eye syndrome. If discomfort of the eyes occurs commonly or with prolonged tasks such as reading, computer work and long distance driving, seek evaluation and management of this condition with your eye care provider. Donna Brown, MD, FACS Virginia Eye Institute Richmond | 804.287.4200 www.vaeye.com
The body produces energy for work in three main ways, two that do not depend on the presence of oxygen and one that does. These three systems are always on, and we depend on them to varying degrees depending on the intensity of effort required to meet a task’s energy demand. High intensity efforts result in energy demands being met by the two pathways of anaerobic metabolism because the aerobic system does not provide fuel fast enough for hard work (think strength training and/or cardio that produces mild muscular discomfort and heavy breathing) Anaerobic exercising can provide tremendous benefits in building fitness in short periods of time, but if overused can also lead to stalled training progress and overtraining symptoms. Mark Reinke
Director of Personal Training Director ACAC Midlothian Midlothian | 804.464.0997 www.acac.com
What is Hyperhidrosis? Hyperhidrosis (excess sweating) is a condition which can affect the underarm area, palms and soles. The triggers for excess sweating include emotional stress, caffeine, hot spices, nicotine, and increased ambient temperatures. Mild cases of hyperhidrosis can be treated using an aluminum chloride compound applied to the affected areas daily. Another treatment, “tap water iontophoresis,” uses a weak electrical current to temporarily decrease sweat production. Hands/ feet/underarms need to be placed in contact with moist pads for 30 minutes daily for at least two weeks then continued on and off to maintain effect. In 2004, the Federal Drug Administration (FDA) approved botulinum toxin A for use in primary axillary (underarm) hyperhidrosis. The treatment is safe and decreases sweating by 82-87 percent. The effects are seen in as little as two to four days. Dryness can last for four to 12 months or longer in some patients, but patients report a high level of satisfaction with this approach. It is important to talk with your healthcare provider regarding your hyperhidrosis problems and find a treatment approach that best fits your particular needs. Sharon Camden, MD, PhD Dominion Dermatology Glen Allen | 804.262.6060 www.dominiondermatology.org
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H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
How is Polycystic Ovarian Syndrome diagnosed and treated? The diagnosis of Polycystic Ovarian Syndrome (PCOS) requires meeting two of the three following criteria: • Evidence of overproduction of male hormones. Excess hair, “male pattern baldness” and excess acne are all signs of potential overproduction of male hormones. To confirm this, a doctor must test testosterone levels. • Evidence of ovulatory dysfunction. Having less than six menstrual cycles per year, very irregular menstrual cycles or inability to become pregnant despite having unprotected sex for over 12 months are all signs of possible ovulatory dysfunction. • Evidence of multiple ovarian cysts. This requires an ultrasound of the ovaries. In addition to meeting the criteria, there are other medical conditions that must be excluded before the diagnosis of PCOS can be made. They include: dysfunction of the thyroid, overproduction of a hormone called prolactin or a condition called congenital adrenal hyperplasia. Once the diagnosis is made, the primary treatment is hormone replacement to help with the excess hair, acne and menstrual irregularities. To treat issues of infertility, a medication called clomiphene is typically used. Robert Sealand, MD
Richmond Diabetes and Endocrinology Bon Secours Medical Group Mechanicsville | 804.764.7686 www.bonsecours.com
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What are some ways of preventing Anterior Cruciate Ligament (ACL) Tears 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 should 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 will last 45-75 minutes. In the unfortunate circumstance that an ACL tear occurs, there have also been several advances in the past five years that have produced improved surgical outcomes. The first was the development of a more anatomically correct ACL reconstruction (i.e. replacement). The most recent surgical advancement 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. Vic Goradia, MD
G2 Orthopedics and Sports Medicine Glen Allen | 804.678.9000 www.G2orthopedics.com
How many tonsils do people have? Most people think they have two tonsils, which is partially correct. We usually think of the tonsils as the two ball-like structures seen in the back of the throat, the palatine tonsils. We also have tonsil tissue, called lingual tonsils, on the base of our tongues. Adenoids are a similar type of tissue found behind the nose and soft palate. Enlarged tonsils and adenoids can cause snoring, and potentially obstructive sleep apnea (OSA) in children. OSA symptoms include pauses in breathing during sleep, waking up gasping for air, restless sleep and daytime symptoms such as fatigue, hyperactivity and attention problems. Enlarged palatine tonsils and adenoids are the cause of OSA in most children and a doctor may recommend removal of the tonsils and adenoids. Even though these tissues are a part of the immune system, their removal does not seem to put people at increased risk of infection. Rajanya Petersson, MD
Ear, Nose and Throat Specialist Children’s Hospital of Richmond at VCU Richmond | 804.828.2467 www.chrichmond.org
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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
Virginia Cancer Institute Opens New Location Virginia Cancer Institute has opened a new location at the Puddledock Medical Center. Located at 4730 Puddledock Road, Suite 100, Prince George, VA 23875, the new location serves the Tri Cities with practicing physicians Yogesh Gandhi, MD, Mitchell Machado, MD and Shobha Nalluri, MD. For more information on Virginia Cancer Institute, visit www.vacancer.com.
Bon Secours Wants Input from Metro Richmond Residents Bon Secours is conducting systemwide community health survey Bon Secours Richmond Health System is conducting a community health needs survey of residents within the areas of its hospitals: Bon Secours St. Mary’s Hospital, Bon Secours Memorial Regional Medical Center, Bon Secours Richmond Community Hospital, and Bon Secours St. Francis Medical Center. The survey will help Bon Secours identify the areas of greatest need in the metro Richmond community where the not-for-profit health system might improve the health of the community. All residents ages 18 and older living in Richmond are invited to participate in the 25-question survey, available online in English and Spanish at www.chna.bonsecours.com.
The deadline for participation is December 20, 2015.
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VCU has Only Accredited Adult and Adolescent Bariatric Surgery Centers in the State Virginia Commonwealth University Medical Center and the Children’s Hospital of Richmond at VCU earned a distinction that identifies them as the state’s only accredited metabolic and bariatric surgery centers for adults and adolescents. The American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program accredits inpatient and outpatient bariatric surgery centers that have undergone an independent, voluntary and rigorous peer evaluation in accordance with nationally recognized bariatric surgical standards. Accreditation for metabolic and bariatric surgery not only promotes uniform standard benchmarks, but also supports continuous quality improvement.
Rebecca Aycock-Brown, PhD
Wendy Bond, FNP
Justin Brockbank, MD
Yuvraj Choudhary, MD
Zhi-jian Chen, MD, PhD
Joanna Chin, MD
Hernan Gatuslao Jr., MD
Luis Guzman, MD
Erika Kopinski, AuD
Marlon Levy, MD
VCU Health Family Medicine and Population Health Downtown Richmond 804.828.5883 www.vcuhealth.org
Virginia Ear Nose & Throat Richmond |804.484.3700 www.virginiaent.com
Children’s Hospital of Richmond at VCU Pulmonary and Sleep Medicine | Downtown Richmond and Stony Point 804.828.CHOR www.chrichmond.org
“This MBSAQIP accreditation for VCU Medical Center formally acknowledges our commitment to providing and supporting quality improvement and patient safety efforts for metabolic and bariatric surgery patients,” said Guilherme M. Campos, MD, professor of surgery and chair, Division of Bariatric and Gastrointestinal Surgery. The Division of Bariatric and Gastrointestinal Surgery includes a multidisciplinary team of nurses, nurse-practitioners, dietitians, endocrinologists, gastroenterologists, radiologists and other specialists as needed. CHoR’s comprehensive approach to adolescent bariatric surgery includes a multidisciplinary team of surgeons, physicians, nurses, dietitians, exercise specialists and psychologists. The program has seen significant results with improvements to medical conditions, psychological benefits and little to no complications. “Weight-loss surgery has been shown to reliably produce significant, longterm weight loss in obese adolescent patients when used in conjunction with healthy lifestyle modification,” said David Lanning, MD, surgeonin-chief at CHoR. “Most of the medical problems related to obesity are completely reversible if addressed soon enough, whereas after a certain period of time the effects from some diseases, such as hypertension and diabetes, can become permanent. So waiting to have surgery until 18 years of age can often have significant negative consequences.” “Being the only accredited weight-loss surgical program for children in Virginia reaffirms that we have all of the critical components necessary to provide this surgical care to children in a safe and multidisciplinary manner.” For more information visit www.chrichmond.org or www.vcuhealth.org.
Virginia Cancer Institute Richmond | 804.330.7990 www.vacancer.com
Xinli Du, MD, PhD
VCU Parkinson’s & Movement Disorder Center Neurology Henrico | 804.828.9350 www.vcuhealth.org
Sarah Hoffman, MD Children’s Hospital of Richmond at VCU Rheumatology Downtown Richmond 804.828.CHOR www.chrichmond.org
VCU Health | Neurology Downtown Richmond 804.828.9350 www.vcuhealth.org
VCU/MCV Physicians at Temple Avenue Neurology | Prince George 804.957.6287 www.vcuhealth.org
Virginia Ear Nose & Throat Richmond |804.484.3700 www.virginiaent.com
VCU Health Internal Medicine Downtown Richmond 804.828.9357 www.vcuhealth.org
VCU Health Internal Medicine ACC Downtown Richmond 804.828.2161 www.vcuhealth.org
VCU Health | Surgery Downtown Richmond 804.828.1875 www.vcuhealth.org
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David Marcello, MD Children’s Hospital of Richmond at VCU Hospital Medicine Downtown Richmond www.chrichmond.org
Daniel Millan, MD
Children’s Hospital of Richmond at VCU Children’s Hospital Foundation Heart Center Anesthesiology Downtown Richmond www.chrichmond.org
Guru Mohanty, MD, FACC
Cardiovascular Elecrophysiologist Virginia Cardiovascular Midlothian/Prince George 804.288.4827 www.vacardio.com
Mihran Ozbalik, MD VCU Health | Neurology Downtown Richmond 804.828.9350 www.vcuhealth.org
Welcome Brian Fishero, MD Otolaryngology
Krishnaseree Rao, MD Stephanie Ann VCU Health Sherrell, CNM Internal Medicine Downtown Richmond 804.828.4571 www.vcuhealth.org
VCU Health | OB/GYN Richmond | 804.828.4409 www.vcuhealth.org
Jonathan Silverman, MD
Children’s Hospital of Richmond at VCU Emergency Medicine Downtown Richmond www.chrichmond.org
Evan Silverstein, MD Children’s Hospital of Richmond at VCU Ophthalmology Downtown Richmond, Fredericksburg and Stony Point | 804.828.CHOR www.chrichmond.org
Commonwealth Ear Nose and Throat Specialists, PC
804.525.4231
St. Mary’s Office Medical Building South 5875 Bremo Road | Richmond, VA www.commonwealthentpc.com Services Provided:
Flora Szabo, MD
Children’s Hospital of Richmond at VCU Gastroenterology and Nutrition Downtown Richmond 804.828.CHOR www.chrichmond.org
Deepak Thomas, MD VCU/MCV Physicians at Temple Avenue Internal Medicine Prince George 804.957.6287 www.vcuhealth.org
Mireille Truong, MD
VCU Health | OB/GYN Stony Point & Nelson Clinic Richmond | 804.828.4409
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Sebastian Tong, MD, MPH
UVA Health Family Medicine and Population Health Downtown Richmond 804.828.5883 www.vcuhealth.org
Rashida Woods, MD Children’s Hospital of Richmond at VCU Emergency Medicine Downtown Richmond www.chrichmond.org
Nasal and Sinus Surgery including • “Balloon Sinuplasty” Procedures • Pediatric Otolaryngology • Hearing Tests/ Ear Disease • Skin Cancer & Facial Reconstructive Surgery
“My family and I are so happy to call Richmond home. I sincerely look forward to serving this wonderful city for years to come.” Scan here to visit our website!
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T I P S , T I D B I T S A ND MO R E TO I NF O R M A ND ENT ERTA I N YO U
Don’t be
SAD!
Seasonal Affective Disorder (SAD), sometimes called winter or seasonal depression, is a type of depression that occurs during the same season each year. Most people with SAD start to have symptoms in September or October and feel better by April or May. If you think you may suffer from SAD, here are some healthy tips that may help beat the ‘winter blues’: hh Soak up the sunshine – open curtains as much as possible to get exposure to natural light
hh Maintain a routine – keep up everyday activities, and don’t neglect favorite hobbies just because it’s winter. hh Exercise – during exercise, the body releases endorphins, which will boost energy and moods.
hh Get outside – breathing in some fresh air each day can help to relieve stress, and also exposes the body to natural light hh Practice relaxation – activities such as yoga meditation can help to alleviate symptoms of depression and anxiety.
hh Ditch the sugar – not only will too much sugar lead to weight gain, it can also worsen anxiety.
hh Book a trip – people who suffer from SAD will benefit from additional sunshine, so booking a trip to a warmer climate may help. *If you struggle with serious and continuous depressive symptoms, be sure to reach out to a local healthcare provider to discuss your condition. For additional information on seasonal depression, visit the National Institute of Mental Health at www.nimh.nih.gov
Safe Snow Shoveling Tip 18
Wet snow can be very heavy. One full shovel load can weigh as much as 25 pounds! Try pushing the snow, don’t lift it. Pushing puts far less strain on the spine than lifting.
OurHealth | The Resource for Healthy Living in Greater Richmond
Have You Received Your
Flu Vaccine?
It’s not too late! December 6-12 is National Influenza Vaccination Week (NIVW). Sponsored by the Centers for Disease Control and Prevention (CDC), NIVW is a national observance that was established to highlight the importance of continuing influenza vaccination. While vaccination is recommended for everyone six months and older, it is especially important for protecting those at high risk for serious flu complications, including: hh Young children
hh Pregnant women
hh Adults 65 an older
hh Anyone with chronic health conditions such as asthma, diabetes, and heart disease
Visit www.cdc.gov for more information about the flu vaccine and clinic locations.
