March • April 2018 ourhealthrichmond.com
IN HEALTHCARE a new
generation of
Richmond providers
are making care better for our communities
PLUS:
LIPOSUCTION: IS IT RIGHT FOR YOU?
THE LONG ROAD TO RECOVERY FROM AN
EATING DISORDER
BEATING THE URGE TO GO
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TABLE OF CONTENTS MARCH • APRIL 2018
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The Pulse | People. Places. News to Know.
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Q&A on Health | Questions. Answers. Knowledge.
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Calendar | Things to Do in March and April for your Mind, Body
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Health A-Z | Insight. Awareness. Mindfulness for the
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Health Scene | Happenings. Who’s Who. Trending.
and Soul
30 - Family: Online vision screenings stop short in seeing into your total eye health.
People throughout Richmond attended the American Heart Association’s Go Red for Women luncheon in February and helped raise more than $330,000.
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Volunteer Spotlight | Heros. Champions. Community Minded Twin sisters Kimberly Ketter and Shaun Rivers help educate the community about heart disease in their roles as National Ambassadors for the American Heart Association’s Rise Above Heart Failure initiative.
Whole Family.
32 - Men: A Richmond man shares how he found relief from the pain and constant need to urinate associated with having an enlarged prostate.
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RISING STARS IN HEALTHCARE Eight professionals under the age of 40 share how they are making healthcare better for residents in the Richmond community.
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TABLE OF CONTENTS MARCH • APRIL 2018
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SNEEZY, WHEEZY RICHMOND There’s no better time than spring to take control of allergens in the places we live and work.
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Ask the Expert | Allergies: Get tested, get treated,
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THE LONG ROAD TO RECOVERY
get better.
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58 - Treating saggy breasts with options ranging from supportive bras to breast lift surgery. 60 - .Is liposuction right for you? A local plastic surgeon weighs in.
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Health Observances | Educate. Eradicate. Victory.
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Referral Reach | Expertise. Collaboration. Connection.
A Chesterfield woman shares her struggle with an eating disorder in hopes of helping others.
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Food and Fitness | Nutrition. Exercise. Prevention. Let fruits and vegetables take center stage in your spring diet plans.
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OurHealth | The Resource for Healthy Living in Greater Richmond
Beauty | Conviction. Expression. Confidence.
April is Limb Loss Awareness Month. Amputee and technician Scott Poindexter with Powell Orthotics and Prosthetics in Richmond discusses how he helps give fellow amputees a leg up.
Richmond-based Envera Health improves the experience for consumers, patients and providers.
www.OurHealthRichmond.com
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MARCH • APRIL 2018
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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2018 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Richmond is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 3420 Pump Road, #314 • Richmond, VA 23233 • P: 540.387.6482 F: 540.387.6483 MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.
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The Pulse PEOPLE. PLACES. NEWS TO KNOW. words | ELISSA EINHORN
Innovations Bon Secours heart team brings LVAD innovation to Central Virginia
Recognition Henrico Doctors’ Hospital receives several recognitions HCA Virginia’s Henrico Doctors’ Hospitals: •
Received the Healthgrades 2018 Distinguished Hospital Award for Clinical Excellence™. The distinction recognizes Henrico Doctors’ Hospitals as one of the top five percent of nearly 4,500 hospitals nationwide for its clinical performance as measured by the leading online resource for comprehensive information about physicians and hospitals. Visit www.healthgrades.com/quality.
•
Is one of only eight hospitals in Virginia – and the only community hospital – to receive a five-star rating on the CMS Hospital Compare in Central Virginia. This prestigious distinction recognizes superior performance in providing high-quality patient care and outcomes. Visit www.medicare.gov/hospitalcompare.
•
Ranked 12th out of 107 hospitals on the list of top hospitals to work for and has one of the highest levels of satisfaction among its nurses. Henrico Doctors’ Hospital reviewers cited supportive coworkers, flexible scheduling and competitive pay, ranking the facility with an overall fourstar rating via Nurse.org, and 88 percent of Henrico Doctors’ nurses recommended the facility to others as a great place to work.
More Information: www.henricodoctors.com/careers
As part of its ongoing commitment to provide exceptional care for advanced heart failure patients, Bon Secours’ heart team has a new option for patients in need of bridge-to-transplant or bridge-to-myocardial recovery – the HeartMate 3™ left ventricular assist device (LVAD). The HeartMate 3 LVAD provides new benefits such as improved blood flow in a pump that uses full magnetic levitation to reduce trauma to blood passing through the system. “The HeartMate 3’s next-generation technology complements our comprehensive approach of providing personalized treatment plans for patients in the Bon Secours Advanced Heart Failure program,” says Roberta Bogaev, MD, FACC, FACP, medical director of Bon Secours Advanced Heart Failure and Circulatory Support Center. “With the development of smaller, continuous flow LVADs, such as the HeartMate 3, mechanical circulatory support systems are becoming more anatomically correct for many of the people who need them.” More than 5.7 million people in the US suffer from heart failure and approximately 915,000 new patients are diagnosed with the disease each year. For advanced heart failure patients who can no longer rely on earlier stage treatment options, an LVAD can help their weakened heart pump blood through the body and provide crucial support as patients await further treatment. More Information: www.bonsecours.com/richmond
Partnerships Foot & Ankle Center joins Mid-Atlantic’s largest podiatry team Mitchell R. Waskin, DPM, FACFAS, owner and founder of The Foot & Ankle Center, LLC has teamed up with Foot & Ankle Specialists of the Mid-Atlantic, LLC (FASMA). Dr. Waskin will offer wider insurance coverage, more efficient scheduling, expanded services, and collaborate with other FASMA specialists on complex foot issues. More Information: www.320-foot.com
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OurHealth | The Resource for Healthy Living in Greater Richmond
New Names & Faces Goochland Free Clinic & Family Services announces new name Goochland Free Clinic and Family Services has changed its name to GoochlandCares Free Clinic and Family Services (GoochlandCares). “GoochlandCares continues its commitment to provide access to healthcare and basic human services to Goochland residents in need,” says Vicki Sharps, president of the board of directors. The 10-year-old organization moved into a new 20,000 square foot facility in January. According to Sally Graham, executive director, “Bringing our 11 programs under one roof has improved our ability to serve clients efficiently, safely and with dignity. The name change reflects our evolution as an organization and our vision for the community.” GoochlandCares is the continuation of a community of caring. In 1952, Goochland Fellowship began providing help to individuals and families not eligible for government assistance. Goochland Free Clinic was founded in 1998 to respond to health care needs for those without health insurance. The two groups merged in 2007 and became Goochland Free Clinic and Family Services (GFCFS). More Information: www.GoochlandCares.org
The Sarah Cannon Cancer Institute at HCA Virginia’s Johnston–Willis and Henrico Doctors’ Hospitals are participating in a new study that focuses on developing a test for early breast cancer detection. The STRIVE study is designed to determine if a blood test can complement mammography screenings by identifying genetic material arising from tumors to help discover breast cancer at its earliest stages. More Information: www.grail.com
Partnerships Connecting Hearts and Jewish Family Services partner to support children Two of Richmond’s leading non-profit organizations for adoption services, Connecting Hearts in Virginia and Jewish Family Services, have joined forces under one roof. Their combined strength provides an incredible resource for adoption and foster care in Virginia. “Jewish Family Services is all about family, taking care of individuals from infants to older adults, and offering a wide variety of services,” said Connecting Hearts founder Debbie Johnston. “Working with such a well-established, deep-rooted organization in our community can only have a positive impact on everyone in the foster and adoption arena.”
Community Support
HCA Virginia’s Chippenham and Johnston-Willis Hospitals, as well as Chippenham Hospital’s Swift Creek ER, raised nearly $1,800 in two weeks to benefit the March of Dimes. As part of the “Tutu for 2/2” fundraiser, staff were nominated to wear a tutu for a designated amount of time as well as donate $5 to the cause. This is the second year the hospitals participated in fundraising efforts.
Founded in 2014, Connecting Hearts specializes in awareness for the need of foster care and adoption in and around the Commonwealth. Richmond’s most established non-profit resource for care, counseling and adoption, Jewish Family Services has provided exceptional guidance and support to individuals and families of all ages, faiths and income levels for more than 165 years.
More Information: www.marchofdimes.org
More Information: www.jfsrichmond.org
HCA Virginia employees raise funds to benefit the March of Dimes
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People. Places. News to Know.
HCA Virginia joins Sarah Cannon early breast cancer detection study
THE P ULSE |
Research
THE PULSE
Innovations New technology at Johnston-Willis Hospital allows doctors to expand stroke treatment window HCA Virginia’s Johnston-Willis Hospital Comprehensive Stroke Center is the first medical center in Virginia to use the ischemaView RAPID neuroimaging platform, which allows a neurovascular physician to quickly and more accurately evaluate patients who have had a major stroke and also identify those who would most likely benefit from this life-saving process. RAPID is a fully automated technology that delivers real-time maps from magnetic resonance imaging (MRI) and computed tomography, or CT scans resulting in an easily interpreted view of the circulation of blood through the brain, also known as brain perfusion. These maps allow physicians to facilitate clinical decision making, patient triage, collaboration between community hospitals and specialists and appropriate patient transfers to specialty centers. “Johnston-Willis Hospital remains dedicated to delivering advances in neurosciences for our patients,” says Zach McCluskey, chief executive officer of Johnston-Willis Hospital. “We are proud to be the first in Virginia to offer this new technology, and hope it will provide stroke patients with healthier outcomes and the quality of life they deserve.” According to the Centers for Disease Control and Prevention, stroke kills about 140,000 Americans annually. More than 795,000 people in the United States have a stroke, of which about 610,000 are first or new strokes. More Information: www.cdc.gov/stroke/facts.htm
Innovations Johnston-Willis Hospital launches new rehabilitation program for Parkinson’s Disease HCA Virginia’s Johnston-Willis Hospital now offers a specialized treatment program to help patients whose symptoms of Parkinson’s disease interfere with daily activities. Specially-trained therapists assist individuals living with speech and movement impairments based on the “Lee Silverman Voice Treatment” or “LSVT, named after a patient who inspired the development of two evidence-based treatment protocols: LSVT LOUD focuses on increasing vocal loudness with data supporting improvements in articulation, intonation, facial expression and voice quality. In addition, LSVT BIG is an intensive amplitudefocused approach to improve walking speed, balance, trunk rotation, arm/leg movement and reaching endurance and other daily living activities. “The goal of this program is to help patients recognize their new movements or speech as normal, thereby contributing to functional changes in all aspects of their lifestyle,” says Ryan Mauzy, director of rehabilitation services at Johnston-Willis Hospital. “We’re proud to offer this specialized care and hope it will serve a great need for those living with Parkinson’s disease in our community.” More Information: www.hcavirginia.com
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OurHealth | The Resource for Healthy Living in Greater Richmond
New Names & Faces Henrico Doctors’ Hospital opens Sarah Cannon Cancer Institute HCA Virginia’s Henrico Doctors’ Hospital announced the opening of the Sarah Cannon Cancer Institute, a state-of-theart cancer center and medical office building that redefines cancer care for patients. The 98,500 square-foot facility is located on Henrico Doctors’ Hospitals’ Forest Campus and provides a full range of coordinated cancer care services ranging from screening, diagnosis, clinical treatments, support and survivorship services for patients and residents in Central Virginia. More Information: www.henricodoctors.com/cancer
Virginia moves toward nurse practitioner reform
HB 793, introduced by Del. Roxann Robinson (R-Chesterfield), would remove restrictions on board certified NPs as recommended by the Institute of Medicine and the Federal Trade Commission, moving Virginia closer to Full Practice Authority. Nearly two dozen other states, as well as the District of Columbia and the entire Veterans Health Administration, have already passed similar legislation. The bill will first be reviewed by the House Health, Welfare and Institutions Committee and, if approved, would go for a vote on the House floor. “Nurse practitioners are an instrumental part of healthcare in Virginia,” Robinson says. “The bill will modernize the way they are allowed to practice, a way that almost half of the country has already seen as valuable.” More Information: www.CareForVA.com
New Names & Faces Farm to table luxury hair and skin care manufacturer expands to Shockoe Bottom area Adiva Naturals, a leading manufacturer of luxury hair and skincare products recently announced its expansion efforts to include a showroom and manufacturing facility housed in the Shockoe Bottom neighborhood. Sourcing many of its ingredients from local natural resources, this farm to table hair and skincare product manufacturer uses highest quality ingredients, without any compromise, to provide customers with a total wellness experience. Products include hair and body refresher, milk and lavender face cleanser, coconut cream and avocado conditioning shampoo, apple cider vinegar clarifying herbal rinse and more. Adiva Naturals will host its grand opening at 1802 East Franklin St. on Saturday, April 14, 2018 from 4 – 7 pm. More Information: www.adivanaturals.com
Innovations Local clinic finds success with FIT colon cancer screening Health Brigade is able to screen for signs of colon cancer by providing patients an at-home alternative to an onsite colonoscopy. The FIT kit (Fecal Immunochemical Test) is a highly sensitive test that screens for signs of the third most commonly diagnosed cancer and the leading cause of cancer death for men and women combined according to the Colorectal Cancer Alliance. Patients watch a two-minute video explaining how to use the kit and then are asked to return the test at their next visit where the clinic can test for immediate results. More Information: www.healthbrigade.org
Milestones Chippenham Hospital’s Levinson Heart Institute performs 100th valve replacement procedure HCA Virginia’s Levinson Heart Institute at Chippenham Hospital performed its 100th transcatheter aortic valve replacement, a minimally invasive surgical procedure to treat patients with severe aortic valve stenosis and who are at greater risk of open heart surgery More Information: www.chippenhammed.com/service/aorticstenosis-treatment www.OurHealthRichmond.com
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People. Places. News to Know.
