OurHealth Magazine for Richmond: March/April 2019 by OurHealth Media LLC

SPOTLIGHTING SPECIALTY CARE SERIES: Counting on Colonoscopies to Cure Cancer + Are Allergies Affecting Us More Than Ever?

How each is making medicine better just might surprise you.

Bringing Beauty Back to Your BODY, SKIN AND SMILE Before Bathing Suit Season

BROADENING YOUR BABYâ&#x20AC;&#x2122;S BRAIN with RVA Basics

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22 44

FEATURES

MARCH • APRIL 2019

2019 Richmond Leaders in Local Healthcare

9 Cosmetic Procedures That Turn Back Time on Your Face, Body and Skin

Learn how 16 of the brightest members of the Greater Richmond medical community are giving back not because it’s a part of their job description, but because it is the right thing to do. As plastic surgery becomes more affordable and technology advances, more people are electing to reshape themselves for added confidence, anti-aging benefits and enhanced physical health.

Spring Cleaning for Better Health: What you Shouldn’t Sweep Under the Rug No matter how tidy you are, some spots in your home always attract bacteria, fungus, mold, pet dander and more. These microorganisms and allergens can impact your breathing, sleep and overall health.

Understanding the Basics of Developing Your Baby’s Brain The Basics™ are five fun, simple and powerful ways that we can help all children — from birth to age 3 — grow to be happy and smart. The best part is that no special equipment is required, you can do all these activities at home or wherever you happen to be, and it is free.

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DEPARTMENTS MARCH • APRIL 2019

The Pulse | People. Places. News to Know.

Health Scene | Happenings. Who’s Who. Trending. 17th Annual Richmond Women’s Health and Fitness Expo was held at the Greater Richmond Convention Center, and featured more than 100 booths and exhibits, all focused on ways women can lead healthier, more balanced lifestyles.

Q&A on Health | Questions. Answers. Knowledge.

Health A-Z | Insight. Awareness. Mindfulness for the Whole Family. Are you an Anti-Vaxxer When it Comes to Your Furbaby? There are risks if pet owners vaccinate, but there are also risks if they don’t. Like parents of human children, pet owners can stay informed using evidence-based research and input from trusted veterinarians.

Specialty Spotlight | Gastroenterology Colonoscopies: Not So Strange and Scary After All: Patients worried about risks of colonoscopies or unsure what the procedure involves are less likely to get it done. But when you strip away the myths surrounding colonoscopies, they’re a simple, life-saving procedure — not so weird or scary after all.

Specialty Spotlight | Allergy, Asthma and Immunology Are Allergies Affecting Us More Now Than Ever? There’s a good chance that you have allergies or know someone who does. In the U.S., more than 40 percent of children and 30 percent of adults now suffer from the condition, and it appears this trend is on the rise.

Funny Bone | Spot the Seven Differences

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MARCH • APRIL 2019

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CONTRIBUTING RICHMOND MEDICAL EXPERTS

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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 © 2019 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 | ourhealthroanokenrv.com | ourhealthlynchburg.com | ourhealthrichmond.com | ourhealthcharlottesville.com | Advertising rates upon request.

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The Pulse

INFORMATION • EVENTS • AWARENESS

New Locations, Ventures, Mergers and Acquisitions Virginia Cancer Institute Opens Virginia Surgical Institute – A New Surgery Practice Virginia Cancer Institute has opened Virginia Surgical Institute, a new practice comprised of six local general surgeons who were formerly with Surgical Associates of Richmond, including: Christine Bouchard, MD, Joanne Glanville, MD, Bryan Johnson, MD, Melissa Marinello, MD, Amy Rose, MD and Michael Rose, MD. Virginia Surgical Institute surgeons specialize in general surgery, advanced laparoscopy, breast surgery and breast biopsy, colon and rectal surgery, endocrine surgery, endoscopy, robotic surgery and surgical oncology. The new practice, which opened January 1, 2019, is located at 10710 Midlothian Turnpike, Suite 139, Richmond, VA 23235. Office hours are Monday – Friday, 8 am – 5 pm. For more information: Visit www.vasurg.com or call 804.348.2814.

Recognitions and Accreditations Henrico Doctors’ Hospital Named One of Healthgrades 2019 America’s 250 Best Hospitals Henrico Doctors’ Hospital has achieved the Healthgrades 2019 America’s 250 Best Hospitals Award™ for the second consecutive year. The distinction places Henrico Doctors’ in the top 5 percent of more than 4,500 hospitals assessed nationwide for its superior clinical performance as measured by Healthgrades. “This continued recognition is a testament of our commitment to providing compassionate high quality care for our patients,” says Will Wagnon, Chief Executive Officer of Henrico Doctors’ Hospitals. “I commend our teams for their demonstration of excellence in attaining quality outcomes for our surrounding communities.” From 2015 through 2017, patients treated in hospitals achieving the award had, on average, a 27.1 percent lower risk of dying than if they were treated in hospitals that did not receive the award, as measured across 19 rated conditions and procedures for which mortality is the outcome. (Statistics are based on Healthgrades analysis of MedPAR data for years 2015 through 2017 and represent three-year estimates for Medicare patients only.) Henrico Doctors’ Hospitals is a 767-licensed bed facility that consists of five community campuses, Henrico, Parham and Retreat Doctors’ Hospitals, West Creek Emergency Center and Hanover Emergency Center.

From left to right: Christine Bouchard, MD | Joanne Glanville, MD | Amy Rose, MD Michael Rose, MD | Bryan Johnson, MD | Melissa Marinello, MD

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For more information: Visit www.henricodoctors.com for additional information, including other clinical achievements earned by Henrico Doctors’ Hospital for 2019. Visit www.healthgrades.com/quality to learn how Healthgrades determines award recipients.

Bon Secours Patients Now Can Securely Access Health Records on iPhone

Previously, an individual’s health information was held in multiple locations, requiring patients to log in to each care provider’s website and piece together the information manually. Apple worked with the health care community to take a consumer-friendly approach and created Health Records based on Fast Healthcare Interoperability Resources (FHIR), a standard for transferring electronic medical records. “We are excited to offer our patients another convenient way to access their medical information,” says Laishy Williams-Carlson, Chief Information Officer, Bon Secours Mercy Health. “This innovative technology will empower patients to make better, informed decisions about their health and enhance engagement between patients and their care providers.” Now, individuals will have medical information from participating institutions organized into one view, covering allergies, conditions, immunizations, lab results, medications, procedures and vitals, and will receive notifications when their data is updated. Health Records data is encrypted and protected with the user’s iPhone passcode, Touch ID or Face ID. To set up Health Records, go to the Health Records section of the Apple Health app, search for Bon Secours Health System, and then log in with your MyChart account username and password. After you log in once, your health records will start to appear in the Apple Health app, and you will be notified when new records are available. If you do not have a free MyChart account, visit www.bonsecours.com/mychart to enroll. For more information: www.apple.com/healthcare/health-records

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• NEWS TO KNOW

Bon Secours now supports Health Records on iPhone, which brings together hospitals, clinics and the existing Apple Health app to make it easy for individuals to see their available health data from multiple providers whenever they choose. Health Records is available for iPhone users running iOS 11.3 or higher.

The Pulse

New Technologies

The Pulse

• NEWS TO KNOW

New Locations, Ventures, Mergers and Acquisitions Sheltering Arms Institute Names Chief Executive Officer Sheltering Arms Hospital and VCU Health System have named Alan J. Lombardo, FACHE as Chief Executive Officer (CEO) of Sheltering Arms Institute, a new joint venture rehabilitation facility between Sheltering Arms Hospital and VCU Health. Lombardo became CEO effective February 1, 2019. He has served as the Interim Medical Center Director and CEO of the Veterans Health Administration in Richmond.

Caitlin Anzalone, OT

Sara Barr, NP

Mary Bath, PT

Jonathan Bennett, MD

Kevin Bibona, DDS

Kathleen Cosco, LPC

Brittney E. Dodt, MSN, FNP-C

Kayla Flynn, PA

Sheltering Arms Physical Rehabilitation Centers Richmond | 804.764.1000 www.ShelteringArms.com

Lead Nurse Practitioner KidMed Pediatric Urgent Care Richmond www.kidmedva.com

“Alan has an extensive and successful history of executive-level healthcare leadership. He has steered the Veterans Health Administration through bold initiatives,” says Paul Wesolowski, Chief Operating Officer of VCU Health System.

“[Alan’s] impressive capabilities are matched by his enthusiasm and passion for developing Sheltering Arms Institute as one of the top rehabilitation facilities in the nation and the patients it will serve.”

Sheltering Arms Physical Rehabilitation Centers Richmond | 804.764.1000 www.ShelteringArms.com

VCU Health Acute Care Surgical Services Richmond | 804.828.7748 www.vcuhealth.org

– Mary Zweifel, President and CEO of Sheltering Arms. Lombardo has held both clinical and leadership positions at Veterans Alan J. Lombardo, FACHE Health Administration facilities across the country. He earned his bachelor of science in biology from Slippery Rock University in Pennsylvania and his master of science in physical therapy from Shenandoah University. Additionally, Lombardo holds master’s degrees in healthcare administration and business administration from Army-Baylor University. Construction began on the Sheltering Arm Institute facility, located on 25 acres in the West Creek Medical Park off Broad Street Road, just east of the state Route 288 interchange in Goochland County, in May 2018. The joint venture combines inpatient beds from both organizations to create a multimillion dollar state-ofthe-art destination hospital focused on caring for individuals who have survived strokes, spinal cord injuries or brain injuries, as well as those in need of general rehabilitation or various neurological diseases and disorders. Sheltering Arms Institute is on schedule to open its doors in late spring of 2020. Upon embarking on the joint venture, both partners agreed to consolidate several of their locations into one 114-bed hospital. Sheltering Arms Institute will combine 68 beds from Sheltering Arms’ two inpatient facilities, one on the Bon Secours Memorial Regional Medical Center campus in Hanover County and the other on the Bon Secours St. Francis Medical center campus in Midlothian, and 46 beds from the inpatient facility operated by VCU Health Systems located in downtown Richmond. For more information: Visit www.shelteringarms.com or www.vcu.edu for construction or other updates.

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Orthodontics Virginia Family Dentistry Brandermill | 804.739.6494 Midlothian | 804.417.0245 www.vadentist.com

Richmond Gastroenterology Associates Midlothian | 804.330.4021 www.richmondgastro.com

Children’s Hospital of Richmond at VCU Virginia Treatment Center for Children Child and Adolescent Psychiatry Richmond | 804.828.3129 www.chrichmond.org

VCU Health Plastic Surgery Richmond | 804.828.3060 www.vcuhealth.org

The Pulse

Sarah Glass, DDS

Emily Godbout, DO, MPH Mahmoud Jawhar, MD Children’s Hospital of Richmond at VCU Infectious Diseases Downtown Richmond 804.828.2467 www.chrichmond.org

Bon Secours Kilmarnock Surgical Associates Kilmarnock | 804.435.1608 www.BonSecours.com

Nicholas Johnson, MD

Jin Lee, MD

Melissa Litzinger, PT

Elizabeth Mangano, FNP-C

Tika Z. McGuiness, FNP-BC

Irfan Moinuddin, MD

Michelle Olson, MD

Muhammad Raza, MD

Julia L. Robinett, AG-PCNP

Julia Stark, NP

Richmond Gastroenterology Associates Midlothian | 804.330.4021 www.richmondgastro.com

Sheltering Arms Physical Rehabilitation Centers Richmond | 804.764.1000 www.ShelteringArms.com

Hadie Razjouyan, MD

VCU Health Gastroenterology Richmond | 804.828.4060 www.vcuhealth.org

VCU Health Dentistry Richmond | 804.828.9190 www.vcudentalcare.com

Bon Secours Cancer Institute at St. Mary’s Richmond | 804.287.7804 www.BonSecours.com

Bon Secours Cancer Institute at St. Francis Midlothian | 804.893.8717 www.BonSecours.com

VCU Health Nephrology Richmond Cardiology Richmond | 804.828.2161 Associates Mechanicsville | 804.730.1481 www.vcuhealth.org www.BonSecours.com

Lead Nurse Practitioner KidMed Pediatric Urgent Care Richmond www.kidmedva.com

VCU Health Neurology Children’s Hospital of Richmond at VCU Richmond | 804.828.9350 www.vcuhealth.org

Children’s Hospital of Richmond at VCU Critical Care Downtown Richmond 804.828.2467 www.chrichmond.org

Children’s Hospital of Richmond at VCU Cardiology/Interventional cardiology Downtown Richmond 804.828.2467 www.chrichmond.org

Children’s Hospital of Richmond at VCU Virginia Treatment Center for Children Child and Adolescent Psychiatry Richmond | 804.828.3129 www.chrichmond.org

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• NEWS TO KNOW

Virginia Foote, PA-C

The Pulse

• NEWS TO KNOW

New Locations, Ventures, Mergers and Acquisitions

The Joy Concierge, Offering Beauty, Floral, and Lifestyle Services, Opens in Richmond

Sarah Cannon Cancer Institute at Henrico Doctors’, Johnston-Willis Hospitals Achieve National Accreditation for Breast Multidisciplinary Care Program

Bernice Stafford Turner, also known as the RVA Flower Lady, has merged with Mobile Spa America to create The Joy Concierge. The Joy Concierge provides full-service wellness assistance, specializing in the management of the wellness of your home and business. Clients can request subscriptions or one-time services for everyday tasks ranging from laundry and business assistance to mobile massages, facials, manicures and pedicures. “Virginia has a diverse business population and I saw a void in the concierge arena. So, I merged my businesses and added a few of my favorite services like laundry, cleaning and running errands,” says Turner. “The Joy Concierge is a network of professionals ready to take on the responsibilities that you don’t have time to do, but need done.” For more information: www.thejoyconcierge.com

The Sarah Cannon Cancer Institute at Henrico Doctors’ and JohnstonWillis Hospitals have received a three-year accreditation for their Breast Multidisciplinary Care Programs from the American College of Surgeons’ National Accreditation Program for Breast Centers (NAPBC). “It is an honor to be part of a team that is truly committed to excellence and dedication toward each other, our patients and their families,” says Jonathan Tinker, Vice President of Oncology Services at HCA Virginia’s Sarah Cannon Cancer Institute. “Achieving this accreditation is a testament to the proficient skills and specialized knowledge that as a result translate to outstanding patient care.” NAPBC Accreditation is the seal of approval from the American College of Surgeons and formally acknowledges their commitment to providing the highest quality evaluation and management of patients with breast disease. Receiving care at an NAPBC-accredited center ensures that a patient will have access to: •

Comprehensive care, including a full range of state-of-the-art services

•

A multidisciplinary team approach to coordinate the best treatment options

•

Information about ongoing clinical trials and new treatment options

•

Quality breast care close to home.

