OurHealth Richmond May 2013 Edition

SENIORS AND TRAVEL

ST. MARY’S NEW PEDIATRIC EMERGENCY DEPARTMENT

NEW FACTS ABOUT HEALTHY SLEEP

HEALTHY MEMORIAL DAY GRILLING RECIPES

MAY 2013 | GREATER RICHMOND EDITION | OURHEALTHRICHMOND.COM

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Our Health proudly recognizes the recipients of the 2013 Hometown Healthcare Heroes Awards

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our health | BASIC

table of contents |may 2013

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

JUST ASK!..................................12 A variety of health questions answered by local professionals

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

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

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COVER STORY 2013 Inaugural Hometown Healthcare Heroes Awards

47

NUTRITION Healthy Memorial Day grilling recipes

SCIENCE OF SLEEP...................57 Some new facts about healthy sleep

PEDIATRIC ER ............................61

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BEHAVIORAL HEALTH

St. Mary’s new bigger, better pediatric emergency department

PHARMACY ................................67 What is a compounding pharmacy?

SENIOR LIVING...........................71 Seniors and travel

There’s no health without mental health

www.ourhealthrichmond.com | 7

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OUR HEALTH RICHMOND MAGAZINE ON YOUR TABLET

may 2013

OUR HEALTH’S EXCLUSIVE MEDIA PARTNER McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Angela Holmes Jennifer Hungate Stephanie Taylor Karrie Pridemore Ed Ip Lew Fraga WEBMASTER Adapt Partners and Brain Swell Media

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CONTRIBUTING RICHMOND PROFESSIONAL EXPERTS Paul Charron, MD, FACS

Jan-Eric Esway, MD

Tricia Foley, MS, RD Warren L. Felton, III, MD Aaron Gibbs, LPL Alistair Jones, MAc, OM Michael R. Monteiro Tonya Tira, OD Elaine S. Turner, MD, FACP CONTRIBUTING PROFESSIONAL WRITERS Sarah Cox Rich Ellis, Jr. Anika Imajo Diana Legere 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: 305 Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.355.3071 Information in all print editions of Our Health and on all Our Health’s websites (www.ourhealthrichmond.com and www.ourhealthvirginia.com) social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations.

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

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our health | MEDI•CABU•LARY & JUST ASK

me d i • ca bu • l ar y

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

What are the signs of a stroke?

A leading cause of death and disability, stroke causes damage to the brain and is a medical emergency. There are two types of stroke. An ischemic stroke, is caused by a blood clot that blocks a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain.

Symptoms almost always occur suddenly and without warning. Use F-A-S-T as a way to remember the signs of a stroke: F for Face Does one side of the face droop or is it numb? Ask the person to smile.

A for Arm Is one arm (or leg) weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S for Speech Is speech slurred, are they unable to speak, or are they hard to understand?

T for Time Call 9-1-1 and get them to the hospital immediately.

Time is critical in treating a stroke.

Acute stroke treatments try to stop a stroke while it is happening by quickly dissolving the blood clot or by stopping the bleeding.

Warren L. Felton III, MD VCU Medical Center Medical Director, VCU Stroke Center Richmond | 800.762.6161 10 | www.ourhealthrichmond.com

What is elevated vacuum?

What are bunions?

What is Crohn’s disease?

Elevated Vacuum Prosthetic Socket Design, also referred to as Sub-Atmospheric Suspension, is accomplished by means of a rechargeable electric or weight activated vacuum pump. The system utilizes a custom intimately fitting socket, a liner, the pump and usually a sealing sleeve. By withdrawing air from a sealed socket system the patient’s tissues are stabilized within the socket. With an elevated vacuum socket, the pump regularly adjusts and restores vacuum to the system. Some systems are patient adjustable for different activity levels. This offers many advantages to the prosthetic user from a reduction in perspiration, residual limb loss (shrinkage) and the need to adjust socks during the day, to improved circulation, enhanced suspension and a feeling of the prosthesis being ‘more a part of me’.

Bunions are a common and easily recognized foot condition. They appear as a prominence at the big toe’s base. Factors causing bunions include genetics and tight-fitting footwear. If shoes are the cause, then wearing ones that better accommodate the foot’s natural structure may relieve discomfort.

Designers now make shoes that offer comfort without compromising style.

A permanent solution is surgical intervention and this is appropriate when the bunion is impacting daily function of living. This includes impairment of gait and pain that is unrelieved by medications.

Crohn’s disease is an autoimmune inflammatory disease that can affect anywhere in the GI tract, from the mouth to the anus.

Crohn’s disease along with the disease Ulcerative Colitis, are grouped together as Inflammatory Bowel Disease (IBD). IBD should not be confused with Irritable Bowel Syndrome, which is not related.

Michael R. Monteiro ABC Certified Prosthetist Powell Orthotics & Prosthetics Richmond | 804.649.9043

Bunion treatment can be complex.

So, it’s extremely important that your surgeon has the training and experience necessary to achieve good results. Surgery aims to relieve pain and restore normal alignment. Depending on the degree of deformity, this often is achieved by an osteotomy, which involves removing the prominence, tightening loose tissues, releasing tight tissues and, usually, realigning bones. Thanks to technological advancements, screws are only necessary for the most severe bunions. Post-surgical recovery periods vary depending on the patient and the procedure.

However, many people return to normal routines in 12 weeks.

Jan-Eric Esway, MD OrthoVirginia North Chesterfield | 804.320.1339

The pattern of disease fluctuates from periods of quiescence punctuated by acute flares.

Hallmarks of acute flares are discontinuous involvement of the GI tract, referred to as “skip lesions”. Symptoms are nonspecific but may involve crampy abdominal pain or bloody, frequent diarrhea.

Treatment of Crohn’s disease is primarily with medicine. Surgery is reserved for complications.

There is no known cause although a familial component may be seen.

Men and women are affected equally. Peak onset is the 2nd and 3rd decade of life, with a later peak in the 6th decade.

Paul Charron, MD, FACS Colon and Rectal Specialists Richmond | 804.249.2465

our health | MEDI•CABU•LARY & JUST ASK

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

I’m worried about running out of money if I (or my parents) have to go into a nursing home.

Are there ways to protect our assets if that happens?

You are right to be concerned as nursing care costs can eat up decades worth of savings in a very short period of time. The good news is there are some ways to help protect assets in the event you or your parents find yourself in this situation. One way is Long Term Care Insurance. The younger and healthier you are, the more affordable this option is going to be so this takes some planning ahead.

If the Long Term Care option is not affordable there are other ways to deal with this issue but they get quite complicated. If you work with a Financial Advisor he or she may partner with Insurance Agents, Estate Planning Attorneys, and Tax Advisors that could work together to help you find a plan that makes the most sense for your individual situation. *Securities offered through LPL Financial, Member FINRA/SIPC

Can acupuncture help with my seasonal allergies?

What is glare and how does it affect my night vision?

Licensed acupuncturists are part of continuous written and clinical tradition of medicine which has been successfully treating seasonal allergies for more than two thousand years. Seasonal allergies reflect an overreaction by the body’s immune system in the presence of pollens or molds.

Effective treatment addresses both the symptom and the underlying cause. For example, Acupuncture is very effective at opening the sinuses, but if there is pre-existing heat and inflammation there, then clearing the heat and reducing inflammation must also be addressed as part of the treatment.

Glare occurs when light entering your eye interferes with your vision instead of helping it. Light normally enters the eye and focuses sharply on the retina in the back of your eye, allowing you to see clearly.

When your eye has difficulty managing the light coming in, such as from bright headlights of oncoming traffic at night, you may experience symptoms of discomfort, tearing, and decreased vision. Common eye conditions such as astigmatism, cataracts, and dry eye contribute to glare.

Anti-reflective lens coating on a proper glasses prescription may help improve the symptoms of glare, especially at night.

The amount of treatment needed to cure allergies is dependent upon the severity of a person’s underlying imbalance. Long time allergy sufferers tend to need more treatment than those who are experiencing allergies for the first time, but acupuncture, herbs and dietary changes can produce significant changes in a short amount of time for many people.

The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any individual.

Aaron Gibbs, LPL Financial Advisor Claris Financial Glen Allen | 804.935.3000

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Alistair Jones, MAc, OM Director of Oriental Medicine Advanced Wellness Centre RVA 804.673.WELL (9355)

Tonya Tira, OD Grove Avenue Eye Center Richmond - Midlothian 804.353.EYES (3937)

My allergies typically flare up the same time each year; what could be causing that?

Allergy sufferers can guess what is causing their symptoms by noting the time of the year in which they suffer. Typical symptoms from airborne allergens include runny nose, stuffy nose, sneezing, itchy red runny eyes, and in some cases wheezing.

For pollen in the Mid-Atlantic area, seasons look like this: • Tree pollen: mid-February through as late as May • Grass pollen: May-June • Weed pollen: Mid-August to October So now you can guess what is causing your allergies based on the time of year that you have symptoms. Of course, all of this must be confirmed by an allergist.

At Allergy Partners, we take a thorough history, do a physical exam and then skin tests to determine what is really bothering you and then plan treatment accordingly in a very specific way. For more detailed allergy information, visit http://www. allergypartners.com/richmond/blog/ Lists/Posts/Post.aspx?ID=88 Elaine S. Turner, MD, FACP, FAAAAI Allergy Partners of Richmond Richmond | 804.288.0055

THE LATEST | our health

the l atest

Gaurav Gupta, MD VCU Medical Center Hume-Lee Transplant Center Downtown | 804.828.4104

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

Deborah A. Koehn, MD VCU Medical Center Division of General Internal Medicine, Women’s Health Stony Point | 804.560.8950

Michael S. Schechter, MD, MPH Children’s Hospital of Richmond at VCU Division of Pulmonary Medicine Downtown | 804.828.2980

Kevin Silver, DO VCU Medical Center Department of Physical Medicine and Rehabilitation Stony Point | 804.827.7463

Anil R. Kumar, MD, CDE Pediatric Endocrinology & Diabetes Associates 5875 Bremo Road, Suite 303, MOB South, Richmond | 804.287.7322

Nandita Kalahasty, MD Laburnum Medical Center 4620 S. Laburnum Ave Richmond | 804.222.7744

VCU Medical Center is proud to announce that Internal Medicine and Pediatric Associates has joined its physician practice group and welcomes Darren Witte, MD and Ericka Young, DO. Dr. Witte is board certified in Internal Medicine and Pediatrics. Dr. Young is board certified in Osteopathic Family Medicine.

Jake O’Shea, MD HCA Capital Division Chief Medical Information Officer

Both will continue to provide primary care services for patients of all ages at their current location in Chesterfield, located at 6433 Centralia Road in the Chesterfield Meadows Shopping Center. For more information or to schedule an appointment, please visit www.medpedsassoc.com or call 804.425.3627.

Darren Witte, MD Ericka Young, DO Internal Medicine and Pediatric Associates Chesterfield | 804.425.3627

VCU Medical Center First in Virginia to Implant Telescope for Macular Degeneration Implant improves vision for patients suffering from the leading cause of blindness in older Americans.

Physicians at the Virginia Commonwealth University Medical Center have become the first in Virginia to successfully implant a telescope in a patient’s eye to treat macular degeneration.

The telescope implant is designed to correct end-stage age-related macular degeneration (AMD), the most advanced form of AMD and the leading cause of blindness in older Americans. Patients with end-stage AMD have a central blind spot. This vision loss makes it difficult or impossible to see faces, to read and to perform everyday activities such as watching television, preparing meals and self-care.

William H. Benson, MD, a cornea specialist and chairman of the Department of Ophthalmology at the VCU School of Medicine, performed the procedure.

