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November • December 2017 ourhealthrichmond.com

LEADING A

BETTER LIFESTYLE IS THE BEST WAY TO BEAT DIABETES PLUS: IS YOUR TEEN AT RISK FOR DEPRESSION & ANXIETY? HELPFUL TIPS FOR

the Annual Best Bedside Manner Awards

EATING HEALTHY THIS HOLIDAY SEASON

Did your favorite

HEALTHCARE PROVIDER make the

CUT?


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TABLE OF CONTENTS NOVEMBER • DECEMBER 2017

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THE PULSE

| KEEPING THE PULSE ON HEALTHCARE

MEDICAL PROFILES

| LOCAL HEALTHCARE

12 – Q&A ON HEALTH

56 – JENCARE SENIOR MEDICAL CENTER

16 – NEW PEOPLE & PLACES

57 – RICHMOND ENT

BREAKING THE SILENCE: GUILLIAN-BARRE SYNDROME This series explores medical conditions that can be devastating to the patients and families they affect — yet no one is talking about them. That is, until now.

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2017 BEST BEDSIDE MANNER AWARDS OurHealth’s Best Bedside Manner Awards honor medical providers who were voted by the local community for their kindness, empathy and attentiveness—attributes that go a long way in gaining a patient’s confidence.

58 – SPARKLE PEDIATRIC DENTISTRY

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HEALTHCARE OBSERVANCES

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NUTRITION

| NOVEMBER OurHealth Richmond partners with local healthcare organizations and medical professionals to raise awareness about monthly health observations. | LOCAL FOODS & RECIPES

64 – HELPFUL TIPS FOR EATING HEALTHY THIS HOLIDAY SEASON

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TABLE OF CONTENTS NOVEMBER • DECEMBER 2017

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LEADING A BETTER LIFESTYLE IS THE BEST WAY TO BEAT DIABETES Type II Diabetes, a disease in which there is a high level of sugar in the blood, is on the rise. A poor diet and lack of exercise are partially to blame.

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IS YOUR TEEN AT RISK FOR DEPRESSION AND ANXIETY? How to help your child navigate a brave new world of challenges.

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FAMILY CARE

| HEALTH FOR THE WHOLE FAMILY

78 – ARE LEG CRAMPS KEEPING YOU UP AT NIGHT? 80 – SNORE NO MORE | Addressing Men’s Snoring

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november • december 2017

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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 © 2017 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Richmond is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 3420 Pump Road, #314 • Richmond, VA 23233 • 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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HEALTH H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS

Is it possible to reverse damage to the skin caused by the sun in hopes of preventing skin cancer? There are several excellent options available to help treat conditions that have been caused by sun damage, including: •

Unless you involuntary lose coverage during the year, the only time to purchase an individual health insurance policy is during Open Enrollment. This year’s Open Enrollment period is shorter than year’s past. It runs from 11/1/17 – 12/15/17 for a January 1, 2018 effective date.

– Tracy Corntazer

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5-Flurouracil cream, a topical chemotherapy medication, works by blocking the growth of abnormal cells that cause the skin condition. Another topical option is Imiquimod, which enhances the body’s immune system to destroy and repair sun damage. Both of these options can also treat some superficial skin cancers. While they can cause redness during treatment, they are very effective. A third option is topical Picato, which is a plant-based product that repairs sun damage. Photodynamic therapy is another available option. This is a procedure performed in the doctor’s office during which a photosensitive chemical is applied to the affected area and allowed to activate. The affected area is then placed in a blue light machine for 16 minutes. Patients experience a burning sensation during the procedure and need to avoid all sunlight and indoor UV light for two days post treatment. Sometimes multiple treatments are required. This treatment is not as effective as topical treatment, but does help. It is covered by insurance with prior approval.

Georgia Seely, MD

Dermatology Associates of Virginia Colonial Heights, Glen Allen and Richmond | 804.549.4040 www.dermva.com

OurHealth | The Resource for Healthy Living in Greater Richmond

My mother’s hearing loss is beginning to have a noticeable effect on her social activities. How can I encourage her to have her hearing checked? Gently explain that her hearing difficulty is isolating her from her family and activities, and offer to go with her to a licensed, certified audiologist. The visit is painless and can be very educational and beneficial. Sometimes people have hesitations about their first appointment. The points below address some of these concerns: •

Most people are concerned about a hearing check because they think it will lead to a recommendation for hearing aids. This is definitely NOT always the case. Hearing difficulty may simply be the result of cerumen (earwax) buildup in the canal.

There is good research showing that people with untreated hearing loss are more likely to develop dementia.

Hearing aids today are less visible and have more sophisticated electronics than in the past. They sound quite natural and are so discreet that she may not know which of her friends are wearing them!

You may need to remind her that her hearing loss is often much more noticeable than a well-fit set of hearing aids would be!

Betty Anderson, AuD

Elizabeth Anderson Hearing & Speech Richmond | 804.382.4137 www.EAHSHearing.com

I’m so confused about my individual health insurance options right now. Where do I begin to learn more? If you are not insured through your employer’s group health plan, one option is individual coverage. When the Affordable Care Act was signed into law in 2010, it was a game changer. When you could purchase coverage and the types of plans you could purchase changed. Unless you involuntary lose coverage during the year, the only time to purchase an individual health insurance policy is during Open Enrollment. This year’s Open Enrollment period is shorter than year’s past. It runs from 11/1/17 – 12/15/17 for a January 1, 2018 effective date. Your plan options will vary based on the county in which you live. To find the options available to you, you can either visit www.Healthcare.gov or contact a local health insurance agent. Either will be able to guide you through which plans are available and show you how to search for medical providers and prescriptions options. You can also learn if you qualify for either a premium subsidy or a costsharing subsidy. If you miss Open Enrollment, contact a local agent and ask about temporary policies. Tracy Corntazer

Virginia Farm Bureau Experient Health Richmond | 804.290.1115 www.vafb.com


Local health. Anywhere you go. OurHealth magazine is Richmond’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

My acid reflux gets to be unbearable around the holidays. What advice can you give me to help me during holiday gatherings? Holidays can be tough if you suffer from acid reflux. Don’t fear. Here are a few simple tips to help you survive them: •

During the initial meeting with a home care specialist, he or she will gain insight on your family’s specific needs to identify an appropriate level of care. The key is total flexibility.

– Tina Bell

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Nibble, don’t gorge: It’s OK to sample a few bites of different foods, but remember that moderation is key. Also, avoid fried or fatty foods and skip second and third servings. It can be hard to skip desserts, so try lighter ones like angel food cake instead of chocolate cake.

Use small plates: Light appetizers and small plates are the best bet to avoid heartburn. Look for protein rich but low volume foods such as steamed shrimp or grilled chicken. Veggies are also a good option.

Take your time: Slow down and savor your food. You are more likely to get heartburn it you eat too quickly.

Monitor alcohol intake: Enjoy a glass of wine or champagne to celebrate, but avoid refills. Remember, the more you drink, the more likely you are to experience heartburn. Plan ahead: If you are on prescription medication, don’t forget to take it. Keep antacids handy. Speak with your doctor about medications you can take as needed.

Shweta Joshi, MD

Richmond Gastroenterology Associates Richmond | 804.330.7840 www.richmondgastro.com

OurHealth | The Resource for Healthy Living in Greater Richmond

What does a palliative care provider do that’s different from what my other doctors do? A palliative care team offers an extra layer of support for patients and families living with a serious illness. This extra layer of support controls symptoms such as pain or difficulty breathing that are impacting quality of life, supports advance care planning and other decision-making, provides relief from emotional strain (especially for caregivers) and offers guidance in times of transition. Palliative care clinicians (physicians, nurse practitioners, nurses, social workers and chaplains) are trained in areas of medicine that many healthcare clinicians find challenging, such as communication and pain management. Creating a safe space for conversation and using the gift of time, palliative care teams will question, listen, and explore in an effort to uncover a person’s values, which are then used to provide the best care possible. Leanne Yanni, MD

Medical Director, Palliative Medicine Bon Secours Virginia Health System Richmond | 804.288.2673 www.bonsecours.com

My mom is moving in with my family this month. I know I cannot care for her alone. How do I know what level of assistance to request from a home health agency? It can be overwhelming, no matter how much you love your parent(s), to have them move into your home. A home health agency can assist and eliminate much of this stress. Your home health partner will walk you through the process and will help determine the right support you and your mom are comfortable with and need. During the initial meeting with a home care specialist, he or she will gain insight on your family’s specific needs to identify an appropriate level of care. The key is total flexibility. You do not sign a contract or commit to a certain number of hours; the care can grow or taper as needed. A home health nurse may also visit the home to assess and offer suggestions on the level of assistance needed. With our team of specialists and dedicated caregivers working together for you, we are able to make the process a seamless and stress-free one, providing you and your loved one with peace of mind. Tina Bell

Care Advantage Richmond | 800.473.0022 www.careadvantageinc.com


THE P ULSE | Q&A on Health

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THE PULSE

Joo Cho, MD

VCU Health/Radiology Richmond vcuhealth.org

Andrew Colhoun, MD Virginia Urology Stony Point & Midlothian 804.330.9105 www.uro.com

Elna Kochummen, MD Michael J. Bon Secours Pediatric Menen, MD, FACC Endocrinology and Diabetes Associates Richmond | 804-281-8303 www.goodhelpdocs.com

Chief Medical Officer Bon Secours St. Francis Medical Center Midlothian www.bonsecours.com

Natario Couser, MD

Jose Diaz, MD

Adam Fox, MD

Sean Huiras, PA

Tiffany Powers, NP

Zachary Reed

Lisa Rubinsak, MD

Chantel Rusz, NP

Nicholas Serrano, MD

Lauren Siff, MD

Diane Sinnatamby, MD, FACP

VCU Health Ophthalmology Stony Point | 804.323.0830 vcuhealth.org

Bon Secours Lee Davis Pediatrics Mechanicsville 804.730.4690 www.goodhelpdocs.com

Bon Secours Richmond OB-GYN Richmond | 804.320.2483 www.goodhelpdocs.com

Chief Operating Officer Henrico Doctor’s Hospital Richmond | 804.289.4500 www.henricodoctors.com

VCU Massey Cancer Center Radiation Oncology Richmond | 804.828.7232 massey.vcu.edu

VCU Health General Internal Medicine Richmond | 804.828.2161 vcuhealth.org

VCU Massey Cancer Center Gynecologic Oncology Richmond | 804.828.9080 massey.vcu.edu

VCU Health Urogynecology Richmond | 804.828.4409 vcuhealth.org

Bon Secours Commonwealth Gynecologic Oncology Richmond | 804.288.8900 www.goodhelpdocs.com

Bon Secours Behavioral Health Group at Memorial Regional Mechanicsville 804.325.8882 www.goodhelpdocs.com

Bon Secours Laburnum Medical Center Mechanicsville 804.764.2200 www.goodhelpdocs.com

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Breaking the Silence:

Guillain-Barre Syndrome words | SUSAN DUBUQUE

This series explores medical conditions that can be devastating to the patients and families they affect — yet no one is talking about them. That is, until now. We will talk openly about these disorders and dedicate these stories to the courageous individuals living with them and the healthcare providers and researchers committed to treating and seeking cures for these enigmatic diseases.

Imprisoned in a lifeless body. Unable to move or to communicate with even the merest flick of a finger or blink of an eye. Yet fully conscious and aware —hearing everything from the warm and reassuring croons of family and friends to the cool, clinical assessments of the doctors. For more than two weeks, Joel Elmore remained in this state of suspended animation. Until the mystery was solved and a diagnosis was confirmed: Guillain-Barré syndrome.

Spring 2016 | Joel Elmore was anxiously working to complete his senior thesis at Covenant College, a small Christian school in Lookout Mountain, Georgia, where he was majoring in psychology. Life was grand. He shared a log cabin with six roommates, all close friends and fellow students. He was at his peak of fitness, playing collegiate soccer and club team rugby. And best of all, he was about to ask for his girlfriend’s hand in marriage. In just a few months, Joel looked forward to graduation and pursuing his ultimate goal of attending seminary and becoming a pastoral counselor. What could possibly go wrong? A lot.

www.OurHealthRichmond.com

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BREAKING THE SILENCE

As spring break approached, Joel’s roommates packed up for a well-deserved respite from school — a week spent at a friend’s parent’s church camp. But Joel, dealing with a nagging respiratory infection, was too sick to go. But a quick trip to the doctor, a little rest and one “Z-Pak” later, Joel appeared to have recovered.

When my roommates got home, I tried to talk, but ALL THAT CAME OUT was a hoarse, croaking sound. And then, when I TRIED TO EAT a piece of pizza, I couldn’t swallow. – Joel Elmore

March 13 | “I woke up Sunday morning too sick to go to church. Instead I stayed home in bed. Later that day, I felt dizzy and I stumbled when I got out of the shower,” says Joel. “When my roommates got home, I tried to talk, but all that came out was a hoarse, croaking sound. And then, when I tried to eat a piece of pizza, I couldn’t swallow.” Joel drove himself to an urgent care clinic, where he tested positive for mononucleosis and was given a steroid injection. But his condition continued to deteriorate. Joel’s mother, Cindy Elmore, called and suggested that he might be dehydrated and in need of fluids. Too weak to drive himself, Joel called his girlfriend and asked her to take him to the emergency room of a local community hospital. There, a nurse practitioner admonished him for “listening to his mom” and reminded him that he had a simple case of mono. She sent him home without seeing a doctor. Within a few hours, Joel’s breathing became labored and his motor functions became even more impaired. This time, all six of his roommates drove Joel back to the hospital, demanding that a doctor see him. Deeply concerned by the reports from Joel’s roommates, Cindy and Joel’s sister, Annamarie, began driving from their home in Roanoke, Virginia, arriving at the hospital around 9:00 pm.

The first time I tried to talk to Joel on the phone, I knew something was SERIOUSLY WRONG. – Cindy Elmore

SPREAD AWARENESS Help us spread awareness about Guillain-Barre syndrome by sharing Joel’s story on social media! Don’t forget to tag us.

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“After Cindy pleaded with the doctor, telling him that Joel could not breathe, the doctor gave Joel a breathing treatment. It was suffocating him.” The doctor sent him for a chest X-ray, but while on the imaging table, the unthinkable happened — Joel began to choke and stopped breathing. He had to be resuscitated and a breathing tube had to be inserted in his trachea in order to save his life.

March 14 | Joel was admitted to the hospital’s intensive care unit, where his condition plummeted. Within 12 hours, Joel went from thrashing movements to complete paralysis. He couldn’t open his eyelids, and his pupils would not even dilate.

It was like BEING FROZEN. I had NO WAY OF LETTING ANYONE KNOW I was still in there. – Joel Elmore

“My roommates and my family would talk to me as if I could hear,” describes Joel. “But the doctors would sometimes talk about me like I was unconscious. It was apparent from their comments that they didn’t think I would make it.” 20

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B R EAK I NG THE SI LENC E |

as if I could hear. But

Guillain-Barre Syndrome

“My roommates and my

family would talk to me

the doctors would some times talk about me like I wa s unconscious. It was apparent from their co mments that they did n’t think I would make it.” – Joel Elmore

For Joel, the whole experience was surreal. “Although my eyes were closed and I couldn’t see a thing, I was having a continuous stream of bizarre dreams. In one dream, I was hanging upside down like a bat.” The mere act of breathing was the most stressful part of Joel’s ordeal. “I was on a respirator and when the staff had to move me for a test or a procedure, they would ‘bag’ me — manually breathe for me — while we were going down the hall. I would pray that they would keep me breathing until I could be hooked up to the respirator again.” Despite being in this terrifying state, Joel was able to maintain some semblance of calm and control as he tried to establish a rhythm to his altered existence.

I knew the neurologist MADE ROUNDS in the morning, so with every visit, I would CHECK OFF – Joel Elmore ONE MORE DAY. Immediately, the family wagons quickly began to circle. Joel’s father, Joe Elmore; his brother, Josiah; aunts and grandmother came to offer comfort and support. His uncle and aunt, both physicians, also lent valuable medical insights.

Guillain-Barré Syndrome (gee-YAH-buh-RAY) An autoimmune disorder in which the body’s immune system begins to attack the peripheral nervous system. The first signs are typically a tingling sensation and weakness that start in the feet and legs and may spread to the arms and upper body. In the most severe cases, muscle weakness can evolve into paralysis, potentially interfering with breathing, blood pressure and heart rate.