The NAPBC is a consortium of professional organizations dedicated to the improvement of the quality of care and monitoring of outcomes of patients with diseases of the breast. Accreditation by the NAPBC is only given to those centers that have voluntarily committed to provide the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance. During the survey process, the center must demonstrate compliance with standards established by the NAPBC for treating women who are diagnosed with the full spectrum of breast disease. The standards include proficiency in the areas of center leadership, clinical management, research, community outreach, professional education, and quality improvement. A breast center that achieves NAPBC accreditation has demonstrated a firm commitment to offer its patients every significant advantage in their battle against breast disease. “This accreditation challenges breast cancer centers to enhance the care they provide by addressing patient-centered needs and measuring the quality of the care they deliver against national standards,” says Will Wagnon, Chief Executive Officer of Henrico Doctors’ Hospitals. “I commend the entire team for their persistence in ensuring that they continuously exceed the needs of our breast patients.” For more information: www.accreditedbreastcenters.org

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New Technologies Richmond 9-1-1 Using New Service to Help Locate 9-1-1 Calls from Mobile Devices A new tool called RapidSOS NG911 Clearinghouse is now helping the Richmond Department of Emergency Communications get fast, accurate location information from mobile devices for emergencies. RapidSOS NG911 Clearinghouse is an online platform to help pinpoint the location when the caller is unsure or unable to provide the location or when information provided by the cell phone company based on tower location is not specific enough. This was the case on Jan. 13, when a Richmond 9-1-1 call-taker answered a call for domestic violence but was not able to get a location from the caller immediately. The 9-1-1 supervisor was able to find the location through the RapidSOS NG911 Clearinghouse. “In this case, the first responders were there more quickly, because of our use of RapidSOS, rather than waiting for the caller to give the address,” says Stephen Willoughby, Director of the Richmond Department of Emergency Communications. “Rather than using radio signals from the telephone and triangulating the towers to get a general idea of the location, RapidSOS asks the cell phone where it is.” Jackie Crotts, the Richmond Department of Emergency Communications Deputy Director of Technology, says that it is simple to use. “Essentially when the enabled device (iPhone iOS 12 or Android version 4.0 and up) calls 9-1-1, the location is sent to the RapidSOS NG911 Clearinghouse. Our 9-1-1 emergency communications supervisors make a request for the location, using one of our automated systems,” he says. Crotts says that the location information is only available for active calls and only for those calls coming from the 9-1-1 emergency communications centers’ area. “It helps us better locate callers, but nothing bypasses having a smart person behind the headset to get the best location and response,” Willoughby says. RapidSOS is a free service available to authorized 9-1-1 emergency communications centers. For more information: Visit www.rapidsos.com/ng911clearinghouse or www.youtube.com/watch?v=PFoRYuW5hps to learn more about how the new tool works.

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www.ourhealthrichmond.com Do you have health-related news to share for The Pulse? Send to Stephen McClintic Jr. via email at steve@ourhealthvirginia.com. www.OurHealthRichmond.com

Health Scene HAPPENINGS • WHO’S WHO • TRENDING original photography | WTVR CBS6 CREATIVE SERVICES TEAM

17TH ANNUAL RICHMOND WOMEN’S HEALTH AND FITNESS EXPO SHINES AGAIN On Saturday, February 2, 2019, the 17th Annual Richmond Women’s Health and Fitness Expo, presented by WTVR CBS 6 – OurHealth Magazine for Richmond’s media partner – was held at the Greater Richmond Convention Center, and featured more than 100 booths and exhibits, all focused on ways women can lead healthier, more balanced lifestyles. Attendees came from a broad spectrum of ethnic, social, and economic backgrounds with a shared interest in learning, experiencing, trying, and purchasing health-related products and services. This year’s Expo featured three stages: The Fitness Stage, The Cooking Stage, and The Lifestyle Stage. Each stage was filled with high-energy, motivational speakers showcasing the newest trends in living healthy. Also featured was “The Doctor Is In” session, which brought together local doctors to answer important and insightful questions posed by attendees, as well as the Expo’s newest offering: a holistic and natural living area that provided information to people looking to enhance their mind, body and spirit connections.

After spending the day with an amazing array of speakers, chefs, nutritionists, fitness experts, trainers, and physicians, Expo attendees left with tools and ideas needed to help lead healthier and more active, fulfilling lives.

Started in 2002, the Expo attracts a dedicated community of followers, including thousands of attendees, local businesses, wellness professionals and healthcare institutions, making it Richmond’s largest women’s health event. To learn even more about the vendors and services that were featured at the 2019 Richmond Women’s Health and Fitness Expo, and to receive updates about the 2020 event, visit www.rvahealthexpo.com.

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Health Scene

• HAPPENINGS

1 Expo attendees participating in the Yoga Pop-Up of All Pop-Ups 2 Fitness Motivator, Shaun T leads hundreds in an intense, but fun, group workout 3 The Kid’s Zone, presented by Children’s Hospital of Richmond at VCU features Spotlight Acro and Cheer with a fun Gymnastics demonstration 4 Expo attendee participating in the Yoga Pop-Up of All Pop-Ups 5 Katie Brown with Real Food with Gratitude shares a delicious Air Fryer recipe on The Virginia This Morning Cooking Stage 6 Beachbody Coach, Savannah Butler, joins in the Shaun T workout 7 Dr. Inzhili Kitto with Kitto Plastic Surgery consults with an Expo attendee 8 A sweaty Shaun T takes a moment to inspire a workout participant 9 Evidential Medium, J.Marie, connecting with and sharing spirit on The Lifestyle Stage 10 Expo attendee participating in the Yoga Pop-Up of All Pop-Ups 11 Shaun T joins the crowd to motivate attendees throughout his workout 12 The Women of CBS 6 “Flip The Script” on The Lifestyle Stage sharing stories about how they incorporate health and wellness into their daily lives 13 Jessica DeLuise with Eat Your Way to Wellness shares a delicious Instant Pot recipe on The Virginia This Morning Cooking Stage 14 CBS 6 Evening News Anchor, Candace Burns, motivates the crowd before introducing Shaun T to the stage 15 Aaron Berry with American Family Fitness warms up the Shaun T crowd with a fun Fight routine 16 Expo vendor showcasing her beautiful jewelry 17 Jessica DeLuise is joined by CBS 6 Noon News Anchor, Cheryl Miller to talk about “How To Keto the Right Way” 18 Dr. Jeff Ferguson with VCU Health answering questions about Emergency Medicine from an Expo attendee 19 Eugene Park, MD with Southside Regional Medical Center answering medical questions about Urologic Surgery from an Expo attendee 20 Shaun T workout attendee is all smiles as she joins in the workout www.OurHealthRichmond.com

Questions. Answers. Knowledge. How do I continue having conversations with my mom, who is suffering from Alzheimer’s? Alzheimer’s is one of the more than 70 different types of dementia that causes problems with memory, thinking and behavior, including the ability to carry on a conversation. This latter symptom of the disease can be disheartening and frustrating to both the person diagnosed with the condition as well as his/her loved ones, but one method centering around how to listen with empathy, reduce anxiety and manage dignity may offer help.

You might recognize

NAOMI FEIL,

founder of Validation Therapy and TEDx speaker, from a YouTube video that is part of the

PBS documentary, There is a Bridge. The video – which received over 40 million views – shares Feil’s inspiring, breakthrough moment of communication with Gladys Wilson, an Alzheimer’s patient with whom she worked. To watch the video, visit https://youtu.be/CrZXz10FcVM.

At Magnolias of Chesterfield, a memory care community in Chester, a technique called “Validation” teaches how to enter an Alzheimer’s patient’s reality rather than trying to bring the patient back to actual reality. Created by social worker and gerontologist Naomi Feil, the “Validation” method of communication is a practical way of communicating with advanced dementia sufferers that helps reduce stress, enhance dignity and increase happiness. This method, along with others, is part of the Moments in Time program used for residents and their families at Magnolias of Chesterfield that helps encourage quality of life through the progression of Alzheimer’s disease and other related dementias. Stephanie Quick, LPN, LNHA, MBA Executive Director Magnolias of Chesterfield Chester | 804.409.2481 www.meridiansenior.com/community/ magnolias-of-chesterfield

OurHealth | The Resource for Healthy Living in Greater Richmond

What is vaginal laxity and how can it be treated? Vaginal laxity is a feeling of looseness of the vagina due to relaxation or stretching of the support structures of the vaginal wall. Occurring in about 76 percent of women, vaginal laxity is generally caused by trauma and stretching associated with vaginal childbirth, surgery or normal aging. The condition can affect surrounding organs, including the bowel and bladder, leading to urinary incontinence issues. There are a variety of treatment options available for vaginal laxity, including: •

Pessaries: pessaries are “props” that fit in the vagina and prop up sagging tissues.

•

Surgery: surgical options are generally performed in the hospital and involve a prolonged recovery. Downtime can be extensive.

•

Energy-based devices: energy-based devices for vaginal rejuvenation apply thermal (heat), non-thermal and laser energy to the various layers of the vaginal tissue, which restores elasticity, sensation, and natural lubrication with minimal recovery. There is no downtime and you can resume normal activities right away.

Lawrence Miller, III, MD Renew Health and Wellness Glen Allen | 800.656.8386 www.renewmetoday.com

What is the best treatment for early arthritis pain in my hands? The best treatment for early arthritis pain is to protect the joints. You can protect your joints by simply being mindful of the activity, pace, and adjustment of the tool you’re using to lessen stress on the joint, and then listening to the joint’s response. For instance, tasks that require a tight, prolonged grip of the hand may cause pain in the thumb, fingers and wrist. Be aware of the tightness of your grip. Do you need that amount of force, or would less force do the job? Simple changes such as taking breaks during a task and using items with enlarged, padded grips or a grip assist can decrease joint stress. During breaks, stretch fingers and wrists, change positions, and take a deep breath. If pain occurs during or after a task, you may have overworked your joints and will need to further modify the task to decrease joint stress. If you are having joint pain during daily activities or exercise, ask your primary care physician for a referral to occupational therapy. Melinda K. Jermer-Gu, OTR/L, MEd Occupational Therapist Sheltering Arms Physical Rehabilitation Centers Richmond | 877.56.REHAB www.shelteringarms.com

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Questions. Answers. Knowledge. How do I know what type of hearing device is best for me? There are many factors that go into the decision to purchase a specific set of hearing aids. The most important first step is seeking professional help from an audiologist who will facilitate a full hearing test (audiogram).

A SLEEPLESS, RESTLESS NIGHT CAN CAUSE VARIATIONS IN

BLOOD GLUCOSE

levels, which can be potentially dangerous for diabetics. At the same time, changes in blood glucose levels can also affect the quality of sleep received, causing a never-ending cycle.

The amount of hearing loss determined from a hearing test factors into the type of hearing devices that are best. Other priorities and considerations should be discussed openly with the audiologist. Popular features that don’t necessarily increase the cost of hearing aids are rechargeable batteries, Bluetooth connections and apps that connect with smartphones, as well as T-coils for use with telephone and loop systems. Having an honest conversation about the budget, priorities and goals sets everyone up for success. There are many great hearing options available today. Anyone who hopes to hear better will be able to find a hearing device that’s best for his or her specific situation.

How does sleep affect diabetes?

What is sensorineural hearing loss?

A sleepless, restless night can cause variations in blood glucose levels, which can be potentially dangerous for diabetics. At the same time, changes in blood glucose levels can also affect the quality of sleep received, causing a never-ending cycle.

Sensorineural hearing loss is the most common type of hearing loss that most adults experience, resulting in higher pitched tones sounding muffled. It occurs when the hair cells in your inner ear (cochlea) are damaged, impeding the ability of the signal to be sent to the brain to be processed.

Because sleeplessness puts chronic stress on the body, blood glucose levels rise. When blood glucose levels rise, the body tries to eliminate the extra production through urination. This adds another factor to a sleepless night. Research has shown that even four hours of good quality sleep will decrease insulin sensitivity by 20 percent. Speak with your primary care doctor if you are experiencing sleep issues, especially if you are diabetic, to learn if you may benefit from seeing a sleep specialist.