“We are excited to provide this new surgical option to our advanced macular degeneration patients, who up until now have had limited options for improving vision,” Benson said. “Advanced macular degeneration is a devastating disease, which cannot be treated by any available drugs or surgical procedures. The telescope implant offers a new hope for patients with limited vision.”

Smaller than a pea, the telescope implant uses micro-optical technology to magnify images that would normally be seen in one’s “straight ahead” or central vision. The images are projected onto the healthy portion of the retina not affected by the disease, making it possible for patients to see or discern the central vision object of interest.

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Subscribe today by emailing Jennifer Hungate at jenny@ourhealthvirginia.com

The Implantable Miniature Telescope (By Dr. Isaac Lipshitz) is a product of VisionCare Ophthalmic Technologies, Inc. www.ourhealthrichmond.com | 13

our health | THE LATEST

the l atest

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

Richmond’s First Outpatient TMS Therapy Treatment Center for Depression Opens in Glen Allen

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Virginia Interventional Psychiatry began treating patients with Transcranial Magnetic Stimulation (TMS) Therapy this month in their Glen Allen Clinic, just North of Innsbrook. TMS Therapy is FDA-approved treatment for depression of patients who have not found relief from antidepressants, are unable to or do not want to take typical antidepressants. VIP is the first outpatient clinic in the Richmond area specializing in only TMS Therapy.

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Richmonders encouraged to Step UP for Down syndrome 5K run/walk, Free Family Festival Benefits DSAGR, Celebrates Individuals with Down syndrome The Down Syndrome Association of Greater Richmond (DSAGR) will hold its seventh annual Step UP for Down Syndrome 5K and Family Festival Saturday, Oct. 12 from 8:30 a.m.-noon at The Shops at White Oak Village. The annual fundraiser, which raised more than $103,000 and had over 1,300 participants last year, features a 5K run/walk and a free family festival that is open to the public that celebrates the abilities and accomplishments of children, teens and adults with Down syndrome.

“This day is a celebration of all of the amazing individuals with Down syndrome in our community,” said Allison Wixted, executive director of DSAGR. “The funds and awareness we raise directly impact these individuals and their families throughout Central Virginia.”

Among the day’s festivities:

TMS Therapy, a non-invasive, non-sedative form of outpatient depression treatment is quickly gaining popularity among patients prescribed antidepressants, but unable to achieve symptomatic relief. Rather than electroconvulsive therapy, which requires anesthesia and a longer treatment regimen, TMS Therapy has very little side effects; the patient remains awake and cognizant of the entire procedure. Patients are able to come in for the roughly 45-minute treatment session and resume normal activity immediately afterwards.

Virginia Interventional Psychiatry’s psychiatrist, Dr. William Sauvé, said that “Transcranial Magnetic Stimulation (TMS) Therapy provides a new hope in the treatment of depression that creates the potential for remission, not just management. Depression can be a devastating illness, and TMS Therapy represents a real, concrete strategy for sufferers to get well.”

The clinics founders began their work with TMS at an inpatient hospital treating the nation’s veterans suffering with mood disorders and found its efficacy in treating depression promising. In February of this year they opened Virginia Interventional Psychiatry to begin treating Richmond area residents suffering with treatment-resistant depression and those not wishing to take antidepressants.

Virginia Interventional Psychiatry is located at 5231-C Hickory Park Drive in Glen Allen, VA. For more information, please visit www.viptms.com or call 804.464.8471.

• 5K Run/Walk (beginning at 8:30 a.m.)

• Lots of free family-friendly entertainment and activities • Superstars Fashion Show featuring individuals with Down syndrome • Live music by The Groove Motive • The Great DSAGR Pumpkin Patch • Sponsor/Exhibitor/Advocacy Displays • Down Syndrome Superstars Ceremony honoring all with Down syndrome in attendance Registration will begin mid-June at www.dsagr.com.

Sponsorship opportunities are available by contacting Nancy Nietman, Event Coordinator at 804-525-7731.

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CORRECTION – In the “a pain in the neck? Look Elsewhere” article of the March/April Richmond issue, the image used for the article was a stock image. Gloves are worn at all times when a patient undergoes a dry needling procedure.

THE LATEST | our health

HCA Virginia Nursing Leader Honored for Excellence in Oncology Nursing Wendy Hendrick, R.N., BSN, OCN, clinical coordinator for infusion and pain management at Henrico Doctors’, Retreat Doctors’ and Parham Doctors’ Hospitals, is the recipient of the 2013 Excellence in Patient/Public Education Award by the Oncology Nursing Society (ONS).

The award recognizes Hendrick’s contributions in offering creative and innovative educational programming for her patients, their families and the surrounding community.

This is the third time that Hendrick has been honored by the ONS. Her previous awards include recognition in the areas of oncology certification and nurse leadership career development.

“My focus remains on improving healthcare and providing compassionate care to those who are in need,” said Hendrick. “To be recognized by an exceptional organization that continues to dedicate its work to the field of oncology nursing is truly humbling and I am honored to receive this award.”

Hendrick leads the extensive outreach educational and screening program at Henrico Doctors’ Cancer Center. The Cancer Outreach Program is a collaboration between the hospital and many community groups and churches providing innovative cancer screenings and education across a 75 mile radius.

Hendrick manages and coordinates treatment provided at Henrico Doctors’ Hospitals Infusion Centers. She also educates nurses on chemotherapy biotherapy administration by offering the two-day ONS course in the Richmond market and in Virginia.

She will present her work on developing a paperless scheduling system, during the ONS national conference in Washington, D.C., where she also will be recognized during the opening ceremonies of the annual ONS Congress.

As the president of the ONS Richmond Chapter, she collaborates with the American Cancer Society, Sister’s Network of Richmond Inc., Camp Kessem and Be the Match.

The Oncology Nursing Society is a professional organization of over 35,000 registered nurses and other healthcare providers dedicated to excellence in patient care, education, research, and administration in oncology nursing.

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HEALTH AND FITNESS ON THE GO | our health

Health and Fitness

On the Go

Ready to jump-start your fitness routine or find out if it may be time to get your hearing tested? In our new Health and Fitness on the Go section, we recommend a variety of health-focused apps you can download to your smartphone or tablet.

Couch-to-5k® from Active.com Follow this easy and fun training plan for beginning runners. Get off the couch and run a 5k in just 30 minutes a day, three days a week for nine weeks!

This app features loads of training tools to help you stay on track: »» Track your route, distance and pace with GPS »» Access your own music playlist in-app »» Take advantage of your own “trainer” as they coach you through each workout »» Log your workouts in a journal »» Track your progress online »» Get support from the Couch-to-5k® community »» $1.99 for iPhone | $2.99 for Android

Android

iPhone

First Aid App by American Red Cross The official American Red Cross First Aid app puts expert advice for everyday emergencies in your hand. This First Aid app gives you instant access to the information you need to know to handle the most common first aid emergencies. With videos, interactive quizzes and simple step-by-step advice it’s never been easier to know first aid.

This app features: »» Simple step-by-step instructions guide you through everyday first aid scenarios »» Fully integrated with 911 so you can call EMS from the app at any time. »» Videos and animations make learning first aid fun and easy. »» Safety tips for everything, from severe winter weather to hurricanes, earthquakes and tornadoes help you prepare for emergencies. »» Preloaded content means you have instant access to all safety information at anytime, even without reception or an Internet connection. »» Interactive quizzes allow you to earn badges that you can share with your friends and show off your lifesaving knowledge. »» Free for iPhone and Android

Android

iPhone

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our health | HEALTH AND FITNESS ON THE GO

uHear uHear is a hearing loss screening test which allows you to test your hearing to determine if it is within normal range, or if you have a potential hearing loss.

It is a free, self-administered hearing test, along with tips and resources for preventing hearing loss. uHear lets you assess your hearing on any one or all three of these tests: »» Hearing Sensitivity is used to determine the quietest sounds you can hear »» Speech in Noise is a measurement of your ability to understand speech in the presence of noise »» Questionnaire is a series of twelve questions regarding your performance in common listening situations. »» Plus uHear can also help you locate a hearing healthcare provider in your area.

After each test, you get your results along with helpful context and recommendations-and for the Hearing Sensitivity test, you also see results mapped out on a graph, showing performance charted across different levels of pitch for each ear. It’s a quick (and even kind of fun) way to see how well you hear.

If you do suspect a hearing loss, please seek the advice of a professional. uHear was designed by Donald Hayes, Ph.D. Director of Audiology for Unitron Hearing. »» Cost: Free »» Device: iPhone (currently not available for Android)

iPhone

My Chart for Bon Secours My Chart is a new personal, online medical record app offered by Bon Secours. With this connection to your doctor’s office, you can: »» »» »» »»

Communicate with your doctor Access your test results Request prescription renewals View your recent clinic visits

Android

SHARE YOUR FAVORITE HEALTH AND FITNESS APP!

You must first create an account through your healthcare provider in order to access your information through MyChart. If your healthcare iPhone provider is not listed, or if you require support accessing your existing account, contact them directly about accessing your account through the MyChart app. »» Cost: Free »» Device: Android and iPhone

18 | www.ourhealthrichmond.com

Scan this QR code with your smartphone or tablet to visit and “Like” Our Health’s Facebook page, then post a “Comment” with your favorite health and fitness APP!

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This past January, Our Health magazine began accepting nominations for the first annual 2013 Hometown Healthcare Heroes Awards. The nomination announcement was promoted on-air through our exclusive media partner, WTVR6, in the January/February 2013 edition of Our Health and through direct mail cards. Nominators were directed to www.ourhealthrichmond.com to submit their nominations.

The recipients of the 2013 Hometown Healthcare Heroes Awards were determined by a panel of community members who reviewed the nominations submitted. The criteria for selection included: community involvement, dedication to the field of healthcare and commitment to improve upon services and procedures.

These next pages highlight those recognized this year. Be sure to congratulate and thank both these recipients as well as all others who dedicate their lives to working in healthcare in our communities.

our health | HOMETOWN HEALTHCARE HEROES

kathryn HOLLOWAY, MD Kathryn Holloway, MD, is a neurosurgeon and researcher at the VCU Medical Center. Her field is functional neurosurgery, which includes surgeries for movement disorders, trigeminal neuralgia (a neuropathic condition marked by facial pain), and epilepsy surgery. She also specializes in pituitary tumors and carpel tunnel syndrome and pursues brain mapping of eloquent areas of the cortex and basal ganglia as a primary research interest.

Pioneering new approaches to deep brain stimulation surgery, she was the lead developer of a piece of equipment that is now being used by physicians in 20 hospitals around the world to perform delicate procedures deep inside the brain. A frameless alternative to the stereotactic frame that is traditionally bolted to the head of the patient – who must be awake during much of the procedure -- Dr. Holloway’s innovation offers an effective tool to minimize the patient’s discomfort.

“Now the patient isn’t claustrophobic, doesn’t have this fear of that medieval cage, and more importantly, they can move around a little during surgery, lift their head, and adjust their neck or their back.”

Dr. Halloway’s ongoing efforts to create a more humane experience for patients undergoing deep brain stimulation are particularly significant given the current growth of the field. As our understanding of the brain’s circuits increases, she explains, new applications for deep brain stimulation – beyond treating movement disorders – come to light. According to Dr. Halloway, the procedure has been approved for treatment of obsessive-compulsive disorder and will likely be approved for treatment of depression. Alzheimer’s disease, addiction, and possibly even obesity are among other conditions for which deep brain stimulation shows promise as a remedy.