Virginia is one of only 12 states remaining in the country with outdated practice statutes for Nurse Practitioners (NPs), classifying the state as having one of the most restrictive practice statutes in the country. That might change after the House of Delegates introduced a bill that would remove the requirement of NPs to work under a “collaborative agreement.”
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Reform
THE PULSE
Partnerships Bon Secours & VCU Health establish joint thoracic surgery practice Comprehensive thoracic surgery and care is now available to the Richmond-metro area and beyond through a new surgery practice at Bon Secours St. Mary’s Hospital in partnership with VCU Health.
Survivor Support Central Virginia’s first transition shelter for human trafficking opens Safe Harbor and Bon Secours Richmond Health System announce the establishment of a second human trafficking shelter to serve the Central Virginia area. The shelter will provide transitional housing and services for survivors of human trafficking. This will be the region’s first dedicated shelter of its kind to provide transitional shelter, counseling and case management in a single location to adult female human trafficking victims. The primary goal of the transition shelter is to provide victims with a place to live while they learn life skills, secure employment and gain an education while also focusing on the next stage of their counseling program.
Thoracic surgeons treat conditions that affect the lungs or chest, such as lung cancer, lung tumors and emphysema, and perform chest reconstruction surgery after major trauma. They also provide care for esophageal cancer and pleural diseases. “Growing our reach ensures that more people have convenient access to this critically important health service,” says Marsha Rappley, MD, CEO of VCU Health and vice president of health sciences at VCU. The clinic treats a full spectrum of illnesses, from benign to malignant diseases of the chest cavity, and has begun to see patients for elective surgeries and office visits. Francine Barr, CEO of St. Mary’s Hospital, notes, “Through state-of-the-art surgical techniques and our integrated care network, we are providing thoracic surgery patients with a full spectrum of care.”
More Information: www.safeharborshelter.com
New Names & Faces
More Information: www.bonsecours.com
HCA Virginia names new chief medical officer for Johnston-Willis Hospital Ajit Singh is the new chief medical officer at Johnston-Willis Hospital. Singh previously served as chief medical officer of Terre Haute Regional Hospital in Indiana where he focused on improving quality outcomes, patient safety and medical staff relations. The chief medical officer provides leadership, direction and planning for a wide variety of medical and related activities for the hospital.
For More of The Pulse Visit: ourhealthrichmond.com Do you have health-related news to share for The Pulse? Send to Stephen McClintic Jr. via email at steve@ourhealthvirginia.com.
More Information: www.johnstonwillismed.com
Frances Austin, MD Children’s Hospital of Richmond at VCU Oncology/Hematology Downtown Richmond 804.828.2467 www.chrichmond.org
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Doug Barnas, MD
Bon Secours Richmond OB/GYN at Richmond Community Richmond | 804.371.1689 www.bonsecours.com
Barbara Baynard, PA-C Darshna Bhatt, DO Advanced Surgical Partners of VA Richmond | 804.360.0600 www.advancedsurgical partnersofva.com
OurHealth | The Resource for Healthy Living in Greater Richmond
Children’s Hospital of Richmond at VCU Neonatology Downtown Richmond 804.828.9956 www.chrichmond.org
Laura Boomer, MD Children’s Hospital of Richmond at VCU Pediatric Surgery Downtown Richmond 804.828.2467 www.chrichmond.org
Shields Callahan, MD VCU Health / VCU Massey Cancer Center Dermatology Stony Point 9109 804.828.9361 www.vcuhealth.org
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VCU Health Internal Medicine Stony Point 9000 804.828.2161 www.vcuhealth.org
Christina Ching, MD Children’s Hospital of Richmond at VCU General Pediatrics Downtown Richmond 804.828.2467 www.chrichmond.org
Oliver Karam, MD, PhD Cristin Kaspar, MD
Joo Cho, MD
Children’s Hospital of Richmond at VCU Diagnostic Radiology Downtown Richmond 804.828.2467 www.chrichmond.org
Craig Kelman, MD
Children’s Hospital of Richmond at VCU Critical Care Downtown Richmond 804.828.4987 www.chrichmond.org
Children’s Hospital of Richmond at VCU Nephrology Downtown Richmond & Stony Point | 804.828.2467 www.chrichmond.org
Santosh Padala, MD
Joanna Rosenthal, MD Yavuz Sahzene, MD
VCU Health Cardiology Stony Point 9000 804.628.4327 www.vcuhealth.org
Children’s Hospital of Richmond at VCU Fetal Cardiology Downtown Richmond 804.628.6173 www.chrichmond.org
Ashlie Tseng, MD Children’s Hospital of Richmond at VCU Hospitalist Downtown Richmond 804.828.2467 www.chrichmond.org
VCU Health Neurosurgery Downtown Richmond 804.828.9165 www.vcuhealth.org
VCU Health Endocrinology Downtown Richmond 804.828.2161 www.vcuhealth.org
Jeffrey Donowitz, MD
Christy Johnson-Oliver, NP
Mansi Kanhere, MD
Charles Leiner, MD
David Leszczyszyn, MD
Michael L’Heureux, MD
Kimberly Salkey, MD
Stephanie Stephens, DO Jessica Stone, NP
Children’s Hospital of Richmond at VCU Infectious Disease Downtown Richmond 804.828.2467 www.chrichmond.org
VCU Health Internal Medicine Downtown Richmond 804.828.2161 www.vcuhealth.org
VCU Health Dermatology Stony Point 9109 804.828.9361 www.vcuhealth.org
Jeremy Turlington, MD Christien Vagts, MD VCU Health Cardiology Stony Point 9000 804.628.4327 www.vcuhealth.org
VCU Health Internal Medicine Downtown Richmond 804.828.2161 www.vcuhealth.org
Blackstone Family Practice Blackstone | 434.292.7261 www.bonsecours.com
Bon Secours Pediatric Neurology Clinic Richmond | 804.281.8303 www.bonsecours.com
VCU Health / VCU Massey Cancer Center Oncology/Hematology Downtown Richmond 804.828.5116 www.vcuhealth.org
Morgan Vargo, MD VCU Health Internal Medicine Downtown Richmond 804.828.2161 www.vcuhealth.org
Children’s Hospital of Richmond at VCU Endocrinology & Metabolism West End & Downtown Richmond | 804.828.2467 www.chrichmond.org
VCU Health Internal Medicine Downtown Richmond 804.828.2161 www.vcuhealth.org
Bon Secours Kilmarnock Pediatrics Kilmarnock | 804.435.1152 www.bonsecours.com
Anne Vierela, CNM
Bon Secours Richmond OB/ GYN at St. Francis Midlothian | 804.423.8462 www.bonsecours.com
www.OurHealthRichmond.com
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People. Places. News to Know.
Renee Carter, MD
CALENDAR 15 THINGS TO DO FOR YOUR MIND, BODY AND SOUL DURING MARCH & APRIL 2018 words | ELISSA EINHORN
2nd Annual Honors Awards
National Kidney Foundation Serving Virginia The Honors Awards is a reception and fundraiser for the National Kidney Foundation on World Kidney Day honoring members of the local community who have been outstanding in the fight against kidney disease. The dollars raised from this event support the National Kidney Foundation’s awareness, prevention and treatment efforts. $85/person; $150/couple (Sponsorships Available) 6 pm Cocktail Reception & Silent Auction; 7:30 pm Awards Presentation 8 pm Mission Appeal & Live Auction; 8:30 pm Dessert Reception John Marshall Ballrooms | 101 North 5th Street | Richmond w www.kidney.org/events/social/honors-awards
3.3 BOWLING FOR
BLEEDING DISORDERS
Annual fundraiser in honor of Bleeding Disorders Awareness Month. Proceeds support Camp Youngblood at Camp Holiday Trails, a week-long summer camp designed to promote independence, fun and learning for children and teens affected by bleeding disorders. Help reach the peer-to-peer fundraising goal of $8,000 by registering as an individual, making a personal donation and fundraising. Put a team of friends and family together to do the same and then join us for a fun afternoon bowling in celebration of our success! $30/person registration fee | 2 – 4 pm AMF Sunset Lanes 6540 West Broad Street | Richmond w www.vahemophilia.org/event-program/ bowling-for-bleeding-disorders/
3.12 FUNCTIONAL FORUM RVA MEETUP
This month the RVA Functional Forum welcomes Melanie Dorion, NP, who discusses the topic of Weight Management from a functional medicine perspective. Melanie practices at Downtown Family Healthcare in Charlottesville, focusing on fatigue, Lyme disease, weight management and gastrointestinal health. Also includes a video presentation about past forums. Free | 7 – 9 pm Ellwood Thompson’s Market – The Beet Café 4 North Thompson Street | Richmond w www.bit.ly/2obSm7M
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OurHealth | The Resource for Healthy Living in Greater Richmond
3.2
TALK WITH T
MARCHING ON:
Mental Health Illness in the Church Tara Culton, author, speaker, motivater and creator of Talks with T, addresses the silence, stigma, struggle and triumph of experiencing mental health illness while serving in ministry. “Let the church be KINGDOM and not silent,” is her mantra. As a result of her personal journey, she is intimately acquainted with the issue of silence around mental health illness. Her heart is to help us all understand the need for transparency in this area. She shares her journey so that others may be set free. Free | 7 – 9 pm Shepherd’s Heart Evangelistic Ministries 2136 Hull Street Richmond w www.bit.ly/2CxJJJL
UFC GYM
OPEN HOUSE Are you ready to try something different? Join us for a boxing, kickboxing, TRX or BootCamp Workout! Discounts available for those interested in joining after the workout. Guests entered to win a free year of membership. Community vendors on site. Special charity workout at 11:00 am benefiting Wounded Warriors. Free | 9 am – 1 pm UFC Gym Richmond 7546 West Broad Street Henrico w www.bit.ly/2HsRZhY
CALENDAR |
3.17
National Coalition of Black Woman,
Women’s Health Summit
March & April
Inaugural Women’s Health Summit under the theme “A Holistic Approach to Women’s Health.” Features experts in medicine, mental health and the spirit. Moderated by Daphne Reid. The National Coalition of 100 Black Women, Inc. Richmond Metro Area Chapter advocates on behalf of women and girls who live in poverty, suffer with mental illness and are victims of domestic violence. Free | Vendors welcome ($75 fee) | 11 am – 4 pm Virginia Union University Claude G. Perkins Living & Learning Center 1500 North Lombardy Street | Richmond | c 804.347.9912
3.178th Annual
Lifting the Silence Gala
Join Community Brain Injury Services for photo booths, champagne welcome, silent and live auctions, Irish-themed games and raffles, live music from the Lawrence Olds Band and more. Proceeds benefit Community Brain Injury Services and community-based programs for survivors of brain injury. Free | Vendors welcome ($75 fee) 11 am – 4 pm Virginia Union University Claude G. Perkins Living & Learning Center 1500 North Lombardy Street Richmond | c 804.347.9912
3.21 Spring Ayurvedic Cleansing with Whole Foods & Herbs
Embarking on a cleanse should be a building and strengthening experience rather than a “quick fix” or rapid weight loss endeavor. With the wisdom of Ayurvedic nourishment, participants are guided through selecting appropriate foods for their unique body type and given instruction on how to complete a three-day holistic kitchari cleanse using whole foods and digestive supporting herbs. $35 | 5:30 – 7 pm Richmond Natural Medicine 2201 West Broad Street Richmond w www.bit.ly/2EC9iQ1
www.OurHealthRichmond.com
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CALENDAR
National Eating Disorders Association (NEDA) Walk
Join NEDA and its National Walk Sponsor, Aerie. Together, they raise awareness and vital funds to support the fight against eating disorders. “We walk to inspire others. We walk away from stigma to send the message that eating disorders and dangerous illnesses, not lifestyle choices.” Eating disorders are the deadliest of all mental illnesses, but we’re in this fight together and we’re walking to win. 9 am Check-in; 10 am Opening Ceremony VCU Commons Plaza 907 Floyd Avenue | Richmond tullyke@mymail.vcu.edu w www.nedawalk.org/richmond2018
4.7
The Gift of Food
An evening of enlightened conversation to learn to explore food in different ways. Professor Norman Wirzba discusses the importance of recognizing food as a gift to be treasured vs. food as a commodity. Presentation and Q&A. Wirzba is a professor of theology, ecology and agrarian studies at Duke Divinity School and the author of several books. $20 – $25 | 7 – 9 pm Saint Stephen’s Episcopal Church 6000 Grove Avenue | Richmond w www.bit.ly/2GpbHtF
m
4.12
Healthcare Professional Education Day: Parkinson’s Disease
