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PLUS: State of Local Healthcare | High Blood Pressure Redefined | Breaking the Silence: Organ Transplantation February • March 2018 ourhealthswva.com

HEALTHY MADE A L FOR MEA THE FAMILY

TOO ELEV K TH ATO E R MAD APPOIN E T WITH P MENT RIMARY CARE P HYS FOR AN ICIAN NU PHYSIC AL AL

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LOADED CO U APP ON CH T PHO O NE 5K STED EXHAU ORK. W FROM TO SKIP T F E GO L ND GET ICE YM A . THE G M INSTEAD N A E CR GHT FOR A R OF O RI OR G ATING HOU ER EXHIL CARDIO

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DROPPED 10 POUNDS AND KEPT IT OFF

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– EE ENT N Y K TM ACH P OIN IEST IAL E AP MAK H SPEC WIT

SO SOM AKED UP E SU NS


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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys


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TABLE OF CONTENTS FEBRUARY • MARCH 2018

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THE PULSE

| KEEPING THE PULSE ON HEALTHCARE

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WHAT’S NEW WITH YOU?

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BREAKING THE SILENCE: ORGAN TRANSPLANTATION

14 – NEW PEOPLE, PLACES & ANNOUNCEMENTS 21 – HIGH BLOOD PRESSURE REDEFINED: WHAT SHOULD YOU KNOW?

This series explores medical conditions and procedures that can be devastating to patients and their families, but that no one is talking about. In this edition, OurHealth shares a local story about the impact of organ transplantation.

24 CALENDAR

| FEBRUARY & MARCH 15 Things to Do for Your Mind, Body and Soul

28 HEALTH SCENE

| LOCAL HEALTH Green Ridge Recreation Center

30 THE CHECK-UP

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KEEPING YOUR HEALTH IN THE GAME OF LIFE

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FAMILY LOVE LETTER | PART SIX

| LOCAL HEALTH & MEDICINE

30 – A VOLUNTEER FOR LIFE 32 – Q&A ON HEALTH

36 STATE OF HEALTHCARE IN ROANOKE & NEW RIVER VALLEYS

Local healthcare providers share significant changes and advancements their medical practices made throughout 2017.

Physician support and determination help Brooklyn Dooley lose nearly 90 pounds.

More than anything, drafting this one document now can help ease your loved ones’ pain and stress in the event of your death or incapacitation.

A look at the healthcare landscape in the Roanoke and New River Valleys. www.OurHealthswva.com

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FITSTYLES

64 – SIDELINE HEROES: ATHLETIC TRAINERS KEEP HIGH .SCHOOL ATHLETES HEALTHY, READY FOR COMPETITION

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| LOCAL FITNESS & ATHLETICS

NUTRITION

69 – COOL CUCUMBER DIP 71 – SALMON WITH CILANTRO PESTO 73 – PINEAPPLE UPSIDE-DOWN CAKE

| HEALTH TIPS FOR MEN

75 – SNORE NO MORE: ADDRESSING MENS SNORING

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| LOCAL FOODS & RECIPES

67 – GET PUMPED: HEART HEALTHY TIPS

MENS HEALTH

HEALTH A-Z

| HEALTH AWARENESS

78 – A ROADMAP TO SUCCESSFUL JOINT REPLACEMENT

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MISSION

| PREVENTION

83 – WORLD HEALER: LOCAL OBSTETRICIAN PROVIDES MEDICAL EXPERTISE THROUGH DOCTORS WITHOUT BORDERS 89 – THE ROANOKE VALLEY SPCA LAUNCHES A MOBILE SPAY/NEUTER AND PET WELLNESS CLINIC

CORRECTION: In the Orthopaedic Urgent Care article that appeared beginning on page 110 of the December 2017/January 2017 edition, the name of the urgent care was listed as “VAO Direct”. The full name of the urgent care is “Virginia Orthopaedic Direct”. To read the article with the additional clarification, visit https://issuu.com/ourhealthvirginia/docs/rnrvdecjan2018, and go to page 110.

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february • march 2018 PUBLISHER PRESIDENT/EDITOR-IN-CHIEF VICE PRESIDENT OF PRODUCTION VICE PRESIDENT OF BUSINESS DEVELOPMENT CHIEF DESIGNER GRAPHIC DESIGNER WEBMASTER ACCOUNTING MANAGER DIGITAL CONTENT MANAGER | EVENT SPECIALIST DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY

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

CONTRIBUTING MEDICAL EXPERTS

Kara K. Beatty MD Colleen Mitchell, OD Anita Sites, NP Laura Smith, MD, FACOG, SREI

CONTRIBUTING PROFESSIONAL E. Lynn Atkinson EXPERTS & WRITERS Catherine Brown Brandy Centolanza Susan Dubuque Elissa Einhorn Rich Ellis Linda Kirkner Michelle McLees Christy Rippel Brandon Shulleta

ADVERTISING AND MARKETING Kim Wood | P: 540.798.2504 kimwood@ourhealthvirginia.com SUBSCRIPTIONS Subscriptions are $19.95 per year. To receive OurHealth via U.S. Mail, please contact Jenny Hungate at jenny@ourhealthvirginia.com

@ourhealthSWVA

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 © 2018 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Roanoke and New River Valleys 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. MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.

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THE PULSE

The Pulse PEOPLE. PLACES. NEWS TO KNOW. words | ELISSA EINHORN

Recognitions LewisGale Medical Center recognized by the American Orthopaedic Association (AOA) The medical center joins one of only 75 hospitals nationwide to be named a Star Performer in the AOA’s Own the Bone program. Through a clinically-proven, web-based patient registry and 10 prevention measures, the program helps reduce the incidence of future fractures as well as the impact of osteoporosis in patients. The program provides tools that enable hospitals and medical centers to establish a Fracture Liaison Service that identifies, evaluates and treats fragility fractures in patients over 50 who are at risk of osteoporosis, while coordinating patient care among different specialties and physicians for each patient. Visit www.lewisgale.com.

Fundraiser Docs Rock Fashion benefit for Bradley Free Clinic After a sold out debut event in 2017, Bradley Free Clinic invites you to watch local healthcare professionals go from white coats to black ties for a good cause during the 2018 Docs Rock Fashion event on April 14, 2018 at the Roanoke Country Club. The event benefits the clinic’s free medical, dental, pharmaceutical and preventative healthcare services for low income and uninsured people in the Roanoke Valley who lack the resources necessary to maintain their health and productivity. Last year, Docs Rock netted more than $50,000 to benefit the working uninsured in the Roanoke Valley. The evening begins at 6:30 pm with heavy hors d’oeuvres, followed by an entertaining fashion show emceed by WDBJ’s Neesey Payne and Q99’s David Page. The show features prominent area physicians, dentists and other Bradley Free Clinic volunteers taking to the fashion runway. The “models” will be outfitted with the finest jewelry, unique accessories and newest formalwear, sportswear, loungewear, cocktail and leisurewear from local retailers. Silent and live auctions will be ongoing throughout the evening. Wheelock & Johnson Orthodontics will serve as the platinum sponsor for the event. Fueled by the energy of its volunteers, the Bradley Free Clinic has provided free healthcare to those in need since 1974. The clinic delivers general medical and specialty care services to more than 2,100 patients annually. For a complete list of sponsors and auction items or to purchase tickets, visit www.docsrock.org. Learn more about Bradley Free Clinic at www.bradleyfreeclinic.com.

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Openings New audiology clinic specializing in children opens in Roanoke The Sensory Centre, a clinic specializing in the diagnosis and treatment of children with developmental delays, has opened in Southwest Roanoke by its founder and chief audiologist Margaret Glenney, MA, CCC-A. The clinic is located at 4526 Old Cave Spring Road, Southwest. Call 540.525.6108 or visit www.sensoryctr.com.

University Physical Therapy opens Daleville clinic University Physical Therapy has opened its ninth Southwest Virginia office in at 65 Shenandoah Avenue, Daleville. Office hours are Monday and Wednesday from 9 am – 6 pm and Tuesday, Thursday and Friday from 7 am – 4 pm. Call 540.352.4304 or visit www.universityptonline.com.


THE P ULSE |

Mergers

Officials from Carilion Clinic, Jefferson College of Health Sciences (JCHS) and Radford University have announced their intention to merge JCHS into the Radford University family of colleges and departments. The potential merger, expected to take 18 to 24 months, will create the second largest nursing program in Virginia. Currently owned and operated by Carilion Clinic, JCHS brings 35 years of history as an accredited institution and has grown from 200 to about 1,150 students in that time. It is one of the top producers of nursing and allied health professionals in the region and is in the top 10 in the Commonwealth of Virginia. “Jefferson College already enjoys a wonderful relationship with Radford University,” says Dr. Nathaniel Bishop, president of JCHS. “This next step makes sense for both institutions, and serves to enhance Radford University’s reputation as a premier educational destination for those seeking careers in nursing, health care and health sciences.” Students from both Radford University and Jefferson College will have access to enhanced educational opportunities, including clinical rotations and internships, and Radford University will continue to partner with Carilion Clinic to utilize its facilities and research capabilities. “We are confident this partnership will help better prepare our students by providing access to the latest research and top-notch clinical experiences,” says Dr. Brian O Hemphill, president of Radford University. “We believe this will encourage potential students to seek healthcare careers and stay in the Commonwealth to work. There’s no doubt this will provide increased access to health care education.”

Radford University, JCHS and Carilion Clinic boast a long list of collaborative endeavors •

When the Roanoke Memorial Hospital School of Nursing closed in 1988, a partnership was developed to transition the program to Radford University. The partnership increased the size of Radford University’s nursing program and allowed students to receive half of their training at Roanoke Memorial. Today, many Radford University students continue their clinical education at the hospital.

Carilion Clinic has provided student health services to Radford University since 1999.

Carilion Clinic employs hundreds of Radford University graduates, including more than 350 Radford University nursing graduates on its staff – 40 of whom were hired in 2016 alone.

Radford University, JCHS and the Virginia Tech Carilion School of Medicine collaborated in 2015 to establish the Virginia Intercollegiate Anatomy Lab, housed at JCHS.

Radford University’s Doctor of Physical Therapy program was integrated with JCHS’s Roanoke campus in 2011, and it has promoted interaction between program participants and major healthcare providers in the region.

More than 500 Radford University students participated in job shadowing, clinical rotations or internships with Carilion Clinic from 2016 to 2017.

Carilion Clinic provides event coverage, athletic training and sports clinics to Radford University Athletics.

Carilion Clinic’s active patient treatment areas provide Radford University students invaluable access to real-world clinical experiences.

New Technology Carilion Children’s NICU uses new technology for germ prevention
 Preventing the spread of germs and reducing the risk of infections is vitally important in the neonatal intensive care unit (NICU). In the NICU at Carilion Roanoke Memorial Children’s Hospital, UVC light boxes are now available to disinfect personal items, such as cell phones and glasses, protecting vulnerable patients from exposure. With a 45-second cleaning cycle, these boxes are for use by employees as well as visitors. This peace of mind allows parents to communicate with family and friends about the health of their baby through pictures and videos, with the added measure of preventing the spread of germs and reducing the risk of hospitalacquired infections. Carilion Children’s is the region’s only children’s hospital with a fullservice, 92-bed “hospital within a hospital” that includes a regional Neonatal Intensive Care Unit for 60 newborns, a pediatric intensive care unit, an inpatient unit designed specifically for children, and a staff of more than 350 medical professionals specially trained in infant and children care. This technology was made possible by community donations. Visit www.carilionclinic.org for more information.

Visit www.jchs.edu for more information. www.OurHealthswva.com

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People. Places. News to Know.

Jefferson College of Health Sciences intends to merge with Radford University


THE PULSE

Expansion Carilion Giles Community Hospital constructing new building to house specialty services A new clinical office building for cardiology, orthopaedics, general surgery and other specialties is being built adjacent to Carilion Giles Community Hospital (CGCH) in Pearisburg. The new facility will add 10,410 square feet to the CGCH building and have a separate entrance. It will include 11 exam rooms, two treatment rooms, and clinical work areas for staff and nursing and office spaces for physicians and business needs. The construction project also will increase the size of the rehabilitation department, which is located at the front of the hospital. The facility will add a treatment room and double the size of the gym and cardiac rehab areas. A mid-summer completion date is planned, and construction will not affect current patient services. Visit www.carilionclinic.org for more information.

Mergers Coots, Cross, Lavinder, Quinn and Park Family Dentistry merges with Vinton dentist The dental practice of Coots, Cross, Lavinder, Quinn and Park Family Dentistry has joined Steven Kanetzke, DDS in his Vinton office located at 224 Virginia Avenue, Vinton. Coots, Cross, Lavinder, Quinn and Park Family Dentistry’s existing locations at 1930 Electric Road in Roanoke and 175 Market Ridge Lane in Daleville remain open. For appointments, call 540.342.8756 or visit www.dentistroanoke.com.

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys


THE P ULSE |

Openings

People. Places. News to Know.

LewisGale Brings new emergency room concept to the Roanoke Valley Standalone ER differs from urgent care because it’s open 24/7/365 and provides the same services found in a hospital ER. words | RICH ELLIS

LewisGale Regional Health System introduced a unique concept new to both the Roanoke Valley and Southwest Virginia recently with the opening of its new Cave Spring Emergency Room (ER). What makes this ER truly unique is that it’s a standalone emergency room, not attached to a hospital, but still offers all the same advanced medical technologies and services found in a hospital emergency room and is staffed by board-certified emergency room physicians and nurses. The new 10,000-square-foot ER is located at the corner of Route 419 and Ogden Road, near Tanglewood Mall, in Roanoke County. Open 24 hours a day, 365 days a year, the Cave Spring ER provides convenient, fast pediatric and adult emergency care, from treating minor illnesses and injuries to major medical conditions using the new facility’s features that include: •

Pedestrian and ambulance entrances

CT capabilities

Eight private treatment rooms

Digital ultrasound

Digital diagnostic and portable X-rays

On-site laboratory

Secure hold exam area for behavioral health patients

Brian Baumgardner, CEO of LewisGale Medical Center and market president of the Health System explained the importance in building this new facility. “LewisGale Medical Center has seen a 30 percent increase in ER volume over the past three years and that number is expected to continue growing. With this demand for emergency services increasing in our community – partly due to an aging population – we recognized a need to provide additional, high-quality emergency services.” Baumgardner went on to explain that the ER is the hospital’s front door for most patients – in that a majority of hospital admissions are through the ER – and that more individuals are choosing LewisGale for their emergency care needs due to the Health System’s reputation of providing fast, quality care. “It’s our priority to provide the fastest care possible,” Baumgardner says, “because evidencebased studies have demonstrated that faster care is essential for better health outcomes. It also reduces the stress and anxiety among patients and their family members.” Baumgardner also cited the hospital’s recent “A” rating from the Leapfrog Group recognizing a commitment to patient care and evidence-based care as another reason more consumers are choosing LewisGale’s emergency rooms. As for the Cave Spring ER’s location, that was chosen because it allows LewisGale to provide closer, more convenient care to the many patients it serves in Roanoke City, Roanoke County, and those traveling from nearby Route 220. Should a patient require admission to LewisGale Medical Center for treatment, observation, surgery or a procedure after being seen in the Cave Spring ER, they’ll be transported at no charge to the Medical Center. Visit www.lewisgale.com/service/cave-spring-er or call 540.970.8000 for more information.