March 16 | During these trying early days, Joel’s uncle, Dr. Jay Freeman, and aunt, Dr. Nikki Brannon, were searching frantically for an answer. They soon suspected that Joel might have a very rare form of Guillain-Barré syndrome called Bickerstaff www.OurHealthRichmond.com

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BREAKING THE SILENCE

s, I py session ra e th l a ic s of my phy admill, “In some over a tre s s e n r a h nded in a legs as if was suspe moved my m te s y s c y oti retrain m and a rob ea was to id e h T . g in .” I was walk w to walk nerves ho d n a s le c mus e – Joel Elmor

brainstem encephalitis, and discussed this finding with the hospital physicians. Joel was immediately started on intravenous immunoglobulin (IVIg) — antibodies that help to fight inflammation and infection. But after one week of treatment at the community hospital, it became clear that he needed more advanced care.

March 21 | Joel was transferred to a major teaching hospital in Tennessee where

I CONSTANTLY PRAYED, ‘Don’t leave me here,’ and I clung to a favorite passage from the Bible: ‘BY HIS WOUNDS YOU HAVE BEEN HEALED’ (Isaiah 53). – Joel Elmore

he could receive plasmapheresis, a blood exchange treatment that removes harmful antibodies from the bloodstream, preventing the antibodies from attacking his own nervous system. After completing seven treatments, seven more were ordered. Although Joel couldn’t move, he did have some sensation. During the plasmapheresis treatments, he experienced intense cold as the chilled plasma infused with calcium was reintroduced into his bloodstream.

March 23 | Joel opened his eyes for the first time in more than two weeks. He was able to respond to questions by moving his eyes — showing that his cognitive functions were still intact. Extraordinary measures were taken to keep Joel alive and allow time for the plasmapheresis to work. A tracheotomy was performed to create an opening in Joel’s airway so he could breathe with the aid of the ventilator. He had a feeding tube inserted in his stomach. His heart, blood pressure and brain function were monitored.

March 27 | There was movement. “Over the next few days, I was gradually able to move my head and neck and even whisper my first word,” says Joel. With this slight improvement, in a few days he was moved to a step-down unit. 22

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B R EAK I NG THE SI LENC E | Guillain-Barre Syndrome

Joel may not be

hitting the socc er or rugby field an ytime soon, bu t he is now able to ru n a mile. And with his determination, there is no lim it to how far he can go.

April 7 | Joel was accepted at Shepherd Center, a rehabilitation hospital in Atlanta, and made the two-hour trip by ambulance. He was still paralyzed from head to toe, but now there was hope on the horizon. “The first positive thing that happened at Shepherd,” recalls Joel, “was receiving a special TV remote that I could operate by blowing through a straw. That was my first step toward regaining control over my body — and my life.” The team at Shepherd wasted no time in helping Joel do just that, and he was thrust into a busy schedule of physical, occupational and speech therapy. As Joel’s sensation returned, it was in the form of pain — stabbing nerve pain with every movement. But perhaps the most stressful part of Joel’s therapy was weaning him from the ventilator. “They had to get me breathing on my own,” reflects Joel.

We did it step by step. First, two hours at a time, then longer. Imagine HAVING TO CONCENTRATE on taking EVERY SINGLE BREATH you take. – Joel Elmore

“While I was at Shepherd, I just focused on making it through one day at a time,” says Joel. “I constantly prayed, ‘Don’t leave me here,’ and I clung to a favorite passage from the Bible: ‘By His wounds you have been healed’ (Isaiah 53). There were little things that helped make it bearable, like when one of my roommates came to visit and rolled a lollipop on my tongue. It was blueberry flavored — the first thing I had tasted in weeks.” www.OurHealthRichmond.com

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BREAKING THE SILENCE

Joel remained at Shepherd for a total of three months — the first six weeks as an inpatient and the second six weeks in outpatient therapy. Very gradually he regained feeling, strength and movement. “In some of my physical therapy sessions, I was suspended in a harness over a treadmill, and a robotic system moved my legs as if I was walking. The idea was to retrain my muscles and nerves how to walk.”

August 1 | A happy day for the Elmore family — Joel’s homecoming. “By this “Medical science does not yet know the exact cause of Guillain-Barré syndrome, but the disorder often appears days or weeks after a respiratory or digestive tract infection. In rare instances, GBS may be triggered by recent surgery, trauma or immunizations.” SCOTT VOTA, DO A neurologist at VCU Health.

time I was able to walk with a walker and I could dress myself,” says Joel. “Believe it or not, the first thing I did when I got home was mow the grass. I didn’t have strength yet to pull the cord and start the motor, but I could walk behind it and use it for balance.

It just felt like A WONDERFUL, ‘NORMAL’ THING – Joel Elmore to do. After returning to his home in Roanoke, Joel resumed outpatient therapy at Carilion Clinic until November 2016. While at Shepherd, Joel was fitted for leg braces that allowed him to walk independently. But the nerve damage to his left hand and right foot was severe, and he continued to experience some mobility issues and challenges with fine motor skills, like writing, tying shoes and buttoning buttons. Joel’s primary care physician at the Carilion Clinic in Vinton, Russell Slayton, MD, diligently coordinated Joel’s follow-up care.

February 2017 | Always an athlete, Joel wasn’t satisfied with just walking. He was determined to run again. David Lawrence, a physical therapist at Lawrence Rehabilitation’s Gait Center in Richmond, was willing to take on the challenge. He fabricated special leg braces and began training Joel to run.

But now, I realize a lot of things that I worried about WEREN’T REALLY A BIG DEAL. It brought things into perspective. IT’S BETTER TO LOOK FOR JOY and happiness than sweat the small stuff. – Joel Elmore

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Spring 2017 | When he was struck down by GBS, Joel was only one semester shy of graduating from Covenant College, and it was time to start thinking about finishing his degree and moving on with his career. In order to ease back into the rigors of school, Joel started by taking some elective classes at Virginia Western Community College in hopes of completing all requirements, including his thesis, in time to graduate in December 2017.

TODAY | After surviving a near-death experience and living through the sheer terror of being entombed in his own body, Joel Elmore has emerged a strong, resilient young man. “I used to feel anxious a lot of the time. I guess I was a bit of a perfectionist, like my mom,” reflects Joel. “But now, I realize a lot of things that I worried about weren’t really a big deal. It brought things into perspective. It’s better to look for joy and happiness than sweat the small stuff.” Joel lives each new day with an incredible sense of gratitude. “My family and my friends never gave up on me. They stayed with me in the hospital and came to see me in Atlanta. They talked to me, read to me and, most of all, prayed for me — along with a huge faith community. I was lucky to have great medical care. Thanks to that — and God’s mercy — I’m here today.”

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B R EAK I NG THE SI LENC E |

“One other thing I learned is that change is inevitable. You won’t be the same person you are tomorrow as you are today. You just have to embrace your strengths and work with what you have.” Joel may not be hitting the soccer or rugby field anytime soon, but he is now able to run a mile. And with his determination, there is no limit to how far he can go.

The Signs and Symptoms of

Guillain-Barre Syndrome

Guillain-Barre Syndrome may include: When it comes to healthcare, knowledge is power. So let’s learn more about Guillain-Barré syndrome or GBS — the nature of the disorder, how it is diagnosed and treated, and what the future holds.

What is Guillain-Barré Syndrome? Guillain-Barré syndrome (gee-YAH-buh-RAY) is an autoimmune disorder in which the body’s immune system begins to attack the peripheral nervous system. The syndrome is named after the French physicians Georges Guillain and Jean Alexandre Barré, who described it in 1916. The first signs are typically a tingling sensation and weakness that start in the feet and legs and may spread to the arms and upper body. In the most severe cases, muscle weakness can evolve into paralysis, potentially interfering with breathing, blood pressure and heart rate. “Medical science does not yet know the exact cause of Guillain-Barré syndrome, but the disorder often appears days or weeks after a respiratory or digestive tract infection,” says Scott Vota, DO, a neurologist at VCU Health. “In rare instances, GBS may be triggered by recent surgery, trauma or immunizations.”

tingling or prickly sensations in your fingers and toes

muscle weakness in your legs that travels to your upper body and gets worse over time

unsteady walking

difficulty moving your eyes or face, talking, chewing or swallowing

severe pain that may feel achy or cramplike and may be worse at night

rapid heart rate

Anyone can get Guillain-Barré syndrome, but the condition is more common in adults than in children, and more men than women are diagnosed with GBS. Fortunately, this is a rare condition, and only one or two in 100,000 people develop the disorder each year in the United States.

There are several variations of Guillain-Barré syndrome along a spectrum. The most common form is called Acute Inflammatory Demyelinating Polyneuropathy (AIDP). Rarer and more serious forms of the disorder are Miller Fisher syndrome and Bickerstaff brainstem encephalitis.

low or high blood pressure

problems with bladder or bowel control

Signs and Symptoms

difficulty breathing

In GBS, the immune system — which typically attacks foreign bodies and invading organisms — starts to destroy the protective coating (the myelin sheath) that surrounds the nerves. This damage prevents nerves from transmitting signals to the brain.

paralysis

After the first signs appear, symptoms of GBS can progress over the course of hours, days or weeks, typically peaking in two to three weeks. www.OurHealthRichmond.com

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BREAKING THE SILENCE

Diagnosis and Treatment

Until there is a proven cure, the best way to PROTECT YOURSELF AND YOUR FAMILY is to become familiar with the signs and symptoms of GUILLAIN-BARRÉ SYNDROME and have an open conversation with your healthcare provider.

“Guillain-Barré syndrome can be difficult to diagnose, as the symptoms are similar to those of other neurological disorders or conditions that affect the nervous system, like botulism, heavy metal poisoning and meningitis,” says Dr. Vota. Arriving at an accurate diagnosis involves a medical history — including any recent illnesses, vaccinations or surgeries — a complete physical exam, a neurological assessment and additional studies such as spinal tap, MRI, electromyography and nerve conduction test.” While there’s no cure for Guillain-Barré syndrome, there are treatments that can reduce the severity of the illness, manage complications and help speed recovery. Most individuals with GBS require hospital treatment.

Two main types of GBS therapy are: 1. High-dose immunoglobulin therapy: Injections of high doses of special

proteins that help reduce the immune system’s attack on the body’s nerve cells. 2. Plasma exchange (plasmapheresis): Blood purification procedure used to treat

certain autoimmune diseases. A critical aspect of treating GBS is keeping the patient’s body functioning while the nervous system recovers, including: Breathing difficulties. The weakness or paralysis associated with GBS can

affect the muscles that control breathing — a potentially fatal complication. Up to 30 percent of patients with GBS need to be temporarily placed on a respirator or ventilator to support breathing.

– Scott Vota, DO

Heart and blood pressure issues. Blood pressure fluctuations and irregular

heart rhythms (cardiac arrhythmias) are common side effects of GBS. Pain. Up to half of people with Guillain-Barré syndrome experience severe

nerve pain, which may be eased with medication. Blood clots and pressure sores. Patients who are immobile due to GBS are

at risk of developing blood clots and bedsores. READ THIS EDITION OF

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Most individuals have a good recovery from Guillain-Barré syndrome, although the recovery period may vary — from as little as a few weeks to as long as a few years. Some people may experience lingering effects, such as weakness, numbness or fatigue, and a small number may suffer a relapse years after the initial attack. David A. Lawrence, physical therapist and founder of Lawrence Rehabilitation, notes, “Patients may need physical therapy as well as emotional support following the initial acute treatment.”

What does the future hold? Neurologists, immunologists, virologists, pharmacologists and other specialists are working collaboratively to learn how to prevent Guillain-Barré syndrome and how to treat it more effectively when it strikes. 26

OurHealth | The Resource for Healthy Living in Greater Richmond


B R EAK I NG THE SI LENC E |

Researchers are investigating the workings of the immune system to find which cells are responsible for initiating and carrying out GBS’s attack on the nervous system. The fact that so many cases of Guillain-Barré syndrome begin after a viral or bacterial infection suggests that certain characteristics of some viruses and bacteria may activate the immune system inappropriately.

EXPERT CONTRIBUTORS

“Patients may need physical therapy as

David A. Lawrence, MSPT, ATC is the founder of Lawrence Rehabilitation-The Gait Center in Richmond.

well as emotional

Scott Vota, DO is a Neurologist with VCU Health System. Dr. Vota is certified by the American Board of Psychiatry & Neurology.

support following

SOURCES Centers for Disease Control and Prevention (CDC) GBS/CIDP Foundation International National Institutes of Health — National Institute of Neurological Disorders and Stroke

ON THE WEB

Guillain-Barre Syndrome

“Until there is a proven cure, the best way to protect yourself and your family is to become familiar with the signs and symptoms of Guillain-Barré syndrome and have an open conversation with your healthcare provider,” concludes Dr. Vota.

the initial acute treatment.” DAVID A. LAWRENCE, MSPT, ATC Physical therapist and founder of Lawrence Rehabilitation.

More at ourhealthrichmond.com

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27


Celebrating Excellent

BEDSIDE MANNER

In room one, a single mother waits. Her headaches have been getting more intense and frequent lately. Is it the stress of raising three energetic boys on her own, or does she have a brain tumor? She isn’t normally so pessimistic, but her fears have taken hold. In room two, a retired grandfather sits and worries. Although he has worked hard to manage his type 2 diabetes, he struggles with his wife’s developing dementia. He tries to have strong willpower, but finds himself eating too many candy bars to cope with the loneliness and stress. In room three, an anxious mother tries to comfort her coughing child. He has never been this sick in his five years of life, and she worries. Is this just a normal cold that will lead to a quick recovery, or could it be something more serious? Could he be developing life-threatening asthma like his dad has? In room four, a middle-aged father tries to read a sports magazine in an uncomfortable chair. He has noticed his hand shaking lately, and he worries. Is it something perfectly explainable, or could he be developing a potentially debilitating disease that will rob him of the chance to play basketball with his sons?

28

OurHealth | The Resource for Healthy Living in Greater Richmond


Across the country, patients sit in medical providers’ offices, waiting anxiously. They bring to their brief appointments their life stories, cultural contexts, anxieties, responsibilities and challenges. As they sit in small rooms sharing their experiences, patients want to know that their medical providers care, even if their medical conditions aren’t as serious as they fear they might be. To be effective, medical providers need to understand and relate to every single patient they see, which is often nearly 20 patients per day. In other words, bedside manner matters. Providers with an excellent bedside manner treat their patients well; they listen and are kind, understanding, patient and empathetic. According to a recent study, patients whose medical providers interacted positively with them had better outcomes in the areas of obesity, diabetes, asthma, heart health and osteoarthritis. Researchers have also found that patients are more likely to adhere to treatment plans when their medical providers are compassionate and patient-focused. In addition, studies have found that, when physicians treat patients with empathy, it helps not only the patients, but also the medical providers themselves, who report decreased burnout and an increased sense of well-being. Incidents of malpractice also decrease, thus alleviating physician stress. That happens because a patient is more likely to share information that might impact the treatment plan when she feels comfortable and valued. A medical provider with a good bedside manner will walk into a room and focus completely on the patient. He makes eye contact and engages the patient in conversation in a kind, friendly way. The medical provider also expresses to the patient that he feels empathy; the provider wants to hear the patient’s story and is willing to understand her perspective. These qualities distinguish an outstanding doctor from one who is merely competent.

For the fifth year in a row, OurHealth Richmond is pleased to present the awards for local medical providers with the best bedside manner. While other awards recognize medical providers for their knowledge and competence, the Best Bedside Manner Awards are unique because they ask members of the public—not other medical providers—to share their input about how doctors relate to patients. Polling for the Best Bedside Manner Awards took place in May, and over 35,000 local people voted for medical providers in over 50 medical specialties. Because of the value that patients place on medical providers’ compassion and care, the number of people voting for these awards has increased by double digit percentages each year. For many people, meeting with a doctor can be stressful and overwhelming. Thankfully, so many of our community’s medical professionals recognize that challenge and walk into the room with a warm smile and the willingness to hear their patients’ stories. While the region lays claim to many medical providers who deliver excellent care, those who receive the Best Bedside Manner Awards have developed exceptional interpersonal skills and deserve to be recognized for this.

Please join us in congratulating this year’s 5th Annual Best Bedside Manner Award winners. The Voting Process: During the month of May 2017, the Best Bedside Manner Awards Voting Form was available on OurHealth’s website, www.ourhealthrichmond.com. The form consisted of over 40 medical specialties (with definitions of each specialty) in which the public could submit the first and last names of local medical providers by the applicable specialty. If you have any questions, please contact Stephen McClintic Jr., publisher of OurHealth, at steve@ourhealthvirginia.com or 540.387.6482.

