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Gout Treating a chronic condition

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Patient Care Introducing MyChart, an online tool to empower patients

14 Stroke When every minute counts

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Taylor Swift Her life reflected in music

Photo by Joseph Anthony Baker

Summer 2010

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Departments 3

Letter

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Cardiac Care

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Facilities

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Chronic Conditions Patient Care

President and CEO ..........................

Chief Operating Officer, Carilion Clinic and President, Carilion Clinic Hospital Division ....

Vice President of Strategic Development ...............

Media Relations Director.................

Edward G. Murphy, M.D.

Nancy Howell Agee Shirley Holland Eric Earnhart

verve:

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Profile

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Technology

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News & Notes

Editor................................................

Design ..............................................

Photography ....................................

Printing.............................................

Maureen Robb Gordon Garrett Darryle Arnold Chocklett Press

Contributing Writers Mary Brewer, Allison Buth, Shanna Flowers, Meredith Hite, Kate Jones, Gail Nordhaus, Matthew Sams Cover Photography Joseph Anthony Baker

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Women’s Health www.CarilionClinic.org

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Services

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New Physicians

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Online

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Excursions

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Lifestyle

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Food

Summer 2010

540-266-6000 or 800-422-8482 Carilion Clinic is a health care organization with more than 600 physicians in a multi-specialty group practice and eight not-for-profit hospitals.

verve is published quarterly by Carilion Clinic 1906 Belleview Ave. P.O. Box 13367 Roanoke, VA 24033 540-981-7000 Copyright 2010 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-todate 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.

verveletter

welcome

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f a friend or family member has ever had a stroke, you’re probably aware of how critical it is to seek immediate help. In this issue of verve, we tell you about new stroke initiatives being launched by Carilion Clinic. We have instituted a new Stroke Alert program that speeds stroke victims to life-saving care. We are also recruiting leading stroke specialists and dedicated stroke neurologists; using new, advanced stroke intervention technology; and are beginning two important clinical research trials on stroke in Roanoke.

Other articles in this issue address our new cardiac arrhythmia center, expanded orthopaedic practice, and gout—a chronic condition that’s on the increase. We also take a look at the health benefits of owning a pet and cultivating your own vegetable garden.

For those of you who are looking for fun ways to incorporate exercise into your busy lives, you might want to consider hiking or biking the New River Trail.

Stretching across four counties in southwest Virginia, it is part of a special nationwide network of trails built on abandoned railroad right-of-ways. What sets it apart is its 39 miles of continuous path paralleling the historic New River that meanders across scenic towns and byways.

In this issue we also profile Taylor Swift, a delightful performer with legions of fans internationally who will attest to her talent. At 20, she has notably followed her own path to success—resisting those who might have otherwise shaped her career. Swift is a fascinating blend of young wisdom—singing about hard emotional lessons learned—and irrepressible enthusiasm for life.

Edward G. Murphy, M.D. President and CEO Carilion Clinic

Summer 2010

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Resources to Keep You Healthy Nurse Line Carilion Clinic’s physician referral and health information service is here to help.

Call us at 540-266-6000 or 800-422-8482, or e-mail us at direct@carilionclinic.org.

Speaker’s Bureau If you’d like a speaker on a health topic for your community group, call 540-224-4961. For a speaker at your workplace, call 540-224-4967.

Or visit www.CarilionClinic.org/Carilion/speakers.

Community Health Screenings Health screenings throughout the community are available at little or no cost.

Call 540-266-6000 or 800-422-8482, or e-mail us at direct@carilionclinic.org.

New, Improved Website Check out these features at www.CarilionClinic.org: • A multi-media health library with audio, video and interactive tools • Health news headlines, updated several times a day • A physician search tool (with multiple criteria) • A community health education calendar

News Blog Keep up with the latest news, photos, videos and more at Carilion Clinic’s news blog. Visit newsblog.CarilionClinic.org.

Social Media Stay connected with us through Facebook, Twitter, YouTube and Linkedin: www.facebook.com/carilionclinic www.twitter.com/CarilionClinic www.youtube.com/carilionclinic www.linkedin.com/companies/carilion-clinic.

Publications Pick up a copy of verve, Carilion Clinic’s health and lifestyle magazine, at a magazine rack or grocery store near you. Or read past issues of verve and the Carilion Clinic Report at www.CarilionClinic.org/Carilion/Publications. For health tips and news about health events, check out our e-newsletter, Carilion Clinic Living, at www.CarilionClinic.org/Carilion/living.

Support Groups Support groups are available for a wide range of health and emotional needs, including gynecologic cancer, breast cancer and perinatal loss. Learn more at www.CarilionClinic.org/Carilion/Support+Groups.

Health Information Centers Computer stations with health information are available at Carilion Clinic’s 3 Riverside building at the corner of South Jefferson Street and Reserve Avenue in Roanoke. Check out the audio library, video library, clinical wizards, health news and interactive tools.

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Summer 2010

Carilion Clinic Opens a

Cardiac Arrhythmia Center World-class Expertise and Technology in Western Virginia

By Maureen Robb Carilion Clinic has opened a cardiac arrhythmia center that provides state-of-the-art treatments for atrial fibrillation and other heart disorders.

It is being directed by a leading cardiologist, Soufian AlMahameed, M.D., who was recruited by Carilion Clinic during the past year. Dr. AlMahameed is a cardiologist, a cardiac interventional electrophysiologist, and an internist who has practiced at the Cleveland Clinic.

The new Center for Advanced Therapy of Atrial Fibrillation, as the cardiac practice is being called, is located in Roanoke and Dr. Soufian AlMahameed offers the most comprehensive therapies for atrial fibrillation and other heart disorders in western Virginia.

These include cardiac pacing, resynchronization, and defibrillation device therapy.

Also included are a variety of catheterbased ablation procedures to correct abnormal electrical impulses in the heart, and Dr. AlMahameed’s own specialty— radio-frequency ablation therapy. It is a highly advanced procedure now being done only at select hospitals.

Ablation procedures destroy abnormal tissues in the heart that lead to abnormal rhythms.

Two other electrophysiology cardiologists now also practice at the center: William J. Welch, M.D. and Shelby C. Dickerson, M.D. In August, Carl W. Musser Jr., M.D. will join them after relocating from the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, where he has had fellowships in cardiology and cardiac electrophysiology.

Atrial fibrillation is a disorder afflicting some 2.5 million Americans and is the most common heart arrhythmia in the country. It doubles a person’s chances of dying, and left un-

treated may lead to congestive heart failure or stroke. Its incidence grows with age; an estimated three to five percent of those over 65 suffer from it.

Strong drugs used to treat A-Fib may have a variety of side effects, however, and many patients cannot tolerate them. In such cases, catheter-based ablation procedures may be used to restore normal heart rhythm.

Dr. AlMahameed completed his residency in internal medicine at the Cleveland Clinic Foundation. He was then awarded fellowships in cardiovascular disease at Cleveland Clinic Florida and in clinical cardiac electrophysiology at Brown University School of Medicine and Rhode Island Hospital.

He is actively involved in education and research and is widely published in peer-reviewed journals including Circulation, the Journal of Cardiovascular Electrophysiology, and Heart. He has presented his research at the national annual scientific meeting of the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society. He is certified by the American Board of Clinical Cardiac Electrophysiology; the American Board of Cardiovascular Medicine; and the American Board of Internal Medicine.

Carilion Clinic is the most comprehensive heart care provider in western Virginia, with more than 30 cardiologists, four heart surgeons, three dedicated cardiac operating rooms, and six catheter labs.

The Center for Advanced Therapy of Atrial Fibrillation is located at 127 McClanahan St. in Roanoke. For more information, talk to your doctor, or call the center at 540-982-8204.

