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the

Health Journal February 2010 Vol. 5 No. 9

TM

Williamsburg Edition

FITNESS

TRENDS

Remembering

Josephine

NO PROBLEM

PARTNERS IN PRACTICE

FREE

COVER PHOTO BY VICTORIA SUTHERLAND

AGE SPOTS?


OSC Community Lecture Series Pre OSC Provides Open MRI for Patient Comfort

Magnetic Resonance Imaging (Open MRI) is an advanced diagnostic imaging procedure that creates detailed images of internal anatomic structures. By using powerful magnetic waves and a computer, nerves, discs, ligaments, cartilage and tendons can be seen clearly. Open MRI refers to the larger space that is given for patients in the machine. This is better for all patients, especially those who are claustrophobic, of a large build, pediatric patients or for those who suffer from Post-traumatic Stress Syndrome. Our Open system is quiet, comfortable and very easily tolerated. We will help to make your MRI a very pleasant experience.

Improving Quality of Life - Interventional Pain Management

Join Raj Sureja, M.D. for an evening of interactive discussion regarding the latest advancements in Chronic Pain Management. Understand how Interventional Medicine can provide relief for individuals who suffer with Chronic Pain. Educational literature and refreshments Join OSC for the 2010 Arthritis Walk, Saturday, April 24th, at 9:00 AM at Port Warwick will be provided. We encourage you to bring a friend! When:

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Where:

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Tuesday,April 21st, at 7:00 pm at our Port Warwick location! To register – call 757-596-1900

Raj N. S

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OSC

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Raj N. Sureja, M.D. • Tonia Yocum, Jeffrey Carlson, M.D. Jamie McNeely, P.A.

Don’t miss Dr. Carlson’s appearance with Dr. Mehmet Oz at the Successful Aging Forum, May 14th, 2010, at the Hampton Roads Convention Center!

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February Contents

2010

[ Features ] 6 Partners in Practice

Four local couples share their passion.

17 Cross Over to the Cables

A step-by-step crossover cable workout.

28 IPL for the Hands

Laser treatments have the upper hand on age spots.

32 The Heart of the Matter

Understanding congestive heart failure.

22

42 Family Keeps Him Grounded Riverside Cardiologist Joseph Adinaro, IV.

[

In Every Issue

4 Editor’s Note 5 Inbox

]

17 Fitness

34 Snapshots

35 Health Directory 38 Second Opinion 40 Calendar

6

Remembering Josephine


the

Health Journal

TM

Editor’s

NOTE

The Health Journal is a free, monthly consumer health magazine distributed throughout Hampton Roads. Three editions are currently available: Williamsburg, Peninsula and Southside, with a combined circulation of over 78,000 copies.

PUBLISHER Brian M. Freer

EXECUTIVE DIRECTOR Rita L. Kikoen EDITOR Page Bishop-Freer

ASSOCIATE EDITOR Beth Shamaiengar

MEDICAL EDITOR Ravi V. Shamaiengar, MD

ADMINISTRATIVE ASSISTANT Danielle Di Salvo SALES EXECUTIVES David C. Kikoen

GRAPHIC DESIGNERS Natalie Monteith Jean Pokorny PHOTOGRAPHY Brian M. Freer Page Bishop-Freer

CONTRIBUTING WRITERS Sharon Miller Cindrich Bridgit Kin-Charlton, CPT Edwin Lampitt Loel Payne, MD Keith Schumann, MD Greg Tudor, CPT Joy Vann The Health Journal—Williamsburg Edition is directmailed to homes and businesses in Williamsburg, James City County and Northern York County. Newsstand, rack and countertop distribution supplement our hand-delivery program. Subscriptions are available for $24/year. Please send a check or money order, payable to RIAN Enterprises, LLC, to the address below. Include current mailing address and other contact information. Notify us of any change in address. The editorial content of The Health Journal is produced with the highest standards of journalistic accuracy. However, readers should not substitute information in the magazine for professional health care.

It’s true what they say about couples; opposites really do attract. In my marriage, for example, it’s those polar-opposite personality traits that interlock with surprising ease, complementing one another to form a whole. Brian is the classic “Type B” artist, dreamer, philosopher—unwilling to wear a watch much less conform to “the rules.” Then there’s me—the “Type A,” the natural-born planner. I manage our work and social calendars, pay our bills, keep a system of files for everything and remind Brian of what he’s most likely to forget. And like most moms, I stay on top of Cami’s bedtime, naptime, eating and childcare schedules and never, ever leave home without a diaper bag over-stocked with the essentials. It’s no coincidence, then, that an editor’s job is just as much about planning ahead as it is working with copy to correct grammar and refine language. At any given time, I could be working two, three, four or more months ahead, laying the foundation for upcoming issues. But every once in a while a story comes along that is so compelling that we follow our instincts and adjust our plans. Sometimes a story just has to be told. We’d originally planned to run a feature story this month on ways people can become more heart-healthy. I’d sought input from local cardiologists and searched for artwork that would best illustrate the story. That’s when I got the e-mail: a local father, Ed Lampitt, asked whether The Health Journal would consider publishing an essay he’d written chronicling his family’s recent emotional journey beginning with the shocking diagnosis of his daughter, Josephine Rose, and ending with her tragic death, at only 10 months of age. This Feb. 16 marks the one-year anniversary of Josephine’s death; at the same time, however, the Lampitts are anticipating the arrival of their second son, due early this March. They now wrestle with a question of great magnitude: how to celebrate the birth of one child while still grieving the loss of another. In “Remembering Josephine,” which begins on page 22, Lampitt shares insight into his family’s pain after Josephine was diagnosed with Gaucher disease Type II, an incurable and untreatable metabolic disorder, which began as a set of minor symptoms and progressed rapidly. Josephine’s struggle ended one year ago, but her family’s continues. Once rendered helpless by the disease, the Lampitts are now channeling their grief towards a larger cause: raising awareness about Gaucher Type II and helping a little-known charity in California raise money for research in hopes of one day having an effective treatment for the disorder. This story has found a special place in my heart, and I hope it will in yours, too. We thank the Lampitt family for allowing us to share with readers some of their most treasured photos. Many of these images (including this month’s cover photo of Josephine and her father) were captured by Josephine’s great aunt, who, last February, made an overnight drive from Georgia to give the Lampitts a precious gift—a series of photographs taken during Josephine’s last days. Though sections of it are extremely painful to read, Lampitt’s essay offers us a precious gift, too: A reminder to make the most of our time with loved ones, because we never know what tomorrow may hold. Plan as we might, he writes, we must learn to accept those things we cannot control.

Editorial contributions are welcome. All submissions become the property of the publisher. We reserve the right to edit for style, clarity and space requirements.

Page Bishop-Freer, Editor page@thehealthjournals.com

For Advertising and editorial Information, call or write: The Health Journal 4808 Courthouse Street, Suite 204 Williamsburg, VA 23188 (757) 645-4475 • Fax (757) 645-4473 info@thehealthjournals.com www.thehealthjournals.com

4 THE HEALTH JOURNAL

CORRECTION “Local Gym Lineup” [January 2010, page 9]: The web site for the Peninsula Metropolitan YMCA was incorrectly listed. The correct Web site is www.peninsulaymca.org. Also, Phil Curtin’s name was spelled incorrectly.


page’s picks

February Favorites Chobani Greek Yogurt ($12 for a 12-pack, Costco) This smooth, creamy, fruit-on-the-bottom, Greek-style yogurt tastes too good to be fatfree—but it is! Each cup packs a whopping 14 grams of protein and only 140 calories. Other attributes: Gluten-free, Kosher, no preservatives, live and active cultures for digestive health. My new breakfast-on-the-go.

Skechers Shape-Ups ($110, www.skechers.com) After some hinting, Brian bought me these shoes for Christmas. I’ve been wearing them while running errands and pushing Cami around the block in her stroller. They’re designed to tone and firm, promote weight loss, strengthen the lower back and reduce ankle strain. I definitely feel the burn in my calves and glutes, a feeling similar to walking in wet sand. Skechers now carries these in all kinds of styles, not just tennis shoes (I’ve seen calf-high boots and Mary Janes)—plus famous athletic-wear brands like Avia and Reebok have followed suit with their own fitnesswalking shoes.

Hot Yoga (classes range from $10 to $15 each) Every winter I find myself returning to this great source of stressrelief. Warm, moist air makes muscles more flexible and forces your body to sweat out toxins—just be sure to drink plenty of water before, during and after a class. Most local studios offer an introductory trial week at a discounted rate (Body Balance in Williamsburg and Tidewater Hot Yoga in Yorktown both do), so check out our Health Directory in this issue for a hot yoga studio near you.

inbox

Kudos “I love your magazine! It’s one thing to always look forward to at my doctors’ offices.” —Lynne S., Williamsburg “Thank you for providing this resource to our community.” —Cynthia B., Virginia Beach “Thanks so much for the wonderful articles on ‘Caring For You, Caring For Me’ [Jan. 2010, p. 28, Williamsburg Edition only] and Faith Amoroso [January 2010, p. 38 all editions]. Your publication is a wonderful service to citizens of the Peninsula, and CEAGH is very proud to be a prominent part of this edition.” —Rick Jackson, executive director, The Center for Excellence in Aging and Geriatric Health Redesign “I just wanted to let you know that I received the newest copy of The Health Journal and love it! You all do such a wonderful job with this publication.” —Heather Cheek, graphic designer, Tidewater Physical Therapy, Inc. “I love the new look of The Health Journal. I was pleasantly surprised to see it in Harris Teeter. Thank you and your staff for the wonderful job you all do.” —Marie C., Virginia Beach Distribution “My family did not receive a copy of the January issue. What local business or hospital can I stop by to pick up a few copies? A location in Hampton, Newport News or York County would be best.”    —Crystal P., Poquoson Ed.: Every hospital on the Peninsula carries The Health Journal; just look for one of our racks in the lobby or cafeteria. Also, the York County Public Library and Poquoson Library should have copies available.

TRX Training System (www.fitnessanywhere.com, starts at $189.95) I’ve started using the TRX regularly in my twiceweekly strength and conditioning sessions, and I can already see and feel the results in my back, shoulders and arms. On page 30, personal trainer and all-around-athlete Bridgit Kin-Charlton shows you how to use the TRX system for a total-body workout unlike any other.

THE HEALTH JOURNAL

5


local beat

Partners in Practice WRITTEN BY JOY VANN

PHOTO COURTESY OF OPERATION SMILE

In the spirit of Valentine’s Day, The Health Journal brings you stories of local couples who share more than just a marriage—they both work in the medical field, often in the same office. Read what the following four couples have to say about the joys and challenges of being partners in practice…and in life.

Dr. William & Kathy Magee: Operation Smile

A

s founders of Norfolk-based Operation Smile, the world-renowned non-profit organization dedicated to treating children with cleft lips, cleft palates and other facial deformities, Bill and Kathy Magee work together tirelessly. Add five children of their own to the equation, and miraculously is more like it. The couple, married 42 years, started dating in their hometown of Fort Lee, N.J., while in high school. They married eight years later when Bill was still in dentistry school at the University of Maryland. Though the two didn’t work together until founding Operation Smile, they worked hard to take care of their children, starting with the first who was born 15 months after they married. Their dual career, which they describe as a “passion,” began when the Magees founded Operation Smile in 1982. Today Kathy is the full-time volunteer president and Bill is the chief executive officer. Taking advantage of unforeseen opportunities and chances has been the cornerstone of the Magee marriage. For instance, during one pregnancy when Kathy went into early labor, they went to the hospital where Bill’s father was a physician. It was there that an oral surgeon encouraged Bill to pursue medical school. Bill asked Kathy her opinion about con6 THE HEALTH JOURNAL

tinuing his education and becoming a craniofacial surgeon, along with the loans that went with such an endeavor. She didn’t hesitate and said, “If that’s what you want to do, do it.” While Bill attended George Washington University Medical School (while seeing dental patients for extra income), Kathy continued her nursing and social work education at night. With children, that required a lot of coordination and sacrifice on each spouse’s part. “We had three children under [the age of] three, and it was worth it for me to stay home, Kathy says. “At night, Bill took over. I saw the children to bed and then went to school for my master’s degree.” For instance, while in his last year of medical school, Bill had an opportunity to study in Switzerland with a leading oral surgeon. He’d saved enough money through his dental practice to take a leap of faith and bring his family to Europe. It was a worthwhile risk that led to a stint in Paris with world-renowned craniofacial physician Dr. Paul Tessier. Though the Magees then had four children under the age of five, they left for Paris, unknowingly planting the roots for Operation Smile. “One thing led to the next and the next, and our openness about not having money and worrying about the shoestrings and loans paid off,” Bill says. “Both of our personalities are very accepting of challenges.”

Kathy added: “People we met along the way all became part of Operation Smile—in Switzerland, France, New York. We began to gather people, seemingly in the short term, making friends along the way who became long-term friends.” Another opportunity presented itself when the Magees received an invitation to go to the Philippines on a medical mission. “The experience shocked all of us,” Bill says. “We treated 40 kids and watched as 250 were sent away. It’s one thing to watch it on TV, but to be in a small room and see what’s really going on, it’s an overwhelming experience.” That’s when Operation Smile was born. When the couple returned from that trip, they knew that they had to go back to continue the work. They enlisted the help of a few friends, who then enlisted the help of their friends. Since that inspired beginning, Operation Smile has provided free surgeries to more than 140,000 children in 50 countries. Today Bill maintains a private practice in Norfolk and is co-director of the Institute for Craniofacial and Plastic Surgery at Children’s Hospital of The King’s Daughters. (He is also an associate professor at Eastern Virginia Medical School.) Through their shared journey the Magees have learned to turn whatever stress they face in working so closely together into something positive and productive. “We’re two different individuals with two different approaches and skill sets,” Bill says. “Fortunately for us, they complement each other and that has become our advantage.” Having such passion for their work means that OpSmile talk is rarely off the table, though it doesn’t overwhelm their lives. Says Bill: “You talk about what’s important to you. We have a lot of other interests. Family is a very big interest, and our family is centered around one another. We take vacations, sometimes with 25 to 30 family members. We play a lot of sports and do a lot of things together. Whatever is dominant at that moment is what we talk about.” When asked what advice the Magees could offer to other couples embarking on a shared career, Bill says, “You have to be cognizant of what each other’s strengths are and celebrate those strengths and hope that your weakness will be their strength. You have to be respectful in the process and maintain your own independence. You have to know who you are to know who the other person is.” Kathy offers a pragmatic suggestion for couples who work together: Know when to turn the phone off. “Some calls can wait until morning,” she says. “You have to respect that. There’s a reason it’s called a ‘crackberry.’ You have to be able to say, ‘Put that crackberry down.’”


Bon Secours Announces Director of Advocacy and Community Affairs Bon Secours Health System has appointed Thomas Prevette as Director of Advocacy and Community Affairs. Prevette will direct all legislative activities and initiatives for Bon Secours in Hampton Roads and will support state and federal legislative activities for Bon Secours Virginia. In addition, he will serve as the organization’s liaison with local government officials and local community and business leaders.