ON THE WEB

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29


— Lawrence Gelber, MD

LAWRENCE GELBER, MD

Good bedside manner is very important to me in order to connect with my patients and show them compassion, respect, understanding, and my investment in their care. I spend as much time with my patients as necessary to put them at ease and enable them to voice their needs

AUDIOLOGY BARIATRIC MEDICINE

WEI ZHAO, MD Children’s Hospital of Richmond at VCU Chesterfield | 804.828.CHOR (2467) www.chrichmond.org

ROBERT CALL, MD Richmond Allergy & Asthma Specialists Henrico | 804.285.7420 www.richmondallergy.com

THIRD PLACE

BARRY FEINSTEIN, MD Advanced Allergy and Asthma of Virginia Richmond | 804.739.9005 www.advancedallergyva.com

PATRICK POWERS, MD Allergy Partners of Richmond Richmond | 804.288.0055 www.allergypartners.com/richmond

HONORABLE MENTION

— Ann Marie Harman

FIRST PLACE ANN MARIE HARMAN

Commonwealth Anesthesia Associates Richmond | 804.594.2622 www.caa-med.com

— Lawrence Gelber, MD

30

HONORABLE MENTION CONTINUED

“As an anesthesiologist, you have a very small window, to gain the confidence of the patient and family. It is of utmost importance to relieve the anxiety of the upcoming surgery and portray your expertise, and I find HUMOR is always helpful!”

and concerns.

FIRST PLACE

SECOND PLACE

MICHAEL BLUMBERG, MD, MSHA Allergy Partners of Richmond Richmond | 804.288.0055 www.allergypartners.com/richmond

Richmond Allergy & Asthma Specialists Henrico | 804.285.7420 www.richmondallergy.com

ANESTHESIOLOGY

ALLERGY & IMMUNOLOGY

FIRST PLACE

“I am honored to receive this recognition and truly appreciate the many patients who voted for me. Good bedside manner is very important to me in order to connect with my patients and show them compassion, respect, understanding, and my investment in their care. I spend as much time with my patients as necessary to put them at ease and enable them to voice their needs and concerns. This allows for better medical management and ultimately the best possible outcome. I strive to thoroughly explain the treatment options and answer any questions they may have. It is a privilege to provide allergy care to each and every patient.”

FIRST PLACE JESSICA POE, AUD

“I want my patients to feel comfortable and at ease when they enter my office and to leave not only hearing better but also feeling like I gave them my undivided attention and addressed their needs. I take care of every patient exactly as I would my family and friends.” — Jessica Poe, AuD

Virginia Ear Nose & Throat Mechanicsville | 804.484.3700 www.virginia-ent.com

“As physicians, we have the honor and privilege of being intimately involved in people’s lives. Obesity is a chronic, progressive, complex, relapsing disease that requires lifelong treatment. Only by establishing meaningful relationships with patients, can we help work through the complex factors that affect body weight to develop an evidence-based, patient-centered treatment plan to achieve successful long-term weight loss and improved health and well-being.”

JEFF SICAT, MD, FACE

Virginia Weight & Wellness Glen Allen | 804.726.1500 www.virginiaweightloss.com

OurHealth | The Resource for Healthy Living in Greater Richmond

— Jeff Sicat, MD, FACE

ANN MARIE IRANI, MD Children’s Hospital of Richmond at VCU Chesterfield | 804.828.CHOR (2467) www.chrichmond.org

SECOND PLACE

HONORABLE MENTION

PHILIP DEWITT Commonwealth Anesthesia Associates Richmond | 804.594.2622 www.caa-med.com

DAVID PALOMBO, MDD, MSHA Virginia Urology Richmond | 804.330.9105 www.uro.com JAMES STONE JR., MD Commonwealth Anesthesia Associates Richmond | 804.594.2622 www.caa-med.com

THIRD PLACE JOHN BOOTH, MD North American Partners in Anesthesia HCA Virginia Richmond | 804.254.5100 www.retreatdoctors.com

SECOND PLACE

HONORABLE MENTION

LEAH BALL, AUD Richmond Hearing Doctors Richmond | 804.282.0022 www.richmondhearingdoctors.com

ELIZABETH ANDERSON, AUD Anderson Hearing & Speech Richmond | 804.382.4137 www.eahshearing.com

THIRD PLACE

HOLLY LAW, MED, CCC-A Richmond Hearing Aids Richmond | 804.937.EARS (3277) www.RichmondHearingAids.com

SUSAN FOWLER, MED, CCC-A Comprehensive ENT Glen Allen | 804.228.4484 www.comprehensiveent.us

SECOND PLACE

HONORABLE MENTION

DAPHNE BRYAN, MD Bon Secours Bermuda Crossroads Primary Care Chester l 804-287-4550 www.bonsecours.com

MATTHEW BRENGMAN, MD, FACS Advanced Surgical Partners of Virginia HCA Virginia Physicians Richmond | 804.360.0600 www.advancedsurgicalpartnersofva.com

THIRD PLACE GREGORY SCHRODER, MD, FACS Advanced Surgical Partners of Virginia HCA Virginia Physicians Richmond | 804.360.0600 www.advancedsurgicalpartnersofva.com


2 01 7 B EST B EDSI DE MANNER AWAR DS |

CARDIOLOGY FIRST PLACE MARK JOHNS, MD, FACC Cardiology of Virginia Midlothian | 804.560.8782 www.cardiovirginia.com

SECOND PLACE

HONORABLE MENTION CONTINUED

WILLIAM COBLE, JR., MD, FACC Virginia Cardiovascular Specialists Richmond | 804.323.5011 www.vacardio.com

BRADFORD MATTHEWS, MD FACC Virginia Cardiovascular Specialists Richmond | 804.323.5011 www.vacardio.com

THIRD PLACE

CLIFFORD V. MORRIS, MD Morris Cardiovascular and Risk Reduction Center Hopewell | 804.530.1044 www.morriscardio.com

HONORABLE MENTION JIHO HAN, MD FACC Virginia Cardiovascular Specialists Richmond | 804.323.5011 www.vacardio.com

Greater Richmond

MARK DOLORESCO, MD Bon Secours Cardiovascular Associates of Virginia Chester | 804.285.6018 www.bonsecours.com

KEYUR SHAH, MD VCU Health Richmond | 804.628.4327 www.vcuhealth.org

CHIROPRACTIC FIRST PLACE MARK GUARINO

Guarino Chiropractic Glen Allen | 804.747.7474 www.guarinochiropractic.com

SECOND PLACE

HONORABLE MENTION

LISA HOLLAND, DC Ariya Family Chiropractic Centers Innsbrook/Westend | 804.270.5700 www.ariyafamilychiropractic.com

DAVID BERV, DC Back In Action Chiropractic Center, PC Richmond | 804.254.0200 www.feelgr8.com

THIRD PLACE ANNA BENDER, DC Atlee Chiropractic Center Mechanicsville | 804.730.7010 www.alteechiropractic.com

*As of October 1st, Dr. Berv is no longer seeing patients at Back In Action. You may now find him at The Float Zone as the chief experience officer.

ELAINE BOLTE, DC, CCWFN Health Link Family Chiropractic Mechanicsville | 804.559.6818 www.healthlinkva.com

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31


HEALTHCARE PROVIDER

DENTISTRY: GENERAL

DENTISTRY: COSMETIC

make the

CUT?

CONCIERGE MEDICINE

Did your favorite

“Tests provide results which can sometimes point to a diagnosis, while taking the time to develop good rapport with your patients fosters trust and openness. Ultimately, the ability to provide the best personal care and subsequently better outcomes stem from relational interactions between doctor and patient.”

FIRST PLACE

— Karen McAndrew, DMD, MS KAREN MCANDREW, DMD, MS

Virginia Center for Prosthodontics Richmond | 804.741.8689 www.vapros.net

“Being the recipient of the Gold Award for the Best Bedside Manner in Dentistry is very humbling. Aside from the complex and technical aspects of our profession, which I enjoy, it is the connection with the people that endears me to my work. I feel it is important to listen to each individual patient so that their treatment can be customized to fit their needs and ensure a comfortable patient experience. We are truly grateful for each and every one of our patients at River City Dentistry. Thank you for bestowing this honor on me.” — Susan Richardson-Overstreet, DDS

SUSAN RICHARDSON-OVERSTREET, DDS

HONORABLE MENTION

HONORABLE MENTION ROMAN HAUEIS, DMD, CAGS Short Pump Dental Henrico | 804.747.0116 www.shortpumpdental.com

THIRD PLACE

AL STENGER, DDS Drs. Stenger, Cole & Gupta Richmond | 804.320.7147 www.richmonddentist.net

SECOND PLACE (TIE)

HONORABLE MENTION

KEITH ELDRIDGE, DDS Virginia Family Dentistry Chesterfield | 804.743.8166 www.vadentist.com

LYNN BOOTH, DDS Penterson & Booth Family and Cosmetic Dentistry Midlothian | 804.739.1600 www.pbddssmiles.com

AILIN SHAN, DMD Glenside Dental Richmond | 804.756.6658 www.glensidedental.com

THIRD PLACE BENJAMIN CROWLEY, DDS Crowley Dentistry Richmond | 804.223.5264 www.drcrowleydds.com

River City Dentistry Glen Allen | 804.270.7737 www.rivercitydentistryrva.com

— Jeff Sicat, MD, FACE OurHealth | The Resource for Healthy Living in Greater Richmond

JIM MUMPER, MD Partner MD Richmond | 804.237.8282 www.partnermd.com

STEPHEN BROWN, DDS Brown, Reynolds, Snow, LeNoir Dentistry Richmond | 804.288.5324 www.richmondcosmeticdentistry.com

As physicians, we have the honor and privilege of being intimately involved in people’s lives... Only by establishing meaningful relationships with patients, can we help develop an evidence-based, patient-centered treatment plan to achieve improved health and well-being. 32

THIRD PLACE

SECOND PLACE

JEFF BLACKBURN, DDS, FAGD South River Dentistry Midlothian | 804.409.0588 www.midlothiandentist.com

FIRST PLACE

JOY ROWE, MD Partner MD Richmond | 804.237.8282 www.partnermd.com

J. RAND BAGGESEN, MD Executive Health Group Richmond | 804.560.3295 www.executive.md

Health Visions MD Midlothian | 804.601.6599 www.healthvisionsMD.com

“I am humbled to again receive this recognition for the most important aspect of our practice is patient care and comfort. As a specialist in prosthodontics, it is our responsibility to treat the many needs of our patients. Spending time providing information and addressing concerns is just as important as the actual delivery of care. Our time with you is the most important part of our day.”

FIRST PLACE

— John Verheul, MD, MPH

JOHN VERHEUL, MD, MPH

SECOND PLACE

MISHA GHAZARIAN, DDS, DICOI Virginia Family Dentistry Midlothian | 804.794.9789 www.vadentist.com ALEX HAWKINS, DDS Hawkins Family Dentistry Midlothian | 804.897.9800 www.Hawkinsdentist.com ELIZABETH REYNOLDS, DDS Brown, Reynolds, Snow, LeNoir Dentistry Richmond | 804.288.5324 www.richmondcosmeticdentistry.com


www.OurHealthRichmond.com

33


DENTISTRY: PEDIATRIC DERMATOLOGY

“As a pediatric dentist, I find that establishing a caring, compassionate relationship with my young patients keeps them from developing anxiety about going to the dentist throughout their entire lives. I strive to treat each of my patients as I would my own children.” — Holly Lewis, DMD, MS

FIRST PLACE HOLLY LEWIS, DMD, MS

Sparkle Pediatric Dentistry Henrico | 804.746.7382 www.sparklepediatricdentistry.com

“I approach each individual that walks into my office as a person first, a patient second. I dedicate my work day to listening, connecting and learning about people because it gives me the opportunity to provide the best care tailored to each individual’s unique needs.” — Melissa King, MD, JD

FIRST PLACE MELISSA KING, MD, JD

SECOND PLACE

HONORABLE MENTION

MALINDA HUSSON, DDS, MSD Atkins, Maestrello, Miller, & Associates Pediatric Dentistry, PC Richmond | 804.741.2226 www.pediatricdentistrichmond.com

JOHN FLOWERS, DDS Children’s Dentistry of Virginia, PC Midlothian | 804.639.6445 www.childrensdentistryofva.com

THIRD PLACE NAVIN SHETTY, DDS, MS Virginia Dental & Anesthesia Associates Glen Allen | 804.273.6818 www.vdaa.info

ROGER WOOD, DDS Drs. Wood, Dunlevy & Lombardozzi Midlothian | 804.794.3498 www.kidsdentists.com

SECOND PLACE (TIE)

HONORABLE MENTION

CAMILLE HAISLEY-ROYSTER Commonwealth Dermatology Richmond | 804.282.0831 www.comderm.com

JO BOHANNON-GRANT, MD Midlothian Dermatology Midlothian | 804.378.3048 www.midloderm.com

GEORGIA K. SEELY, MD Dermatology Associates of Virginia PC Glen Allen/Richmond | 804.549.4025 www.dermva.com

VICTORIA GROSS, MD Richmond Dermatology & Laser Specialists Richmond | 804.282.8510 www.richmonddermlaser.com

THIRD PLACE

LAURIE L. SHINN, MD Commonwealth Dermatology (Pediatric) Richmond | 804.282.0831 www.comderm.com

SHARON S. CAMDEN, MD PHD Dominion Dermatology Glen Allen | 804.262.6060 www.dominiondermatology.org

Richmond Dermatology & Laser Specialists Richmond | 804.282.8510 www.richmonddermlaser.com

CHRIS MAESTRELLO, DDS Atkins, Maestrello, Miller, & Associates Pediatric Dentistry, PC Richmond | 804.741.2226 www.pediatricdentistrichmond.com

“My hope for my clients is to not only be healthy but to see the beauty within themselves!”

Did your favorite

HEALTHCARE PROVIDER make the

34

CUT?

DIETETICS

— Trish Wilkins, MS, RD

OurHealth | The Resource for Healthy Living in Greater Richmond

SECOND PLACE ASHLEY MANNELL, RD, NP, IFMCP Richmond Integrative Psychiatric & Nutrition Services Richmond | 804.513.9507 richmondfoodandmood.com

THIRD PLACE

FIRST PLACE TRISH WILKINS, MS, RD Richmond | 804.346.9866 www.trishwilkins.com

MARY-JO SAWYER, RD VCU Health Richmond | 800-762-6161 www.vcuhealth.org


2 01 7 B EST B EDSI DE MANNER AWAR DS |

EMERGENCY MEDICINE “From the moment a patient enters the Emergency Department until they are discharged, building trust and engaging the patient is perhaps one of the most important elements of their visit and many result in better healthcare outcomes. Medical knowledge, concern for the patient and an ability to understand the patient through smiling, appropriate touch and humor, lets the patient know they are more important and matter. All patients want and need a physician who listens, cares and take the time to engage with them.” — Robert Powell, MD

FIRST PLACE ROBERT POWELL, MD

Bon Secours Richmond Emergency Physicians Richmond | 804.287.7066 www.bonsecours.com

HONORABLE MENTION

KEVIN J. NOREIKA, DO James River Emergency Group, LLC Richmond

ERIC ENGLISH, MD Virginia Emergency Physicians Richmond | 804.330.2000

THIRD PLACE

KENNETH S. HICKEY, MD, FACEP James River Emergency Group, LLC Richmond

RENEE REID, MD VCU Health Richmond | 800.762.6161 www.vcuhealth.org

Greater Richmond

SECOND PLACE

ENDOCRINOLOGY FIRST PLACE LEANZA LIU, MD

Modern Richmond Endocrinology Richmond | 804.267.6920 www.modernendocrine.com

SECOND PLACE

HONORABLE MENTION

CYNTHIA RYAN, MD, FACE Virginia Endocrinology Midlothian | 804.423.3636 www.virginiaendo.com

MEREDITH BERGER, MD Virginia Diabetes & Endocrinology, PC Midlothian | 804.272.2702 www.vadiabetes.com

THIRD PLACE

ROBERT P. CASTELLUCCI, MD Henrico | 804.282.9899

KELSEY SALLEY. MD Virginia Endocrinology Midlothian & Henrico | 804.423.3636 www.virginiaendo.com

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35


FAMILY PRACTICE

“A compassionate bedside manner is the antidote to today’s often cold and impersonal hi-tech medical environment. It is also what every person deserves. I am fortunate to work for an organization that puts a high priority on love, accountability and passionate service to those in need.”