Summer 2010

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A Healing Hand at Home Carilion Clinic Home Care For most of us, home is a special place as unique as our fingerprints and personality. Because it’s special and comfortable, home can also be the best medicine during an illness. That’s why providing quality home care is an important goal at Carilion Clinic Home Care.

Focused on community, Carilion Clinic Home Care was one of the very first home health agencies in the Roanoke Valley. Certified by Medicare and accredited by the Joint Commission, we provide high-level technology in the home setting with professionals who understand your needs.

For more information, please call a home care office in your area or 800-964-9300.

Roanoke New River Valley Bedford Franklin Lexington Tazewell

540-224-4800 540-633-9330 540-587-2900 540-489-6383 540-458-3111 276-979-9099

New Giles Community Hospital Debuts

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arilion Giles Community Hospital, serving residents of Giles County, Virginia and Monroe County, West Virginia, has opened.

The new facility, which replaces Carilion Giles Memorial Hospital, is larger and has room for additional services.

It offers 25 inpatient rooms, including four special-care rooms, two state-of-the-art operating suites, eight Emergency Department examination rooms, and gym-like facilities where patients can receive rehabilitative and cardiac therapies.

It also has an impressive imaging department with updated digital services, convenient lab areas, and an expanded in-house pharmacy. As with all Carilion Clinic hospitals, it has a helipad to accommodate emergency helicopters.

The new 85,000-square-foot building—larger by onethird than the 64,000-square-foot Giles Memorial—is located on approximately 25 acres on the hilltop behind the Pearisburg Square Shopping Center on Hartley Way. It is just 1.4 miles from the older hospital and is convenient to Route 460 via the Pearisburg/Ripplemead exit.

The new, tobacco-free hospital opened to patients on May 22 and is built to provide modern care to a rural community in an efficient configuration. Its features include: • A single main entrance encircled by an original mural by internationally known artist Robert E. Tuckwiller, a resident of Giles County.

• Private, spacious rooms with views of the surrounding countryside.

• Services not requiring an inpatient stay are clustered toward the front of the building to allow patients easy access for care.

• Digital imaging and lab services are located adjacent to the Emergency Department to enhance patient care. Nuclear medicine will be available in the near future.

• A full-service café with indoor and outdoor dining serves employees and visitors.

• A memorial garden located outside the café offers mountain vistas and areas for quiet contemplation.

Paving memorial bricks are being sold and installed in the garden in memory of employees, residents, and loved ones. Proceeds will go to the CGCH Auxiliary, which supports hospital services.

Summer 2010

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Gout: It’s on the Rise

By Maureen Robb

It can cause excruciating pain, and it often strikes suddenly.

Many of those afflicted report waking in the dead of night to a severe pain in their big toe.

Once called the disease of kings—due to its association with rich foods and alcohol that were the purview of aristocrats—gout is now striking those from all walks of life. And as American baby boomers age and grow heavier, they are particularly susceptible.

Gout occurs most often in men over 40, but postmenopausal women are also among its victims. It is thought that estrogen protects most women from the condition before menopause, but they often catch up afterwards.

An estimated 5 million Americans live with gout, and the number of cases reported is rising. Studies suggest that the number of diagnoses may even have doubled in the past 30 years.

Gout is a form of arthritis that strikes periodically—and gout attacks typically last for 3 to 10 days. Sufferers describe searing, knife-like pains, along with heat and swelling, in the affected joint. Gout often lodges in the big toe, but it can also occur in the heel of the foot or instep, and the ankles, knees, elbows, wrists, or fingers.

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Summer 2010

A chronic condition, gout is caused by deposits of uric acid in the body, particularly around the joints. Everyone makes uric acid as a byproduct of the breaking down of proteins, but some make more than others. In these individuals, uric acid accumulates over many years, eventually leading to painful episodes of arthritis.

After years of gout attacks, episodes also last longer and involve multiple joints. Eventually, gout deposits may form lumps under the skin and then break the skin, draining a chalk-like material. In this stage, joints may be permanently damaged, leading to deformity and disability.

Gout can also lead to deposits in many soft tissues of the body, including the kidneys, and may contribute to high blood pressure, kidney failure, and atherosclerotic heart disease.

People who inherit the tendency for gout also inherit the tendency for diabetes, high cholesterol, obesity, and hypertension—what is called metabolic syndrome. This leads to a high risk for heart attacks and strokes.

Gout is on the rise because we are living longer with chronic diseases and taking medications that increase the risk of gout.

Obesity, poor diet, and diabetes also contribute to the increase in cases.

In Good Company “Fortunately, we do have good medications for gout,” says Robert R. Johnson, M.D., of Carilion Clinic Rheumatology. “ And last year the first new gout drug in 40 years was approved by the FDA. That will help us control the more difficult cases.”

“First, we must treat the painful joint inflammation, but we shouldn’t stop there,” he says. “If we don’t reduce a patient’s uric acid, gout will continue to worsen and may cause permanent damage to joints, kidneys and even the heart. We should address high uric acid early and aggressively to prevent problems later on.”

“Patients ask about diet as treatment, since some foods are high in purines, the chemical that is broken down to uric acid,” Dr. Johnson says. “But there are only a few foods that need to be avoided. I tell patients no animal organs—liver, kidney, brain, sweetbreads, chitlins, or pork rinds. Dietary manuals also suggest limiting beans, peas, lentils, tomatoes, and spinach, but vegetable sources of purine seldom cause gout attacks.

The best diet advice is to eat a heart-smart diet with a goal of achieving ideal body weight. This will automatically be low in red meat and shellfish, which are high in purines.”

Then there is alcohol. “Wine in moderation does not cause an increase in gout attacks,” says Dr. Johnson. “An occasional mixed drink is also OK. But beer will likely cause an increase in painful gout flares due to a purine substance called guanosine. So it’s not just the alcohol.”

Gout is the most treatable form of arthritis, however. In most patients, uric acid can be lowered to the point where a painful flare is an uncommon event. The key is daily medication; most gout can be controlled in six to 12 months if uric acid is successfully lowered. This requires follow-up blood tests. “The worst thing you can do is stop medication once we get gout under control,” says Dr. Johnson. “Gout is for life.”

The other thing he tells patients is: “We can take care of your gout, but you may also be at risk for heart attacks and strokes, so it’s time to get serious about your health. See your primary care doctor to help control blood pressure, sugar, and cholesterol. Stop smoking and control weight if that is an issue. As painful as gout is, it never killed anyone.”

Today a diagnosis of gout need not be cause for alarm. If you are having problems with gout or are suffering from gout attacks despite medication, help is as close as your doctor’s office.

For more information, talk to your doctor, or call Carilion Clinic Rheumatology at 540-224-5170.

Gout has afflicted many notable figures in history, including King Henry VIII, Christopher Columbus, the Emperor Charlemagne, Queen Anne, Leonardo da Vinci, Isaac Newton, Thomas Jefferson, and Benjamin Franklin.

The illness has been recognized as a chronic condition for centuries and was duly noted by Hippocrates in Ancient Greece. During the Middle Ages, it was thought to be caused by over-indulging in food or alcohol, since it primarily affected the wealthy.

Top: Statue of Christopher Columbus in Barcelona, Spain.

Clockwise: Benjamin Franklin, Queen Anne, Thomas Jefferson, Leonardo da Vinci, King Henry VIII, and the Emperor Charlemagne.

Summer 2010

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Bonnie and Greg Land are among the many local residents using MyChart.

Carilion Clinic Introduces MyChart

By Mary Brewer

10 Summer 2010

Patients Take a More Active Role in their Care You’re almost out of your pills but are rushing out the door to work and don’t have time to call your doctor.