Sensorineural hearing loss is caused by many factors, including age, excessive noise exposure, genetics, and ototoxic medications, which are medications that can cause ear damaging side effects. Sensorineural hearing loss is permanent and can usually be treated with the use of amplification and/or assistive listening devices. Kristen Hood, AuD, CCC-A Live Better Hearing Richmond | 877.762.1041 www.livebetterhearing.com

Hope White, RRT

Director of Sleep Services ABC Health Care Richmond | 866.363.3678 www.abc-hc.com

Kristen Koch, AuD, F-AAA Evolution Hearing Richmond | 804.215.0001 www.evolutionhearing.com

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LEADERS A

LOCAL HEALTHCARE

nthropologists tell us that the healer is one of the most important and revered roles of any culture. While the warriors, producers and merchants all have their uses and value, a functioning and thriving society always needs individuals with the proper training, wisdom and compassion to help their fellow men, women and children with any physical or mental condition, whether they practice in a tiny jungle hut or a cutting-edge medical clinic in a major modern city.

stressful conditions; and establishing processes that are patient-focused, efficient and fiscally sound. Others focus on making sure access to quality healthcare is available to all segments of our population, striving to leave no one behind.

that employees enjoy where they work even when under

2019 Richmond Leaders in Local Healthcare.

OurHealth Magazine for Richmond recently

invited community members to nominate online who they think best represents the Richmond area’s ideal healthcare leaders. We received many worthy suggestions, and we also learned that there’s a lot going on behind the scenes not everyone knows about. Colleagues shared “secret” details about afterToday’s healthcare providers and administrators hours activities some perform like helping shoulder the responsibility of continually kids at schools, coaching sports advancing the quality of care made teams, volunteering at community available in our communities all while Giving back clinics, or going on church medical overcoming more than their share of to their community mission trips to help others in need obstacles and challenges. Yet, many of not because it’s a part around the world. them extend themselves even further of their job description, to go above and beyond in an effort to We were encouraged to learn that but because it is the help us all become better humans. They all of these leaders are unified in right thing to do. research, they teach, they serve, and thinking that giving back, performing they look for other ways to give back to community service and building their professions and their communities to relationships all are the things they don’t inspire future generations and future healers. just do because it’s a part of a job description, but because they genuinely believe it’s the right thing to do. Some leaders in the healthcare community don’t even have to work directly with patients to have vital roles. In that spirit, we invite you to learn more about They could make sure an office, medical center or health 16 of the brightest members of our local exchange runs optimally; training and placing the right medical community who make up our list of people in the best position for them to prosper; ensuring

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Tom Gallo, MS, MDA

Linda Hines, RN, MS, MBA

Ann E. Honeycutt

RICHMOND

Executive Director Virginia Cancer Institute www.vacancer.com

Chief Executive Officer Virginia Premier www.virginiapremier.com

Executive Director Virginia Cardiovascular Specialists www.vacardio.com

MD Value Care Board of Directors Member

Virginia State Board of Health Member

Richmond Academy of Medicine Trustee

President, Association of Community Cancer Centers (ACCC)

Association for Community Affiliated Plans

American College of Cardiology, Virginia Chapter, Administrative Liaison

Virginia Association of Hematologists and Oncologists Board of Directors Member

For the last 24 years, Tom Gallo has worked to make sure people battling cancer have access to skilled care along with plenty of support. As Executive Director of Virginia Cancer Institute, he manages a team of 300 employees that includes 30 medical providers across eight medical offices, ambulatory infusion centers and labs. He’s also responsible for everything from financial management to operations to strategic planning. Gallo is the current president of the Association of Community Cancer Centers (ACCC), where he’s been a member for more than a decade. He has also served on and chaired ACCC’s Governmental Affairs Committee and has presented at several national ACCC meetings. Gallo has served in a variety of capacities in local and state organizations designed to educate governmental officials about current needs in oncology care as well as the importance of collaboration between multiple local health systems. This level of cooperation is especially important for people diagnosed with cancer who need quality care throughout various medical facilities and locations. Cancer treatments have a reputation of being confusing, complicated and frightening, but Gallo strives to ensure that patients in the area have the answers they need from a group of cooperative, collaborative providers they can trust.

VCU School of Nursing Former Adjunct Faculty Member

Virginia Premier is the Commonwealth’s second largest Managed Care Organization and a non-profit entity owned by VCU Health System. As CEO since 2016, Linda Hines, RN, MS, MBA has a key role in making sure the organization properly carries out its mission to provide health services for more than 250,000 members. The one billion dollar operation includes Medicaid, Medicare Advantage and a variety of individual and family plans on the federal health exchanges, along with offering outreach, education and community service. Under Haines’ leadership, Virginia Premier has been recognized nationally and has increased coverage in the northern region of the state through a partnership with Kaiser Permanente. She began her medical training as a Licensed Registered Nurse and was an adjunct faculty member at VCU School of Nursing. Hines has been with Virginia Premier since 1996 and has held a variety of leadership positions. Haines also is a member of the Virginia State Board of Health and the Association for Community Affiliated Plans, and has presented on Medicare topics at a national level. She enjoys sharing her expertise with community groups, and previously has spoken with a wide variety of organizations including Planned Parenthood, the Virginia Nurses Association and the VCU Health Institute of Women’s Health Professions.

Cardiology Advisory Board Member Children’s Hospital Board, Past Member

For more than 30 years, Ann E. Honeycutt has been active in Virginia’s medical community, and today is recognized as an expert in the ‘behind the scenes’ area of healthcare: the administration side. She’s currently the Executive Director of Virginia Cardiovascular Specialists, the region’s largest independent cardiology practice. Part of her duties include placing a focus on marketing and building partnerships and relationships with the area’s medical centers and other independent organizations, as well as making sure patients, physicians and nurses are aware of Virginia Cardiovascular Specialists and the skills of its nearly 40 specially-trained providers spread over seven offices, which is a part of MD Value Care, a network of providers. Honeycutt previously worked as CEO for Stuart Circle Hospital and Executive Director for St. Mary’s Hospital. She’s been a trustee of the Richmond Academy of Medicine and serves as the administrative liaison for the Virginia chapter of the American College of Cardiology. She has also been part of the Cardiology Advocacy Board since its founding in 2005, and served as its president in 2007, and she has been a member of the Children’s Hospital Board, where she served as chairman for four years.

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Olivia Jones MIDLOTHIAN Senior Vice President Care Advantage, Inc. www.careadvantageinc.com Virginia Association of Personal Care Providers Past President and current Board of Directors Policy Chair Historic Triangle Senior Center Past Member of the Board of Directors

Olivia Jones often hears from people that they wish they would have learned about Care Advantage sooner once they discover all the home health and personal care services the organization provides to the elderly, disabled or anyone seeking or needing assistance. As senior vice president for the Commonwealth-wide program, she helps arrange services for more than 5,000 patients cared for by the company’s 3,500+ employees, just one of the many responsibilities she takes on with such passion and purpose. Jones joined Care Advantage in 1998, and during the last 21 years, she has worked with all types of patients and their families in the variety of positions she’s held within the company, including office assistant, personnel supervisor, branch manager, regional vice president of operations and now senior vice president of the personal care division. For more than 10 years, she’s been a member of the Virginia Association of Personal Care Providers, where she served as past president and is currently the board of directors policy chair and she has also served on the board for the Historic Triangle Senior Center. Today, Jones is considered by many –patients and colleagues – as one of the go-to experts in Virginia’s healthcare system, with few approaching her level of experience, enthusiasm, industry knowledge and general empathy for clients and employees. Having worked in just about every capacity of her industry has given Jones the knowledge and insight that is deserving of the respect she’s earned, but don’t expect her to take time and toot her own horn. To her, it’s all part of doing a job she loves so dearly the right way and by treating others the way she would like to be treated – standards that have and continue to serve her and others so well.

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Paul Junod, PHR

Karen Legato, MSW, MPS

RICHMOND

Vice President and Strategic Human Resource Partner Bon Secours Mercy Health www.bsmhealth.org

Executive Director Health Brigade (formerly Fan Free Clinic) www.healthbrigade.org

Society of Human Resources Managers, Richmond Chapter Board of Directors Member Maymont Foundation Board of Directors Member Capital Region Workforce Development Board Member

As Vice President and Strategic Human Resources Partner at Bon Secours Mercy Health, Paul Junod has an important role in making sure 9,000 employees are properly supported. He also is part of the Bon Secours Richmond market’s leadership team focusing on retention, recruiting and relations, along with operations of the Bon Secours Child Care Centers. Junod has built positive relationships with the local military and veteran communities and has been commended for his efforts helping active and reserve members, their families and veterans become aware of healthcare resources and employment opportunities. These efforts have resulted in Bon Secours hiring more than 650 veterans since 2012. Junod also encourages collaboration with other private and public entities, as well. Bon Secours was recognized for being part of the new Living Wage Certification program, created by the Virginia Interfaith Center for Public Policy and the Richmond Office of Community Wealth Building. Junod is on the board of the Richmond chapter of the Society of Human Resources Managers, the Maymont Foundation and the Capital Region Workforce Development Board. He volunteers at a local elementary school and has been nominated for the annual Catholic Health Assembly Tomorrow’s Leader award.

VCU Health Equity Planning Steering Committee

Karen Legato takes her role as Executive Director of Health Brigade seriously, which consists of making sure underserved, underinsured and uninsured members of the Richmond community can access healthcare services. This makes it vital to create partnerships and perform ongoing fundraising to support the organization’s programs that help populations who need it the most. Health Brigade, formerly Fan Free Clinic, has an operating budget of $2.2 million and delivers services to more than 10,000 people annually. Legato has been referred to as a ‘bridge builder’ and is as comfortable talking with anyone, from lawmakers to clients, and always addresses the need for communities that need their voices heard, including African-American, Latino and LGBTQ populations. Her past roles have included the Leadership and Training Coordinator for the Friends Association for Children; Director of Medical Social Work Services at Brookside Home Health Care and Director of Youth and Young Adult Ministry at St. Mary Catholic Church in Richmond. Legato is part of VCU’s Health Equity Planning Steering Committee and spent two years at Virginia Commonwealth University’s School of Social Work.

To Olivia Jones, it’s all part of doing a job she loves so dearly the right way and by treating others the way she would like to be treated – standards that have and continue to serve her and others so well.

Charles Cheyne Levermore

Holly C. Lewis, DMD, MS

Greg Lowe

VIRGINIA BEACH, RICHMOND

RICHMOND

OPO Quality Systems Director LifeNet Health www.lifenethealth.org

Pediatric Dentist/Owner and President Sparkle Pediatric Dentistry

Compliance Officer for the Richmond area and the chair of LifeNet Health’s Quality Assurance and Performance Improvement Board

www.sparklepediatricdentistry.com

Chief Executive Officer HCA Virginia’s Chippenham and Johnston-Willis Hospitals www.hcavirginia.com

Southeastern Society of Pediatric Dentistry, Virginia Director

American College of Health Care Executives, Member

Donate Life Virginia Committee Member Association of Organ Procurement Organization Member

One-on-one healthcare is great, but things get more complex the more people and processes are involved. That’s why problem solvers like Charles Cheyne Levermore are needed bring clarity and to identify ways to improve efficiencies. As the Director of OPO Quality Systems for LifeNet Health, a statewide organ procurement organization and global leader in regenerative medicine, Levermore ensures that regulatory standards are met and important processes are followed in support of organ donation. LifeNet Health works with nearly 80 hospitals around Virginia to facilitate these selfless gifts, and Levermore focuses on quality initiatives designed to improve patient outcomes and save lives. He also serves as LifeNet Health’s corporate compliance officer for the Richmond area and leads the organization’s Quality Assurance and Performance Improvement boards, and his quality improvement efforts have earned national recognition. Levermore also teaches LEAN project management to LifeNet Health employees and shares these techniques with students at the VCU School of Business, his alma mater. Beyond LifeNet Health, he’s an active volunteer for Donate Life Virginia, a popular guest speaker and a member of the Association of Organ Procurement Organization.

Virginia Society of Pediatric Dentistry Past Board Member

As the owner and primary provider of dental care at Sparkle Pediatric Dentistry, Holly Lewis, DMD, MS prides herself on offering the highest level of care to all patients. She especially looks forward to working with special needs patients and has also helped mentor other dental providers who are interested in providing this specialized care. Prior to opening the Mechanicsville and Short Pump locations, she was an instructor in pediatric dentistry at Virginia Commonwealth University and practiced dentistry at the Children’s Hospital and at Dentistry for Children. Dr. Lewis began her academic career at the University of Mississippi, where she attended the dental program. She went on to earn a master’s degree at VCU, where she received the honor of Best Specialty Faculty and Professor of the Month. She’s earned a variety of other industry awards honoring teachers and women in the dentistry field, along with achievement in periodontics. Dr. Lewis has served on the board of the Virginia Society of Pediatric Dentistry, including president and secretary positions, and is currently serving as Virginia’s director for the Southeastern Society of Pediatric Dentistry. A significant honor took place in 2017 when she was inducted into the Pierre Fauchard Academy, an honorary dental organization that promotes dentistry and community service.

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Greg Lowe oversees the daily operations of HCA Virginia’s two large medical centers, Chippenham and Johnston-Willis, abbreviated as CJW. Although each has its own separate administration and boards of trustees, Lowe works with the various medical teams and the internal and external community at each to ensure both institutions perform and serve well. This includes intangibles like building culture and developing better relationships between other community organizations, as well as overseeing specific capital projects like expansions and renovations. Lowe is also committed to improving patient satisfaction, employee retention and recruiting, and addressing turnover trends. One popular recognition program he initiated presents a t-shirt to an employee observed doing something well. The shirt has the message “My CEO Thinks I’m Awesome.” Prior to moving to the Richmond area in 2016, Lowe held leadership positions at several medical centers around the country, including a Fort Pierce, Florida hospital that was designated by HCA as one of the “Top 5 Most Improved Hospitals for Employee Engagement” under Lowe’s leadership. Lowe is a member of the American College of Health Care Executives and an Eagle Scout.

Daniel McCarter, MD RICHMOND Market Chief Medical Officer JenCare Senior Medical Center www.jencaremed.com American Academy of Family Physicians Member Virginia Academy of Family Physicians Member Society of Teachers of Family Medicine Member Medical Society of Virginia Member Founder of Stoney Creek Family Practice

As Market Chief Medical Officer for JenCare Senior Medical Center in Richmond, Daniel McCarter, MD maintains multiple responsibilities for the organization that specializes in valuebased care from coaching, mentoring and training medical staff to scheduling the various physician partners at JenCare Senior Medical Center’s four Richmond locations. He also has the opportunity to work directly with patients himself, which include low – and middle-income seniors, many with multiple chronic health conditions. Dr. McCarter joined JenCare Senior Medical Center in 2017 after previously serving as Associate Professor of Family Medicine at the University of Virginia School of Medicine and Associate Chief Medical Officer of Ambulatory Services at University of Virginia Health System, which for the latter, he supervised 70 medical directors overseeing 90 clinics. He separately served as Medical Director for Regional Primary Care for the University of Virginia Physician Group that handles 20 percent of all outpatient visits in the health system. Recognizing Virginia’s tremendous need for better rural healthcare, Dr. McCarter founded the Stoney Creek Family Practice that has been enriching the clinical experience for University of Virginia Medical School residents interested in learning about or pursuing a career in rural medicine since 1990. He has practiced and taught medicine for more than 30 years, and is considered one of the Commonwealth’s most respected physicians and healthcare administrators and a leading expert in family medicine and population health. He’s a member of the American Academy of Family Physicians, the Virginia Academy of Family Physicians, Society of Teachers of Family Medicine and Medical Society of Virginia, and has served on numerous committees tasked with addressing transformational healthcare challenges. Dr. McCarter often compares the doctor-patient relationship to a rowboat, with he and the patient sitting side-by-side. “To be successful, we must each pick up an oar and pull together,” he says, a sentiment that may sound simple enough, but when lived by as Dr. McCarter has, translates into significant benefits realized for healthcare as a whole. www.OurHealthRichmond.com

“To be successful, we must each pick up an oar and pull together,” he says, a sentiment that may sound simple enough, but when lived by as Dr. McCarter has, translates into significant benefits realized for healthcare as a whole.

