OurHealth Richmond Mar/Apr 2014 Edition by OurHealth Media LLC

MARCH â&#x20AC;¢ APRIL 2014 | OURHEALTHRICHMOND.COM

table of contents | march • april 2014

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

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

NEW & NOTEWORTHY.............14

Cover Story “Second Chances”

In their darkest moments, Chandler Bolin of Mosley and Candi Spraggins of Dinwiddie were rescued by those who do it best

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 about our anatomy? In this issue, test your knowledge when it comes to our respiratory system!

ALLERGY AWARE? .................... 22 Just another spring fever? Or is it allergies? Richmond allergy specialists weigh in with insightful information

REHAB AFTER TRAUMA:........ 37 The importance of rehabilitation and physical therapy for trauma patients

hello, HEALTH!.............................. 42 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos

The Resource for Healthy Living in Greater Richmond

Men, Women and the Total Body Colon Health: An important test gets easier

Kids Care Living with Cystic Fibrosis: A Richmond Family's Journey

MEN, WOMEN AND THE TOTAL BODY..................................51 Preventative tips to keep young colons healthy

NUTRITION........................ 53 HEALTHY EATS: Roasted Cauliflower with Almonds, Roasted Red Pepper Hummus, Asian Cole Slaw

GIVING TO THE COMMUNITY............................... 66 A local place to call home for 30 years: Hospital Hospitality House

LOOKING BACK........................... 74 Images reflecting the history of healthcare in Richmond * PLUS * a chance to win prizes!

The Resource for Healthy Living in Greater Richmond

march • april 2014

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CONTRIBUTING RICHMOND MEDICAL EXPERTS John Goreczny, MD Nathan L. Guerette, MD, FPMRS, FACOG, FAAFP Carrie Ham, MD Karl Koenig, MD David P. Roberts, Jr., DDS Nathan Zasler, MD CONTRIBUTING PROFESSIONAL EXPERTS & WRITERS Susan Dubuque Tina Joyce Steve McClintic, Jr. Rick Piester Edwin Schwartz

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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 and www.ourhealthvirginia.com), social media sites 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 © 2014 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 | www.ourhealthvirginia.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 Sacrocolpopexy? Sacrocolpopexy, also called Sacral Colpopexy or sometimes Colposacropexy, is considered the “Gold Standard” surgery to correct pelvic organ prolapse in women. Pelvic organ prolapse is a common issue women face once they enter childbearing years and beyond. It involves a spectrum of symptoms including bladder leakage, bowel leakage, difficulty emptying, severe pelvic pressure, sexual problems, pelvic and low back pain, and a bulging out of the vagina. Sacrocolpopexy is a comprehensive surgical repair of the pelvic organs. This surgery has numerous advantages over other treatments. It is a very strong repair and has the highest success rate of any option. It works well even when someone has had prior surgeries. The result returns normal anatomy and sexual function is usually excellent following the procedure. With the advancement of minimally invasive robotic surgery this can now be done through a few tiny incisions. The recovery has changed from a long process to an overnight hospital stay and a return to most normal activities almost immediately. For more information visit FPMIofVA.com or Voicesforpfd.org. Nathan L. Guerette, MD, FPMRS, FACOG, FAAFP The Female Pelvic Medicine Institute of Virginia Richmond | 804.523.2533 www.fpmiofva.com

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What is post-concussive syndrome? Post-concussive syndrome is a term used to describe an array of problems including cognitive, behavioral and physical that may occur following a concussion (i.e. mild traumatic brain injury). This phrase is actually a misnomer in that there are significant inconsistencies in the array of symptoms reported by persons following concussions. This condition is probably more appropriately referred to as a postconcussive disorder. The symptoms typically are worst early after injury and get better over days to weeks… on rare occasions sometimes longer with most individuals making full functional recoveries by 3-6 months post injury. Common symptoms include headache, dizziness, fatigue, insomnia, memory and processing difficulties, irritability, and increased emotionality, among other complaints. Appropriate education regarding the condition and early management are key to facilitation of recovery. Interested persons should contact the Brain Injury Association of Virginia at 1.800.444.6443. Nathan Zasler, MD

Medical Director Concussion Care Centre of Virginia Richmond | 804.346.1803 www.concussioncarecentre.com

What is malocclusion? Malocclusion is an incorrect relationship between the maxilla (upper jaw) and the mandible (lower jaw). It occurs when a tooth or some teeth are not able to fit together comfortably. Common examples of malocclusion include over bite, under bite, and open bite among others. It can be caused by problems with the alignment of the teeth or problems with the alignment of the upper and lower jaw bone. Many of these causes are genetic and can be fixed comfortably through orthodontics typically at a young age. Depending on the severity of the malocclusion, additional procedures or surgery may be required. David P. Roberts, Jr., DDS

Virginia Family Dentistry (formerly Baxter Perkinson & Associates) Tri-Cities | 804.526.4822 www.wbperkinson.com

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

What are the symptoms of kidney disease?

When is BOTOX® used to treat migraines?

Perhaps more important than symptoms is the lack of symptoms in kidney disease. The kidneys have substantial reserve so that even at a relatively low level of function very few if any symptoms occur. Thus, regular testing (simple blood tests) is essential to detect early problems.

BOTOX® (botulinum toxin) is one of the newest therapies available to treat chronic migraines. Migraines are unique in that they are associated with nausea, vomiting, sensitivity to light and / or sound. Depending on the frequency of migraines we use different treatment strategies. With less frequent migraines we use “rescue” medicines that are only taken at the onset of a migraine and aimed at stopping it in its tracks. With three or more migraines per month, we often add a daily preventative medication, and if migraines occur 15 or more days per month (“chronic migraines”), I often recommend treatment with BOTOX®. It is given as a series of injections into the forehead, temples, and back of the head every 12 weeks. The procedure is done in an outpatient setting and only takes about 15 minutes. The goal of the treatment is to reduce both the frequency and severity of migraines.

However, at less than 25% of normal kidney function, symptoms can emerge. Progressive fatigue is often an early sign, caused by the accumulation of waste products and an anemia that accompanies significant kidney dysfunction. Appetite declines, often associated with nausea and sometimes vomiting. In addition, food may not taste normal, some describe a metallic taste. Sleep disturbances can occur, ranging from insomnia to excessive sleepiness. Salt and water accumulation can result in swelling (edema) of the ankles or hands and shortness of breath. Other retained toxins can lead to diffuse itching that is difficult to relieve. Cognitive function can also decline with progressive kidney disease. None of the above symptoms alone are specific but, taken in total, suggest the presence of kidney disease. Karl Koenig, MD

Richmond Nephrology Associates and Virginia Transplant Center Richmond | 804.272.5814 www.richmondnephrologyassociates.com

OurHealth | The Resource for Healthy Living in Greater Richmond

Carrie Ham, MD

VCU - Assistant Clinical Professor of Neurology MCV Physicians at Mayland Court Richmond | 804.527.4540 www.vcuhealth.org/mayland

We usually only think of immunizations for children, but is there an immunization schedule that healthy adults should follow? The adult immunization schedule is more dependent than the children’s on the age and health status of the individual. There are a few immunizations that healthy adults should get including a yearly flu shot and a Tetanus shot every ten years. There is also an immunization for young men and women to protect against the virus that causes cervical cancer. Whether they’ve had shingles or not, adults age 60 and older should get the shingles vaccine. Every adult should have a Well Visit with their primary care physician every year to discuss recommended shots. Patients with chronic medical problems will have different requirements. There is a tool for patients on CDC.gov that can be useful for reviewing available immunizations. John Goreczny, MD

Chesterfield Family Practice Richmond | 804.276.9305 www.chesterfieldfamily.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

Crisis resource team training at Advanced Orthopaedics (AO) in Richmond in partnership with the faculty and staff of the Department of Nurse Anesthesia at Virginia Commonwealth University (VCU) Earlier this year a group of nearly 40 health care professionals consisting of providers from Advanced Orthopaedics in Richmond and faculty and staff of the Department of Nurse Anesthesia at VCU joined for their annual simulation training program. This program promotes excellence in teaching, research, and emergency care through the use of simulation resources. With the advent of new technology, medications and management techniques, anesthesia and surgery are safer today than perhaps at any point in history. Evidence exists, however, that despite the multitude of success stories, patients can still experience unexpected and unintentional harm when they come to the hospital for surgery.

The human patient simulators have the capacity to mimic real human physiological responses to medications and other treatments as well as other human functions such as crying, sweating, urinating, bleeding, and coughing making for a most realistic learning environment. The purpose of this hands-on high-fidelity simulation offers opportunities for learning new skills as well as training to help prevent these unexpected, unintentional outcomes in order to improve patient safety and quality of care at Advanced Orthopaedics. Advanced Orthopaedics strives to provide the best and most well trained providers for your orthopaedic care.

Richmond cosmetic surgeon Joe Niamtu, DMD has received the 31st annual William F. Harrigan award from the Bellevue Hospital Oral & Maxillofacial Surgery Alumni Program. The award was presented to Dr. Niamtu in recognition of his accomplishments in the field of oral & maxillofacial surgery. Dr. Niamtu was also awarded the prestigious Golden Scalpel award from the American Board of Cosmetic Surgery, which is presented annually to four surgeons who exhibit excellence, dedication, advancement and contribution to the field of cosmetic surgery. Dr. Niamtu specializes in cosmetic rejuvenation of the face and neck. He has been in practice in Richmond for 30 years and has performed thousands of procedures. In addition to his local practice, Dr. Niamtu lectures internationally and has taught on six continents. He has written four textbooks, authored hundreds of publications, and filmed an instructional DVD series on cosmetic facial surgery. For more information on Dr. Niamtu, go to lovethatface.com or call 804.934.FACE (3223).

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Virginia Cancer Institute Announces New Locations, Adds Physicians The Virginia Cancer Institute (VCI) recently opened new offices in Petersburg and Hopewell, bringing the number of VCI locations in greater Richmond to six. VCIâ&#x20AC;&#x2122;s Petersburg practice is located in the recently opened cancer treatment facility at Southside Regional Medical Center (SRMC). The office is in the new 32,500-square-foot Southside Regional Medical Arts Pavilion, which is adjacent to SRMC. Mitchell Machado, MD has joined VCI and will be the primary physician assigned to the Petersburg location. He is certified in internal medicine, medical oncology, and hematology by the American Board of Medical Specialties (ABMS). VCIâ&#x20AC;&#x2122;s new Hopewell office is located at John Randolph Medical Center, an affiliate of HCA Virginia. With a 147-bed hospital, this location serves the cities of Hopewell, Colonial Heights and Petersburg, as well as nearby counties, including Prince George and Chesterfield.

the Southside Regional Medical Arts Pavilion in Petersburg. Dr. Gandhi is certified in internal medicine and medical oncology by the ABMS. He completed an internship and a residency in internal medicine at the College of Medicine at the University of Illinois and the Veterans Administration West Side Medical Center in Chicago. He also completed a fellowship in hematology and oncology at the Medical College of Virginia. Dr. Nalluri is certified in internal medicine, medical oncology and hematology by the ABMS. He completed an internship and a residency in internal medicine at the State University of New York at Stony Brook. He also completed a hematology/oncology fellowship at the same school. In 2012, VCI observed its 30th anniversary of serving patients and their families. The practice includes 20 physicians who are experts in medical oncology, hematology and clinical research.

