Part 5: Primary Care Series | How to in Healthcare Series: Time to Put the Skills to the Test | Freezing the Pain october | november 2016 www.ourhealthrichmond.com
14 12
18
10
21
22
26
TABLE OF CONTENTS OCTOBER • NOVEMBER 2016
10
MEDI•CABU•LARY
21
Local experts define health-related terms
12
JUST ASK
14
NEW & NOTEWORTHY
18
Test your knowledge when it comes to the SHOULDER
22
Healthcare questions answered by local professionals
A listing of new physicians, providers, locations and upcoming events in the Greater Richmond communities
THE ANATOMY CHALLENGE FREEZING THE PAIN Follow the story of Diane Short and her journey of identifying and treating “frozen shoulder.”
26
THE DRIVE TO SURVIVE When breast cancer backed these four women into a corner, they found the drive to move forward with courage, determination and the power of positive thinking.
HEALTH POINTS Interesting facts and tidbits about health www.OurHealthRichmond.com
5
47
56
58
37
48
40
TABLE OF CONTENTS OCTOBER • NOVEMBER 2016
37
BRACE YOURSELF FOR THE NEW BRACES Getting a jumpstart on braces—if your child needs them—will save loads of time once class is back in session. Key words: If your child needs them. So how do you know if your kiddo does?
40
THE BRIDGE TO BETTER HEALTH STARTS WITH PRIMARY CARE SERIES PART 5 | MEASURE YOUR CARE This article, the fifth in a yearlong OurHealth series about primary care, focuses on how you can Measure Your Care.
47
6
FIT BITS Add some new ‘TRIX’ to your workout | Deidre Wilkes, OurHealth’s resident fitness specialist, shares the many training benefits of total body resistance exercises.
OurHealth | The Resource for Healthy Living in Greater Richmond
48
HOW TO IN HEALTHCARE SERIES PART 4 | TIME TO PUT THE SKILLS TO THE TEST The final in our series, part IV of OurHealth’s four-part series explores how to obtain a job in healthcare by creating an appealing, hire-worthy portfolio.
56
HELLO, HEALTH Capturing the spirit of those working in healthcare and of people leading healthy lives through photos.
58
CLOSER LOOK Images reflecting the landscape of healthcare in Richmond * PLUS * a chance to win a free year's subscription to OurHealth!
october • november 2016 OURHEALTH’S EXCLUSIVE MEDIA PARTNER PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT ACCOUNTING MANAGER CHIEF DESIGNER GRAPHIC DESIGN COPY EDITOR DIGITAL CONTENT MANAGER/EVENT SPECIALIST ORIGINAL PHOTOGRAPHY
McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Deidre Wilkes Laura Bower Karrie Pridemore Tori Meador Bobbi Hoffman Heidi J. H. McClintic Shawn Sprouse
CONTRIBUTING RICHMOND MEDICAL EXPERTS Melanie DeHart, MD Jennie Draper, MD Peter Miller, MD Sarah Peterson, MD Andrew Poklepovic, MD CONTRIBUTING PROFESSIONAL Geri Aston EXPERTS & WRITERS Susan Dubuque Tina Joyce Christine Stoddard Bernice Stein Deidre Wilkes ADVERTISING AND MARKETING Rob Robb Account Executive P: 804.539.3955 F: 540.387.6483 rob@ourhealthvirginia.com SUBSCRIPTIONS To receive OurHealth Richmond via U.S. Mail, please contact Deidre Wilkes via email at deidre@ourhealthvirginia.com or at 540.387.6482
@ourhealthmag
COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2016 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Richmond is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 3420 Pump Road, #314 • Richmond, VA 23233 • P: 540.387.6482 F: 540.387.6483 MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.
LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S
What is ABUS (Automated Breast Ultrasound Screening)?
Women who have dense breasts are four to six times more likely to develop breast cancer. Mammograms may miss over one-third of breast cancers in these women.
Automated Breast Ultrasound Screening (ABUS) is a way to improve the detection of breast cancer in patients with dense tissue on mammograms. Forty percent of women have dense tissue. Women who have dense breasts are four to six times more likely to develop breast cancer. Mammograms may miss over one-third of breast cancers in these women. ABUS is an FDAapproved screening tool that uses sound waves to make 3D images of the breasts. Images are acquired of the whole breast in 2mm increments and displayed by computer in a 3D manner. ABUS is meant to be an adjunct to mammography, not a standalone screening for patients with new symptoms. ABUS has been shown to improve cancer detection by 35 percent over the use of mammography alone. However, it cannot be used for every patient, depending on breast size. If you have dense tissue, you should speak with your radiologist to determine whether ABUS is right for you. Melanie DeHart, MD Henrico Doctors’ Hospital Richmond | 804.289.4500 www.henricodoctors.com
What is endometrial ablation? Endometrial ablation is an outpatient surgical procedure used to treat heavy menstrual bleeding. This is a great option for women who have completed childbearing and whose medical treatment did not have a satisfactory result. A patient who is considering this procedure will have an evaluation prior, including an ultrasound and an endometrial biopsy. This is done to evaluate for other causes of bleeding that would require different treatments. There are several devices used to perform an endometrial ablation, so the choice is physiciandependent. These devices all involve a heat source that is applied to the inside of the uterus to treat the endometrial lining. This is done in an office or outpatient surgery setting with sedation or local anesthesia. Recovery is short, with side effects of cramping lasting up to a few days and a watery discharge lasting for several weeks. The intended result of these procedures is to decrease menstrual flow, and the majority of patients are extremely satisfied postoperatively. For some patients, the procedure even causes the complete cessation of menstruation. Jennie Draper, MD
Virginia Physicians for Women Richmond | 804.897.2100 www.vpfw.com
10
OurHealth | The Resource for Healthy Living in Greater Richmond
What is adjuvant therapy? In cancer care, it is often necessary to use multiple treatments to ensure that you have eliminated all of the cancer cells. An adjuvant therapy is a treatment — such as chemotherapy, radiation therapy or hormone therapy — that is given after surgery with the intent to improve the chances of a cure. Adjuvant therapies are very common in cancer care. For example, a breast cancer patient may first undergo surgery to remove as much of the tumor as possible and then, depending on her individual cancer’s analysis, receive adjuvant chemotherapy or radiation to kill any remaining cancer cells. Clinical trials help determine which adjuvant therapies work best in which scenarios. By sequencing patients’ DNA or testing tumor samples for the presence of certain hormones, we can often pinpoint what is driving the cancer in order to determine the most effective therapy. New forms of adjuvant therapy are currently under investigation in the hopes of improving cure rates. Andrew Poklepovic, MD VCU Massey Cancer Center Richmond | 804.828.0450 www.massey.vcu.edu
H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
While hormonal fluctuations can influence weight gain, weight gain can contribute quite significantly to hormonal imbalances.
Can hormonal imbalance contribute to obesity in women?
Can hemorrhoids be treated in pregnant women?
How can rehabilitation help manage multiple sclerosis?
The body has a very complex system of hormones and regulatory mechanisms that affect metabolism and contribute to a person’s tendency to gain or lose weight. There are many different types of hormones, but when people think of hormones, they are often specifically referring to sex hormones like estrogen, progesterone, and testosterone. Fluctuations in these hormone levels have been associated with changes in metabolic rate, thus influencing patterns of weight loss or gain.
Yes. Up to half of all women are affected by symptoms related to hemorrhoids during their pregnancies. The best treatment is prevention. Studies have shown that increasing the amount of fiber in your diet, limiting the time spent sitting on the toilet, and stool softeners can help prevent the symptoms of hemorrhoids.
Inpatient rehabilitation provides multiple sclerosis (MS) patients with an action-oriented interdisciplinary clinical team specializing in rehabilitation. Offering personalized programs to minimize the signs and symptoms associated with MS, this team strives for positive outcomes at every disease stage, most often following an exacerbation or flare up.
Treatment options include soaking in a warm tub, applying products that contain witch hazel or topical lidocaine, and taking oral analgesics such as Tylenol. If you have persistent pain after attempting these treatments or if you have bleeding that fills up the toilet bowl, you should consider making an appointment to see a physician.
Exacerbations can have a negative effect on a patient’s energy level, swallowing abilities, bowel and bladder function, cognition, strength, balance, range of motion, flexibility and gait. MS patients are also likely to experience hand dysfunction, requiring specialized occupational therapy.
Interestingly, the reverse is also true. While hormonal fluctuations can influence weight gain, weight gain can contribute quite significantly to hormonal imbalances. For example, obesity influences the level of sex hormones in the body. Specifically, obesity is associated with excess androgens (such as testosterone), thus contributing to problems like menstrual irregularity, acne, and excess hair growth. In sum, there is not a simple answer to this question. There are many factors (both modifiable and unmodifiable) that contribute to obesity, and many types of hormones play a role in the body’s regulatory processes. Sarah Peterson, MD
Bon Secours Richmond OB-GYN Midlothian | 804.320.2483 www.richmondobgyn.com
12
OurHealth | The Resource for Healthy Living in Greater Richmond
Pregnant women may be candidates for minor procedures that are commonly performed by colon and rectal surgeons in their offices. It is very rare to require surgery for hemorrhoids during pregnancy, and surgery is considered a last resort because of the risks associated with undergoing anesthesia. Peter Miller, MD
Colon & Rectal Specialists Richmond | 804.249.2465 www.crspecialists.com
Some patients present a high risk of dysphagia and aspiration and need to be closely monitored by the medical team, receiving 24/7 nursing care and speech therapy. Patients are also seen daily by the physiatrist, the rehabilitative medicine doctor. Successful inpatient rehabilitation hospital programs address these conditions through comprehensive plans of care. With this higher level of care, MS patients are better able to reach their goals of independence for a safe return home and into the community. Bernice Stein
HealthSouth Rehabilitation Hospital of Petersburg Petersburg | 804.894.4746 www.healthsouth.com
NEW
NOTEWORTHY
NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS
Henrico Doctors’ Hospital’s Virginia Transplant Center to Participate in National
Kidney Registry’s New Advanced Donation Program HCA Virginia’s Henrico Doctors’ Hospital’s Virginia Transplant Center recently was recognized as one of 12 hospitals across the country that has agreed to participate in the National Kidney Registry’s Advanced Donation Program (ADP).