FIRST PLACE DANIEL JANNUZZI, MD

JenCare Senior Medical Center Richmond | 804.344.9848 www.jencaremed.com

THIRD PLACE

HONORABLE MENTION CONTINUED

WILLIAM MOORE, MD Bon Secours Laburnum Medical Center Richmond l 804.226.2444 www.bonsecours.com

ERIC HAACKE-GOLDEN, MD Virginia Family Physicians Midlothian | 804.323.1264 www.virginiafamilyphysicians.com

PAMELA WRATCHFORD, MD Ashcake Family Practice Mechanicsville | 804.559.2916 www.ashcakefamilyphysician.com

XIAOHUA YAN, MD Patient First Richmond | 804.360.8061 www.patientfirst.com

HONORABLE MENTION

DONALD YEATTS, MD Family Practice Associates Midlothian | 804.320.3999 www.familypracticeassociates.com

FERTILITY SPECIALIST

SECOND PLACE (TIE)

M. LEE BLACKBURN, JR. MD Hanover Family Physicians Mechanicsville | 804.730.0990 www.hanoverfp.org

“In this highly technical world, in general, and in medicine in particular; it is important we strive to ensure a personal, human, compassionate experience in patient care. We want our couples comfortable and confident as we move through our treatments.”

FIRST PLACE

— Kenneth Steingold, MD

KENNETH STEINGOLD, MD

Virginia Fertility Associates Richmond | 804.379.9000 www.virginiafertilityassociates.com

THIRD PLACE

HONORABLE MENTION

ANISH SHAH, MD Virginia Fertility Associates Richmond | 804.379.9000 www.virginiafertilityassociates.com

GEOF TIDEY, MD Virginia Fertility Associates Richmond | 804.379.9000 www.virginiafertilityassociates.com

MICHAEL EDELSTEIN, MD Virginia Fertility Associates Richmond | 804.379.9000 www.virginiafertilityassociates.com

GASTROENTEROLOGY

SECOND PLACE

“Patients may be nervous or worried, and a smile or warm handshake can go a long way to make them more comfortable and provide reassurance. Like any individual, they deserve compassion, respect and empathy. I consider it a great honor to win this award.”

FIRST PLACE

— Robert S. Flynn, MD

ROBERT S. FLYNN, MD

Richmond Gastroenterology Associates Richmond | 804.330.4021 www.richmondgastro.com

SECOND PLACE

THIRD PLACE

HONORABLE MENTION CONTINUED

HENRY ELLETT, MD Gastrointestinal Specialists, Inc. Richmond | 804.285.8206 www.gastrova.com

YIPING RAO, MD Digestive Care Center of Virginia Petersburg | 804.504.5570 www.virginiagi.com

HOWARD O. HAVERTY JR., MD Richmond Gastroenterology Associates Richmond | 804.330.4021 www.richmondgastro.com

HONORABLE MENTION

SHANNON TOWNSEND, PA-C Richmond Gastroenterology Associates Mechanicsville | 804.559.6194 www.richmondgastro.com

WILLIAM BRAND JR., MD Gastrointestinal Specialists, Inc. Henrico | 804.285.8206 www.gastrova.com

36

— Daniel Jannuzzi, MD

OurHealth | The Resource for Healthy Living in Greater Richmond


www.OurHealthRichmond.com

37


GERIATRIC CARE FIRST PLACE JEFFREY GRAVES, MD

JenCare Senior Medical Center Richmond | 804.674.3425 www.jencaremed.com

“Patients entrust physicians with their most prized possession, their health. This responsibility should be treated with respect and courtesy.” — Jeffrey Graves, MD

SECOND PLACE

HONORABLE MENTION

KHALID KARIM, MD Bon Secours Senior Care Services Glen Allen l 804.893.8627 www.bonsecours.com

VICKI LATHAM-SOLOMON, MD Bon Secours Canal Crossing Internal Medicine Richmond l 804.298.3460 www.bonsecours.com

THIRD PLACE SARAH HOBGOOD, MD VCU Health Richmond | 800.762.6161 www.vcuhealth.org

HEMATOLOGY/ONCOLOGY FIRST PLACE SEABORN WADE, III, MD

Virginia Cancer Institute Mechanicsville | 804.559.2489 www.vacancer.com

“Our patients are going through the toughest battle they have ever faced. I try to show them hope and empathy to help them not only fight their cancer, but live their lives to the fullest.” — Seaborn Wade, III, MD

SECOND PLACE

HONORABLE MENTION CONTINUED

HUI LIN, MD Hunter Holmes McGuire VA Medical Center Richmond | 804.675.5000 www.richmond.va.gov

GORDON GINDER, MD VCU Health Richmond | 804.828.5116 www.masseycancercenter.org

THIRD PLACE PABLO GONZALEZ, MD Virginia Cancer Institute Richmond | 804.330.7990 www.vacancer.com

HONORABLE MENTION ELKE FRIEDMAN, MD Virginia Cancer Institute Richmond | 804.330.7990 www.vacancer.com

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OurHealth | The Resource for Healthy Living in Greater Richmond

LAWRENCE LEWKOW, MD Virginia Cancer Institute Richmond | 804.330.7990 www.vacancer.com RYAN RADDIN, MD Bon Secours Cancer Institute at St. Francis Medical Center Midlothian l 804.893.8717 www.bonsecours.com WILL VOELZKE, MD Virginia Cancer Institute Richmond | 804.330.7990 www.vacancer.com


HOSPITALIST INFECTIOUS DISEASE INTERNAL MEDICINE NEONATOLOGY

FIRST PLACE AMY SCHEER, DO

Before going into medicine, a good friend of mine expressed the difficulties she had had with doctors – the feelings of powerlessness and vulnerability one feels when sick or hospitalized. Every day, I remind myself that the person across from me could just as easily be my mom, dad, friend, or child. I strive to treat everyone with the same compassion and empathy I would want a doctor to show to me or my parents if we were in the same situation.

AD Senior Medical Richmond | 214.957.2898

— Amy Scheer, DO

Patients may be nervous or worried, and a smile or warm handshake can go a long way to make them more comfortable and provide reassurance. Like any individual, they deserve compassion, respect and empathy. I consider it a great honor to win this award.

SECOND PLACE MARK DAVIS, MD Hospitalists of Virginia, LLP Richmond

THIRD PLACE YI SUN, MD CareMore Richmond

HONORABLE MENTION BRIAN HANRAHAN, MD James River Hospitalist Group, LLC Richmond

— Robert S. Flynn, MD

SECOND PLACE SHARIKA TRIPATHI, MD Richmond Nephrology Associates Richmond | 804.464.1028 www.richmondnephrologyassociates.com

FIRST PLACE MARK GENTZ, DO

Bon Secours St. Mary’s Hospital Richmond (no phone) www.bonsecours.com

THIRD PLACE JAMES W. BROOKS, MD HCA – Infectious Disease Specialists Richmond | 804.285.1833 www.hcavirginia.com

“This award means a great deal to me and I am so grateful for the privilege and opportunity to care for my patients. I couldn’t have earned this if it wasn’t for my outstanding staff that allows me to have the ability and time to give excellent care and attention to each and every patient that comes to our practice.” — Minh Q. Tran, MD

FIRST PLACE

athelas

MINH Q. TRAN, MD

SECOND PLACE

HONORABLE MENTION

KIMBERLY ROGERS, MD JenCare Senior Medical Center Richmond | 804.674.3425 www.jencaremd.com

BETH DU, MD Bon Secours Associated Internists Richmond l 804.288.3079 www.bonsecours.com

THIRD PLACE

WILLIAM FERRAR, MD, FACP Primary Health Group – Henrico HCA Virginia Physicians Richmond | 804-282-2580 www.phg-henrico.com

FRANCESCA GLYNN, MD Bon Secours Internal Medicine Associates of Chesterfield Midlothian | 804.423.8470 www.bonsecours.com

Reynolds Primary Care Richmond | 804.346.1515 www.vaphysicians.com

“As a neonatologist, it’s my privilege to care for NICU babies and their families during times of great stress. I try never to let that get lost in the maze of technology and alarms.” — Russell Moores, MD

FIRST PLACE RUSSELL MOORES, MD

Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org

ANAND LOTHE, MD Virginia Physicians, Inc. Glen Allen | 804.346.1780 www.vaphysicians.com

SECOND PLACE LYNN JOHNSON, MD Pediatrix Medical Group Richmond | 804.282.8082

THIRD PLACE JENNY FOX, MD, MPH Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org

Did your favorite

HEALTHCARE PROVIDER make the

CUT?

www.OurHealthRichmond.com

39


OBSTETRICS & GYNECOLOGY

NURSE PRACTITIONER (NP)

NEUROLOGY

NEPHROLOGY

“A good patient result starts with a happy patient. My contribution is putting the patient at ease with me personally and my commitment to helping them feel better.”

40

— Ari Hirsch, MD

SECOND PLACE

HONORABLE MENTION

TIM BUNCHMAN Children’s Hospital of Richmond at VCU 804.828.CHOR (2467) www.chrichmond.org

DOMENIC SICA, MD VCU Health Richmond | 804.828.2161 www.vcuhealth.org

THIRD PLACE

MARTIN STARKMAN, MD HCA Virginia Richmond | 804.282.8005 www.hcavirginia.com

PETER CONDRO, MD, FASN Richmond Nephrology Associates Richmond | 804.272.5814 www.richmondnephrologyassociates.com

FIRST PLACE ARI HIRSCH, MD

Richmond Nephrology Associates Richmond | 804.272.5814 www.richmondnephrologyassociates.com

“It is a great honor to be nominated for this award by my patients and peers, and an even greater honor to be selected as the winner. Patients heal better when they have positive interaction with their doctors and nurses and feel supported by the members of the health care team. Having a good bedside manner and developing good patient rapport is one of our most important skills as healthcare providers.” — John O’Bannon

FIRST PLACE JOHN O’BANNON, III, MD Neurological Associates HCA Virginia Physicians Richmond | 804.288.2742 www.nairichmond.com

“Establishing a good rapport with families is essential to great healthcare and provides the foundation for a trusting partnership.” — Stephanie Smith, CPNP, CLC

FIRST PLACE

HONORABLE MENTION

DAWEN BU, MD Neuro-Care of Virginia Prince George | 804.452.4546

STEPHEN THURSTON, MD Neurological Associates HCA Virginia Physicians Richmond | 804.288.2742 www.nairichmond.com

THIRD PLACE STACEY EPPS, MD Bon Secours Neurology Clinic Midlothian l 804-325-8750 www.bonsecours.com

Richmond Pediatric Associates, Inc. Mechanicsville | 804.559.0447 www.richmondpediatrics.com

“As physicians, we are entrusted with a significant responsibility to care for our patients, but at the same time it is a privilege. Connecting with patients and their families may require a little more time, but in the end, the extra effort allows for better care and is more rewarding for all involved.” — Mark Hyde, MD, FACOG

MARK HYDE, MD, FACOG

VPFW (Virginia Physicians for Women) Richmond | 804.897.2100 www.vpfw.com

OurHealth | The Resource for Healthy Living in Greater Richmond

ROBERT WHITE, MD Neurological Associates HCA Virginia Physicians Richmond | 804.288.2742 nairichmond.com

SECOND PLACE

HONORABLE MENTION

AMY L. FOSTER, ACNP Richmond Gastroenterology Associates Richmond | 804.330.4021 www.richmondgastro.com

DALIA ELSAYED, FNP-C Family Practice Specialists of Richmond Midlothian | 804.330.3335 www.fpsrichmond.com

THIRD PLACE (TIE)

NANCY THOMPSON Children’s Hospital of Richmond at VCU 804.828.CHOR (2467) www.chrichmond.org

CATHERINE DOUGLAS, WHNP-BC Virginia Women’s Center Richmond | 804.288.4084 www.virginiawomenscenter.com MARYANN ROBERTS, MS, FNP-C JenCare Senior Medical Center Richmond | 804.228.1143 www.jencaremed.com

STEPHANIE SMITH, CPNP, CLC

FIRST PLACE

SECOND PLACE

LAUREN WOOLFOLK, PMHNP-BC Richmond Creative Counseling Richmond | 804.592.6311 www.richmondcreativecounseling.com

SECOND PLACE

HONORABLE MENTION

ALICE HIRATA, MD Bon Secours Richmond OB-GYN Richmond l 804.320.2483 www.bonsecours.com

RAMZI ABOUJAOUDE, MD, FACOG VPFW (Virginia Physicians for Women) Richmond | 804.897.2100 www.vpfw.com

THIRD PLACE (TIE) JERRY LUCAS, MD Virginia Complete Care for Women HCA Virginia Physicians Richmond | 804.231.9691 www.vacompletecare.com EMILY STONE, MD, FACOG VPFW (Virginia Physicians for Women) Richmond | 804.897.2100 www.vpfw.com

NANCY ARMSTRONG The OB/GYN Group Richmond | 804.447.3627 www.theob-gyngroup.com HEIDI BRAUN, MD Virginia Women’s Center Richmond | 804.288.4084 www.virginiawomenscenter.com

HONORABLE MENTION CONTINUED GREGORY MOORE, MD James River Obstetrics & Gynecology Richmond | 804.272.5508 www.jamesriverobgyn.com DAVID REUTINGER, MD, FACOG VPFW (Virginia Physicians for Women) Richmond | 804.897.2100 www.vpfw.com


OPHTHALMOLOGY

“I consider a doctor’s ability to listen to patients and understand how their medical illness impacts their quality of life as an important factor in their care. Open communication helps to establish a relationship and build trust between patient and provider which enhances the healing process.” — Joseph D. Iuorno, MD

FIRST PLACE

OPTOMETRY

EVAN LESLIE, MD Virginia Eye Institute Richmond | 804.287.4200 www.vaeye.com

THIRD PLACE HEROLD BERNSTEIN, MD Richmond Eye Associates, PC Richmond | 804.270.0330 www.richmondeye.com

HONORABLE MENTION

JOSEPH D. IUORNO, MD

STEPHEN BUSCH. DO Chesterfield Ophthalmology, PC Midlothian | 804.739.2220 www.chesterfieldophthalmology.com

Commonwealth Eye Care Associates Richmond | 804.271.6363 www.commonwealtheye.com

“I enjoy getting to know my patients and taking the time to listen. Not only does it make my day more fun, it also allows me to better optimize correction for their specific visual needs.”

ORAL SURGERY

SECOND PLACE

— Kensington Hatcher, OD

KENSINGTON HATCHER, OD Virginia Eye Institute Richmond | 804.287.4200 www.vaeye.com

“Unlike primary care practitioners, as a specialist I don’t have the opportunity to establish long-term relationships with most of my patients. As a result, I have a much smaller window to gain their confidence. I take every opportunity to create a positive experience very seriously and pride myself in doing so with compassion, expertise, and occasional humor.”

FIRST PLACE ROSS WLODAWSKY, DDS

Virginia Oral & Facial Surgery Midlothian | 804.934.3223 www.oralfacialsurgery.com

— Ross Wlodawsky, DDS

HEALTHCARE PROVIDER make the

SECOND PLACE

HONORABLE MENTION

RICHARD DOUGLAS, OD Douglas Optometry Chester | 804.748.6983 www.douglasoptometry.com

PETER NARDONE, OD Patterson Eye Clinic Richmond | 804.285.7638 www.pattersoneyeclinic.com

THIRD PLACE

ERIC NILSEN, OD Nilsen Eye Care Richmond | 804.858.2020 www.nilseneyecare.com

DAVID LEROUX, OD Family Vision Care of Richmond Glen Allen | 804.217.9883 www.familyvisioncareofrichmond.com

FIRST PLACE

Did your favorite

CUT?