In addition, Yogesh Krishnalal Gandhi, MD, and Shobha R. Nalluri, MD have also recently joined VCI. Both will see patients at the Hopewell location, with rotations to the new VCI office at

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NEW

NEW PHYSICIANS,

NOTEWORTHY

Inna Marcus, MD

Virginia Eye Institute Pediatric Ophthalmology and Adult Strabismus Henrico and Prince George 804.287.4200

Mitchell Machado, MD

Virginia Cancer Institute Southside Regional Medical Center Petersburg | 804.431.1100

Samantha Chou, PT

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

Hannah

Orthopedic Physical Therapy Bendahmane, PT, DPT Richmond | 804.285.0148 Richmond Hope Therapy Center | Glen Allen 804.747.HOPE (4673)

Shobha R. Nalluri, MD Virginia Cancer Institute John Randolph Medical Center Hopewell | 804.452.3850

Patient First - Parham Richmond | 804.270.2150

Christopher McKenney, PA-C

Virginia Cancer Institute Parham Doctors’ Hospital Henrico | 804.346.3182

Pulmonary Associates of Richmond Richmond | 804.320.4243

Motsumi Moja, MD Patient First - Colonial Heights Colonial Heights 804.518.2597

Carrie Peltz, MD

Pulmonary Associates of Richmond Richmond | 804.320.4243

OurHealth | The Resource for Healthy Living in Greater Richmond

Bon Secours Behavioral Health Group at St. Mary’s Richmond | 804.287.7788

Ghulam D. Qureshi, MD James T. May, IV, MD

Yogesh K. Gandhi, MD

Virginia Cancer Institute John Randolph Medical Center Hopewell | 804.452.3850

Elizabeth Bigelow, MD

Virginia Ear Nose and Throat Patient First - Short Pump Richmond, Mechanicsville Richmond | 804.360.8061 and Prince George 804.484.3700

PHOTO UNAVAILABLE

Robert Dausch, MD

Adele Karp, LCSW

PHOTO UNAVAILABLE

Rebecca Muminovic, MD

Patient First - Genito Midlothian | 804.744.6310

Ann Vaughters, MD, FAAP Lee Davis Pediatrics Mechanicsville 804.730.4690

Bhavnita Thacker, MD

Patient First - Carytown Richmond | 804.359.1337

Alexis Aplasca, MD

Children’s Hospital of Richmond at VCU, Child & Adolescent Psychiatry Downtown Richmond 804.828.3129

Cecilia Bergh, MD

Pulmonary Associates of Richmond Richmond | 804.320.4243

Charles V. Clevenger, MD, PhD

VCU Medical Center – Pathology Richmond | 800.762.6161

David Jaffe, MD

Children’s Hospital of Richmond at VCU Neurology Chesterfield 804.828.CHOR

Jyoti P. Kapil, MD

VCU Medical Center – Pathology Richmond | 800.762.6161

Alia Marie O’Meara, MD Children’s Hospital of Richmond at VCU Critical Care Medicine Downtown Richmond 804.828.CHOR

Robert Laughlin, DDS Children’s Hospital of Richmond at VCU Dentistry Downtown Richmond 804.828.9095

Kathryn Ann Rizzo, DO, PhD

VCU Medical Center Pathology Richmond | 800.762.6161

Thomas Lee, MD

VCU Medical Center – Otolaryngology Downtown Richmond and Stony Point 804.828.4715

Michael Schechter, MD Children’s Hospital of Richmond at VCU Pulmonary Medicine Downtown Richmond 804.828.CHOR

Jessica Malloy, MD

Children’s Hospital of Richmond at VCU, Child & Adolescent Psychiatry Downtown Richmond 804.828.3129

Roopa Shankar, MD

Children’s Hospital of Richmond at VCU Endocrinology & Metabolism West End | 804.828.CHOR

Stephanie B. Mayer, MD

VCU Medical Center Endocrinology & Metabolism Downtown Richmond and West End | 804.828.2161

Cynthia Yazbeck, MD

VCU Medical Center Endocrinology & Metabolism Downtown Richmond, Stony Point and West End 804.828.2161

www.OurHealthRichmond.com

both

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

If parents have allergies, their children have

60-80%

a likelihood of developing allergies. People who

do these

neither

4 things

live an average of 14 additional years, compared to

If parent has allergic tendencies, a child’s chances of developing them drop to

about 10%

those who do not. 1. Eat five servings of fruits and vegetables per day 2. Drink alcohol in moderation 3. Don’t smoke 4. Exercise

Source: thehealthyeatingguide.com Source: National Institutes of Health

More than 90 percent of the pancreas can be removed and still produce enough insulin for the body. Source: Brian Kaplan, MD VCU Medical Center

OurHealth | The Resource for Healthy Living in Greater Richmond

Truths about

Trauma

• Trauma kills more people beneath the age of 44 than cancer, heart disease, AIDS, and other diseases. • Each year, trauma accounts for 37 million emergency room visits and 2.6 million hospital admissions. • Annual trauma costs in the U.S. are estimated at more than $700 billion. Source: American Trauma Society, National Trauma Institute

Drink Up!

Fun Facts About Water: By the time a person feels thirsty, his or her body has lost over 1 percent of its total water amount. The weight a person loses directly after intense physical activity is weight from water, not fat. Source: AllAboutWater.org

EARTH DAY 2014 • The Official Theme for Earth Day 2014 (April 22) is Green Cities • Below are some steps you can take to help your city accelerate its transition to a cleaner, healthier, and more economically viable future!

6 Super Snacks Packing 100 Calories*

OR LESS

6 cups of light microwave popcorn • 100 calories

½ cup of low fat cottage cheese with a small wedge of cantaloupe • 100 calories 14 almonds • 98 calories 12 rice crackers • 91 calories 8 baby carrots with two tablespoons of hummus • 90 calories ¾ cup of apple slices with thin layer of unsalted peanut butter • 90 calories * Calorie content may vary among different brands

• Walk, Hike, Ride a Bike • Keep that car in park and put your body in drive instead! Not only will you help save fuel, you will also get to enjoy the great outdoors while getting in some exercise! • Plant a Tree • Trees generate oxygen, control air pollution and soil erosion and provide shade to keep homes and cities cooler! • Give Weeds a Hand • Pull weeds by hand instead of using herbicides! • Lighten Your Energy Bill • Choose Compact Fluorescent Lamps (CFLs) – they last ten times longer than regular bulbs, use one-fourth the energy and produce 90 percent less heat while producing more light per watt! • Reduce, Reuse and Recycle • Return hangers to the cleaners, donate clothing and computers to charity and pack lunches in reusable containers! • Richmond Earth Day Celebrations • The celebration begins April 26th, 2014! • Kick off Earth Day with the Earth Day 5k • Race without a Trace! For more information and to register, visit www.earthcraftvirginia.org and select Events! • Earth Day Richmond Festival • The Festival will be held 11:00 am - 5:00 pm at the 17th Street Farmers Market in Shockoe Bottom. Admission is FREE. Experience local music, drink, art, eco-kids activities and more! Sources: worldpress.com; rustletheleaf.com

ON THE WEB

More at ourhealthrichmond.com www.OurHealthRichmond.com

the

The Anatomy Challenge is proudly sponsored by

Anatomy CHALLENGE Hereâ&#x20AC;&#x2122;s your chance to see how much you know about the respiratory system! First, find all the hidden words in the word search below. Next, match up the correct word with the part of the body in the illustration.

[ the respiratory system ]

WORD SEARCH

______________ ______________ ______________ ______________

______________

nasal cavity

oral cavity

nostril

pharynx

larynx

left main bronchus

trachea

bronchi

right main bronchus

alveoli

left lung

right lung

ribs

diaphragm

______________

______________ ______________ ______________

______________

______________ ______________

words | EDWIN SCHWARTZ STEVE MCCLINTIC, JR.

With winter winding down and spring starting up, one question will be on the mind of many people in the Richmond community and beyond: Are those lingering sniffles and sneezes just a stubborn cold or could they be the onset of allergies? OurHealth turned to experts at Allergy Partners of Richmond to find the answer.

Allergies do not Discriminate Against Age “One of the common myths about allergies is that if symptoms don’t surface during early youth, they never will,” explains Ananth Thyagarajan, MD, an American Board of Allergy and Immunologycertified allergist with Allergy Partners of Richmond. “The truth is that everyone is born with the ability to develop an allergy to anything. Exposure to high amounts of an allergen can trigger symptoms, regardless of age.”

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What are some common signs of infection? Fever, sore throat, swollen glands, muscle aches and colored mucus do not occur with allergies and generally indicate an infection. Dr. Thyagarajan says this is especially true when it comes to pollen allergies, where symptoms often overlap with those of the common cold, such as sneezing, fatigue and congestion. He says a significant indicator that separates colds from allergies is fever. “A fever indicates an infection, which occurs with the common cold or flu,” Dr. Thyagarajan says. “Symptoms like itching in the nose, ears and eyes can point toward allergies. Also, symptoms that last more than two weeks are most likely caused by allergies.” Spring allergies come in two main components, tree and grass pollen. And because there are so many kinds of both, it is very difficult to pinpoint which types cause the most number of allergic reactions. “For a pollen to cause allergic symptoms, it must be airborne, light and of a certain size,” says Michael Blumberg, MD, MHA, an American Board of Allergy and Immunology-certified allergist, also of Allergy Partners of Richmond. “The spring season for tree pollen can arrive as early as mid-February and last until late May,” adds Dr. Thyagarajan. “The grass season can run from May through the end of June.” “With tree pollen, the pollen count runs from 1,000 to 2,000,” says Dr. Blumberg. “The grass counts run far less, from 50 to 100. And the symptoms are not as explosive.” “With colds and flu, people usually feel better after two weeks as the body’s defenses have

fought it off,” says Dr. Thyagarajan. “Any longer than that and I would be concerned about an allergy. An additional factor to consider is if you have been in contact with anyone who has a cold. Colds are contagious and allergies are not.” “If you see pollen on your car and begin to itch, sneeze or get watery eyes, this most likely points to some sort of seasonal allergy,” continues Dr. Thyagarajan. “If that is something you’re concerned about, even in the non-pollen months, you can take an over-the-counter (OTC) antihistamine. ZYRTEC®, Claritin® and Allegra® are all medications that work pretty fast.” “If you take one and in a couple of hours you feel better, this may be a sign you suffer from an allergy and not a cold,” adds Dr. Thyagarajan. “If you don’t feel better you could have a cold or severe allergy. If you take OTC medications and have partial relief of symptoms, this means you have an allergy.” “If you’re only having symptoms in the spring, it’s usually tree or grass pollen. If you only have symptoms in the fall, then it’s weed pollen,” says Thyagarajan. “If you’re having symptoms yearround, then it’s probably caused by year-round allergens like dust mite, cat or dog dander.”

Diagnostic and Treatment Option Steps* There are three primary categories in the testing and treatment of allergic disease – avoidance, medications and immunotherapy. “With avoidance, you stay away from what

Trees pollinate in late winter and spring. Ash, beech, birch, cedar, cottonwood, box, elder, elm, hickory, maple and oak pollen can trigger allergies. Grasses pollinate in late spring and summer. Those that cause allergic reactions include Kentucky bluegrass, Timothy grass, Johnson grass, Bermuda grass, redtop grass, orchard grass, ryegrass and sweet vernal grass.

What is the pollen count? The pollen count tells us how many grains of plant pollen are in a certain amount of air (often one cubic meter) during a set period of time (usually 24 hours). Pollen is a very fine powder released by trees, weeds and grasses. Weather affects how much pollen is carried in the air each year. Much pollen is released early in the morning, shortly after dawn. This results in high counts near the source plants. Pollen travels best on warm, dry, breezy days and peaks in urban areas midday. Pollen counts are lowest during chilly, wet periods.

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What are Antihistamines? Antihistamines are drugs used to treat the symptoms of allergies and allergic rhinitis (allergic inflammation of the nasal airways) by blocking the action of histamine, a chemical released by the immune system in allergic reactions. you’re allergic to. Determining this requires some testing,” explains Dr. Thyagarajan.

The Skin Test “The skin test is generally the most accurate and economical method for testing,” says Dr. Blumberg. “The problem with the blood test is there are so many kinds that vary by company, and it is difficult to know which one to choose.” Since pollen is prevalent in the southeast for nine to ten months a year, avoiding it is a challenge. Dr. Thyagarajan recommends simple avoidance measures such as keeping bedroom windows closed, using central air or window air conditioning units and changing filters monthly. He also suggests showering and shampooing after spending time outside and keeping animals outdoors. “I prefer to look at trends versus dayto-day numbers,” says Dr. Thyagarajan. “We provide real time data on when spring pollen starts and ends. This is important because it means our patients may be able to take medications for shorter periods of time.”

OTC Options In the second category of treatment, medications, there are as many options as there are kinds of prescription nasal sprays and OTC pills. “Antihistamines are useful for alleviating itching and sneezing, while decongestants alleviate congestion,” says Dr. Thyagarajan. “Nasal sprays, both steroid and antihistamine, effectively treat many nasal symptoms, www.OurHealthRichmond.com

In February 2014, a new resource was introduced to the OTC market. Nasacort®, formerly a prescription medication nasal spray, is now available on the shelves. Nasacort® treats differently in that it is a topical steroid and can take up to five to seven days to reach maximum effectiveness. while a variety of antihistamine eye drops are available for eye symptoms.” Many allergy sufferers ask how long they should try a certain OTC medication. Allergy Partners of Richmond is the only organization in central Richmond that does a true pollen count. On top of their office at Henrico Doctors’ Hospital resides a machine called a Rotorod® Sampler. The Rotorod® is a slowly rotating air sampler that collects and deposits particulate matter (extremely small particles and liquid droplets suspended in the air) on a microscopic slide. Five days a week, the pollens on the slide are counted through a microscope that provides actual, real-time pollen counts.