Laura Alberg, CNM
The Woman’s Center Midlothian | 804.423.8462 www.goodhelpdocs.com
Anna Beth Barton, MD Bon Secours Richmond Diabetes and Endocrinology Richmond | 804.287.7570 www.goodhelpdocs.com
Kimberly Caylor, CNM Adrianne Colton, MD The Woman’s Center Midlothian | 804.423.8462 www.goodhelpdocs.com
Virginia Physicians for Women Midlothian | 804.897.2100 Prince George | 804.520.0205 www.vpfw.com
The ADP is a paired exchange separated in time. With ADP donations, the program allows medically and psychosocially acceptable donors an opportunity to donate their kidney before their intended recipient receives a kidney. Some ADP donors have donated only weeks before their intended recipient was transplanted and others may be donating now, while they are healthy enough to donate, to secure a future transplant for a loved one who may not yet need a transplant (or another transplant). “The program gives folks the opportunity to pay it forward,” says Melissa VanSyckle, Living Donor coordinator at the Virginia Transplant Center. “We often times see family members, wanting to donate on their loved ones behalf, but they may not be a compatible match. In the case of the ADP program, we can better meet the timing needs of donors and recipients, giving the donor an opportunity to give to another individual suffering from kidney failure, while at the same time guaranteeing a kidney match through the NKR paired exchange program for their loved one in the future. With this program, more people can save lives for the greater good.” The Virginia Transplant Center has been a long-standing partner with the National Kidney Registry for eight years providing patients the best chance of safely finding a well matched kidney donor. With three types of living kidney donations – direct donation, paired exchanged donation and the “Good Samaritan” donation – the Virginia Transplant Center is proud to provide more paired exchange kidney transplant experiences through the NKR than any other transplant center in Virginia.
Marissa Esquivel, MD Bon Secours Blackstone Family Practice Center Blackstone | 434.292.7261 www.goodhelpdocs.com
14
Jose Exaire, MD
VCU Health Pauley Heart Center Internal Medicine, Cardiology Richmond | 804.628.4327 www.pauleyheart.vcu.edu
OurHealth | The Resource for Healthy Living in Greater Richmond
The Virginia Transplant Center is located in HCA Virginia’s Henrico Doctors’ Hospital in Richmond and specializes in kidney transplants, living kidney donations and paired exchange kidney transplants. For more information on HCA Virginia’s Henrico Doctors’ Hospital, visit www.henricodoctors.com
Bon Secours earns ‘Circle of Life’ Award Daniel Falcao, DO
VCU Health | Neurology Richmond | 804.828.9350 www.neurology.vcu.edu
Eric Floranda, MD
Bon Secours Neurology Clinic Richmond | 804.325.8750 neuro.richmond.bonsecours.com
Jan Gannon, Chief
Nursing Officer Chippenham Hospital Richmond | 804.320.3911 www.chippenhammed.com
George Georges, MD
Bon Secours Richmond Diabetes and Endocrinology Richmond | 804.764.7686 www.goodhelpdocs.com
Bon Secours Palliative Medicine was one of three programs in the nation to earn the American Hospital Association’s 2016 Circle of Life Award: Celebrating Innovation in Palliative and End-of-Life Care. The Circle of Life Award, now in its 17th year, celebrates programs across the nation that have made great strides in palliative and end-of-life care.
Hlynur Georgsson, MD Allison Giles, DO VCU Health | Neurology Richmond | 804.828.9350 www.vcuhealth.org
Virginia Physicians for Women Richmond | 804.897.2100 www.vpfw.com
Christopher Hayes, MD Talonna Bon Secours Pediatrics Iser, PharmD, RPh Gastroenterology Associates Richmond | 804.281.8303 www.goodhelpdocs.com
Jeremy Gray
Chief Operating Officer Chippenham Hospital Richmond | 804.320.3911 www.chippenhammed.com
Sarah Jenkins, PA
Bon Secours Hartfield RX3 Compounding Pharmacy Medical Center Hartfield | 804.776.9221 Chester | 804.717.5000 www.goodhelpdocs.com www.rx3pharmacy.com
Amy Harper, MD
Children’s Hospital of Richmond at VCU Neurology Richmond | 804.828.2467 www.chrichmond.org
Myrlene Jeudy, MD
VCU Health | OBGYN Richmond | 804.828.4409 www.vcuhealth.org
Bon Secours Palliative Medicine in Richmond offers in-patient consultative services at St. Mary’s Hospital, St. Francis Medical Center, Memorial Regional Medical Center and Richmond Community Hospital and sees patients in the office setting at St. Mary’s and St. Francis, says Julie MacPherson, practice administrator with Bon Secours Palliative Medicine in Richmond. Palliative care is specialized medical care for people with serious illnesses. Bon Secours Palliative Medicine supports patients when their symptoms are overwhelming, when they are facing difficult decisions and when they are dealing with chronic medical conditions. This care is done “without walls,” by providing consultation in the hospital, home and office, MacPherson explains. To learn more about Bon Secours Palliative Medicine, visit www.bonsecours.com.
Arun Kalra, MBBS
Children’s Hospital of Richmond at VCU Neurology Richmond | 804.828.2467 www.chrichmond.org
Eugene Kim, MD
Bon Secours Palliative Medicine Richmond | 804.288.2673 www.goodhelpdocs.com
Ashok Kumar, MD
VCU Health Pauley Heart Center Internal Medicine, Cardiology Richmond | 804.628.4327 www.pauleyheart.vcu.edu
Quinn Lippmann, MD, MPH Virginia Urology Urogynecology Richmond | 804.330.9105 www.uro.com
www.OurHealthRichmond.com
15
NEW
NOTEWORTHY
Aivi Nguyen-Cao, MD
Melissa Oldham, NP
Kenichiro Ono, DO
Richard Pang, MD
Kara Parker, NP
Kathleen Pearson, MD
Sarah Peterson, MD
Rachna Raman, MD, MS
Mary Ransom, MD
Sanjay Rao, DO
Trevor Reichman, MD
Robert Rose, MD
Jennifer Salluzzo, MD
Emily Slater, FNP
Jonathan Snider, MD
Edward Springel, MD
Siddhartha Varma, MD
Bon Secours Neurology Clinic at St. Mary’s Richmond | 804.893.8656 www.goodhelpdocs.com
Mallory Sandridge, NP Purvi Shah, MD
Bon Secours Richmond Virginia Cancer Institute Community Hospital Cancer Richmond | 804.559.2489 Institute – Medical Center www.vacancer.com Richmond | 804.287.7804 www.goodhelpdocs.com
16
AND UPCOMING EVENTS
George Mueller, MD
Bon Secours Associated Internists Richmond | 804.288.3079 www.goodhelpdocs.com
Bon Secours Hospice Richmond | 804.627.5360 www.goodhelpdocs.com
P R O V I D E R S , L O C AT I O N S
Mark Mochel, MD
VCU Health Anatomic Pathology Richmond | 804.828.7284 www.vcuhealth.org
Aparna Ranjan, MD
NEW PHYSICIANS,
Virginia Cardiovascular Specialists Mechanicsville 804.288.4827 www.vacardio.com
Virginia Urology Richmond | 804.330.9105 www.uro.com
Children’s Hospital of Richmond at VCU Neurology Richmond | 804.828.2467 www.chrichmond.org
Bon Secours Senior Care Services Glen Allen | 804.893.8627 www.goodhelpdocs.com
OurHealth | The Resource for Healthy Living in Greater Richmond
Bon Secours Patterson Avenue Family Practice Richmond | 804.741.6200 www.goodhelpdocs.com
Bon Secours Richmond Community Hospital Cancer Institute – Medical Center Richmond | 804.287.7804 www.goodhelpdocs.com
VCU Health | Neurology Bon Secours Richmond Henrico | 804.360.4669 OB-GYN www.vcuhealthnowcenter.org Richmond | 804.320.2483 www.richmondobgyn.com
VCU Health and Children’s Hospital at VCU Transplant Surgery Richmond | 804.828.2467 www.chrichmond.org
Bon Secours Aylett Medical Center King William | 804.746.1677 www.goodhelpdocs.com
VCU Health VCU Health | OBGYN Neurology, Movement Richmond | 804.828.4409 Disorders www.vcuhealth.org Henrico | 804.360.4669 www.vcuhealthnowcenter.org
VCU Health Neurology, Epilepsy and EEG Richmond | 804.828.9350 www.vcuhealth.org
Bon Secours Richmond Community Hospital Cancer Institute – Medical Center Richmond | 804.287.7804 www.goodhelpdocs.com
VCU Health Surgery, Bariatric and Gastrointestinal Richmond | 804.628.4327 www.vcuhealth.org
Bon Secours Neurology Clinic at Memorial Regional Mechanicsville 804.325.8720 www.goodhelpdocs.com
River Run Dental Refreshes Brand with Expansion and Growth
River Run Dental, formerly known as Rusnak Family Dentistry, officially unveiled its new brand and renovation as it prepares for growth. In line with the rebrand, River Run Dental is in the midst of a large renovation project, expanding from eight to 14 treatment rooms. Once complete, the renovation will feature a refreshed reception area with a warm and welcoming aesthetic and six new treatment rooms as well as additional patient consultation areas. Post expansion, the practice will have a total of 5,000 square feet in space and new patient availability will increase by almost 35 percent. For more information on River Run Dental, visit www.riverrundentalspa.com
Monica Washington, MD
Virginia Physicians for Women Richmond | 804.897.2100 www.vpfw.com
Michael White, MD
Bon Secours General Surgery at St. Mary’s Richmond | 804.893.8676 www.goodhelpdocs.com
Alicia Zukas, MD
VCU Massey Cancer Center Neuro-Oncology Richmond | 804.828.5116 www.massey.vcu.edu
www.OurHealthRichmond.com
17
TI P S , T I D B I T S A ND MO R E TO IN F O R M A ND ENT ERTA I N YO U
“If you think taking care of yourself is selfish, change your mind. If you don’t, you’re simply ducking your responsibilities.” - Ann Richards, women and minorities advocate
Get a call back after your last mammogram? For every 1,000 women who have a screening mammogram, over 20 percent get a call back from the doctor’s office!
100
Hey, Lady—
DID YOU KNOW? Women are nearly twice as likely as men to experience depression, and although it can occur at any age, it is most common in women between the ages of 40 and 59. Your emotional health is as important as your physical health. Talk to your healthcare team about being screened for depression. Source: Mayo Clinic
* will return for an additional mammogram or
61 20* 19
ultrasound due to something seen in the initial mammogram will have the additional imaging and find nothing is wrong will find what was seen in the imaging is likely not cancer and return in six months to keep watch on the finding will have a minimally invasive needle biopsy
5 will be diagnosed with breast cancer When breast cancer is found this way, the cure rate is very high! * Figures may be lower for women who have had prior mammograms and higher for women who are having their first mammogram. Source: American College of Radiology
18
OurHealth | The Resource for Healthy Living in Greater Richmond
BONES AND
BARBELLS!
Studies show that strength training for osteoporosis – not just
walking or doing aerobics, but LIFTING weights – can
help protect bones and prevent osteoporosis-related fractures! Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases
November is both
National Alzheimer’s Disease Awareness Month and National Family Caregivers Month If you are a caregiver of any kind, visit www.caregiveraction.org for tools and resources to help manage the care of your loved one.