PAGE BISHOP-FREER

Bon Secours Responds to Haiti Crisis

Oncologists Elizabeth Harden & Richard Hoefer

“W

e fell in love in 1988 while serving in the Air Force in San Antonio,” says Elizabeth “Betsy” Harden. “It was 1989,” Rick gently corrects. They both laugh. Such is the give and take—and sense of humor— that these oncology professionals have employed to build their marriage of 23 years. Betsy is an oncologist with Virginia Oncology Associates, (VOA) and Rick is a surgical oncologist at the Dorothy G. Hoefer Comprehensive Breast Center in Newport News (his mother is the founding benefactor). “Though we’re not in the same practice, we see a lot of the same patients,” Betsy says. “Rick does surgeries and I do medical therapy and chemotherapy.” Rick, a member of Sentara Surgical Specialists, explains that his group has a joint venture with VOA to develop oncology programs throughout the region, which often leads to treating the same patients, particularly breast cancer patients. “We work closely together to decide on what’s best for the patient, along with mammographers and radiographers,” Betsy says. “It’s a very exciting multidisciplinary program that we have here.” The couple doesn’t allow the stress of working together and being in such a high-pressure profession to get to them. “We have a pretty good way of turning things off,” Betsy says. “We’ll talk shop over dinner and things like that. We have a pretty good way of communicating. We have a lot of fun. It’s very rewarding to be on the same wavelength about a lot of things.” Rick continues: “We each understand what the other’s career is like. I have a pretty good idea what

her day is like and what her stresses are like. It’s very helpful when a spouse understands what the other spouse does. I value her opinion and she values mine, which is always a good thing in a relationship.” While both work many hours and often don’t see each other at home, they also work hard to keep their romance alive. Says Betsy: “We try to reserve time for us. Friday night is our standing date night, and we make sure to have time with each other.” She adds that

“I value her opinion and she values mine, which is always a good thing in a relationship.” —Dr. Richard Hoefer carving out time together has become easier since she scaled back on her on-call duty to care for her ailing mother. Adds Rick: “There always has to be some give and take. We’ve really been blessed in that we love what we do, and that’s a big help. We each respect each other in terms of his or her own career and that’s played a big part as well.” While healing cancer patients is still the main goal for the couple, they now are willing to take a little more time for themselves. “We both love to work and hope to keep working a long time,” says Betsy. “But we’re hoping for more vacation time together as the years go on.”

Bon Secours Health System Incorporated (BSHSI) is working with various Catholic health agencies to provide relief to survivors of the Haiti earthquake. BSHSI sent $50,000 to begin relief efforts. The Bon Secours Mission Fund (BSMF) is also accepting donations from employees to support relief efforts. BSHSl will match any employee donation up to $100,000.

Sentara Williamsburg Celebrates Babies To help new moms and families feel good about their experience at the Family Maternity Center, Sentara Williamsburg Regional Medical Center has added a few new services. Patients and visitors will now hear a lullaby overhead every time a baby is born. Plus, new moms can enjoy a brief in-room massage to alleviate discomfort after childbirth. New infant massage classes will also be offered monthly.

HTSAC Announces New Interim Director Historic Triangle Substance Abuse Coalition has named Kimberly Lucas Interim Director. Kimberly holds a PhD in health care administration and has over 13 years of experience in grant writing and management.

TPMG Williamsburg Diagnostic Cardiology Awarded Accreditation The office of Dr. Keith Hanger was recently awarded full accreditation by the Intersocietal Accreditation Commission in both echocardiography and stress echocardiography. The commission was established with the support of the American Society of Echocardiography (ASE) and the American College of Cardiology (ACC) to provide peer review and to recognize the provision of highquality echocardiography testing.

Continued on page 9

THE HEALTH JOURNAL

7


Your attorney should be as qualified and specialized as your physician.

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Continued from page 7

D

rs. Michelle and Scott Eichelberger, pediatricians at CHKD’s Chesapeake Pediatrics, fell in love while attending James Madison University. At the time, neither imagined that in the future they might marry and work together. The two went on to Eastern Virginia Medical School and completed residency training at East Carolina University, marrying and having their first child along the way. When Scott changed his career path from internal medicine to pediatrics, the two began to interview together, hoping to be hired at the same practice. They were thrilled when they were both offered jobs at Chesapeake Pediatrics.

“One of the nice things about working together is that when he was on call and wanted to coach one of the children’s ball games, I’d hold the beeper for him. We could cover each other that way.”

—Dr. Michelle Eichelberger “It was a very young practice and we had the opportunity to get in on the ground level and help to build it up,” Scott says. “And we’ve been here ever since.” The Eichelbergers have four children, ages 12 to 21, and they say that working at the same practice hasn’t hindered them from balancing their personal and professional lives. “Our practice is good about granting schedule requests, and that really helps us out,” Scott says. Michelle adds: “That helps because we can take care of the kids in shifts. One of the nice things about working together is that when he was on

call and wanted to coach one of the children’s ball games, I’d hold the beeper for him. We could cover each other that way.” Being married and working together has also enhanced their professional life. As Scott says: “It’s been good to bounce medical issues off each other. If a patient comes in presenting with difficult issues, we’ll talk about it. It’s like having a built-in consult all the time.” When asked about the difficulty of ceasing talk about patients and their practice, they laugh. “Our children have a distinct answer to that,” says Michelle. Scott follows: “At the dinner table, they’ll say, ‘OK. No more shop talk.’” For young couples starting out, the Eichelbergers agree that having a foundation built on faith and trust is the most important thing for two people to share. “We feel like our Christian faith helped us through difficult times, Scott says. And you’ve got to have trust.” “If you’re on shaky ground to start with and you’re not solid going into [a marriage], you’re put in some jeopardy because [relationships are] hard. Our advantage was that we knew each other for several years before medical school. Sometimes couples who meet in med school or residency have difficulties as their relationship grows. We got to know each other without [the] stress of med school.” Having a married couple on the team also brings a lot of humor for the staff. “The nurses love to hear my stories about Scott,” says Michelle, “so they can use them for ammunition [to tease him]. Nothing is secret around here.” That “everybody-knows-what-everybody-is-doing” element of the medical community is one that they’ve grown comfortable with over the years. Says Michelle, “When I got pregnant during residency, I had to call Scott and tell him on the phone because I knew that before I got back to the hospital, he’d hear it from someone other than me.” She continues: “Our lives are an open book, and

PAGE BISHOP-FREER

Drs. Michelle & Scott Eichelberger: Chesapeake Pediatrics

local beat

we’re comfortable with that. Other people in relationships might not be as comfortable with that and prefer to be more private.” All and all, raising a family and working together has been a boon for the Eichelbergers. “It’s been a good ride,” says Scott. “I can’t imagine doing this without her. I can’t imagine not doing medicine, period—and I can’t imagine being in practice without her.” Continued on page 10

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9


PHOTO COURTESY OF THE LACKEY FREE CLINIC

local beat

In an upcoming issue, The Health Journal will recognize a few more dynamic duos— friends committed to improving health in Hampton Roads—in “It Takes Two,” also written by Joy Vann.

Continued from page 9

Patricia “Cooka” & Dr. James “Jim” Shaw: Lackey Free Clinic

J

im and Cooka Shaw met in the eighth grade and married while Jim was a fourth-year medical student. When the Shaws’ first child arrived, Cooka, a nurse, became a stay-at-home mother. Though she worked part-time on and off through the years, the thought of working alongside Jim “never crossed the radar screen.” That changed when Jim, a pulmonologist, was still in full-time practice at Riverside Regional Medical Center. The couple felt a shared calling to serve the Peninsula’s growing number of uninsured people. In 1995, the Shaws and a friend from Rising Sun Baptist Church in Yorktown started offering free medical treatment one night per week at the church. Two years later, as patient numbers increased along with the number of volunteers to treat them, the clinic moved to the nearby Charles E. Brown Community Center. As word spread about the clinic, it increased its hours to be open two days a week, then three, and it is now open five days a week. In 2003, the Lackey Free Clinic opened on Old Williamsburg Road (in the Lackey area of Yorktown), providing a full range of medical services daily. Today, with more than 60 volunteer physicians, physician assistants, nurse practitioners, pharmacists and administrative staff, the Shaws have stepped back from day-to-day operations. Jim still sees patients, and Cooka works the front desk one day a week, but they now primarily enjoy watching their faith-based ministry thrive through dedicated volunteers. 10 THE HEALTH JOURNAL

“I was focused on medical issues because that’s the way I was trained and the way my brain works. Cooka has always focused on love and compassion.” —Dr. Jim Shaw Says Cooka: “When someone has to quit or others move to warmer weather during the winter, the phone will ring with someone who wants to do just that job of the person who left….We give the credit to God.” Working together has never been stressful for the Shaws, largely because of their calm demeanors and the fact that they kept operations manageable, growing gradually over the years. Jim says their strengths grew to complement one another, with him providing medical oversight and Cooka providing the warm embrace they wanted their patients to feel. “I was focused on medical issues because that’s the way I was trained and the way my brain works,” says Jim. “Cooka has always focused on love and compassion. Because these patients are turned away from so

many doctors’ offices, it was our vision that we make them feel welcome. They are so often pushed aside because they don’t have health insurance.” Cooka summarizes their shared vision and work by saying, “We care about the whole person, not just the medical problem.” Though the clinic has been prominent in the couple’s life, family, friends and outside interests have provided balance—though Cooka adds that maintaining balance takes some effort. “You have to understand each other’s strengths and weaknesses,” she says. “Through the years, we’ve gained an understanding. He’s the brains and I’m the hands, feet and heart. He keeps me in line, and I keep him in line.” After 44 years of marriage, the Shaws feel they can offer some solid advice to young couples considering marriage or shared careers: “Pray about it, and try to understand what each other’s position is going to be,” says Cooka. “So many people jump into marriage and don’t discuss the serious aspects. You have to ask, ‘What are your expectations of me? What do you need from me in this endeavor?’” Having created a successful free clinic that meets the needs of the medically disadvantaged, the Shaws are happy with its success. “We just put one foot in front of the other and went at it,” Cooka says. “It just took on a life of its own. We believe in God’s plan. We never imagined working as a team, but it’s been wonderful.”


healthwire

Mayo Clinic Diet Book Promotes

Healthy Weight Loss

WRITTEN BY PATRICIA REANEY

NEW YORK (Reuters Life!)

Confused by the myriad of diet books that promise to help you melt away those excess pounds and produce the body of a supermodel? Scientists at the Mayo Clinic in Rochester, Minn., have produced a weightloss program based on clinical research and experience that they say will help people lose weight and keep it off permanently. Dr. Donald Hensrud, a diet expert at the clinic and a co-author of The Mayo Clinic Diet, spoke about why the program is so effective, the research it is based on and what sets it apart from most other diet books.

Q: Why has the Mayo Clinic decided to publish a diet book? A: For a number of reasons. The first and most obvious one is that weight and obesity has become more of a problem in this country and around the world over the past decades. So, there is a need. Secondly, many other people have been promoting so-called Mayo Clinic diets over the years but there has never been an official Mayo Clinic diet book before. Thirdly, we think the timing is good right now. There is a lot of scientific evidence for the things we have put in the book based on research and evidence that we have accumulated here. We think we have a program that is effective, healthy, enjoyable and sustainable long-term. Q: What is it about the Mayo diet that sets it apart from others? A: There are some unique features about the Mayo Clinic diet. It is more than a diet. It is a lifestyle change program. It is divided up into two phases. The ‘lose it’ phase lasts two weeks, and we think this is the healthiest way to lose weight quickly….That transitions into the ‘live it’ phase. Once people see what they are capable of doing, they change those habits into a long-term lifestyle change. Another unique feature is the Mayo Clinic healthy weight-eating pyramid based on energy density.

Q: Why do people have such a hard time losing weight? A: It starts with the approach and we try to address that. This is one of the biggest paradoxes I know—eat right, exercise more. It sounds so simple but yet it is such a complex statement. The mindset that goes along with this [equation] is negative and restrictive, and therefore it is going to be temporary and not enjoyable. So what we do is to try to help people have realistic goals and to change their attitudes so [dieting] doesn’t have to be deprivation. Q: How big a component is exercise in your program? A: It is a big component, as it should be. That seemingly simple equation gets down to calories in versus calories burned. And energy expenditure, exercise, is very important. Exercise is the most important way to burn calories.

Q: Is the program applicable for children and adults? A: In the ‘lose it’ phase, it is based on sudden changes and habits but there isn’t anything in there that is unhealthy or unsafe—eating breakfast, eating more vegetables and fruit. What we are trying to do is take all the knowledge and the clinical experience and put it all together in one package that people can use to come up with a program for them that is effective, safe, healthy, enjoyable and sustainable.

Q: Is the book effective for someone who wants to lose 20 pounds or 200 pounds? A: Yes. It is. The principles of it apply to everyone. Admittedly, and this is in the medical literature, the greater the starting weight, the more people can lose initially, but they have a longer way to go. So, the greater the starting weight the more challenging it is to lose it and keep it off.

Q: What advice would you give to people who want to lose weight but don’t know how to get started, who find it just so daunting? A: That is exactly what we are trying to do with the book. I’d say pick up the book and read the first few chapters. THE HEALTH JOURNAL

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parenting

What’s Up, Doc? Talking with kids about the doctor WRITTEN BY SHARON MILLER CINDRICH

“Am I going to get a shot?” It is the most popular—and anxiety-laden—question kids ask when they hear they have an appointment at the doctor’s office. “Needles, shots and finger pricks are by far the greatest fear kids have when it comes to going to the doctor,” says Sam Fabian, parent educator with Children’s Hospital of the King’s Daughters in Norfolk. While it may be the most common reason for a child’s apprehension, getting a shot is not the only thing that causes a child’s nerves to fray when visiting a doctor. “The anxiety [also] stems from pain [and] fear of [the doctor] looking at their body and, more specifically, private parts,” explains Fabian, adding that generally kids between the ages of four and 12 experience the most anxiety. Parents may view their child’s occasional doctor visit as inconsequential, but the experiences can leave lasting impressions. “Each visit will bring a new experience, and the way the parent and doctor handle even the most distraught child can make a difference in future visits to the doctor,” says Fabian. Whether you’re taking your toddler in for the sniffles or your teen needs a flu shot, follow these tips to make the experience as painless as possible:

Avoid a surprise. “Often parents hold off in telling the child until the last minute about going to the doctor,” says Fabian. “Children are no different than adults. They like to know what to expect. When we are surprised or feel like we do not have enough information, we will react and panic.”

14 THE HEALTH JOURNAL

Manage expectations. “Parents should prepare the child, depending on their age, a day or two before and give them age-appropriate information that will help them understand what will happen,” says

Fabian. Talk about the waiting room, the sign-in desk and what happens once the nurse calls your child back to see the doctor. Details will help your child create a picture of the experience in his or her mind. Be honest. Protect the trust your child has in you by answering his or her questions honestly, even if there is a little pain in the picture. “If the child is getting a shot, never lie”, says Fabian. “Let them know it is to keep them from getting sick and that it may feel like a pinch, but it will be over in two seconds or less. Never tell them it won’t hurt.” Acknowledge anxiety. It is completely normal to be worried about getting blood drawn, a flu shot or a finger prick. Even children who are acting brave will benefit from a reminder that a little bit of worry is normal and that they aren’t alone in feeling anxious.

Remain calm. A toddler can throw a tantrum. Even an older child can be rude out of fear. As tensions get high, however, parents need to stay cool. “The more upset you get, the more the child will, too,” says Fabian. “The fear-anxiety response is something they cannot control, and it is OK.” He adds that pediatricians and their staff are well trained in working with children of every age and will not judge you if your toddler or teen gets upset.

Talk about the experience. No matter what happens in the doctor’s office, talk about it. Did the shot hurt as much as your child expected? Was the doctor nice? Did your child like the sticker he or she received? Giving children an opportunity to talk about their feelings will lay a foundation for their next visit and reassure them that you care about their experience.


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I Cross Over to the

fitness

n most gyms, the most versatile piece of equipment is the cable crossover—yet many people are intimidated by it. The cable crossover is nothing to fear—it’s simply a pulley system attached to a weight stack and is mounted on two towers. It can bring variety to any fitness routine and, if used correctly, can work every muscle group. Plus, the crossover’s attachments make it easy to transition from one exercise to another. Cable exercises provide a unique training stimulus. The crossover’s pulley system allows muscles to maintain constant tension, allowing for greater muscle isolation and contraction. In other words, it works your muscles in a completely different way than traditional free weights.