An Actual ER, Not an Urgent Care This standalone ER differs significantly from an urgent care center. It’s open every day, around the clock, unlike an urgent care center that is typically open eight to 16 hours per day. The new ER also is capable of treating major medical conditions, including those that are beyond the scope of treatment for most urgent centers such as chest pain, heart attack, cardiac arrest, respiratory distress issues, neurological issues, abdominal pain, dehydration, orthopedic injuries and behavioral health issues.

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THE PULSE

Public Need

Angela Algire, PA

Caitlin Anderson, PA

April Andrews, NP

Emily Davis, NP

Joseph Eddins, PA

Jacqueline Groff, NP

Asma Habib, MD

Avery Matthews, MD

Teri McCormickGoodhart, PA-C

William Pauley, III, NP

Samuel Pearce, III, PA

Benjamin Perler, PA

Dublin Family Medicine Dublin | 540.674.4560 www.lgphysicians.com

Carilion Clinic Family Medicine Dublin | 540.966.0400 www.carilionclinic.org

Eva Quiroz, MD, FACP

Ryan Reopelle, DDS

Carol Runyan, AuD

Jacob (JR) Sakiey, PA-C

Carilion Clinic Sleep Medicine Christiansburg 540.731.7460 www.carilionclinic.org

Carilion Clinic Pulmonary Medicine Roanoke | 540.985.8505 www.carilionclinic.org

Carilion Clinic Family Medicine Dublin | 540.674.8805 www.carilionclinic.org

Carilion Clinic Family Medicine Waynesboro | 540.949.8241 www.carilionclinic.org

Nationwide blood shortage: What you can do The nation is experiencing a shortage of blood supplies. Virginia Blood Services is encouraging people to donate when able. One donation of blood can save up to three patients’ lives. Donating this time of year is particularly important considering the typical donors in other parts of the country who might be experiencing inclement weather and unable to get out and donate. Reach out to Virginia Blood Services’ Michelle Westbay to learn more at 804.213.4119 or mwestbay@vablood.org or visit www.vablood.org.

Carilion Clinic VelocityCare Salem | 540.375.8190 www.carilionclinic.org

Carilion Clinic VelocityCare Lexington | 540.462.3950 www.carilionclinic.org

Carilion Children’s Pediatric Cardiology Roanoke | 540.982.8204 www.carilionclinic.org

Carilion Clinic Cardiology Roanoke | 540.981.7000 www.carilionclinic.org

LewisGale Physicians Psychiatry and Behavioral Health Blacksburg | 540.552.1246 www.lgphysicians.com

Carilion Clinic Cardiology Roanoke | 540.981.7000 www.carilionclinic.org

For More of The Pulse Visit:

ourhealthswva.com Do you have health-related news to share for The Pulse? Send to Elissa Einhorn via email at elissa@ourhealthvirginia.com.

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LewisGale Physicians Infectious Disease Salem | 540.772.3407 www.lgphysicians.com

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

Darcy Amacher, DDS Pediatric Dentistry Christiansburg 540.394.3300 www.darcyamacherdds.com

Anderson Audiology LewisGale Physicians Wytheville | 276.228.0866 Orthopedics www.anderson-audiology.com Blacksburg | 540.951.6000 www.lgphysicians.com


THE P ULSE |

Kathyrn Sandifer, NP

Cassie Sheffey, NP

Jonathan Stewart, MD

Jennifer Tarter, NP

James Taylor, DO, FACOS Ronald Taylor, NP

Sarah Turner, DO, CAQSM

Courtney Wilson, NP

Brian Wood, DO, DFAPA Danielle Young, PA

Carilion Clinic Cardiology Roanoke | 540.982.8204 www.carilionclinic.org

Carilion Clinic Family Medicine Roanoke | 540.427.9200 www.carilionclinic.org

LewisGale Physicians Family Medicine Blacksburg | 540.443.3700 www.lgphysicians.com

Carilion Clinic Neurosurgery Roanoke | 540.224.5170 www.carilionclinic.org

Carilion Clinic Family Medicine Wytheville | 276.228.8686 www.carilionclinic.org

Carilion Clinic Family Medicine Staunton | 540.885.3525 www.carilionclinic.org

Carilion Clinic Family Medicine Wytheville | 276.228.8686 www.carilionclinic.org

LewisGale Physicians Cardiovascular Surgery Salem | 540.776.2020 www.lgphysicians.com

LewisGale Physicians Psychiatry and Behavioral Health Salem | 540.772.3485 www.lgphysicians.com

People. Places. News to Know.

Carmen Salmon, PA

Christi Stewart, MD Carilion Clinic Center for Healthy Aging Roanoke | 540.981.7653 www.carilionclinic.org

Carilion Clinic Interventional Radiology Roanoke | 540.981.7083 www.carilionclinic.org

Carilion Clinic Family Medicine Salem | 540.387.0441 www.carilionclinic.org

George Zimmerman, DO, FAOAO

LewisGale Physicians Orthopedics Blacksburg | 540.951.6000 www.lgphysicians.com www.OurHealthswva.com

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys


THE PULSE THE P ULSE | High Blood Pressure Redefined

Q&A HIGH BLOOD PRESSURE REDEFINED What should you know?

words | MICHELLE MCLEES, SPECIAL CONTRIBUTER FROM THE AMERICAN HEART ASSOCIATION

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early half of American adults are at risk for major health problems because of high blood pressure, according to recently released guidelines by the American Heart Association and the American College of Cardiology. University of Virginia professor of medicine Robert Carey, MD, who served as vice chairman of the committee that wrote the guidelines, says, “The new rules should help catch warning signs of heart and kidney disease and encourage early treatment.” OurHealth Roanoke & New River Valleys Magazine sat down with Dr. Carey and asked him questions about the new guidelines and other related information we should all be aware of.

What is the new definition of high blood pressure? Dr. Carey: The guideline changes the definition of high blood pressure. It is now considered any measurement at or above 130 systolic or 80 diastolic. (Systolic is the term for the top number, diastolic the bottom.) High blood pressure used to be defined as readings at or above 140 systolic or 90 diastolic.

Why did the guidelines need updating? Dr. Carey: There is a growing body of evidence that lower blood pressure is better for your health. The 2017 guideline reflects this new information to help people prevent and treat high blood pressure sooner.

Why do the guidelines no longer identify prehypertension? Dr. Carey: The guideline committee moved away from the term “prehypertension” because the data shows the risk for heart attack, heart failure, stroke and other consequences of high blood pressure begins to occur at any level above 120 mmHg. Heart disease and stroke risk is doubled at 130-139/80-89 compared to blood pressure below 120/80.

How many Americans now have high blood pressure, according to the 2017 guidelines? Dr. Carey: We are going from one in three US adults with high blood pressure (32%) to nearly half of the US adult population (46%) with high blood pressure.

Does lowering the baseline for diagnoses increase the number of people taking meds? Dr. Carey: The new definition of high blood pressure results in more persons being actively counseled on lifestyle changes to reduce blood pressure but only a small increase (1.9%) in the percentage of US adults for whom antihypertensive medication is recommended in conjunction with lifestyle management.

How does this change the percent of Americans at risk for stroke and heart attack? Dr. Carey: Risk has not changed. The new guidelines recognize identify that risk and encourage patients and providers to take significant action, and take it sooner, to prevent heart attacks and strokes.

The guidelines say I now have high blood pressure, when I didn’t before. What will change at my next doctor visit? Dr. Carey: Your doctor will talk to you about how this new definition changes the approach in managing your blood pressure and reducing future risk. Most of those who are newly diagnosed due to the guideline update will be advised to take action (dietary changes and increased physical activity, for example) to keep their blood pressure from rising further and may not require medication immediately.

www.OurHealthswva.com

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THE PULSE | High Blood Pressure Redefined

Robert M. Carey, MD

Professor of medicine and dean emeritus at the University of Virginia School of Medicine and vice chairman of the 2017 Hypertension Guideline Writing Committee.

What types of lifestyle changes will help me manage my blood pressure? Dr. Carey: The following lifestyle information should be considered: Regular physical activity (90-150 minutes per week) A healthy diet rich in fruits, vegetables, whole grains and low-fat dairy products with reduced content of saturated and total fat Maintaining a healthy weight Reduced intake of dietary sodium (<1,500 mg/d is optimal goal but at least reduce your current intake by 1,000 mg/d) Enhanced intake of dietary potassium Moderation in alcohol intake (for men, two or less drinks daily and for women, one drink daily)

My blood pressure level is now considered “Stage 2” – does that mean I’m at higher risk for heart attack or stroke? Dr. Carey: While the definitions for the stages of high blood pressure have changed, it doesn’t mean you face a dramatic increase in risk. Rather, the guideline is more aggressively identifying the risk that exists, and recommending action earlier. According to the new guidelines, most adults diagnosed with Stage 2 high blood pressure should be prescribed two antihypertensive medications in addition to lifestyle change recommendations.

HIGH BLOOD PRESSURE is now considered any measurement at or above:

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

EXPERT CONTRIBUTOR Robert M. Carey, MD with the University of Virginia School of Medicine in Charlottesville.

ON THE WEB

More at ourhealthswva.com


www.OurHealthswva.com

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CALENDAR

15 THINGS TO DO FOR YOUR MIND, BODY AND SOUL DURING FEBRUARY & MARCH 2018 words | ELISSA EINHORN

SURVIVING &

THRIVING:

Trauma and Resilience Basics Training

Hosted by United Way of the Roanoke Valley, this program raises awareness and provides training for Adverse Childhood Experiences (ACEs), otherwise known as childhood trauma, which impacts physical and mental health. In the public behavioral health system, 90 percent of people have at least one (and often multiple) ACEs. Led by John Richardson-Lauve, LCSW, Director, Mental Health and Lead Trauma and Resilience Educator at ChildSavers. $10 includes a meal | Noon – 2 pm and 6 – 8 pm Kizam Shrine Ballroom | 628 W. Campbell Ave | Roanoke c 540.283.2778 | m gail@owrv.org

w bit.ly/2DGfP8A

2.1 Delivered:

An Essential Workshop for Your Pregnancy Journey If you are a first-time mom, second-time mom, or even if this is not your first rodeo, but your desire for a natural birth is high on the list, this workshop is for you. Many women start their pregnancies with an ideal birth in mind, but slowly (through loving family and friends) hear negative feedback due to others’ experiences. This is the time to surround yourself with others who will empower you in your decision and help you get the birth you want. Join us for a night of uplifting stories, great company and action steps to achieve and enhance your pregnancy and birth. If applicable, significant others are highly recommended to attend. $5 | 6:30 – 7:30 pm Cotton Chiropractic 117 Sheraton Dr | Salem c 540.765.2990 w cottonchiropractic.com

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OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

2.1 Roanoke Higher Education Center

OPEN HOUSE

Drop in and learn about the more than 200 degree, licensure and certificate programs currently being offered at the Roanoke Higher Education Center, including gerontology, nursing, social work and more. Meet personally with representatives from nearly a dozen universities. Free | 4 – 6 pm Roanoke Higher Education 108 North Jefferson St | Roanoke c 540.767.6010 | m info@education.edu

2.2 If These Walls Could Talk

Have you ever wondered what it is like to step into a counselor’s office and know the impact Family Service has on our neighbors across the Roanoke Valley? Come out with a friend or colleague for a virtual tour of the agency’s history and services, and hear from clients about how counseling has given them hope for a happier, healthier future. Family Service of Roanoke Valley serves more than 4,000 families a year, and has been strengthening families, healing trauma and restoring hope for 114 years. Those benefiting from counseling and prevention services at Family Service range from children to older adults, from couples to families, and from abuse survivors to those suffering the loss of a loved one. Free | 9 am Family Service of Roanoke Valley 360 Campbell Ave SW | Roanoke w fsrv.org


TONS OF FUN

2.10

CALENDAR |

19th Annual

Free | 10 am – 4 pm Tanglewood Mall | 4420-A Electric Rd | Roanoke

c 540.777.6325

2.10 UNITED WAY’S

VALENTINE’S IN VEGAS This annual United Way fundraiser benefits the local human and health building efforts of United Way and the 25 local charities they support. These charities include the Community Health Center of the NRV, NR Family Shelter, Women’s Resource Center Intellectual Disabilities Agency of the NRV, NRV cares and many more. Cocktails and casino games are followed by dinner, live music and dancing, photo booth and silent auction. Formal attire. 21+. $65 - $115 | 6 pm – 10:30 pm The German Club Manor 711 Southgate Dr | Blacksburg w unitedwaynrv.org

February & March

This high energy, family fun day of activities includes clowns, puppet shows, music, magicians, games, craft activities, caricatures, carnival rides, entertainment and much more spread throughout the Mall. “Tons of Fun” is designed to enthrall, engage and bring a smile to the faces of children and their families. Organizations like the Roanoke County Department of Parks, Recreation and Tourism, Camp Roanoke, Mill Mountain Zoo, Macaroni Kid Roanoke, Clean Valley Council, Taubman Museum of Art, Roanoke Star Soccer Club and Roanoke Ballet Theatre are just a few of the organizations that help continue the growth and excitement of this family event. AGAINST SEXUAL EXPLOITATION OF WOMEN One Billion Rising Roanoke invites community members to join together and become part of the global movement to raise awareness and help bring an end to violence against women. The event includes resources, speakers, Valentine’s flash dance and more. The goal is to break the chain of silence and oppression, whether in the family, at the neighborhood level or in the local board rooms where investments and policies that perpetuate poverty and the abuses across the planet. Free | 11 am – 2 pm Valley View Mall 4802 Valley View Blvd. NW Roanoke w onebillionrising.org

2.17 Roanoke Heart Ball 2018

Eat, dance, bid and support a great cause at the American Heart Association of Western Virginia. It’s an elegant fundraiser attracting physicians, business leaders and other community members who believe in the goals of the American Heart Association and the American Stroke Association. This event raises money to fund life-saving research and prevention programs to help free our communities from cardiovascular diseases and stroke. There will be dinner, a live band and silent and live auctions to round out an engaging evening of fun and passion. $125 | 6 – 11:30 pm The Hotel Roanoke and Conference Center | 110 Shenandoah Ave | Roanoke c 540.206.9588 | w roanokeheartball.heart.org

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2.17 CHAKRA SHENANIGANS!

