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Expanding Bellies Mean Growing Concern | Toenail Fungus: The Agony of the Feet, the Thrill of Effective Treatment


november • december 2016

PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT CHIEF DESIGNER GRAPHIC DESIGNER DIGITAL CONTENT MANAGER | EVENT SPECIALIST COPY EDITOR DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY ACCOUNTING MANAGER

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Deidre Wilkes Karrie Pridemore Tori Meador Heidi McClintic Bobbi Hoffman Dalton Holody Shawn Sprouse / www.sdsimages.com Laura Bower

CONTRIBUTING MEDICAL EXPERTS

Joseph DiGirolamo, OD Arun Mannem, MD JoAnn Pinkerton, MD, NCMP Matthew Pollard, MD Sara Warden, LNHA

Geri Aston Sandy Chirico Tricia Foley, RD, MS Tina Joyce Rick Piester Deidre Wilkes

CONTRIBUTING PROFESSIONAL EXPERTS & WRITERS

ADVERTISING AND MARKETING Kim Wood • Vice President of Business Development 540.798.2504 • kimwood@ourhealthvirginia.com Cindy Trujillo • Senior Media Consultant 434.907.5255 • cindy@ourhealthvirginia.com

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SUBSCRIPTIONS To receive OurHealth Shenandoah Valley & Charlottesville via U.S. Mail, please contact Deidre Wilkes at deidre@ourhealthvirginia.com or at 540.387.6482

ONLINE DIGITAL EDITION SOCIAL MEDIA E-NEWSLETTERS

@ourhealthcville

MORE THAN A MAGAZINE l

y

T

F

COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2016 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Charlottesville/Shenandoah Valley is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483.

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MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.


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TABLE OF CONTENTS NOVEMBER • DECEMBER 2016

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MEDI•CABU•LARY

46

Local experts define health-related terms

8 10

A listing of new physicians, providers, locations and upcoming events in the Charlottesville & Shenandoah Valley's communities

HEALTH POINTS

15

THE ANATOMY CHALLENGE

Interesting facts and tidbits about health

HEALTHY RECIPE SWAP

53

5 HEALTH TIPS FOR THE HOLIDAYS

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THE BRIDGE TO BETTER HEALTH STARTS WITH PRIMARY CARE SERIES PART 6 | CELEBRATE YOUR CARE

Test your knowledge when it comes to GESTATIONAL DIABETES.

2016 BEST BEDSIDE MANNER AWARDS OurHealth's Best Bedside Manner Awards honor medical providers who were voted by the local community for their kindness, empathy and attentiveness—attributes that go a long way in gaining a patient’s confidence.

Tricia Foley RD, MS, OurHealth's resident nutritionist, shares pumpkin recipes with healthy ingredient swaps.

Check out these simple tips that will help you ring in the new year happy and healthy!

The final article in our yearlong series about primary care, focuses on how you can Celebrate Your Care. We’ll delve into your part of the patient-physician partnership.

GROWING BELLIES MEANS GROWING CONCERN The abundant information provided by the internet and social media might make having a healthy pregnancy and preparing a mother’s body for the rigorous road ahead seem easier. However, a lingering concern for some women is whether or not they will develop gestational diabetes.

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48

NEW & NOTEWORTHY

12

16

Capturing the spirit of those working in healthcare and of people leading healthy lives through photos

JUST ASK Healthcare questions answered by local professionals

HELLO, HEALTH

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FIT BITS | Add Some New 'TRIX' to Your Workout Deidre Wilkes, OurHealth's resident fitness specialist, shares the many training benefits of total body resistance exercises.

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TOE NAIL FUNGUS: THE AGONY OF THE FEET, THE THRILL OF EFFECTIVE TREATMENT In Charlottesville, new hope for sufferers of this malady.

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CLOSER LOOK Images reflecting the landscape of healthcare in Charlottesville & Shenandoah Valley* PLUS * a chance to win a free year's subscription to OurHealth! www.OurHealthCville.com

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LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S

What is the difference between diverticulosis and diverticulitis?

Spondylolisthesis can occur in children and teens involved in sports. Gymnastics or weight lifting may cause overuse of the backbone, causing stress fractures, which can then result in spondylolisthesis. Older adults can develop spondylolisthesis simply as a result of wear and tear on the back.

– Matthew Pollard, MD

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A diverticulum (plural diverticuli) is an outpouching that occurs at a weak point in the bowel wall. Diverticuli can occur throughout the gastrointestinal tract but are more common in the colon. Diverticulosis refers simply to the presence of diverticuli. This condition is found equally in men and women, and the risk of developing it increases with age. Most people have no symptoms, and therefore diverticulosis is usually diagnosed incidentally by colonoscopy or radiographic studies pursued for other reasons. However, approximately four percent of individuals will develop inflammation of the diverticuli, which is called diverticulitis. The most common symptom of diverticulitis is abdominal pain; but a person may also experience diarrhea, constipation, fevers, nausea or vomiting. Depending on the severity of symptoms, the treatment is usually bowel rest, as well as oral or intravenous antibiotics. Some major risk factors for diverticular disease are tobacco use and obesity. Despite popular belief, evidence shows that diets containing nuts, seeds and corn do not lead to an increased risk of diverticulitis.

Arun Mannem, MD

Charlottesville Gastroenterology Associates Charlottesville | 434.817.8484 www.cvillegi.com

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

What is Spondylolisthesis? In the spine, the vertebrae are stacked on one another much like building blocks. Spondylolisthesis is caused when one vertebrae slips forward on the one below. This means that they are no longer aligned. This most often occurs in the lower spine (lumbosacral area). This can cause back pain or sciatica. Sometimes when a vertebra slips out of place, there are no symptoms at all. Spondylolisthesis can occur in children and teens involved in sports. Gymnastics or weight lifting may cause overuse of the backbone, causing stress fractures, which can then result in spondylolisthesis. Older adults can develop spondylolisthesis simply as a result of wear and tear on the back. This condition can be treated with medication, physical therapy, spinal injections or surgery.

Matthew Pollard, MD

Augusta Health Spine Clinic Fishersville | 540.221.7400 www.augustahealth.com

What is Snoezelen therapy? Snoezelen, or controlled multisensory environment, was first used in the 1970s for those with intellectual disabilities. Today it is used in a variety of applications, including in therapy for people with dementia who are living in longterm care communities. Due to their progressive loss of cognitive function, residents with dementia are at risk of social isolation and sensory deprivation. They may also suffer from behavioral disturbances. A Snoezelen room can offer a virtual-reality experience based on a resident’s specific needs. An invigorating environment to stimulate sight, smell, hearing and touch can be created through the use of colorful lights, upbeat music, bubble tubes, aroma therapy, fiber optics, and exciting picture projection throughout the room. The resident can interact with the environment in a manageable way without becoming overwhelmed. Alternatively, calming pictures and sounds, dimmed lighting and soothing aromas can create an especially relaxing space to help reduce anxiety and agitation.

Sara Warden, LNHA

Executive Director Our Lady of Peace Retirement Community Charlottesville | 434.973.1155 www.our-lady-of-peace.com


www.OurHealthCville.com

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H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS

Even a slightly outdated lens prescription can have a striking effect on your ability to see at night. Eyeglass lenses that are free of scratches— purchase a quality scratch-resistant lens treatment— and that use the latest “nonglare” treatment technology will reduce the amount of glare caused by eyeglass lenses and the environment.

– Joseph DiGirolamo, OD

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I see ‘halos’ around lights while driving at night. What can I do to improve my night vision while driving? Glare is usually the cause of halos. Headlights from oncoming traffic or in the rearview mirror, cell phones, navigation screen displays, and reflective road signs can all cause glare. The weather plays a role too. Foggy, rainy or snowy conditions, streaking from old windshield wipers, and debris on headlights or windshields all diffract light to cause halos and glare. To reduce glare, keep the windshield clean inside and out, and make sure to replace windshield wipers regularly. But the single most effective method is to keep your eyeglass and contact lens prescriptions current and up-todate. Even a slightly outdated lens prescription can have a striking effect on your ability to see at night. Eyeglass lenses that are free of scratches—purchase a quality scratch-resistant lens treatment— and that use the latest “non-glare” treatment technology will reduce the amount of glare caused by eyeglass lenses and the environment. By maximizing light transmittance to the eyes, these features reduce halos very effectively. Joseph DiGirolamo, OD

Primary Eyecare Charlottesville | 434.977.2020 www.cvilleeyecare.com

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

How can rehabilitation help patients who have suffered a stroke?

Can genetics predispose a woman to low bone density and osteoporosis?

The purpose of a rehabilitation program is to help a patient relearn skills that were lost when a stroke occurred. Intense rehabilitation should begin as soon as possible after the acute incident. Individualized therapy should focus on the deficit areas identified during the comprehensive evaluation. Goals need to be established that are important to the patient and the achievement of which maximizes function and independence. Techniques that are commonly integrated into treatment sessions for patients recovering from a stroke include repetition, feedback and adaptive equipment. Recent advances in equipment like the Alter G treadmill, patented by NASA and found exclusively at Albemarle Health & Rehabilitation Center, enable stroke patients to stand and walk much earlier than was once possible. Task-specific training and daily repetition are key to building new neural pathways, so daily rehab is key to recovery. The brain needs feedback to recognize how a specific task is to be completed during the tough path to recovery. Home evaluations are recommended and necessary to prepare the patient (and the caregiver) for a safe discharge to the home environment at the patient’s highest functional level.

Osteoporosis is associated with low bone mass, which increases the risk of fractures. Studies have shown that genes may play a big role in risk for osteoporosis. For instance, if a parent or other family member has a history of bone fractures, you are more likely to have weaker bones and a higher risk of fractures.

Sandy Chirico, Rehab Manager

Albemarle Health & Rehabilitation Center Charlottesville | 434.422.4800 www.albemarlehealthrehab.com

If osteoporosis runs in the family, speak with your healthcare provider. Risk is greater in people whose diet is low in calcium or vitamin D, who are sedentary, or who are taking steroids, anti-seizure or acid-reflux medications. Preventive steps include ingesting 1,200 mg calcium and 1,000 units of vitamin D daily and engaging in weight training, strength training or resistance exercise. Calcium-containing foods include milk, yogurt, cottage cheese, leafy green vegetables, salmon and fortified orange juice. Speak with your physician about having a bone-density test if you have a family history of osteoporosis or fractures, if you have had bone fractures, or if you take medications that might cause bone loss.

JoAnn Pinkerton, MD, NCMP

University of Virginia Health System’s Midlife Health Center Charlottesville | 434.243.4720 www.uvahealth.com


www.OurHealthCville.com

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NEW

NOTEWORTHY Don't Miss the final article of the Primary Care Series

T PAR

NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS

UVA Named to 100 Great Neurosurgery and Spine Programs List Becker’s Hospital Review selected the University of Virginia Neurosciences Center at UVA Medical Center to its most recent list of “100 hospitals and health systems with great neurosurgery and spine programs.”

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Health systems earning the award “are remarkable leaders in neurosciences, providing treatment for patients with various brain and spine conditions,” according to the staff of the national healthcare publication. This honor reflects the efforts of our team to provide cutting-edge, highquality care in a range of specialties,” said Mark Shaffrey, MD, chair of UVA’s Department of Neurosurgery.

54 on page

According to Becker’s, award winners were chosen based on rankings and awards from several outside groups. UVA Medical Center has also earned Magnet designation for nursing excellence, while UVA’s neurology and neurosurgery programs were rated high performing by U.S. News & World Report. BlueCross BlueShield has named the UVA Spine Center a Blue Distinction Center for spine surgery, which according to the Blue Cross website means UVA meets quality measures for patient safety and outcomes. In its overview, Becker’s highlighted the array of specialty care available at UVA Neurosciences Center, including neuro-oncology, a stroke center, a spine center that performs more than 1,500 procedures annually and care for neurodegenerative diseases such as ALS and Alzheimer’s. For more information, visit neurosciences.uvahealth.com.

Carilion Clinic Opens Family Medicine Practice in Clifton Forge Carilion Clinic announces the opening of its latest family medicine practice in Clifton Forge. The practice, located at 609 Church Street in Clifton Forge is open Monday – Friday from 8 a.m. – 5 p.m. The office is equipped with three exam rooms, access to X-ray services and a small lab to perform minor testing. The clinic will also offer occupational medicine services to the surrounding community. For more information or to schedule an appointment, visit www.CarilionClinic.org or call 540.862.5440.

