Fauquier Health's Healthy Happenings Winter 2019-2020

Healthy

HAPPENINGS THE QUARTERLY JOURNAL OF

The Wellness Center: Treating Vascular Conditions & Chronic Wounds The Cath Lab: Serving local cardiac patients

EMERGENCY?

You’re in Good Hands

WINTER 2020

FAUQUIER HEALTH WELCOMES Vascular Surgeon James Laredo, MD, PhD, FACS Peripheral Artery Disease (PAD)

J

ames Laredo, MD, PhD, FACS has joined the Fauquier Health team as a board certified vascular surgeon, treating conditions and diseases of the vascular system — the blood vessels in the body that bring oxygen to and from the heart to all areas of the body.

Dr. Laredo’s patients have circulatory problems often resulting in leg swelling, bulging varicose veins, wounds in the lower extremities that are slow healing, or muscle pain, cramping, or burning during exercise.

A physician referral is required.

Vascular surgeons treat conditions that obstruct or prevent healthy blood flow to the body’s muscles and tissues. Without sufficient blood flow and oxygen to all the extremities and organs of the body, tissue can suffer and die, resulting in complications, some very serious and limb threatening.

“The main reason I became a vascular surgeon is that vascular conditions can be treated in many different ways, from minimally invasive procedures to surgery.”

Dr. Laredo said. “But I can also help patients avoid surgery with lifestyle changes; I talk to them

2

HEALTHY HAPPENINGS

about quitting smoking, exercising, eating a healthy diet, and managing other health conditions such as high blood pressure, high cholesterol, and diabetes.”

A vascular surgeon can perform minimally invasive procedures such as angioplasty, which uses a small balloon inserted via a catheter through a small incision, to open a blocked artery, and stenting, which involves placing a small metal cylinder in the artery which will hold the vessel open. He can also perform further surgery in the event these are not appropriate, such as using a vein from another part of the body to bypass the closed artery.

Dr. Laredo concluded, “I’m very impressed with the team here at Fauquier Health, I can tell we all have the same goal of working together to provide excellent patient care, and that comes from the top down.”

Issue photographed by Doug Stroud

An interview with James Laredo, MD, PhD, FACS: What is PAD? A disease causing narrowing of arteries, usually in the legs.

What causes it?

Atherosclerosis, a buildup of plaque inside artery walls, which allows less blood to flow.

Why is this important?

Without adequate blood flow, the legs and feet can suffer tissue damage.

What are the complications of PAD? Slower wound healing, a higher risk of heart attack or stroke, the risk of loss of the limb.

What are the signs of PAD? Pain in the affected limb during exercise, slow healing wounds.

How is PAD treated?

Usually with healthy lifestyle changes and exercise. In the event that isn’t enough, further medical treatments may include medication to prevent blood clots, minimally invasive procedures to open blocked arteries (angioplasty and stent placement), or surgery to replace a blocked artery with a vein from another part of the body.

The role of Fauquier Health’s Wellness Center in

Treating Vascular Conditions Patient Testimonial

▶ Ronnie Plaster, a Culpeper resident, has been treated at the Wellness Center for cardiac rehabilitation and then the Peripheral Artery Disease (PAD) program. This process started when he noticed cramping in his legs. “At first I thought I wouldn’t fool with that, but then I thought, well, maybe I ought to go,” said Plaster. “What impresses me about the Wellness Center is that while other facilities have the machines, they don’t have the type of personnel they’ve got here. I think that’s the whole key, that’s what sold me. I didn’t know the difference until I came up here.

After the SET-PAD program, I feel healthy and able to do what I want to do and live my life. I give it my highest recommendation.”

I

n many conditions affecting the circulatory system – such as Peripheral Artery Disease (PAD) – lifestyle changes can be effective at controlling and improving a patient’s condition.

One key factor to improving blood flow in the body is exercise.

At Fauquier Health, patients may be referred to the Wellness Center by their vascular surgeon, cardiologist, or general practitioner. Here, patients have the opportunity to participate in the Supervised Exercise Training (SET) for PAD where exercise encourages new blood vessels to bypass blocked arteries. Patients are medically supervised under a medical director and monitored during exercise by exercise physiologists, registered nurses, and respiratory therapists.