Chakra Shenanigans is a fun and educational class for children ages 6-12. Chakras, internal energy centers in the body, will be introduced in fun and practical ways through various activities, songs, games and crafts. Children will explore self-nurturing tools that will serve them for years to come. By learning how to align, balance, energize and calm their chakras, your children will master skills that will not only provide them with alternative tools to overcome difficult situations, but will also set them up for success. Parents are invited to join their children in this class! Free | 1-3 pm Unity Church of Roanoke Valley 3300 Green Ridge Rd | Roanoke

3.9 3rd Annual

Networking in the City Join us for our 3rd Annual Networking social event for professionals from every background who are interested in meeting like-minded people with similar or different cultural and professional backgrounds. Whether you are an entrepreneur, small business owner, legal or medical professional, in the finance, real estate or entertainment industry, this event offers the perfect occasion to expand your business, social or enterprise contacts. Building business relationships should be a comfortable, sophisticated and relaxed venture. 21+. Dress Code: Business Casual. Free | 5 – 9 pm Luxe Lounge 213 Williamson Rd Northeast | Roanoke c 540.353.1770

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CANDLELIGHT PARTNER YOGA Experience the benefits of partner yoga! The class will progress through a variety of poses that can be practiced with the support of others in order to deepen, expand, soften and strengthen traditional yoga asanas. Come with a friend or alone to share some good laughs and have fun in this special yoga offering! Class instructor is Sally Wesley. (18+) $12 Mountain View Center 714 13th St SW | Roanoke c 540.853.1027

3.10 Medicare Decisions Made Easy

You and a guest are invited to an educational workshop where you can get answers to your Medicare questions. You’ll have a better understanding of Medicare and how it works so you can make the right choice for your needs. Free | 10 am Christiansburg Recreation Center, Classroom 2 1600 North Franklin St | Christiansburg

Tail Chaser 5k & 1 Mile Walk Come join the Roanoke Valley SPCA for a tail-wagging good time at the Tail Chaser 5K and 1 Mile Walk! Put your paws to the pavement and run for your life at Wasena, Smith and Vic Thomas Parks along the Roanoke Greenway. Sign yourself and your canine friend up by March 10th to take advantage of the Early Bird Registration, only $25 for yourself and $5 for every dog you would like to have join you. Registration fees vary. Packet Pick up and Registration on Friday night will be at Fleet Feet Sports from 4:00 – 7:00 pm. Day of Registration & Packet Pick up will be from 8:30 am – 9:45 am. $25 – $35 | 10 am Wasena Park | Roanoke c 540.339.9520 | w ktobin@rvspca.org

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CALENDAR |

3.25 KIDWIND CHALLENGE

Free | 8 am – 4 pm Science Museum of Western Virginia | 1 Market Square Southeast | Roanoke panglerm@jmu.edu | w www.kidwindchallenge.org

m

February & March

While this is a KidWIND Challenge, think of it more as a celebration of wind power! The overall goal is to have fun exercising your children’s mind by building a device that converts moving wind into electricity. If along the way they learn some physics, engineering, environmental science and policy, all the better! Competing students must be in 4th-12th grade. Each team needs an adult coach.

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3.31 STOP THE BLEED

The Bleeding Control Basic (BCon) Course is designed for individuals who have little or no medical training but who may be called upon as immediate responders to provide initial trauma care and bleeding control to a victim of traumatic injury prior to the arrival of emergency medical services (EMS) or in an austere environment. In this course, you will receive classroom and hands-on practice with bleeding control, including the use of tourniquets and hemostatic gauze (QuikClot). Free | 1 – 2:30 pm Blacksburg Volunteer Rescue Squad | 1300 Progress St NW | Blacksburg w www.facebook.com/blacksburgrescue

Do you have an event that our readers simply must know about? Tell us about it by emailing Elissa Einhorn at elissa@ourhealthvirginia. com. Please submit your information at least three months in advance to be considered for publication in the magazine.

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Health Scene

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GREEN RIDGE RECREATIONAL CENTER photos | SHAWN SPROUSE

Thinking about a gym membership but not sure it’s right for you? Roanoke County’s Green Ridge Recreation Center stays abuzz with activity! From the basketball court to the wellness center and the pool to the climbing wall, there are plenty of options for gym-goers of every age. OurHealth’s staff photographer, Shawn Sprouse, recently caught up with a few members, both seasoned and newbies, and here’s what they’re into!

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1 Emorie McClintic of Roanoke County 2 Devon Ramsburg 3 Aaron McNair and Davionne Carter of North Roanoke County 4 Barbara Krzysko of Salem 5 Psalm Kemp, Aaron McNair and Davionne Carter of North Roanoke County 6 Louanna Mazey of North Roanoke County and Kathy Dunn of Botetourt 7 Imani Spangler 8 Bonnie Pritchett of Roanoke City 9 Jim Gibson of North Roanoke County 10 Vivian Fields of North Roanoke County 11 Emorie McClintic of Roanoke County 12 Peter Fields of North Roanoke County 13 Penelope Bleiweiss 14 Betty Hungate of Botetourt 15 Tyler Hungate, Blair Hungate and Carter Webb of North Roanoke County 16 Kari Decker, CTRS, Acting Wellness Supervisor and Yeni Webb of North Roanoke County 17 Chris Smith (Smitty) and Joshua Carlisle of Roanoke County 18 Nathan Hungate of North Roanoke County. www.OurHealthswva.com

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THE CHECKUP

Elizabeth Cain-Kelly welcomes patients, visitors and staff at Carilion Roanoke Memorial Hospital.

A Volunteer for Life Elizabeth Cain-Kelly helps senior citizens age safely words | BRANDY CENTOLANZA

photos | JARED LADIA

Since retiring in 2016, Elizabeth Cain-Kelly has dedicated most of her time to volunteering at Carilion Clinic. She started that August as a volunteer at the guest services desk at Carilion Roanoke Memorial Hospital, answering questions and directing people to their appointments. “Sometimes I help with delivering flowers if needed,” she says. “I’ll walk people to where they need to be. I’m on my feet and walking most of the day. I like to be active.” Cain-Kelly also accompanies family members in the surgery ward and the emergency department, and she is involved with the Emergency Department Advisory Council, which works to improve emergency services, and the Volunteer Advisory Council, which plans and prepares activities for the hospital volunteers. “I appreciate what they do for the volunteers, and I like how they really listen to us,” Cain-Kelly says. “I enjoy seeing our suggestions implemented and put into practice.” More recently, Cain-Kelly trained to be a coach with the new Matter of Balance program. Carilion’s Community Education Department launched this program in March 2017 as a way to help senior citizens remain independent safely within their own homes. Cain-Kelly is one of 35 coaches who assist seniors through Matter of Balance. 30

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THE C HEC K UP |

“One of the biggest fears seniors have is a fear of falling,” she notes. “They are afraid to continue to do

A Volunteer for Life

the things they enjoy because of that. That leads to inactivity and can hasten death.” In Matter of Balance, Cain-Kelly and the other coaches help seniors with exercises for strengthening their muscles, particularly around the ankles, to prevent falls. The coaches also offer tips for staying safe in the home. The program runs two hours a week in eight-week sessions at local senior living communities and churches. Since it began, roughly 100 senior citizens have taken part. “It’s about changing their mindset and showing them that they can still continue doing the things they love,” Cain-Kelly says. Outside her volunteer work at Carilion Clinic, Cain-Kelly enjoys creating hand-made cards and is also active in her church. “My grandmother taught me altruism at a very young age, so volunteering just became a part of life for me,” she says. Cain-Kelly especially enjoys spending her time helping others through Carilion Clinic. “It’s very important to be involved and volunteer,” Cain-Kelly says. “It provides a link to others through your community.” I’ve met a lot of people and made a lot of friends through volunteering. It’s been a very positive experience for me.” EXPERT CONTRIBUTOR Elizabeth Cain-Kelly, volunteer with Carilion Roanoke Memorial Hospital.

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

The greatest chances of pregnancy following tubal reversal surgery are if a woman is less than 35 years old, has normal egg supply, her partner has a normal sperm count, a “filshie clip” laparoscopic tubal ligation, and if there is not extensive pelvic scarring found at surgery.

How likely is pregnancy after a tubal reversal surgery? The chance of pregnancy after tubal reversal surgery depends on several factors. A woman’s age, egg supply, uterine and tubal anatomy, and men's sperm count all affect pregnancy. The surgical technique used to perform the tubal ligation, whether or not she has had cesarean sections or other pelvic surgery, pelvic scarring, and tubal length are also critical. The greatest chances of pregnancy following tubal reversal surgery are if a woman is less than 35 years old, has normal egg supply, her partner has a normal sperm count, a “filshie clip” laparoscopic tubal ligation, and if there is not extensive pelvic scarring found at surgery. In this “ideal” instance, we would predict that she would have an approximately 50-75 percent chance of having a baby following tubal reversal. At her initial consultation, our physicians discuss a woman’s specific history and surgery, recommended testing, and estimate her chances of pregnancy following tubal reversal.

Laura Smith, MD, FACOG, SREI Reproductive Medicine and Surgery Center of Virginia, PLC Charlottesville | 434.654.8520 www.rmscva.com

– Laura Smith, MD, FACOG, SREI

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Does alcohol kill brain cells? Alcohol can lead to altered communication between brain cells by damaging dendrites, the part of the neuron that sends messages between cells. It can also affect functions of brain cells indirectly by causing organ system failure and vitamin deficiency. People can present with different symptoms, depending on the area of the brain that is affected.

Kara K. Beatty MD

Center for Neurorehabilitation Services PC Richmond | 804.272.0114 www.centerforneurorehabservices.org

Does Medicare cover longterm care costs? Long-term care is a range of services and support for your personal care needs. Most long-term care isn’t medical care, but rather help with basic personal tasks of everyday life, sometimes called activities of daily living, such as bathing and dressing. Medicare doesn’t cover long-term care (also called custodial care), if that’s the only care you need. Most nursing home care is custodial care. Medicare does cover: •

Care in a long-term care hospital

Skilled nursing care in a skilled nursing facility-where you are receiving rehabilitation services. Your progress and improvement is measured and you are expected to return home. Medicare limits this care to 100% coverage for days 1-20 and a cost sharing copayment from day 21-100.

Eligible home health services

Hospice & respite care

E. Lynn Atkinson

Humana Roanoke | 540.685.3817 www.humana.com/eatkinson


The Resource for Healthy Living in Southwest Virginia

Local health. Anywhere you go. OurHealth magazine is Southwest Virginiaâ&#x20AC;&#x2122;s only resource entirely dedicated to delivering information about local healthcare services and healthy living topics. Pick up our print edition at more than 900 locations throughout the area or get the digital edition by visiting

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

From a future health perspective, kidney donors are encouraged to maintain a healthy diet, weight and to stay active to decrease the likelihood of developing high blood pressure and/or diabetes, both of which can cause kidney disease.

– Anita Sites, NP, Living Donor Transplant Coordinator

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What is myopia control? Myopia control refers to how doctors can now slow down the progression of nearsightedness. Myopia happens when the eye changes shape over time and cannot focus objects correctly. This causes far away objects to look blurry. With the increased use of digital screens and near vision demands, far more children are nearsighted now than previous generations. Myopia currently affects roughly half of all adult Americans – double the prevalence of just 50 years ago. Myopia is not only a nuisance of blurred vision. High myopic prescriptions increase the risk for retinal detachment, cataracts, glaucoma, and even blindness. By turning down the growth signals that the eye receives during childhood we aim to slow the progression towards these higher prescriptions. Methods for myopia control can include the use of eye drops, soft contact lenses, and specialty contact lenses (orthokeratology). Make an appointment with your optometrist if your child’s myopic prescription is changing rapidly – there may be something you can do! Colleen Mitchell, OD

Blacksburg Eye Associates Blacksburg | 540.953.2020 www.blacksburgeye.com

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys

Mom needs a little more assistance than what is offered in Assisted Living, but not so much that would require Long-term Nursing Care. What type facility should I consider for her? The need for care in the context of assisted living is typically categorized based on an individual’s ability to perform activities of daily living (ADLs). These include bathing, dressing, toileting, transferring, incontinence care and feeding. If a resident requires assistance with more ADLs than the facility in which they are living can provide, they may seek a residence that provides what used to be referred to as intensive assisted living or is staffed to care for higher needs. An example is Level 2 Assisted Living at Warm Hearth Village. The Kroontje Health Care Center offers care for residents with higher needs who are not quite ready for long-term nursing care. Our nurses are trained to provide for these more intense needs and staffing levels are higher providing the right mix of care and environment to allow residents to remain as independent and engaged as possible. Linda Kirkner, Marketing Consultant Warm Hearth Village Blacksburg | 540.552.9176 www.retire.org

How will my lifestyle change following a kidney donation? Recovery from kidney donation surgery takes several weeks, depending on the individual patient, but once recovered, kidney donors can continue to live a full and active lifestyle. From a future health perspective, kidney donors are encouraged to maintain a healthy diet, weight and to stay active to decrease the likelihood of developing high blood pressure and/or diabetes, both of which can cause kidney disease. Transplant centers are required to gather information from, and follow, living donors for a period of two years after surgery. This follow up includes lab testing, blood pressure, weight, activity levels and other general functionality data on each donor. Having annual check-ups with a local primary care provider, however, is important for general health maintenance and to keep a check on blood pressure and kidney function long-term. It is also advised that kidney donors avoid nonsteroidal anti-inflammatory drugs (NSAIDs) as they can be toxic to a single kidney. Part of the role of the Transplant Center is to educate donors on general short and long-term risks of donating a kidney, but they can help donors with assessing their individual risks based on medical and family history. Anita Sites, NP, Living Donor Transplant Coordinator Donate Life Virginia N. Chesterfield | 866.823.6667 www.donatelifevirginia.org


THE C HEC K UP | Q&A on Health

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STATE OF

HEALTHCARE IN ROANOKE & NEW RIVER VALLEYS words | BRANDON SHULLEETA

From a new emergency room in Cave Spring and a new wellness center in the Smith Mountain Lake area, to new stroke treatments at Carilion Clinic and LewisGale Medical Center and the use of robotics to fight pancreatic cancer, medical leaders in the Roanoke and New River Valleys area have been making striking progress. Like many regions of the country, southwest Virginia is focused on using the latest proven methods and technologies and expanding its facilities. And with Virginia Tech remaining a powerful force for research and training, medical professionals are seizing opportunities to partner with the university.

