OurHealth Richmond Jan/Feb 2015 Edition by OurHealth Media LLC

OurHealth

•

The Resource for Healthy Living in Greater Richmond

January • February 2015 | www.ourhealthrichmond.com

table of contents | january • february 2015

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

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

The Prequel to Poor Health is OUR good HEALTH

With New Year’s being the time for resolutions — those promises we make to ourselves to start exercising, stop smoking or lose the extra 10 pounds we put on during the holidays — how about making a resolution to head off poor health at the pass?

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

THE ANATOMY CHALLENGE..................................21 How much do you about our anatomy? In this issue, test your knowledge when it comes to the VESTIBULAR SYSTEM!

ANATOMY: A Matter of Balance...................... 22 You’re stepping off a curb and suddenly the world seems to tilt. Or, you’re going down the stairs and there’s no longer a step where you expect it to be. And down you go.

Stand Up to Sitting Disease......................................... 33 Researchers and some in the medical field are calling sitting “the new smoking” because links have been found between excessive sitting and chronic diseases like obesity, type 2 diabetes and heart disease.

POLLS OPEN 2/1/15

p.36

Cardiology Resource Guide......................................... 37 Where do you go for heart care? What are some common heart and cardiovascular conditions? Where can you find knowledge and support if you have heart issues? What questions should you ask your doctor? OurHealth

provides a comprehensive guide to answer these questions and more to help you preserve your heart’s health.

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The Resource for Healthy Living in Greater Richmond

FIT BITS!............................................. 42 Indoor, at-home circuit workout to fight the winter blues. With minimal space and equipment, you can do an at-home circuit workout that will work all major muscle groups. Circuit workouts are quick and challenging, and a great alternative to the gym.

NUTRITION............................. 43 HEALTHY EATS: Shop seasonally for better flavor and extra value—Tomato Basil Soup, Harvest Rice and Dark Chocolate Oatmeal Cookies with Flaxseeds

hello, HEALTH!................................... 46 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos throughout Greater Richmond

The Benefits of Beauty Sleep Until recently, Tamara Chini was tired. All the time. At Fort Lee, where she works as a licensed practical nurse, she would sleep through her lunch hour. When she got home to husband Roy Jr. and sons, Alex and Roy III, she lacked the energy to do anything but go through the motions with housework and family.

Guide to Good Sleep..................... 54 Seven tips to help you get a better nights sleep

LOOKING BACK........................... 58 Images reflecting the landscape of healthcare in Richmond * PLUS * a chance to win prizes!

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january • february 2015

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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-at-Large: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Information in all print editions of OurHealth and on all OurHealth’s websites (www.ourhealthrichmond.com, www.ourhealthcville.com, www.ourhealthLBSS.com, www.ourhealthswva.com, and www.ourhealthvirginia.com (corporate site), social media sites and email newsletters 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. The OurHealth Greater Richmond edition is published seven times annually by McClintic Media, Inc. 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthrichmond.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 a heart catheterization? Cardiac catheterization is an invasive diagnostic procedure done through an artery in the leg or the wrist for several reasons. The most common reason for catheterization is to identify significant blockages of the coronary arteries, which are vessels that supply the heart muscle with blood. It can also further evaluate the heart valves and measure pressures inside the heart. Cardiac catheterization may involve a therapeutic procedure called balloon angioplasty. This therapy reduces blockage in one of the coronary arteries to relieve chest pain and improve blood flow to the heart muscle. Balloon angioplasty is performed on patients with chest pain, or who are suffering a heart attack. Usually, a deployment of a stent (a tube-like structure that keeps the blood vessel open) follows the balloon angioplasty procedure. After cardiac catheterization, pressure is placed over the artery and patients may be discharged. Kenneth Ellenbogen, MD

Kontos Professor of MedicineÂ Chair, Division of Cardiology, Medical College of Virginia/VCU School of MedicineÂ Richmond | 804.828.8885 www.pauleyheart.vcu.edu

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What is arrhythmia?

What is hypertension?

An arrhythmia is an abnormal heart rhythm that may feel like fluttering in your chest. It may be so short that it does not change your overall heart rate or in other instances it may cause your heart to beat too slow (bradycardia) or to fast (tachycardia).

Hypertension is simply elevated blood pressure (BP). The systolic (SBP), or top number, which is the higher of the two numbers, measures the pressure in the arteries when the heart beats and the heart muscle contracts. The diastolic (DBP), or bottom number, measures the pressure in the arteries when the heart muscle is resting between beats and refilling with blood. Stress, smoking, salt and obesity can raise these numbers.

An arrhythmia can have almost no symptoms or simply feel like a skipped heartbeat. A more severe arrhythmia can begin to impact how the heart is working and its ability to pump enough blood throughout the body. This can make someone feel tired, short of breath, experience chest pain or lightheadedness. Diagnosis of an arrhythmia often includes an initial conversation with your doctor including when you experienced the arrhythmia and how long it lasted. Doctors may order a test called an electrocardiogram to assist with diagnosis. You may be referred to a cardiologist with special training in heart rhythm disorders, an electrophysiologist to treat the arrhythmia. Saumil Shah, MD

Virginia Cardiovascular Specialists Midlothian | 804.915.1400 www.vacardio.com

The recent Eighth Joint National Committee (JNC-8) guidelines suggest most patients should have a goal systolic BP <150 mm Hg and goal diastolic BP <90 mm Hg. How can you help your blood pressure? Eat less fat and salt, exercise at least three times a week and make sure to see your doctor regularly. If these lifestyle changes do not get you to the BP goal, you may need medication. Mark Warner, MD

Cardiovascular Associates of Virginia Midlothian | 804.794.6400 www.bonsecours.com

What is the difference between a cardiologist and a cardiovascular surgeon?

H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS

A cardiologist is a doctor specially trained in the diagnosis, treatment, and prevention of diseases of the heart and blood vessels. The training involves 4 years of medical school, 3 years of training in general medicine, and 3 or more years of specialty training in cardiology. The cardiologist is usually the first specialty doctor seen when heart disease is suspected. A cardiology evaluation usually requires an EKG and may require a sound wave test of the heart called an echocardiogram. Interventional Cardiologists are specialized cardiologists that perform more invasive tests such as cardiac catheterizations and coronary balloon angioplasty and stenting. The cardiac catheterization is a test with tubes or catheters placed in blood vessels to diagnosis problems in the heart. Balloon angioplasty and stenting is a procedure with tubes to fix blocked heart arteries. There are also specialized cardiologists called electrophysiologists who specialize in electrical problems or arrhythmias of the heart. These doctors can implant medical devices such as pacemakers and implantable defibrillators to treat these electrical problems. They can also perform catheter procedures called ablation procedures to correct electrical problems. A cardiovascular surgeon specializes in operations of the heart and blood vessels. Cardiac surgery training includes 4 years of medical school, 3-4 years of general surgery training, and 3 years of cardiac surgery training. These doctors perform coronary artery bypass surgery to treat blocked arteries of the heart as well as heart valve repair or valve replacement surgery. Diseases of the major artery of the body called the aorta will also be repaired by cardiovascular surgeons. Certain cardiovascular surgeons have advanced training in heart transplantation, heart assist pumps, and artificial hearts for patients with advanced heart failure. Patients are usually diagnosed with a heart condition by a cardiologist and then referred to a cardiac surgeon for the necessary procedure. In most cases, the cardiac surgeon assumes the care of the patient throughout the surgery and recovery period. There are procedures in which the cardiologist and cardiovascular surgery work together in one procedure. Hybrid procedures are cases where the cardiologist will perform coronary stenting of one heart vessel while the cardiac surgeon performs bypass surgery on another blocked artery. There is also a new cardiac procedure where a blocked heart valve can be replaced through catheters without open heart surgery. This procedure is called transcatheter aortic valve replacement or TAVR. This procedure requires a heart team which includes a cardiologist and a cardiovascular surgery. Robert Levitt, MD

Henrico Cardiology Associates Richmond | 804.288.0134 www.henricocardiologyassociates.org

What causes a heart to be enlarged? The heart is a muscular pump. Like most pumps, it has an electrical system with valves and chambers. It is a power source made of muscle fibers that are supplied with fuel in the form of blood, which moves through a series of arteries, and a protective outer layer called a pericardium. The heart can become enlarged when any of its components are not working properly. In adults the most common cause of an enlarged heart is either from blockage of the heart’s blood supply or arteries, which deprives the muscle of blood causing it to malfunction. A blocked artery or a damaged pump can lead to permanent damage such as a heart attack. An abnormal muscle, caused by untreated high blood pressure, can also lead to an enlarged heart. Other causes of heart enlargement include valve narrowing, stenosis, leaking and regurgitation. Richard Cook, MD

Associate Professor, Internal Medicine VCU School of Medicine Richmond | 804.828.8885 www.pauleyheart.vcu.edu

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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

Bon Secours Richmond Health System

Introduces New CEO

In December, Peter Bernard, Chief Executive Officer (CEO) of Bon Secours Virginia, announced the promotion of Toni Ardabell to CEO of Bon Secours Richmond Health System. Ardabell assumed her new role January 1st. As CEO, Ardabell is responsible for all operations in Central Virginia, with the exception of the Medical Group and HealthSource, which Bernard continues to oversee. Ardabell continues to serve as CEO of Bon Secours St. Mary’s Hospital. Ardabell joined Bon Secours in 2009 as the CEO of St. Mary’s Hospital. Under her leadership, St. Mary’s Hospital has received numerous awards, including re-designation of Magnet status, Top 50 Cardiovascular Hospital, Best Place in Richmond to Have a Baby, Emergency Medicine Award, Leapfrog A rating and Healthgrades’ Distinguished Hospital Award for Clinical Excellence. Ardabell serves on the American Heart Association’s Richmond and Regional Boards, the Greater Richmond Chamber of Commerce Foundation Board, the Bon Secours Richmond Foundation Board, and is a member of St. Gertrude High School’s Board of Visitors.

