Carilion Clinic Living - Fall 2015

Living Inspiring better health.

FALL 2015

in this issue SPORTS MEDICINE NEWS 8 STROKE RECOVERY PROGRAMS 10 HOW HEALTHY ARE WE? 12 TAKE A FALL HIKE 20

A SENSE OF

PURPOSE Why It’s Good for Your Health Douglas Martin has been helping patients at Carilion for over 50 years.

Dr. Ben Lewis Martinsville, Va.

. e s u f o s r a e y y ow n b

.

N O I L I R A C Y B T L I U REB d n r o w Hip

We partner closely with patients to keep them healthy and out of the hospital. But when surgery becomes necessary, you can trust the region’s most experienced orthopaedics team. Just ask Dr. Lewis, who can now get back to worrying about his patient’s aches and pains and not his own. Let us help you rebuild from an unexpected injury or ongoing health condition.

ORTHOPAEDICS 877-544-3770 | CarilionClinic.org/ortho

President’s Message Do you have a sense of purpose in your life? If so, it could help you live longer.

A new study found that a strong sense of meaning and direction in life is linked to a 23 percent reduction in death from all causes, and a 19 percent lower risk of heart attack, stroke, and the need for certain heart procedures.

In our cover story, we explore these findings and introduce you to people in our region who are living purposeful lives.

How healthy are we as a community? Another study discovered this unsettling fact: 88 percent of the money we spend on our health is for medical services—often to counteract the effects of an unhealthy lifestyle. Only a paltry 4 percent is spent on healthy behaviors like exercising and eating well. We take a look at how we can all achieve a better balance and create healthier habits in our region.

Two of the major health threats we face, of course, are heart disease and stroke. We now have two new programs to help when these illnesses strike. One involves a new heart treatment, called PCI (percutaneous coronary intervention), to find and treat blockages without open surgery.

We recently began PCI at Carilion New River Valley Medical Center. The other helps patients recover from a stroke with the use of a new wireless technology called FES, or functional electrical stimulation. We tell you about both in this issue.

Now that cooler mornings and nights are here, can beautiful fall foliage be far away?

And since our region is known as a hiking mecca, what better way to enjoy both than to spend a fall day out on a scenic mountain trail? Our article on fall hiking reviews some of the most popular local paths. If you’ve never tried hiking in autumn, this could be your perfect opportunity!

WARM REGARDS,

NANCY HOWELL AGEE PRESIDENT AND CEO CARILION CLINIC

CarilionClinic.org | FALL 2015 1

OUR CONTRIBUTORS CARILION CLINIC PRESIDENT AND CEO Nancy Howell Agee CARILION CLINIC 1906 BELLEVIEW AVE. P.O. BOX 13367 ROANOKE, VA 24033 540-981-7000

Su Clauson-Wicker is the author of two travel books and the former editor of Virginia Tech magazine. Her articles have also appeared in The Washington Post and other publications.

She lives in Blacksburg.

Kathie Dickenson is an award-winning writer and editor whose work has appeared in Roanoke Business and RU, Radford University’s magazine. She has also edited books, websites, and other publications.

Sarah Beth Jones blogs about personal development, was an op-ed columnist for the Greensboro News & Record, and has written for publications including Valley Business FRONT, Mother Earth News online, and Today’s Woman magazine. She lives in Floyd.

CARILION CLINIC LIVING IS PRODUCED BY MARKETING, RESEARCH AND COMMUNICATIONS: VICE PRESIDENT Shirley Holland SENIOR DIRECTOR, COMMUNICATIONS Mike Dame SENIOR DIRECTOR, COMMUNICATIONS Amy Hoots-Hendrix CREATIVE SERVICES MANAGER John Griessmayer EDITOR Maureen Robb LEAD DESIGNER David Porter CONTRIBUTING WRITERS Karen Doss Bowman, Karen A. Chase, Su Clauson-Wicker, Jay Conley, Bruce Ingram, Sarah Beth Jones, Dan Radmacher, Donna Reynolds, Dan Smith, Erica Stacy, Randolph Walker, Alison Weaver PHOTOGRAPHERS Darryle Arnold, Jared Ladia

Heidi Ketler has been a writer and editor for Sentara Healthcare in Norfolk and for The Triangle Physician magazine in the RaleighDurham-Chapel Hill region of North Carolina.

She lives in Roanoke.

Dan Smith is an award-winning journalist and photographer, an essayist on public radio, and a member of the Virginia Communications Hall of Fame. He is the author of a novel and several nonfiction books.

Randolph Walker is a writer and musician in Roanoke. Formerly a staff writer with The Roanoke Times, his work has appeared in many publications including Virginia Living, Valley Business Front, and The Roanoker.

PRINTING Chocklett Press

CARILIONCLINIC.ORG | 800-422-8482

Carilion Clinic is a not-for-profit health care organization based in Roanoke, Va. Through our comprehensive network of hospitals, primary and specialty physician practices, and other complementary services, we work together to provide quality care close to home for nearly 1 million Virginians. With an enduring commitment to the health of our region, we also seek to advance care through medical education and research to help our community stay healthy and inspire our region to grow stronger.

Copyright 2015 by Carilion Clinic. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Carilion Clinic. Articles in this publication are written by journalists or authors who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional advisor. All editorial rights reserved. Opinions expressed herein may or may not reflect the views of Carilion Clinic.

If you would like to be added to or removed from the mailing list for Carilion Clinic Living, please call 800-422-8482, email us at direct@carilionclinic.org, or write to us at Marketing, Research and Communications, 213 McClanahan St., Roanoke, VA 24014.

2 FALL 2015 | CarilionClinic.org

CONTENTS

8 10 features 5 TRAUMA CARE Saving a young man’s life.

7 HOSPITALS

Carilion adopts a green plan.

8 SPORTS MEDICINE

A doctor brings unique credentials to the region.

10 STROKE

16

departments 1 PRESIDENT’S MESSAGE Having a sense of purpose is healthy.

New programs help patients recover.

12 COMMUNITY HEALTH How healthy are we?

14 HEART DISEASE Introducing PCI, a new treatment.

4 SUPERFOODS

16 A SENSE OF PURPOSE

6 HEALTH NEWS

20 RECREATION

24 IN YOUR COMMUNITY

22 IMAGING

How it can prolong your life.

Yes, pumpkin is good for you.

Research findings that can improve your life.

Making a difference in western Virginia.

26 NEW PROVIDERS

New physicians and advanced care providers.

Enjoy a scenic hike this fall.

20

Mobile service brings advanced imaging.

23 VACCINES Which do you need?

28 RECIPE

Enjoy a delicious bowl of soup.

CarilionClinic.org | FALL 2015 3

SUPERFOODS

Superfoods: Pumpkin ‘Tis the season for pumpkins: Pumpkin lattes, muffins, and, ever so soon, Thanksgiving feasts topped off with pumpkin pie. Lip-smacking as these treats are, they also provide health benefits.

Though pumpkin-flavored treats can be sugar- and calorie-laden, one cup of freshly cooked pumpkin contains only 49 calories, less than a quarter of a gram of fat, and zero cholesterol while offering up 1.76 grams of protein, 2.7 grams of fiber, and a range of vitamins and nutrients including: »» Well over 100 percent of the recommended daily intake (RDI) of vitamin A »» 20 percent of the RDI for vitamin C »» 10 percent or more for vitamin E, riboflavin, potassium, copper, and manganese »» And at least 5 percent for thiamin, B-6, folate, pantothenic acid, niacin, iron, magnesium, and phosphorous.

Its orange flesh isn’t just for flash, either. Instead, the color indicates that pumpkin is a great source of beta carotene, a nutrient that may stave off certain types of cancer and delay age-related degeneration.

As with most plant foods, pumpkin can also help you maintain a healthy weight, keep your heart healthy, and control or prevent diabetes.