USING ROBOTS FOR PANCREATIC CANCER SURGERY LewisGale Regional Medical Center is now using a robot-assisted system to perform the Whipple procedure, combining computer and robotic technologies to carry out a complex surgery for patients with pancreatic cancer. The procedure involves removing parts of the pancreas and intestines, and it has the potential to significantly improve five-year survival rates for sufferers. Research indicates robotic assistance gives surgeons more precise control over their instruments, according to representatives of LewisGale Regional Medical Center. “It is our goal and expectation that the patient returns to as functional a life as possible,” Dominique Dempah, MD, a general surgeon with LewisGale Physicians, says of the Whipple procedure. He adds that the hours-long surgery is “extensive,” and patients often need to stay in the hospital for seven to 10 days afterward.

STROKE OUTCOMES IMPROVED WITH TECHNOLOGY Carilion Clinic is continuing with a procedure it has been conducting for nearly five years to reduce stroke-related deaths and disabilities: thrombectomy, which allows doctors to quickly extract a clot manually using catheters and a stent-on-wire, also known as “stroke stent” or “stentriever.”

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FEATURES

“For every 2.5 patients treated, one more patient has a better disability outcome,” says Biraj M. Patel, MD, Carilion Clinic’s neurointerventional radiology section chief. “And for every four patients treated, one more patient is independent at long-term follow up.” He adds, “With new technology and devices and improved techniques over the years, we are able to recanalize — or unblock and restore blood flow — for more and more patients.” DOMINIQUE DEMPAH, MD A general surgeon with LewisGale Physicians.

According to the American Stroke Association, stroke ranks fifth among causes of death in the US. The number of deaths, however, has decreased 34 percent in the last decade due to new technology.

CARILION CLINIC AND VIRGINIA TECH COLLABORATE ON NEUROSCIENCE Virginia Tech and Carilion Clinic are teaming up to better prepare undergraduate students for careers in neurosurgery. Students taking the new “Clinical Neuroscience in Practice” course at Virginia Tech can actually see what happens in the operating room during a brain surgery. “I am a very visual learner, and for me, to see the cases and see what is happening, that is a very big learning tool,” explains Amy Wells, a neuroscience student. BIRAJ M. PATEL, MD Carilion Clinic’s neurointerventional radiology section chief.

The course began in the fall of 2016 and continues today. “I keep telling the students that every single time we come here, that this is not normal,” Harald Sontheimer, a co-director of the course, says. “You are seeing a neurosurgery team opening their world to undergraduates.” Eight neurosurgeons and six neurosurgery residents from Carilion are adjunct faculty at Virginia Tech’s School of Neuroscience.

CARILION CLINIC OPENS NEW WELLNESS CENTER IN HARDY Carilion Clinic opened a new wellness center in December to reach people in the Smith Mountain Lake area. This is Carilion’s fifth wellness center, with other centers in Botetourt and Blacksburg, along with two in Roanoke.

KIM ROE Vice president for family and community medicine for Carilion Clinic.

The new, 18,000-square-foot facility is located in the Westlake Professional Park in Hardy. It has an indoor pool, strength and cardio equipment, and a golf simulator. Group exercise classes are offered, and plans are underway to add pickleball courts and other amenities. The center is open Monday to Friday from 5 am to 9 pm and on weekends from 7 am to 4 pm.

CARILION OPENS NEW ROCKY MOUNT OFFICE Carilion Clinic’s Rocky Mount Family Practice now has a new location. Located near Lowe’s on Old Franklin Turnpike, this office allows easier access to patients, according to a statement from Carilion. It has automatic doors, a covered drop-off area, and no stairs.

STEVEN PASTERNAK, MD Medical director for emergency services at LewisGale's new Cave Spring ER.

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“This new location, along with the addition of another doctor, will allow us to grow with our community here in Franklin County,” says Kim Roe, vice president for family and community medicine for Carilion Clinic. “It should also be a more comfortable space for our many patients in the area — more parking, new exam rooms, and an ability to offer both well and sick waiting areas.” The new facility replaces the one at 195 Maple Avenue. It also has 12 exam rooms, providing enough space for three providers to practice. Two physicians are currently seeing patients, and a third is planned to join the practice later in the year.

OurHealth | The Resource for Healthy Living in Roanoke and New River Valleys


FEATUR ES | State of Local Healthcare

LEWISGALE MEDICAL CENTER’S FREESTANDING EMERGENCY ROOM OPENS In response to a 30-percent increase in ER patient numbers in the last three years, LewisGale Medical Center has opened a new emergency room. The Cave Spring area freestanding emergency room, located at the corner of Route 419 and Ogden Road, opened its doors to patients in December. It provides the same services as the ER at LewisGale Medical Center, and it is staffed constantly to treat patients experiencing life-threatening emergencies as well as minor illnesses and injuries. In a statement, Steven Pasternak, MD, medical director for emergency services at Cave Spring ER and LewisGale Medical Center, stresses the importance of faster care in emergency situations. “This new ER fills a gap by providing high-quality emergency services in this area, saving valuable minutes for patients experiencing chest pain, heart attack, shortness of breath, broken bones, stroke, or other emergencies or illnesses,” Dr. Pasternak says. The new ER is nearly 10,000 square feet and has on-site lab testing, scanning, pediatric capabilities, and more. It contains eight private treatment rooms; advanced imaging services such as computed tomography (CT), ultrasound and X-ray; and a clinical laboratory. Patients who require hospital admission for treatment, observation, surgery, or another procedure are transported at no charge to LewisGale Medical Center.

ER AT LEWISGALE HOSPITAL MONTGOMERY EXPANDED LewisGale Hospital Montgomery also unveiled a newly renovated emergency room. More than $1 million in renovations to the hospital’s 9,000 square-foot emergency room have been used to expand the triage area, where patients are assessed upon arrival. And the development of a new super track area for patients with lower-acuity conditions means even faster care.

LEWISGALE HOSPITAL PULASKI RECEIVES NATIONAL RECOGNITION FOR PERFORMANCE LEADERSHIP IN QUALITY LewisGale Hospital in Pulaski was ranked in the top 25 percent of rural hospitals in the country by the Chartis Center for Rural Health/iVantage Health Analytics and the National Organization of State Office of Rural Health. The rankings were announced in November, on National Rural Health Day. They are determined every year through analytics from the iVantage Health Analytics Hospital Strength Index. LewisGale Regional Health System consists of four hospitals, two regional cancer centers, and six outpatient centers. “This recognition reaffirms what we set out to do each and every day, and that is to provide the very highest level of safe, high-quality healthcare to all of our patients,” says Sean Pressman, CEO of LewisGale Hospital Pulaski. “We’ve always seen our overarching strength as ‘family caring for family,’ and this recognition doesn’t happen without the commitment and dedication of every member of the LewisGale Pulaski family.”

LEWISGALE DOCTOR MAKING WAVES WITH PROCEDURE FOR REMOVING POLYPS FROM THE COLON Jonh Pineda-Bonilla, MD, a gastroenterologist with LewisGale Physicians, recently shared with the World Congress of Gastroenterology a procedure to remove polyps from the colon.

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Representatives of LewisGale Physicians describe the procedure as complex and â&#x20AC;&#x153;revolutionary,â&#x20AC;? of the sort that is typically found only in medical centers in a university setting. Patients stand to benefit from the new procedure because they can be treated locally, often via endoscopy, for diagnostic procedures that would previously have required surgery, according to LewisGale. SEAN PRESSMAN CEO of LewisGale Hospital Pulaski.

EXPERT CONTRIBUTORS Dominique Dempah, MD, a general surgeon with LewisGale Physicians. Steven Pasternak, MD, medical director for emergency services at Cave Spring ER and LewisGale Medical Center. Biraj M. Patel, MD, neurointerventional radiology section chief with Carilion Clinic. Jonh Pineda-Bonilla, MD, a gastroenterologist with LewisGale Physicians. Sean Pressman, CEO of LewisGale Hospital in Pulaski. Kim Roe, vice president for family and community medicine with Carilion Clinic.

JOHN PINEDA-BONILLA, MD A gastroenterologist with LewisGale Physicians.

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WHAT'S NEW WITH YOU?

WARM HEARTH VILLAGE 2387 Warm Hearth Drive | Blacksburg | 540.552.9176 | www.retire.org

2018 is a year of continued growth and advancement for the New River Valleyâ&#x20AC;&#x2122;s only nonprofit retirement community. In addition to all the wonderful things that happen on our 220-acre campus on a daily basis, weâ&#x20AC;&#x2122;ll be adding some new opportunities for our residents and the community.

CARILION CLINIC COMING TO CAMPUS Construction of a new medical clinic will commence in February. The clinic will be operated by Carilion and serve the Warm Hearth campus and the nearby community. Initially staffed three days per week by a nurse practitioner, the clinic will provide wellness and acute care services along with physical exams, immunizations, screenings and related services.

PRETTY IS AS PRETTY DOES The Kroontje Health Care Center at Warm Hearth offers assisted living, memory care, skilled care and long-term nursing care. The building is currently being completely remodeled. The new design creates a warm and inviting haven that complements our lush natural surroundings that include gardens, walking paths, gazebos and the serene sounds of nature. All this, combined with the exceptional care and attention for which our staff is known, creates the ideal environment for those needing higher levels of nursing assistance and specialized memory care.

WARM HEARTH VILLAGE PROVIDES A FULL CONTINUUM OF LIVING OPTIONS ON OUR CAMPUS AND IN YOUR HOME. CALL US TODAY TO LEARN MORE.

COMING SOON - INDEPENDENT LIVING APARTMENTS Walnut Pointe independent living apartments are on the horizon. Seniors from throughout the New River Valley provided input as we planned these new apartment homes that will range in size from 1200 to 1800 square feet. They will be housed in two buildings on a plot of land just across from the Village Center and will boast beautiful woodland surroundings and access to a host of amenities. Plans are currently being refined and soon will be submitted to our board with hopes of moving to construction in late 2018.

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WHAT'S NEW WITH YOU?

RALEIGH COURT HEALTH & REHABILITATION CENTER 1527 Grandin Road | Roanoke | 540.342.9525 | www.raleighcthealthrehab.com

“AS MY LOVE AND PASSION FOR NEUROLOGICAL PHYSICAL THERAPY HAS GROWN OVER THE YEARS, I WAS NOW READY TO PROVE NOT ONLY TO MYSELF, BUT TO OTHERS THE EXTENT OF MY KNOWLEDGE IN THIS AREA.” - Stefanie Watts, PT, DPT, NCS

THERAPIST RECEIVES SPECIAL NATIONAL NEUROLOGICAL CERTIFICATION Raleigh Court Health & Rehabilitation Center announces the recent accomplishment of Physical Therapist, Stefanie Watts, PT, DPT, NCS. Ms. Watts has achieved certification for Neurologic Clinical Specialist (NCS) for physical therapy. Clinical specialization in neurologic physical therapy requires knowledge, skill, and experience exceeding that of the physical therapist at entry to the profession and unique to the specialized area of practice. For anyone who is not a therapist, it’s worth noting that there are only 1,800 individuals nationally who have attained this certification. Ms. Watts is one of only four therapists in the Roanoke Valley to receive this certification! “As my love and passion for neurological physical therapy has grown over the years, I was now ready to prove not only to myself, but to others the extent of my knowledge in this area,” says Ms. Watts.

with individuals who have neurologic dysfunction. Through hundreds of hours of research and preparation, she was able to successfully demonstrate competency in the areas of patient care, patient education, interpretation of research, administration and consultation in the passing of her neurologic clinical specialist examination. Ms. Watts is certified by the American Board of Physical Therapy Specialties in Neurology Physical Therapy. Her specialty focus is in balance and gait disorders, cerebral vascular accident, and neuromuscular disorders. Raleigh Court Health & Rehabilitation Center is honored to have Stefanie Watts on staff and looks forward to offering her specialty physical therapy services to patients and clients.

To achieve the certification, Ms. Watts completed over 2,000 hours of neurologic clinical practice while working

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FEATUR ES | Breaking the Silence: Organ Transplantation

Breaking the Silence:

Organ Transplantation words | SUSAN DUBUQUE

This series explores medical conditions and procedures that can be devastating to patients and their families, but that no one is talking about. We will talk openly about these disorders and dedicate our stories to the courageous individuals living with them and the healthcare providers and researchers committed to treating and curing these enigmatic diseases.

The consulting room provided a small, private place for the Sandone family to rest and wait. The lights were off, but no one could sleep. Minutes ticked by, and then hours, each one excruciating as the family worried and prayed. Finally, at one o’clock in the morning, they heard a sound like no other: the beating of the rotor blades as a helicopter landed on the roof of VCU Medical Center’s Critical Care Hospital. It was carrying the last vestige of hope for saving Bethany’s life: a donor organ flown in from Memphis, Tennessee. Thanksgiving 2016 started like any other. Bethany Sandone spent four days at home in Pennsylvania, eating way too much turkey, hitting the mall for Christmas gifts, and enjoying time with her parents, three sisters, and various friends. After a wonderful long weekend, she headed back to Virginia Tech to finish the second semester of her junior year. But the days and weeks that followed were anything but typical. They were worse than any nightmare Bethany’s family could imagine. “I woke up Monday morning with a pounding headache and abdominal pains,” says Bethany. “But half my relatives were sick with a stomach virus, so I really didn’t think too much about it.” She stayed in bed that day and the next, but on Wednesday she dragged herself to school to take two exams. “By then I was also throwing up, even though I hadn’t eaten for two days.” Thursday morning she could barely walk downstairs to the kitchen, and she texted her roommate to bring her a glass of water. “My roommates were pretty freaked out by how sick I was. I was throwing up blood, so they called my parents. When my friends said my skin looked like ‘cookie dough’ — yellow and doughy — my mom told them to take me to the hospital emergency room immediately.”