Children’s Hospital of Richmond at VCU announces $28 million gift to develop Children’s Hospital Foundation Heart Center Largest gift to pediatric healthcare in VCU’s history Children’s Hospital of Richmond at Virginia Commonwealth University (CHoR) has announced an unprecedented $28 million gift from Children’s Hospital Foundation, the single largest gift to pediatric health care in VCU’s history and one that will establish a pediatric cardiac surgery program in Richmond. The gift advances pediatric heart care in Central Virginia through the development of the Children’s Hospital Foundation Heart Center at CHoR. “This is another example of how VCU is helping to ensure that the children of the Richmond region have access to world-class health care in their own backyard,” said Michael Rao, PhD, president of VCU and VCU Health System. “We have committed again and again that we will help the people who need us, including children, and will be the best partner and colleague for our entire region and state to serve young patients and their families.” Children’s Hospital of Richmond at VCU has made many advancements in children’s health thanks to the unwavering support of Children’s Hospital Foundation. Since 2010, the hospital has hired more than 40 new pediatric specialists, opened a dedicated pediatric emergency room, broken ground on a new psychiatric facility, developed new research initiatives and expanded multiple programs. John Duval, chief executive officer of MCV Hospitals, VCU Health System, says the Children’s Hospital Foundation Heart Center will be led by Thomas Yeh, Jr., MD, PhD, a senior board-certified cardiothoracic surgeon. Duval says Yeh’s nearly 20 years of surgical experience, including thousands of successful

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pediatric cardiac surgeries, and his impressive training pedigree, are what led to his recruitment. “With this incredible gift and the recruitment of Dr. Thomas Yeh, Children’s Hospital of Richmond at VCU has the ability to stand up a robust heart center to care for any cardiac need a child might have around the clock,” Duval says. “From increased access with same-day appointments to 24/7 coverage of emergent issues, this gift will advance comprehensive cardiac surgical care in our community and prevent families from feeling they must leave Richmond – and their support system – during a critical and stressful time.” The $28 million gift will fund the people necessary to support the new comprehensive Children’s Hospital Foundation Heart Center, including the recruitment of Yeh and additional anesthetists, perfusionists, cardiologists, nurses, nurse practitioners and additional specialists for the care of children with congenital and acquired heart disease. VCU Medical Center will supplement the major gift with a $14 million commitment toward equipment and operating expenses.

Michael Barker, MD Advanced Surgical Partners of Virginia Richmond | 804.360.0600 www.advancedsurgical partnersofva.com

Sosipatros Boikos, MD Megan Cassidy, MD VCU Massey Cancer Center Medical Oncology Richmond | 804.828.5116 www.massey.vcu.edu

Amy Foster, ACNP

Richmond Gastroenterology Associates Richmond | 804.560.9856 www.RichmondGastro.com

Emily Rivet, MD, MBA, FACS, FASCRS Colon & Rectal Specialists Richmond | 804.249.2465 www.CRSpecialists.com

Katherine Helfrich, DDS

General Dentist Virginia Family Dentistry Brandermill Location Midlothian | 804.739.6500 www.vadentist.com

Joanna Horstmann, MD

Children’s Hospital of Richmond at VCU Orthopaedic Surgery Richmond - Downtown, Stony Point | 804.828.CHOR www.chrichmond.org

Sarah Sherman, ACNP

Mary Stettmeier, MD

Alex Vaclavik, MD

Ammie White, MD

Richmond Gastroenterology Associates Richmond | 804.560.9852 www.RichmondGastro.com

William Dahlke, DMD

Virginia Women’s Center Children’s Hospital of Richmond | 804.288.4084 Richmond at VCU–Dentistry www.VirginiaWomensCenter.com Richmond | 804.828.9095 www.chrichmond.org

Bon Secours Freedom Healthcare Associates Richmond | 804.431.3400 www.bonsecours.com

Virginia Women’s Center Children’s Hospital of Richmond | 804.288.4084 Richmond at VCU – Radiology www.VirginiaWomensCenter.com Richmond | 804.828.CHOR www.chrichmond.org

Paulina Essah, MD Theresa A. Thomas Medical Center Richmond | 804.798.9208 www.bonsecours.com

Rishika Kaundal, MD Chesterfield Family Practice Center, PC Richmond | 804.276.9305 www.chesterfieldfamily.com

Ife Torrance, NP

Bon Secours Primary Health Care Associates Richmond | 804.644.1665 www.bonsecours.com

Joshua Wong, DDS General Dentist Virginia Family Dentistry Midlothian | 804.379.1011 www.vadentist.com

John Fortunato Jr., MD Children’s Hospital of Richmond at VCU Gastroenterology and Nutrition Richmond – Downtown and Stony Point | 804.828.CHOR www.chrichmond.org

Enrique Oltra, DDS, MSD

Endodontist Virginia Family Dentistry Midlothian | 804.379.1011 Ashland | 804.550.3324 www.vadentist.com

Shannon Townsend, PA-C

Alfredo Urdaneta, MD

Richmond Gastroenterology Associates Hanover | 804.559.6194 www.RichmondGastro.com

VCU Massey Cancer Center Radiation Oncology Richmond | 804.828.5116 www.massey.vcu.edu

Nina Xiao, MD, MS

Children’s Hospital of Richmond at VCU – Nephrology Richmond – Downtown and Stony Point, Fredericksburg, Petersburg | 804.828.CHOR www.chrichmond.org

www.OurHealthRichmond.com

NEW

NOTEWORTHY

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

Bon Secours expands primary care presence to Petersburg with new medical center

Facility serves military personnel and veterans, their families and civilians In December, Bon Secours Virginia Health System celebrated the opening of the Bon Secours Freedom Healthcare Associates in the newly renovated Freedom Support Center, located at 32 W. Washington Street in Petersburg. The new medical center, designed to meet the medical needs of active and retired military personnel and their families, marks the health system’s first primary care presence in Petersburg and the Tri-Cities region. [Terry McAuliffe, Governor of the Commonwealth of Virginia], noted that the new medical center represents a significant milestone for the region, which is home to thousands of military personnel, both active and retired, their families and the community at large. “This forward-thinking initiative to offer more health care services to the Petersburg community is the culmination of a collaborative vision by the City of Petersburg, Ft Lee and Bon Secours, along with other local, state and federal partners. Expanding access to quality and affordable health care is central to my vision for a new Virginia economy, and that effort should begin with Virginians who serve and sacrifice to keep our nation safe,” says Governor McAuliffe. “The brave men and women in our Armed Forces perform best when they know their loved ones are being well cared for back home,” says James Dunn, vice president for advocacy and community affairs, Bon Secours Richmond Health System. “And when they return home from defending our country and freedoms, they deserve the best possible healthcare. Bon Secours Freedom Healthcare Associates is an extension of our mission to serve those in need and to build healthy communities.” Construction and renovation of the Freedom Support Center and the 5,000-square-foot facility for the new medical practice began in September 2014. Bon Secours Freedom Healthcare Associates include primary care physicians, specialists, preventive care, chronic disease management programs and nutrition and health education programs, such as healthy cooking classes for families. “We are pleased to partner with Bon Secours Virginia. We are thrilled about the new healthcare services Bon Secours will offer soldiers, veterans and their families in the Petersburg and Fort Lee communities at this facility,” says Brian A. Moore, mayor of Petersburg. “Because of the great leadership in the community and vision for this center, we have been able to bring invaluable partners to the table and make this center a resource for our military community.” The Freedom Support Center is an extension of the Serving Our Service Members’ Families (SOS) Program. It is designed to be a one-stop resource center for military personnel, veterans and their families offering customized wrap-around services from vetted providers to help with sustainment of employment, housing, mental health, healthcare and finances.

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HCA Virginia Physicians Launches HCA’s and Central Virginia’s First Physician Network App Tool that will improve patient access and health information availability Patients now have a convenient new way to access physician and health information for free in the palm of their hand via HCA Virginia Physicians’ mHealth App. HCA’s and Central Virginia’s first physician network app combines with a market-unique online scheduling platform to give patients ultimate control over when and how they learn about physicians, read about current health topics, view video content, check the events calendar, and schedule appointments with 24/7 access to appointment availability. It also will give HCA Virginia Physicians the ability to communicate real-time updates with app users such as delays and/or closings due to inclement weather. To download the app, visit either the Apple App Store or Google Play and search “HCA Virginia.” More information on functionality, as well as screen shots, can be found at www.hcavirginia.com/app.

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

February is...

AMERICAN

HEART MONTH

During the month of February, Americans see the human heart as the symbol of love. February is American Heart Month, a time to show yourself the love. Learn about your risks for heart disease and stroke and stay “heart healthy” for yourself and your loved ones.

Are YOU at Risk for Heart Disease? Cardiovascular disease (CVD)—including heart disease, stroke, and high blood pressure—is the number 1 killer of women and men in the United States. It is a leading cause of disability, preventing Americans from working and enjoying family activities.

Take it One Step at a Time You can control a number of risk factors for CVD, including: • Diet

• High blood pressure

• Physical activity

• High blood cholesterol

• Obesity

• Diabetes

• Tobacco use

For more information, visit www.heart.org

***** You can burn 400 calories per hour* shoveling snow (*Assuming a body weight of 150 lbs)

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Physical Activity is Anything that Makes You Move Your Body... AND BURN CALORIES • Physical activities that burn more calories than you might think: climbing

stairs, doing housework & shoveling snow!