Happily, incorporating pumpkin into your diet can happen in a variety of tasty ways. Start by purchasing small baking or sugar pumpkins. Save the seeds from larger jack-o-lantern pumpkins for snacks, but for the tastiest recipes, the smaller varieties reign.

Roasted pumpkin croutons are a great addition to green and grain salads or as a topper for lentil or kale soups. Simply toss peeled, diced pumpkin with a little coconut or olive oil and salt, and roast on a foil-lined baking sheet in a 450 degree oven. Shake the pan every 5 minutes until the pieces are golden brown and fork tender.

Pumpkin puree can be used in place of butter or oil in baked goods at a ratio of 3/4 cup puree to each cup of butter. Though canned puree is fine, a greater nutritional punch can be had by roasting a seeded, oiled pumpkin in a 400 degree oven for 45-60 minutes and then pureeing everything but the stem in a food processor or blender. You can also cook a quartered pumpkin in a slow cooker for four hours.

Finally, for a nutritionally dense snack, don’t forget the seeds! Roasted pumpkin seeds are delicious and packed with nutrients that support your body in numerous ways. From heart health to tooth formation, sounder sleep to smoother digestive functioning, menopausal relief to prostate health, these seeds can’t be beat when it comes to healthful lunchbox stuffers.

Whether you’re snacking or creating a healthy meal, add a little pumpkin for a delicious and body-nurturing boost.

4 FALL 2015 | CarilionClinic.org

MEDICAL NEWS

Trauma Doctors Save a Life Steven Myers (center) walks with his parents Carlan and Norma Myers in Green Hill Park in Salem.

Inset: Norma holds a portrait of the Myers’ late son, Aaron.

On Aug. 13, 2012, Carlan and Norma Myers of Salem got the

A LEVEL I CENTER

news no parent wants to hear. Their sons, Aaron and Steven,

Roanoke Memorial is the region’s only Level I Trauma Center (the highest designation of trauma care), providing comprehensive trauma services and specialists for the region. The Trauma Center sees patients who must be treated in a narrow window of time in order to survive, and when treated at a Level I Trauma Center, odds of survival increase by 20 to 25 percent.

Steven has undergone several surgeries in the past three years, continues physical therapy for his left hand, and is involved in brain-injury support groups. He’s enrolled at Virginia Western Community College and strives to live a healthy lifestyle—eating a clean diet and exercising often. He enjoys long walks and hiking, a pastime he was passionate about prior to the accident.

“His desire is to honor his brother Aaron by keeping his ‘never give up’ positive attitude,” Norma Myers says.

Carlan Myers adds: “You wouldn’t wish this on anybody, but as a family we could not have asked for better care for our son.

And I just want to be able to say thank you from the bottom of our hearts. I don’t believe Steven would be here today if he had not gotten the level of care he had at the hospital here.”

“We thank God every day for Steven’s miraculous recovery and for our precious Aaron memories,” Norma says. “Thanks to our family, friends, and community we have not traveled this journey alone!”

had been in a serious car accident. Aaron, 26, did not survive and Steven, 22, was in critical condition at Carilion Roanoke Memorial Hospital’s Trauma Center.

The Myers were told the next 48 hours of treatment would be critical in determining Steven’s fate.

“Of course, there was a lot of confusion on our part, not knowing what he was going through,” says Carlan Myers. “But the doctors really took their time explaining things to us. The nurses were just fantastic.”

The family credits the Trauma Center’s team for saving Steven’s life and says their compassion extended well beyond the care of their son.

“For me, it was the professionalism of everyone, and the level of care,” Carlan Myers says. “We’re blessed in the Roanoke Valley to have great health-care givers that seem to really love what they do and want to be there and are passionate. We really felt like family. We felt like everyone cared and wanted to see Steven get up and go. It was like having our own cheerleading squad.”

The Myers say they realized Steven faced a long road of recovery but were confident he was in good hands at Carilion.

CarilionClinic.org | FALL 2015 5

HEALTH NEWS

FDA Strengthens Warning on Painkillers The Food and Drug Administration has strengthened warning labels for some non-steroidal anti-inflammatory drugs (NSAIDs). Taking such painkillers even for a short time can boost the risk of stroke or heart attack, the agency said. NSAIDs include such widely used drugs as ibuprofen and naproxen and may appear in multi-symptom cold products. Consumers are warned not to take more than one product containing NSAIDs at a time. Learn more at bit.ly/nsaid-warnings.

Sugary Drinks May Raise Diabetes Risks for the Slim Even if you’re slender, consuming sugary sodas or other drinks may raise your risk of type 2 diabetes. In a study of normal-weight people, drinking just one sweetened drink daily was tied to a 13 percent higher risk of developing type 2 diabetes over a decade. For more information, go to bit.ly/sweet-drinks.

Young Achievers Can Thank Their Parents High-achieving children probably have parents who dedicate themselves to their success, according to a new study. Talent might be partly inherited, but kids who are nationally ranked in sports, music, or other fields likely have significant parental help, researchers said. The study included Olympic champions and college athletes. Read more at bit.ly/young-achievers.

Giving CPR Could Save More Lives A new study shows that if more people gave CPR in an emergency, many lives could be saved. According to the American Heart Association, about 92 percent of sudden cardiac arrest victims die before reaching the hospital. To learn about CPR classes offered by Carilion Clinic, call 800-422-8482.

6 FALL 2015 | CarilionClinic.org

s l a t i p s o H r e i Health PLAN ’ N E E R ‘G A S T P O D A N IO IL R A C Carilion Clinic has signed the Healthier Hospitals Initiative and made a commitment to operate “greener” hospitals.

The initiative, developed by 12 of the largest U.S. health care systems, provides a guide for hospitals to reduce energy and waste, choose safer and less toxic products, and buy and serve healthier foods.

Integrate environmental measures into its core business strategies.

Use solar energy at Carilion New River Valley Medical Center. It will be the first hospital in Virginia to use solar panels supplied by a third party; the panels will generate over 17 percent of the hospital’s energy and result in significant cost savings.

Track and share results with other health care systems who are part of the Healthier Hospitals Initiative.

Create a sustainability program and develop and implement sustainable, measurable projects. Also to share information about these projects within Carilion on a regular basis.

CarilionClinic.org | FALL 2015 7

MEDICAL NEWS

L to R: Dr. Jon Maher, who served as a team physician for the Boston Celtics, is shown on the team’s court; Dr. Maher and his wife Jill pose with their family; Dr. Maher takes time out to shoot hoops during his deployment as a Navy surgeon in Afghanistan; Dr. Maher and his son Josh courtside at the Celtics.

From the Boston Celtics to Southwest Virginia

By Andie Gibson Whether it’s getting a professional basketball player back on the court, a Marine back into action, or a weekend warrior back to her golf game, Jon Maher, M.D., has found his calling— sports medicine.

Growing up in Blacksburg and loving sports, Dr. Maher dreamed of making it to the NBA. And eventually, he did, although not playing the position he envisioned while racking up all those hours in the gym.

Dr. Maher spent the past year as a team physician for the Boston Celtics before joining Carilion Clinic Orthopaedics in August.

“It was an honor and thrill to be a part of the Celtics and contribute to making a playoff run with a team that was supposed to be in a ‘rebuilding period,’ ” he 8 FALL 2015 | CarilionClinic.org

says. The Celtics were 40-42 in the regular season and advanced to the playoffs before being eliminated by Cleveland.

“It takes a team of medical personnel to keep professional athletes performing at the highest level for such a long, grueling season,” Dr. Maher says. “I have been very fortunate to have had the opportunity to contribute to the success of a program with such an illustrious history.”

But it’s not just high-profile athletes who have benefited from the expertise of Dr. Maher, who has also served as a physician for Harvard University’s athletics department and the U.S. Navy.