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Bethany’s roommates drove her to LewisGale Hospital in Montgomery. “I really don’t remember much about being in the ER,” she recounts. “I was pretty much out of it. I felt like I was drunk. I had no sense of balance and couldn’t think straight. The doctors initially thought it was a drug overdose.” After an evaluation and a battery of tests, the physicians realized what they were really dealing with: Bethany’s liver was failing. Friday morning, she was airlifted to VCU Health’s VCU Medical Center. At 2 am, Scott and Cricket Sandone received a call from the emergency department in Roanoke telling them of their daughter’s hospitalization. “At 5:30 am, they called again,” Scott says, “and we knew Bethany was being taken to Richmond.”

needed emergency kidney dialysis to help manage her fluid levels and remove the toxins that were poisoning her system. But the ICU team worked relentlessly to ensure that Bethany survived the arduous surgery to replace her failed liver. In the early hours of Sunday, December 4, Amit Sharma, MD, a VCU Health transplant surgeon, started the eight-hour operation. The organ had been donated by a 55-year-old man from Tennessee who had died in a car accident. One life was sadly ended, but thanks to this generous gift, another one was saved. For two days after the surgery, Bethany floated in and out of consciousness, but her sassy personality and quick wit still shone through. As she was coming out of anesthesia, her doctor came into the room to check on her and Bethany quipped, “Have no fear, Sharma’s here.” That slogan was posted on her whiteboard for the remainder of her stay, and after her discharge, Bethany gave Dr. Sharma a framed copy of it that he proudly displays in his home.

The family arrived a few hours after the medivac helicopter, having made the drive from Downington, Pennsylvania, in record time. Todd Stravitz, MD, FACP, a VCU Health hepatologist (liver specialist) determined that Bethany had acute liver failure. By Saturday morning, her condition showed no sign of improvement, and she was placed on the national waiting list for “When I first woke up in the ICU after surgery, a transplant. Patients on this list can wait for my mom and dad and sisters, Chelsea and months or years for a liver, but Bethany didn’t - Cricket Sandone Hollie, were there. I thought I was in the have the luxury of time. Her life was hanging hospital in Pennsylvania,” recalls Bethany. in the balance, so she was moved to the top of “And I didn’t realize that I had surgery. When the doctor first told the list for the region. Within hours, a good match was located in me I had a liver transplant, I was in a stupor from the surgery Memphis, Tennessee. and half-dreaming. My brain was so fuzzy I actually thought But serious complications still threatened Bethany’s transplantation Dr. Sharma printed a 3-D liver for me and that we were going to be surgery. Her liver failure had produced an increase in ammonia in her famous and do a TED Talk together. My doctor got a real kick out of body, which had led to swelling of the brain. She suffered a small bleed that one.” when a catheter was placed in her brain to monitor the pressure. She

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FEATUR ES | Breaking the Silence: Organ Transplantation

“I didn’t realize that I had surgery. When the doctor first told me I had a liver transplant, I was in a stupor from the surgery and half-dreaming. My brain was so fuzzy I actually thought Dr. Sharma printed a 3-D liver for me and that we were going to be famous and do a TED Talk together. My doctor got a real kick out of that one.” - Brittany Sandone

From that point on, Bethany seemed to recover at warp speed, the way only a healthy 20-something can. Dr. Sharma encouraged walking and prescribed breathing exercises, so Bethany did laps around the hospital floors, toting her IV pole, tubes, bags, and all. On December 13, she was discharged — an astonishing nine days after receiving her new liver. “We have a video of Bethany walking out of the hospital, a sight we prayed that we would see,” says Scott. “The whole experience was surreal. When we were in the hospital in the thick of it, I felt like I was watching a movie — as if this kind of thing couldn’t possibly be happening to me, to our family.” For three days, Bethany and her parents stayed at the Doorways, a facility that provides hoteltype accommodations for patients at local hospitals and their families. Then they moved into a two-bedroom apartment nearby while Bethany recuperated. “We needed to be close by so I could see my doctor frequently,” says Bethany. “They wanted to make sure my new liver was functioning as it should.” Bethany had blood drawn and saw her surgeon first twice a week, then once a week, then every other week until January 31, when she could finally return home to Pennsylvania. But she would have to keep coming back to VCU Health for at least a year after her transplant. No matter where she is, Bethany is never out of touch with the team at VCU Health. “I check in with Shawn Fenner, my transplant coordinator, regularly. He wants to know how I’m feeling and if my medications are all doing their jobs. I also have a hotline I can call 24/7 if I have any concerns or problems. And I can always email Dr. Sharma directly.” Medication is now a big part of Bethany’s life. “When I first got out of the hospital I was taking 17 pills in the morning and 13 at night. Now I take 11 in the morning and 8 at night.” And she takes every single one happily, knowing that her life-saving medications protect her from infections and organ rejection. Today, as Bethany continues to heal, she is looking to the future and is eager to get back to school. She will take a few online courses this summer and then return to Virginia Tech in January 2018 to complete her degree in environmental science. “I foresee a long, healthy life ahead for Bethany,” predicts Dr. Sharma.

What is acute liver failure? Acute liver failure is a sudden and severe failure of the liver. It can be life threatening. The cause might be an underlying infection, such as hepatitis, or exposure to toxins, alcohol, or medication, including antibiotics and Tylenol. In some cases, including Bethany’s, the condition is cryptogenic: its cause is unknown. Depending on the cause, 40 to 70 people out of 100 will recover without major treatment. In a smaller number of cases, liver transplant offers the only chance for survival.

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“Before this, I never gave organ donations a second thought. I checked the box on my license because I thought it was a good thing to do. ‘What the heck, if I no longer need an organ, why not share it with someone who does?’ But it wasn’t real. Now I get it.” - Scott Sandone

When Bethany reflects on her experience, she is matter-of-fact, telling the story with little drama or emotion. It happened. It was bad. Now it’s time to move on to the next chapter of my life. For her mom, though, it’s a different story altogether — one of unimaginable terror of the kind that can only be aroused when one’s child’s is threatened. “We got through this thanks to continual prayer from our family and circle of friends and the team at VCU Health who did everything possible to save our daughter,” says Cricket. “The way they worked together, never giving up, was nothing short of amazing.” Through this ordeal, the Sandones gained a new perspective on organ transplantation. “Before this, I never gave organ donations a second thought,” says Scott. “I checked the box on my license because I thought it was a good thing to do. ‘What the heck, if I no longer need an organ, why not share it with someone who does?’ But it wasn’t real. Now I get it.”

“Organ donation is one of the most selfless acts one human being can do for another. Living donation allows the donor to see the impact their gift can have on someone in need.” Lisa Matthias, RN Virginia Transplant Center at Henrico Doctors’ Hospital

They also came to appreciate how many people are affected by transplants. “I always thought this type of surgery was rare,” remarks Cricket, “something that happens to one in a million people.” But this past April, she learned otherwise. Bethany’s sister, Hollie, a nurse at the Children’s Hospital of Philadelphia, organized a team of co-workers to participate in the Gift of Life Donor Dash — a fun run to raise awareness of transplantation. The team’s theme was “Miracles Do Happen — Walking for Wob.” Wob is Bethany’s nickname. “I was stunned by the thousands of people — organ donors, recipients and family members — whose lives have been touched by transplants.” But perhaps the biggest surprise was the fact that Bethany was among them — alive, thriving, smiling and able to walk a mile, thanks to the selfless gift of an organ donor from Tennessee.

When it comes to healthcare, knowledge is power. So let’s learn more about organ transplantation — how many people are affected, the medical conditions that can require it, and the services available here in Virginia. If you think organ transplantation is a rarity, or you assume that no one in your family will ever need a transplant, read on. The facts will astound you. More than 116,500 people in the United States are on the waiting list for a life-saving organ transplant. Even so, only 33,611 transplants were performed in the country last year. Every day, twenty people die while waiting for an organ, another person is added to the waiting list every 10 minutes. One day, that person could be you or a loved one.

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What organs can be transplanted?

Breaking the Silence: Organ Transplantation

Most people are familiar with heart, kidney, and liver transplants, but you may be surprised to learn that the pancreas, intestines, and even hands and faces can be transplanted as well. Around 80 percent of the people on the list are waiting for a kidney, 12 percent for a liver, 3.4 percent for a heart, 1.2 percent for a lung, and 2.5 percent for another organ. Many medical conditions can lead to the need for an organ transplant. Kidney failure is most commonly linked to chronic high blood pressure and diabetes. Liver failure is not always the result of excessive alcohol use. It can also be due to hepatitis, viral infection, injection of a poisonous substance, or genetic disorders. A heart transplant may be needed due to weakened heart muscles (cardiomyopathy) resulting from coronary artery disease, heart valve disease, abnormal heart rhythms (ventricular arrhythmias), or congenital heart defects. Lung transplantation may be needed for a variety of conditions, such as cystic fibrosis, chronic obstructive pulmonary disease, pulmonary fibrosis, pulmonary hypertension, or sarcoidosis of the lung. A pancreas transplant — sometimes alongside a kidney transplant — may be needed for certain patients with diabetes. The impact of being a donor is far reaching. One person can donate up to eight lifesaving organs: heart, liver, pancreas, two lungs, two kidneys, and intestines. In addition, donated tissues — including skin, bone, veins, cartilage, tendons, and ligaments, as well as the cornea, middle ear, and heart valves — can save or dramatically improve the quality of life for their recipients. As an organ or tissue donor, your generosity can have a remarkable effect on the lives of up to 50 people.

What is a living donor? About 40 percent of donated organs come from living donors — typically a relative or friend of the patient. With so many patients on the waiting lists, a living donor can shorten wait times significantly and produce better outcomes. “Organ donation is one of the most selfless acts one human being can do for another,” says Lisa Matthias, RN, director of the Virginia Transplant Center at Henrico Doctors’ Hospital. “Living donation allows the donor to see the impact their gift can have on someone in need. Kidney paired donation (KPD) is a program that matches incompatible pairs with other incompatible pairs throughout the country so that recipients receive from someone they are compatible with and donors give to someone they are compatible with. Kidney paired donation has allowed willing, suitable donors to be compatible donors.” Some living donors are Good Samaritan or altruistic donors — people like Christoffer Friend, who donated a kidney to an unknown recipient. Christoffer was confident that donating an organ would be safe, and he felt empowered and grateful to be able to save a life in this way. We could make a huge dent in the waiting list if more people considered organ donation, either living or deceased. In the U.S., 95 percent of adults say they support organ donations, yet only

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54 percent actually sign up as donors by checking the box on their driver’s licenses or visiting www.donatelifevirginia.org

Where do I start if I need a transplant or want to donate an organ? Richmond is fortunate to have two transplant programs. The Virginia Transplant Center was established in 1990 and offers kidney transplants. It is located in HCA Virginia’s Henrico Doctors’ Hospital. To learn more, contact: Virginia Transplant Center at Henrico Doctors’ Hospital Professional Office Building, Suite 303 1602 Skipwith Road | Richmond, VA 23229 804.289.4941, or toll-free, 877.626.4581 henricodoctors.com/service/transplant-services

donated a a living donor who Christoffer Friend, own recipient. kidney to an unkn

VCU Health’s Hume-Lee Transplant Center was one of the first organ transplant centers in the country and is celebrating its sixtieth anniversary this year. Hume-Lee performs kidney, liver, pancreas, and islet cell auto-transplants. VCU Health’s Pauley Heart Center performs heart transplants too. VCU Health Hume-Lee Transplant Center Gateway Building, Seventh Floor 1200 East Marshall Street Richmond, VA 23219 804.828.4104, or toll-free, 800.762.6161, ext. 4104 vcuhealth.org/transplant VCU Health Pauley Heart Center 1200 East Marshall Street Richmond, VA 23219 804.828.4571 | vcuhealth.org/pauley

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EXPERT CONTRIBUTOR Lisa Matthias, RN with Virginia Transplant Center at Henrico Doctors’ Hospital

REFERENCES U.S. Government Information on Organ Donation and Transplantation: organdonor.gov Donate Life America: donatelife.net United Network for Organ Sharing: unos.org

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FEATUR ES | Keeping Your Health in the Game of Life

Physician Support and Determination Help Brooklyn Dooley

Lose Nearly 90 Pounds words | CATHERINE BROWN

Since May of 2017, Brooklyn Dooley has worked hard to lose nearly 90 pounds with the help of Kenneth Luckay, DO of Luckay Doc in Roanoke, and his individualized weight management program. Now 29, Dooley has struggled with her weight for much of her life, but she has committed to becoming healthier to keep up with her two-year-old daughter and set a good example in years to come. “It will be important for me to demonstrate how to manage weight and add healthy activity into daily life,” she says. Dr. Luckay and his team see a variety of patients of all ages and from all walks of life. “Sometimes our waiting room looks like a perfect cross-section of southwest Virginia,” he says. The doctor strives to provide an individualized weight loss program for each patient. “We look at the whole person,” he says. “There is no ‘one size fits all’ when it comes to managing weight issues. Above all, it’s about helping people achieve a state of wellness or a return to health.” Dr. Luckay, who works with his wife, Melinda, a psychiatric and mental health nurse practitioner, initiates his work with patients by trying to understand any underlying issues. “Weight issues are multifactorial,” Dr. Luckay says. “Sometimes they can be due to a medication, an emotional issue, an undiagnosed medical problem or even early childhood trauma.”

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Before

After

Before Photo: Brooklyn Dooley holding her sweet and spunky little girl. After Photo: Brooklyn Dooley with brother, Kyle.

After talking to patients, the doctor, who is the medical director at Luckay Doc, and his team administer a full workup of their Body Composition Analysis to determine fat percentage, fat location, water percentage and muscle mass, among other factors. From there, Dr. Luckay determines whether the patient requires medication and designs a meal plan to help him/her lose weight. Dooley describes herself as a “comfort eater,” and explains that she gained weight during her pregnancy and subsequent postpartum depression. Because of her age, she has remained relatively healthy, but her blood pressure has always been on the high side. Fortunately, she has never been prescribed blood pressure medication and she hopes her weight loss will help her avoid having to take medication in the future.

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“Starting to deal with a chronic problem is obviously not a great idea when I’m not even middle-aged,” she says. Dooley feels her health has suffered enough because of excess weight. It contributed to hypertension during pregnancy, which resulted in induction of labor and a C-section. According to Dr. Luckay, “Like many people, Brooklyn can lose weight just fine but needs help maintaining her weight loss.” In working with Dooley, the doctor and his team developed a meal plan involving a balance of carbohydrates, fruits, vegetables, fats and proteins consumed at planned times. At this stage,

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FEATUR ES |

Dooley was also prescribed, medications that help with appetite suppression. For her, the plan’s primary benefit is its flexibility.