“I think that to be able to do this surgery that’s going to be done with increasing frequency in a way that’s much more comfortable for the patient is a huge advance in the field,” she notes.

Dr. Holloway, who grew up around her parents’ veterinary hospital, says medicine is a family tradition for her. Her four siblings also entered professions in healthcare.

But her pure passion for neuroscience, combined with her love of working with her hands, drew her to neurosurgery specifically.

“It is just the most fascinating thing,” she shares. “I think you could study the brain or you could study subatomic particles, and the rest of the world is boring.”

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HOMETOWN HEALTHCARE HEROES | our health

www.ourhealthrichmond.com | 23

our health | HOMETOWN HEALTHCARE HEROES

donna COX One of the most noticeable side effects of chemotherapy is hair loss. And although hair normally grows back after treatments are complete, most cancer patients find it hard to cope with this temporary challenge.

Through her work at Massey Cancer Center’s (MCC) Magical Touch Salon, manager Donna Cox applies her skills as a licensed cosmetologist to help patients take charge of their appearance. Offering compassionate consultation—as well as a selection of wigs, turbans, scarves, and hats— she prepares them for the cosmetic transformations they will undergo and she empowers them with a range of options.

“They can come in and pick out wigs, try them on, and educate themselves,” she observes. “And they can decide what they want to do. Do they want to shave their heads? Do they want wait for it to come out?

They have choices.”

Cox, who says her work with cancer patients is close to her heart, first entered the salon when she accompanied her mother-in-law there to pick out a wig.

Understanding the ordeal that her clients are facing, as well as the emotional impact that hair loss can have on both men and women, Cox says she feels blessed to have the opportunity to present “a bright spot in what they’re going through.”

“Cancer’s such a devastating disease that it takes a lot of your choices away. And this puts some of that control back into their hands.”

She feels most proud, she says, when she knows her clients are leaving the salon feeling a little better.

“When they want to walk out the door with that wig on or when they stop and give me a hug on their way out, then I know they like it.”

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HOMETOWN HEALTHCARE HEROES | our health

A medical oncologist and hematologist, John McCarty, MD, is medical director of the Bone Marrow Transplantation (BMT) program at VCU Massey Cancer Center. Under his leadership, the program has become the largest, most comprehensive BMT provider in Virginia, offering every available form of transplant source for the treatment of blood cancers and blood disorders.

The contributions of Dr. McCarty -- who is also a professor at the VCU School of Medicine – and his team are not limited to the approximately 170 surgeries they perform annually and the diligent follow-up care they provide, but extend to their role in taking the science of BMT in new directions.

“We’re also involved in and creating the research that helps drive the best ways of doing transplants on a national basis,” he explains. “So what we do on a daily basis helps locally, nationally, and internationally.”

john MCCARTY, MD Considered personable and caring by his patients and staff, he has been known to sing the National Anthem to patients and be plunged by them into dunking booths to raise money for cancer research. Dr. McCarty is a health care hero for his leadership in BMT and excellence in care.

He and his team of professionals take a personalized, long-term approach to treatment, providing “an arc of therapy” that he says creates lifetime relationships with patients.

Dr. McCarty’s early interest in medicine was sparked when he was in third grade and a neighbor, who was a pathologist, invited him to watch open-heart surgery. Through this experience, he found his calling.

“To me,” he recalls, “there was no question as to what I was going to do.”

He narrowed his focus to oncology while in high school, when both of his parents underwent treatment for cancer.

“I saw some very good things,” he explains of his observations at the time, “but I also saw how it could be done better, in terms of trying to apply the science in a humanistic way.”

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our health | HOMETOWN HEALTHCARE HEROES

ellie COYNE Considered by staff and patients around the VCU Medical Center as a fixture of the Thomas Palliative Care Unit (TPCU), volunteer coordinator Ellie Coyne helps lift the spirits of patients who suffer from chronic illness by providing bedside reading, music, reflexology, and more.

A champion of dignity and quality of life, she caters to the unique circumstances, needs, and wishes of each TPCU patient. Palliative care, she says, “is thinking outside of the box.”

Journaling, legacy work, and memory-making projects -- such as creating personalized jewelry and blankets – are among the activities that Coyne and her staff of volunteers facilitate.

A member of the executive committee for Dogs on Call, offered by VCU Medical School’s Center for Human Animal Interaction, she also shares the joy and comfort of pet therapy.

In addition, Coyne guides TPCU patients and their loved ones through important processes that can bring peace of mind at difficult times. Living wills, advanced directives, and other measures that help establish the patients’ wishes “take pressure off the families,” she explains. And empowering them to ask questions about their options is a service that she considers most valuable.

Named after an older sister who succumbed to cancer at age four, Coyne says working on behalf of patients has been a

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life-long calling and a passion shared by her entire family.

It was after years of service to the American Cancer Society that she dedicated her efforts to TPCU. “It was just meant to be,” she says. “I’ve always been doing it, and I love it.”

Noting that her ability to talk and listen to anybody at any time goes a long way in aiding her efforts, she shares, “I hope I can help make a difference to their quality of life. And letting them know that their special.”

HOMETOWN HEALTHCARE HEROES | our health

Gale Grant is making a difference. As the Adolescent Health Coordinator for the Richmond City Health District, she’s helped reduce the teen pregnancy rate in Richmond by 30 percent – from 916 pregnancies in 2008 to 614 in 2011.

She entered the healthcare field for just that reason – to affect change. “I entered the field not intentionally,” Gale explains. “I came in because of my interest in doing prevention work and working with youth and discovered the whole field of public health and how you can address risk behaviors.”

With good reason, Gale feels that her greatest contribution to the field is the experience she brings in working with youth, and particularly in addressing sexual risk taking behavior with youth and the interrelatedness of risk behaviors in young people. “I’ve had some success in my career addressing teen pregnancy rates and delaying sexual debut, and helping young people navigate relationships in a safer way,” she explains.

The reduction in Richmond’s teen pregnancy rate is what she’s presently most proud of, in part because it was one of the tasks she was given when she assumed her present responsibilities in 2007. She’s quick to point out, however, that she didn’t achieve these results alone. “I really do appreciate the staff I work with and am successful because they are so good at their job,” Gale says.

Her work’s impact is felt far beyond Richmond, however, as Gale has previously consulted nationally, working for the Office of Adolescent Pregnancy Programs and also for the Administration for Children and Families. Additionally, she’s worked on HIV prevention and conducted proposal reviews at the federal level.

gale GRANT www.ourhealthrichmond.com | 27

J. Michael Simpson, MD, is a widely recognized and respected orthopaedic spine surgeon specializing in major reconstructive deformity surgery as well as surgery for degenerative conditions of the cervical and lumbar spine.

Through his fellowship training at the Rothman Institute & Thomas Jefferson University Hospital, he gained expertise in both neurosurgical and orthopaedic spine surgery. This rare combination of fields qualifies him to engage both perspectives in the treatment of complex spinal disorders.

Dr. Simpson, who has practiced at Tuckahoe Orthopaedics for 22 years, has operated on over 10,000 patients in his career. But this number doesn’t adequately illustrate the full range of care he provides.

“I look at myself as a spine doctor and surgery’s part of what I do, but the reality is that our role in the community in taking care of our patients goes well beyond that,” he explains, pointing out that he and his colleagues at Tuckahoe Orthopaedics actually operate on a small percentage of the patients they see.

Familiarizing himself with each patient’s needs, expectations, and general health – and helping them understand their conditions -- he creates individualized treatment plans, whether surgical or non-surgical.

“I do pride myself in taking a lot of time with patients,” he says.

j. michael SIMPSON, MD Growing up in a small town, Dr. Simpson says his admiration for the local family physician inspired him to enter medicine. But his love of woodworking and working with his hands drew him to orthopaedics.

Through exchanging ideas with colleagues throughout the country and co-writing/ co-editing two text books, Dr. Simpson has contributed to the broader discourse within his field.

Locally, he provides an uncommon set of skills that helps raise the community’s standard of care.

“Hopefully, through the type of training and experience I’ve had, as well through my own personal experiences over 20 years, I’ve been able to elevate the level of spine care and expertise that we have here in Richmond.”

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kathleen CARSON

HOMETOWN HEALTHCARE HEROES | our health

Making people feel comfortable is something Kathleen Carson, Clinical Coordinator of the Cardiac Step-down Unit at Henrico Doctor’s Hospital, takes seriously.

Carson’s 14-year stretch as a healthcare professional is evidence of her genuine love and compassion for others. Her greatest contribution to healthcare has been to advance the professionalism of nursing, one patient at a time. She works closely with patient families to ease their tension and maintain the integrity of the hospital.

“Each patient allows us in his/her life,” says Carson. “It’s a privilege to take care of them in their weakest moment,” she said.

Carson also knows that a positive environment can make a significant difference in care. She works hard to help create this difference in atmosphere around the hospital, to build team morale and keep her nurses healthy and happy.

“As a leader and coordinator I let them do their thing in a framework that we provide,” explains Carson.

This team leader says that she really works for the nurses, and her goal is to improve their lives within the workplace. To achieve this, she gives them the autonomy they need to remain happy and fulfilled, including letting them write their own schedules.

“There is no turnover in my unit right now,” explains Carson, who has been at HDH for five years, and says it’s a direct result of her desire to give her staff an excellent work-life balance.

In addition to building relationships with patients and staff, Carson plays a key role conducting research studies and evidence-based practice, which are necessary to drive nursing to the professional heights she envisions for her team.

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dustin KELLAM

Dustin Kellam, Surgical Technician at HCA’s Chippenham Hospital in Richmond, provides exemplary care and quality excellence to the patient population of Richmond. Currently enrolled full-time in VCU’s Paramedic Program, Kellam plans to continue in the healthcare sector as a Flight Medic or an ER/ Trauma Physician.

When not working for CJW, Kellam is humble and eager to give back, and serves as an active volunteer in his community, working closely with organizations such as, Leukemia and Lymphoma Society’s Richmond Virginia Chapter. Kellam has been volunteering with fire and EMS for nine years and currently works as an EMT with Manchester Volunteer Rescue Squad and is also a volunteer Firefighter for Chesterfield County.

Dedicated to responder projects throughout Chesterfield County, he is in the midst of forming a non-profit organization that will work in conjunction with the Red Cross to provide first response to the entire east coast.

“East Coast Disaster Response is a first response agency designed to provide emergency medical care to victims of natural and man-made disasters,” explained Kellam.

Using a model that’s been successful in other parts of the country, Kellam’s agency will increase the capabilities of local EMS and Fire departments, which can be overwhelmed during crisis situations.

“Our purpose will be to respond to 911 calls and provide first response care at the ALS level and advise the hospitals of our findings,” Kellam said. “The other part of our mission will be to assist in clearing blocked streets, helping run shelters, working to make sure survivors are fed, warm and dry, as well as to do search and rescue operations.”

our health | HOMETOWN HEALTHCARE HEROES

tonya MALLORY Tonya Mallory, the CEO of HD Labs, Inc. in Richmond, has come a long way since the third grade, when she made her decision to work in the healthcare field.

In just four years, HDL has grown to include 700 staff who are dedicated to making cardiovascular diseases, diabetes, and other related diseases a thing of the past. Their mission is to prevent and reverse these diseases by introducing accurate and highly advanced cardiovascular testing that was once available only to the wealthy.

Mallory says of her breakthrough products, “We have found a way to offer a high value product at a low cost to a marketplace that is demanding better than the status quo. And, we’re saving lives and healthcare dollars in the process.”

HDL is a leader in cardiovascular and diabetes testing, running close to 200,ooo patient tests daily. Mallory says that hundreds of thousands of Americans have access to more accurate information than offered by inadequate lipid panel or cholesterol screening tests of the past.