More Than
Nearly
15 million 5 million family members, friends and neighbors care for a loved one with Alzheimer’s disease!
Americans are living with Alzheimer’s, and almost
60 Percent of Alzheimer’s and dementia caregivers are women.
Two-Thirds
of them are women.
Want to be part of the cure for Alzheimer’s ? Sign up for TrialMatch, a free clinical matching service that connects individuals with Alzheimer’s, caregivers and healthy volunteers to current studies. For more information visit www.alz.org/research.
Haven’t Run Richmond Yet? What are you waiting for?! The Anthem
and cold refreshments! Not quite ready for the
Richmond Marathon has a scenic course
‘full’ experience? No worries – there is a half
that winds through the city’s most historic
marathon option as well as an 8K – something
and beautiful neighborhoods and runs
for every runner!
over and along the James River. This race
FASCINATING
has earned its’ reputation as “America’s Friendliest Marathon” because of features like junk food stops and wet washcloth stations! But the perks don’t end there. As you run, you’ll encounter live bands, DJs, spirit groups and Party Zones that will help push you through to the finish. Then, after the race, you can kick back and relax on Brown’s Island and celebrate with hot pizza
Date: November 12, 2016 Time: 7:00 a.m. Location: 5th and Tredegar Street Richmond For more information and to register, visit www.richmondmarathon.org
FACT
The tooth is the ONLY PART OF THE BODY THAT CAN’T REPAIR ITSELF. Don’t forget to schedule regular dental exams! www.OurHealthRichmond.com
19
T H E F OU RTH A N N U A L
IN GREATER RICHMOND
Votes have been cast and counted! Don’t miss the 2016 Best Bedside Manner results in the December edition of OurHealth Richmond. www.ourhealthrichmond.com
The Anatomy Challenge is proudly sponsored by:
Anatomy
the
CHALLENGE How much do you know about the
Experience the Tidewater Difference Over 30 locations throughout Southeast and Central Virginia Southeast Virginia | 757.873.2302 Greater Richmond | 804.323.7874 www.tpti.com
Shoulder? First,
complete the word search below. Next, match up the correct word with the part of the body in the illustration.
[ the shoulder ]
WORD SEARCH acromion
glenoid socket
biceps muscle
humerus
bursa
rotator cuff
clavicle
scapula
deltoid muscle
For answers, visit
OurHealth Richmond's Facebook page at
www.OurHealthRichmond.com
21
22
OurHealth | The Resource for Healthy Living in Greater Richmond
FREEZING
THE PAIN
I dentifying and treating “FROZEN
words | TINA JOYCE
SHOULDER”
Improving patients’ quality of life, increasing their range of motion, and striving to help their days be pain-free following a surgical procedure are goals for all healthcare professionals. Proactive care in the days and weeks following a lumpectomy or mastectomy may greatly reduce both acute and chronic pain as well as minimize a patient’s long-term limitations. Diane Short, a patient who underwent a successful lumpectomy 18 months ago, found herself experiencing symptoms of adhesive capsulitis, otherwise known as “frozen shoulder.” However, she had no previous knowledge that this condition existed and was treatable. This complication is not uncommon, but can be misdiagnosed or ignored if patients are not persistent with their post-surgery care provider. Often, a patient may feel that the pain or discomfort is normal following a lumpectomy and wait to disclose the severity or details of the symptoms, resulting in unneeded suffering for months or years. Diane explains, “No one ever called my symptoms ‘frozen shoulder,’ but my pectoral muscle was very sore, and I was unable to raise or straighten my right arm above my head. When I tried to raise it, I would have a sharp pain in my shoulder. I had a hard time reaching up in the cabinets or hanging or getting down items in a closet. I would shift my body and use my other arm or get a step stool to get to what I needed. It seemed like I had no strength to lift or carry items. I finally asked my surgeon about physical therapy options a few months later. He set me up with an appointment at Tidewater Physical Therapy.”
It is important for patients to continually ask their doctors clarifying questions and communicate with them both before and after a procedure. Patients may have to be their own advocates and ask for options to alleviate their pain or improve their mobility.
www.OurHealthRichmond.com
23
“The first thing patients need to do is ask the question ‘Is this normal?’ so they can be proactive in their treatment. It is very important to listen to your body. It is also invaluable to be as descriptive as possible about the symptoms a patient is experiencing so we can provide that best plan for treatment,” explains Ken Morris, PT, DPT of Tidewater Physical Therapy. Ken Morris PT, DPT, CMTPT is the clinical director for Tidewater Physical Therapy’s Hidenwood Clinic.
Adhesive capsulitis is a pattern of restriction of the shoulder joint due to pain caused from an injury or surgery.1 A patient who experiences this, like Diane, will refrain from moving the arm and shoulder in order to avoid additional pain and discomfort. The joint then becomes “frozen” or stiff from lack of use and inflammation. It is fairly common for patients to experience pain, joint restriction, and functional limitations after surgeries related to breast cancer, although it is also not uncommon after a stroke, rotator cuff injury, or other arm injuries. Muscle weakness, swelling, numbness, and tingling may also persist. Typically, these symptoms are more prevalent after a mastectomy than a lumpectomy because more tissue is removed. Also, depending on whether or not any lymph nodes are removed, the complications may be more intense. Prompt, proactive care can greatly reduce the symptoms of this condition. Typically, a patient can begin physical therapy as early as three days post-surgery, depending on the surgeon’s recommendation. According to Ken Morris, PT, DPT at Tidewater Physical Therapy, ”The most important thing is the healing; once they are healed, then ask ‘What’s next?’ A lot of times, the quicker we can get to [the patient] once they start experiencing healing, the prognosis is much better.”
Therapists agree that early physical therapy significantly improves the patient’s joint mobility and overall recovery time and ultimately decreases the cost of healthcare associated with their post-operative limitations. The American Cancer Society explains, “It’s important to complete exercises [after breast cancer surgery] to get the arm and shoulder moving again. Exercises help to decrease side effects of surgery and help patients get back to usual activities.” A thorough evaluation needs to be completed at a physical therapist’s office in order to discuss the patient’s medical history and assess their posture, range of motion, strength, balance, and functional level; this will allow the physical therapist to determine the best plan of care. During the following appointments, the focus shifts to teaching exercises and hands-on treatments targeting the joint as well as strength deficits that were found during the initial evaluation. 24
OurHealth | The Resource for Healthy Living in Greater Richmond
“I really appreciate everything he [Ken] at Tidewater did for me. He conducted my initial evaluation and referred me to a physical therapist trained in lymphedema management. I was grateful to end up in that office because not all physical therapy offices have a lymphedema specialist onsite,” shares Diane. A physical therapist can teach patients range-of-motion exercises in order to assist them in recovering their mobility. However, the degree to which patients are willing and able to commit to consistently performing the exercises, both in the office and at home, will affect their results.
The Stages of Frozen Shoulder When a patient suffers from “frozen shoulder,” the shoulder capsule thickens and becomes tight. Stiff bands of tissue called adhesions develop. In many cases, there is less synovial fluid in the joint. The primary symptom of this condition is being unable to move your shoulder, either on your own or with the help of someone else. It develops in three stages:
STAGE 1
Therapists also integrate functional training to develop the use of the painful area in order to improve the patient’s daily living or working activities. Additionally, manual therapy improves soft tissue, scar or joint restriction, while some therapists use modalities such as electrical stimulation to increase circulation and decrease pain.
“Continue to inform your doctors how you are feeling or ask if there is a treatment that would help with any pain. It’s important that you continue to ask questions until you are satisfied,” shares Diane. Physical therapy offers patients who are recovering from breast cancer surgeries an option to proactively enhance their speed and quality of recovery. Patients and providers who are looking to eliminate or minimize post-surgery “frozen shoulder” symptoms may begin treatment shortly after surgery, once a proper evaluation can be completed.
STAGE 3
STAGE 2
Diane reveals that today, 18 months after the procedure and 10 months after she began physical therapy, she is doing much better, but must continually perform the exercises that she learned. “If I do too much, I will feel [pain] in the shoulder, and especially if I haven’t kept up with what I should be doing. The pectoral muscle is still sore, and it might be a while before that pain is no longer there.”
Freezing In the “freezing” stage, you slowly experience more and more pain. As the pain worsens, your shoulder loses range of motion. The freezing stage typically lasts from six weeks to nine months.
Frozen The condition’s painful symptoms may actually improve during this stage, but the stiffness remains. During the four to six months of the “frozen” stage, performing normal daily activities may be very difficult.
Thawing Shoulder motion slowly improves during the “thawing” stage. A complete return to normal or close to normal strength and motion typically takes anywhere from six months to two years.2
Expert Contributer: • Ken Morris PT, DPT, CMTPT with Tidewater Physical Therapy
Sources: The Mayo Clinic. www.mayoclinic.org Frozen Shoulder. American Academy of Orthopaedic Surgeons. www.orthoinfo.aaos.org • American Cancer Society. www.cancer.org • Tidewater Physical Therapy. www.tpti.com 1 2
ON THE WEB
More at ourhealthrichmond.com www.OurHealthRichmond.com
25
words | SUSAN E. DUBUQUE
Whether you are a man or woman, an adult or a child, old or young, you have probably been touched by breast cancer. It may be your mother, aunt, sister or friend who has suffered, or perhaps you have been personally affected. Among the more than three million women in the U.S. who have breast cancer, many serve as inspirations to us all. These are women who demonstrate grace and dignity in the face of a life-threatening illness and women who transform a devastating medical condition into a positive, life-altering opportunity. Additionally, there are still more who selflessly extend a hand to others rather than focusing on their personal circumstances.
This article is a tribute to four of these amazing women. It is our hope that their stories will offer insight and inspiration to even more women who must face the challenges of breast cancer now or in the future.
www.OurHealthRichmond.com
27
Denise’s Story Photo by Megan Garrison Denise with her husband Eric and boys, Hunter and Easton.