CROSSOVER CABLES WRITTEN BY GREG TUDOR, CPT PHOTOGRAPHY BY BRIAN M. FREER

The full-body workout on the following page uses only the cable crossover. The workout was designed to help you understand the machine while experiencing a radically different strength workout. I recommend that you aim for three sets of each exercise, 12 repetitions each. Try the entire routine, or add one or more of these exercises to your existing program. You will definitely feel the difference and see increased results. So, turn the page—and learn how the cable crossover can create a fitter, stronger you. Continued on page 18

Greg Tudor is a certified personal trainer and co-founder of Results Personal Training Studio, Inc.

THE HEALTH JOURNAL

17


fitness

Continued from page 17

Squat & Row ❙ Attach handles to low pulley cable.

❙ Stand facing the weight stack with feet shoulder-width apart. Grasp both handles, keeping the elbows bent, hands even with your waist.

1

❙ Slowly lower your body by bending at your hips and knees while allowing your arms to extend in front of you.

❙ When you are in a seated (squat) position, slowly reverse your movement and repeat.

Chest Squeeze

❙ Attach handles to each high pulley cable.

❙ Standing in the center of the machine, with your feet shoulder-width apart, grasp each handle with an overhand grip.

❙ With your arms out to the sides and elbows slightly bent, slowly pull each handle forward and meet them between your waist and chest. (Keep your back as straight as possible while performing this exercise.) Slowly return your arms to the starting position and repeat.

2

Pose Curls

❙ Attach handles to each high pulley cable.

❙ Standing in the center of the machine with your feet shoulder-width apart, grasp each handle with an underhand grip.

❙ Slowly bend at the elbows until you have formed an “L” with your arms. Squeeze and slowly return to starting position, then repeat.

3

Handle Pull-down

❙ Attach both handles to one high pulley cable.

❙ While seated on a fitness ball or bench, grasp each handle with palms facing each other and arms straight up.

4

❙ Slowly pull the handles down towards your chest and begin to separate them as you reach the bottom.

❙ Slowly return and repeat.

Tricep Rope Push-down ❙ Attach the rope to high pulley cable.

❙ Stand facing the weight stack with your feet shoulder width apart, grasping each end of the rope with arms bent, elbows toward the floor, and palms facing each other at chest level.

5

❙ Slowly pull down while keeping your elbows towards the floor and close to your sides. As you pull down, separate each handle until your arms are fully extended. ❙ Slowly return and repeat.

Lateral Raise

❙ Attach handles to each low pulley cable. ❙ Standing in front of the weight stack with feet shoulder-width apart, grasp each handle with an overhand grip and cross the wrists. With your elbows slightly bent, slowly raise each handle to shoulder height at your sides. ❙ Slowly return and repeat.

6 18 THE HEALTH JOURNAL


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ammograms should begin at 40 for women with an average risk of breast cancer and by 30 for high-risk women, according to guidelines released in January by two groups that specialize in breast imaging, contradicting controversial guidelines from a U.S. advisory panel last year. The joint recommendations from the American College of Radiology and the Society of Breast Imaging take into account the success of annual mammography screening starting at age 40, said Dr. Carol Lee of Memorial Sloan-Kettering Cancer Center in New York, whose study appears in the Journal of the American College of Radiology. “The significant decrease in breast cancer mortality, which amounts to nearly 30 percent since 1990, is a major medical success and is due largely to earlier detection of breast cancer through mammography screening,” Lee said in a statement. The recommendations have been in the works for about two years, but they serve in part as a rebuttal to guidelines issued in November by the U.S. Preventive Services Task Force, which recommended against routine breast mammograms for women in their 40s to spare them some of the worry and expense of extra tests to distinguish between cancer and harmless lumps. Those recommendations contradicted years of messages about the need for routine breast cancer screening starting at age 40, sparking a rebellion from among breast cancer specialists who argued the guidelines would confuse women and result in more deaths from breast cancer. “Amidst all the furor, the ACR and the SBI stand firmly behind their recommendation that screening mammography should be performed annually beginning at age 40 for women at average risk for

breast cancer,” Lee and colleagues wrote. The recommendations also cover the use of magnetic resonance imaging or MRI and breast ultrasound in women who are at high risk of breast cancer because they have mutations in the BRCA1 or BRCA2 genes or a family history of breast cancer. In these women, breast mammograms should begin by age 30, but not before age 25, when the risk of radiation exposure from the mammograms begins to outweigh the benefits of screening. Dr. Phil Evans of the University of Texas Southwestern Medical Center in Dallas and president of the Society for Breast Imaging said the guidelines are based on the latest clinical trial data. “Where the data was not present, we looked at recommendations that reflect expert consensus opinion,” he said in a telephone interview. He said they also help fill in some gaps in terms of how to screen high-risk women. In women who have BRCA mutations, the group recommends annual MRI screening, a more sensitive test, in addition to mammograms starting by age 30. Women who have a greater than 20 percent lifetime risk of breast cancer based on family history should also have annual MRI scans starting at 30. For high-risk women who cannot get an MRI, often because of claustrophobia, a breast ultrasound should be used instead, Evans said. The two groups did not consider the harms associated with routine screening at an earlier age, such as false positive results, which the task force was trying to balance. “The reason for that is there have been studies that have shown women would rather have their cancer found, even if it means having to have a biopsy. The harms, from most studies we’ve seen, did not seem to be all that real,” Evans said.


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feature

Remembering

PHOTO BY VICTORIA SUTHERLAND

Josephine WRITTEN BY JOSEPHINE’S FATHER

PHOTOS COURTESY OF THE LAMPITT FAMILY

This month, expectant parents Ed and Claire Lampitt of Williamsburg wrestle with a storm of conflicting emotions: While anticipating the birth of their second son, due in early March, the couple continues to mourn the loss of their daughter, Josephine Rose, who died Feb. 16, 2009, at just 10 months of age. Here, in a poignant narrative, Josephine’s father recounts the family’s emotional journey from Josephine’s initial diagnosis to how they are coping now as another chapter of their lives unfolds. 22 THE HEALTH JOURNAL


O

Until Josephine’s diagnosis, we naively believed that this was the type of tragedy that affected others, the proverbial “people down the street.” We could not have been more wrong.

ur story began in early December 2008. We were scheduled to bring our then eight-month-old daughter, Josephine Rose Lampitt, to Children’s Hospital of The King’s Daughters (CHKD) in Norfolk. She had been seen by other doctors before for what various specialists had repeatedly described as “severe reflux,” a relatively common and benign disorder that most children outgrow. We expected our visit to include a continuation of the reflux diagnosis but also a more detailed read-out on the cause for her newer symptoms, among them poor weight gain, unusual eye movements and persistent crankiness. The weight gain issue in particular was perplexing as we had tried for months to increase Josephine’s body weight with breast milk supplements, then formula, and eventually a high-calorie formula concentrate. Nevertheless, we’d been assured that there was no reason to worry. To our horror, we soon found ourselves confronting every parent’s worst nightmare: a diagnosis of an extremely rare and incurable disease that would take our infant daughter from us. The doctors explained that Josephine had a rare metabolic disease— specifically, a lysosomal storage disorder known as Gaucher (pronounced “go-shay”) disease. Of the three forms of the disease, only Type I has a sustainable treatment while Types II and III have a degenerative neurological component that is untreatable and incurable. Josephine had the rarest form, Type II, which affects approximately one in 100,000 live births. The average life span, we were told, was about nine months, though some children had lived as long as two to three years. Words fall short of capturing the emotions we felt then and have felt ever since, but shock, disbelief and horror are starting points. We had no known family history of that disease nor any disease for that matter. My wife and I had above-average health. We were both college-educated and from seemingly average American families. We were financially stable with a sound marriage and strong faith. We already had one healthy son. Until

that time we naively believed that this was the type of tragedy that affected others, the proverbial “people down the street.” We could not have been more wrong. We learned that Gaucher disease passes down via mutated recessive genes (present in approximately one in 400 people in the general population). Neither my wife nor I had ever displayed symptoms, nor had any of our relatives. For symptoms of Gaucher disease to manifest, both parents must have the recessive gene, and even then, the couple’s offspring have only a one in four chance of manifesting the disease (each child also has a 50-percent chance of carrying the disease with no symptoms and a 25-percent chance of having no trace of the disorder). We soon found ourselves looking back fondly on Josephine’s first six months when she behaved and appeared, for the most part, as a normal, healthy baby girl. She had been irritable at points, but that in itself had not alarmed us. Likewise, she had raspy breathing, but that had been attributed to the reflux. She made unusual facial expressions from time to time, but we (and her doctors) had reminded ourselves that every baby has his or her own ‘isms,’ quirks and silly expressions. She had made our family complete—a mom, a dad, a son and then sweet Josephine to balance the gender mix. We had all been thrilled when she was born, especially our son, who was eager to see his little sister grow up before his eyes. Now, my wife and I were faced with how to take care of a dying child, how to ensure Josephine had the best short little life possible with the best access to doctors, the most quality time with family possible and the most comfort science and faith could offer. We also had to consider our son’s emotional and mental health through her illness and, we feared, her impending death. My wife and I put our own needs—physical, mental, emotional—largely on hold, though we remained attuned to the fact that preserving our marriage during this time of chaos would be key to giving Josephine and our son the best support. Josephine’s doctors reminded us of the disease’s low incidence rate and admitted their lack of experience and comfort in treating children diagnosed with it. Dr. Virginia Proud, our pediatric genetic specialist at

PHOTO BY VICTORIA SUTHERLAND

Continued on page 25

THE HEALTH JOURNAL

23


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We went to bed each night not knowing whether Josephine would still be with us in the morning. It was terrifying.

Continued from page 23 CHKD, admitted she had only seen one other case of Gaucher Type II in her career; our local pediatrician, Dr. Jennifer Altman, had seen none. We scoured the Web for every morsel of information we could find on Gaucher disease, Type II. We found very little. We learned of a single organization dedicated specifically to Gaucher Type II and III—the Children’s Gaucher Disease Research Fund—through which we gained some insight but also fear and increased sadness. The group’s Website (www.childrensgaucher. org) conveyed the stories of children who had already succumbed to the disease. Each child’s story drilled home to us the reality of Josephine’s future. By mid-December 2008, Josephine started receiving all of her meals through a nasal-gastric tube inserted through her nose. This was the only means of increasing her caloric intake since the disease had begun to impair her ability to swallow and/or swallow without liquid entering her lungs. The lasting image in my mind of a tube protruding from our child’s nose is indescribable. Moreover, the mechanical and logistical challenges of administering meals and medications through the tube only added to our physical fatigue. On Dec. 23, Josephine had her first round of enzyme replacement therapy (ERT). The treatments, which she would need two to three times a month, helped to ease some of her non-neurological symptoms such as an enlarged spleen and liver. We undertook the lengthy, costly therapies to improve the quality of her life as no treatment can stop or even stall the neurological degeneration caused by Gaucher. In the end, the ERT treatments cost tens of thousands of dollars, but we never once hesitated to incur the cost for ourselves or our insurance provider. (Our provider, Anthem, did not balk at a single expense.)

By January 2009 we decided to bring Josephine to one of the world’s premier institutions for medical research—the U.S. National Institutes of Health (NIH) outside of Washington, D.C. We were reminded in advance that NIH’s mission is to research treatments, but that the dividends of the research process would be our (and future generations’) better understanding of the disease. Clearly, our goals for Josephine had changed. We continued to hope for a miracle, but we conceded that modern science could not save our child. We sought information from researchers to help us enhance Josephine’s quality of life and, ultimately, quality of death. Though our NIH doctors proved to be a tremendous resource as they interpreted a battery of tests, they couldn’t predict how Josephine’s specific gene mutations would manifest themselves in the coming weeks or months. We decided we’d keep Josephine at home as much as possible, out of arm’s reach of doctors who openly admitted they could not help us. This decision, in effect, removed the uncertainty over an extremely long-shot, unproven option of a bone marrow transplant in North Carolina. An oxygen pump and pulse-oxygen monitoring machine soon arrived at our home. The monitoring device measured the oxygen level in Josephine’s blood at night while she slept (and eventually during the day as her disease progressed). With increasing frequency, the device would emit a piercing alarm— indicating that her ever-weakening lungs couldn’t meet her body’s demands for oxygen. The alarms became so frequent that (with approval from doctors) we gradually adjusted the device’s sensitivity to allow us to sleep through some of her less-serious spells. Other nights were so rough that we took shifts sleeping

on her floor huddled in a blanket. Being closer to Josephine allowed us to respond more quickly with a direct, focused administration of life-saving oxygen and, equally important, a warm, reassuring hug for our sick, panicked child. In short, we went to bed each night not knowing whether Josephine would still be with us in the morning. It was terrifying. Through all our hospital visits, and especially the home visits of our warm-hearted and gifted pediatric nurse, Mr. Jaime Budy, we became increasingly wellversed in terms and concepts we had never before grappled with. We learned what a palliative care expert was, and we learned the names of medicines such as Ativan (for anxiety), Robinul (an expectorant) and morphine (for pain) and the proper method for administering these potent drugs around the clock. We came to understand the nuances of a Do Not Resuscitate (DNR) order, a legal document designed to clarify to emergency responders whether to give lifesaving resuscitation. On a more mundane level, we had to walk past the children’s spring clothing lines at stores, knowing Josephine would likely not need new outfits. We had to stop saying “It will be OK” in response to our daughter’s cries when we knew in our hearts that it would not. More disturbing, but necessary, we had to consider how, when and where Josephine might die. In the latter half of January, Josephine’s nasal-gastric tube was replaced with a tube that went directly to her stomach, giving her tender nose reprieve from the constant rubbing of the feeding tube and allowing her hands to swing more freely. Now that the feeding tube was hidden securely under her clothes, she could finally feel her face again without risk of pulling the tube out. Due to increasingly frequent and alarming sleep disturbances, we admitted Josephine to CHKD in early February 2009 so that doctors could conduct an overnight sleep study and hopefully determine the cause. The study revealed that the disease was causing severe sleep apnea (obstructive and central) and depriving her of “active sleep,” which is similar to REM in adults. [Ed.: Obstructive sleep apnea is the result of a collapsed or blocked airway while the central type is neurological, meaning the brain stops telling the body to breathe.] It was during that visit that CHKD Sleep Expert Dr. Michael Dubik noted the precious manner in which electrode-peppered Josephine caressed her mother’s face. His passing comment inspired me to snap a photo (above). That photo tells our story; it motivates me to this day. We had a serious scare on Feb. 15. Whereas previous apneic episodes had occurred at night, Josephine experienced one in the middle of the day during naptime. By chance—the monitor was not set up for daytime alerts—we discovered her mid-nap, a pronounced shade of blue. We quickly administered the oxygen pump and seconds later were relieved to have her back in our arms as a smiling child. Nonetheless, we were reminded that she was living on borrowed time. We called nearby relatives for moral support and were comforted by their visit. We sent our Continued on page 27 THE HEALTH JOURNAL

25


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As we approach the one-year anniversary of Josephine’s death, we are confronted with an overlap of conflicting emotions.

Josephine licking an apple on the morning of Feb. 16. This is the last picture ever taken of her.