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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


Christopher T. Bell, MD Heather Buck, CNM Harrisonburg Physicians for Anesthesiology Harrisonburg 540.897.2583 www.sentara.com

Augusta Health Care for Women Fishersville | 540.213.7750 www.ahcfw.com

Stephanie Corn, MD

Harrisonburg Community Health Center Harrisonburg 540.433.4913 www.hburgchc.org

John Gaughen, MD

Sentara Martha Jefferson Medical & Surgical Associates Charlottesville 434.652.5260 www.sentara.com

Welcome

Amy Randolph, PA DERMATOLOGY

Services Provided: Einsley-Marie Janowski, MD, PhD UVA Cancer Center Radiation Oncology Charlottesville 434.924.9333 cancer.uvahealth.com

Michael Mendoza, MD UVA Children’s Hospital Gastroenterology Charlottesville 434.243.5500 childrens.uvahealth.com

Caitlin Jenkins, CNM

Augusta Health Care for Women Fishersville | 540.213.7750 www.ahcfw.com

Hannah Rice, MD Sentara Greene Family Medicine Charlottesville 434 985.2891 www.sentara.com

Michael Longo, MD

Sentara Martha Jefferson Inpatient Services Charlottesville 434.654.8888 www.sentara.com

Kari Ring, MD, MS UVA Cancer Center Gynecologic Oncology Charlottesville 434.924.9333 cancer.uvahealth.com

Joanne Mendoza, MD UVA Children’s Hospital General Pediatrics Charlottesville 434.243.5500 childrens.uvahealth.com

Andrew Romano, MD Sentara Martha Jefferson Hematology and Medical Oncology Associates Charlottesville 434.654.8390 www.sentara.com

Skin cancer screening and treatment

Skin care wellness and facial rejuvenation

Laser and light treatment

Collagen vascular diseases treatment

Skin, hair and nail disorders

Aesthetic services for cosmetic and medical conditions

“My expertise and knowledge of dermatology will expand the availability of the outstanding care that the Valley receives from SADC.” Savola Aesthetic Dermatology Center, PLC. 66 Parkway Lane Suite 101A | Fishersville Dermatology: 540.451.2833 Spa: 540.451.2836

www.SavolaDermatology.com Amy Randolph, PA is now accepting new patients. Guaranteed appointment availability within the week, if not earlier. Melissa Schoelwer, MD Karoly Varga, MD UVA Children’s Hospital Endocrinology Charlottesville 434.243.5500 childrens.uvahealth.com

Sentara RMH Neurology Harrisonburg 540.689.5400 www.sentara.com

Anthony Zarella, OD Primary EyeCare Charlottesville 434.977.2020 www.cvilleeyecare.com

Scan here for more information about our services and providers. www.OurHealthCville.com

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T I P S , T I D B I T S A ND MO R E TO I NF O R M A ND ENT ERTA I N YO U

“If you think taking care of yourself is selfish, change your mind. If you don’t, you’re simply ducking your responsibilities.”

Portion Control in the PALM OF YOUR HAND

– Ann Richards, women and minorities advocate

Palm = 3-4 ounces beef, pork, poultry, fish

Two Cupped Hands = 1 ounce chips, crackers, pretzels Fist = 1 cup beverages, cereal, casseroles, soups, fresh fruit, raw veggies and salads

BONES AND BARBELLS!

Studies show that strength training – not just walking or doing aerobics, but LIFTING weights – can help protect bones and prevent osteoporosis-related fractures! Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Cupped Hand = 1/2 cup pasta, rice, beans, potatoes, cooked veggies and ice cream Thumb = 1-2 tablespoons salad dressing, sour cream, cream cheese, peanut butter and hard cheese Thumb Tip = 1 teaspoon butter, margarine, mayonnaise and oil

Source: Prevention

FASCINATING FACT

The tooth is the only part of the body that can’t repair itself. Don’t forget to schedule regular dental exams! 12

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

Every Bit Counts! Did you know that for every one hour of regular, vigorous physical activity, some people may increase their life expectancy by two hours! Source: American Heart Association


November is both

National Alzheimer’s Disease Awareness Month and National Family Caregivers Month If you are a caregiver of any kind, visit www.caregiveraction.org for tools and resources to help manage the care of your loved one.

Nearly

More Than

15 million 5 million family members, friends and neighbors care for a loved one with Alzheimer’s disease.

Americans are living with Alzheimer’s, and almost

60 Percent of Alzheimer’s and dementia caregivers are women.

Two-Thirds

of them are women.

Want to be part of the cure for Alzheimer’s ? Sign up for TrialMatch, a free clinical matching service that connects individuals with Alzheimer’s, caregivers and healthy volunteers to current studies. For more information visit www.alz.org/research.

BER

DECEM

MAKING YOUR HOLIDAY WISH LIST? How about a new pair of shoes? Walking or running shoes should be replaced every six months. The cushioning starts to break down with repeated use, and can cause overuse injuries to the joints of the foot, leg and hip.

The best way to prevent the flu is by getting a flu vaccine each year. For the 2016-2017 season, the Centers for Disease Control recommends use of the flu shot (inactivated influenza vaccine or IIV) and the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not be used during 2016-2017. More information as well as the 2016-2017 influenza vaccination recommendations can be found at www.cdc.gov.

Keep those hands CLEAN! Washing hands with soap and water is the best defense against bacteria and germs. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. www.OurHealthCville.com

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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


Anatomy

the

CHALLENGE

How much do you know about Gestational Diabetes? 1. On average, of pregnant women are diagnosed with gestational diabetes each year.

percent

B:

9.2

C:

percent

3

3. Women with gestational diabetes need A:

20.5%

B:

three times

9.2%

1.8

D:

percent

ten times

4. Which of the following risk(s) are associated with gestational diabetes? A: Increased likelihood of preterm birth B: Babies born with higher than average birth weight

percent

more insulin. C:

D:

five times

seven times

6. On average,

5. Which of the following is NOT a risk factor for gestational diabetes?

of pregnant women with gestational diabetes will suffer from diabetes after pregnancy.

C: The baby has increased likelihood of Type 2 diabetes later in life D: Increased likelihood of C section

1.8%

A: Race

E: All of the above

50

A:

7. Which of the following methods are used to treat gestational diabetes?

percent

B: Weight

10

B:

A: Daily blood sugar monitoring

B: Healthy diet and exercise

C: Sex of baby

4. E

5. C

6. B

7. D

Sources: www.diabetes.org and www.mayoclinic.org

D: Family history

percent

1

percent

3. A

D: All of the above

5

C:

D: C: Medication

percent

2. True

20.5

Gestational diabetes is most common in pregnant women twenty-five or older.

1. B

A:

2. True or False:

www.OurHealthCville.com

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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


Mean Growing Concern words | TINA JOYCE

The road to motherhood begins long before the birth of the child. Women of different ages and backgrounds sacrifice their bodies, time, and rest to ensure the health of their unborn babies. It may seem like there is no shortage of unsolicited advice given by family members and complete strangers to women who are trying to become pregnant or to mothers expecting their first children. However, there are many proactive women who are trying to alleviate worry and risk by seeking wise counsel on pregnancy concerns early in the process. The abundant information provided by the internet and social media might make having a healthy pregnancy and preparing a mother’s body for the rigorous road ahead seem easier. However, a lingering concern for some women is whether or not they will develop gestational diabetes.

What is Diabetes? Diabetes is a condition in which the body does not properly process food for use as energy. Most of the food eaten is turned into glucose — or sugar — for the body to use as energy. The pancreas makes a hormone called insulin to help glucose leave the blood and penetrate the body’s cells; it also helps manage blood sugar levels. When a person has diabetes, the body either doesn’t produce enough insulin or cannot use its own effectively, causing sugar to build up in the blood.1

www.OurHealthCville.com

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SYMPTOMS OF

GESTATIONAL DIABETES MELLITUS (GDM) The symptoms of GDM might be difficult to notice at first, but may include:

High levels of sugar in the blood can eventually cause damage to the pancreas and changes in the body that lead to the hardening of blood vessels, which can cause kidney disease, stroke, heart attack, vision loss and more. There are two types of diabetes, type 1 and type 2. Type 1 diabetes is caused by genetics and other unknown factors; type 2 is caused by genetics and lifestyle.

Gestational Diabetes Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes mellitus, also known as GDM.2 Unusual thirst

During pregnancy, a woman’s body not only makes more hormones than usual, her existing hormone levels change. These changes, in addition to other bodily shifts such as weight gain, can cause her body to use insulin less effectively, thus increasing the need for more. According to the American Pregnancy Association, “Approximately 2-5

Sugar in urine (revealed in a doctor’s check-up)

percent of pregnant women develop gestational diabetes; this number may increase to 7-9 percent of mothers who are more likely to have risk factors. The screening for this disease usually takes place between the 24th and 28th week of pregnancy. Doctors test for gestational diabetes during this time because the placenta is producing large amounts of hormones that may cause insulin resistance. If the results indicate elevated levels, further testing would be done to confirm a gestational diabetes diagnosis.”

Fatigue or nausea (common with many pregnancies)

Frequent bladder or vaginal infections

Blurred vision

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How will I know? Most often, the early signs of gestational diabetes are noticed during routine prenatal exams. If a healthcare provider determines that a woman is at risk of developing GDM, he or she will administer a glucose-screening test. The expecting mother will drink a sugary liquid and undergo a blood test one hour later. If the results show high blood sugar after an hour, then an oral glucose tolerance test will be given at a later time to confirm a diagnosis of gestational diabetes. The OGTT requires a 12-hour fast prior to the test being administered. Although the American Diabetes Association confirms that professionals do not know the exact cause of gestational diabetes, they do offer suggestions to lower the risk of developing the condition during pregnancy. Women can greatly reduce the risk of developing GDM by improving their daily habits prior to becoming pregnant. Being more active and quitting smoking are two low-cost initiatives that not only improve a woman’s own health, but also the health of her unborn baby. Simply shedding a few pounds (if a woman is over 20 percent her ideal body weight) prior to becoming pregnant, furthermore, can increase her self-esteem, lower her blood pressure and stress and decrease her likelihood of developing GDM.

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


Women who are at risk of developing

Risks and Treatment

GESTATIONAL DIABETES

The dangers of GDM include high blood pressure, jaundice, cesarean births, premature delivery, and a large birth weight for the baby. Larger birth weights may also lead to delivery risks such as injures to the infant’s shoulders and arms. Additionally, a woman who develops gestational diabetes has an increased risk of developing type 2 diabetes later in life, as does her child.3

are those who:

The treatment for patients with gestational diabetes is a collaborative effort between the patient, the obstetrician, possibly a nurse practitioner or midwife, and a dietician to regulate the blood sugar levels. The treatment for gestational diabetes always includes a strategic meal plan and routine physical activity. In some cases, medication may also be prescribed.

Are overweight

According to the American Diabetic Association, a healthy meal plan for

Have high blood pressure

people with diabetes (or gestational diabetes) is generally the same as a healthy diet for anyone – low in saturated and trans fat and moderate in salt and sugar, with meals based on lean protein, non-starchy vegetables, whole grains, healthy fats and fruit. Diabetic and “dietetic” foods generally offer no special benefit. Most of

Have unhealthy cholesterol levels

them still raise blood glucose levels, and they are usually more expensive and can also have a laxative effect if they contain sugar alcohols.

A well-balanced diet includes plenty of fruits and vegetables and lean proteins (such a chicken or fish). Combined with moderate exercise, this will help to improve the overall health of any individual. A woman who is looking to improve her own health as well as that of her unborn child should consult her doctor regarding a safe plan that will help her achieve long-term results. Women going into pregnancy with a healthy lifestyle are more likely to return to a healthy weight after delivery in addition to reducing their risk of developing gestational diabetes. A pregnant woman’s growing belly is a beautiful gift, but it can also lead to increased worry and concern. By working together with her healthcare team before, during, and after pregnancy, a woman can be proactive in reducing her chances of complications during pregnancy and childbirth and increasing the probability of bringing a healthy child into the world.

Are related to anyone with diabetes

Smoke

Are physically inactive or have unhealthy eating habits

Sources: 1

Center for Disease Control and Prevention, www.cdc.gov

2 American Diabetes Association, www.diabetes.org 3 American Pregnancy Association, americanpregnancy.org

ON THE WEB

Are of Hispanic/Latina, African American, American Indian, Alaskan Native, Asian American or Pacific Islander descent.

More at ourhealthcville.com

www.OurHealthCville.com

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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


Medical expertise and compassionate care should always go hand-in-hand when it comes to treating patients. Going to the doctor or health provider can be an unnerving experience for many people. Professionals who incorporate The Golden Rule into their practice philosophy are ones that stand out in people’s minds for the better. The 2016 Best Bedside Manner Awards, presented by OurHealth Charlottesville & Shenandoah Valley magazine, honor medical providers who were voted by the local community for their kindness, empathy and attentiveness—attributes that go a long way in gaining a patient’s confidence. Please join us in congratulating this year’s 2nd Annual Best Bedside Manner Award winners. The Voting Process: During the month of May 2016, the Best Bedside Manner Awards Voting Form was available on OurHealth’s website, www.ourhealthcville.com. The form consisted of over 40 medical specialties (with definitions of each specialty) in which the public could submit the first and last names of local medical providers by the applicable specialty. If you have any questions, please contact Stephen McClintic Jr., publisher of OurHealth, at steve@ourhealthvirginia.com or 540.387.6482.

www.OurHealthCville.com

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of diagnoses, ranging from nasal and sinus problems and severe food or bee sting allergy to recurrent infections due to sinus disease, immune deficiency and asthma conditions.

Allergy & Immunology encompasses a broad array

medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery.

Anesthesiology is the practice of

studies hearing, balance, and related disorders. Its practitioners treat those with hearing loss and proactively prevent related damage.