“I refused to let cancer dominate my life.” —Denise
When a diagnosis of breast cancer at age 32 threatened to hijack Denise Waff’s life plan, she fought back and regained control in some surprising ways. “I wasn’t very diligent in performing breast self-examinations,” admits Denise, “but one time when I did check my breasts, I discovered a hard lump.” A few years earlier, Denise had had a benign mass removed from her breast, so she wasn’t particularly concerned. After all, she was too young to have breast cancer, right? Nonetheless, her doctor referred her to a surgeon for a biopsy. On July 7, 2010, Denise was stunned to hear the results: “You have breast cancer.” Denise was a young wife and mother of a nearly two-year-old son, Hunter. The couple was planning on having a second baby soon, but all that came to a screeching halt with the diagnosis. The next two years were a continuous whirlwind of treatments and procedures. First, Denise had a lumpectomy. Before beginning chemotherapy, however, she learned something that was life-altering, even more so than being diagnosed with breast cancer. She has the BRAC2 gene mutation that markedly increases her risks of developing both breast and ovarian cancers. “I refused to let cancer dominate my life,” declares Denise. “I made the decision to have a prophylactic double mastectomy after I finished chemo.” Denise was also
28
OurHealth | The Resource for Healthy Living in Greater Richmond
determined to have the second child that she and her husband, Eric, had always planned. “I knew that chemotherapy could wreak havoc on my reproductive system, and the type of breast cancer I had [estrogen receptor-positive] would make getting pregnant risky. We went to see a fertility specialist, Michael Edelstein, MD with Fertility Institute of Virginia, and my eggs were harvested.” Ten embryos were frozen in the hopes that the Waff family could have another child in the future. Denise then began eight rounds of chemotherapy. “Treatments lasted an entire afternoon, so I invited a friend or family member to join me for each one,” says Denise. In her typical take-charge style, she never missed a day of her work as a probation officer throughout her treatments. She had radiation therapy from April to June 2011 and surgery to complete her breast reconstruction in January 2012. Denise received her cancer care at Thomas Johns Cancer Hospital at Johnson Willis Hospital and the Virginia Cancer Institute. During this same period, Denise began seeing a gynecological oncologist to monitor her for ovarian cancer. Once again, Denise took a proactive step — she opted to have an oophorectomy, the removal of her ovaries and fallopian tubes. In 2013, Denise was healthy and ready to put the disease behind her. She and her husband finally felt comfortable adding to their family. “My best friend from college, Amanda Hoban, had offered to be our gestational carrier [surrogate],” says Denise. In December, the embryos were transferred, and although Amanda became pregnant, she miscarried a few weeks later. Fortunately, Amanda proved to be as tenacious as Denise, and the second embryo transfer was a success. Amanda carried the Waff baby to term, and, she delivered a healthy baby boy in November 2014. Denise’s cancer may have had a genetic cause. By taking assertive action, however, she remained in control of her disease, her treatment and, occasionally, her very active 21-month-old son, Easton.
Above Left: Denise with her husband Eric and son Hunter along with best friend and surrogate, Amanda. Above Right: Denise’s youngest son, Easton.
FOUNDATIONS AND SUPPORT GROUPS Sisters Network Central VA, Inc. Richmond | 804.447.4027 www.sistersnetworkcentralva.org Susan G. Komen Central Virginia 1403 Johnston-Willis Drive | Richmond | 804.320.1772 www.komencentralva.org Virginia Breast Cancer Foundation 5004 Monument Avenue | Henrico | 804.285.1200 www.vbcf.org Advanced Breast Cancer Support Group Meets first Thursday of each month Henrico Doctors’ Hospital Cancer Center Specialty Clinics Richmond | 804.289.4837 Breast Cancer Support Group Meets first and third Tuesday of each month Virginia Breast Center Waiting Room 601 Watkins Centre Parkway | Midlothian | 804.893.8623 Breast Cancer Support Group Meets second Wednesday of each month Southside Regional Medical Center, 3rd Floor Classroom 200 Medical Parks Boulevard | Petersburg | 804.765.5884 Newly Diagnosed with Breast Cancer Meets first Wednesday of each month The Hawthorne Cancer Resource Center 1401 Johnston-Willis Drive | Richmond | 804.330.2136
$$$ www.OurHealthRichmond.com
29
DeeDee’s Story Dee Dee and Geep with family and friends in the 2014 UKrops 10k in Richmond.
“...I choose to look for the good in my journey. And most of all, I choose to win this battle.” —DeeDee
30
When her doctor said the words, “You should get your affairs in order,” DeeDee Schurman and her husband, Geep, visited Hollywood Cemetery and selected a beautiful plot along the James River, “Magnolia 47.” Once that task was completed, DeeDee set about the process of healing. It was November 2012, one week before Thanksgiving Day, recalls DeeDee, and her mind “was moving a million miles an hour on holiday plans.” The findings of a routine mammogram, however, stopped her in her tracks. It revealed a tumor the size of a chickpea that turned out to be breast cancer. “I had a lumpectomy between Thanksgiving and Christmas, followed by six chemo sessions and five weeks of radiation therapy,” says DeeDee. “From the day I was diagnosed, I never once thought I would die from breast cancer. It seemed like more of an inconvenience. Throughout my treatment, I continued to work, maintained all my activities, and I even exercised on a regular basis.” In 2013, while DeeDee was in recovery mode, she completed a 10K race and a half marathon, and she ramped up her training in 2014 to complete her sixth marathon.
OurHealth | The Resource for Healthy Living in Greater Richmond
“At this point, my life was great,” says DeeDee. “Both my husband and I were healthy and fit after two years of living in cancer hell.” The day after DeeDee completed her last radiation treatment, however, Geep was diagnosed with tongue cancer. He went through months of treatment and is now fully recovered. Unfortunately, the good times were short-lived for this couple. In February 2016, DeeDee began experiencing annoying symptoms. “I had a constant dull pain in my stomach and a sense of fullness,” says DeeDee. “I went to see my oncologist just in case it was an after-effect of my cancer treatment or, heaven forbid, a recurrence.” For four months, DeeDee was treated for digestive ailments. By late June, though, it was apparent that something else was wrong. On June 29, the pain became so intense that Geep took DeeDee to the Henrico Doctors’ Hospital ER, where she had a CT scan, followed by a biopsy on July 5. On July 7, after waiting through an excruciating week, DeeDee heard the devastating news: her breast cancer had returned, this time with a vengeance. The cancer had metastasized to both lobes of her liver. There was not a minute to waste. DeeDee’s treatment needed to commence immediately. “I realized I had a major problem,” says DeeDee. “At that point I began seeing a specialist at VCU Massey Cancer Center. The last two months have been a series of hospitalizations, struggles to keep my white blood cell count up and my food down, and massive amounts of chemotherapy.”
MEDICAL FACILITIES AND IMAGING CENTERS Allison Breast Center 731 Forest Avenue, Suite 110 | Richmond | 804.288.8321 www.allisonbreastcenter.com Bon Secours www.bonsecours.com Bon Secours Richmond Imaging 6605 West Broad Street, Suite B | Richmond | 804.287.3500 Bon Secours St. Francis Imaging Center 8013 Midlothian Turnpike | Richmond | 804.330.4600 Richmond OB-GYN St. Francis Medical Center 13700 St. Francis Boulevard | Suite 305 | Midlothian 804.320.2483
Despite all of the challenges, though, DeeDee’s positive attitude has never wavered. “The first time I had cancer, I coined the expression, Just Keep Going — or JKG — and that became my mantra,” says DeeDee. “I still embrace JKG, just at a little slower pace.” If DeeDee is learning anything from this experience, it has been patience. “Healing takes time. I just enjoy every moment of every day as it comes.”
HCA Mammography Services www.hcavirginia.com/service/mammography
“I can’t change my circumstances,” declares DeeDee, “but I do have choices. I choose not to live in fear. I choose to be grateful for my wonderful husband Geep, my family and a huge circle of friends. I choose to look for the good in my journey. And, most of all, I choose to win this battle.”
John Randolph Medical Center 411 West Randolph Road | Hopewell | 804.541.7462
The day she visited Hollywood Cemetery, DeeDee announced, “I’m not staying. I’m just passing through.” It is obvious that DeeDee still has a lot of living to do. JKG! $$$
CJW Medical Center-Chippenham Campus Mammography and Breast Health Center 7101 Jahnke Road | Richmond | 804.327.8706 Henrico Doctors’ Hospital 1602 Skipwith Road | Richmond | 804.289.4500
Johnston-Willis Hospital 1401 Johnston Willis Drive | Richmond | 804.330.2000 Retreat Doctors’ Hospital 2621 Grove Avenue | Richmond | 804.254.5100 The Ellen Shaw de Paredes Institute for Women’s Imaging www.paredesinstitute.com 804.523.2303 4800 Cox Road, #100 | Glen Allen 2530 Gaskins Road | Richmond Virginia Breast Center www.vabreastcenter.com Northside – Memorial Regional Medical Center 8220 Meadowbrook Ridge Road | MOB I, Suite 309 Mechanicsville | 804.594.3130
www.breastcancer.org www.OurHealthRichmond.com
31
Jennifer’s Story Pictured Left to Right, Back to Front: Jennifer’s biggest support team, mother Jean, daughter Caleigh, husband Jim, sister Stephanie, daughter Ilysa, family pooch million on Jennifer’s lap and daughter Moira.
“Control the controllable, and then let everuthing else go.” — Jennifer
32
When Jennifer Bocrie found out that she had to have chemotherapy, she was even more distressed than when she was told she had breast cancer. She thought losing her hair would be a big deal. And it was, but not in the way she expected. When Jennifer turned 40, she began having screening mammograms every year without exception — and every year, she received a clean bill of health. In August 2015, however, something different happened. “I was called back for a second mammogram and ultrasound,” says Jennifer, “and I really got suspicious when the technician concentrated on one area of my breast.” Jennifer had a biopsy after that, and she was diagnosed with breast cancer on September 16. Jennifer may have been the one with the diagnosis, but she was far from alone in this journey. “My husband, Jim, was with me every step of the way,” she explains. “When I was first diagnosed, we met with the surgeon, Diane Cox, MD with Surgical Associates of Richmond. At that time, she thought my cancer was stage I and only 1 cm in size. She gave us the options for treatment, but we did our own research as well. We have a saying that we like to use: ‘Control the controllable’ and then let everything else go.”
OurHealth | The Resource for Healthy Living in Greater Richmond
Jennifer getting her hair cut by her daughter, Moira.