SECOND PLACE

HONORABLE MENTION

GREGORY M. ZOGHBY, DDS Commonwealth Oral and Facial Surgery Richmond | 804.354.1600 www.commonwealthofs.com

NEIL AGNIHOTRI, DMD, MD, FACS Virginia Oral & Facial Surgery Richmond | 804.270.5028 www.oralfacialsurgery.com

THIRD PLACE

D. OMAR WATSON, DDS, MD, FACS Virginia Oral & Facial Surgery Midlothian | 804.794.0794 www.oralfacialsurgery.com

MICHAEL MILLER, DDS Commonwealth Oral and Facial Surgery Richmond | 804.354.1600 www.commonwealthofs.com

www.OurHealthRichmond.com

41


ORTHODONTICS FIRST PLACE GRAHAM GARDNER, DDS Gardner Orthodontics Richmond | 804.282.0505 www.gardnergrins.com

“We have a simple philosophy: we treat our patients like family – with compassion and understanding. Every patient is a special individual and needs to be treated as such. A little kindness and a positive attitude go a long way.” — Graham Gardner, DDS

SECOND PLACE

HONORABLE MENTION

PAUL WHITE, DDS White Orthodontics Richmond | 804.715.1998 www.smilerichmond.com

RICHARD MARCUS, DDS, MS Virginia Family Dentistry Henrico | 804.351.5432 www.vadentist.com

THIRD PLACE

LARRY SCARBOROUGH, DDS James River Orthodontics Henrico | 804.672.8607 www.jamesriverorthodontics.com

WAKESHI BENSON, DDS WB Orthodontics Chester | 804.454.1888 www.wb-orthodontics.com

ORTHOPAEDICS FIRST PLACE GLENN KERR, MD

OrthoVirginia Midlothian | 804.379.2414 www.orthovirginia.com

“I strive to treat my patients like family. I am honored to have the opportunity to take care of so many wonderful people in the Richmond and Chesterfield area.” — Glenn Kerr, MD

SECOND PLACE (TIE)

HONORABLE MENTION

PETER WHITE OrthoVirginia Midlothian | 804.379.2414 www.orthovirginia.com

CHRISTOPHER KIM, MD OrthoVirginia Midlothian | 804.379.2414 www.orthovirginia.com

SHANNON WOLFE, MD Tuckahoe Orthopaedics Richmond | 804.285.2300 www.tuckahoeortho.com

VIVEK SHARMA, MD Colonial Orthopaedics Chester | 804.530.3330 www.colonialorthopaedics.com

THIRD PLACE MARK JONES, MD OrthoVirginia Richmond | 804.379.8088 www.orthovirginia.com

42

OurHealth | The Resource for Healthy Living in Greater Richmond


OTOLARYNGOLOGY (ENT) PAIN MANAGEMENT PALLIATIVE MEDICINE PEDIATRICS

“During residency, my boss constantly reminded me that physicians must be teachers. I think the habit of making sure patients understand what is happening with them goes a long way toward improving their experience.” — David Salley, MD

FIRST PLACE

SECOND PLACE

HONORABLE MENTION

JULIE REDMON, MD Comprehensive ENT Glen Allen | 804.228.4480 www.comprehensiveent.us

ROBERT BRAGER, MD Virginia Ear Nose & Throat Henrico | 804.484.3700 www.virginia-ent.com

THIRD PLACE

DAVID CROSS, PHD, MD, FACS Pediatric & Adult ENT Mechanicsville | 804.569.6240 www.ent-doctors.com

MICHAEL ARMSTRONG, MD Richmond ENT Richmond | 804.622.3782 www.richmondent.com

DAVID SALLEY, MD

Virginia Ear Nose & Throat Richmond | 804.484.3700 www.virginia-ent.com

SECOND PLACE P. DUKE CRANE, MD Neurosurgical Associates, PC Richmond | 804.288.8204 www.neurosurgicalva.com

THIRD PLACE

FIRST PLACE PEYMAN NAZMI, MD

Richmond Spine Interventions & Pain Center Midlothian | 804.378.1800 www.richmondspinepain.com

YAOMING GU, MD National Spine & Pain Center Glen Allen | 804.270.7262 www.treatingpain.com

“Engaging with patients and families is the most valuable time spent by our palliative care team. It leads to trust and helps empower them to become more involved in decisions about medical care.” — Danielle Noreika, MD

DANIELLE NOREIKA, MD

VCU Massey Cancer Center Richmond | 804.628.1295 www.masseycancercenter.org

“I feel honored to be a pediatrician, elected to take care of children and their families. Every child and their advocate deserves respect, understanding and the best of my service. It’s important to me that children feel at ease, have fun and enjoy their experience at our office.” — Melani de Silva, MD, FAAP

MELANI DE SILVA, MD, FAAP RVA Pediatrics Richmond | 804.754.3776 www.rvapediatrics.com

I consider a doctor’s ability to listen to patients and understand how their medical illness impacts their quality of life as an important factor in their care. — Joseph D. Iuorno, MD

SECOND PLACE DAVID BUXTON, MD Insight Physicians and The Center for Palliative Psychiatry Richmond | 804.323.8282 www.palliativepsychiatry.com

THIRD PLACE MARC FLICKINGER, MD Bon Secours Palliative Medicine Richmond l 804-288-2673 www.bonsecours.com

FIRST PLACE

FIRST PLACE

PATRICK GIBBONS, MD Commonwealth Ear Nose and Throat Specialists, PC Midlothian | 804.378.7443 www.commonwealthentpc.com

SECOND PLACE

HONORABLE MENTION

GAURI GULATI, MD Children’s Hospital of Richmond at VCU Richmond | 804.828.CHOR (2467) www.chrichmond.org

PETER HEYMAN, MD, FAAP RVA Pediatrics Richmond | 804.754.3776 www.rvapediatrics.com

THIRD PLACE

ROXANA SERRAN BANTLE, MD Swift Creek Pediatrics Midlothian | 804.378.4420 www.swiftcreekpediatrics.com

DAVID GOSSELIN, MD Richmond Pediatric Associates, Inc. Richmond | 804.747.1750 www.richmondpediatrics.com

PAUL STREHLER, MD, FAAP Commonwealth Pediatrics Richmond | 804.320.1353 www.commonwealthpeds.com

www.OurHealthRichmond.com

43


— David Salley, MD

PERIODONTICS

— Chris Richardson, DMD

FIRST PLACE

CARL BLOCK, DDS, FASO Virginia Family Dentistry Midlothian | 804.379.1011 www.vadentist.com

THIRD PLACE THOMAS KOERTGE, DMD, PHD VCU Health Dental Richmond/804-828-9356 www.periodontics.vcu.edu

HONORABLE MENTION

CHRIS RICHARDSON, DMD

BEN OVERSTREET, DDS Drs. Richardson, Overstreet & Glazier Richmond & Midlothian | 804.355.6593 www.richmondperioonline.com

Drs. Richardson, Overstreet & Glazier Richmond & Midlothian | 804.355.6593 www.richmondperioonline.com

“Bedside manner is essential to achieving optimal patient outcomes. Being a reliable source of information that is communicated in an effective and honest manner is fundamental to helping patients reach their health goals.” — Holly Lake, PharmD

FIRST PLACE

PHLEBOLOGY PHYSICAL MEDICINE

BAYLOR RICE, RPH, FIACP South River Compounding Pharmacy Henrico | 804.897.6447 www.southriverrx.com

THIRD PLACE JENNIFER HELMKE, PHARMD Bremo Pharmacy Richmond | 804.288.8361 www.bremorx.com

HONORABLE MENTION

HOLLY LAKE, PHARMD

MARY BETH GRIMES, PHARMD Buford Road Pharmacy Richmond | 804.272.1423 www.bufordrx.com

Rx3 Compounding Pharmacy Chester & Short Pump | 804.717.5000 www.rx3pharmacy.com

“Good bedside manner is important because people remember how you make them feel. Kindness, caring and compassion go a long way to help people get well.”

44

SECOND PLACE

SECOND PLACE

PHARMACY

During residency, my boss constantly reminded me that Physicians must be teachers. I think the habit of making sure patients understand what is happening with them goes a long way toward improving their experience.

“Having a courteous, respectful, and calm bedside manner let’s the patient know you are sincere and creates an environment where the patient can relax. Dental surgical procedures can be challenging for the patient, and it is important for me to make them feel comfortable.”

— Charles Gould, II, MD

FIRST PLACE

SECOND PLACE WILLIAM TORRES, MD Torres Centers of Virginia Midlothian | 804.897.LEGS (5347) www.veinclinicsofvirginia.com

CHARLES GOULD, II, MD

Richmond Vein Center Richmond | 804.249.VEIN (8346) www.richmondveincenter.com

“You have to actively listen to the patient and build on your conversation throughout the multiple exchanges you may have during a hospitalization. This exchange is the foundation for trust and establishing a relationship that is based upon good open communication.”

FIRST PLACE TIMOTHY SILVER, MD

— Timothy Silver, MD

Sheltering Arms Physical Rehabilitation Centers Mechanicsville | 877.56.REHAB www.shelteringarms.com

SECOND PLACE NATHAN ZASLER, MD, FAAPM&R, FACRM, FIAMIME, DAIPM, CBIST Concussion Care Centre of Virginia, Ltd. Richmond | 804.270.5484 www.concussioncarecentre.com

THIRD PLACE ALBERT JONES, JR, MD Sheltering Arms Physical Rehabilitation Centers Mechanicsville | 877.56.REHAB www.shelteringarms.com

HONORABLE MENTION MANMOHAN S. KHOKHAR, MD Colonial Rehabilitation Group, LLC HCA Virginia Richmond | 804.483.6563


2 01 7 B EST B EDSI DE MANNER AWAR DS |

PHYSICAL THERAPY FIRST PLACE TRACEY ADLER, DPT, OCS, CMTPT Orthopedic Physical Therapy Inc. Richmond | 804.285.0148 www.orthopedicptinc.com

“In my opinion, good bedside manner is part of being a good health care professional. Patients deserve to be “heard”, respected and understood. At Orthopedic Physical Therapy, Inc, the entire staff is committed to these principles.”

— Tracey Adler, DPT, OCS, CMTPT

HONORABLE MENTION CONTINUED

ALLISON WADDELL, PT, DPT, OCS Sheltering Arms Physical Rehabilitation Centers Chester | 877.764.1001 www.shelteringarms.com

JANIE FITZGERALD, DPT Center for Physical Therapy & Sports Medicine, PC Glen Allen | 804.747.7472 www.centerforpt.net

THIRD PLACE

AMANDA LYONS, PT, DPT, NCS Sheltering Arms Physical Rehabilitation Centers Mechanicsville | 877.56-REHAB www.shelteringarms.com

DEREK METZLER, MPT Restore PT Richmond | 804.644.1221 www.restore-pt.com

HONORABLE MENTION DANENE BROWN, PT, DPT Lawrence Rehabilitation: The Gait Center Richmond | 804.523.2653 www.lawrencerehabilitation.com

Greater Richmond

SECOND PLACE

LANCE TOWNSEND, PT King William Physical Therapy Aylett | 804.769.7504 www.kingwilliamphysicaltherapy.com KRISTEN WRIGHT, PT, MPT, CMTPT Orthopedic Physical Therapy Inc. Richmond | 804.285.0148 www.orthopedicptinc.com

PHYSICIAN ASSISTANT (PA) FIRST PLACE SHANNON TOWNSEND, PA-C

Richmond Gastroenterology Associates Mechanicsville | 804.559.6194 www.richmondgastro.com

“In my experience, good bedside manner helps patients feel more comfortable opening up and in turn, facilitates good communication. Our ability to make the correct diagnosis is enhanced by the information we receive from our patients.”

— Shannon Townsend, PA-C

SECOND PLACE

HONORABLE MENTION

JENNIFER BAUER, MPA, PA-C Dermatology Associates of Virginia, PC Richmond | 804.285.2006 www.dermva.com

LAURA DAGEFORDE, PA-C, CDE Virginia Endocrinology & Osteoporosis Center Midlothian | 804.423.3636 www.virginiaendo.com

THIRD PLACE

ERIN POSTON, PA-C Virginia Weight & Wellness Glen Allen | 804.726.1500 www.virginiaweightloss.com

KACIE ALEXANDER, PA-C OrthoVirginia North Chesterfield | 804.320.1339 www.orthovirginia.com

WILLIAM WARREN, PA-C Tuckahoe Orthopaedics Richmond | 804.285.2300 www.tuckahoeortho.com www.OurHealthRichmond.com

45


PLASTIC SURGEON: COSMETIC PLASTIC SURGEON: RECONSTRUCTIVE 46

“My mother was a nurse, and I worked as a nurse’s aide for a while during college. I try to treat all of my patients with the same dignity and respect with which I would expect my family members to be treated.” — Darrin Hubert, MD, FACS

FIRST PLACE DARRIN HUBERT, MD, FACS

SECOND PLACE

HONORABLE MENTION

ISAAC WORNOM, III, MD Bon Secours St. Mary’s Hospital Richmond l 804-585-3420 www.richmondplasticsurgeons.com

DANIEL LUPPENS, MD VCU Health Richmond I 804.828.3060 www.vcuhealth.org

THIRD PLACE

JOSEPH MCKEOWN, MD, FACS McKeown Cosmetic & Reconstructive Surgery Richmond | 804.288.0101 www.virginiacosmetic.com

JOHN ZINSSER, MD Zinsser Plastic Surgery PC Richmond | 804.474.9805 www.zinsserplasticsurgery.com

Richmond Plastic Surgeons, Inc. Richmond | 804.585.3420 www.richmondplasticsurgeons.com

“We aim to treat our patients the way we would like our family to be treated, with compassion and respect. We strive to empower our patients to be healthy, to live beautifully and to face the world with confidence. Winning this award means so much because it let’s us know we are meeting these important goals.”

FIRST PLACE

— Leslie Cohen, MD, FACS

LESLIE COHEN, MD, FACS

Plastic & Reconstructive Surgery Richmond | 804.288.2800 www.lesliecohenmd.com

OurHealth | The Resource for Healthy Living in Greater Richmond

MATTHEW STANWIX, MD Richmond Plastic Surgeons Richmond | 804.285.4115 www.drstanwix.com

SECOND PLACE

HONORABLE MENTION

NADIA BLANCHET, MD Richmond | 804.320.8545 nadiablanchetmd.com

ALLEN BURKE, MD Virginia Ear Nose & Throat Henrico | 804.484.3739 www.virginia-ent.com

THIRD PLACE SHARLINE ABOUTANOS, MD, FAAP, FACS Richmond Plastic Surgeons, Inc. Richmond | 804.585.3420 www.richmondplasticsurgeons.com

ANDREA POZEZ, MD VCU Health Richmond I 804.288.5222 www.vcuhealth.org


SECOND PLACE

HONORABLE MENTION

JAMES SHADBOLT, DPM, FACFAS Henrico and Midlothian | 804.754.7400 www.lovethosefeet.com

KRISTIN GINGRICH, DPM Total Footcare Glen Allen | 804.934.0661 www.totalfootcareva.com

PROSTHETICS AND ORTHOTICS

PODIATRY

THIRD PLACE

FIRST PLACE DAVID WEISS, DPM, DABPS

SCOTT VANTRE, MD Virginia Foot & Ankle Center Mechanicsville | 804.285.3933 www.vafootankle.com

MARYELLEN WALTZ, DPM Central Virginia Foot & Ankle Laser Center Richmond | 804.658.1883 www.cvillefootankle.com

Did your favorite

HEALTHCARE PROVIDER make the

West End Foot and Ankle Richmond | 804.346.1779 www.richmondpodiatry.com

“Good bedside manner is important to me because I want to ensure the patient feels as though they are being taken care of by someone who truly cares about them and their treatment. The reason I switched careers more than 15 years ago was to make a difference in people’s lives and I pride myself on treating my patients like members of my family. I always want my patients to feel comfortable and at ease during our appointments and confident that I have every intention of giving them the best care I can provide.”

FIRST PLACE BETH MARTIN, ABC

Powell Orthotics & Prosthetics Richmond | 804.649.9043 www.powelloandp.com

— Beth Martin, ABC

CUT?

SECOND PLACE JOE SULLIVAN, CP, ABC Powell Orthotics & Prosthetics Richmond | 804.649.9043 www.powelloandp.com

athelas

THIRD PLACE MICHAEL MONTEIRO, ABC Powell Orthotics & Prosthetics Richmond | 804.649.9043 www.powelloandp.com

www.OurHealthRichmond.com

47


— Charles Gould, II, MD

PSYCHIATRY

“Patients sense the sincere concern and compassion of their healthcare providers. This awareness of their physician’s sincerity, honesty and empathy all lead to better outcomes.”

PSYCHOLOGY & COUNSELING

Good bedside manner is important because people remember how you make them feel. Kindness, caring and compassion go a long way to help people get well.

— Martin Buxton, MD

SECOND PLACE WALID FAWAZ, MD, ABPN Virginia South Psychiatric & Family Services, PC Midlothian | 804.378.0800 www.vasouth.com

THIRD PLACE

FIRST PLACE

CHARLES HALL, IV, MD Tucker Psychiatric Clinic Richmond | 804.320.7881 www.tuckerpsychiatric.com

MARTIN BUXTON, MD

Insight Physicians Richmond | 804.323.8282 www.hcavirginia.com *Dr. Buxton in now retired.