WINTER SKIN CARE
Wet socks and gloves can irritate your skin and cause itching, cracking, sores, or even a flareup of eczema. Keep a dry pair handy when outdoors this winter!
How Much Exercise is Needed to Burn Off that Holiday Dinner? The average Holiday meal packs a whopping 3,000 calories.* That’s way more than most people need for an entire day! Below are some exercise guidelines of how many hours are needed to burn off 3,000 calories: hh Running (10 min/mile)
4.5 hours
hh Circuit training
5.25 hours
hh Cycling (12-14 mph)
Tacky Light Run Date: Time: Location:
Saturday, DECEMBER 12th 6 PM Midlothian Mines Park N. Woolridge Road Midlothian, VA 23114
RVA holds the bragging rights for tacky holiday lights, a festive craze that has made Richmond a holiday destination! Experience this fun tradition in a new way this year by participating in the CarMax Tacky Light Run! For more information, and to register for this fun, family-friendly event, visit www.sportsbackers.org.
5.5 hours
hh Tennis 6.25 hours
hh Brisk walking
9 hours
*Calculated for a person weighing 150 pounds. Based on WebMD’s Fit-o-Meter Exercise Calorie Calculator. For customized calorie burning information, scan the code to access the Fit-o-Meter fitness and exercise calorie calculator http://www.webmd.com/diet/ healthtool-fitness-calorie-counter
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the
Anatomy
CHALLENGE How much do you know about the
Thyroid? First,
complete the word search below. Next, match up the correct word with the part of the body in the illustration.
[ the Thyroid ]
WORD SEARCH clavicle
isthmus of thyroid
thyroid
external carotid artery
thyroid cartilage internal jugular vein right common carotid artery
left lobe of thyroid trachea
For answers, visit OurHealth Richmond's
Facebook page at
__________________ __________________
__________________
__________________ __________________
__________________
__________________ __________________
__________________ www.OurHealthRichmond.com
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EXAMINING
Thyroid
Health
words | EDWIN SCHWARTZ
A functionally balanced thyroid gland is vital for the well-being of the entire body. To learn more about how the thyroid works and its most common ailments, OurHealth consulted an expert at VCU School of Medicine.
What is the thyroid? The thyroid is a butterfly-shaped endocrine gland located on the front of the neck below the Adam’s apple. It is controlled by the pituitary gland, a small organ at the base of the brain just above the nasal passages. 22
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What are endocrine glands? Endocrine glands produce and secrete hormones that regulate the activity of cells and multiple organs. Hormones control growth, metabolism and sexual function. As hormones are released into the bloodstream, they act like chemical messengers that communicate information from one group of cells to another.
Typically, the thyroid remains invisible but can be felt as a soft mass. It varies in size, ranging from 18 to 60 grams in adults.
What is the function of the thyroid? The primary role of the thyroid is to produce two types of hormones, commonly referred to as T4 (thyroxine) and T3 (triiodothyronine). Thyroid hormones regulate overall body growth, metabolism and development of the nervous system. They also play an important role in brain growth during fetal development. Approximately 80 to 90 percent of the hormones secreted from the thyroid gland are T4 hormones; the remaining 10 to 20 percent are T3. However, up to 80 percent of T4 hormones are converted to T3 after they are released into the blood stream.
How does the thyroid work? The pituitary gland controls the thyroid’s production of T4 and T3 in a thyroid-pituitary negative feedback loop. As thyroid production of T4 and T3 decreases, the pituitary gland secretes a hormone called thyroid-stimulating hormone, which causes the thyroid to produce more hormones. When thyroid production of T4 and T3 increases, the pituitary gland reduces TSH production. These hormones are in constant communication, but although TSH regulates the thyroid, it doesn’t tell the thyroid how much T4 and T3 to produce and secrete.
Common conditions of the thyroid Thyroid conditions are common and affect women more than men. The two most common thyroid diseases are hyperthyroidism and hypothyroidism. Others are thyroiditis, thyroid nodules and thyroid cancer.
Hyperthyroidism Hyperthyroidism, or overactive thyroid, is the excessive production of thyroid hormones by the thyroid gland. Common symptoms include increased heart rate, anxiety, poor sleep, fatigue, muscle weakness, poor heat tolerance, increased metabolism, diarrhea and weight loss despite increased eating. Patients may have a goiter (enlarged thyroid), bulging eyes and hand tremor. www.OurHealthRichmond.com
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Hyperthyroidism is typically diagnosed with a blood test that reveals high or normal T4 and T3 with a suppressed TSH level. The three treatment options include radioactive iodine, anti-thyroid medication to control thyroid function and, occasionally, surgery to remove the thyroid.
Hypothyroidism With hypothyroidism, or underactive thyroid, the thyroid gland does not produce enough thyroid hormones. Common symptoms include lowered metabolism, decreased heart rate, weight gain, lack of energy, poor tolerance of cold, dry skin and depression. Hypothyroidism affects women to men at a 2-to-1 ratio. It causes menstrual irregularity, impaired fertility and increased risk of miscarriage. Diagnosis is relatively simple and consists of a blood test that shows an elevated TSH with low thyroid hormones. The TSH is high because it functions like a thermostat that keeps trying to stimulate without effect.
Francesco S. Celi, MD, is chair of the Division of Endocrinology and Metabolism at Virginia Commonwealth University School of Medicine. He is certified by the American Board of Internal Medicine with a subspecialty in endocrinology, diabetes and metabolism.
According to Francesco S. Celi, MD, chair of the Division of Endocrinology and Metabolism at VCU School of Medicine, hypothyroidism is typically treated with replacement hormones. Treatment includes generic T4 hormones (for example, levothyroxine) or a combination of T3 and T4. Patients are advised to have blood work done every four to six weeks while the dosage is being adjusted. Once it is set, it does not change. “Symptoms of hyperthyroidism or hypothyroidism should be assessed by either a primary care physician or an endocrinologist,” says Dr. Celi.
Thyroiditis Thyroiditis, or inflammation of the thyroid, can be chronic or acute, depending on the cause. The common form is Hashimoto’s thyroiditis, which is a frequent cause of hypothyroidism. Patients with Hashimoto’s thyroiditis usually show no symptoms until they develop hypothyroidism. In cases of acute thyroiditis, patients can have neck pain with symptoms similar to either hyperthyroidism or hypothyroidism. Although there is no cure for Hashimoto’s, hormone replacement with medication can regulate hormone levels and restore normal metabolism.
Common myths about the thyroid
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• The most common misnomer about the thyroid is that it increases energy and helps people lose weight. • Many people believe being chronically tired or unable to lose weight indicates their thyroid function must be low and a thyroid supplement would help. But many people with normal thyroid function experience these symptoms. Blood work is necessary to determine if a patient’s thyroid is underactive. • While numerous thyroid supplement or remedy products are available in the marketplace, patients are advised to consult their physicians before taking any of them. Patients with normal thyroid function should work with their doctors to find the real causes of their symptoms.
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Thyroid nodules Thyroid nodules are growths within the thyroid. They are very common in the elderly and can cause anxiety when discovered. Most are benign, cause no symptoms and are found when medical professionals are looking for something else. For benign nodules without symptoms, treatment is not required; regular ultrasound monitoring is usually adequate. Surgical removal of tissue could be in order for nodules causing symptoms or if malignancy is a concern.
Thyroid cancer Thyroid cancer is three times more common in women than in men. Most thyroid cancers demonstrate slow growth with no symptoms. The most effective management for thyroid cancer is surgical removal of the thyroid followed by radioactive iodine ablation — where radioactive iodine is administered to destroy residual healthy thyroid tissue remaining after the thyroidectomy — and TSH suppression therapy.
Thyroid health There is not much one can do to maintain or improve thyroid health. The thyroid requires iodine to make thyroid hormones. In the past, iodine deficiency was common in noncoastal areas where seafood was in short supply. Today however, iodine deficiency is less common because it is in most foods via salt. The recommended dietary allowance for iodine in adults is 150 micrograms per day. One teaspoon of iodized salt contains approximately 400 micrograms of iodine. “Adequate iodine intake in the diet is necessary for the prevention of goiter,” says Dr. Celi. “But severe iodine deficiency is very rare in the United States.”
ON THE WEB
More at ourhealthrichmond.com
www.OurHealthRichmond.com
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The third Annual
Best Bedside
Manner Awards
Medical expertise and compassionate care should always go hand-in-hand when it comes to treating patients. Going to the doctor or health provider can be an unnerving experience for many people. Professionals who incorporate The Golden Rule into their practice philosophy are ones that stand out in people’s minds for the better. The 2015 Best Bedside Manner Awards, presented by OurHealth Richmond magazine and CBS6, honor medical providers who were voted by the local community for their kindness, empathy and attentiveness—attributes that go a long way in gaining a patient’s confidence. Please join us in congratulating this year’s 3rd Annual Best Bedside Manner Award winners. The Voting Process: During May and June 2015, the Best Bedside Manner Awards Voting Form was available on OurHealth’s website, www.ourhealthrichmond.com. The form consisted of over 40 medical specialties (with definitions of each specialty) in which the public could submit the first and last names of local medical providers by the applicable specialty. If you have any questions, please contact Stephen McClintic Jr., publisher of OurHealth, at steve@ourhealthvirginia.com or 540.387.6482.
www.OurHealthRichmond.com
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Allergy & Immunology encompasses a broad
array of diagnoses, ranging from nasal and sinus problems and severe food or bee sting allergy to recurrent infections due to sinus disease, immune deficiency and asthma conditions.
Lawrence Gelber, MD
Richmond Allergy and Asthma Specialists Henrico | 804.285.7420 www.richmondallergy.com
Anesthesiology is the practice of medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery.
First Place
Jeffrey Schul, MD
Robert Call, MD
3 Third Place
Ann-Marie Irani, MD
3 Second Place
Commonwealth Anesthesia Associates Midlothian | 804.594.2622 www.caa-med.com
Commonwealth Anesthesia Associates Midlothian | 804.594.2622 www.caa-med.com “As an anesthesiologist, my window of opportunity for establishing rapport with my patients and their families is very brief. Therefore, to me, bedside manner is the ability to promptly convey to each of my patients how deeply vested I am in their safety, their comfort and their overall experience while under my care.” — Farnas Milani Gazoni, MD
3 Third Place
David Palombo, MD
Richmond Allergy and Asthma Specialists Henrico | 804.285.7420 www.richmondallergy.com
Barry K. Feinstein
Advanced Allergy and Asthma of Virginia Richmond | 804.739.9005 www.advancedallergyva.com
3 Honorable Mention
Jason Davis, MD
Commonwealth Anesthesia Associates Midlothian | 804.594.2622 www.caa-med.com
Adam Henceroth, MD
Commonwealth Anesthesia Associates Midlothian | 804.594.1383 www.caa-med.com
Virginia Urology Richmond | 804.330.9105 www.uro.com
Audiology is the branch of science that studies hearing, balance, and related disorders. Its practitioners treat those with hearing loss and proactively prevent related damage.
OurHealth | The Resource for Healthy Living in Greater Richmond
Allergy Partners of Richmond Greater Richmond | 804.559.0370 www.allergypartners.com/richmond
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
James Stone, MD
Farnas Milani Gazoni, MD
28
Elaine Turner, MD
Allergy Partners of Richmond Greater Richmond | 804.559.0370 www.allergypartners.com/richmond
“Good bedside manner is very important to me because it puts my patients at ease so they can better convey their medical issues and concerns. This enables me to listen and communicate with them more effectively and is an important component in providing high quality medical care and accurately diagnosing medical conditions.” — Lawrence Gelber, MD
3 Honorable Mention
Michael Z. Blumberg, MD, MSHA Allergy Partners of Richmond Greater Richmond | 804.559.0370 www.allergypartners.com/richmond
First Place
...good bedside manner means showing my patients how invested I am in their care.”
3 Second Place (tie)
3 Second Place
Bridgette Fowler, Med, CCC-A
First Place
Holly Law, MEd, CCC-A
Hearing Solutions Midlothian | 804.794.9087 www.hearingsolutions.us
VCU Medical Center Richmond | 804.323.0830 www.vcuhealth.org
3 Third Place
Lori Klein Gardner, AuD, FAAA Hear Virginia Richmond | 804.477.1630 www.hear-virginia.com
Bariatric Medicine is the branch of medicine that deals with the causes, prevention, and treatment of obesity.
3 Second Place
First Place
Tejwant Datta, MD, FACS
Gregory Schroder, MD, FACS
Advanced Surgical Partners of Virginia | HCA Virginia Physicians Richmond | 804.360.0600 | www.advancedsurgicalpartnersofva.com “Good Bedside manner means connecting with the patient in more than just a treatment manner. It means connecting on an individual basis with each patient and engaging that patient in a caring compassionate way that provides the patient with the confidence and comfort that they are getting the care they need from someone who truly cares about them and wants to help them…engaging the patient in a way that establishes trust and confidence…..by providing information, empathy, laughter and healing touch and confidence”. — Gregory Schroder, MD, FACS
Cardiology is the branch of medicine focusing on the structures, functions and disorders of the heart.