• Aerobic exercise benefits your heart, and includes playing sports, walking, jogging, swimming or biking. • The American Heart Association recommends 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week to lower the risk for heart attack and stroke.

*****

FASCINATING

FACT

During an average lifetime,

the heart pumps million gallons of blood

– enough to fill New York’s Central Park 50 feet deep!

Winter Fitness:

Safety Tips for

Exercising Outdoors Even though it might be cold, exercising outdoors during winter months is a great way ‘get out’, enjoy the winter views and get a breath of fresh air! Here are some tips to help stay safe and healthy when exercising outdoors during cold weather: • Dress in layers

• Pay attention to the forecast

• Be sure to protect your hands and feet

• Stay hydrated

• Wear a hat to help ‘keep the heat in’

• Know the signs and symptoms of frostbite and hypothermia

Ever Wonder...

What is Reiki?

Reiki is a Japanese stress reduction and healing technique with roots in ancient Tibet. It is a non-invasive practice involving the channeling of universal energy to stimulate the body’s innate ability to calm, balance, and heal itself. A typical Reiki session takes place while reclining on a massage table, although it can be done in any position that works best for the client. A practitioner places hands gently on the body in various positions, holding for a few minutes at a time. Reiki can also be performed completely hands-off, making it a good option for those recovering from surgeries or who have other causes of acute pain. It is a great complement to traditional medicine, yoga, and massage and is effective for both physical and emotional healing. Reiki is

DATE February 20, 2015

2015 Richmond

GO RED

TIME 10:00 am

for women

LOCATION Downtown Richmond Marriott

Luncheon

SPONSOR Bon Secours

Go Red for Women is the American

Heart Association’s national cause campaign to increase awareness of heart disease — the leading cause of death for women — and to inspire women to take charge of their heart health. The annual Go Red for Women Luncheon is the culminating event of the campaign year

not a religion and is appropriate for people

and is designed to educate and

of all beliefs and traditions.

empower women about their greatest risk threat — heart disease.

Erin Forsyth, Reiki Level II Practitioner, E-RYT 200/RYT 500

Glenmore Yoga and Wellness Center Henrico | 804.741.5267 www.glenmoreyoga.com

For more information, visit www.richmondvagoredluncheon.ahaevents.org

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the

Anatomy

CHALLENGE

Hereâ&#x20AC;&#x2122;s your chance to see how much you know about your Vestibular

System! First, fill in the word search puzzle below. Next, match up the correct word with the part of the body in the illustration.

[ the VESTIBULAR system ]

WORD SEARCH static equilibrium

otoliths

cupula

otolithic membrane

sensory nerve fibers

nerve fibers

hair cell

dynamic equilibrium

_______________________ _______________________

_______________________ For answers, visit OurHealth Richmond's

Facebook page at

_______________________ _______________________

www.OurHealthRichmond.com

abaofl r e t t a m words |RICK PIESTER

ance

It seems like a usual day. Everything’s normal. Then it comes out of nowhere.

You’re stepping off a curb and suddenly the world seems to tilt. Or, you’re going down the stairs and there’s no longer a step where you expect it to be. And down you go.

In a flash, before you can even think about it, you’re among the one in three adults over 65 who will suffer a fall each year. More than 2.4 million older Americans were treated in hospital emergency departments in 2012. Maybe you’ll be lucky enough to escape serious injury. Although there’s still a 50-percent chance that you will fall again soon, and next time you probably won’t be as lucky. But the chances are that you will suffer serious injury, serious enough to prevent your ability to walk a city block.

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Falls and the fear of falling are among the most serious health issues facing the growing population of older adults. And if you break a hip when you fall, as many do, there’s a pretty good chance (1 in 4) of you will die within a year. Aging is no guarantee of a fall, but experts say that because of the aging process, the chances do increase dramatically. “As we age, our sense of balance does get worse,” notes Luis Eljaiek Jr., MD, medical director of the senior services emergency department at Bon Secours St. Mary’s Hospital in Richmond. “Muscle mass and tone and conditioning of the body can diminish,” he says, “and we see deterioration of the core muscles”. Core muscles are those in the back, side, pelvis and abdomen that form a strong central link between the upper and lower body. A weak core drains the power and stability from many of the body’s movements. VCU Medical Center orthopaedic surgeon Gregory Golladay, MD, says that he and his colleagues frequently see the same lack of flexibility in the body’s core, as well as disorders around the hip joints that cause people to limp or tilt to one side. Additionally, arthritis or other problems with joints in the feet or knees can force changes in the way we walk and lead to problems with our balance, he says. There’s a difference between dizziness and imbalance, the physicians note. Dizziness, or vertigo, is when the world seems to be going ‘round and ‘round. It’s often associated with disorders of the inner ear (see

the OurHealth Anatomy Challenge feature on page 21.)

Imbalance is usually not announced by a feeling of dizziness. It’s a case of failures in the transmission of signals between your brain and your body. However, the gradual, age-related decline of the vestibular system (the complex structure of fluid-filled tubes in the inner ear) can also result in balance problems without a feeling of dizziness. Either way, it can be a serious problem. Falls and the fear of falling are among the most serious health issues facing the growing population of older adults. And people who restrict their activities can further reduce their independence. It’s a vicious cycle — the more inactive you become, the less you are eventually able to do, and that can well damage your overall health. Dr. Eliaiek explains that our sense of balance depends on a complicated combination of sensory factors that allow us to walk a straight line. There’s the inner ear, a sort of compass that keeps us on an even keel. There’s our vision, which provides continual clues as to where we are in space. And our muscles and joints, particularly our feet, which give us a sense of strength, stability, and mobility. As we become older, particularly in people who are inactive, our muscle mass deteriorates and joints and ligaments lose strength, limiting our range of motion. Aging eyes can and often do develop such problems as cataracts and glaucoma, which can curb vision dramatically. Diseases like diabetes and kidney ailments can produce peripheral neuropathy, the loss of sensation in our feet. 'Falls' —continued on page 24

Fall Statistics Among Older Adults • In 2012, 2.4 million nonfatal falls among older adults were treated in emergency departments and more than 722,000 of these patients were hospitalized. • Among older adults, falls are the leading cause of both fatal and nonfatal injuries.

• One out of three older adults (those aged 65 or older) falls each year but less than half talk to their healthcare providers about it. • In 2012, the direct medical costs of falls, adjusted for inflation, were $30 billion. *Source: CDC.gov www.OurHealthRichmond.com

'Falls' —continued from page 23

A combination of medical causes — “co-morbidity” in medical-speak — can further accelerate the body’s inability to respond to the brain’s commands. And medicines, particularly blood-pressure medications, can sometimes have a profound effect on our sense of balance. Sometimes, we don’t really have a sense of deteriorating balance. We create unconscious accommodations to make up for it, such as lightly touching a piece of furniture while walking through a room. We don’t recognize the signs, or simply ignore them, until that first fall. Gregory Golladay, MD, VCU Medical Center orthopaedic surgeon

So what are some of the signs? Physical therapists such as Kshitija Raje, DPT, of the Bon Secours homecare department often ask new patients to stand on one foot for a moment or two, sometimes with their eyes closed. If you are unable to do that, you should speak with your physician about a possible problem with your balance. Try to walk a short distance backwards. If that doesn’t work, it may be a sign of diminished balance. Or try to walk a short distance using what’s called “tandem” walking. That’s walking with the toes of the back foot touching the heel of the front foot with each step. Or, simply talk with your physician about ordering a baseline physical evaluation, often done by physical therapists. If you have the evaluation done, even in your 40s or 50s, it can go a long way toward spotting little problems that may turn into big ones later on. And, it can set you on your way to helpful exercises that very likely will help avoid many problems as you grow older. The three Richmond-area health professionals say there are a number of measures that older people can take to manage difficulties with balance and prevent falls. One of the first things health experts recommend is to get into an exercise program tailored to improve or preserve balance. The American Geriatrics Society recommends tai chi — slow-motion Chinese exercises — as an effective way to prevent falls. Tai chi is based in part upon the correct alignment of the chest, pelvis and head to provide strength and maintain balance. The slow, controlled motions of tai chi are also a non-impact form of exercise that builds strength without raising the fear of falling. Yoga is also 'Falls' —continued on page 25

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Yoga: it may make a difference In addition to doing wonders for your flexibility, stress levels and muscle tone, yoga has been shown in research to improve both balance and confidence. Stroke survivors who completed an eight-week course of twice-weekly yoga classes showed an impressive 15% increase on balance scores, according to study author Arlene Schmid, PhD, a rehabilitation research scientist at the Roudebush VA Medical Center and assistant professor at Indiana University. They were also more confident in their ability to perform everyday tasks, too. How does yoga do this? Yoga improves balance because it’s complex—it includes the mind and the body, and helps to coordinate movements. Whereas, simple strengthening exercises usually just work on one plane of movement. Source: Prevention.com 'Falls' —continued from page 24

great, because it also lowers the stress and anxiety felt by people with balance problems. Daily supplements of vitamin D is increasingly recommended for a constellation of health reasons, muscle strength and balance among them. In a review of nine research projects, the United States Preventive Services Task Force found that a daily dose of 800 international units (I.U.) of vitamin D reduces the risk of falling by 17 percent, compared to people who do not take the vitamin. (As with all things medical, check with your physician or pharmacist before taking any kind of medication, to avoid the risk of harmful drug interactions.) Every health professional who works with older patients can recite a laundry list of things to do at home to reduce the risk of falls. Among them:

• Drink plenty of fluids during the day. A dehydrated body can suffer dramatic drops in blood pressure, which in turn can play havoc with your sense of balance. • Slow down a bit. Take a beat or two between standing up and further movement to be sure that you have your bearings. This is especially important when getting up in the morning. All night, you’ve been lying flat, with blood pumping nicely to your brain. You wake up in the morning and sit up, and all of a sudden the heart has to pump against gravity. That’s one of the danger times for falls. So take a minute or two for 'Falls' —continued on page 26 www.OurHealthRichmond.com

Fall-Related Deaths • The death rates from falls among older men and women have risen sharply over the past decade. • In 2011, about 22,900 older adults died from unintentional fall injuries. • Men are more likely than women to die from a fall. After taking age into account, the fall death rate in 2011 was 41% higher for men than for women. Source: CDC.gov

'Falls' —continued from page 25

the heart and blood vessels to become adjusted so that they’re moving blood to your brain efficiently. • Be careful on stairs. Not surprisingly, stairs are among the most likely places for a serious fall. Put up handrails, on both sides of the stairs. It’s best for stairs to have no coverings, no carpet or runners. And keep them clear. • Use good lighting. Deploy plenty of night lights, and even motion-sensor lighting through the house, especially between the bedroom and bathroom. • Be careful in the bathroom. Bathrooms are a big fall zone. Surfaces in the bathroom are hard and often slippery, an awful combination for bones of any age, but especially bad for the fragile bones of older adults. Install grab bars — the kind that are securely screwed in to wall studs, not the type with suction-cups — at easy-to-grab spots in the bathroom. Commodes that are built higher make sitting down and 'Falls' —continued on page 27 26

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Fall Injuries • People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer. • Rates of fall-related fractures among older women are more than twice those for men. • Over 95% of hip fractures are caused by falls. In 2010, there were 258,000 hip fractures and the rate for women was almost twice the rate for men. Source: CDC.gov

'Falls' —continued from page 26

standing up easier and reduce the chance of losing balance. • Use a cane and, if you need it, a walker. There’s a lot of old-age stigma attached to them, but try to think of them as just another way to maintain contact with the floor or ground. • Keep floors clear. Newspaper and magazines, even pet toys and feeding dishes can be hazardous, as well as the pets themselves. Putting a bell on a pet’s collar or even a glow-at-night collar can reduce the chances of being tripped up by Fido or Fluffy. Despite what some folks think, falling isn’t a natural part of aging. You can avoid falls by taking stock of your risk factors, getting the right kind of exercise and removing the hazards that can cause trips and slips.

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POOR health is OUR good HEALTH the prequel to

words | SUZANNE RAMSEY photography | KG THIENEMANN

With New Year’s being the time for resolutions — those promises we make to ourselves to start exercising, stop smoking or lose the extra pounds we put on during the holidays — how about making a resolution to head off poor health at the pass?

After all, it’s been said that it’s “easier to stay well than to get well.” ••••• A couple of years ago, Maureen Green started worrying about her health. It wasn’t because she’d been diagnosed with heart disease, diabetes or some other serious medical problem. It wasn’t that she wasn’t exercising, because Maureen — who goes by “Mo” — had been running marathons. And every time she went to the doctor for blood work, Mo says her numbers — cholesterol, blood sugar, etc. — were always good. That is, all but one number: the one on the scale. “My blood work was fine,” she says. “It was just my weight.”

Reprints To order reprints of the artwork featured on this issue’s cover, contact Deidre Wilkes at 540.387.6482 or via email at deidre@ourhealthvirginia.com.

At the time, Mo weighed about 235 pounds, and even though she was training regularly with a Sports Backers running group in Richmond, she noticed she was getting slower and slower. Eventually, she realized that while she had been running a lot she’d been eating a lot, too. “I didn’t realize it because you don’t think like that when you’re in the moment,” Mo, 55, says. “I got to a point where I was so slow. [I thought,] ‘If I want to continue running marathons I’m going to have to lose weight. This is it, my wake up call.’ I knew, if I didn’t do something, what was ahead of me from a health perspective, because I work in the medical field.” 'Prequel' —continued page 30

www.OurHealthRichmond.com

What is Body Mass Index? Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI provides a reliable indicator of body fat for most people and is used to screen for weight categories that may lead to health problems. Source: CDC.gov

'Prequel' —continued from page 29

Mo, director of radiology for a local hospital, says she “sees sick people all the time,” people with diabetes and people walking through the hospital with oxygen tank in tow. “You know what’s ahead of you if you don’t make changes,” she says. Mo started using a smart phone app called “Lose It!” It helped her track daily calories and exercise, among other things. The app also turns weight loss into a game of sorts, telling you how many calories you have left each day, based on the number of calories you’ve burned. It worked for Mo, who says one night she even went for a four-mile run just so she could earn back the calories to go out to dinner with her husband. “You work for food,” she says. Since she’s been using Lose It!, Mo has lost 60 pounds. Her goal is to lose about 30 more and improve her Body Mass Index, or BMI. “I want to have a healthy BMI,” she says. “I went from a very obese BMI, but I’m still in the overweight category. I’ve got to be around 140 to 145 [pounds] to have a healthy BMI and that’s what my goal is.” 'Prequel' —continued on page 31 30

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What is Type 2 Diabetes? Type 2 diabetes, once called non-insulin-dependent diabetes, is the most common form of diabetes, affecting 90% to 95% of the 26 million Americans with diabetes. Unlike people with type 1 diabetes, the bodies of people with type 2 diabetes make insulin. But either their pancreas does not make enough insulin or the body cannot use the insulin well enough. This is called insulin resistance. When there isn’t enough insulin or the insulin is not used as it should be, glucose (sugar) can’t get into the body’s cells. When glucose builds up in the blood instead of going into cells, the body’s cells are not able to function properly.

“The fear was if I didn’t do something I could get up to 300 pounds,” she

(Source: WebMD)

says. “I was petrified.

'Prequel' —continued from page 30

Mo is currently training for a March marathon in Newport News, where she lives, and a few other shorter races. Still, she wonders how she ever got up to 235 pounds and says being afraid of gaining even more weight was what drove her to make changes.

I didn’t want that to happen. Being in control,

    

that’s the whole thing.

In August 2014, Montez Jennings, of Ashland, also took steps to improve his health before it was too late. Having watched his mother and grandfather struggle with diabetes his whole life, the 24-year-old started experiencing symptoms of diabetes himself: headache, increased urination and dizziness.

control and it’s so easy

You think you’re not in to make excuses. Life

“I needed to get it checked out,” he says.

is crazy, it’s busy, but

Montez went to Bon Secours Theresa A. Thomas Medical Center, in Ashland, where he saw Mary Stettmeier, MD, a family medicine doctor. Since then, Dr. Stettmeier, a “floater” at the time with Bon Secours, has transferred to Freedom Healthcare Associates, a new Bon Secours practice in Petersburg.

you just have to stop

Dr. Stettmeier commends Montez for taking charge of his health and making changes. After being diagnosed with type 2 diabetes, Montez started a diet and exercise program and has been taking the drug Metformin. Dr. Stettmeier says, "Metformin is commonly prescribed to help manage type 2 diabetes by physicians because it “slows the progression of the disease.”

making excuses and do something.”

Dr. Stettmeier says Metformin alone “shouldn’t have fixed Montez. The diet and exercise made all the difference. He told me he was watching his sugar, exercising, riding his bike. I thought he would end up on insulin. He’s my big hero success patient.” Not too long ago, Dr. Stettmeier herself feared she also was headed for trouble with her health. A pharmacist for 20 years before going to medical school, she was finishing up her medical residency last spring when she realized she’d let things get out hand and needed to do something about it. “I was overeating and not making my health a priority, and being away from an exercise regimen,” Dr. Stettmeier, a 56-year-old former marathon runner, says. “No exercise and too much food. I was finishing my residency and studying for my boards. Sitting and studying, hour after hour each day. No exercise and a lot of eating.” 'Prequel' —continued on page 31 www.OurHealthRichmond.com

What are the Symptoms of Type 2 Diabetes? Type 2 diabetes symptoms often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: • Excessive thirst and frequent urination. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. • Fatigue. If your cells are deprived of sugar, you may become tired and irritable.

Mary Stettmeier, MD, practices family medicine at Freedom Healthcare Associates, a new Bon Secours practice in Petersburg.

• Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. • Slow-healing sores or frequent infections. Type 2 diabetes affects your ability to heal and resist infections. • Areas of darkened skin. Some people with type 2 diabetes have patches of dark, velvety skin in the folds and creases of their bodies — usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance. Source: MayoClinic.org

'Prequel' —continued from page 32

She says she was in “rough shape,” having gained a lot of weight. “I became very narrowly obese, right on the line, and my cholesterol, for the first time, had gone out of normal range,” she says, adding that none of her clothes fit, which was frustrating. “That is something women will understand. I had all these great clothes and nothing fit.” Dr. Stettmeier started a diet and exercise program, walking and eventually running six days a week. She has lost 35 pounds, her cholesterol is back to normal, and her clothes fit again. “It’s improved my quality of life, my functioning, and that’s everything,” she says.

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Andrew Kennedy, sponsorship manager, and Molly Johnson, health promotions coordinator, both use company-provided standing desks in the Sports Backers offices

Stand up to ‘sitting disease’ words | SUZANNE RAMSEY • photography | KG THIENEMANN

“Sitting disease,” a term coined by scientists to describe the terrible things that can happen to your body from sitting too much, is said to be as bad for you as smoking. In fact, researchers and some in the medical field are calling sitting “the new smoking” because links have been found between excessive sitting and chronic diseases like obesity, type 2 diabetes and heart disease. Nan Turner, a customer engagement coordinator, uses a treadmill desk at Sports Backers—one of the most physically active business offices in Richmond.