Patients with Parkinson’s Disease and other movement disorders require specialized treatment by clinicians in acute care, inpatient rehabilitation, outpatient clinics, skilled nursing facilities and home health. Interdisciplinary teams of healthcare professionals must communicate this awareness into a comprehensive, patient-centered plan. Dr. Claudia Testa discusses means of improving the delivery of an interdisciplinary model across these clinical settings, as well as what it takes to provide optimal care for patients with movement disorders. Free | 5 pm – 7:30 pm | Sheltering Arms Rehabilitation Center 140 Eastshore Drive | East Shore Location 2nd Floor, Glen Allen w www.bit.ly/2FcFm9X
4.12 5th Annual
SCOTT SCORPIOS
Run the Rocks 5k Support Elizabeth Scott Elementary by participating in the 5th Annual “Scott Scorpions Run the Rocks 5K.” The race begins and ends at Elizabeth Scott Elementary and is followed by a Healthy Family Festival including food, games, bounce house, face painting, gardening classes, arts/crafts and lots of family fun for all ages! $10 – $1,000 | 9 am – 12:30 pm Elizabeth Scott Elementary School 813 Beginners Trail Lane | Chester w www.bit.ly/2C7sAee
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OurHealth | The Resource for Healthy Living in Greater Richmond
4th Annual
Bridging the Health Gap
Community Health Fair This Health Fair promotes awareness and emphasizes the importance of good health habits. Features the Bridging the Health Gap Joy Run/Walk, a combined 5K and 2k run/walk. Attendees need not participate to enjoy the many vendors. Free (registration fee per church members, individuals and teams for the Run/Walk) 9:30 am – 11:30 am Tabernacle Baptist Church 418 Halifax Street | Petersburg w www.tbcptg.org
4.28
Trees of Hope Beacon Tree Foundation and Sponsor VCU Health invite neighbors to the Trees of Hope 2018, a youth concert of talented performers, awareness and fundraising event to support youth mental health and suicide prevention. This moving program is an opportunity to hear stories of those helped, and is focused on hope, memorials and music. $50/person 6:30 pm – 9 pm Lewis Ginter Botanical Garden 1800 Lakeside Avenue | Henrico w www.beacontree.org
4.29 Petal
through Petals
Join us on your bike for a guided tour of Richmond’s most beautiful architecture and gardens. Bring your bike, a water bottle and a bike helmet (required to ride). Proceeds from the bike tour and raffle are for the benefit of Amy’s Army of Cancer Warriors. Proceeds are donated to the Massey Cancer Center at VCU, to be used for life-saving research. After the ride enjoy local food and beverages at Lakeside Farmer’s Market. $5 – $500 | 8 am – 2:30 pm Lakeside Farmer’s Market 6106 Lakeside Avenue | Henrico w www.amysarmyrva.com/home/ pedal-through-petals/
For More Events Visit: ourhealthrichmond.com Do you have an event that our readers simply must know about? Tell us about it by emailing Stephen McClintic Jr. at steve@ourhealthvirginia.com. Please submit your information at least three months in advance to be considered for publication in the magazine. www.OurHealthRichmond.com
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Health Scene AMERICAN HEART ASSOCIATION’S GO RED FOR WOMEN® LUNCHEON
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hroughout the month of February, the American Heart Association and Richmond community helped bring awareness to the number one killer of American men and women, heart disease and stroke, through various events and fundraising campaigns to support more research, including its 14th Annual Go Red For Women luncheon. This year’s Go Red for Women luncheon was held on February 23rd at the Jefferson Hotel and raised more than $300,000 for women’s heart health research and programs in our community. photos | DAVID PROETT
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1 Richmond ladies looking lovely in red while pledging to support women’s heart health and research programs. 2 Morgan Hamlin and Elizabeth Brooks admire the designer purses at the What’s in the Bag? silent auction. 3 Tina Johnson receives the Macy’s Lifestyle Change Award. 4 Kim Epps and her daughter Harper flash their beautiful smiles while enjoying the event. 5 Heart failure survivor and guest speaker Amber Eck with her husband Jacob. 6 Roberta Bogaev, MD, a cardiologist at Bon Secours, talks to the audience about ways to prevent heart disease. 7 Holly West from the campaign’s national sponsor, Macy’s, applies the perfect shade of red lipstick on a guest.
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Local health. Anywhere you go. OurHealth magazine is Richmond’s only resource entirely dedicated to delivering information about local healthcare services and healthy living topics. Pick up our print edition at more than 900 locations throughout the area or get the digital edition by visiting
ourhealthrichmond.com .
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VOLUNTEER SPOTLIGHT
A Cause Close to the Heart Twin sisters are National Ambassadors for American Heart Association words | BRANDY CENTOLANZA
Nine years ago, at the age of 40, Kimberly Ketter and her twin sister, Shaun Rivers, were both diagnosed with Congestive Heart Failure, a condition in which the heart pumps at a slower rate than normal. The experience led the sisters to become National Ambassadors for the American Heart Association’s Rise Above Heart Failure initiative. “We became involved with the American Heart Association initially through our ministry work at Saint Paul’s Baptist Church in Richmond,” says Ketter. “The American Heart Association has always been a cause that is close to my heart, excuse the pun. The research, community engagement, and educational programs are so important to the folks that we serve every day. It is even more important now.” Rivers agrees. “After the initial shock of our own diagnosis, we turned the pain and hurt into a chance to help educate and encourage the community and our church about heart disease,” Rivers explains. “Heart disease is the number one killer of women, especially African American women.” As National Ambassadors for the Rise About Heart Failure initiative, the twins address questions about heart failure and speak to others going through a similar situation through an online support network. “The platform is a wonderful way to connect and be a part of a community that gets it, that understands the ups and downs of living with heart failure as well as offering encouragement and resources,” says Ketter.
Ketter and Rivers also lead the Caring Hearts Medical Ministry at Saint Paul’s Baptist Church. “We saw a need not only to educate our church family on health issues but to stand at the ready for any medical emergencies that might arise during Sunday services and special events,” says Ketter. The sisters, both nurses, co-own the Case Management Associates Diabetes Wellness Center in Petersburg. “I always wanted to be a nurse,” Rivers says. “I remember my sister and I would operate on our Barbie dolls as little girls and put together pretend clinics for the dolls to make them feel better. I really can’t imagine doing anything else.” In addition to the American Heart Association, Rivers and Ketter are also active with the American Diabetes Association and have a partnership with the non-profit organization Hope with A Vizion, which provides support and resources for those living with visual impairment so they can live full, healthy lives. “I think everyone should take the time to give back to the community,” Rivers says. “Our communities grow stronger when we all do our part. If we all reach out to educate, empower and strengthen someone, we enrich our communities.” EXPERT CONTRIBUTORS Kimberly Ketter, a National Ambassador for the American Heart Association’s Rise Above Heart Failure initiative. Shaun Rivers, a National Ambassador for the American Heart Association’s Rise Above Heart Failure initiative.
The sisters are both honored to be National Ambassadors. “We have had the privilege to speak to many individuals not just in Virginia but across the nation and not just share our story about heart failure, but also hear theirs,” Rivers says. 24
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VO LUNTEER SPOTLI G HT | A Cause Close to the Heart
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HEALTH H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
Can you recover from paralysis after a stroke? Recovery from the loss of control of muscles that commonly occurs after a stroke is possible due to the brain’s capability to change. This ability to alter both structure and function in the brain is called neuroplasticity and is a concept that started emerging in science in the twentieth century.
BMI = kg (person’s weight in kilograms) DIVIDED BY
m2
Regaining function in the first days and weeks after as stroke may be related to recovery in the brain tissue immediately around the stroke. After this time, additional recovery will be gained by “rewiring” the brain in response to the activities the person performs after a stroke. There are certain qualities to these activities that we believe are important to make positive brain changes – making the activities specific to the task to be learned, adding difficulty, performing them with hundreds of repetitions, and ensuring the person is attentive to the changes they are trying to make.
Amber Walter, PT, DPT, NCS
(person’s height in meters squared)
Sheltering Arms Physical Rehabilitation Centers Mechanicsville | 804.764.1000 www.shelteringarms.com
Is having an alcoholic drink after a workout a bad idea?
How do I know what my ideal body weight should be?
Drinking alcohol immediately after a workout is far from ideal. If your routine consistently includes alcohol post workout, recovery between sessions will likely suffer which will negatively affect your performance and progress. The severity will depend on a variety of factors such as your age, gender, hydration status and dietary intake as well as a host of other constraints.
The term “ideal” weight is used as a starting point to assess health risks related to excess weight.
Though alcohol is toxic to the body, there will be no significant impact to long-term adaptations if you rarely have a drink post workout. It would be better to make time for exercise before a date with friends that may include a Friday night drink rather than put off exercise for another day. As the performance demands of your short to long term exercise goals intensify, it would be smart to limit alcohol consumption in general and especially post workout.
Jeff Diritto, MS
VCU Department of Kinesiology Richmond | 804.828.1948 www.khs.vcu.edu
Heart disease, diabetes, high blood pressure and certain cancers can be associated with overweight and obesity. Therefore, promoting weight loss to reduce these risks is recommended. Additionally, Body Mass Index (BMI) is the relationship of your height to weight and is a screening tool often used to determine if you are at “ideal” weight or if you are over/underweight. For adults 20 years old and older, BMI is interpreted using standard weight status categories. These categories are the same for men and women of all body types and ages. BMI can be used as a screening tool but is not diagnostic of the body fatness or health of an individual. BMI = kg (person’s weight in kilograms / m2 (person’s height in meters squared) • Underweight: less than 18.5 kg/m² • Normal: 18.5-25 kg/m² • Overweight: 25-29.9 kg/m² • Obese: 30 kg/m² or higher
Valerie Rakes, RD
Bon Secours Richmond Health System Richmond | 804.285.2011 www.bonsecours.com
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HEALTH H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
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From a future health perspective, kidney donors are encouraged to maintain a healthy diet, weight and to stay active to decrease the likelihood of developing high blood pressure and/ or diabetes, both of which can cause kidney disease.
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– Anita Sites, BSN, MSN, ACNP
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What is a lipid panel and should it be included as part of my regular wellness checkup? A lipid panel is a measure of cholesterol, triglycerides or fats in your blood. Other components are also identified based on their densities and particle size. As levels of these components rise they deposit in blood vessel walls. The narrowing caused by this deposition can lead to health problems including heart disease and stroke. It does require time for clinically significant narrowing to develop. Therefore, a patient’s risk of developing these diseases can be reduced with early interventions. Screening is advocated at your initial wellness check to identify those that may benefit from early intervention. Recommendations for follow up screening intervals varies based the individual patient risk factors. Although some patients and physicians elect to screen annually, every three to five years is reasonable. Risk factors such as age, smoking history, or hypertension, influence the decision to use shorter intervals for screening.