Linda Nash

Eddie Peloke

RICHMOND

Founder and CEO WellcomeMD www.wellcomemd.com

Chief Executive Officer Workpath www.workpath.co

SpecialDocs Board of Directors Member

Virginia Healthcare Innovation Leadership Council Member

Children’s Museum of Richmond Board of Directors Past Member Powell Economic Education Foundation Board of Directors Past Member Ellen Shaw de Paredes Breast Cancer Foundation Board of Directors Past Member Visual Arts Center of Richmond Board of Directors Past Member Science Museum of Richmond Board of Directors Past Member

In 2003, entrepreneur Linda Nash opened a concierge medical company, which offered the services of 26 physicians in 11 locations helping 5,000 patients. Although she sold the company to Markel in 2011, she continued to have an interest in the potential of this business model to help patients. So, in 2016 she founded Wellcome MD, which she called “Concierge Medicine 2.0.” WellcomeMD, which has locations in Richmond and Chicago, has a concierge focus, but with greater emphasis on disease management and helping patients overcome their dependency on prescription drugs. Nash also focuses on recruitment, building relationships with the physician community and looking for other business ventures. She’s been a high school teacher and has founded and launched other schools/education ventures and enjoys mentoring community and healthcarerelated ventures. Nash is a board member of Specialdocs, and has served on the board of the Children’s Museum of Richmond, the Powell Economic Education Foundation, the Ellen Shaw de Paredes Breast Cancer Foundation, the Visual Arts Center of Richmond and the Science Museum of Richmond. Nash is especially proud of the honor given by Concierge Medicine Today, declaring her the Most Influential Woman in Concierge Medicine.

Richmond Technology Council Member RVA Chamber of Commerce Scott’s Addition Boulevard Association Member

As CEO of Workpath, a healthcare technology company, Eddie Peloke leads a team focused on helping healthcare providers better connect with one other more efficiently. Workpath has created a HIPAA-compliant online nationwide network that allows medical providers to easily find and hire a specialist or other position when or where they’re needed most, including physicians, nurses, phlebotomists and even hospice specialists. Faster, more responsive access can improve patient care and outcomes, whether someone needs services at a hospital, clinic or home. It can also help administration staff trying to ensure all shifts are fully staffed and scheduled and patients receive proper care. For the last 17 years, Peloke has guided the company from a start-up named Iggbo to the nationwide organization it is today, all with the goal of helping the industry work faster and smarter. Prior to joining Workpath, Peloke worked for various public and private logistics companies. He’s part of the Virginia Healthcare Innovation Leadership Council, the Richmond Technology Council, the RVA Chamber of Commerce and Scott’s Addition Boulevard Association. He was a finalist in the RVA “Awesome Awards” from the Venture Forum, and Workpath has been recognized as one of the top startups in the U.S. by Healthcare Technology Outlook magazine and Tech Tribune.

Zack Smith RICHMOND President and CEO PartnerMD www.partnermd.com Sportable Board of Directors Member American Heart Association, Richmond Chapter, Board of Directors Member

Zack Smith joined PartnerMD in 2017 when he was hired as CEO of the concierge primary care and executive health company owned by Markel Ventures. The company includes approximately 200 employees and 26 physicians in seven East Coast offices along with its headquarters in Richmond. Previously, Smith spent more than 30 years in various roles at WestRock, an international packaging company with more than 42,000 employees. His last position there was Executive Vice President of the Beverage Packing division. Since joining PartnerMD, Smith has focused on improving employee satisfaction, increasing membership, growing revenue and better profitability. He also serves on the board of directors for Sportable and the Richmond chapter of the American Heart Association. Under Smithâ&#x20AC;&#x2122;s leadership, the company has pushed to improve patient access to physicians, increase the amount of time that clients spend with providers, and emphasize the importance for the staff and providers to focus on developing stronger relationships. Smith also sees parallels from the packaging industry to the healthcare realm: the scale is different but there always needs to be a firm commitment to service, quality and relationship-building. www.OurHealthRichmond.com

Kay Stout, MD, MBA

Deepak Thomas, MD

J. Neil Turnage, DDS

RICHMOND

SHORT PUMP

OBGYN Physician/President Virginia Women’s Center www.virginiawomenscenter.com

Interventional Cardiologist VCU Health Pauley Heart Center www.vcuhealth.org

Richmond Academy of Medicine Member

Assistant professor, Department of Internal Medicine, VCU School of Medicine

Partner Dentist/Co-Chairperson of the Board Virginia Family Dentistry www.vadentist.com

Medical Society of Virginia Member Northern Neck Medical Association Member

Kay Stout, MD, MBA is a boardcertified OBGYN physician who has been practicing in Kilmarnock along with guiding Virginia Women’s Center for more than 20 years. As President of Virginia Women’s Center, she helps the staff provide an extensive variety of services to the community that go beyond OB/GYN, including consultations about breast health, urology, weight and wellness, mental health, bone density and more. Dr. Stout also has had a role in the recent strategic alignment between the Virginia Women’s Center and physician-led Privia Health to create Privia Women’s Health aimed to create opportunities to provide care to more patients and offer access to national experts and additional technology. She has earned Diplomate and Fellow status from the American Board of Obstetrics and Gynecology and is a member of the Richmond Academy of Medicine, the Medical Society of Virginia and the Northern Neck Medical Association. Dr. Stout’s focus has been on making women’s health transformational, not just transactional. She received her medical training from the University of Texas Southwestern Medical School and she completed residency at the Medical College of Virginia. She later earned a MBA from William & Mary’s Raymond A. Mason School of Business.

Society for Cardiovascular Angiography and Interventions Member Health Connection Volunteer

Deepak Thomas, MD, a highly recognized board-certified cardiologist and member of the Society for Cardiovascular Angiography and Interventions, brings a truly global perspective to Richmond heart patients and even future cardiologists. He’s an assistant professor in the Department of Internal Medicine at VCU Health, specializing in interventional cardiology. He also practices at three VCU Health locations, including the VCU Medical Center downtown, performing a variety of cardiac interventions. The Norfolk native studied literature and cultures and received a master’s degree in philosophy. He then received a postgraduate degree in British Literature from Cambridge University before deciding to attend VCU School of Medicine. He received his medical internship, residency and cardiology training at Yale University. Dr. Thomas and his wife Mareen Thomas, MD, a pediatric endocrinologist in Richmond, have established a scholarship at VCU for a promising medical student. Past volunteer activities have included providing care at Mother Theresa’s Sisters of Charity in Calcutta, India; offering medical outreach to inner-city St. Louis; and being part of a 50-person medical ward in Eritrea, East Africa as a Yale/Stanford Johnson & Johnson Global Health Scholar.

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Adjunct Faculty at Virginia Commonwealth University/Medical College of Virginia MCV Alumni Association of Virginia Commonwealth University Board of Trustees Vice President – Dentistry The Steward School Athletic Hall of Fame

Neil Turnage, DDS came into dentistry via sports and school leadership roles. The partner dentist at Virginia Family Dentistry’s Short Pump office spent several years as a soccer coach, facilities director and a dean at The Steward School in Richmond. He’s even been inducted into the school’s Athletic Hall of Fame for accomplishments on and off the field. In the early 1990s, Dr. Turnage decided to pursue a new career, enrolling at the Virginia Commonwealth University School of Dentistry. Today, he is considered a caring and laid-back practitioner who is committed to advancing the dental specialty field as both a practice partner and co-chairperson of the board with Virginia Family Dentistry. Although he took a different career path many years ago, Dr. Turnage has never forgotten his roots in education and the importance of teaching and molding young minds today to become tomorrow’s next generation of leaders, which he continues as an adjunct faculty member at VCU/MCV, as a board member with The Steward School and as MCV Alumni Association of Virginia Commonwealth University Board of Trustees Vice President – Dentistry. Dr. Turnage has been honored for his work in implant dentistry, oral surgery and general dentistry, and remains excited to learn about cutting edge advances in his field, especially new practices and techniques that are intended to improve the quality of patient care and oral health. Dr. Turnage’s career is one that has truly come full circle, but no matter his path, it’s clear that caring for and teaching others has always been at the center of everything he embodies.

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Most Popular Surgeries

The

to Improve Your Body Shape 1. Liposuction WHY IT’S POPULAR:

Slims down chin, thighs, stomach, waist, hips, calves, buttocks, back, arms, face and breasts

HOW IT’S DONE: •

Local or general anesthesia, or IV sedation

•

Areas of fat are removed from directly beneath the skin by using a vacuum-suction canula, a tube-shaped instrument. Ultrasound or laser (SmartLipo) may also be used to break up fat deposits prior to removal.

BEST CANDIDATES: •

Those who are within 30 percent of their ideal weight with pockets of fat that don’t respond to diet or exercise

•

People with firm, elastic skin and more muscle tone

WORST CANDIDATES: •

People who want to use it for weight loss or treatment for obesity

•

Those who are trying to treat cellulite

TYPE OF PROVIDER TO LOOK FOR: Board-certified cosmetic, plastic or dermatologic surgeon AVERAGE COST:

$3,374*

2. Breast Augmentation – Enlargement and/or Lift HOW IT’S DONE: •

General or local anesthesia

•

Implants – silicone or saline

•

Fat transfer enlargement: using liposuction to take fat from other parts of your body and inject into your breasts has the benefit of being safer but without as much volume as silicone implants.

BEST CANDIDATES: •

Enlargement: those who have fully developed breasts, but are bothered by the feeling they’re too small

•

Lift: women who are dissatisfied with breast shape after pregnancy, weight loss or aging, and have a good amount of breast tissue left

WORST CANDIDATES: •

Those with severely sagging breasts. A breast lift may have to be done at the same time as an enlargement to correct severe situations.

TYPE OF PROVIDER TO LOOK FOR: Board-certified cosmetic or plastic surgeon AVERAGE COST: Implants –

$3,718*

| Lift – $4,672*

3. Tummy Tuck WHY IT’S POPULAR: •

Gives you a flatter, contoured abdomen that’s more proportionate with your body type and weight

•

Sometimes part of a “mommy makeover” to restore a woman’s body after childbearing. Mommy makeovers involve multiple sites depending on the patient’s circumstances. Possible procedures alongside a tummy tuck are breast augmentation, breast lift, buttock augmentation, vaginal rejuvenation and liposuction.

HOW IT’S DONE: •

General anesthesia (most often) or IV sedation

•

The skin over the lower abdominal area is removed and the remaining skin is tightened.

Myth vs. Reality? Cosmetic Surgery and Plastic Surgery are the Same. Although we tend to use the terms interchangeably, cosmetic surgery is not the same as plastic surgery. Cosmetic surgery can be performed by several different types of doctors who may not have training in plastic surgery. Plastic surgeons are trained in reconstruction and in cosmetic surgery.

BEST CANDIDATES: •

Those that aren’t carrying too much excess fat in the abdomen, but have loose skin after pregnancy or after losing a large amount of weight

•

Finished with childbearing

•

Close to ideal body weight

WORST CANDIDATES: •

Those who may get pregnant again in the future

TYPE OF PROVIDER TO LOOK FOR: Board-certified cosmetic or plastic surgeon AVERAGE COST:

$3,000*

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ASK THE EXPERT

LESLIE V. COHEN, MD, FACS 9900 Independence Park Drive | Suite 110 | Richmond, VA 23233 c 804.288.2800 | w www.lesliecohenmd.com

I need to lose a lot of weight to improve my health. What can I do to help prevent excess sagging skin from developing? Losing extra weight is great for your overall health, yet sagging skin after extensive weight loss can be a problem for both men and women. The amount of excess skin is largely determined by genetics, the amount of weight lost and the age and condition of your skin. Although we cannot usually prevent skin from sagging, the good news is there are treatment options available to help solve this problem and complete the rejuvenation of your body. Generally, the best treatment for removing a large amount of excess skin is a body contouring surgical procedure. Skin tightening lasers may be useful when the laxity or looseness of the skin is mild. We do caution against investing in expensive creams or gels that may promise to alleviate excess skin. To date, there is no research showing these products effectively work, and they can lead to disappointment and wasted dollars. Body contouring surgical procedures that address excess sagging skin following significant weight loss include face lifts, breast lifts, tummy tucks, arm lifts, lower body lifts, and thigh lifts. These procedures not only permanently remove excess skin, but also tighten underlying tissue and muscle to reveal the leaner body you have worked hard to achieve. As a board certified plastic surgeon skilled in using the safest and most effective techniques and state-of-the-art technology, we develop a personalized treatment plan to help each patient achieve his or her desired goal. Congratulations on improving your overall health! Contact us if you have questions and would like to schedule a consultation.

Tummy Tuck

BEFORE

AFTER Face Lift

BEFORE

AFTER Lower Body Lift

BEFORE

AFTER

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Spotlight On: Kate Doss, DDS Virginia Family Dentistry Kate Doss, DDS, has a passion for dentistry and its artistic aspects. She helps patients at Virginia Family Dentistry in Midlothian find their own personal best smiles with both surgical and non-surgical treatments. “My personal esthetic trifecta,” says Dr. Doss, is “first, orthodontics to reposition, align, and perfect the bite. Then, esthaetic crown lengthening if the smile is gummy and teeth are small. Finally, veneers or crowns, if needed, to perfect color, shape, and length of teeth; especially if they are short due to wear from grinding.” Virginia Family Dentistry offers cosmetic dentistry as part of a multi-specialty practice. Along with crown lengthening (gingival contouring), the top three non-surgical treatments they perform are whitening, enamel micro-abrasion and veneers. “Enamel micro-abrasion is a chemical and mechanical process that removes a very thin layer of enamel over imperfections to reduce the appearance of stains and surface irregularities,” adds Dr. Doss.

The Most Effective Ways to Take Years Off Your Face 1. Facelift (Rhytidectomy) WHY IT’S POPULAR: Smooths wrinkles and sagging skin all over the face – on the forehead, eyes, cheeks, jowls and chin. Often performed with a forehead lift and eyelid reshaping (blepharoplasty) for better, more youthful results.

HOW IT’S DONE: •

General anesthesia or IV sedation

•

Tissue is lifted and repositioned through small incisions just behind the hairline. Excess skin is removed, while deep folds are smoothed out and skin is tightened.