You might think you don’t sit all that much, but the website Active.com reports that the average American sits or is at least sedentary for 22 hours a day. This includes eight hours sleeping, seven and a half hours at work, three hours eating, and an hour and a half each of watching TV, sitting in front of the computer and sitting in a car. “We know that getting up and moving helps us,” Lisa Ellis, MD, a women’s health specialist at Virginia Commonwealth University Health System, says. “We want to try to make sure people are active and don’t spend a huge percentage of their hours sitting. “When you’re up and moving, you increase metabolism some. You can think of it as a fuel thing. ... When you’re sitting, you don’t have to burn a lot of fuel. When you get up, walking around, you burn fuel. You help reduce body fat, help insulin come out faster. I helps your joints and you don’t get arthritis as easily.” Dr. Ellis says being active also releases endorphins, which make you feel good. Dr. Ellis suggests the following ways people — even those who say they don’t have time to exercise — can be more active: 'Sitting Disease' —continued on page 35 www.OurHealthRichmond.com

'Sitting Disease' —continued from page 33

• Pace while talking on the phone. • While watching TV, get up during commercials to walk in place or go up and down the stairs. • Get a pedometer and count your steps. (Experts suggest about 10,000 steps a day, which equals about 5 miles.) • Start a competition with coworkers to see who can walk or exercise the most. When it comes to combating “sitting disease,” the people at Sports Backers, a local nonprofit with the mission of making Richmond “the most physically active region in the country,” are practicing what they preach. At their offices on Avenue of Champions, next to The Diamond minor league baseball field in Sports Backers Stadium, most of the organization’s 28 employees use standing or treadmill desks. For those who might not be familiar with what a standing desk is, it’s pretty self explanatory: a desk that you stand in front of, as opposed to using a chair or stool. With a treadmill desk, the worker walks on a treadmill while working at a standing desk. Some standing desks are adjustable, so the worker can alternately sit or stand throughout the day. Pete Woody, public relations and communications manager for Sports Backers, made his first standing desk from boxes and milk crates in 2012. He’d been reading articles about the benefits of standing desks and decided to see if he could make one. This initial attempt evolved to a modified IKEA desk held up with brackets and eventually a store-bought standing desk. Woody’s desk is adjustable, enabling him to sit or stand. Soon, the higher ups got on board and offered standing desks to all Sports Backers employees. “We’ve really enjoyed them,” Woody says. “Once it became known that the company would provide them, people jumped on it. Woody, who says he used to sit for most of the workday, noticed that since using the standing desk his back has felt better, and he’s more alert and flexible. “I’ve noticed it’s nicer to stand for a couple of hours in the morning and a couple of hours after lunch,” he says, adding that he thinks many of his coworkers “would say the same thing.”

Pete Woody, the PR and Communications Manager at Sports Backers, was one of the first employees to use the standing desk.

What are endorphins? Improved self-esteem is a key psychological benefit of regular physical activity. When you exercise, your body releases chemicals called endorphins. These endorphins interact with the receptors in your brain that reduce your perception of pain. Endorphins also trigger a positive feeling in the body, similar to that of morphine. For example, the feeling that follows a run or workout is often described as "euphoric." That feeling, known as a "runner's high," can be accompanied by a positive and energizing outlook on life. (Source: WebMD)

For the employees at Sports Backers, it’s also about setting a good example. Among numerous other things, Sports Backers puts on the Monument Avenue 10K, Richmond Marathon and other road races. It promotes walking, biking and other active community events, along with programs aimed at increasing wellness in the workplace and schools. “For us as an organization, our mission is to make Richmond the most physically active region in the country,” Woody says. “What can we do to live that mission? If we’re pushing workplace wellness, how can we go about doing it? We want to be that example. ... We live that mission and encourage an active work place for our employees.”

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introducing the Inaugural

GREATER RICHMOND

presented by: The Resource for Healthy Living in Greater Richmond

Senior Health Categories To Vote For • After Life Services

• Medical Equipment

• Assisted Living

• Memory Care

• Rehab (Inpatient)

• Nursing Home

•Rehab (outpatient)

• Palliative Care

• Home Health

• Skilled Nursing

• Hospice

• Speech Therapy

• Independent Living

• Stroke Care

VOTING OPENS

February 1, 2015 To vote for your favorite senior health WINNERS ANNOUNCED

MAY

2015

services and for more information, visit

www.ourhealthrichmond.com Winners will be announced in the May 2015 edition of OurHealth Richmond magazine. Only one vote per person. Voting is tracked via IP address. Questions? Email steve@ourhealthvirginia.com.

Heart Health Care Resource Guide

Where to Go for Heart Health Care

Bon Secours Heart and Vascular Institute www.bonsecours.com

Locations for Care:

• Memorial Regional Medical Center 8260 Atlee Road Mechanicsville, VA 23116 804.764.6000

• Richmond Community Hospital 1500 N. 28th Street Richmond, VA 23223 804.225.1700

• St. Francis Medical Center 13710 St. Francis Boulevard Midlothian, VA 23114 804.594.7300

• St. Mary’s Hospital 5801 Bremo Road Richmond, VA 23226 804.285.2011

• The Heart Institute at Reynolds Crossing 7001 Forest Avenue Richmond, VA 23230 804.359. 9355 •••••

HCA Virginia Heart and Vascular Care Richmond

www.hcavirginia.com/service/heart-andvascular-care

Locations for Care:

• John Randolph Medical Center 411 West Randolph Road Hopewell, VA 23860 804.541.1600

• Johnston-Willis Hospital 1401 Johnston-Willis Drive Richmond, VA 23235 804.330.2000

• Levinson Heart Institute at Chippenham Hospital 7101 Jahnke Road Richmond, VA 23225 804.320.3911

• Parham Doctors’ Hospital 7700 East Parham Road Richmond, VA 23294 804.747.5600

• Retreat Doctors’ Hospital 2621 Grove Avenue Richmond, VA 23220 804.254.5100

• The Heart Center at Henrico Doctor’s Hospital 1602 Skipwith Road Richmond, VA 23229 804.289.4500

Other HCA Affiliations:

• Cardiothoracic Surgical Associates at CJW Medical Center 7101 Jahnke Road Richmond, VA 23225 804.320.2751

• Virginia Heart Specialists 281 East Hundred Road Chester, VA 23836 804.530.5178 •••••

VCU Medical Center and Children’s Hospital of Richmond (CHoR) www.vcu.edu www.chrichmond.org

Locations for Care:

• VCU – Pauley Heart Center 1250 East Marshall Street Richmond, VA 23298 804.628.5432 www.pauleyheart.vcu.edu 'VCU locations' —continued on page 38

www.OurHealthRichmond.com

'VCU locations' —continued from page 37

• Children’s Hospital Foundation Heart Center at Children’s Hospital of Richmond at VCU (CHoR) www.chrichmond.org/Services/ Cardiology.htm

• Children’s Pavilion 1001 E. Marshall Street Richmond, VA 23219 804.828.2467

• West Hospital 1200 E. Broad Street Richmond, VA 23219 804.828.2467

Satellite Locations for Care: • Fredericksburg Therapy and Multispecialty Center

10530 Spotsylvania Avenue Suite 101–Multispecialty Center: 804.828.2467 Suite 102–Therapy Center: 540.891.4485 Fredericksburg, VA 22408

• MCV Physicians at Ridgefield Parkway 2200 Pump Road, Suite 210 Richmond, VA 23233 804.740.1100

• MCV Physicians at Temple Avenue 2035 Waterside Road, Suite 100 Prince George, VA 23875 804.957.6287

Independent Cardiology/ Cardiovascular Medical Practices • Cardiology of Virginia, Inc.

• James River Cardiology

• Cardiovascular Associates of Virginia

• Morris Cardiovascular and Risk Reduction Center

13572 Waterford Place Midlothian, VA 23112 804.560.8782 www.cardiovirginia.com

13700 St. Francis Blvd. Suite 600 Midlothian, VA 23114 804.794.6400

• Dominion Cardiology 2731 S. Crater Road Petersburg, VA 23805 804.520.1080 www.dominioncardiology.com

• Heart Care Associates Dave Kamlesh, MD 5303 Plaza Drive, Suite 102 Hopewell, VA 23860 804.541.3800

• Hunter Holmes McGuire VA Medical Center 1201 Broad Rock Boulevard Richmond, VA 23224 804.675.5000 www.richmond.va.gov

Locations in Colonial Heights, Petersburg, Franklin & Lawrenceville 804.520.1764 www.jamesrivercardiology.com

228 Johnson Creek Drive Chester, VA 23836 804.530.1044 www.morriscardio.com

• Pediatric Cardiology of Virginia, PC 7603 Forest Avenue #401 Richmond, VA 23229 804.285.1611 www.pediatriccardiologyva.com

• Virginia Cardiovascular Specialists Locations in Richmond, Midlothian, Mechanicsville & Tappahannock 804.288.4827 www.vacardio.com

• Virginia Medical Group, PC 2905 Boulevard Colonial Heights, VA 23834 804.526.0682 www.vmgphysicians.com/cardiology

For a complete listing of local screenings and heart health events, be sure to check