“I hear daily the impact we have on patients and the statistics are showing a very significant reduction of events in our patients,” Mallory said. “Hundreds and possibly thousands of lives are changed for the better.”

Mallory said that Clinical Health Consultants offer counseling to all patients after testing, which puts people on the right path to reversing these deadly diseases.

“Heart disease is the nation’s No. 1 killer, and therefore the leading healthcare expenditure, contributing to one-third of the nation’s medical bill,” explained Mallory.

She concluded that Type 2 Diabetes has increased by 41% in the last five years, adding $245 billion to our healthcare expense.

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HOMETOWN HEALTHCARE HEROES | our health

clifford MORRIS, MD Clifford V. Morris, MD is the founder and president of the Morris Cardiovascular and Risk Reduction Center in Chester, VA. The Center’s primary goal is to improve health through education and by helping patients create a balanced, hearthealthy lifestyle.

Dr. Morris feels that his contributions to healthcare are making a difference, in part by setting an example for other businesses to follow and by helping people realize that their health should be their primary concern.

Dr. Morris is a motivational speaker in the Hopewell schools, encouraging and educating students to make healthy lifestyle choices. He coordinates efforts to raise one million dollars for school district children to travel. He delivers community lectures and supports continuing education of primary care providers, is an advocate for revitalizing the Hopewell community and works with Hopewell’s Committee for the Downtown Partnership.

Dr. Morris entered the healthcare field after he was studying to be a marine biologist and realized he didn’t want to exclusively perform research for the rest of his life. Medicine seemed like the next logical step, and specifically cardiology because of his interest in the heart.

He feels that his greatest contribution to healthcare is the ability to work in the community, because as he says, “It’s important to strengthen the community if each member of the community wants to get stronger. “ Dr. Morris is most proud of what he’s been able to accomplish through the practice in just over a year and a half.

“We have a very healthy patient base,” he explains. “We started a 10-week medical fitness program. We’ve done a lot out in the community to try and help others.”

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our health | HOMETOWN HEALTHCARE HEROES

jon LUGBILL The staff of Sports Backers, a 501 (c) (3) non-profit corporation, say, CEO and Executive Director, Jon Lugbill, “gets his hands dirty” as he motivates his team to create, support and produce events and programs that encourage individuals and families to adopt a healthier and more active lifestyle.

Lugbill’s vision is to lead the residents of the greater Richmond area to embrace and celebrate an active lifestyle and ultimately transform them into the most physically active community in the nation. With 13 exceptional annual events under their belt, such as UKrop’s Monument Avenue 10K Run, Dominion Riverrock, Times Dispatch Go! Discover Richmond, Patrick Henry Half Marathon, International Dragon Boat Festival, and many others, Sport’s Backers is on the right track.

Not a surprise coming from a fitness powerhouse who has engaged in extreme sports since the age of 12, when he paddled the falls of the James River in a kayak. He later became a fivetime individual world champion in whitewater canoeing and a member of the 1992 Olympic Team.

“When I retired from competitive kayaking, I was looking for a way to mesh my passion for sports and outdoors with my career,” said Lugbill.

Sports Backers was founded in 1991 and Lugbill came on board two years later as Executive Director in 1993.

“The organization started as a sports commission working to promote sports in the region,” he explained. “We’ve since transformed into an organization that promotes participatory sports in the region – sports that give residents an opportunity to get active and lead healthier lives.”

Such events are held at the Sports Backers Stadium, a 3,250 seat venue which features the Irwin Athletic Center and Richard A. Hollander Track, a championship track that hosts regional, national meets, such as the USA Track and Field Junior National Championships.

Sports Backers also works to support non-profit sports tourism events. In 2012, they supported 22 events, and provided marketing grants to help organizations grow their events.

“Richmond is now an active place, and you can feel it. You can see it. There are always people walking, running, and biking down the streets,” says Lugbill. “We started organizing events when we took over the Richmond Marathon in 1998. In 2000, we created the Ukrop’s Monument Avenue 10k, which in 14 years has grown into the 3rd largest 10k in the country and the 7th largest 10k in the world with nearly 40,000 participants. It is our signature event, and it is Richmond’s celebration of physical activity. You see people of all shapes, sizes, ages, and income levels participating.”

During the past 21 years, Lugbill has locally contributed not only to health and wellness of Richmond natives but his organization has played a key role in boosting the region’s economy through sports tourism, by contributing a record-setting $61.6 million in economic impact in 2011 “Because Richmond doesn’t have major sports facilities, we’ve been able to create spectacular venues around some of Richmond’s best attributes – the James River, Monument Avenue, etc.,” explained Lugbill. “These events have put Richmond on the map as not only a destination with great events, but as a city that prides itself on what is happening here. Richmonders are jumping on the fitness bandwagon because this city makes fitness fun and enjoyable.”

His brainchild, Active RVA, is a region-wide initiative to motivate area residents, businesses and local governments to make physical fitness a priority. As a result, Richmond ranks as the “Best River Town Ever,” according to Outside Magazine.

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jennifer GRAY As President of the Richmond-based chapter of F.R.E.E., the Foundation for Rehabilitation Equipment and Endowment, Jennifer Gray devotes countless hours to fulfilling the organization’s mission of providing mobility-related equipment to patients who can’t afford it.

Jennifer was instrumental in starting F.R.E.E.’s Richmond chapter while she was still a student in the Occupational Therapy program at the Medical College of Virginia. In addition to her responsibilities at F.R.E.E., she is also an Occupational Therapist at Chippenham Medical Center.

She became interested in healthcare as an undergrad at James Madison University. “I thought I wanted to do athletic training because I’ve played sports my whole life,” she explains. But when she realized she didn’t have the passion for athletic training, a friend in the occupational therapy field suggested she give OT a try. After performing some volunteer work, she fell in love with the profession.

She counts F.R.E.E. as her greatest contribution to healthcare, having helped start the Richmond chapter when she was a graduate student by writing a grant with her professor that was instrumental in the chapter’s startup. “I’ve been very proud and passionate about F.R.E.E. over the years, which is why I’ve taken on a larger role than when I first started,” Jennifer explains. She also cites being an occupational therapist and working with patients and seeing them progress among her contributions and endeavors of which she’s most proud.

Jennifer feels that her efforts have had the greatest impact locally. “In the Richmond area, there’s a huge need for medical equipment from patients that either don’t have insurance or have no way to pay for anything out of pocket,” she explains.

“I feel like we have allowed more clients to live a better life.”

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Jeannette Cordor is the Founder and CEO of Faces of HOPE – Healthy Options for Personal Empowerment. The non-profit’s mission is to fight and prevent childhood obesity by helping children and their families lose weight and maintain healthy lifestyles.

That mission is accomplished through education, empowerment, and by providing the tools necessary for success.

Jeannette’s passion for quality of life led her to enter the healthcare field. “Obesity and poor nutrition and poor knowledge about what people are putting into their bodies became this drive for me because of where I came from,” Jeannette explains. Living in rural Mississippi, she saw firsthand the devastating results of poor nutrition choices and the impact it had on her family members health and lifespan.

“If you educate yourself, you can make sound decisions , you can make good choices about nutrition and therefore you can have good quality of life,” Jeannette explains.

jeanette CORDOR When asked what she believes is one of her greatest contributions to healthcare, she says it’s her no nonsense approach and being very realistic and not sugarcoating the facts. At the same time, she believes that she can connect and have credibility with others because of the real-life story she can share, and being able to tell people, “I’ve lived the life I’m telling you about.”

She’s most proud of having built The Faces of HOPE with her husband, Jeramin, into a solid staple in the Richmond community. And, because the organization was one of the first in-home obesity prevention programs, and championing childhood obesity prevention before the topic became popular, The Faces of HOPE made both local and national impact when it was propelled into the national spotlight as focus on the disease increased.

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HOMETOWN HEALTHCARE HEROES | our health

mindy CONKLIN Melinda (Mindy) Conklin, CEO of Designed Wellness discovered early on, as a peer counselor in high school, that she would dedicate her life to help others maintain physical, emotional and mental health. Now after working in a health and wellness field for nearly two decades, she says that spiritual health has also become a large part of her work.

Blessed with an innate ability to empathize with her clients, Conklin enjoys relating to and attentively listens to the stories behind each individual’s personal journey.

“Everyone’s journey involves specific challenges, pain, needs, and desires,” explained Conklin. “These challenges - physically, emotionally, and spiritually, create obstacles which block progress towards healthy transformations.”

screenings,” she said. “Proceeds benefit American Cancer Society and ‘Access Now’.

Conklin’s mission is to fight disease and increase the quality of life for each one of her clients. Her organization, Designed Wellness, is committed to ‘unlocking the healing power of the human body’. Through helping others she’s ultimately healed and improved the quality of her own life.

“After my husband passed I needed some time to grieve, process my life and regain some energy,” she explained.

“A co-worker said to me recently, ‘Welcome back’. That remark struck my heart and I thought, ‘Yeah, it’s nice to be back’.”

Conklin’s passion for disease prevention and weight reduction is the main focus of her organization, but she is instrumental in providing support and information that will empower clients to face challenges.

“Invariably in the end, we’ve prevented disease and clients have lost weight in the process,” she says.

One of Conklin’s achievements ironically came out of a tragedy situation following the passing of her husband, who battled colon cancer. After that, she took time to rewrite her journal, which became the book, Richly Exposed, which was published and released by Tate Publishing last month.

“I am not really ‘proud’ of the book, I just feel overly blessed with the response of the initial readers,” she explained. “It seems to be helping folks and I am incredibly humbled

by God’s work in my life.”

She feels that no matter what a person’s faith, spiritual wellness is critical for overall wellness.

Conklin continues to contribute locally by working with individuals and small groups. She recently launched a non-profit organization, Hitting Cancer Below the Belt, Inc., which promotes community events to raise awareness and funds for the benefactors of below-the-belt cancers.

“Our first event this year is the ‘Boxer Brief Battle’ 5K Run, which will raise colon cancer awareness and funds for colon cancer research, advocacy and www.ourhealthrichmond.com | 37

vigneshwar KASIRAJAN, MD Vigneshwar Kasirajan, MD, is a cardiothoracic surgeon, professor, and chairman of the Division of Cardiothoracic Surgery at Virginia Commonwealth University Medical Center (VCUMC) whose extensive training, experience, and expertise ranks him among the top cardiothoracic surgeons at medical centers in the US. His interests include the evolution of cardiac surgery, cardiac transplantation, and the impact of new innovations on the treatment of adult cardiac patients.

Dr. Kasirajan has considerable knowledge of mechanical circulatory support mechanisms, such as the CardioWest Total Artificial Heart and left ventricular assist devices. As principal investigator of a landmark clinical trial -- for which the VCU Pauley Heart Center is the leading site in the US -- he has tested the efficacy of the Freedom Driver, a smaller version of the driver currently used to run artificial hearts. The apparatus could allow patients to await heart transplants at home, rather than in the hospital.

The son of a cardiologist, Dr. Kasirajan grew up around discussion of the rapidly evolving field of cardiac surgery. He is now playing a significant role in the field’s ongoing progress.

“My contributions are not tremendous,” he humbly asserts, “but I think the biggest thing I have done is to help the growth of the field of surgery for heart failure, including the use of pumps to help patients with failing hearts. And that’s going to continue.”

Dr. Kasirajan is pleased with the substantial growth he has seen in the VCU cardiothoracic program since he first arrived 12 years ago, and appreciates the mutually supportive relationship the institution has built with the local community.