3 Second Place
Mark Newton, MD, FACC
First Place (tie) Mark Johns, MD, FACC Cardiology of Virginia Midlothian | 804.560.8782 www.cardiovirginia.com
First Place (tie)
Jiho Han, MD FACC, FSCAI
Virginia Cardiovascular Specialists Richmond | 804.323.5011 www.vacardio.com
“We as physicians are privileged to be included in the lives of our patients. We care about them as people with families and loved ones and interests. They strengthen our outlook on life. Dr. Peabody’s famous quote is: “The secret of caring for patients is to care about them.” I am fortunate to have so many people around me that care about patients as people. They are not just cases or LAD lesions or heart failure readmissions. They are Mr. and Mrs. Smith who have three cats and a dog with arthritis. We are only as good as our last encounter and we want to make every person special. We touch each other’s lives.” — Jiho Han, MD FACC, FSCAI
Virginia Cardiovascular Specialists Richmond | 804.288.4827 www.vacardio.com
3 Third Place
Kenneth Ellenbogen, MD VCU Medical Center Richmond | 804.828.7565 www.vcuhealth.org
3 Honorable Mention
Clifford V. Morris, MD
Morris Cardiovascular and Risk Reduction Center Hopewell | 804.530.1044 www.morriscardio.com
Steven W. Cross, MD, FACC
Virginia Cardiovascular Specialists Richmond | 804.288.4827 www.vacardio.com
Martin Caplan, MD, FACC
Virginia Cardiovascular Specialists Richmond | 804.288.4827 www.vacardio.com
Charles Nelson, MD
Cardiovascular Associates of Virginia Richmond | 804.288.3132 www.bonsecours.com
Southside Metabolic & Bariatric Surgery Petersburg | 804.504.7900 www.srmconline.com
3 Third Place
Michael Barker, MD, FACS
Advanced Surgical Partners of Virginia HCA Virginia Physicians Richmond | 804.360.0600 www.advancedsurgicalpartnersofva.com
Chiropractic is a health profession concerned with the
It is a privilege to serve as a patient’s physician.
diagnosis, treatment (without drugs or medication) and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.
First Place David Berv, DC
Back In Action Chiropractic Center, PC Richmond | 804.254.0200 | www.feelgr8.com “I respect others’ time by staying on time, while being present in your presence. I smile often, questioning you with one mouth and listening with two ears. I explain with ease and simplicity while delivering experienced confidence through my hands.” — David Berv, DC
3 Second Place
Michael Placide, DC
Midlothian | 804.745.7822
3 Third Place
Joseph Santarsieri, DC
Richmond | 804.264.1286
3 Honorable Mention
Lisa Holland, DC
Aryya Family Chiropractic Centers Glen Allen | 804.270.5700 www.ariyafamilychiropractic.com
Michael Mulvaney, DC
Spinal Correction Center Richmond | 804.740.9300 www.lovethatspine.com
Dentistry: Cosmetic improves the appearance
and function of a person’s teeth. Dentistry is the art and science of improving the appearance (esthetics), function and health of the teeth and associated structures.
First Place
Catherine P. Crichton, DDS Virginia Family Dentistry Midlothian | 804.794.9789 www.vadentist.com
“Specializing in cosmetic dentistry requires passion in the field and patience bedside. I not only get excited about my smile makeovers but also the meaningful and lasting relationships that are formed in the process.” — Catherine P. Crichton, DDS
3 Second Place
Karen McAndrew, DMD, MS
Virginia Center for Prosthodontics Richmond | 804.741.8689 www.vapros.net
3 Third Place
Davey Crockett, DDS
Davey Crockett Dentistry Richmond | 804.282.2990 www.daveycrockettdentistry.com
Dentistry: General is the evaluation, diagnosis, prevention and/or treatment (non-surgical,
surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity.
First Place
Elizabeth Reynolds, DDS
Drs. Brown, Reynolds & Snow | Richmond Family and Cosmetic Dentistry Richmond | 804.288.5324 | www.richmondcosmeticdentistry.com “The perception of dentistry is certainly one associated with angst and trepidation. For this reason, patients often come to their appointments with a preconceived notion of what is going to happen at that appointment. Anything I can do as a practitioner to alleviate my patient’s anxiety provides a tremendous service to my patient. I truly feel it is imperative that the patient feel as comfortable as possible with me and the procedure. That falls into “bedside manner” I suppose. I love practicing dentistry but I truly love my patients; they are why I do what I do, and my team and I always try to make sure that our patients know that”. — Elizabeth Reynolds, DDS 30
OurHealth | The Resource for Healthy Living in Greater Richmond
3 Honorable Mention
Stephen Brown, DDS
Brown Reynolds Snow Dentistry Richmond | 804.288.5324 www.richmondcosmeticdentistry.com
Brent Rusnak, DDS
Rusnak Family Dentistry and Orthodontics Richmond | 804.625.4080 www.rusnakfamilydentistry.com
Al Stenger, DDS
Drs. Stenger, Cole & Gupta Richmond | 804.320.7147 www.richmonddentist.net
3 Second Place
Susan Richardson-Overstreet, DDS
Cooke, Richardson & Overstreet, DDS, PC Glen Allen | 804.270.7737 www.crodentistry.com
3 Third Place
Baxter Perkinson, Jr., DDS
Virginia Family Dentistry | Midlothian 804.794.9789 | www.vadentist.com
3 Honorable Mention
Jeff Blackburn, DDS, FAGD South River Dentistry Midlothian | 804.378.7888 www.midlothiandentist.com
Dentistry: Pediatric specializes in treating
children from birth through adolescence.
First Place
Christopher Maestrello, DDS
Atkins, Maestrello, Miller & Associates Pediatric Dentistry, PC Richmond | 804.741.2226 www.pediatricdentistrichmond.com “Children are very perceptive, and a healthcare facility can often be intimidating. Making them at ease is important. I always acknowledge the child before the parent. I like to comment on their pretty smile or the cool action hero T-shirt.” — Christopher Maestrello, DDS
Dermatology is a specialty focusing on the diagnosis and treatment of diseases of the skin.
First Place
Georgia K. Seely, MD
Dermatology Associates of Virginia PC Glen Allen/Richmond | 804.549.4025 www.dermva.com “It is a privilege to serve as a patient’s physician. As such I am entrusted with a person’s physical and emotional health. I must remember to serve with compassion and tenderness as they are someone’s beloved family. I must make time to listen to their concerns and to find a way to know and relate to them on a personal level.” — Georgia K. Seely, MD
Emergency Medicine is the specialty of providing care for patients requiring prompt medical attention and urgent medical evaluation and treatment.
First Place
Kenneth Scott Hickey, MD Emergency Consultants Inc. Richmond | 804.320.3911 www.hcavirginia.com
3 Second Place
Nicholas Lombardozzi, DDS
Drs. Wood, Dunlevy & Lombardozzi Midlothian | 804.794.3498 www.kidsdentists.com
3 Third Place
John Flowers, DDS
Children’s Dentistry of Virginia, PC Midlothian | 804.639.6445 www.childrensdentistryofva.com
3 Second Place
Victoria Gross, MD
Richmond Dermatology & Laser Specialists Richmond | 804.282.8510 www.richmonddermlaser.com
3 Third Place (tie)
Eileen Cantor Kitces, MD
Richmond Dermatology & Laser Specialists Richmond | 804.282.8510 www.richmonddermlaser.com
3 Honorable Mention
Elizabeth Miller
Atkins, Maestrello, Miller & Associates Pediatric Dentistry, PC Richmond | 804.741.2226 www.pediatricdentistrichmond.com
John Unkel, DDS
Bon Secours Pediatric Dental Associates Richmond | 804.893.8715 www.bsrkidsdentistry.com
3 Honorable Mention
Jo Bohannon-Grant, MD
Midlothian Dermatology Midlothian | 804.378.3048 www.midloderm.com
Camille Haisley-Royster
Commonwealth Dermatology (Pediatric) Richmond | 804.282.0831 www.comderm.com
Lisa Edsall, MD
Dermatology Associates of Virginia, PC Colonial Heights | 804.549.4040 www.dermva.com
Laurie L. Shinn, MD
Commonwealth Dermatology (Pediatric) Richmond | 804.282.0831 www.comderm.com
3 Second Place
Robin Foster, MD, FAAP, FACEP
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
3 Third Place
Eric Bachrach, MD
Emergency Consultants Inc. Richmond | 804.320.3911 www.hcavirginia.com
www.OurHealthRichmond.com
31
Endocrinology is the study of the glands and hormones of the body and their related disorders.
3 Second Place
Ben Phillips, MD
First Place
Allen S. Burris, MD, FACP
Virginia Diabetes & Endocrinology, PC Richmond | 804.272.2702 www.vadiabetes.com
Family practice is the medical specialty that includes
diagnosis and treatment of disease, injury, and illness for patients of any age.
First Place
Richard L. Gergoudis, MD
Commonwealth Primary Care, Inc. Richmond | 804.288.1800 www.cpcva.com “A good bedside manner means being a caring, respectful listener. This allows me the privilege to establish honest relationships and genuine friendships with many special people and provides a foundation for lifelong learning and growth.” — Richard L. Gergoudis, MD
Fertility Specialist or reproductive endocrinology and infertility (REI) is a subspecialty of obstetrics/gynecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility.
First Place
Kenneth Steingold, MD
The Fertility Institute of Virginia Ltd. Richmond | 804.379.9000 www.fertilityinstituteofva.com “Infertility patients feel particularly vulnerable when they begin treatments. Our office understands and responds to this by welcoming our patients in safe and reassuring atmosphere where they can express their feelings and be treated with respect”. — Kenneth Steingold, MD 32
OurHealth | The Resource for Healthy Living in Greater Richmond
Virginia Endocrinology Midlothian | 804.423.3636 www.virginiaendo.com
3 Third Place
Gary Francis, MD, PhD
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
3 Second Place
Eric Haacke-Golden, MD
Virginia Family Physicians Midlothian | 804.323.1264 www.virginiafamilyphysicians.com
3 Third Place (tie)
John Siedlecki, MD
Family Practice Specialists of Richmond Midlothian | 804.330.3335 www.fpsrichmond.com
Raymond Decker, MD
Family Practice Associates Midlothian | 804.320.3999 www.fampracticeassociates.com
3 Second Place
Michael Edelstein, MD
The Fertility Institute of Virginia Ltd. Richmond | 804.379.9000 www.fertilityinstituteofva.com
3 Third Place
Sanford Rosenberg, MD
Richmond Center for Fertility and Endocrinology Richmond | 804.285.9700 www.richmondfertilitycenter.com
3 Honorable Mention
Meredith M. Berger, MD
Virginia Diabetes & Endocrinology PC Richmond/Midlothian | 804.272.2702 www.vadiabetes.com
Diedre Tyson, MD
Bon Secours Pediatric Endocrinology and Diabetes Associates Richmond | 804.287.7322 www.goodhelpdocs.com
3 Honorable Mention
Caroline Cella, MD
HCA Virginia Physicians Primary Health Group – Johnston-Willis Richmond | 804.320.1333 www.phgjohnstonwillis.com
Joseph Goddard
Virginia Physicians – Midlothian Family Practice Midlothian | 804.794.5598 www.vaphysicians.com
Tami Fountain-Ellis, MD
Patterson Avenue Family Practice Richmond | 804.741.6200 www.richmond.bonsecours.com
3 Honorable Mention
Joseph Gianfortoni, MD Lifesource Fertility Center Henrico | 804.673.2273 www.lifesourcefertility.com
Gastroenterology is the specialty dealing with the
3 Second Place
treatment of disorders of the digestive gastroenterology or GI system.
First Place
Howard O. Haverty, MD
Richmond Gastroenterology Associates Midlothian | 804.330.4021 www.richmondgastro.com “These three influences in my life have shaped my bedside manner: God, family and the Medical College of Georgia. I believe good bedside manner is essential and consider it a privilege and honor to care for my patients.” — Howard O. Haverty, MD
Rufus Davis MD
Gastrointestinal Specialists, Inc Richmond | 804.285.8206 www.gastrova.com
3 Third Place
Ted Williams, MD
Bon Secours Pediatric Gastroenterology Associates Richmond | 804.281.8303 www.bonsecours.com
Geriatric Care is a medical specialty that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease.
VCU Medical Center | Richmond | 800.762.6161 | www.vcuhealth.org “The key to bedside interactions with patients is to give them your full attention, listen to them, and pay attention to what is really bothering them or their families, communicating in words they can understand, translating our foreign medical terms and concepts into something more approachable. I like to add some humor when I can do so appropriately. Being sick and miserable is hard enough.” — Peter A. Boling, MD
Lawrence Lewkow, MD
Virginia Cancer Institute Richmond | 804.287.3000 www.vacancer.com “We are honored to have been recognized by our community for our dedicated care and bedside manner. My colleagues and I will continue to earn this distinction every day for the sake of our patients, and would like to extend our gratitude to all patients that voted for our practice.” — Lawrence Lewkow, MD
Gastrointestinal Specialists, Inc. Richmond | 804.285.8206 www.gastrova.com
Robert Flynn
Richmond Gastroenterology Associates Midlothian | 804.330.4021 www.richmondgastro.com
Cary Gentry, MD
Colon & Rectal Specialists Richmond | 804.249.2465 www.crspecialists.com
3 Second Place
Senior Health Center | Richmond 804.237.1665
Peter A. Boling, MD
First Place
William Brand Jr., MD
Stanley N. Furman, MD
First Place
Hematology/oncology is the diagnosis, treatment and prevention of blood diseases (hematology) and cancer (oncology) and research into them.
3 Honorable Mention
3 Second Place (tie)
3 Third Place
Joseph James, MD
HCA Virginia Physicians Primary Health Group – Johnston-Willis Richmond | 804.320.1333 www.phgjohnstonwillis.com
3 Honorable Mention
Gita V. Massey, MD
Pablo M. Gonzalez, MD
Will Voelzke, MD
Susan Schaffer, DO
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org Virginia Cancer Institute Richmond | 804.287.3000 www.vacancer.com
Virginia Cancer Institute Richmond | 804.330.7990 www.vacancer.com Bon Secours Cancer Institute Medical Oncology at St. Mary’s Richmond | 804.287.7804 www.richmond.bonsecours.com
3 Third Place
Elke K. Friedman, MD
Virginia Cancer Institute Richmond | 804.287.3000 www.vacancer.com
www.OurHealthRichmond.com
33
Infectious Disease is the medical specialty focusing on the diagnosis, cause and treatment of contagious disease.