Or you work the graveyard shift and just remembered at 3 a.m. that it’s time to schedule your annual physical.

Maybe you’re sitting at your computer, wondering if your medical test results are back.

If any of these scenarios sounds familiar, Carilion Clinic’s MyChart can help.

MyChart is a state-of-the-art online tool that empowers patients—giving them a more active role in their care. “We feel MyChart will be a tool that will improve our patients’ experience,” says Ursula Lee, Technology Services Group manager.

“It will also enhance our ability to use our electronic medical records to benefit our patients.”

As a result, MyChart is already increasing satisfaction among the 3,018 patients using it at 13 Carilion Clinic Family Practice offices in Roanoke and the New River Valley.

(Other leading U.S. health care systems offering MyChart in-

With MyChart, you can: • • • •

View your medical records Get test results Renew prescriptions Ask your doctor questions

• • •

Make appointments Check your immunization history Request referrals

MyChart can be a timesaver for families. clude the Cleveland Clinic.)

What is MyChart? A secure software program that allows you to view your medical records, get test results, request or cancel appointments, e-mail your doctor with questions, and renew prescriptions. It also lets you view your list of prescribed medications, note any allergies you may have, view your health summary, check for reminders about immunizations or preventive care you are due, and request referrals.

MyChart does not provide access to your full medical record but is rather designed as a communication tool between you and your physicians.

Local patients are excited about having MyChart. “I use it to get my test results,” says Roanoke resident Greg Land, a business owner and father of five. “It’s so much quicker than waiting for them in the mail— you get them online in 24 to 48 hours usually. And I have five kids, so I don’t have time to wait on the phone.”

Land’s wife, Bonnie, a Carilion Clinic dietitian, also uses MyChart. “I love it,” she says. “It’s so easy to contact the doctor and get an answer to a question, or get a prescription refill. I work fulltime and with all the kids, we’re so busy. This is just ideal for us.”

“It’s meeting a lifestyle need, with so many

people not home during the day,” says Stephen A. Morgan, M.D., regional medical director of Carilion Medical Group. “I believe this enhances our quality of care. It enhances the patient-physician communication process.”

“Right now, Carilion Clinic physicians are offering MyChart individually to patients,” Dr. Morgan says. “Our patients have a choice. For those who prefer to interact with the office by telephone, that option will always be available. Our doctors will have that conversation with their patients to determine the willingness, and everyone will have to be comfortable with how the communication will go.”

“As MyChart catches on, we expect people to ask for it, and their doctors will add more and more patients to the system,” Dr. Morgan says. “As both patients and doctors realize how convenient it is—and how much phone tag it cuts down on—they will see its benefits.”

“MyChart is also extremely protected,” says Lee. “You can access it from your home or work computer, but it’s housed within Carilion Clinic’s secure network.”

Patients choose their own MyChart password, so only they can call up their records— unless they want to share access. “We’re (continued on page 12) Summer 2010

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MyChart

MyChart makes it easy to contact your doctor. (continued from page 11)

looking into proxy access now,” Dr. Morgan says. “This would allow the Sandwich Generation, those taking care of children and their own parents, to manage the health care of their loved ones.”

“Our intent is to continue to expand the capabilities of MyChart, such as allowing patients to send data to their doctors,” he says. This might include their blood pressure or blood sugar readings. “Another future capability will be the opportunity for doctors to send reminders to patients and provide them with educational resources.”

MyChart is not for emergencies, however. “If you’re having chest pain, for example, this is not the vehicle to use,” says Dr. Morgan. “You want to pick up the phone and call someone, because it can take 24 to 48 hours for your doctor to respond to your e-mail on MyChart.”

“But,” he says, “if you want to know if your blood work is back or ask for a refill on your prescription without picking up the phone, this is ideal.”

During the ongoing implementation of MyChart at Carilion Clinic primary care practices, the service may not be available at all locations. Please contact your doctor for more information about MyChart.

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National Recognition MyChart is an extension of the Epic electronic medical records system that Carilion Clinic has been introducing in its eight hospitals and many physician offices.

Over the past few years, Carilion Clinic has won national recognition for its leadership in introducing new technology to health care.

In 2009 alone, it won several national achievement awards, including those from Modern Healthcare and CIO magazines.

The online Epic system significantly improves patient care by giving doctors instant access to up-to-date patient records at all of Carilion Clinic’s facilities.

The Opportunity to Touch Lives New Director of Breast Care Center Reflects on Patient Care

By Meredith Hite

Dr. Eileen C. Kenny

“If

you can touch other people’s lives on a daily basis— Together, the team of 21 mammography technologists has that is what’s important,” says Eileen C. Kenny, M.D., the new over 360 years of combined experience. section chief of Carilion Clinic Breast Imaging and medical diDr. Kenny particularly values her staff’s compassion and rector of Carilion Clinic’s Breast Care Center. empathy with all patients. In fact her own decision to become Dr. Kenny, whose specialty is diagnostic radiology, has a doctor reflects this focus, and her decision to join Carilion always recognized the importance Clinic was due in part to its emof patient care. “This line of work phasis on patient care. brings a challenge every day,” she “Our department chairman, Dr. says. “It’s difficult to tell a patient Wayne Gandee, believes strongly in she has breast cancer, but mediputting patients first,” says Dr. cine today is always changing, and Kenny. “I knew when I met him we have more hope than ever bethat this would be the right pracfore in getting our patients well.” tice for me.”

“When you’re able to diagnose Dr. Kenny initially entered the breast cancer early, it just makes medical profession as a nurse and you feel so good to make a differthen went back to school to ence in someone’s life,” she says. become a physician. Her residency Dr. Kenny also has confidence training included two years of in the expertise of the Breast Care general surgery and four years of Center’s other radiologists and staff. radiology, followed by a fellowship The center has four dedicated in women’s imaging at the Univerbreast imagers (more than anysity of Florida College of Medicine. where else in the region), and She is board-certified and has been biopsy results are almost always in practice since 1996. available the same day. All mamToday, Dr. Kenny says her patients mograms are read locally and oncan call her at any time, as well as site by board-certified radiologists. Women today have more choices than ever when it comes to the practice nurse. “It’s about our The breast care center also offers breast care. team taking good care of our digital mammography, large-forpatients,” she says. mat imaging, breast MRI, genetic screening, and bone density testing. In addition, an interdisciplinary team works together The Carilion Clinic Breast Care Center is at 1211 S. Jefferson St. in to review malignant and benign breast cases and to provide Roanoke. For more information, call 540-985-9885 or visit overall state-of-the-art breast cancer prevention and treatment. www.carilionclinic.org/Carilion/Breast+Care+Center.

Summer 2010

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Treating a Stroke: When Every

By Maureen Robb It was 4:30 in the afternoon and Jonathan White was at his office computer when he suddenly felt his right side go numb.

“I realized I’d had a stroke and tried to think of what to do next,” he says. “But I was in a daze.” Alone in his Lynchburg office, it took him an hour to stumble next door, where someone called 911.

He was rushed to a local hospital, where doctors quickly referred him to Carilion Roanoke Memorial Hos-

pital and its Stroke Unit. A Carilion Clinic Life-Guard helicopter arrived, and sped him to emergency care.

At Roanoke Memorial, meanwhile, Jeffery Shay, M.D. was making preparations for White’s arrival. He also knew that the window of time was running out to administer the drug TPA (tissue plasminogen activator) to dissolve White’s clot. “You have three hours to give systemic TPA, and Mr. White was just past that window,” Dr. Shay says.