“Most OTC medications work within a couple of hours, maybe a couple of days,” says Dr. Thyagarajan. “So if you’re trying an OTC antihistamine and within two days nothing has improved – stop taking that medication. Try another one in that category. Allegra® works for some people, while Claritin® works for others.” “Because there are now so many OTC medications, people are often taking the wrong one,” says Dr. Blumberg. “If your symptoms last longer than a week or two or if you’re experiencing infections, wheezing or shortness of breath – you need to be treated.” Dr. Blumberg continues, “The reason to see an allergist is to learn what is causing the problem. Most people assume they know. But the reality is, they don’t. Usually, it’s a blind guess and people often guess wrong.” In some cases, people with allergies discover their medication has stopped working. “This is really common,” says Dr. Thyagarajan. “Unfortunately, with some of these kinds of OTC medications, they work initially but then they stop working after six months or even longer. We have some prescription medications that can help. The ultimate therapy is allergy shots as they really treat the underlying disease. The medications only treat the symptoms.”

Immunotherapy Options Allergy shots make up the third category of treatment, immunotherapy. “This involves taking the actual allergen—such as dust mites, animal dander or mold—sterilizing it 26

OurHealth | The Resource for Healthy Living in Greater Richmond

and slowly increasing the amount you give the patient,” says Dr. Thyagarajan. “As the therapy continues, the body builds up a natural immunity to the allergen. The advantages are two-fold, because it is the most effective treatment at decreasing symptoms and offers the greatest potential for long term relief.” “Unlike medications that treat symptoms only, immunotherapy truly modifies the immune system and prevents symptoms from developing,” adds Dr. Thyagarajan. “Immunotherapy is effective in approximately 85 percent of patients and reduces symptoms, need for medications and may prevent asthma in young children.”

Spring Asthma? Many people wonder if there is such a thing as “spring asthma”. With asthma, there are multiple triggers such as exercise, smoke, infection and allergies. Tree and grass pollen, or a year-round allergen like dander could trigger asthmatic symptoms. “Thirty percent of children with severe allergies will also have asthma,” says Dr. Blumberg. “Part of the reason is nasal congestion. If you can’t breathe through your nose, you’re more likely to develop asthma.”

Allergy Partners of Richmond Resources “Allergy Partners of Richmond sponsors free webinars on important allergy topics and presents them to the public,” says Dr. Blumberg. “These are prepared on subjects such as asthma, hay fever and food allergies. Each session also includes time for questions and answers so that the public can interact with the experts.” Dr. Thyagarajan contributes to the Allergy Partners of Richmond blog, located online at http://www.allergypartners.com/richmond/ blog/, where he has written about the widespread myth that eating locally harvested honey can cure allergies. The idea is based on the same theory behind immunotherapy – that a person can build up immunity to pollen by ingesting locally harvested honey. But the theory does not work, because the pollen in honey is not the kind that causes allergic reaction.

Knowing when to see an allergist can make all the difference in feeling better “Anyone who has allergies can come in and get evaluated and receive specialized care,” says Dr. Thyagarajan. “Many of our patients have tried the OTC medications and their symptoms aren’t controlled. If this describes you, then you are definitely a person who needs to come in and get evaluated.” “Determining when to see an allergist relates to your general well being and how debilitated you are,” adds Dr. Blumberg. “If your performance is decreasing at work or you are missing school, then you need to be seen.” “People without allergies tend to minimize others’ conditions,” concludes Dr. Thyagarajan. “Respiratory allergies can be really debilitating as they affect the ability to focus and concentrate. There are great treatments out there. Talk to your primary care doctor to find out if your condition is allergy-related, or seek the assistance of a qualified allergist. With today’s options, living a healthier and happier life without fighting allergies is possible.” Footnote *Always consult your physician or provider before taking any OTC medications. This is especially important if taking other medications, prescription or OTC, to avoid adverse drug reactions.

Michael Z. Blumberg, MD, MSHA, of Allergy Partners of Richmond, is certified in allergy and immunology by the ABMS and has been practicing in the Richmond community for over 30 years.

Ananth Thyagarajan, MD of Allergy Partners of Richmond is certified in allergy and immunology by the ABMS. He has special interests in environmental allergy, asthma and food allergy.

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TUNED. www.OurHealthRichmond.com

CHANCE second CHANCES The smell of your first morning cup of coffee awakens your senses. Your routine begins slow, but steadily increases as you prepare for the day. As the early morning wears on, the sun peers over the horizon and dances through the trees—as if seeking to find you standing in your own kitchen looking out the window.

words | TINA JOYCE

Your thoughts are beginning to come into focus. The tasks and details of the day ahead soon consume your mind. So with a pen in hand, you scribble notes to yourself of items you surely won’t want to forget as the busyness of your day takes over. Glance down at your to do list.

Imagine that one item listed says, give someone a second chance.

Reprints To order reprints of the original artwork featured on this issue’s cover, contact Jenny Hungate at 540.387.6482 or via email at jenny@ourhealthvirginia.com. To view additional work by our artist, Joe Palotas, visit www.salemartcenter.com

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Dawn Kain, RN is a pediatric charge nurse at HCA Virginia’s Chippenham Hospital. What if the daily choices you make, and the skills you continually hone in your career help determine if someone celebrates another birthday? What if your job could help a person resume working or caring for his or her family? What if your workday’s focus often balances life and death? This is true for healthcare providers working in the multidisciplinary field of trauma care. One of the largest facilities in the nation’s largest hospital system (HCA), Chippenham Hospital is a state-authorized Level III trauma center. HCA Virginia's Chippenham Hospital also offers Central Virginia’s only Pediatric ER staffed 24-hours a day by pediatric-trained ER nurses and physician specialists (Photography courtesy of HCA Virginia)

Often beginning with a 911 call, dispatchers, first responders, and paramedics work together as a collaborative team to transport critically ill patients to the emergency room (ER). Patients are admitted to the ER, and are transitioned to an intensive care unit (ICU). From there, they may be transferred to a medical/surgical unit, and then ultimately released. Throughout this process, a multitude of physicians, nurses, therapists and other healthcare professionals are involved. They work together orchestrating a plan of care to assist patients and their families through admittance, recovery and release. ••••• Chandler Bolin, of Moseley, Virginia and Candi Spraggins, of Dinwiddie County share their individual stories of how trauma care teams came together to serve their critical needs. Although they faced different circumstances, as well as odds, they both were dependent on the trusted care of trauma professionals in their respective accidents.

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It was after 3:00 pm on January 10, 2014, a seemingly normal day for Chandler Bolin, a junior in high school. He was staying after school to make up schoolwork when he simply called a friend to ask for a ride home. A relatively routine day was progressing as planned, and was on course to end just as any other day in the past. The road was familiar to them both, and they enjoyed conversation and music on the relatively short drive to Chandler’s house. The rain was falling and making the roads dark with moisture. At age 17, life seems like a wide-open book with endless opportunities—and time. Laughter and friendship make up many afternoons in high school, and rarely does a youthful spirit get bogged down with thoughts of physical limitations and mortality. Without much warning, the car Chandler was riding in hydroplaned, veered into the other lane, and headed directly into oncoming traffic. The result was a violent, head-on collision with an unsuspecting motorist. “Every day the accident still flashes back through my mind,” says Chandler. “I saw another car coming straight for us and in a split second my whole body jerked; it was so loud.” He seemed to black out for a few minutes, and remembers awakening to the car filling with engine smoke. He had a piercing pain in his chest as he tried to recover his breath. He looked to open the passenger door—still fighting for air—but he couldn’t get the door open. Trying not to panic, he and the driver both crawled out the driver’s side door. Chandler crawled away from the car, and could see people running from their vehicles toward them as they came upon the accident. The remnants of the crash were eerily similar to the car crashes seen in movies, but this was not orchestrated or scripted. These were not actors, but real life people whose lives may be in the balance. Chandler remembers thinking “Is this really happening?”

Seventeen year old Chandler Bolin of Moseley, Virginia, reflects on thankfulness and second chances, following a traumatic car accident he survived in early January 2014.

Time seemed to stand still, while also racing by. His hearing was fading as he saw a police officer approaching. “I just kept calling out Jesus’ name,” Chandler recalls. “I really thought I was dying; I couldn’t talk or breathe well.” Chandler then went into shock, struggling with breathing and maintaining body temperature. Paramedics were able to move him to the ambulance, where they took his vital signs and stabilized him. “The paramedics kept asking me so many questions, but I had to focus on breathing. It was very painful,” he remembers. Once he arrived in the emergency room at HCA Virginia’s Chippenham Hospital, the medical team immediately connected him with IVs to replace fluids. Then, they began numerous tests to determine the exact extent of his injuries. “I was so happy to be there [ER]. I knew everyone was there to help me,” remembers Chandler. “One doctor was very caring and made me feel so comfortable.” Chippenham Hospital is a certified level III trauma center with a designated pediatric emergency room. A majority of the nurses are trauma certified, and are qualified to meet the needs of trauma patients of all ages. “We look forward to providing high quality and compassionate patient-centered health care in a patient’s time of need,” shares Dawn Kain, RN, pediatric charge nurse at Chippenham Hospital. Emotional trauma can be paralyzing, especially for young people with such limited life experience. The isolation of the ambulance ride and admittance into the ER without parents by your side can be frightening. In addition to his mental distress, Chandler also suffered from www.OurHealthRichmond.com

a chest contusion, a fractured finger, severe bruising in his shoulder and an injured foot. Mike Bolin, Chandler’s dad, made it to the ER about 15 minutes after the ambulance transporting Chandler pulled into the hospital. His mother, Tracea, arrived shortly after. “It was a very emotional time,” recalls Chandler. “My parents were crying; I guess it’s hard to see your kids hurting. I started crying seeing them so scared.”

The VCU LifeEvac helicopter program

serves the people of central and Southside Virginia as well as portions of North Carolina 24-hours per day, 7 days per week. In cases where seconds count, more efficient transport service could mean the difference between life and death.

Fortunately, after a myriad of tests and evaluations, the doctors determined his injuries were significant, but not life threatening. For these healthcare providers, the pendulum swings between minimal injuries to life threatening or life altering. In this particular case, Chandler’s injuries did not require an overnight hospital stay. The medical team at Chippenham was able to make accurate assessments, and complete care prior to his late evening release. “They were very helpful and caring. They were willing to do anything to help me feel better,” says Chandler. “If you ever find yourself in the misfortune of a motor vehicle collision, it is important to always be evaluated in a timely manner. It is often after such a traumatic event [as an auto accident] that patients are not thinking as clearly as normal, and might not be aware of all possible injuries,” explains Kain. “It is common for patients to have an increase in pain and symptoms in the days following collisions.” Despite being released the same evening of the accident, Chandler’s hand injuries will require months of physical therapy once the pins are removed. He will have to learn to grasp things again and relearn certain fine motor skills. The therapy following any surgery can be one of the most important phases in the recovery process, and to complete healing. Although only 17-years-old, Chandler Bolin learned an important life lesson many others learn too late in life, “Always be thankful for things,” he explains. “It all happened so fast. I feel like in a way, I got a second chance.” Fortunately, all others involved in the two-car collision survived that afternoon as well.

“I was busy doing a lot of things,” he says. “You can really take things for granted.” Busy activities perhaps don’t matter as much to Chandler as he once thought. These things kept him from being where he needed to be, and from where he wanted to be, church. He said the first Sunday he was in church after the accident, he broke down and “I just asked God for forgiveness. It was such an emotional day.” In essence, he feels like he received another opportunity to find a balance in life. 32

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Trauma care may not always be a matter of life and death, but is important for the short-term and long-term healing of a patient. From first responders to physical therapists, healthcare professionals work together to bring complete, holistic healing to patients of all ages and under all circumstances. ••••• Candi Spraggins, now age 30, left her home shortly after noon on January 19, 2013. She was traveling down a familiar county road on her way to the Dinwiddie County Sherriff’s department, to complete needed hours for her externship as part of her Criminal Justice classes. Typically, her externship hours were in 5-10 hours shifts, and included ride-a-longs, paperwork, and typical department surveillance responsibilities. “Based on the fact I turned in the opposite direction from my externship, I believe I was going to a friend’s home. I never made it to her house,” explains Candi. She remembers nothing about the afternoon or the month following the accident. Candi is a wife and mother of a 7 yearold daughter, Maria. Working and attending college full time, Candi is also pursuing her Bachelor’s degree. She represents many working mothers trying to balance multiple roles, stay organized and contribute to family finances while accepting the challenges life offers. The accident reports say she veered off the road and over an embankment, ending up against a tree. She was less than ten minutes from her house. Candi was driving their fairly new Mazda MPV (Minivan). The Spraggins purchased the vehicle about a year ago, and were excited to get a more spacious vehicle. “It had great room for our daughter and we were talking about trying to have another baby, so it [van] was nice,” Candi shares. First responders found her outside the vehicle, ejected through an open window. She found it odd that she was ejected because “anyone who knows me would say I always wear my seatbelt,” Candi explains. At the scene www.OurHealthRichmond.com

of the accident, it appeared as if Candi had been crawling around on the ground, possibly looking to call for help. This desperate attempt to find assistance may have caused further damage to her hips and legs. Candi had a friend working at the Sherriff’s department the day of the accident who heard the 911 call on the scanner, and recognized the description of her and the van. He went to her parents’ house to share the news. Obviously, he had difficulty finding the appropriate words to deliver such sorrowful news to her family about the accident. Due to her rural location, combined with the extent of her injuries and the size of the closest hospital, the Emergency Aviation/LifeEvac unit (air ambulance) at The Virginian Commonwealth University (VCU) Medical Center was contacted for a transport.