BEST CANDIDATES: •

People who want to rejuvenate their face and feel they look older than they are

•

Those who still have supple, elastic skin and a well-defined bone structure

WORST CANDIDATES: •

Those who are overweight

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic or cosmetic surgeon

AVERAGE COST:

$7,448*

2. Non-Surgical “Tweakments” Laser Skin Resurfacing, Fillers and Microdermabrasion WHY THEY’RE POPULAR: Without surgery, they minimize problem areas:

Kate Doss, DDS Dentist at Virginia Family Dentistry

•

Fine lines and wrinkles around or under eyes, forehead and mouth

•

Sun-damaged skin and dark spots

•

Acne or chickenpox scars

•

Birthmarks and freckles

•

Thin lips and hollow cheeks

•

Large pores

•

Skin irregularities and pre-cancerous growths

HOW IT’S DONE:

Did You Know?

The Real Reason You Have Cellulite Cellulite is not “normal” fat. As most women are keenly aware, it’s a formidable opponent that flips the bird at diet or exercise. Appearing on nearly 90 percent of women and 10 percent of men, cellulite forms on both thin and overweight people alike. The issue is in the connective tissue of fibrous strands (collagen septae) under the skin. If the septae isn’t strong or tightly woven, fat cells bulge between the strands and get trapped in the dermal layer, creating the dreaded orange peel effect. The septae in men is thicker, stronger and more closely knit than in women. Genetics, thinner skin, diminishing estrogen levels and hormonal imbalances also play a role.

LASER SKIN RESURFACING – short, concentrated beams of light pulsate against the area of damaged skin to remove one layer at a time. Collagen growth is stimulated to improve the skin’s elasticity.

DERMAL FILLERS – often made from Hyaluronic Acid (HA) which is naturally occurring in the body and moisture-rich, fillers plump lips, cheeks and add definition to the jawline. Brands include Juvederm, Restylane, Radiesse and Voluma.

MICRODERMABRASION – a special tool “sands down” the top layer of skin, essentially refinishing it to give a smooth appearance.

BEST CANDIDATES: •

People who want to rejuvenate their face, look younger and aren’t ready yet to “go under the knife.”

•

Those who know non-surgical options are temporary, requiring repeat treatments

WORST CANDIDATES: •

LASER THERAPY – those with acne, deep wrinkles, excessive skin or very dark skin

•

DERMAL FILLERS – those who may be allergic to any of the components in the fillers, or if pregnant or breastfeeding

• MICRODERMABRASION – people who develop rashes or suffer from cold sores, or have acne or very dark skin

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic, cosmetic or dermatologic surgeon, or nurse practitioner

AVERAGE COST:

Ablative Laser Therapy – $2,124*

Dermal Fillers – $450 – $750* per syringe. (Some procedures only need one syringe but most patients need several.) Microdermabrasion – $1,170*

3. Gingival Contouring – the “Gummy” Smile Fix WHY IT’S POPULAR: Enhances the smile, shows more teeth and makes the mouth more proportionate and comfortable

HOW IT’S DONE: •

Local anesthetic

•

Using a laser (most often) or cutting tool, excess gum tissue is removed and sculpted to lengthen the crown of the tooth and expose more of the enamel. Bone is sometimes removed if necessary.

BEST CANDIDATES: •

Those with thick, puffy gums or smiles that show more gum than teeth.

•

People with asymmetric, uneven gums

WORST CANDIDATES: •

Those with poor oral hygiene and periodontal disease

TYPE OF PROVIDER TO LOOK FOR: Cosmetic dentist, periodontist or oral surgeon AVERAGE COST: $300 –

$3,000

(depending on how much gum tissue needs to be contoured)

The

Treatments that Help Your

Skin & Hair Glow

1. Cellulite Treatment – Cellfina WHY IT’S POPULAR: Smooths out dimpling on thighs and buttocks up to three years HOW IT’S DONE: •

Local anesthesia and minimally invasive

•

A small, needle-size incision under the skin releases the tight bands of connective tissue that are trapping the bulging fat cells. Once released from this tension, the skin appears smooth.

BEST CANDIDATES: •

People who are a healthy weight but want to reduce cellulite

•

Those who know treatments won’t completely eliminate cellulite

WORST CANDIDATES: •

Those who are significantly overweight

•

Those who are trying to eliminate fat, not cellulite

•

Those who have excessive varicose veins or other vein-related illnesses

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic, cosmetic or dermatologic surgeon, or a licensed physician working under the supervision of a board-certified plastic surgeon

AVERAGE COST: $3,500 –

$6,500*

depending on the size and number of dimples

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Community Care Connection How to Find a Surgeon: Choosing a surgeon and a facility is one of the most important decisions to make if you’re considering cosmetic surgery. Go beyond Google reviews and even HealthGrades to really vet your doctors. Look for board certifications and accredited hospitals. The American Board of Plastic Surgery (ABPS) is part of the American Board of Medical Specialties (ABMS). www.abplasticsurgery.org

2. Scar Revision WHY IT’S POPULAR: Although no revision technique can completely erase scars, revision minimizes scars anywhere on the body where they are conspicuous, bothersome or disfiguring.

HOW IT’S DONE: •

Local anesthesia for minimally invasive procedures

•

General anesthesia for surgical revision requiring advanced wound closure techniques

BEST CANDIDATES: •

People of any age

•

Those with scars that are painful, itchy or preventing a joint from moving properly

WORST CANDIDATES: •

Those who have acne or other infections in the area to be treated

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic, cosmetic or

The American Society of Plastic Surgeons (ASPS) members are certified by the American Board of Plastic Surgery and is a terrific resource for consumer information. www.plasticsurgery.org

dermatologic surgeon

The American Board of Cosmetic Surgery (ABCS) offers a helpful checklist to consumers to vet cosmetic surgeons. www.americanboardcosmeticsurgery.org

WHY IT’S POPULAR:

Who to Check Out in Richmond for a Gorgeous New Smile:

AVERAGE COST:

3. Hair Restoration Restores a balding or thinning scalp with transplanted hair from an area of thick growth and becomes permanent. This procedure helps the two-thirds of all men and one-fifth of all women suffering from hair loss to bypass the hereditary and/ or hormonal factors that cause it.

HOW IT’S DONE: •

Local anesthesia with sedation

•

Small pieces of hair-bearing scalp are removed from a donor site and grafted to a bald or thinning area of the scalp.

Virginia Family Dentistry offers cosmetic dentistry at all 12 of their locations. The more popular treatments include teeth whitening, bonding, veneers and gum recontouring.

BEST CANDIDATES:

Virginia Family Dentistry Kate Doss, DDS 6510 Harbour View Court 804.739.6500 | Midlothian www.vadentist.com

$500 – $3,000*

depending on the size and complexity of the procedure

•

Candidates with a healthy growth of hair at the back and sides of the head to serve as ‘donor areas.’

•

People who know that sometimes two or more techniques are used together, or treatments repeated, to achieve the best result

WORST CANDIDATES: •

Those who are completely bald

•

People who take medicines or have medical illnesses that cause hair loss

TYPE OF PROVIDER TO LOOK FOR: Board-certified plastic, cosmetic or dermatologic surgeon

$6,000 $15,000

– * depending on how many grafts are placed * 2017 costs published by the American Association of Plastic Surgery AVERAGE COST:

Did You Know? You can acquire new dimples in about 30 minutes If you think you’d be cuter with dimples, you may be right. Performed as an outpatient procedure, a “dimpleplasty” costs between $2,000 and $5,000. And, when done right, it makes you undeniably adorable.

With these and any other cosmetic procedure, it’s important to be as healthy as possible when undergoing treatment. People who have the best outcomes share the following factors:

A B C D

As close to ideal weight as possible Non-smoker (Smoking causes spasms of the small blood vessels needed for normal blood circulation and healing afterward.) Free of illnesses that can impair healing Positive outlook with stable mental health and realistic expectations

Where Should You Start? Cosmetic surgeries and minimally invasive treatments are medical procedures that carry risks, and they’re also an art form. Know who’s a DaVinci and who’s a Picasso during his Surrealism phase: •

The doctor you choose should have plenty of ‘before-and-after’ photos. Start there and don’t be afraid to ask for more. Because results are everything, you’ll want a skilled physician who consistently produces many quality results.

•

Do extensive research on any treatment and doctor you are considering. Confirm whether your surgeon is board-certified by searching on the American Society of Plastic Surgeons (ASPS) website.

•

Use a physician with extensive knowledge of facial anatomy and structure when having even non-invasive procedures done. For instance, you may know you want a filler, but do you know the best kind to get? They’re all different and not created equal. Know your stuff before they put it in your face.

Arming yourself with knowledge will give you the safest, most optimal (a.k.a. natural) results. With laser advancements, new techniques and the boom in effective anti-aging procedures, cosmetic procedures are safer, quicker and more effective than ever before. EXPERT CONTRIBUTORS Kate Doss, DDS, is a dentist with Virginia Family Dentistry in Midlothian Danny Shaban, MD is the Medical Director with Dominion Women’s Health & Wellness Med Spa, Richmond

Spotlight On: Dominion Women’s Health & Wellness Med Spa Dominion Women’s Health & Wellness Med Spa in Richmond offers SculpSure and other non-invasive laser and skin treatments including chemical peels, fillers and injectables, microdermabrasion and microneedling (the insertion of very fine, short needles into the top layer of the skin to stimulate collagen growth. SculpSure is an FDA-cleared, laser-based treatment that uses specific wavelengths and heat to eliminate fat cells. It’s cleared for use on the outer thighs, and upper and lower abdominal areas. According to Danny Shaban, MD, Medical Director at Dominion Women’s Health & Wellness Med Spa, the 25-minute procedure destroys up to 24 percent of fat cells in the treated area. Even better, multiple areas can be treated at the same time. Danny Shaban, MD Medical Director at Dominion Women’s Health & Wellness Med Spa

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Spring Cleaning Better Health WHAT YOU SHOULDN’T

SWEEP UNDER THE RUG words | KATHARINE PALJUG

No matter how tidy you are, some spots in your home

always attract bacteria, fungus, mold, pet dander and more. These microorganisms and allergens can impact your breathing, sleep and overall health. The start of spring is the ideal time for a thorough cleaning of areas in and around your home and other places that you may not always have on your “To-Do” list.

www.OurHealthRichmond.com

BATHROOM TOWELS:

Towels are often homes for Staphylococcus bacteria, which causes staph infections. Bathroom humidity keeps towels damp, breeding mold and fungus that can exacerbate allergies, asthma, and COPD. Towels shared by multiple people, such as hand towels, get especially dirty.

How to Clean: Wash every three to seven days, and add bleach or white vinegar to kill even more bacteria. Eliminate as much air moisture as possible.

TOOTHBRUSH HOLDER:

Toothbrushes transfer saliva and bacteria from your mouth, hands and bathroom surfaces. (On more than a quarter of toothbrush holders, this includes Salmonella and E. coli bacteria.) Damp holders are also a breeding ground for mold and fungus, which end up on your toothbrush, hands and mouth.

How to Clean: Put toothbrush holders in the dishwasher every week, or scrub by hand and rinse with hot water.

» BONUS TIP:

Every time you flush the toilet, contaminants such as fecal matter and bacteria fly out. Close the lid before flushing to keep those germs contained.

KITCHEN COFFEE MAKER:

Nearly half of coffee makers have yeast and mold in them. “These allergens can lead to nasal congestion, sneezing and coughing,” says Cralle. They can also cause skin irritation, along with exacerbating allergies and asthma.

SPONGES:

Bacteria and mold grow on sponges, especially if they get reused frequently.

How to Clean: Instead of a sponge, use cleaning cloths that you wash after every use. If you use a sponge, replace with a new one every week. (This applies to kitchen sponges too!) Terry Cralle, RN

Certified professional in healthcare quality and sleep educator in Richmond.

“Dust mites and mold thrive in a humid environment,” says Terry Cralle, RN, a certified professional in healthcare quality and sleep educator in the Richmond area. “Use bathroom exhaust fans and dehumidifiers to keep dampness at a minimum.”

REFRIGERATOR DRAWERS:

Mold, yeast, Salmonella and E. coli often live in refrigerator drawers. Food packaging, raw meats, and vegetables from grocery store bins transfer these allergens and germs to your home, where they multiply in the humid interior of a refrigerator.

How to Clean:

Once a week, put all the removable parts of your coffee maker in the dishwasher. Anything that can’t go in the dishwasher should be wiped down with soap and hot water.

Clean refrigerator drawers once a month, either in the dishwasher or by hand with soap and hot water. Wipe with white vinegar to kill bacteria, mold and yeast.

BONUS TIP: Instead of throwing away baking soda away when it’s finished its 30-day stint in your fridge, dump it down the garbage disposal with running water. It will keep your disposal fresh too! 46

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BEDROOM MATTRESSES:

“Dust mites like to live in mattresses because their only diet is human dead skin cells,” says Elaine Turner, MD, an allergist with Allergy Partners of Richmond. “Since we spend eight hours in one place over our mattress every day, that’s where the dust mites like to stay.” This can be especially irritating if you have allergies, asthma or breathing difficulties like COPD.

How to Clean: Vacuum both sides of your mattress at least twice a year. Pay special attention to edges and crevices, where dust and dead skin get trapped. Use a mattress protector to keep dust mites out. “The fabric has to be a very tight weave because dust mites are so small,” says Dr. Turner. “Protectors go around the whole mattress or box spring and zipper shut.” They can be washed with your sheets.

PILLOWS:

“People constantly shed skin, saliva and hair,” says Cralle. “These get trapped in your pillows, along with dust, pollen, pet dander, fungi and mites, causing stuffy noses and aggravating asthma, which will interfere with sleep.”

How to Clean: Launder pillows at least

twice a year in water that is at least 140° F to kill bacteria and mites. As with your mattress, use machine-washable pillow protectors.

STUFFED ANIMALS:

Well-loved stuffed animals are magnets for dust, mites and bacteria, especially when kids are sick.

How to Clean: Stuffed animals should

be laundered at least once a month and after every illness. To kill more bacteria and viruses, add white vinegar to the rinse cycle.

BONUS TIP: Pets carry dust, bacteria and dirt around, along with shedding dander. “Consider keeping pets off of the bed or out of the bedroom entirely,” says Cralle, especially if you have allergies or trouble sleeping. www.OurHealthRichmond.com

LIVING ROOM REMOTES:

Everyone in the family touches the TV remotes, covering them in food, bacteria and other particles. Many have yeast, mold and Staphylococcus bacteria growing on them.

How to Clean: Use a light cleaner and cloth to wipe them down weekly, or daily if anyone is sick.

Elaine Turner, MD

Board certified allergist with Allergy Partners of Richmond.