Audiology is the branch of science that 22

FIRST PLACE

SECOND PLACE

ARVIND MADAAN, MD Charlottesville Allergy & Respiratory Enterprises Charlottesville | 434.295.2727 www.cvilleallergy.com

GARY RAKES, MD Allergy Partners of Charlottesville Waynesboro | 540.949.5154 www.allergypartners.com/charlottesville

I am honored to be chosen for the Best Bedside Manner Gold Award by public choice. I accept this award on behalf of all my patients who have allowed me the opportunity to care for them and offer them wellness instead of just treating episodes of sickness. We believe in direct and honest engagement with our patients as a team, listening carefully and empathetically. Our patients appreciate the fact that we distill the latest scientific advances into simple, easy to understand terms and allow our patients to select the best possible plan of care. In the end, it is all about good clinical outcomes and satisfied patients. — Arvind Madaan, MD

THIRD PLACE LARRY BORISH, MD UVA Asthma, Allergy and Immunology Charlottesville | 434.924.5917 | www.uvahealth.com

HONORABLE MENTION MADELINE DILLON, MD Allergy Partners of Charlottesville Charlottesville | 434.951.2191 www.allergypartners.com/charlottesville

FIRST PLACE

SECOND PLACE

JACOB CHACKO, MD Anesthesia Associates of Augusta Fishersville | 800.249.5835 www.augustahealth.com

NADIA LUNARDI, MD UVA Anesthesiology Charlottesville | 434.924.2283 | www.uvahealth.com

THIRD PLACE SWEN E. LASER, MD Anesthesia Associates of Augusta Fishersville | 800.249.5835 | www.augustahealth.com

HONORABLE MENTION BURKHARD SPIEKERMANN, MD Albemarle Anesthesia, PLC Charlottesville | 434.654.7000 www.albemarleanesthesia.com

FIRST PLACE KRISTIN KOCH, AUD Evolution Hearing Charlottesville | 434.260.8007 www.evolutionhearing.com

I am honored to receive this award again in 2016. I believe that each patient deserves a great experience. Listening to people, hearing their stories and providing good solutions allows me to take care of my patients and help them stay connected to their family and friends. — Kristin Koch, AuD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

SECOND PLACE KAREN KLOTZ Virginia Hearing Group Verona | 540.248.1670 | www.virginiahearinggroup.com

THIRD PLACE JULIE FARRAR-HERSCH, PHD Augusta Audiology Associates, PC Fishersville | 540.932.5790 | www.augustaaudiology.com

HONORABLE MENTION MARIAN FREDNER, MS, CCC-A, F-AAA Albemarle Audiology Charlottesville | 434.975.4327 | www.hearbetternow.com


SECOND PLACE

TIMOTHY WILLIAMS, MD Cardiovascular Associates of Charlottesville Charlottesville | 434.293.4072 www.cvilleheart.com

THIRD PLACE

Everyone experiences healthcare in different ways. For some it is simple and straight forward, but for others it is complex, emotional, and stressful. I strive to make all patients and their families comfortable and try to get to know them first as people. — Timothy Williams, MD

“We believe in direct and honest engagement with our patients as a team, listening carefully and empathetically.”

ROBERT W. BATTLE, MD UVA Adult Congenital Heart Disease Clinic Charlottesville | 434.243.1000 | www.uvahealth.com

JAIME ESCANELLAS, MD UVA Specialty Care Augusta Cardiology and Vascular Fishersville | 434.243.7121 | www.uvahealth.com

2016

Cardiology is the branch of medicine focusing on the structures, functions and disorders of the heart.

FIRST PLACE

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Chiropractic is a

health profession concerned with the diagnosis, treatment (without drugs or medication) and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.

FIRST PLACE ANDREW DODGE, DC Valley Family Wellness & Chiropractic Staunton | 540.885.1735 valleyfamilywellness.com

We see a lot of kids and moms who have never seen a chiropractor before and are typically nervous on their first visit. A positive bedside manner helps my patients to relax and gain trust that this is the right place for them. — Andrew Dodge, DC

SECOND PLACE SCOTT WAGNER, DC Scott Wagner Chiropractic and Sports Medicine Charlottesville | 434.978.4888 www.scottwagnerchiropractic.com

THIRD PLACE DOUGLAS COX, DC Cox Chiropractic Clinic Charlottesville | 434.293.6165 www.coxclinic.com

HONORABLE MENTION WAYNE FUSCO, DC Cox Chiropractic Clinic Charlottesville | 434.293.6165 www.coxclinic.com MARC DEGENNARO, MA, DC Albemarle Family Chiropractic Charlottesville | 434.978.4473 www.drdegennaro.com

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WAYNE REMINGTON, DDS Drs. Remington & Stover Family and Cosmetic Dentistry Charlottesville | 434.973.7744 www.cvillefamilydentistry.com

THIRD PLACE

FRANK BARBERIO, DMD Frank D. Barberio, DMD, PC Charlottesville | 434.296.3941 | www.drbarberio.com

TED GALBRAITH, DDS UVA Health System Charlottesville | 434.924.1774 | www.uvahealth.com

HONORABLE MENTION

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DOUGLAS WRIGHT, DDS Harrisonburg Family and Cosmetic Dentistry Harrisonburg | 540.432.6616 www.harrisonburgsmiles.com

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We try to treat every patient as though it is us or our family. None of us want to have less than a great smile or have pain so we do our utmost to make sure our patients are completely comfortable through the entire process of getting their smile where they want it to be. — Wayne Remington, DDS

U

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SECOND PLACE

JAMES WILLIS, DDS Willis & Associates Family Dentistry Fishersville | 540.885.8037 www.willisdentistry.com

STEVE BROWNING, DDS Browning & Cunningham Family Dentistry Waynesboro | 540.943.4215 www.bcfamilydentistry.com

THIRD PLACE DJ BICKERS, DDS Charlottesville | 434.984.6400 | www.djbickers.com

HONORABLE MENTION DANIEL LAGRUA, DMD Dental Health Associates Harrisonburg | 540.433.2613 www.mydentalhealthassociates.com

SECOND PLACE

AARON STUMP, DDS Charlottesville Pediatric Dentistry Charlottesville | 434.975.7336 www.cvillepedo.com

THIRD PLACE

BRIAN BRUMBAUGH, DDS Brian Brumbaugh Pediatric Dentistry Staunton | 540.213.2244 | www.cavityfreekid.com

BARRETT PETERS, DDS Piedmont Pediatric Dentistry Charlottesville | 434.973.4344 | www.piedmontpd.com

HONORABLE MENTION KEVIN CLIFFORD, DDS Crozet Pediatric Dentistry, PC Crozet | 434.205.4594 | www.crozetpediatricdentistry.com

Pediatric Dentistry specializes in treating children from birth through adolescence.

FIRST PLACE

Bedside manner is essential in pediatric dentistry. Children are capable of amazing things but they need to be approached gently and with care. The dental team's job is more than just rendering dental treatment. It is about giving kids a fun, compassionate dental experience which starts with “hello.” — Aaron Stump, DDS

General Dentistry is the evaluation, diagnosis prevention and/or treatment (non-surgical, surgical or related procedures) of diseases, disorders or conditions of the oral cavity.

r Manne d aw ar

FIRST PLACE

Trust is the most important thing in a relationship with my patients, it's important that we have established a rapport and understanding in order to get the results they are looking for in modern dentistry- this is why good bedside manner matters to me. — James Willis, DDS

Cosmetic Dentistry

SECOND PLACE

improves the appearance and function of a person's teeth. Dentistry is the art and science of improving the appearance (aesthetics), function and health of the teeth and associated structures.

FIRST PLACE

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diagnosis and treatment of diseases of the skin.

Dermatology is a specialty focusing on

of providing care for patients requiring prompt medical attention and urgent medical evaluation and treatment.

Emergency Medicine is the specialty

hormones of the body and their related disorders.

Endocrinology is the study of the glands and 26

FIRST PLACE KRISTEN SAVOLA, MD Savola Aesthetic Dermatology Center, PLC Fishersville | 540.451.2833 www.savoladermatology.com

Bedside manner is important to me because in addition to being a doctor, I am also at times, a patient. I strive to treat my patients as I myself would like to be treated; with compassion, respect, honesty and understanding. I want my patients to “feel listened to” and hopefully by the end of the visit, they feel satisfied that I have addressed their concerns. — Kristen Savola, MD

SECOND PLACE DEBORAH ELDER, MD Charlottesville Dermatology Charlottesville | 434.984.2400 | www.cvillederm.com

THIRD PLACE BURTON V. BURKHOLDER, MD Dermatology PLC Charlottesville | 434.296.0113 | www.dermatologyplc.com

HONORABLE MENTION DEBORAH LOCKMAN, MD Albermarle Dermatology Associates Charlottesville | 434.923.4651 www.albemarledermatology.com VANDANA NANDA, MD Advanced Dermatology of Charlottesville Charlottesville | 434.977.0027

FIRST PLACE

SECOND PLACE

CHRISTOPHER HOLSTEGE, MD UVA Health System Charlottesville | 434.924.5185 www.uvahealth.com

LISA HARDY, MD Sentara Martha Jefferson Hospital Charlottesville | 434.654.7150 | www.sentara.com

When a medical emergency occurs, it can be frightening for patients and their families. I strive with my emergency medicine team to care for patients in the same manner as I would want my own family treated by assuring that the appropriate medical management is calmly performed in a timely manner while taking the time to address their specific questions and concerns. — Christopher Holstege, MD

THIRD PLACE WILLIAM TALBOTT, MD First Med Urgent Care Charlottesville | 434.984.4200 www.firstmedcharlottesville.com

FIRST PLACE

SECOND PLACE

NELLY MAYBEE, MD Augusta Health Diabetes & Endocrinology Clinic Fishersville | 540.245.7180 www.augustahealth.com

MICHAEL SANTULLI, MD Charlottesville | 434.295.5155

Taking time to explain things and really educate patients, as well as getting to know them, is time well spent. In my experience, it improves compliance and gives better health outcomes; patients want to do well when you have a good rapport and when they understand what’s at stake. — Nelly Maybee, MD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

THIRD PLACE JENNIFER KIRBY, MD UVA Diabetes and Endocrine Clinic Charlottesville | 434.924.1825 | www.uvahealth.com

HONORABLE MENTION ANGELA SUTTON, MD Augusta Health Diabetes & Endocrinology Clinic Staunton | 540.245.7180 | www.augustahealth.com MARGARET CROOK, MD UVA Blue Ridge Endocrinology Charlottesville | 434.293.7811 | www.uvahealth.com


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includes diagnosis and treatment of disease, injury, and illness for patients of any age.

Family Practice is the medical specialty that

endocrinology and infertility (REI) is a subspecialty of obstetrics and gynecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility.

Gastroenterology is the specialty

dealing with the treatment of disorders of the digestive gastroenterology or GI system.

Fertility Care or reproductive 28

FIRST PLACE

SECOND PLACE

JOHN MARSH, MD Middlebrook Family Medicine Middlebrook | 540.887.2627

RAYMOND MAROTTA, MD Family Medicine of Albemarle Charlottesville | 434.973.9744 | www.fmoa-online.com

THIRD PLACE Bedside manner is a communication style that facilitates the doctor-patient interaction. There are two important aspects. The first is listening and the second is explaining. Listening means understanding the patient’s concerns and complaints, as well as appreciating their expectations and desires. Explaining requires that the physician put into understandable phrases the reason and the meaning of medical tests, medical procedures, and most importantly, the treatment plan. In summary, bedside manner exemplifies the art of medicine that physicians need to master in order to effectively treat their patients. —John Marsh, MD

JOHN DAVISON, MD UVA Forest Lakes Health Center Charlottesville | 434.975.7700 | www.uvahealth.com

HONORABLE MENTION OCTAVIO DE LOS REYES, DO Carilion Clinic Family Medicine Staunton | 540.885.3525 | www.carilionclinic.org

FIRST PLACE

SECOND PLACE

CHRISTOPHER WILLIAMS, MD Reproductive Medicine & Surgery Center of Virginia, PLC Charlottesville | 434.654.8520 www.rmscva.com

BRUCE BATEMAN, MD Reproductive Medicine & Surgery Center of Virginia, PLC Charlottesville | 434.654.8520 | www.rmscva.com

Most couples who work with us are eventually successful but not knowing how long it might take is often a source of stress. A significant part of what I do is to support couples so they maintain the emotional reserve they need to reach their goal. My coworkers and I try to make the journey as positive as possible. — Christopher Williams, MD

THIRD PLACE LAURA SMITH, MD Reproductive Medicine & Surgery Center of Virginia, PLC Charlottesville | 434.654.8520 | www.rmscva.com

FIRST PLACE

SECOND PLACE

DAVID BALABAN, MD Charlottesville Gastroenterology Associates Charlottesville | 434.817.8484 www.cvillegi.com

THIRD PLACE

In the face of increasing demands on a doctor’s time, our practice remains committed to providing the most meaningful interaction between the patient and our physicians, nurses, nurse practitioners, and staff. Patients express to us the desire for two qualities they seek most: that we listen, and that we care. We strive to do that every day. — David Balaban, MD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

JAVIER POU, MD Shenandoah Valley Gastroenterology Waynesboro | 540.946.1662 | www.svgastro.com

CYNTHIA YOSHIDA, MD UVA Division of Gastroenterology and Hepatology Charlottesville | 434.244.5008 | www.uvahealth.com

HONORABLE MENTION ALLAN HARDY, MD Augusta Health Gastroenterology Fishersville | 540.245.7350 | www.augustahealth.com


DAVID CHESLER, MD Charlottesville Family Medicine Charlottesville | 434.973.1831 www.charlottesvillemedicine.com

SECOND PLACE KURTIS ELWARD, MD Family Medicine of Albemarle Charlottesville | 434.973.9744 | www.fmoa-online.com

THIRD PLACE MARISA CHRISTENSEN, MD Charlottesville Family Medicine Charlottesville | 434.973.1831 www.charlottesvillemedicine.com

NICHOLAS PAPHITIS, MD UVA Cancer Center Augusta Fishersville | 800.860.6731 | www.uvahealth.com

THIRD PLACE PRANAV PATEL, MD UVA Culpeper Medical Center Cancer Care Culpepper | 540.829.4352 | www.uvahealth.com

Why is good bedside manner important? Because it is a pretty fundamental thing for a physician to have in the care of people who are sick and in need of help. I just try to treat people as I appreciate being treated. — Michael Douvas, MD

“Bedside manner is a communication style that facilitates the doctor-patient interaction.”

2016

Hematology/Oncology

SECOND PLACE

MICHAEL DOUVAS, MD UVA Emily Couric Clinical Cancer Center Charlottesville | 434.982.6399 www.uvahealth.com

is the diagnosis, treatment and prevention of blood diseases (hematology) and cancer (oncology) and research into them.

FIRST PLACE

Geriatrics is a medical specialty that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic diseases.