The VCU LifeEvac helicopter transports approximately 600 patients per year, and serves an approximate 100-statute mile radius. Medical Transport Manager and Head Flight Nurse, Bert Bogue, recalls Candi’s transport details. “We could see, as we approached the scene [by air], that the emergency responders were already with the patient. In Dinwiddie County, they provide great care as pre-hospital providers. My partner that day was Jeff Salyes; trauma care is always about merging teams together to build one strong team.” Through training and experience, the flight team assesses the patient’s needs before ever landing the aircraft. “We knew right away, by viewing the scene, we would have to secure her airway.” The team knew Candi was a time-critical patient, and their primary goal was to get her stabilized and in the aircraft in minutes. She was hypertensive, and paramedics could not find a radial pulse, which indicated life-threatening blood pressure concerns. Since a patient in an ejection accident can have a multitude of injuries, healthcare professionals are always racing against time. “Candi was unresponsive, and did not have good vitals; our ventilators were breathing for her, but we were careful not to over sedate her. I knew the odds were stacked against her,” remembers Bogue. The flight crew alerted the emergency room at VCU. They attempted to paint a very clear picture of the accident, as well as the extent of her injuries to best prepare the trauma team awaiting her arrival. Once the helicopter landed at VCU, Candi was immediately rushed into the emergency department and “coded”, losing her pulse completely. She was resuscitated and stabilized. Then, her injuries were further assessed before heading into the operating room. Once in the OR, she again had to be resuscitated before finally reaching stabilization long enough to complete her first round of surgeries and moved to the ICU. Candi’s family and friends couldn’t see her for almost 12 hours after being admitted to the ER. She suffered from multiple pelvic fractures, lower extremity fractures, intra-abdominal injuries and chest injuries. Candi doesn’t remember anything. She woke up at the end of February (4 weeks after the accident), essentially losing an entire month of her life. The trauma team placed Candi in a medically induced coma to give her body the best chance for recovery. Stephanie Goldberg, MD is a trauma and critical care surgeon at VCU Medical Center.

“The coma gives the brain and body the ability to rest while the patient attempts to heal from the trauma. She suffered severe trauma and faced incredible obstacles that many wouldn’t have the strength to overcome. Candi’s recovery was remarkable because of the magnitude of her

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injuries. Our team, combined with the support of her family, was integral in this process. This [collaboration] is the essence of trauma care,” admits Dr. Stephanie Goldberg, attending trauma surgeon at VCU Health System. “I started to try to move or talk, but couldn’t. I had a trache, which prevented me from talking, and there was no moisture to even lick my lips. The tears started to well up, and I started to panic. Luckily, my husband calmed me down,” Candi’s shaky voice recalls.

According to the American Psychiatric Association, trauma, in part, is described as the direct personal experience of an event that involves actual or threatened death or serious injury or other threat to one’s physical integrity.1 Trauma care provides complete care for every aspect of a serious injury – from prevention through rehabilitation. DSM-IV-TR; American Psychiatric Association [APA], 2000

Candi’s husband of 8 years, Reggie, kept a journal from the time she was first admitted to the hospital. On January 24, 2013 around 5:15 p.m., he wrote, “When I walked in the room, your mom said ‘Reggie is here’ and you opened your eyes and looked at me. That made me so happy.” Although Candi was placed in the medically-induced coma, she was able to react to the sound of her husband’s name and voice. Many people within the medical community believe the family surrounding a patient can provide significant healing, and their presence can be enormously reassuring. Reading these words in her husband’s journal a year after the accident, still makes her cry by reliving the emotion of the time through her husband’s eyes. “The hardest part was that I couldn’t talk. I am naturally expressive and it really bothered me,” remembers Candi. She spent more than three months in the ICU, and another month on the trauma acute care floor. Candi then spent more than a month in rehabilitation, and continued ongoing therapy, including several surgeries since her hospital discharge. During her five-month hospital stay, her husband never left her side. This shows true commitment on his part. The Spraggins have been together for 13 years, and married for eight. Candi and Reggie’s parents came together to help their daughter, Maria, stay in school. Their assistance was so helpful, and provided Maria a stable environment while her mother was undergoing intense recovery. On June 19th, five months to the day after the accident, Candi was released from the hospital. There were many nurses and doctors that saw her over those five months, and many who will continue to see her in the months to come. Candi’s indebted spirit and earnest words explain, “The night nurses were so helpful to me. They helped me hang up pictures; they read to me, they talked to me about my family.” “We go early to our follow up appointments just so we can visit the nurses. Specifically Kaitlyn, Katie and Diana. They made such a huge difference in my recovery,” remembers Candi. “Also, Dr. Colbert, my trauma doctor… ‘She is amazing!’ There was never a bad time for her. I could call her anytime. I honestly didn’t realize just how many doctors had seen me during my stay. I am very grateful.” Candi’s severe lower extremity injuries required doctors to take out part of her pelvic bone. Today, more than a year after

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the accident, she is still confined to a wheel chair. She can use a walker to some extent, and continues to strive to use it more frequently. She explains, “The whole experience is so humbling; my husband has been helping me every step of the way.” She says she knew her daughter would be fine, but she was a little worried about her husband at times. Working and caring for a spouse with significant medical needs can be very taxing. “It still amazes me everything my friends and family did for me,” Candi shares. In 2011, the Spraggins had moved in with Candi’s parents to save money to buy a house. Then, a couple of years later, the accident happened. Buying the house is out of the question, for now, but Candi remains optimistic. They are fortunate. Their family is together and shares in taking care of her recovery needs. Her husband’s employer (Walmart Distribution) has been remarkable. He has been with them for 8 years, and the insurance has been vitally important. Since he was such a reliable employee, he was not only able to utilize Family Medical Leave Act (FMLA) benefits, but they gave him time off plus allowed him use sick and personal time. “We are very fortunate,” Candi expresses. “I used to complain about being ‘broke’, but we were so blessed to have a great job and insurance.” Reggie’s job also allows him flexibility to leave work at 3:00 so he can pick up their daughter from the school bus (since Candi cannot make it to the bus stop in her wheel chair). “He is the best husband in the world! It takes a really special person to help me the way he has. He works all day, then comes home and helps me. I feel incredibly lucky,” Candi expresses. “There are days I would cry from the pain and feeling sorry for myself, but I tell myself ‘I have a daughter and an amazing husband.’” Now, it takes even longer for her body to break down salt, so she has significant swelling in her legs, which makes use of the walker more difficult. Candi has goals to walk again, but she is managing her own rehabilitation and it is progressing slower than she would like. www.OurHealthRichmond.com

She is utilizing the therapy taught to her during her hospital stay to try to regain strength and stamina by walking with a walker for a few feet at a time.

The skills and composure needed to be a service provider in trauma care cannot be underestimated. The intense pressure and timeliness of their minute-to-minute decisions can be life altering for many families. Beth Broering, MSN, RN, and Trauma Program Manager at VCU shares, “Trauma care goes beyond the ER; it is so much more than that! It is the entire continuum of care. In trauma care, life is suddenly and unexpectedly interrupted, sometimes temporarily, sometimes permanently. We cannot just focus on the physical injuries, we also seek to help heal the emotional and spiritual trauma that is often experienced.” On March 29, 2014 the VCU Medical Center is hosting the 6th Annual Shining Knight Gala. This formal event is to recognize and highlight patients and healthcare professionals impacted by the trauma care system. The goal of the Gala is bring awareness to the daily commitment professionals, working in the multidisciplinary field of trauma care, provide to the Richmond community. For more information about the event, visit www.ivpp.vcu.edu

Due to her time on dialysis, Candi’s hair also fell out. “But seriously, I’m not gonna complain about hair. I am alive!” Candi adamantly explains. Her upbeat outlook and life-appreciating perspective is heartwarming. Candi looks back over the past year and reflects over the accident. She thinks about what she has learned, and what she might change if she had the opportunity. “We both worked so much before the accident. I didn’t realize how much I was gone. I was so busy all of the time. Before the accident, I was only three months away from getting my Bachelors degree. Now, after the accident, I feel blessed because I am home with my family.” She worked full time, was a fulltime college student, a mother, and a wife. “I feel more forgetful now. I used to be so organized.” But none of that seems to matter as much now. She feels grateful she can talk to her husband and smile at her daughter. Candi has to retake the classes she was enrolled in at the time of the accident, but is now on track to graduate in April from ECPI University with a Bachelor’s degree in Criminal Justice. Candi is realistic explaining, “Obviously I cannot be a police officer now, so my plan is to work for the Sherriff’s department, possibly in dispatch, just to get my foot in the door.” Her goals are lofty, but realistic. She plans to walk in the next six months. Her goal is to rid herself of the wheelchair and other inhibiting devices she is still managing on a daily basis. Candi not only has her life to be thankful for each day, but she also has a new perspective. “Honestly, I will have fond memories of this time with my family. I might not have appreciated it in the same way without the accident.” Health is a state of complete physical, mental and spiritual well-being. When patients experience trauma, their therapy involves more than just physical recovery. Healing takes place when patients regain physical mobility, emotional stability and spiritual growth. As days and months are often wished away, many learn that time is a precious commodity that can never be recovered. Those who have experienced life-altering incidents, and relied on the professionals in trauma care, have an appreciation for the second chance they feel they have been given.

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Importance of Rehabilitation and Physical Therapy for Trauma Patients words | Rick Piester

Rehabilitation plays a critical role in a patient’s recovery. Whether a patient has experienced an unexpected health event such as a car accident, or needs assistance managing a chronic health condition such as arthritis; healing comes from a complete continuum of healthcare and providers. Often, patients’ post-hospital care determines the extent to which they may return to their lifestyle, or learn lifeassisting skills after an accident or illness. “Once patients are medically stable, physical rehabilitation plays an extremely important role in helping them regain function,” says Stephanie Sulmer, Director of Public Relations for Sheltering Arms Physical Rehabilitation Centers. “Combining advanced clinical knowledge with the latest technology available in the field, our team focuses on getting to know patients as individuals

with unique goals, hobbies and lifestyles; and helping them return to those things following traumatic injury.” Sheltering Arms, a Central Virginia rehabilitation and physical therapy provider, has a variety of services and facilities available to provide care to patients with short-term and long-term rehabilitation needs. The facility, which is celebrating its 125th year, was conceived in 1889 as a free hospital; and originally run entirely by volunteers. Local doctors and nurses gave their time to care for patients, and the public provided funds and supplies. In 1981, the organization became the first private, free standing physical rehabilitation hospital in Virginia. Today, Sheltering Arms is nationally recognized as a leader in physical rehabilitation.

Sheltering Arms seeks to help patients find the Power to Overcome the obstacles of illness and injury with a complete range of physical rehabilitation and wellness services. Sheltering Arms has two hospitals. One hospital is in Mechanicsville, and the other is located in Midlothian. The hospitals are complemented by nine outpatient clinics.

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To celebrate its 125th birthday, a special Historical Exhibit and Tour of Former Sheltering Arms Hospital will be held on Saturday, September 20th, 2014 at 1008 East Clay Street in Richmond. The Clay Street location was Sheltering Arms’ home from 1894 until 1965.

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OurHealth’s activities photographer, Sarah Mattozzi, captured Richmonders at their healthy, happy best at the February 1st

CBS6 Healthy LifeStyle Expo.