Keeping Your Health in the Game of Life

“As long as I am reasonable with my portions, I can truly eat whatever my heart is after,” she notes. “I just have to make sure I count everything so I’m not kidding myself about my portions.” While the program’s flexibility enables Dooley to eat a variety of foods, Dr. Luckay’s support helps her stay focused and committed. As she explains, when nobody else is supporting her weight loss efforts, she often engages in a dangerous cycle of feeling bad about herself and eating for comfort. “Knowing that I have to be weighed right in front of someone who is also going to take my blood pressure is a huge incentive to stay on the straight and narrow,” she says. Dr. Luckay strives to deliver support without judgement and offer compassionate care. “We listen, we advocate, we teach, we counsel,” he says. “We never shame. Our philosophy is that obesity is a chronic disease and not a character flaw.” At times, Dooley feels discouraged and fears she won’t ever meet her goals. When that happens, she tries to divert her attention by working towards her degree, or spending time with her husband and daughter. When she focuses on other facets of her life, while also sticking to the plan provided by Dr. Luckay and his team, she finds that her weight loss efforts start moving in the right direction. Little rewards help, too. “I try to reward myself by practicing a little pampering in the form of hair or nail appointments, or with a new outfit,” Dooley says. “Anything except a food-based reward!” Thanks to her weight loss, Dooley also experiences the rewards of improved physical health. Her blood pressure is lower, and she experiences less pain when she stands for long periods of time. In addition to managing what she eats, Dooley has also incorporated more regular exercise into her life, even if that means doing an abdominal workout while her 2-year-old climbs all over her. Her www.OurHealthswva.com

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commitment to weight loss has also improved her emotional health. “I have really felt renewed, like I do deserve to feel good about myself,” she says.

“Weight issues are multifactorial. Sometimes they can be due to a medication, an emotional issue, an undiagnosed medical problem, or even early childhood trauma.” KENNETH R. LUCKAY, DO Certified in Age Management Medicine and Medical Director at Luckay Doc PLLC in Roanoke.

Perhaps most importantly, Dooley has gained a sense of accomplishment and the ability to achieve her goals. “If you make weight loss a top priority, you will absolutely be able to succeed despite obstacles put in place,” she says. “Even if someone puts your favorite sweet in front of you, you have the option to say no.” That willpower and focus has helped Dooley throughout the process. “She is an amazing and accomplished young woman,” says Dr. Luckay. “I wish we could bottle her determination!” EXPERT CONTRIBUTOR Kenneth R. Luckay, DO, certified in Age Management Medicine and Medical Director at Luckay Doc PLLC in Roanoke.

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Part Six of a Six-Article Series More than anything, drafting this one document now can help ease your loved ones’ pain and stress in the event of your incapacitation or death. words | RICH ELLIS

Part one of the Family Love Letter series examined this informational document’s importance in serving as a roadmap to financial and personal details, and how having a completed Letter helps ease heirs’ and caregivers’ pain and stress in the event of a loved one’s incapacitation or death. Part two took a closer look at the Family Love Letter’s first section – Advisors and Assets – and why those components are the foundation on which all other sections of the Letter are built. Part three explored an individual’s liabilities and what details were important to record and share as part of the Financial Information section. Part four examined insurance and benefits, and how not recording details could result in benefits going unused, while part five focused on a wide variety of other documents and their importance to survivors or caregivers. This final article in the six-part series focuses on family history, emotions, and final thoughts, and explores the importance they too hold for survivors.

Sharing a family history and ethical will are ways to leave a piece of you behind with the people you love. Section six, the final chapter in the Family Love Letter, shifts the focus from the previous sections’ emphasis on finances and important documents to examining personal thoughts that an individual wants to see live on even after they’re gone. Sheryl Crawford is a financial advisor with The Myrias Group, a private wealth advisory practice of Ameriprise Financial Services, Inc. in Roanoke. She explains that this last section of the Family Love Letter is important and impactful because of what’s being shared.

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“Think of this section as more of a family vision and prayer,” Crawford says. “It’s an opportunity to share your wishes, hopes and dreams for those you leave behind, as well as some of your own life lessons. It’s a way to leave a personal piece of yourself with your family at a time when you or they may not be ready to have it communicated face-toface. That’s why it needs to be written down – so that they are able to learn about it when they are ready and when they need it.”

“Think of this section as more of a family vision and prayer. It’s an opportunity to share your wishes, hopes and dreams for those you leave behind, as well as some of

What is shared is akin to an internal reflection or understanding, Crawford adds. It’s a time for the writer to find their happy place and think about the values they have and want to pass on to loved ones. Consider it a conversation that begins with, “I wish I had been able to tell you this…” Included in section V is space for workshop participants to complete their “Ethical Will.” This isn’t a legal document, Crawford says, but rather a way to document the voice of the heart or the window into the soul of those who are writing the Ethical Will.

your own life lessons.”

“It’s more of an explanation ‘about me’ – an introspection and place to share what you hope people will remember when they think about you,” Crawford says.

SHERYL CRAWFORD

Sharing these emotions and recording them on paper may be difficult for some people, depending on an individual’s personality. Crawford says it’s “the elephant in the room, in that we are facing our own mortality, which is something no one relishes.

A financial advisor with The Myrias Group, a private wealth advisory practice of Ameriprise Financial Services, Inc.

“We let people know that this section may be challenging, and that they should give themselves credit for being responsible adults and looking out for loved ones,” she continues. “You want to think about family members first, instead of yourself and the fact that you may not want to share this information, and you want to act now and do this today because you might not be able to capture the facts in time. One thing we find is that younger people think they are going to live forever, but the fact is young people die every day. This is not just for older generations – everyone should do this.”

A family history will cease to exist, unless it’s shared. “You have to ask yourself, ‘what do you want to leave your family that they wouldn’t otherwise know about you? What is the last impression that you want to leave?’ That’s the purpose of this last section.” MATTHEW ELY

A financial advisor with The Myrias Group, a private wealth advisory practice of Ameriprise Financial Services, Inc.

The “My Family History” section of the Family Love Letter is where one can capture stories they’ve heard from older relatives to ensure the narrative continues for younger generations. It also opens the door and is a tool for anyone researching his or her family history. And an important part of any family history are details about a family’s medical history. “There may be diseases that weren’t apparent or that didn’t seem relevant at the time, but later on in life a relative may want to know if they could have inherited a disease, particularly if a cure becomes available,” Crawford says. “This is the one place where that medical data can be recorded and saved and passed on.”

Businesses and organizations have mission statements. People should too. The Family Love Letter also encourages participants to draft their own personal “Family Mission Statement.” But unlike in other sections, for this exercise, a blank page, free from any guidance or prompts, is all that’s provided.

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FEATUR ES | Family Love Letter - Part 6

Pictured below: Left to right – 1st row – Stewart Barnes, CFP®, APMA®, Private Wealth Advisor, Angela Holmes, Paraplanner, Eddie Barnes, CFP®, Financial Advisor, Matt Ely, CFP®, ChFC®, Financial Advisor. 2nd row Vicki Lee, Client Service Specialist, Ava Thorsted, Intern, Jay Harlow, CFP®, Financial Advisor, Sheryl Crawford, Financial Advisor, Stefan Vulevic, Financial Planning Consultant.

Other photos: Attendees listen closely as Sheryl explains the confusion families could face during the incapacitation or death of a loved one if they cannot find clear details of their wishes or plans.

“It’s up to you what to write,” Crawford explains. “It could be lessons you learned that you’d like to see your family members follow, dreams that you have for them on how to spend their inheritance, or possibly traditions you’d like to see continued. We encourage people to write this section out longhand on a separate paper, rather than within the book or on a computer because handwriting is going to be more impactful and heartfelt and feel like it is coming directly from you. “The Mission Statement is as unique as you are,” Crawford continues. “And it’s something you can continue to update as long as you are living. This is a challenging section for people to complete because they have to believe it and have a vision of this road map before they can write it. It is your living legacy and it takes time to put something like this together.”

Begin the process today. Your loved ones will thank you. “People have the best intentions to leave this information,” Crawford explains, “but procrastination is the number one reason for not completing it. Through the workshops, we provide tips and shortcuts so you don’t have to do it all on your own. Many people will struggle with this topic, and the Family Love Letter may be the tool that helps communicate this important legacy to your family.

STEWART BARNES A private wealth advisor with The Myrias Group, a private wealth advisory practice of Ameriprise Financial Services, Inc.

Matthew Ely, CFP®, ChRC®, who is a financial advisor at The Myrias Group and cofacilitates numerous Family Love Letter workshops, says that what participants provide is a gift to their family. www.OurHealthswva.com

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“Adults frequently reflect on

You can get information about upcoming

Family Love Letter

events and workshops by contacting The Myrias Group at 540.769.0052 or emailing sheryl.e.crawford@ampf.com.

a parent who’s passed away and all the things they would have loved to have asked their opinion about or things they wished the parent had written down,” Ely explains. “You have to ask yourself, ‘what do you want to leave your family that they wouldn’t otherwise know about you? What is the last impression that you want to leave?’ That’s the purpose of this last section.” Details about upcoming Family Love Letter events and workshops that can help readers complete their own document is available by contacting The Myrias Group at 540.769.0052 or Sheryl.E.Crawford@ampf.com.

EXPERT CONTRIBUTORS Stewart Barnes is a private wealth advisor with The Myrias Group, a private wealth advisory practice of Ameriprise Financial Services, Inc. Sheryl Crawford is a financial advisor with The Myrias Group, a private wealth advisory practice of Ameriprise Financial Services, Inc. Matthew Ely is a financial advisor with The Myrias Group, a private wealth advisory practice of Ameriprise Financial Services, Inc.

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Sideline Heroes Athletic Trainers Keep High School Athletes Healthy, Ready for Competition words | CHRISTY RIPPEL

You see them on the sidelines at your local high school’s football, volleyball, and soccer games, watching the action and the athletes. They’re hoping not just for a home-team victory, but for a safe competition for everyone. And when a player goes down, they’re the first ones on the field, assessing the injury. Athletic trainers are the angels on the shoulders of today’s young athletes, and with increasing attention being given to concussions, their role on the field is being noticed like never before.

ANDY CHAPMAN Athletic trainer at Glenvar High School in West Roanoke County.

Andy Chapman is the athletic trainer at Glenvar High School in West Roanoke County. He’s responsible for the athletes on 14 high school teams and several middle school teams. In his 21 years at Glenvar, he has seen firsthand how interest in concussions and knowledge of them have changed. “A big part of my job now is making sure that concussion protocols are followed and that we are appropriately returning athletes to the field and the classroom following a head injury,” says Chapman. “The state has regulations in place now governing all of this, and several years ago we didn’t have that.”

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Chapman says coaches and parents are more aware of the dangers of concussions than in the past, and they feel more comfortable reporting troubling symptoms.

Sideline Heroes

“I think, with all the publicity that concussions have gotten with NFL players and all the studies that have been done, people are now changing from that old-school attitude of ‘Well, he just got his bell rung’ to understanding the dangers of head injuries,” he says. Although concussions are a hot-button topic, athletic trainers have more responsibilities than just assessing head injuries. They also work with physicians to prevent, examine, diagnose, treat, and rehabilitate many other acute and chronic injuries. On any given day, that might mean assessing a baseball player’s sprained ankle, referring a tennis player to an orthopedist for a nagging elbow injury, running a soccer player through the concussion protocol, and bandaging a runner’s blister. Athletic trainers are sometimes confused with personal trainers, but there is a big difference in the education and skills these two professions require. Athletic trainers must hold a degree in athletic training and must pass a certification exam to practice. Seventy percent of ATs have a master’s degree. But AT programs are currently in the process of becoming master’s level only, so in the future they will all hold advanced degrees. This intense training and high skill level are good news for today’s athletes, as is the move toward hiring ATs at more high schools across the country. Chapman is a full-time school system employee— he teaches during the day and covers practices and games in the afternoons and evenings. He explains that some school systems contract with hospitals or physical therapy groups to provide coverage for sports, rather than employing someone directly. But he thinks his daily presence at the school helps him do his job—one he’s enjoyed for more than 20 years. “I like being around sports and engaging with the students,” Chapman says. “It helps that I’m in the school, that I get to know their backgrounds and get to watch them grow and progress. When I know their histories, I’m able to keep track of them a lot better, as far as injuries go. Building a rapport with these students is important.” Although plenty of high schools and most middle schools do not have athletic trainers, Chapman says we are moving “in the right direction” to put more of them in public high schools—a move that will help more athletes stay healthy and safe while competing on the field, around the track, in the pool, and on the courts. EXPERT CONTRIBUTOR Andy Chapman, an athletic trainer at Glenvar High School in West Roanoke County.

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NUTRITION

Get Pumped

WITH

HEART HEALTHY EATING TIPS words | MICHELLE MCLEES

The start of the New Year is a perfect time to reflect on the past 12 months and assess what habits you want to take with you, and what you want to leave behind. Remember: it takes 21 days to make a habit and only one day to break it. To ensure your success, the American Heart Association recommends following these rules:

Make lifestyles changes to your diet by knowing what to keep, what to moderate and what to kick!

What to Keep:

1

CHOOSE WISELY, EVEN WITH HEALTHIER FOODS:

Ingredients and nutrient content can vary by brand and preparation.

2

COMPARE NUTRITION INFORMATION ON PACKAGE LABELS:

Select products with the lowest amounts of sodium, added sugars, saturated fat and trans fat and no partially hydrogenated oils.

Fruits and Vegetables | Nuts and Seeds | Beans and Legumes | Fat-free and Low-fat Dairy Products Whole Grains | Fish, Skinless Poultry, and Plant-based Alternatives | Healthier Fats and Nontropical Oils

What to Moderate:

Fatty or Processed Meats (if you choose to eat red meat, select the leanest cuts) | Saturated Fat Sweets and Added Sugars (including sugar-sweetened beverages) | Sodium and Salty or Highly Processed Foods

What to Kick: Trans fats, partially hydrogenated oils and excessive calories

3

WATCH YOUR CALORIE INTAKE:

To maintain weight, consume only as many calories as you use up through physical activity.

4

IF YOU WANT TO LOSE WEIGHT:

Consume fewer calories or burn more calories.

5

EAT REASONABLE PORTIONS:

6

EAT A WIDE VARIETY OF FOODS:

7

LOOK FOR THE HEART-CHECK MARK:

Often this is less than you are served.