SECOND PLACE “It is a true honor and privilege to share this journey with the individuals I serve and without a solid relationship, that journey just isn’t possible. Good bedside manner is really the foundation of what we do and who we are as counselors.” — Carrie Walker, LPC, RPT-S, CTP, ADS

FIRST PLACE

JENNIFER MCCAULEY, LCSW Discovery Counseling & Consulting Richmond | 804.591.0002 www.vadcc.com

THIRD PLACE ANNE SITARZ, PHD, LCP The Westwood Group Richmond | 804.264.0966 www.thewestwoodgroup.org

HONORABLE MENTION

CARRIE WALKER, LPC, RPT-S, CTP, ADS

JAMES BULLOCK, PSYD, LCP Commonwealth Counseling Associates Hanover | 804.730.0432 www.commonwealthcounseling.com

Richmond Creative Counseling Richmond | 804.592.6311 www.richmondcreativecounseling.com

PULMONARY MEDICINE

SECOND PLACE

48

“Good medical care requires open and easy communication between healthcare providers and patients. Including a social component to patient visits, can help achieve this.” — Jamie C. Hey, MD

FIRST PLACE JAMIE C. HEY, MD

Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com

OurHealth | The Resource for Healthy Living in Greater Richmond

ALICE HERLIHY, MD Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com

THIRD PLACE ANDREA MIKSA, MD Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com

HONORABLE MENTION SCOTT RADOW, MD Pulmonary Associates of Richmond, Inc. Henrico | 804.320.4243 paraccess.com


RADIATION ONCOLOGY SECOND PLACE

FIRST PLACE (TIE) JUDY CHIN, MD

Bon Secours Cancer Institute Radiation Oncology And Virginia Urology Midlothian l 804.594.4900 www.radiationoncologyassociates.co

“Good bedside manner is important to me because I know that it is important to my patients. Communication and compassion are major factors in good outcomes for my patients. Patients have to be informed so that they can make good decisions and be comfortable with me so that we can work together towards better health for them.” — Judy Chin, MD

FIRST PLACE (TIE) TIMOTHY HARRIS, MD, PHD VCU Massey Cancer Center Richmond | 804.828.7232 www.masseycancercenter.org

DAVID M. RANDOLPH, MD Virginia Radiation Oncology Associates Sarah Cannon Cancer Institute at Johnston-Willis Hospital HCA Virginia Richmond | 804.483.5164 www.johnstonwillismed.com/cancer

THIRD PLACE SHIYU SONG, MD, PHD VCU Health Richmond I 804.828.7232 www.vcuhealth.org

HONORABLE MENTION THOMAS EICHLER, MD Virginia Radiation Oncology Associates Sarah Cannon Cancer Institute at Johnston-Willis Hospital HCA Virginia Richmond | 804.483.5164 johnstonwillismed.com/cancer TIMOTHY J. WALLACE, MD, PHD Bon Secours Cancer Institute Radiation Oncology And Virginia Urology Midlothian l 804.594.4900 www.radiationoncologyassociates.co/

www.OurHealthRichmond.com

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— Jamie C. Hey, MD

RADIOLOGY

FIRST PLACE RAKESH AGARWAL, MD

Hunter Holmes McGuire VA Medical Center Richmond | 804.675.5000 www.richmond.va.gov

HONORABLE MENTION

KEITH THOMPSON, MD Radiology Associates of Richmond Richmond | 804.727.8806 www.rarichmond.com

MICHAEL BIGG, MD, JD Allison Breast Center Richmond | 804.288.8321 www.allisonbreastcenter.com

THIRD PLACE

A. VADEN PADGETT, MD Commonwealth Radiology Richmond | 804.288.8327 www.commonwealthradiology.com

MATTHEW BASSIGNANI, MD Virginia Urology Midlothian | 804.330.9105 www.uro.com

SECOND PLACE

RHEUMATOLOGY

Good medical care requires open and easy communication between healthcare providers and patients. Including a social component to patient visits, can help achieve this.

SECOND PLACE

“It is a great honor when patients entrust their health to me and my office staff at a time when they are sick and feeling vulnerable. My courtesy and respect should be the least I offer.” — Steven Maestrello, MD

FIRST PLACE

TAMMY SPRINGS, MD Premier HealthCare Associates Richmond | 804.288.7901 www.premierhealthcare-va.com

THIRD PLACE PETER COUTLAKIS, MD Arthritis Specialists, Ltd. Richmond | 804.323.1401 www.arthritisspecialistsltd.com

HONORABLE MENTION

STEVEN MAESTRELLO, MD

E. FORREST JESSEE JR., MD Arthritis Specialists, Ltd. Richmond | 804.323.1401 www.arthritisspecialistsltd.com

Virginia Physicians, Inc. Richmond | 804.346.1551 www.vaphysicians.com

SPORTS MEDICINE

SLEEP MEDICINE

SECOND PLACE

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“Patient centered medicine is the best approach to caring for people that puts them and their concerns first. Bedside manner is the way that a physician interacts with their patients to build and grow the relationship that is necessary to give them and their families the best medical care possible.” — Douglas W. Puryear, MD, FCCP

FIRST PLACE

FIRST PLACE LARRY BENSON, MD

Ortho On Call Richmond | 804.440.4878 www.orthooncall.me

OurHealth | The Resource for Healthy Living in Greater Richmond

RICHARD PARISI, MD Sleep Disorder Center of Richmond Richmond | 804.282.7770 www.richmondsleep.com

MICHAEL POLSKY, MD Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com

Pulmonary Associates of Richmond, Inc. Richmond | 804.320.4243 www.paraccess.com

— Larry Benson, MD

THIRD PLACE

HONORABLE MENTION

DOUGLAS W. PURYEAR, MD, FCCP

“Best bedside manner comes from a place of always putting yourself in the patient’s shoes.”

SAMUEL TAYLOR, MD VCU Health, Center for Sleep Medicine Richmond I 804.323.2255 www.vcuhealth.org

SECOND PLACE

HONORABLE MENTION

KATHERINE DEC, MD VCU Health Richmond | 804.828.0713 www.sportsmed.vcu.edu

WILLIAM BEACH, MD Tuckahoe Orthopaedics Richmond | 804.285.2300 www.tuckahoeortho.com

THIRD PLACE

PAUL KIRITSIS, MD OrthoVirginia Midlothian | 804.379.2414 www.orthovirginia.com

THOMAS LOUGHRAN, MD VCU Health Richmond I 804.828.7069 www.vcuhealth.org


www.OurHealthRichmond.com

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SURGERY: CARDIAC SURGERY: GENERAL SURGERY: NEUROSURGERY

HONORABLE MENTION

LEO GAZONI, MD, FACS Cardiothoracic Surgical Associates HCA Virginia Physicians Richmond | 804.320.2751 www.heartsurgeryva.com

CHIWON HAHN, MD, FACS Cardiothoracic Surgical Associates HCA Virginia Physicians Richmond | 804.320.2751 www.heartsurgeryva.com

THIRD PLACE STEVEN FISER, MD Bon Secours Cardiac Surgery Specialists Richmond l 804.287.7840 www.bonsecours.com

FIRST PLACE VIGNESHWAR KASIRAJAN, MD, FACS Pauley Heart Center Richmond | 804.828.2774 www.vcuhealth.org

“The most fundamental way to convey my respect for a patient, and to build their trust, is through “bedside manners”. Plus, I find it incredibly inspiring to learn a patient’s story of struggle and/ or triumph. It pushes me to be a better surgeon and person.” — Paul Charron, MD, FACS

FIRST PLACE PAUL CHARRON, MD, FACS

SECOND PLACE

HONORABLE MENTION CONTINUED

MELISSA MARINELLO, MD Surgical Associates of Richmond Richmond | 804.474.3341 www.thesar.com

THIRD PLACE

WILLIAM KELLY, JR. MD, FACS Richmond Surgical HCA Virginia Physicians Richmond | 804-285-9416 richmondsurg.com *Dr. Kelly is now retired.

CARY GENTRY, MD Colon & Rectal Specialists Richmond | 804.249.2465 www.crspecialists.com

STEVEN SWARTZ, MD Surgical Associates of Richmond Richmond | 804.716.7758 www.thesar.com

HONORABLE MENTION

ANDREW VORENBERG, MD, FACS Colon and Rectal Specialists Richmond | 804.249.2465 www.crspecialists.com

RICHARD BINNS, MD Surgical Associates of Richmond Richmond | 804.560.5972 www.thesar.com

Colon & Rectal Specialists Richmond | 804.249.2465 www.crspecialists.com

Greater Richmond

SURGERY: SPINE

— Vigneshwar Kasirajan, MD

SECOND PLACE

2 01 7 B EST B EDSI DE MANNER AWAR DS |

“Good bedside manners are a reflection of the compassion and care for our patients and is an essential part of being a physician. We must make patients feel comfortable at their most vulnerable time with an illness.”

SECOND PLACE “A good bedside manner is the fundamental building block to a patient-physician relationship that is based on mutual trust and respect. A smile and a genuine caring attitude is just good medicine!” — Charles Miller, MD

FIRST PLACE CHARLES MILLER, MD

STEVEN FIORE, MD

OrthoVirginia Midlothian | 804.379.2414 www.orthovirginia.com

THIRD PLACE K. SINGH SAHNI, MD, FACS Neurosurgical Associates, PC Richmond | 804.330.4990 www.neurosurgicalva.com

HONORABLE MENTION

Neurosurgical Associates, PC Richmond | 804.330.4990 www.neurosurgicalva.com

FIRST PLACE

GARY TYE, MD, FAANS Children’s Hospital of Richmond at VCU 804.828.CHOR (2467) www.chrichmond.org

Did your favorite

HEALTHCARE PROVIDER make the

PETER A. ALEXANDER, MD Neurosurgical Associates, PC Richmond | 804.288.8204 www.neurosurgicalva.com

“I believe that a patient’s belief in their doctors and willingness to participate in their care and their attitude with all parts of the surgery enhances the result. The first step in building these qualities in your patient is by having a good bedside manner showing them that you care about them not just as somebody you’re going to operate on but as someone you’re going to help in regard to all aspects of their life. This builds mutual respect and willingness to participate fully in their care. The results only get better from there. I believe my patients truly feel that I care about them as human beings and I’m going to do whatever I can to help them surgical or nonsurgical. Thank you for your support sincerely, Dr. Steve.” — Steven Fiore, MD

CUT?

SECOND PLACE

HONORABLE MENTION

MATTHEW MAYR, MD Neurosurgical Associates, PC Richmond | 804.330.4990 www.neurosurgicalva.com

RICK PLACIDE, MD OrthoVirginia North Chesterfield | 804.320.1339 www.orthovirginia.com

THIRD PLACE SCOTT GRAHAM, MD VCU Health Richmond I 804.828.9165 www.vcuhealth.org

JED VANICHKACHORN, MD Tuckahoe Orthopaedics Richmond | 804.285.2300 www.tuckahoeortho.com

www.OurHealthRichmond.com

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SECOND PLACE

URGENT CARE MEDICINE

SURGERY: VASCULAR

A good bedside manner is the fundamental building block to a patient-physician relationship that is based on mutual trust and respect. A smile and a genuine caring attitude is just good medicine! — Charles Miller, MD

“It is a high honor to care for my patients. It is my desire to always treat my patients with respect in a friendly, caring manner.” — Frank Stoneburner, Jr, MD, FACS

FIRST PLACE

JEFF BROWN, MD, FACS Vascular Surgical Associates Richmond | 804.288.1953 www.vascularsurgeryassociates.com

BARKLIE W. ZIMMERMAN, MD, FACS Richmond Surgical Group Richmond | 804.968.4435 www.richmondsurgical.net

Vascular Surgical Associates Richmond | 804.288.1953 www.vascularsurgeryassociates.com

SECOND PLACE “I try to treat people the same way I would want my loved ones treated when they present sick or in pain. A good bedside manner allows me to get a better history and exam on a patient.” — Melissa Aquilo, MD

FIRST PLACE

Virginia Urology Richmond | 804.330.9105 www.uro.com

HONORABLE MENTION

DAVID GLAZIER, MD Virginia Urology Richmond | 804.330.9105 www.uro.com

ROBERT T. NELSON JR, MD Virginia Urology Richmond | 804.330.9105 www.uro.com

THIRD PLACE

EUGENE PARK, MD Urology Specialists of Virginia Richmond | 804.323.0226 www.urologyspecialistsva.com

The most fundamental way to convey my respect for a patient, and to build their trust, is through “bedside manners”. Plus, I find it incredibly inspiring to learn a patient’s story of struggle and/ or triumph. It pushes me to be a better surgeon and person.

— Paul Charron, MD, FACS

OurHealth | The Resource for Healthy Living in Greater Richmond

ALVARO ZEBALLOS, MD BetterMed Urgent Care Midlothian | 804.639.7555 www.bettermedcare.com

SECOND PLACE

MICHAEL BRYNE, MD Virginia Urology Richmond | 804.330.9105 www.uro.com

ANTHONY SLIWINSKI, MD

THIRD PLACE

XIAOHUA YAN, MD Patient First Richmond | 804.360.8061 www.patientfirst.com

Patient First Mechanicsville | 804.559.9900 www.patientfirst.com

FIRST PLACE

NERMINE SALEH, MD Bon Secours Good Health Express Glen Allen l 804.893.8702 www.bonsecours.com

HONORABLE MENTION

MELISSA AQUILO, MD

— Anthony Sliwinski, MD

UROLOGY

THIRD PLACE

HONORABLE MENTION

FRANK STONEBURNER, JR, MD, FACS

“A good bedside manner is important to me because it demonstrates a physician’s fundamental commitment of caring for our patient and showing compassion.”

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SHAREE WRIGHT, MD Surgical Associates of Richmond Richmond | 804.560.4629 www.thesar.com


www.OurHealthRichmond.com

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athelas

JENCARE SENIOR MEDICAL CENTER www.jencaremed.com

JenCare Senior Medical Center Daniel Jannuzzi, MD | MaryAnn Roberts, MS, FNP-C | Kimberly Rogers, MD | Jeffrey Graves, MD

E

veryone wants high quality medical care that is affordable. Yet, for many seniors, high-quality health care is often beyond reach.

Seniors average just 21 minutes yearly in face-to-face time with their primary care physicians according to the most recent National Ambulatory Care Survey. Plus, since the Centers for Medicaid and Medicare Services (CMS), reports that seniors are living with an average of four or more major and complex health conditions, doctors may be dedicating as little as five minutes annually to treat each disease.

The JenCare Difference

In stark contrast, seniors served by four JenCare Senior Medical Centers in Richmond, and by 39 more ChenMed practices in six states, annually benefit from an average of 189 minutes of face-toface time with their primary care physician. That’s nine times more time with PCP yearly than the national average for family and general physicians. Dramatically more PCP attention, is why JenCare and other ChenMed medical practices consistently outperform CMS reported county wide quality measures for seniors, including: •

34% fewer emergency room visits

28% fewer in-patient hospital admissions

26% fewer in-patient hospital days

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“We honor seniors with affordable VIP care that delivers better health,” explains Dan McCarter, Market Chief Medical Officer for JenCare Richmond. “And, because we practice medicine so differently, it’s not surprising that four of our doctors just earned Best Bedside Manner awards from Our Health magazine.”

Total Care Champions

When seniors select JenCare PCPs, they benefit from industryleading access that includes same-day walk-in appointments when needed, and their doctor’s cell phone number. Since JenCare PCPs intentionally serve one-fifth as many patients as the national average of 2,300 patients per doctor, JenCare PCPs can give VIP service to each of the 450 patients for whom they serve as total care champions. By seeing their patients frequently, JenCare PCPs earn trust, and have an uncanny ability to detect and manage high-risk diseases. Plus, since JenCare centers have specialist doctors on-site (including cardiologists, oncologists, podiatrists, and more), on-site medication delivery, on-site tests and screenings, and on-site acupuncture, seniors served by JenCare benefit from a broad range of PCP-led services. The net result is more healthy days for seniors to enjoy with family and friends.

JenCare Senior Medical Center. Affordable care. Superior experience.

COLONIAL HEIGHTS

HULL STREET

MECHANICSVILLE

SHOCKOE BOTTOM

524 Southpark Boulevard Colonial Heights | 804.504.7980

6530 Hull Street Richmond | 804.674.3425

3806 Mechanicsville Turnpike Richmond | 804.228.1143

1712 E. Broad Street Richmond | 804.344.9848

OurHealth | The Resource for Healthy Living in Greater Richmond

F

T

P


RICHMOND ENT

8700 Stony Point Parkway | Richmond | 804.330.5501 | www.richmondent.com

Richmond ENT

Photo from left: Holly Law, M.Ed., CCC-A and Mike Armstrong, MD

Mike Armstrong, MD | Holly Law, M.Ed., CCC-A

R

ichmond ENT and Richmond Hearing Aids are honored that two of our providers have been recognized for compassionate care by OurHealth Richmond magazine. Mike Armstrong, MD founded Richmond ENT in 2001 with a goal to provide patientcentered, comprehensive care for the ears, nose and throat. Dr. Armstrong is a board-certified otolaryngologist and facial plastic surgeon who specializes in nasal, sinus and allergic diseases. He pioneered office-based endoscopic sinus surgery in the 1990’s and is an expert in minimally invasive sinus and nasal procedures. As a facial plastic surgeon, Dr. Armstrong is able to reconstruct the nose inside and out – whether damaged by disease, injury or cancer.