FIRST PLACE

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Infectious Disease is the medical specialty focusing on the diagnosis, cause and treatment of contagious disease. medicine that deals with diagnosis and nonsurgical treatment of diseases affecting adults.

Internal Medicine is the branch of

that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units (NICUs).

Neonatology is a subspecialty of pediatrics 30

FIRST PLACE

SECOND PLACE

ALLISON BAROCO, MD Augusta Health Infectious Disease Fishersville | 540.213.2630 www.augustahealth.com

DANIEL SAWYER, MD Charlottesville | 434.977.1933 www.danielsawyermd.com

It is much more important to know what sort of patient has a disease than what sort of disease a patient has (Osler, 1904). Our job is to understand our patients, so we can communicate on their terms and communicate a plan that will work for their situation. — Allison Baroco, MD

FIRST PLACE JEFFREY DAVIS, MD Internal Medicine LTD Charlottesville | 434.977.7950 www.internalmedicineltd.com

THIRD PLACE AMY MATHERS, MD UVA Health System Charlottesville | 434.982.1700 | www.uvahealth.com

SECOND PLACE BARBARA POST, MD UVA Northridge Internal Medicine Charlottesville | 434.243.4500 | www.uvahealth.com

THIRD PLACE CAROLYN DALLDORF, MD Piedmont Internal Medicine Charlottesville | 434.293.5548 | www.sentara.com

HONORABLE MENTION KIMBERLEY BAUMAN, MD UVA Northridge Internal Medicine Charlottesville | 434.243.4500 | www.uvahealth.com

FIRST PLACE

SECOND PLACE

JONATHAN SWANSON, MD UVA Health System Charlottesville | 434.924.5428 www.uvahealth.com

ROBERT SINKIN, MD UVA Health System Charlottesville | 434.924.5428 | www.uvahealth.com

Developing a trusting relationship with parents and caregivers while their infant is in the NICU is paramount for healing the family as a whole. Conversations with families at the bedside improves my ability to care for the infant and more importantly, provides them with knowledge and hopefully the strength to keep fighting for their infant every day. — Jonathan Swanson, MD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

THIRD PLACE ROBERT BOYLE, MD UVA Health System Charlottesville | 434.924.5429 | www.uvahealth.com


GARLAND CAMPBELL, MD UVA Specialty Care Pinnacle Drive Fishersville | 844.472.8711 www.uvahealth.com

For many patients, how a physician interacts with the patient is almost as important as what the provider says and does about the patient's medical problem. When a patient can see that the physician is there to interact with them as a person, not just a patient, it helps build the trust and understanding needed for the patient to engage and succeed with the treatment plan. — Garland (Adam) Campbell, MD

SECOND PLACE KEVIN MCCONNELL, MD Sentara Martha Jefferson Hospital Medical & Surgical Associates Charlottesville | 434.654.5260 | www.sentara.com

THIRD PLACE BRENDAN BOWMAN, MD UVA Dialysis - Orange Orange | 434.971.8888 | www.uvahealth.com

HONORABLE MENTION TERRY OVERBY, MD UVA Page Dialysis Stanley | 540.778.3484 | www.uvahealth.com

SECOND PLACE

RENZO FIGARI, MD Shenandoah Valley Neurology Associates Fishersville | 540.932.5878 www.augustahealth.com

PARI NIKPEY, MD Pari Nikpey, MD, PC Charlottesville | 434.293.5181

KARI SOMERS, CNM, WHNP Augusta Health Care for Women Fishersville | 540.213.7750 www.ahcfw.com

As a Certified Nurse Midwife, I am committed to partnering with the women in my community to help them meet their healthcare needs. — Kari Somers, CNM, WHNP

THIRD PLACE KAREN JOHNSTON, MD UVA Health System Charlottesville | 434.924.5323 | www.uvahealth.com

SECOND PLACE KELLY VINCEL, CPNP Pediatric Associates of Charlottesville Charlottesville | 434.296.9161 www.charlottesvillepeds.com

THIRD PLACE ANANDA CRONIN, FNP Central Virginia Health Services Charlottesville | 434.227.5624 www.cvhsinc.org

HONORABLE MENTION KAREN MARTIN, WHNP Augusta Health Care for Women Fishersville | 540.213.7750 www.ahcfw.com

HONORABLE MENTION CONTINUED... SHANNON IKENBERRY, RNC-WHNP The Woman’s Center Fishersville | 540.932.5577 www.thewomanscenterva.com NICOLE LEPSCH, NP Sentara Martha Jefferson Aesthetic and Reconstructive Surgery Charlottesville | 434.654.8920 www.sentara.com TINA RUTT, NP Charlottesville Family Medicine Charlottesville | 434.973.1831 www.charlottesvillemedicine.com

Nurse Practitioner is a registered nurse with advanced academic and clinical experience, which enables him or her to diagnose and manage most common and many chronic illnesses, either independently or as part of a healthcare team.

FIRST PLACE

Neurology is the specialty of medicine which focuses on the diagnosis and treatment of disorders of the nervous system.

FIRST PLACE

I treat my patients like family and not a disease. I treat them with respect and the same way I would want my family treated. — Renzo Figari, MD

Nephrology is the study of function and diseases of the kidney and related organs.

FIRST PLACE

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is trained and skilled in examining and testing the eyes for defects in order to prescribe corrective lenses or treatment.

Optometry is the specialty where the practitioner

Ophthalmology is the medical specialty that

treats eye disorders, including injuries, infections, tumors and cataracts.

is the specialty of medicine that includes care for women before, during and after pregnancy and child birth and the diagnosis and treatment of disorders affecting the female reproductive system.

Obstetrics & Gynecology (OB/GYN)

SECOND PLACE

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FIRST PLACE DANIEL MCMILLAN, MD, FACOG Augusta Health Care for Women Fishersville | 540.213.7750 www.ahcfw.com

EDWARD WOLANSKI, MD Edward Wolanski, MD, PC Charlottesville | 434.293.9800 | www.wolanskiobgyn.com

THIRD PLACE MATTHEW MONTGOMERY, MD Jefferson OB/GYN Charlottesville | 434.977.4488 | www.jeffersonobgyn.net

HONORABLE MENTION To provide good care you must speak to your patients in terms to which they can relate and to make them comfortable enough to ask or tell you anything. If I don't do that, I'm not doing my job as a physician. — Daniel McMillan, MD, FACOG

AMI KEATTS, MD, FACOG, CPPS Augusta Health Care for Women Fishersville | 540.213.7750 | www.ahcfw.com CHRISTINE WAMHOFF, MD Jefferson OB/GYN Charlottesville | 434.977.4488 | www.jeffersonobgyn.net JOHN HOOVER, MD, FACOG, FACS The Woman’s Center Fishersville | 540.932.5577 | www.thewomanscenterva.com

FIRST PLACE MARC SHIELDS, MD EyeOne Staunton | 540.213.7720 www.eyeoneva.com

Alford Sloan once said, “Bedside manners are no substitute for the right diagnosis.” While there is truth in this statement, bedside manners are the way we strive to show that we respect and care for our patients. —Marc Shields, MD

SECOND PLACE CHRISTIAN CARTER, MD Albemarle Pediatric Ophthalmology & Strabismus, PC Charlottesville | 434.295.5193 | www.aposva.com

THIRD PLACE ELLEN SANDERS, MD Blue Ridge Ophthalmology Charlottesville | 434.295.3227 | www.blueridgeeyemd.com

HONORABLE MENTION JAMES TIEDEMAN, MD, PHD EyeOne Fishersville | 540.213.7720 | www.eyeoneva.com TODD LONG, MD EyeOne Charlottesville | 540.213.7720 | www.eyeoneva.com

FIRST PLACE

SECOND PLACE

MICHAEL HENDERSON, OD Primary EyeCare Charlottesville | 434.977.2020 www.cvilleeyecare.com

KATHY CLARK-GELBURD, OD My Eye Dr Charlottesville | 434.973.5361 | www.myeyedr.com

I regard bedside manner as cornerstone in the doctorpatient relationship. When a patient feels comfortable in my office, they are more receptive of their diagnosis, better informed of treatment options and more likely to follow through with success. — Michael Henderson, OD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

THIRD PLACE JOSEPH DIGIROLAMO, OD Primary EyeCare Charlottesville | 434.977.2020 | www.cvilleeyecare.com


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is limited to the diagnosis, surgery and treatment of diseases, injuries, deformities and defects of the mouth.

Oral Surgery is the dental specialty that

concerned with the study and treatment of malocclusions (improper bites), which may be a result of tooth irregularity, disproportionate jaw relationships or both.

Orthodontics is the specialty of dentistry that is

FIRST PLACE

SECOND PLACE

TODD BRANDT, DDS, MD Blue Ridge Oral & Maxillofacial Surgery Fishersville | 540.886.2956 www.blueridgeoralsurgery.com

COREY BURGOYNE, DMD Blue Ridge Oral & Maxillofacial Surgery Fishersville | 540.886.2956 www.blueridgeoralsurgery.com

Providing excellent bedside manner requires active listening, honest communication, integrity, and dedication to treating the whole patient, not just the illness. I believe successful surgeons are not only affable and able, but also begin each day with a promise to provide care to each patient as if they were a family member. — Todd Brandt, DDS, MD

FIRST PLACE BART WEIS, DDS Charlottesville Orthodontics Charlottesville | 434.971.9601 www.charlottesvilleorthodontics.com

We enjoy creating a comfortable environment to inform our patients about the benefits of orthodontic treatment and the many available treatment options. We want to give our patients the most attractive smile and the best bite for the rest of their life. — Bart Weis, DDS

THIRD PLACE NATHANIEL TRICKER, DDS Central Virginia Oral & Facial Surgeons, PLC Charlottesville | 434.973.3348 | www.cvofs.com

HONORABLE MENTION WILLIAM BIGELOW, DDS Oral and Maxillofacial Surgery Staunton | 540.213.8750 www.bigelowstauntonoralsurgery.com

SECOND PLACE CHANDA ASHLEY, DDS Ashley Orthodontics Staunton | 540.885.6815 | www.ashleyortho.com

THIRD PLACE QUAY PARROTT, DDS Parrott Orthodontics Staunton | 540.949.6600 | www.parrottortho.com

HONORABLE MENTION BILL HORBALY, DDS Horbaly Orthodontics Charlottesville | 434.973.6542 | www.horbalyortho.com

and conditions of the musculoskeletal system related to the body's muscles and skeleton, as well as the joints, ligaments, tendons and nerves.

Orthopaedics is focused on diseases, injuries

SECOND PLACE

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FIRST PLACE JACK OTTENI, MD Orthopedic Associates, Ltd. Fishersville | 540.332.5850 www.orthopedicassoc.com

WILLIAM GRANT, MD Albemarle Orthopaedics, PLC Charlottesville | 434.817.7200 | www.drwilliamgrant.com

THIRD PLACE DAVID NIELSEN, DO Charlottesville Orthopaedic Center Charlottesville | 434.244.8412 | www.cvilleortho.com

HONORABLE MENTION I became a surgeon in order to help people. I don’t know any way to help people without first learning their goals, expectations, and concerns. — Jack Otteni, MD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

RAMON ESTEBAN, MD Orthopedic Associates, Ltd. Fishersville | 434.332.5850 | www.orthopedicassoc.com STEPHEN HOOVER, MD Sentara Martha Jefferson Orthopedics Charlottesville | 434.654.5575 | www.sentara.com ERIC CARSON, MD UVA Sports Medicine Clinic Charlottesville | 434.243.7778 | www.uvahealth.com


Otolaryngology is a surgical specialty focusing

on the diagnosis, management and treatment of diseases and disorders of the ear, nose, throat (ENT) and related structures of the head and neck.

FIRST PLACE STEPHEN D. KEEFE, MD Ears, Nose and Throat & Facial Cosmetic Surgery Fishersville | 540.245.7027 www.drKEEFEent.com

I can truly say I enjoy my patients. Listening to their story and applying clinical expertise and understanding of their concerns and medical issues to a plan of treatment which is understood and agreed upon by both patient and physician is the hallmark of the patient-physician relationship; one that I personally adhere to and strive to achieve every time I walk into the exam room. — Stephen D. Keefe, MD

SECOND PLACE JOHN MASON, MD UVA Charlottesville ENT Associates Charlottesville | 434.243.9415 | www.uvahealth.com

THIRD PLACE PAIGE POWERS, MD Piedmont Otolaryngology Charlottesville | 434.220.0045 | www.entdoc.com

HONORABLE MENTION MICHAEL PLAUTZ, MD Augusta Health Otolaryngology Fishersville | 540.221.7010 | www.augustahealth.com

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35


pharmacological, non-pharmacological and other approaches to prevent, reduce or stop pain sensations.

Pain Management encompasses

multidisciplinary approach to specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress and mental stress of the serious illness - whatever the diagnosis. treatment and prevention of diseases in children, ages infant to 18 years of age.