3 Second Place
William Koch, MD
First Place
James W. Brooks, MD
HCA - Infectious Disease Specialists Richmond | 804.285.1833 www.hcavirginia.com
Internal Medicine is the branch of medicine that deals with the diagnosis and nonsurgical treatment of diseases affecting adults. Minh Q. Tran, MD
Reynolds Primary Care Richmond | 804.346.1515 www.vaphysicians.com “This award means a great deal to me and I am so grateful for the privilege and opportunity to care for my patients. I couldn’t have earned this if it wasn’t for my outstanding staff that allows me to have the ability and time to give excellent care and attention to each and every patient that comes to our practice.” — Minh Q. Tran, MD
34
Sharika Tripathi, MD
Commonwealth Infectious Disease Richmond | 804.601.0609 www.hcavirginia.com
3 Honorable Mention
Brian W. Hanrahan, MD
Stephen Young, MD
Judith McKenzie, MD
Virginia Diabetes Endocrinology Midlothian | 804.272.2702 www.vadiabetes.com
3 Third Place
Beth S. Du, MD
Associated Internists Richmond | 804.288.3079 www.bonsecours.com
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units (NICUs).
First Place
Jenny Fox, MD, MPH
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org “For that brief time that you spend with your patient and their family, you put aside your agenda for the day. You give your full attention to not just address medical concerns, but you acknowledge and attempt to meet social, developmental, religious, and psychological goals as well.” — Jenny Fox, MD, MPH
OurHealth | The Resource for Healthy Living in Greater Richmond
3 Third Place
Katherine Smallwood, MD Reynolds Primary Care Richmond | 804.346.1515 www.vaphysicians.com
First Place
Smile, laugh and joke, but deliver the message regardless of whether the news is easy or tough.
3 Second Place (tie)
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
Hospitalists of Virginia, LLP Richmond | 804.327.4046 www.hcavirginia.com Memorial Medical Center Mechanicsville | 804.764.1253 www.richmond.bonsecours.com
Sonia Shah-Pandya, MD
Internal Medicine Associates of Chesterfield Midlothian | 804.423.8470 www.richmond.bonsecours.com
Darren Witte, MD
VCU MCV Physicians at Chesterfield Chesterfield | 804.425.3627 www.vcuhealth.org
3 Second Place
Bonnie Makdad, MD
Commonwealth Neonatology Richmond | 804.282.8082 www.commonwealthneonatology.com
3 Third Place
Russell Moores, MD
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
Nephrology is the study of the function and diseases of the kidney and related organs.
First Place
Timothy Bunchman, MD
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org “Be relaxed and calm. Sit face to face with patients and families, and talk directly to the child. Smile, laugh and joke, but deliver the message regardless of whether the news is easy or tough. “ — Timothy Bunchman, MD
Neurology is the specialty of medicine which focuses on the diagnosis and treatment of disorders of the nervous system.
First Place
Amandeep Sangha, MD
Bon Secours Neurology Clinic at St. Mary’s Richmond | 804.893,8656 www.bonsecours.com “Bedside manner to me means treating patients with respect and compassion, no matter what the situation may be.” — Amandeep Sangha, MD
Nurse Practitioner (NP)
is a registered nurse with advanced academic and clinical experience, which enables him or her to diagnose and manage most common and many chronic illnesses, either independently or as part of a health care team.
First Place
Lynn Woodcock, FNP
Family Practice Specialists of Richmond Midlothian | 804.330.3335 www.fpsrichmond.com “I try to convey respect and compassion to my patients. This is what they deserve.” — Lynn Woodcock, FNP
3 Second Place
H. Brian Peppiatt, MD
Richmond Nephrology Associates Greater Richmond Metropolitan Area 804.272.5814 www.richmondnephrologyassociates.com
3 Honorable Mention
Ari Hirsch, MD
Richmond Nephrology Associates Greater Richmond Metropolitan Area 804.272.5814 www.richmondnephrologyassociates.com
3 Third Place
Martin Starkman, MD
HCA Virginia | Richmond 804.282.8005 | www.hcavirginia.com
3 Second Place (tie)
Stacey L. Epps, MD
Bon Secours Neurology Clinic Chester | 804.284.6880 Midlothian | 804.325.8750 www.bonsecours.com
Robert White, MD
HCA Virginia Physicians Neurological Associates Richmond | 804.272.9146 www.nairichmond.com
3 Second Place
Shelley Woodley, DNP, FNP-BC Bon Secours Surgical Dermatology Center Glen Allen | 804.977.8938 www.bonsecours.com
3 Third Place
Amy Foster, ACNP
Richmond Gastroenterology Associates Midlothian | 804.560.9844 www.richmondgastro.com
3 Honorable Mention
Ashley Beavers, ACNP
3 Third Place
Jonathan Bekenstein, MD, PhD
VCU MCV Physicians at Mayland Court Henrico | 804.527.4540 www.vcuhealth.org
3 Honorable Mention
Warren Felton III, MD
VCU MCV Physicians at Mayland Court Henrico | 804.527.4540 www.vcuhealth.org
Laura Duke, RN, CPNP
Pediatric Associates of Richmond Richmond | 804.282.4205 www.parpeds.com
Julie Julian, FNP-C
Virginia Physicians – Midlothian Family Practice Midlothian | 804.794.5598 www.vaphysicians.com
George Proffitt, NP-C
Colonial Heights Medical Center Colonial Heights | 804.520.3105 www.colonialheightsmedicalcenter.com
Karen Saunders, CPNP
Primary Care Family Practice Prince George | 804.526.1111 www.primecarefamilypractice.com
Pulmonary Associates of Richmond Inc. Richmond | 804.320.4243 www.paraccess.com
www.OurHealthRichmond.com
35
Obstetrics & Gynecology
is the specialty of medicine that includes care for women before, during, and after pregnancy and child birth and the diagnosis and treatment of disorders affecting the female reproductive system.
First Place
Mark Hyde, MD, FACOG
Virginia Physicians for Women Richmond | 804.897.2100 www.vpfw.com “Good bedside manner is important because it opens the door for trust and confidence from the patient’s perspective and a sense of responsibility and connection for the physician.” — Mark Hyde, MD, FACOG
3 Second Place (tie)
3 Honorable Mention
John Partridge, MD, FACOG
Wendy Bowman, MD
Alice Hirata, MD
Leemore Burke, MD
Virginia Physicians for Women Richmond | 804.897.2100 www.vpfw.com
Virginia Women’s Center Richmond | 804.288.4084 www.virginiawomenscenter.com
3 Third Place
Jennifer Hollings, MD
Bon Secours Capitol OB/GYN Richmond | 804.371.1689 www.bonsecours.com
Alliance Women’s Health Richmond | 804.523.9200 www.alliancewomenshealth.com HCA Virginia Physicians Commonwealth Ob/Gyn Specialists Richmond | 804.285.8806 www.commonwealth-obgyn.com
Erica Royal, MD
Virginia Physicians for Women Richmond | 804.897.2100 www.vpfw.com
David Reutinger, MD
Virginia Physicians for Women Richmond | 804.897.2100 www.vpfw.com
Occupational Medicine
is the branch of medicine dealing with the prevention and treatment of jobrelated injuries and illnesses.
Good bedside manner is important because it opens the door for trust and confidence
First Place
William Brickhouse, MD Advanced Orthopaedics Richmond | 804.270.1305 www.advancedortho.me.
“I am appreciative of this honor. We physicians know that oftentimes we are challenged to use our knowledge, gifts and talents to effectively treat patients. Recognition of this by our patients is indeed a stimulus”. — William Brickhouse, MD
Ophthalmology is the medical specialty that treats eye disorders, including injuries, infections, tumors, and cataracts.
3 Second Place
Joseph D. Iuorno, MD
First Place
Theodore Wu, MD, PhD
Virginia Eye Institute Richmond | 804.287.4200 www.vaeye.com
Commonwealth Eye Care Associates Richmond | 804.271.6363 www.commonwealtheye.com
3 Third Place
Jason Chiappetta, MD
Virginia Eye Institute Richmond | 804.287.4200 www.vaeye.com
Optometry is the specialty where the practitioner is trained and skilled in examining and testing the eyes for defects in order to prescribe corrective lenses or treatments.
First Place Michael Kish, OD
Virginia Eye Institute Richmond | 804.287.4200 www.vaeye.com “We now see more patients than ever before. With less time per patient, I focus on that person as the most important one I see. I Wlisten to their concerns intently, then help them see and feel better.” — Michael Kish, OD
38
OurHealth | The Resource for Healthy Living in Greater Richmond
3 Second Place
Joseph Andriano, MD
HCA Virginia Richmond | 804.254.5467 www.hcavirginia.com
3 Third Place
James Cisek, MD
Bon Secours Good Health Clinic Richmond | 804.288.1326 www.bonsecours.com
3 Honorable Mention
Chris Petras, MD
Richmond | 804.320.8385 www.drpetras.com
Paul Bullock, MD
Virginia Eye Institute Richmond | 804.287.4200 www.vaeye.com
Edwin Wortham
Virginia Pediatric Opthalmology Specialists Richmond | 804.272.8040 www.vposonline.com
3 Second Place
Peter Nardone, OD
Patterson Eye Clinic Richmond | 804.285.7638 www.pattersoneyeclinic.com
3 Third Place
Scott Bailey, OD
Midlothian | 804.739.8646 www.drscottbaileyod.com
3 Honorable Mention
Nina Cox, OD
Nina Cox, OD PC North Chesterfield | 804.745.1922 www.ninacoxod.com
Oral Surgery is the dental specialty that is limited to the diagnosis, surgery and treatment of diseases, injuries, deformities, and defects of the mouth.
First Place
Damon Watson, DDS, DMD, MD
Virginia Oral & Facial Surgery | Midlothian 804.608.3200 | www.oralfacialsurgery.com “I absolutely love what I do — especially my interactions with patients. I always hope to genuinely connect with them in some way. It’s priceless to witness an anxious patient start to smile and eventually thank us for a job well done...Awesome!” — Damon Watson, DDS, DMD, MD
3 Second Place
Gregory M. Zoghby, DDS
Commonwealth Oral and Facial Surgery Richmond | 804.354.1600 www.commonwealthofs.com
3 Third Place
Neil Agnihotri, DMD, MD
3 Honorable Mention
Ross Wlodawsky, DDS
Virginia Oral and Facial Surgery Glen Allen | 804.673.8061 www.oralfacialsurgery.com
Michael Miller, DDS
Commonwealth Oral and Facial Surgery Richmond | 804.354.1600 www.commonwealthofs.com
Virginia Oral & Facial Surgery Midlothian | 804.608.3200 www.oralfacialsurgery.com
Orthodontics is the specialty of dentistry that is concerned with the study and treatment of malocclusions (improper bites), which may be a result of tooth irregularity, disproportionate jaw relationships, or both.
First Place
Graham Gardner, DDS
Gardner and Jones Orthodontics | Richmond 804.282.6436 | www.gardnergrins.com “We have a simple philosophy: we treat our patients like family — with compassion and understanding. Every patient is a special individual and needs to be treated as such. A little kindness and a positive attitude go a long way”. — Graham Gardner, DDS
3 Second Place
Dale Rogers, DDS
Virginia Family Dentistry Midlothian | 804.379.1011 | www.vadentist.com
3 Third Place
Richard Byrd, DDS
Dr. Richard Byrd & Associates Richmond | 804.330.0508 | www.drbyrddds.com
3 Honorable Mention
Wakeshi Benson, DDS
WB Orthodontics Chester | 804.454.1888 | www.wb-orthodontics.com
Brian Brassington, DDS
Richmond Orthodontics Richmond | 804.740.7281 | www.rwbbraces.com
David Nyczepir, DDS
Davis & Nyczepri, Specialists in Orthodontics Chester | 804.748.3234 | www.richmondorthodontist.com
Orthopaedics is focused on diseases, injuries, and
conditions of the musculoskeletal system relating to the body’s muscles and skeleton, as well as the joints, ligaments, tendons, and nerves.
First Place Mark Jones, MD
OrthoVirginia Richmond | 804.379.8088 www.orthovirginia.com “I try to treat each patient as if they were a friend or a member of my family; with honesty, respect, and compassion.” — Mark Jones, MD
3 Second Place
Chester Sharps, MD
Tuckahoe Orthopaedics Richmond | 804.285.2300 www.tuckahoeortho.com
3 Third Place
Glenn Kerr, MD
3 Honorable Mention
Vivek Sharma, MD
Colonial Orthopaedics Chester | 804.530.3330 www.colonialorthopaedics.com
Michael Wind Jr., MD
Ortho Virginia Richmond | 804.379.8088 www.orthovirginia.com
OrthoVirginia Midlothian | 804.379.2414 www.orthovirginia.com
Otolaryngology (ENT) is a surgical specialty
focusing on the diagnosis, management, and treatment of diseases and disorders of the ear, nose, throat (ENT) and related structures of the head and neck.
First Place Alan Burke, MD
Virginia Ear Nose & Throat Henrico | 804.484.3700 www.virginia-ent.com “Manners make the man. This does make me feel totally “old school”, but if you have ever been on the receiving end of medicine or surgery, it’s easier to feel more empathy for the patients we meet. No one ever wants to see the doctor unless they need to.” — Alan Burke, MD
3 Second Place
Patrick Gibbons, MD
Commonwealth Ear Nose and Throat Specialists PC Richmond | 804.525.4231 www.commonwealthentpc.com
3 Third Place
Kelley Dodson, MD
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
3 Honorable Mention
Daniel Coelho, MD
VCU Medical Center Richmond | 804.628.4368 www.vcuhealth.org
Jin Lim, MD
Virginia ENT Richmond | 804.484.3700 www.virginia-ent.com
Michael Armstrong, MD
Richmond ENT Richmond | 804.622.3782 www.richmondent.com
Pain management encompasses pharmacological, non-pharmacological, and other approaches to prevent, reduce, or stop pain sensations.