Continued from page 25 son home with his cousins for a sleepover out of fear that Josephine would not make it through the night. To our surprise, the night was uneventful. Josephine woke up the next morning looking and feeling great. We cut up an apple and let her taste it. This was consistent with doctors’ advice to allow Josephine to enjoy one of life’s most basic pleasures. As with lollipops a few days before, and decaffeinated coffee and tea before that, she lit up with excitement. Such tastes would probably excite any child, but they took on special meaning for Josephine. By this point, she was not tasting any food or liquids; her nutrients were delivered straight to her stomach via a gastrointestinal tube. After Shutterbug Dad snapped a few photos of Josephine licking the apple, we packed her up in the car and drove to pick up her brother at our relatives’ house. Since she was doing so well and we planned to return home shortly, we left her medicines and equipment at home. We had a good visit, and Josephine even had some pleasingly strong laughs and giggles as she tasted some tea from her mother’s mug. Monday, Feb. 16—President’s Day, I remember—was warm enough that the older children went outside to play. My wife laid Josephine down to change her diaper, and that’s when we noticed Josephine was getting short on breath. And then it happened. Despite weeks of nervous anticipation and inconsistent medical advice about how long she might live, Josephine was gone. We had known this moment would come, and had made various preparations, but nothing could prepare us for the shock. We were allowed privacy as we said goodbye to Josephine, holding her in our arms for an hour or so before we made the dreaded phone calls. She escaped this world in a natural state, free from tubes and machines and hospitals and doctors. She cutely circumvented every man-made device designed to hold on to her, undermined every plan we’d made for her last days and minutes. She reminded us of those things we cannot control. Josephine’s death marked an important crossroads in our struggle. Her weight shifted from our arms and into our hearts, where it has remained. But we view her death as a turning point, not an end. This is not to say we are not still grieving. Under any other circumstances we’d have an almost-two-year-old running around the house. We miss her giggles, her smiles and all her silly quirks. Thoughts of her fill our lives yet we feel her absence. In the months since Josephine’s death, bold acquaintances have asked if we feel her presence. Are there angels, and does she send us signs? Are there miracles? What else could explain the strong scent of flowers in the family van on the morning of her death and, in the months that followed, the mysterious workings of not one but two car radios, the inexplicable healing of my back pain after years of suffering, and too many rainbows over the house to count? It had always been our dream to have a larger family of three to four children.

Doctors presented various means for us to have biological children with no risk of Gaucher disease, but those options were inconsistent with our beliefs. Likewise, we knew we would not consider terminating a pregnancy if our child tested positive. After countless hours of weighing the considerations, we decided to let go and open our hearts to the possibility of conceiving again. Our conclusion rested somewhat on the realization that, had we known of the defects in our genes years ago, we might have scared ourselves out of having our healthy son and even Josephine—whose impact on the world and people who knew her will outlive even us. Some may wonder whether Josephine’s short life was somehow not worth the pain, that perhaps she, too, would have preferred to not have experienced it all. We remind everyone that she experienced laughter and love from the first day until her very last. How many of us can really expect to be that fortunate? Last July we learned that we would be parents once again—our son is due in early March. Many weeks were filled with uncertainty—but surprisingly, not fear—as we awaited the results of amniocentesis tests that would reveal whether our child in utero would display Gaucher disease. Last October we learned the results: negative. Like our older son, this child will not manifest symptoms. As we approach the one-year anniversary of Josephine’s death (or, her “Angel Day” as we like to call it), we are confronted with an overlap of conflicting emotions. We are joyful and thankful for the expected arrival of our next son, but his arrival cannot “replace” Josephine, nor will we “move on” or “let go.”  She’s still a part of our family. We talk about her, and to her, on a regular basis. We visit her grave as well as her still-intact bedroom to feel close to her. Photos of her are prominently displayed in our home. And when videos of Josephine play on a digital picture frame, our son runs towards it just to catch a glimpse of her giggling again. At the same time, my wife must make snap decisions as to how much to tell strangers when they innocently ask about our baby-to-be, “Is this your second child?”, or comment, “Wouldn’t it be sweet to have a little girl?” While these remarks pierce our hearts, our hard-earned Ph.D. in life and death has made us largely unfazed by what others may consider important issues or major life stresses. We’ve lived through the worst hand life can deal, and we feel we can tackle anything new that comes our way. A year ago we felt utterly helpless; we feel invincible now. And that feeling of weathered strength allows us to leverage our suffering for a greater cause (see below, “How You Can Help”). To quote Greg Macres, founder of the Children’s Gaucher Disease Research Fund and father to the late Gregory Macres, lost 13 years ago to the disease: “We can accept our pain and do nothing, or we can channel it to make the world a better place.”

HOW YOU CAN HELP

1. Share this story with a friend. 2. Visit www.childrensgaucher.org to learn more. 3. Make a donation. • Donate directly to the Children’s Gaucher Disease Research Fund (PO Box 2123, Granite Bay, CA 95746). One hundred percent of funds raised through this organization goes to medical research. • Federal employees may consider a donation via payroll deduction through the 2010 Combined Federal Campaign(CFC). Search the CFC catalog to get the code for the Children’s Gaucher Disease Research Fund. (Thanks in part to Josephine’s parents, this is the first year that this charity will be listed in the CFC catalog.) THE HEALTH JOURNAL

27


skin & beauty

IPL: Bringing a Youthful Look Back to Your Hands WRITTEN BY DR. KEITH W. SCHUMANN

Keith W. Schumann, M.D., is a board-certified dermatologist with advanced training in lasers. The founder of Ageless Dermatology & Laser Center, he has practiced in Williamsburg for the last 10 years. He can be reached at info@agelessderm.com.

What am I looking at?

These two hands (at left) show the regenerative power of laser skin care treatments. The brown sun spots that many of us have on our hands can be removed with two 10-minute non-invasive IPL (intense pulsed light) treatments. On this patient, the treated hand is clear while the untreated hand remains spotted.

Why rejuvenate the hands? Your hands are often one of the first things people notice upon meeting you. Repairing sun damage to the hands with a series of IPL laser treatments can contribute to a more youthful look.

28 THE HEALTH JOURNAL

How does IPL work?

IPL systems are based on the same principles as lasers in that light energy is selectively absorbed by targeted cells. The light energy is converted to heat, which causes thermal damage to these cells, resulting in smooth, even skin color and tone.

How much downtime?

One advantage of IPL is that it’s a non-ablative technique, which means that it targets the lower layers of skin without affecting the top layers of skin. The result is minimal downtime—you can usually return to work or social activities immediately afterwards.

Who performs IPL treatments?

It is recommended that patients see a boardcertified dermatologist with advanced training in lasers.


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WHY USE THE TRX SYSTEM? It’s portable > While TRX Suspension classes are offered at gyms around the country, various attachments enable you to fasten the system to doors or walls at home, in hotel rooms or just about anywhere. It’s adaptable to every fitness level > Because the TRX uses your own body weight, you can change the difficulty of any exercise by changing the length of the straps and your body position. Transitions are easy > The system allows you to change exercises in less than 15 seconds. This means that you can make the most of your training with fast-paced, circuit-style workouts. Strengthens core muscles > Works the body across different planes and directions, mimicking real-life movement. Perfects your posture by strengthening the stabilizer muscles in your back. Improves flexibility > Your body is forced to stretch and flex in new ways and directions.

WRITTEN BY BRIDGIT KIN-CHARLTON | PHOTOGRAPHY BY BRIAN M. FREER

T

he TRX (Total Resistance eXercise) suspension training system is new, but it looks and feels old. A simple, lowtech exercise modality—all substance and no flash—it uses straps, a central pivot point and your own body weight to transform the way you work out. Celebrities, professional athletes, U.S. Marines, Navy Seals, Ultimate Fighting Champs and NFL teams use this system. It’ll work you harder than any other gym session, and you’ll feel the benefits immediately. Best of all, it’s portable. You can use it at home, in a hotel room or even in your office.

30 THE HEALTH JOURNAL

To understand the strengths of this system, you need to know its origins. While serving in the U.S. Military, Navy Seal Randy Hetrick (now retired) often did body weight exercises like push-ups and pull-ups, but he found that he couldn’t work the muscles of his back and legs effectively. So, in 1996, he created his own suspension system from extra parachute harnesses. Once it became popular, he started manufacturing the TRX system on a commercial scale. Since then, it has become widely used throughout the U.S. and the world.

Bridgit KinCharlton is the founder of B-defined Innovative Personal Training and Wellness, located in Williamsburg.


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Here is a circuit of six exercises designed to rebuild your body from head to toe. Perform each exercise for 60 seconds, moving quickly between each one. Work your way up to completing three sets of the entire circuit, for a total of 20 minutes.

1. CHEST PRESS works: chest, shoulders and triceps With back to the TRX, stand with feet hip-width apart, holding handles with arms extended forward and parallel to floor, palms down. Lean forward onto balls of feet. Bend elbows and lean body further forward, lifting one leg behind you (as shown). Return to start position and repeat with opposite leg.

1

2. SINGLE-LEG SQUAT works: glutes, legs and core Convert straps to the single-handle position. With back to TRX, place right toes into handle and hop left foot forward, hands on hips. Bend left knee, lowering to a lunge, keeping knee over ankle (as shown). Rise to standing position and repeat for 30 seconds. Switch legs. 3. SQUAT TO ROW works: glutes, shoulders, back and legs Facing the TRX, hold one handle in each hand. Squat (as shown). As you return to standing position, pull elbows back until the wrists are at your hips. Repeat. 4. MOUNTAIN CLIMBERS works: chest, shoulders and core Kneel, facing away from the TRX, and hook toes into handles. Walk hands forward until legs and back are straight (plank position). Bring one knee to chest (as shown) and continue to alternate. 5. HAMSTRING CURL足 works: hamstrings, glutes and low back Lie on your back and place heels in the TRX handles, legs extended, arms at sides. Lift hips until torso aligns with the legs and body forms a straight line. Bend knees, bringing heels toward glutes (as shown). Return to starting position and repeat. 6. SINGLE-LEG PUSH-UP TO PIKE works: entire body Kneel, facing away from the TRX, and hook right toes into handles. Walk hands forward until legs and back are straight (body is in a push-up position) and cross left foot over right. Lower into a push-up, keeping body in a straight line. Push your body up and lift glutes to ceiling, keeping legs straight and shoulders over hands (as shown). Extend body back to start position and repeat.

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THE HEALTH JOURNAL

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heart health

GETTING TO THE HEART OF THE MATTER:

Congestive Heart Failure WRITTEN BY DR. VASUDEV ANANTHRAM

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n a normal, healthy heart, blood vessels called veins deliver impure (oxygen-deficient) blood to the right upper and lower chambers of the heart. This blood is then pumped into the lungs by the right lower chamber of the heart. Once in the lungs, the blood is enriched with oxygen and then poured into the heart’s left upper and lower chambers. From there it is pumped by the strong muscle of the left lower chamber to the rest of the body to keep it well nourished and energized. Valves guard each of the exit points of the heart’s chambers to prevent the blood from flowing backwards.

What is Congestive Heart Failure?

Dr. Vasudev Ananthram is a board-certified cardiologist and founder of Cardiovascular Health, a member of Riverside Medical Group.

Congestive heart failure, simply put, is an inability of the heart to pump enough blood. This, in most cases, is a result of malfunction in the heart’s mechanics. If the heart cannot pump adequate amounts of blood, the blood backs up from the left side of the heart into the lungs and then through the right side of the heart, leaking into the lungs, the gastrointestinal tract (gut) and the legs. The most common symptom of congestive heart failure is shortness of breath initially noted with low levels of exertion. Symptoms then progress to shortness of breath at rest and then result in an inability to lie down or even sleep. Sometimes the breathing difficulty may come on so suddenly and severely that an individual finds himself or herself gasping for air. Other symptoms may include cough (typically worsening at night or with exercise), chest discomfort, fatigue or lethargy, loss of appetite, leg swelling and a bloating sensation in the abdomen.

Why Does the Heart Fail?

While congestive heart failure is nearly always caused by mechanical failings of the heart, there are several reasons why the heart might fail: 1. Rhythm disturbances of the heart. If the heart rate is too fast, irregular or too slow, the heart pumps less efficiently.

2. Weakness in the heart muscle. Heart muscle weakness can be caused by a heart attack, multiple blockages in the blood vessels of the heart, certain viral infections, diabetes and/or uncontrolled high blood pressure, excessive alcohol use or illicit drug use.

3. Heart valve abnormalities. Leakage of heart valves, especially in the left side of the heart, results in a back flow of blood. The heart must then pump harder to maintain adequate forward blood flow. This ultimately enlarges and weakens the heart muscle, leading to progressive congestive heart failure. If the leakage occurs suddenly, the heart has no time to compensate, and the individual immediately enters a state of congestive heart failure and may begin gasping for air. Sometimes age or conditions such as high blood pressure, high cholesterol or structural abnormalities may cause the heart muscle to thicken or become too rigid. As a result, the valves do not open freely. As the valve openings narrow, the heart must work harder to push the blood through them. This process can also ultimately cause congestive heart failure. 32 THE HEALTH JOURNAL

4. Abnormal relaxation of the heart muscle. When the heart muscle is unable to relax adequately, blood does not flow freely into the heart’s left lower chamber. This can result in congestive heart failure. The two most common causes of abnormal relaxation are uncontrolled high blood pressure and advanced age. Much less frequently, congestive heart failure can occur in a normal, otherwise healthy heart—when the body develops an abnormally high demand for blood. This can be due to: • Severe anemia (low red blood cell count) • Severe and abnormally high activity of the thyroid gland, causing a very high metabolism • Extremely strenuous exercise to unaccus tomed levels • Very high fever and/or severe infections Any of the above causes of congestive heart failure can coexist. For instance, a valve leakage and a rhythm abnormality can develop in an already weak heart and result in congestive heart failure. Also, if a heart is weak but still functioning adequately, even a modest degree of increase in the demands of the body can cause congestive heart failure.

How is CHF Treated?

The goal of treatment is to improve quality and quantity of life for patients. Several medications are available which can prevent deterioration or even improve the heart’s ability to pump blood. Under appropriate circumstances, surgery can be recommended to improve blood flow to the heart and also to correct valve abnormalities. In some patients, certain types of pacemakers and implantable cardiac defibrillators* (ICDs) can also be useful. Lifestyle modification is an integral part of treating congestive heart failure. Here are some take-away tips to live by if you are showing early signs of this disease or may be at risk: • Limit salt intake to less than two grams (2,000 mg) a day. • Start a regular exercise program under the guidance of a physician. • Avoid strenuous exercise that your body is not accustomed to. (In other words, don’t be a weekend warrior!) • Eat sensible, moderately portioned meals. • Strive to achieve your ideal body weight— this reduces the demands on the heart. (Visit www.cdc.gov/healthyweight/index.html to calculate your current body mass index versus where you need to be.) • Quit smoking.

*An implantable cardiac defibrillator recognizes and corrects abnormal heart rhythms (arrhythmias). The device is surgically implanted within the chest wall. The ICD can prevent sudden cardiac arrest/death while a pacemaker is generally used to correct an unusually slow heartbeat.


. y a Just P l

We’ll do the rest.

The Sports Care Program at Riverside Orthopaedics and Sports Medicine is your resource for diagnosing and treating sports-related injuries and all other injuries related to physical activity. Our physician specialists, rehabilitation specialists and home care and fitness professionals take a team approach to developing a completely personalized care plan that helps get you back in the game or to your highest possible level of functioning. For exceptional orthopaedic care, call (757) 875-7880. The Sports Care Program of Riverside Orthopaedics and Sports Medicine: The team that gets you back in the game.

RIVERSIDE H Ariversideonline.com M P TO N R OA D S U R O L O G Y

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snapshots

Chesapeake native and New York Mets third baseman David Wright recently visited patients and families at Children’s Hospital of The King’s Daughters. Wright recorded a special message of encouragement for CHKD’s pediatric patients to hear when they call the hospital operator to order movies and games to their rooms.

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Dr. Richard Harris, chairperson of The Consortium for Infant and Child Health, presented Lisa Wright-Martin the Hampton Roads Child Health Advocate Award in the category of Faith-Based Advocate at the organization’s annual conference in Virginia Beach on Dec. 11.

