Non-Surgical Facial Enhancement | Taking Virginia’s Political Pulse | Counterfeit Medications: Prescription for Danger
Greater Richmond edition • September 2012
the premier issue
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our health | BASIC
table of contents | september 2012
the premier issue
EDITOR’S LETTER........................ 8 Hello, Richmond! Editor Rick Piester introduces the premier issue of Our Health Richmond
MEDI•CABU•LARY.....................12 Local experts define healthcare related terms
JUST ASK!..................................14 A variety of health questions answered by local professionals
THE LATEST...............................15 A listing of new physicians, providers, locations and upcoming events in the greater Richmond community
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16
COVER STORY Richmond healthcare leaders 40 and under
BASIC | our health
46 34
HEALTHCARE AND THE ELECTION
SAVING ON HEALTHCARE Clark Howard on health costs: America’s favorite penny pincher talks about saving money on healthcare
Taking Virginia’s political pulse: how the November elections may impact the future of healthcare in the Commonwealth
62
SENIOR LIVING Prescription for danger: buyer beware when it comes to Internet pharmacies
HOLISTIC TRUTH.......................49 Should you detox? It’s a good choice for some, but be careful!
SPECIALIZED SERVICES FOCUS.......................51 Getting it right in the NICU: national honors for the Henrico Doctors’ Hospital unit
HEALTHY READING REVIEW.....65 BODY BEAUTIFUL......................39 Face time: how long will the procedure last? Will people know?
CUTTING EDGE...........................43 A new technology marketed by two Virginians is set to make a difference in the way infectious diseases are controlled
MEN’S HEALTH...........................55
Healthy reading: a basic home library
The prostate puzzle
MIND MATTERS..........................58 New treatment for depression shows promise
QUIZ YOURSELF! .......................61 Test your health knowledge and win!
www.ourhealthrichmond.com | 7
HELLO,
Richmond!
What a thrill it is to be able to welcome you to this, the inaugural issue of Our Health Virginia’s new edition especially for the greater Richmond area. This magazine is the product of years of lessons learned from our company’s earlier and successful publishing ventures — principally our specialized geographic editions for the Roanoke and New River Valleys and for Lynchburg and Southside Virginia. We’ve learned that Richmond-area readers want to know what’s going on in healthcare in their region, in their city, even in their neighborhood. So that’s what we will try to bring to you with each issue. That is a very big story to tell, but we’ll try to tell it right, in a way that you will find interesting and relevant to your life. This is who we are: Our publisher is Stephen C. McClintic, Jr., founder and president of McClintic Media. Steve is steeped in healthcare communications, with deep experience heading the communications activities of major hospitals and physician groups in Virginia, and who had the courage, skill, and talent to launch a publishing venture that is proving to be a tremendously valuable vehicle in every community where it operates. Richard Berkowitz is our senior vice president of business development. His work combines all that is necessary to establish a presence for a magazine in a brand-new market, filling a brand-new niche and, while he’s at it, attracting advertisers, the lifeblood of any magazine venture. No mean feat.
Rick Piester Editor-in-Chief rickpiester@ourhealthvirginia.com
I’ve spent many years in healthcare communications, ranging from hospitals to large health systems, to major medical associations. And now I’ve got the best job on the magazine. I get to work with the best writers to produce the best articles that we can think of, to inform you and offer some guidance in your healthcare choices and activities. And then there are the people that you don’t see, but who are so important. Chief among them is Jenny Hungate, production manager, who keeps everything coordinated. I don’t know how she does it, but I am so glad that she does. Next, there are the writers — along with the photographers and designers — who make up the creative side of Our Health Virginia. It’s been my particular delight to find, to guide, and then to enjoy their very special craftsmanship. We’re new to Richmond, and we are so grateful to the ever-expanding circle of friends and supporters who have helped us on this journey. Many people have taken their time in marvelous ways to welcome us, and to guide us. Thank you all. And, last but hardly least, are the advertisers. These are the individuals and organizations that have entrusted us, based on our many years of proven experience, to bring a vehicle like Our Health Virginia to Richmond. So that’s the cast and crew. You are the audience. The curtain is about to go up, and we really hope you like what we have for you.
Rick Piester, Editor-in-Chief 8 | www.ourhealthrichmond.com
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McClintic Media, Inc. Stephen McClintic, Jr. | steve@ourhealthvirginia.com Rick Piester | rick@ourhealthvirginia.com Angela Holmes Jennifer (Jenny) Hungate | jenny@ourhealthvirginia.com Karrie Pridemore Ed Ip Heidi McClintic Ryan Dohrn
CONTRIBUTING RICHMOND MEDICAL EXPERTS David L. Armstrong, OD Debbie Burbic, RN Alan Burke, MD Carolyn Burns, MD Vijay Dhande, MD Walter Foliaco, MD Michael Godin, MD Ruth Hillelson, MD Charles Jung, MD Bryan Lowry, DC Michael Miller, MD Joe Niamtu, III, DMD Ananda Pandurangi, MD Victoria Rennie, MD William U. Roodman, DC Amy W. Rudenko, PharmD Kenneth Simpson, MD William Suavé, MD Hazel Vernon, MD Timothy Wallace, MD, PhD CONTRIBUTING PROFESSIONAL WRITERS Rod Belcher Susie Galvez Anika Imajo Rick Mayes Edwin Schwartz
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COMMENTS/FEEDBACK/QUESTIONS Our Health Richmond magazine welcomes your feedback. Please send your comments and/or questions to: “Letters,” Our Health Richmond, PO Box 8383, Richmond, VA 23226. You can also call 540.355.3071 or send an email to steve@ourhealthvirginia.com Content in this magazine is for informational purposes only. It 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 OR OTHER PROVIDER. All matters concerning physical and mental health should be supervised by a licensed 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 ©2012 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. Our Health Richmond is published monthly by McClintic Media, Inc. www.ourhealthrichmond.com. Advertising rates upon request.
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our health | MEDI•CABU•LARY & JUST ASK
me d i • ca bu • l ar y
LO C A L E X P E R T S D E F I N E H E A LT H C A R E R E L AT E D T E R M S
What is Mitral Valve Prolapse? Mitral valve prolapse is a common condition that occurs when the valve between your heart’s left upper chamber (the atrium) and the left lower chamber (the ventricle) do not close properly. With mitral valve prolapse, one or both of the valve leaflets can bulge, or “prolapse” back into the atrium. Sometimes, this can allow blood to leak back into the atrium –a condition called mitral valve regurgitation. In most, mitral valve prolapse doesn’t cause symptoms, require treatment or changes in lifestyle. However, some people may require treatment for the regurgitation or other associated problems. Carolyn Burns, MD, FACC Virginia Cardiovascular Specialists Richmond | 804.521.5800
What is Molluscum Contagiosum, and where did my toddler get it? Molluscum contagiosum is a common skin infection in children. It appears as small, skin-colored to pink shiny bumps. The virus is found only on the skin surface; it does not go internally. It is almost always spread through direct skin-to-skin contact or contact with contaminated surfaces such as towels. Any situation where children are playing together can result in spread. Keeping the skin covered may minimize spread. The infection is more common in children who go to the pool (although it is not yet clear whether it is spread through the water itself or by body contact and its presence on the pool surfaces). The virus is not found in air or saliva. Most often the little bumps go away on their own after several weeks to months. Occasionally the bumps get itchy, inflamed, or sore, or continue to spread, at which time, treatment is required. Hazel Vernon, MD Commonwealth Dermatology Richmond | 804.440.SKIN
12 | www.ourhealthrichmond.com
What is Macular Degeneration? Age Related Macular Degeneration (ARMD) is the leading cause of vision loss among older adults. It gradually destroys sharp, central vision making it difficult to read, recognize faces, watch TV and drive. There is no cure for ARMD. Use of appropriate nutritional supplements has been shown to slow or stop the progressive vision loss. Many people with ARMD are helped by special microscopic or telescopic glasses. Risk factors include increased age, family history, smoking cigarettes, being white and female. David L. Armstrong, OD Optometrist Central and SW Virginia | 540.982.2020
What is post-traumatic stress disorder? Posttraumatic Stress Disorder (PTSD) is a syndrome defined by three categories of symptoms: Re-experiencing, avoidance or emotional numbing and persistent arousal, all of which begin following a severe traumatic event. Re-experiencing symptoms can manifest as “flashbacks” in which the sufferer typically acts out the memory they are reliving, but more commonly manifests as intrusive recollections, a persistent memory that continually comes to mind in spite of efforts to keep it out. Avoidance can mean avoiding places, people or things that are reminiscent of the event, and emotional numbing can manifest as depressed mood. Arousal symptoms and include constant anxiety, hyper vigilance, exaggerated startle and insomnia. William Suavé, MD Poplar Springs Hospital Petersburg | 804.733.6874
What are early
our health | MEDI•CABU•LARY & JUST ASK
ju st a sk!
A VA R I E T Y O F H E A LT H Q U E S T I O N S A N S W E R E D B Y LO C A L P R O F E S S I O N A L S
What are early warning signs or symptoms of prostate cancer that men should take notice of?
What is the difference between Family Practice and Internal Medicine?
Most often, prostate cancer is asymptomatic and is only diagnosed as a result of current screening methods. Symptoms of prostate cancer may resemble symptoms of a normally enlarged prostate gland (BPH). Increased frequency of urination both in the daytime and at night, a weak stream associated with hesitancy, intermittency or straining or burning with urination may be present. Difficulty with ejaculation may also be present. These may include difficulty having an erection, pain with ejaculation or blood in the semen. Prostate cancer may also present with pain in the low back or hips. Prostate cancer screening, when done appropriately, will differentiate between prostate cancer and other benign causes.
The historical difference between family practice and internal medicine has to do with Pediatrics and perhaps OB/GYN services. In the past, few internists dealt with Gynecology and not obstetrics at all. Most internists do not see patients younger than 18 although some will see 16 year olds. More recently, internists are training to do more gynecology routinely. As for adult medicine, the type of training is similar, but internists often take more extended training in one discipline or another and are usually the physicians who become subspecialists in a variety of areas like cardiology or neurology. Family doctors are more generalists capable of managing perhaps 80-85% of a family’s healthcare needs at all ages and also trained to recognize the need for subspecialty consultation, the latter a responsibility of internists as well.
Timothy Wallace, MD, PhD Radiation Oncology Associates Richmond | 804.330.9105
Kenneth Simpson, MD Virginia Physicians, Inc. Cold Harbor Family Medicine Mechanicsville | 804.730.1111
14 | www.ourhealthrichmond.com
Is a compound fracture the same thing as a broken bone?
What is Hypertension and what can I do to prevent it?
A broken bone is the same as a fractured bone. In some fractures the broken ends of the bone don’t move out of place at all and that causes less damage and a good position for bone healing. Other fractures may have the bone ends out of line with each other and require repositioning to get a good result when healed.
Hypertension is persistent elevation of arterial blood pressure. It is predominantly an age related phenomenon that is genetically driven. Hypertension however, manifests at an earlier age because of lifestyle choices. It is these choices that a person can most impact how soon the blood pressure will become a problem in their life. A healthy, low salt diet defined as less than 2 grams of salt per day is a good start at prevention. In addition to low salt, at least 3-4 hours of aerobic type exercise, no tobacco products and weight control all help prevent high blood pressure from needing treatment too early in life.
A compound fracture has the broken ends of the bone showing or sticking through a wound in the skin. This is also called an open fracture. This means the ends of the fractured bone are very much out of position and damage may have been done to nerves and blood vessels as well as muscles and tendons. In addition to the interior damage caused during the fracture, there is also the risk of contamination to the open wound and bones. Infection is a very big risk with an open fracture. Victoria Rennie, MD Patient First Mechanicsville | 804.559.9900
Walter Foliaco, MD Chesterfield Family Practice Richmond | 804.276.9305
THE LATEST | our health
the l atest
Daniel W. Hwang, MD Ophthalmologist Commonwealth Eye Care Associates Richmond | 804.217.6363
N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S
Jason R. Hull, MD Tuckahoe Orthopaedics St. Mary’s Hospital Campus Richmond | 804.285.2300
Saumil R. Shah, MD Virginia Cardiovascular Specialists Richmond | 804.323.5011
Four physicians have recently joined Tuckahoe Orthopaedics for a one year, accredited fellowship in Arthroscopy and Sports Medicine for residency-trained orthopaedic surgeons. The fellows work closely with the sports medicine physicians in the clinic and also in surgery and are exposed to arthroscopic procedures for the knee, shoulder, elbow, ankle, and wrist. The new fellows are Matthew R. Byington, DO; Jeffrey S. Johnson, MD; Chad J. Muxlow, DO; and Paul W. Schuppner, DO. The fellowship program, in cooperation with Orthopaedic Research of Virginia, has been in operation since 1982.