After graduating from Blacksburg High School, Dr. Maher spent two years studying chemical engineering at Johns Hopkins University before

transferring to Roanoke College, where he earned a bachelor’s degree in biology and Academic All-American honors in basketball. He returned to Blacksburg for a master’s degree in accounting information systems from Virginia Tech, but had a change of heart regarding his future career path.

“I realized I would likely be looking at a computer screen all day and instead wanted more interaction with people,” says Dr. Maher, who applied for and received a U.S. Navy scholarship to attend Jefferson Medical College in Philadelphia. “I switched gears to medicine as a way to solve difficult problems in people rather than in equations.

“Orthopaedics and the subspecialty of sports medicine were a natural fit for me to stay involved in athletics, as well

as incorporate a first-hand understanding of the rigors athletes go through in their training.”

Upon graduation, Dr. Maher landed at Naval Hospital Portsmouth for an internship in general surgery with an emphasis in orthopaedics. He then served as a battalion surgeon at Camp Schwab in Okinawa, Japan. After completing the orthopaedic surgery residency program in Portsmouth, it was off to work as a surgeon at Naval Hospital Camp Lejeune in North Carolina.

Dr. Maher’s professional game plan took a seven-month detour in July 2012 when he was deployed to Afghanistan in support of Operation Enduring Freedom, an assignment he described as humbling and life-changing.

“The [patient] injuries are tremendous,” says Dr. Maher, who was stationed with the Marine’s 1st Medical Battalion as part of a team that provided resuscitative surgical and shock trauma care to soldiers on the front lines, as well as Afghan soldiers and civilians.

“The force of explosion, damage, and destruction to patients is not like anything we experience in the U.S. I worked in a rural facility up in the front lines, close enough that we could feel and hear the explosions and know we were get-

ting casualties coming from a chopper within 10 minutes.”

With his commitment to Navy service nearing a 14-year end, Dr. Maher began applying for sports medicine fellowship programs. He began his fellowship at New England Baptist Hospital in April 2014 when he joined the clinical staff at Harvard, serving as a physician for a number of the university’s sports teams.

Dr. Maher and his wife Jill (his Roanoke College sweetheart) have a son, Josh, who is ten, and two daughters— Jessie, 7, and Julia, 5. He says the family enjoys the abundance of outdoor activities available in the Roanoke and New River valleys, which was an added incentive for him to return to the region.

“There were many things, but primarily it was the opportunity to be a part of a non-profit organization whose mission is to help the community,” Dr. Maher says. “After serving our country for 14 years in the Navy it is a natural transition to return home and serve our local community.

“I am thankful for the opportunity and privilege to take care of our friends and neighbors.”

For more information on the fall sports clinics, call 540-725-1226 or go to CarilionClinic.org/sportsmed.

CARILION EXPANDS SPORTS MEDICINE PROGRAM Carilion Clinic Sports Medicine has expanded its services in a number of ways to better serve patients during the busy fall sports season, says T. K. Miller, M.D., the Sports Section’s chief.

From mid-August through late November, Carilion physicians offer sports medicine clinics on Saturday mornings at their Lexington, Roanoke, and New River Valley offices.

Services include post-event and acute injury assessment.

The clinics start at 8:30 a.m. and patients are seen on a first-come, first-served basis until all have been evaluated.

In addition, two Carilion Clinic physicians—Priscilla Tu, D.O., in family medicine and Mark Kasmer, M.D., at Carilion Clinic PCA in Salem—provide primary care-based sports medicine services.

“As we have expanded, we are now able to provide full-time certified, athletic training services to nine regional high schools and on-field provider coverage to 12 high schools and four colleges,” Dr. Miller says.

CarilionClinic.org | FALL 2015 9

MEDICAL NEWS

NEW PROGRAM HELPS STROKE

PATIENTS RECOVER

By Heidi Ketler

It was Saturday, May 23—Memorial Day weekend. Ralph Greenway, a retired Vinton dentist, had just finished mowing the lawn and running the weed trimmer. He was headed to the garage when he suddenly felt unsteady on his feet.

His medical instincts led the 81-year-old into the house to check his blood pressure. It was okay. His wife Ann’s nursing intuition convinced her to call the doctor, who advised an immediate trip to the emergency department.

Before that day, Dr. Greenway described himself as healthy and active. Today, he is a stroke survivor on the road to recovery.

10 FALL 2015 | CarilionClinic.org

L: After a stroke, retired Vinton dentist Dr. Ralph Greenway lost all movement on his left side. He has since regained some mobility in his left leg and arm through therapy.

After five days in acute care at Carilion Roanoke Memorial Hospital, Dr. Greenway was transferred to Carilion Clinic’s acute inpatient rehabilitation unit. During his 50-day stay there, he completed three hours of occupational and physical therapy sessions each day.

“I wanted to stay there as long as possible, so I could make as much measurable progress as I could before I came home,” he says. “When I first came to intensive rehab, I had no movement on my left side. I worked extremely hard, and I’ve regained some mobility in my leg and arm at this point.”

site five to six days a week with 24-hour availability.”

RETRAINING THE BRAIN

The most common neurological damage caused by stroke is loss of function of the upper and the lower extremities on one side of the body, with more severe injury to the upper extremity due to its complexity. Therapy to regain lost function begins soon after stabilization—about two to four days.

“Basically, task-specific therapeutic activities following a stroke have been proven to encourage the brain to create new pathways to replace those affected by a stroke, allowing for motor re-learnNO TIME TO WASTE ing,” says Coleman.

A stroke occurs when blood flow to a Frequent, intensive exercise and the part of the brain stops. A stroke is some- use of electrical stimulation can help. times called a “brain attack.” Immediate “Historically, orthotics and bracing were treatment, preferably within 4 ½ hours used to facilitate compensation for of stroke symptoms (i.e., facial drooping, limited function in the arms and legs,” limb weakness, speech difficulty), is imColeman says. Electrical stimulation portant in reducing brain injury. Today, using mild electrical currents to activate new drugs and treatments are used to extremities was a separate therapy. control bleeding and break up and even Today, Carilion physical and occuparemove blood clots. tional therapists use advanced Bioness Carilion Clinic is certified as a PriInc. technology called “functional mary Stroke Center by The Joint Comelectrical stimulation (FES).” Wireless, mission on Accreditation of Healthcare programmable devices “provide neuroOrganizations. Here, patients receive re-education while allowing patients to the most advanced acute stroke care and walk or use their arm or leg for funcintensive rehabilitation available. tional tasks,” says Coleman.

“We are staffed and prepared to proCarilion introduced Bioness in its invide the best environment possible for patient rehabilitation unit in March. stroke recovery—from an acute-care The device for upper-extremity funcand post-acute rehabilitation perspection is worn on the forearm and can tive,” says Jeff Coleman, M.P.T., manhelp the hand open and close. The leg ager of Carilion Inpatient Rehabilitation cuff worn on the thigh and/or calf can Therapy Services at Carilion Roanoke help patients regain mobility. In either Community Hospital. case, FES reduces stiffness, increases “As an acute inpatient rehabilitation range of motion and strength, improves facility, we provide more minutes of circulation, increases functional mobiltherapy than is required in a less-intenity, and assists in regaining awareness of sive skilled nursing facility, and we have an impaired limb. physicians who are board-certified in The Bioness technology helped Dr. physical medicine and rehabilitation on Greenway, who also used it at home for

a month. He now goes to occupational and physical therapy three times a week, has pool therapy, and walks around the house and at the mall.

A THERAPEUTIC ALTERNATIVE

FIT Rx, a Carilion Wellness medical membership program, may be an option for stroke survivors in need of longterm rehabilitation.