This is the best way to get all the nutrients your body needs. Prepare and eat healthier meals at home: Youâ&#x20AC;&#x2122;ll have more control over ingredients.

Easily identify foods that can be part of an overall healthy diet. Learn more at heartcheck.org.

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NUTRITION NUTR I TI O N |

COOL CUCUMBER DIP Crushed toasted almonds provide crunch, and the just-right seasoning blend adds zing to this unusual dip. It’s convenient and stress-free for parties. You can make it up to four days in advance and serve it with colorful precut vegetables.

INGREDIENTS 1/4 cup plus one tablespoon sliced almonds 3/4 cup fat-free sour cream 1/4 medium cucumber, peeled, seeded, and coarsely chopped (about 1/2 cup)

2 medium green onions, cut into 1/2-inch pieces 2 teaspoons red wine vinegar 1

NUTRITION ANALYSIS (PER SERVING): Calories: 47, Total

Fat: 2.0g, Saturated Fat: 0.0g, Trans Fat: 0.0g, Polyunsaturated Fat: 0.5g, Monounsaturated Fat: 1.0g, Cholesterol: 4mg, Sodium: 20mg, Carbohydrates: 5g, Fiber: 1g, Sugars: 2g, Protein: 2g, Dietary Exchanges: 1/2 carbohydrate

HEALTH BENEFITS OF EATING MORE CUCUMBERS NATURAL HYDRATION: Cucumbers are made up of 96 percent water, therefore they are an excellent source of hydration.

VITAMIN C: Cucumbers are loaded with Vitamin C, an antioxidant that protects the body against illness due to damaged cells.

VITAMIN K: The peel of a cucumber is loaded with Vitamin K. Like

vitamin A, vitamin K plays a role in building bone, as well as other tissues of the body.

POTASSIUM: This mineral, also found in cucumbers, aids in metabolic functions and also plays a role in the development of muscle tissue.

source: Livestrong

teaspoon salt-free extra-spicy seasoning blend

DIRECTIONS 1.

In a medium skillet, dry-roast the almonds over medium heat for three to four minutes, or until golden brown, stirring occasionally. Put one tablespoon almonds in a small bowl. Set aside to use as a garnish.

2.

In a food processor or blender, process the remaining almonds for three to five seconds, or until coarsely crushed (1/4-inch irregular pieces). Transfer to a medium serving bowl.

3.

Process the remaining ingredients until the desired consistency, five to ten seconds if you prefer a chunky texture, 15 to 20 seconds for smooth. Stir into the crushed almonds.

4. To serve, sprinkle with the reserved almonds.

COOK’S TIP For a decorative presentation, peel a medium cucumber in lengthwise strips about 1/2 inch wide and 1/2 inch apart, leaving 1/2-inch strips of peel intact. Cut the cucumber crosswise into 3/4-inch slices. Using a melon baller or the tip of a small spoon, partially hollow out the slices, making little cups with enough of one end intact to hold the filling in place. Spoon the filling into the cups.

This recipe is brought to you by the American Heart Association’s Go Red For Women movement. Recipe copyright © 2005 by the American Heart Association. Look for other delicious recipes in American Heart Association cookbooks, available from booksellers everywhere or online at americanheart.org/cookbooks. www.OurHealthswva.com

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Heart Health Recipes

SERVES 8 | Two tablespoons per serving


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NUTRITION NUTR I TI O N |

SERVES 4 | Three ounces fish and one tablespoon pesto per serving Vibrant orange salmon fillets get a double dose of crunchy almonds, one in the pesto and one in the topping. The lovely green pesto is easy to make and gets a delightful flavor boost—without salt—from the garlic-herb seasoning blend. For a quick and pretty dish, scatter the almonds over the surface, as instructed below. If you prefer a fancier presentation, after spreading the pesto over the salmon, slightly overlap the almonds on the fillets to resemble fish scales, then bake as directed.

INGREDIENTS CILANTRO PESTO 1/2 cup loosely packed fresh cilantro

NUTRITION ANALYSIS (PER SERVING): Calories: 206, Total

Fat: 9.5g, Saturated Fat: 1.5g, Trans Fat: 0.0g, Polyunsaturated Fat: 3.0g, Monounsaturated Fat: 4.0g, Cholesterol: 66mg, Sodium: 129mg, Carbohydrates: 2g, Fiber: 1g, Sugars: 0g, Protein: 28g, Dietary Exchanges: 3 1/2 lean meat

3

tablespoons fat-free, low-sodium chicken broth

2

tablespoons sliced almonds

2

tablespoons shredded or grated Parmesan cheese

1

teaspoon salt-free garlic-herb seasoning blend

SALMON 4 salmon fillets (about four ounces each), rinsed and patted dry

1/4 cup sliced almonds

HEALTH BENEFITS OF EATING MORE

DIRECTIONS

SALMON

OMEGA 3 FATTY ACIDS: The body cannot create Omega 3 on its own and requires intake from food or vitamins in order to supply the nutrients. Omega 3 reduces the risk of heart disease.

PROTEIN: Salmon contains up to 58 percent of the daily required

intake of protein per four-ounce serving. The protein found in salmon helps the body maintain metabolism at levels to promote weight loss.

VITAMIN ENRICHED: A three-ounce baked fillet will give you

more than 40 percent of your daily intake of vitamin B-12; over 30 percent of niacin; over 25 percent of vitamin B-6 and more than 10 percent of thiamin and pantothenic acid.

1.

Preheat the oven to 400°F. Line a baking sheet with aluminum foil or lightly spray with cooking spray.

2.

In a food processor or blender, process the pesto ingredients for 15 to 20 seconds, or until slightly chunky.

3.

Place the fillets about two inches apart on the baking sheet. Spread the pesto evenly over the top of the fillets. Sprinkle with 1/4 cup almonds.

4. Bake for 10 to 12 minutes, or until the fish flakes easily when tested with a fork.

source: Livestrong

This recipe is brought to you by the American Heart Association’s Go Red For Women movement. Recipe copyright © 2005 by the American Heart Association. Look for other delicious recipes in American Heart Association cookbooks, available from booksellers everywhere or online at americanheart.org/cookbooks. www.OurHealthswva.com

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SALMON WITH CILANTRO PESTO


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NUTRITION NUTR I TI O N |

SERVES 8 Say aloha to a heart-healthy version of an American favorite. This cake recipe has the familiar rich, fruity taste and topping of caramelized pineapple rings, but has shed the excess sugar and replaced the unhealthy fats in the batter with mashed banana. Covered with a design of pineapple rings but with banana used in place of additional fat in the recipe, this isn’t just impressive on the eyes, it’s also a healthy cake that tastes indulgent.

DIRECTIONS 1.

Preheat the oven to 350°F.

2.

Make the pineapple glaze: Drain pineapple juice from the canned pineapple slices (about one cup) into a medium heavy-duty pot. (Reserve pineapple slices.) Add low-calorie brown sugar blend and ¼ cup no-calorie granulated sweetener into the pot and bring to a boil over high heat. Let boil until bubbly and reduced by about one-fourth, around eight to ten minutes. (Make sure to keep an eye on it while boiling in case it reduces quickly.) Remove from heat; the amount of liquid should be around ¾ cup.

3.

Coat a 9-inch cake pan with cooking spray. Pour the pineapple glaze into the dish. Arrange as many pineapple rings as will fit over the glaze—about seven. Reserve the remaining pineapple rings.

NUTRITION ANALYSIS (PER SERVING): Calories: 188, Total

Fat: 3.3g, Saturated Fat: 0.6g, Trans Fat: 0.0g, Polyunsaturated Fat: 0.8g, Monounsaturated Fat: 1.6g, Cholesterol: 47mg, Sodium: 187mg, Carbohydrates: 35g, Fiber: 2g, Sugars: 17g, Protein: 4g, Dietary Exchanges: 1 fruit, 1 starch, 1/2 other carbohydrate, 1 fat

INGREDIENTS 1

(20-ounce) can pineapple slices in juice, undrained

1/4 cup low-calorie brown sugar blend 3/4 cup granulated, no-calorie sweetener (divided use) 1

cup all-purpose flour

1

teaspoon baking powder

4. Meanwhile, into a small bowl, add all the dry ingredients: ½ cup no-calorie, granulated sweetener, flour, baking powder, baking soda, cinnamon, and salt. 5.

1/2 teaspoon baking soda 1/2 teaspoon cinnamon 1

medium ripe banana (peeled, chopped)

1

tablespoon canola oil

1

tablespoon water

Into a large bowl, add the chopped banana. Use a fork to mash the banana. Add oil, water, eggs, buttermilk, and extract into the bowl with the banana, stirring together to combine. Stir in the dry ingredients until mixed together. Chop remaining pineapple rings and stir into the batter.

2 large eggs

6. Pour batter over the pineapple rings. Bake in the oven until a toothpick inserted in the center of the cake comes out clean, about 50 minutes.

½ cup 1 percent buttermilk

7.

1

teaspoon vanilla extract

pinch of salt Copyright © 2017 American Heart Association, Healthy For GoodTM, heart.org/healthyforgood

Remove cake from the oven and let cool 10 minutes. Run a butter knife along the edges of the cake pan to make sure the cake won’t stick. Place a plate on top of the pan and use pot holders to flip cake over to invert. Serve warm or at room temperature.

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PINEAPPLE UPSIDE-DOWN CAKE


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MENS HEALTH

Addressing Men’s Snoring words | CATHY BROWN

When I got married, my sister gave me a “survival kit” that included nighttime breathing strips for my husband so that I could sleep peacefully. Because approximately half of men snore, she could safely assume I was marrying a snorer.

The Prevalence of Snoring Among Men Men are more likely than women to snore because of anatomical differences. The increased prevalence of snoring in men results from differences in the shape of the throat and palate. In men, the throat tends to be narrower, and that makes snoring more likely to occur. As men age, they tend to be more likely to snore, yet, at age 70, snoring tapers off.

The Causes of Snoring Although the distinctive sound of snoring results from obstructed airways, it is not necessarily dangerous. Sameh Aziz, MD of Carilion Clinic of Pulmonary and Sleep Medicine explains that snoring occurs because of a “vibration of the upper airway soft tissues.” That fluttering makes the sound many of us know so well. Individual traits like having narrower airways, being overweight, having a deviated septum and experiencing chronic congestion can all contribute to snoring. www.OurHealthswva.com

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The Dangers of Snoring For most men and their partners, snoring is an annoyance. However, the minor frustration can lead to poor sleep quality, resulting in fatigue and headache, explains Dr. Aziz. “It is not uncommon for their partners to also have fragmented sleep and sleep deprivation.” Although snoring is just a frustration, it can be a more serious problem. “Severe snoring usually needs attention,” explains Dr. Aziz, “especially in individuals with underlying hypertension, heart disease, irregular heart rate, or history of stroke.”

“Patients may consider referral to a sleep oriented physician for full evaluation and to rule out underlying sleep apnea.” SAMEH AZIZ, MD A pulmonologist at Carilion Clinic Pulmonary and Sleep Medicine.

EXPERT CONTRIBUTOR Sameh Aziz, MD, Pulmonary Medicine with Carilion Clinic Pulmonary and Sleep Medicine in Roanoke.

In some cases, snoring can indicate obstructive sleep apnea, in which airways collapse and block breathing. As Dr. Aziz explains, sleep apnea contributes to other serious medical problems like hypertension, heart disease and diabetes. Men who choke or have trouble breathing for ten seconds or more during sleep need to seek medical help. If they have sleep apnea, a doctor can recommend a CPAP (continuous positive airway pressure) machine, which applies air pressure through the nose and throat and reduces snoring. Even when snoring does not result from sleep apnea it can have long-term health effects. According to several studies, snoring can alter the inner lining in the carotid arteries, ultimately raising the risk of a stroke.

Ways to Improve Snoring There are many ways to improve snoring, depending on its causes. For instance, sleeping on one’s side can alleviate it. “Treatment and correction of any upper airway abnormalities and treatment of underlying seasonal allergies” can be helpful, explains Dr. Aziz. For men who are overweight, weight loss can help. Dr. Aziz also encourages patients to cut down on smoking and avoid alcohol and narcotics close to bedtime. If none of the above methods improve snoring, there are several medical options that might. For instance, an ENT doctor can evaluate patients for surgery that can curb snoring. Other men might benefit from an oral device fitted by a dentist. Whether snoring is a minor annoyance or a potentially serious health concern, it can help to consult a medical professional. “Patients may consider referral to a sleep oriented physician for full evaluation and to rule out underlying sleep apnea,” says Dr. Aziz. After all, a sleep evaluation seems a small price to pay for years of wedded bliss.

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HEALTH A-Z

Your ROADMAP to a Successful

JOINT

REPLACEMENT Newer surgical techniques allow patients to heal faster with less pain. words | CHRISTY RIPPEL

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HEALTH A-Z |

Are you bothered by an aching hip that’s hampering your golf game or a bad knee that keeps you from walking with friends? You might need a joint than you wish. Some of that fear may come from friends and family who’ve shared stories of their own surgeries that happened years ago. However, joint replacements have improved significantly in the last decade. These improvements—including better surgical techniques, more effective pain management, and more advanced implants—allow patients to recover faster and quickly return to their favorite activities. “Most people, once they’ve gone through joint replacement, wish they would have done it much sooner,” says Jack Sproul, MD, an orthopedic surgeon with LewisGale Physicians in Dublin. If you wait too long to seek treatment, you’ll extend your rehab time because the more inactive you become, the more your muscles weaken. The weaker your muscles are, the more they’ll need to be built back up after surgery. Most surgeons try to caution patients against getting to the point where function and activity are significantly decreasing. “Pain is the main indicator,” says Joseph T. Moskal, MD, chair of orthopedics at Carilion Clinic, “I often tell patients that if it’s the last thing they think about when they go to bed, and it’s the first thing they think about in the morning, then it may be time.” If you’ve been stalling on a possible joint replacement, read on for expert advice about navigating this journey and creating your own roadmap to success. Get on the path to recovery from joint pain.

STOP I: The Consult YELLOW LIGHT THOUGHT: “I’ve overwhelmed by the whole process. I don’t know which surgeon to choose and how to get started.”