Julie Kerr, MD Commonwealth Ear, Nose, & Throat Specialists PC Richmond | 804.525.4231
Stuart M. Motley, II, M.D. Virginia Physicians, Inc Parham Primary Care Division Richmond | 804.346.1515
Steven Mohlie, M.D. Named Medical Director at Patient First, Short Pump Richmond | 804.360.8061
Henrico Doctors’ Hospital Labor and Delivery Only in U.S. to Receive Joint Commission Certification for Induction of Labor Program Henrico Doctors’ Hospital Labor and Delivery Unit is the first and only hospital in the United States to earn Joint Commission certification for its Induction of Labor Program. This prestigious certification recognizes Henrico Doctors’ clinical excellence and leadership in caring for mothers and their newborns. The Labor and Delivery Unit underwent a rigorous on-site survey. A team of Joint Commission expert surveyors evaluated the hospital for compliance with standards of care specific to the needs of patients and families, including leadership, quality of care and medication management. The hospital was recognized for putting into place processes and procedures for advanced safety standards, pain management related to induction of labor, and standardization of labor induction practices. “Henrico Doctors’ Hospital continues to demonstrate its commitment to outstanding care for women’s services,” says Jean Range, MS, RN, CPHQ executive director, DiseaseSpecific Care Certification, The Joint Commission. “I commend Henrico Doctors’ Labor and Delivery program for successfully advancing the standard of induction of labor care and continuing to instill confidence in the community it serves.” “The physicians and staff in the Women’s Services program at Henrico Doctors’ continue to exceed national quality standards for obstetric care,” says Patrick Farrell, CEO of Henrico, Parham and Retreat Doctors’ Hospitals. “This Joint Commission certification recognizes our culture of clinical excellence in the program and the exceptional environment of care we strive to maintain for our mothers and smallest patients.” Henrico Doctors’ Hospital delivers more babies than any other single hospital in the Richmond area. The Henrico Doctors’ Neonatal Intensive Care Unit (NICU) is one of only four hospitals in the nation – and the only in Central Virginia – to receive Joint Commission certification for it Prematurity Program. The hospital was the first community hospital in Richmond to establish a NICU and the only in the area with 24/7 in-house neonatologist coverage.
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LEADERS 40 & UNDER | our health
Richmond Healthcare Leaders
40 & UNDER
SOME OF OUR BEST AND BRIGHTEST words | RICK PIESTER & ROD BELCHER photography | ED IP AND KEITH THIENEMANN
There is a kernel of conventional wisdom that suggests that real leadership ability must wait for age. It has to do with seasoning, experience, wisdom, and other virtues. That is true, but equally true is the emergence, at a relatively young age, of tomorrow’s leaders. These are the people who, sometimes for reasons you can’t quite articulate, have “star” quality. You get a sense that if they work hard, keep their eye on the prize, and get a break once in a while, they will become leaders in every good sense of the word. So for this premier issue of the Our Health Virginia’s Richmond edition, we thought that we would acquaint ourselves, and our readers, with some of the rising stars of healthcare in the Richmond area. And we went looking for them. The criteria were quite broad. To be eligible, a nominee must have been age 40 or under at the time of the submission of the nomination, and must be making significant contributions to healthcare in Virginia. Nominees could come from any field, so long as their work involved some aspect of healthcare. We welcomed nominations of physicians, nurses, or any other health professional. People could have been nominated from the ranks of healthcare providers, regulators, government, the law, academia, even the news media — anyone with a demonstrable impact on healthcare in our state. We recommend that you keep an eye on the careers of the 15 people profiled here. Our bet is that they will be highly influential in their respective fields for years to come.
www.ourhealthrichmond.com | 17
our health | LEADERS 40 & UNDER
“We want healthcare students to be better listeners,” Dow says, “and to pick up non-verbal cues from patients.”
“I’ve always been interested in how people think,” says Alan Dow, MD, “how complex things work.” Dow, who was honored in 2010 with VCU School of Medicine’s highest honor—the Enrique Gerszten, MD Faculty Teaching Excellence Award—has developed a reputation as an innovator in medical education by helping to make complex concepts easier for students to understand, and giving them new tools and new ways to understand the human component of medicine. Over the past six years, Dow has been the creator of numerous new training programs to help medical students learn the team-based practice of medicine. “At VCU, it is critical for medical students to learn to work as a team to maximize efficiency,” Dow says. Dow walks the talk of maximizing efficiency, having undertaken many projects in many capacities. For example, Dow partnered with VCU’s Theatre Program to develop his Theater-Medicine Communication Curriculum. This program uses the technique of theater education to teach communication skills to healthcare professionals. “We want healthcare students to be better listeners,” Dow says, “and to pick up non-verbal cues from patients.”
Alan W. Dow, MD 18 | www.ourhealthrichmond.com
Dow says the great thing about his dual roles as a physician and an educator is that he gets to be present for meaningful moments in his patients’ and his students’ lives. “It’s great to have an impact on people’s lives,” he concludes.
LEADERS 40 & UNDER | our health
Colin Banas, MD Dr. Banas, the Chief Medical Information Officer (CMIO) for the VCU School of Medicine, is a recognized expert in the field of informatics — where processing digital information and healthcare intersect. He was recently named one of the top 25 clinical informaticists in the country by the editors of Modern Healthcare, one of the country’s leading magazines for people in the profession. He was recognized for work in moving the medical profession toward an entirely digital medical record system that can be accessed by both physicians and patients. Banas, who also specializes in internal medicine at VCU Medical Center, has served as the medical school’s CMIO since 2010. “I often tell my students that our electronic medical record is like our stethoscope – it’s integral to providing patient care,” Banas said. “As the healthcare industry continues the march to becoming entirely digital, there will be an increasing need for expertise to bridge the gap between the technical and clinical enterprises. In a nutshell, that’s what informatics does – it bridges the gap.” Banas says that the medical community is at the tipping point for adoption of electronic medical records. “Electronic medical records are rapidly becoming a necessity for doing business,” Banas says. “The best part is that it’s the patients who are demanding and expecting it. It’s what I call ‘the smartphone effect’. Patients are increasingly expecting to be able to manage their own data and health communications digitally.” Banas says he has the best of both worlds. “To me,” he says, “healthcare is the venue for that unique blend of analytics, challenge, and human touch. It’s a fantastic cerebral venue for problemsolving and making an impact on an individual and aggregate level.”
“I often tell my students that our electronic medical record is like our stethoscope – it’s integral to providing patient care.” www.ourhealthrichmond.com | 19
our health | LEADERS 40 & UNDER
Jennifer Rhodes, MD Dr. Rhodes has the distinction of being Virginia’s only dedicated craniofacial and pediatric plastic surgeon. She is medical director and program coordinator for the Center for Craniofacial Care at Children’s Hospital of Richmond at VCU. In her work, she takes on the always-challenging surgery on youngsters with craniofacial deformities (birth defects or injury to the head and face) along with cleft and pediatric plastic surgery. “I am so grateful to VCU for realizing the importance of having a dedicated craniofacial and pediatric plastic surgeon,” Rhodes says. “It really highlights VCU’s dedication to children’s healthcare.” “We work to help children affected by birth defects, accidents, infections, and tumors,” she explains. “I believe it’s really the best that medicine has to offer.” Although Rhodes spends the majority of her time at VCU, She also consults at all hospitals in the greater Richmond area. Her work also takes her across the world as a volunteer with the World Pediatric Project, which provides free services to children from less developed countries. She was a key member of the celebrated surgical team that separated 19-month-old conjoined twins, who traveled from the Dominican Republic to Richmond last year under the World Pediatric Project. “It was an incredible experience,” says Rhodes, “but there are many other children who travel to Richmond for help from our team.” At the Center for Craniofacial Care, more than 15 different pediatric specialists work together to provide coordinated care for children.
“I am so grateful to VCU for realizing the importance of having a dedicated craniofacial and pediatric plastic surgeon,” Rhodes says. “It really highlights VCU’s dedication to children’s healthcare.”
“I am so grateful to be able to dedicate all my time and energy toward improving the care for children affected by craniofacial conditions in Central Virginia and beyond. I am so proud of our craniofacial team, which is one of the most comprehensive in the mid-Atlantic.”
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LEADERS 40 & UNDER | our health
Mark Ryan, MD Dr. Ryan is widely recognized for his work with communities that are underserved by the medical community, both locally and abroad. “My main areas of focus are Spanish-speaking patients, and patients who lack health insurance here in Richmond,” says Ryan, who is an assistant clinical professor in the VCU Department of Family Medicine. He also works in the outskirts of Santo Domingo in the Dominican republic, traveling there twice a year to take care of marginalized patients there under a program operated by VCU and the College of William and Mary. Besides his clinical care work at the VCU Health System, Ryan is active with the CrossOver Health Care Ministry in Richmond, Virginia’s largest free healthcare clinic. The clinic provides services to almost 6000 patients each year. Most of the patients are the working poor, unable to qualify for Medicaid insurance. Ryan also leads a community outreach program known as Una Vida Sana! (A Healthy Life), operating diabetes, blood pressure, and cholesterol screenings for Spanish-speaking adults in Richmond. “The greatest need in these communities is holistic, patientcentered, primary care that focuses on all aspects of health,” Ryan says. “We need physicians who work within communities to address non-clinical determinants of health, such as pollution and nutrition, while also bringing the clinical skill to provide comprehensive primary care services in communities that lack necessary resources.”
Ryan leads a community outreach program known as Una Vida Sana! (A Healthy Life), operating diabetes, blood pressure, and cholesterol screenings for Spanish-speaking adults in Richmond.
www.ourhealthrichmond.com | 21
our health | LEADERS 40 & UNDER
“The most rewarding part of my work has been watching people, both inside and outside of government, work toward something that is going to help people for decades to come.”
Keith Hare
As Virginia’s Deputy Secretary for Health and Human Resources, Keith Hare works with other state agencies, interest groups, and citizens to develop strategies and policies to help state residents face difficult issues. “We are asked to look at the healthcare system and work toward making that system more patient-friendly,” Hare explains. “Working in broad collaboration allows us to find workable solutions to complex health issues.” Hare cites one example—the Virginia Health Reform Initiative. The initiative is an effort to build on what is already successful in Virginia healthcare and to revisit and renovate or reorganize practices that have not achieved optimal results. The initiative was created as a partnership, utilizing the strengths of government with the experience and knowledge of the private sector. “The work of the Virginia Health Reform Initiative is a great example of how this type of effort has been effective,” Hare says. “Members of an advisory council have worked hand-in-hand with interested citizens to craft ideas about how to reform Virginia’s healthcare system.” “The most rewarding part of my work has been watching people, both inside and outside of government, work toward something that is going to help people for decades to come.” Hare says his parents were instrumental in leading him to his career. His father was a federal employee for 40 years. His mother was teacher. “I have been positively influenced by a family who believed that public service was an honorable way of life,” he concludes.
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LEADERS 40 & UNDER | our health
“People say you go into medicine to help people. I really get that feeling when I’m helping someone in a developing nation.” Dr. Shah uses his medical expertise to help hearts keep beating around the world. He is a cardiovascular electrophysiologist, a leader in the growing field of atrial fibrillation (treatment of irregular heart rhythm disorders) with Richmond-based Virginia Cardiovascular Specialists. “My interests in electrophysiology has developed along with my training in cardiology,” Shah says. “This field has many facets. In some patients it allows me to eliminate symptoms associated with irregular heart beat, and in others it requires placing specialized devices such as pacemakers and defibrillators to reduce heart failure and sudden death.” For the last three years, Shah has been part of Project Pacer International. Project Pacer is a group of cardiologists, support staff and industry colleagues from around the world who travel overseas to provide cardiac care to indigent patients. In recent years, Shah has twice visited Cochabamba, Bolivia, as well as Nairobi, Kenya, in Africa. “Every time I go, I wish I had more time to stay,” Shah says. The work Shah and his fellow Project Pacer team members do while on these missions includes seeing patients, doing diagnostic tests, implanting pacemaker devices, and performing surgeries to correct problems with heart rhythms. “We try to get as much done as possible on each trip,” he says.