And taking control is just what Jennifer and Jim did. First, they told their three daughters, Moira (age 18), Caleigh (age 16) and Ilysa (age 14), about the cancer. “Jim did most of the talking,” recalls Jennifer. “He was calm and strong, and that made the girls feel less frightened.” Next, they told Jennifer’s parents. “They really encouraged me to have genetic testing. We wanted to see if our girls were at risk as well as my mother and sister.” Although the testing revealed that Jennifer did not have the BRCA gene mutations, she made the decision to have a double mastectomy. Further analysis of her tumor showed that the size was actually closer to 2 cm, and it was a Luminal B subtype, a somewhat more aggressive form of cancer. Based on these findings, Jennifer accepted the doctor’s recommendation to begin chemotherapy. “Chemo meant I would lose my hair,” says Jennifer, “and that was incredibly upsetting to me. My surgery scars could be covered with clothing, but the loss of my hair was right out there for everyone to see. It made me feel incredibly exposed.” However, Jennifer and Jim once again took control of the situation and invited their friends and family to a head-shaving party. “It was a beautiful day at the end of February,” Jennifer recalls. “We made Bloody Marys and mimosas and enjoyed a wonderful brunch. We all went outside and each of our guests, including all three of our daughters, took a turn sharing words of support and love and shaving off a little of my hair. Then, we went inside and tried on a collection of crazy wigs that I borrowed for the day.” With strength and resiliency, Jennifer and Jim took what could have been a traumatic and depressing time and turned it into a memorable and enjoyable event. “Most of all, it took the sting out of having to shave my head — especially for our girls,” says Jennifer. “I actually did buy a really nice wig to wear, but never put it on. Instead, I wore cute hats or scarves — or I just rocked my bald head.” Jennifer celebrates her renewed health and is now training for a half marathon in November. Later that month, she will have her final surgery to reconstruct her breasts. For Jennifer, one of the most gratifying aspects of her cancer experience has been participating in the Breast Cancer Support Group meetings at the Hawthorne Center in Johnston Willis Hospital. “It’s wonderful to talk with other women and men who have had breast cancer,” says Jennifer. “We can truly understand what we have all been through. We all have our stories to tell.” And I’ll bet that Jennifer’s story of her head-shaving party is one that everyone remembers.
MEDICAL FACILITIES AND IMAGING CENTERS CONTENUED... Southside – Watkins Center 601 Watkins Centre Parkway Suite 200 | Midlothian 804.594.3130 West End – St. Mary’s Hospital 5875 Bremo Road, South Medical Building, Suite 701 and G11 Richmond | 804.594.3130 VCU Breast Imaging www.breastimaging.vcu.edu Nelson Clinic 401 North 11th Street Room 300 | Richmond | 804.828.5261 Stony Point 9000 Stony Point Parkway Richmond | 804.237.6666 Virginia Cancer Institute www.vacancer.com VCI Bell Creek 7501 Right Flank Road, Suite 600 Mechanicsville | 804.559.2489 VCI Parham Doctors’ Hospital 7660 East Parham Road, Suite 102 Henrico | 804.346.3182 VCI Reynolds Crossing 6605 West Broad Street, Suite A Richmond | 804.287.3000 VCI Southside Regional Medical Center 210 Medical Park Boulevard Suite 200 | Petersburg | 804.431.1100 VCI St. Francis 14051 St. Francis Boulevard Suite 1200 | Midlothian | 804.378.0394 VCI Thomas Johns Cancer Hospital 1401 Johnston Willis Drive, Suite 100 Richmond | 804.330.7990
$$$ www.OurHealthRichmond.com
33
Penny’s Story Pictured from left to right: Taylor LaPrade McSwain, Penny LaPrade, Casey LaPrade
MEDICAL FACILITIES AND IMAGING CENTERS CONTINUED... Virginia Women’s Center www.virginiawomenscenter.com 7515 Right Flank Road Mechanicsville | 804.288.4084 Henrico Doctors’ Forest Medical Plaza 7611 Forest Avenue, Suite 200 Richmond | 804.288.4084 John Rolfe Commons 2240 John Rolfe Parkway Richmond | 804.288.4084 St. Francis Medical Pavilion 13801 St. Francis Boulevard Suite 100 | Midlothian | 804.288.4084
34
January 26, 2016 is a date that is imprinted on Penny LaPrade’s memory. It is the day that she heard the devastating news: she had breast cancer. “I’ve always been strong and healthy, working long hours outdoors taking care of my horse. There is no history of breast cancer in my family, and I don’t have the BRCA gene. I pretty much thought I was immune,” says Penny. “So it was shocking when it happened to me.” Penny had a routine mammogram and annual physical exam in late Fall 2015. Her daughter was getting married on October 10, and Penny wanted to take care of her personal medical appointments before the big day. The test results were fine, but the technician told Penny that she had dense breasts and advised her to be checked regularly. In late December, Penny noticed that her right breast had an odd, almost angular shape. When she examined it, she felt a lump. “I made an appointment with my gynecologist, and even though he didn’t think it was anything to worry about, he sent me for a mammogram and ultrasound. The same day, I had a biopsy, and the radiologist said she didn’t even have to see for the result,” says Penny. “She was sure that I had breast cancer.” Penny’s husband, Steve, her two daughters and her niece went with her to the doctor. “On January 26, my diagnosis was confirmed,” says Penny. “Initially, I was told that I only needed a lumpectomy and a little radiation. But to be safe, and at the urging of my daughter, I saw James Pellicane, MD at Bon Secours Virginia Breast Center for a second opinion. He conducted further tests and determined that my cancer
OurHealth | The Resource for Healthy Living in Greater Richmond
was estrogen positive and I was at a high risk of recurrence. No matter how I tried to wiggle out of it, Dr. Pellicane convinced me we should do it his way and have chemotherapy. My cancer was aggressive, and he wanted to be just as aggressive in treating it.” Penny underwent chemotherapy from March until July 2016, and she had a lumpectomy in September. “My tumor was the size of a walnut, but by the time I had surgery, it had completely disappeared,” says Penny. “I will begin radiation treatment as soon as I heal from surgery.” Throughout Penny’s treatment, she continued to work full-time in her position as an accountant for a hotel corporation. “I was given a promotion at work at the same time I was diagnosed with cancer. My employer was great. I was told that my new position would be waiting for me as soon as I recovered,” says Penny. She is now training and ready to assume her new role as a supervisor. Additionally, Penny feels very grateful for her family’s love and support. “Throughout our 31-year marriage, I loved caring for my husband, and I waited on him hand and foot,” she reminisces. “When I got sick, the tables were turned, and my husband took incredible care of me. He was my rock. My daughters, Taylor (age 27) and Casey (age 23), and my son, Steve “Boomer” (age 25), were just wonderful. My mother told me how strong and brave I was. She was so worried about me, even though she was very sick herself.” Penny lost her mother to pancreatic cancer in 2016. “My friends were also there for me — coming to visit, bringing flowers and meals.” “Cancer takes you away from you,” reflects Penny. Now, however, she feels that she is rediscovering the former Penny a little more each day. “My hair is growing back, my taste has returned, and I can go outside and tend my animals.” Despite everything that she has been through in this past year, Penny’s future is looking bright. In fact, her daughter Taylor is expecting a baby, Penny and Steve’s first grandchild. Furthermore, the baby is due on January 26, 2017. The circle is complete. $$$
Above left, pictured left to right: Steve LaPrade, Penny LaPrade, Taylor LaPrade McSwain, Tyler McSwain, Casey LaPrade, Steven LaPrade Above right: Steve and Penny LaPrade
OTHER RESOURCES Oftentimes, family and friends of those going through breast cancer treatments are overwhelmed and can begin to feel helpless. Here are some ways you can help and maybe put a smile on the face of someone who really needs it! CaringBridge.com – CaringBridge helps family and friends create a free personal website to quickly share updates about loved ones and their health journey Sendameal.com – SendaMeal is an online service that allows family and friends to purchase gourmet prepared meals and gifts to be delivered to loved ones who may not have time to cook during times of treatment and hospital stays MealTrain.com – MealTrain is a free service that allows family and friends to organize home-cooked meals during specified time periods. People are invited to sign up for specific meals and dates that they would like to prepare and take to the home.
ON THE WEB
More at ourhealthrichmond.com www.OurHealthRichmond.com
35
36
OurHealth | The Resource for Healthy Living in Greater Richmond
words | CHRISTINE STODDARD
Fall is full of back-to-school to-dos. These include making dental appointments for your son or daughter and, depending on your child’s age and needs, possibly appointments with an orthodontist too. Getting a head start on braces — if your child needs them — will save many headaches as your child continues to grow during the school year. The key words here are “if your child needs them.” So how do you know? If it seems as if your child’s teeth are a little off or as if every kid in the class is flashing a new set of braces, you probably have plenty of questions. You probably also have plenty of preconceived notions about braces.
ADVANCES
IN
TEETH-STRAIGHTENING TECHNOLOGY “Improvements are made every year,” says Dwight V. Buelow, DDS of Virginia Family Dentistry in Richmond. “New research www.OurHealthRichmond.com
37
is published monthly that helps us determine what works better, faster, and more comfortably. A primary focus of orthodontic research in the last 20 years has been which treatments for younger children are more effective and predictable. And, of course, Invisalign treatment for adults and teens has expanded greatly.” The prevalence of Invisalign isn’t the only change in orthodontics since you were a tween. Traditional braces have been modernized too. Today they incorporate elastic wires that make for a less painful treatment, smaller brackets that are more efficient and discreet, and thermal wires.
Dwight Buelow, DDS, MS is an orthodontist with Virginia Family Dentistry. Dr. Buelow sees patients in the Bon Air and Powhatan locations.
If everything you know about braces is based on your experiences in middle school or high school, it’s time to take a fresh look at the subject. A lot has changed in childhood orthodontics since you were growing up. That includes the rise of braces that you can’t even see.
AT WHAT AGE SHOULD MY CHILD BE EVALUATED
FOR BRACES? Hearing of these advances may convince you to take your child to the orthodontist this fall. But if you’re still wondering, wonder no more. A checkup can do no harm. Your child may be too young for braces, but a first- or second-grade child isn’t too young for a checkup. Early planning now can save you both from a lot of anxiety down the line. Age seven may sound startlingly young, much younger than you remember. That’s because technology has improved and made it possible for younger children to get braces that are smarter and more effective. “The research I mentioned has helped orthodontists be more precise about what treatments are most effective and predictable for younger kids,” says Dr. Buelow. “Using braces to correct crossbites is an example of a treatment for kids that really helps them out in the long term.” Even with the assurance that orthodontic technology has advanced and that an early checkup is a sound idea, whether to actually put your child in braces can be a difficult decision. How do you know if your son or daughter is ready?
When Should My Child be Evaluated for Braces?
No Later than
7
YEARS OLD
38
“The biggest factor for young kids is the amount of space they have for their teeth to come into their mouths,” says Dr. Buelow. “An X-ray of a 7-year-old might show six
“The American Association of Orthodontists recommends the first visit with an orthodontist at age 7,” says Dr. Buelow. “I agree with them and so does Virginia Family Dentistry as a whole. Most kids won’t need treatment at that age, but it is very helpful to get a baseline snapshot of the child’s dental development.”
OurHealth | The Resource for Healthy Living in Greater Richmond
teeth or more at present. (I only have 24!) That’s because they have permanent teeth developing while some of the baby teeth are still present. It’s rush hour at age seven, and the dental traffic can be crazy. “Various types of space maintainers and space increasers are much more common than braces for kids at that age. So it’s important for parents not to think of ‘going to the orthodontist to get braces’ for the younger kids. Instead, they should think of ‘going to the orthodontist to keep the dental traffic under control.’ ”
WHEN GENETICS
COME INTO PLAY
“Genetics plays a big role,” he says. “Kids that have larger-than-average teeth but smaller-than-average mouths will be crowded. Kids with big jaws and small teeth will have lots of space. Genetics also plays an important role in the position of the lower teeth and jaw, from a profile view. If Mom and Dad have a prominent jaw, Junior is likely to have the same and might need braces to help the teeth bite correctly.”