“The biggest thing for me is just being in Richmond, helping to build a cardiothoracic practice at VCU that’s nationally recognized,” he says, adding, “And I think we’re very proud of the fact that patients can come here and get the care that they would otherwise have had to travel to get.”

our health | HOMETOWN HEALTHCARE HEROES

Mandy Gatesman, Pharm.D, is an oncology pharmacist at VCU Massey Cancer Center (MCC) whose leadership through the recent global shortages of common chemotherapy drugs has distinguished her as a health care hero. Supplies are slowly returning, but for several years the cancer community faced a scarcity of chemotherapy drugs needed to treat a variety of cancers.

While stories of patients being denied treatment circulated throughout the country, Dr. Gatesman worked with MCC leaders to develop protocols to forestall disruption of patient care due to shortages.

In 2011, the New England Journal of Medicine published an editorial that Dr. Gatesman co-authored with Thomas J. Smith, M.D., of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, exploring the shortage’s broader implications.

But aside from rising to the challenge of a potential crisis, Dr. Gatesman provides exceptional service to patients on a daily basis.

mandy GATESMAN, PharmD “I think, for pharmacy in general, our greatest contribution is that day-to-day effective management of medications,” she explains. “Because, particularly in oncology, there are so many new medications that are coming out that have complicated interactions with other medications, with food, with different disease states.”

Counseling patients about what they can expect and how they should approach often complicated drug regimens helps put them at ease.

“That’s one of my favorite parts of the job,” she shares, “just trying to help them navigate through this scenario that they find themselves in.”

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And because cancer treatment relies so heavily upon medications, the expertise that Dr. Gatesman and her colleagues bring to MCC’s multidisciplinary team is of particular value.

Dr. Gatesman, who says she was always drawn to the dynamism of medicine, explains that pharmacy first appealed to her because of its flexibility and range of applications.

“And once I got into pharmacy,” she notes, “I realized the impact that a pharmacist could have on the medical team and on the patients.”

HOMETOWN HEALTHCARE HEROES | our health

susan KEEN

Susan Keen is a Thoracic Nurse Navigator at the Thomas Johns Cancer Hospital at Johnston-Willis Hospital, helping newly diagnosed cancer patients navigate the different aspects of their treatment. Her commitment to patients and the community is evident in her efforts to facilitate a support group for cancer survivors; in the professional role she plays in leading patients through cancer treatment, support and recovery; and in her commitment to the Free to Breathe event that creates public awareness about lung cancer.

National Coalition of Nurse Navigators, makes an impact locally and nationally.

“I really feel like what I do is an honor – to be able to work with these patients and their families, I feel it’s my calling.”

Her healthcare career began because she was interested in becoming either a teacher or a nurse, and felt that being a nurse would be a better fit for her schedule, which includes four children. “I could still be a mom, but wanted to do something that serves other people,” Susan explains. “I love what I do. I love working with cancer pates – it helps keep me grounded on what’s important.”

Susan points her involvement with the Free to Breathe Richmond 5k walk and run as being one of her greatest contributions to healthcare. The event has raised over $140,000 for cancer research over the last three years.

As for what she’s most proud of, Susan says that while she doesn’t like the word “proud,” she does like the idea that she can help patients.

Susan says she’s spoken nationally and authored articles about the nurse navigator role and that this hard work, in addition to her contributions to the

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our health | HOMETOWN HEALTHCARE HEROES

For every door that closes a window opens. This age old insight refers to the belief that with each loss we endure in life, we will not let it smother our strength and courage to move forward and make a difference.

Heather Lineberry knows all too well the importance of this belief. Throughout her youth, she lost many close family members to cancer. Her grandmother. Her grandfather. Two of her great aunts. And her uncle.

“I watched people I loved fight for their lives,” explains Heather. “My only wish was to be able to help them.”

Heather has always had a caring nature about her. One of her earliest childhood memories was applying cocoa butter to her grandmother’s incisions following open heart surgery.

“I always wanted to be nurse,” she explains.

That dream became a reality in May 1998 when she received her nursing degree and began working in oncology at Carilion Clinic {in Roanoke, VA] helping others in their fight against cancer, including her uncle.

“In my first year as a nurse, my uncle relapsed and periodically was admitted to my floor,” explains Heather. “I worked nights so I would check on him during the night and eat breakfast with him before I left.”

Heather says having cancer hit so close to home so many times has given her added perspective when it comes to patient care.

heather

“For me, what’s most important is the patient. To be their teacher. Their confidant. Their cheerleader.

To treat every patient like family.”

For the last decade, Heather has been with Virginia Cancer Institute (VCI) in Richmond. As clinical director, she has been working toward developing quality

LINEBERRY, RN, OCN measures to improve cancer patient care. She says she learns something everyday in her field through new discoveries, processes and treatments. In 2001, VCI obtained QOPI certification status and became the only oncology practice in Central Virginia to achieve this designation.

“We continue to maintain these standards every year and set new ones to improve the care we delivery to the community,” Heather concludes. “Every one of us at VCI is committed to doing all we can in hopes that we can bring an end to this terrible disease some day.”

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HOMETOWN HEALTHCARE HEROES | our health

kelly KOOGLER Kelly Koogler pays it forward. The movie of the same name, in which the recipient of a good deed returns the favor by doing a good deed for three other people, is “awesome,” in her opinion.

“I try to do that all the time,” Kelly explains. “I always keep that in the back of my mind, whether it’s somebody I see out on the street needing assistance getting their car or they drop something – I was raised like that to give back and try to help people.”

As the office manager for OrthoVirginia, Kelly’s concern for others is well-known among co-workers. Kelly’s efforts include arranging to help community blood drives, food bank drives and Coats for Kids collections, and she is instrumental in organizing OrthoVirginia’s six offices’ fundraising activities for Massey Cancer Center. All of these service projects are planned outside of Kelly’s responsibilities as office manager.

Kelly’s interest in healthcare came at an early age. As a teen, she volunteered as a candy striper at Chippenham Hospital, and later as a member of the Chester Women’s Club, she helped care for and comfort babies born addicted to drugs.

Helping, caring, and giving back are what Kelly views as her greatest contributions to healthcare. “It’s a way to help and touch people here and help them medically but also to give back to the people who are less fortunate than we are,” Kelly explains.

She’s most proud of OrthoVirginia’s employees and working for the practice. “I have 37 employees under me and I have the best group of people that are so willing to give. I think we have a great practice and great leaders here.”

Locally, Kelly thinks the practice makes a huge impact as do the food, blood and clothing drives.

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Susan Uhle is a nurse practitioner at Richmond Surgical and works with patients with breast cancer and benign breast disease. She’s been described as a leader in her field, and one who works tirelessly with breast cancer patients and survivors in both body and spirit, in conjunction with the practice’s physicians to provide pre- and postoperative care, as well as family and genetic counseling. Her commitment to patients goes beyond the normal work day, however, as she uses her personal time to implement and host a monthly, evening meeting for breast cancer patients and survivors to help them through the disease’s process and its aftermath.

Her interest in healthcare was sparked at a very early age by another nurse practitioner whom Susan describes as very accessible and approachable. “She did a lot of teaching, talking about the dangers of cigarettes and drugs and alcohol but in such a way that I was able to accept it.”

susan UHLE, NP When asked what she views as her greatest contribution to healthcare, Susan is modest, preferring instead to focus on the patients she helps. “I’ve had the opportunity to be available to women during a very difficult time in their lives. My job has been set up so I’d have time for teaching and support.” At the same time, Susan says she’s proud to have that opportunity to work with women intimately, viewing it as a privilege to accompany them for at least a part of their journey.

And while she’s unsure if her efforts have had a national impact, she’s hopeful that she’s made a difference. “My hope is that there have been moments that I’ve met with patients that made a difference for them in terms of comfort and knowledge.”

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HOMETOWN HEALTHCARE HEROES | our health

jeff CRIBBS Jeff Cribbs, CEO of the Richmond Memorial Health Foundation (RMHF), is curious too.

In 2007, after reviewing applications for grant money from organizations providing services to the elderly, he wondered, how are the baby boomers going to affect Virginia?

Has anyone studied the impact of the state’s changing demographics? Are Virginia communities prepared for an aging population?

“I do think if we can get relevant, timely information to communities and then have communities identify who the right leaders are…the information that is gleaned out of the ODP can have a positive influence on community engagement and community planning,” says Cribbs.

Cribbs’s curiosity spawned a movement. One he believes will help Virginia greet the “silver tsunami” with optimism, not trepidation.

Cribbs discovered that the last statewide study on the implications of an aging community was completed in 1979.

With Virginia’s senior population projected to double between now and 2030 (swelling to 1.8 million, almost 20 percent of Virginia’s total projected population), Cribbs worried, “If we don’t take time to think about the changing demographics, they could overwhelm us.”

Cribbs and the RMHF launched a preliminary study and quickly found “that the issue was larger than we are.”

To address the enormity of the problem, a new non-profit organization was established, the Older Dominion Partnership (ODP).

A coalition of business, government, non-profit, philanthropic and academic leaders, the ODP is spearheading the state’s first survey of older adults in over 30 years. Across the state, 5,000 Virginians over the age of 50 are giving their opinions on the topics of finance, health and well-being, housing, transportation, caregiving, employment and civic and community involvement. The survey results, due in November, will highlight the attitudes and preferences of Virginia’s maturing population.

Armed with this information, the ODP hopes to work with local leaders across the Commonwealth to get their communities ready.

Cribbs acknowledges that while the ODP can emphasize what boomers like, it’s up to individual communities to determine what solutions are best given their local culture. www.ourhealthrichmond.com | 45

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HealthyEats M ME

Y GRILLING A D L ORIA

Grass Fed Beef on the Grill: Ingredients:

1-2 tablespoons coarse sea salt 1-2 teaspoons ground black pepper 1-2 cloves garlic, minced 1

16 ounce tenderloin (filet mignon) steak at least 1 ¼ - 1 ½ inches thick.

Note: The amount of seasoning you will use depends on the size of your steak. If it is close to one pound, use less. If it is closer to two pounds, use more.

2. Start the grill, and allow it to get hot. If you’re using a gas grill, turn off all but one of the burners after it has gotten up to temperature. If you’re using charcoal, rake all the coals to one side. When you can’t hold your hand three to four inches above the metal for more than three seconds, you know the temperature is hot enough.

4. Sear the steaks for two to three minutes on each side directly over the flame, with the lid down. Then, move the steaks to the part of the grill that’s not lit. Set the lid in place and allow the steaks to cook, without flipping them, until they reach 120-135 degrees, about ten to twenty minutes, depending on the size of the steak.

3. Cut a sixteen ounce steak into four different steaks.

5. Remove the steaks to a platter, and allow them to rest a few minutes before serving.

Directions:

1. Combine the salt, pepper, and garlic in a small bowl. Rub the mixture into both sides of the steak, and then allow the meat to come to room temperature while you prepare the grill.

Tricia Foley’s

GRILLED STEAK Tricia Foley is Our Health Magazine’s resident nutritionist.

HealthyEats M ME

Y GRILLING A D L ORIA

Vegetable Medley: Makes 4 servings

Ingredients:

2 red bell peppers, seeded and halved 2 yellow squash, sliced lengthwise into 1/2-inch-thick rectangles 2 zucchini (about 12 ounces total), sliced lengthwise into 1/2-inch-thick rectangles 1 bunch (1-pound) asparagus, trimmed 10 green onions, roots cut off 3 tablespoons olive oil, plus 2 additional tablespoons

Salt and freshly ground black pepper

3 tablespoons balsamic vinegar 2 garlic cloves, minced 1 teaspoon chopped fresh basil leaves 1/2 teaspoon finely chopped fresh rosemary

Directions:

1. Place a grill pan over medium-high heat or prepare the barbecue (medium-high heat).

2. Brush the vegetables with three tablespoons of the oil to coat lightly.

Sprinkle the vegetables with salt and pepper.