Saumil Shah, MD
“We maximize our time. On the last trip, we started an implant surgery at 11:30 at night, because we wanted to get it done before we had to leave.” Shah says that this kind of field work was a motivation for him to enter medicine. “I decided to go into medicine after seeing my uncle taking care of patients in a village in India,” he says. “People say you go into medicine to help people. I really get that feeling when I’m helping someone in a developing nation. Putting in a pace maker is an hour of my time, but for the person receiving it, it’s making a huge difference in his or her entire life.” www.ourhealthrichmond.com | 23
our health | LEADERS 40 & UNDER
Danny Avula, MD Dr. Avula is the Deputy Director of the Richmond City Health District (RCHD) for the Virginia Department of Health. In this role he oversees a number of departments that relate to the overall health and safety of the city’s resident. Avula was attracted to a career in public health because he said it gave him an opportunity to bring positive change in an entire community.
“What drew me to public health was being able to influence the health of an entire community.”
“What drew me to public health was being able to influence the health of an entire community,” he says. “Being able to have an impact on a large number of people is very rewarding. My family and I live in the city, so we get to see outcomes in our own community.” Avula, his wife Mary Kay, and their four children have lived in the Church Hill Neighborhood for the past eight years, and they are active in community development efforts there. During the past three years, Avula has worked to strengthen a partnership between the Richmond City Health District and the Richmond Redevelopment and Housing Authority to bring health resource centers to four of Richmond’s largest public housing developments. The centers provide the development’s residents with public health information, education and clinical support for the health problems plaguing these communities. “Through the centers, we are able to bring health information and services to the low income families that need it,” Avula says. “We do classes, teaching and screening for diabetes and high blood pressure as well as sexually transmitted diseases. We address major health problems that residents of the community face, including teen pregnancy, chronic diseases, and infant mortality. It’s a resident-driven program. The community gives us feedback on what kind of services they are looking for and we work with different agencies to develop those resources.” In addition to his work with the RCHD, Avula continues to practice clinically at several area hospitals. He also serves on the board of First Things First, a community organization that promotes responsible fatherhood. He is also active with Urban Hope, a program designed to help people become home owners in the inner city.
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LEADERS 40 & UNDER | our health
Dia Nichols
Dia Nichols is Chief Executive Officer for John Randolph Medical Center, an HCA Virginia Health System affiliate located in Hopewell. “I think being a hospital CEO is the most exciting career in the world,” Nichols says. “Not a day goes by when I don’t get to talk to a housekeeper, a pharmacist, or an orthopaedic surgeon, then maybe have dinner with a member of our board. I get to see our center from many different viewpoints. It brings a lot of excitement, day in and day out.” Nichols is committed to not only provide quality, affordable healthcare to the patients in his hospital; he is also looking to develop a sense of community among staff, administration and patients.
“When people come in, we want them to feel a family atmosphere.”
“When people come in, we want them to feel a family atmosphere,” he says. As part of the commitment to making patients feel at home, Nichols and the other members of the medical center’s leadership make regular rounds visiting patients and introducing themselves. Nichols introduces himself as a patient advocate. Nichols also is a proponent of giving back to the community. He urges his hospital staff to take part in at least three community events a year, including donating blood and participating in walks or runs for charity. “The hospital does so much in the community,” Nichols says. “That commitment from everyone makes us special. Everyone gets involved and it reflects our commitment to our patients and the community we share.” www.ourhealthrichmond.com | 25
our health | LEADERS 40 & UNDER
Brett Butler
As Administrative Director for Planning and Medical Economics for Bon Secours Virginia Health System, Brett Butler is responsible for the organization’s strategic planning, market analysis and business plan development. “Simply put,” Butler says, “I help determine what services the community needs and put forth plans for programs, facilities, and services to meet those needs.” Bon Secours Health System, Inc. is a not-for-profit Catholic health system sponsored by Bon Secours Ministries. In Richmond, the system includes St. Mary’s Hospital and St. Mary’s Reynolds Crossing, Memorial Regional Medical Center, Richmond Community Hospital, St. Francis Medical Center and St. Francis Watkins Centre, and other facilities. Butler began his work with Bon Secours as a part of the system’s hospice programs. The VCU graduate says that he was so impressed by Bon Secours that he knew it was where he wanted to work. “It’s one of the best jobs you could ever have,” he says. “You have an opportunity to help other people and that degree of compassion is not just encouraged, it’s expected.” He was then tapped to lead the development of two health system strategic plans spanning six years of Bon Secours development and growth. “To be able to leave my fingerprint on such a vibrant and growing ministry is incredible,” Butler says. “Our plans are well balanced and center on building healthy communities. One aspect of the plan is focused on meeting the business need of the health ministry and improving the quality of the care we provide. The other focuses on really reaching the community and taking the ministry to the forefront of health innovation.”
“Doing what is right for the patient is my philosophy. If you put the patient first, everything will work out.”
While part of his job is to look at the bottom line, Butler says one of the things he most enjoys about his work is the service to others it allows him.
“Doing what is right for the patient is my philosophy,” he notes. “Every day, every interaction, every program, every project, I always make the decision for the patient. If you put the patient first, everything will work out.” 26 | www.ourhealthrichmond.com
LEADERS 40 & UNDER | our health
“It’s exciting to help people. That is what keeps me so passionate about what I do as a physician, as a speaker and educator.” Dr. Dall, the Chief Medical Officer for Health Diagnostic Laboratory of Richmond, is on a mission. “My children and the world’s children are my motivation,” she says. “I don’t want them to have to fight these widespread incidents of obesity, diabetes, and heart disease that we seem to be seeing all of the time. I want to someday show them that we have found a way to beat it.” Dr. Dall is one of a handful of physicians in the United States treating pediatric dyslipidemia — high cholesterol in children — which can lead to a higher risk for cardiovascular disease and a host of other health problems. She is nationally recognized as a leader in this field medically, and as an author and speaker. Dall is at the forefront of using laboratory biomarker testing to help detect and alter outcomes for patients at risk for developing cardiovascular disease and diabetes. Because of her passion and expertise, Dall has been asked to lecture in a variety of venues, from hospital and medical school grand rounds to large-scale community events. She is frequently invited to provide expert comment for radio and television news and public affairs programming, and she has been a keynote speaker for the American Heart Association’s GO RED for Women community events. “I am most proud of the patients’ lives that have been impacted by early identification of risk factors and subsequent treatment,” she says. “These illnesses are a huge burden on our society,” Dall states. “It’s very concerning. “When we identify these diseases early, there are so many things we can do to reverse them. It’s exciting to help people. That is what keeps me so passionate about what I do as a physician, as a speaker and educator.”
Tara Dall, MD www.ourhealthrichmond.com | 27
our health | LEADERS 40 & UNDER
R. Brent Rawlings Rawlings is an associate in the Richmond office of the worldwide law firm, McGuire Woods, LLP, which specializes in the full spectrum of healthcare law. His clients include hospitals and health systems, physician groups, ancillary providers, long-term care facilities, academic medical centers, and senior care communities, as well as managed care plans. In addition to his legal training and experience, Rawlings has a master’s degree in health administration. His work in healthcare organizations led to his interest in law. “I started my career in managed care in the mid-90s,” he says. “I was involved in negotiating contracts between managed care plans and providers such as hospitals. That was an exciting time for the industry and negotiations were pretty cutthroat. Whenever things went wrong, the lawyers were called in and I got the chance to work alongside them. I was always impressed with the disciplined approach to problem-solving and critical thinking that they brought to situations. I was inspired to become a lawyer not for the sake of becoming a lawyer, but to bring that kind of skill to whatever situation with which I would be faced.” Rawlings works to keep his focus on his clients’ problems and to not be sidetracked by the often complicated nuances of healthcare regulation.
Rawlings works to keep his focus on his clients’ problems and to not be sidetracked by the often complicated nuances of healthcare regulation.
28 | www.ourhealthrichmond.com
“I try really hard to keep things simple,” he says. “It’s easy to become overwhelmed with detail, especially in healthcare law where you are faced with complex and overlapping laws and regulations at the federal, state, and local levels. I work to communicate with our clients, opposing counsel, regulators, and the community at large, in as boiled-down a manner as possible. If you don’t, you can become easily paralyzed and overwhelmed, which impedes progress.”
LEADERS 40 & UNDER | our health
Delegate Christopher Peace Del. Peace (R-Hanover) traces his interest in healthcare to a real-world set of circumstances. He himself is a caregiver, responsible for his 99 year-old grandmother. “I got involved in policy-making in the area of rights for older citizens and issues surrounding long-term care,” he explains. “My work evolved from senior healthcare matters to a wider spectrum of interests related to healthcare.” A member of the state House of Delegates since 2005, Peace has sponsored legislation on an array of health concerns, including the Interstate Health Care Compact, new regulations for surgeons, dental laboratories, occupational therapy, and healthcare boards to create clear definitions of many healthcare professions in advance of healthcare reform. “Assuring access to quality healthcare for the residents of my district—the 97th House of Delegates District—and across Virginia is vital to my role as a legislator,” Peace states. “I’m very proud to have worked on the health safety net legislation.” Peace worked to preserve and strengthen health programs for Virginians, including funding for the health safety net by restoring $4.8 million in funding for free clinics, community healthcare clinics, and the Virginia Health Care Foundation. He also has worked on $6 million in funding to continue long-term care Medicaid eligibility for elderly and disabled individuals, and $2.5 million for local Area Agencies on Aging to address the growing number of elderly citizens in need of health and nutritional services funding.
“Assuring access to quality healthcare for the residents of my district—the 97th House of Delegates District—and across Virginia, is vital to my role as a legislator.”
www.ourhealthrichmond.com | 29
our health | LEADERS 40 & UNDER
“We help healthcare executives across the country address the critical challenges generated by healthcare reform, an aging population, and changing reimbursement.”
As a member of a global consulting company that helps other leaders untangle the intricacies of modern healthcare, Brian Epley sees issues confronting the industry from a very high level indeed. Epley is in the Richmond office of North Highland, working with for-profit and not-for-profit health providers, payers, and life sciences companies to implement healthcare solutions and help them navigate the often-shifting healthcare landscape. In his work, he’s responsible for identifying strategies for organizational growth and developing business transformation plans, technical program operations, and service delivery for the state and federal government, as well as the private sector. “We help healthcare executives across the country address the critical challenges generated by healthcare reform, an aging population, and changing reimbursement,” Epley says. Earlier in his career, Epley was a program director with the U.S. Department of Veterans Affairs and looks back on his work for the VA with great pride.
Brian Epley 30 | www.ourhealthrichmond.com
Epley says his mother’s and grandfather’s dedication to careers in healthcare led him to want to work with others striving to make a difference in that field. “Their efforts to help people through healthcare have always been an inspiration,” he says.
Karin Talbert Addison Karen Addison’s work in state government as Special Advisor to the Governor on Children’s Transformation gives her many opportunities to have a direct impact on child mental health and child welfare issues in the Old Dominion. “My job is to coordinate policy to services that affect children,” she says. “That includes child welfare and health issues, mental health and child protective services.” Addison has had a great deal of public policy experience in social services, education, and health policy issues for children during her career. Before she entered government, she represented numerous child advocacy organizations at the Virginia General Assembly for more than 10 years as a professional legislative affairs consultant and the owner and CEO of Addison “We try Elwood Consulting. “I was a lobbyist for the American Academy of Pediatrics,” Addison says. “I covered a wide range of children health issues. The pediatricians I worked with, their dedication, was always so inspiring to me.”
to work with each agency and communicate with each of them and have them communicate with each other, to have a similar approach to addressing issues.”
In her current role, Addison says she has the challenge of working to get multiple agencies and groups to work toward common goals, while managing the added problem of limited resources. “It’s a coordinating role,” she explains. “We try to work with each agency and communicate with each of them and have them communicate with each other, to have a similar approach to addressing issues. We have limited funds, so we have to work together with what we have.” “It’s like trying to put puzzle pieces together sometimes, or trying to connect the dots,” she says. “I love it, especially when we see the results.”
www.ourhealthrichmond.com | 31
Anna Healy James Anna James’ influence on healthcare in Virginia has been felt across both the private and public sectors. As the Manager for State Government Affairs for the lobbying firm Troutman Sanders Strategies, her clients include American Healthcare LLC, Magellan Health Services, Molina Healthcare, the Pharmaceutical Research & Manufacturers of America, the Virginia Oral Health Coalition and VCU Health System. James provides government relations expertise at the state level in healthcare as well as education, capital outlay, procurement and appropriations. She also consults on a number of matters including the impact of federal health reform, healthcare financing needs for providers and business development opportunities with government.
“I enjoy helping clients that work with people who really need help with the issues being discussed in health care reform—clients with a mission to help people.”
Her prior healthcare and political experience includes service as the Director of Government Relations for Virginia Commonwealth University and the VCU Health System. James also worked with the state administration the General Assembly and the Virginia Congressional delegation on issues of higher education policy, Medicaid and Medicare reimbursement, physician issues, higher education funding needs and regulatory matters.