What is a gum lift? A “gum lift” is a term coined by a California dentist to describe a procedure known as cosmetic crown lengthening. This procedure contours the soft and hard tissues surrounding the front teeth to enhance the aesthetics or symmetry of a smile. Some people have “gummy smiles” or the appearance of very short teeth which may be treated with cosmetic crown lengthening. A dentist or a periodontist (a gum specialist) may perform the procedure which is generally done with local anesthesia like many dental procedures. It involves the removal of gum tissue and often underlying bone to expose the full crown of the tooth. Sometimes other procedures such as crowns or veneers are done in conjunction with cosmetic crown lengthening. As with any dental procedure there are possible side effects such as sensitivity, gum numbness, and spaces between teeth that may take time to fill with gum tissue. The end result is an improved contour to the gums and enhancement of the esthetics of the smile.
Colleen E. Nash, DDS Richard Peebles, MD
Primary Health Group – Retreat Richmond | 804.822.3480 www.phgretreat.com
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Virginia Family Dentistry – Atlee Ashland | 804.550.3324 www.vadentist.com
How will my lifestyle change following a kidney donation? Recovery from kidney donation surgery takes several weeks, depending on the individual patient, but once recovered, kidney donors can continue to live a full and active lifestyle. From a future health perspective, kidney donors are encouraged to maintain a healthy diet, weight and to stay active to decrease the likelihood of developing high blood pressure and/or diabetes, both of which can cause kidney disease. Transplant centers are required to gather information from, and follow, living donors for a period of two years after surgery. This follow up includes lab testing, blood pressure, weight, activity levels and other general functionality data on each donor. Having annual check-ups with a primary care provider, however, is important for general health maintenance and to keep a check on blood pressure and kidney function long-term. It is also advised that kidney donors avoid non-steroidal anti-inflammatory drugs (NSAIDs) as they can be toxic to a single kidney. Part of the role of the Transplant Center is to educate donors on general short and long-term risks of donating a kidney, but they can help donors with assessing their individual risks based on medical and family history.
Anita Sites, BSN, MSN, ACNP Donate Life Virginia N. Chesterfield | 866.823.6667 www.donatelifevirginia.org
THE C HEC K UP | Q&A on Health
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HEALTH A-Z
Online Vision Screenings
STOP SHORT IN SEEING YOUR
Total Eye Health words | ELISSA EINHORN
In 2016, the American Optometric Association (AOA) issued a press release in
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response to the growth of online eye tests that attempt to determine the refraction, or lens power needed to compensate for nearsightedness, farsightedness or astigmatism.
Reasons to
STAY AWAY from Online Vision Screenings
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They don’t look at the patient’s medical history.
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They are unable to identify possibly serious eye conditions.
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They don’t exam the patient’s overall eye health.
The accuracy of results is questionable.
The technology can’t replace meeting with a medical professional.
“Online vision tests are increasingly being marketed to consumers as time-saving and cost-efficient alternatives to in-person, personalized comprehensive eye examinations by a doctor of optometry that are an important part of general preventive healthcare,” stated the online release. “The AOA is concerned about patients receiving inferior ‘care’ and believing that online vision tests provide more than they do. Online vision tests do not include a comprehensive examination of the patient’s eye health by an eye care professional and do not take into account the patient’s overall medical history.” Jeffrey Michaels, OD, FAAO, an optometrist with Family Vision Care of Richmond, couldn’t agree more. “Online vision tests are not an eye health evaluation at all,” Dr. Michaels emphasizes. “A patient doesn’t come in and say, ‘I think I have glaucoma’ because glaucoma has no symptoms. They say, ‘My vision is blurry.’ Vision testing is not the same as vision exams. (Online tests) give the false impression that it’s a full eye exam.”
What to expect from online tests Online options, Dr. Michaels explains, take users through a series of questions and attempt to mimic an eye exam that would be administered by an eye doctor. Questions about past and current prescriptions are posed, and users are instructed to look at their phone or tablet from a certain distance. One of the differences between this approach and what Dr. Michaels has been providing in Richmond since 1999 is subjective measures. These would be the questions anyone who has had an eye exam would be familiar with: “Which is better? Lens 1 or 2?” Still, Dr. Michaels
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HEALTH A-Z |
“Prescriptions are based on experience, subjective concerns and previous concerns,” he explains. “If that wasn’t the case, I could walk up to a machine anywhere to get a prescription.” An additional problem is terminology, with some online vision testing companies saying people with ‘more severe prescriptions’ should not be evaluated online. “What patient knows what that means?” Dr. Michaels asks. “All a patient knows is that he needs his glasses before walking out the door. It’s a disservice to say a non-descriptive term like ‘severe prescription.’ It is not even an eye-care term.”
Telehealth in the eye care industry The Virginia Optometric Association supports telehealth, according to Dr. Michaels, “but you need to make sure the telehealth meets the standards of an in-person health exam. There is nothing in place to ensure that it does and no way to compare it to an in-person evaluation. By definition, it’s a lower standard of care.”
“Online vision tests are not an eye health evaluation at all. A patient doesn’t come in and say, ‘I think I have glaucoma’ because glaucoma has no symptoms. They say, ‘My vision is blurry.’ Vision testing is not the same as vision exams. (Online tests) give the false impression that it’s a full eye exam.” Jeffrey Michaels, OD, FAAO Family Vision Care of Richmond
Dr. Michaels gives a rundown of the battery of tests that comprise an in-person comprehensive eye exam and there are many: a review of patient concerns, medical history and vision history; visual acuity; evaluation of the pupils and peripheral vision; color, vision and depth perception for many patients; blood pressure; refraction and eye pressure testing; dilation, as appropriate; retina exams; contact lens fitting, as needed; diagnosis; creating and managing a plan; and other tests, as needed, for example, for dry eyes. He also notes that an exam can reveal other than vision-related conditions, for example, a stroke that is indicated by bleeding in the inside of the eye, or a cardiovascular condition. Doctors of optometry, says Dr. Michaels, are required by law to meet the standard of care of in person eye exams. That means it is not the use of technology that is being debated; rather, it is the quality. Dr. Michaels is confident that the technology will evolve and that optometric practice will be different in the future. “Who would have thought we would be getting emails directly through our telephones?” he points out. “Technology will revolutionize the eye care industry. There is no doubt about that. We are just not there yet.” EXPERT CONTRIBUTOR Jeffrey Michaels, OD, FAAO with Family Vision Car of Richmond.
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Online Vision Screenings Stop Short in Seeing Your Total Eye Health
is quick to warn that patient responses to these questions do not always determine the final result.
HEALTH A-Z
Beating the Urge to Go
Virginia Urology offers a low-risk procedure that’s helping men find relief from the pain and constant need to urinate that’s associated with having an enlarged prostate. words | CATHERINE BROWN
UroLift
®
STEP 1
After suffering for years from an enlarged prostate, Robert Wilson* of Richmond needed a workable solution. He was experiencing a severe, strong urgency to urinate frequently through the night, often having to get out of bed between four and six times. In addition to experiencing pain from the urgency to urinate, he often felt tired for most of the day and had trouble concentrating on his work. That made commuting to his job in Northern Virginia tiring – and unsafe.
The permanent Implants are delivered through a small needle that comes out of the UroLift Delivery Device and into the prostate.
STEP 2
Small UroLift Implants are permanently placed to lift or hold the enlarged prostate tissue out of the way and increase the opening of the urethra.
STEP 3
To combat his health problem, Wilson consulted with several urologists. The first did not offer any useful advice, and the second tried pushing him to undergo an invasive procedure that carried with it many risks, including urinary incontinence, erectile dysfunction and retrograde ejaculation. As an active older adult, Wilson didn’t feel comfortable taking on those risks; “I didn’t want to trade one bad lifestyle impact for another lifestyle impact,” he says.
News of a newer treatment offers hope After Wilson retired from his job, he conducted more research into enlarged prostates and connected with Jason Szobota, MD, a urologist with Virginia Urology in Richmond. Dr. Szobota talked to Wilson about undergoing the UroLift procedure, a relatively new permanent implant designed to relieve symptoms of an enlarged prostate. As Dr. Szobota explains, the UroLift procedure, which was cleared by the US Food and Drug Administration in 2013, “is somewhat new but has been around long enough that it’s been tested, and we’ve had good follow-up.”
No cutting, heating or removal of prostate tissue The procedure takes only about 15 to 20 minutes to perform and requires only conscious sedation with local anesthetic in most circumstances. Unlike other procedures for this problem, the UroLift involves no cutting, heating, or removal of prostate tissue. It provides instant results and has low complication rates. While changes in erection and ejaculation can happen with other procedures, this device has limited effect on erectile and ejaculatory function. Because of the UroLift’s low risk profile, Wilson says, “it seemed like a much better solution than anything I’d seen.”
The UroLift Delivery Device is removed, leaving an open urethra designed to provide symptom relief.
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A solution that makes sense Although not every patient is eligible for the procedure, depending on the size and placement of their prostate, Dr. Szobota describes UroLift as “an elegant solution
HEALTH A-Z | Beating the Urge to Go
that makes sense for all ages.” Men in their early 50s who have an enlarged prostate benefit from the procedure because it enables them to avoid taking medicine long-term and experiencing its potentially damaging side effects. For older men with an enlarged prostate, the procedure helps them urinate more comfortably. Because it takes little time and only involves local anesthesia, it is a good option for men with breathing or heart issues.
Technique does not inhibit prostate cancer monitoring Dr. Szobota says that, as a surgeon who has seen other devices and techniques used to treat an enlarged prostate, he is always cautious. He initially wondered, for instance, how the implanted device would impact future monitoring for prostate cancer. After several years of performing the UroLift, he feels reassured that a prostate exam and bloodwork are still viable options for cancer screenings. Also, a patient who has undergone the UroLift procedure can still have an MRI, if Dr. Szobota consults the radiologist in advance. “If my family member needed UroLift,” Dr. Szobota says, “I would want them to have it done.” When Wilson underwent the UroLift procedure, he spent about four to five hours for follow up care in the hospital and then recovered at home. He reports that his symptoms mostly disappeared within a week, and he is urinating with much less urgency and frequency than he had been before. He has returned to all the activities he engaged in prior to the surgery without any negative impact. “There’s a tremendous improvement in quality of life,” Wilson says. “My calculation was correct that this procedure would do the most good with the least risk.” * To protect the identity of the patient, the name Robert Wilson has been used in this article.
EXPERT CONTRIBUTOR Jason Szobota, MD, Urologist, Virginia Urology
“The UroLift procedure is an elegant solution that makes sense for all ages.”
Jason Szobota, MD Urologist, Virginia Urology
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IN HEALTHCARE UNDER
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FEATUR ES | Rising Stars in Healthcare
Meet the
MEN and WOMEN
who are making a difference in
HEALTHCARE in the
Greater Richmond community! words | BRANDY CENTOLANZA
Whether they’ve gone into the field of healthcare intentionally or by happy accident, scores of community healthcare providers and staff are making a difference where they work and live every day. From dentists, doctors, and nurses to those who ensure hospitals are safe environments for all who walk through the doors to others who care for the young and the elderly, those who’ve chosen to work in the healthcare realm do it because they are passionate. They truly want to improve the health and wellbeing of their friends and neighbors in their town and beyond. Whether it’s making a cancer patient’s day less stressful or putting a smile on an ill child’s face, these young men and women who’ve been chosen as this year’s crop of Rising Stars – through their clinical and non-clinical positions – have had a positive impact on others in the medical industry as well as their patients and their families. As a result, they are paving the way for a better future in healthcare.
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FEATURES
Impactful Preventative Care Erica Davis entered the world of healthcare in part to fulfill a dream of her grandmother’s. She started out as a nurse and is now a family nurse practitioner specializing in neurology at Bon Secours Richmond Community Hospital. “My grandmother’s overall desire was to help others, but she was never able to become a nurse,” Davis says. “When she got sick, that’s when I really knew that I wanted to be a nurse. She had dementia, and that is what made me want to focus on neurology.” Davis, 28, spends much of her day teaching her patients ways in which to alter their lifestyle in order to improve their health and wellbeing, especially when it comes to high blood pressure.