So Dr. Shay, an interventional radiologist, immediately

Stroke patient Jonathan White

Know the f

iv

e. Stay alive Signs of a Str . oke: 1. WALK - Loss of ba lance 2. TALK -Slurred sp eech or droopy face 3. REACH - Numbn ess or leg, especially on on weakness of the face, arm or e side of the body 4. SEE - Impaired vi sion or difficulty se eing in one or both eyes 5. FEEL - Severe he adache with no kn own cause If you experience any of these sym ptoms, call 911.

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Minute Counts Carilion Clinic Launches Major Stroke Initiatives Dr. Jeffery Shay

took a CT scan when White arrived, determined the exact position of the clot, and injected TPA directly into it to dissolve it. He then performed a thrombectomy, going into the brain’s blood vessels with a new FDA-approved intracranial instrument to break up the clot and remove clot particles.

By now it was almost six hours from the onset of White’s symptoms. But by acting so quickly, Dr. Shay was able to reopen the blood vessels and restore blood flow to much of White’s brain. “There was a lot of salvageable brain tissue that did recover,” Dr. Shay says.

“It was a large clot, and a serious stroke,” says White, 63. “I feel very blessed that I came out of it as well as I did. I give Dr. Shay and the other Carilion doctors a lot of credit for acting so quickly. As a result, I don’t have any physical problems.”

“I know several men who’ve had strokes, and they suffered irreversible damage, and lost a lot of quality of life,” he says.

Although White does have minimal deficits— he can have trouble finding the right word—he says his prognosis is to make a full recovery. To this end, he is taking weekly therapy to help with his word association skills. “I’m very good, and getting better,” he says. “It’s something that takes a while.”

Otherwise, he is living normally since his stroke in October and his five days of hospitalization. “I went back to work almost the next day,” he says.

(White owns a firm that makes dispenser valves for bottled water.)

“I talked to Dr. Shay afterwards, and we both agreed that it was a pretty remarkable procedure,” White says. “He had a very limited time frame to accomplish what he did.”

Carilion Clinic, with over 600 physicians and eight hospitals, is rapidly becoming a leader in stroke intervention.

Only last fall, Carilion Clinic launched Stroke Alert, a program that fast-tracks stroke victims to life-saving care. Stroke Alert allows for an immediate, coordinated response by ambulance crews and doctors while patients are being sped to the hospital.

The program is but one of a number of initiatives Carilion Clinic is launching to combat stroke—the third leading cause of death in the U.S., and the number one cause of disabilities. Carilion Roanoke Memorial Hospital, one of the largest hospitals in Virginia, also has one of the highest caseloads of stroke patients in the state.

Carilion Clinic is also in the vanguard in recruiting leading stroke specialists. These include Sidney Mallenbaum, M.D., medical director of Carilion Clinic’s Stroke Unit. He came to Roanoke from Sentara Virginia Beach General Hospital, where he was instrumental in obtaining its accreditation as a Primary Stroke Center.

Another leading new specialist to join Carilion Clinic is Jeffery Shay, M.D., an interventional radiologist. In the treatment of stroke, Dr. Shay specializes in using image guidance to help dissolve blood clots with drugs or minimally invasive medical procedures.

(See adjacent story.)

Carilion Clinic is also taking the lead in hiring dedicated stroke neurologists. While many hospitals do not have in-house neurologists around the clock to evaluate stroke patients—many send their CT or MRI scans to remote sites for evaluation—Carilion Clinic has identified the need to have such neurologists available at all times.

To this end, Carilion Clinic has hired three neurologists, including Dr. Mallenbaum, to ensure that one will always be available to evaluate stroke patients at any time of the day or night. (Carilion Clinic may recruit more in the future.) The other neurologists are James Schmidley, M.D., who came from the University of Arkansas and who is section chief of the Stroke Program, and Robert F. Saul, M.D., who relocated here from the University of Mississippi.

In addition, Carilion Clinic is in the forefront in conducting research on stroke intervention. It has been approved to start two important clinical research trials in Roanoke this spring.

Summer 2010

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The Power of a Song

By Maureen Robb

Photos of Taylor Swift by Joseph Anthony Baker 16 Summer 2010

Taylor Swift was always precocious. At 10, she was singing at every festival, county fair, and karaoke contest in her home town of Wyomissing, Pennsylvania. At 11, she made her way to Nashville, amusing record company receptionists by presenting her homemade demo tape. By age 12, she was writing songs and at 14, she became the youngest person ever to sign on as a staff songwriter at Nashville’s Sony/ATV. Her parents, who had always believed in Swift’s talent and determination, soon relocated their family to the Nashville area so she could pursue her dreams.

Their faith was not misplaced. Now 20, Swift recently became the youngest-ever winner of the Grammy Award for Album of the Year—the music industry’s top honor.

Every show on her Fearless tour sold out within minutes, with tickets for the New York Madison Square Garden event going in just 60 seconds.

Swift is now the best-selling digital artist in music history, and she enjoys the status of having the #1 best-selling album in any genre of music in both 2008 and 2009.

Life is good for Taylor Swift, singersongwriter and most recently, actress.

If anyone has earned her success, Swift has. She endured a string of early rejections, and over the past eight years, she has dedicated herself to her music—writing and playing her own songs. Even as a straight-A student in high school, she was doodling lyrics in her notebooks.

She has also taken risks. When she was 15, she rejected a recording contract with RCA Records because it wouldn’t let her sing her own songs. Soon after, she signed a deal with a new label, Big Machine Records—where she is today. In 2006, her debut single “Tim McGraw” and her eponymous first album, Taylor Swift, were released.

Swift’s music straddles two genres—country and pop—and she first realized she’d made it during the 2007 Country Music Association Awards, when they called out her name as the Horizon Award winner. “I looked over and saw the president of my record label crying,” Swift says. “Walking up those stairs, it just occurred to me that that was the night things changed. It changed everything.”

The daughter of a stockbroker father and a homemaker mother, Swift has one younger brother. Her best friend is a girl she’s known since ninth grade. Her musical influences are Shania Twain, LeAnn Rimes, Patsy Cline, Dolly Parton, Tina Turner, Tim McGraw, and her own grandmother, who was a professional opera singer. As a high-school freshman, she wrote songs about “trying to find a place in this world.”

Finding Her Voice Swift’s songs are famously autobiographical. She writes and sings about her feelings, and the relationships in her life. “It’s always fun for me to put something on the album that is personal,” she says. “Something I know I’m going to have to deal with when the record comes out.” Glimpses into her romantic life have come through such songs as “Forever & Always,” inspired by her relationship with pop singer Joe Jonas of the popular Jonas Brothers.

Swift believes the power of a song is in its lyrics. In every song she writes, she seeks to make a connection—to comfort

listeners, or to laugh or cry with them. “I want my fans to know—I feel the same things [as they do],” she says. “And my songs are where I’ll never hold back.”

When writing a song, Swift imagines an emotional situation.

“I do this mental exercise,” she says. “I’m 15-years-old and my boyfriend just broke up with me and I’m crying on the way home. What song am I going to listen to? Or, I’m 17 and I just got back from the best date that I’ve ever been on. I’m so happy about it. What am I going to listen to?

“Or I’m 45,” she says. “I’m sending my 15-year-old daughter off to her freshman year of high school for the first time. What am I going to listen to? I won’t be satisfied until I have a song for each person, for each thing.”

On Being Fearless Swift is also fascinated by the gap between reality and the stories we tell. “When we’re little, we read these books and we see cartoons and the bad guy is always wearing black,” she says.

“You always know who he is. But in real life, the bad guy can be incredibly charming and have a great smile and perfect hair. He says things that make you laugh and he’s sweet and he’s funny, but you don’t realize that he’s going to cause you a lot of pain.”