James also worked as Special Assistant to the Governor for Policy during Governor Mark Warner’s administration. During her tenure in the Governor’s Policy Office, she established and oversaw the Governor’s Healthy Virginians Initiative. James’ efforts have resulted in increased funding for Medicaid and indigent care. She also advocated on behalf of health plans in the areas of mandated benefits, health information technology, Medicaid Managed Care, assignment of benefits and coordination of benefits. “I like all my clients,” James says. “I enjoy helping clients that work with people who really need help with the issues being discussed in healthcare reform—clients with a mission to help people.” 32 | www.ourhealthrichmond.com
our health | HEALTHCARE AND THE ELECTION
Taking Virginia’s Political Pulse HOW THE NOVEMBER ELECTIONS MAY IMPACT THE FUTURE OF HEALTHCARE IN THE COMMONWEALTH words | RICK PIESTER & ROD BELCHER photography | ED IP
The Affordable Care Act (ACA), thanks to a Supreme Court ruling, is now the law of the land. Upheld as constitutional, the ACA — also known as “Obamacare” — will begin to be implemented over the next two years. The legislation, which proposes changes to the cost and accessibility of health insurance and promises to provide coverage to millions of uninsured Americans, has been the flashpoint of major political, economic and ideological battles during the last few years. And now opponents of Obamacare, shocked by the Court’s ruling, are gearing up for the last chance they see to have the ACA stopped – at the ballot box this November. How will the outcome of the November race directly impact the average Virginians’ healthcare? “One of the ironies related to the Affordable Care Act is that the majority of Americans will not see an immediate, or any, change to their health insurance or the medical care they receive,” says Rick Mayes, PhD, an associate professor in the department of political science at the University of Richmond. Mayes is the author of Universal Coverage: The Elusive Quest for National Health Insurance and co-author of Medicare Prospective Payment and the Shaping of U.S. Health Care. “The average Virginian benefits indirectly from the ACA’s new health insurance
34 | www.ourhealthrichmond.com
HEALTHCARE AND THE ELECTION | our health
“The economy in general is difficult to predict and will play a major role in deciding the outcome of this election,” Sabato explains. “Obviously, if the president wins reelection, the healthcare law will survive to be implemented.” regulations and protections,” Mayes continues, “and the opportunity to shop for individual health insurance plans from a centralized ‘health exchange’ online that will be available in January 2014.”
process in the Senate, meaning they only needed 51 votes, and because the Supreme Court allowed the mandate to survive as a tax, the Republicans only need a 50-50 tie in the Senate to be able to repeal the law, with the Republican VP breaking the tie.”
The exchanges, online marketplaces for Virginians to shop for health insurance from various participating vendors as provided under the ACA, would be developed in each state. States opposed to Obamacare, including Virginia, have been delaying the implementation of the exchange concept.
Sabato feels confident that the Republicans will almost certainly keep control of the House.
“If Republicans win the White House and both chambers in Congress, the ACA would be somewhat more vulnerable to repeal,” Mayes says. “Although, it’s not likely that supporters of repeal would be able to marshal enough votes in the Senate to achieve this. At the same time, if Republicans win the presidency and control of the Senate and House, they could dramatically slow implementation of the final, major components of the ACA.”
Mayes also thinks that much of the fate of Obamacare could lay in the senate and house elections.
Mayes says such a slowdown would impact thousands of Virginians who might benefit from the expanded Medicaid and health insurance subsidies the ACA provides. As far as other economic impacts from the law, if the November elections go the president’s and the Democrats’ way, it’s still not a clear cut path for healthcare reform, in part because of the current state of the national economy, says political analyst, Larry J. Sabato, PhD, professor of politics at the University of Virginia and director of the UVA Center for Politics. Sabato has written more than twenty books on the American political process, including his most recent, Pendulum Swing. “The economy in general is difficult to predict and will play a major role in deciding the outcome of this election,” Sabato explains. “Obviously, if the president wins reelection, the healthcare law will survive to be implemented. But, because Republicans will likely retain control of the House, the GOP may continue trying to slow implementation by interfering with the funding for certain parts of the law so there still could be a delay.” However, if Republican nominee Mitt Romney and the Republican Party prevail come November, Sabato says there are several scenarios that could play out with regard to ACA. “The GOP will seek to repeal the law,” Sabato states, “or at least most of the key provisions. But they will have to take control of the Senate in order to pursue this course. Considering the Democrats passed the bill into law through the reconciliation
“If Romney wins the White House, the chances are quite good the Republicans will also take control of the Senate,” he says.
“If Romney wins the election,” Mayes says, “the fate of Obama’s healthcare plan will depend on how Republicans do in congressional elections. If the House remains in Republican control and the Senate in Democrat control, it’s not clear what, if anything significant, would happen to the ACA.” Mayes points out that while the ACA as a whole has not been very popular, there are many parts of the law that do hold appeal with some voters, such as the ability of children to remain under their parents’ insurance coverage until age 26 or insurance companies now being unable to exclude individuals who have a pre-existing condition from getting health coverage. The contest for Jim Webb’s Senate seat is pitting two former governors, Tim Kaine and George Allen, against each other in a race where there are clearly drawn lines in the healthcare debate. “The Senate contest between Kaine and Allen is one of the most watched and highly contested Senate races in the country,” Mayes says. “Kaine is a big supporter of Obama and the ACA; Allen is not.” Kaine has publicly supported the president and his healthcare plan, saying he wants to see the “important reforms continue,” while Allen has stated that he found the plan to be “antibusiness.”
With so many voices, so many opinions, and so many avenues to acquire information, what do the experts recommend as good sources of information for the average Virginian voter? “The candidate websites are probably the best source for getting the candidates’ general positions on a wide array of issues,” Sabato says. “Major news sources, online or in print, www.ourhealthrichmond.com | 35
our health | HEALTHCARE AND THE ELECTION
“Here’s an interesting, contra-conventional wisdom fact,” Sabato says. “The party platforms are actually quite revealing. Studies have shown that the winning candidate actually tries to implement a large majority of the pledges and succeeds in a large number of cases. A platform is not just hot air.” will also discuss candidate positions on certain issues, but the media often focuses more on the horse-race aspects than policy disagreements.” “PBS is usually a safe and reliable source of non-partisan information,” Mayes adds. “As for advertising,” Sabato notes, “almost all of it will be negative. What voters can learn from TV spots will be ‘the other guy is bad and here’s why.’” Sabato adds a piece of information that almost sounds too good to be true during the political storm season. “Here’s an interesting, contra-conventional wisdom fact,” he says. “The party platforms are actually quite revealing. Studies have shown that the winning candidate actually tries to implement a large majority of the pledges and succeeds in a large number of cases. A platform is not just hot air.” So how do the experts call the “horse-race”? Who do they think will win the presidency? “The race appears to be extremely close at this point,” Mayes says. “But so much can still happen with the debates and Romney’s VP choice in Paul Ryan. The economy’s sluggish, modest growth makes things hard for Obama, but Romney’s complicated relationship with his wealth, taxes and the middle class has allowed Obama to remain competitive.” “Plain and simple, the race is too close to call, and anyone who claims otherwise is guilty of analytical malpractice,” Sabato says. “The twists and turns of the economy over the next couple of months will play a pivotal role in determining the outcome of the election. If the country starts getting some positive news on that front, the president’s position will be strengthened. However, if the news continues to be mediocre or worse, Romney will have a real shot of winning on November 6. This one could be a nail-biter.”
When the dust clears and the election is over, will there be a new tone in Washington? Will partisan bickering and rancor diminish if the president gets his second and final term? Will a new President Romney be met with cooperation and bipartisanship or stonewalling? 36 | www.ourhealthrichmond.com
“The country has been and will likely remain politically polarized for some time to come regardless of the outcome of the presidential election,” Mayes says. “The philosophical differences that exist between conservatives, libertarians, and liberals are large and, try as he has, Obama has not been able to bridge them very successfully. “The one thing that could calm down the political animosity and acrimony would be a resurgent economy and decreasing level of unemployment. Clinton’s experience with a roaring economy from the mid to late 1990s is evidence that political differences diminish in great economic times.” “It’s tough to see the partisan rancor dying down regardless of who wins in November,” Sabato says. “Our nation’s politics are deeply polarized at the moment. Considering that less than 10 percent of voters are truly independent or undecided, most of our citizenry hold partisan perspectives just like the folks they elected to office in Washington.” And Sabato says that the partisanship and fighting is not new - it is woven into the fabric of American politics: “It’s not like this is a completely new phenomenon in the U.S. We’ve had eras of strong partisanship – in the 1840s, before the Civil War, at the end of the nineteenth century, and even just after World War II.” “Until there’s a major shift in public opinion on a number of issues, we’ll likely continue to see a nation that is 50-50 on most political matters,” Sabato concludes.
Rick Mayes, PhD Associate Professor Department of Political Science University of Richmond
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BODY BEAUTIFUL | our health
face
TIME words | SUSIE GALVEZ
photography | ??????? ????????
HOW LONG WILL THE PROCEDURE LAST? WILL PEOPLE KNOW? words | SUSIE GALVEZ
Have you ever looked in the mirror and thought you looked older than you feel? Even if you take care of yourself, eat right, and exercise, you can never “lifestyle away” wrinkles. Fortunately, many excellent facial rejuvenation options are available in Richmond for those seeking a younger appearance. These options range from noninvasive and minimally invasive injectables, such as BOTOX©, Restylane®, JUVÉDERM®, RADIESSE®, Perlane and Sculptra® Aesthetic to help lessen wrinkles, fill in lines, or restore facial fullness, to cosmetic facial techniques such as Thermage® and laser technology that tighten or resurface the skin with minimal downtime, to plastic surgery procedures that require a little more recovery time. “Thirty years ago, a simple facelift required a four-day hospital stay with many weeks of recovery time. With today’s modern cosmetic facial surgeries, patients are home the same day, with the recovery time greatly reduced,” says Joe Niamtu III, DMD, of Cosmetic Facial Surgery in Midlothian. “In the past, patients waited until they looked old to have cosmetic facial surgery, but now the trend is smaller procedures at a younger age, rather than waiting to do the ‘full overhaul’ the previous generation experienced,” he continues.
www.ourhealthrichmond.com | 39
our health | BODY BEAUTIFUL
For those considering cosmetic procedures in hopes of looking younger, the number one question is: How long do the results last? Joe Niamtu III, DMD. of Cosmetic Facial Surgery in Midlothian
While modern science can turn back the clock, the clock still keeps ticking. Our Health asked some prominent Richmond plastic surgeons to share the average staying power of the most popular procedures. BOTOX©: FOUR MONTHS. Richmond plastic surgeon Michael Godin, MD, says that he prefers BOTOX©. “Not only does it make patients look better almost immediately, it also prevents lines from forming or deepening by stopping repetitive movements. It gives the skin a break.” For several years, BOTOX© has been the most popular cosmetic procedure, which is a testament to its effectiveness.
Richmond plastic surgeon Michael Godin, MD
Dermal Fillers (Restylane®, JUVÉDERM®, RADIESSE®, and Perlane): FOUR TO NINE MONTHS, depending on the filler and where it is applied. Fillers are designed to help restore the contours of the face by padding folds and wrinkles and replacing lost volume, contributing to a younger, more well-rested appearance. Sculptra® Aesthetic: UP TO TWO YEARS. This product does not provide the kind of instant plumping that other fillers do. Instead, it gradually stimulates the body to regenerate its own collagen. Sculptra® Aesthetic is done in a series of three to six injection sessions about a month apart.
Plastic surgeon Alan Burke, MD of Richmond
Ruth Hillelson, MD of American Self in Richmond
Profractional Laser: TWO-PLUS YEARS. Ruth Hillelson, MD, of American Self in Richmond says this laser has more technological capabilities for improving skin texture and rejuvenation than any medical laser developed to date. “I’m incredibly excited about this new technology,” she says, “because now we can treat targeted areas that were previously unresponsive, such as those tiny wrinkles that appear around the mouth as we age, as well as full face, with wonderful results.” Facelift: TEN YEARS. Plastic surgeon Alan Burke, MD, of Richmond says, “For the best facelift surgical outcome, the procedure must fit the patient’s anatomy. There’s no cookie-cutter approach. Every individual facial detail must be studied to produce the best possible and longest-lasting results.” He adds that a facelift goes hand in hand with other facial rejuvenation techniques such as a brow, eye or forehead lift, and they should be done in tandem to achieve superior results. Rhinoplasty (nose surgery): LIFETIME RESULTS. In addition to improving the appearance and proportion of your nose, surgery of the nose may correct impaired breathing caused by structural abnormalities. “Although the nose undergoes changes with age, any differences post-surgery are very subtle,” says Dr. Godin. “While rhinoplasty is a difficult procedure to perform, noses are the most prominent feature on the face, and proper attention to support as well as aesthetics is paramount.”