How have braces changed? There have been a number of advancments in teeth straightening techonology including:
He adds that although parents should make an effort to correct thumb-sucking habits, they should never ignore the impact of genetics. And it’s important to get the need for braces evaluated early on.
•
Introduction of Invisalign
•
Super-elastic, thermal wires
“Regular visits with the family dentist and/or orthodontist can reduce the need for braces by keeping the dental traffic under control using space maintainers and space increasers,” he says.
•
Smaller, self-ligating brackets
•
Digital impressions
•
And more
BRACES IN STAGES,
OR ALL AT ONCE?
Your child may be a good candidate for getting braces in stages. In fact, this approach could save your family a lot of hassle. “Braces on upper teeth first can reduce the tendency for new patients to temporarily bite on the lower braces,” says Dr. Buelow. “In my practice, we usually put upper and lower braces on together to save the parents and patients a visit. We sometimes use small plastic ‘bumpers’ to keep the patients comfortable if they are biting on their lower braces. There’s no right or wrong answer about this topic!”
CONSULT WITH A PROFESSIONAL
TO
MAKE THE MOST INFORMED DECISION With so many advancements in orthodontic care available today, identifying which direction is best for your child can be challenging without advice from a dental health professional. Speak with your child’s dentist or schedule an appointment with an orthodontist for more information.
EXPERT CONTRIBUTOR:
Some parents may be tempted to think that their children need braces because they did something wrong. Did they let a child’s thumb sucking get out of control? According to Dr. Buelow, genetics is a bigger culprit when it comes to which children need braces.
• Dwight V. Buelow, DDS is an orthodontist at Virginia Family Dentistry in Richmond.
ON THE WEB
More at ourhealthrichmond.com www.OurHealthRichmond.com
39
series
5
the 2016 OurHealth Richmond Primary Care Series: an issue-by-issue overview
+++ january
| february
KNOW YOUR CARE: understanding your health and how to maintain it
+++ march
| april
DO YOUR CARE: words | GERI ASTON
MEASURE
YOUR
care
Improving your health requires lasting lifestyle changes that affect the way you eat, your activity level, your mindset and your interactions with your doctor.
Tracking Your Efforts to Ensure You’re on the Right Path!
Oftentimes the plan includes losing weight because overweight and obesity play a major role in many chronic conditions — high blood pressure, heart disease, diabetes, arthritis and sleep disorders, for example. The temptation is to measure your success by your weight. But the scale is just one measuring tool, and it doesn’t capture the full impact of the lifestyle changes you’ve made.
This article, the fifth in a yearlong OurHealth series about primary care, examines other ways to keep tabs on your progress toward better health.
taking action with your health
+++ june
| july
SHARE YOUR CARE: setting good examples for others to learn and live by
+++
| september
august
INSPIRE YOUR CARE:
keeping creative with fresh care ideas
+++ october
| november
MEASURE YOUR CARE:
tracking your efforts to ensure you’re on the right path
+++ december
CELEBRATE YOUR CARE: rejoicing the rewards realized from taking good care of yourself
“Raid” the fridge Storm your fridge and pantry — not to grab a snack, but to check their contents. Primary care providers we have interviewed for this OurHealth series have recommended that people move away from foods made in a factory, sweets, sugary beverages and junk food. Instead, they have suggested that people eat more fresh foods, especially vegetables and fruit. If money is tight, frozen vegetables and fruits can be good, less-expensive alternatives.
STOCK THE FRIDGE with Fresh Foods •
Load up on the fruits and vegetables
•
Shop for simple foods with real ingredients
•
Start reading the labels of the foods in your pantry, the fewer the ingredients, the better
•
Avoid foods with unrecognizable ingredients
•
Avoid high doses of salt, saturated fat and/or trans-fat
Is your fridge stocked with fresh items? Are there plenty of vegetables and fruits? If so, you’re on the right track. If not, it’s time to re-evaluate your buying choices. Doctors also recommend that people shop for simple foods with real ingredients. Read the labels on the food in your cupboard or pantry. Do the items have just one or only a few ingredients that you don’t recognize? Are they low in sugar, salt and saturated fat and contain no trans fat? If you answered “yes,” it’s a sign you’re eating right. Or is your pantry full of chips, sweets and other products with long lists of unrecognizable ingredients and high doses of sugar, salt, and saturated or trans fat? If you answered “yes,” you need to shop healthier.
Put pep in your step Keeping physically active is part of a healthy lifestyle. The health improvement plan you developed with your doctor likely includes some goals for being more active. One way to measure success is to monitor how much physical activity you weave into your day or week. The Centers for Disease Control and Prevention says typical adults should get two and a half hours of moderate activity a week and perform muscle strengthening activities two or more days a week. Moderate activity means exercise you could do while carrying on a conversation without getting out of breath, like brisk walking. Tracking the amount of activity you get is just one measure, though. It’s also helpful to evaluate the effect your activity has had on the way you feel and on your endurance. If your goal was to improve your fitness by walking, are you feeling more energetic? Are you able to walk farther than before? Do you breathe easier while you walk? The same measures apply to jogging. Maybe your increased activity level has given you the ability to do something you weren’t in shape to do before, like taking an aerobics class, walking the golf course instead of riding a cart or chasing after your grandchildren in the park. These would all be positive signs of a healthier you. 42
OurHealth | The Resource for Healthy Living in Greater Richmond
GETTING YOUR ZZZZ’S Getting a good night's sleep does more than keep you feeling refreshed. According to the National Heart, Lung, and Blood Institute, it plays an important role in your physical and mental health. In the extreme, the damage from not getting enough sleep can occur in an instant, such as a car crash, the National Institutes of Health notes. Meanwhile, the National Highway Traffic Safety Administration estimates that 83,000 crashes annually between 2005 and 2009 were related to drowsy driving. Over time, the lack of sleep can hurt your health in a number of ways, NHLBI says. Sleep is involved in the healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure and stroke. Sleep helps maintain a healthy balance of important hormones, including the ones that make you feel hungry or full. Lack of sleep makes you feel hungrier and increases your risk for obesity. Sleep also affects the hormone that controls your blood glucose (sugar) level. Sleep deficiency results in a higher than normal blood sugar level, which over time can increase the risk for diabetes. Your immune system relies on sleep to stay healthy. Ongoing sleep deficiency can change the way your immune system responds, for example, by making it more difficult to fight common infections. Sleep also helps your brain work properly, NHLBI says. During sleep your brain is preparing for the next day — it's when your brain forms new pathways to help you learn and remember information. If you don’t get enough sleep, you may have trouble making decisions, solving problems, controlling your emotions and behavior and coping with change. Sleep deficiency also has been linked to depression and suicide.
Sleep also helps your brain work properly. During sleep your brain is preparing for the next day — it's when your brain forms new pathways to help you learn and remember information. If you don’t get enough sleep, you may have trouble making decisions, solving problems, controlling your emotions and behavior and coping with change. Sleep deficiency also has been linked to depression and suicide. Source: National Heart, Lung, and Blood Institute
How do you know if you’re getting enough sleep? Last year, the National Sleep Foundation came out with the following recommendations for healthy amounts of sleep.
Age Young Adults (18-25)
Adults (26-64)
Older Adults (65+)
Recommended
May be appropriate
Not recommended
7 - 9 hours
6 hours; 10 - 11 hours
< 6 hours or > 11 hours
7 - 9 hours
6 hours; 10 hours
< 6 hours > 10 hours
7 - 8 hours
5 to 6 hours; 9 hours
< 5 hours > 9 hours
www.OurHealthRichmond.com
43
Minding your mind Improving your health isn’t a neck-down endeavor. Positive mental health is part of the whole picture. Research shows that exercise can help reduce anxiety and improve mood. Sunshine and exercise boost the level of serotonin, a chemical your body produces that is important for healthy brain function. Exercising with friends or family is good for your physical and mental health because socializing eases anxiety and depression.
The Lowdown on CHECKUPS FOR ADULTS Regular checkups are important even for people who feel well. They give your doctor a chance to screen for diseases, determine if you’re at risk for future medical problems and update vaccinations. Checkups also help you maintain a relationship with your doctor so he or she can better help you when you are ill.
If you’re nine months into your health improvement plan, it’s time to take stock of its impact on your mental health. Are you feeling more motivated, happier or less stressed now than you were before?
But how often do you need a checkup? Here are some recommendations.
Eye Exam 18 to 39: Every two years if you have a vision problem, more often if recommended by your eye doctor. 40 to 54: Every 2 - 4 years 55 to 64: Every 1 - 3 years 65 and older: Every 1 - 2 years
Dental Exam Adults should go to the dentist once or twice a year for an exam and cleaning. Your dentist will decide if you need more frequent visits.
Physical/Wellness Visit There’s no rule of thumb about when to get a physical. It depends on how healthy you are in addition to your age. Under 30: If you’re healthy — don’t smoke, have no disease risk factors (including being overweight) and don’t take prescription medications — get a checkup every two-three years. Others should ask their doctors how often they need a physical. 30-40: Healthy individuals should get a physical every other year. 50 and over: Annual physicals are recommended.
Sometimes a mental health problem can block efforts to improve your physical health. Depression can make a person unmotivated to exercise, eat right or take their medications. That can lead to a chronic illness or worsen an existing one. An underlying mental health issue could be the reason for a physical problem such as obesity. When mental health symptoms affect your ability to work or to enjoy relationships or your life, doctors recommend getting help from a mental health professional. If that’s the case with you, have you made an appointment yet? If you have, are you continuing to keep your appointments? If you were prescribed mental health medications, are they working? (Many medicines for mental health don’t take full effect for several weeks or months.) If you answered “yes” to these questions, it’s a good indication that you’re on the way toward better mental health. If you answered “no,” it’s time to check in with your doctor to figure out what’s going on so you can come up with solutions.
Better labs and less medicine People with chronic diseases often need to get regular lab tests. The results help you and your doctor measure whether your lifestyle changes and medication are working.
At nine months into your health improvement plan, have your lab results improved? If you’re diabetic, is your blood sugar in better control? If you’ve got high blood pressure or high cholesterol, are those numbers coming down?
MEASURING
MENTAL HEALTH When mental health symptoms affect your ability to work or to enjoy relationships or your life, doctors recommend getting help from a mental health professional. YES NO
Have you made an appointment yet? YES NO
Are you continuing to keep your appointments? YES NO
If you were prescribed mental health medications, are the they working? If you answered YES to these questions, it’s a good measure that you’re on the way toward better mental health. If you answered NO, it’s time to check in with your doctor to figure out what’s going on and come up with solutions.