Of her second album, Fearless, she says: “To me, fearless isn’t not having fears … fearless is having a lot of fears, but you jump anyway.” She took pains to find an appropriate name for the album. “I wanted to make sure that it was the right call,” she says. “You really have to make sure that it explains this body of work….”

Mastery of detail is another Swift trademark. She is known for her command of her craft, and for her tireless efforts to get everything right on an album—and on stage. “When I was writing [Fearless], I knew what every instrument was doing,” she (continued on page 18)

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(continued from page 17)

says. “The strings, or mandolin, or banjo, or dobro. I heard it all. It was just really cool to have all those instruments I heard end up on the album.”

Those who know her also speak of her remarkable poise for her age—evident in all the television interviews she gives—and her sincerity and, well, niceness. She also reaches out to her fans. Early in her career, she made a point of personally answering questions from fans every day on her MySpace page.

Charitable Causes As her fame—and royalties—have grown, Swift has given freely to philanthropic causes.

In 2007, she teamed up with Tennessee’s Governor Phil Bredesen and law enforcement officials to launch a campaign to protect children from online predators. She has since donated $100,000 to the Red Cross to aid flood victims in Iowa and given $250,000 to schools across the country.

She has also donated her pink Chevy pickup truck—a gift from her record label’s executives—to the children’s charity the Victory Junction Gang. An autographed, gently-worn pair of Betsey Johnson high heels went to the Wish Upon a Hero Foundation for its fundraiser for women with cancer. Her prom dress was auctioned off to raise $1,200 for the charity DonateMyDress.org, and the proceeds from Swift’s merchandise sales at the 2008 Country Music Festival benefited the Red Cross’ disaster relief funds. Other gifts have gone to the St. Jude Children’s Research Hospital, the BBC’s Children in Need, and other charities.

Swift also supports @15, funded by Best Buy; it offers teenagers a chance to help steer the firm’s philanthropic giving. Swift’s song “Fifteen” has been featured in Best Buy’s campaign for the program.

The Future On the cusp of adulthood, Swift has already received dozens of prestigious awards and soared to the top of record charts around the world. In 2009, she was named one of Time magazine’s People Who Mattered and one of NBC’s People of the Year. Earlier this year, she made her film acting debut in Valentine’s Day. What lies ahead for this talented young woman? Stay tuned—and listen to her songs.

Swift will let you know.

Photo by Ash Newell 18 Summer 2010

News&Notes Hospital Infections Decrease Over the past two years, Carilion Clinic has succeeded in reducing its number of central line-associated bloodstream infections (known as CLABSI infections). An estimated 250,000 or more of these occur in U.S. hospitals annually. All Carilion Clinic hospitals now report rates of CLABSI infections that are below the national benchmark of 5%.

Because they are associated with the insertion of a central vascular catheter, proper insertion and care can decrease the risk of CLABSI infections. Carilion Clinic was able to reduce its infections by forming a quality team that reviewed and instituted best practices. These include selecting the optimal catheter site, using an insertion checklist, and following strict hand hygiene.

Director of Research Institute Named Michael J. Friedlander, the Wilhelmina Robertson Professor and chair of the Department of Neuroscience and the director of Neuroscience Initiatives at the Baylor College of Medicine, has been named the founding executive director of the Virginia Tech Carilion Research Institute. Dr. Friedlander has an international reputation for research in the area of neuroscience, including synaptic plasticity, brain development, and traumatic brain injury.

The mission of the research institute is to be a premier institute of interdisciplinary and translational research within the medical sciences; to facilitate discovery-based medical education; and to work to sustain and strengthen the Virginia Tech / Carilion Clinic partnership, which allows Carilion Clinic to continually improve patient care through discovery and research.

Carilion Clinic CEO on Top Physician Executives List Carilion Clinic President and CEO Edward G. Murphy, M.D. was again named one of the country’s 50 Most Powerful Physician Executives by Modern Healthcare magazine. Dr. Murphy was ranked 24th on the 2010 list. He was also recognized as one of only five persons to make the list in all its six years.

Coronary Care Unit Wins Award The Coronary Care Unit staff at Carilion Roanoke Memorial Hospital has received the Beacon Award for Critical Care Excellence from the American Association of Critical Care Nurses for its dedication to serving critically ill patients. The unit is now nationally recognized as a leader in acute and critical care nursing.

A New Guide for Cardiac Patients Carilion Clinic has developed a new, multi-media patient guide to serve as the ultimate resource for patients undergoing cardiac surgery. It covers a variety of topics including cardiac risk factors, discharge instructions, and nutrition information. The guide was months in the making and represents a personal commitment to patients by Carilion Clinic’s cardiac surgery staff, who developed it. The guide includes written, DVD, video, and closed-circuit television formats.

Carilion Clinic Medicare Health Plan You may be able to enroll in a Medicare Advantage plan before the Annual Election Period begins this fall if you are just turning 65, have become Medicare-eligible because of a disability, or have been left without Medicare health care coverage due to a special circumstance.

Now is the time to gather information about eligibility and coverage options so that you can be ready to enroll in the plan that is right for you. For details on benefits, enrollment periods and eligibility, call Carilion Clinic Medicare Health Plan at 800228-9916 Monday through Friday from 8 a.m. to 8 p.m.

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Doctor Thrives at New Salem Practice Talented Physician Cares for Patients and Develops Medical School Curriculum

By Allison Buth

Like many physicians, Andrea Cobb, M.D. always A Specialist in Salem She brings her wealth of expertise and enthusiasm for knew that she wanted to be a doctor.

When it came to choosing a specialty, Dr. Cobb de- medical education to her consultations with patients in cided she wanted to be able to perform surgeries while Salem. Since last November, Dr. Cobb has been one of the also nurturing relationships with her patients. She found rotating specialists at Carilion Clinic’s new obstetric and gynecologic practice there. The practice provides comobstetrics and gynecology to be a nearly perfect fit.

It wasn’t until 2008 that she found the missing piece to prehensive OB/GYN care for women in all of life’s stages, her career puzzle. That year, she was practicing in Salem as well as complete maternity care, annual exams, and and saw an opportunity she couldn’t pass up. With the preventive screening.

“While I love teaching, this clinic allows me to have development of the Virginia Tech Carilion (VTC) School of Medicine under way, she felt a strong pull to get involved. the best of both worlds,” says Dr. Cobb. “While I am here, She joined Carilion Clinic that year and has since prac- I function as a private practice physician, seeing my paticed as a physician while also teaching students and res- tients with whom I have built a relationship and following them over time. I also now have idents and developing courses for the time to take on new patients, medical school, which will open in which I enjoy.”

August. She has been extensively inThe office is Carilion Clinic’s first volved in developing courses on reOB/GYN practice in Salem— production, among other subjects. where Carilion Clinic has also “The curriculum will promote liferecently expanded its family medlong learning, which is extremely imicine practice. portant,” Dr. Cobb says. “Instead of Many area residents have exspending hours in lectures, VTC stupressed excitement about the dents will learn through a guided, opening of the OB/GYN practice, self-taught approach. The VTC proincluding patient Susan Carter. “I gram will help place everything really would follow Dr. Cobb anylearned in the context of why it is imwhere she went, but it’s so conportant from a patient’s perspective.” venient having her five minutes Unlike most medical schools in from my house now that she’s the country, VTC will offer patientback in Salem,” Carter says. centered learning, which provides in“It’s especially nice now since terdisciplinary training, encourages —Salem patient Susan Carter I’m 32 weeks pregnant.” teamwork, and includes a strong research component. By the end of four years, each student The new Carilion Clinic obstetric and gynecologic practice will write a publishable research piece.