Erica Davis, FNP Family Nurse Practitioner
Bon Secours Richmond Community Hospital
RICHMOND
“I love educating my patients every single day and making a difference,” Davis says. “Most of the patients I deal with have conditions that are preventable. It’s about guiding and encouraging the patients on how to make those lifestyle changes.” Davis recently implemented a weekly hypertension clinic on Fridays, providing patients with an individualized plan and educational resources in order to help manage hypertension and prevent the occurrence of strokes in the city of Richmond. “The goal is to decrease the number of people with strokes and heart disease in the city,” she says. “I enjoy getting to know my patients and making them feel better. When they come here, they are vulnerable, so I work on building a trusting relationship with them in order to better access their health and take care of them. It’s nice to know that what I am doing is impacting the community.”
Specialized Care “I enjoy interacting with and helping patients and their families,” says Jonathan Snider, MD. “They are all such wonderful people, and it is very satisfying to be able to work with them closely to improve their health and independence.” As an assistant professor in the Department of Neurology with the Virginia Commonwealth University Health System’s Parkinson and Movement Disorder Center, Dr. Snider, 33, works daily with physical, occupational, and speech therapists, social workers, neuropsychologists, neurosurgeons, and others as a team to provide the best treatments for patients. “I’ve always really wanted to help people, and I felt that improving people’s health and well-being was one of the most fundamental ways to do that,” says Dr. Snider. “I am also fascinated by the science of medicine, specifically neurological disorders.”
Jonathan Snider, MD Assistant Clinical Professor
Department of Neurology, Virginia Commonwealth University
RICHMOND
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In his current role, “My primary focus is clinical, specifically the diagnosis and management of patients with a wide variety of movement disorders, including Parkinson Disease, Tremors, Dystonia, and Tourette’s syndrome,” explains Dr. Snider. “I also am involved in the use of botulinum toxin, or BOTOX®, and Deep Brain Stimulation for the management of these conditions.” Dr. Snider also provides education to future doctors and other physicians as well as patients and their families. “My next goal is developing a movement disorder fellowship program at VCU so we can train future generations of movement disorder neurologists to care for this complex and rapidly growing patient population,” Dr. Snider concludes.
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FEATUR ES |
Rewarding Research
Rising Stars in Healthcare
Before moving to the United States, Salvatore Carbone, MS worked as a clinical dietitian at Sapienza University in Rome. “While studying in Italy, I had the opportunity to do two summer internships at VCU,” says Carbone, 29. “I decided that VCU was a great place to work because it is full of opportunities, especially for people like myself who are extremely fascinated by the interconnection between clinical practice, clinical research, and translational research.” “I dedicate the majority of my time to clinical research, but also to pre-clinical research in the laboratory,” Carbone says. “I am the principal investigator or coprincipal investigator in clinical trials related to the role of metabolic diseases like obesity and Diabetes in the setting of cardiovascular disease, particularly heart failure.” Carbone was also involved in the recent establishment of a Clinical Cardio Nutrition service within the Cardiology division. The goal with this service is to increase the awareness of the importance of diet and nutrition to prevent and treat cardiovascular and metabolic diseases for patients and clinical providers. “Working in healthcare is particularly rewarding,” continues Carbone. “Seeing patients improving their health status, and perhaps preventing or controlling a chronic disease like Diabetes and heart failure is gratifying. Particularly in the field of diet and nutrition, often minor changes to the diet can result in significant improvement in health. Therefore, the education toward increasing awareness of what a healthy diet looks like is the central point of our daily clinical and research practice.”
Salvatore Carbone, MS Research Instructor of Medicine Department of Internal Medicine Pauley Heart Center, VCU Health System
RICHMOND
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FEATURES
Compassionate Care “I became interested in healthcare because I saw the opportunity to make a difference,” says Susan Frantz, Director of Sales for The Pediatric Connection. “I saw a need, especially in pediatrics. I am lucky to interact and work with so many wonderful and inspiring people every day.” Frantz, 32, oversees the sales team for The Pediatric Connection, which has locations in Richmond as well as Charlottesville and Fredericksburg. The Pediatric Connection is a subsidiary of Thrive Skilled Pediatric Care, which offers pediatric home health care, services, and equipment across the country. “I enjoy working in healthcare because I learn something every single day,” Frantz says. “Whether it is learning something about a type of procedure, a piece of equipment, or a diagnosis, I am always challenged at work and enjoy growing in an industry that is always changing.”
Susan Frantz
Director of Sales
The Pediatric Connection
RICHMOND
Frantz is especially proud to be a part of an organization like The Pediatric Connection because “we touch the lives of so many families through our services and equipment,” she notes. “We help to support the transition of children who are medically fragile from hospital to home so that they can have a better quality of life. I am extremely grateful to be able to work for a company that truly makes an impact in the community.” Frantz is honored to be recognized for her work with The Pediatric Connection. “There are so many deserving individuals in the healthcare industry that work hard, and I am grateful to be considered among them,” Frantz says. “My job is rewarding on so many levels. It is satisfying to know at the end of the day we helped children in need. Every day is rewarding because of the impact we make by striving to alleviate the distress, pain, and suffering of the families we serve.”
CONGRATULATIONS Rising Stars! Thank you for the impact you continue to make in the Greater Richmond healthcare community.
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FEATUR ES |
Inspired Pediatric Care
Rising Stars in Healthcare
“During and after college I worked as a YMCA youth counselor and director,” says Ethan Puryear, DDS. “Through my work with the YMCA, I realized my passion for working with children.” Dr. Puryear explains that the turning point for wanting to go into healthcare was when one of the children in the YMCA program came to camp with obvious gingivitis that caused his gums to bleed when eating. “My father was a general dentist so I had some basic dental knowledge at the time,” explains Dr. Puryear. “I remember buying the child a tooth brush and teaching him about the importance of brushing his teeth after lunch. My journey toward a career in pediatric dentistry began that day.” Dr. Puryear, 34, is a pediatric dentist, working out of two Virginia Family Dentistry locations. “As a pediatric dentist, I have the opportunity to watch my patients grow up and guide them toward optimal oral health,” he says. “I find it extremely fulfilling to see my patients in the community and hear stories about their oral health journey. Whether it is changing habits that affect growth and development, or treating or preventing dental disease, I love being able to play a small role in their overall health.” He also enjoys building positive relationships with his patients. “Many people find dental care to be intimidating and downright unpleasant,” Dr. Puryear notes. “Working with a child to build positive experiences and grow up loving their dental visits is the most rewarding part of my job and the reason I decided to specialize in pediatric dentistry. My goal is for my patients to grow up enjoying their dental visits and striving for excellent oral health care that will lay the foundation for a lifetime.”
Ethan Puryear, DDS Pediatric Dentist
Virginia Family Dentistry
RICHMOND
Contributing to Future Care “I began my studies with the idea of going into engineering, but discovered that I enjoyed my interactions with the patient more so than working with the actual medical device,” says Brian Q. Le, MD, an assistant professor of plastic surgery with VCU Health System. In addition to caring for patients, Dr. Le’s role includes teaching medical students as well as surgical residents. “I find the variety that working in the healthcare field provides very rewarding,” says Dr. Le, 35. “Teaching, contributing to medical knowledge, and, of course, delivering patient-focused care brings immense satisfaction.” Dr. Le, who specializes in hand and microvascular surgery as well as burn surgery, enjoys interaction with both students and patients. “Surgical training has a stigma within graduate medical education as being a malignant environment,” he says. “I’m working hard to break that culture and treat medical students and residents like I do with my patients: with dignity and mutual respect. The reward is hearing from former medical students who have chosen a surgical specialty and have told me how much I have influenced their decision in choosing a specialty.” He’s also proud when he makes a difference in a patient’s life. “I really enjoy the continuity of care and seeing someone who first comes to you with a condition that you can make better and seeing how much of an improvement in their quality of life you have provided by the time they are healed,” Dr. Le concludes. “There is no better feeling than this.”
Brian Q. Le, MD Assistant Professor
Department of Surgery, Division of Plastic and Reconstructive Surgery, VCU Health System
RICHMOND www.OurHealthRichmond.com
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FEATURES
Quality of Life Care When Julie MacPherson first moved to Richmond, she signed on with a temp agency looking for work. “The first temp opportunity was an administrative assistant position with Bon Secours at St. Mary’s Hospital,” MacPherson says. “It was during my time in this position that I became passionate about the field and decided I wanted to be a practice administrator when I grew up.” Today, MacPherson, 27, is Director of Comprehensive Care for Bon Secours Virginia. “My focus is on strategic growth, development, and operations for COPE (the Continuum of Palliative Excellence), which is a comprehensive line of programs serving the serious illness population and their loved ones,” says MacPherson. “These programs include Palliative Medicine, Hospice, Home Health, Home Based Primary Care and Supportive Services, and Noah’s Children, a pediatric palliative care program.” MacPherson spent four years as a Practice Administrator contributing to the development of a nationally recognized Palliative Medicine program.
Julie MacPherson Director of Comprehensive Care
Bon Secours Virginia
RICHMOND
“In 2014, we achieved the Advanced Certification in Palliative Care from The Joint Commission at three of our hospitals during one review,” she states. “We were the first health system in the country to do this.” There is a lot involved with Palliative Medicine. “A lot of people would assume working in a field serving the sick and dying would be depressing, but actually it’s the opposite,” MacPherson says. “Our programs are committed to enhancing life. What can we do to understand and respect patients’ wishes? How can we relieve patient suffering and support caregivers? How can we help them navigate such a large and complex health system, and how can we offer seamless transitions? When it’s all said and done, I believe the end of life should be as dignified and honorable as the beginning. Having a job focused around these operations is rewarding beyond words.”
Collaborative Care “I knew I wanted to be a physician when I was young,” says Hem Bhardwaj, MD. “The cliché that one would want to go into medicine to help people is really true. I wanted to be able to have a positive impact on people and help them achieve their health goals. One of the reasons I went into cardiology is because of the high prevalence of cardiovascular disease in our society.” Dr. Bhardwaj, 38, wears many hats. In addition to being an assistant professor of Cardiology/Internal Medicine at the Pauley Heart Center, she is Director of Cardiology Inpatient and Consultation Services, Director of Cardiology Quality Improvement and Safety, and Director of the Echocardiography Lab. “I wake up every day excited to go to work,” she says. I love helping patients achieve a heart healthy life. It is rewarding when a patient has not seen a doctor in years, finally makes a visit, and after a certain time frame, becomes healthier.” Dr. Bhardwaj is proud to be a leader in her field.
Hem Bhardwaj, MD
Assistant Professor
Department of Cardiology/Internal Medicine Pauley Heart Center, VCU Health System
RICHMOND
“I feel very lucky that I am able to have both a clinical impact as well as an organizational impact with my leadership roles,” she says. Dr. Bhardwaj also enjoys her interactions with all her patients. “I love that patients come from all different backgrounds and have different stories to tell,” Dr. Bhardwaj notes. “Once a patient picks you as a physician, you are joining them on their journey to becoming healthy and maintaining their health. I look forward to the day when I can say that the prevalence of cardiovascular disease in our society has lessened.”
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FEATUR ES | Rising Stars in Healthcare
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FEATUR ES |
Sneezy,
Sneezy, Wheezy Richmond
Richmond How allergen prevention can help allergy symptoms. words |ELISSA EINHORN
When it comes to allergies, Richmond’s record suffers right alongside those who suffer from actual allergy symptoms. In 2014, the city topped the Asthma and Allergy Foundation of America’s list of “allergy capitals.” That came on the heels of finding itself at the top of the same list in 2010 and 2011. A 2015 report released by the Natural Resources Defense Council (NRDC), an environmental action advocacy group, designated the city as the country’s “sneeziest and wheeziest.” Headway was made in 2016, when Richmond dropped to 14 out of the top 15 “most challenging places to live with spring allergies.” That progress was short lived since 2017 ushered in Richmond’s fourth highest tree pollen count in 30 years, and this year, early spring-like temperatures brought along with them an equally early burst of tree pollen. “In the spring, it tends to be tree pollen,” confirms Theodore Schuman, MD, of VCU’s Department of Otolaryngology. It’s the most common environmental cause of allergies in the Commonwealth’s capital city. “Oak trees are a particular trigger. In the summer, grass pollen like Timothy, Johnson or Bermuda grasses are triggers. A lot of people that have symptoms when they mow the lawn may actually be sensitive to mold in the soil.” Dr. Schuman explains, “an allergy is when your body is having an immune reaction to a stimulus in the environment and treating it as a pathogen.” These reactions are somewhat evolutionary in nature. The body believes it is defending itself against harmful invaders; however, its biologically heroic efforts are misguided because the substances that trigger an allergic reaction are usually harmless.