3. Working in batches, grill the vegetables until tender and lightly charred all over – about eight to ten minutes for the bell peppers, seven minutes for the yellow squash and zucchini, four minutes for the asparagus and green onions.

4. Arrange the vegetables on a platter. The key to getting those great grill marks is to not shift the vegetables too frequently once they’ve been placed on the hot grill.

5. Whisk the remaining two tablespoons of oil, balsamic vinegar, garlic, basil, and rosemary in a small bowl to blend.

6. Add salt and pepper to taste. Drizzle the herb mixture over the vegetables.

7. Serve the vegetables, warm or at room temperature.

Tricia Foley’s

SUMMER VEGGIES Tricia Foley is Our Health Magazine’s resident nutritionist.

HealthyEats M ME

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Grilled Peaches: Makes 4 servings

Ingredients:

1/4 stick unsalted organic (grass-fed) butter, at room temperature 1 teaspoon cinnamon 2 tablespoons Stevia

Pinch salt

4 ripe peaches, halved and pitted

Mint leaves, for garnish

Directions:

1. In a small bowl, add the butter and stir until smooth. Add the cinnamon, Stevia, and salt and mix until combined.

2. Heat grill to high. Brush peaches with butter and grill until golden brown and just cooked through. Garnish with mint leaves.

Tricia Foley’s

FRUIT ON THE GRILL Tricia Foley is Our Health Magazine’s resident nutritionist.

NO

there is health without

MENTAL HEALTH words | EDWIN SCHWARTZ

May is mental health month. And for more than 60 years, groups like Mental Health America (MHA) and its affiliates have observed it through media outreach, local events, and screenings. This year’s theme is Pathways to Wellness.

Pathways to Wellness focuses on approaches to help all

Americans achieve good mental and overall health. MHA defines wellness as more than an absence of disease, as it involves the complete mental and social well being needed to live a full and productive life.

According to Sultan Lakhani, MD, MPH, of Bon Secours Behavioral Health Group, the most common mental health condition of all ages is generalized anxiety disorder (GAD).

GAD is a pattern of constant worry and anxiety over a range of life issues. Genes may play a role, while stress may also contribute to its development. Anyone at any age can develop this disorder, and most say they have been anxious for as long as they can remember.

The primary symptom of GAD is the constant feeling of worry or tension, even when there is no identifiable cause.

Worries can jump from family or relationship problems to work, money and health issues. People with GAD often have difficulty controlling their worries even when they know these feelings are unnecessarily strong.

our health | BEHAVIORAL HEALTH

Other symptoms include difficulty concentrating, irritability, fatigue, problems falling or staying asleep, restlessness and being startled easily. Physical symptoms may also be present and include muscle tension and stomach problems. Most patients respond well to two types of treatment, psychotherapy (also called talk therapy) and medication, which can be administered alone or in combination.

Dr. Lakhani says the second most common mental health condition is depression. More than 20 million people in the United States have this serious medical disorder. It is more than feeling “down” or “blue” for a few days as the feelings do not go away and interfere with the entire spectrum of everyday life. Symptoms of depression can include sadness, weight change, difficulty sleeping or oversleeping, loss of interest in previously enjoyed activities, lack of energy, feelings of worthlessness and suicidal thoughts.

Depression is a brain disorder and has a variety of causes. These include genetic, psychological, environmental and biochemical factors. Depression usually begins between the ages of 15 and 30 and is much more common in women. Women may also get postpartum depression after giving birth. Some people suffer from seasonal affective disorder in the winter. And for others, depression can be a part of bipolar disorder. Effective treatments for depression do exist as most patients do best by using a combination of antidepressants and talk therapy.

“Serious mental illnesses cut across any culture,” says Dr. 52 | www.ourhealthrichmond.com

BEHAVIORAL HEALTH | our health

Lakhani. “Conditions like schizophrenia and bipolar disorder, known as manicdepressive illness, are common to all societies.”

Schizophrenia is a lifelong brain disorder in which patients may hear voices, see things that do not exist or believe others are controlling their minds.

Symptoms include hallucinations and delusions such as hearing voices. Other symptoms include having unusual thoughts, difficulty speaking, movement disorders and problems with attention, organization, and memory.

The causes of schizophrenia are unknown, but genetic makeup and brain chemistry are believed to play a role. Medicines may require several trials to relieve symptoms, but with treatment many people are able to lead satisfying lives.

Another serious mental illness common to all societies is bipolar disorder. Patients experience unusual mood changes as they go from being very happy and active to very sad and inactive. They then start over again, often with normal moods in between. The up feeling is called mania, while the down feeling is depression.

The causes of bipolar disorder are not clear. It may be genetic, and abnormal brain structure may also play a role.

Bipolar disorder often begins in the late teens or early adult years. Children and adults can develop it, and the illness typically lasts a lifetime. If untreated, the disorder can cause poor job or school performance, damaged relationships, and even suicide. A combination of medicine and talk therapy has proven to be an effective treatment.

According to Dr. Lakhani, there are no significant advancements in the

words | EDWIN SCHWARTZ

Too Many Suffer In Silence Most people who are dealing with a child’s mental health issue are not talking about it. And common fundraising efforts, like bake sales, do not exist for families with children who suffer from mental illness.

“The unfortunate reality is that there is precious little support and too few solutions,” says Anne Moss Rogers, Creative Director and Owner of Impression Marketing.

“Parents have to figure their way through the mental health maze and it’s very, very difficult – like being dropped in a desert with no compass.”

“Parents don’t know where to turn. In healthcare, if you have cancer, they have a tumor board where all the medical professionals meet and discuss patient cases to establish a treatment plan,” says Rogers. “But in the mental health field there is no equivalent to a treatment planning board.”

“Most of those dealing with the mental health problem of a child suffer in silence due to humiliation and judgment by others and by ourselves,” Rogers notes. “Parents feel they have failed at the most important job of their lives, which is devastating.”

Insurance coverage for mental health, rehabilitation, and drug abuse lacks considerably when compared to other parts of healthcare. “Many cannot get help because they cannot afford it or don’t even know where to find it,” she explains. “And treating people when they are young helps give them the tools to make the most of their lives.”

The most traditional resource for cost minimization is medical insurance. But uninsured families do have options. “They can negotiate their charges ahead of time.

Insurance companies do it,” says Rogers. “And offices are willing to do this most of the time, so I’d encourage parents to negotiate. Remember that healthcare practices don’t get insurance money right away. But if you pay on the spot, that’s an advantage.”

“If you have to go beyond what’s available locally, we are all uninsured when it comes to mental health,” Rogers continues. “This is where we really fall short as a society.

It’s hard enough for those with the means to get loans for treatment to turn a life around. Insurance doesn’t cover long-term treatment options.”

For adults, the paradox is that those who need drug treatment the most typically do not have insurance. But there are options for those who cannot afford to pay for rehabilitation out of pocket. The first is to attend a state funded drug treatment center provided by the Virginia Department of Behavioral Health and Developmental Services (http://www.dbhds.virginia.gov/). Another option is a charitable drug rehabilitation facility like the Salvation Army. Many drug treatment facilities offer scholarships or hardship opportunities.

At the federal level, the Health Resources and Services Administration (HRSA) health centers provide mental health and substance abuse care to those without health insurance. You pay what you can afford, based on your income (http:// findahealthcenter.hrsa.gov).

For children with mental illness, it helps to have the child in an environment where professionals can observe them on a longer-term basis. “Most programs are a week to 30 days and that is just not much time,” says Rogers. “If they are abusing drugs, this

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diagnosis of mental health conditions. “Diagnosis is usually a clinically based, clinical interview where we use the same criteria as before,” he says. “We sit down with patients and talk with them. We don’t perform brain image scans or conduct blood tests.”

“With treatment, however, there are definite advances taking place,” Dr. Lakhani continues, “as there are new medicines and procedures.”

He adds, “Transcranial magnetic stimulation (TMS) is new. And deep brain stimulation (DBS) is now being used to treat Parkinson’s disease.” TMS is a non-invasive, no-drug treatment where pulsed magnetic fields stimulate the part of the brain believed to regulate mood. DBS therapy uses a device similar to a pacemaker that generates mild pulses of current to regulate specific areas of the brain.

Just as serious mental illnesses are common to all cultures, the stigma associated with them cuts across all societies as well. Combating these preconceived notions is a national as well as global undertaking. Dr. Lakhani says, “It is a teaching process that goes on through state and federal organizations. Their mission is one of education.” He cites the National Institute of Mental Health, the American Psychiatric Association and the National Alliance on Mental Illness as excellent teaching resources.

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BEHAVIORAL HEALTH | our health

Dr. Lakhani also recommends Medlineplus.org as an education source for people new to the field of mental health conditions. MedlinePlus is the National Institute of Health’s website whose mission is to present information about diseases, current medical research, new drug treatments, and wellness issues in easily understandable language.

Serious mental illnesses such as schizophrenia or bipolar disorder rarely appear without any signs. Usually family members, friends or the individuals themselves recognize something aberrant about their behavior, thinking or feelings. The recognition of early warning signs can lead to intervention that can help reduce the severity of an illness. It is also possible to delay or prevent a major mental condition from developing.

can often interfere with prescribed medications. And it’s often hard to see what is a real issue versus one caused by an illegal drug.”

Therapeutic Boarding Schools (TBS) are institutions designed for troubled teenagers that combine the academics and traditions of regular boarding schools with intense therapeutic interventions. The average stay is usually a full school year, and scientific outcome studies indicate that most students maintain or continue to improve on a long-term basis after they leave.

“Before going the TBS route, I’d recommend families seek the counsel of an educational consultant,” Rogers notes. “These schools are so expensive; you want to make sure you choose one that suits the needs of your child.”

Second Nature’s wilderness therapy program is another option. In this program, young people are placed in a remote setting where they learn from consequences to their actions. “It is a back to basics approach. Like in the army, they tear you down to build you back up,” says Rogers.

She adds, “Wilderness programs do a really good job of diagnosis and initial treatment, particularly with kids who have mental health or behavioral problems as well as drug abuse problems. They isolate the child from outside stimuli and influences and take them back to the most basic level of survival.”

“The key for any program’s success is follow-up. Once they come home from a treatment facility, there needs to be a transition plan,” Rogers explains. “It’s a process and it often requires multiple steps, follow up, relapse, and failures.”

“Most people are treated and diagnosed by primary care physicians,” says Dr. Lakhani. “If they can’t handle the patient’s condition, they defer it to specialists. That’s the reality. Most people won’t go to a psychiatrist first.”

“I recommend parents confide in good friends, refrain from self-blame, and find a support group for your own serenity,” says Rogers. “The best treatment typically includes more than just medication in the form of additional counseling or a support group.”

Dr. Lakhani says there are three typical options for finding treatment. First, every county and city has a community services board (CSB) where people can ask for help. CSBs serve as the point of entry to the publicly funded system of services for mental health, substance abuse and intellectual disability.

Second, those with insurance can go see a primary physician. And third, people can learn about mental health providers through insurance companies.

Both Families Anonymous (http://familiesanonymous.org) and Al-Anon (http://alanon.alateen.org) are free support groups with local chapters for families concerned with the illness of addiction and other mental health issues.