“It’s a great feeling to be able to be a part of some- is located at 150 Spartan Drive in Salem. For more inforthing as exciting as developing curriculum for medical stu- mation, call 540-389-5174. dents without having to give up practicing as a physician,” says Dr. Cobb.

“I really would follow Dr. Cobb anywhere she went….”

20 Summer 2010

New Orthopaedic Center is Open Pediatric orthopaedics and sports medicine are among the specialties provided at the new center.

The most comprehensive orthopaedic practice in southwest Virginia—Carilion ClinicOrthopaedics—is now open to patients.

A merger of Carilion Clinic Bone and Joint and Roanoke Orthopaedic Center, the new practice is the only orthopaedic center in the region to offer a full range of services.

These include joint replacement and reconstruction; spine, fracture, and trauma care; hand and microvascular surgery; foot and ankle surgery; arthroplasty and sports medicine; and pediatric orthopaedics.

Carilion Clinic and Roanoke Orthopaedic, formerly the largest independent orthopaedic practice in the region, announced last fall that they would merge on April 1. Both groups had practiced at Carilion Roanoke Memorial Hospital for

many years, providing advanced technology to patients.

In deciding to merge, they cited a common vision for the future of orthopaedics in the region and a desire to provide better-integrated care.

Both sets of physicians in the new practice have previously engaged in research to advance the practice of orthopaedic medicine. They are also nationally recognized and known for their team approach to care.

“Forming a new, comprehensive practice is the best way to move our common vision forward,” says Thomas Shuler, M.D., Carilion Clinic orthopaedist.

The new practice, among other things, allows collaboration between Carilion Clinic’s trauma specialists and Roanoke Orthopaedic’s sports medicine specialists when treating sports accident victims in the emer-

gency room.

As part of Carilion Clinic’s patient-centered philosophy, the practice will also build an integrated-care program with Carilion Clinic specialists in neurosurgery and physical medicine and rehabilitation. The new Virginia Tech Carilion School of Medicine and Research Institute, meanwhile, will support the development of new orthopaedic technologies and treatments.

The physicians of Carilion ClinicOrthopaedics are now seeing patients at the former Roanoke Orthopaedic location at 4064 Postal Drive (540-776-0200) as well as at the 3 Riverside building (540-2245170) in Carilion’s Riverside Center near Carilion Roanoke Memorial Hospital.

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Carilion Clinic

New Physicians Department of Medicine Gabriel S. Gorin, M.D. Specialty: Physical Medicine and Rehabilitation Education: PontiďŹ cia Universidad Javeriana, Bogota, Colombia Residency: William Beaumont Hospital 3 Riverside Circle, Roanoke 540-224-5170 Rebecca Y. Mumpower, M.D. Specialty: Hospitalist, Internal Medicine Education: Virginia Commonwealth University Residency: Virginia Commonwealth University 1906 Belleview Ave., Roanoke 540-853-0201

David C. Sane, M.D. Specialty: Cardiology Education: Duke University School of Medicine Residency: Duke University Medical Center Fellowship: Duke University Medical Center 127 McClanahan St., Roanoke 540-982-8204 Robert F. Saul, M.D. Specialty: Neurology/Neuro-Ophthalmology Education: Virginia Commonwealth University Residency: Virginia Commonwealth University Fellowship: Virginia Commonwealth University 3 Riverside Circle, Roanoke 540-224-5170 James W. Schmidley, M.D. Specialty: Neurology Education: University of Virginia School of Medicine Residencies: Cornell University Medical Center, University of California, San Francisco 3 Riverside Circle, Roanoke 540-224-5170 Manni Sethi, M.D. Specialty: Hospitalist Education: University College of Medical Sciences Residency: Jersey City Medical Center, Mount Sinai School of Medicine 1906 Belleview Ave., Roanoke 540-853-0201

22 Summer 2010

Ernesto UmaĂąa, M.D. Specialty: Cardiology Education: Francisco Marroquin University, Guatemala City, Guatemala Residency: University of South Alabama Hospitals and Clinics Fellowship: University of South Alabama Hospitals and Clinics 127 McClanahan St., Roanoke 540-982-8204

Department of Obstetrics and Gynecology Allison R. Durica, M.D. Specialty: Maternal Fetal Medicine Education: Pennsylvania State University School of Medicine Residency: York Hospital Fellowship: Magee-Womens Hospital 3 Riverside Circle, Roanoke 540-985-9985 Saju D. Joy, M.D. Specialty: Maternal Fetal Medicine Education: University of North Carolina School of Medicine Residency: University of Florida-HSC Jacksonville Fellowship: The Ohio State University Medical Center 3 Riverside Circle, Roanoke 540-985-9985 Manjusha Sahni, M.D. Specialty: Obstetrics and Gynecology Education: Government Medical College, Aurangabad, India Residency: Henry Ford Health System 102 Highland Ave., Roanoke 540-985-9715

Department of Psychiatry

Department of Surgery

Benedicto R. Borja, M.D. Specialty: Psychiatry Education: University of Santo Tomas, Manila, the Philippines Residency: University of Maryland, Sheppard Pratt Psychiatry Residency Training Program Fellowship: Duke University Medical Center 2017 S. Jefferson St., Roanoke 540-981-8025

Stephen A. Grubb, M.D. Specialty: Spinal Surgery Education: Northwestern University Medical School Residency: University of North Carolina School of Medicine Fellowships: University of North Carolina School of Medicine, Toronto East General Hospital 2900 Lamb Circle , Christiansburg 540-633-0523

Shelly McIntyre, M.D. Specialty: Psychiatry Education: American University of the Caribbean Residency: Texas Tech University Fellowship: University of South Florida 2900 Lamb Circle, Christiansburg 540-731-7311

Victor Stelmack, M.D. Specialty: General Surgery Education: New York Medical College Residency: St. Vincent’s Hospital and Medical Center 2900 Lamb Circle , Christiansburg 540-731-7600

Anthony J. Thornton, M.D. Specialty: Psychiatry Education: University of Virginia School of Medicine Residency: Wilford Hall USAF Medical Center, Lackland Air Force Base Clinical Fellow Rotation: Massachusetts General Hospital 2017 S. Jefferson St., Roanoke 540-981-8025

Carilion Medical Group Deepani Dias, M.D. Specialty: Family Medicine Education: The University of Ruhuna, Galle, Sri Lanka Residency: St. Luke’s Hospital, University of Toledo Family Medicine Residency Program 199 Hospital Drive, Galax 276-236-5181 Andrea R. Lough, D.O. Specialty: Family Medicine Education: Philadelphia College of Osteopathic Medicine Residency: Department of Family Medicine, Eglin Air Force Base 1611 Wenonah Ave., Pearisburg 540-921-3636

For more information or to find a physician go to: www.CarilionClinic.org or call: 540-266-6000 or 800-442-8482.

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Carilion Clinic Offers New Ways to Stay Connected

By Matthew Sams

Last year, Carilion Clinic’s Interactive Media team set out to rethink and revamp Carilion's Web presence to deliver a better user experience. This past January, a significant website makeover made its public debut.

The redevelopment process was grounded in Carilion Clinic's vision. Within the clinic model, communication among physicians leads to coordinated patient care.

Patient-centered care extends to the Web. At CarilionClinic.org, the user experience centers on simple navigation, powerful search, access to educational content, fresh ways to stay connected and much more.

efficiently and delivers accurate results.

Simpler Navigation One of the first things you notice upon visiting CarilionClinic.org is the horizontal blue navigation bar near the top of each page. This menu-oriented navigation scheme provides one-click access to all of the major sections of CarilionClinic.org.