“We’ve had quite a few stroke patients,” says Jenna Bartlett, director of wellness development for Carilion. “After they have completed their allotted therapy sessions, they need regular exercise, especially if they still need to regain muscle control, strength, coordination, range of motion, and endurance. A lot of times they become long-term clients.”

The 60-day FIT Rx membership for $60 is only available through a medical referral. Members benefit from direct access to a personal trainer and Carilion Wellness centers. Members get two fitness consultations, an individualized fitness plan, and weekly one-on-one training sessions. It’s a $270 value.

FIT Rx trainers have specialized certifications in such areas as functional training and experience designing fitness plans for improved strength and balance, as well as the basic functions of daily living. Depending on the severity of the stroke, the trainers will work on mental exercises, such as counting while exercising, says Bartlett.

Carilion also will provide a complimentary, temporary wellness center membership for caretakers who accompany and assist Fit Rx members with limited mobility. If the member cannot come to a Carilion Wellness center, the trainer can devise a home exercise plan.

For more information, go to CarilionClinic.org/inpatient-rehabilitation or CarilionWellness.com/wellness/fitrx.

CarilionClinic.org | FALL 2015 11

MEDICAL NEWS

HELPING PEOPLE

STAY HEALTHY

By Su Clauson-Wicker

Did you know that 50 percent of what makes us healthy is our own health behavior?

Or that 88 percent of the money we spend on health is for medical services— often to counteract the effects of an unhealthy lifestyle—and only 4 percent is spent on healthy behaviors such as exercising, eating nutritious food, and pursuing healthy habits?

If you look at everything that goes into determining whether you will be healthy or not, including genetics, environment, even access to health care, it turns out that good personal health behaviors far outrank all else in keeping you well.

In fact, healthy practices such as exercising, eating well, and avoiding tobacco and drugs account for a full 50 percent of your health, while your heredity and environment account for only 20 percent each, and access to health care a mere 10 percent, according to a national health promotion initiative called Healthy People 2020.

12 FALL 2015 | CarilionClinic.org

“How people live, the choices they make in their daily lives, is the biggest factor in whether they’re healthy or not,” says Shirley Holland, Carilion Clinic vice president of community outreach. “It’s the main social determinant of health— each of us taking responsibility for our own wellness.”

WHAT IS A HEALTHY COMMUNITY?

Carilion takes its mission of improving the health of the community seriously, Holland says. With its community partners, it has been exploring such questions as: What can we do in western Virginia to improve the health of our communities? And: What level of health should we aspire to?

With its partners, Carilion has been conducting ongoing community health needs assessments and getting involved in helping people establish habits that will help them stay healthy.

This year, health needs assessments were conducted in the Roanoke Valley,

the Rockbridge area, and Giles County.

Those surveyed—low-income and chronically ill people without adequate medical insurance—indicated what they felt prevented them and their neighbors from being healthy.

As in previous surveys in 2012, residents said they had difficulty accessing primary care, dentistry, and mental health/substance abuse services, says Aaron Boush, Carilion manager of community outreach. They also reported eating fewer than one fresh or frozen vegetable per day. Almost half said they were physically active an hour per week or less.

Troubling information, yes. But progress has been made. Since 2012, Carilion has collaborated with the United Way of Roanoke Valley and others to create the Healthy Roanoke Valley community partnership, representing more than 50 agencies, schools, and organizations.

Their goals are to improve the general wellness of underserved community res-

What Makes Us Healthy ACCESS TO CARE 10%

GENETICS 20%

ENVIRONMENT 20%

HEALTHY BEHAVIORS 50%

What We Spend On Being Healthy

88% MEDICAL SERVICES

8% OTHER 4% HEALTHY

BEHAVIORS Source: Healthypeople.gov

idents and provide better care access and coordination.

“Healthy Roanoke Valley’s work over the past three years has focused on providing education to community partners regarding mental health and substance use issues; reducing risky behaviors in youth and young adults; addressing obesity through programs that increase access to healthy foods and physical activity; and creating a community-based coordination of care system,” says Healthy Roanoke Valley Program Director Pat Young.

“We recently received a Grassroots Engagement Initiative grant from DentaQuest Foundation to improve the public’s perception of oral health as a key component to overall health,” she adds.

“Healthy Roanoke Valley is working at creating a culture of wellness,” says Boush. “We’re talking about increasing people’s health literacy and valuing of good health behaviors.”

The assessments have demonstrated a great need for better health education,

he says. Checking blood pressures, for instance, doesn’t give people helpful information if they don’t understand that eating fresh vegetables, managing their weight, and exercising play a role in keeping the numbers down.

PROMOTING WELLNESS

Another link in the evolving culture of wellness is Fresh Foods Rx, a new program launched by Healthy Roanoke Valley in May to make fresh, local food available to patients whose health could be improved by a better diet. Carilion physicians write patients a fresh food prescription, and patients get $25 weekly vouchers for fresh fruits and vegetables.

They use the vouchers at an on-site mobile farmers market and attend weekly sessions with Carilion, YMCA, and Coop­ erative Extension health educators.

Healthy Roanoke Valley worked with Carilion Family Medicine and LEAP, a Roanoke-based nonprofit that strives to make healthy, local food accessible, to create and pilot the program.

Partnering with Feeding America’s mobile food bank, Carilion also sends health educators to distribution sites to discuss nutrition with clients when they pick up their produce. And Carilion helps to support the Roanoke Community Garden Association and the Happy Healthy Cooks nutrition education program in elementary and middle schools.

In 2012, Carilion was commended by the Virginia Hospital & Healthcare Association for having a “best practice” in Virginia of evaluating and dealing with community health needs. “They looked at our grass-roots approach of directly involving community residents in assessing their health needs, and how we are partnering with communities to address what we learned,” says Holland.

Carilion’s efforts at building healthier communities will continue well into the future. “We’re happy to be working with so many partners in this important work,” Holland says. “But we still have so much to do.”

CarilionClinic.org | FALL 2015 13

MEDICAL NEWS

Carilion Brings New Heart Treatment to the NRV

By Kathie Dickenson Mollie Killian, 72, understands the importance of listening to your body.

Last fall during her walks near her Christiansburg home, she began to notice “a weird feeling in my chest and a little cramping in the calf of my right leg.” She described the sensations to Carilion Clinic cardiologist Dhun Sethna, M.D., who had already been treating her for atrial fibrillation.

After a coronary stress test and a carotid ultrasound, Dr. Sethna prescribed medication to lower Killian’s blood pressure, but when the symptoms didn’t go away, he referred Killian for diagnostic catheterization and possible PCI.

14 FALL 2015 | CarilionClinic.org

L: Doctors found and treated a 99 percent blockage in Mollie Killian’s right coronary artery during a procedure called PCI, or percutaneous coronary intervention.

EXAMINING ARTERIES

PCI, or percutaneous coronary intervention, makes use of a catheter to examine arteries and treat blockages immediately, without open surgery. The catheter is inserted through the skin of the upper thigh or arm and is guided by a physician who watches its path via X-ray.

Unlike coronary artery bypass surgery, PCI is done under local anesthetic, and the patient can be discharged the next day.

If this diagnostic angiogram (X-ray) reveals a blockage, it can potentially be treated via catheter-based therapies such as angioplasty, where a balloon is inflated in the artery to open up the blood vessel, or with placement of a stent.

The procedure requires both a PCIequipped catheterization (cath) lab and a board-certified interventional cardiologist. And until recently, a New River Valley patient like Killian could have a diagnostic angiogram at Carilion New River Valley Medical Center, but if the diagnosis called for intervention, she would have to go to Carilion Roanoke Memorial Hospital.

Then in October 2014, board-certified interventional cardiologist Shen-Li Tan, M.D., joined Carilion, to be home-based in the New River Valley, with the main aim of establishing a PCI program to serve the local community.