If so, keep up the good work. If not, it’s time to contact your physician. Primary care physicians interviewed for this series urge their patients to call their office when they’re having trouble sticking with a health improvement plan. More often than not, doctors can suggest solutions. But doctors can’t help if they don’t know there is a problem. It’s also important to keep follow-up appointments and get the lab tests your doctor suggests. Life is busy, but you have to make time for your health. A reduction in the amount of medication you need to take can also serve as a measure of your success. Maybe because you’re eating better and exercising, you’ve gotten healthy enough for your doctor to lower the dose of your blood pressure medicine. Or perhaps your healthier lifestyle means you’re reaching less often for the pain relievers in your medicine cabinet. Positive results like these count whether you’ve lost weight or not.
Don’t give up What if you don’t see the results you hoped for when you started on your health improvement plan? Doctors say you shouldn’t give up or beat yourself up over it. Talk to your physician about your concerns to get advice on how to achieve the change you want. If any of your results are negative, you can use them as motivation to improve. Every day is a new day to make good health choices.
Next in our series Part VI of OurHealth magazine’s six-part series, “The Bridge to Better Health Starts With Primary Care,” examines ways you can celebrate the rewards www.OurHealthRichmond.com
45
realized from taking good care of yourself. Be on the lookout for Part VI in the December issue!
Sources • “How Much Sleep Do We Really Need,” National Sleep Foundation, www.sleepfoundation.org • “Physical Exam Frequency,” MedLinePlus, National Institutes of Health, National Library of Medicine, www.medlineplus.gov • “Research on Drowsy Driving,” National Highway Traffic Safety Administration, www.nhtsa.gov • “Should you get an annual physical?” DukeHealth, www.dukehealth.org • “Why Is Sleep Important?” National Heart, Lung, and Blood Institute, www.nhlbi.nih.gov
ON THE WEB
More at ourhealthrichmond.com
46
OurHealth | The Resource for Healthy Living in Greater Richmond
S T I ITB
F
words | DEIDRE
ADD S
WILKE
S
ND TH A HEAL N SS O FITNE O THE G
OME N
Deidre Wilkes, AFAA, ACSM Certified Personal Trainer
Deidre is the resident fitness specialist for OurHealth Richmond.
EW 'TR
IX' TO Y
OUR W
ORKOU
T
TRX Suspension Training Suspension training is nothing new, and it is a highly effective form of resistance exercise. If this piques your interest, read on to learn about this unique training format. TRX (Total–Body Resistance Exercise) was first created by Navy SEAL, Randy Hetrick in the mid 1990’s, who was looking for a way to exercise and keep fit while out on the field. The concept caught the attention of the fitness industry, and it wasn’t long before those black and yellow straps started showing up in gyms across the country and the TRX Suspension System was born.
TRX Suspension Training uses body weight as resistance to develop strength, balance, flexibility and core stability simultaneously. It requires the use of the TRX Suspension Trainer, a performance training tool that leverages gravity and the user’s body weight to complete hundreds of exercises. The TRX System uses two suspension straps that hang from an anchor. The straps are adjustable allowing for many variations as well as the ability to make exercises more challenging or easier, depending on the length and angle of the straps. This makes TRX Suspension Training ideal for all fitness levels.
FIND A CLASS: Check out these local facilities that offer core classes and training:
WORKOUT STATS:
HIGH INTENSITY
*fees may be required
Victory Lady Fitness Centers Southside and Westend locations 804.272.0708 | 804.965.9741 www.victorylady.com
Balance Pilates Training Center
STRENGTH
Richmond | 804.615.9891 www.pilatesrichmond.com
BALANCE
RVA4Fitness
FLEXIBILITY
Midlothian | 804.704.7019 www.rva4fitness.com
www.OurHealthRichmond.com
47
48
OurHealth | The Resource for Healthy Living in Greater Richmond
HOW TO IN
HEALTHCARE part SERIES
the 2016
OurHealth Richmond
HOW TO IN HEALTHCARE SERIES: an issue-by-issue overview
words | TINA JOYCE
TIME TO PUT THE SKILLS TO
THE TEST OurHealthâ&#x20AC;&#x2122;s four-part healthcare education series is a step-by-step guide for those interested in pursuing a career in
healthcare.
In Part I, the March/April issue, OurHealth offered insights into the fascinating world of healthcare education. Anyone with a passion for serving others, a love of science or a fascination with the way the body works is a prime candidate for a career in healthcare. These traits often develop in childhood, which is why we began our expert advice with tips for the families of students interested in healthcare opportunities in college. In Part II, the June/July issue, college and university professionals gave advice on certificate and degree programs for students transitioning into healthcare professions after completing two- or four-year degrees. In Part III, the August/September issue, we began outlining the steps for entering graduate and medical school programs and exploring the best options for individual students. Now, in our fourth and final article, we seek to open the doors to employment. Even when students are diligently focused on completing their educational requirements, they can easily lose sight of the details of creating an appealing, hire-worthy portfolio.
part one
Preparing for a Career in Healthcare as Early as High School march
|
april
part two
Choosing The Right Undergraduate School For Your Healthcare Specialty june
|
july
part three
Entering Graduate School and Residency/Fellowship/ Clinical Training august
|
september
part four
Insight on How to Find the Right Job in Oneâ&#x20AC;&#x2122;s Field of Specialty october
|
november
Education plus experience should equal employment. Why, then, are so many graduates moving back in with their parents to pay off their college debt?
QUESTIONS STUDENTS SHOULD ASK HEALTHCARE PROFESSIONALS:
According to the Association of American Medical Colleges,1 78 percent of medical school graduates have $180,000 in debt upon graduation. This certainly isn’t the figure their parents will boast about in the next Christmas letter. But if medical students and graduate students seek careers proactively, beginning early in the educational process, they can lighten these financial burdens and broaden their future opportunities. Of course, not everyone seeking a career in healthcare has to complete four years of undergraduate work and medical school. But training for any healthcare profession takes time and financial commitment. These are valuable commodities and should be used wisely.
hh What was your path through education?
Students should seek wisdom, education and experience. One of the best ways to gain wisdom is to ask the wise. By gathering information from people working in or retired from the healthcare professions, you create opportunities to learn from others—both from their successes and from their mistakes.
hh What was the best advice you received in school?
As early as high school, students can start preparing their professional portfolios to include pertinent work experience and positive references. Building relationships is crucial. You might admire a particular educator or medical professional you meet through study, practicums or residencies. If you want their help, simply ask. By the time a student is in the final stages of education, a career path will hopefully have become clear, and the student can focus on landing the job or career of their choice. It is important to be flexible, persistent, and patient.
hh What would you do differently?
hh What was your greatest professional struggle? hh What was your greatest professional reward?
hh What was your first job in the field?
hh What’s the most important thing I can do to prepare for my first interview? hh What stands out the most to you in a résumé or CV?
hh What healthcare associations do you belong to, and which do you benefit from the most? hh What have you learned the most about from your patients?
Whether you can choose a particular location for work depends on several factors. Can you relocate, and are you willing to? What connections do you have at a particular facility? (Do you know someone who works there now or has in the past?) Does your educational institution offer career placement services? What credentials (academic or experiential) does the facility require for employment?
“It is highly essential that resumes in the healthcare industry be accurate to include the correct spelling of medical procedures and medical terminology. An effective resume that is tailored to the job you are applying for, and speaks to your qualifications, skill set and experience can open many doors for you. Don’t forget to include internships, certifications and residency on your resume to showcase your skills and qualifications. A single page of three to four references that can speak to your qualifications is essential to the job search. The names you provide as references must include the name of the organization, person’s current job title, email address, and telephone number. Do not include family or friends. Most importantly, please get permission in advance from your reference prior to listing them. Explore many options in your job search paying particular attention to healthcare jobs at agencies such as the Food and Drug Administration, the Veterans Administration, Drug Enforcement Agency, dialysis centers and the military.” Brenda Sands Hines, BS, MS | Director of Business Development and Community Relations | Bryant & Stratton College
50
OurHealth | The Resource for Healthy Living in Greater Richmond
I encourage prospective employees to identify what they like in a patient care setting and foster networks with those who match their preferences. Many of our employees come to us after doing a clinical rotation in one of our centers while they are in school. Others seek us out based on our reputation or insight they have gained from a family member or friend. At Medical Facilities of America, our positions are advertised on our company websites and on www.Indeed.com. To learn more, just go to www.mfa.net/careers. Todd Putney | Vice President of Human Resources | Medical Facilities of America
Students completing residency programs are often approached by recruiters. Drug companies and staffing companies that focus on healthcare recruitment might contact residents or graduating students about opportunities. It is vitally important to examine every employment offer with discernment. Proceed cautiously and do your research. It is especially advantageous to get to know someone at the facility you’d like to work in. Volunteering and working part time are great ways to gain insight into an organization before applying for permanent employment. If you earn the respect of employees, board members, or supervisors, your chances of being asked to submit a resume and of gaining an interview increase drastically.
BUILDING
YOUR RÉSUMÉ OR CV
Students should consider several factors when building a résumé or a curriculum vitae. First, the difference between them is important. A résumé simply and concisely presents your skills and your qualifications for a particular position or career. It should be one or two pages long. A CV includes a more complete history of your academic credentials. CVs are used by students seeking fellowships, grants, postdoctoral positions and teaching and research positions at postsecondary colleges and universities. The length can vary a lot.2 A résumé or CV cannot be built overnight. Compiling accolades and experience takes time, and if you wait until graduation to start, then by industry standards you are far too late. Many key components of a résumé can be acquired only through volunteer work, hours of commitment to a job or residency program or rigorous academic training. Regardless of age or year of school, students should always be thinking about building a résumé. It takes far more work than checking a box to indicate “done” on an application. Volunteer work and work experience should reflect not only your values but your passion. Employers are always seeking the “best fit” employees for their organizations. Students should also seek the “best fit” employers to help them fulfill their goals and purposes.
www.OurHealthRichmond.com
51
FIVE TIPS TO BUILD AND EXPAND
YOUR PROFESSIONAL NETWORK
The following five tips can help you build and expand a professional network so you can explore more employment opportunities, according to the Harris Casel Institute.5
STEP 1: MAINTAIN
AN ACTIVE LINKEDIN PROFILE. This vast professional platform is a great way to network with others if you stay active on it. Create a profile and market your experience for free. LinkedIn helps you stay up to date on healthcare news and advances. Optimize your profile with keywords related to your specific healthcare profession.