The second-most-asked question: Will people know I had “something” done? In most cases, people will notice a change but usually cannot pinpoint what is different. You might hear, “Did you just return from vacation?” or “You look great!” or “Have you lost weight?” Whether others notice will depend on what type of facial rejuvenation procedure you’ve had and the perceptiveness of the observer. The most important thing to remember is that cosmetic procedures are medical procedures. Your physician should answer any questions you have regarding your situation. Research all that you can before the treatment to be sure that your mirror will show your best reflection. Editor’s Note: Susie Galvez is a Richmond-based beauty, image, and wellness writer, speaker, and author of nine books. To learn more, go to www.SusieGalvez.com 40 | www.ourhealthrichmond.com
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CUTTING EDGE | our health
Under the Light words | TINA JOYCE
Simply say the word germs and healthcare providers, educators, and parents alike immediately begin scrambling to remedy the invasion and determine the origin. Nothing makes your skin crawl more than watching a documentary on microorganisms and learning where they lurk in your home, office, favorite vacation spot, and many other places you frequent. In recent years, stories have been hitting the wire revealing how germs prowl in many places and on surfaces we touch every day. From Reader’s Digest to NBC’s Dateline, concerns are prevalent about the health risks of sharing and transporting the microscopic bacteria and how viruses spread as quickly as the germs themselves. A recent CNN story revealed the airline industry has been taking a beating and is under scrutiny for lack of effective disinfection policies. Tray tables and seat pockets are simply a breeding ground for germs and are rarely disinfected—despite thousands of travelers boarding the planes every year.
NanoTouch™, has been researched and developed to offer printable, selfadhesive and non-adhesive surfaces with safe, self-cleaning, antimicrobial properties
Due to media attention, the hotel industry has felt the impact of the war on germs as guests become more aware of typical hotel sanitary practices. Guests are realizing that although their bedding is routinely washed, the same cleaning cloth may be used to wipe down vanities in multiple bathrooms—easily spreading bacteria from guest to guest. Additionally, remotes and lamp switches are seldom cleaned, leaving guests subject to a multitude of undesirable microorganisms. In May of 2012, Best Western released information from an independent research study that discovered “the importance of a clean and well-maintained hotel has become the number one priority for guests—surpassing customer service.” The hotel chain has risen to the challenge and is implementing several new tools for housekeeping as part of their “I Care Clean” program. Hospitals and health departments across the country have also implemented programs and spearheaded campaigns to aid in the battle against germs. In 2010, the Orange County Health Department created an educational campaign communicating the importance of reducing the spread of bacteria. Their well-intended initiative cost taxpayers approximately $25,000. Virginia is at the forefront of addressing the issue. In fact, the Commonwealth is home to a new, patent-pending product now hitting the market addressing these health concerns for both businesses and consumers. The product, NanoTouch™, has been researched and developed to offer printable, self-adhesive and non-adhesive surfaces www.ourhealthrichmond.com | 43
our health | CUTTING EDGE
with safe, self-cleaning, antimicrobial properties. An antimicrobial is a substance that kills or inhibits the growth of microorganisms such as bacteria, viruses, and fungi that can cause illnesses such as N1H1 and MRSA. NanoTouch™ products offer bacteria-fighting solutions for facility touch points, portable surfaces, and specialty products. After extensive testing and product development, the production methods were finalized giving end users the ability to apply the NanoSeptic™ technology to high-contact printed materials in two forms. The adhesive backed products can include door push pads, and grocery cart handle wraps. Non-adhesive products range from vanity and travel mats, to TV channel guides, hospital patient guides, menus and desk, tray table, and snack mats. The product’s ability to inhibit the transfer of bacteria and viruses from one person to another makes its uses widespread across many industries. The unique germ-deflecting concept was brought to light by Dennis Hackemeyer and Mark Sisson, founders of NanoTouch Materials, LLC. Both entrepreneurs are experts in the print and technology industry and embarked on a mission to develop this antimicrobial product. As a result, the Lynchburg-based company is meeting the demands of both healthcare facilities and businesses striving to communicate their commitment to the health of patients and customers. The technology allows a practical medium for communicating the health conscious message while also providing a usable vehicle to fight against the spread of bacteria and viruses.
NanoTouch™ products offer bacteriafighting solutions for facility touch points, portable surfaces, and specialty products.
Safety is of principal concern to many health experts. According to NanoTouch™ founders, both of the primary active ingredients are exempt from EPA registration. Zinc, is a safe mineral used in many sunscreens, vitamins, and food supplements. Titanium dioxide, a proven safe food additive, is a photo-catalyst and is also exempt from registration. So how does it work? Co-founder, Dennis Hackemeyer explains, “Our NanoSeptic™ surfaces electrostatically attract and trap microbes reducing the likelihood of transfer from one contact to the next. In addition to killing microbes and limiting their growth, NanoTouch™ surfaces also kill dangerous spores such as Clostridium difficile and decomposes their toxins.” The printable, antimicrobial material is a bioactive environmental surface, which claims to reduce bacterial and viral contamination and destroys adherent organisms. More importantly, the product allows users to communicate the importance of antimicrobial touch points on doors, shopping carts, or placemats—educating consumers on safe places to touch. Some products have a removable, repositionable, adhesive backing so the products may be utilized at different locations. Properly washing your hands is the most effective way to reduce the distribution of bacteria. Unfortunately, many people do not take the time to consistently and thoroughly wash their hands throughout the day. Additionally, facilities that are heavily contaminated, such as nursing homes and hospitals, need more than latex gloves to prevent the spreading of germs onto medical equipment and tray tables. Early adopters of the NanoTouch™ technology are finding great benefit in the product’s uses and overall message. “Bacteria, viruses and other germs are not only an ongoing threat, but a growing concern for the public,” explains Michael Miller, DDS of Commonwealth Oral & Facial Surgery in Richmond. “For this reason, anything we can do in the medical community to help in this fight is a good thing. There’s no one fix. We need many
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CUTTING EDGE | our health
tools. NanoTouch™ works in concert with disinfectants, cleaners, hand sanitizers and other methods for stemming the spread of germs. It’s a great, new addition to the tools we have at our disposal.” Elite hotels are also showing their commitment to the health and safety of their guests by adopting new sanitation methods. Cornerstone Hospitality, management firm for the Craddock Terry Hotel, is committed to using the technology and is considering providing NanoTouch™ products for use by every guest. The historic boutique hotel, located in Lynchburg, serves some of the regions most prestigious guests. In May, NanoTouch Materials, LLC received TechEDGE’s 2012 Entrepreneur of the Year award presented by Virginia’s Region 2000 Technology Council. The Technology Council works to foster an environment that stimulates innovation and growth of technology-focused organizations in the Central Virginia region.
Orthopaedic Excellence Since 1981
“This year’s winner approached the growing health and safety problem from a different angle, creating low cost, self-cleaning surfaces. Recognizing the importance of public perception, the communication and branding opportunities that NanoTouch™ products provide can be its greatest value. [Telling] people where to touch or place personal items, and letting them know the provider is committed to their health and wellbeing is highly important,” shares Jonathan Whitt, Executive Director of the Region 2000 Technology Council. NanoTouch Materials, LLC has plans to position their fabrication facility in Lynchburg’s Center for Advanced Engineering and Research (CAER). With the advent of this new line of printable antibacterial products, Virginia appears to be a national trendsetter for innovative ways to communicate antimicrobial messages directly on the end-use products themselves. For more information about NanoTouch, visit the company’s website at nanotouchmaterials.com.
Sources:
◊ www.bestwestern.com/newsroom/ pressreleases_detail.asp?NewsID=834 ◊ www.rd.com ◊ www.cnn.com/2010/TRAVEL/12/22/bt.germs. breed.on.plane/index.html ◊ Jonathan Whitt, Region 2000 Technology Council www.region2000.org ◊ Dr. Michael Miller, Commonwealth Oral & Facial Surgery in Richmond ◊ Dennis Hackemeyer, NanoTouch materials, LLC http://nanotouchmaterials.com
The Dream Team of Orthopaedic Excellence Since 1981 Colonial Orthopaedics has been serving the residents of the Tri-Cities area, recruiting a “Dream Team” of physicians with a reputation for providing the highest quality of orthopaedic care. Our commitment to our patients, referring physicians, staff and friends is simple: as the communities we serve continue to grow, Colonial Orthopaedics will continue to strive for excellence in serving all of your orthopaedic needs such as... Joint Replacement Foot & Ankle Spine Surgery Sports Medicine
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Locations: 13048 Rivers Bend Rd., Chester, VA 23836 (804) 530-3330 131 Jennick Drive, Colonial Heights, VA 23834 (804) 526-5888
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our health | SAVING ON HEALTHCARE
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SAVING ON HEALTHCARE | our health
AMERICA’S FAVORITE PENNY PINCHER TALKS ABOUT SAVING MONEY ON HEALTHCARE words | RICK PIESTER
CLARK HOWARD ON
HEALTH COSTS With healthcare costs claiming 17 cents out of every dollar in the American economy, it pays for each of us to find ways to economize on health spending without sacrificing the quality and effectiveness of the things that keep us healthy. To get some pointers, Our Health spoke with consumer expert Clark Howard, who advises consumers how to save more and spend less as cost savvy individuals. Howard’s radio show is heard every day on more than 200 radio stations throughout North America. He is also co-host of HLN’s nightly news program: Evening Express with CNN’s Ryan Smith and Isha Sesay, and he’s the author of nine books on ways we can spend wisely. Inspired by a chapter in Howard’s No. 1 New York Times best selling book: Clark Howard’s Living Large in Lean Times, we contacted Howard for this exclusive, Our Health interview. Many of the following tips are discussed in the book’s chapter on health and healthcare.
Shop for Non-Emergency Care Howard says that healthcare is one of the few things that we buy, but we don’t know the cost until after the service is delivered. But he says the time is coming when healthcare pricing will become more consumer-driven. In the meantime, Howard says, “people in medicine are getting used to having patients offering to pay cash upfront in exchange for a discount. There’s even a website that helps.” The website is bidonhealth.com. In Richmond, for example, the site features a long list of laboratory tests. Get an order for a test from your physician’s office, enter it on the site, and you will see local discount pricing for the test. Then, in a process very much like travel and lodging sites such as Priceline.com, you can establish an account and find qualified service providers for the test you are seeking, at a significant discount.
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our health | SAVING ON HEALTHCARE
“...healthcare is one of the few things that we buy, but we don’t know the cost of until after the service is delivered.” Preventive Care and Exercise are Important Howard notes that more than half of what we spend on healthcare in America goes to pay for health problems that could have been prevented by following a healthier lifestyle. “That’s one of the most overlooked things in healthcare,” he says, “and it’s so important to know how to keep from needing so many health services to begin with.” Howard, an obsessive exerciser since he was 19 (he’s 57 now), says that he could eat whatever he wanted and not gain weight until he reached his late 40s. “I was a junk food junkie,” he says, “I never got fat. But that all changed four or five years ago. I saw a photo of myself in the newspaper, and I had a spare tire. I was horrified. So I changed my eating habits. Everyone is different, but what works for me is that I eat 2,000 calories a day, Monday through Saturday. On Sundays, I have whatever I want. For me, it works. I went from 215 to 180, and that’s what’s good for me. And I weight myself every morning, even though it drives my wife crazy. It’s immediate feedback.”
Know when it’s best to access an emergency room Howard notes that the hospital emergency department is one of the most expensive places to get medical care. “The emergency room,” he says, “is for serious, life-threatening illnesses or injuries. It’s not set up for minor illnesses or injuries.” As he talks, he is looking up another web site, minuteclinic.com, operated by national pharmacy chain CVS Caremark. The Web site names seven CVS pharmacy locations in the Richmond area where there are certified nurse practitioners and physician assistants who can diagnose, treat and even write prescriptions when medically appropriate. In his book, he writes of a study published in the Annals of Internal Medicine that concluded that care from a retail-type clinic came at a lower cost than a physician’s office, urgent care center, or emergency department, with no adverse effect on the quality of care.
Get free or discounted prescription drugs Clark says that when your physician writes a prescription, he or she may have no idea what the prescription might cost. He says that such big-box stores as Walmart and Target have many medications from $4 per month or $10 for three months. Next time you’re at one of those stores, Howard suggests going to the pharmacy section and pick up a copy of the brochure that has the drug prices. Take it with you when you go to the doctor to see if anything on the list will work for your ailment. Or ask 48 | www.ourhealthrichmond.com
the doctor if they have a savings card for a discount for the drug (also called prescription co-pay assistance cards).