Studies from the American Association of Cardiac and Pulmonary Rehabilitation have shown that the SET program can be equally as effective as the placement of a stent

in treating some vascular conditions.

Dr. Laredo noted, “The Wellness Center here is one of the few supervised exercise programs in our area, which is a very big plus for local patients. It is an excellent program, and we are lucky to have it here.”

1

Healthy artery

Initial fatty deposits

2

3

Plaque obstructs bloodflow

Near complete blockage

4

The Role of Vascular Services in Healing Chronic Wounds

M

edical Director Lynn Samuel, MD, and Program Director Sarah Bales, RN, lead an experienced team at Fauquier Health’s Wound Center to help heal chronic wounds of patients in our community. “What sets us apart from other wound healing services is our multi-specialty physician team: Infectious Disease, Pathology, Internal Medicine, Family Practice, General Surgery, and now, Vascular Surgery,” said Sarah.

The first essential step in treating a patient with a chronic wound is to assess the adequacy of blood flow in the limb. Sarah said, “If a patient has impaired blood flow to the lower extremity, time is critical. A vascular surgeon can correct the blood flow quickly to save the limb which is our priority. Once the vascular issue has been identified and treated, healing the wound can become achievable with advanced wound care. With

Dr. Laredo, a highly skilled and experienced vascular surgeon joining our team these procedures are offered right here at Fauquier Health.”

“Dr. Laredo joining the Fauquier Wound Center physician team and performing Vascular Surgery procedures in this community will increase the services we can offer local patients, and give them the option to stay near home for their treatment,” said Dr. Samuel.

THE QUARTERLY JOURNAL OF

3

Heart Attack

Prevention

By Eugene Soh, MD, FACC Whether I am doing a house call in the White House in my prior career in the military or meeting a new patient in our office in Warrenton, one of the most frequently asked questions that I hear is, “What can I do to prevent a heart attack?” The answer can be stunningly simple.

Regular physical activity is one of the best ways to reduce the risk of heart attacks and strokes. Studies published in the New England Journal of Medicine have demonstrated that people who engage in light or moderate physical activity such as walking or doing yard work for as little as one hour per week can reduce the risk of a heart attack or dying by as much as 20 to 50 percent.

Exercise can help to lower this risk by lowering blood pressure, lowering bad cholesterol and raising good cholesterol, lowering blood sugar, and reducing inflammation.

Despite these known benefits of exercise, less than half of Americans achieve the recommended amount of physical activity. Current recommendations from the American Heart Association are for everyone to engage in a minimum of 150 minutes per week of moderate physical activity such as brisk walking (2.4 to 4 mph), yoga, or even recreational bicycling. Alternatively, for those more energetic people, a minimum of 75 minutes of vigorous activity (jogging/ 4

HEALTHY HAPPENINGS

Eating a Heart Healthy Diet ➥ Eat low fat protein such as fish and poultry and limit intake of carbohydrates in order to lose weight. ➥ Reduce portion size. The amount you eat is just as important as what you eat. ➥ Consume plant-based food rich in vitamins, fiber and other nutrients, which can reduce the risk of heart disease. ➥ Choose whole grains and avoid saturated and trans fats to reduce your cholesterol.

Source: Merdod Ghafouri, DO, FACC, FAHA

running, cycling greater than 10 mph, playing tennis, or swimming laps) is recommended. Talk to your doctor before beginning an exercise program. Your heart and the rest of

your body will thank you!

Exercise is a powerful way to reduce the risk of heart attacks and strokes, but there are other important modifiable risk factors which also need to be addressed. According to a Harvard Alumni Health Study, smoking is the leading cause of avoidable premature death and can increase the risk of a heart attack by six or seven times more than a nonsmoker. If you smoke, you should quit.

Quitting is one of the most powerful things anyone can do to reduce their future risk.

A healthy diet high in fruits and vegetables reduces the risk of cardiovascular events. High blood pressure and diabetes should be managed. And finally, achieving and maintaining an optimal weight has many benefits including reducing the risk of a heart attack, congestive heart failure, and certain arrhythmias.

When you call 911...