OurHealth Richmond calendar of events on our website the

at www.ourhealthrichmond.com

Local Screenings

& Heart Health Events 38

OurHealth | The Resource for Healthy Living in Greater Richmond

Common

Heart & Vascular Conditions* Aneurysm: The bulging of an artery caused by uncontrolled blood pressure, injury or weakness. As the aneurysm continues to grow, it may rupture or leak and cause massive internal bleeding. Aortic Dissection: A tear in the lining of the aorta (the largest blood vessel in the body) which can cause it to rupture, causing serious internal bleeding. Atrial Fibrillation: A disorder in which the heart beats in an irregular, chaotic rhythm. Atrial or Ventrical Septal Defect: When a hole in the wall that separates the right and left lungs causes excess blood flow to the lungs. Blood Clot (thrombosis): A hardened glob of blood within an artery or vein which breaks away and blocks the flow of blood to a particular area of the body. Chest Pain (angina): Pain in the chest, arms, shoulders, neck or jaw caused by narrowing of the coronary arteries, thus resulting in an insufficient supply of blood and oxygen to the heart. Coarctation of the Aorta: Constriction of the large blood vessel (aorta) as it curves down to supply the lower body, thus causing an elevation in blood pressure before the narrowed area. Coronary Artery Disease: When the arteries that carry blood to the heart become blocked or narrowed by a gradual buildup of fat (cholesterol). Diabetes: A disease in which the amount of sugar (glucose) in the blood is too high, because the pancreas either cannot produce or use insulin. When blood sugar is not turned into energy, it 'Common Conditions' —continued on page 40

Where to Find

Knowledge & Support Heart Health Resources • American College of Cardiology – Virginia Chapter

3445 Seminole Trail, Suite 253 | Charlottesville, VA 22911 877.793.8171 | www.vcacc.org

• American Heart Association – Greater Richmond 4217 Park Place Court | Glen Allen, VA 23060 | 804.747.8334 www.heart.org/HEARTORG/Affiliate/GlenAllen/Virginia/Home_UCM_MAA014_ AffiliatePage.jsp

• Heart Rhythm Society 1325 G Street, NW, Suite 400 | Washington, DC 20005 | 202.464.3400 www.hrsonline.org

Virginia Department of Health • Heart Disease and Stroke Prevention Program The Heart Disease and Stroke Prevention Program is funded by the Centers for Disease Control and Prevention. The Program's mission is to enhance the State's capacity to plan, implement, track, and sustain population-based interventions to address heart disease, stroke, and related risk factors. Chronic Disease/Health Promotion Programs Manager: Kathy Rocco 804.864.7756

Local Heart Health Support Groups • Mended Hearts of Richmond PO Box 70234 | Richmond, VA 23255 | 804.873.7889 www.mendedheartsrichmondva.org The purpose of Mended Hearts is to offer help, support, and encouragement to heart disease patients and their families in the Richmond area.

9.1.1. fast! dial

Heart attack and stroke are life-and-death emergencies — every second counts. If you see or have symptoms (see list on page 41), immediately call 9-1-1 to get help right away!

www.OurHealthRichmond.com

'Common Conditions'—continued from page 39

Heart & Cardiovascular

Disease

Questions to Ask Symptoms vary depending on what kind of heart or cardiovascular disease you have, but informing your doctor of any chest pain, shortness of breath, or pain or numbness in your limbs could save you from having a heart attack, stroke, or worse. If you haven’t yet been formally diagnosed with heart or cardiovascular disease, and you suspect your may, talk to your doctor about arranging a cardiac evaluation. Once you have a formal diagnosis and know which type of heart or cardiovascular disease you have, your doctor will give you information about the condition and recommend a course of treatment. You'll probably have questions and concerns about your diagnosis and how heart or cardiovascular disease will affect your overall health and your life. Consider asking your doctor the following: • I have a family history of heart disease; how might that affect my health? • Are there any pretest restrictions I need to know about? For example, do I need to fast if I’m going to have a cholesterol test? • What form of heart or cardiovascular disease do I have? What is the severity? What is my prognosis? • What does high blood pressure (hypertension) have to do with heart and cardiovascular disease? Should I be concerned about high blood pressure? Do I need to lower my blood pressure? If so, how? • What role does cholesterol play in heart and cardiovascular disease? Do I have high cholesterol? Do I need to lower my cholesterol? If so, how? • What role does diabetes play in heart disease? Do I have diabetes? Do I need to lower my blood sugar? If so, how? • What caused my heart condition? Did I do something to cause it? Is heart disease a hereditary condition? • Am I at risk for a heart attack? What symptoms would indicate a heart attack? • What is the best method of treatment for my heart or cardiovascular disease? • What are the risks of not treating my heart or cardiovascular disease? • How will my heart or cardiovascular disease affect me over the long term? • Do I need surgery for my cardiovascular disease? Will I need surgery in the future? • What should I do if my symptoms worsen? Source: www.everydayhealth.com

can accumulate in the bloodstream and damage the heart. Heart Attack (acute myocardial infarction): A complete blockage of blood flow in an artery leading to the heart. Heart Failure: When the heart loses its ability to pump enough blood, because the heart muscle has been weakened or injured by high blood pressure or a heart attack. Heart Rhythm Disorder (arrhythmia): An unusual rhythm of the heartbeat, either too fast or too slow. High Blood Pressure (hypertension): When the pressure of the blood is so great against the walls of the artery, it causes the heart to work harder to pump blood throughout the body. Mitral Valve Prolapse: A leak in the mitral valve, which controls blood flow through the left side of the heart. Patent Ductus Arteriosus (PDA): When the PDA artery present in the fetus fails to close properly, causing an excess blood flow to the lungs. Peripheral Vascular Disease: When the same fat buildup that causes coronary artery disease occurs in arteries and veins supplying blood to other areas of the body. Stroke: The condition that occurs when an artery or vessel that supplies blood to the brain either bursts or is blocked by a clot. Within minutes, the nerve cells in that area of the brain are damaged, and they may die within a few hours. Sudden Cardiac Death: Death caused by dangerously fast electrical signals that limit the heart’s ability to pump blood to the body and brain. Tetralogy of Fallot: Four cardiac malformations that appear together. Due to a hole in the wall between the ventricles and a narrowing in the outlet, blood lacking in oxygen is directed away from the lungs until the baby becomes increasingly blue. *Source: healthwise.net

OurHealth | The Resource for Healthy Living in Greater Richmond

Helpful Tips for

Heart Health

Some risk factors for heart disease are beyond our control. But the good news is that there are many lifestyle choices you can make to help you take charge of heart health and reduce your risk of heart disease. • Maintain Regular Doctor Visits Even if you feel healthy and have few risk factors for heart disease, you should still make regular appointments with your doctor. It’s important to take control of your health. An important part of doing this includes being proactive about preventive care.

• Quit Smoking It’s a well-known fact that smoking is bad for your health. In fact, smokers can be at two to three times greater risk of developing heart disease than nonsmokers. So if you smoke, be sure to make time to talk to your doctor about how to quit.

• Eat Smart By eating a diet low in saturated fat and cholesterol, you can reduce your risk for heart disease. This includes foods such as fish, poultry, lean meats, low-fat or nonfat dairy products, and plenty of fruits and vegetables. In addition, to help lower blood pressure, strive to limit your daily sodium intake to less than 1500 mg per day.

• Be Active* Just as eating well is important to your health, it’s just as important to make exercise part of your daily routine. Regular physical activity not only can help people lose weight, it’s also good for your heart! Studies show that physically active people have a lower risk of heart disease than sedentary ones. The American

Heart Association recommends 40 minutes of aerobic exercise, at a moderate to vigorous intensity, three to four times per week.

• Watch Your Alcohol Intake Although many studies have debated the connection between drinking alcohol and heart health, drinking too much can have a negative impact on your health. Overindulging in alcohol can put you at risk for high blood pressure, obesity, stroke, and breast cancer. If you plan to drink alcohol, do so in moderation.

• Take Charge It’s important to set realistic and achievable goals that can become part of your life and routine.

• Make yourself a priority By maintaining your health, you’ll be better prepared to be your best at work, at home with family, or anywhere else.

• Tackle your health as a team It’s essential to have open communication and regular dialogue with your doctors to identify the best approach to supporting your health.

• Seek out support Partner with friends and family to help you accomplish your goals. Support a healthy lifestyle by connecting with other people who enjoy similar activities, such as biking or sharing health recipes.

• Celebrate your success. Feeling good about yourself and reinforcing the positive steps you’re taking will help you stay on track for success. Source: www.truheart.com *Be sure to check with your doctor before starting any kind of exercise routine.

Warning Signs of

Heart Attack, Cardiac Arrest & Stroke Signs of Heart Attack

Signs of Cardiac Arrest

• Chest Discomfort

• Sudden loss of responsiveness • No response to tapping on shoulders • No normal breathing

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

• Discomfort in Other Areas of the Upper Body • Shortness of Breath

Stroke Warning Signs • Face Drooping Does one side of the face droop or is it numb? Ask the person to smile.

• Arm Weakness Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

• Speech Difficulty Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly?

TIME TO CALL 9-1-1

If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

FITBITS

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

Deidre Wilkes, AFAA, ACSM, Certified Personal Trainer

THE GO

INDOOR, AT-HOME WORKOUT

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 Richmond.

to Fight the Winter Blues

One day thereâ&#x20AC;&#x2122;s snow and the next thereâ&#x20AC;&#x2122;s rain. There may be days when getting out of the house to go to the gym is impossible. With minimal space and equipment, you can do an at-home circuit workout that will work all major muscle groups. Circuit workouts are quick and challenging, and a great alternative to the gym.

At-Home Circuit Workout

Rest 20 seconds in between each exercise and do up to 3 sets total, resting a full minute in between set.

15 squats 20 second rest

Beginner:

Go through once.

Intermediate: Go through twice.

Advanced:

Go through three times.

15 medicine ball back extensions 20 second rest

15 push-ups 20 second rest

20 side leg lifts on medicine ball right, then left 20 second rest

1 minute plank 20 second rest

15 bicep curls with weights 20 second rest

20 alternating lunges 20 second rest

OurHealth | The Resource for Healthy Living in Greater Richmond

1 minute abdominal crunch 1 minute rest

HealthyEats

proudly sponsored by

Good Foods Grocery

These recipes are some of our favorites and they bring a variety of delicious sweet and savory flavors to table for the New Year.