“Dr. Tan’s skills are superb, her judgment excellent, and her ability to act appropriately under pressure is outstanding,” says Rodney Savage, M.D., director of Carilion’s Interventional Cardiology Fellowship, a one-year program for training interventional cardiologists. “She’s a heavyweight fighter in her arena.”

MAYO CLINIC TRAINING

Dr. Tan graduated from medical school at the National University of Singapore, then spent 8 years at the Mayo Clinic in

Rochester, Minn., where she completed an internal medicine residency, a cardiology fellowship, and an interventional cardiology fellowship.

Looking for a warmer climate and attracted by the Roanoke region’s beauty and friendly people, she came to the Salem VA Medical Center, where she was the director of the Cardiac Cath/PCI Lab. She spent 8 years there developing the PCI program and was instrumental in obtaining a new PCI lab for the facility.

Dr. Tan now serves on the faculty of Carilion’s fellowship program and sees a variety of heart patients, both stable and unstable, in her regular practice at Carilion Clinic Cardiology-New River.

Stable patients are those referred by a Dr. Shen-Li Tan is a primary care physiMayo Clinic-trained cian, a family clinic, specialist who performs or in Killian’s case, the new procedure. a cardiologist. They may have had a positive stress test, classic symptoms of heart disease, or a long family history of heart disease. “These are the outpatients,” says Dr. Tan, “who come to the cath lab, we do a coronary angiogram, and if we find critical disease we can fix it.”

The less stable patients come into the hospital with acute coronary syndromes involving severe symptoms. “These are called ACS patients,” says Dr. Tan, “and depending on what lesions (abnormalities) we find on the angiogram, they might be appropriate for PCI.” Others are referred for medical therapy or open surgery, for which they must go to Roanoke Memorial.

If a PCI candidate is too high-risk, he or she will be sent to the Roanoke cath lab, where surgical back-up is available, says Dr. Tan. “Basically, if we can do it safely,

we do it here.”

For those New River Valley residents who are candidates, having PCI close to home allows them to be treated more quickly, avoid risks of transfer, and be close to their family and support network during treatment.

A SUCCESSFUL OUTCOME

When Dr. Sethna recommended PCI for Killian, she assumed she would go elsewhere. But “Dr. Sethna was fairly emphatic” about Dr. Tan’s qualifications and the need to diagnose and treat the problem right away, she recalls.

Within two weeks, Killian was in Carilion’s New River Valley cath lab. Lightly sedated but awake, she was aware of doctors and nurses talking as they conducted the procedure. “Then they found a 99 percent blockage in the artery on the right side of my heart,” says Killian. Dr. Tan treated this by implanting a stent in the right coronary artery.

The next morning, Dr. Tan and Jose Rivero, M.D., visited Killian in the hospital. “Do you realize how lucky you are to be here?” they asked. Dr. Tan said it was very fortunate Dr. Sethna had referred her for the heart cath, and it was important that she follow up with Dr. Sethna for further medical treatment to prevent future problems.

After that sank in, Killian replied, “Well, I’m glad that you took such good care of me.”

Now, when she sees Dr. Sethna for check-ups, Killian can report that she is able to take her walks without chest pain.

Killian’s advice to other patients? “If something is wrong in your body, make it known,” she says. “The doctors won’t laugh at you, and it could save your life. It did mine.”

For more information, call 800-422-8482 or go to CarilionClinic.org/heart-vascular.

CarilionClinic.org | FALL 2015 15

COVER STORY

A SENSE OF PURPOSE: WHY IT’S GOOD FOR YOUR HEALTH

By Randolph Walker Alex Obenauer, a young software entrepreneur, has a way to tell whether he’s staying focused on his goals in life.

“When I have my eye on our purpose, it’s incredibly easy to get to sleep and to get up,” says Obenauer, co-founder and CEO of Mindsense, makers of a successful app that helps organize e-mail. “I find it very easy to stay motivated and energetic, very easy to stay positive even in the face of difficulties.”

Mindsense, which is based at the Virginia Tech Corporate Research Center, even states prominently on its website that “our goal is to improve people’s lives.”

Obenauer says this applies to customers, employees, and members of the community.

16 FALL 2015 | CarilionClinic.org

Software entrepreneur Alex Obenauer (left) and science teacher Betsey Miles are each motivated by the goal of improving people’s lives.

While some in his industry feel they need to “stay up writing code until three or four in the morning,” Obenauer finds he’s most effective when he takes care of himself. That includes getting enough sleep, spending quiet time, and connecting with other people.

This young man with a mission is increasing his chances of enjoying lifelong good health. According to recent studies, people who feel a strong sense of purpose experience some amazing health benefits, including lower rates of heart disease and stroke and protection against the harmful effects of stress hormones.

Researchers from Mount Sinai Health System in New York, for instance, reviewed 10 studies involving more than 137,000 people. They found that a high sense of purpose—defined as a sense of meaning and direction, and a feeling that life is worth living—is associated with a 23 percent reduction in death from all causes and a 19 percent reduced

risk of heart attack, stroke, or the need for certain heart procedures. Those with a low sense of purpose were more likely to die or experience heart problems.

“The benefit could come from two possible mechanisms,” says lead study author Randy E. Cohen, M.D. “One being that people with a higher sense of purpose have lower levels of stress hormones in their body; they have lower markers of inflammation. That has a very cardio-protective effect.

“The other relates to behavioral factors. It’s possible that people who have a higher sense of purpose are also engaging in a lot of health-promoting behaviors. They might be more inclined to eat a healthy diet. They might be more committed to getting regular physical activity. I believe both physiologic and behavioral mechanisms are responsible.”

Such protective effects aren’t limited to the heart. Researchers at the Rush Alzheimer’s Disease Center in Chicago found that a sense of purpose reduces

the occurrence of damage associated with blockages of blood flow in the aging brain.

Researchers analyzed autopsy results of 453 people who volunteered for the Rush Memory and Aging Project and underwent annual physical and psychological evaluations until they died. All had agreed to organ donation at death.

Participants who had reported a stronger purpose in life were 44 percent less likely to have areas of damaged brain tissue visible to the naked eye.

“Purpose in life is robustly protective against a variety of negative health outcomes in old age,” neuropsychologist and researcher Patricia Boyle, Ph.D., says.

“Finding a sense of purpose will not only improve psychological health but may also improve physical health.”

While this study involved older adults, Boyle feels it “absolutely” applies to younger people as well. “Purpose in life is likely important and may improve health at all ages.”

CarilionClinic.org | FALL 2015 17

COVER STORY As director of the Roanoke Area Youth Substance Abuse Coalition, Kathy Graham Sullivan is committed to helping young people avoid underage drinking and drug use; Jeff Beeler, Radford University’s head coach of women’s golf, says it’s gratifying to help others achieve their goals.

WHAT’S YOUR PURPOSE IN LIFE? “That’s a real personal question for people and one that’s worth practitioners asking of their patients,” says Randy E. Cohen, M.D., of the Mount Sinai Health System in New York.

Some studies have examined mindfulness and meditation, “which help people get more in touch with what might be important and relevant to them,” Dr. Cohen says.

“Think about what drives/motivates you—what you think is important (volunteerism, social ties),” says Patricia Boyle, Ph.D., who has studied a sense of purpose among older adults at Rush University Medical Center in Chicago.

“Then, set specific goals and actively work toward them. Try to be aware of how you spend your time, and engage in meaningful activity.”

Brian K. Unwin, M.D., who works with older patients at Carilion Clinic, defines his own purpose in terms of “relationship and service to people. Without that, there would be no wind under my wings.”

As for his patients, he observes: “Those who have successfully aged have not done so in isolation, or as rugged individualists.”