RUGS AND CARPETS:

COMPUTERS:

How to Clean:

Vacuum at least once a week using a vacuum cleaner equipped with a High Efficiency Particulate Air (HEPA) filter. Shake rugs outside every season. Rugs and carpets should be cleaned yearly with a professional-grade steam cleaner.

Dust computers every week using antibacterial wipes or a damp cleaning cloth with white vinegar to kill bacteria. Vacuum keyboard surfaces weekly or monthly; vacuum inside if the keyboard opens.

“It is better to have hardwood floors than carpeting because it is practically impossible to get mold and mites out of carpet,” says Dr. Turner. They also trap dust, mud, fungus, pet dander and food. All of these cause poor air quality, exacerbate allergies and breathing problems and expose you to germs.

“It is better to have hardwood floors than carpeting because it is practically impossible to get mold and mites out of carpet,” says Dr. Turner.

The average desktop computer has 400 times more bacteria than a toilet seat. These are transferred from your hands, usually after you touch your nose or mouth, or from eating while using the computer. Computers also collect dust, pollen and animal dander.

BONUS TIP: Take shoes off before coming inside! You’ll avoid tracking in mud, pollen, animal feces, and other particles.

Expert Contributors For more information about possible allergens and how they are affecting us now more than ever, don’t miss our ALLERGY, ASTHMA AND IMMUNOLOGY

SPECIALTY SPOTLIGHT

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PAGE

Terry Cralle, RN is a certified professional in healthcare quality and sleep educator in Richmond. Elaine Turner, MD is a board certified allergist with Allergy Partners of Richmond.

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Understanding the

asi s of eveloping Your Baby’s Brain words | SUSAN DUBUQUE

Kissing your baby’s fingers and toes. Singing “Itsy Bitsy Spider.” Counting the bananas and oranges in the grocery cart. Playing peek-a-boo. Sharing a book and talking about the pictures. It’s natural to do sweet and silly things with babies. We coo and babble. Sing and make funny faces. Chatter about the most mundane happening around us. And babies love it. They laugh and respond, and reward us with bright eyes and smiles. But did you know that these activities can have a lasting and positive effect on a child’s development? What may seem like simple, enjoyable interactions actually help develop a baby’s cognitive ability. Babies’ brains are amazing and complex. From birth to age three, the brain develops rapidly — generating more than a million neural connections per second. In fact, 80 percent of a child’s brain growth happens by age three. As a parent, grandparent, or caregiver, what can you do to give an infant or toddler a strong start in life?

Just Follow the Basics

80% Eighty percent of a child’s brain growth happens during the first three years of life.

The Basics™ are five fun, simple and powerful ways that we can help all children — from birth to age three — grow to be happy and smart. The best part is that no special equipment is required, you can do all these activities at home or wherever you happen to be, and it is free. So let’s get started and learn the Basics.

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Maximize Love, Manage Stress Babies and toddlers thrive when their world feels loving, safe, and predictable. Respond with smiles, words, and touch to help them see, hear, and feel your love. You will help them develop a sense of security and self-control.

Infants

ba P lo by rov vi w id ng ith e y an att lot ou d en s o r to tio f uc n h.

(0-12 months) HOLD, KISS, AND CUDDLE

Provide your baby with lots of loving attention and touch. Babies donâ&#x20AC;&#x2122;t get spoiled, so there is no need to hold back on showing love.

(12-36 months) SNUGGLE UP

Regularly hug and cuddle your toddler to help them feel safe and loved. And, remember that boys need just as much love as girls do.

TALK ABOUT FEELINGS

Your infant depends on you to meet their needs. Watch and listen for clues about how they feel and what they need. For example, a cry or whimper may mean that they are hungry or hot.

Teach your toddler to name their feelings. This will help them understand and express emotions. Let them know that all feelings are OK, and that you are there for them when they are happy or upset.

TAKE CARE OF YOURSELF

HAVE A ROUTINE

RESPOND TO THEM

Stress is normal, but too much stress is bad for a babyâ&#x20AC;&#x2122;s brain. Things that cause stress for an infant are loud noises, adults who seem upset or angry, or when adults do not respond to their needs.

Toddlers

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Have consistent times and ways of doing activities like feeding, bathing, reading, and bedtime. Your child will have an easier time with activity transitions when they know what to expect.

Talk, Sing, and Point Babies are learning language from the moment they are born. At first, to a newborn baby, speech is just sound. Then, day by day, they learn that the sounds have meaning. It doesn’t matter what language you speak with your infant. All languages are equally beneficial.

Infants

Toddlers

USE A PLAYFUL VOICE

DESCRIBE LIFE

(12-36 months)

Smile and look into your baby’s eyes. Talk with a gentle, playful voice. Exaggerate the sounds of the words.

Talk about the things you’re doing and what is going on around you.

USE REAL WORDS

The more specific you can be with words, the more your child will learn.

Don’t just use “baby talk,” also use real words.

GO BACK AND FORTH

When your baby makes a sound, show excitement on your face and in your voice.

POINT TO OBJECTS

BE SPECIFIC

LISTEN AND RESPOND

Listen to your toddler’s questions and answer them. Have a conversation.

ASK QUESTIONS

Point to objects and name them— especially the things that seem to interest your baby.

Get your toddler thinking. Have them explain what they are doing or what they think is going to happen. You may get some funny answers!

SING

SING AND RECITE

Sing songs to your baby. This is a fun way for them to learn language.

Si n an g s d on n re g rh urs cite s ym er es y .

(0-12 months)

Sing songs and recite nursery rhymes. Choose ones you remember from your own childhood, read in books, or make up new ones.

Count, Group, and Compare Every child’s brain is wired for math. Talk about numbers, shapes, patterns, and comparisons as you go about your routines together. Watch your child learn to love math.

Infants

Toddlers

PLAY MUSIC

COUNT

Play gentle music or sing when you are together. This is a fun and easy way to expose your child to rhythm and patterns. Lots of nursery rhymes and children’s songs involve counting!

COUNT OBJECTS

Count groups of things, starting with small numbers. Count your child’s toes or pieces of fruit. Infants learn through all of their senses, so hold objects up for your child to see and touch. “Look, there’s one…two bananas.”

COMPARE

Provide opportunities for your child to touch and explore things that are the same and different. For example, let your baby shake things that make different sounds, or touch fabrics with different textures. Talk about how they are similar or different.

(12-36 months) Count with your toddler. Move to bigger numbers as they get the hang of it.

ADD AND SUBTRACT

Explore what happens when you add or take away items from a group. “You have three crackers. How many will you have if you eat one?”

LOOK FOR SHAPES

C ou nt sm sta o gr al rti f th oup l n ng in s um w gs be ith , rs .

(0-12 months)

Point out shapes and describe them to your child. See if they can find shapes. “The clock is a circle. Do you see any other circles?” This is a great way to pass the time when you are doing errands.

COMPARE SIZES AND AMOUNTS

For example, describe things as “large, small, light,” or “heavy.” Ask your child which objects are larger or smaller.

Explore through Movement and Play Babies are like scientists who love making discoveries. Watch to see what interests your child, then encourage their curiosity and help them learn when they play and explore.

Infants

Toddlers

DO TUMMY TIME

FOLLOW THEM

To le dd ex arn ler pe a s rim lo t en by tin g.

(0-12 months) Give your infant regular “tummy time.” When they lift their head to look around, they strengthen the upper body and prepare muscles to crawl.

PLAY PEEK-A-BOO

HELP THEM BUILD

GIVE THINGS TO HANDLE

MAKE ART

Provide objects of different colors, shapes, and textures to play with. Handling objects helps with hand-eye coordination and motor skills.

Drawing is a good way to exercise little hands and be creative. Put out some crayons and paper. Your child can also experiment with tearing and folding the paper.

SUPPORT DISCOVERY

ROLL A BALL

Use blocks to build a tower. How high can you go? What happens when you knock it over?

Roll a ball or a bottle back and forth to develop coordination and teach about cause and effect.

Read and Discuss Stories Reading turns kids into confident thinkers. Make books a regular part of your relationship from the very beginning. With infants, point at the pictures and speak with excitement. With toddlers, just make it fun.

Infants

Toddlers

READ REGULARLY

COMMIT TO READ EVERY DAY

(0-12 months) Make book time part of your baby’s daily routine. What is important is that they hear your words, see the pictures, and start to develop positive feelings about books and reading time.

Y w ou m ill l r to d os ea dd yo iscu t if rn t ler u ss yo he re io u ad ns ha . w ve hi le

Toddlers learn a lot by experimenting. If your child looks like they are concentrating on something, like pouring water in the bath, stand back for a moment and let them problem-solve for themselves.

This game teaches infants that objects (and people) exist even when hidden. It’s also a fun way to bond with your child.

Your infant discovers how the world works by experimenting. They also learn through repetition, so they might drop a spoon over and over to see what happens.

KEEP IT SIMPLE

If you can, choose books that are sturdy, short, and have simple, colorful pictures. Use an exaggerated voice to make it more fun and interesting!

SNUGGLE UP

Hold your child in your lap as you read so they can see the pictures and feel cozy.

DESCRIBE THE PICTURES

Point to the page and describe what is happening in the pictures. Talk about the colors, shapes, and what the characters are doing.

ACTIVELY INVOLVE THEM

As your baby develops coordination, involve them more in the reading experience. Let them hold the book or turn the pages.

(12-36 months)

(12-36 months) Try to set aside 15 minutes every day to read together. Get books from your local library

WARM UP

Before you open the book, check out the cover. Read the title. Look at the picture. Ask your child what she thinks the book might be about.

READ AND DISCUSS

Your toddler will learn the most if you have discussions while you read. Ask questions and respond to their comments and questions about the story and the pictures.

DON’T BE TOO SERIOUS

Make it fun! Your toddler may want to turn the page before you’ve finished it. If they can’t sit still for the whole book, that’s okay.

SET A GREAT EXAMPLE

If toddlers see grownups reading and know that they enjoy it, they will learn that reading is a fun and important part of life.

“RVA Basics is making this program available to anyone who cares about the growth and development of children,” says Amy Bartilotti, coordinator for the Office of Family and Community Engagement for Chesterfield County Public Schools, and the individual responsible for bringing the Basics to Central Virginia. “There are videos for each of the five principles and helpful guides for families, as well as videos for healthcare professionals and implementation guides for any organization that wishes to use the program.”

Families Resources | RVA.theBasics.org Professional Resources | www.theBasics.org

Where the Basics Began Ronald Ferguson, PhD, an economist, recognized that lifelong emotional, educational, physical, and economic well-being is dependent upon a solid foundation of early cognitive development. In his role as director of the Achievement Gap Initiative at Harvard, with support from the Black Philanthropy Fund and input from the Department of Pediatrics at Boston Medical Center, Dr. Ferguson founded the Boston Basics in September 2016. The campaign has spread to more than 30 locations around the country and was launched in Richmond as RVA Basics on May 3, 2018, at a reception at The Children’s Museum.

“Learning begins the moment your child is born. Every child has a vast potential for success. And the first three years have the greatest impact on your child’s learning.”

– Ronald Ferguson, PhD

Continued on page 57...

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Here are suggested books that support each of the Basics principles: Maximize Love, Manage Stress •

Always by Emma Dodd

•

I Love You Like a Pig by Mac Barnett

•

I Just Want to Say Good Night by Rachel Isadora

This Story Is for You by Greg Pizzoli •

Where’s Bunny? by Theo Heras

Talk, Sing, and Point •

Every Little Thing by Cedella Marley

•

Little Chickies = Los Pollitos by Susie Jaramillo (boardbook)

Little Blue Truck by Alice Schertle •

Mama, Look! by Patricia Murphy

•

The Library Book by Tom Chapin and Michael Mark

Count, Group, and Compare •

Ducks Away by Mem Fox

•

Weather Girls by Aki

Goodnight Numbers by Danica McKellar •

Why Am I Me? By Paige Britt

•

Grandma’s Tiny House by JaNay Brown-Wood

Explore through Movement and Play •

Leo Loves Baby Time by Anna McQuinn

•

I Got the Rhythm by Connie Schofield-Morrison

•

Dig In! by Andy Jenson-Elliott

Beautiful by Stacy McAnulty •

Tap to Play by Salina Yoon

Read and Discuss Stories •

Another Way to Climb a Tree by Liz Garton Scanlon

•

Brave by Stacy McAnulty

Llama Llama Loves to Read by Anna Dewdney •

How to Find an Elephant by Kate Banks

•

We’re All Wonders by R. J. Palacio Scan the QR provided for even more books that support each of the Basics principles.

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continued from page 55...

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“When I first heard Dr. Ferguson speak at Harvard, I was blown away by his research and I really felt called to bring this to others,” says Bartilotti. “We know that not everyone comes to school ready to learn. I’ve spent most of my career working to close the gaps that exist for some of our students, but his work really spoke to preventing it.”

But Bartilotti knew that she couldn’t do it alone. Meg Pienkowski, PhD, director of strategic engagement and evaluation for Smart Beginnings of Greater Richmond, soon joined Bartilotti in building a community-wide coalition of organizations who share a commitment to early childhood development.

Off to a Good Start As trusted advisors to expectant and new parents, healthcare providers are well suited to share the Basics principles. And it’s never too early to start the conversation.

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“Our goal is to saturate the entire community with information about the Basics,” remarks Dr. Pienkowski. “We’re inviting any individual or group that touches parents, grandparents, or caregivers to join the program — including healthcare, educational, and human service organizations, as well as businesses and faith communities.”

“Virginia Premier places special emphasis on ensuring healthy pregnancies and early childhood development,” says Carol Wilson, director of disease management with the managed care organization. “The principles of the Basics are fundamental to a baby’s growth and tie in beautifully with our own Healthy Heartbeats and Watch Me Grow programs.” Virginia Premier plans on implementing the Basics across the state. “We are thrilled to be providing parents with information from a new and exciting program called the ‘Basics,’ in conjunction with our initiative around safe sleep. All parents who choose to receive a Baby Box at the time of their newborn’s delivery will also receive information in their box on the Basics program and how to participate. We love empowering new families to give their child the best possible start to life,” says Tiffany Kimbrough, MD, pediatrician at Children’s Hospital of Richmond at VCU and medical director of the newborn nursery at VCU Health.