Sections are organized into three navigation tabs titled “Patient Care,” “Education,” and “Research.” These tabs represent the three pillars that Carilion Clinic stands upon, and each provides different navigation options.

Within the blue bar, clicking on links such as “Find a Doctor” or “Hospitals & Centers” will open a menu that provides a menu of links from which to choose.

Connecting with Patients at their Computers At the top of each page, “portal” links provide primary audiences (patients and visitors, medical professionals, employees, and volunteers) quick access to different avenues of information. For example, if you are looking for details about a Carilion Clinic facility, simply clicking the “for Patients and Visitors” link will deliver that information.

Carilion Clinic’s online presence does not end with its website. Carilion was the first health care organization in the region to reach out to the community via social media, utilizing Facebook, Twitter, YouTube, and a blog to stay connected with our many audiences and to share news, photos, videos, health tips, and more.

With so many ways to stay connected, patients can count on CarilionClinic.org to be a valuable resource in their health care experience.

Improved Search Prior to last year’s redesign, we heard calls for better search functionality on CarilionClinic.org. We’ve answered that call by implementing Google’s custom search solution. Search works 24 Summer 2010

Health and Wellness Information on Demand CarilionClinic.org delivers health and wellness information very efficiently. In fact, website visitors are just a click away from resources to help them stay healthy and happy.

A yellow bar in the middle of the homepage is the hub for online health and wellness information from Carilion Clinic. This bar connects users to a health library that provides information about specific conditions, illnesses, symptoms, and medical terms.

Enjoy Nature— and History— on The New River Trail

By Gail Nordhaus

If you’d like to reconnect with nature or enjoy scenic outdoor recreation, the 57-mile New River Trail offers both in abundance.

Stretching across four counties in southwest Virginia, the trail is part of a special nationwide network of trails built on abandoned railroad right-of-ways.

There are more than 1,400 nationally, with at least one in every state; many are connected to a recreational water resource. These so-called rail-trails have been converted to multi-purpose community paths for public recreation.

Virginia has 20 rail-trails, and many other trail-building projects are under way in the state. Many of Virginia’s trails are designated as state parks and also serve as wildlife habitats and historic preservation sites.

What sets the New River Trail apart is its 39 miles of continuous path paralleling the historic New River. The trail meanders across seven towns and a city, linking many natural resources and creating a corridor for memorable hiking, biking, kayaking, tubing, and horseback riding. In addition, numerous means of entry along the trail allow visitors easy access to other recreational activities such as picnicking, camping, fishing, and boating.

The New River Trail’s northernmost boundary is at Dora Junction, near the town of Pulaski. From Dora Junction heading south toward the terminus in Galax, you soon encounter old bridges and railroad trestles, such as the 950foot-tall Hiawassee stretching across the A bicyclist pauses along the New River Trail.

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Scenic spots along the New River Trail.

Photos courtesy of Jan and Jack O’Connell.

26 Summer 2010

Jack and Jan O’Connell

Local Couple Enjoys Trail

New River. At mid-point on the trail is Foster Falls, an access point with a livery offering public rentals of canoes, kayaks, tubes, bikes, and guided horse rides.

About a mile south of Foster Falls is historic Shot Tower, an old limestone ammunitions factory site that stands 75 feet above ground and extends an additional 75 feet below ground. Continuing south along the New River, you pass through an old train tunnel before crossing the 670-foothigh Ivanhoe trestle bridge. The trail then leads you past the sounds of water cascading over several river dams before you approach the largest trestle along the trail. Fries Junction Trestle is a grand timber bridge expanding to an impressive height of 1,089 feet. From here you’ll travel through a second train tunnel and on to Chestnut Creek Waterfalls, an ideal resting stop before completing the tour in Galax.

The New River Trail grew out of a gift of land by the Norfolk and Southern Corporation. A portion of the initial trail was created with the help of volunteer organizations and local chambers of commerce, who foresaw all the recreation and health benefits a rail-trail would offer their communities.

In addition to recreation, the New River Trail offers programs on nature, history, and environmental education, as well as community events.

At times certain portions of the trail may be closed for repair or upkeep. To view trail availability, go to www.dcr.virginia.gov. Also, those taking the trail from north to south may encounter a moderate incline.

Anyone who’d like an easier outing should start at the trail’s southern points and proceed north after arranging for transportation at both their starting and ending points. For more information, call 1-800-933-PARK, e-mail resvs@dcr.virginia.gov, or visit www.dcr.virginia.gov/state_park.

Jan and Jack O’Connell of the Roanoke Valley have enjoyed bicycle trips along the New River Trail, including one recently with fellow members of the Roanoke Ski Club.

The O’Connells, who have biked many other rail-trails, like being able to get on the New River Trail quickly and safely. They also like being able to unload their bikes easily.

On warm, sunny days, Jan and Jack enjoy the dense tree coverage along most of the trail, which helps protect them from the sun. Jack says that getting out and exercising with family and friends—and enjoying a little history along the way—is one of the biggest pleasures of biking on a rail-trail.

Roanoke River Greenway Extended Along with the New River Trail, area residents can also enjoy the Roanoke River Greenway, which meanders through the Roanoke Valley and now has a new segment in downtown Roanoke.

Earlier this year, a 600-foot section across from Carilion Roanoke Memorial Hospital was dedicated, thus completing over 5 miles of continual greenway. The new section connected a 2mile path that stretches west to Wasena Park with a 3-mile trail that runs east.

Although the sections had been completed over a year ago, they lacked a connecting link, thus posing a potential hazard at the intersection near the hospital’s entrance.

The new link has been called a big safety improvement.

Carilion Clinic donated $145,000 toward the $420,000 cost of the project.

Photo courtesy of the Roanoke River Greenway.

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Adopt a Furry Friend—It

L to R: Chris and Hayden Barnes at home in Roanoke with their Labrador Retriever Worth and their Scottish Terrier Finnean.

By Allison Buth What can lower your blood pressure, offer pleasant companionship, and make you laugh out loud?

A loving pet, of course.

Studies show that having a pet is good for your health—whether the object of your affection is large or small—or furry, feathery, or leathery. And that’s good news for most of us, since more than half of all U.S. households own one or more animals.

The Centers for Disease Control and Prevention report that pets can decrease blood pressure, cholesterol levels, and triglyceride levels; ward off feelings of loneliness; and increase opportunities for exercise, outdoor activities, and socializing. Researchers have also found that just petting an animal can reduce anxiety and promote relaxation.

Pets are the best listeners (and they don’t judge you).

They can also keep a secret and are great at cuddling— all of which lessens feelings of isolation. Loneliness can be a damaging risk factor for many people, and in fact studies have shown that cardiac patients who are pet owners 28 Summer 2010

have a higher survival rate than patients who are not.

In addition, pets can provide an external focus of attention. Instead of concentrating on themselves, pet owners have the responsibility of taking care of another living being. This often serves as a mood-enhancer.

While all pets are special, dogs are particularly good at getting their owners off the couch. Walking a dog is a great way to get exercise, manage stress levels, and increase opportunities for socializing. Research has shown that while walking a dog, people tend to make more eye contact with others, thus making them more approachable.

(Studies also show that people with more social relationships have a tendency to live longer and are less likely to show mental and physical declines as they age.)

Animal-Assisted Therapies Because the health benefits of animals have become widely recognized, animal-assisted therapies are a grow-

Can Improve Your Health ing trend in hospitals and nursing homes. Clinicians nationwide report immediate improvements in patients, such as better mood and less anxiety.

This has certainly been true locally at Carilion Clinic. Through the volunteer program PetPals at Carilion Roanoke Memorial Hospital, Delta Society-certified dogs are taken all over the hospital to visit patients. The pediatric floor gets priority over other areas.