Holly Law, M.Ed., CCC-A. is the Director of Audiology at our Stony Point location. She is dedicated to keeping her patients active and enjoying life to the fullest. She understands that untreated hearing loss can lead to social isolation, withdrawal, depression, and even early dementia. She is passionate about keeping her patients engaged with friends and family. She specializes in low-profile, open fit hearing aids that come with numerous options, including rechargeable hearing aids and BlueTooth® connectivity to all makes of cell phones.

- Compassionate Care of the Ears, Nose and Throat www.OurHealthRichmond.com

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SPARKLE PEDIATRIC DENTISTRY 11934 W Broad Street | Suite 120 | Henrico | 8203 Center Path Lane | Mechanicsville 804.746.7382 | www.sparklepediatricdentistry.com

“The office is so kid friendly with bright colors and even video games for the kids!” Following a recent appointment with her child, Chelsea Ketron stated, “We had an amazing experience yesterday! The staff was so friendly to my 5-year-old son and me. The office is very kid friendly with bright colors and even video games for the kids to play while you wait. Dr. Lewis is awesome and I would recommend her to anyone and everyone!”

About Holly Lewis, DMD, MS Dr. Lewis earned her Doctor of Dental Medicine from the University of Mississippi School of Dentistry and completed her residency in pediatric dentistry and Master’s of Science degree at VCU. She also earned a certificate in Advanced Education in General Dentistry from the University of Mississippi Medical Center.

Sparkle Pediatric Dentistry Holly Lewis, DMD, MS

S

parkle Pediatric Dentistry, formally Hanover Pediatric Dentistry and founded by Holly Lewis, DMD, MS, is a private dental practice specializing in dental care for infants, children, adolescents, and special-needs patients. Our goal is to combine the very best in dental care using state-of-the-art technology in a friendly, inviting environment. For many families, especially those with young children, going to the dentist can be a daunting experience. We have tailored our environment to be a welcoming place where children can actually enjoy their check-up. We offer video games in our waiting areas and televisions mounted over our dental chairs to entertain our patients. Our kid-friendly staff know exactly how to put children at ease and teach them about proper oral hygiene. Many of our new patient families tell us that their children have had negative experiences in the past, but that after visiting our office, their children are actually excited to come back for their next dental visit.

“We travel an hour to see Dr. Lewis!” When asked about her family’s experience at Sparkle Pediatric Dentistry, Laura Noyes (the mother of two or our patients) says that she “absolutely loves Dr. Lewis and her amazing staff! My kids love it there! Like me, my kids have enamel issues with their teeth like me and she has been amazing with caring for their teeth. I couldn’t ask for a better place! We travel an hour to go there the two times a year and it is well worth it.”

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Dr. Lewis is a Fellow of the American Academy of Pediatric Dentistry, a Diplomate of the American Board of Pediatric Dentistry and member of the American Academy of Pediatric Dentistry, the American Dental Association, Southeastern Society of Pediatric Dentistry, Virginia Society of Pediatric Dentistry, Richmond Association of Women Dentists, American Association of Women Dentists, and Omicron Kappa Upsilon. She has been awarded the Eleanor Bushee American Association of Women Dentists Award, the Water Pik Prosthodontic Award, the Organization of Teachers of Oral Diagnosis Award, the Quintessence Publishing Company Clinical Achievement in Periodontics Award, and has been accepted into the Omicron Kappa Upsilon National Honor Society. Dr. Lewis has been recognized by Richmond Magazine as one of the area’s Top Dentists in pediatric dentistry and has received OurHealth Richmond Magazine’s Best Bedside Manner Award for pediatric dentistry.

Award Winning Dental Services


HEALTHCARE OBSERVATIONS | NOVEMBER 2017

SLOWING THE

REVOLVING DOOR AT THE HOSPITAL FOR THOSE WITH

COPD

November is COPD Awareness Month

words | RICK PIESTER

Being diagnosed with any chronic condition can cause a mix of emotions. For many, what they have heard about it can seem mysterious and frightening. Others may have a sense of relief in finally knowing what has been going on. The latter can be especially true when a person learns he or she has chronic obstructive pulmonary disease, or COPD (an umbrella term for a group of serious, progressive lung ailments including emphysema and chronic bronchitis). Lung disease symptoms can mimic other conditions such as lung cancer. There is more awareness about lung cancer and the graveness of it as a disease, and while many who have been diagnosed with COPD may perceive it as a less serious illness, it should be approached with a committed level of concern and care. That’s why each November, health professionals dedicated to preventing and treating the disease observe COPD Awareness Month, a time to focus extra attention on the disease and its causes, diagnosis, and treatment. And this November, a Richmond physician group and staff is working with area hospitals and nursing agencies to take on one of the biggest problems being faced by COPD patients and caregivers alike — the tendency of far too many people with COPD to have to return to the hospital within 30 days of an earlier inpatient stay.

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Addressing the problem — healthcare professionals call it “readmission” — puts the physician group, Pulmonary Associates of Richmond, squarely in the forefront of a new national conversation about healthcare quality. (Pulmonary medicine is the specialty that deals with diseases of the respiratory system.) Spurred by Medicare initiatives and by provisions of the Affordable Care Act, the aim of the effort is to reduce the number of unnecessary hospital readmissions among COPD patients. As expert as American hospitals are, no one wants to be hospitalized. Avoidable readmissions translate into lost productive time, family upheaval, dangers of hospital-related infections, and billions in hospital costs borne by patients, insurers, and government.

WHAT IS IT? COPD refers to a group of lung diseases — chief among them emphysema and chronic bronchitis — that make breathing very difficult, and over time pushes your heart to work harder. Untreated, COPD gets progressively worse and it often leads to serious disability and death.

WHAT ARE SYMPTOMS? Early signs of COPD can vary greatly, but some worrisome symptoms include coughing up a lot of phlegm from your lungs, shortness of breath, and a stubborn cough that will not go away.

According to pulmonologist Michael B. Polsky, MD, of

WHO DEVELOPS COPD?

Pulmonary Associates, about 23 percent of patients

is among the highest rate for any ailment,” he notes,

You’re subject to developing COPD if you are now or have ever been a smoker (a major cause), if you have had heavy or lengthy exposure to chemicals, fumes or dust in the air, or if you’ve inhaled a lot of second-hand smoke.

“and it is a scary statistic.” COPD readmissions are

WHAT IF I THINK I MIGHT HAVE COPD?

with COPD who leave the hospital after a stay have to return for a repeat hospitalization within 30 days. “This

second only to those for congestive heart failure. On the healthcare provider side, barriers are presented by breakdowns in communications, patient education, and lack of clarity in responsibilities for patient care between hospitals, doctors’ offices, nursing agencies, etc. Patients may unknowingly create obstacles to the transition from hospital to home if, for example, they don’t understand the severity of their ailment or if there are limited financial or family resources. “Our aim,” Dr. Polsky says, “is to work to bring a better sense of coordination from the day a patient with COPD leaves the hospital, and even before. Any physician or hospital-based case manager (the professional whose

HEALTHCARE OBSERVATIONS | NOVEMBER 2017

THE BASICS: COPD

Speak with your doctor. Far too much COPD goes undiagnosed until it’s advanced, when less can be done to slow the progress. There’s a simple breathing test called spirometry, which can diagnose COPD even before you start to feel serious effects.

MICHAEL B. POLSKY, MD A pulmonologist with Pulmonary Associates in Richmond.

duties include making sure that each patient has the in-hospital and post-hospital care he or she needs) can refer a patient to our follow-up program.” Before each patient is returned to the care of their regular pulmonary specialist, or assigned a specialist if they’re a new patient, a nurse practitioner from Pulmonary Associates spends time with the patient to make sure that everyone is clear on medication needs and the right way to use inhalers, identify and schedule any necessary clinical tests, determine any oxygen needs, review any needs for vaccinations, and clear any other “loose ends” that could result in a repeat hospitalization so soon after discharge.

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HEALTHCARE OBSERVATIONS | NOVEMBER 2017

Healthcare professionals who take care of people with COPD often speak in terms of “exacerbations.” It’s these exacerbations, sudden and oftentimes debilitating flare-ups of difficulty breathing and increased production of phlegm, increased coughing and other symptoms that frequently lead to hospitalization and readmission. The more severe a person’s COPD is, the more likely there will be a flare-up. And the flare-ups are often the result of a fragmented approach to healthcare that often leaves patients and families confused about how best to care for themselves.

PULMONARY ASSOCIATES OF RICHMOND INC.

That’s the cycle that Pulmonary Associates of Richmond is determined to break. “Our goal is to make sure that COPD patients in the Richmond area get better care,” Dr. Polsky says, “and that fewer of them are in the revolving door of a hospital as a result.”

1000 Boulders Parkway | Suite 200

EXPERT CONTRIBUTOR

Richmond, VA | 804.320.4243

Michael B. Polsky, MD is a pulmonologist with Pulmonary Associates in Richmond. Dr. Polsky is certified by the American Board of Internal Medicine with subspecialties in Critical Care Medicine, Pulmonary Disease, and Sleep Medicine.

www.paraccess.com HOURS: Monday - Friday 8:00 AM - 4:30 PM

ON THE WEB

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Helpful Tips F O R E AT I N G

HEART HEALTHY THIS

Holiday Season words | OURHEALTH STAFF WRITER

The holiday season is all about family, fun and food! Getting your family to eat heart-healthy, especially during the holidays, takes effort. In partnership with the American Heart Association, OurHealth Richmond magazine brings you these great tips and recipes to help you navigate the holiday season in a healthy way.

1

WATCH THE SODIUM Limit your sodium.

Did you know that many of your favorite holiday dishes may be packed with sodium? Breads and rolls, poultry, and canned soups are three common foods that can add sodium to your diet. When shopping for ingredients to prepare your holiday meal, compare the labels and choose options with the lowest amount of sodium.

Savor the flavor.

Use herbs and spices, like rosemary and cloves, to flavor dishes instead of salt or butter.

Rinse away.

When using canned beans or veggies, drain and rinse in a colander to remove excess sodium.

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OurHealth | The Resource for Healthy Living in Greater Richmond


2 TURKEY TALK Outsmart the bird.

Reach for the lighter pieces of meat; they have fewer calories and less fat than the darker ones. Another way to cut calories and fat is to take off the skin.

Keep portions in check.

A serving size of meat is 3 ounces, about the size of a deck of cards. So, be conscious of how much you put on your plate, and pass on that second helping. If you’re also having another meat, like ham or lamb, take smaller portions of each.

Watch out for the gravy train. Turkey usually comes with gravy, which can add excess fat, calories and sodium. Limit gravy to a tablespoon, and keep it off other items, like the dressing.

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HEART HEALTHY HOLIDAYS CHECKLIST

CASSEROLES

WHAT YOU SHOULD INCLUDE:

What’s in it?

Fruits and vegetables Whole grains Beans and legumes Nuts and seeds Fish, skinless poultry, and plant-based alternatives

Holiday casseroles can be filled with fat, sugar or sodium. Your best bet is to limit yourself to a small spoonful of casserole and fill the rest of your plate with a serving of lean protein along with roasted or sautéed veggies and tossed salad instead.

Fat-free and low-fat dairy products Healthier fats and nontropical oils WHAT YOU SHOULD LIMIT: Sodium and salt Saturated fat Sweets and added sugars, including sugar-sweetened beverages Red meats — if you choose to eat red meat, select the leanest cuts WHAT YOU SHOULD AVOID: Trans fat and partially hydrogenated oils

DRESSING Call it what it is. Dressing is intended to be a complement to your meal, not an entree. To keep calories and excess fat in check, aim for 1/4 cup (or about half a scoop with a serving spoon).

Judge it by its cover. If the dressing is filled with fatty meats like sausage and pork, looks greasy or buttery, or is made with white bread or sweet rolls, it may be best to pass. Better options would be dressings that have whole grain or cornbread, lean meat (or no meat), nuts (like almonds or walnuts), and lots of veggies and fruits. Aim for 1/4 cup serving of dressing. This is about half a scoop with serving spoon.

REMEMBER TO STAY PHYSICALLY ACTIVE! The holiday season is about family and food – and all too often, adding a few extra pounds to our waistlines. Being physically active throughout the entire year is important to maintaining a healthy weight. The American Heart Association recommends that children (up to age 18) get at least 60 minutes a day and adults get at least 150 minutes per week of moderately vigorous physical activity. 66

DESSERTS Treat yourself right. The best way to enjoy an occasional sweet without losing control is by sampling a selection or two, rather than having full servings. For example, have one bite of pie, half a cookie or one small square of fudge. Find a friend or family member who will stick to the sampling rule with you.


ORANGE-GLAZED TURKEY WITH POTATOES & CARROTS

6 servings

INGREDIENTS

DIRECTIONS

Cooking spray

1. Preheat oven to 375 degrees.

1 ½ to 1 ¾ pound boneless turkey breast roast, skin and fat removed

2. Spray a 9x13-inch casserole dish with cooking spray and place the turkey in the dish.

2 teaspoons mixed dried herbs (mix a combination of any/all – rosemary, basil, parsley, tarragon, chives, thyme, sage)

3. In a small bowl, mix dry ingredients (herbs, salt, pepper, garlic powder). Rub half of mixture over the turkey.

¾ teaspoon salt ½ teaspoon black pepper ½ teaspoon garlic powder

4. Spread marmalade over turkey. 5. Stir potatoes, carrots and oil into remaining herb mixture. Place vegetables in dish around the turkey. Bake for 1 hour. 6. Remove from oven and let sit 5-10 minutes to allow juices to redistribute.

3 tablespoons no-sugar added orange marmalade 1 pound potatoes scrubbed and cut in to 1-inch cubes (can use any type of potatoes) 1 tablespoon extra virgin olive oil 4 medium carrots, peeled and cut in to 1-inch sections

NUTRITION FACTS: Per Serving Calories: 257. Total Fat: 3.5 g, Saturated Fat: .5 g, Trans Fat: 0.0 g, Polyunsaturated Fat: .5 g, Monounsaturated Fat: 2.0 g, Cholesterol: 76 mg, Sodium: 389 mg, Carbohydrate: 23 mg, Fiber: 3 g, Sugar: 7 g, Protein: 32 g, Dietary Exchanges: 1 starch, 1 vegetable, 4 lean meat

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MAPLE SYRUP-GLAZED

SWEET POTATO CASSEROLE

6 servings | 1 cup per serving

INGREDIENTS

DIRECTIONS

40 ounces canned, chopped sweet potatoes in light syrup, drained (or 1 1/2 pounds cooked sweet potatoes)

1.

1 ¼ teaspoon pumpkin pie spice, divided ¼ teaspoon salt 1 teaspoon vanilla extract 2 large egg whites ¼ cup unsalted pumpkin seeds (pepitas) 1 tablespoon olive oil 2 tablespoons maple syrup 2 tablespoons all-purpose flour

Preheat oven to 400 degrees.

2. Drain the sweet potatoes and add to large bowl. Using a potato masher or fork, mash well. Stir in 1 teaspoon pumpkin pie spice, salt, and extract. 3. Add egg whites into mixer bowl. Using a whisk attachment (or a hand mixer) whip the egg whites on high speed until firm peaks form, about 3 to 4 minutes. Use a spatula to gently fold egg whites into the sweet potato mixture. 4. Coat a 1.5-quart baking dish with cooking spray. Transfer the sweet potato mixture into the baking dish. 5. In a small bowl, stir together pumpkin seeds, oil, maple syrup, flour, and remaining ¼ teaspoon pumpkin pie spice. Sprinkle over the sweet potatoes. 6. Bake in preheated oven until sweet potatoes are fluffy and topping is golden-brown, about 20 to 25 minutes.

NUTRITION FACTS: Per Serving Calories: 249, Total Fat: 5.5 g, Saturated Fat: 0.9 g, Trans Fat: 0.0 g, Polyunsaturated Fat: 1.6 g, Monounsaturated Fat: 2.0 g, Cholesterol: 0 mg, Sodium: 176 mg, Carbohydrates: 46 g. Dietary Fiber: 5 g, Total Sugars: 13 g. Protein: 5 g, Dietary Exchanges: 3 starch, ó fat 68

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GREEN BEAN SALAD VINAIGRETTE 12 servings | 1/2 cup per serving

INGREDIENTS

DIRECTIONS

1 quart water for fresh green beans or ¼ cup for frozen

1.