1. Pat Niemi, Health Assessment and Nutrition Specialist at Zacharias Ganey Health Institute. 2. Healthy food samples being passed out at The Fresh Market booth. 7 3. Authia Haden, MA, Jamie Young, Tina Martin, MA, Camisha Smith, RN, Shante Lee, MA, Bon Secours Heart & Vascular Health. 4. Attendees “Dance It Out” with Billy Blanks Jr. & Sharon Katherine Blanks. 5. Richmond family participates in CBS6 Healthy Lifestyle Expo . 6. Farmbus Market at the Cooking Stage. 7. Elaina Russell and Adam Long with Helping Hands play with Chilly, a rescued therapy dog. 8. Sonja and Kathy, of VA Physicians for Women. 9. Rick from OurHealth meeting with Olympian Shannon Miller. 10. Attendees “Dance It Out” with Billy Blanks Jr. & Sharon Katherine Blanks 11. VCU Pharmacy student, Heather Putnam, volunteering at the Walgreen’s booth. 12. Participants at the Kettlebell Work-‐Out with Girya Garage. 13. Sonja, of VA Physicians for Women. 14. Bob Jameson with daughter Mariah Jameson, Richmond, VA 15. Amanda Griffin, RN, VA Urology. 16. Jayvon, 11, Jeremiah, 7, Jaia, 9, of Richmond, VA.

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an important test

easier GETS

words | RICK PIESTER photography | SARAH MATTOZZI

Colorectal cancer, and the tests to detect it, seems to be one of the major inconsistencies of modern medicine. On the one hand, it’s a slow-growing cancer. As cancers go, detecting it is a relatively straightforward process. Detected early, surgery is most often highly successful. Recovery can be longish, but often uncomplicated. Medicine even considers colorectal cancer, along with cervical cancer, preventable. But on the other hand, cancer of the colon is still the second deadliest form of cancer, after lung cancer. Up to a third of the people who should have the preferred method of detection—called a colonoscopy—don’t.

MARCH COLOR IS ECT CANCE AL AWARE R NE MONTH SS

Data from the Centers for Disease Control and Prevention tells us that 10 million people have the procedure each year. Wider use of the procedure has resulted in a decades-long decline in the rate of colon cancer. Yet colon cancer is still a major killer of American adults. The American cancer Society estimates that this nation will record nearly 97,000 new cases of colon cancer this year, and about 40,000 people will be diagnosed with rectal cancer. In 2014 alone, the Cancer Society says, an estimated 53,310 men and women will die as a result of colorectal cancer.

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“It’s a lot less intimidating than it used to be…”

says Paul Charron, MD of Richmond-based Colon and Rectal Specialists with patient Fernandez Scott.

THE BARE ESSENTIALS The Symptoms of Colorectal Cancer

Precancerous polyps and colorectal cancer don’t always produce symptoms, especially at first. You could have polyps or colorectal cancer and not know it. That’s why screening test is so important. Symptoms for colorectal cancer can include: • Blood in or on the stool. • Stomach pain, aches, or cramps that do not go away. • Unexplained weight loss These symptoms may be caused by something other than cancer. If you’re having any of these symptoms, the only way to know what is causing them is to see your physician.

Paul Charron, MD of Colon and Rectal Specialists in Richmond specializes in laparoscopic colorectal surgery and screening colonoscopies; treatment of colorectal cancer, inflammatory bowel disease, diverticular disease, and anorectal disorders.

With March designated as National Colorectal Cancer Awareness Month, Our Health Richmond talked with two local physicians who are experts in colorectal cancer, and two area residents who had the screening technique and now recommend it without hesitation. First, some basics: the colon and the rectum form a long, muscular tube in the lower digestive system. Together, they are called the large intestine. The colon is the first six feet of the large intestine in the average adult, and the rectum is the last 8-10 inches. Colon cancer occurs when abnormal cells— cancer cells—that line the colon begin to grow and multiply uncontrollably. As the cells multiply, they tend to grow in a ring shape around the circumference of the colon. If the cancer is detected early enough, the cells tend to be confined to the colon. If they are undiscovered, the cancer cells may invade adjacent organs and travel through the body’s lymph and blood systems to other parts of the body—the liver, the lungs, and other organs. The gold standard screening test for colorectal cancer is colonoscopy (pronounced kohluh-nos-kuh-pee), which involves inserting a flexible lighted tube through the entire rectum and colon. At the tip of the tube is a tiny camera that allows health professionals

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to look directly at the inner surfaces of the entire large intestine. Physicians not only see the surface of the large intestine, but they can also surgically remove precancerous growths, called polyps. Colonoscopy is not the only screening method for colorectal cancer. A somewhat less invasive procedure, called a sigmoidoscopy, involves inserting a flexible camera-tipped tube through the rectum and only into the lower part of the colon. And a very widespread primary screening method is the fecal occult blood test. The test, available at physicians’ offices or from the drug store, can be done at home. You collect small stool samples at home at send them to a lab for testing, and the test results are reported to your physician. There is still debate among medical professionals as to the accuracy and effectiveness of the tests, yet colonoscopy has become the go-to test for prevention and detection of colorectal cancer. In 2000, the American College of gastroenterology (the professional society of physicians who specialize in the digestive system) declared colonoscopy the “preferred strategy” for cancer detection. That same year, popular television personality Katie Couric, who had lost her husband to colorectal cancer, had an on-air

colonoscopy. In turn, the televised procedure prompted patients to demand the test. And in 2001, Medicare and private insurers began to cover the test.

The colonoscopy was performed by Paul D. Charron, MD, who specializes in colon and rectal surgery and who is a member of the staff of Richmond-based Colon & Rectal Specialists.

And now, the American Cancer Society recommends that men and women of average risk, over the age of 50, have a screening colonoscopy every 10 years.

It showed a tumor of about 6 centimeters (a little under 2 ½ inches).

•••••

“Something you need to do.” Fernandez Scott knew he was overdue for a colorectal cancer screening. A veteran health care public affairs professional, he knew of the importance of screenings. What he didn’t know was his family history of colorectal cancer. At age 52, he went for an annual checkup with his primary care physician, who sent him for his first colonoscopy in December 2013. “I was having no symptoms at all, but my doctor said it was something I needed to do. He was right.”

“I was fast-tracked,” Fernandez Scott says. “That tumor had to go. Dr. Charron and I met for two hours. He was very methodical, educating me on the disease, on the surgery, what I would be facing afterward in terms of post-operative care.” On December 16, Dr. Charron performed a three-hour laparoscopic surgery to remove the tumor and about 12 inches of Fernandez’s small intestine. Laparoscopic surgery is a less-invasive alternative to tradition “open” surgery. In laparoscopic surgery, small incisions are made in the abdomen to provide “ports” for the insertion of surgical instruments and a small camera—the

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laparoscope. The camera transmits video images to a large, high-resolution monitor that allowed Dr. Charron to do the surgery through the smaller incisions. Compared to traditional open surgery, patients often have less pain, a shorter recovery, and less scarring with laparoscopic surgery.

Fernandez Scott’s tumor was found to be a Stage II cancer—one that had penetrated the wall of the colon but did not invade any local lymph nodes. Dr. Charron and the surgical team were able to remove all cancerous tissue. Fernandez spent a week in the hospital and two months of at-home recovery before returning to his duties in the public affairs department of the Hunter Holmes McGuire VA Medical Center in early February. But in days prior to his surgery, he discovered that he did, indeed, have a family history of colon cancer. “We just never talked about it much in my family, but I learned that my sister had similar surgery two years ago, and my brother also had similar surgery about eight years ago. That’s a main thing I took away from this experience—that families really need to talk and share health information.” A second side benefit—Fernandez lost 15 pounds working out on the treadmill, a part of his post-surgical care routine. “There’s a huge emotional aspect to all of this,” Fernandez says. “You can’t help but be scared going through this process. It’s so important to have a great support system around you — people you can share with, cry and pray with, people who know about the disease and who can speak with you at length about it.” Fernandez says he is now doing “great,” and is well on the road to recovery. Dr. Charron says that people who believe they have no family history of colon cancer, and who are free of the symptoms of what might be colorectal cancer, are the “poster children for why we should screen.” To make the procedure less of a taboo subject and less of a perceived ordeal, medicine has developed ways to perform a kinder, gentler colonoscopy. In fact, Dr. Charron’s practice has assembled what it calls a

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“I wish I had it done sooner” says Marie Green, a nurse at Gastrointestinal Specialists Inc.

“Kinder Colonoscopy,” that combines more tolerable bowel preparation techniques, fastacting sedation that leads to quicker recovery, and other measures aimed at taking the embarrassment and dread out of being tested. “It’s a lot less intimidating than it used to be,” Dr. Charron notes, “and we’re hoping that as the word gets out, there’ll be more of a grassroots-level change in attitudes about having a colonoscopy. We finally have a tool that is not only very effective in treating cancer, but also in actually preventing it.” •••••

“I wish I had done it sooner.” Marie Green was (and still is) in a perfect position to know the importance of colorectal screening.

She’s a nurse at Gastrointestinal Specialists Inc., a large medical practice with multiple locations in the Greater Richmond area. At 52, she was the same age as Fernandez Scott when she decided to have a colonoscopy in the autumn of 2013. “I should have had the test before that,” she says, “but like too many people, I dreaded the prep. I thought I’d be in the bathroom all night long. I dreaded not being able to eat, and as a diabetic, I have to be careful of what and when I eat.” “But,” she says now, “I wish I’d had it done sooner.” Marie had been having a lot of abdominal pain. She and her physicians had ruled out her gall bladder and her pancreas as the culprit, and turned next to a colonoscopy. www.OurHealthRichmond.com

When You Should Be Screened You should begin screening for colorectal cancer soon after turning 50, then keep getting screened regularly until the age of 75. Ask your doctor if you should be screened if you’re older than 75. Some people are at a higher risk than others for developing colorectal cancer. Your risk may be higher if you already have inflammatory bowel disease, or if you have a personal or family history of colorectal polyps or colorectal cancer.

Jayant P. Talreja, MD of Gastrointestinal Specialists, Inc. in Richmond specializes in upper and lower GI tract diseases and conditions including gastroesophageal reflux disease (GERD), inflammatory bowel disease (ulcerative colitis and Crohn’s disease), irritable bowel syndrome, gastrointestinal polyps, disorders of the biliary tract and pancreas, liver diseases, and endoscopic management of GI cancers.

“What I learned, and what people need to realize, is that the test is changing, getting better for the patient, every year,” she says. “The prep I chose tasted like Tang, the orangeflavored drink. I didn’t spend all night going back and forth to the bathroom. After about an hour, I was ready.” Her colonoscopy was performed by Paul Monroe, MD, the now-retired physician with whom she worked regularly. It proved to be “normal,” free of anything that would cause her pain, free of polyps, free of cancer. Not long after her test, she saw a television commercial for a medication that she was taking for her diabetes. The obligatory litany of side-effects for that medication included back pain and abdominal pain. “Dr. Monroe saw the same commercial,” she says, and the next day they agreed that the diabetes medication may have been the problem all along. With the help of her own physician, she switched medications and the pain disappeared. Jayant P. Talreja, MD, a physician on the staff at Gastrointestinal Specialists, speaks of the attention that health care professionals are paying to patient comfort. The colon is a floppy, compressible, organ, Dr. Talreja notes, and part of the testing procedure

is inflation of the colon. To get a better view of the colon, air is introduced to inflate it to allow more room to see and maneuver inside the organ. Oxygen and water were most commonly used, but Dr. Talreja says many practices, including his, now use carbon dioxide (CO2) as a way to reduce discomfort. The tradition four-liter prep has been largely replaced with easier-to-tolerate fluids to clear the bowel before the procedure, and sedation agents have been modified to allow for more of a “twilight” sleep than a full-blown deep anesthesia. In addition to the traditional four-liter prep, Dr. Talreja says, there are newer options to clear the bowel before the procedure, and that can be easier for the patient to tolerate. Sedation options have been modified to permit a faster acting deep sleep, as opposed to the “twilight” sleep that sometimes has variable success from patient to patient. So medicine is doing whatever it can to make a lifesaving technique a more approachable concept for people. The one factor that is still missing is you, the patient, if you’re over age 50 and haven’t started having a colonoscopy at least every 10 years.