For those who would like to help raise awareness of children’s mental health issues, 1in5kids.org is a Richmond-based advocacy group. The following are some local options for those seeking help for a behavioral health condition.

Beacon Tree Foundation (www.BeaconTree.org) is another local organization that is organizing a support group for families with kids with mental health problems. The foundation is based in Richmond and focuses on advocacy for children and teens with mental health issues such as depression, anxiety, the illness of addiction, bipolar, eating disorders, and more. It also helps young people with college scholarships and assists parents financially with TBS. Part of Beacon Tree’s mission is to build a local, long-term mental health facility.

Acute care resources include Tucker Pavilion at CJW Medical Center, St. Joseph’s Villa Crisis Stabilization Unit, and emergency room (ER) units. For private drug treatment, The Coleman Institute (www.thecolemaninstitute.com) has a local facility.

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our health | BEHAVIORAL HEALTH

and economic prospects,” says Dr. Lakhani. “Also, their relationships, social activities and day-to-day functions are impacted. All of it is jeopardized if you’re depressed all the time.”

Dr. Lakhani adds, “Mental health issues become a mental health disorder only when people are not functioning. Just like with physical sickness, nobody will go for treatment if they feel they are functioning. The same holds true in mental health. If the condition becomes a hindrance, that’s when people typically go to see a doctor.”

Dr. Lakhani believes the World Health Organization’s (WHO) slogan, “There is no health without mental health,” speaks volumes. While groups like MHA focus on mental health in America, the WHO also takes on a global role in mental health advocacy.

Every year on the 10th of October, the WHO helps recognize World Mental Health Day. The day is celebrated at the initiative of the World Federation of Mental Health, and the theme of the day in 2013 is Mental Health And Older Adults.

Sultan Lakhani, MD, MPH provides an array of mental health services on behalf of the Bon Secours Medical Group.

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Ann Moss Rogers is a board member for Beacon Tree Foundation. Beacon Tree is a non-profit that serves as advocates for children’s mental health.

SCIENCE OF SLEEP | our health

Some New Facts About words | EDWIN SCHWARTZ

Healthy Sleep

Sleep health is a hot topic these days.

It seems as soon as you get out of bed, you hear somewhere that Americans aren’t getting enough sleep. Or worse, how so many of us have a sleep disorder and don’t know it.

It’s no surprise that people require different amounts of rest according to their age. What is surprising is that there is no difference between the amount of sleep required by both young and senior adults. For this entire range, 7-8 hours is appropriate.

According to David Leszczyszyn, MD, PhD, Medical Director for the VCU Center for Sleep Medicine, there are both genetic short sleepers and long sleepers. “To say everybody needs eight hours is too broad a statement,” says Dr. Leszczyszyn. “If you can, it would be good. But for many of us, seven hours would easily be sufficient.”

“Getting less than six hours of sleep can put one at risk of having problems with sleep deprivation,” says Gerard Santos, MD, of Bon Secours Sleep Disorders Centers. “Not getting six hours in one night is equal to being sleep deprived for two days.”

One of the three most widely believed misconceptions is that we need less sleep when we get older. “As we age, our quality of sleep changes. We become less good at getting sleep,” explains Dr. Leszczyszyn.

This false belief can endanger older people as they push themselves beyond their safety limits.

A sleep technologist attaches various sensors to a patient in preparation for his undergoing an overnight sleep study.

Many people have a problem with the timing of their sleep. “They can be sleep deprived but actually get enough hours of sleep,” says Santos. “When we break up our sleep into different times of day we don’t get the best kind of sleep.”

Santos adds, “Time zones have different optimum sleep periods. The best time to sleep in Eastern Standard Time is from 10 pm to 6 am. Any deviation from that is not optimum sleep.” www.ourhealthrichmond.com | 57

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A Bon Secours Sleep Disorders Centers sleep technician monitors a varity of body functions during sleep, including breathing patterns and oxygen levels in the blood, heart rythems, and limb movement.

“Someone who sleeps a total of eight hours, four in an afternoon nap and four at night, gets less quality sleep than someone who sleeps six hours, all at night,” says Santos.

Maintaining healthy sleep levels is important, because sleep deprivation can weaken our immune systems. “Chronic sleep deprivation leads to chronic stress within the body,” says Dr. Leszczyszyn. “Bodies under chronic stress are less efficient at getting rid of foreign agents like bacteria, fungus, cancer, or tumors that circulate in the immune system.”

Conversely, there is such a thing as getting too much sleep. “Some people can sleep beyond their normal amount and experience fatigue and a sleep drunkenness,” he says. “But this is only true for those who are fairly sensitive and is not universal to everyone.”

Despite what you may hear, sleep apnea is not the most common sleep disorder. The most common is insomnia. “When we look at prevalence, based on the number of people who likely have it, the number two sleep disorder is shift work sleep disorder,” says Dr. Leszczyszyn. “Perhaps we hear so much about sleep apnea (which places third) because it has a more clear and alert set of symptoms.

Also, sleep apnea can cause other health risks like diabetes, stroke, and hypertension.”

“A landmark study is the Sleep Heart Health Study,” says Santos, “where data collected for ten years revealed a relationship between sleep health and cardiovascular health.”

Santos adds, “We are a sleep deprived country. Not only is sleep apnea prevalent but it also affects other disease processes. What makes sleep apnea so insidious is most times people have no idea they have it.”

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SCIENCE OF SLEEP | our health

awakenings accompanied by a gasping sensation or shortness of breath, awakening with dry mouth or sore throat, morning headache, difficulty staying asleep, and attention problems during the day.

The most common prescribed treatment for sleep apnea is the continuous positive airway pressure (CPAP) machine. Obstructive sleep apnea (OSA) occurs when throat muscles relax, and the airway becomes partially or completely blocked multiple times during sleep. CPAP machines are designed to keep the airway open so you stay in a deeper level of sleep and get more rest. To get the required prescription for a CPAP unit, patients must have an overnight sleep test in which they wear a multitude of diagnostic sleep sensors.

According to Judy Moss of Health Management Services, Inc., which specializes in the treatment of sleep disorders, finding the right mask is the most important issue with CPAP units. “There are as many types of masks as there are faces,” notes Moss.

Dentists are also now playing a role in the treatment of OSA. According to Erika Mason, DDS, there is a correlation between teeth grinding and sleep apnea. Teeth grinding can occur as patients move their jaw to open the airway. Dr. Mason explains that patients who are claustrophobic or have a latex allergy may not do well with a CPAP machine.

“There are oral appliances that many physicians don’t realize really do work,” she says. “This is because the dentists who make them have picked a snoring appliance instead of a true mandibular anterior device where the mandible is brought forward to open the airway.”

A common symptom of sleep apnea is snoring. But it is actually more of a nuisance than a definitive sign of serious sleep apnea. “While most sleep apnea patients snore, many of them have mild sleep apnea,” explains Dr. Leszczyszyn. The truth is only two to four percent of adults have moderate or severe sleep apnea.”

“Snoring may cause a moderate to severe case to be recognized. If left untreated, there is an increased chance of medical complications,” says Dr. Leszczyszyn. “But there is not much data that says mild sleep apnea is linked to stroke, diabetes, heart disease or mood disorders.”

The second biggest misconception about sleep has to do with going to bed. “People focus too much on keeping a specific bedtime. The most effective way to fall asleep regularly is to keep a stable wake-up time,” notes Dr. Leszczyszyn. “The time we wake starts our internal clock. We need to be awake 1416 hours to be ready to fall asleep at night.”

“If you feel tired at the beginning of the week, chances are you’re sleeping late on weekends,” Dr. Leszczyszyn says. “If you wake at 9 a.m. on www.ourhealthrichmond.com | 59

Sunday, this means you may not be ready to sleep until 1 a.m.

So your Monday morning starts very poorly as you begin your week on a bad foot. The way to prevent it is to not sleep late on weekends.”

The third biggest misconception about sleep health is to remain in bed when you cannot fall asleep. “You should not try to force yourself to go to sleep by lying in bed,” says Dr. Leszczyszyn. “If you’re trying to fall asleep for more than 30 minutes, you’re not ready to sleep. You should get up, do a quiet, non-stimulating activity (something you enjoy and can easily put down) for one hour and go back to bed when you feel ready to sleep.”

But perhaps the most surprising fact regarding sleep lies at the head of your bed. “The easiest way to ruin someone’s night is to take their pillow away,” Dr. Leszczyszyn says, “but pillows are clearly a creature comfort we associate with sleep. Actually, we don’t need them at all.”

Erika Mason, DDS specializes in sleep dentistry at Sleep Better Virginia in Midlothian. www. sleepbetterva.com

David Leszczyszyn, MD, PhD is the Medical Director for the VCU Center for Sleep Medicine.

Gerard Santos, MD is board-certified in sleep medicine and internal medicine and serves a medical director of Bon Secours Sleep Disorders Centers.

PEDIATRIC ER | our health

Staff at the new Pediatric Emergency Department (ED), St. Mary’s Hospital, provide fun distractions to make an ER experience the best it can be.

St. Mary’s New Bigger, Better Pediatric Emergency Department words | AINE NORRIS

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Emergency rooms aren’t likely to become popular destinations for visitors of any age. But with the debut of its bigger and better Pediatric Emergency Department (ED), St. Mary’s Hospital is offering little patients and their families a far less daunting experience.

Katie Goodman, whose two children have been treated at the new facility on separate occasions, is a very satisfied repeat customer.

“You just get this really warm feeling when you walk in,” says Goodman, adding, “It didn’t even smell like a hospital. It had this nice, welcoming smell.”

Part of a $12 million makeover and expansion of the hospital’s emergency departments, the revamped Pediatric ED, which opened on September 5, was designed and staffed to provide children with warm, efficient, exceptional care.

“I’ve just never been greeted by such happy, chirpy, charming people, who you can tell are there because they have a passion for what they’re doing,” says Goodman.

The staff, which includes nurses and physicians trained in pediatric emergency care as well as a child life specialist, is equipped to administer treatment with limited stress and discomfort. www.ourhealthrichmond.com | 61

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The waiting area in the Pediatric ED strives to create a comfortabale and relaxed atmosphere for both children and care givers.

“Our staff is made up of more specialists in pediatric emergency medicine than all other facilities in central Virginia combined,” notes William Lennarz, MD, Chief Medical Officer of Pediatrics and Vice- President of Children’s Services with the Bon Secours Virginia Health System.

The employment of J-tips allows for painless insertion of IV tubes, while the skillful use of comfort holds and various diversions help minimize the anxiety children may experience while undergoing potentially unpleasant procedures.

Goodman, whose son Konner was treated for an ear infection at the Pediatric ED, describes one such diversion technique that proved effective. In order to keep her 21-month old blissfully distracted while he had his temperature taken rectally, not one, but two nurses blew bubbles for his amusement.

“And it’s not just a couple of bubbles,” she remarks. “They blow bubbles for you.”

Thoughtful touches and amenities make every step of the visit less taxing for both parent and child.

From the moment she first arrived, Goodman says she appreciated the fact that the Pediatric ED’s entrance and waiting areas are separate from those of the general ED.

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“It provides a lot of comfort, knowing kids aren’t exposed to a busy waiting room full of people with germs,” she notes.

The hospital took care to provide pediatric visitors with this special access, isolating them from potentially upsetting sights and from the comings and goings of ambulances.

Upon entry to the reception area, visitors find themselves in a light, open space furnished with pint-sized tables and chairs. Colorful butterflies grace an illuminated, interactive wall.

But as inviting as the waiting room is, Goodman was most impressed by the fact that she didn’t have to spend any time there. She was helped immediately.