3 Second Place
Jawad Wazir Bhatti, MD
First Place P. Duke Crane, MD
Neurosurgical Associates, PC Richmond | 804.288.8204 www.neurosurgicalva.com
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Virginia Pain Network and Clinics 804.302.8571 www.virginiapainnetwork.com
3 Third Place
Stephen Long,
Commonwealth Pain Specialists Richmond | 804.288.7246 www.commonwealthpain.com
3 Honorable Mention
Michael DePalma, MD
Virginia iSpine Physicians Richmond | 804.330.0303 www.vaispine.com
Palliative Medicine is a multidisciplinary approach to specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis.
First Place Tahira Naviwala, MD
Thomas Johns Cancer Hospital Richmond | 804.267.6814 | www.hcavirginia.com
“Good bedside manner is important to me because it is the first step in providing humanistic care. It is essential to comfort, connect and communicate with the patient to promote healing.” — Tahira Naviwala, MD
Pediatrics focuses on the detection, diagnosis, treatment and prevention of diseases in children, ages infant to 18-years of age.
First Place Charles Terry, MD
RVA Pediatrics Richmond | 804.754.3776 www.rvapediatrics.com
3 Second Place
Leanne Yanni, MD
Bon Secours Palliative Medicine Richmond | 804.288.2673 www.bonsecours.com
3 Third Place
Elizabeth Phan, DO
VCU Massey Cancer Center, Dalton Oncology Clinic Richmond | 804.828.9723
Bedside manner is honesty and truth with your patients, along with compassion and understanding.
www.vcuhealth.com
3 Second Place (tie)
3 Honorable Mention
Paul M. Strehler, MD
Kevin Campbell, MD
Gauri Gulati, MD
Timothy O’Neil, MD
Chippenham Pediatrics Richmond | 804.320.1353 www.chippenhampediatrics.com Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
3 Third Place
Patricia Mulreaney, MD
Chester Pediatrics Chester | 804.748.9090 www.chesterpeds.com Pediatric Associates Richmond | 804.320.7139 www.pediatricassocitespc.com
Jennifer Clark, MD
Woodlake Village Pediatrics Midlothian | 804.639.0717 www.woodlakevillagepediatrics.com
Pediatric Adolescent Health Partners Midlothian | 804.794.2821 www.pahpartners.com
Periodontics is the specialty of dentistry that studies supporting structures of teeth, diseases, and conditions that affect them.
3 Second Place
Joy Moretti, DDS
First Place
Chris Richardson, DMD
Richmond, Virginia Periodontist and Dental Implant Specialists Richmond & Midlothian | 804.355.6593 www.richmondperioonline.com
Midlothian Family Dentist Midlothian | 804.794.8745 www.midlodental.com
3 Honorable Mention
Stephanie Voth, DDS, MS Virginia Family Dentistry Midlothian | 804.379.1011 www.vadentist.com
3 Third Place
Benita Miller, DDS
Kaugars & Miller Richmond | 804.285.4867 www.richmondperio.net
www.OurHealthRichmond.com
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Pharmacy is the health profession of experts in the use of medicines.
First Place
Physician Assistant (PA) is licensed to practice medicine under the supervision of a licensed physician, and who thereby extends the physician’s capacity to provide medical care.
Baylor Rice, RPh
First Place
South River Compounding Pharmacy Henrico | 804.237.5970 www.southriverrx.com “To me bedside manner is a reflection of the respect and empathy I have for my patients and their issues or concerns. It is always my goal to make my patients feel at ease and involved in their healthcare decisions”. — Baylor Rice, RPh
3 Second Place
Daniel Weeks, PharmD
CVS Robious Road Richmond | 804.560.9082 www.cvs.com
3 Third Place
Sheila Pedigo, PharmD
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org
Jennifer Bauer, MPA, PA-C
Dermatology Associates of Virginia, PC Richmond | 804.285.2006 www.dermva.com “Bedside manner is all about making a patient feel comfortable: listening to their concerns, explaining medicine in understandable terms, educating them about their health, and letting them know that you are one of their greatest advocates.” — Jennifer Bauer, MPA, PA-C
3 Second Place
William Polhamus, PA
OrthoVirginia North Chesterfield | 804.379.8088 www.orthovirginia.com
3 Third Place
Charles Wadsworth, PA, MPAS Virginia Urology | Richmond 804.330.9105 | www.uro.com
3 Honorable Mention
Lindsey Jones, PA-C
Pulmonary Associates of Richmond Richmond | 804.320.4243 www.paraccess.com
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Plastic Surgery: Cosmetic
is the field of surgery that is performed to reshape structures of the body in order to improve appearance and self-esteem.
First Place
Isaac L. Wornom, III, MD, FACS
Richmond Plastic Surgeons Richmond | 804.285.4115 www.richmondplasticsurgeons.com
3 Second Place
Nadia P. Blanchet, MD
Nadia Blanchet Plastic and Reconstructive Surgery Richmond | 804.320.8545 www.madiablanchetmd.com
3 Third Place
Thomas Dewire, MD, PC
Advanced Art of Cosmetic Surgery Glen Allen | 804.290.0200 www.aacs-drdewire.com
3 Honorable Mention
Darrin Hubert, MD
Richmond Plastic Surgeons Richmond | 804.285.4115 www.richmondplasticsurgeons.com
John Zinsser, MD
Zinsser Plastic Surgery Richmond | 804.474.9805 www.zinsserplasticsurgery.com
I believe that when a patient feels “heard� by a health care professional, it is good bedside manner. www.OurHealthRichmond.com
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Plastic Surgery: Reconstructive
is the field of surgery concerned with reducing scarring or disfigurement that may occur as a result of accidents, birth defects, or treatment for diseases, such as melanoma.
Bedside manner is all about making a patient feel comfortable
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First Place
Jennifer Rhodes, MD
Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org “Having bedside manner means making an effort to care for the whole person and take the time to listen to their concerns. It also means being open to people from different cultures, backgrounds, and orientations to provide a nonjudgmental atmosphere in which everyone can feel comfortable. “ — Jennifer Rhodes, MD
OurHealth | The Resource for Healthy Living in Greater Richmond
3 Second Place
Sharline Aboutanos, MD, FAAP
Richmond Plastic Surgeons Richmond | 804.285.4115 www.richmondplasticsurgeons.com
3 Third Place
Leslie V. Cohen, MD
Plastic and Reconstructive Surgery, PC Richmond | 804.288.2800 www.lesliecohenmd.com
3 Honorable Mention
Lewis Ladocsi, MD
Richmond Plastic Surgeons Richmond | 804.285.4115 www.richmondplasticsurgeons.com
Physical medicine and rehabilitation, also referred to as physiatry, is a medical specialty concerned with diagnosis, evaluation, and management of persons of all ages with physical and/or cognitive impairment and disability.
First Place
Manmohan S. Khokhar, MD HCA - Physical Medicine & Rehabilitation of Richmond Richmond | 804.378.2233 www.hcavirginia.com
Physical therapy (or physiotherapy), often abbreviated PT, is the art and science of physical care and rehabilitation.
First Place
Tracy Adler, DPT, OCS, CMTPT Orthopedic Physical Therapy Richmond | 804.285.0148 www.orthopedicptinc.com
“I believe that when a patient feels “heard” by a health care professional, it is good bedside manner. A patient should feel that they are at ease, safe, understood and respected. At Orthopedic Physical Therapy, Inc, the entire staff is committed to these principles”. — Tracy Adler, DPT, OCS, CMTPT
Podiatry is the branch of medicine that deals with the diagnosis, treatment, and prevention of diseases of the human foot.
3 Second Place
Albert Jones, MD
Sheltering Arms Physical Rehabilitation Centers Richmond | 804.764.1001 www.shelteringarms.com
3 Third Place
Michael DePalma, MD
Virginia iSpine Physicians, PC Richmond | 804.330.0303 www.vaispine.com
3 Second Place
Fegan Hewitt, PT, DPT
Tidewater Physical Therapy, Inc. Midlothian | 804.639.2359 www.tpti.com
3 Third Place
Ann Dunbar, PT, MS
James Shadbolt, DPM, FACFAS
Henrico and Midlothian | 804.754.7400 www.lovethosefeet.com
3 Honorable Mention
Kristen Wright, PT, MPT, CMTPT Orthopedic Physical Therapy Richmond | 804.285.0148 www.orthopedicptinc.com
Louis Mazakas, DPT
Chester Physical Therapy Chesterfield | 804.706.1803 www.chesterphysicaltherapy.net
VCU Medical Center Richmond | 804.828.4409 www.vcuhealth.org
3 Second Place
David Weiss, DPM
First Place
Be the calmest person in the room. Instill hope, hopelessness is dangerous.
West End Foot and Ankle Richmond | 804.346.1779 www.richmondpodiatry.com
3 Honorable Mention
Allen Wax, DPM
Colonial Orthopaedics Chester | 804.518.1300 www.colonialorthopaedics.com
3 Third Place
Jeffrey Frost, DPM
The Foot & Ankle Center Richmond | 804.320.3668 www.320-foot.com
www.OurHealthRichmond.com
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Prosthetics and Orthotics
3 Second Place
is the evaluation, fabrication, and custom fitting of artificial limbs and orthopedic braces.
Michael Norton, CP
First Place Joe Sullivan, CP
Powell Orthotics & Prosthetics | Richmond | 804.649.9043 | www.powelloandp.com “I want to make a difference using my amputee life experiences to enhance the lives of others for more positive outcomes. My goal has always been to make Powell Orthotics and Prosthetics’ number one emphasis on quality of care and quality of products to help our patients regain their lives. It is a primary focus of Powell Orthotics and Prosthetics to become that support system in our community letting our patient population know they are not alone and there is light at the end of the tunnel! I love what I do, every day I get the chance to give back and change the lives of others!” — Joe Sullivan, CP
Psychiatry is the branch of medicine that deals with the diagnosis, treatment, and prevention of mental and emotional disorders.
3 Second Place
First Place
Martin Buxton, MD
Insight Physicians Richmond | 804.282.0655 www.hcavirginia.com
David Gould III, MD
Tucker Psychiatric Clinic Richmond | 804.320.7881 www.tuckerpsychiatric.com “Be the calmest person in the room. Instill hope, hopelessness is dangerous. Treat patients as I would have someone treat my family. Laugh when you can.” — David Gould III, MD
3 Third Place
Alexis Aplasca, MD
is the branch of medicine that deals with the diagnosis, treatment, and prevention of mental and emotional disorders.
First Place Pamela Siegel, LPC
MCA Network Richmond Richmond | 804.282.9100 www.mcanetwork.net
“Emotional pain is caused when relationships fail to meet basic needs for empathy, esteem and empowerment. In therapy, healing begins when these needs are met. Emotional wellbeing is assured when we learn to meet them ourselves”. — Pamela Siegel, LPC
OurHealth | The Resource for Healthy Living in Greater Richmond
3 Third Place
Paul Valentine, CO
Paul L. Valentine Orthotics & Prosthetics, LLC Richmond | 804.355.0283 www.valentineorthotics.com
3 Honorable Mention
Bella Sood, MD
Virginia Treatment Center for Children Richmond | 804.828.3129 www.chrichmond.org
Elliott Spanier, MD
Tucker Psychiatric Clinic Richmond | 804.320.7881 www.tuckerpsychiatric.com
Children’s Hospital of Richmond at VCU Richmond | 804.828.9632 www.chrichmond.org
Psychology & Counseling
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American Orthotic and Prosthetic Center Richmond | 804.353.9077 www.americanopc.com
3 Second Place
William Nay, PhD
VCU Department of Psychiatry Richmond | 804.828.9452 www.vcu.edu
3 Third Place
Carrie Walker, LPC, RPT-S, CTP
Richmond Creative Counseling Richmond | 804.592.6311 www.richmondcreativecounseling.com
Pulmonary (aka pneumology) is the specialty that deals with diseases of the respiratory tract and respiratory disease.
3 Second Place
First Place
Gregory Elliott, MD
Sujoy Gill, MD
Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com “Bedside manner is honesty and truth with your patients, along with compassion and understanding during patients and family’s difficult times.” — Sujoy Gill, MD
Bon Secours Pediatric Lung Care Richmond | 804.281.8303 www.bonsecours.com
3 Honorable Mention
Jamie C. Hey, MD
Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com
3 Third Place
Glenn Giessel, MD, FCCP, D.ABSM, CPI Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body.
First Place Laura Carucci, MD VCU Medical Center Radiology Richmond 804.828.9000 www.vcuhealth.org
“To me, bedside manner means taking the time to listen, treating all patients with empathy and compassion, and recognizing that each patient, each person is special. Every patient is a ‘VIP.’” — Laura Carucci, MD
3 Second Place
Nicole Kelleher, MD
Radiology Associates of Richmond Richmond | 804.282.8806 | www.rarichmond.com
3 Third Place
Rakesh Agarwal, MD
Hunter Holmes McGuire VA Medical Center Richmond | 804.675.5000 | www.va.gov
Honorable Mention
Charlotte Cockrell, MD
Virginia Physicians Imaging Center Glen Allen | 804.346.1741 | www.vaphysicians.com
Listen more, and talk less. www.OurHealthRichmond.com
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Sports medicine is an area of health and special services that apply medical and scientific knowledge to prevent, recognize, manage, and rehabilitate injuries related to sport, exercise, or recreational activity.
First Place Paul Kiritsis, MD
Ortho Virginia Richmond | 804.379.8088 www.orthovirginia.com “I appreciate the significance of patients trusting me with their health, and am humbled by it. Over time I have learned that often the right answer to their knee or shoulder problem is found from me listening more, and talking less.” — Paul Kiritsis, MD
3 Second Place
Larry Benson, MD
Advanced Orthopaedics Richmond | 804.270.1305 www.advancedortho.me
3 Third Place
Douglas Cutter, MD, CAQSM HCA Virginia Physicians HCA Virginia Sports Medicine Richmond | 804.560.6500 www.hcavasportsmed.com
3 Honorable Mention
Steven Reece, MD
Advanced Orthopaedics Richmond | 804.270.1305 www.advancedortho.me
Surgery: General is the treatment of injury, deformity, and disease using operative procedures.