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FEATURES
Tell that to the 109 million allergy sufferers—that’s one-in-three Americans—who live in Richmond and across the United States. For them, an intricate combination of genetics and the environment leads to well-known signs like itchy noses, watery eyes, congestion and sneezing, plus a list of lesser-known symptoms such as migraines, eczema (especially in children) and even gastrointestinal distress.
HYGIENE HYPOTHESIS: A hypothesis that proposes that childhood exposure to germs and certain infections helps the immune system develop. This teaches the body to differentiate harmless substances from the harmful substances that trigger asthma. In theory, exposure to certain germs teaches the immune system not to overreact. So
urc e: w ww .ma yoclin ic.org
Identify the Allergy Before taking steps toward allergy prevention, you first need to determine whether you even have an allergy. Positive skin tests or blood tests can be used to establish a biologic sensitivity, but they don’t necessarily mean a person has a specific allergy. It is the pairing of a positive test with a history of symptoms that confirms an allergic condition. Because allergy symptoms can mimic those of the common cold, Dr. Schuman also points out that allergies last longer than the five to seven days typical of a viral infection; this longer course of effect is predictable with exposure, and symptoms will last as long as the triggers are present. For Richmonders, these predictors include ragweed pollen, a major offender in the fall, and mold, dust mite and dander which cause symptoms year-round. The phrase ‘allergy season’ refers to the spring and fall when tree and weed pollen is highest. “If symptoms continue, numerous medications are available,” Dr. Schuman says. “These are antihistamines, nasal sprays saline rinses and others. Nasal saline irrigation is a great home remedy for sinus and allergy issues. Another new development is the availability of grass and ragweed tablets that can be taken daily to improve symptoms.” In his practice, Dr. Schuman uses a ‘stepwise’ approach, meaning that he adds medicines until symptoms are controlled. For those who continue to present significant symptoms, allergy shots might be a good option. “Someone would be a good candidate for shots if allergy symptoms have a significant impact on quality of life multiple times a year despite medications and environmental avoidance,” Dr. Schuman explains. “Many studies show immunotherapy (allergy shots) improves allergy symptoms, but a minimum of a three-year time commitment is required.”
“There are areas of the country where pollen loads are higher based on the environment and the climate.”
Theodore Schuman, MD An allergist in VCU’s Department of Otolaryngology
Allergy-Proofing Your Home The first step toward allergy treatment in the home or workplace is actually prevention, says Chris Gilson with Re-Freshen, a company that provides odor removal, environmental testing and other services that address allergies in Richmond and several other local and regional areas. “If you don’t know what’s there, you don’t know what to do about it,” Gilson says. “Normally, it’s about a health issue in the home or workplace. People are getting sick. Then they go on vacation and feel better. When they come back to work, they go through an entire box of tissues.” Re-freshen conducts a visual test of indoor locations and also tests the air for mold and other particulates—small particles that can hang in the air for long periods of time— because as Gilson explains, “There is always stuff floating around in the air, like dander or soot. Every house has dander even when there are no animals because we shed our skin.” The best-case scenario is to find the source of the allergen and rid the location of it. If that’s not possible, Gilson recommends investing less than $100 in a high efficiency particulate
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Wherever You Go, Your Allergies Will Follow Although it seems counterintuitive, the incidence of allergies in the industrialized world is actually increasing. “There is debate about why,” Dr. Schuman opines, “but the thought is that we’re living in such a sterile world, so we are not being exposed to germs. One hypothesis, called the ‘Hygiene Hypothesis,’ is that living a more hygienic lifestyle predisposes us to allergies. Pollution may also play a role; however, research needs to be done to truly understand the increase. There may be other environmental factors.” Dr. Schuman himself suffers from allergies, with his symptoms following him from Nashville—ranked #26 on the 2015 NRDC list—to Richmond, where he has been in practice since 2011. Also counterintuitive is that with each passing year of exposure, symptoms worsen because your immune system has been exposed to the triggers for a longer period of time. And if you think you can escape the seasonal suffering by moving elsewhere, think again. “There are areas of the country where pollen loads are higher based on the environment and the climate,” Schuman explains. “If you’re trying to escape allergens, say moving from Richmond to the Southwest, it may be different, but your genetics and immune system will catch up. You are bound by your own biology.” EXPERT CONTRIBUTOR Theodore Schuman, MD of VCU’s Department of Otolaryngology
Approaches for overall allergen reduction are to:
Sneezy, Wheezy Richmond
“Carpeting is the biggest filter in your house,” Gilson notes. “Particulates fall down and then you’re walking and grinding them into the carpet, making them harder to remove.”
FEATUR ES |
air (HEPA) purifier to catch particulates; using a HEPA vacuum as part of an overall cleaning regimen; changing HVAC filters regularly and even considering a service that delivers filters to your door each month as a reminder; and removing carpet in favor of hardwood or linoleum flooring.
Keep the relative humidity no higher than 50 percent. Clean or replace smallparticle filters in heating and air conditioning systems monthly. Use traps to control pests or hire an exterminator. Close doors and windows during the warm weather to prevent mold and remove materials such as carpeting. Damp mop and vacuum floors, tops of doors, windowsills and window frames. Don’t allow smoking inside your house.
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ASK THE EXPERT
LAWRENCE E. GELBER, MD Richmond Allergy & Asthma Specialists 9920 Independence Park Drive, Suite 100 | Henrico 804.285.7420 www.richmondallergy.com | g
U
ALLERGIES: GET TESTED, GET TREATED, GET BETTER.
Q:
What kinds of allergies can be treated?
Q:
What happens during an allergy evaluation?
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Common allergies are the classic nasal symptoms of congestion, runny nose, postnasal drainage, itchy nose and sneezing. Other symptoms include itchy, red and watery eyes, itchy ears, ear pressure and popping, ear infections, sinus infections, sinus pain and pressure, headaches, skin problems such as itching, eczema and hives, and gastrointestinal problems such as gas, cramps, bloating and diarrhea.
An allergist, a specialist trained to perform and interpret allergy testing, takes a detailed history, conducts a physical exam and performs skin testing to determine what you are and are not allergic to. This is the quickest, most reliable and cost-effective method of evaluation. The allergist will then review the results and discuss a stepwise approach to improving your quality of life.
OurHealth | The Resource for Healthy Living in Greater Richmond
Q:
What is skin testing?
Q:
How do allergy shots work?
Skin testing, around for over 100 years, is the most effective and safest way to identify your triggers which may be dust mites, mold, pollen, animal dander, foods, drugs, or stinging insects. Prick tests involve pricking the skin with a small amount of allergen. Intradermal tests, more sensitive than prick tests, involve injecting a small amount of allergen under the skin when prick tests are inconclusive. The results help the allergist formulate a customized treatment plan.
Allergy shots, or immunotherapy, are small amounts of allergen extracts injected weekly over a period of three to five years. They trigger the production of antibodies to help build up a natural resistance to dust mites, mold, animal dander, and pollen. Allergy shots are over 90% effective in decreasing symptoms, medication use and health care costs, providing long-lasting relief.
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FEATURES FEATURES
Photos captured from Greater Richmond’s 2017 National Eating Disorder Walk.
The Long Road to Recovery From An Eating Disorder How one local woman hopes her struggles can help others words | BRANDY CENTOLANZA
photos | TRACY CORNATZER
Struggles with anxiety and depression along with family issues led Carly Stansfield of Chesterfield to develop an eating disorder at a mere 14 years old. Now aged 20, Carly is on the road to recovery, but admits her relationship with food is still a daily challenge. Carly, who currently works as a barista for Starbucks, says a rocky relationship with her father is what started her troubles with eating. “That, along with my growing anxiety and depression were the perfect storm for the onset of anorexia,” she explains. “I began eating less, exercising more, and severely isolating myself.”
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FEATURES
Functioning under a façade Stansfield’s mother, Beth Ayn, at first didn’t notice how much dieting and exercise had taken over her daughter’s life. “She still maintained her perfectionistic lifestyle with excellent grades and awards and her people-pleasing behavior,” Beth Ayn recalls. “But within a few months, I noticed her making excuses not to eat meals with others, spending more time in her room, obsessing over exercise, and, at times, displaying violent verbal outbursts. One day, I noticed she had hidden her lunch in a bush in the yard. I put all of the pieces together and realized she was in trouble, medically and emotionally.” Beth Ayn sought treatment for her daughter at the Eating Recovery Center in Denver, CO. The Eating Recovery Center is an international treatment facility for those struggling with eating disorders. “While I was there, I was put on a strict meal plan with intense therapy sessions,” Carly shares. “I was forced to deal with not only the food but the true issues behind the illness.” Carly returned home after two months at the Eating Recovery Center, seemingly on her way to a full recovery. She began weekly appointments with a therapist, psychiatrist, and a nutritionist. But, during her sophomore year of high school, she relapsed.
A battle with bulimia and binge eating begins “I went from struggling with anorexia to struggling with bulimia and binge eating disorder,” Carly explains. Carly began overeating, sometimes purging afterward. She stopped exercising and instead slept as much as 15 hours a day. She went from being severely underweight to being severely overweight in just six months. “Before I knew it, I became extremely out of control with food,” she says. “I would sneak downstairs in the middle of the night to eat. I felt it was the only way to calm my anxiety. I became even more depressed. I felt more alone than ever.” Beth Ayn never gave up hope on finding help for her daughter. She flew Carly back out to Colorado for more treatment at the Eating Recovery Center. “No one talks about eating disorders,” Beth Ayn says. “While Carly was receiving treatment, I attended daily educational classes at the Eating Recovery Center to learn more about her illness and strategies best to support her.”
A strong support system throughout the journey Carly is grateful for her mother for staying by her side.
Photos captured from Greater Richmond’s
2017 National Eating Disorder Walk.
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“This disorder is very complex; it’s about the food but at the same time it isn’t,” Carly explains. “The main person in my life that I have turned to for support has been my mom. She has been there for me since day one and has never judged or discounted anything that I was struggling with. My treatment team has also been incredibly supportive during this whole journey. My dietitian, Trish Wilkins, who I have been seeing now for around six years, has been my voice of reason throughout the whole thing.”
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FEATURES | The Long Road to Recovery
In addition to a dietitian, Carly has also been seeing a psychiatrist and attending group therapy sessions as she tries to get a handle on the eating disorder. “They all brought a different aspect to my recovery,” Carly says. “My dietitian has been one of my main rocks. I’ve known her from the start of it all until now and she knows me better than most people. It’s helped so much to have such a strong connection with her. My psychiatrist has always listened to me and what I feel like I need. She has never forced anything unless I felt comfortable with it, and that is huge.”
Group therapy has also been beneficial. “My therapist, Christine Lamps, has also been a huge support,” Carly notes. “She holds monthly groups for people struggling with eating disorders, and that has been a way for me to connect with other individuals in our area who are going through the same struggles as me.”
Recovery is possible
“Be persistent in getting care for your child.” SUSAN JONES, MD
Carly wanted to share her story in part to help those in a similar situation.
A child and adolescent psychiatrist with the Virginia Treatment Center for Children.
“I want anybody who is also struggling to know that recovery is possible,” Carly says. “I remember being in the depth of my disorder and thinking to myself that this was how the rest of my life would be, miserable and sad. Every day you have to fight, no matter how difficult or impossible it might seem. I hope one day that others can also realize how beautiful and worthy of life they are.” EXPERT CONTRIBUTOR Susan Jones, MD a child and adolescent psychiatrist with the Virginia Treatment Center for Children
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Eating Disorder Warning Signs Warning signs that someone may have an eating disorder include:
A B C D E F
Restricted patterns of eating Unusual dietary preferences Rigidity about eating or refusal to eat a variety of foods Counting calories Excessive exercise Weight loss or weight gain
Stay Strong Virginia AN ONLINE RESOURCE ABOUT EATING DISORDERS
“Stay Strong Virginia is a resource created by a parent for other
“My advice to parents and caregivers supporting someone who is struggling with an eating disorder is to locate eating disorder specialists, educate yourselves, connect with a support group, and be patient,” Beth Ayn says.
families and can provide invaluable
Susan Jones, MD, a child and adolescent psychiatrist with the Virginia Treatment Center for Children in Richmond, recommends Stay Strong Virginia (www.staystrongvirginia.org), an eating disorders resource for families, friends, and professionals.
recovery from an eating disorder.”