T

You’re in Good Hands in Fauquier County

he teamwork between the Emergency Medical Services of Fauquier County Department of Fire, Rescue, and Emergency Management and the Emergency Department makes Fauquier Health stand out in the event of an emergency. From the time of the 911 call until arrival in the Emergency Department, the patient is in the care of two teams that work together to achieve the best care possible.

Director of the Emergency Department, Brandi Trottman, RN,

Management, who works closely with the Emergency Department team. “When you see these people consistently, you build a relationship with them. It becomes easier to communicate. We’re just like coworkers, one big team.” said RJ. “They know each other well; when an EMS calls in on the radio, our nurses often know the medic just by their voice,” said Michael Jenks, MD, Medical Director of Emergency Services.

Communication is key in the smooth operation of caring for

Department can communicate with the EMS team over the radio and make recommendations for treatments that might benefit the patient before they arrive,” said Dr. Jenks. “This makes the transfer of the patient from the EMS to the Emergency Department staff move smoothly and helps achieve the best possible outcome.”

The physician in the Emergency Department can communicate with the EMS team over the radio and make recommendations for treatments that might benefit the patient before they arrive.

and her staff consider the Emergency Medical Services (EMS) team as part of her Emergency Department team. “They’re the first to have contact with the patient, so they’re basically our team out on the street.

Our relationships with them are definitely something we continue to focus on and nurture,” she said.

It all goes back to our small, caring community atmosphere, believes RJ Arft, Battalion Chief at Fauquier County Department of Fire, Rescue and Emergency

patients in emergency situations.

The EMS and the Emergency Department staff are in almost constant communication from the time of the 911 call. During that time, the EMS relates the basics of the case and gives all the information to the Emergency Department staff that physicians will need to prepare to care for the patient. “At this time, there is the opportunity for what we call online medical control, meaning the physician in the Emergency

“When patients are picked up

by EMS, they are really being cared for by our patient team, which extends out to include the EMS folks. We’re very fortunate because we have such terrific care providers that do such a great job in the pre-hospital setting, which allows us to be comfortable knowing that the patients are going to get care before they get to the Emergency Department,” concluded Dr. Jenks.

THE QUARTERLY JOURNAL OF

5

Fauquier Health’s Cath Lab extends its services to better serve local cardiac patients

F

auquier Health’s new Cardiac Catheterization Lab, or Cath Lab, has grown since its opening at the end of February under the guidance of Interventional Cardiologist Robert Stenberg, MD, Mark Masonheimer, RN, and their experienced team. With its debut, the lab increased care options for local cardiac patients.

Patients are usually referred to the Cath Lab through their cardiologist if blockages in the arteries of the heart are suspected, or after a heart attack for diagnosis and treatment of issues that restrict the blood flow to the heart muscle.

Procedures in the Cath lab are performed through a catheter, or a long, thin tube which is inserted through a small incision, usually in the

wrist. The catheter is guided through the vessels to the heart. Then, dye is injected through the catheter and x-ray technology provides continuous moving pictures of the area being examined, looking for evidence of narrowing or blockage.

When the Cath lab opened, it offered diagnostic procedures for those with cardiac disease: procedures that enable the cardiologist to look at what is happening in and around a patient’s heart, diagnose problems, and formulate treatment plans.

In May, the Cath Lab added interventional procedures in addition to its diagnostic capabilities. “This is a huge benefit to cardiac patients in Fauquier County,” said Dr. Stenberg.

“Now, we can perform common treatment procedures at the time of

catheterization, saving the patient a second trip to an off-site lab.”

The interventional procedures that were added in May are angioplasty and the insertion of stents, or stenting.

Angioplasty involves inserting a small balloon through the catheter to help stretch and open the vessel to improve the blood flow. The angioplasty site can then be treated with a stent. This involves the insertion of a small metal cylinder into the artery which can remain in place to keep the vessel open permanently.

Dr. Stenberg and his team are looking forward to the future of the Cath Lab and its eventual expansion.

“This is a growing area, and there are more and more patients that need cardiac treatment. We are optimistic for the future of the Cath Lab services at Fauquier Health, and look forward to providing high quality care right here at a patient’s home hospital.”