3 Second Place
David Bettinger, MD
First Place Michael Rose, MD
Surgical Associates of Richmond | Richmond 804.320.2705 | www.thesar.com
Surgical Associates of Richmond Richmond | 804.320.2705 www.thesar.com
3 Third Place
Clifford Deal, III, MD, FACS
3 Honorable Mention
Amy T. Rose, MD
Surgical Associates of Richmond Richmond | 804.320.2705 www.hcavirginia.com
Dennis Cohen, MD
Bon Secours General Surgery St. Mary’s Richmond | 804.893.8676 www.bonsecours.com
HCA Virginia Physicians Richmond Surgical Richmond | 804.285.9416 www.richmondsurg.com
Surgery: Cardiac is surgery on the heart to correct
congenital heart disease or the complications of heart disease or valve problems created by various causes.
First Place
Vigneshwar Kasirajan, MD
VCU Division of Cardiothoracic Surgery Richmond | 804.828.2774 www.vcu.edu “Bedside manner means really caring about patients not just medically, but also to comfort and reassure.” — Vigneshwar Kasirajan, MD
Surgery: Neurosurgery is a surgical specialty for the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system.
First Place
Peter A. Alexander, MD, FACS Neurosurgical Associates, PC Richmond | 804.288.8204 www.neurosurgicalva.com
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3 Second Place
Marc Katz, MD
Cardiac Surgery Specialists Richmond | 804.287.7840 www.bonsecours.com
3 Honorable Mention
HCA Virginia Physicians
Cardiothoracic Surgical Associates Richmond | 804.282.8777 www.heartsurgeryva.com
3 Third Place
Chiwon Hahn, MD, FACS
HCA Virginia Physicians Cardiothoracic Surgical Associates Richmond | 804.282.8777 www.heartsurgeryva.com
3 Second Place
Scott Graham, MD
VCU Department of Neurosurgery Richmond | 804.828.9165 www.vcu.edu
3 Third Place
K Singh Sahni, MD, FACS
Neurosurgical Associates of Richmond Richmond | 804.330.4990 www.hcavirginia.com
3 Honorable Mention
Rajesh Mehta, MD
Neurosurgical Associates, PC Richmond | 804.288.8204 www.neurosurgicalva.com
Surgery: Spine is the medical specialty concerned with
the prevention, diagnosis, treatment, and rehabilitation of disorders which affect the spinal cord.
First Place
Jed Vanichkachorn, MD Tuckahoe Orthopaedics Richmond | 804.285.2300 www.tuckahoeortho.com
“For me the practice of medicine has always been about the person. If you demonstrate compassion and caring to the person then the “patient” always has a better outcome. I would not do this work if it was not for the people I get to know.” — Jed Vanichkachorn, MD
3 Second Place
Ricky Placide, MD
OrthoVirginia North Chesterfield | 804.320.1339 www.orthovirginia.com
3 Third Place
Stephen Fiore, MD
Advanced Ortho Richmond | 800.966.1718 www.advancedortho.me
3 Honorable Mention
Prakasam Kalluri, MD
Colonial Orthopaedics Colonial Heights | 804.518.1300 www.colonialorthopaedics.com
Joseph Kim, MD
OrthoVirginia Midlothian | 804.379.2414 www.orthovirginia.com
Thomas Scioscia, MD
OrthoVirginia Richmond | 804.288.8512 www.orthovirginia.com
Surgery: Vascular
is the treatment of surgery on diagnosed patients with diseases of the arterial, venous, and lymphatic system.
3 Second Place
Raymond Makhoul, MD
First Place Richard Binns
Surgical Associates of Richmond Richmond | 804.320.2705 www.thesar.com
Urology is a medical specialty that deals with disturbances of the urinary (male and female) and reproductive (male) organs.
First Place Kent Rollins, MD
Virginia Urology Richmond | 804.330.9105 www.uro.com “I’m honored to be selected for the best bedside manner award. It’s a tribute to the great team I work with at Virginia Urology. Their background work allows me to see patients in a timely unhurried fashion.” — Kent Rollins, MD
Surgical Associates of Richmond Richmond | 804.320.2705 www.thesar.com
3 Third Place
Barklie W. Zimmerman, MD, FACS Richmond Surgical Group Henrico | 804.968.4435 www.richmondsurgical.net
3 Second Place (tie)
Bedside manner means really caring about patients not just medically, but also to comfort and reassure.
3 Honorable Mention
Jeffrey Lou, MD
Kinloch Nelson, MD
Anthony Sliwinski, MD
Jeffrey Rebman, MD
Urology Specialists of Virginia Richmond | 804.323.0226 www.urologyspecialistsva.com Virginia Urology Richmond | 804.330.9105 www.uro.com
Virginia Urology Richmond | 804.330.9105 www.uro.com Urology Associates of Richmond Richmond | 804.320.1355 www.urologyassociatesofrichmond.com
3 Third Place
Michael Franks, MD
Virginia Urology Richmond | 804.330.9105 www.uro.com www.OurHealthRichmond.com
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FITBITS
H EA LT H A ND F I T NES S O N THE GO
pickle-what?
Pickleball! words | DIEDRE WILKES
Pickleball was invented in the mid-1960s as a children’s backyard game, but quickly became popular among adults as a fun game for players of all levels!
Pickleball shares features of other racquet sports such as tennis, racquetball, table tennis and badminton. It can be played by two, three or four players using solid paddles made of wood or composite materials to hit a perforated ball – similar to a waffle ball, over a net. Pickleball can be played on a recreational as well as a competitive level.
Is pickleball for you? Absolutely! Pickleball is for tennis players, raquetball players, ping pong players, as well as ANYBODY who has never even picked up a racquet, paddle, bat, etc. The unique aspects of pickleball make it easy to learn and enjoy almost immediately! Interested in learning more? Visit www.virginiapickleball.org for information on rules, equipment, tournaments and places to play.
Find a Class:
Here are a few locations in the Richmond area where you can find pickleball:
Workout Stats: cardio toning
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.
Midlothian Family YMCA
Shady Grove Family YMCA
Midlothian Athletic Club
Rockwood Park Pickleball Center
• 737 Coalfield Road Midlothian | 804.379.5668 www.midlothianymca.org
• 10800 Center View Drive Richmond | 804.322.2222 www.macrichmond.com
• 11255 Nuckols Road Glen Allen | 804.270.3866 www.shadygroveymca.org
• 3401 Courthouse Road North Chesterfield 804.683.8481 www.chesterfield.gov
Intensity:
moderate
www.OurHealthRichmond.com
53
Step Out: Walk to STOP Diabetes It was a chilly start to the day in Richmond with 40-degree temperatures. But, by the time the American Diabetes Association “Step Out: Walk to STOP Diabetes,” began and the sun rose, the conditions improved making perfect weather for a 5K walk – sunny and comfortable with temperatures in the 60’s.
behalf of people with diabetes and education for everyone in the greater Richmond area.
The event was held at the Bon Secours Washington Redskins Training Center in downtown Richmond. More than 1,000 people showed their support for people living with diabetes. Over $220,000 was raised to support research for a cure, advocacy on
All of the participants received valuable information at the Wellness Village exhibits by local area vendors, and lunch was provided by Subway, one of the national sponsors. With music, food and post-walk sunshine, many people stayed and relaxed into the afternoon.
The Walk consisted of four loops around the Training Center and immediate blocks around the Center. Beads were handed out to all walkers to help keep a count of the laps.
Photos courtesy of Amy Garelick
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ON THE WEB
More at ourhealthrichmond.com
www.OurHealthRichmond.com
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family
joy work
beauty
skill
sadness
spee
words | SUSAN DUBUQUE research | ARTHUR OLIVAREZ
ang
This series explores diseases that can be devastating to the individuals and families they affect — yet no one is talking about them. That is, until now. In OurHealth, we bring these medical issues into the light and dedicate these stories to the courageous patients and families living with them and the providers and researchers who commit their lives to treating and seeking cures for these silent killers.
It started with subtle symptoms — little bouts of dizziness and headaches that would only last a few minutes. At first it only happened about once a week. Then two or three times a week. Finally, the spells became a daily occurrence.
Scott Garrett, a busy industrial equipment supplier, spent long days driving throughout his sales territory that spanned from Gloucester to Chesapeake, calling on as many as 10 clients a day. “When the dizziness would hit, I would pull off the highway and rest for two or three minutes until it passed,” he says. “I knew I should see a doctor to find out what was going on, but life and work just kept getting in the way.”
laught lls On July 10, 2014, the daily grind came to a sudden halt when his wife, Keeley Garrett, found him lying on the floor at the foot of the stairs. When Scott Garrett was roused, he tried to convince his wife that he was just tired and was “lying on the floor resting.”
By early September — less than two months after suffering a stroke and having brain surgery — Scott Garrett was back at work.
Fortunately, Keeley Garrett is a nurse, and she was not fooled by Scott Garrett’s story. She checked his blood pressure, and when she discovered it was elevated, she insisted on calling 911. He was taken to a hospital close to their home. “I was asked to stay in the waiting area while Scott was being examined,” says Keeley Garrett. “By the time I was taken back into the exam room, Scott was chatting and laughing with the medical staff. He assured them that his only problem was a ‘touch of vertigo’ — which he had self-diagnosed on the Internet.” The hospital conducted an EKG, CT scan and physical examination and took his medical history but could not pinpoint any reason for Scott Garrett’s dizziness, so he was discharged from the hospital. “A few hours later, I felt that something was just not right. I know my husband better than anyone,” says Keeley Garrett. She called 911 again, and Scott Garrett was taken back to the hospital where a second CT scan revealed a small area of blockage in an artery in his brain. “Scott’s speech was now slurred, one side of his mouth seemed slightly twisted and he had vision problems. The scariest part was when Scott told me he could only see about a quarter of my face,” recalls Keeley Garrett. It was apparent that more advanced care was needed, and Scott Garrett was transferred by ambulance to VCU Health’s Comprehensive Stroke Center in Richmond.
Warren Felton, MD, is a neurologist and medical director with VCU Health Comprehensive Stroke Center in Richmond. He is certified in neurology by the American Board of Psychiatry & Neurology with a subspecialty in vascular neurology.
Additional tests conducted at VCU Health showed that he’d had an ischemic stroke. Since too much time had passed, he was not able to receive the clot-busting drugs to treat his stroke. “We were fortunate to be at a major medical center,” says Keeley Garrett. “Dr. Felton immediately called in Dr. John ReaveyCantwell, a neurovascular surgeon. He was able to remove the blood clot in Scott’s brain through a catheter inserted through his upper leg.” Warren Felton, MD, is medical director of VCU Health’s Stroke Center.
Scott Garrett was admitted to the Neuroscience Intensive Care Unit, and after a few days he was transferred to the progressive care neuroscience 58
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floor. “We were all pretty amazed at how quickly he recovered,” says Keeley Garrett. “I was in a hurry to go home,” says Scott Garrett, “and that motivated me. When I first woke up I couldn’t move my left arm or leg. But by the next morning I had feeling on that side of my body. I was anxious for the physical therapist to come help me walk.” “Scott’s short-term memory was impaired. But that only lasts for about two days,” says Keeley Garrett. “The doctors told me I had ‘the trifecta’ — three major problems related to my stroke,” says Scott Garrett. The first was a patent foramen ovale — a small hole between the upper chambers of the heart. Millions of people have PFOs, and they typically cause no problems. Medical issues can occur when the blood leaking from the right to the left chamber of the heart contains a blood clot. The PFO doesn’t cause a stroke, but it does provide a portal where the blood clot can enter the circulatory system and travel to the brain. Scott Garrett’s second problem was a narrowing of the vertebral arteries that carry blood to the brainstem. “That’s what caused my dizziness and vertigo,” he says. “So, my Internet research wasn’t totally off base.” In only six days, Scott Garrett had improved enough to be discharged from the hospital. Unfortunately, he suffered a setback. His third problem was a blood clot in his leg called a deep vein thrombosis. “A few days after going home, I had to go back to the hospital to be treated for the DVT,” he says. “But once that was taken care of, a physical therapist came to the house twice and gave me exercises that I could do on my own to regain my strength. I was on my way.” By early September — less than two months after suffering a stroke and having brain surgery — Scott Garrett was back at work. “I started slowly, working mostly in the office,” he says. “But, by the end of September, I was back to 100 percent.” “For a while, I would have little flashes of anxiety,” he admits. “For instance, if I stumbled over something, I would think, ‘Did
I trip or is it another stroke?’” Thankfully, those moments of unease have passed. When the Garretts look back over Scott Garrett’s illness, they do so with a genuine sense of gratitude. “We were blessed that Scott received such good care at VCU,” reflects Keeley Garrett. “We have a lot of confidence in Dr. Felton, Dr. Reavey-Cantwell and the entire staff.” “We feel fortunate that we know what caused my stroke,” says Scott Garrett. “And we know what it will take to prevent it from happening again. I’ve made some changes for the better in how I live. I take my medication (Warfarin and a baby aspirin) every day to prevent blood clots. I get plenty of exercise by walking. And I actually lost some weight.” When it comes to living a healthy lifestyle, he refers to himself as “a work in progress.” And he learned another lesson. “If I could give any advice to others, it would be not to wait.
And don’t rely on what you read on the Internet. If you’re not feeling right or if you have any symptoms of a stroke, get medical help right away. I was lucky not to have any permanent damage. But I have too much to live for. With a wonderful wife and our daughters, Ebonee and Sidney, I won’t ever take that for granted.
Scott Garrett with his wife Keeley and their daughters, Ebonee & Sidney.