“We’re reaching out to provide health education, wellness, prevention, and service coordination to residents of Richmond’s East End through the new VCU Health Hub,” says Sheryl Garland, chief of health impact for VCU Health. “It’s exciting to explore opportunities to work with our community partners to introduce the Basics as a valuable and supportive service for children and families of this neighborhood.”

– Alina Betts

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“I can see my baby responding and reacting to the Basics activities we do with him every day. My husband, Mathew, and I sometimes laugh at how silly we sound making up songs about socks or narrating a walk to the mailbox, but I can tell he’s taking it all in. I love feeding his curiosity, and best of all, seeing his little toothless smile.”

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In addition to educational systems, libraries, and healthcare providers, many other community groups are joining RVA Basics, including organizations that serve children with special needs. “The Basics are exactly what our therapists use with all of our families,” says Cara Coffman, director of Infant and Child Development Services at the Greater Richmond ARC. “We enthusiastically support the Basics, as these principles are critical to a young child’s development. We are eager for all parents to know about this program.”

Mother-Approved The beauty of the Basics is its ease and simplicity. You can make the Basics part of your everyday activities.

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“As a working mom of a 5-month-old, I usually have less than an hour of time with my baby after work before he’s ready for bed,” comments Alina Betts, a Richmond area resident. “I think the Basics are really smart ways to fill this time. The singing, dancing, playing, reading, and chatting we do are all such fun ways to bond with him, but knowing even that short amount of time is helping him developmentally makes me feel like I’m getting my ‘mom job’ done, too.”

Join the Basics Families are welcome to visit rva.thebasics.org for videos, handouts, and guides on using the Basics with infants and toddlers. Healthcare providers, schools, faith communities, daycare centers, social service organizations, or any other individual or group who is committed to giving every baby a strong and healthy start, are welcome to join RVA Basics. Contact Meg Pienkowski at meg.pienkowski@smartbeginningsrva.org to learn more. The Basics materials are available in both English and Spanish.

SPECIAL THANKS to Silvia Ramos, director of The Chattanooga Basics, and Lee Hope, head of children’s service, Chattanooga Public Library, for contributing tips for implementing the Basics principle and the recommended book list. The Basics was created by the Achievement Gap Initiative at Harvard University for use by The Basics, Inc., a nonprofit organization, and local campaigns in the Basics Learning Network. © 2018 President and Fellows of Harvard College

Ronald Ferguson, PhD Director of the Achievement Gap Initiative at Harvard and founder of RVA Basics

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Are You an Anti-Vaxxer When It Comes to Your words | JENNIFER LAMONT

Furbaby?

Ever since Louis Pasteur hesitantly – but successfully – injected a 9-year-old boy named Joseph with the first rabies vaccine in 1885, it has saved millions of people around the world. The boy had been mauled by a rabid dog that, at the time, was a death sentence. He survived, thanks to Pasteur and his partner, Emile Roux, who helped develop the vaccine. There are still occasional deaths, even today. On January 4, 2019, the Centers for Disease Control and Prevention (CDC) confirmed the cause of death in 2017 for a Virginia woman was rabies. She had been bitten by a rabid puppy while traveling overseas and hadn’t gotten vaccinated against the disease. But these cases are rare. The World Health Organization estimates the vaccine saves more than 250,000 people each year. As advancements in science and technology change the landscape of healthcare each day for humans, pet medicine follows alongside on a parallel path. Advances in science have made it possible to almost eradicate diseases like canine distemper, which only has a 20 percent survival rate. On the other hand, diseases that were once rare or even eradicated are impacting pet populations again – and differently than in years past. In 2017, the River City Veterinary Hospital in Richmond reported three confirmed cases of leptospirosis, a dangerous bacterial disease that once only infected dogs in rural areas. Now, it’s showing up in suburban areas and can be easily transmitted to humans. The vaccine for leptospirosis isn’t considered a core vaccine but many vets, in the face of increasing cases, are recommending it in addition to the core vaccines.

Vaccinations Save Lives

Do you know if your pet is getting under or over vaccinated? While most vets follow science-based guidelines like those published by the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP), some may not. Research the guidelines so you know.

Even though vaccines save both pet and human lives, there is almost as much controversy surrounding our pet’s immunizations as there is surrounding vaccines for humans. Even pet owners who are pro-vaccination want to make sure their pets are not getting too many vaccines because of possible dangerous side effects. But here’s the thing: there are risks if pet owners vaccinate. There are also risks if they don’t. Like parents of human children, pet owners can stay informed using evidence-based research and input from trusted veterinarians. www.OurHealthRichmond.com

Are the fears unfounded? Or, are pet owners right to worry about the vaccines their pets are getting? Understanding what’s occurring when your pet gets vaccinated – or not – can help pet parents make informed decisions.

Core Vaccines for Cats

Is your pet getting vaccinated too often?

» Rabies » Feline Viral Rhinotracheitis (Herpes Virus) » Panleukopenia (Feline Distemper) » Calicivirus

Core Vaccines for Dogs » Rabies » Canine Distemper Virus » Canine Adenovirus Type 2 » Canine Parvovirus Type 2

Some vets think so. Many do not. Talk to your veterinarian and check the recommended schedules published by the AAHA and AAFP to see what minimum recommended doses are for your pet. Core vaccines, like canine parvovirus, distemper and feline panleukopenia, are advised regardless of circumstances. These prevent severe, lifethreatening diseases that are universal threats. There are certain vaccines that new studies have shown to be effective for much longer than originally thought, and many vets are taking this into consideration. For example, new research shows that parvo and distemper give immunity for some dogs for at least five years. For other dogs, immunity can last a lifetime. So, individual dogs will respond to vaccines differently. Because of that, vets want to err on the side of caution without causing harm to the animal.

Vets also determine what other vaccines are needed based on the pet’s location and activities. If your Golden Retriever is frequently outdoors and may come into contact with wildlife, it will need core vaccines, plus others which won’t be necessary for a Yorkie that doesn’t leave his condo in the city.

What happens when you don’t vaccinate your pets? As with humans, herd immunity develops when enough of a population has been vaccinated against a particular disease. So, vaccinating your pet doesn’t only protect your beloved pet, but also protects the community as a whole. When enough are vaccinated, it prevents the disease from gaining a foothold in the community.

What is Herd Immunity? Herd immunity is a form of immunity that occurs when the vaccination of a significant portion of a population (or herd) provides a measure of protection for individuals who have not developed immunity.

When there is a lack of herd immunity, however, diseases like canine distemper start showing up more frequently in animals. It’s no different from the new cases of smallpox showing up in humans in recent years. This was a deadly disease the World Health Organization once deemed completely eradicated, but is making a comeback, along with measles. Did you know? Even if your pet stays indoors, it needs protection. A pet’s geolocation, environment and circumstances influence what types of protection it needs but some diseases are highly contagious, and transferable to you. Although immunizing your pet is up to you, except in the case of rabies, there are direct risks to your pet with all vaccines. But the risks are minimal, while vaccines have saved millions of pet lives. Without vaccination, the risks are much greater to your pet, you and the community at large.

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SOURCES The American Animal Hospital Association – www.aaha.org The Associated Press – www.apnews.com The National Center for Biotechnology Information – www.ncbi.nlm.nih.gov World Health Organization www.who.int/rabies/en

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Specialty Spotlight

March is Colon Cancer Awareness Month

GASTROENTEROLOGY

COLONOSCOPIES: Not So Strange and Scary After All words | KATHARINE PALJUG

If you’re over 50, your doctor likely has mentioned a colonoscopy. But have you followed through and scheduled one? A colonoscopy screens the rectum and large intestine, or colon, for abnormal growths. It’s a standard procedure that doctors recommend, but many adults still hesitate to get. “For some people, they’re worried about how they prepare for it,” says Alex Seamon, MD, a gastroenterologist with Gastrointestinal Specialists, Inc. in Richmond. “Some people, the biggest problem is the privacy, being uncomfortable with that. And some people worry about the risks.” “There is also the fear that it will be painful,” says Howard Haverty, MD, who practices at Richmond Gastroenterology Associates.

Patients worried about risks of colonoscopies or unsure what the procedure involves are less likely to get a it done. But when you strip away the myths surrounding colonoscopies, they’re a simple, life-saving procedure — not so weird or scary after all.

Myth #1 You’ll Have Diarrhea the Day Before The prep for a colonoscopy is easier than you might imagine. “The day before the test can be relatively normal for most people,” says Dr. Seamon. “We recommend eating light meals, then before the test, patients “The day before drink two separate amounts of fluid to flush the colon. Within a couple hours they start to have bowel movements. You drink one the test can be part of the fluid, then you get a break, then you drink the second relatively normal round of fluid a few hours later.” for most people.” Patients having a morning procedure can prep the – Alex Seamon, MD night before, then consume only liquids until the colonoscopy is done. For an afternoon procedure, many people have a normal morning, then start preparing before lunch. “There’s no diarrhea, you’re not going to be up all night using the bathroom,” Dr. Seamon says. “And it all happens at home, so by the time you get in for the procedure, you’re empty and ready to go.” Continued on page 66...

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GASTROENTEROLOGY ...continued from page 64

Myth #2 It’s Going to be Awkward and Uncomfortable Getting a colonoscopy is no more awkward than a visit to the dentist — and for many people, less uncomfortable than having their teeth cleaned. “Patients should expect privacy, confidentiality, and professionalism,” says Dr. Haverty. After checking in, you can expect to meet the team who will be taking care of you, including your anesthesiologist and nurses. You’ll have a private space to change into a gown, and only necessary medical staff will be in the room during the procedure.

“Patients should expect privacy, confidentiality and professionalism.” – Howard Haverty, MD

You’ll be sedated for the colonoscopy, which should eliminate discomfort or awkwardness. During the actual exam, the scope is carefully slid all the way through your colon to check for anything abnormal. If doctors do find anything, they will typically remove it right away so you don’t have to come in for a second procedure.

After you wake up, the team will make sure you’re not feeling any side effects of the anesthesia. Then your doctor will sit down with you to discuss your results and any follow-up steps. “You should expect an explanation for any concerns raised after the exam,” says Dr. Haverty, including, “a post exam summary that is written that includes your results and any expected follow up.”

“The rate of colon cancer is almost five percent. Your lifetime risk for getting colon cancer is much higher than any risk associated with a colonoscopy.”

“It’s a pretty smooth process,” Dr. Seamon says. “And it’s a very private industry. Very respectful and very discreet.”

Myth #3 You Don’t Have Time to Get One A colonoscopy takes about 20 minutes, and most patients need another 15 to 20 minutes to wake up from sedation. Even with time to talk with the doctor afterwards, you’ll probably be out of the office in less than two hours. Afterwards, most people need very little time to recover. “It’s not a surgery with healing wounds or anything like that,” explains Dr. Seamon. “People tend to feel like they’ve had a nice nap.” Due to the sedation, someone else should drive you home, and you should take it easy for the rest of the day. But for most people, a colonoscopy doesn’t require more than 24 hours out of your normal routine. “If you have an afternoon procedure, you can work and do your prep that morning, then take the rest of the day off,” Dr. Seamon says. “There’s no pain afterwards. Most people feel pretty good, pretty normal.”

Myth #4 It’s Too Risky Alex Seamon, MD A gastroenterologist with Gastrointestinal Specialists, Inc. in Richmond.

“Nothing is without any risks,” says Dr. Seamon. “But most people have procedures without any complications.” Some people react to the sedation, either during the procedure or with some sickness afterwards. But that’s uncommon. “Most exams these days are done using CO2 gas, which eliminates the bloated feeling from instillation of air during the exam,” Dr. Haverty notes. If the doctor removes a precancerous growth, called a polyp, there’s a risk of bleeding afterwards. This tends to be minimal and ends quickly. The most serious risk is a tear in the colon from the procedure itself, which can cause pain and further complications. “But that’s really rare,” says Dr. Seamon. “One out of thousands of people.”

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Continued on page 68...

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GASTROENTEROLOGY ...continued from page 66

You’re more likely to develop colon cancer as a result of not having a colonoscopy than to experience complications from having one. “The rate of colon cancer is almost five percent,” says Dr. Seamon. “Your lifetime risk for getting colon cancer is much higher than any risk associated with a colonoscopy.”

Myth #5 You Don’t Need a Colonoscopy if You Feel Fine During many screening tests, doctors are looking for tumors. But colonoscopies find and remove polyps before they develop into cancer. This means that the best time to get a colonoscopy is when you feel perfectly fine — and hopefully, getting one will mean that you continue to stay healthy and free from colon cancer. Dr. Haverty recommends that most patients get colonoscopies by age 50, though some groups with higher risk levels should have them earlier. “If you are over 40 or 45 and African American, you should get your first screening exam then,” explains Dr. Haverty. “Patients with a history of polyps or colon cancer in first degree relatives such as parents or siblings should seek advice from their doctor about early screening.” “Talk to your doctor by age 45, or 50 at the latest,” advises Dr. Seamon. “We’re diagnosing colon cancer in younger and younger patients, so making sure that people at least get them on time is the least we can do.”

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“Patients with a history of polyps or colon cancer in first degree relatives such as parents or siblings should seek advice from their doctor about early screening.”

Howard Haverty, MD A gastroenterologist with Richmond Gastroenterology Associates in RIchmond.

EXPERT CONTRIBUTORS Howard Haverty, MD is a gastroenterologist with Richmond Gastroenterology Associates in Richmond. Alex Seamon, MD is a gastroenterologist with Gastrointestinal Specialists, Inc. in Richmond.

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Specialty Spotlight ALLERGY, ASTHMA AND IMMUNOLOGY

Are Allergies Affecting Us More Now Than Ever? words | KATHARINE PALJUG

There’s a good chance that you have allergies or know someone who does. In the U.S., more than 40 percent of children and 30 percent of adults now suffer from the condition, and it appears this trend is on the rise. “The incidence rate of allergies in people today seems to be increasing,” says Elaine Turner, MD, a board certified allergist with Allergy Partners of Richmond. Medical experts can’t point to exactly why this is the case, but some potential causes may be attributed to excessive hygiene and early antibiotic use. Called “The Hygiene Hypothesis,” it’s when the immune system is not exposed to many infectious agents, and thus doesn’t have the chance to build up an immunity. It looks for something else to do, and allergies may result. While research continues, there’s good news: most environmental allergies can be managed with environmental control, medication and desensitization with allergy shots.