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Keeping Young Colons Healthy words | RICK PIESTER

Grownups aren’t the only ones at risk of colon diseases. Youngsters are subject to their own version of gastrointestinal ills. “Colon cancer is extremely rare in young people, thankfully,” says Juan F. Villalona, MD, Pediatric Gastroenterology of Richmond. However, he does note there are some disorders that occur at young ages. Of those, many can be prevented by following good general health, and nutrition practices. It’s fairly common for kids to have a stomach ache once in a while. If a youngster has repeated stomach aches, diarrhea, chronic fatigue, nausea, or rectal bleeding; it’s time to see a physician. These symptoms may indicate that the young person has an inflammatory bowel disease. Inflammatory bowel disease is not a single ailment, Dr. Villalona cautions. The term refers to a number of disorders that cause inflammation — even tears or ulcers — in the digestive tract. Inflammatory bowel disease is often confused with irritable bowel syndrome, a somewhat less-serious disorder of the digestive system. One of the ailments is Crohn’s disease, which can affect any part of the digestive system, from mouth to anus. It can cause inflammation that extends deep into the layers of the intestinal wall. A second ailment, ulcerative colitis, inflames only the inner lining of the colon (the large intestine). Both Crohn’s disease and ulcerative colitis can be very serious conditions for many years, and cause frequent flare-ups, especially if left untreated. According to Dr. Villalona, medicine doesn’t yet know what causes the onset of inflammatory bowel disease. It may be caused by environmental factors, or by eating specific foods. Inflammatory bowel disease is not contagious, and may be hereditary. Approximately 20 percent of people with the disease also have a relative who suffers from it.

Juan F. Villalona, MD, FAAP provides quality subspecialty care for a wide range of acute, chronic and complex gastrointestinal, liver, pancreatic, and nutritional disorders for infants, toddlers, and adolescents up to age 18 at Pediatric Gastroenterology of Richmond

To prevent or lessen the onset of these ailments, Dr. Villalona recommends the almost textbook virtues of a healthy, balanced diet. Avoid the grab-and-go aspects of fast food and sugary drinks, in favor of a balanced high-fiber diet. Be sure your youngsters drink plenty of water and fresh juices, as well as eat plenty of fruits and vegetables. According to Dr. Villalona, just about everyone can benefit from the probiotics found in a daily serving or two of foods like yogurt.

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HealthyEats

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When the weather starts to warm, we look for things to serve that are seasonal, easy, and delicious. These recipes stand out because they are easy to make for a spring outing or to serve at home. We have what you need for these healthy dishes.

Roasted Cauliflower with Almonds Serves 4

Ingredients: 1 head cauliflower ½ cup toasted almonds, chopped ½ cup scallions, chopped ¼ cup parsley, chopped

Marinade Ingredients: ¼ cup olive oil 1 T. curry powder 1 t. sea salt ½ t. black pepper 2 T. lemon juice

Directions: 1. Preheat oven to 350ºF. 2. Cut cauliflower into florets. Toss with marinade and bake for 10-15 minutes. (Do not overcook.) 3. Add scallions, parsley and almonds to toasted cauliflower and toss in a bowl. Add more sea salt as needed.

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ROASTED CAULIFLOWER

Good Foods Grocery—two convenient, neighborhood stores: Open 9am -9pm Mon - Sat. Closed Sundays. | www.goodfoodsgrocery.com Gayton Crossing Shopping Center (West End) | 1312 Gaskins Road | (804) 740-3518 & Stony Point Shopping Center (Southside) | 3062 Stony Point Road | (804) 320-6767

HealthyEats Roasted Red Pepper Hummus

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Ingredients:

Directions:

2 cans chick peas

1. Drain & rinse chick peas.

¼ cup olive oil

2. Drain roasted red peppers.

2 T. lemon juice 1 T. tahini

3. Add all ingredients into food processor and blend until smooth.

1 16 oz. jar roasted red peppers

4. Add sea salt to taste.

1 t. sea salt

5. Serve with veggies, crackers or with pita chips

¼ t. black pepper 1 t. ground cumin

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RED PEPPER HUMMUS

HealthyEats Asian Cole Slaw

Serves 6

Ingredients:

½ cup red cabbage, shredded ½ cup green cabbage, shredded 1 T. sesame oil, light 1

T. sesame oil, dark

½ cup shredded carrots

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2 T. toasted sesame seeds 3 T. agave 2 T. rice wine vinegar ¼ cup diced scallions

Directions: 1. Put all ingredients into a bowl and mix well. 2. Let marinate for 2 hours before serving.

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ASIAN COLE SLAW

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One Family’s Journey

It was a time for celebration—May 17, 2007— the day Addyson “Addy” Kelley was born. With delicate features and downy tufts of white hair, she was just perfect. But the joy of having a second beautiful little girl evaporated one week later when Addy’s parents, Amy and Brian Kelley, received a call from their pediatrician. Their newborn’s screening tests had come back with some abnormal findings. Shortly after that, a diagnosis was confirmed—Addy had cystic fibrosis. And the Kelley family’s lives would never be the same.

Addy (right) and her older sister Campbell playing outside of their Princess Fort in their Richmond home

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At right: Campbell and Addy playing pose for photos Below: Addy playing in the Princess Fort in her Richmond home

Just imagine the pain and fear of learning that your child was suffering from a lifethreatening disease. Amy and Brian were heartsick. But a warm flood of reassurance soon came in the form of Joel Schmidt, MD, a leading specialist in pediatric pulmonology at Children’s Hospital of Richmond at VCU (CHoR). “I don’t know how we would have gotten through those first few weeks and months if it weren’t for Dr. Schmidt and the staff at CHoR,” said Amy. “They took the time to teach our family—and even our babysitters—how to take care of Addy. And believe me there was a lot to learn. But it was comforting to know they’d be with us every step along the way.” Fast forward six years. With a headful of blonde curls flying and blue eyes filled with mischief, Addy takes off after her older sister, Campbell, snatching away the soccer ball. Nothing could be sweeter for Amy and Brian than the sounds of their little girls giggling. “We’ve been through incredible low periods, but just as many bright spots,” says Amy as she reflects back over the years since Addy’s birth. “It’s been quite an adventure.” Let’s join the Kelley family on their journey and explore cystic fibrosis—what it is, the signs and symptoms, how it is detected and treated and what the future holds for those who are affected.

Understanding Cystic Fibrosis Joel H. Schmidt, MD is a pediatric pulmonologist at VCU Medical Center

Cystic fibrosis (CF) is a genetic disease that causes a thick, sticky substance to build up in the breathing passages of the lungs and in the pancreas, liver and intestines, the organs that help to break down and absorb food. This collection of mucus results in serious lung infections and digestion problems. The disease also affects the sweat glands and the reproductive system. You may be surprised to learn that cystic fibrosis is not a rare disease, affecting about 30,000 people in the United States and 100,000 people worldwide. According

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to Dr. Schmidt, “CF is the most common lifeshortening genetic disease among Caucasians.” It does occur in other races, but is most typically found in individuals of European heritage. “CF is caused by a defect in the cystic fibrosis transmembrane regulator (CFTR) gene,” says Dr. Schmidt. “There are more than 1,200 known mutations of the CFTR gene, the majority of which can cause the disease.” Cystic fibrosis is a recessive trait, meaning a child must receive two defective genes—one inherited from the mother and one from the father—in order to be born with the disease. People who have only one defective gene are called carriers. They will not have CF and will not have any symptoms. In order to have a baby with CF, both parents must be carriers or have CF themselves. It is estimated that 4 percent of all Caucasians are CF carriers. If both parents are carriers, there is a 25 percent chance that they will pass on their defective genes and their baby will have cystic fibrosis. There may be many generations of carriers in a family without anybody ever having cystic fibrosis. Often, people do not know they are carriers until their baby is born with the disease.

Signs and Symptoms A variety of symptoms may point to cystic fibrosis. The first signs in a newborn may be salty-tasting skin and the failure to have a bowel movement in the first 24 to 48 hours of life. “Later, the baby will fail to grow and gain weight,” explains Dr. Schmidt. “Other indications include coughing, mucus in the sinuses and lungs, shortness of breath and recurrent episodes of pneumonia. Issues that may appear later in life are diabetes due to damage to the pancreas as well as osteoporosis and increased risk of bone fractures due to poor absorption of calcium and vitamins.” About 97 percent of men with cystic fibrosis are infertile, but they may be able to have children with assisted reproductive techniques. Some women have fertility difficulties due to thickened cervical mucus or malnutrition. There are a number of tests that can be used to detect cystic fibrosis. Couples who are pregnant or planning a pregnancy can be tested for the CFTR gene mutations to determine the risk that their child will be born with cystic fibrosis. Testing may be performed on one or both parents and, if the risk of CF is high, the fetus may also be tested. The American Congress of Obstetricians

and Gynecologists (ACOG) recommends testing for couples who have a personal or close family history of CF. They also recommend that carrier testing be offered to all Caucasian couples and be made available to couples of other ethnic backgrounds. Brian and Amy were offered CF testing when they were pregnant with Campbell. “Since we were not aware any family history of cystic fibrosis, we decided not to be tested,” recalls Amy. When the couple was expecting the second time, again they saw no reason to undergo testing. “After Addy was diagnosed we had relatives come out of the woodwork to tell us about babies who died many years ago for unexplained reasons,” says Amy. “Now we can’t help but wonder if they had cystic fibrosis.”

Joel Schmidt, MD examines Addy at Children’s Hospital of Richmond at VCU (CHoR)

Most children with CF are diagnosed by age two. However, a small number are not diagnosed until age 18 or older. These individuals usually have a milder form of the disease. “As of December 2011, Virginia requires that all newborns receive a two-tier screening for CF. The first step is immunoreactive trypsinogen (IRT) testing. If the IRT is high, genetic mutation analysis will also be performed,” says Dr. Schmidt. Ultimately, the diagnosis is confirmed with a sweat chloride test. A high salt level in the patient’s sweat indicates the presence of the disease. “When Addy’s initial screenings showed that she might have CF, we were in shock,” says Amy. “Then we had a double whammy.” Campbell, then nearly three years of age, shared Addy’s genetic risk factors and also had to be tested. To make matters even more distressing, Campbell suffered from repeated respiratory infections and she was significantly underweight for her age. “We really thought she might have CF.” “Addy and Campbell went for sweat tests together, and the doctor told us she would call with the results by noon,” says Amy. “We went home and stared at the phone. When she called at 11:59, it was the worst news and the best news we could imagine. Addy’s CF was confirmed, but Campbell was OK.” Now that the Kelleys are aware of their genetic makeup, they will have Campbell tested to see if she is a CF carrier before she is ready to have children. Similarly, the Kelleys’ nieces and nephews will be tested.

Treatment Options The outlook for cystic fibrosis patients has improved dramatically. Seventy years ago, an infant born with CF would have been unlikely to survive beyond the first year. Thanks to recent medical advances, infants born today with CF are likely to live well into adulthood and can enjoy fuller lives, less encumbered by the disease. 60

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Early diagnosis of CF and a comprehensive treatment plan can improve both the health outlook and the quality of life for a CF patient. Since CF affects so many systems of the body, care is best managed by a multispecialty cystic fibrosis clinic. Virginia is fortunate to have five such clinics— Children’s Hospital of Richmond at VCU, UVA in Charlottesville, Children’s Hospital of the King’s Daughters in Norfolk, Inova Fairfax (supervised by UVA) in Northern Virginia and Naval Medical Center in Portsmouth.

Most children with CF are diagnosed by age two. However, a small number are not diagnosed until age 18 or older. These individuals usually have a milder form of the disease.

“The cornerstone of managing CF is proactive treatment of respiratory infections,” explains Dr. Schmidt. “Antibiotics are used to treat chronic and acute infections and inhalation medications are used to thin and clear the thickened mucus.” Caring for a child with this medical challenge is a major commitment and it’s a “family affair,” according to Brian. One of the most time-demanding aspects of Addy’s routine is called chest physiotherapy. Twice a day, every day—without exception—Addy puts on her percussion vest. For 20 minutes this device pounds, pats and vibrates her chest to loosen the buildup of mucus in Addy’s lungs so that it can be expelled. “We are so relieved to have a percussion vest for Addy,” says Amy. The alternative would be manually pounding Addy’s back and chest—a process that is not only physically exhausting for the parents but emotionally grueling as well. Addy’s nutritional needs are another important aspect of managing her CF. “Addy may be tiny—she weights a slight 49 pounds—but she can eat as much as her father and never gain weight,” says Amy. Addy regularly consumes a high-calorie diet, rich in protein including special milkshakes designed to help her gain weight. With every meal or snack she must take pancreatic enzyme capsules to help absorb the fats, starches and proteins in her food. Addy also takes an array of nutritional supplements including vitamins A, D, E and K. Maintaining an active lifestyle is also an important part of living with CF. Regular exercise—like swimming, jogging and cycling—is recommended to support lung function and enhance the quality of life for a CF patient. “Addy certainly has no problem meeting this requirement,” laughs Brian. “Just try to slow her down.” Brian coaches her soccer team and Addy plays basketball—scoring 10 points during her last game. A confirmed tomboy, she especially enjoys playing football and kickball with the neighborhood children. For CF patients with advanced disease, a lung transplant may be an option. “When a patient’s lung function is less than 30 percent, that is the window for transplantation,” says Dr. Schmidt. “At that point, the risk and the potential benefits are www.OurHealthRichmond.com

The outlook for cystic fibrosis patients has improved dramatically. Seventy years ago, an infant born with CF would have been unlikely to survive beyond the first year. Thanks to recent medical advances, infants born today with CF are likely to live well into adulthood and can enjoy fuller lives, less encumbered by the disease. roughly equal.” Individuals with cystic fibrosis must have both lungs replaced at the same time because the remaining lung might contain bacteria that could infect the newly transplanted lung. Addy surrounded by her Hokie family during game day on the campus of Virginia Tech

“Transplantation is not a perfect solution,” notes Dr. Schmidt. “These patients must take immunosuppression therapy for the remainder of their lives. But for some CF patients, transplantation can improve the quality of their remaining years.”