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Board-certified family physicians Drs. Dena Hall (3), Scott Fowler (4) and Attiyah Ismaeli-Campbell (5) are now seeing patients at the new Riverfront Family Medicine and Specialty Care, located in the Konikoff Building at Harbour View. The new facility will provide the Suffolk community with specialty care services in a convenient location and reflects Suffolk’s mission to attract quality health care providers.

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On Dec. 17, city officials, volunteers and senior leaders at Chesapeake Regional Medical Center held a ribbon-cutting ceremony opening the newly expanded Emergency Department. The $6.5-million expansion/renovation project almost doubled the Emergency Department.

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Students at Star of the Sea Elementary School in Virginia Beach participated in “A Wave of Exercise,” a national program that encouraged students to exercise for a total of 10 hours in a row. (7) Star of the Sea principal Dr. Cathryn Whisman (left), with physical education teacher Louise O’Konek (right), took part in the effort. (8) Students, led by Louise O’Konek, marched in place during the event.

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The Peninsula Women’s Network held its annual Holiday Social at Heritage Commons, an active adult community in Williamsburg. The gathering was a celebration among PWN friends, members, spouses and guests.

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Marking the start of construction on Bon Secours’ DePaul Medical Center, work crews demolished the hospital’s old School of Nursing dormitory/clinic.

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SEND US YOUR SNAPSHOTS! 9 34 THE HEALTH JOURNAL

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E-mail your photos along with a brief description to page@thehealthjournals.com


the

Health Journal Williamsburg Edition

Health Directory EMERGENCY NUMBERS National Response Center Toll-Free: (800) 424-8802 National Suicide Crisis Hotline Toll-Free: (800) 784-2433 National Suicide Prevention Hotline Toll-Free: (800) 273-8255 Poison Control Center Toll-Free: (800) 222-1222

ALLERGISTS & ENT Allergy & Asthma of Oyster PointWilliamsburg 217 McLaws Cir., Suite 5 Williamsburg (757) 873-3882 Riverside Williamsburg Ear, Nose, Throat & Allergy Clinic 120 Kings Way, Suite 2600 Williamsburg (757) 345-2600 VA Adult & Pediatric Allergy & Asthma PC 1144 Professional Drive Williamsburg (757) 259-0443 Williamsburg ENT - Allergy 400 Sentara Circle, Suite 300 Williamsburg (757) 253-8722

Chiro Care Plus, PC 3204-A Ironbound Rd. Williamsburg (757) 565-6464

Carol F. Morgan, DDS 1130 Old Colony Ln. Williamsburg (757) 220-6727

Riverside Diagnostic Center 120 Kings Way, Suite 1200 Williamsburg (757) 345-6700

Knee Pond Yoga, LLC 3356 Ironbound Rd., Bldg. 2, Ste. 202B Williamsburg (888) 524-4985

Hampton Roads Ear, Nose and Throat 11842 Rock Landing Dr., Ste. 100 Newport News (757) 873-0338

Commonwealth Family Chiropractic 140 Professional Cir. Williamsburg (757) 220-9670

Thomas J. Morris, DDS 491 McLaws Cir., Suite 1 Williamsburg (757) 253-0598

Tidewater Diagnostic Imaging 100 Sentara Circle Williamsburg (757) 984-6000

Ladies Workout Express 3709-B Strawberry Plains Rd. Williamsburg (757) 220-2992

Women's Imaging Center 100 Sentara Circle Williamsburg (757) 984-6000

The Pilates Center 1130 Old Colony Lane, Suite 201 Williamsburg (757) 229-5002

Hearing Evaluation & Noise Protection Assoc., Inc. 1321 Jamestown Rd., Suite 104 Williamsburg (757) 229-4335

ENDOCRINOLOGY

Pilates With Cindy 6580 Wiltshire Road Williamsburg (757) 645-2542

Christopher Connolly, DC 5252 Old Towne Rd. Williamsburg (757) 220-0060

Integrative Chiropractic & Acupuncture 1318 Jamestown Rd., Suite 102 Williamsburg (757) 253-1900

Robert F. Morrison, DMD William Broas, DDS Pete Foster, DDS Ira Goldstein, DDS Shanail Moorman, DDS Stephen L. Murphy, DDS 1131 Professional Drive Williamsburg (757) 220-0330 7151 Richmond Rd., Ste. 305 Williamsburg (757) 258-7778

Terry Liber, DC, CST 489 McLaws Cir., Ste. 1 Williamsburg (757) 565-6363

Mark M. Neale, DDS, MAGD 5000 New Point Rd., Ste. 2101 Williamsburg (757) 229-8050

Riverside Diabetes Education 120 Kings Way Williamsburg (757) 534-5918

Performance Chiropractic 1307 Jamestown Rd., Suite 103 Williamsburg (757) 229-4161

Sebastiana Springmann, DDS Sonia Tao Yi, DDS Maria L. Freyfogle, DMD, MAGD, ABGD 4939 Courthouse Street Williamsburg (757) 259-0741

FAMILY PRACTICE

Teresa Green, L Ac 7131 Richmond Rd., Ste. 302 Williamsburg (804) 561-1258

Pinto Chiropractic & Rehabilitation 5408 Discovery Park Blvd., Ste. 200 Williamsburg (757) 645-9299 Platinum Chiropractic 3709-D Strawberry Plains Rd. Williamsburg (757) 229-6069

ASSISTED CARE & SENIOR LIVING

Tai Acupuncture 362 McLaws Cir., Ste. 2 Williamsburg (757) 565-9611

Chambrel of Williamsburg 3800 Treyburn Dr. Williamsburg (757) 220-1839

The Spine Center of Williamsburg 219 McLaws Circle Daniel S. Carlson, DC Williamsburg (757) 259-0077 Mark Croucher, DC Williamsburg (757) 259-1122

Colonial Manor 8679 Pocahontas Trail Williamsburg (757) 476-6721 Consulate Health Care 1811 Jamestown Rd. Williamsburg (757) 229-9991 Dominion Village of Williamsburg 4132 Longhill Rd. Williamsburg (757) 258-3444 Heritage Commons 236 Commons Way Williamsburg (888) 711-6775 Madison Retirement Center 251 Patriot’s Lane Williamsburg (757) 220-4014 Morningside Of Williamsburg 440 McLaws Circle Williamsburg (757) 221-0018 Patriots Colony at Williamsburg 6000 Patriots Colony Dr. Williamsburg (757) 220-9000 Riverside Adult Daycare 3435 John Tyler Hwy., Bldg. 2, Ste. 1-A Williamsburg (757) 565-5305 Ruxton Health of Williamsburg 1235 S. Mt. Vernon Ave. Williamsburg (757) 229-4121 Spring Arbor 935 Capitol Landing Rd. Williamsburg (757) 565-3583 Williamsburg Landing 5700 Williamsburg Landing Dr. Toll-Free (800) 554-5517 WindsorMeade of Williamsburg 3900 Windsor Hall Drive Williamsburg (757) 941-3615

CARDIOLOGY Advanced Cardiovascular Institute 5215-A Monticello Ave. Williamsburg (757) 229-1440 Cardiovascular Health 117 Bulifants Blvd., Ste. B Williamsburg (757) 259-9540

Walsh Family Chiropractic, PC 1309 Jamestown Rd. Williamsburg (757) 220-4917 Williamsburg Chiropractic Clinic 5252-A Olde Towne Rd. Williamsburg (757) 220-0060

Parks Orthodontics 1116-A Professional Dr. Williamsburg (757) 253-0521 Christine Piascik, DDS 1769 Jamestown Rd., Suite B Williamsburg (757) 229-8920 Richard A. Pugliese, DDS 502 Strawberry Plains Rd. Williamsburg (757) 259-9703 Nancy Yang Schumann, DDS 5309 Discovery Park Blvd. Williamsburg (757) 564-0900

Boxx, Blaney Lachine & Bowe 1118-A Professional Drive Williamsburg (757) 229-5570

K. L.Tankersley, DDS, MD 1147 Professional Dr. Williamsburg (757) 258-8913

D. W. Cherry, DDS 2225 S Henry St. Williamsburg (757) 253-2500

David G. Walker, DDS 813 Richmond Rd. Williamsburg (757) 229-6278

Michael J. Coleman, DDS 6969 Richmond Rd. Williamsburg (757) 564-0041

Williamsburg Oral & Maxillofacial Surgery 195 Strawberry Plains Rd. Williamsburg (757) 229-6692

Curry Dental Center 312-H Lightfoot Rd. Williamsburg (757) 220-3450

Williamsburg Orthodontics 4097-A Ironbound Rd. Williamsburg (757) 253-1200

Bruce DeGinder, DDS 240 McLaws Circle, Ste. 153 Williamsburg (757) 220-9492

Williamsburg Dental Group 1319 Jamestown Rd. Williamsburg (757) 229-7210 106 Bacon Ave. Williamsburg (757) 229-3099

John P. Doley, DDS 1116-A Professional Dr. Williamsburg (757) 229-4181 Sam E. English, DDS 4680-16A Monticello Ave. Williamsburg (757) 258-1042 Peter S. Evans, DDS 120 Kings Way, Ste. 1300 Williamsburg (757) 220-1999 Gisela K. Fashing, DDS 325 McLaws Circle, Suite 1 Williamsburg (757) 229-8991 Gilbert J. Frey, DDS Lawrence R. Samiere, DDS 1161 Professional Dr. Williamsburg (757) 253-0400 Terry H. Hake, DDS 1761 Jamestown Rd. Williamsburg (757) 229-4115

TPMG Williamsburg Diagnostic Cardiology 4125 Ironbound Rd., Ste. 201 Williamsburg (757) 565-0600

Hampton Roads Oral & Maxillofacial Surgery 1147 Professional Drive Williamsburg (757) 258-8913

Beverly E. Boone, DC 213 McLaws Circle, Ste. 1 Williamsburg (757) 596-7605

Edward A. Owens, DMD 211 Bulifants Blvd., Bldg. 14, Ste. A Williamsburg (757) 229-6414

DENTISTRY & ORAL HEALTH

Hampton Roads Neuromuscular & Aesthetic Dentistry 1313 Jamestown Rd., Ste. 205 Williamsburg (757) 229-3052

Acupuncture Works, Inc. 362 McLaws Circle, Suite 2 Williamsburg (757) 565-9611

Norge Dental Center 7450 Richmond Rd. Williamsburg (757) 564-0804

Ronald J. Smalls, DDS 1309 Jamestown Rd., Suite 103 Williamsburg (757) 229-0620

Sentara Cardiology Specialists 500 Sentara Cir., Ste. 100 Williamsburg (757) 984-9800

CHIROPRACTIC & ACUPUNCTURE

We’ve done our best to include every health-related practice or service in Greater Williamsburg. If your organization is not listed, or if your listing is not current, send your updates to info@thehealthjournals.com.

Paul Hartman, DDS 1323 Jamestown Rd., Suite 203 Williamsburg (757) 253-2393 Adam J. Kadolph, DDS 7151 Richmond Rd., Suite 303 Williamsburg (757) 565-3737 Lifetime Family Dental 7349 Richmond Rd. Williamsburg (757) 564-8942

Williamsburg Family Dentistry 213 Bulifants Blvd., Ste. 15-E Williamsburg (757) 345-5500 Williamsburg Periodontics & Implants 200 Packets Court Williamsburg (757) 221-0249 Walter G. Winneberger, DDS 104 Bypass Rd., Suite 202 Williamsburg (757) 229-6960 Wyatt Orthodontics 7151 Richmond Rd., Suite 303 Williamsburg (757) 565-3737

DERMATOLOGY Ageless Dermatology & Laser Center 5309 Discovery Park Blvd. Williamsburg (757) 564-1200 Dermatology Center of Williamsburg 5335-A Discovery Park Blvd. Williamsburg (757) 645-3787 Dermatology Specialists 475 McLaws Cir., Suite 1 Williamsburg (757) 259-9466 Joseph W. Musgrave, MD 1139 Professional Dr. Williamsburg (757) 220-2266 Pariser Dermatology Specialists 207 Bulifants Blvd., Suite C Williamsburg (757) 564-8535

DIAGNOSTIC IMAGING Cranial Facial Imaging Center 7151 Richmond Rd., Ste. 306 Williamsburg (757) 476-6714

Williamsburg Endocrinology, Inc. 207 Bulifants Blvd., Ste. D Williamsburg (757) 565-9586

Family Care of Williamsburg 117-A Bulifants Blvd. Williamsburg (757) 565-5440 Tommy Johnson, MD 1313 Jamestown Rd., Ste. 103 Williamsburg (757) 229-1259 Bruce Mayer, MD, PC 4622 Rochambeau Drive Williamsburg (757) 566-2045

Quarterpath Recreation Center 202 Quarterpath Rd. Williamsburg (757) 259-3770 R. F. Wilkinson Family YMCA 301 Sentara Circle Williamsburg (757) 229-9622 Reach for Performance, Inc. 312-J Lightfoot Rd. Williamsburg (757) 258-1221 Results Personal Training Studio, Inc. 3206-C Ironbound Rd. Williamsburg (757) 565-5000 Sante Living! 5301 Birdella Dr. Williamsburg (757) 208-0314

Riverside Williamsburg ENT & Allergy Clinic 120 Kings Way, Suite 2600 Williamsburg (757) 253-1832 Williamsburg ENT-Allergy 400 Sentara Circle, Suite 300 Williamsburg (757) 253-8722

HEARING AIDS Beltone/Ledford Audiology & Hearing Aid Center 1303 N. Mount Vernon Ave. Williamsburg (757) 220-8975 Bowers Assistive Hearing Service 113-L Palace Lane Williamsburg (757) 220-3674 Moran Hearing Aid Center 1158-C Professional Dr. Williamsburg (757) 564-5902

HOSPICE & HOME CARE

Tidewater Systema Russian Martial Art Williamsburg (757) 810-8104

Agape Home Care 354 McLaws Circle, Suite 1 Williamsburg (757) 229-6115

Transitions Lifestyle 3244 Windsor Ridge S. Williamsburg (757) 645-5737

At Home Senior Consultants 213-A Quarter Trail Newport News (757) 528-0552

Williamsburg Indoor Sports Complex 5700 Warhill Trail Williamsburg (757) 253-1947

Riverside Williamsburg Medical Arts Urgent & Primary Care 5231 John Tyler Highway Williamsburg (757) 220-8300

At-Home Care 366 McLaws Circle, Suite 2 Williamsburg (757) 220-2112

WJCC Recreation Center 5301 Longhill Road Williamsburg (757) 259-4200

Bayada Nurses 7151 Richmond Rd., Suite 201 Williamsburg (757) 565-5400

TPMG Family Medicine 132 Professional Circle Williamsburg (757) 645-2981

GASTROENTEROLOGY

Brookside Home Health 460 McLaws Circle, Ste. 250 Williamsburg (800) 296-2536

New Town Family Practice 4374 New Town Ave., Ste. 200 Williamsburg (757) 220-2795 Riverside Williamsburg Medical Arts Family Practice 120 Kings Way, Suite 1400 Williamsburg (757) 345-2555

TPMG Norge Family Practice 7151 Richmond Road., Suite 405 Williamsburg (757) 564-3700 Williamsburg Family Physicians 227 McLaws Circle Williamsburg (757) 564-8182 Williamsburg Internal Medicine 400 Sentara Circle, Suite 400 Williamsburg (757) 345-4600

Colonial Gastroenterology 400 Sentara Circle, Suite 350 Williamsburg (757) 253-5771 TPMG Specialist Center 4125 Ironbound Rd. Williamsburg (757) 903-4807 Williamsburg Gastroenterology 457 McLaws Circle, Suite 103 Williamsburg (757) 221-0750