What is a stroke? According to the National Stroke Association, a stroke is a brain attack that occurs when a blood vessel that carries oxygen to the brain bursts or is blocked by a clot. When the brain is deprived of oxygen, brain cells begin to die. A stroke can affect movement, speech, perception, memory or other mental and bodily functions. www.OurHealthRichmond.com
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“How a person is affected by a stroke will depend on the area of the brain where the stroke occurs and the extent of the brain damage,” says Dr. Felton. “Some people have very minor problems, like temporary weakness of an arm or leg, while others may suffer significant impairment, including permanent paralysis on one side of the body or loss of the ability to speak. Many people make a complete recovery from a stroke, but more than two-thirds of those who survive have some type of disability.” Stroke is the fifth-leading cause of death and the No. 1 cause of adult disability in the United States. Each year 800,000 people experience a new or recurrent stroke. Virginia is located in the “stroke belt” — a region in the southeastern U.S. that is recognized by public health authorities for having an unusually high incidence of stroke and other forms of cardiovascular disease.
Approximately 80 percent of strokes are preventable.
“There are different types of stroke,” says Dr. Felton. The major categories are: Ischemic strokes account for about 85 percent of strokes. They occur when the artery that supplies oxygen-rich blood to the brain becomes blocked. Hemorrhagic stroke occurs when an artery leaks blood or a brain aneurysm ruptures. The leaked blood puts pressure on brain cells, which damages them. Transient ischemic attack (TIA), also known as a “mini stroke,” is caused by a temporary clot. TIAs produce strokelike symptoms but do not cause lasting damage.
Risk factors for stroke Anyone can have a stroke, but there are a number of factors that increase the risks. “Some risk factors cannot be controlled,” says Dr. Felton, “but you can take action to prevent a stroke by understanding and managing factors that you can control.”
Risk factors that cannot be controlled • Age – Although individuals of any age can have a stroke, the risk increases with age. The chance of having a stroke doubles every 10 years after age 55. 60
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• Gender – Stroke is more common in men than in women for most age groups. But women of all ages are more likely to die from a stroke, which kills twice as many women as breast cancer every year. Women also suffer greater disability than men after having a stroke. • Ethnicity – African Americans, Hispanics, Native Americans, and Alaska Natives have a greater chance of having a stroke than do non-Hispanic whites or Asians. African Americans have a greater chance of having a stroke, in part due to their higher prevalence of high blood pressure, diabetes and sickle cell disease. • Family history – Stroke risk increases if a family member (parent, grandparent or sibling) has had a stroke or a heart attack at an early age.
Risk factors that can be managed Amandeep Sangha, MD, medical director of the Joint Commission Advanced Stroke Program at Bon Secours St. Mary’s Hospital, offers the following insights into understanding and managing the medical conditions that increase the risk for stroke. • Hypertension – Hypertension, or high blood pressure, can cause both ischemic and hemorrhagic strokes. Many people don’t know they have high blood pressure, so regular blood pressure checks are essential. Eat a balanced diet, maintain a healthy weight and exercise regularly to help reduce blood pressure, and talk with your healthcare provider about medication if needed. • Diabetes – Individuals with diabetes are up to four times more likely to have a stroke than those who don’t. In part, this is because people with diabetes often have other risk factors for stroke, such as high blood pressure and high cholesterol. Diabetes can be controlled by losing weight, exercising, changing your eating habits and, if needed, taking oral medications or insulin shots. • Cholesterol – Cholesterol is the fatty substance in the blood. It is produced by the liver and found in certain foods. If we take in more cholesterol than the body can
use, the extra cholesterol can build up in the arteries, including those in the brain, which can lead to narrowing of the arteries, stroke, heart disease and atherosclerosis. Cholesterol levels can be checked with a simple blood test. Healthy eating, exercise, fish oil supplements and medications can help lower cholesterol.
whole-grain foods contain fiber that can help lower blood cholesterol and help you feel full, which may help you manage your weight. Recent research shows that eating oily fish containing omega-3 fatty acids — including salmon, trout and herring — can help lower your risk of death from heart disease or stroke.
• Heart disease – Certain heart disorders can increase the risk for stroke because plaque builds up in the arteries and blocks the flow of oxygen-rich blood to the brain. Other heart conditions, such as heart valve defects, irregular heartbeat — including atrial fibrillation — and enlarged heart chambers, can cause blood clots that could break loose and cause a stroke.
• Exercise. “Exercise is a huge factor in reducing your stroke risk,” says Dr. Sangha. “You don’t have to run a marathon. Walk or do other physical activities for at least 30 minutes on most days. You will lower your risk for heart disease, hypertension, diabetes and stroke.” But before you start, check with your doctor.
• Prior stroke or TIA – An individual who has had a stroke is at increased risk for having another one. Someone who has had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and gender who has not. It is important to recognize and treat a TIA as a medical emergency in order to reduce the risk of a major stroke. “About 80 percent of strokes are preventable,” says Dr. Sangha. “You can reduce your risk of having a stroke through lifestyle changes. It isn’t magic. There are some basic guidelines that I recommend to my patients.” They include: • Quit smoking. Smoking doubles the risk of stroke and is even higher among women who also take oral contraceptives. It increases clot formation and plaque buildup in arteries, and it thickens the blood. If you smoke, try to quit. If you can’t quit on your own, ask your doctor about stop-smoking aids like nicotine patches, counseling and smoking cessation programs. • Use alcohol in moderation. Drinking too much alcohol can elevate blood pressure and increase your risk of stroke. If you drink, do so in moderation — no more than two drinks a day for men and one drink a day for women. • Eat healthy. Eat a variety of nutritious foods from all the food groups. Vegetables and fruits are high in vitamins, minerals and fiber, and they’re low in calories. Unrefined
• Maintain a healthy weight. To lose weight, use more calories than you eat every day. Before starting a diet, check with your doctor.
Signs and symptoms of stroke According to the American Stroke Association, someone in the U.S. suffers a stroke every 40 seconds. The warning signs of stroke can be subtle and often going unnoticed by the individual experiencing symptoms and the people around them. “A stroke is a medical emergency,” says Mary Morrissette, neuroscience administrator at Chippenham and Johnston-Willis hospitals. “Learn the signs, and if you or a loved one experiences these symptoms, seek help immediately. Too often people wait, hoping the symptoms will pass.”
Amandeep Sangha, MD, is a neurologist and site lead in the department of neurology and the medical director of the stroke program at Bon Secours St. Mary’s Hospital in Richmond. He is certified in neurology by the American Board of Psychiatry & Neurology with a subspecialty in clinical neurophysiology.
Treating a stroke within three hours is vital to avoiding serious and permanent damage. An ischemic stroke, caused by a blocked artery, can be reversed 85 percent of the time if treatment is initiated in a timely manner. Donna Doherty, SCRN, a stroke certified registered nurse at Chippenham and JohnstonWillis hospitals, teaches this simple, easy-torecall acronym to help identify the signs of stroke: BE FAST. • Balance – The severe, sudden onset of balance problems and ataxia, the inability to walk normally. • Eyes and vision – Unusual trouble with sight in one or both eyes. www.OurHealthRichmond.com
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• Face drooping – Numbness or tingling of the face, a crooked or uneven smile. • Arm weakness or leg numbness – Weakness, numbness or tingling on one side of the body. • Speech difficulty – Trouble speaking or understanding words, slurred or garbled speech. • Time to call 911 – Even if symptoms appear temporarily, call 911 immediately. Survive, don’t drive. Make note of the time the symptoms first appeared. Remember, time is brain. “I can’t stress enough the importance of not waiting,” says Doherty. “The symptoms of stroke are usually not painful making them easy to ignore. And many people don’t want to be a bother.” Mary Morrissette, BSN, RN, is the neuroscience administrator at Chippenham Hospital and Johnston Willis Hospital Comprehensive Stroke Center in Richmond.
Donna Doherty, MSN, SCRN, RN, is the stroke coordinator at Chippenham Hospital and Johnston Willis Hospital Comprehensive Stroke Center in Richmond.
How is stroke diagnosed and treated? When a patient arrives in the emergency department with an apparent stroke, accurate diagnosis is the vital first step. The signs of stroke can be caused by a variety of medical conditions. For example, Bell’s palsy produces paralysis or weakness of the muscles on one side of your face that may look like a stroke. The type of stroke — ischemic caused by a clot or hemorrhagic resulting from a leaky or ruptured blood vessel — will dictate the appropriate treatment, according to Dr. Sangha. A CT scan or MRI typically will be done to show if a stroke has occurred and the location and type of the stroke. The gold standard for treating ischemic strokes is tissue plasminogen activator, commonly referred to as “tPA.” This clot-busting drug, given through an IV, must be administered within three hours of the onset of symptoms — up to four and a half hours in certain circumstances. The tPA dissolves the blood clot and improves blood flow to the brain, which can improve the chances of recovering from a stroke. “This is why it is important to identify a stroke and call 911 immediately,” advises Doherty. Another treatment option is an endovascular
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— which means within the blood vessels — procedure called “mechanical thrombectomy.” A neurosurgeon, interventional radiologist or endovascular-trained neurologist will attempt to remove a large blood clot by sending a stent retriever that resembles a tiny wire cage to the site of the blocked blood vessel in the brain. The doctor threads a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot, and the physician removes the stent with the trapped clot. This procedure should be done within six hours of acute stroke symptoms. Hemorrhagic strokes may be treated in several ways. If you’re taking blood thinners, you’ll be taken off the medication. Medicines to lower blood pressure might be prescribed. A leaky or ruptured blood vessel (aneurysm) can be repaired with endovascular embolization, or “coiling.” Similar to the process used to remove a clot, a catheter is threaded through an artery in the groin or arm to the brain, and a tiny platinum coil is inserted to block or reduce the flow of blood. The blood then clots around the coil, essentially sealing the leak. An alternative surgical procedure, referred to as “clipping,” could be performed to treat hemorrhagic strokes. “Once a patient is stabilized from the initial assault of a stroke, it is important that we understand the reason for the stroke,” explains Dr. Sangha. “That way we can take steps to reduce the risk of a recurrence.”
Treatment continues Treatment for stokes can continue for many months following the initial event to help patients regain as much function as possible and learn skills to compensate for any lasting deficiencies. “Stokes can result in physical, sensory, communication, cognitive and emotional deficits,” says Stacie Stevens, stroke program coordinator for VCU Health. Stroke survivors can experience muscle weakness or paralysis, typically on one side of the body. Physical and occupational therapy could be prescribed to help patients regain mobility, dexterity and the skills of daily living, such as dressing, feeding, tying shoes and the like.
Speech therapy can be useful for treating communication deficits, including the inability to understand or produce speech correctly (aphasia), slurred speech due to weak muscles (dysarthria), difficulty in programming oral muscles for speech production (apraxia) and problems swallowing (dysphagia).
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A speech therapist can also help patients with exercises to improve cognition, including memory, attention, problemsolving, reasoning, following directions, initiating activity and comprehension. “Thanks to the plasticity of the brain — particularly among younger stroke patients — individuals may be able to redevelop some capabilities,” says Dr. Sangha. Plasticity refers to the brain’s ability to repair and reorganize cells; healthy brain cells create new pathways to unaffected parts of the brain, taking over the jobs previously carried out by brain cells that have been destroyed. “Addressing the physical effects of stroke is only part of the journey back to health,” says Morrissette. “Stroke patients may also need support and treatment for mental health problems that can include extreme mood fluctuations or inappropriate emotions, such as laughing when something isn’t funny or crying for no apparent reason. This behavior is particularly common early in the recovery process. “Stroke survivors may mourn the loss of capabilities and should be screened and, if needed, treated for depression.” says Morrissette. Younger stroke patients can have different concerns, such as educational, career and relationship issues that can require special attention. And the patient is not the only person affected by a stroke. “Caregivers must also cope with dramatic changes in their lives, such as the loss of a spouse as they once knew or a parent now caring for her once-independent middle-aged child,” says Stevens. www.OurHealthRichmond.com
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What does the future hold? “Medical and surgical treatments for patients with stroke are rapidly developing,” says Dr. Felton.
Below are a few of the advances that suggest new hope for stroke patients: • Research studies published in the New England Journal of Medicine in 2015 found that ischemic stroke patients who were treated within six hours of the onset of symptoms with both tPA and a clot-removal device had significantly better outcomes than patients treated with tPA alone.
Stacie Stevens, PHD, FNP-BC, RN, is the stroke program coordinator at the VCU Health Comprehensive Stroke Center in Richmond.
• Researchers at the University of TexasDallas are conducting early studies of a new treatment to aid in the recovery of limb function after a stroke. Vagus nerve stimulation is an FDA-approved method for treating various illnesses such as depression and epilepsy. It involves sending a mild electric pulse through the vagus nerve, which causes the release of chemicals in the brain (neurotransmitters) that enhance learning and memory. It is hoped that vagus nerve stimulation will support neuroplasticity — the brain’s ability to change its neural circuitry — leading to long-lasting improvement in function for stroke patients. • When the brain is deprived of oxygen during a stroke, brain cells die. A second wave of brain injury can occur when excess amounts of toxic chemicals are released in the brain following a stroke. Researchers at the National Institute of Neurological Disorders and Stroke are studying the mechanisms underlying this secondary assault, which involves inflammation, toxicity and a breakdown of the blood vessels that provide blood to the brain. From this research, scientists hope to develop neuroprotective agents to prevent secondary damage. • “New developments in stroke care are happening right here in Richmond,” notes Dr. Felton. • Research at VCU Health includes newer blood thinners to reduce the chance of recurrent stroke and a drug to improve walking after stroke.
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• VCU Health Virginia Women’s Stroke Prevention Initiative is a study to determine whether incorporating enhancements to the electronic health record will lead to more effective screening and treatment of patients with stroke and cardiovascular risk factors. “No matter how far we go in developing new techniques for diagnosing and treating stroke, prevention is still the best medicine. That is where our focus should be,” concludes Dr. Felton. ”We can make major strides in reducing the devastating effects of stroke by understanding and managing the controllable risk factors.”