Cath Lab Services at Fauquier Health ➥ Diagnostic procedures Right Heart Catheterization Left Heart Catheterization Pacemaker Implantation Pericardiocentesis Hemodynamics Assessment ➥ Interventional Procedures Angioplasty Stenting

6

HEALTHY HAPPENINGS

Events & EDUCATION

Please visit the Events & Education page on FauquierHealth.org to see the full listing of upcoming events, dates, times, and locations. Most events are free to the general public, but may still require registration online. Additional updates and events can be found at FauquierHealth.org/events-education.

Healthy Lifestyles AARP Safe Driver Course See online calendar for dates Non-AARP Members: $20.00 AARP Members: $15.00 Registration required: 703.591.1847 American Red Cross Blood Drive See online calendar for dates Register at redcrossblood.org Walk-ins also welcome Medicare Made Easy Informational event to learn the ins and outs of Medicare See online calendar for dates Walk-ins are welcome Center for Weight Loss Information Seminars See online calendar for dates

Support Groups Alzheimer’s and Dementia Related Illnesses Support Group Fourth Wednesday of each month 4:00 pm – 5:30 pm Bereavement Support Group First and third Mondays of each month 1:00 pm – 2:30 pm Beyond Addiction: How Science and Kindness Help People Change Third Friday of each month 7:00 pm – 8:00 pm Diabetes Support Group (Adult) Third Tuesday in November 6:30 pm – 7:30 pm

For Parents Fauquier Health is here for you through your entire childbirth experience, from pregnancy through caring for your newborn. Informational classes are held at Fauquier Hospital’s fourth floor OB Training room. Call 540.316.2640 or visit FauquierHealth.org/ events-education for details and registration information Baby Basics 101 See online calendar for dates 7:00 pm – 8:30 pm Breastfeeding Made Simple See online calendar for dates 6:30 pm – 8:30 pm Your Childbirth Experience (Multi-session classes) See online calendar for dates Prenatal Yoga for Expecting Mothers Every Tuesday, 5:30 pm – 6:30 pm Fee applies Postnatal Mommy & Me Yoga for New Mothers Every Thursday, 5:30 pm – 6:30 pm Fee applies

Diabetes Support Group (Youth) Third Tuesday in September and December 6:30 pm – 7:30 pm Families Overcoming Drug Addiction (F.O.D.A.) First and third Thursdays of each month 6:30 pm – 7:30 pm Lyme Disease Support Group Third Thursday of each month Meetings start at 6:30 pm NAMI (National Alliance on Mental Illness) Connections Individuals Living with Mental Challenges and Family Support Third Monday of each month 6:30 pm – 8:00 pm Stroke Support First Wednesday of each month 12:00 pm – 1:30 pm

Cancer Support Groups Blue CREW Prostate Cancer Support Group Second Wednesday of each month 5:00 pm – 6:30 pm CREW (Cancer Resources, Education and Wellness) Support Group Second Monday of each month 4:30 pm – 6:00 pm ▶ Updates and more events at: fauquierhealth.org/community

THE QUARTERLY JOURNAL OF

7

PRSRT STD US POSTAGE PAID PPCO

Published quarterly by

500 Hospital Drive Warrenton, VA 20186 Chad Melton President/CEO For more information on Fauquier Health services, call (540) 316-DOCS

Stay

IN TOUCH

Fauquier Hospital 540-316-5000

Medical Imaging 540-316-4500 (Fauquier Hospital)

Sleep Center 540-316-2660

Patient Scheduling 540-316-5800 or 866-341-0845

Outpatient Registration 540-316-5819

The Villa at Suffield Meadows Assisted Living Facility 540-316-3800

Physician Referral 540-316-DOCS (3627) or 800-322-7500 Class Registration Support Group Information 540-316-2600 Family Birthing Center 540-316-4000 Home Care Shop 540-316-4437

Patient Accounts 540-316-2970 Patient Information 540-316-INFO (4636) Physical Medicine and Rehabilitation 540-316-2680 (outpatient) 540-316-5488 (inpatient) Fauquier Health Rehabilitation & Nursing Center (FHRNC) 540-316-5500

Volunteer Services 540-316-2910 Wellness Center 540-316-2640 Wound Healing Center 540-316-HEAL (4325)