Pediatrics focuses on the detection diagnosis,

Palliative Medicine is a 36

FIRST PLACE

SECOND PLACE

RASHEED SIDDIQUI, MD Charlottesville Pain Management Center Charlottesville | 434.295.3600

AKHTAR PURVEZ, MD Pain and Spine Center of Charlottesville Charlottesville | 434.328.2774 www.painspinecenters.com

www.charlottesvillepain managementcenter.com

Pain management encompasses pharmacological, nonpharmacological, and other approaches to prevent, reduce, or stop pain sensations. — Rasheed Siddiqui, MD

THIRD PLACE JARED DAVIS, MD Augusta Health Pain Management Clinic Fishersville | 540.332.5747 | www.augustahealth.com

FIRST PLACE

SECOND PLACE

PATRICK BAROCO, MD Augusta Health Palliative Care Fishersville | 540.245.7262 www.augustahealth.com

TIMOTHY SHORT, MD UVA Health System Charlottesville | 434.243.3922 | www.uvahealth.com

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It’s sometimes easy to get lost in the technology of medicine today. And yet it is at the bedside of my patient, or sitting with them in their home, that I feel most able to heal and comfort. — Patrick Baroco, MD

FIRST PLACE CARLOS ARMENGOL, JR, MD, FAAP Pediatric Associates of Charlottesville Charlottesville | 434.296.9161 www.charlottesvillepeds.com

Parents and patients are happiest when we physicians make the time to engage the children, listen to their complaints, and present ourselves as genuine and authentic. Visiting a doctor's office is scary. Parents appreciate when I can get the kids to smile and converse with me. During the majority of my encounters there is no specific treatment to offer so the parents appreciate a moment to commiserate about childrearing and illnesses. — Carlos Armengol, Jr., MD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

SECOND PLACE STEVEN MUMBAUER, MD, FAAP Valley Pediatric Group Verona | 540.885.8143 | www.valleypediatricgroup.com

THIRD PLACE KARYN WOLFE, MD, FAAP Pediatric Associates of Charlottesville Charlottesville | 434.296.8300 | www.charlottesvillepeds.com

HONORABLE MENTION AMANDA JONES, MD, FAAP Pediatric Associates of Charlottesville Charlottesville | 434.296.9161 | www.charlottesvillepeds.com ROBERT GUNTHER, MD UVA Augusta Pediatrics Fishersville | 540.932.0980 | www.uvahealth.com JOCELYN SCHAUER, MD Piedmont Pediatrics Charlottesville | 434.975.7777 | www.piedmontpediatrics.net


www.OurHealthCville.com

37


ANGEL RAY, DDS Waynesboro | 540.943.5389

SECOND PLACE DAVID KRESE, DDS Charlottesville | 434.971.8159 www.davidlkresedds.com

THIRD PLACE ELLEN KELLY, DMD Daniel and Ellen Kelly, DMD Charlottesville | 434.977.4592 www.cvillekellydentist.com

O

studies supporting structures of teeth, diseases and conditions that affect them.

Periodontics is the specialty of dentistry that

practice medicine under the supervision of a licensed physician, and who thereby extends the physician's capacity to provide medical care.

Physician Assistant is licensed to

abbreviated PT, is the art and science of physical care and rehabilitation.

Physical Therapy or physiotherapy, often 38

FIRST PLACE

H R U

E A LT H

Best Bedside

FIRST PLACE DENISE JACKSON, PA UVA Pediatric Otolaryngology Charlottesville| 434.924.0123 www.uvahealth.com

Mannedr SECOND PLACE aw ar GARY MICHAEL PUGH, PA-C, ATC Albemarle Orthopaedics, PLC Charlottesville | 434.817.7200 www.drwilliamgrant.com

THIRD PLACE For me, it's about one thing: “Do unto others as you would have them do unto you.” I try to honor patients by respecting, serving, and treating them in an unbiased, comprehensive manner. It's such an honor to be affiliated with an otolaryngology team and academic institution as a whole so committed to excellence and providing quality care for every patient who walks through our doors. — Denise Jackson, PA

KATHERINE LOOSE, PA-C Charlottesville Dermatology Charlottesville | 434.984.2400 | www.cvillederm.com

FIRST PLACE

SECOND PLACE

DEBBIE OICKLE, PT, MHSC,OSC,MTC Atlantic Sports and Rehabilitation Services, Inc. Charlottesville | 434.978.4915 www.atlanticsportsandrehab.com

JAMES COLLINS, PT, CSCS Pantops Physical Therapy & Occupational Therapy Charlottesville | 434.245.6472 www.pantopsphysicaltherapy.com

Physical therapists work closely with patients to help them become free of pain and restore their functional mobility. Patients need to trust and believe in their therapist to achieve maximal benefits. Without a good bedside manner that relationship could not be established. — Debbie Oickle, PT

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

THIRD PLACE BRYAN ROMIG, PT Barren Ridge Physical Therapy Fishersville | 540.949.5383 | www.barrenridgept.com


SECOND PLACE

BRIAN SHOWALTER, MD Sentara Martha Jefferson Aesthetic and Reconstructive Surgery Charlottesville | 434.654.8920 www.mjhplasticsurgery.org

VICTORIA VASTINE, MD Sentara Martha Jefferson Aesthetic and Reconstructive Surgery Charlottesville | 434.654.8920 www.mjhplasticsurgery.org

I value the personal doctor-patient relationships that form throughout the course of treatment. I derive great satisfaction in getting to know people beyond their medical condition and really gaining a sense of who they are as a person. This is one of the most satisfying aspects of practicing medicine and good bedside manner is essential for building that relationship and level of trust with my patients. — Brian Showalter, MD

THIRD PLACE SAIED ASFA, MD, FACS ASFA Plastic Surgery Harrisonburg | 540.432.0303 www.asfaplasticsurgery.com

J. JARED CHRISTOPHEL, MD, MPH, FACS Facial Plastic and Reconstructive Surgery at UVA Charlottesville | 434.982.0251 | www.cosmeticuva.com

Good bedside manner establishes the foundation of the doctor-patient relationship. My hope is that patients see me as a person who cares about improving the life of another person. — Jonathan Black, MD

Plastic Surgery – Reconstructive

SECOND PLACE

JONATHAN BLACK, MD UVA Plastic Surgery Clinic Charlottesville | 434.924.5244 www.uvahealth.com

is the field of surgery concerned with reducing scarring or disfigurement that may occur as a result of accidents, birth defects, or treatment for diseases, such as melanoma.

FIRST PLACE

Plastic Surgery – Cosmetic is the field of surgery that is performed to reshape structures of the body in order to improve appearance and self-esteem.

FIRST PLACE

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39


Podiatry is the branch of medicine that deals with the diagnosis, treatment and prevention of diseases of the human foot.

FIRST PLACE JOSEPH DISABATO, DPM Virginia Foot & Ankle Surgical Associates Charlottesville | 434.977.8040 www.vfasa.com

Patients can become anxious when issues arise about their health. It is our task as healthcare providers to treat patients with compassion and understanding. — Joseph Disabato, DPM

SECOND PLACE CHRISTOPHER STEWART, DPM Central Virginia Foot & Ankle Laser Center Charlottesville | 434.979.0456 | www.cvillefootankle.com

THIRD PLACE JOHN OCHELTREE, DPM John L Ocheltree, Jr, DPM - Podiatry Staunton | 540.886.6424 | www.augustahealth.com

Psychiatry is the branch of medicine that deals with diagnosis, treatment and prevention of mental and emotional disorders.

FIRST PLACE THOMAS JAYNE, MD Augusta Psychological Associates Fishersville | 540.949.4202 www.augustapsychological.com

Patient care is largely about a personal relationship with the individual. I relate to others as I would wish to be treated. — Thomas Jayne, MD

SECOND PLACE MEREDITH LEE, DO UVA Health System Charlottesville | 434.924.2241 | www.uvahealth.com

THIRD PLACE DAVID BYRNES, MD Dr.Lewis Weber & Associates Charlottesville | 434.971.9809 | www.weberpsychotherapy.com

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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


SECOND PLACE

EMILIE THOMAS, MA, LMFT Valley Pastoral Counseling Center Waynesboro | 540.943.8722 www.valleypastoral.org

NEG MAHMOODZADEGAN, PHD Charlottesville | 434.409.9338

I can make astute observations and offer coping strategies all day long to my clients, but without also offering myself as a nonjudgmental witness to their experience, I know such interventions will fall short of any permanent healing. Real growth blossoms from the quality of the therapeutic relationship, which must be one of safety, trust, caring and compassion. — Emilie Thomas, MA, LMFT

C. LAURA GONZALEZ, MD Augusta Health Pulmonology Fishersville | 540.245.7190 www.augustahealth.com

To be able to diagnose accurately, you need to listen to the patient’s history. This is only achieved by gaining the patient’s trust and confidence. Treating the patient with respect and genuine interest helps in obtaining the most crucial element of the art of medical diagnosis. Do unto others… — C. Laura Gonzalez, MD

VALARI PINEO, LPC Augusta Psychological Associates Fishersville | 540.949.4202 www.augustapsychological.com

HONORABLE MENTION CHAPIN FAULCONER LPC Charlottesville | 434.996.6362 www.chapinfaulconer.com

SECOND PLACE SARAH KILBOURNE, MD UVA Health System Charlottesville | 434.924.3627 | www.uvahealth.com

THIRD PLACE NARINDER ARORA, MD Pulmonary Allergy Clinic Charlottesville | 434.971.9696

HONORABLE MENTION WILLIAM HAMMOND, MD Sentara Martha Jefferson Medical & Surgical Associates Charlottesville | 434.654.5260 | www.sentara.com

SECOND PLACE

PAUL READ, MD UVA Emily Couric Clinical Cancer Center Charlottesville | 434.924.5191 www.uvahealth.com

ROBERT KYLER, MD Shenandoah Radiation Oncology Associates Fishersville | 540.245.7100

Cancer patients are under tremendous stress, anxiety, and are frequently in pain and feel poorly for many reasons. They rely on their doctors to not only advise and treat them, but also to care for them and their families’ wellbeing. In academic medicine, the advancement of healthcare is our mission and this means continuously improving both the health of our patients and the care they need for their best outcomes. — Paul Read, MD

THIRD PLACE HEATHER MORGAN, MD Shenandoah Radiation Oncology Associates Fishersville | 540.245.7100

Radiation Oncology is the specialty for the treatment of cancer patients, using radiation therapy as the main modality of treatment.

FIRST PLACE

Pulmonary Medicine is a specialty that deals with diseases of the respiratory tract and respiratory disease.

FIRST PLACE

THIRD PLACE

Psychology/Counseling is the branch of medicine that deals wit the diagnosis, treatment and prevention of mental and emotional disorders.

FIRST PLACE

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41


the use of images to both diagnose and treat disease visualized within the human body.

Radiology is a medical specialty that employs

non-surgical treatment of rheumatic illnesses, especially arthritis.

Rheumatology is the specialty in the

subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders.

Sleep Medicine is a medical specialty or 42

FIRST PLACE

SECOND PLACE

SEAN LYMAN, MD, PHD Charlottesville Radiology, LTD. & CRL Surgical Associates Charlottesville | 434.224.4580 www.crlsurgical.com

THOMAS ZUMSTEG, MD Blue Ridge Radiologists Inc. Staunton | 540.886.0988 | www.augustahealth.com

As an interventional radiologist, I see people on what is often one of the hardest days of their lives. I think it is important to do whatever I can to help them through. — Sean Lyman, MD

THIRD PLACE JENNIFER HARVEY, MD UVA Cancer Center’s Breast Care Center Charlottesville | 434.924.9391 cancer.uvahealth.com

FIRST PLACE

SECOND PLACE

DONALD KIMPEL, MD UVA Health System Charlottesville 434.924.5214 www.uvahealth.com

ANN HENRY, MD Ann Henry MD – Rheumatology Waynesboro | 540.943.2833

I savor the chance to learn from each patient's experiences. After thousands of patient interactions, I am still learning at each visit, and I can share the collective wisdom of these patients to benefit the next.

THIRD PLACE M. SCOTT HOGENMILLER, MD Augusta Health Rheumatology & Osteoporosis Clinic Fishersville | 540.245.7170 | www.augustahealth.com

— Donald Kimpel, MD

FIRST PLACE CHRISTOPHER WINTER, MD Charlottesville Neurology and Sleep Medicine Charlottesville | 434.293.9149 www.cvilleneuroandsleep.com

SECOND PLACE EVAN WENGER, MD Augusta Health Sleep Center Fishersville | 540.332.4169 | www.augustahealth.com

THIRD PLACE ERIC DAVIS, MD UVA Health System Charlottesville | 434.924.0000 | www.uvahealth.com

The most important skill a doctor must possess is that of a good listener. We diagnose and solve patient problems more with our bedside relationship than we do with tests or images. I work hard to continually improve my bedside manner with patients, so this award is important to me. — Christopher Winter, MD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


ROBERT WILDER, MD UVA Health System Charlottesville | 434.243.5600 www.uvahealth.com

Sports Medicine is an area of health and special services that apply medical and scientific knowledge to prevent, recognize, manage and rehabilitate injuries related to sport, exercise or recreational activity.

FIRST PLACE

SECOND PLACE DAVID DIDUCH, MD UVA Sports Medicine Clinic Charlottesville | 434.243.7778 www.uvahealth.com

THIRD PLACE Our patients are vulnerable. What may seem routine to us is often a real challenge to them. Taking the necessary time to put them at ease and ensure them that we have their best interest at heart is an important part of the patient encounter. We also see several patients a day, yet for that patient we may be the only physician that helps them with their injury or illness. We need to make that visit count. Lastly, our approach to patients serves as a model for our residents and students. How we approach patients will be modeled in the years to come. — Robert Wilder, MD

STEPHEN BROCKMEIER, MD UVA Sports Medicine Clinic Charlottesville | 434.243.7778 www.uvahealth.com

SECOND PLACE

LEORA YARBORO, MD UVA Heart and Vascular Center Charlottesville | 434.924.2158 www.uvahealth.com

GORAV AILAWADI, MD UVA Health System Charlottesville | 434.924.5052 www.uvahealth.com

Learning that you or a loved one needs to have open-heart surgery can be very stressful. An important part of my job is to establish trust and empower patients at a time when they may feel most vulnerable. In my opinion, good bedside manner is about open communication and dedicating time to understand the unique needs of each individual. — Leora Yarboro, MD

It may sound simple, but I strive for good bedside manner because more than anything it’s how I would want to be treated. The spectrum of patients we interact with can range from a nuisance problem to life or death situations. Under these circumstances, the bedside interaction can mean the difference between a positive thinking, encouraged, well-educated patient and one that is fragmented with a head full of negative thoughts. These experiences are one of the fundamental reasons I went into medicine in the first place. — Turner Lisle, MD

JAMES GANGEMI, MD UVA Health System Charlottesville | 434.924.6828 www.uvahealth.com

SECOND PLACE WILLIAM THOMPSON, MD, FACS Shenandoah Valley Surgical Associates Fishersville | 540.332.5999 | www.svsainc.com

THIRD PLACE SHAYNA SHOWALTER, MD UVA Health System Charlottesville | 434.924.9725 www.uvahealth.com

HONORABLE MENTION KRISTIN TURZA, MD Augusta Surgery Staunton | 540.332.5909 www.augustahealth.com

injury, deformity and disease using operative procedures.