Cut pills in half and disregard expiration dates* According to what Howard has read, some medications can be used up to five years after the expiration date, retaining 90 percent of their potency. “Always consult with your doctor before taking expired medications,” he cautions, “save money, but do it safely.” He suggests also that you ask your doctor if the medication is cheaper in a higher dosage pill, and then cut the pill accordingly. As an example, pills of 10 mg of medication are generally the same cost as pills containing 20 mg of the same medicine. So Howard says to get the 20 mg pills and cut them in half and get “twice the bang for the buck.”
A study published in the Annals of Internal Medicine concluded that care from a retail-type clinic came at a lower cost than a physician’s office, urgent care center, or emergency department, with no adverse effect on the quality of care. Together Rx Access® card offers 25 to 40 percent discount Howard says that this is a good deal for anyone in the Richmond area who doesn’t have prescription drug coverage, and isn’t eligible for Medicare. The card is available by calling 1.800.444.4106, or by visiting www.togetherrxaccess.com to enroll or to get more information. The card is widely accepted for discounts on drugs in pharmacies throughout the Richmond area. And he urges that you also check Costco, BJ’s, or Sam’s Club, where you do not have to have a membership to buy medications there. For more easy ways to save money on what you pay for healthcare, the healthcare chapter Clark Howard’s Living Large in Lean Times is chock full of suggestions, including why you should set up a health savings account (and why that’s different from a flexible spending account for healthcare), why you should be careful with dietary supplements and herbal remedies, the importance of establishing advance directives for healthcare, and more. The book is in most bookstores for about $18. Or you could take a tip from the author and find it in many online stores for as low as about $6.
HOLISTIC TRUTH | our health
Should You Detox?
it’s a good choice for some, but be careful!
words | SUSIE GALVEZ photography | ED IP
Above: Bryan P. Lowry, DC, of the Advanced Wellness Centre in Richmond explains how detox works to patient.
Many cultures around the world have long known that toxins accumulate in the body and can be an underlying cause of a variety of health problems. For centuries, different therapies have been used to “cleanse” or detoxify, from simple water fasts to sometimes elaborate regimens of bowel cleansing, steams, and saunas. But Bryan P. Lowry, DC, a chiropractor with Advanced Wellness Centre in Richmond, says that mainstream medicine is getting interested in the process. “Western medicine previously ignored or criticized these techniques for many years,” he notes, “but it has finally started to recognize detoxification as a vital bodily process.” Co-clinic director, William U. Roodman, DC, adds, “When you consider our highly industrialized world – with continued production of more and more toxic compounds that find their way into the air we breathe, the water we drink, and the food we eat — detoxification is critical.” We also produce toxins within our bodies in the processes of digestion and elimination, combating disease and infection, and dealing with stress. Some people produce additional toxins as a result of food allergy or “sensitivity” reactions. The body must rid itself of these external and internal dangerous toxins by transforming and then excreting them through our vital organs, most critically the www.ourhealthrichmond.com | 49
our health | HOLISTIC TRUTH
liver. In fact, the liver is our detoxification “control center,” as it processes and directs wastes to and through these organ channels for elimination: ◊ Lymphatic system: Removes and transports wastes from our cells ◊ Colon: Excretes solid wastes ◊ Kidneys: Filter and excrete acidic wastes in our urine ◊ Lungs: Filter and purify the air we breathe ◊ Sinuses: Primary channel for mucous removal ◊ Skin: Controls our body temperature and provides backup removal of acids and other wastes if the preferred channels become overloaded. Unfortunately, not all of the excess toxins get excreted efficiently—some are circulated back into the bloodstream and others are stored in various body tissues, such as fat. This is in part due to the increasing levels of toxins we are exposed to, and it may be exacerbated by a lack of nutrients needed to fuel the detoxification process. Through the years, toxins can build up in fat, joints, the brain, and various other tissues, potentially leading to a variety of health concerns.
“A gentle, safe, and effective detox program, properly administered, can do wonders for the body,” Dr. Roodman says. “Our patients report that their detox programs helped them sleep better, have more energy, think more clearly, and have an overall general feeling of vibrancy. And, often, digestion improved too.” To have the most successful outcome, each detox patient at Advanced Wellness Centre answers an extensive detox questionnaire. Their answers help create an individualized detox program based on each patient’s needs, lifestyle, and health condition. “Our programs are clinically based, using high quality ingredients along with a realistic, real-world food plan to maximize detox outcomes,” Dr. Lowry adds. Below are some healthy guidelines to use no mater what detox method you choose – medical, over the counter, or do-it-yourself: ◊ Always consult a physician before proceeding if you have any doubts about your health status. ◊ Cut down your caffeine intake throughout a week before staring a detox to avoid caffeine withdrawal headaches.
Perhaps it’s time for you to consider detoxifying—but how, with which product(s), and where do you find them? Stop by your local pharmacy and you will see row upon row of detox kits for sale, some with unpronounceable ingredients, and all of them touting best, fastest, easiest, or newest! Or simply look at the magazines in the checkout line at the grocer to see the detox miracle of the month recipe listed on the covers.
◊ Drink lots of water (at least 2 quarts daily) to help flush your system and aid in toxin removal.
Before attempting to self-prescribe your own detox program, here are some important considerations:
◊ Include some oily fish (if you dislike fish, substitute organic, grass-fed chicken). If you are vegetarian, nuts and seeds will provide protein (modest amounts of which are vital for the detox process).
◊ Research has substantiated that an individual’s ability to detoxify substances to which they are exposed varies tremendously. ◊ No two people have exactly the same dietary needs or health problems. ◊ A single detox program is not suitable for everyone. ◊ Herbal and vitamin supplements, including over-the-counter detox kits, are not regulated by the FDA. ◊ Herbal and vitamin manufacturers are not required to adhere to medical standards. ◊ Will the program provide healthy nutrition while eliminating excess toxins? ◊ Are the needed foods and liquids easy to find in your local area? ◊ Is the program simple to follow? ◊ Will the detox program fit your lifestyle? ◊ How can you expect to feel during the program? 50 | www.ourhealthrichmond.com
◊ Don’t detox for too long (one to two weeks is ideal). Note: It can be longer if medically administrated. ◊ Base your diet around a wide variety of seasonal (ideally organic) vegetables. Add whole grains – brown rice, millet, quinoa – and seasonal fruit.
◊ Use a little organic extra virgin olive oil for cooking. Use coldpressed seed oils for dressings. You can add herbs and spices liberally to add flavor. ◊ If you have any significant reactions or feel ill, consult your doctor immediately. Once you have completed your chosen program, keep it healthy! Choose to continue your healthy habit of eating good-for-you foods to keep your “new and improved system” at its best!
Editor’s note: Susie Galvez is a Richmond-based beauty, image, and wellness writer, speaker, and author of nine books. To learn more about Susie, go to www.SusieGalvez.com
SPECIALIZED SERVICES FOCUS | our health
words | ANIKA IMAJO photography | KEITH THIENEMANN
Getting it Right in the NICU
Holding court in the lobby of the Women’s Pavilion at Henrico Doctors’ Hospital (HDH), Collin, Marley, and Alexis revisit the site of the first haven they ever knew.
Their births, at 27 weeks and three days, were premature. But the community of caregivers that greeted the triplets on this recent July afternoon had greeted them seven months before, prepared for their arrival and dedicated to giving them—and their family—the tools they would need to make a robust debut into the wider world. Presenting a lively triptych on wheels in their stroller built for three, the hearty infants reveal no sign of the trials they endured during their residency at the facility’s Neonatal Intensive Care Unit (NICU). Mom, Kristy Black, who delivered them in the wake of two miscarriages, beams while recounting their journey. “When I got pregnant the third time, I just knew something was a little different. When I had my blood taken, the nurse said, ‘I’m no doctor, but this is usually the sign of multiples.”’ Anticipating twins, abundant on her father’s side, Black and her husband Marlon prepared to double their household. But when the time came for her eight-week ultrasound, a familiar source would deliver some unexpected news, advising her to take a deep breath. “It was the same lady who had discovered the first two miscarriages. Her name is Faith. I looked at her and I said, ‘No, Faith, not again.’ She said, ‘Kristy, there are three.’ And my husband went, ‘three what?!!!’” Black—faced with a challenging pregnancy—was confident that she and her babies would receive superlative care at HDH, which was recommended by her obstetriciangynecologist. “They just have an awesome reputation,” she remarks.
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our health | SPECIALIZED SERVICES FOCUS
Henrico Doctors’ Hospital is a part of the HCA Virginia Health System. The excellence that earned HDH its stellar reputation merited national recognition in April, when its NICU’s Prematurity Program became the fourth such facility in the nation—and the first in Central Virginia—to be awarded the Gold Seal of Approval by The Joint Commission, an independent healthcare accreditation and certification board. (Formerly the Joint Commission on Accreditation of Healthcare Organizations, the commission is a not-for-profit organization that accredits healthcare organizations and programs in the United States.) Contributing to the quality of care at HDH’s NICU is the multidisciplinary team, composed of professionals ranging from physicians to social workers, that meets weekly to discuss the needs of each baby, says Debbie Burbic, RN, director of Labor and Delivery for the Neonatal Critical Care Center. HDH, she points out, delivers more babies than any other hospital in the Richmond area and is known for its care of high-risk babies. Black illustrates her experiences at HDH through examples of genuine commitment and compassion, evidenced throughout her ten-week stay, through the trying weeks following the triplets’ birth, and during the delivery itself on Thanksgiving night, when her off-duty physician—who was hosting family from out of town—dropped in. “He said, ‘Kristy, I’ve been tracking you all day on my cell phone.
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I wouldn’t have missed this for the world.’” Reflecting on such displays of personalized attention, she observes, “That’s what you walk away with.” In the moments surrounding her deliveries, Black recalls how the floor’s eerily calm atmosphere suddenly erupted into a controlled maelstrom, as staff members prepared for the marathon ahead. Delivered by Caesarian section, Marley was born at 9:25 pm, weighing one pound, nine ounces. Collin followed one minute later, weighing one pound, 15 ounces. And Alexis, weighing one pound, 13 ounces, arrived at 9:27 pm. Born with Patent Ductus Arteriosus, a condition that arises when the blood vessel connecting the pulmonary artery to the aorta fails to close, Collin and Marley underwent open-heart surgery. The triplets were immediately taken to the NICU, where they would remain for eight weeks, monitored around the clock, in the primary care of a physician specializing in treatment of premature babies. Neonatology is a field that demands vigilance, both in caring for the tiny patients who cannot communicate their discomforts and in keeping abreast of rapidly evolving advances. But its
SPECIALIZED SERVICES FOCUS | our health
inherent challenges are matched by its rewards, explains Vijay Dhande, MD, medical director of the unit. “I think that the greatest joy is on a day like this,” he says, “when the babies come back to see us.” Immediate access to specialists such as Dr. Dhande, according to Burbic, is an important part of the care that distinguishes the HDH NICU from many of its peers. “We’re the only hospital in the area that has a true neonatologist in house, 24 hours a day.” “That’s something we feel strongly about,” adds Dr. Dhande, one of seven neonatologists serving the NICU, “because if something happens, whether it’s during the daytime or in the middle of the night, we have a board certified neonatologist in the hospital to take care of the problem and also look after the family.” Black, who suffered anxiety while separated from her newborns, recalls the moment when a nurse responded to her concerns and coached her and her husband as they held one of their infants for the first time. “It was the best feeling in the world,” says Black, describing the reassurance and support she and her husband experienced in the weeks to come, as they awaited their infants’ graduation from the NICU to the PCN (Progressive Care Neonatal Unit) and finally to their home. NICU Family Support, through the March of Dimes, as well as a host of educational resources—classes on breastfeeding, bathing, CPR, and more—are also available to help families navigate new waters and make sure they feel comfortable caring for their newborns.
Vijay Dhande, MD, medical director of the NICU at Henrico Doctor’s Hospital
“We spend a lot of time one on one with them while they’re in the hospital, getting them ready to go home,” says Beth Duvall, RN, while cradling one of the triplets. “We just love them like they’re ours. That’s what makes a big difference, too.” When the Blacks finally brought the last triplet home, they left HDH secure in the knowledge that the care they received wouldn’t end at the hospital doors. They carried with them enduring friendships and a support system that will follow them for years to come. A developmental follow-up clinic will track the babies’ progress for the next five years, making sure they reach the appropriate milestones along the way. And the Black triplets are doing just fine.