Looking to the Future Two medical breakthroughs have significantly extended the lives of CF patients. “In the 1950s we made huge strides in recognizing the importance of nutritional support, and the 1980s led to the aggressive application of antibiotics to reduce premature deaths due to respiratory infections,” says Dr. Schmidt. And the future looks even more promising. The Kelleys personally experienced an advance that foreshadows and gives hope for an eventual cure for cystic fibrosis. “When Addy was nearly a year old, we went to see Dr. Schmidt for a regular visit. He was smiling from ear to ear,” recalls Amy. “He told us about a clinical trial that might give Addy a chance for a full life. It was so incredible—we all cried.” “Addy has a particular type of gene mutation that affects a small number of CF patients,” explains Dr. Schmidt. “These early trials were designed to evaluate both the effectiveness and safety of the treatment—and all indications were positive.” By November 2011, the trials were complete, and in February 2012—in record time—the FDA approved this new medication called Kalydeco (the generic name is ivacaftor). But there was a glitch. The new drug was approved for children age six and over—and Addy was just five at the time. “The insurance would not pay for the treatment for another year,” says Brian. “That might not sound like much, but when it is your child’s health on the line, it felt like forever.” Not to be deterred, Dr. Schmidt with support from the president of the Cystic Fibrosis Foundation, appealed to the Kelleys’ insurance company. Addy was approved to take the drug, and the results have been nothing short of remarkable. Within one month, her lung function improved by 20 percent, she began to gain more weight and her sweat tests returned to normal. “It’s the next best thing to a cure,” says Amy. Addy still has to take medication every day, and she continues her breathing therapies, but the new medication means her chances for a long, fulfilling life are within reach. 62

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And what does the future hold? In large part, thanks to the relentless effort of the Cystic Fibrosis Foundation, the future looks a lot brighter for CF patients. In 2012, Forbes magazine named Kalydeco “The Most Important New Drug of the Year” in recognition of the advances in science that are made possible through philanthropy. The Cystic Fibrosis Foundation provided significant financial support for this effort and continues to fund clinical research with hopes of finding an eventual cure for this disease. “Kalydeco is an ‘orphan’ drug—that will help only a few people,” says Dr. Schmidt. “Yet, the development costs are no less than a broad-sweeping medication that could be used by millions of people.” Like other orphan drugs, the price for Kalydeco is very high: $294,000 per patient per year. Kalydeco was also called as “a genomic triumph.” In 1989, Francis Collins, who later headed the Human Genome Project, discovered the gene that, when mutated, causes cystic fibrosis. Kalydeco was extolled as the first drug to directly affect the defects caused by the mutations, resulting in improved lung function. “This is only the tip of the iceberg,” remarks Dr. Schmidt. “Kalydeco treats a specific mutation that affects five percent of all CF patients. But we’re on the brink of discovering a similar treatment that can be used by 85 percent of CF patients.” The largest clinical trial involving cystic fibrosis patients is going on right now around the world and here in Virginia at CHoR. “Right now we’re striving to make CF a disease that people no longer die from—but rather a disease they can live with,” says Dr. Schmidt. Perhaps one day gene therapy will develop to the point that mutated genes can be replaced and cystic fibrosis will be relegated to medical history books.

Great Strides is the Cystic Fibrosis Foundation’s largest national fundraising event. Each year, more than 125,000 people participate in hundreds of walks across the country to raise funds for cystic fibrosis research and drug development. The CF Foundation has raised and invested hundreds of millions of dollars to support the development of new CF drugs and therapies. But the lives of people with this disease are still cut far too short. We need the public’s continued support to fulfill our mission of finding a cure and improving the quality of life of those with the disease. Great Strides Events Are Coming To Your Community! Richmond – May 7 Lynchburg – April 26 Roanoke – May 3 LINK TO VIDEO: Great Strides http://fightcf.cff.org/site/PageServer?pagename=gs_why_we_stride

Getting on with Life But until that day comes, life goes on—at least that’s the philosophy at the Kelley household. “Having a child with CF is tough,” says Amy, “but then raising two active children is challenging in any circumstance. It all about balance.” Amy and Brian have a routine they follow to manage their busy lives. “There are jobs, school, homework, plenty of activities that the girls are involved in, bath time, mealtime—and in between we have to make time for Addy’s treatments,” says Brian. Cystic fibrosis is more than a medical condition—it takes an emotional toll on everyone it touches. “Learning that your child has a life-threatening illness can be paralyzing,” says Brian. “Dr. Schmidt and the staff at CHoR were incredibly supportive from the start. They truly have become like family to us,” says Amy. The feeling is mutual. “We follow almost 140 children and adults in our CF Care Center and we see most of them about every three months,” says Dr. Schmidt. “You can’t help but get attached. And Addy stole everyone’s heart right from the start.” “Most people don’t understand the disease and they don’t have a clue about what families have to go through on a daily basis,” observes Amy. The Kelleys have formed close ties with many other CF parents through the Cystic Fibrosis Foundation. “It’s www.OurHealthRichmond.com

a close community and we try to be there for each other, helping emotionally, physically and sometimes financially.” The financial aspect of CF can be overwhelming. For example, Addy’s percussion vest cost more than $15,000 and insurance covers a mere fraction of the cost. Unfortunately, the children with CF cannot meet and play together due to the risk of one child passing an infection on to another. “It’s tough for kids with CF,” says Dr. Schmidt, “especially when they get older.” He recalls one teenage patient who had not told a single friend about her disease. “I’m sure she felt very alone.” And what about the siblings? “It can be tough on other children in the family,” says Dr. Schmidt. “‘Why does Bobby get all the attention? Why can he have a milkshake before dinner and I can’t?’ It’s hard for parents to have enough time and energy to go around when there is a CF child to care for.” Somehow the Kelleys have figured it out. “Campbell is a wonderful big sister to Addy,” says Amy. “She is very protective. Sometimes she sits with Addy when she is having her chest treatments,” says Amy. “But we made the decision not to let CF dominate our lives. We want both our girls to have as normal a life as possible.”

Amy and Brian Kelley of Richmond with their daughters Campbell (standing) and Addy

Amy and Brian have high hopes for Addy’s future. They are heartened by the amazing medical advances that are happening today and warmed by the compassionate care they receive at CHoR. But most of all, they are deeply touched by the notion that they just might get to see Addy do all the things that a mother and father hope for their children. Like graduate from high school and then college. Have a fulfilling career. “And one day,” Brian reflects, “I want to walk Addy down the aisle and I want to see her and her sister stay close for the remainder of their lives. That’s all a parent can ask for.” Sources: • National Heart, Lung and Blood Institute, U.S. Department of Health & Human Services • Forbes, December 2012 • Boyle, MP, MD. “Adult Cystic Fibrosis.” Journal of the American Medical Association. 2007 298:1787-1793. 17 June 2008 Expert contributor: • H. Joel Schmidt, MD, Associate Professor, Pediatric Pulmonology, CF Care Center Pediatric Program Director, Children’s Hospital of Richmond at VCU Resources: • Cystic Fibrosis Foundation, cff.org, Local Chapter, 1500 Forest Avenue, Suite 124, Richmond, VA 23229, 804.527.1500 • LINK TO A VIDEO: Addy’s Story: chrichmond.org/Addy

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Thousands of patients, their family members and caregivers come to Richmond, VA, each year seeking the highest level of medical care. They arrive from all over the state, across the country and around world. They are frightened and overwhelmed. Someone had to intervene and provide these visitors with a comforting bed, a warm meal, a welcoming respite. After all, isn’t that what southern hospitality is all about? “We were a bunch of little housewives in tennis shoes,” laughs Dolly Hintz, as she describes the group responsible for founding the Hospital Hospitality House of Richmond. But they were a force to be reckoned with—and this year marks the 30th anniversary of this home-away-from-home. In 1981, Dolly and her husband, Bob, an executive with CSX, moved to Richmond from Cleveland. “Three of our children were grown and my 16-year-old was pretty independent,” says Dolly. She was ready for a new adventure. Dolly and her friend Jackie Nichols, both former nurses, found the perfect outlet for their boundless energy—volunteering with the MCV Hospital Auxiliary. “Mary Still, the director of volunteer services, asked us to serve on a committee to explore the possibility of a Hospital Hospitality House for Richmond,” says Dolly. “Patients and families were sleeping in waiting rooms and halls, and doing their laundry in the bathrooms. They simply had nowhere to stay.” This concept was in its infancy. The committee learned that UVA offered beds in a converted house for out-of-town family members, and they discovered six houses in other parts of the country. Dolly, Jackie and Mary traveled to Atlanta to meet with auxiliary members from hospitals that had existing hospitality houses as well as hospitals trying to start such facilities. The delegation returned from the junket to report their findings. Their enthusiasm was infectious and the board initiated a feasibility study. Where would the facility be located? How would they pay for the building and cover its operation? At the time, the auxiliary held one fund-raiser a year that produced about $5,000—hardly enough for an undertaking of this size and scope. The auxiliary board spun off a separate Hospital Hospitality House (HHH) board to lead the effort. They recruited additional members with specific talents like finance, fund-raising and construction.

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“Our first task was to clearly establish the need for a house,” says Dolly. “This was before patient records were computerized, so we spent weeks combing through files and manually tabulated the number of patients coming to the hospital from outside the Richmond area.” Armed with substantiating data, Jackie, president of the newly formed board, and Dolly, vice president, approached Edmund F. Ackell, MD, DMD, then president of Virginia Commonwealth University, and asked for a building on the MCV Campus. Impressed by both the need and the zeal of the board leadership, Dr. Ackell agreed to lease the Zeigler House to the HHH board for one dollar, provided they could raise $250,000 for renovations. The Zeigler House, a 19th-century brownstone, had formerly been used as a nursing dorm. The structure was slated for demolition to make way for a parking lot. “The building was abandoned for years. The stairs were rickety and the place was filled with pigeon droppings,” recalls Dolly. But it had eight large bedrooms on the second and third floors and all Dolly and Jackie could see was the potential for a beautiful home. “For the next 18 months, Jackie and I were obsessed,” admits Dolly. The fund-raising effort was kicked off with an impressive $50,000 donation from CSX. “This major gift gave us a huge jumpstart, but most of all it gave us credibility.” The board successfully applied to local foundations for grants, but the lion’s share of the funds came from small individual gifts. “Envelopes came pouring in with $5, $10 and $20 donations.” “Early on, while we were raising money to renovate the house, we had a family whose mother was a patient at the hospital,” says Dolly. “They were from Cumberland County and were willing to talk about how important it would have been for them to have had a place to stay while mom was a patient. They invited Ce Ce Bullard (chair of the fund-raising committee) and me to attend a church service in their town and talk to the parishioners about what we were trying to do. Then they had a collection and we left with something like $175—which was a big deal because it was not a wealthy church. Ce Ce and I were very emotional when we left—even more convinced we were doing the right thing.” The HHH board capped off its development campaign by hosting one of Richmond’s first fund-raising auctions with high-ticket items. “We had art, jewelry and five beautiful coats from Alan Furs,” recalls Dolly. The event generated $120,000 and the organization had enough money to meet President Ackell’s challenge. All the furnishings, draperies, appliances, kitchen equipment and linens were donated, which meant every penny raised could be used for the renovation. It took months of scrubbing and scraping and rebuilding to make this rundown structure habitable. On December 5, 1984, Hospital Hospitality House of Richmond was dedicated. Governor Charles Robb was the featured speaker. “At the outset, we had only two employees—a fulltime executive director, Charley Strickland, and half-time assistant. Every other job was performed by volunteers,” says Dolly. The house had a total of 28 beds set up dormitory style to accommodate family members of patients being treated at MCV Hospital (now VCU Medical Center).