Creamy Tomato Basil Soup

½ tsp onion powder

3 28 oz cans salsa style tomatoes

1/8 cup of powdered broth

1 yellow onion

1 quart of water

1. Dice and sauté tomatoes until tender.

The beautiful selection of bulk spices available at Good Foods Grocery will make you want us to be your first stop for New Year baking. With so much variety, we have what you need to fulfill your shopping list. Buying in bulk doesn’t have to mean buying a lot; it means getting as much or as little as you want, which keeps everything fresh and the price affordable. If you don’t feel like cooking, let our deli do it for you! We have an abundant selection of side dishes and sweets sure to please all your guests.

1/8 cup of fresh Basil

2. Add spices.

1 T salt

3. While tomatoes are sautéing, mix broth with quart of water.

lb. chopped carrots

½ tsp black pepper 4 oz of sour cream 1/8 cup of sugar

4. Add broth mixture to tomatoes. 5. Add remaining ingredients and cook until carrots are tender

Good Foods Grocery’s

TOMATO BASIL SOUP

Good Foods Grocery—two convenient, neighborhood stores: Open 9 am -9 pm Mon - Sat. Closed Sundays. | www.goodfoodsgrocery.com Gayton Crossing Shopping Center (West End) | 1312 Gaskins Road | 804.740.3518 and Stony Point Shopping Center (Southside) | 3062 Stony Point Road | 804.320.6767

HealthyEats

proudly sponsored by

Good Foods Grocery

Harvest Rice 2 cups wild rice 6 cups water

½ cup dried cranberry ¼ cup pecans 8 oz mandarin oranges canned 1 T scallions chopped

1. Bring 6 cups of water to a boil. Add uncooked wild rice, reduce heat and simmer covered 40-45 minutes or just until kernels puff open.

3. Drain mandarin oranges and mix in a medium bowl with cranberries, scallions, pecans & zest.

2. Uncover and fluff rice with a fork and simmer an additional five minutes. Drain any excess liquid.

5. Let rest at room temperate for 10 minutes to combine flavors.

4. Add to rice and mix well.

2 tsp orange zest

Good Foods Grocery’s

HARVEST RICE GOES WILD

HealthyEats Dark Chocolate Oatmeal Cookies with Flaxseeds Ingredients: 3

cups whole wheat pastry flour

2½ cups oats 1 cup flaxmeal 1

T + 1tsp baking soda

2 tsp salt

proudly sponsored by

Good Foods Grocery

4 eggs

3. Add eggs and vanilla.

1 T vanilla

4. Add dry ingredients to wet mixture.

2½ cups dark chocolate chips

5. When just combined, add chocolate chips.

Directions:

6. Chill dough for at least 2 hours (this is important!)

1. In a bowl, combine flour, oats, flaxmeal, baking soda, salt and all three spices. 2. In a separate bowl, beat sugar and butter until light and creamy.

7. Drop by rounded tablespoons onto cookie sheet and bake at 325 degrees for 10-15 minutes.

½ tsp cinnamon ½ tsp ginger ½ tsp allspice 1

lb butter room temp

16 oz brown sugar

Good Foods Grocery’s

CHOCOLATE OATMEAL COOKIES off your entire purchase next time you visit Good Foods Grocery

One per customer, one time use. Valid at both Good Foods Grocery locations (West End & Southside) until February 28, 2015.

take a tour of THE

YMCA OF GREATER RICHMOND

The Y is so much more than a gym! Celebrating 160 years of service, the YMCA OF GREATER RICHMOND is a nonprofit dedicated to making our community a better place to live, work and play. With thousands of programs for youth development, healthy living and social responsibility at 17 locations, the Y is seen as having the expertise, friendly staff and tools in place to help Richmond become one of the healthiest cities in America. Under the direction of its new strategic plan, the Y is committed to reducing obesity among youth and adults, reducing the occurrence of diabetes in adults, increasing leadership opportunities for teens, being accessible and inclusive to all and more! Youâ&#x20AC;&#x2122;re invited to come to the Y and see how we can fit into your life and together we can be so much more! Visit www.ymcarichmond.org

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To find the nearest YMCA, scan here:

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www.OurHealthRichmond.com

(Tamara Chini and husband Roy Jr. of Colonial Heights)

the

Benefits of

BEAUTY

SLEEP

words | SUZANNE RAMSEY photography | KG THIENEMANN

“Everything that I did in my day I did because I had to do it,” Tamara, a 52-year-old Colonial Heights resident, says. “You have to get up. You have to go to work. You have to fix dinner. You have to wash clothes. I had no motivation to do anything. I did it because I had to do it.”

Until recently, Tamara Chini was tired. All the time. At Fort Lee, where she works as a licensed practical nurse, she would sleep through her lunch hour. When she got home to husband Roy Jr. and sons, Alex and Roy III, she lacked the energy to do anything but go through the motions with housework and family. After living that way for a year or so, Tamara says she started to suspect she might have sleep apnea, a condition the National Institutes of Health (NIH) defines as a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. According to the NIH, people with sleep apnea stop breathing for a few seconds to minutes and these pauses may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud gasp or choking sound. As a result, the quality of sleep is poor, which makes a person tired during the day.

Tamara had read about the symptoms, among them fatigue, daytime sleepiness and, as she puts it “being able to fall asleep at the drop of a hat.” Her husband also said she’d been snoring loudly — also a sign of sleep apnea — and that she stopped breathing off and on during the night. 'Sleep'—continued on page 50

At top, from left: Roy III, Tamara, Alex, and Roy Jr.

'Sleep'—continued from page 49

Roy was familiar with sleep apnea, having been diagnosed with it himself during the summer of 2014. The 63-year-old, retired from a career in the U.S. Army, says he’d always had trouble falling asleep — sometimes staying awake for an hour or more, just “thinking, thinking, thinking” — but Tamara had noticed he was also snoring and having breathing pauses. Encouraged by his wife and his physician, Roy underwent a sleep study and was diagnosed with obstructive sleep apnea. Richard Parisi, MD says obstructive sleep disorder, in which “the throat collapses intermittently overnight,” is the most common problem he diagnoses and treats in his practice. Dr. Parisi is a physician with Sleep Clinics of America in Richmond, a medical practice exclusively dedicated to the field of sleep medicine. It’s most common in those who are overweight, he says, but family history and the shape of a person’s airway are also factors. In kids, tonsils and adenoids are often to blame and surgically removing them often takes care of it. Left untreated, however, sleep apnea can lead to serious medical problems. 'Sleep'—continued on page 51

Richard Parisi, MD is a board certified sleep physician with Sleep Clinics of America in Richmond. 804.269.8291 www.scaclinics.com

What is a sleep study? Sleep studies are tests that record what happens to your body during sleep. The studies are done to find out what is causing your sleep problems. Sleep studies are usually done in a sleep lab, but sleep studies also can be done with portable equipment you use at home.

OurHealth | The Resource for Healthy Living in Greater Richmond

What is CPAP Therapy? Continuous positive airway pressure therapy (CPAP) uses a machine to help a person who has obstructive sleep apnea breathe more easily during sleep. A CPAP machine increases air pressure in the throat so that the airway doesn’t collapse when breathing in. 'Sleep'—continued from page 50

After he was diagnosed with sleep apnea, Roy and his physician discussed CPAP therapy and decided it was the best treatment option for him. Still, Roy says, he was “frustrated” and “upset” about having to sleep in a mask that was hooked up to a machine, especially when he’d always been in pretty good health. Suleman Iqbal, MD, also a sleep medicine physician with Sleep Clinics of America, understands these feelings. “Part of it is psychological and part physical,” says Dr. Iqbal. “The nature of having to strap a mask to your face blowing air into your nose and/or mouth c an understandably be frustrating. Patients are accustomed to going to sleep with just their pajamas on one night and then the following night they are sleeping with a CPAP machine and associated tubing and mask. It can be uncomfortable, but over the last few years CPAP masks have become much more comfortable and the machines are whisper quiet.” Still, he adds, “Nothing’s going to change the fact that you have to sleep with a mask on your face.” "Married couples often do better with it, explains Dr. Iqbal. "However, many patients realize quickly how much better they sleep with CPAP therapy and get over vanity issues soon thereafter. Moreover, once patients realize improvement in their health, they truly become believers in CPAP therapy. I have had patients come off their blood pressure medications as well as realize better control of their blood sugars associated with diabetes. Ultimately, most patients are willing to tolerate CPAP therapy because of their overall improvement in health as well as daytime energy levels."

“Oxygen levels decline when you’re not breathing and blood pressure increases every time you have one of these pauses for breathing,” Dr. Parisi says. “That combination of things increases the risk of heart disease, including heart arrhythmias like atrial fibrillation, and strokes are more common. Diabetes [risk is] increased to an even greater degree in those with sleep apnea.”