18 FALL 2015 | CarilionClinic.org

The findings aren’t surprising to Carilion Clinic doctors. Brian K. Unwin, M.D., chief of geriatrics and palliative medicine, has “lots of examples in my rehab work where patient motivation for recovery is connected to helping their spouse back at home.”

People with something to live for are “more likely to follow up with the recommendations of their physician,” says Michael Jeremiah, M.D., Carilion’s chair of family and community medicine.

“They’re adhering to their medications and getting their screening tests done.

They’re people who seem to accept the things that are not always easy in taking care of ourselves, but they kind of embrace that and say ‘That’s just something I need to do. It’s kind of the way I can get towards my goals.’ I have seen that association and I think it’s a powerful one, and I believe in that personally.”

Kathy Graham Sullivan believes in it too. She is with Blue Ridge Behavioral Healthcare and serves as director of the Roanoke Area Youth Substance Abuse Coalition.

She’s strongly committed to helping young people. “We work within our communities to educate them and mobilize

them about the dangers of underage drinking and drug use,” she says. “At the end of the day, you have to feel like you’ve made a difference.”

Sullivan, who’s also a member of the Botetourt County School Board, takes care of herself by exercising four to five times a week. “A healthy lifestyle helps you make positive choices, which can influence those around you in a positive way,” she says.

Chris Morrill, who as city manager has one of the toughest jobs in Roanoke, stays focused on his goal of building a better community. “When you wake up in the morning knowing you can come in and really help improve people’s lives, it does make a difference,” he says. “It gives you a little bit of energy, which is what you need for this job, and helps you get through some of those stressful situations.”

He also thinks exercise can help you meet your goals. Morrill exercises three or four times a week, uses a stand-up desk, and walks outside at lunchtime.

When he needs added inspiration, it helps him to look at the fruits of his work. For example, Morrill says if he’s having a rough day, he can walk to the

Douglas Martin (left), a Carilion Clinic clinical support supervisor in transport services, is motivated by making a difference in others’ lives; Roanoke City Manager Chris Morrill, shown at his stand-up desk, has a goal of building a better community.

Carilion Clinic Children’s Hospital Playground in Elmwood Park—a collaboration between the city and Carilion—and watch kids having fun.

Making a difference in others’ lives also helps Jeff Beeler stay motivated as head coach of women’s golf at Radford University. “When you see you’ve had an impact on someone’s life, it’s extremely gratifying,” he says.

Beeler’s mission is simple. “Be better today than you were yesterday. If you’ve been blessed with the day, make the most of it, whether [as] a better person, father, husband, or coach.”

Someone else who makes the most of every day is Douglas Martin. As a clinical support supervisor in transport services, Martin can be seen at the front doors of Carilion Roanoke Memorial Hospital wearing a Stetson hat—white from Memorial Day to Labor Day, black or brown the rest of the year.

“My job is to make sure patients get seated in their cars safely,” he says.

“We’re talking about people who had total hip or knee operations, or arm or abdominal surgery—very delicate surgery. I look forward to coming to my job every day because I know I’m making a difference. I have patients who tell me

how much it’s appreciated.”

The work keeps Martin, 72, feeling good physically and mentally. “It keeps me active,” he says. “I don’t have to sit around and worry about things. It gives me a sense of purpose to come here each day.”

Martin has been helping patients at Carilion for over 50 years.

For teacher Betsey Miles, educating children is both her purpose and reward. Miles, who teaches fourth- and fifth-grade science at Herman L. Horn Elementary School in Vinton, seeks to fully engage her students “so they’ll be motivated to learn and seek knowledge for themselves.”

Knowing that she can make a difference in their lives is a powerful motivator. “My reward is the good feeling I get from their success,” she says. (This year, Miles also won the Roanoke County Public Schools Education Foundation’s Golden Apple Award for excellence in teaching.)

Whether it’s helping others—or pursuing your own unique dream—it’s worth taking the time to think about your purpose in life. The person you help most of all may be yourself.

HELPING KIDS DEVELOP A SENSE OF PURPOSE Betsey Miles, a science teacher at Herman L. Horn Elementary School in Vinton, is faculty sponsor of the Student Council Association, composed of third-, fourth-, and fifth-graders.

“I have an obligation to teach them about community involvement,” says Miles.

The students have created messages for children in Carilion Clinic hospitals and have performed holiday concerts at the Salem Veterans Affairs Medical Center, the Trust House, and nursing homes. After one concert at a nursing home, a man with tears in his eyes approached Miles to thank her. “He was so moved and so touched,” she says.

“It takes a lot of time, but we always tell the children: ‘You’re doing it for others.’ And a lot of the children feel really good about that, especially when you see the emotion from the residents. It makes them understand that what they’re doing is worthwhile, and it does have a purpose.”

CarilionClinic.org | FALL 2015 19

REGIONAL INTEREST

ENJOY THE BEAUTY G O TA K E A H I K E

By Sarah Beth Jones

Autumn is a spectacular season in the mountains of southwest Virginia, and there’s no better way to enjoy it than to take a hike.

After the summer’s heat and humidity, fall brings crisp air, quieter trails, and brilliant colors. Beginning in late September and extending into November, the mountains show off their dazzling foliage across hundreds of miles of hiking paths.

For Pete Eshelman, director of outdoor branding for the Roanoke Regional Partnership, the Bottom Creek Gorge Trail at the top of Bent Mountain in Floyd County is one of the best for fall hiking.

“It’s really easy to do,” he says. “It’s a great hike because the trail is wide enough for groups of people to walk sideby-side. There are wildflowers and all sorts of birds. When you get to the top, you’re looking over a 200-foot waterfall, the second-highest in Virginia.” The trail extends four miles but can be walked in shorter increments.

20 FALL 2015 | CarilionClinic.org

Bottom Creek Gorge affords a view of maple, oak, and tulip poplar trees that promise a spectacular leaf show, and it is home to a rare plant, the chestnut lipfern.

It’s not the only regional hiking trail to display a rare species, though. “The Poor Mountain Natural Area Preserve in Roanoke County protects the globally rare pirate bush,” says Eshelman. Poor Mountain Trail, another four-mile loop, has a creek at the bottom that is perfect for kids to explore during sunny autumn days.

When certified personal trainer and health and fitness coach Caroline McKean wants a hike closer to home, she heads for the Roanoke Star overlooking the greater Roanoke area.

“I love the Mill Mountain trail system and the Chestnut Ridge Trail,” she says.

“These are easy trail systems to make a three-mile loop or a longer six-mile loop with limited elevation gain and trail obstacles. They are convenient for an

evening hike, and the view from the Star is worth the effort!”

In addition to getting exercise, Don Defreeze, founder of the guided hiking service Excihiking Treks, has found a connection to natural history while on the region’s trails.

“I was hiking up Tinker Cliffs with a customer, a woman from Illinois,” he says. “I noticed what I thought was a rock. I put it in my pocket but when I looked at it again, I realized it had to be a tooth. I had heard rumors that you could find fossils on Tinker Cliffs because the land above is bedrock that’s worn away. The land we see was covered by other land where giant creatures lived, died, and got washed away.”

Defreeze moved to Roanoke from Long Island, New York in 1989 specifically for its proximity to hiking and camping.

“You don’t have to make a big plan to drive somewhere,” he says, noting the hundreds of miles of trails within an hour of Roanoke.

Two views from the Blue Ridge Parkway near Roanoke capture the region’s scenic beauty in autumn. Inset: McAfee Knob on the Appalachian Trail in Catawba, and the Roanoke Star at the top of Mill Mountain.

The 6.6-mile Tinker Cliffs trail in to the west, the Roanoke Valley to the Rather than being afraid of possible east, and Tinker Cliffs to the north.