FOOD ALLERGIES Any food can trigger an allergic reaction, but the more common ones are peanuts, tree nuts, eggs, dairy, soy, wheat, “fin” fish and shellfish. “We are seeing more people complaining of food allergies,” says Dr. Turner. “But often people think they are allergic to foods when they are not.” Some people may experience food sensitivity or intolerance, which may make them feel poorly and experience similar symptoms as those associated with allergies. But unless the reaction is caused by immunoglobulin E (IgE) – antibodies produced by the immune system in response to allergies, thus causing an allergic reaction – it’s not.

Food Allergy Symptoms

Hives, as well as swelling around the eyes, lips, hands and feet – a condition called angioedema – may be a sign of an allergic reaction. In more severe cases, the swelling can involve the tongue, back of the throat (causing trouble swallowing) or the larynx (cutting off breathing). This can progress to anaphylaxis where there is also a shock-like state with a rapid heartbeat and low blood pressure. These more severe reactions are considered medical emergencies and should be treated immediately in the emergency room, then followed up with a visit to an allergist.

Elaine Turner, MD A board certified allergist with Allergy Partners of Richmond

“Sometimes people have projectile vomiting shortly after ingestion of food that is occasionally followed by diarrhea,” says Dr. Turner. “When a person comes into our office complaining of abdominal pain, bloating, nausea or diarrhea after most meals, it’s rarely ever determined to be caused by allergies. Gastrointestinal www.OurHealthRichmond.com 69 issues like these should be seen and treated by a gastroenterologist first instead of an allergist.”

ALLERGY, ASTHMA AND IMMUNOLOGY

Diagnosing Food Allergies “Food allergies are assessed with a careful history of the patient followed by skin tests. If some of the skin tests are positive for allergies, a blood test is sometimes ordered afterwards to check for food-specific IgE, or allergic antibodies to foods,” says Dr. Turner. “It is never appropriate to order a screening blood test for a large variety of foods. Skin tests and blood tests for allergies should be done after a certified allergist has taken a thorough account of the patient’s history to determine the right type of tests to administer.” After testing, your doctor may recommend an elimination diet, in which foods are removed from the diet and reintroduced one by one to see if that helps. Some “laboratories” offer screening immunoglobulin G (IgG) blood tests for a large variety of foods. Dr. Turner says these tests have been shown to be inappropriate and unproven. According to the American Academy of Asthma, Allergy and Immunology (AAAAI), a test that claims to be able to diagnose food sensitivities and is commonly available is the food immunoglobulin G (IgG) test. This test, offered by various companies, reports IgG levels to multiple foods (usually 90 to 100 foods with a single panel test), suggesting that removal of foods with high IgG levels can lead to improvement in multiple symptoms. Certain websites even report that changing diets as a result of the IgG test’s results can help with symptoms of irritable bowel syndrome, autism, cystic fibrosis, rheumatoid arthritis and epilepsy. Still, Dr. Turner warns this is not accurate. “It is important to understand that an IgG test has never been scientifically proven to be able to accomplish what it reports to do,” explains Dr. Turner. “The scientific studies that are provided to support the use of this test are often out of date, in non-reputable journals and many have not even used the IgG test in question. The presence of IgG is likely a normal response of the immune system to exposure to food. In fact, higher levels of IgG4 to foods may simply be associated with tolerance to those foods, according to the AAAAI website.”

the amount every 15 minutes under careful supervision, making sure epinephrine and antihistamines are readily available. “This can sometimes allow the patient to safely re-introduce that food into their diet,” Dr. Turner says. “If you have a severe food allergy, especially if there is any angioedema, you should also carry an epinephrine device, such as an EpiPen or an Auvi-Q, in case of an anaphylactic reaction.

The sequence of treatment for an acute allergic reaction should be done in this order:

A Administer epinephrine B Call 9-1-1 C Take Benadryl

“If you need to take epinephrine, you should always go the emergency room,” affirms Dr. Turner. “Don’t take Benadryl first as it takes an hour to work. You need epinephrine that works in 10 minutes if you can’t breathe.”

ENVIRONMENTAL ALLERGIES “Environmental allergies are the most common type of allergies,” says Dr. Turner. “These include pollen, dust mites, mold, animal dander and cockroach.” Synthetic air fresheners and cleaning sprays can also sometimes cause reactions as some contain harsh chemicals that irritate the eyes, throat and nasal passages, though usually not on an allergic basis.

Environmental Allergy Symptoms

Managing Food Allergies The best way to manage a food allergy is by cutting the food that triggers it out of your diet. Sometimes, an allergist may recommend a food challenge in the office where a food is given to the patient in very small amounts and increasing

Runny nose, itchy eyes, throat or ears, sneezing, coughing, wheezing or asthma can all be symptoms of environmental allergies.

The American Academy of Pediatrics (AAP) advises introducing new foods to babies one at a time and watching for allergic reactions. Though the AAP used to recommend delayed introduction of highly allergenic foods, such as peanuts, new guidelines recommend early exposure to reduce food allergies.

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Diagnosing Environmental Allergies Allergists use a skin test to determine if the patient has specific environmental allergies. “Your doctor will prick areas of the skin with different substances and watch for a reaction, which appears in 15 – 20 minutes and looks like a mosquito bite but without the central mark,” says Dr. Turner. “These are sometimes followed by intradermal tests to double-check prick test negatives.”

Cleaning for Dust Mites and Mold Allergies:

Managing Environmental Allergies

People who have dust mite or mold allergies need to go the extra mile when it comes to cleaning. Vacuum frequently, clean or replace air filters monthly and wash sheets and towels at least once a week in very hot 130-degree water. You’ll also need to protect your bed from dust mites with a pillow protector, full mattress encasement and box spring encasement – ones that are made with fabric of a very tight weave, as three dust mites are small enough to fit end-to-end across the eye of a fly. It is also helpful to keep humidity levels between 37 percent and 50 percent as molds and dust mites thrive in humid conditions.

When Should You See an Allergist? “You should seek treatment when OTC medications are no longer effective for your condition,” recommends Dr. Turner. Your doctor may prescribe stronger antihistamines or an inhaler. You should also see a medical specialist immediately if your allergies cause wheezing, trouble breathing, constant hives or severe swelling in the face and throat.

VACUUM FREQUENTLY

ALLERGY, ASTHMA AND IMMUNOLOGY

Environmental allergies are managed by limiting exposure and taking over the counter (OTC) medications such as nasal sprays or antihistamines. Dr. Turner also recommends living somewhere with hardwood floors, rather than carpets or rugs, which can trap allergens. It is also best to avoid blinds and heavy curtains.

CLEAN OR REPLACE AIR FILTERS MONTHLY

WASH SHEETS AND TOWELS AT LEAST ONCE A WEEK in very hot 130-degree water.

MEDICATION ALLERGIES “Allergies to medications are much less common,” says Dr. Turner. One common medication allergy is to penicillin and its family of antibiotics, including amoxicillin. “The only medication for which we have reliable proven tests is penicillin,” states Dr. Turner. “Some adults outgrow allergies to antibiotics that developed more than 20 years ago when they were children, but this should be checked and confirmed through testing.” Allergic reactions to other medications or antibiotics are much more complicated to diagnose. Reactions to medication may happen quickly. This is an important piece of information to share with the doctor when he or she is taking a history. It is especially difficult to diagnose medication allergies when there are multiple medications involved.

PROTECT YOUR BED FROM DUST MITES with a pillow protector, full mattress encasement and box spring encasement.

KEEP HUMIDITY LEVELS BETWEEN 37 PERCENT AND 50 PERCENT as molds and dust mites thrive in humid conditions.

Medication Allergy Symptoms Rashes, hives, swelling or gastrointestinal discomfort can be the result of an allergy to a medication. Less common are difficulty breathing or anaphylaxis.

Managing Medication Allergies Doctors won’t prescribe medication to which you are allergic, but if you are seeing a medical provider for the first time, always make sure you disclose your known medication allergies. It is helpful to bring a list of your current medications as well as your medication allergies every time you see a doctor. People who are severely allergic to medications often wear an alert bracelet or carry a card that lists their medication allergies at all times.

Always consult a doctor if you believe you are reacting to a medication. If you experience trouble breathing, throat tightness, wheezing, hives or angioedema, go to an emergency room immediately.

What is an Intradermal Test? Intradermal allergy testing is another method of skin testing to help determine whether an individual is allergic to a specific allergen, often used in follow-up after a negative prick test. The test involves injection of a small amount of the suspected allergen in the very top layer of the skin called the dermis. www.OurHealthRichmond.com

ALLERGY, ASTHMA AND IMMUNOLOGY

ASTHMA AND ITS SYMPTOMS Asthma makes the airways in your bronchial tubes tighten due to spasm of the muscles around the bronchi and swelling and excess mucous due to inflammation inside the bronchi, causing wheezing, coughing and trouble breathing.

Diagnosing Asthma Asthma is assessed with a lung function test to see how much and how fast you can expel air out, and is often followed by a nebulizer treatment with a bronchodilator if abnormal and then followed by another lung function test to see if the bronchodilator helped.

Managing Asthma “I am of the opinion that everyone who has asthma should see an allergist, as 75 percent of people with asthma have at least one allergy,” says Dr. Turner. “If these triggers are identified, the asthma can be more easily controlled.”

Asthma is treated with an inhaler or nebulizer. Most patients with asthma need inhaled corticosteroids or inhalers that combine corticosteroids with bronchodilators. These should be administered every day as a preventative measure for all asthma patients that have asthma episodes more than two times per week during the day or more than two times per month during the night. Those who have only mild intermittent asthma can be treated with an as needed albuterol inhaler. There are asthma controllers, which are usually inhaled corticosteroids or Singulair, and asthma relievers – usually albuterol, a bronchodilator. “Both are necessary,” says Dr. Turner. “The relievers or “rescue inhalers are for acute asthma which is not being controlled by the preventative medication.”

ASTHMA, ALLERGIC RHINITIS AND ECZEMA Many patients – especially children – who have allergic rhinitis and asthma also have eczema, a dry, red, scaly and extremely itchy skin condition.

Eczema Symptoms Eczema affects your skin, dryness, red patches, peeling and extreme itching. Even mothers who exclusively breast feed their infant child should be advised they can possibly cause their child’s eczema to worsen if the infant is allergic to certain foods that the mother has consumed, as food proteins can transfer into the breast milk. Food allergies are more common in children with eczema.

“Eczema is one of the itchiest conditions known to man,” says Dr. Turner. “It often makes people miserable.”

Managing Eczema Eczema is treated topically, including daily soaking baths in lukewarm water to let the moisture soak into the skin, prescription corticosteroid creams and moisturization, which is a process called the Soak and Seal Method that was developed at Duke. Anti-itch medication, such as antihistamines are also essential to keep the patient from scratching. Eczema is known as the “itch that rashes,” not the “rash that itches.” It is also important to test for food allergies as they can exacerbate the rash and eliminating these foods from the diet can improve the eczema. “You should always see a doctor if you have trouble breathing or a rash that won’t clear up, but keep in mind that not all symptoms that are common in allergies means it is allergies,” explains Dr. Turner. “For example, most rashes that are not hives or eczema should be seen by a dermatologist to be treated as a skin condition.” No matter the cause of your symptoms, seeing a doctor is the first step towards managing them and finding relief. With the treatment options available today, no one should feel they must live in discomfort. Break free from the burden allergies, asthma or eczema may be causing you, and start feeling better than you ever imagined you could. EXPERT CONTRIBUTOR Elaine Turner, MD is a board certified allergist with Allergy Partners of Richmond.

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ASK THE EXPERT

ELAINE TURNER, MD

75 percent

About of people with asthma have at least one environmental allergy — to dust, mold, pollen, animal dander, and the like. So allergists are intent on finding and dealing with the cause of asthma, a much more thorough approach and treatment.

Why should I see a board-certified allergist? Certification by a medical specialty board is a highly reliable indicator that a physician is extremely skilled, very knowledgeable, and has dedicated herself or himself to meeting the very highest standards in the practice of medicine. Board-certified physicians have taken that “extra step” to reach and maintain the pinnacle of their specialty. For allergists, the path to board certification begins with completing a four-year undergraduate degree and four years of medical school followed by a threeyear residency program in either pediatrics or internal medicine. If a physician intends to become an allergist, she or he pursues fellowship training, a two-year, hands-on experience in a teaching hospital, treating allergy, asthma and immunological disorders in both children and adults. After successfully completing the required education and residency and fellowship training, the physician then sits for a very thorough exam in either pediatrics or internal medicine, as well as a second rigorous exam in allergy and immunology. If she or he passes, it leads to board certification. In the area of asthma treatment, for example, there are specialists other than allergists who can treat the symptoms of this condition. But the difference is that allergists are trained to find the root cause, or “trigger,” of the asthma. About 75 percent of people with asthma have at least one environmental allergy — to dust, mold, pollen, animal dander, and the like. So allergists are intent on finding and dealing with the cause of asthma, a much more thorough approach and treatment.

So how does someone find an allergist who is board certified? The first step I recommend is to conduct research. For most, this means going online, which can be reliable as long as she or he uses a credible, third party resource such as the American Academy of Asthma, Allergy and Immunology (www.aaaai.org) or the American College of Asthma, Allergy, and Immunology (college.acaai.org) – the two leading organizations representing only allergists and immunologists who are board certified. Both provide a “Find an Allergist” tool to assist in the search. But even after a person has identified a board certified allergist and scheduled an appointment, she or he should wait until after one or more appointments before deciding if the physician is best for her or his needs. Taking note of how thorough the physician is during the evaluation, such as whether or not she or he asks detailed questions while performing a thorough, unrushed examination using advanced techniques and state-of-the-art diagnostic tests to develop a personalized treatment plan that ultimately works goes a long way in establishing trust and assurance that the patient has made the best decision for her or his health.

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56 Richmond Acupuncture Care 65 Richmond Gastroenterology Associates

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31 Sheltering Arms Physical Rehabilitation Centers 63 Sitter & Barfoot Veterans Care Center 58 Sparkle Pediatric Dentistry 60 Spring Arbor Cottages 55 Step Up for Downs

CONGRATULATIONS

DWIGHT MITCHELL of Richmond

Dwight Mitchell of Richmond was the first person to email the correct seven differences in last issue’s Funny Bone.

For the full list of answers visit our facebook page @OurHealthRichmond.

Valley Denture Care

VCU Health

Virginia Cancer Institute

26 Virginia Commonwealth Bank 2

Virginia Family Dentistry

49 Virginia Urology 24 Westminster Canterbury 47 Westport Rehab & Nursing Center 33 Workpath