GENERAL SURGERY

FITNESS & WEIGHT MANAGEMENT

Hampton Roads Surgical Specialists 120 Kings Way, Ste. 2800 Williamsburg (757) 345-0141

Anahata Yoga Center 104 Bypass Road, Suite 201 Williamsburg (757) 253-0080

TPMG Specialist Center 4125 Ironbound Rd. Williamsburg (757) 345-2071

Baeplex Family Martial Arts Center 3435-A John Tyler Highway Williamsburg (757) 229-2237

Williamsburg Surgery, PC 500 Sentara Circle, Ste. 202 Williamsburg (757) 984-9850

B-defined Personal Training 4801 Courthouse St., Suite 122 Williamsburg (757) 345-6801

HAND SURGERY

Body Balance Studio 370 McLaws Cir. Williamsburg (757) 221-0774

Robert A. Campolattaro, MD Nicholas Smerlis, MD 5208 Monticello Ave., Suite. 180 Williamsburg (757) 206-1004

Bodyfit 5251 John Tyler Hwy. Williamsburg (757) 221-6688

HEALTH PRODUCTS & EQUIPMENT

CORE FITNESS Performance Training Center 344 McLaws Circle Williamsburg (757) 564-7311

Bike Beat 4640 Monticello Ave., Ste. 9-B Williamsburg (757) 229-0096

Curves For Women 4511-B John Tyler Hwy. Williamsburg (757) 221-0330 107-A Bulifants Blvd. Williamsburg (757) 565-5655 Equilibrium Exercise Gallery 7880 Richmond Rd. Toano (757) 566-0077

FT - Fitness Together 4854 Longhill Rd., Ste. 1-A Williamsburg (757) 345-2246 Healthy Equation 701 Merrimac Trail, Ste. K Williamsburg (757) 200-5838 Ironbound Gym 4325 New Town Avenue Williamsburg (757) 229-5874 Jazzercise 455 Merrimac Trail Williamsburg (757) 220-8020

Bikesmith of Williamsburg 515 York Street Williamsburg (757) 229-9858 Bikes Unlimited 141 Monticello Avenue Williamsburg (757) 229-4620 Ceo Maidin Feirm Community Supported Agriculture Toano (757) 566-0009 Conte's Bicycle & Fitness 4919 Courthouse Street Williamsburg (757) 565-1225 General Nutrition Center 4680-18B Monticello Ave. Williamsburg (757) 565-5100

HEARING & AUDIOLOGY Colonial Center For Hearing 337 McLaws Circle, Suite 3 Williamsburg (757) 229-4004

Comfort Keepers 15441-A Pocahontas Trail, Lanexa (757) 229-2777 Concordia Group 1524-C Merrimac Trail Williamsburg (757) 229-9930 Hand 'N' Heart 461 McLaws Circle, Ste. 3 Williamsburg (757) 565-0216 Harmony Care 106 Queen Anne Dr. Williamsburg (757) 784-7650 Hope In-Home Care 4512 John Tyler Hwy., Ste. G Williamsburg (757) 220-1500 Hospice of Virginia 7231 Forest Ave., Ste. 100 Richmond (804) 281-0451 Hospice Support Care 4445 Powhatan Pkwy. Williamsburg (757) 253-1220 Intrepid USA 212 Packets CT., Williamsburg (757) 220-9331 Karya Home Care, Inc. 376 McLaws Circle, Ste. B1 Williamsburg (757) 259-7411 Personal Touch Home Care & Hospice of Va. 5581 Bulifants Blvd. Williamsburg (757) 564-6455 Sentara Home Care Services 1100 Professional Dr. Williamsburg (757) 259-6251 Riverside Home Care 856 J. Clyde Morris Blvd., Ste. C Newport News (757) 594-5600 Riverside Hospice 12420 Warwick Blvd., Ste. 7-D Newport News (757) 594-2745 Therapeutic Holistic Wellness Care 311 Raven Terrace Williamsburg (757) 645-2926

HOSPITALS & CLINICS Angels of Mercy Medical Clinic 7151 Richmond Rd., Suite 401 Williamsburg (757) 565-1700 Berkeley Outpatient Medical & Surgical Center 136 Professional Circle Williamsburg (757) 253-2450

THE HEALTH JOURNAL

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First Med of Williamsburg 312 Second St. Williamsburg (757) 229-4141 Lackey Free Family Medicine Clinic 1620 Old Williamsburg Rd. Yorktown (757) 886-0608 MedExpress Urgent Care 120 Monticello Ave. Williamsburg (757) 564-3627 New Town Urgent Care 4374 New Town Ave., Ste. 100 Williamsburg (757) 259-1900 Olde Towne Medical Center 5249 Olde Towne Rd. Williamsburg (757) 259-3258 Riverside Williamsburg Medical Arts Urgent & Primary Care 5231 John Tyler Highway Williamsburg (757) 220-8300 Sentara Outpatient Care Center 301 Sentara Circle Williamsburg (757) 984-9900 Sentara Williamsburg Regional Medical Center 100 Sentara Circle Williamsburg (757) 984-6000 Travel Health of Williamsburg 287 McLaws Cir., Suite 2 Williamsburg (757) 220-9008

HYPNOSIS Joan R. Milkavich, LPC 352 McLaws Cir., Suite 3 Williamsburg (757) 564-4590 Linda Pincus, RN, CH 240 Patrick's Crossing Williamsburg (757) 565-6156 Williamsburg Healthy Hypnosis 1769-107 Jamestown Rd. Williamsburg (757) 254-1104

INTERNAL MEDICINE Kevin R. Bedell, MD 4622 Rochambeau Dr. Williamsburg (757) 566-4246 Greensprings Physicians 2000 Easter Circle Williamsburg (757) 564-5540 Internal Medicine of Williamsburg 227 McLaws Circle Williamsburg (757) 564-8182 Kingsmill Internal Medicine 477 McLaws Circle, Suite 1 Williamsburg (757) 208-0010 The Massey Clinic 322 Monticello Ave. Williamsburg (757) 229-0919 New Town Internal Medicine 4374 New Town Ave., Ste. 102 Williamsburg (757) 259-6770 Riverside Norge Internal Medicine & Pediatrics 7364 Richmond Rd. Williamsburg (757) 345-0011 Riverside Williamsburg Primary Care 5231 John Tyler Hwy. Williamsburg (757) 2208300 Williamsburg Internal Medicine 400 Sentara Circle, Suite 400 Williamsburg (757) 645-3150

MEDICAL TRANSPORTATION Lifeline Ambulance 24-Hour Service/ Emergency & Non-Emergency Transportation Toll-Free: (800) 476-5433 LogistiCare Toll-Free: (866) 386-8311 RIDES (Non-Emergency) 7239 Pocahontas Trail Williamsburg (757) 345-6166

NON-PROFIT ORGANIZATIONS Alzheimer’s Association 213-B McLaws Circle Williamsburg (757) 221-7272 American Red Cross 1317 Jamestown Rd., Suite 105 Williamsburg (757) 253-0228 Arthritis Foundation-Va. Chapter Toll-Free (800) 456-4687 Avalon 312 Waller Mill Rd., Ste. 300 Williamsburg (757) 258-9362 Bike Walk Virginia P.O. Box 203 Williamsburg (757) 229-0507 Child Development Resources 150 Point O' Woods Rd. Norge (757) 566-3300 DreamCatchers 10120 Fire Tower Road Toano (757) 566-1775 Faith in Action 354 McLaws Circle Williamsburg (757) 258-5890 FISH 312 Waller Mill Road Williamsburg (757)220-9379 Historic Triangle Substance Abuse Coalition 161-A John Jefferson Square Williamsburg (757) 476-5070 La Leche League of Virginia Williamsburg (757) 220-9187 Meals on Wheels 227 Richmond Rd. Williamsburg (757) 229-9250 National Alliance on Mental Illness Williamsburg Area Williamsburg (757) 220-8535 National Federation of the Blind Williamsburg (757) 565-1185 Peninsula Health District 1126 Professional Drive Williamsburg (757) 253-4813 Senior Services Coalition 161-A John Jefferson Sq. Williamsburg (757) 220-3480 SpiritWorks Foundation 5800 Mooretown Rd. Williamsburg (757) 564-0001 The ARC of Greater Williamsburg 202-D Packets Ct. Williamsburg (757) 229-3535 The Center for Excellence in Aging and Geriatric Health 3901 Treyburn Dr., Ste. 100 Williamsburg (757) 220-4751

Hampton Roads Neurosurgical & Spine Specialists 120 King's Way, Suite 3500 Williamsburg (757) 220-6823 Riverside Williamsburg Neurology & Sleep Disorders Center for Adults & Children 120 Kings Way, Suite 2700 Williamsburg (757) 221-0110 Sentara Neurology Specialists 400 Sentara Circle, Suite 305 Williamsburg (757) 388-6105

36 THE HEALTH JOURNAL

Retina & Glaucoma Associates 113 Bulifants Blvd., Suite A Williamsburg (757) 220-3375

Anne K. Sullivan, Ed 1769 Jamestown Rd., Ste. R Williamsburg (757) 564-7002

Anne K. Sullivan, EdD, LCP 1769 Jamestown Rd., Ste. R Williamsburg (757) 564-7002

The Spa at Manor Club 101 St. Andrews Dr. Williamsburg (757) 258-1120

OPTOMETRY

Williamsburg Hand Therapy Center 156-B Strawberry Plains Rd. Williamsburg (757) 565-3400

Williamsburg Center for Therapy 217 McLaws Circle, Suite 2 Williamsburg (757) 253-0371

Transformative Energy Work 7151 Richmond Rd., Ste. 302 Williamsburg (757) 229-7819

Williamsburg Physical Therapy 4125 Ironbound Rd., Suite 100 Williamsburg (757) 220-8383

Williamsburg Psychiatric Medicine, PLLC 372 McLaws Circle, Suite 1 Williamsburg (757) 253-7651

PLASTIC & COSMETIC SURGERY

Your Next Chapter Coaching & Counseling Services 1769 Jamestown Rd. Williamsburg (757) 258-0853

Tranquil Reflections Massage Therapy & Spa at King's Creek Plantation Resort 111-B Petersburg Circle Williamsburg (757) 345-6789

Cullom Eye & Laser Center 120 Kings Way, Suite 1300 Williamsburg (757) 345-3001 Eye 2 Eye 1147-A Professional Dr. Williamsburg (757) 259-2300 Eyewear Plus Optometric Center 101 Tewning Rd. Williamsburg (757) 229-1131

Aesthetic Center for Cosmetic & Plastic Surgery 333 McLaws Circle, Suite 3 Williamsburg (757) 345-2275

Hampton Roads Eye Associates 120 Kings Way, Suite 1300 Williamsburg (757) 345-3004

Peninsula Plastic Surgery Center 324 Monticello Ave. Williamsburg (757) 229-5200

Richard K. Lodwick, OD Pamela Lundberg, OD 101-A Bulifants Blvd. Williamsburg (757) 564-1907

Plastic Surgery Center of Hampton Roads 4374 New Town Ave., Ste. 205 Williamsburg (757) 873-3500

Carter Murphy, OD 5251 John Tyler Hwy. Williamsburg (757) 229-8660 Rosser Optical 150-B Strawberry Plains Rd. Williamsburg (757) 220-2020 Jeanne I. Ruff, OD, LLC 1107 Richmond Rd. Williamsburg (757) 229-4222 Forest Schaeffer Monticello Marketplace Williamsburg (757) 258-1020 Williamsburg Eye Care 101 Bulifants Blvd., Ste. A Williamsburg (757) 564-1907

TPMG Orthopedics Spine/Sports Medicine & Virginia Center for Athletic Medicine 4125 Ironbound Rd., Suite 200 Williamsburg (757) 345-5870

Virginia Oncology Associates 500 Sentara Circle, Suite 203 Williamsburg (757) 229-2236

PSYCHIATRY & MENTAL HEALTH ADR Clinical Associates 1309 Jamestown Road, Suite 101 Williamsburg (757) 220-8800

PAIN MANAGEMENT

Colonial Services Board 1657 Merrimac Trail Williamsburg (757) 220-3200

Williamsburg Pediatric, Adolescent & Sports Medicine 4374 New Town Ave., Ste. 202 Williamsburg (757) 253-5757 400 Sentara Circle, Ste. 310 Williamsburg (757) 253-5757

PHYSICAL THERAPY BonSecours In Motion Physical Therapy & Sports Performance 5700 Warhill Trail Williamsburg (757) 221-0101 Comber Physical Therapy 101-B Bulifants Blvd. Williamsburg (757) 229-9740 5388 Discovery Park Blvd., Ste. 100 Williamsburg (757) 903-4230 Dominion Physical Therapy & Associates, Inc. 243 McLaws Cir., Suite 102 Williamsburg (757) 564-9628

Lester Dubnick, EdD 1309 Jamestown Road, Suite 101 Williamsburg (757) 220-0645 Eastern State Hospital 4601 Ironbound Rd. Williamsburg (757) 253-5161 Jose A. Erfe, MD and Associates 481 McLaws Circle, Suite 1 Williamsburg (757) 229-9286 Family Living Institute 1318 Jamestown Rd., Ste. 101 Williamsburg (757) 229-7927 Insight Neurofeedback & Counseling 354 McLaws Circle, Suite 3 Williamsburg (757) 345-5802 Charles L. Koah, LPC 1769 Jamestown Road, Suite 104 Williamsburg (757) 871-3693 New Horizons Family Counseling Center 205 Jones Hall Williamsburg (757) 221-2363 Poplar Creek Psychological & Counseling Center 3305 Poplar Creek Ln. Williamsburg (757) 564-8522 Psychological Associates of Williamsburg 1313 Jamestown Rd., Suite 105 Williamsburg (757) 253-1462 Paul D. Reilly, MD 1115 Old Colony Lane Williamsburg (757) 253-0691

RHEUMATOLOGY Arthritis & Rheumatic Diseases, PC 329 McLaws Circle Williamsburg (757) 220-8579

SLEEP DISORDERS Pulmonary & Sleep Consultants of Williamsburg, PC 120 Kings Way, Suite 2200 Williamsburg (757) 645-3460 Sentara WRMC Sleep Center 400 Sentara Circle Williamsburg (757) 345-4050 Sleep Disorders Center at Williamsburg Neurology 120 Kings Way, Suite 2700 Williamsburg (757) 221-0110

SPAS & MASSAGE All of You Salon & Day Spa 511 York Street Williamsburg (757) 784-1869 Blue Sky Wellness - Reiki & Reflexology 5008 Liza Lane Williamsburg (757) 876-6185 Nicole Carson, NCTMB 1769-210 Jamestown Rd. Williamsburg (757) 561-9591 Elements Spa at Great Wolf Lodge Resort 559 E. Rochambeau Dr. Williamsburg (757) 229-9700

William A. Diog Health Club & Spa 3000 The Mall Williamsburg (757) 565-6545 Williamsburg Pain Relief Breakthrough 1769 Jamestown Rd., Ste. 109 Williamsburg (757) 869-1936 Williamsburg Salt Spa 1111 Old Colony Lane Williamsburg (757) 229-1022

SUBSTANCE ABUSE & ADDICTION 24-Hr. Addictions Referral Network Toll-Free: (800) 511-9225 Al-Anon Toll-Free: (888) 425-2666 Alcohol-Drug Treatment Referral Toll-Free (800) 662-4357 Alcoholics Anonymous (757) 253-1234 Bacon Street Youth Counseling Center 247 McLaws Circle Williamsburg (757) 253-0111 Colonial Services Board 921 Capital Landing Road Williamsburg (757) 253-4061 Families Anonymous Toll-Free: (800) 736-9805 Narcotics Anonymous (757) 875-9314 Opiate Addiction Specialists Williamsburg (757) 229-4141