Troutville also offers scenic views, unwildlife interactions, consider walking McAfee Knob is also the Appalachian usual rock formations, rushing streams, quietly and softly in order to spot shy Trail’s most photographed site. and pretty forest lands. creatures, Eshelman suggests. And while Another challenging trail with a magA connection with more recent history snakes often flee at the vibration of is in store at the Peaks of Otter near Bed- nificent scenic payoff is the Dragon’s footfalls on the path, he says it’s a good ford. A popular destination for locals and Tooth near Catawba. Hikers ascend 4.5 practice to step on logs on a trail rather miles on Cove Mountain to view the travelers alike since the turn of the 20th than over them in case sleeping snakes “tooth,” a unique geologic formation comcentury, the area still draws painters are curled against the opposite side. posed of Tuscarora quartzite spires that with its fall colors, astronomy fans with With its majestic mountains, breathextends 35 feet beyond the surrounding its pristine autumn skies, and hikers taking foliage, inviting temperatures, rock. with its variety of wooded trails. and captivating views, southwest What to know about hiking in the “For younger families, the Johnson Virginia offers memorable hikes all fall? Despite the cooler temperatures, Farm Trail is a great option,” says Lisa through autumn. Pack a picnic lunch carrying water is just as important as in Moyer, who co-owns Muddy Squirrel and set out with your family or friends— warmer months.

Wear layers of clothing in Troutville, which provides outdoor you’re all sure to remember the thrill and bring a flashlight or headlamp in guides and instructors. case you’re caught out after dusk. long after the leaves fall.

The two-mile Johnson Farm Trail, accessible from the Peaks of Otter Visitor Center, leads to the Johnson Farm, reRESOURCES stored to replicate life there in the 1930s. roanokeoutside.com/get-outside/land/hiking Costumed interpreters work on the farm and tell visitors about daily life in the appalachiantreks.blogspot.com/p/hikes.html past. thehikinghokie.blogspot.com/p/hikes-in-southwest-virginia.html For those who seek a more ambitious everytrail.com/best/hiking-virginia climb, a popular 8-mile hike leads to peaksandpaths.blogspot.com/p/best-unknown-hikes-of-southwest-virginia.html McAfee Knob in Roanoke County; it has panoramic views of the Catawba Valley CarilionClinic.org | FALL 2015 21

MEDICAL NEWS

Mobile Imaging Aids Rural Residents If you live in rural southwest Virginia, you can still have access to advanced imaging services.

Carilion Clinic’s mobile imaging trucks serve patients at smaller rural hospitals in Rocky Mount and Bath, Bedford, Buchanan, Giles, Montgomery, Rockbridge, and Tazewell counties. By conservative estimates, the units have traveled over 3 million miles in the past 33 years, says James Crowley, Carilion’s mobile imaging manager.

“Many hospitals in smaller communities don’t have access to MRI,” says Kelley Whitmer, M.D., medical director of imaging at the 37-bed Carilion Franklin Memorial Hospital in Rocky Mount. “Carilion’s mobile imaging allows patients at the periphery of our coverage area to travel less but still receive the highest level of diagnostics,” he says.

Carilion operates four mobile imaging units—three MRI units and one PET/CT unit—to serve outlying hospitals on a regular schedule. MRIs are suited for examining soft tissue in ligament and tendon injuries, spinal cord damage, brain tumors, internal injuries, and most cancers.

Positron emission tomography (PET) scans use radioactive tracer drugs to reveal how tissues and organs are functioning. PET scans are useful in evaluating some cancers, heart disease, and brain disorders such as cancer or dementia. Both 22 FALL 2015 | CarilionClinic.org

scans can help determine if a treatment or surgery is necessary.

“In addition to scheduled patients, our units help out with inpatients and in the ERs,” Crowley says.

A new MRI unit is also state-of-the-art. “Carilion Clinic has once again demonstrated its commitment to the patients and communities we serve by installing the Avanto MRI, the most advanced mobile MR system offered by Siemens,” says Daniel Karolyi, M.D., Carilion’s vice chair of imaging.

“In addition to providing faster imaging and higher spatial/contrast resolution, the Avanto will allow us to expand the types of studies we can offer on the mobile platform to include more advanced brain, spine, joint, vascular, and abdomen/pelvis imaging.”

Says Dr. Whitmer: “The Avanto allows us to perform scans for many additional health problems, allowing our patients to stay closer to home while confident their health is being evaluated with state-of-the-art equipment. Mobile imaging is a big part of our mission.”

ABOUT THE FLU VACCINE

ABOUT THE FLU

5-20%

Between of U.S. residents get the flu each year; more than 200,000 are hospitalized

Getting the flu vaccine is your

BEST PROTECTION against the flu

OCTOBER

FACTS

While the flu peaks in January or February,

FLU ACTIVITY STARTS IN OCTOBER

Mild to severe flu symptoms can last up to TWO WEEKS

for

FALL Source: U.S. Department of Health and Human Services

FLU SPREADS

when a person with the flu coughs, sneezes, or talks and droplets containing their germs land in your mouth or nose; you can also get the flu by touching a surface or object that has the flu virus on it and then touching your mouth, eyes, or nose

It takes about TWO WEEKS after being vaccinated

for you to be protected

The flu vaccine

CANNOT cause the flu

Under the Affordable Care Act, many insurers are required to cover preventive services like the flu vaccine at

NO COST TO YOU

CarilionClinic.org | FALL 2015 23

IN YOUR COMMUNITY

ROANOKE MEMORIAL RANKED HIGH IN STATE Carilion Roanoke Memorial Hospital was ranked the fifth best hospital in Virginia by U.S. News & World Report. Four adult specialties were also ranked as “high-performing”: diabetes and endocrinology, geriatrics, orthopaedics, and pulmonology. Two adult procedures/conditions— heart failure and chronic obstructive pulmonary disease, or COPD—were also ranked as high performing. Separately, Carilion Clinic received 27 “Excellence in Healthcare Awards” for outstanding achievements in patient experience from Professional Research Consultants. The awards were based on patient surveys.

ORTHO-NEURO INSTITUTE TO OPEN Carilion Clinic’s new Institute for Orthopaedics and Neurosciences is on track to open in January. The center will bring specialists in orthopaedics together with those in neurosurgery; physical medicine and rehabilitation; pain management; physical, occupational, and hand therapies; and imaging so they can collaborate on patient care. The center, located at the site of the former Ukrop’s market in Roanoke, is expected to meet a growing need for services required by an aging population.

HEALTH EDUCATION SERIES PLANNED Join Carilion Clinic for a new health education series to be held in Lexington. The series kicks off Oct. 27 with a luncheon and talk: “Exercise as Medicine: A Prescription for Good Health.” It will be given by Allison Bowersock, Ph.D., director of the Health and Exercise Science Program at Jefferson College of Health Sciences. Future events will focus on heart health and nutrition, sleep, and orthopaedic care. For more information or to register, call 800-422-8482.

24 FALL 2015 | CarilionClinic.org

GETWELLNETWORK EXPANDS The GetWellNetwork, first offered to patients at Carilion Roanoke Memorial Hospital, is now available to Carilion Clinic’s more than 110,000 MyChart users. Patients can watch educational videos about their conditions, treatments, and medications at home or on the go, 24/7. Anyone with a MyChart account can log in through a home computer or smartphone to select from over 850 videos.

CARILION FOUNDATION CREATES FIRST PROFESSORSHIP The Carilion Clinic Foundation has established Carilion’s first professorship: The William S. Erwin, M.D., Professorship of Internal Medicine in honor of Dr. Erwin, who celebrated his 50th anniversary in medicine in September. The foundation has also moved to new offices in the Fralin House at 903 S. Jefferson St. in Roanoke. The historic, three-story house was built in 1906 for D.W. Flickwir, Esq. and has been renamed in honor of Horace and Ann Fralin of Roanoke. To learn more about the professorship and how to make a gift, go to CarilionFoundation.org/erwin.