“The dogs distract patients from their problems,” says Linda Perdue, PetPals volunteer. “Even though patients only concentrate on the dog for a brief time, it brings great joy. We have all different breeds of dogs that people are drawn to, to a point where we have trouble getting down the hall. Families stop us to make sure we pay a visit to their loved one. It’s wonderful.”

Similarly, dogs are often used around the country as companions for those with seizure disorders, hypoglycemia, Parkinson’s Disease, and other health problems.

The Delta Society, meanwhile, reports that even animals such as miniature horses, guinea pigs, dolphins, and llamas can have therapeutic effects on humans.

knowing that they need me makes me smile.”

“I honestly believe that my dogs improve my health—they help me de-stress and take time to relax,” Thomas says. “They remind me of what’s important: to exercise, take naps, play, and indulge in the occasional treat!”

“There is nothing like a wagging tail and a flurry of fur to greet you after a long day,” adds Hayden Barnes. “I look forward to our afternoon walks as a time to relax and let go of the stress from work. Pets are also a great way to break the ice and meet new people,” she says. “We’ve met and struck up conversations with other dog owners when we head to the dog park or simply walking the neighborhood.”

Before you add a pet to your family, however, it is important to do a bit of research. A pet should have a personality that fits you and your lifestyle, and you should be sure you can meet its particular needs.

The Delta Society is an excellent resource on the health benefits of pets for people of all ages.

The society also offers links to articles and research on human-animal bonds at www. deltasociety.org.

Local Testimonials Local pet owners also extol the health benefits of their pets. “There’s something special to be said about owning pets,” says Lauren Thomas of Roanoke. “My dogs bring me happiness every single day. Their constant companionship, unconditional love, and just Pets of all types can offer health benefits.

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vervefood

Think Globally,

Eat Locally

By Kate Jones

If you enjoy good food, the show “Iron Chef America” on the Food Network might interest you. The premise of the show is this: A secret ingredient is unveiled just before the competition begins. Then, under a time constraint, a professional chef takes on an “Iron Chef” (each with the help of his or her assistants and a full kitchen) in an attempt to outdo the Iron Chef’s gastronomic creations.

When time is up, the chefs’ dishes are judged for style, originality, and taste.

One memorable episode had an extra-special secret ingredient—any veggie that could be plucked straight from the White House garden. The colors and flavors portrayed were unlike those in any previous Iron Chef competitions, and the creativity was astounding.

Granted, most of us aren’t professional chefs, nor do we maintain massive vegetable gardens, so it might seem a little far-fetched to just grab some veggies and create a plethora of gourmet meals…but maybe, just maybe, we could all step it up a little. After all, I bet very few of us are guilty of eating too many vegetables, yet we all know the benefits: fiber, antioxidants and phytochemicals, vitamins and minerals—all the things that keep us looking and feeling great.

Plus, by filling up on veggies, you can keep your calorie intake relatively low, so you might find yourself moving toward (or maintaining) a healthier weight as well.

Enough said? Ok, now get to work!

First things first: think locally. The “fresh” produce you’re buying in the grocery store has been picked before it’s had time to ripen, and it’s traveled thousands of miles to get to the grocery store shelf. Then it’s sat on the shelf for a few days before you bought it, and on your kitchen counter for a few days before you ate it. Not only has its nutritional value and taste been significantly reduced, it’s also created a fairly large carbon footprint along the way.

Ideally speaking, you have two options: either patronize your local farmers’ markets (there are two open-air markets in Roanoke alone), or grow your own produce.

Don’t think you have time to manage a garden? Start small 30 Summer 2010

Betty Black in her backyard.

with maybe just a couple of vegetables that you eat on a regular basis and go from there. Use pots or hanging baskets if you don’t have a backyard. All you need are sunlight, water, some decent soil, and a little patience.

Betty Black of Roanoke County is one example of a local resident who is reaping the rewards. Black started gardening because she enjoys being able to walk out her back door and pick her own fresh veggies. She says nothing compares to the taste of a tomato picked right out of the garden. She also loves the fact that she knows where it came from and that it’s natural. (She doesn’t use any chemicals or fertilizers.)

How does she find time to manage her garden? “I just take a few minutes every time I go out to pick the veggies,” she says. “I weed in small sections, not all at once, so it doesn’t take so much time.” Black’s advice is to start small so you don’t get overwhelmed by trying to do too much.

Besides the enjoyment of the fruits of her labor, she says it’s also relaxing. She forgets about all of her other chores (like vacuuming) and just enjoys the fresh air while

growing her own food.

Hopefully you’ve been inspired to try your hand at your very own garden, but if you still don’t think it’s for you, please patronize your local farmers’ market. Either way, once you’ve managed to bag some local veggies, you’ll get to flex your creative muscles in the kitchen.

Need more inspiration? Check out recipe websites where you can plug in the ingredients you want to use and get several recipes to try them in (for instance, www.allrecipes.com). Another option is to speak with the local farmers who sell you their produce—they often have great cooking ideas.

Finally, feel good about what you’re doing.

You’re not only enhancing the health of your body, mind and spirit (especially if you’re gardening)—you’re also improving the health of the environment.

So think globally and eat locally—you’ll be glad you did.

Summer 2010

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ervetal 32 Summer 2010

vervetalk Tell us what gives you life + energy.

Whether it’s a home remedy, a family recipe, or just something that makes life worth living, share it with the readers of verve. We would also love to hear your opinions in letters to the editor. After all, sharing things that matter is what makes us a community.

Food Share your grandmother’s recipe or a new discovery that keeps your family healthy and happy.

Fitness If you’ve got a routine that’s anything but routine, tell us about it and start the next fitness craze.

Parting shots Send us your photos or artwork that you think reflects our lives.

verve E-mail: verve@carilionclinic.org Mail: 711 S. Jefferson St. Roanoke, VA 24016 Phone: 800-422-8482

Replaced in March 2007: 213 walks in the park

* Replaced in December 2009: 459,282 pain-free steps taken

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Replacing Used Joints Since 1972

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When it comes to joint replacement, Carilion Clinic’s orthopaedic team has the experience and expertise you need. If your used joints aren’t functioning, we have you covered.

Our dedicated team offers several joint replacement options, customized to each patient. From traditional joint replacement surgeries to new computer-assisted techniques, our surgery goals include pain relief, improved activity level and possible elimination of the need for a cane or assistive device.

We also offer the anterior approach to joint replacement. This minimally invasive procedure is done through a small incision in the front of the hip. This procedure reduces pain and recovery time because it does not detach muscles and tendons from the bone, sparing your tissues from trauma and a lengthy healing process.

Give your hips and knees the tune-up they deserve. Talk to your doctor today to see if joint replacement is the right option for you.

Awarded the “Gold Seal of Approval” designation by The Joint Commission.

For more information, call 540-266-6000 or 800-422-8482.

www.CarilionClinic.org

It’s About Keeping Our Employees Safe Precision Fabrics Group, Inc. Vinton, Virginia Precision Fabrics Group, Inc. has relied on Carilion Clinic Occupational Medicine for more than 20 years to educate our employees about working safely and taking control of their health. They assist us with regulatory compliance, injury management and our employees’ safe return to work.

Carilion Clinic Occupational Medicine is a full service occupational health provider, serving more than 900 businesses in the Roanoke Valley. Services include: • • • • • • •

Workers’ compensation/injury management Physical examinations (including DOT, FAA, executive, fitness-for-duty) On-site nursing Consulting Substance abuse testing Safety programs Travel services

For more information about Carilion Clinic Occupational Medicine, visit us at www.CarilionClinic.org/occmed.

101 Elm Ave. Roanoke, VA 24013 540-985-8521