GREEN MEANS GO: Just take the first step! Start with your primary care doctor, and find out if your insurance requires a referral to see an orthopedic surgeon—the type of specialist who does joint replacements. Your doctor may recommend a surgeon, and you also can ask for advice from friends, family, and colleagues who have had joint replacements. Book an appointment for a consult with the recommended surgeon to discuss your options. At the consult phase, your surgeon should take the time to discuss your fears and give you the facts. Write down your questions and concerns on a piece of paper, and bring those with you to your appointment—along with any imaging studies (X-rays, etc.) of your joint. Ask about your doctor’s experience with joint replacement and what he or she expects for your surgery day and recovery. If you aren’t comfortable with the first surgeon you see, make an appointment for additional consults until you find someone you trust. Some hospitals and practices have specialized education programs for joint replacement patients. “We require all surgical patients and a family member, if possible, to attend [a class],” says Dr. Moskal, “During class, patients and their families learn what to do prior to surgery and what to expect during and after their hospital stay. This provides a forum for patients to learn, ask questions, and address their fears and anxiety.” Also at this stage, make sure you call your insurance company or speak with the surgeon’s business manager to understand what your financial responsibilities will be.

Pain is the main indicator. I often tell patients that if it’s the last thing they think about when they go to bed, and it’s the first thing they think about in the morning, then it may be time. - Joseph T. Moskal, MD

Your Road Map to Successful Joint Replacement

replacement but have put it off for fear that you’ll be sidelined for longer


HEALTH A-Z

STOP 2: Surgical Joint Replacement YELLOW LIGHT THOUGHT: “I don’t want to be in the hospital for days. Will my joint pain really go away?”

GREEN MEANS GO: Many patients can be discharged the day of or the day after surgery, Lorraine Jacobi, PT Physical therapist at Salem Health and Rehabilitation Center in Salem.

Joseph T. Moskal, MD Chair of orthopedics at Carilion Clinic.

and most wake up from their procedures with immediate feelings of pain relief. A majority of joint replacements are due to arthritis—which can occur for some patients as early as their 20s or 30s. The cartilage on the end of your bones wears away with age, and you have pain because your body is trying to heal. The problem is that the joint can’t be healed because the body can’t remake cartilage. In a joint replacement, the old cartilage is removed, and the joint is replaced with metal and plastic. The body no longer tries to respond, and the pain goes away—sometimes immediately. Hip patients usually know as soon as they wake up from surgery that the deep, aching pain is gone. Temporary pain from the surgery is to be expected, but it’s a different type of pain and can be well-controlled throughout the rehabilitation process. Dr. Sproul says that his hip-replacement patients usually stay one night in the hospital and that knee patients are typically discharged within two days. Dr. Sproul believes that hip replacements will become typical outpatient procedures in the future. According to Dr. Moskal, “patient selection plays an important role in determining if same-day surgery is right for a patient, and we expect to see the patient selection criteria continue to expand.”

STOP 3: Recovery & Rehabilitation Christi Nicely The director of rehabilitation at Brandon Oaks.

YELLOW LIGHT THOUGHT: “Will I be in a lot of pain from the surgery? Will I have to be transferred to a rehab facility? When will I be able to return to the activities I love?”

GREEN MEANS GO: Physical therapy after joint replacement is no longer a necessity for most patients, and many quickly return to regular activities. In the decades since joint replacement became a mainstream treatment option for joint deterioration and pain, doctors and researchers have learned a lot about what patients require in order to return to the mobility they desire. Jack Sproul, MD An orthopedic surgeon with LewisGale Physicians in Dublin.

EXPERT CONTRIBUTORS Lorraine Jacobi, PT, physical therapist at Salem Health and Rehabilitation Center in Salem. Joseph T. Moskal, MD, chair of orthopedics at Carilion Clinic. Christi Nicely, the director of rehabilitation at Brandon Oaks. Jack Sproul, MD, an orthopedic surgeon with LewisGale Physicians.

Because more nerves may be affected during surgery, knees can take a little longer to heal. However, patients still often experience an immediate relief of the pain that had been dogging them—sometimes for years. The deep ache is replaced by temporary surgical pain, which can be managed with proper medications. According to Dr. Moskal, “Patients can now benefit from multimodal pain management, meaning they can have greater pain relief with less opioid medication.” While most patients will recover well with outpatient therapy and home exercises, approximately 10 percent of patients may need rehabilitation at a skilled facility such as Salem Health & Rehabilitation Center in Salem. Lorraine Jacobi, a physical therapist at the facility, says that benefits include “seven-days-a-week therapy, a recovery map to chart progress and in-house therapists.” Christi Nicely, who is the director of rehabilitation at Brandon Oaks, says that the goal at her facility for joint replacement patients is “to have close to 95 percent of patients return home with their prior level of mobility.” Home health and outpatient services can follow a stay at a rehabilitation facility. As for getting back to the golf game or back to the walks with friends?

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Physicians say that they expect joint-replacement patients to be able to return to the activities they love. Driving should resume in a few weeks, and once they have the all-clear, patients are free to lace up their golf spikes or sneakers.

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MISSION MI SSI O N | World Healer

Dr. Gustafson in South Sudan in early 2018 with Doctors Without Borders.

World Healer Local obstetrician provides medical expertise through Doctors Without Borders words | BRANDY CENTOLANZA

photos | COURTESY OF MARK GUSTAFSON, MD

Mark Gustafson, MD, an ob/gyn with LewisGale Medical Center in Salem, spent part of his childhood learning about medicine in Pakistan, so it’s only fitting that he wants to work internationally through Doctors Without Borders. “I was living in Pakistan and hung around a hospital where there were international physicians working,” Dr. Gustafson says. “In those days, you could watch people working in the operating room when you were 11 years old. I think growing up outside the country got me interested in doing international health care.”

Doctors Without Borders in South Sudan Doctors Without Borders, or Médecins Sans Frontières (MSF), provides medical services to people in countries afflicted by conflict, disasters, or epidemics, or who otherwise would not have access to health care. Dr. Gustafson spent six weeks in December 2017 and January 2018 participating with Doctors Without Borders in South Sudan. He first became interested the organization when it was awarded the Nobel Peace Prize in 1999. www.OurHealthswva.com

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MISSION

Dr. Gustafson was the only obstetrician on call at a hospital in Aweil, South Sudan. This African country has been plagued by conflict for more than 30 years and has a high maternal mortality rate as well as a high mortality rate for newborns and young children. Dr. Gustafson’s main role during his stint was treating patients for various conditions, including breast abscesses, sepsis, and other infections; ectopic pregnancies; uterine ruptures; obstructed labor, in which babies are breech or transverse; and providing other emergency obstetrical care. His patients ranged in age from seven to 40. He also provided management training to nurses and midwives and helped care for patients who had been assaulted or raped, a common occurrence in the country.

GLOBAL HEALTH EDUCATORS Global Health Educators is a non-profit organization run entirely by volunteers in both Uganda and the United States. The organization provides no salaries, travel expenses, or financial benefits to its board members or the many active participants living in the U.S. and abroad. Global Health Educators was created to improve health through educational health programs. Since our first visit to Uganda in 2013, it has developed into a far greater experience with the sharing of ideas and experiences. Donations for the non-profit go toward funding supplies needed for multiple projects including Albinism, vision, newborn warming, and traditional birth referral agent educational projects.

Global Health Educators in Uganda Working with patients in such dire situations “was the kind of thing I expected to see,” Dr. Gustafson says. “I knew what I was getting into.” Providing medical care to individuals throughout the world is nothing new to Dr. Gustafson. “For the past few years, my wife and I have been running a nonprofit in Uganda focused on medical education, emergencies and medical resuscitation, and working with traditional birth attendants there,” he relates. Dr. Gustafson and his wife Judy, an anesthesiologist, started Global Health Educators four years ago and travel to Uganda twice a year. His experience with the organization is what led him to apply to Doctors Without Borders last year.

Care Under Pressure Douglas Mercer, the field human-resources recruitment coordinator for MSF, says Dr. Gustafson was chosen for his medical expertise, his background in international healthcare work, and his ability to provide care under pressure with limited resources. “Obstetrics is a huge problem, and we are always in need of obstetricians,” Mercer says. “We also look for personality, availability, and flexibility when choosing applicants. Applicants need to be able to adapt.” Among the challenges Dr. Gustafson faced in South Sudan was treating patients with severe anemia due to malaria, parasites, iron deficiencies, and multiple births. Fortunately, the hospital where he worked had a blood bank. Many of his patients had also delayed obtaining healthcare because of the distances they had to travel to reach the hospital. Some did not survive.

For more information, visit www.globalhealtheducators.org.

“The road systems are terrible there, and there are no paved roads in the country,” Dr. Gustafson says. “People didn’t have transportation and were coming from long distances, so they had severe problems due to delayed healthcare. You do see death in situations there more than in the United States, but you just do the best you can do with the limited resources you have.”

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MI SSI O N | World Healer

Dr. Gustafson treated between 10 and 20 patients during rounds and performed roughly 30 operations during his time in South Sudan. In addition to local medical personnel, he worked with a Doctors Without Borders team that included a general medical provider, a pediatrician, an anesthesiologist, and a nurse. Being the only obstetrician on call posed its own challenges. “Not having other support was sometimes difficult,” he says. “The environment was also definitely a challenge. We were near the Sahara Desert, and during the day it would get into the mid-90s to 100 degrees. It was dry and dusty with no rain.” Despite the difficulties, Dr. Gustafson would do it all again in a heartbeat. “It was a very rewarding experience,” he says.

Committed Care – Overseas and at Home Those who know Dr. Gustafson at LewisGale Regional Health System expect nothing less from him. “It is an honor to have one of our LewisGale-affiliated physicians volunteering and chosen for this program,” says Brian Baumgardner, CEO of LewsiGale. “I am not surprised at Dr. Gustafson’s selection because it is a natural extension of what he has committed his professional life to and what he does every day at LewisGale: providing exceptional patient care. His compassion, willingness to go above and beyond for patients, and his desire to personally connect with patients are also characteristics he possesses that help make him successful here and will ensure his success while serving around the world.”

Dr. Gustafson with fellow colleagues in South Sudan.

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MISSION

Although he’s returned to LewisGale, Dr. Gustafson is already considering another stint in international healthcare, perhaps with MSF again or another similar organization. His wife is also considering applying for Doctors Without Borders.

“I was living in Pakistan and hung around a hospital where there were international physicians working. In those days, you could watch people working in the operating room when you were 11 years old. I think growing up outside the country got me interested in doing international healthcare.”

“I have the skills and the training, and I want to share my skills with others,” Dr. Gustafson says. “It’s a small world, and for us to get out and help others in other parts of the world is so important. It is just such a good thing to do.”

EXPERT CONTRIBUTORS Brian Baumgardner, CEO of LewsiGale Medical Center. Mark Gustafson, MD, an ob/gyn with LewisGale Medical Center in Salem. Douglas Mercer, the field human-resources recruitment coordinator for MSF.

MARK GUSTAFSON, MD An ob/gyn at LewisGale Medical Center in Salem.

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MISSION MI SSI O N | The Roanoke SPCA Launches A Mobile Spay/Neuter and Pet Wellness Clinic

Left photo (pictured from left to right): Janice Annis, DVM, Mobile Clinic Veterinarian; Melissa Crowder, Licensed Veterinary Technician; Dominique Hunter, Veterinary Assistant.

The Roanoke Valley SPCA Launches A Mobile Spay/Neuter and Pet Wellness Clinic words | CATHERINE BROWN

The Roanoke Valley SPCA was founded in 1916 and opened the community’s first animal shelter in 1958 after purchasing a 1917 farmhouse. Since February 2004, it has helped more than 20,000 homeless animals find refuge, safety, and companionship. According to Jennifer McFarling, DVM, the medical director of the Roanoke Valley SPCA, the organization’s mission is “to create, through the power of adoption, prevention and intervention, a community where there are no homeless cats or dogs.” By developing the foster program, the Pets Eat Too program, and community education programs, the SPCA has helped animal populations throughout the community. In 2010, the SPCA added humane spay-neuter clinics in Christiansburg and in Roanoke to its services. According to Dr. McFarling, these clinics “primarily reach pets from lowincome households, pets from rescue groups, and stray cats.” Since the clinic’s opened, the SPCA has performed more than 55,000 surgeries.

THE MOBILE CLINIC This year, the SPCA used a generous donation to convert the Roanoke Mountain View Spay-Neuter Clinic into a mobile clinic. This 35-foot-long wheeled unit contains 22 holding cages and a surgery suite. It is staffed by a team of three medical providers: Janice Annis, DVM, veterinarian, Melissa Crowder, a licensed veterinary technician, and Dominique Hunter, a veterinary assistant.

“To show compassion to humans as well as animals and extend resources where needed can create long-term and meaningful social change.” JENNIFER MCFARLING, DVM Medical Director at the Roanoke Valley SPCA

BENEFITS OF SPAYING AND NEUTERING PETS The Roanoke Valley SPCA firmly believes in the many benefits of spaying and neutering pets. Most importantly, preventing unwanted litters reduces cases of pet homelessness and www.OurHealthswva.com

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euthanasia. “In addition to helping to fight pet overpopulation,” says Dr. McFarling, “there are also many health benefits to spaying and neutering pets: we help pets live longer lives, prevent them from wandering, and improve their behavior. It is also costeffective to have one surgery rather than multiple litters.”

COSTS Spaying and neutering services range from $55 to $80, depending on species and gender. As the clinic grows, the SPCA hopes to offer discounted services based on grants. Dr. Annis performs surgeries on publicly owned animals at the mobile clinic on Tuesdays and Thursdays. The clinic is parked in a number of public access areas, such as churches and libraries, in Roanoke City and County, in Salem, and in Botetourt, Bedford, Craig, Floyd, Alleghany, and Rockbridge Counties. After scheduling surgery, pet owners can drop their dogs or cats off at the appointed location in the morning and pick them up in the afternoon with instructions for post-surgery care. Pet owners can learn more about the Roanoke Valley SPCA’s Mobile Spay/Neuter & Pet-Wellness Clinic from its website, at www.rvspca.org, or by contacting the mobile clinic at mobileclinic@rvspca.org. The website offers online scheduling and information on surgery and resources for public assistance. With the mobile clinic, the SPCA hopes to prevent even more cases of pet homelessness and euthanasia. “With scheduled stops at locations throughout Roanoke City and Roanoke County and the greater Roanoke Valley area, the mobile clinic allows us to have an ongoing presence and a real impact in the communities where people live their lives,” explains Dr. McFarling. “To show compassion to humans as well as animals and extend resources where needed can create long-term and meaningful social change.”

EXPERT CONTRIBUTOR Jennifer McFarling, DVM, Medical Director at the Roanoke Valley SPCA.

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