European Beauty Concepts 1248 Richmond Rd. Williamsburg (757) 229-2440

Williamsburg Place & The Farley Center 5477 Mooretown Rd. Toll-Free: (800) 582-6066

European Day Spa 3206 Ironbound Rd., Ste. A Williamsburg (757) 220-4959

UROLOGY

Illusions by Marcus 374 McLaws Circle, Ste. 1 Williamsburg (757) 253-7790 Jamestown Therapeutic Massage 4608 Yeardley Loop Williamsburg (757) 784-8093 Jana Roselynn Laird, NCTMB 4939 Courthouse Road Williamsburg (757) 846-5707 Massage Therapy Center 1158-A Professional Drive Williamsburg (757) 880-9020 Refresh! Center for Massage & Healing 7151 Richmond Rd., Ste. 302 Williamsburg (757) 345-2457

Hampton Roads Urology 120 Kings Way, Suite 3200 Williamsburg (757) 253-0051 TPMG Williamsburg Urology 105 Bulifants Blvd., Ste. B Williamsburg (757) 903-4807

VASCULAR SURGERY Peninsula Vascular Surgery 156-A Strawberry Plains Rd. Williamsburg (757) 229-7939 Pitman Surgical Associates 326 Monticello Ave. Williamsburg (757) 229-4958

The Right Touch 5252 Olde Towne Rd. Williamsburg (757) 229-1866 Positive Energy Massage, LLC 1769 Jamestown Rd. Williamsburg (757) 810-4482 Saving Face Day Spa 7151 Richmond Rd., Suite 301 Williamsburg (757) 221-0490 Serenity Nail & Spa Studio 1781 Jamestown Rd. Williamsburg (757) 220-8510 Serenity Place Spa & American Spirit Institute 360 McLaws Circle, Ste. 1 Williamsburg (757) 220-8000 The Skin Clinic 483 McLaws Circle, Suite 1 Williamsburg (757) 564-SKIN The Spa of Colonial Williamsburg 307 S. England St. Williamsburg (757) 220-7720

Norge & The Lymphedema Treatment Center 7151 Richmond Rd., Ste. 191 Williamsburg (757) 345-0753

OPHTHALMOLOGY

PEAK Physical Therapy & Sports Rehabilitation 344 McLaws Circle Williamsburg (757) 564-7381

Advanced Vision Institute 5215 Monticello Ave. Williamsburg (757) 229-4000

Reach for Performance, Inc. 312-J Lightfoot Rd. Williamsburg (757) 258-1221

Cullom Eye & Laser Center 120 Kings Way, Suite 1300 Williamsburg (757) 345-3001

Riverside Rehabilitation Outpatient Therapy at Williamsburg 120 Monticello Ave., Suite 200 Williamsburg (757) 345-3795

Anthony J. DeRosa, MD 101 Tewning Rd. Williamsburg (757) 223-5321

Certified Prosthetic & Orthotic Specialists 156-D Strawberry Plains Rd. Williamsburg (757) 833-0911

Virginia Orthopedics & Sports Medicine 5335-B Discovery Park Blvd. Williamsburg (757) 253-0603

OBSTETRICS & GYNECOLOGY

Radiation Oncology Specialists 3901 Treyburn Dr., Ste. B Williamsburg (757) 220-4900

Reneau Medical 120 Kings Way, Ste. 2550 Williamsburg (757) 345-3064

PROSTHETICS & ORTHOTICS

Riverside Norge Internal Medicine & Pediatrics 7364 Richmond Rd. Williamsburg (757) 345-0011

Peninsula Cancer Institute 120 Kings Way, Suite 3100 Williamsburg (757) 345-5724

PREVENTATIVE MEDICINE

Tidewater Orthopaedic & Spine Specialists 5208 Monticello Ave., Suite. 180 Williamsburg (757) 206-1004

Pediatric Associates of Williamsburg 119 Bulifants Blvd. Williamsburg (757) 564-7337

Hampton Roads Surgical Specialists 120 Kings Way, Suite 2800 Williamsburg (757) 873-6434

Williamsburg Foot & Ankle Specialists 453 McLaws Cir., Ste. 1 Williamsburg (757) 220-3311

Williamsburg Health Evaluation Center 332 N. Henry St. Williamsburg (757) 565-5637

The Nutrition and Wellness Center 151 Kristiansand Dr., Suite 101 Williamsburg (757) 221-7074

Williamsburg Obstetrics & Gynecology 1115 Professional Dr. Williamsburg (757) 253-5653

Lightfoot Podiatry Center 213 Bulifants Blvd., Suite A Williamsburg (757) 345-3679

Riverside Orthopedics & Sports Medicine 120 Kings Way, Ste. 3500 Williamsburg (757) 838-5055

PEDIATRICS

Wetchler and Dineen Gynecology 217 McLaws Cir., Suite 5 Williamsburg (757) 229-3254

Michael Dente, DPM, PLC 120 Kings Way, Suite 2900 Williamsburg (757) 345-3022

Renaissance Integrative Therapy 1158 Professional Dr., Suite D Williamsburg (757) 220-4996

NUTRITION

TPMG Williamsburg OBGYN 105 Bulifants Blvd., Ste. B Williamsburg (757) 903-4807

PODIATRY

ORTHOPEDICS & SPORTS MEDICINE

Williamsburg AIDS Network 479 McLaws Circle, Suite 2 Williamsburg (757) 220-4606

ONCOLOGY

NEUROLOGY & NEUROSURGERY

The Spa at Kingsmill 1010 Kingsmill Rd. Williamsburg (757) 253-8230

Tidewater Pain Management 4125 Ironbound Rd. Williamsburg (757) 258-2561

DaVita Williamsburg Dialysis 500 Sentara Circle, Suite 103 Williamsburg (757) 206-1408

TPMG Williamsburg Nephrology 105 Bulifants Blvd., Ste. B Williamsburg (757) 903-4807

Richmond Road Counseling Center 1001-A Richmond Rd., Ste. 2 West Williamsburg (757) 220-2669

Tushar U. Gajjar, MD 400 Sentara Circle Williamsburg (757) 345-4400

Womancare Of Williamsburg 120 Kings Way, Suite 3400 Williamsburg (757) 253-5600

Sentara Nephrology Specialists 500 Sentara Circle, Suite 102 Williamsburg (757) 984-9700

Sentara Rehabilitation Services 301 Sentara Circle Williamsburg (757) 984-9900

United Way 312 Waller Mill Rd., Suite 100 Williamsburg (757) 253-2264 Help Line: (757) 229-2222

NEPHROLOGY & RENAL HEALTH

Renal Advantage, Inc. 4511-J John Tyler Hwy. Williamsburg (757) 229-5701 7364 Richmond Rd. Williamsburg (757) 229-5890

Paul J. McMenamin, MD 1155 Professional Dr. Williamsburg (757) 565-2500

Sentara Pediatric Rehabilitation Services 5301 Longhill Road Williamsburg (757) 984-9900

Williamsburg Dialysis Dr. Shuping Wang, MD, Medical Director Nicole Lee, RN, Administrator

(757) 206-1408 500 Sentara Circle, Suite 103 | Williamsburg, VA 23188

In-center hemodialysis, peritoneal dialysis, and home hemodialysis. Visiting dialysis patients also welcome.


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second opinion

Q:

I injured my shoulder months ago ulder several sev and it is still painful. nful. What Wh could be wrong?

Loel Payne, M.D., is an orthopaedic surgeon with Tidewater Orthopaedic Associates Shoulder Specialists. He completed a fellowship in shoulder surgery and sports medicine at the Hospital for Special Surgery in New York. He has written multiple articles and book chapters and lectured nationally on shoulder conditions.

38 THE HEALTH JOURNAL

A: Each year an estimated four million people seek medical attention for shoulder injuries. As a shoulder surgeon, I frequently see patients with one of three main shoulder complaints: their shoulder is unstable after an injury or dislocation, their shoulder is stiff and they have limited movement, or they feel pain and weakness when trying to reach overhead—pain that often gets worse at night. Here’s a look at the three most common sources of shoulder pain: Shoulder instability is more prevalent in younger patients and often occurs after a fall when the ball (humeral head) of the shoulder joint is knocked out of the socket (glenoid). The cartilage (labrum) that supports the glenoid may tear, or the ligaments that connect the humeral head to the glenoid may stretch. This injury can lead to a continuing sensation that the shoulder is slipping out of its socket.

Shoulder stiffness, or “frozen shoulder,” is a condition where the shoulder spontaneously stiffens and becomes painful even though the patient has not experienced an injury. For reasons not well understood, the lining of the shoulder joint thickens and contracts, thus limiting movement. The condition is more common in middle-aged women and is particularly worse in diabetics. People often tolerate a stiff, painful shoulder for months until they can’t reach behind their back or out to the side. Arthritis of the shoulder causes similar symptoms but can be ruled out with X-ray imaging.

Rotator cuff pain is the most common cause of shoulder pain. The rotator cuff is comprised of four muscles and their tendons that attach to the humeral head. Rotator cuff pain is usually caused by inflammation of the tendons, a condition called tendonitis or bursitis. The bursa is a small, fluid-filled sac that rests on top of the rotator cuff tendons and helps lubricate the tendons as they glide under the acromion, a bony ledge found on top of the shoulder. If a bone spur develops here, it pinches or rubs (impinges) on the tendons and bursa, causing bursitis. Repetitive overhead motion produces a similar type of pain. The outer portion of the upper arm hurts each time the arm is raised overhead (some people feel pain when lying on their side, which makes sleeping uncomfortable). The rotator cuff tendons can also tear as a result of repetitive rubbing, similar to how rubbing an old rope between your hands will cause it to tear, as a result of a traumatic injury such as a fall. The pain of a rotator cuff tear is similar to that caused by bursitis, but the night pain is worse and weakness in the shoulder and arm may develop.

Q: What are my treatment options for chronic shoulder pain? A: Exercises designed to strengthen the rotator cuff are often the best means of treating shoulder instability caused by stretched ligaments. A torn labrum, however—especially in younger patients—often requires a surgical repair to prevent further dislocation. If detected early, a frozen shoulder can be managed with non-surgical interventions such as anti-inflammatory medications (e.g., ibuprofen), physical therapy to stretch the shoulder and cortisone injections into the joint. Sometimes a patient will benefit from physical manipulation—stretching the shoulder while a patient is under anesthesia—to help regain mobility in the shoulder. If other measures fail, a surgeon can cut through the tight areas of the joint’s lining to improve movement. Bursitis pain usually resolves with rest, ice and occasional medication. Physical therapy or a cortisone injection may be needed if the pain persists. Arthroscopic surgery to remove the bone spur and inflamed bursa is recommended as a last resort treatment. Complete rotator cuff tears do not heal without surgery, though some patients choose to live with the condition. Q: Is shoulder surgery painful? How long is the recovery time?

A: Advancements in the understanding of shoulder injuries as well as newer treatment options are dramatically improving surgical outcomes with better results and reduced pain. For most patients, today’s surgeons can restore shoulder function to near normal. In the past, shoulder repairs were done through large, open incisions and required an overnight hospital stay. Modern arthroscopic techniques now allow surgeons to repair tears directly, without compromising other structures in the shoulder. Arthroscopic surgery works like this: A small camera is inserted into the shoulder joint to inspect the problem, and the tear is repaired through two or three additional quarterinch incisions. Anchors that are eventually absorbed by the body are inserted into the bone where the rotator cuff tendon or cartilage has torn, and sutures are passed through the torn tissue and tied to secure the repair. The surgery is performed in an outpatient setting and can be done without general anesthesia. There is still a lengthy three-to four-month recovery process involved, but sparing healthy tissues starts the patient on the right path toward full rehabilitation.


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February Calendar 7

Pilates Demo

th

Stop by Body Balance (370 McLaws Circle, Williamsburg) with a friend between noon and 3 p.m. to learn about classes offered and see yoga and Pilates demonstrations. New clients will receive a free class pass, and current clients who bring a friend will get a discount on any purchases made that day. Cailin Yates, independent consultant with Arbonne International, will provide samples of Arbonne’s Sea Source Spa Detox Set. For more information, call (757) 221-0774

11

th

18 th 20 th

Meet and Greet

Join Pediatric Associates of Williamsburg (119 Bulifants Blvd.) at 5:30 p.m. for an open house. If you are a new parent, new to the area, or simply looking for a pediatrician, you’ll enjoy meeting their physicians and nurse practitioners as well as receive a tour of the facility. Call (757) 564-7337, option 3, to register.

Baby Care 101

New and expectant parents are invited to learn ways to provide a safe and secure environment for their infant during a free class offered at Pediatric Associates of Williamsburg (119 Bulifants Blvd.) from 7 to 9 p.m. Topics will include soothing your baby, belly button and diaper care, how to position your baby for sleep and general household and car seat safety tips. Call (757) 564-7337, option 3, to register.

Health & Wellness Expo

Meet The Health Journal staff during a free health and wellness expo, to be held from 10 a.m. to 2 p.m. at the offices of Maidstone Dental and Chickahominy Family Physicians Maidstone in New Kent. Contact Lisa Robertson at Lisa_Robertson28@ msn.com for more information.

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20 th 24 th 28

40 THE HEALTH JOURNAL

2010

Youth Athletics & Camp Registration

From 9 a.m. to 1 p.m., James City County residents are invited to the James City/Williamsburg Community Center to learn about the recreational programs and services available through James City County Parks and Recreation. Parents can opt for early enrollment in summer camps, and all local athletic leagues will be providing information.

“The Doctor Is In”

After a brief hiatus during the holidays, Riverside’s free monthly health lecture series, “The Doctor is In,” resumes with a fresh lineup of Riverside Medical Group’s physicians eager to share information on health topics related to aging. Each month’s talk begins at 9 a.m. in the Food Court at Patrick Henry Mall (near the fireplace). Chick-fil-A provides complimentary coffee at each meeting.

31st Annual Colonial Half Marathon

Head to William and Mary Hall for the 31st Annual Colonial Half Marathon, hosted by the college’s Department of Track and Field. Registration will be held from 10 a.m. to noon, with a half marathon (13.1 miles) beginning at 1 p.m. and a 5K (3.1 miles) starting at 1:10 p.m. Both events are open to the public. Cost to register is $55 for the half marathon and $30 for the 5K. Apply online at www.tribeclub.com or www.active.com. For more information, call William and Mary Special Events at (757) 221-1599.