TURNER LISLE, MD Sentara Martha Jefferson Medical and Surgical Associates Charlottesville | 434.654.5260 www.sentara.com

THIRD PLACE

Surgery – General is the treatment of

FIRST PLACE

Surgery – Cardiac is surgery on the heart to correct congenital heart disease or the complications of heart disease or valve problems created by various causes.

FIRST PLACE

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43


surgical specialty for the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system.

Surgery – Neurosurgery is a

of surgery on diagnosed patients with diseases of the arterial, venous and lymphatic system.

Surgery – Vascular is the treatment

disturbances of the urinary (male and female) and reproductive (male) organs.

Urology is a medical specialty that deals with 44

FIRST PLACE

SECOND PLACE

MARK SHAFFREY, MD UVA Health System Charlottesville | 434.924.1843 www.uvahealth.com

KELLY MAHANEY, MD UVA Health System Charlottesville | 434.243.5749 | www.uvahealth.com

Bedside manner is so important to me because it facilitates the four most important components of the doctor-patient relationship: listening intently, understanding, communicating effectively and developing trust. — Mark Shaffrey, MD

FIRST PLACE

SECOND PLACE

LEWIS OWENS, MD, FACS Charlottesville Radiology, LTD. & CRL Surgical Associates Charlottesville | 434.224.4580 www.crlsurgical.com

KENNETH CHERRY, MD UVA Heart and Vascular Center Charlottesville | 434.243.7052 | www.uvahealth.com

A person's health is the greatest gift. Being sick is always unnerving no matter if you are old or young, rich or poor, educated or illiterate. I believe one of the most important parts of the healing process is being kind. That is what I try to be for all the patients for whom I care. — Lewis Owens, MD, FACS

THIRD PLACE CHARLES GOFF, MD, FACS Shenandoah Valley Surgical Associates, Inc. Fishersville | 540.332.5999 | www.svsainc.com

HONORABLE MENTION JOHN LIGUSH, JR, MD Charlottesville Radiology, LTD & CRL Surgical Associates Charlottesville | 434.244.4580 | www.crlsurgical.com

FIRST PLACE

SECOND PLACE

C. BUCKLEY GILLOCK, MD Blue Ridge Urological, PC Fishersville | 540.932.5926 www.blueridgeurological.com

ROBERT OSBORNE, MD Urological Associates LTD Charlottesville | 434.295.0184 | www.cvilleurology.com

Many of us had the good fortune of training under great physicians who enjoyed spending adequate time with their patients. Contemporary healthcare processes consume much of our time deconstructing human beings with layers of numeric codes, templates, and anonymous classifications. When we engage our patients face to face and confront their disease with them, we experience a mutual vulnerability, build trust, and humanity is restored. This is how we can honor our role models. — C. Buckley Gillock, MD

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville

THIRD PLACE SEAN CORBETT, MD UVA Pediatric Urology Charlottesville | 434.924.9559 | www.uvahealth.com

HONORABLE MENTION WILLIAM JONES, III, MD Blue Ridge Urological, PC Fishersville | 540.p32.5926 www.blueridgeurological.com


www.OurHealthCville.com

45


Photos courtesy of Alzheimer's Association Central and Western Virginia Chapter

It was a day for umbrellas for sure! More than 300 people braved a steady rain and joined the Alzheimer’s Association’s Walk to End Alzheimer’s® and united in a movement to reclaim the future for millions at the Albemarle County Office Building in Charlottesville. As of walk day, participants had raised more than $157,887 to fund Alzheimer's care, support and research programs. Walk to End Alzheimer’s participants did more than complete the two mile walk in the rain. They learned about Alzheimer’s disease and how to get involved with this critical cause, from advocacy opportunities, clinical studies and support programs and services. The event also included an emotional tribute to those who have experienced or are experiencing Alzheimer’s. For more photos, visit our website at www.ourhealthcville.com. For more information or to make a donation, visit alz.org/walk.

46

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


ON THE WEB

More at ourhealthcville.com

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47


Tricia Foley’s

PUMPKIN PANCAKES REGULAR INGREDIENTS: (serves 4) 1½ 1 1 2 2 2 3 2 1 1 1 ½ ½

cups whole milk cup pumpkin pie filling egg tablespoons vegetable oil tablespoons white vinegar cups all-purpose flour tablespoons brown sugar teaspoons baking powder teaspoon baking soda teaspoon ground allspice teaspoon ground cinnamon teaspoon ground ginger teaspoon salt

SWAP INGREDIENTS: (serves 4) SWAP FOR SWAP FOR SWAP FOR SWAP FOR SWAP FOR SWAP FOR

1½ 1 1 2 2 2 2 2 1 1 1 ½ ½

cups reduced fat (2%) milk cup pumpkin puree farm-fresh egg tablespoons olive oil tablespoons white vinegar cups white wheat flour tablespoons maple syrup teaspoons baking powder teaspoon baking soda teaspoon ground allspice teaspoon ground cinnamon teaspoon ground ginger teaspoon salt

DIRECTIONS

DIRECTIONS

NUTRITION (per serving): 428.5 calories, 11.7g

NUTRITION (per serving): 345.5 calories, 12.1g

In a bowl, stir the milk, pumpkin pie filling, egg, oil and vinegar together. In a separate bowl, blend the flour, brown sugar, baking powder, baking soda, allspice, cinnamon, ginger and salt, then stir this into the pumpkin mixture. Heat a pan coated with non-stick spray over medium high heat. Pour or spoon the batter onto the pan, using ¼ cup portions for each pancake. Brown on each side and serve immediately. fat, 2.8g saturated fat, 79.15g carbohydrates, 2.5g fiber, 29g sugar, 300mg sodium, and 11g protein.

In a bowl, stir the milk, pumpkin puree, egg, oil and vinegar together. In a separate bowl, blend the flour, maple syrup, baking powder, baking soda, allspice, cinnamon, ginger and salt, then stir this into the pumpkin mixture. Heat a pan coated with non-stick spray over medium high heat. Pour or spoon the batter onto the pan, using ¼ cup portions for each pancake. Brown on each side and serve immediately.

fat, 1.5g saturated fat, 58g carbohydrates, 8.3g fiber, 12g sugar, 43mg sodium, 11.6g protein.

Source: www.allrecipes.com

Swap Notes: Substituting pumpkin puree for pumpkin pie filling reduces sugar and adds fiber, and using wheat flour also enhances fiber content. Swapping olive oil for vegetable oil adds more healthy fats, as do the farm-fresh eggs. Finally, using maple syrup instead of sugar increases the dish’s nutrient density.

48

OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


aves Swap S 8.25g

ries, 44 calo te and 9.5g ydra carboh ile lowering h r suga w d fat by 1g e a r u sat t

Tricia Foley’s

PUMPKIN CHOCOLATE CHIP OATMEAL BARS REGULAR INGREDIENTS: (serves 4) 2½ ¼ ¾ ½ ½ 2 ¼ ¼ 1 1 1 ¼

cups instant oatmeal cup all-purpose flour cup pumpkin pie filling cup mini milk chocolate chips cup whole milk eggs cup maple syrup teaspoon salt teaspoon cinnamon teaspoon pumpkin pie spice teaspoon vanilla cup brown sugar

SWAP INGREDIENTS: (serves 4) SWAP FOR SWAP FOR SWAP FOR SWAP FOR SWAP FOR SWAP FOR

2½ ¼ ¾ ½ ½ 2 ¼ ¼ 1 1 1

cups slow-cooked oatmeal cup white wheat flour cup pumpkin puree cup mini dark chocolate chips cup reduced fat (2%) milk farm-fresh eggs cup maple syrup teaspoon salt teaspoon cinnamon teaspoon pumpkin pie spice teaspoon vanilla

DIRECTIONS

DIRECTIONS

Heat oven to 350 degrees. Line an 8 x 8-inch baking sheet with parchment paper. Combine all dry ingredients. In a second bowl, combine pumpkin pie mix, milk, eggs, vanilla extract and maple syrup. Mix the dry ingredients into the wet ingredients. Pour the batter into the pan and pat down lightly to spread evenly. Bake for 20-25 minutes. Allow to cool before slicing.

NUTRITION (per serving): 212 calories, 5.35g fat, 2.8g saturated fat, 3.3mg sodium, 37.25g carbohydrates, 2g fiber, 24.5g sugar, 3.3g protein.

Heat oven to 350 degrees. Line an 8 x 8-inch baking sheet with parchment paper. Combine all dry ingredients. In a second bowl, combine pumpkin puree, milk, eggs, vanilla extract and maple syrup. Mix the dry ingredients into the wet ingredients, then pour batter into the pan and pat down lightly to spread evenly. Bake for 20-25 minutes. Allow to cool before slicing.

NUTRITION (per serving): 168 calories, 4.35g fat, 1.8g saturated fat, 3.3mg sodium, 29g carbohydrates, 2g fiber, 15g sugar, 3.3g protein.

Source: www.foodlion.com

Swap Notes: Although not significantly lowering the recipe’s calories, the swap uses ingredients that are packed with other health benefits, including fiber in the white wheat flour and antioxidants in the dark chocolate. Farm-fresh eggs are also often richer in omega 3 fats than store-bought eggs. Also, the swap omits brown sugar and reduces saturated fat by substituting 2% milk for whole milk.

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49


Tricia Foley’s

SPICY CHIPOTLE PUMPKIN HUMMUS REGULAR INGREDIENTS: (serves 6)

SWAP INGREDIENTS: (serves 6)

1 1 2 2 1 1 ¼ ¼ ½ ½ 1

1 1 2 2 1 1 ¼ ¼ ½ ½ 1

(15 ounce) can chickpeas, drained

and rinsed (15 ounce) can pumpkin puree tablespoons soybean oil chipotle chilies clove garlic, grated tablespoon sugar teaspoon cinnamon teaspoon cayenne powder teaspoon cumin teaspoon oregano teaspoon chili powder Salt and pepper to taste

DIRECTIONS

Combine the chickpeas, pumpkin and oil in a food processor and puree until smooth. Finely chop the chilies and mix them in a bowl with the garlic, sugar, and all dried herbs and spices. Add half of the chipotle mix into the hummus, and put the remaining half on top of the hummus.

NUTRITION (per serving): 156 calories, 5.6g fat, 0.6g saturated fat, 24.5g carbohydrates, 6g sugar, 5g fiber, 5g protein, 18 mg sodium. Source: www.tablespoon.com

SWAP FOR

SWAP FOR

(15 ounce) can chickpeas, drained

and rinsed (15 ounce) can pumpkin puree tablespoons olive oil chipotle chilies clove garlic, grated tablespoon honey teaspoon cinnamon teaspoon cayenne powder teaspoon cumin teaspoon oregano teaspoon chili powder Salt and pepper to taste

DIRECTIONS

In a bowl, stir the milk, pumpkin puree, egg, oil and vinegar together. In a separate bowl, blend the flour, maple syrup, baking powder, baking soda, allspice, cinnamon, ginger and salt, then stir this into the pumpkin mixture. Heat a pan coated with non-stick spray over medium high heat. Pour or spoon the batter onto the pan, using ¼ cup portions for each pancake. Brown on each side and serve immediately.

NUTRITION (per serving): 161 calories, 5.6g

fat, 0.6g saturated fat, 25g carbohydrates, 5g fiber, 5.8g sugar, 5g protein, 18mg sodium.

Swap Notes: Instead of using regular sugar, the altered recipe uses local honey that can sometimes alleviate allergies and has added enzymes that benefit digestion. The soybean oil was also swapped for olive oil, which is richer in mono and poly unsaturated, “heart healthy” fats.

50


Saves fat, p a w S .8g g ies, 17

.5 calor at, 11 236.8 turated f and sa 5.4g ohydrates carb g sugar 5.6

Tricia Foley’s

PUMPKIN CHILI

REGULAR INGREDIENTS: (serves 12)

SWAP INGREDIENTS: (serves 12)

2 1 1 2 1 1 ½ 1 1 ¼

2 1 1 2 3 1 ½ 1 1 2

SWAP FOR pounds ground beef large onion, diced green bell pepper, diced (15 ounce) cans kidney beans, drained SWAP FOR (46 fluid ounce) can tomato juice (28 ounce) can peeled and diced tomatoes SWAP FOR with juice cup canned pumpkin puree tablespoon pumpkin pie spice tablespoon chili powder cup white sugar

DIRECTIONS

Over medium heat, cook beef in a large pot until browned and drain. Stir onion and bell pepper into the pot and cook for five minutes. Next, add the beans, tomato juice, diced tomatoes and pumpkin puree. Season with pumpkin pie spice, chili powder and sugar. Simmer for one hour.