“If something happens, whether it’s during the daytime or in the middle of the night, we have a board certified neonatologist in the hospital to take care of the problem and also look after the family.” - Dr. Dhande
“We’ve had no complications,” Black says. “We go to a learning development specialist, and they can tell this early that they’re right on track, where they need to be.” At their first birthday bash in November, the triplets will share their big moment with friendly faces from the HDH NICU and PCN, says Black. “We’re calling it their birthday celebration, to thank everyone who helped bring them into the world.”
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MEN’S HEALTH | our health
The Prostate Puzzle words | RICK PIESTER AND ROD BELCHER
For roughly 30 years, American men and their physicians have relied on a simple blood test to screen for cancer of the prostate. A positive result on the test would lead to a biopsy and possibly a decision about further treatment. A negative result would lead to peace of mind. But now, after a government panel’s recommendation that healthy men should no longer be screened for prostate cancer because doing so may do more harm than good, most American men are left with unsettling and conflicting information. Should the test that is credited with diagnosing cancer and saving lives suddenly be shunned? The medical community seems to be divided on how best to address the furor that has sprung from the recent stance. Some basics: The prostate is a gland about the size and shape of a walnut. It lies just below the bladder. Its primary function is to produce semen, the fluid that carries sperm. The prostate surrounds a portion of the urethra—the tube that carries urine from the bladder. One in six American males will have prostate cancer sometime during his lifetime. Prostate cancer is the second largest cause of cancer deaths, second only to cancer of the lung, with the disease killing about 30,000 men each year. Before any screening measure, cancer of the prostate was usually detected only when it was in its later stages, posing a lethal threat to life. www.ourhealthrichmond.com | 55
our health | MEN’S HEALTH
What’s Your Risk? The decision about whether to be screened for prostate cancer is a complicated one that each man must make for himself. Prostate cancer risk factors include the following: Family history: Having a father or brother with prostate cancer doubles a man’s chances of getting the disease. Those who have several relatives with prostate cancer also run a greater risk—especially if the cancer was found at a younger age. Age: The disease is rare before age 40, but the risk increases after age 50. Race: African Americans are more likely to develop prostate cancer and are more likely to die of it. The cancer occurs less often in Asian Americans and Hispanics than in white men. Source: American Cancer Society
The good news is that a blood test — called PSA, for the prostate-specific antigen that in elevated levels is a marker for possible cancer—came into use in the late 1980s. Prostate-specific antigen is a protein produced by the prostate and released into the bloodstream. If the prostate experiences an “event”—not necessarily prostate cancer—PSA levels rise. Normal results on a PSA test do not always mean that cancer is absent, nor do elevated results always mean that cancer is in the prostate. Never completely free of controversy, the PSA test, along with a digital rectal exam, was generally recommended each year for men over age 50. Some physicians advised men who are at a higher risk for prostate cancer (principally men with a family history of prostate cancer and African American men) to begin screening at age 40 or 45. Widespread implementation of the test produced a surge in diagnoses of prostate cancer in the 1990s, which in turn led to worries of over-diagnosis or overtreatment. The death rate from prostate cancer took a noticeable drop — from 39.22 deaths per 100,000 males in 1992 to 23.50 deaths per 100,000 males in 2007, according to the National Cancer Institute. But along with that encouraging result came troubling complications. Among them were infections and other problems related to the biopsy procedures to further diagnose and pinpoint cancer in the prostate. More troubling still were reports of such complications as impotence and incontinence among men who had their cancer treated with surgery or radiation. Another worrying note about prostate cancer is that the great majority of men who have it will never feel the ill effects of it. Part of the American psyche, however, is that if there is cancer in your body, you treat it aggressively to get rid of it. The widespread understanding of cancer is that if it is allowed to progress unchecked, you will die. In early October 2011, the U.S. Preventive Services Task Force, an independent panel of health experts charged with measuring the effectiveness and safety of medical procedures, issued a recommendation that healthy men should no longer be routinely screened for prostate cancer. The recommendation provoked a firestorm of objections from the medical community, but the task force issued a statement in June 2012 reaffirming its position.
(This is the same task force that caused an uproar when it announced new guidelines in 2009 recommending that most women start regular breast cancer screening at age 50, not 40.) It leaves men — and their physicians — in a quandary: continue the PSA test and possibly detect cancer that may never affect the man and can possibly harm him if treated versus do away with the blood test and miss a cancer that may eventually kill a man. The task force based its findings on a review of studies that those who oppose the new recommendation say are flawed. Many urologists find fault with not only the task force’s recommendation against PSA testing but also the scientific rationale underlying the recommendation. “I can’t base my medical opinion on a flawed study,” says Charles Jung, MD, a urological surgeon practicing with Virginia Urology in Richmond. “The PSA is the best screening test we have available. Before we had the PSA test, prostate cancerrelated deaths were 40 percent higher. We’ve seen a drop in deaths. We’ve seen a 70 percent drop in advanced prostate cancer cases.” Dr. Jung says that many in the urology field have problems with the studies that were used and with the composition of the Task Force. “There wasn’t a single urologist on the panel,” he explains. “I think that has upset a lot of people in the field.” 56 | www.ourhealthrichmond.com
MEN’S HEALTH | our health
He adds that the methodologies of research for the two large studies, one in the U.S and one in Europe, have created debate. “You want your trials to be randomized and large,” Dr. Jung says. “The grouping for this study was one group of men that got the PSA tests and one group that did not. But many of the men in the group that was not supposed to be getting the PSA test were getting it anyway. The studies had a 40 to 50 percent contamination rate. They are flawed, not just in minor ways, but big ways. The study did not do follow up and did not test the subjects the way a urologist would be testing patients in 2012.” Dr. Jung says that every man should discuss the test with his doctor, and, if he is 40 or over and has a family history of prostate cancer, he should consider the PSA test. “As a whole, we may indeed be over-treating some men with prostate cancer,” he states. “However, I think the best answer is to keep the screening method of the PSA test, and be judicious in treatment methods and the priority of treatment.” The American Urological Association, the professional organization for the advancement of urologic patient care, has taken a strong stand against the U.S. Preventive Task Force recommendation, saying that the task force is “doing men a great disservice by disparaging what is now the only widely available test for prostate cancer, a potentially devastating disease.” The association and individual urologists urge men to get as much information as they can to form their own opinions on the issue and then to have a frank conversation with their physicians and families so that they can make informed decisions about screening for prostate cancer. “That is part of our job as doctors,” Dr. Jung says, “to get the information out to our patients and help them make the best decision for themselves.” Editor’s Note: Good sources about prostate cancer include the American Cancer Society (http://www.cancer.org/cancer/prostatecancer/), the National Cancer Institute (http://www.cancer. gov/cancertopics/types/prostate), and your physician.
When time is of the essence, OrthoExpress offers quick, attentive orthopaedic care to get you and your family in and out in a SNAP.
• Orthopaedic Specific Care • Quick Appointments • Reduced Wait Time
• Walk-Ins Encouraged • Standard Copay • X-Ray On Site
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Charles Jung, MD, a urological surgeon practicing with Virginia Urology in Richmond
GRAND OPENING SEPTEMBER 2012 13038 Rivers Bend Rd.
Chester, VA 23836
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our health | MIND MATTERS
New Treatment for Depression Shows Promise words | EDWIN SCHWARTZ photography | KEITH THIENEMANN
Barbara Ginsburg had given up hope. Her latest bout with depression had left her bedridden for a year and a half. But last December she began a new treatment for depression—transcranial magnetic stimulation, or TMS, at Virginia Commonwealth University Medical Center. TMS is a relatively new, non-invasive treatment of major depression that specifically targets and stimulates the part of the brain believed to regulate mood. The procedure requires no anesthesia or drug treatments and has none of the side effects common with antidepressant medications. Candidates for TMS therapy at VCU Medical Center must suffer from major depression and have failed to respond to at least four treatment trials. Barbara’s decision to try TMS was not an easy one. Even though the Food and Drug Administration approved TMS therapy in 2008 for the treatment of major depression, insurance companies have not been quick to embrace it. In 2003, Barbara suffered a stroke that left her with an interrupted flow of the tiny electrical impulses in her brain. Barbara, who had no history of depression or anxiety, then had three major bouts over the next few years. The first two were successfully
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MIND MATTERS | our health
treated with conversational therapy and a combination of sleep and anxiety medications. But her third bout was so severe she had to quit her job as a school administrator and became confined to her bed for eighteen months. She described the anxieties as seizure-like sensations. “They would crawl up my back. Getting into bed was the only way I could handle them,” she says. “My husband did everything for me.” After six months of deliberation, Barbara decided to proceed with the TMS. “I did it for my husband and my friends. But I wasn’t hopeful. I didn’t think it would help so spontaneously,” she explains. She sought treatment at the VCU Medical Center under the care of Ananda Pandurangi, MD, professor and vice chair of Psychiatry. Her therapy consisted of twenty treatments—five days a week, for four weeks.
by placing the magnet over the left side of the brain to generate movement in the patient’s right thumb. Once the motor cortex is located, the magnet is moved two inches forward on the same plane to locate the dorsolateral prefrontal cortex (DLPFC). This is the part of the brain responsible for depression. The second part of the procedure is the first of twenty TMS treatments. Each session lasts an hour and involves turning on the magnet for about forty minutes. The magnet generates a train of ten pulses for four seconds each. The train then pauses for twenty-six seconds and then repeats. This totals 3,000 stimuli for one forty-minute session. “Patients feel a sharp tap for a fraction of a second. The first day can be painful,” says Dr. Pandurangi. “But patients can get used to it on the second day and won’t even feel it by the end of the first week.”
During each treatment, the patient remains awake in a comfortable chair. A plastic gantry, or arm, holding an electromagnet is placed twelve inches above the head.
“There were no side effects and at the end you get up and go home,” says Barbara. Her condition began to improve after two weeks of TMS therapy. And by the end of week four she had made a full recovery.
During the initial session, Dr. Pandurangi conducts two procedures. First, he locates the motor cortex, the part of the brain responsible for muscle movement. This is accomplished
Since her treatments, Barbara has resumed her passion for art. “I’m currently in five art exhibits and am having one of the most creative periods of my life,” she says excitedly. She attributes
You don’t need fast E.R. times. You need care now. We see to it that everyone gets the care they need right away. We offer free assessments, 24/7, that are backed by a full continuum of behavioral healthcare services at the region’s only freestanding psychiatric facility. Poplar Springs provides intensive, patient-focused care from a team of expert behavioral health clinicians. When it comes to the healing process and peace of mind, waiting isn’t part of the plan.
At Poplar Springs Hospital no emergency room visit, or referral, is needed. For more information visit poplarsprings.com, or call 804-733-6874 or 866-546-2229.
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our health | MIND MATTERS
this to her new level of energy which has allowed her to resume both driving and entertaining. Barbara is also planning a trip to Europe with her husband. Over the past two years, VCU Medical Center has seen an improvement in sixty percent of its TMS patients (compared to forty percent in FDA trials). Barbara accredits VCU’s success rate to Dr. Pandurangi’s expertise in positioning the magnet. In addition to TMS, VCU Medical Center also plays an active role in the development of other depression therapies. It is currently one of twenty institutions participating in a national clinical trial known as the BROADEN study. These trials will serve to evaluate a medical device used in Deep Brain Stimulation therapy, or DBS.
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DBS is considered experimental and is not approved by the FDA. In this procedure, a wire is inserted in the brain while a pacemaker is implanted under the left collarbone. This pacemaker, or battery, is the size of a silver dollar and generates electric pulses to the specifically targeted wire tip. VCU Medical Center is unique due to its status as a full-service brain stimulation treatment center. The Medical Center is the only facility in the country that offers all four brain stimulation therapies: electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS). Barbara Ginsburg wants people to know her story, because today she is filled with hope. Not just for herself – but for anyone who suffers as she did. When asked if she would recommend TMS therapy, she concludes, “It’s truly a miracle. I didn’t expect anything like it. I didn’t think it would bring me back to where I am.”
Durre Khan, MD
Tara Crisinati, MS, PMHNP/CNS-BC Ananda Pandurangi, MD, Professor and Vice Chair of Psychiatry, VCU Medical Center
TEST YOUR HEALTH IQ!