UROGYNECOLOGY SERVICES EXPANDED TO WESTLAKE Urogynecology services are now available at Carilion Clinic’s Westlake Center at Smith Mountain Lake. Urogynecologists Jonathan L. Gleason, M.D., and W. Jerod Greer, M.D., are available for consultation and follow-up appointments on the second and fourth Thursday of the month. They are experienced in treating urinary incontinence, overactive bladder, recurrent urinary tract infections, fecal incontinence, pelvic organ prolapse, uterine prolapse, and other conditions. For more information, call 540-985-4099.

INTERNATIONAL HEALTH CONFERENCE HELD IN ROANOKE Collaborating Across Borders V, the leading North American conference on interprofessional education and practice in health care, was held in Roanoke this fall. Attendees included health care professionals, researchers, educators, students, patient advocates, and policy makers. The selection of Roanoke as a host city was said to reflect Carilion Clinic’s and the region’s growing reputation in interprofessional education, also referred to as interdisciplinary learning.

Local sponsors were Carilion, Virginia Tech, the Virginia Tech Carilion School of Medicine and Research Institute, and Jefferson College of Health Sciences.

A NEW TOOL FOR VELOCITYCARE PATIENTS Have you heard about iTriage®, a new tool being used at VelocityCare? It allows you to communicate with the staff before you even set foot in the door. You can let them know you’re on the way, and share information such as symptoms, by going to VelocityCareByCarilion.com or via the iTriage app.

CarilionClinic.org | FALL 2015 25

NEW PROVIDERS PHYSICIANS Clarke Andrews, M.D.

Garry Kuiken, M.D.

Angel A. Medina-Bravo, M.D.

Kevin Dye, M.D.

Laura Lanier, M.D. Family Medicine 146 S. Main St., Lexington, VA 540-463-9158

Gary O’Hagan, M.D.

Family Medicine 1818 Electric Road, Roanoke, VA 540-772-8950

Sheila Garnica, M.D.

Appollo Leong, M.D.

Thomas Peck, M.D.

Lucian Grove, M.D.

Keith Madsen, M.D. Family Medicine 1420 N. Main St., Blacksburg, VA 540-951-8380

Robert M. Pickral, M.D.

Family Medicine 146 S. Main St., Lexington, VA 540-463-9158

Gates Hoover, M.D.

Jonathan Maher, M.D. Orthopaedic Surgery; Sports Medicine 2900 Lamb Circle, Christiansburg, VA 540-731-2436

Edwin Polverino, D.O.

Family Medicine 1935 W. Main St., Salem, VA 540-387-0441

Mark Kasmer, M.D.

Eric Marvin, D.O.

John Priddy, M.D.

Adrienne Kinsey, D.O.

Megan McPhee, M.D.

Luzangela Rojas-Mogollon, M.D.

Family Medicine 150 Market Ridge Lane, Daleville, VA 540-992-4100

Gastroenterology 1201 Franklin Road, Roanoke, VA 540-985-0244

OB/GYN 390 S. Main St., Suite 101, Rocky Mount, VA 540-484-4836

Internal Medicine 1935 W. Main St., Salem, VA 540-302-0190

Allergy and Immunology 1935 W. Main St., Salem, VA 540-387-0441 46 Wesley Road, Daleville, VA 540-591-9457 108 Houston St., Suite F, Lexington, VA 540-463-2056

Sports Medicine 1935 W. Main St., Salem, VA 540-387-0441

Internal Medicine 1935 W. Main St., Salem, VA 540-387-0441

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Family Medicine 249 Franklin Pike, S.E., Floyd, VA 540-745-5700

Family Medicine 1818 Electric Road, Roanoke, VA 540-772-8950

Neurosurgery 3 Riverside Circle, Roanoke, VA 540-224-5170

Psychiatry 2900 Lamb Circle, Christiansburg, VA 540-731-7311

Physical Medicine and Rehabilitation 3 Riverside Circle, Roanoke, VA 540-224-5170

Family Medicine 33 Red Hill Road, Fairfield, VA 540-377-2156

Family Medicine 1935 W. Main St., Salem, VA 540-387-0441

Psychiatry 2017 S. Jefferson St., Roanoke, VA 540-981-8025

Mohammad H. Shakhatreh, M.D., M.P.H. Gastroenterology 3 Riverside Circle, Roanoke, VA 540-224-5170

Kyoko “Leann” Yoda, D.M.D. Pediatric Dentistry 101 Elm Ave., Roanoke, VA 540-224-4380

Kelsey Hayden, P.A. Family Medicine 1818 Electric Road, Roanoke, VA 540-772-8950

ADVANCED CARE PROVIDERS Jennifer Wells, M.D.

Beth L. Cullen, F.N.P.-C

Marie T. Nicely, P.A.-C.

Jessica Whiting, D.O.

Kelly Finnegan, P.A.-C.

Lauren Smith, P.A.

Psychiatry 2017 S. Jefferson St., Roanoke, VA 540-981-8025

Family Medicine 1935 W. Main St., Salem, VA 540-387-0441

Family Medicine 33 Red Hill Road, Fairfield, VA 540-377-2156

Internal Medicine 2900 Lamb Circle, Suite 250, Christiansburg, VA 540-639-9071

Internal Medicine 108 Houston St., Suite A, Lexington, VA 540-463-2181

Family Medicine 1935 W. Main St., Salem, VA 540-387-0441

Carilion Clinic PCA Holds Open House Clockwise: Dr. Patrice Weiss, Carilion Clinic’s chief medical officer, speaks at an open house for Salem-Roanoke County Chamber of Commerce members; Dr. Weiss and Dr. Michael Jeremiah present a plaque to Dr. Edwin Polverino, former president of PCA Healthcare, recognizing his dedication and leadership. PCA joined Carilion last summer and is now known as Carilion Clinic PCA; Lisa Bain of Servpro accepts tickets to a Virginia Tech vs. Ohio State football game that she won in a drawing from Allison Brelyn-Porter, a Carilion marketing consultant; The open house was held at Carilion Clinic PCA in Salem during August.

CarilionClinic.org | FALL 2015 27

RECIPE

RELAX OVER A FRAGRANT BOWL OF SOUP What’s better on a cool autumn day than a steaming bowl of fragrant soup? Our creamy, delicious broccoli and cheese soup tastes like you spent hours in the kitchen, but it can be quickly prepared for lunch or a light dinner with a crusty bread and fresh salad.

A pinch of nutmeg offers a sweet, spicy note.

Fresh broccoli is available year-round and is chock full of potassium, folate, and vitamins A, C, and K.

BROCCOLI AND JACK CHEESE SOUP SERVES: 10 INGREDIENTS

• • • • • • • • • •

1 diced small onion ½ cup butter 1/3 cup all-purpose flour 2 cups half and half 6 cups of fresh broccoli florets 1/8 tsp. nutmeg 2 cups of sharp cheddar cheese 1½ cups of shredded pepper jack cheese ½ cup of chicken broth Dash of salt and pepper to taste

PREPARATION 1. Melt butter in a large pot over medium-high heat. Add onions and sauté until translucent.

2. Sprinkle flour over onions and stir until lightly browned. Reduce heat to medium and

slowly pour in half and half, stirring constantly. Add nutmeg and salt and pepper to taste.

3. Stir for 10-15 minutes or until milk begins to bubble just around edges of pan.

4. Add broccoli. Cook for 3-5 additional minutes.

5. Stir in cheese and allow it to melt. Chicken broth may be added if you would prefer your

soup thinner. Serve immediately.

PER SERVING

Calories: 357; Carbohydrates: 10 g; Fat: 30 g; Protein: 15 g; Sodium: 378 mg; Sugar: 1 g 28 FALL 2015 | CarilionClinic.org

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