NUTRITION (per serving): 481 calories, 22.8g

fat, 8g saturated fat, 173.6mg sodium, 38g carbohydrates, 5.9g fiber, 9.6g sugar, 23.3g protein. Source: www.allrecipes.com

pounds ground buffalo large onion, diced green bell pepper, diced (15 ounce) cans kidney beans, drained (16 ounce jars) roasted red peppers, pureed (28 ounce) can low-sodium peeled and diced tomatoes with juice cup canned pumpkin puree tablespoon pumpkin pie spice tablespoon chili powder tablespoons molasses

DIRECTIONS

Pour all three jars of roasted red peppers into a blender and blend until smooth. Set aside. Over medium heat, cook buffalo meat in a large pot until browned and drain. Stir the onion and bell pepper into the pot and cook for five minutes. Next, add the beans, pureed roasted peppers, diced tomatoes and pumpkin puree. Season with pumpkin pie spice, chili powder and molasses. Simmer for one hour.

NUTRITION (per serving): 244.2 calories, 5g fat, 2.6g saturated fat, 116mg sodium, 26.5g carbohydrates, 5.9g fiber, 4g sugar, 23.3g protein.

Swap Notes:

Substituting buffalo for beef reduces the total and saturated fat of the dish. Also, tomato sauce can sometimes be high in sugar, so substituting roasted red peppers for tomato sauce decreases the recipe’s sugar content. Adding molasses instead of sugar also enhances the nutrient density of the chili while not compromising on flavor.

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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville


5

HEALTH TIPS FOR THE

Holidays

words | DEIDRE WILKES

It’s natural to indulge a bit during the holiday season – the trick is not to let it ‘snowball’ out of control and into the New Year. Just a few simple tips can have you ringing in 2017 happy and healthy!

1. Ditch the Scale Weight can fluctuate from day to day – especially when eating certain foods that are common during the holiday season. Make a pact to put your scale away until well AFTER the holidays have passed and your routine is back to normal.

3. Don’t Sweat the Small Stuff

2. Never Leave the House Hungry During the holidays, there is food, food, everywhere! Whether you’re running errands, shopping for gifts, or out on the town at a party, make sure to eat a healthy snack before you leave. This will keep you from grabbing fast food on the go or overindulging at restaurants or parties. Some great ideas for snacks are carrot or celery sticks, fruit and nuts.

Stress can have a major impact on weight and even trigger emotional eating, so don’t let it get to you! Carve out a few minutes each day for ‘me’ time. Doing anything from meditating to taking a power nap or a bubble bath to listening to soothing music may help you relax during this stressful season.

4. Instant Leftovers Most restaurant portions are much more than a single serving. When your meal arrives, immediately separate the food in half and ask the server for a box. As soon as the box arrives, place half of your meal in it. You instantly saved both calories and money, as you now have lunch or dinner for the next day!

5. Do the ‘Mall Crawl’ Holiday shopping is often a necessary evil, but you can work it into your fitness routine. After going from store to store, take some time to walk from one end of the mall to the other without stopping. If you shop at a multi-level mall, take the stairs and walk from end to end on each level. If you’re carrying shopping bags, use them to do some arm curls to help tone your upper body. www.OurHealthCville.com

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the 2016 OurHealth Charlottesville and Shenandoah Valley Primary Care Series: an issue-by-issue overview

+++ january

| february

PART

KNOW YOUR CARE: understanding your health and how to maintain it

6

+++ march

| april

DO YOUR CARE: taking action with your health

+++ may

| june

SHARE YOUR CARE: setting good examples for others to learn and live by

+++ july

| august

INSPIRE YOUR CARE: keeping creative with fresh care ideas

+++ september

| october

MEASURE YOUR CARE:

tracking your efforts to ensure you’re on the right path

+++ november

| december

CELEBRATE YOUR CARE:

rejoicing the rewards realized from taking good care of yourself

words | GERI ASTON

CELEBRATE YOUR

care

As you travel along life’s journey, it can be fun to step back and take a look at how far you’ve come. That holds true in the journey toward better health as well.

Rejoicing the Rewards Realized from Taking Good Care of Yourself

Working with your primary care doctor to make healthy lifestyle adjustments pays off in both the short and the long term. The path to health lasts a lifetime, but it’s important to pause for a moment now and then to reflect on and celebrate your accomplishments along the way. This article, the final in a year-long OurHealth series about primary care, will examine ways that your lifestyle changes can benefit your health so that you can give yourself a muchdeserved pat on the back and keep the momentum going.


Give Yourself “Props” for Losing Weight Eating right and shedding extra weight are often part of the plan to improve one’s health. That’s because being overweight or obese plays a major role in many chronic conditions, including heart disease, diabetes, arthritis, and sleep disorders. Even if you haven’t reached your weight-loss goal, every pound that you drop improves your health. That’s an accomplishment well-worth celebrating. Losing as little as 5 to 10 percent of your weight can reduce your cholesterol levels, decrease your risk of developing type 2 diabetes, and lower your blood pressure. Cholesterol is a big deal because high levels of “bad” cholesterol, known as low-density lipoprotein (LDL), can build up in the walls of your arteries, forming a plaque that makes the arteries hard and narrow. If the plaque tears or ruptures, a blood clot could form, blocking blood flow or breaking loose and plugging an artery. If the blood flow to part of your heart stops, that’s a heart attack. If a clot blocks blood flow to part of your brain, it’s a stroke. Decreasing your risk of developing type 2 diabetes is also a major accomplishment because the disease can cause so many health problems. In type 2 diabetes, the pancreas loses its ability to produce enough insulin to properly control the blood sugar, called glucose, which powers the body’s cells. Over time, high blood sugar will damage your nerves and blood vessels, which can lead to heart disease, stroke, kidney disease, blindness, dental disease, and even amputations. High blood pressure also hurts your blood vessels. It can make your artery walls stiff and create the plaque that can lead to heart attacks or strokes. The narrowing of arteries caused by plaque, furthermore, can also cause kidney failure, dementia, eye damage, and even problems having sex, according to the Mayo Clinic.

When a person reduces his/her “bad” cholesterol, how does this positively impact his/her health?

“Reducing your bad cholesterol lowers your risk for having a heart attack. If you have already had a heart attack, it lowers your risk of dying from one.” BRANDY PATTERSON, MD UVA Club Red ambassador at the UVA Heart & Vascular Center

How does reaching an ideal weight reduce the negative impact on joints? “According to the American Academy of Orthopaedic Surgeons, every pound of body weight places four to six pounds of pressure on each knee joint. Individuals with obesity are 20 times more likely to need a knee replacement than those who are not overweight. The detrimental effects of obesity on surgical outcome results and complication rates are well-documented in medical literature. The Mayo Clinic published a study in the Journal of Bone & Joint Surgery this year that the rates of re-operation, dislocation, and deep wound infection were significantly increased in obese patients who undergo a total hip replacement.” MEGAN SWANSON, MD Sentara Martha Jefferson Orthopedics

The strain on your heart from high blood pressure, moreover, can cause your heart to weaken and work less efficiently. Eventually, your heart will begin to wear out — a condition known as heart failure. High blood pressure also can cause aneurysms, says the Mayo Clinic. This happens when the constant pressure of blood moving through a weakened artery causes part of its wall to bulge out. If that bulge ruptures, it causes internal bleeding, which can be deadly. That’s not all, though — in fact, losing weight offers many other reasons to celebrate as well. It reduces the chances that you’ll get osteoarthritis arthritis, which is caused by wear and tear on the joints, and it can ease the condition if you already have it. Additionally, extra pounds put extra stress on weight-bearing joints like the knees and hips. When you walk across level ground, the force on your knees equals one-and-a-half times your body weight, says Harvard Medical School’s HEALTHbeat.

How does being physically healthy help improve a woman’s chance for conception? “Achieving an ideal body weight, quitting smoking and refraining from heavy alcohol use are some of the best health strategies that women can employ to improve ovarian function and increase their chances of conception.” EMILY HUFFSTETLER, MD Jefferson OB/GYN

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That means that a 200-pound man will put 300 pounds of pressure on his knees with each step. As if that wasn’t enough, the force on each knee increases to two to three times your body weight when you go up and down stairs and four to five times your body weight when you squat to tie a shoelace or to pick up something from the floor — so shedding a few pounds can go a long way toward reducing the pressure on your joints and protecting them.

20 Minutes After Quitting •

Your heart rate drops to a normal level.

12 Hours After Quitting •

The carbon monoxide level in your blood drops to normal.

48 Hours After Quitting •

Your sense of smell and taste begin to return to normal.

2 Weeks to 3 Months After Quitting • •

Your risk of having a heart attack begins to drop. Your lung function begins to improve.

1 to 9 Months After Quitting •

Your coughing and shortness of breath decrease.

1 Year After Quitting •

Your added risk of coronary heart disease is half that of a smoker's.

5 to 15 Years After Quitting • •

Your risk of having a stroke is reduced to the same as a nonsmoker’s. Your risk of getting cancer of the mouth, throat, or esophagus is half that of a smoker's.

10 Years After Quitting • • •

Your risk of dying from lung cancer is about half that of a smoker’s. Your risk of getting bladder cancer is half that of a smoker’s. Your risk of getting cancer of the cervix, larynx, kidney or pancreas decreases.

15 Years After Quitting •

Your risk of developing coronary heart disease is the same as that of a nonsmoker.

Sources: American Lung Association and QuitDay

It also can help you get a good night’s sleep. The risk of developing sleep apnea is four times higher for people who are obese than for people of normal weight, says the Mayo Clinic. Sleep apnea is a potentially serious disorder in which your breathing repeatedly stops and starts while sleeping. Signs of sleep apnea include snoring loudly and feeling tired even after a full night's sleep. The good news is that weight loss helps reduce the severity of obstructive sleep apnea, the most common type of the disorder.

Collecting the Rewards of Exercise Physical activity is part of healthy living. If you’ve worked it into your daily or weekly routine, you’re helping your body in ways that you might not even realize. You should give yourself credit for that. We all know that exercise helps us to lose weight, but did you know that it can also benefit your brain? Exercise can improve memory and thinking, reduce the risk of depression and dementia, and improve your mood. Additionally, according to the National Cancer Institute, exercise lowers the risk of developing heart disease, high blood pressure, stroke and type 2 diabetes. Studies have also found that physical activity can reduce the chances of developing colon, breast and endometrial cancers.

Regular exercise helps to keep bones, muscles and joints healthy. Even though exercising might seem like the last thing that people with arthritis should do, it actually helps them by


increasing their strength and flexibility and reducing their joint pain, notes the Mayo Clinic. If you have arthritis, you should work with your doctor to figure out what types of exercises are best for you. For seniors, exercise and physical activity improve endurance, strength, balance and flexibility, according to the National Institutes of Health (NIH). These benefits can help you stay strong and fit enough to perform your daily activities and maintain your independence. As people age, they run the risk of developing osteoporosis, a condition that could weaken their bones to the point where they easily break. Doing weight-bearing exercises three to four times per week helps to prevent osteoporosis. Want to sleep better? Exercise plays a role there, too. Regular physical activity can help you fall asleep faster and deepen your sleep. Not unexpectedly, finally, people who exercise have more energy in general. That’s because exercise and physical activity deliver oxygen and nutrients to your tissues and help your heart work more efficiently, says the Mayo Clinic. When your heart and lungs work better, you have more energy to go about your daily life.

Health Buzz from Kicking the Habit

When you quit smoking, how soon does the body begin to realize the short-term and long-term improvement to the lungs? “First, the lung detects reduction in tar and tar-associated materials in the airways. Within about 2-5 months, significant reduction in mucus plugging and wheezing is noted. Over next 1-3 years, further clearance of the inflammation in the lung will lead to the slowing down of lung function decline, but in about onethird of patients, significant regaining of lung function can be noted. Third, the risk of lung cancer can be 5-15 times higher in smokers as compared to those who never smoked. This risk starts to decline immediately after smoking cessation. Within 5 years, the risk level will be around 1.5 times higher than someone who never smoked. Unfortunately, the risk level for former smokers seems not to return to the level of those who never smoked.” Y. MICHAEL SHIM, MD UVA Health System

Smoking is a hard habit to break, thanks to nicotine’s addictive properties. If you’ve quit the habit or never taken up smoking, your body is reaping enormous benefits. It’s common knowledge that smoking causes lung cancer, but it also increases the chances of getting many more types of cancer — like cancers of the blood, bladder, cervix, colon, esophagus, kidneys, larynx, liver, mouth, nose, rectum, throat and uterus, says the NIH. Over time, your decision to quit will help reduce your risk of developing all of these. After you stop smoking, furthermore, you begin to breathe more easily and your smoker’s cough starts to go away. But why? The answer is that our lungs are made of tubes that branch out into small sacs. Smoking causes these sacs to lose their elasticity, which prevents them from taking in as much oxygen. That’s why smokers feel short of breath, a condition called emphysema. Normally, the lungs protect themselves with a thin layer of mucus and by moving toxic particles out with small hairs, called cilia. According to the Quit Smoking Community, smoking makes the cilia move slower and struggle to remove harmful particles. The lungs become irritated from the toxins and collect more mucous, and this triggers smoker’s cough. Over time, smoker’s cough can lead to chronic bronchitis, in which the lining of the tubes in your lungs swells and restricts breathing. The combination of emphysema and chronic bronchitis is called chronic obstructive pulmonary disease (COPD). About 20-30 percent of chronic

How does losing 5-10 percent of body weight reduce a person’s chances of diabetes? “Studies indicate that health benefits such as lowering your risk of diabetes may be shown with a weight reduction as little as 5-10 percent. Weight loss can help your body better use the insulin it is making to lower the sugar in the blood stream and move it into the cells where it is used for energy throughout the day. This helps to prevent the sugar from building up in the blood stream. One of the laboratory markers used to screen for diabetes is called the Hemoglobin A1C. Weight loss can help lower this marker and the risk of developing diabetes. For more information and a diabetes risk factor questionnaire go to www.askscreenknow.com.” CAROLINE HACKLEY, MED, RD, CDE Augusta Health

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HOW MUCH ALCOHOL IS TOO MUCH?