“Be persistent in getting care for your child,” Dr. Jones says.
support and information for patients and families on the road to
- Susan Jones, MD -
staystrongvirginia.org
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FOOD & FITNESS
Spring Clean
Your Diet
words | MICHELLE MCLEES, SPECIAL CONTRIBUTOR FROM THE AMERICAN HEART ASSOCIATION
He althy Plate
Starting in mid-to-late spring, lots of fruit and vegetables are coming into season. In case you forgot, fruits and vegetables are the best – they’re typically high in vitamins, minerals and fiber and low in calories and sodium. Fill at least half your plate with them to get the recommended five cups of veggies and four cups of fruits each day. The good news is that all produce counts, which means canned, fresh, frozen and dried varieties can help you reach your goal. Just be sure to compare food labels and choose the products with the lowest amounts of sodium, saturated fat and added sugars. Stick with the simplest forms, without heavy sauces or syrups. If you’re already eating plenty of fruits and veggies every day, you may be ready for the next step: include more color. All fruits and vegetables contain vitamins, minerals and other nutrients that may help prevent heart disease, cancer and other illnesses. Some of these nutrients are fiber, potassium, folate, and vitamin A and C.
The best way to get all the various nutrients is to eat fruits and vegetables of many different colors. And yes, white and brown count, too! Eat as many different colors as you can each day.
Challenge yourself for just one day.
How many cups of fruits and veggies can you commit to eating tomorrow? 54
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50% Fruits & Vegetables
Try to pick non-starchy fruits and veggies such as carrots, Brussels sprouts, apples, and berries.
25%
Starchy Foods Such as potatoes, corn, rice or peas.
25% Protein
Preferably chicken, fish or beans.
FOOD & FITNESS |
Homemade
Frozen
Yogurt Pops
Spring Clean Your Diet
with Peaches 6 servings
Two cups of chopped fresh or frozen fruit can be subbed for the peaches, so you can constantly experiment with these refreshing popsicles.
INGREDIENTS
DIRECTIONS
16
ounces packaged, plain, no-sugar-added, frozen, sliced, thawed peaches (divided, no sauce added)
A
1
cup fat-free, plain yogurt
In the bowl of a food processor, add 1 ½ cups thawed peaches from bag, yogurt, and honey. Process about 1 minute until mixture turns into a puree. (Alternatively, add ingredients into a bowl and puree with an immersion blender.)
1
tablespoon honey
B
Transfer puree to a bowl or large liquid measuring cup with a spout for easy pouring. Chop remaining peaches into bitesized pieces and add into the bowl, along with any lingering peach liquid from the bag.
C
Divide mixture among popsicle molds, filling each one almost to the top. Place in the freezer overnight.
D
To remove from molds, hold under warm water until popsicle can be easily pulled free.
COOKING TIP: This recipe yields around 3 cups; the amount of popsicles may vary depending on the size of your popsicle molds.
KEEP IT HEALTHY: Decrease the amount of fruit by ½ cup and add ½ cup granola into the mix to turn these into breakfast popsicles.
TIP: Don’t have popsicle molds or sticks? Try pouring the mixer into an ice tray, covering with plastic wrap and poking toothpicks through the plastic into the center of each cube. Once they’re frozen, pull off the plastic wrap and eat a bite-size popsicle.
NUTRITION FACTS: Per Serving. Calories 66, Total Fat 0.5 g, Saturated Fat 0.0 g, Trans Fat 0.0 g, Polyunsaturated Fat 0.2 g, Monounsaturated Fat 0.2 g, Cholesterol 1 mg, Sodium 32 mg, Total Carbohydrate 13 g, Dietary Fiber 2 g, Sugars 9 g, Protein 3 g. Dietary Exchanges: 1/2 fruit, 1/2 other carbohydrate. Recipe copyright © 2016 American Heart Association.
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Chilled Avocado Gazpacho with Shrimp 8 servings
This no-cook dish with its vibrant color makes a great appetizer or starter soup.
INGREDIENTS
DIRECTIONS
2 1/2
cups water
A
1
medium avocado
In a food processor or blender, process the water, avocado, and vinegar until smooth.
2
tablespoon red wine vinegar
B
Add 2 cups yellow cherry tomatoes, the cucumber, bell pepper, onion, jalapeño, garlic, and salt, processing until smooth.
2
cups yellow cherry tomatoes and (optional) 8 cherry tomatoes, divided use
C
Cover and refrigerate the soup for at least 1 hour (it may be foamy and will need time to settle).
1
large cucumber (peeled, cut into 1-inch pieces)
1
medium green bell pepper (chopped)
D
1
tablespoon minced, fresh jalapeño (seeds and ribs discarded)
Using 8 cocktail skewers, pierce 1 shrimp and 1 of the remaining 8 cherry tomatoes with each skewer. Garnish the soup with the skewers.
2
medium garlic cloves
1/2
teaspoon salt
NUTRITION FACTS: Per serving. Calories 56, Total Fat 4 g, Saturated Fat 1 g, Trans Fat 0 g, Polyunsaturated Fat 1 g, Monounsaturated Fat 3 g, Cholesterol 0 mg, Sodium 159 mg, Total Carbohydrate 6 g, Dietary Fiber 3 g, Sugars 1 g, Protein 1 g, Dietary Exchanges: 1 fat, 1 vegetable
8
large cooked shrimp
Copyright © 2018 American Heart Association, Healthy For GoodTM, heart.org/healthyforgood
5 HEALTH BENEFITS OF AVOCADOS
A Packed full of VITAMINS
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B Loaded with heart-healthy monounsaturated fatty acids
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C Great sour of FIBER
Source: Mayo Clinic
D Packed full of POWERFUL ANTIOXIDANTS
E Can Improve CHOLESTEROL
FOOD & FITNESS
FOOD & FITNESS |
Mouth-Watering
Lasagna 8 servings
Spring Clean Your Diet
This classic Italian recipe has a healthy twist to include lots of veggies along with some other nutritious ingredients to make it a heart healthy entree that tastes delicious!
INGREDIENTS
DIRECTIONS
1
tablespoon extra virgin olive oil
Preheat oven to 350° F.
4
clove fresh, minced garlic OR 4 tsp. jarred, minced garlic
A B
1
small onion (chopped)
C
In a saucepan, heat oil. Add garlic and onion and cook over medium heat for about 4 minutes. Add kale (or spinach), tomatoes and eggplant (or squash) and pepper and cook 3 minutes. Turn up heat to mediumhigh, add ground beef or turkey and cook until meat browns slightly and liquid is absorbed. Add mushrooms, beans, vinegar, tomato paste, and tomato sauce. Stir in red pepper flakes, 1 teaspoon dried herbs, ½ teaspoon of pepper. Simmer for 15 to 20 minutes, stirring occasionally.
D E
Mix together mozzarella and one teaspoon dried herbs.
1 1/2 cups fresh, chopped kale (about 3 leaves), cut into bite-size pieces, stems discarded OR 1 1/2 cups frozen spinach (thawed) 3
cups fresh spinach (stems discarded, packed tightly)
21/2 cups eggplant or summer squash, (about 1 small eggplant or 2 squash), cut into 1/2-inch cubes 11/2
cups tomatoes (diced) OR 14.5 ounces canned, no-salt-added tomatoes (diced)
1
pound extra-lean, ground beef or turkey, 95% lean or more
2 1/4 cups white mushrooms (sliced) 1
cup low-sodium, or, no-salt-added cannellini beans (drained, rinsed)
3/4
teaspoon black pepper (divided use)
2
teaspoon dried, salt-free herbs, Italian blend, divided use
1/2
cup low-moisture, part-skim mozzarella (shredded)
1/2
teaspoon crushed red pepper
3
tablespoon red wine vinegar
1/2
cup low-fat ricotta cheese
9
whole-grain sheets lasagna noodles
1
tablespoon no-salt-added tomato paste
8
ounces canned, no salt added tomato sauce
Cook lasagna noodles according to package directions; omitting salt, butter and oil.
In a 9x13 ovenproof dish, place 3 lasagna sheets, one third of lasagna filling and half of ricotta in small clumps. Repeat placing the lasagna sheets, filling and ricotta step. Top with 3 more lasagna sheets, remaining filling and top with mozzarella mixture. Bake for 30 minutes.
COOKING TIP: This can be made ahead and frozen or leftovers can be frozen and served again another time. Bake at 350° F degrees for 30-45 minutes, until lasagna is bubbly and cheese is melted.
NUTRITION FACTS: Per serving. Calories 299, Total Fat 7.5 g, Saturated Fat 2.5 g, Trans Fat 0.0 g, Polyunsaturated Fat 1.0 g, Monounsaturated Fat 3.0 g, Cholesterol 39 mg, Sodium 129 mg, Total Carbohydrate 37 g, Dietary Fiber 7 g, Sugars 5 g, Protein 24 g Recipe copyright © 2016 American Heart Association. This recipe is brought to you by the American Heart Association’s Simple Cooking with Heart ® Program. For more simple, quick and affordable recipes, visit heart.org/simplecooking. www.OurHealthRichmond.com
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BEAUTY
Hold Firm
TREATING SAGGY BREASTS Options for women range from supportive bras to surgery words | BRANDY CENTOLANZA
Many pregnant and nursing women experience changes in the shapes of their breasts, which could result in breast ptosis, or saggy breasts. Is there anything that can be done to alleviate the condition? “Age is the most common cause for saggy breasts,” notes Matthew G. Stanwix, MD a plastic surgeon with Richmond Plastic Surgeons. “As everyone ages, the quality of their skin worsens and their breasts can start to become loose and sag. Hereditary and genetics play a big role. Pregnancy and breast feeding are also big contributors to most women.”
Breast Augmentation Breast augmentation surgery involves transferring fat or using breast implants to increase breast size or restore volume.
Multiple pregnancies, cigarette smoking, a higher body mass index, a larger breast cup size and breast implants all may contribute to breast ptosis [saggy breasts]. There are three classifications of sagging breasts ranging from mild to severe, depending on the position of the breast nipple. The most severe cases are when the nipple falls below the infra-mammary fold, which is where the underside of the breast attaches to the chest wall.
Smoking plays a significant role in development of saggy breasts “Bras seem like they would make a difference, but studies have shown they actually do not prevent breast sag or ptosis,” says Dr. Stanwix. “A healthy, active woman can help somewhat to prevent it. But the biggest thing a woman can do is not smoke and choose smaller implants, if they get a breast augmentation with implants.”
Breast lift surgery can help For many women uncomfortable with droopy breasts, the best option may be plastic surgery, particularly a procedure known as mastopexy, or a breast lift. During a breast lift, excess skin is removed and breast tissue is reshaped to better firm and raise the breasts. It is routinely performed on women with saggy breasts or whose nipples point downward. Mastopexy only changes the shape of the breasts, not their size, though the surgery can be done in combination with a breast augmentation or breast reduction. 58
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BEAUTY | Treating Saggy Breasts
“Most women with breast droop need some form of skin removal, or a breast lift, to make the breast more rounded again,” says Stanwix. “If a woman wants additional cleavage or more fullness with her breast lift, then the addition of a breast implant or fat transfer can help provide that.” Brandy Straus, one of Stanwix’s patients, opted for a breast lift to fix her breast ptosis. “I’ve always had large breasts, but, particularly after my second child, I really noticed that they were saggy,” she says. “I did purchase some overpriced bras that were uncomfortable, but it wasn’t a hard choice to have Dr. Stanwix give me a breast lift. It’s worth it. My breasts are firm now and I often don’t require extra support. I am very pleased with the work.” Mastopexy is not covered by insurance, since it is considered cosmetic. Most issues with saggy breasts are cosmetic, although in the most severe cases, there is a risk of developing a fungus infection underneath the breast skin, where moisture from perspiration may become trapped. Recovery time from a breast lift is typically ten days to two weeks, depending on the technique. Some women might experience a change in the sensation of their nipples. Roughly 30 percent of women are unable to breastfeed again after the surgery. These are all factors women should take into consideration before opting for plastic surgery. It is also recommended that women wait four to six months after they are done breastfeeding before having any surgery.