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There was a small kitchen where guests could prepare meals using food that was donated. “From the beginning, the house was always full,” remembers Dolly, “and we knew we were meeting a genuine need.” Guests were asked to make a $10 donation, but only if they could afford it. No one was turned away because they couldn’t pay. With an eye to the future, the HHH board continued to solicit donations and hold fund-raisers. They kept operating costs low and the hospital helped by maintaining the exterior of the building. “One of our board members, Richard Bendheim, started a wonderful tradition,” says Dolly. “He would honor friends and family for their birthdays and other special occasions by making a donation to HHH. Soon, the idea caught on, and other people started doing the same thing.” Richard Bendheim has passed away but his wife, Ann, and daughter, Katy Yoffy, are still actively involved with HHH. By 1990, it became apparent that a larger facility was needed to accommodate more family members and caregivers and to provide housing for patients—both adults and children. This would necessitate having a private room for each family. HHH was at a critical juncture. “At the time that we were considering whether or not to expand,” recalls Dolly, “Charley made a presentation at a women’s club meeting. She received a phone call from one of the attendees who said she would like to donate some money—would Charley come to her home and pick up the check. The lady and her husband lived in a very modest home. She was very gracious and told Charley how impressed she was with our accomplishments. The lady handed her an envelope, and Charley was polite enough not to rip it open right away. But when she did, she was stunned to see it contained a check for $100,000! She could barely drive back to the house.” Some board members were reluctant to expand and grow—thinking the organization would be overextending. “But this remarkable gift truly sent a message—it gave everyone the encouragement to go ahead with our plans. We somehow knew we could raise the money we needed,” says Dolly. “Faith is a wonderful thing.” Connie Goodwin, director of volunteer services at the medical center, served as chair of HHH II—as the board referred to the search for the new house. An old church, located near VCU Massey Cancer Center, was considered. However, an evaluation by an architect revealed that the building would yield only about 30 rooms. This option was ruled out and the quest continued. One afternoon, as Dolly and Connie were having lunch at the food court at 5th Street Marketplace, they heard that the Day’s Inn was in foreclosure and would be sold at auction. They practically ran down the street to check it out for themselves. The hotel seemed perfect—with a vast number of private rooms each equipped with a full bath, a commercial kitchen and dining room, everything HHH would need to expand their mission. The board’s foresight and frugal management style really paid off—HHH had a significant amount in savings to put toward the purchase of a new facility. Combining these funds with support from MCV Foundation and the hospital, Bill Sparrow, a CSX executive, and Jack Kenny, an attorney, negotiated the purchase of the hotel for one million dollars. The new Hospital Hospitality House, located at 7th and Marshall Streets, opened its doors on February 17, 1994. Guests moved in and occupied two floors while the building was under renovation. “Despite the noise, flooding caused by a broken water pipe and general chaos from the construction, our guests were grateful for a place to stay,” says Dolly. 70

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The HHH board had enough money for the bricks and mortar. But another major fund-raising campaign was needed to pay for the renovations and cover the increased operating expenses. Bob Busch, a partner at Ernst & Young, brought a heightened level of financial acumen to the HHH board, which he chaired from 1995 to 1996. He helped the organization evolve from a small, homespun charity to a thriving enterprise. Shortly after the new HHH opened, Maureen Baker, a member of the board, stepped forward and volunteered to serve as executive director on a “temporary basis”—which lasted six years. “Maureen was totally committed to Hospital Hospitality House. Somehow she was able to balance running a hotel, managing the renovation project and attending to the many needs of our guests,” notes Dolly. “She was also a wonderful storyteller, and her stories inspired others to support the house.” When it comes to dedication, Maureen was in good company. Betty Daffron recruited and managed a strong corps of volunteers. “Three loyal employees virtually ‘came with the hotel,’ ” says Dolly. Jasper “Shorty” McLean, Todd Liggon and Debbie Cox continue to work for HHH to this day. Supporting HHH was a Hintz family affair. Dolly and Bob provided the lead gift for the capital campaign, and from 1997 to 2000, Bob chaired the board. Recently retired from CSX, Bob tapped many of his professional contacts to contribute to HHH. He would invite corporate executives to lunch at the house where he would tell them how HHH benefits patients and families as well as the community and the medical center. Maureen liked to say, “There’s no such thing as a free lunch,” when she referred to Bob’s highly successful fundraising strategy and she presented him with a trophy with a sandwich on top. Transformation of the old hotel took place over a period of years. A

Hospital Hospitality House by the Numbers 1984 the year MCV-VCU Hospital Hospitality House of Richmond was founded.

138,000+ patients, family members and caregivers who have stayed at the HHH over the past 30 years.

$6,200 cost to operate the HHH for one day. In 1989 it cost $250 a day to operate the original facility.

46 percent of guests who cannot make a donation to stay at HHH. But no one is ever turned away if they can’t pay.

7,000 guests staying at the HHH each year. 13,000 hours of volunteer service given each year help HHH keep staff costs low.

100+ guest rooms at HHH, each individually decorated and with private baths.

50 states and 31 foreign countries are represented in HHH’s guest book.

144 average number of guests staying at the HHH each night. 365 number of days per year that HHH welcomes guests. 6 average number of days a guest stays at HHH. Most guests stay for a day or two, while transplant patients may reside at HHH for six to eight months or more.

85 percent of patients who are receiving care at VCU Medical Center. 15 percent of patients who are being treated at Hunter Holmes McGuire VA Medical Center, the World Pediatric Hospital and other facilities.

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community dining room and comfortable sitting areas entice guests to mingle and provide comfort and solace to one another. An added measure of support is provided by a social worker who regularly visits the house. The large commercial kitchen was revamped to create four kitchen “pods.” Families can comfortably prepare a meal in one of the fully equipped, homelike kitchens. The food and paper products are donated by local companies, and on a regular basis church and civic groups come in and prepare meals for all the guests staying in the house. Large walk-in refrigerators and freezers are stocked to the brim, giving testimony to people’s generosity to HHH. Individual guest rooms were refurbished and decorated, providing naming opportunities for many donors. “Maureen maintained one room in its original state of disrepair,” says Dolly, “to show prospective donors how far we had come.” The house offers many amenities, including a library with over 3,000 books, a 24-hour laundry room, a fitness center, a chapel and complimentary shuttle service between the medical center and HHH. There is even a “hat room” where cancer patients can choose from a wide selection of warm, cozy hats. In 2000, Barbara “Babs” Jackson assumed the role of HHH executive director. During Babs’ 13-year tenure HHH made incredible advances, including tripling the average number of guests per night, refurbishing all rooms and upgrading amenities. Yet despite the growth and vast improvements at HHH, it is remarkable that the suggested donation for a night’s stay increased slightly from $10 to $15, where it remains today. “It costs $6,200 a day to run and staff HHH,” reports Shawn Walker, chief financial officer, “and only a fraction of that is covered by guest donations.” In fact, 46 percent of all guests cannot afford to make any contribution. “Donations are our lifeblood,” says Beverly Bean, current development director for HHH. “In fact, we are the largest hospital hospitality house in the country supported entirely by contributions.” Hospital Hospitality House of Richmond does not receive any governmental funding and it is not a United Way agency. Some support is provided by VCU Health System for operations.

Hospital Hospitality House of Richmond, Inc. 612 E. Marshall Street Richmond, VA 23219 Phone: 804.828.6901 Ext. 425 Fax: 804.828.6913 www.hhhrichmond.org

In 2000, a small-scale capital campaign enabled HHH to renovate the 5th floor for use by adult transplant patients. And in 2007, the Rotary Club of South Richmond and International Children’s Hospital (now the World Pediatric Project) made significant contributions to HHH for the construction of a dedicated area for pediatric patients. The 8th floor is specially designed to meet the needs of children with cancer or undergoing transplantation. Separate kitchen and laundry facilities employ sterility procedures to ensure that children with suppressed immune systems have a safe place to stay. “We have a robust annual campaign and many faithful donors such as the Massey and Thalhimer family foundations, as well as corporate supporters like HDL, CSX, Georgia-Pacific and New Market, to name a few,” remarks Beverly.

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“Fund-raising events not only generate revenue, they also build awareness and solidify relationships,” says Beverly. But no one says raising money has to be boring. Among the most fun-filled events is the 17th annual Fancy Hat Party to be held May 9, 2014, at the Commonwealth Club. Attendees either find the craziest hat they can or they make their own creative headwear. Each year a special luncheon guest speaker also judges the array of wild chapeaus. The first Fancy Hat Tea Party, held

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in 1989, was an elegant High Tea held at the Richmond Centre. Guests were asked to donate a soft hat for the “Hat’s Off to You Room.” Savor has become yet another signature event for HHH. This elegant chef’s dinner is in its fifth year and has featured notables such as Iron Chef’s Cat Cora and former White House pastry chef Roland Mesnier. Created by Leslie Stack and Mark Herndon, Savor will be chaired by Melissa Ball in 2014. Gifts to HHH come in all forms and sizes. “We recently received a condominium,” says Beverly, “but we have also been given some unusual gifts—like large collections of salt and pepper shakers and Beanie Babies®. Our guests love looking at the collections. It gives them a few minutes of diversion during an incredibly stressful time.” In December 2013, Babs retired and turned the reins of HHH over to Stacy Brinkley, president and CEO. Stacy had previously enjoyed a long and successful career with Anthem and most recently with PACE (Program of All-Inclusive Care for the Elderly). “I was at a point in my life I wanted to do something more missiondriven,” says Stacy. “This organization gives me a unique opportunity to do something truly meaningful and fulfilling.” Stacy is now part of a proud tradition— following in the footsteps of those “little housewives in tennis shoes” who had a dream and the tenacity to make it become a reality. For 30 years, Hospital Hospitality House of Richmond has met a vital need—providing a safe, affordable, welcoming “home” for families in medical crisis. While the healthcare professionals heal bodies, the dedicated staff, volunteers and donors of Hospital Hospitality House of Richmond mend spirits—by offering warm beds, nourishing meals and an abundance of caring hearts.

Kathy’s Story:

Hospitality When We Needed it the Most

The fact that her husband would be undergoing delicate neurosurgery was frightening— but the thought of having to find overnight accommodations in Richmond, park the car and drive back and forth between the medical center and a hotel multiple times a day was nearly as anxiety provoking. That’s just how Kathy Dupuy felt as she and her husband, Wilfred (“Wil”), prepared to travel to VCU Medical Center from their home in Yorktown, VA. “About four years ago, Wil had surgery here in Tidewater,” says Kathy, “but it wasn’t successful. So his doctor referred him to a specialist at VCU Medical Center.” During a presurgical appointment with the surgeon, a staff member told Kathy about Hospital Hospitality House. The night before Wil’s surgery, the couple drove to Richmond and checked in to HHH. Knowing that there was a significant risk associated with the surgery, Kathy and Wil’s grown daughter, Jessica Carr, came to be with her parents throughout the ordeal. “We couldn’t believe how nice the facility was, exclaimed Kathy. “My husband and I travel a lot and we’ve stayed in many hotels. But this place was really special. The staff could not have been more welcoming. Everyone went out of their way to help us.” Kathy and Jessica appreciated many of the thoughtful details that made their stay at HHH just a little bit easier during this incredibly stressful time. “The best feature,” says Kathy, “was the free shuttle service. Whenever we wanted to go to the hospital to see my husband all we had to do was request a ride. And in 10 minutes we were on our way. From the time we arrived until we drove home, we never had to move the car.” When it was time to check out, Kathy noticed a sign that “suggested” a donation for each person per night. “I couldn’t believe how modest the amount was,” remarks Kathy. “We were happy to give.” While waiting to check out, Kathy observed that the family in front of her was not able to make a donation. “The person at the desk was so gracious in the way she handled this. The family was not embarrassed or made to feel bad that they couldn’t donate.” Since their experience with HHH, Kathy and Wil have become real advocates. “We tell everyone who is coming to VCU Medical Center how wonderful this place is to stay at,” says Kathy. “It was a real blessing for our family during a very difficult time. We will continue to support Hospital Hospitality House so others can enjoy the kindness and generosity we experienced. They really do live up to their name!”

Author’s note: This article showcases only a fragment of the rich tapestry that is Hospital Hospitality House of Richmond’s history. And the few individuals cited are a mere representation of the thousands of dedicated staff, volunteers, donors and supporters who offer a welcoming “home” to patients and families who have traveled to Richmond for medical care for 30 years.

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