Reasonable zone Moderate drinking: Up to one drink per day for women of all ages and men older than age 65; up to two drinks per day for men age 65 and younger. One drink means: Beer: 12 fluid ounces (355 milliliters) Wine: 5 fluid ounces (148 milliliters) Hard liquor (80 proof): 1.5 fluid ounces (44 milliliters)

Danger zone

Additionally, according to the Mayo Clinic, smoking causes harm all over the body that you might not be able to see. It increases the risk of developing heart disease, strokes, type 2 diabetes and vision problems as well as fertility problems in women and impotence in men. Smoking is also associated with an increased risk of developing inflammation of the gums and serious gum infections that could destroy the support system for teeth. Finally, women who smoke during pregnancy have a higher risk of miscarriage, early delivery, babies with lower birth weights, and sudden infant death syndrome in their newborns. By quitting smoking, you’re lowering your risk of developing all of these serious problems. You’re also improving your looks. The chemicals in tobacco smoke can change the structure of your skin, causing premature aging and wrinkles. Smoking also yellows your teeth, fingers and fingernails. Quitting smoking begins to reverse these effects, letting you start to look much healthier.

Drinking Less and Living Better The saying “everything in moderation” applies to alcohol. A little alcohol isn’t likely to cause harm, but a lot of alcohol consumed in one sitting or over time can cause life-altering or life-ending damage.

Heavy drinking: More than three drinks on any day or more than seven drinks per week for all women and men older than age 65; more than four drinks on any day or more than 14 drinks per week for men age 65 and younger.

The dangers of driving drunk are obvious — you could injure or kill yourself or others due to your weakened thinking skills and muscle control. Getting drunk, however, also increases your chances of drowning, being a victim of or committing a crime, accidental injury, and having unprotected sex or becoming the victim of sexual abuse or date rape, says the Mayo Clinic.

Binge drinking: Four or more drinks within two hours for women and five or more drinks within two hours for men.

When we think of the long-term harm caused by alcohol abuse, we usually think of liver damage. The liver breaks down alcohol so that it can be removed from the body. Drinking more alcohol than the liver can process damages it over time. This damage comes in the form of three types of liver disease.

Source: Mayo Clinic

smokers may develop COPD, says the Mayo Clinic. When you quit smoking, your lungs’ sacs and cilia begin to heal, which is why you will start to breathe easier and cough less.

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Alcoholic fatty liver disease, first of all, means that you have too much fat in your liver. It’s the earliest stage of alcohol-related liver disease, says the American Liver Foundation. The damage can be reversed at this point if the person stops drinking alcohol.

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Alcoholic hepatitis, secondly, means that there are fat deposits in the liver, plus inflammation and mild scarring. Up to 35 percent of heavy drinkers develop alcoholic hepatitis, the foundation says. Mild alcoholic hepatitis can be reversed by giving up alcohol. Severe alcoholic hepatitis can occur suddenly and lead to liver failure and death. Alcoholic cirrhosis is the most advanced type of alcohol-caused liver injury. It means that the liver has severe scarring. Between 10 and 20

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percent of heavy drinkers develop cirrhosis, the foundation says. Cirrhosis can’t be reversed by giving up alcohol, but doing so could improve the symptoms and prevent more damage from occurring. Additionally, heavy drinking can increase the risk of developing some cancers, including cancers of the breast, mouth, throat and esophagus. It can cause stomach, heart, pancreas and eye problems, says the Mayo Clinic. Drinking while pregnant can cause a miscarriage or permanent brain damage and other problems in an unborn child.

How does maintaining a healthy sleep regimen improve overall long-term wellness? “A regular sleep schedule, along with attention to proper sleep hygiene, promotes more regular sleep habits, less insomnia and more consolidated and restorative sleep. This ultimately contributes to improved long-term wellness. To learn more, I encourage you to speak with your physician about your personal sleep habits.” FRANK H. BISCARDI, MD Pulmonary Medicine, Carilion Clinic

If you don’t drink or only drink in moderation, you’re protecting yourself and those around you from these dangers. That’s one more accomplishment worth celebrating!

Expert Contributers Frank H. Biscardi, MD with Carilion Clinic in Charlottesville. Caroline Hackley, MEd, RD, CDE with Augusta Health in Charlottesville. Emily Huffstetler, MD with Jefferson OB/GYN in Charlottesville. Brandy Patterson, MD with UVA Heart & Vascular Center in Charlottesville. Y. Michael Shim, MD with UVA Health System in Charlottesville. Megan Swanson, MD with Sentara Martha Jefferson Orthopedics in Charlottesville.

Sources American Lung Association, www.lung.org. Mayo Clinic, www.mayoclinic.org. Quit Smoking Community, www.quitsmokingcommunity.org

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Local health. Anywhere you go. OurHealth magazine is Shenandoah Valley and Charlottesville’s only resource entirely dedicated to delivering information about local healthcare services and healthy living topics. Pick up our print edition at more than 650 locations throughout the area or get the digital edition by visiting

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S T I B T I F words | DEIDRE

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Deidre Wilkes, AFAA, ACSM Certified Personal Trainer Deidre is the resident fitness specialist for OurHealth Charlottesville & Shenandoah Valley.

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TRX Suspension Training Suspension training is nothing new, and it is a highly effective form of resistance exercise. If this piques your interest, read on to learn about this unique training format. TRX (Total–Body Resistance Exercise) was first created by Navy SEAL, Randy Hetrick in the mid 1990’s, who was looking for a way to exercise and keep fit while out on the field. The concept caught the attention of the fitness industry, and it wasn’t long before those black and yellow straps started showing up in gyms across the country and the TRX Suspension System was born.

TRX Suspension Training uses body weight as resistance to develop strength, balance, flexibility and core stability simultaneously. It requires the use of the TRX Suspension Trainer, a performance training tool that leverages gravity and the user’s body weight to complete hundreds of exercises. The TRX System uses two suspension straps that hang from an anchor. The straps are adjustable allowing for many variations as well as the ability to make exercises more challenging or easier, depending on the length and angle of the straps. This makes TRX Suspension Training ideal for all fitness levels.

FIND A CLASS:

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ACAC

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STRENGTH BALANCE FLEXIBILITY

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Toenail fungus: The agony of the feet, the thrill of effective treatment words | RICK PIESTER

In Charlottesville, new hope for sufferers of this malady. When the television commercial comes on, you avert your eyes, change the channel, do just about anything to avoid it. When you come upon the full-page magazine ad with the close-up color photos, you almost tear the paper turning the page. It’s an affliction that produces a stream of guaranteed eewwww moments. The current spate of advertising heralds a range of remedies for the ailments, which are grouped under the somewhat off-putting label of “toenail fungus.”

NOT JUST A NUISANCE But for people who actually have it, the fungus is hardly a minor nuisance. It’s unsightly — ugly even. And some people who have it say that others all too often assume that sufferers must be practicing poor hygiene. This is not true. The fungus is stubborn, it’s pretty tough to avoid, it can be painful, and it can even lead to additional infections in other parts of the body. The clinical term for toenail fungus is onychomycosis (on-ee-ko-me-KO-sis). Although the fungus also appears in fingernails, it seems to prefer toenails, where it lurks and grows in the warm, moist, dark environment in which fungi thrive. People who have the fungus can spread it easily, simply by walking barefoot, and even while taking off their shoes and socks.

A LONG WAR ON FUNGUS Just ask Connie Horan. The 44-year-old Keswick resident has been very careful with her personal grooming for her whole life. But in the mid-1990s, during her 62


NovoNail Treatment college years, she began to notice some of the telltale signs of toenail fungus while sharing a communal shower. The toenail on her left foot began to thicken and discolor. Then it started to lift.

Signs and symptoms

NovoNail trained professionals create customized state-of-the-art treatment plans to fit each patient's individual needs. Treatment options include:

Symptoms of toenail fungus are fairly straightforward: thickened or brittle nails, often discolored and with white or yellow spots, sometimes brown or black. It’s caused by the same types of fungi that cause athlete’s foot. And it’s widespread: Dr. Stewart says that some 38 million Americans have it, and that anyone over age 65 has a more than 90 percent chance of contracting some form of it.

Thus began a battle with toenail fungus that has spanned most of Connie’s adult life. She consulted both primary care physicians and podiatrists, physicians who specialize in the care of our feet. She did find temporary respite by applying topical ointments and medications that come with some risk of liver damage. But the fungus always returned.

LASER BASED TREATMENT The laser based protocols utilize 1064 wavelengths to penetrate the nail plate and eliminate fungus.

“In my case,” Connie says, “it was not particularly painful. It was unattractive, but I tried to cover it up with nail polish. I started thinking that this was just something I would have to live with.”

And even the most persnickety practitioner of personal hygiene is not immune. MORE THAN A COSMETIC PROBLEM

NAIL RESTORATION Complex nails with dystrophy often require more than laser alone. The treatment protocol examines onychomycosis at the structural level.

The elevated nail, however, seemed to become a bull’s eye for nearby pieces of furniture, clumsy dancing partners, overactive kids, anything and everything that could pose a painful threat. Her toenail was regularly stepped on, hit, and partially or completely torn off. “For most people when they have their toe stepped on, it’s not a big deal. But when you have a problem with a toe, it can be a very big deal. I can’t tell you how many times that nail was ripped off.” It was one of those mishaps that sent her, in 2012, to Charlottesville podiatrist Christopher Stewart, DPM, to whom she had been introduced by mutual friends. In practice since 1998, Dr. Stewart has long been interested in researching and treating toenail fungus. Over the years, he’s been working to develop a protocol to address the fungus. (“Protocol” is medical-speak for the set of rules and procedures to be followed when treating a given ailment.)

TOPICAL BASED TREATMENT Not all patients are candidates for each treatment level. The physician formulated topical products can also aid with fungal infections of the nails. For more information visit www.novonail.com.

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AN ARCH NEMESIS “Toenail fungus is an arch nemesis. We treat a lot of ailments very well — bunions, ingrown toenails, hammertoes and

Dr. Stewart says that for podiatrists, “toenail fungus is an arch nemesis. We treat a lot of ailments very well — bunions, ingrown toenails, hammertoes and the like. But people would come to us for help with toenail fungus and I felt myself helpless to address all the needs of a person to restore the nail to a cosmetically beautiful condition.”

the like. But people would come to us for help with toenail fungus and I felt myself helpless to address all the needs of a person to restore the nail to a cosmetically beautiful condition.” CHRISTOPHER STEWART, DPM Central Virginia Foot & Ankle Laser Center

NovoNail Techniques NovoNail techniques include state-of-the-art laser based treatment plans that go deep beneath the surface of the nail, attacking the fungus where it lives and breeds. NovoNail also addresses any additional factors that may have caused the fungal infection in the first place and can put you at risk for future reinfection. NovoNail trained professionals strive to provide:

Experienced care and consultation

A treatment plan custom-made to fit your individual needs

Cosmetic restoration of your nail(s)

Removal of unsightly and often uncomfortable fungus

One writer has called toenail fungus “...one of the great unsolved American lifestyle problems, up there with balding and cellulite.” He notes that although plenty of choices were available on the shelf of treatment options — laser treatment, surgery, topical ointments and oral medications among them — they all had limitations, and no one had yet been able to offer tailor-made comprehensive approaches to treating the fungus.

THE MOST EFFECTIVE TREATMENT Dr. Stewart and his associates set out to create a research-based body of information about what sorts of treatments for toenail fungus work best. Enlisting the aid of about 130 of his patients, he eventually wound up with a mix of treatment techniques and results that enabled him to “look people in the eye” and tell a patient whether treatment would be effective — and how effective it would be — for that person’s particular kind and level of toenail fungus. “People are putting down their hard-earned money for this because it’s all cosmetic treatment,” he notes, “and we wanted to be able to let people know what they would be getting.” On the basis of this work, Dr. Stewart created NovoNail (from the Latin novus, for “new” or “renewed”). It’s a patent-pending combination of existing treatment approaches and specialized products, supplemented by education of the patient to prevent recurrence of the fungus. So far, Dr. Stewart’s practice has treated more than 13,000 nails using NovoNail, with encouraging overall success. So successful has the treatment been that NovoNail has branched out with affiliates in Richmond and Newport News, as well as in Tampa, Florida, and Baltimore, Maryland.

KEEPING FUNGUS AT BAY Education to prevent future risk and reinfection For more information visit www.novonail.com.

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When Connie Horan and her mostly-torn-off toenail went to see Dr. Stewart in May 2012, hers was among the most advanced cases of toenail fungus he had seen (although they both agree that her very committed grooming is the main reason that the fungus had not spread to the rest of her foot).

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Connie’s nail required laser treatment, surgical restoration with a technique developed by Dr. Stewart, and a regimen of ointments. She would also have to revisit the office every six months. In addition, Connie chose to use nail polish from a proprietary NovoNail line of non-toxic, durable nail polishes. In most cases, it takes about a year for a missing toenail to grow back. In that time, Connie applied the knowledge she had gained at NovoNail to care for her foot in a way that would prevent a return of the fungus. And so far, so good. Connie’s encouraged that, with continued care, she seems to be finally free of an ailment that she had almost accepted as a constant part of her life. And she’s happy to offer advice: “If you think there’s something wrong, go see a physician, go see your primary care doctor, go see someone qualified.”

Catch it early! “The earlier you catch something like toenail fungus, the better your chances of being free of it.”

EXPERT CONTRIBUTER Christopher Stewart, DPM is a podiatrist with Central Virginia Foot & Ankle Laser Center in Charlottesville.

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OurHealth Charlottesville & Shenandoah Valley Nov/Dec 2016 Edition  

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