See a surgeon who specializes in plastic surgery Together, the patient and a board certified plastic surgeon expert in breast surgery can determine which type of surgery is best. “A full examination with discussion of all the risks and benefits of the surgeries is needed to see which fits best with the desires and wants of the patient.”
“A woman should always seek out a board-certified plastic surgeon who performs breast surgery to have a full discussion of all options. MATTHEW G. STANWIX, MD A plastic surgeon with Richmond Plastic Surgeons
EXPERT CONTRIBUTOR Matthew G. Stanwix, MD, a plastic surgeon with Richmond Plastic Surgeons
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BEAUTY
Is
LIPOSUCTION
RIGHT
for You? words | ELISSA EINHORN
You’ve tried dieting. You’ve tried exercising. You may have even tried some non-surgical procedures, but nothing seems to work on stubborn fat. Is it time to consider liposuction? UNDERARM LIPOSUCTION
BEFORE
AFTER
MIDSECTION LIPOSUCTION
BEFORE
AFTER
The answer has been “yes” for many patients treated by Richmond plastic surgeon Leslie Cohen, MD, FACS. Liposuction is a surgery that was first described in the 1920s. Modern liposuction was developed in 1974 and became popular in the 1980s due to improved techniques. Since then, liposuction has consistently been one of the most popular cosmetic procedures due to its effectiveness, as well as an increased acceptance of cosmetic surgery by society. “Not too long ago, more women opted for liposuction, but it has become increasingly popular among men,” Dr. Cohen notes. “In today’s world, both men and women want to look their best at every age.” The areas of the body that men and woman prefer to treat can differ, although liposuction is popular for shaping the abdomen, neck, and chin for everyone. For men, the love handles also top the list, while many women choose to treat the thighs and buttocks. Although liposuction is a reliable procedure for permanent fat removal because fat will not return to the treated area, Dr. Cohen warns prospective patients that the surgery is not a substitute for weight loss. Rather, it is best used to contour the body after other weight loss measures have not been sufficient. While medical preparation for the procedure is critical, so is emotional preparedness. Dr. Cohen discusses desires and expectations with her patients before surgery. She appreciates when patients provide visuals or “wish pics” so she can determine if their goals are achievable.
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BEAUTY | Is liposuction right for you?
Considering liposuction? Dr. Cohen offers the following guidance to individuals contemplating the procedure. Be close to your ideal body weight and generally healthy. Practice good nutrition. At least two weeks prior to the procedure, do not take medications that are blood thinners or that promote bleeding. After surgery, be prepared to wear a compression garment for several weeks. Dr. Cohen describes these garments as “a little more assertive than Spanks.“ “Imagine that the fatty area is like a block of cheddar cheese. When we suction out the fat in ribbons, it becomes like Swiss cheese or a sponge,” she explains. “You want to compress the areas where fat was removed so that it will heal smoothly.”
Dr. Cohen advises that patients who follow these guidelines and discuss their expectations with their doctor can look forward to a positive result allowing them to achieve the body contouring that exercise and proper nutrition alone are sometimes unable to provide. EXPERT CONTRIBUTOR Leslie Cohen, MD, FACS, a plastic surgeon in Richmond
ON THE WEB
Leslie Cohen, MD, FACS Plastic and Reconstructive Surgery 9900 Independence Park Richmond | 804.288.2800 www.lesliecohenmd.com
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HEALTH OBSERVATIONS
Powell Orthotics and Prosthetics
Gives Local
Amputees a Leg Up words | CATHERINE BROWN
More than two million Americans live with limb loss, a number that grows by
MORE THAN
TWO MILLION Americans live with limb loss,
A NUMBER THAT
185,000 per year. Limb loss affects every generation, from young to old and people from all walks of life. Those who have diabetes or a vascular condition such as peripheral artery disease (PAD) are at the greatest risk of limb loss, however, cancer and traumatic injury also result in amputations.
GROWS BY
The month of April is designated as Limb Loss Awareness Month, during which time attention is given to preventing limb loss and empowering people affected with information and resources that can help them realize their full potential. Helping lead this effort is Powell Orthotics and Prosthetics in Richmond, whose team of experts and advanced technologies have been making a difference for people affected by limb loss for nearly 100 years.
PER YEAR.
At the helm of Powell’s technology is Scott Poindexter, who became an above-the-knee amputee in high school after a car accident. “I was learning who I was all over again,” he says. “I was learning how to walk, and I was falling down in the hallways.”
185,000
The challenges of recovering from his accident were exacerbated when his physical education teacher did not give him the credits he needed to graduate. That frustration turned out to be life-saving, however. Poindexter volunteered at a prosthetic company to earn extra credits. He ended up working there as one of the three technicians and has stayed in the industry since then. “I’m where I need to be,” Poindexter says.
Scott Poindexter Powell Orthotics and Prosthetics in Richmond
In 2007, Poindexter moved over to Powell Orthotics and Prosthetics and took a job as their only technician. “They threw me into a lead technician role, and I was responsible for any and everything that came through the door,” he says. At Powell, Poindexter is more than just the lead technician; he is also a source of support for many patients. “I’m a pretty happy person,” he says, “and that matters in a field where you’re
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HEALTH OBSERVATIONS |
dealing with a part of your body missing.” When a patient is having a hard time, Poindexter can truly empathize with them.
April is Limb Awareness Month
“Sometimes a patient will come to me and say, ‘I want to walk like you’,” Poindexter says. He encourages them but also reminds them that it takes time and effort. “I’ve been an amputee for longer than I was not,” he explains. Because he is naturally upbeat, Poindexter shows patients that losing a limb doesn’t have to be the end of the world. “My prosthetic is the kickstand that keeps me up,” he jokes. While Poindexter provides support informally to patients, he also participates in Powell’s amputee mentoring program. These regular support group meetings, open to all local amputees, give those who have lost limbs a chance to share stories and/or troubleshoot problems. Sometimes the group meets at a restaurant or bar, and at other times they participate in an activity through Sportable, an organization for people with disabilities. “The meetings help to get people out and provide a sense of normalcy,” Poindexter says. In addition to offering support, Poindexter notes that Powell Orthotics and Prosthetics participates in Hill Day, sponsored by the Amputee Coalition, to advocate on behalf of amputees. The issues discussed include improving access to prosthetic care and funding research programs that improve amputees’ lives. Powell’s work throughout the community embodies the company’s philosophy of spirit, support, and science. “I’ve been there. I am there,” says Poindexter. “Being able to help people move on after what life has thrown at them is very rewarding. It’s something I am especially passionate about.” EXPERT CONTRIBUTOR Scott Poindexter with Powell Orthotics and Prosthetics in Richmond
ON THE WEB
More at ourhealthrichmond.com
Additional information about the Greater Richmond Amputee Support Group, including event dates and meeting times, can be found at www.powelloandp.com.
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REFERRAL REACH
Richmond-based Envera Health
offers a “one touch” experience so providers get the whole story. words | RICH ELLIS
photos | TERRY BROWN PHOTOGRAPHY
At the forefront of technology and armed with the knowledge that healthcare providers need support in treating the “whole” patient, Envera Health is unlike many other committed to fixing what’s wrong with our current health system. Their solution—a unified front door approach—improves the experience for consumers, patients and providers. Founded in 2015, Envera Health is an “engagement services partner.” Their approach offers the components of an effective health system. These services are a continuum of managed services and hands-on solutions to advance consumer-driven care to make healthcare better.
“One-touch” creates a good healthcare system Brett Butler, Envera’s vice president of client success, explains that the company partners with providers and health systems to unify their entry points. They serve as a unified front door that spans across all of a health systems’ functions to deliver a one-touch experience. “There’s great work happening in health systems across the country, but that work typically happens in a silo,” Butler says. “For example, a medical group, hospital, and marketing campaign each offer a different experience and they typically don’t talk [to one another] – they’re led by different departments, different data systems, different teams. Through our advanced engagement (call) center and unique CRM-enabled full consumer view, we integrate all of that work into one touch or one conversation.”
Unique technology gives Envera a full 360-degree view of the customer At the heart of Envera’s services is the company’s state of the art Engagement Center Platform. Built with proprietary technology, this unique nerve center is customer relationship management (CRM)-enabled, creating a full 360-degree view of the consumer. 64
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Think of a patient calling their physician’s office to inquire about a prescription refill. That call could be answered by an Envera Agent, and while the patient is on the line, the agent takes the opportunity to remind them that they’re overdue for a mammography screening and offers to set up an appointment. The agent also sees that this patient responded to a recent marketing campaign for orthopedics and asks if they are interested in registering for an upcoming orthopedic seminar. Prevention is an important focus for Envera’s services, Butler says, as is simplifying patient communication. After a hospital stay or doctor visit, patients can get overwhelmed by multiple calls (sometimes as many as six) related to that visit. With Envera’s services, there can instead be one conversation or one touch via phone, email or text, based on the patient’s preferences.
delivers solutions by providing:
GROWTH
“Envera is a pure services organization,” Butler explains. “In terms of how we partner, we don’t come in and rip things out that are working well. Instead, we meet our partners where they are, and offer services to support what they may be missing.”
Envera Health delivers health solutions for provider partners through three distinct service lines Envera custom tailors its services by driving growth, increasing access and coordinating care. The company’s growth services focus on identifying immediate opportunities to increase new patient growth and retain existing patients for specific services, such as weight-loss surgery or mammography screenings. In this situation, Envera serves as an extension of the provider team, working across marketing and clinical operations to create a more unified consumer experience while showing the attributable value that marketing can bring to the health system. They analyze and provide measurable results so providers know they’re offering the best care for patients.
ACCESS
CARE COORDINATION
Envera’s access services go beyond scheduling and appointment reminders. “Every time you call your provider, having someone answer the phone – that’s a basic level of expectation,” Butler www.OurHealthRichmond.com
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REFERRAL REACH
explains. “Our goal is to meet the needs of the “whole” patient with a one-call resolution— keeping them loyal and building relationships that last. In addition, Envera might also conduct a comprehensive audit of a partner’s phone system to gauge its effectiveness. For example, there could be 15,000 different phone numbers in a healthcare system but 3,000 of those lines are dead ends as a result of changes that occurred but were never recorded over the years.”
“We’re looping the patient back to the health system, letting them know we care and want them to recover and stay healthy.”
Envera Health representatives proactively contact every patient who has interacted with the health care system or provider through its coordinated care or transition solutions. This connected experience creates more patient satisfaction and closes care gaps. “As patients leave the emergency room, their provider says, ‘We care about you. We want to know that you’re getting better. Expect a phone call as we’re going to reach out and ask you a couple questions.’ That’s our way of knowing you’re getting better,” Butler explains. “That’s what we do for our partners. And on that call, patients can also talk with a live nurse and ask him or her questions – ‘Should my wound look like this? Should I still have a fever?’ We’re really trying to bring that comfort and peace of mind to the patient. We found that it reduces hospital readmissions and significantly improves patient satisfaction. And it works in a hospital or emergency room or even if you go down the street to an imaging center. We’re looping the patient back to the health system, letting them know we care and want them to recover and stay healthy.”
Finding joy at work In 2017, Envera Health opened their new 27,000-square-foot headquarters in downtown Richmond.
Brett Butler
Vice President, Client Success Envera Health
“There aren’t many companies out there doing what Envera does, and our new office adds one more differentiator,” Butler adds. “Since so many of our employees spend their days speaking by phone with patients who are trying to solve a healthcare problem, they need to find joy in helping patients in those moments of need. So we created a warm physical environment to support making that happen.” Now located along the canal in the heart of Richmond, Envera employees enjoy a full view of the James River. “This really is a differentiator,” Butler adds. “We’re so proud of this new space and encourage site visits. Just reach out and come see it for yourself.” EXPERT CONTRIBUTOR Brett Butler, Envera’s vice president of client success.
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ON THE WEB
More at ourhealthrichmond.com
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