It took just one night for Roy to become a believer in CPAP therapy. When he woke up the morning after using the machine for the first time, he says he “felt like a different person.” He was motivated, he had energy, and it hadn’t taken him hours to fall asleep. “When I put that mask on, I was knocked out right away,” he says. “It was like a sleeping pill to me.” Over the next few weeks, as Roy started feeling better and better, Tamara started thinking maybe she should do something about her sleep apnea, too. She’d been losing weight, which she was told might alleviate the problem, but says she wanted a “quicker fix” because of the risks associated with sleep apnea and heart disease. “Another motivating factor for me to do it was I kind of already knew I had it and we have a 10-year-old and a 15-year-old, and I was afraid of the damage it could do to my heart in the process,” she says. “I really didn’t want to wait until I lost the weight. I wanted to be healthy for them, as well as myself.” 'Sleep'—continued on page 52

Suleman Iqbal, MD is a board certified sleep physician with Sleep Clinics of America 804.269.8291 www.scaclinics.com

www.OurHealthRichmond.com

'Sleep'—continued from page 51

It took just one night for Roy to become a believer in CPAP therapy. When he woke up the morning after using the machine for the first time, he says he “...felt like a different person.” He was motivated, he had energy, and it hadn’t taken him hours to fall asleep.

These days, both Roy and Tamara are using CPAP therapy and sleeping and feeling much better. Like her husband, Tamara saw an immediate improvement in her energy level. She started exercising, something she was always too tired to do before, and has lost 20 pounds. Her goal, she says, is to lose enough weight to be able to stop using the CPAP machine altogether. “It just makes me an all around better person,” she says. “It makes me feel more enthusiastic about daily life activities and gives me ambition, drive and motivation to do things.” Asked what she would say to others who are considering seeking treatment for sleep apnea, Tamara says, “I would say if they want to feel better during the day, if they want to have energy and be motivated, to definitely do it. My only regret is I didn’t do it sooner.”

Lack of sleep is nothing to snore at • The Centers for Disease Control and Prevention says insufficient sleep is a “public health epidemic” affecting 50 to 70 million adults in the U.S. According to Dr. Parisi, the average American adult gets six to six-and-a-half hours of sleep each night, but actually needs seven or eight. • Dr. Parisi says most people are sleep deprived. • The CDC also links sleep deprivation to numerous medical conditions — among them high blood pressure, diabetes, depression, cancer and obesity. • “Sleep is important for lots of physical reasons,” Dr. Parisi says. “There are other body functions that are linked to sleep cycles: hormone levels, metabolism, centers in our brain that regulate food intake. All that is connected. So, people who do not get sufficient sleep are more likely to eat more during the day [and] seek out fatty and high-carbohydrate foods. Weight gain is a very common consequence of sleep loss.” • Lack of sleep also has been linked to an increased risk of accidents, both on the job and on the road. • The National Highway Traffic Safety Administration estimates “drowsy driving” accounts for “more than 100,000 crashes a year, resulting in 40,000 injuries and

OurHealth | The Resource for Healthy Living in Greater Richmond

1,550 deaths.” In keeping with this, WebMD reports, “Reducing your nighttime sleep by as little as one and a half hours for just one night could result in a reduction of daytime alertness by as much as 32%. • “We keep learning more and more about the effects of sleep loss,” Dr. Parisi says. “Very significant things happen. First of all, the most obvious: [you are] less alert during the day when driving and working. It affects work productivity, mood, creativity, memory. There are also physical consequences.”

Dr. Puryear traces the sleep deprivation problem back to a very

What are some consequences of sleep deprivation?

famous invention: the

Short-term

Long-term

“Insufficient sleep is

• Decreased performance and alertness

• High blood pressure

• Mental impairment

probably the most

• Heart attack

• Memory and cognitive impairment

• Heart failure

• Fetal and childhood growth retardation

common sleep disorder

• Stroke

• Injury from accidents

in the U.S.,” he says.

• Obesity

• Disruption of bed partner’s sleep quality

“What caused it? The

• Poor quality of life

light bulb. Before the

• Stress • Occupational injury • Automobile injury • Poor quality of life

• Psychiatric problems • Attention Deficit Disorder

light bulb.

light bulb, people with large families went to

‘Beauty Sleep’

sleep when it got dark."

Is there anything to that? Most people have probably heard someone say, “I’ve got to get my beauty sleep.” Is there anything to that notion? Douglas Puryear, MD with Pulmonary Associates of Richmond says yes. “Proper sleep makes one feel better, and if you feel better, whether you look better or not, you’re going to think you look better,” says Dr. Puryear. “Some people get puffiness around the eyes and more lines around the face. That will take away from one’s physical appearance. “People you run into — they look tired, bags under their eyes, eyes droopy, yawning — that takes away from our general appearance, as opposed to looking bright, chatty, and energetic.” Dr. Puryear adds: “If you sleep more, you aren't going to wake up looking like a supermodel. But you will look and feel better."

Douglas Puryear, MD, FCCP is a board certified sleep medicine physician with Pulmonary Associates of Richmond. 804.320.4243 www.PARsleep.com

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Guide to

Good Sleep words | SUZANNE RAMSEY

Seven Tips for Getting a Good Night’s Sleep How you feel during your waking hours hinges greatly on how well you sleep. Similarly, the cure for sleep difficulties can often be found in your daily routine. Your sleep schedule, bedtime habits, and day-to-day lifestyle choices can make an enormous difference to the quality of your nightly rest. The following tips will help you optimize your sleep so you can be productive, mentally sharp, emotionally balanced, and full of energy all day long.

1: Keep a regular sleep schedule • • • • •

Set a regular bedtime. Wake up at the same time every day. Nap to make up for lost sleep. Be smart about napping. Fight after-dinner drowsiness.

2: Naturally regulate your sleep-wake cycle • • • • • • 54

Spend more time outside during daylight. Let as much light into your home/workspace as possible. Boost melatonin production at night. Turn off your television and computer. Don’t read from a backlit device at night. When it’s time to sleep, make sure the room is dark.

OurHealth | The Resource for Healthy Living in Greater Richmond

How Much Sleep Do We Really Need?

Newborns

12-18 hours

Infants

14-15 hours

Toddlers

12-14 hours

Preschoolers

11-13 hours

School-aged Children

10-11 hours

Teens

9-10 hours

Adults

7-9 hours

Senior Adults

5-7 hours

3: Create a relaxing bedtime routine • • • • •

Make your bedroom more sleep friendly. Make sure your bed is comfortable. Keep noise down. Keep your room cool. Reserve your bed for sleeping and sex.

4: Eat right and get regular exercise • • • • • •

Stay away from big meals at night. Avoid alcohol before bed. Cut down on caffeine. Avoid drinking too many liquids in the evening. Quit smoking—nicotine is a stimulant. You’ll also sleep more deeply if you exercise regularly.

5: Get anxiety and stress in check • Practicing relaxation techniques before bed is a great way to wind down, calm the mind, and prepare for sleep. Some simple relaxation techniques include:

6: Get back to sleep • • • •

Stay out of your head. Make relaxation your goal, not sleep. Do a quiet, non-stimulating activity. Postpone worrying and brainstorming. 'Guide'—continued on page 56

Sponsored by Pulmonary Associates of Richmond, Inc. with locations at Boulders, Colony Crossing and Santa Rosa in Richmond www.PARsleep.com www.OurHealthRichmond.com

Why Do We

Need to

Sleep?

Cleaning the Brain of Toxins Physical Restoration Information Processing & Memorization Mood Regulation

'Guide'—continued from page 55

7: Know when to see a sleep doctor If you’ve tried the tips above and are still struggling with sleep problems, you may have a sleep disorder that requires professional treatment. Consider scheduling a visit with a sleep doctor if, despite your best efforts at self–help, you are still troubled by any of the following symptoms: • • • • • • • • •

Source: helpguide.org

Strengthening Immune System

Persistent daytime sleepiness or fatigue. Loud snoring accompanied by pauses in breathing. Difficulty falling asleep or staying asleep. Unrefreshing sleep. Frequent morning headaches. Crawling sensations in your legs or arms at night. Inability to move while falling asleep or waking up. Physically acting out dreams during sleep. Falling asleep at inappropriate times.

OurHealth | The Resource for Healthy Living in Greater Richmond

Disorders

Sleep

• Sleep-related difficulties – typically called sleep disorders – affect many people. Major sleep disorders include: • Insomnia – an inability to fall or stay asleep that can result in functional impairment throughout the day. • Narcolepsy – excessive daytime sleepiness combined with sudden muscle weakness; episodes of narcolepsy are sometimes called “sleep attacks” and may occur in unusual circumstances.

Relaxing

Bedtime

Rituals to try

• Read a book or magazine by a soft light

• Restless Legs Syndrome (RLS) – an unpleasant “creeping” sensation associated with aches and pains throughout the legs that can make it difficult to fall asleep.

• Take a warm bath

• Sleep Apnea – interrupted sleep caused by periodic gasping or “snorting” noises or momentarily suspension of breathing.

• Do some easy stretches

• Listen to soft music • Wind down with a favorite hobby • Listen to books on tape

What is

REM sleep and what happens there?

• Make simple preparations for the next day

Dr. Parisi says there are “two general sleep stages” — REM and non-REM — that are cycled through during sleep and both are essential to getting a good night’s rest. REM, or rapid eye movement sleep, is when “most of the dreaming occurs,” he says. “Non-REM sleep is also known as quiet or deep sleep. Non-REM sleep is actually the majority of the night in adults — about 75 percent of sleep.” “They both have different functions. Different parts of the brain are involved in different stages. In general, you can say that non-REM sleep is more important for physical regeneration, recovery overnight. That’s the stage where growth hormone is produced and your body recovers from physical injury. REM sleep may be more important for mental regeneration, for memory consolidation, for mood.”

Use the National Sleep Foundation Sleepiness Test to see if you are more or less sleepy than the general population. Similar tests are often used by doctors to test sleepiness levels. If you rate “very sleepy” on this test, you should speak to your physician.

Scan the QR code NOW to take the test! ON THE WEB

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Photo Courtesy of: Valentine Richmond History Center

where is this? Post the correct answer on our Facebook page by

February 7, 2015!

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

The winner will be announced on our Facebook page February 14,

2015.

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