Support Groups ABORTION RECOVERY GROUP Mary Immaculate Hospital Tuesdays, 7 p.m. (757) 886-6364

ABUSE Dating Violence Wednesdays, 4:30 p.m. (757) 221-4813 Domestic Abuse/Assault Mondays, 7 p.m. (757) 258-5022 Williamsburg Baptist Church Mondays, 7 p.m. (757) 258-9362

Williamsburg United Methodist Church 3rd Tuesday, 11 a.m. (757) 724-7001 Eden Pines 2nd Tuesday, 7 p.m. (757) 826-5415 Second Presbyterian Church 1st Tuesday, 7 p.m. (757) 930-0002 James River Convalescent Center 2nd Friday, 10 a.m. (757) 595-2273

ADDICTION

The Chesapeake 3rd Tuesday, 1 p.m. (757) 223-1658

Gamblers Anonymous Williamsburg Place Mondays, 7 p.m. (800) 522-4700

Family Centered Resources 3rd Thursday, 1:30 p.m. (757) 596-3941

Sexaholics Anonymous E-mail for dates/locations. hrsa@hotmail.com

AIDS

Williamsburg AIDS Network 2nd & 4th Wednesday (757) 220-4606

ALCOHOL & DRUG RECOVERY Colonial Chapter Meets monthly. (757) 253-4395

Bethel Restoration Center Mondays, 7 p.m. (757) 220-5480 Kids’ Group Spirit Works (757) 564-0001 Parents’ Group Bacon Street Mondays, 6 to 7:30 p.m. (757) 253-0111 Women Only Spirit Works Wednesdays, 7 to 8:30 p.m. Thursdays, 2:30 to 4 p.m. (757) 564-0001 Al-Anon/Alateen Meetings held daily. Visit www.va-al-anon.org Alcoholics Anonymous Meetings held daily. Visit www.aa.org. Marijuana Anonymous Tuesdays, 7 p.m. Mt. Pleasant Baptist Church (757) 476-5070 Narcotics Anonymous Meetings held daily. Visit www.na.org. Suboxone Therapy Mary Immaculate Hospital 3rd Wednesday, 7 p.m. (757) 886-6700

ALZHEIMER’S DISEASE

Warwick Forest 2nd Thursday, 7 p.m. (757) 867-9618 Family Connections 2nd Tuesdays, 1 to 3 p.m. Registration required. (757) 221-7272 Early Memory Loss Mary Immaculate Hospital 2nd Tuesday, 10 a.m. (757) 599-6847 or (757) 930-0002

ARTHRITIS

Mary Immaculate Hospital 4th Tuesday, 10:30 to noon (757) 886-6700

AUTISM

Peninsula Autism Society King of Glory Lutheran Church Last Thursday, 7:30 p.m. (757) 259-0710 Grafton Baptist Church 2nd Monday (757) 564-6106

BEREAVEMENT/GRIEF Sentara CarePlex Hospital 2nd & 4th Wednesday 5 to 6:30 p.m. (757) 827-2438 Hospice House 2nd Monday, 7 p.m. (757) 258-5166 or (757) 229-4370 Mary Immaculate Hospital 1st & 3rd Thursday, 7 p.m. (757) 886-6595 Mary Immaculate Hospital 2nd & 4th Monday, 6 p.m. (757) 737-2287 Child Loss Williamsburg Hospice House 2nd Monday (757) 645-2192 St. Luke’s United Methodist Church 1st Monday, 7:30 p.m. (757) 886-0948

Immaculate Conception Church 2nd Monday, 1 p.m. (757) 873-0541

Morningside Assisted Living 2nd and 4th Wed., 5:30 p.m. (757) 594-8215

Morningside Assisted Living 3rd Wednesday, 2 p.m. (757) 221-0018

Riverside Hospice 2nd Thursday, 7 p.m. (757) 594-2745

Morningside Assisted Living 2nd & 4th Wed., 5:30 p.m. (757) 594-8215 Dominion Village 3rd Thursday, 2 p.m. (757) 258-3444

Suicide Catholic Charities 3rd Tues., 7 p.m. (757) 875-0060 Young Widow/Widower Williamsburg Hospice House 1st Monday (757) 645-2192

BREASTFEEDING

La Leche League of Va. Church of the Nazarene 1st Tuesday, 10:30 a.m. 3rd Thursday, 6:30 p.m. (757) 766-1632 or (757) 224-8879 Sentara Williamsburg Regional Medical Center Yorktown Room M., W., Thurs., 10 a.m. (757) 984-7299 Riverside Cancer Care Center Mondays, 11 a.m. (757) 594-3399

CANCER

CELIAC DISEASE

St. Stephen Lutheran Church 1st Tuesday, 7 p.m. (757) 220-8535

Mary Immaculate Hospital 3rd Wednesday, 1 p.m. (757) 886-6381

CHRONIC FATIGUE SYNDROME

Depression/Bipolar St. Mark’s Episcopal Church 2nd & 4th Wed., 10:30 a.m. (757) 247-0871

PMS

CROHN’S DISEASE/COLITIS

Obsessive-Compulsive Riverside Behavioral Health Center 3rd Thurs., 7:30 p.m. to 9:30 p.m. (757) 827-1001

Monticello Ukrop’s Call (757) 564-0229 Mary Immaculate Hospital 1st Thursday, 7 p.m. (757) 886-6700

Sentara CarePlex Hospital 1st Saturday, 1 p.m. (757) 736-1234

DIABETES

Mary Immaculate Hospital 2nd & 4th Tuesday, 1 p.m. (757) 886-6100 Sentara Williamsburg Regional Medical Center Call for day and time. (757) 984-7106 or (757) 984-7107 Sentara Center for Health and Fitness 3rd Wednesday, 4 to 5 p.m. (757) 827-2160

Breast Cancer Riverside Cancer Care Center 2nd Thursday, 7 to 8:30 p.m. (757) 594-4229

Mary Immaculate Hospital 3rd Tuesday, 1 p.m. (757) 886-6700

Mary Immaculate Hospital 3rd Wednesday, 7:30 p.m. (757) 874-8328

Type 2 Riverside Regional Medical Center 3rd Tuesday, 11 a.m. (757) 534-5918

Sentara CarePlex Hospital 3rd Tuesday, 7 to 8:30 p.m. (757) 594-1939 Young women's group 3rd Sunday, 2 p.m. Call for location. (757) 566-1774 Post-menopausal group 1st Monday, 1:30 p.m. Call for location. (757) 258-4540 Colorectal Cancer Sentara CarePlex Hospital 3rd Wed., 1 to 2:30 p.m. (757) 736-1234 Leukemia/Lymphoma Sentara CarePlex Hospital 1st Tuesday, 7 to 8:30 p.m. (757) 827-2438 The Leukemia and Lymphoma Society Young Adult Group Call for meeting dates, times and locations. (800) 766-0797 "Look Good, Feel Better" Sentara CarePlex Hospital 2nd Monday, 2 to 4 p.m. (757) 827-2438 Sentara Williamsburg Regional Medical Center 2nd Monday, bi-monthly (757) 984-1218 Lung/Respiratory Cancer Sentara CarePlex Hospital 1 to 2 p.m., call for dates. (757) 827-2438 Prostate Cancer Sentara CarePlex Hospital 2nd Tuesday, 7 to 8:30 p.m. (757) 827-2438

CAREGIVER SUPPORT Mary Immaculate Hospital First Wednesday, 1 p.m. (757) 886-6700

JCC/W Community Center 1st Tues., 7:30 to 8:30 a.m. (757) 253-1220 or allysimone@hotmail.com

Colonial Heritage Clubhouse 3rd Thursdays, 2:30 p.m. (757) 253-1774 or (757) 345-6974

Miscarriage / Stillbirth Mary Immaculate Hospital 3rd Thursday, 7:00 p.m. (757) 886-6791

York Public Library Community Room 2nd Tuesday, 7 p.m. (757) 890-3883

Insulin Pump Riverside Regional Medical Center 4th Tuesday, 7 p.m. (757) 534-5918

EATING DISORDERS Overeaters Anonymous Chestnut Memorial Church Mondays, 7 p.m.; Thursdays, 11 a.m. (757) 898-3455

FIBROMYALGIA

Williamsburg Library 2nd Tuesday, 1 p.m. (757) 879-4725

HEARING LOSS

Hearing Loss Association 2nd Sat., 10:30 a.m. (757) 564-3795

HEART DISEASE

Riverside Regional Medical Center Call for dates/times. (757) 875-7880 Women Only Sentara Williamsburg Regional Medical Center 1st Monday, 7 p.m. womenheart@aol.com

HUNTINGTON’S DISEASE Mary Immaculate Hospital 3rd Friday, 7 p.m. (757) 886-6700

JOB TRANSITION

Great Harvest Bread Co. Wednesdays, 7 a.m.

KIDNEY DISEASE

Sentara CarePlex Hospital 1st Wed., 6 to 7:30 p.m. (757) 244-3923

LOU GEHRIG'S DISEASE (ALS) St. Luke's United Methodist 4th Thurs., 6:30 p.m. (866) 348-3257 or www.alsinfo.org

MENTAL ILLNESS Support St. Stephen Lutheran Church 1st Tuesday, 7 p.m. (757) 220-8535 500-C Medical Drive Wed., 6 to 7:30 p.m. (757) 503-0743 Recovery Denbigh Church of Christ 1st & 3rd Thursdays Call for time. (757) 850-2279

Historic Triangle Senior Center 2nd & 4th Wed., 5:30 p.m. (757) 220-0902

POLIO

Sentara CarePlex Hospital 3rd Saturday, 2 to 4 p.m. (757) 596-0029

MULTIPLE SCLEROSIS

STROKE/BRAIN INJURY

JCC/W Community Center 2nd & 4th Wed., 5:30 to 7 p.m. (757) 220-0902

R. F. Wilkinson Family YMCA 3rd Wednesday, 4 to 5 p.m. (757) 984-9900

African-Americans Hampton Public Library 1st Thursday, 10:30 a.m. (757) 490-9627

Va. Peninsula Stroke Club Riverside Rehabilitation Institute 1st Wednesday, 10 a.m. (757) 928-8327

MYASTHENIA GRAVIS

Riverside Rehabilitation Institute Wednesdays, 3:30 p.m. (757) 928-8327

James City County Library Every other month on the 4th Sat., 1 p.m. (757) 810-1393

OSTOMY

Riverside Rehabilitation Institute Last Wednesday, 4:30 p.m. (757) 928-8050

Sentara Williamsburg Regional Medical Center 1st Sun., 3 p.m. Meets Quarterly. (757) 259-6033

VASCULITIS

PARENTING

VISION LOSS

JCC/W Community Center Thursdays, 6 to 7:30 p.m. (757) 229-7940 Children with Disabilities St. Martin’s Episcopal Church 2nd Thursday, 6:30 p.m. (757) 258-0125 JCC/W Community Center 1st Tuesday, 12 to 1 p.m. (757) 221-9659 or e-mail stuarts@wjcc.k12.va.us Fathers Only York River Baptist Church 1st & 3rd Mondays, 6 to 8 p.m. (757) 566-9777 Grandparents as Parents Williamsburg Library Conference Room C 2nd Tuesday, 10 a.m. (757) 253-2847 Hispanic Parents Wellspring United Methodist Church 1st & 3rd Fri., 10 a.m. Transportation available. (757) 566-9777 New Mothers Sentara Williamsburg Regional Medical Center Thursdays, 10 to 11:30 a.m. (757) 259-6051 St. Mark Lutheran Church Thursdays, 10 to 11:15 a.m. (757) 898-2945

Mary Immaculate Hospital 1st Sat., 10 a.m. to noon (928) 380-0319

1st Saturday, 1 p.m. JCC/W Community Center (757) 565-1185

WEIGHT MANAGEMENT Mall Walking Club Meets at Patrick Henry Mall Call for date/time. (757) 249-4301 Warwick Memorial United Methodist Church Wednesdays, 9 a.m. (757) 850-0994 St. Mark’s Methodist Church Thursdays, 8:30 a.m. (757) 850-0994 Hope Lutheran Church Mondays, 5:45 p.m. (757) 850-0994 First Christian Church Thursdays, 6:00 p.m. (757) 850-0994 Fox Hill Road Baptist Church Mondays, 6:30 p.m. (757) 850-0994 Olive Branch Christian Church Tuesdays, 9:45 a.m. (757) 850-0994

WOMEN'S ISSUES Williamsburg Baptist Church Mondays, 7 p.m. (757) 258-9362

Stay-at-Home Moms Olive Branch Christian Church Fridays, 10 a.m. (757) 566-3862 Stepfamilies Williamsburg United Methodist Church 4th Monday, 7 p.m. (757) 253-2971

PARKINSON’S DISEASE Sentara CarePlex Hospital 1st Tuesday, 3 p.m. (757) 827-2170 Williamsburg Landing 2nd Monday, 1:30 p.m. (757) 898-6674 Riverside Regional Medical Center 4th Wednesday, 7 p.m. (757) 875-7880

THE HEALTH JOURNAL

41


profile Why he chose cardiology: Cardiology became an interest during my medical training. I was looking for something that had continuity. I wanted a relationship with my patients. It is a very research-driven field. It’s very mechanical—fairly complicated, but simple in my mind. You can really wrap your mind around it. On his training in Iraq and Afghanistan: I spent one month in Afghanistan and three months in Iraq. I found it fantastically rewarding. My job in Iraq was critical care. I was flying with an intensive care unit and transporting critically injured soldiers. Within 20 minutes they were in a chopper, in an hour they were in surgery in an operating room to get stabilized, then they could be flying to Germany by the end of the night. Who he helps now: College students. Middleaged people. Seniors. There is a wide range in age, but I see many more 80- and 90-year-olds than any other type of patient.

Joseph T. Adinaro, IV, M.D.

INTERVIEW BY SHARON MILLER CINDRICH PHOTOGRAPHY BY BRIAN M. FREER

J

oseph Adinaro showed an interest in medicine at an extremely early age. In fourth grade, when a fellow classmate fell and hurt his head, Adinaro pushed through the crowd of children gathered around to assess the scene. “I said, ‘Let me have a look at him.’ My teacher turned to me and said, ‘Where’s your doctor’s license?’” The rest is now history. After receiving his undergraduate degree from George Mason University, Adinaro earned his medical degree from Eastern Virginia Medical School in 2000. During his residency, he spent several months as an Air Force doctor, serving in Afghanistan and Iraq. “We had 600 pounds of equipment that could turn any airplane into an emergency room,” he says. While he admits it was sometimes lonely as the only doctor at 30,000 feet, these days Adinaro has his feet planted firmly on the ground. He practices with Cardiovascular Health in Williamsburg and is an active medical staff member at Riverside Regional Medical Center in Newport News and Sentara Williamsburg Regional Medical Center. As a busy father of five young children, his plate is quite full—literally. Finding time for some of his favorite sports—golf and volleyball—can be difficult amid long work hours and taking care of family, so Adinaro has turned to another favorite activity. “I also enjoy cooking,” he says. “When I was young, my grandmother would host dinner for the extended family on Sunday afternoons. I have resumed the tradition and enjoy hosting dinners for family and friends.” Recently, The Health Journal asked Adinaro to offer his top tips for heart health and more. Here are excerpts from our interview:

42 THE HEALTH JOURNAL

The biggest myth about heart health: I think there’s a general misunderstanding about how heart disease really works. We used to believe that blockages would progress over time and eventually close the artery, but we have discovered that mild blockages can break open and the artery can suddenly close with a clot. Inflammation and the endothelium [a thin lining of blood vessels in the arteries] are big players. Treating risk factors—like high blood pressure, high cholesterol, diabetes and smoking—is what makes a difference.

What people can do to keep their heart healthy: Exercise, aerobic exercise specifically, actually keeps your heart in better shape, as does modifying your risk factors. Smoking is the single worst thing you can do for your heart. The nicotine paralyzes the lining of the blood vessels. When that happens, you’re at higher risk for heart disease.

Biggest professional challenge: Trying to get through to patients who have their mind set against making a positive change, like quitting smoking. Or they don’t want to take medications. Also, keeping people from being their own doctor. The patient that frustrates me the most says, “This is what I believe, and that’s the way it is.” Who he admires: The folks who trained me—I’ve trained with some amazing physicians. Their work ethic, tenacity and brilliance are inspiring. I do my best to come close to that. Everyone has their own thing—some docs have great bedside skills, other folks have the science down pat. You take pieces from everyone and try to be the best you can. What surprises him most in his practice: Everybody’s different. I see everyone from the teen with palpitations and it’s nothing, to the 40-year-old who has horrible cancer and will die soon, to the 80-year-old who’s out on the golf course. The most beautiful thing about the human heart: The heart is fascinating and elegant in its design and function with its own mechanical, plumbing and electrical systems. Many animals have the same design—including pigs and cows—which is useful when you need to exchange a part. Honestly, the most beautiful thing about the human heart, which is unique to the species, is its metaphorical exploration by artists, poets, songwriters and philosophers. The fleshy pump keeping us all going is quite humble compared to the lofty poetic heart.


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