QUIZ YOURSELF! | our health
How much do you know about physical rehabilitation? To find out, take this quiz developed in partnership with Sheltering Arms Physical Rehabilitation Centers here in Richmond. After you complete the quiz, visit www.ourhealthrichmond.com and click on the “Quiz Yourself” link to see the answers! What is the name for a doctor that specializes in physical medicine and rehabilitation (PM&R)? A. Physiatrist B. Podiatrist C. Optometrist D. Nephrologist True or False: It is impossible to regain function that is lost as a result of a stroke. True False True or False: Severe back pain lasting several weeks always requires surgery. True False A physical therapist can help with all of the following except: A. TMJ (temporomandibular joint dysfunction) B. Women’s urinary incontinence C. Balance problems D. Poison ivy The third week in September is National Rehabilitation Awareness Week. Who was the first governor to declare it Rehabilitation Awareness Week in Virginia? A. Doug Wilder B. George Allen C. Tim Kaine D. Bob McDonnell
Which of the following therapists can help if you are experiencing difficulty swallowing: A. Physical therapist B. Occupational therapist C. Speech therapist D. Recreation therapist The brain’s remarkable ability to compensate for injury using old and new connections to recover lost function is called: A. Sensation B. Functionality C. Neuroplasticity D. Authenticity True or False: One out of three adults age 65 or older falls each year. True False True or False: An occupational therapist can help if you are struggling with low vision. True False Which of the following can you do with limited mobility following an illness or injury? A. Golf B. Travel C. Bowl D. All of the above
Quiz Yourself! Bonus Challenge! The right answer could make you a winner of a $25 gift card to Martin’s® Food Markets*! Fill in the blank: The physiatrists at Sheltering Arms are ___________________ seeking to restore and maximize functional skills, self-sufficiency and mobility to people who are temporarily or permanently disabled.
(HINT): visit www.shelteringarms.com to find the answer!
*To participate in the Quiz Yourself! Bonus Challenge!, visit and “like” Our Health Richmond’s Facebook page (www.facebook.com/ourhealthrichmond), then post your answer. All answers must be posted by September 30, 2012 at midnight, EDT to be eligible. On October 1, 2012, the names of those who posted the correct answer will be combined and a random drawing will be held. The first two names drawn will each win a $25 gift card to Martin’s® Food Markets. The winners will be announced on Our Health Richmond’s Facebook page at 5 pm. Please submit one answer per Facebook account. You may also submit via mail to P.O. Box 8383, Richmond, VA 23226. For more information, call 540.387.6482.
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our health | SENIOR LIVING
PRESCRIPTION FOR DANGER words | RICK PIESTER photography | ED IP
If you’ve ever been tempted to buy prescription medications from a deepdiscount online retailer, here are a few words of advice—be very, very careful. There are some bargains available from legitimate sellers regulated by the federal government. But there’s also a good chance you’ll be buying from a fake online pharmacy that will sell you authentic-looking but counterfeit medications that include anything from highway paint to chalk to animal and insect hair and who knows what else. It can be hard to tell the difference between the real and the fake. Amy Rudenko has firsthand experience with the dangers involved. Dr. Rudenko, who holds a doctorate in pharmacy and is an assistant professor in the Department of Pharmacotherapy and Outcomes Science at VCU’s School of Pharmacy, was suspicious when her in-laws bought their supplies of the anti-cholesterol drug Lipitor from a Canadian website at a fraction of what they would have paid at any Richmond area pharmacy.
Tips for Shopping for Meds Online If you’re looking for discount drugs online, the Food and Drug Administration has these recommendations: »» Make sure the Web site requires a prescription and has a pharmacist available for questions. »» Buy only from licensed pharmacies located in the United States. The National Association of Boards of Pharmacy has more information about licensing and its program to certify online pharmacies. The site is at www.nabp.net.
“My in-laws even marveled that the price was so low,” Dr. Rudenko says now. “The Canadian seller asked for their prescription before they would send the Lipitor. And that’s supposed to be a good sign that you’re dealing with reputable people.” When they arrived, the pills looked like the real thing. But when the in-laws went to their doctor after taking the “Lipitor” for six months, their cholesterol had skyrocketed. It was out of control. The doctor thought that they had stopped taking their medication. Further investigation showed that the pills—whatever they were—were not Lipitor.
Selling counterfeit medications is a rip-off, to be sure. It’s also illegal, dangerous, and even deadly. In most of the developed countries of the world, government regulation and market controls keep the proportion of counterfeit drugs below 1 percent. Yet counterfeit prescription drugs sold as the real thing kill people every year in the United States and Western Europe. Deaths are even more common in South America, Africa, and Asia.
»» Don’t provide personal information such as credit card numbers unless you are sure the site will protect them.
The Center for Medicine in the Public Interest estimates that the production and sale of counterfeit medications is a $75 billion business. Other sources say that number is much larger. Fake medications from clandestine “labs” located anywhere in the world have made their way to pharmacies and hospitals in 46 countries, including the United States, England, and Canada. In Virginia, the state Board of Pharmacy handles reports of pharmacies, manufacturers, and wholesale distributors dispensing or distributing 62 | www.ourhealthrichmond.com
SENIOR LIVING | our health
counterfeit drugs. The board is “not aware of any patients in the Commonwealth having received counterfeit drugs,” according to an email from the board’s executive director, Caroline Juran, who also notes that it’s rare for fake medications to be sold in reputable pharmacies. But as Amy Rudenko’s experience shows, not all fake drugs coming into Virginia are reported to state officials. She was more intent on getting a legitimate source for her relatives’ medicine. She did call the online pharmacy (which has since disappeared from cyberspace) and was told that there was no way to verify that the bad medicine had come from them and that the online pharmacy was not responsible. Curiously, however, a refund showed up, unsolicited, covering the amount paid for the drugs. It’s easy to find counterfeit medicines on the Internet. Rogue websites prey on consumers, many of them cash-strapped older people looking for bargains on their prescriptions. The websites are designed to give the impression they are Canadian firms because Canada has a widespread reputation of safe and inexpensive drugs. Estimates are that as many as 36 million Americans have unknowingly bought and taken counterfeit medications. A counterfeit prescription drug is one that is manufactured by an illicit firm and masquerades as a legitimate, regulated medication. Like counterfeit currency, they are oftentimes nearly impossible to distinguish from the real thing. The difference is in the ingredients. It can be a cheaper drug that is sold as a more expensive one, a weakened or “watered-down” version of a medication, or even a pill that contains chalk, sugar, or other substitutes for active ingredients. Brand-name and generic pharmaceuticals are counterfeited. Some of the more wellknown brand name drugs that are counterfeited include Lipitor, Zyprexa, Ambien, Xanax, Lexapro, and Ativan, but those are just the beginning. Just about every brand and every type of medicine is counterfeited. According to a report by the World Health Organization, it’s not only drugs that are faked. Medical devices and medicalrelated products have also been counterfeited, including blood glucose test strips, contact lenses, surgical instruments, and even condoms.
Dr. Amy Rudenko holds a doctorate in pharmacy and is an assistant professor in the Department of Pharmacotherapy and Outcomes Science at VCU’s School of Pharmacy.
The fakes usually cost pennies or less to make and sell for $18-$20 or more per pill. The profits are enormous and so are the dangers. One of the more infamous examples in the U.S. was the distribution several years ago of the drug Heparin, an injected blood thinner given to many thousands of people who are being treated for blood clots. Counterfeit active ingredients from China triggered outbreaks of adverse reactions, waves of recalls, and as many as 81 deaths. This is a rare example of counterfeit drugs making it into the legitimate U.S. drug supply. There are some legitimate, safe suppliers of medications on the Internet, however. Caroline Juran, the executive director of Virginia’s Board of Pharmacy, suggests that anyone shopping online for prescription drugs check the National Association of Boards of Pharmacy VIPPS (Verified Internet Pharmacy Practice Sites), which maintains a list of “recommended” and “not recommended” internet pharmacies.
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READING REVIEW | our health
Healthy Reading: A Basic Home Library words | RICK PIESTER
Preparing an article like this can be mighty risky.
Because the overall subject of healthcare and all of its manifestations is such a constant hot topic, bookstores and publishers’ lists are chock full of books about health. And many of them are very, very good. This article began as a “Best of...” collection of books to help you stay healthy. Our intention was to stick to the broad fields of general health, women’s health, and men’s health, and that is what we have attempted to do. But we also realized that the “best” source of information on one issue, question, or occasion may not necessarily be the best for all health matters. There are simply too many areas of knowledge, too many good books out there addressing them all, and too many ways of expressing information to too many audiences with too many needs for any one or two books to consistently come out on top as “The Best.” What we offer instead is a selection of health-related books that we highly recommend for just about any family’s bookshelf. They are broad in scope so that they address questions and interests in many different health areas. They come from authoritative sources, and most of them are available through your local bookstore or in your public library. It’s always best, though, to buy and keep copies of health-related books you like. Health issues have a way of arising in the middle of the night or on weekends, and it’s always a great comfort to have succinct, authoritative information right at hand. Buying Tip: On the web, such sites as Amazon.com and abebooks.com usually have gently-used copies of popular books at a fraction of the price of brand new copies. These recommended books were identified with the help of Booklist, a service of the American Library Association, which helps the nation’s librarians select books of all types for library patrons. Obligatory Caution: Maintaining and improving your health is important, but beware of fads and trends. Always check with your physician before trying any new diet, exercise, or health regimen. So here’s wishing you some healthy reading!
General Interest Mayo Clinic Family Health Book ($49.95) This is the Big Daddy of encyclopedic health tomes. Simply lifting the 1,500-page book is good exercise. But the book is carefully, patiently and logically written, well-organized, and seemingly complete. The one weak feature of this book is that information is not organized in a look-it-up-right-now format to help you solve problems as they arise. So it takes a little work to get to some information, but the effort is worthwhile. YOU: The Owner’s Manual: An Insider’s Guide to the Body that Will Make You Healthier and Younger ($26.95) This very read-worthy volume is as much a franchise as it is a book. Authors Mehmet C. Oz, MD (yes, Dr. Oz of television fame) and Michael F. Roizen, MD have extended the “YOU” brand to embrace additional books on staying young, dieting, having a baby, raising a child, beauty, and more. But still, they sure do know what they are writing about. As they put it: “We won’t do it in doctor-speak, but we also won’t treat you like you’re a fourth-grader. We’re not going to make it simplistic; we’re going to make it simple.” And they deliver. www.ourhealthrichmond.com | 65
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Women’s Health The Real Life Body Book: A Young Woman’s Complete Guide to Health and Wellness. ($22.00) Booklist calls this book “a thorough, enlightening title that every young woman should have access to.” Authors Hope Ricciotti (a Harvard Medical School professor) and Monique Doyle Spencer (a health journalist) have provided a definitive onevolume easy-to-read source of information on a broad range of health concerns for young women. Woman to Woman: A Leading Gynecologist Tells You All You Need to Know about Your Body and Your Health ($7.99) Co-author Yvonne S. Thornton is a practicing gynecologist and obstetrician who in her 20-year practice discovered that her patients simply did not know the basic facts about women’s health and that often they had no plain-spoken source of information to turn to. Working with co-author Jo Coudert, Thornton uses a down-to-earth approach, anecdotes, and familiar terms to give a woman an engaging and up-to-date resource for understanding her body and how it works.
Men’s Health The Harvard Medical School Guide to Men’s Health ($21.95) Author Harvey B. Simon is the founding editor of the highly respected Harvard Men’s Health Watch newsletter, and his direct, no-nonsense approach makes engaging work of what should be a must-read for every male 18 and over. Information in the book is matter-of-factly organized into three areas: how things work, how to stay healthy, and what can go wrong. This is not a perfect book, but it’s as close as we come in a sea of titles about men’s health. The Male Body: An Owner’s Manual ($31.95) This title by the editors of Men’s Health magazine is full of well-presented information about how the male body works and how to make it work better. But half of the fun in this book is the miscellany, the tips, and the just-plain interesting-to-anyone aspect of what makes men tick in terms of health.
Two Books about Health that are Simply Great Reads The Immortal Life of Henrietta Lacks ($26.00; now in paperback $16.00) This is the story of a native Virginian and her unending impact on healthcare. Born in Roanoke and raised in the Halifax County village of Clover, Henrietta Lacks is the unwitting donor of the “first human immortal cells” now called He-La that have made possible a constellation of scientific discoveries that led to the polio vaccine, radiation treatment for cancer, and in vitro fertilization, among many other advances. Rebecca Skloot’s book reads like a novel in tracing the life of the woman whose horrible death in 1951 went practically unnoticed but whose cells, taken without her knowledge or permission, live to this day. The Emperor of All Maladies: A Biography of Cancer ($18.00) Columbia University cancer specialist Siddhartha Mukherjee has written an eloquent “biography” of the disease whose name was not even uttered in polite society until recent generations. At different times painful, hopeful, discouraging and ultimately profound, this is a majestic book.
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