Medical Experts • Donna Doherty, MSN, SCRN, RN, Stroke Coordinator, Chippenham Hospital and Johnston Willis Hospital Comprehensive Stroke Center • Warren Felton, MD, Medical Director, VCU Health Comprehensive Stroke Center • Mary Morrissette, BSN, RN, Neuroscience Administrator, Chippenham Hospital and Johnston Willis Hospital Comprehensive Stroke Center • Amandeep Sangha, MD, Site Lead, Department of Neurology and Medical Director, Stroke Program, Bon Secours St. Mary’s Hospital • Stacie Stevens, PHD, FNP-BC, RN, Stroke Program Coordinator, VCU Health Comprehensive Stroke Center
Research Assistance • Arthur Olivarez, Virginia Commonwealth University
Resources • National Stroke Association – Stroke.org • Centers for Disease Control and Prevention – CDC.gov • National Institute of Neurological Disorders and Stroke – NINDS.NIH.gov • American Stroke Association – strokeassociation.org • YoungStroke (organization for young stroke survivors) youngstroke.org
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HealthyEats Breakfast: Slow Cooked French Toast Casserole
Directions:
(Makes 9 servings)
1. Add the first six ingredients to a medium sized bowl, whisk to combine.
Ingredients:
2.
3 whole eggs (omega 3 rich preferably) 11/2 cups organic 1% milk, 2 tablespoons local honey 1 teaspoon vanilla extract 1/2 teaspoon cinnamon 9 slices 100 percent whole wheat bread
Filling Ingredients: 3 cups finely diced uncooked apple pieces (Honey Crisp or Gala recommended) 3 tablespoons local honey 1 teaspoon lemon juice 1/3 cup diced raw pecans 1/2 teaspoon cinnamon
Lightly coat the inside of the slow cooker with nonstick cooking spray.
3. Combine all of the filling ingredients in a small bowl and mix to coat apple pieces, set aside. 4. Cut bread slices in half, as triangles. 5. Place one layer of bread (six triangles) on the bottom of the slow cooker, add ¼ of the filling and repeat until there are 3 layers of bread. 6. Add the remaining filling to the top. Pour egg mixture over bread. 7. Cover and cook on high 2 to 21/2 or low 4 hours, or until bread has soaked up the liquid. 8. Optional: Drizzle with 100 percent pure maple syrup if desired.
½ teaspoon nutmeg
Fresh Apples from:
Carter Mountain Orchard 1435 Carters Mountain Trail Charlottesville | 434.977.1833 www.cartermountainorchard.com About: Carter Mountain Orchard is open mid-April through November and weekends in December. In addition to apples, they also have pumpkins, gourds, Indian corn, and classic hayrides. They also have a country store with local crafts, gourmet food products, apple butter, jams and jellies and gift items.
Tricia Foley’s Clean Eating
FRENCH TOAST CASSEROLE
Tricia Foley is OurHealth Magazine’s resident nutritionist, as well as the registered dietitian at the Weigh Station in Richmond. www.OurHealthRichmond.com
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HealthyEats Local Sweet Potato from:
Mount Olympus Farm 23298 Jefferson Davis Highway Ruther Glen | 804.448.0395 www.mtolympusfarm.com
About: Mount Olympus Farm is a family owned farm located between Richmond and Fredericksburg. They offer a large variety of high quality fresh vegetables, including many heirloom varieties. There is a garden center with many perennials, herbs, annuals and shrubs. Pick-your-own strawberries, blueberries and blackberries are available in season as well.
Side: Sweet Potato & Cauliflower Mash (Makes 4-6 servings) Ingredients: 6 sweet potatoes 1 pound cauliflower florets 3 tablespoons organic milk of choice ¼ cup plain Greek yogurt ½ teaspoon garlic powder
Salt and pepper to taste
Fresh chopped parsley as desired
Directions: 1. Peel and cut sweet potatoes into 1½ inch chunks. 2. In large pot, steam sweet potato and cauliflower with one inch of water in bottom of pot. 3. Allow to steam for approximately 10 to 12 minutes, or until fork tender. 4. Place in large bowl and mash the potatoes and cauliflower with the milk. 5. Stir in the greek yogurt, garlic powder, salt and pepper. 6. If too thick, add additional milk, one tablespoon at a time, until desired consistency is accomplished. 7. Sprinkle with chopped fresh parsley.
Tricia Foley’s Clean Eating
SWEET POTATO MASH
Tricia Foley is OurHealth Magazine’s resident nutritionist, as well as the registered dietitian at the Weigh Station in Richmond.
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HealthyEats Dessert: Pumpkin Ice Cream (Makes 6 servings) Ingredients: 4 medium bananas, sliced and frozen overnight 1 cup pumpkin puree 1/3 cup maple syrup 2 teaspoons pumpkin spice, no sugar added
Directions: 1. Using a food processor, blend the bananas, pumpkin, maple syrup, and pumpkin spice thoroughly. 2. Transfer to a freezer-safe container and freeze for 24 hours.
Local Maple Syrup from:
Lakeside Farmers’ Market
6110 Lakeside Avenue | Richmond www.lakesidefarmersmarket.net About: Lakeside Farmers’ Market is open year-round on Saturday mornings and all day on Wednesdays. They feature items from local vendors in the Greater Richmond Area.
Tricia Foley’s Clean Eating
PUMPKIN PIE ICE CREAM Tricia Foley is OurHealth Magazine’s resident nutritionist, as well as the registered dietitian at the Weigh Station in Richmond. www.OurHealthRichmond.com
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Earl Mason
Richmond , VA
YMCA’s Diabetes Prevention Program
‘IT’S WORKING!’
Yearlong program aimed at those with prediabetes
words | SUZANNE RAMSEY words | SUSAN DUBUQUE original photography | TYLER DARDEN
Diabetes causes more deaths per year than breast cancer and AIDS combined. Source: American Diabetes Association
About this time last year, Earl Mason joined the local Chester Family YMCA. Diagnosed as a “borderline diabetic” a few years before, Mason says he’d been working with his physician and using diet and exercise to keep his blood sugar under control. But eventually, he started to get a little bored with his exercise routine, so he joined the Y. During his initial briefing, a YMCA staff member told Mason about the Diabetes Prevention Program — a yearlong educational course that aims to help adults who have been diagnosed with prediabetes or are at risk for Type 2 diabetes make lifestyle changes that can help them avoid or delay onset of the disease. “I said, ‘I would like to join that,’” says Mason, a 62-year-old retired government contractor. “I joined it, and it’s working well for me. I keep my [blood glucose] numbers under control and keep my diet and weight under control. It’s working.” The Diabetes Prevention Program is an initiative of the Centers for Disease Control and Prevention, which reports that 1 in 3 American adults have prediabetes and most — about 90 percent — don’t even know it. Prediabetes, as explained by the CDC, is when the blood glucose (sugar) level is higher than normal, but not high enough to be diagnosed as diabetes.
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The YMCA lifestyle coach meets with participants weekly for 16 weeks, then monthly for 8 months. This added support helps participants maintain progress.
Prediabetes: Am I at risk? • You may be at risk for Type 2 diabetes if you • Are 45 years of age or older. • Are overweight. • Have a family history of Type 2 diabetes. • Have high blood pressure. • Are physically active fewer than three times per week. • Ever had diabetes while pregnant (gestational diabetes) or gave birth to a baby that weighed more than 9 pounds. Source: CDC.gov
Having prediabetes puts people at higher risk for Type 2 diabetes, previously called adult-onset diabetes. The American Diabetes Association reports that 29 million Americans — more than 9 percent of the population — have diabetes, and that nearly all of them have Type 2 diabetes. Due to the well-documented childhood obesity epidemic, physicians are increasingly seeing Type 2 diabetes in children as well. To localize these numbers, consider that 9 percent of the population of the city of Richmond is about 19,000 people; 9 percent of the greater Richmond area’s population is about 113,400 people. YMCA of Greater Richmond, which operates 17 branches throughout the metropolitan area, has been offering the Diabetes Prevention Program since 2013. It’s one of more than 625 organizations across the country, including about 165 YMCAs, that are certified to offer the program. “We know that diabetes and prediabetes are a huge factor for America and Virginia,” says Jana Smith, associate director of community health for YMCA of Greater Richmond. “In Virginia, 2.2 million adults have prediabetes, and 9 out of 10 don’t know it. “It’s not something right now that is part of a common conversation with doctors in the regular annual checkup. We’re trying to raise awareness. If you determine you are at risk, number one, talk with your doctor to help manage your risk, and number two, work with the Y to reduce your risk for the onset of Type 2 diabetes.” YMCA of Greater Richmond offers the Diabetes Prevention Program at all of its locations. The course is open to adults, ages 18 and older. Classes start at various times throughout the year and are held during the day, in the evenings and on weekends, depending on need and interest. The Y also offers the course at community centers, churches and other locations. “We offer them all the time,” Smith says. “It really depends on where the need is and when there’s a need. Once we identify enough people to start a class, we get on it.” The YMCA also is collaborating with local businesses and hospitals that might be interested in providing the program to their employees. “Some employers are paying for it,” Smith says, referring the program’s $429 fee. “They recognize
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What is Type 2 diabetes? Diabetes is a problem that causes blood glucose (sugar) levels to rise higher than normal, called hyperglycemia. Type 2 diabetes is the most common form. With Type 2 diabetes, the body does not use insulin properly, which is known as insulin resistance. At first, the pancreas makes extra insulin, but over time it isn’t able to keep up and can’t make enough insulin to keep blood glucose at normal levels. Source: American Diabetes Association
Jana Smith, associate director of community health for YMCA of Greater Richmond
the need is so important. They want to make their workforce and community healthier and also see it reflected in their financials and health benefits that they’re providing. Some of the employers are paying the full cost for their employees to participate. “We have relationships with most of the hospitals. Whether it’s a physician referring a patient to us or they’re paying for their employees, we’re working with the hospitals. We have a great partnership with the Virginia State Health Department, which is really helping us connect with the local health districts, particularly the Crater District — Petersburg, Emporia, Hopewell — and getting some programs going down there.” Demographically, Smith says, most of the Richmond-area participants fall into the 40-andover age bracket. Because prediabetes and Type 2 diabetes are “more prevalent in the AfricanAmerican community, we do see some of that trend in our classes as well.” Reaching older adults is also a priority. Smith has been working with the Better Housing Coalition, Senior Connections and other organizations to identify older adults who could benefit from the program. “Once someone turns 65, they’re at greater risk for Type 2 diabetes, so we’re making a concentrated effort to reduce that risk,” she says. The primary goals of the Diabetes Prevention Program are for participants to lose weight and get more active, actions that have been shown to decrease the risk of developing Type 2 diabetes. According to the YMCA’s fact sheet, the specific goals are reducing body weight by 7 percent and increasing physical activity to 150 minutes per week. The one-hour, small-group classes meet every week for 16 weeks and then monthly for eight months. The course is taught by a certified lifestyle coach and the emphasis is on making healthy www.OurHealthRichmond.com
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Prediabetes Fast Facts What is prediabetes? Having prediabetes means the blood glucose (sugar) level is higher than normal, but not high enough to be diagnosed as diabetes. Nearly 90 percent of adults who have prediabetes don’t know they have it. Source: CDC.gov
••••• How many people have prediabetes? In 2012, 86 million Americans age 20 and older had prediabetes, up from 79 million in 2010. Source: American Diabetes Association
••••• What’s the big deal? Those with prediabetes who don’t lose weight or increase their physical activity could develop Type 2 diabetes within five years. Type 2 diabetes is a serious condition that can lead to health issues such as • • • • •
Heart attack. Stroke. Blindness. Kidney failure. Loss of toes, feet or legs.
Source: CDC.gov
••••• How can I prevent Type 2 diabetes? Having prediabetes does not mean a person will develop Type 2 diabetes. For some with prediabetes, early treatment can return blood glucose levels to the normal range. Research shows the risk for Type 2 diabetes can be lowered by 58 percent by
lifestyle changes. Participants track their progress by recording their meals and physical activity using food and exercise logs and being weighed at each meeting. Data gathered from participants are passed on to the YMCA’s national headquarters and the CDC. Classes typically number about eight students, but no more than 15, and participants can sign up in person at their local YMCA or online. Financial aid is available. Smith says YMCA of Greater Richmond uses a sliding scale and has a generous financial assistance policy for those who might not otherwise be able to attend. “Sometimes we don’t even say it’s $429,” she says, referring to the program fee. “Bring in your financial statement, and we’ll tell you what your program rate is.” By participating, students can earn a YMCA membership, which can make getting 150 minutes of exercise per week a lot easier. For example, since joining the Y, Mason says he’s gone from exercising 30 minutes, five days a week, to more than an hour, five days a week. He’s also lost 15 pounds and has kept his blood sugar levels down. “We want to provide the incentive for them and remove that barrier, because when winter comes we don’t want them to have that barrier,” Smith says. “It’s really pretty simple to earn a membership by just attending class and being engaged.” Mason calls the classes “excellent” and says his instructors are “very supportive, always very concerned and there to give you a helping hand.” “As far as the Y itself, it’s a very loving, family-type place where people get really concerned about you and your health. They really push for you to succeed, and I would encourage anyone that’s had a problem with prediabetes to do that program. There’s so much to gain and nothing to lose,” says Mason. YMCA of Greater Richmond also offers the YMCA Diabetes Control Program. The program goals are similar to those in the Diabetes Prevention Program, but it’s aimed at those who have been diagnosed with Type 2 diabetes. More information on the Diabetes Prevention Program can be found at www.ymca.net/diabetes-prevention and www. ymcarichmond.org.
• Losing 7 percent of body weight (or 15 pounds for a 200-pound individual). • Exercising moderately (such as brisk walking) 30 minutes a day, five days a week. • Losing even 10 to 15 pounds can make a huge difference. Source: American Diabetes Association
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