Katie Goodman with her children, Kaylee, 9 months (left) and Konner, 21 months (right).

“All three times that I’ve been there, I’ve never had to wait, which is a big deal,” she recalls, pointing out that she was able to register once she and her children were settled in a treatment room. “They’ve literally taken the stress out of going to a doctor’s office because they’re so quick.”

The path to the 14 private treatment rooms, decorated with color-coded footprints for easy navigation, is lined with vibrant toy wagons.

“It’s like practicing medicine in a pre-school,” Dr. Lennarz remarks.

The whimsical décor and availability of familiar playthings, says Goodman, “make the kids feel right at home. Kids see them, and they immediately have a calming effect because they can connect with these items.”

Strategically placed shutters hide cords and other potentially hazardous equipment in the exam rooms, while the trauma room comfortably accommodates not only such key apparatuses as the X-ray machine, but also loved ones whose presence is reassuring to the little patients.

“Plenty of literature supports family members at the bedside,” explains Dr. Lennarz.

Attentive to the needs of the families, as well as the patients, the staff makes a point of alleviating their fears and keeping them engaged in the process.

“Every time I’ve been there, it doesn’t matter who the doctor is or who the nurse is, they’ve all found a way to connect with me personally,” says Goodman.

“The nurses were so nice and very attentive to our needs, as well as the baby. They knew we were stressed, or we wouldn’t have been there,” agrees

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PEDIATRIC ER | our health

Goodman’s mother, Sharon Isbell, who accompanied her daughter on a couple of her visits to the Pediatric ED. Even grownups, after all, can use some motherly support under such circumstances.

“They had a lot of empathy and patience with me, because I was nervous,” says Isbell, who also has a nursing background.

When Goodman and Isbell brought nine-month old Kaylee to the Pediatric ED, they were grateful for the staff’s prompt and thorough response to their worries about her persistent coughing and wheezing. They learned during that visit that what they had been treating as a cold was in fact pneumonia.

Sharing her fears with health care professionals who really listened, Goodman points out, gave her confidence that Kaylee’s care was in good hands.

“I just loved the way they took me seriously and they took my daughter’s medical concerns seriously.”

William Lennarz, MD, chief medical Officer of Pediatrics and vice president of Children’s Services, Bon Secours Virginia Health System.

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PHARMACY | our health

what is a

COMPOUNDING PHARMACY? words | SARAH COX

Medications can be customized in many ways to meet the unique needs of a specific patient. Compounding pharmacies solve patient medication problems by using the highest grade of ingredients to formulate medications in the optimal strength and dosage form, customized for each patient. A compounding laboratory contains equipment that is not found in most pharmacies, enabling the pharmacist to precisely compound each medication to the prescriber’s exact specifications. Compounding pharmacists consider the physical and chemical properties of both active and inactive ingredients in order to prepare customized medications with the proper consistency, stability, texture, color, and taste, optimizing the therapeutic benefit of each preparation.

How long have compounding pharmacies been in existence?

Baylor Rice, RPh, FIACP is owner and one of several compounding pharmacists at South River Compounding Pharmacy located in Midlothian and the West End.

Compounding has been traced all the way back to ancient civilizations. Before the ability to mass produce and distribute medications in the mid-1900s, compounding was a routine practice for pharmacists. Now, in the years following the development of the pharmaceutical industry, compounding is a specialty practice. The demand for professional compounding has increased as healthcare professionals and patients realize that commercially available “one size fits all” medications do not always meet the needs of every patient.

Can you provide a couple examples of when a person may benefit from a compounded medication instead of a commercially available one?

If a patient is unable to take or has not responded to certain drugs, or experiences adverse effects from commercially available medications, a custom compound medication can meet the patient’s needs.

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Compounding professionals can provide additional therapeutic options by preparing needed medication in alternate dosage forms, such as a troche, suppository, or transdermal cream. When a patient has trouble swallowing, the drug can be formulated into a transdermal gel or cream that will facilitate drug absorption through the skin. Transdermal administration is a very helpful option that can avoid the cost and inconvenience of intravenous therapy or injections, and it is often used for patients who are nauseated or have chronic illness. Transdermal medications are often preferred by pets and their owners, as well.

Elixirs, syrups, and suspensions may contain preservatives such as alcohol, which can cause reactions or gastrointestinal irritation, or sugar, which makes the medication undesirable for some patients, such as diabetics and autistic children. Compounding specialists can prepare sugar-free and preservative-free dosage forms.

Additionally, if a patient is allergic to a dye or other excipient or has lactose or gluten intolerance, medications can be customized and compounded without the problem causing additives.

Compounding can also customize medications into a dosage form that contains the optimal dose of drug (based on age, weight, and disease state) that is needed to treat the problem, while limiting adverse effects. This can be very beneficial in pediatric and elderly patients.

How are compounding pharmacies regulated?

Compounding pharmacies are regulated by the state Board of Pharmacy in the same manner as all other retail pharmacies. National standards for compounding have also been created by the Pharmacy Compounding Accreditation Board (PCAB).

Does a compounding pharmacist require special or additional training?

Compounding pharmacists do have specialized training above and beyond what’s taught in pharmacy school. All pharmacists are required to have basic compounding skills in order to graduate and become licensed. However, the level of continuing education a pharmacist obtains and his or hers years of experience determine how specialized one becomes in the compounding pharmacy field.

It has been noted that some pharmaceutical manufacturers have stopped making certain medications for various reasons and that compound pharmacists help fill that void. Can you please provide more detail?

Drugs may be temporarily unavailable or pharmaceutical companies may stop making products while there is a limited demand. Many times, compounders can obtain the active ingredient as a bulk pharmaceutical grade powder which can then be used to compound a very similar preparation, or a modified formulation, that will better meet the needs of a specific patient.

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Can you explain how a physician and/or physician practice works together with a compounding pharmacy to customize medications for patients?

When deciding on a treatment protocol, prescribers do not need to be constrained by the limited selection of strengths and dosage forms that are commercially available.

Compounding pharmacists spend a lot of time working one-on-one with physicians in order to provide patients with exactly what they need to improve their health. This is referred to as “The Triad,” which consists of the patient, the physician, and the pharmacist all working together to maximize the patient’s well-being and quality of life. Physicians often develop specific formulations to meet the unique needs of their patient population or to acquire “tried and true” formulas during medical training.

What are some things a physician or physician practice should know before working with a specific compounding practice?

The practice of compounding customized medications is so wide-ranging that if a physician has a question about how to best fulfill their patient’s needs, he or she should simply contact a local compounding specialist. Physicians should keep in mind that compounding pharmacies are not legally allowed to make any medications that are commercially available, unless there is some need for customization as referenced above.

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&TRAVEL

Seniors

words | SARAH COX

When it comes to traveling, seniors are a bit different than the 20-year old backpacker thumbing his way through Europe. Considerations, therefore, should be given to health, finances, packing, and even clothing. John Goreczny, MD, with Chesterfield Family Medicine, says the very first order of business is to visit one’s personal physician a month before traveling for a thorough evaluation.

“It’s a good idea to have a checkup at this time to ensure that any medical problems are stable. We also know that certain immunizations require some time for maximum effectiveness,” he explains.

Stanley Furman, MD, geriatrician and Medical Director of Westport Convalescent Center and Glenburnie Rehabilitation and Convalescent Center, says that the majority of travelers are 50 years old and above, and they need to take precautions.

The first one should be to map out where the medical facilities are in the places they will be visiting. www.ourhealthrichmond.com | 71

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Since almost everyone has a smart phone these days, he suggests that it is easy to “punch in the directions.” This advice is especially helpful if one has medical problems.

Medications are also a consideration. As Dr. Furman explains, “Almost everyone is going to be on some type of drug to prevent something. Always put them in carry-on bags, and especially if you’re a little older, put them in pill boxes with date order, so when you get overseas and get confused [as to what day it is] you can pull out the right box.” He says there are boxes that are split into four parts to cover morning, lunchtime, afternoon, and evening medication times.

Dr. Goreczny suggests taking the medications’ original containers, bringing a list of medications, and taking enough plus a few extra doses for the entirety of the trip. If one loses one’s medications, he says, be aware that “there is an increased possibility of counterfeit medications abroad. Always get medications from a reputable source.”

Dr. Furman points out the fact that there are certain medications that may be illegal in other countries that have been prescribed to patients here – specifically, narcotics, amphetamines, and other controlled substances. If that’s the case, one should carry a letter from a physician explaining why one has those medications.

What happens if your medications are stolen? Email the list to yourself prior to traveling so that it’s on your smart phone and have your personal physician’s contact information. Take that information to the nearest medical facility.

If you get sick while traveling, there are several precautions to take. Dr. Furman suggests taking out short-term travel insurance since Medicare doesn’t cover anything outside of the United States. He says that sometimes the short-term policy will even fly you back to the states. Dr. Goreczny says to be prepared to pay for all medical needs overseas, but also check to see what is covered in your private health insurance policy.

Dr. Furman is in general opposed to anti-diarrheal medication such as Lomotil because if one has diarrhea, that means the poison in your system is coming out. “You do not want to stop the poison from coming out,” he says. But you can consider water-purification tablets that eliminate Giardia, bacteria, and viruses and remove sediment. Add these to a first-aid kit, which should contain different types of band aids, ibuprofen and naproxen (such as Tylenol and Aleve), an ace bandage that can be used as both a sling and a wrap, and antibiotic ointment. According to the Mayo Clinic, first aid supplies should also include adhesive tape, antiseptic solution, disposable latex gloves, gauze pads, tweezers, hand sanitizer, sterile eyewash, a thermometer, and over-the-counter hydrocortisone cream. Dr. Goreczny says to throw in sunscreen as well.

There are also pitfalls to avoid before even landing. One is to make sure you have comfortable shoes that you can slip back on, as one’s feet tend to swell on planes. Also, www.ourhealthrichmond.com | 73

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notes Dr. Furman, don’t decide to wear a brand new pair of shoes without breaking them in. But then again, tennis shoes, he says, are a sure giveaway that you’re an American, as is a ball cap or tee shirt with a team’s logo on it. These will announce that you’re a foreigner and perhaps make you more vulnerable. Dr. Goreczny advises that closed-toed shoes are good, and Dr. Furman says take walking shoes.

Since flights overseas can be lengthy, one must be aware of the propensity for blood clotting. Dr. Furman says that someone who is prone to such may want to think about giving themselves an injection of Lovenox (the generic anti-clotting medicine is Enoxaparin) half-hour before getting on the plane. Obviously, you needs to talk to your physician first.

If you have some arthritis and a long way to walk from one airport gate to another, arrange for what Dr. Furman calls a “meet-and-greet. They literally meet you at the plane and drive you right to the gate, and you never have to worry about missing a flight,” he says.

John Goreczny, MD, with Chesterfield Family Medicine

While it’s always a great thing to try and not lose your passport and money, sometimes it happens. But not to worry – you’ve already made a copy of your passport information, leaving one copy at home and emailing one to yourself, which is on your smartphone. You also have tucked away a couple of extra passport photos so that, when you arrive agitated at the nearest U.S. consulate, your replacement passport can be expedited. You have traveler’s checks because you may run into a challenge in Europe, as many countries are moving away from magnetic strip cards and toward chip-and-PIN cards. You have also alerted your credit card companies ahead of time that you will be making charges overseas, so they know not to freeze your account over a fraud alert.

Last? Maybe extra pairs of contacts, an extra pair of prescription glasses, some hearing aid batteries … Dr. Furman says that one should tuck these into a handy pocket in your carry-on baggage that’s easily remembered.

With all of these precautions, chances are … not taken.

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