HERE ARE SOME WAYS YOU SHOULD USE LINKEDIN: Start conversations. Comment, share, and converse with other healthcare professionals. Get your name out there by asking crucial questions or requesting people keep you in mind when giving updates. Commenting on blog posts regularly is a way to become a part of a wider conversation. Give positive feedback on other professionals’ posts to build your own online presence. Endorse colleagues. On LinkedIn, you can endorse others as a friendly gesture. If you do, there’s a greater chance they’ll endorse you back. Endorsements look good to potential employers. Include a picture. A profile picture improves your chances of endorsements and consideration from employers. It also personalizes your profile. A picture helps people put a name to a face and makes it easier for others to notice you at events.
STEP 2: GET
INVOLVED IN HEALTHCARE ORGANIZATIONS. Getting involved is a crucial part of networking. You might search for associations, societies and groups that revolve around a particular healthcare specialty of your expertise or interest. If you’re interested in medical assisting, you could look at joining the American Association of Medical Assistants. As a member of an organization, you can learn about new developments in your field and gain the benefits of being part of a local or national healthcare community. 52
OurHealth | The Resource for Healthy Living in Greater Richmond
STEP 3: TAKE
PART IN EVENTS.
Keep your eye out for healthcare events. You can search forums, LinkedIn, and healthcare websites for local events where you can meet other healthcare professionals. Events are great occasions for networking with others. If you show up to lots of them, people might start recognizing you.
STEP 4:
VOLUNTEER.
You can show your passion for your profession by volunteering at a local healthcare organization. Not only does this look good on your résumé and help the community, it lets you meet others who are just as passionate about improving people’s health. Volunteering gives you the opportunity to expand your network and learn about new developments in the healthcare world.
STEP 5: BUILD
YOUR PROFESSIONAL PRESENCE. It’s always a good idea to differentiate yourself from your competition. Make sure your online presence and interpersonal skills stand out. Highlight traits of your personality that are good or unique. You could come to be recognized for your passion on a specific healthcare subject. If you build on a specific trait, you might be recognized for it, which makes you stand out from the crowd. With dedication and a positive attitude, you can start building strong professional relationships with others in your healthcare field. You might expand your knowledge and professional horizons too, which could help you to advance in your career and build your technical skills.
Do your research to understand how the employer you’re interested in is transforming itself in order to thrive under the population health model that healthcare reform is driving in the United States. Discern and be prepared to communicate how you, the job applicant, fill the employer’s needs as it goes through that transformation. It is a different mindset than healthcare employers have had in the past. Jim Godwin | Vice President of Human Resources | Bon Secours Virginia Health System
CREATING A
NETWORK
Forbes magazine published a “top ten” list of contacts you should have in your network. “The trick,” the article says, “is to make sure you are building a diverse network by adding people from different industries, backgrounds, age groups, ethnic groups, etc. that fit into different roles. Building a deep network by only including people from your current profession or business focus leaves too many stones unturned, limiting potential opportunities.”4 An active network naturally encourages dialog about new employment opportunities. Lunch with an association president or local hospital board member can lead to insights about upcoming job openings. Regardless of whether you are pursuing a new job or planning to change jobs in the medical community, you should remain active and involved in organizations that fit your personal and professional interests.
PREPARING FOR AN
INTERVIEW
Once you’ve made contact with a potential employer or have an interview scheduled, there are steps you can take to ensure it’s a positive interview. First, conduct more in-depth research. Before seeking an interview, a student should ideally have done research and applied only to organizations that share their mission or goal. It would be a waste of time, and misleading to an employer, to take an interview for a job you have no intention of accepting. Learn about the organization, its history and its vision. Learn who the key stakeholders are and who makes the final hiring decisions. Then ponder interview questions and prepare appropriate, honest answers.
www.OurHealthRichmond.com
53
According to the Integrity Training Institute, “Most managers hire for skills, but fire for character. Because of the overwhelming problems associated with hiring employees who lack required character traits, more and more healthcare managers are asking character-discerning questions when interviewing employees.”6 The box on page 55 offers some sample interview questions in the healthcare community. Being a sought-after employee or student should be a goal. Joining business associations or healthcare organizations can also add to a student’s résumé. However, nothing can replace focus, hard work and strong relationships. In Part I, OurHealth gave parents and students direction for finding a course load suited to entering a healthcare profession. Parts II, III and IV of the series showed how students should begin with academic focus, work hard to earn stellar grades and then build connections with people in their educational institutions and professions. As individuals progress and mature, by asking key questions and seeking wise counsel they can ensure they are guided down a path to success, not toward fear of graduation.
A TYPICAL RESUMÉ
A TYPICAL CV INCLUDES THE
INCLUDES THE FOLLOWING INFORMATION hh COVER LETTER: This provides a permanent written record of the submission of the resume. It says what is being sent, to whom and by whom. hh NAME AND CONTACT INFORMATION: Your residential address might be the most appropriate. hh EDUCATION: List your degrees and certifications and the educational institutions and programs you attended. hh WORK EXPERIENCE: List the companies or organizations you have worked for, the location of each, the dates you worked for them and your job titles and duties. hh REFERENCES (POSSIBLY) : This is a list of people willing to write letters of recommendation for you, including their contact information
54
FOLLOWING INFORMATION
hh Name and Contact Information: Contact information at your current institution or place of employment might work best. hh Areas of Interest: List your varied academic interests.
hh Education: Specify your degrees, earned or in progress, institutions and years of graduation. You might include the title of your dissertation or thesis here.
hh Grants, Honors, and Awards: List any grants you have received, honors bestowed on you for your work and awards for your teaching or service. hh Publications and Presentations: Give a list of your published articles and books and presentations you have given at conferences. If there are a lot, you might make one section for publications and another for presentations.
hh Employment and Experience: This section can include separate lists for teaching experience, laboratory work, field work, volunteering, leadership and other relevant experiences. hh Scholarly or Professional Memberships: Here you list the professional organizations you belong to. If you have held an office or position in one of them, you can say so here or in the Experience section. hh References: This is a list of people willing to write letters of recommendation for you, including their contact information.3
OurHealth | The Resource for Healthy Living in Greater Richmond
TOP QUESTIONS FOR SOURCES: The American Association of Medical Colleges. www.aamc.org 1.
The University of California at Davis. www.icc.ucdavis.edu/materials/resume/resumecv.htm 2.
The University of North Carolina at Chapel Hill. www.writingcenter.unc.edu/handouts/curricula-vitae-cvsversus-resumes 3.
How to Build a Powerful Professional Network. www.forbes.com/job-search 4.
www.harriscasel.com/networking-tips-for-buddingprofessionals 5.
The Integrity Institute. www.characterbasedleadership.com/health1.html 6.
“The best advice I can give to candidates seeking positions in healthcare is to take the time to research. Learn about the organization to which you are considering applying, so that you can determine if its mission and values are congruent with yours. Also, make sure you know and understand the job responsibilities for the position you are seeking. When the time comes to interview, dress professionally, carry extra copies of your current resume, and present your most authentic self. Remember, patient care and experience are the driving forces for the healthcare industry, so whenever possible, emphasize your strengths; highlight your caring attitude; and talk about your desire for high standards and excellence in service. Be prepared to offer examples illustrating these behaviors; it will strengthen your presentation because these are qualities employers are seeking. Network with people who are at the organizations with which you want to work and with people who are currently in similar positions you are seeking. Employee referrals are a principle source for new hires, and face-to-face networking is a strategic opportunity to obtain the position you desire. LinkedIn is also a good venue for networking in your field. Lastly, accepting an opportunity to volunteer or shadow people who work in the positions you desire is also a great way to showcase your skills and exhibit your passion for health-care work and for the organization that you are interested in joining.” Tammy Colatruglio, RN, MSN | Director of Nursing at John Tyler Community College
INTERVIEWING HEALTHCARE EMPLOYEES hh Tell me about your last performance review. What was mentioned about how you could improve? Any re-occurring themes?
hh What situations kept you from fulfilling your job duties or from coming to work on time at your last job? hh Tell me about the most recent problem you had with a co-worker. Listen and then ask, how did you handle it?
hh What about your character makes you a good candidate for this job?
hh Priorities often change suddenly throughout the day. If you are asked to quickly do another task, how does that affect your mood? What if it's the third time before noon? hh What do you feel is an acceptable amount of days to be absent in a calendar year?
hh How do you handle situations that could cause you to be tardy or absent? hh How did you fill downtime at your last job?
hh How have you responded in the past when you found another employee was stealing?
hh How have you responded in the past when your replacement calls in sick and a substitute will take over an hour to come in? hh 24/7 operations are like relay races where you take the baton, run with it and then pass it on smoothly. How do you make seamless transitions on shift changes?
hh During the last year, when your replacement hasn’t shown up and your manager asked you to stay late, what percentage of the time have you stayed late? hh Think about the last time your manager critiqued your work. How did you respond? hh Give an example of when you did something without being asked. Can you give me another example?
hh Describe a recent problem you had with one of your manager's decisions. Listen and then ask, how did you handle it? hh Tell me about your most frustrating experience as a __________(job title). How did you handle it?
www.OurHealthRichmond.com
55
Photos courtesy of Bon Secours
Bon Secours St. Mary’s Hospital 50th Anniversary Celebration in the Park More than 50 years ago, on January 9, 1966, Bon Secours St. Mary’s Hospital was dedicated as the first Catholic hospital in Richmond. On Saturday, September 10, 2016, St. Mary’s held a ‘Celebration in the Park’ to commemorate the hospital’s 50th anniversary. The day kicked off with a half mile Kids Fun Run and a Racin’ on the Avenue 5k, benefiting the Sister Mary Monica Good Samaritan Fund. State Senator of Virginia Siobhan S. Dunnavant presented the St. Mary’s 50th Anniversary Proclamation. In addition to the 50th anniversary, St. Mary’s has another special anniversary to celebrate in 2016. The event also hosted a special 25th reunion and celebration for families, babies and staff of the hospital’s Neonatal Intensive Care Unit (NICU). The state-of-the-art NICU at St. Mary’s opened in 1991. Families gathered on the Westhampton School grounds behind the hospital where they enjoyed cake pops and a butterfly release while catching up with the doctors and nurses that helped care for their babies and bring them home. 56
OurHealth | The Resource for Healthy Living in Greater Richmond
ON THE WEB
More at ourhealthrichmond.com www.OurHealthRichmond.com
57
take a closer
LOOK
CAN YOU IDENTIFY WHICH LOCAL HEALTHCARE FACILITY THE IMAGE BELONGS TO?
Like OurHealth on Facebook and leave your answer in the comments section of the CloserLook post by November 7th for a chance to WIN a FREE Magazine Subscription!
The winner will be announced on our Facebook page by November 20th so make sure you check it out! ON THE WEB
More at ourhealthrichmond.com 58
OurHealth | The Resource for Healthy Living in Greater Richmond