1 pound fresh or frozen green beans

2. Meanwhile, fill a large bowl with cold water. When the beans are ready, drain them in a colander, then plunge them into the cold water to stop the cooking process and cool quickly. Once the beans are cold, drain well and pat dry with paper towels.

1 tablespoon raspberry vinegar or red or white wine vinegar ¾ to 1 teaspoon yellow mustard ½ teaspoon finely snipped fresh thyme or 1 ½ teaspoons dried, crumbled ½ teaspoon finely snipped fresh parsley or 1 ½ teaspoons dried, crumbled ½ teaspoon honey ½ medium garlic clove, minced

In a large saucepan, bring the water to a boil over high heat. Add the beans. Boil for 5 minutes.

3. While the beans are cooling, in a separate large bowl, whisk together the vinegar, mustard, thyme, parsley, honey, and garlic. Slowly whisk in the oil, continuing to whisk until thoroughly combined. Whisk in the salt and pepper. 4. Add the green beans, bell pepper, and onion to the vinegar mixture. Toss to coat. Cover and refrigerate for at least 30 minutes. Just before serving, sprinkle with the lemon zest.

¼ cup canola or corn oil 1/8 teaspoon salt 1/8 teaspoon pepper, or to taste 1 medium red bell pepper, cut lengthwise into thin strips ½ to 1 small red onion, cut lengthwise into thin strips

NUTRITION FACTS: Per Serving Calories: 29, Total Fat: 1.0 g, Saturated Fat: 0 g, Trans Fat: 0 g, Polyunsaturated Fat: .5 g, Monounsaturated Fat: .5 g, Cholesterol: 0 mg, Sodium: 52 mg, Carbohydrate: 4 g, Fiber: 2 g, Sugar: 1 g, Protein: 1 g, Dietary Exchanges: 1 vegetable

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Local experts agree that diet, exercise, and medication are the three keys to controlling Diabetes. words |BRANDY CENTOLANZA

Type II diabetes, a disease in which there is a high level of sugar in the blood, is on the rise. As of 2015, roughly 100 million adults in America were considered pre-diabetic or diabetic. A poor diet and lack of exercise are partially to blame.

It is Reversible “Diabetes is incredibly common in our country, and the increase in type II diabetes diagnoses is a clear consequence of the obesity epidemic,� says Francesco S. Celi, MD, Chair of the Division of Endocrinology, Diabetes and Metabolism within the Department of Internal Medicine at Virginia Commonwealth University. The good news is that this type of diabetes is reversible. (Meanwhile, type I diabetes is considered to be an autoimmune disease in which the body does not produce insulin. Only five percent of those diagnosed with diabetes have type I).

The US Diet Plays a Huge Role in the Increase of Type II Diabetes The reason for the increase in the number of type II diabetes cases is the reliance on the American diet: fast foods and processed foods with an exorbitant amount of calories and sugar. Think refined carbohydrates such as white bread and pasta and sweets such as soda and candy.

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STEP

Approach to

MANAGING DIABETES

Obese individuals who subsist on an unhealthy diet and do not exercise are most at risk for developing type II diabetes. Family history and genetics may also play a factor. Once diagnosed, patients typically work with physicians and diabetes educators to form a plan to help manage the disease before it leads to other health problems. “I think that lifestyle modifications are extremely important, probably as important as the medications we prescribe,” says Dr. Celi.

The Three-Step Approach to Managing Diabetes There is a three-step approach to controlling diabetes that includes maintaining a healthy diet, engaging in daily physical activity and taking any possible prescribed medications.

1

Cut out Sugar

The less sugar you take in, the better it is for your body.

“More than three separate steps, I see this strategy as a three-legged stool whereby each component is essential for the achievement of control,” says Dr. Celi. “The goals of an appropriate diet are to reduce excess of carbohydrates and calories and to promote moderate weight loss in overweight and obese subjects, in the order of five percent or ten percent, respectively.”

Cut out Sugar Patients who are considered pre-diabetic (meaning that they are likely to develop the disease within five years) and those who are diabetic should begin by eliminating any sugary, processed foods from their diets.

Drink Plenty of Water

2

Drink Plenty of Water

Drink water instead of juice or soda.

3

Diabetics should drink water instead of juice or soda and choose foods that are lower in calories, saturated fat, trans fat, sugars and salt. They should also incorporate more foods with fiber, such as whole grain cereals, breads, rice or pasta as well as more fruits and vegetables, especially green, leafy vegetables.

Increase Physical Activity, But Start Slowly In addition to altering their diets, diabetes patients are encouraged to increase their daily physical activity. “Moderate exercise is defined as 150 minutes per week,” shares Celi. “The exercise should be tolerable. A classic example is a brisk walk or light jogging. Individuals who have joint problems greatly benefit from aquatic gyms.” Patients should start small, with a bigger goal of reaching 10,000 steps a day. Aerobic exercise combined with resistance training such as weightlifting or yoga twice a week will help them control their blood sugar levels more effectively. “Additionally, I think it is very important to understand a patient’s

Increase Physical Activity, but Start Slowly Try to get at least 30 minutes of physical exercise daily at least five days a week.

background, lifestyle and barriers to achieving better control,” Dr. Celi says.

Monitor Your Glucose Levels Monitoring the disease is vital. Patients need to keep a glucose meter nearby, check their blood sugar levels frequently and know what to do if the level is too low or too high (a normal reading is 100, with a range between 70 and 120). Blood sugar levels

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“I think that lifestyle

Symptoms of Type II Diabetes

One out of every four people has type II diabetes without realizing it. The disease can lead to further complications, including kidney disease, heart disease and stroke. Diabetics are also more prone to gum infections and problems with their feet. Patients should check their teeth and feet daily and consult their doctors if their gums bleed or look red or swollen or if their feet have sores, redness or swelling that doesn’t heal.

modifications are extremely

Leading a Better Lifestyle is the Best Way to Beat Diabetes

The symptoms of type II diabetes include increased thirst and hunger, dry mouth, frequent urination, unexplained weight loss, fatigue, blurred vision, headaches and numbness and tingling in the hands and feet. If it is not treated, it can lead to more serious conditions that impact internal organs. Medications and insulin therapy may be necessary, which can be costly and come with a series of side effects.

FAMI LY CAR E |

can change in response to food, exercise, alcohol, illness or medications.

important, probably as important as the medications we prescribe.” FRANCESCO S. CELI, MD Chair of the Division of Endocrinology, Diabetes and Metabolism within the Department of Internal Medicine at Virginia Commonwealth University

JOIN THE OURHEALTH COMMUNITY >> We would love to hear from you. Write us, tweet us, or tag us today! facebook.com/ OurHealthRVA

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Controlling the disease may seem difficult at first, but it can be done, especially with the help and support of physicians. “I always tell my patients that treating diabetes is a marathon, and we want to develop a care plan that is sustainable in the long run,” says Dr. Celi. “Drastic changes may work in the short term, but if they are not sustainable, they can lead to frustration and possibly to worse control.” EXPERT CONTRIBUTOR Francesco S. Celi, MD, Chair of the Division of Endocrinology, Diabetes and Metabolism within the Department of Internal Medicine at Virginia Commonwealth University

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Is Your Teen at Risk for

Depression and Anxiety?

words | CHRISTY RIPPEL

How to help your child navigate a brave new world of challenges Teen angst is nothing new — raging hormones and swirling emotions are a part of growing into adulthood. Sometimes, though, the “normal” teenage experience crosses the line into a real battle with anxiety, depression or both. More than 75 percent of all mental health conditions begin before the age of 24, according to the National Alliance on Mental Illness, so the teen years are often when issues crop up. What’s most concerning is that several recent studies have documented an alarming increase in mental health issues among high school and college students. So why are today’s kids stumbling more than previous generations, and what can parents do about it?

Increased Pressure to Succeed Mark Loewen, LPC counsels parents and teens at his practice in Richmond, LaunchPad Counseling. He reports that he often sees a very high level of anxiety among parents — they are concerned about their children’s performance everywhere from the classroom to the music room to the basketball court at very early ages. Mark believes that this has an anxiety trickle-down effect for the children. “What happens is, the child thinks, ‘My mom

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and dad are so worried for me making it, I must not have what it takes. I must be inadequate,’” Loewen explains. The overparenting culture, he also notes, has insulated kids from making low-risk mistakes at early ages. Recovering from those small mistakes builds the resiliency to cope with bigger challenges in the teen years. “If kids don’t make mistakes because parents protect them from doing so, then kids don’t risk anything. If kids don’t risk anything, they don’t learn that they can survive mistakes and still be okay,” says Loewen.

PARENTING TO DO: Allow your kids to mess up and accept the consequences at early ages. Don’t bring their homework and musical instruments to them when they

forget them, and make sure to manage your own anxieties about your child’s performance in school, sports and activities. Getting a bad grade or being cut from a team are not reasons to panic.

Social Media Woes

“If kids don’t make mistakes because parents protect

Previous generations of teens did not have to deal with social media pressures, a 24/7 news cycle and cyber bullying, which can contribute to depression and anxiety in this vulnerable age group. “Social media clearly makes people more anxious,” says Loewen. “There was a study that shows that when we look at social media, our minds take all the different profiles and make them into one big, general profile,” Loewen says. “Even though we see one person who is good at athletics, one who is good at art and one person with a great face, our minds create one perfect persona. And it makes us feel inadequate.” Teens can also fall into the trap of gauging their self-worth based on the number of “likes” and comments that they get on social media.

them from doing so, then kids don’t risk

PARENTING TO DO:

anything. If kids don’t risk anything, they don’t learn that they can survive mistakes and still be okay.”

Monitor your child’s social media use, even if it means taking some time to learn what platforms they like. Ask them to share what they’ve

posted with you and spot check daily to make sure they aren’t being bullied or bullying others. Consider making some rules about turning in devices at nighttime to limit their social media exposure.

MARK LOEWEN, LPC LaunchPad Counseling

Recognize the Warning Signs If your teen shows signs of anxiety or depression such as sleeping more or less than usual, losing interest in activities, bringing home plummeting grades or experimenting with drugs and alcohol — try talking to them before things spiral. “When parents

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address these things, they often get angry,” says Loewen. “They don’t say, ‘Are you trying to escape something? When you smoke pot, you feel better. Why? What are you worrying about?’” If your child seems resistant to sharing, suggest a trusted counselor. In many cases, talk therapy, medication or a combination of both can be life changing. And the basics of good nutrition, exercise and sleep are very important tools in combating mental health issues.

PARENTING TO DO: Approach your child with curiosity rather than anger. Help your teen talk through their feelings — with your or with someone else who can help them sort out what is truly bothering them. Family physicians and school counselors can provide resources to address serious issues, including threats of self-harm.

EXPERT CONTRIBUTOR

Mark Loewen, LPC with LaunchPad Counseling in Richmond

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words | CATHERINE BROWN

Many of us know the experience well: You are sleeping peacefully under your cozy comforter, perhaps dreaming of a romantic walk on the beach, when — OUCH — a severe leg cramp wrenches you from blissful slumber. You sit up in a state of confusion, trying desperately to loosen up the tightened muscles. Although the leg cramp or charley horse only lasts for a few seconds or minutes, going back to sleep seems impossible, particularly when your muscle continues to ache long after it has stopped contracting. “Most often leg cramps are idiopathic, which means there is no known cause.” DAPHNE BRYAN, MD Bons Secours Medical Group

Nighttime leg cramps most often occur in the calf muscle, but they can also happen in the thigh or foot muscles. Leg cramps affect 50 to 60 percent of adults and fewer than 10 percent of children. After age 50, leg cramps become more common. Both men and women experience nocturnal leg cramps; however, women are slightly more likely to experience them. Leg cramps are also more common during pregnancy.

CAUSES “Most often leg cramps are idiopathic, which means there is no known cause,” explains Daphne Bryan, MD, Family Medicine, of Bons Secours Medical Group. Possible causes include structural issues in the legs and feet such as flat-footedness as well as dehydration, electrolyte imbalance, poor circulation and nerve disorders. Leg cramps can occur after long periods of sitting or, conversely, from overexertion.

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FAMI LY CAR E | Are Leg Cramps Keeping You Up at Night?

For many people, nighttime leg cramps are a normal part of life and do not result from a serious medical condition. They can, however, be associated with neuromuscular disorders, chronic kidney disease, anemia, thyroid disorders and diabetes. Certain medications, like statins, asthma inhalers and diuretics, can also contribute to forming leg cramps. While leg cramps may not impact patients significantly, if they happen regularly, they can have a negative effect. “Untreated, nighttime leg cramps can result in frequent interruptions in sleep and the risks associated with operating vehicles and performing at work in such a state,” explains Dr. Bryan.

RELIEF Patients who are experiencing severe or frequent leg cramps should consult a family physician to rule out possible serious medical conditions. “If the cramps become a significant interruption in the patient’s daily and nightly function,” Dr. Bryan tells us, “there are medications that may bring relief.” Those include both anti-inflammatory and antispasmodic medicines. Some supplements, including vitamin E or B complex, can help, but it is important to consult a medical provider before self-treating.

PREVENTION There are several non-medical ways to prevent leg cramps. Staying hydrated by drinking water throughout the day can help. Eating foods that are high in potassium, magnesium and calcium might also help. For instance, yogurt with banana can be a perfect bedtime snack. In addition, stretching the legs before bedtime and keeping blankets loose around the feet can help. Wearing supportive shoes during the day when exercising or standing for long periods of time can also prevent leg cramps. If knotted, tightened muscles wake you in the middle of the night, you can alleviate the cramp by forcefully stretching and kneading the muscle. You can also help the muscles relax by walking around, flexing the foot, sitting in a warm bath and applying ice. As with most health conditions, exercise regularly and eat healthily to sleep well and feel great. EXPERT CONTRIBUTOR Daphne Bryan, MD is a primary care provider with Bons Secours Bermuda Crossroads in Chester. Dr. Bryan is certified by the American Board of Family Medicine.

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Addressing Men’s Snoring words | CHRISTINE STODDARD

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 anatomy. The increased prevalence of snoring in men results from “differences in the shape of the palate and throat, which tends to be narrower in men,” explains Richard Parisi, MD, FAASM, of the Sleep Disorders Center of Richmond. 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. 80

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A poor night of rest can leave you TIRED, IRRITABLE and LESS able to be PRODUCTIVE. - Richard Parisi, MD, FAASM


FAMI LY CAR E | Snoring No More

Snoring is caused by VIBRATION OF STRUCTURES in the upper airway, especially the SOFT PALATE, when the surrounding MUSCLES RELAX DURING SLEEP. - Richard Parisi, MD, FAASM

That vibration makes the sound many of us know so well. “Narrowing at any point along the upper airway may contribute to snoring,” explains Dr. Parisi. For instance, he notes, “nasal obstruction could be due to allergy, viral infection, or a deviated septum. The throat may be crowded by a long or thick soft palate, large tonsils, a relatively large tongue or small jaw.”

The Dangers of Snoring: For most men, snoring is an annoyance. However, the minor frustration can lead to poor sleep quality, which in turn impacts daily performance at work, makes people more susceptible to accidents, strains relationships and possibly leads to depression. “A poor night of rest can leave you tired, irritable and less able to be productive,” says Dr. Parisi. In some cases, snoring can indicate a serious health condition, such as obstructive sleep apnea, in which airways collapse and block breathing. As Dr. Parisi explains, sleep apnea contributes to other serious medical problems like hypertension, heart disease and diabetes. Men who choke or have trouble breathing while sleeping 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, men with chronic nasal congestion can www.OurHealthRichmond.com

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use allergy medication or nasal dilator strips. Staying hydrated can also help thin out mucus and improve snoring. For men who are overweight, losing weight can also help, as can sleeping on one’s side. Dr. Parisi also encourages patients to avoid smoking and drinking alcohol close to bedtime. If none of these methods help, several medical options might work. For instance, Dr. Parisi says, “nasal obstruction may require surgery in some cases, and there are additional surgical treatments that might be worth considering.” Those include surgery on the throat or jaw to prevent the airway from collapsing or a device that stimulates upper airway muscles to prevent apnea. In addition, a dentist can insert a device that stabilizes the airways. RICHARD PARISI, MD, FAASM is a Sleep Medicine specialist with Sleep Disorders Center of Richmond.

Whether snoring is a minor annoyance or a potentially serious health concern, it may help to consult with a sleep specialist who can identify the cause and suggest treatment options. “This might be done using a home sleep testing device or during an overnight sleep study in a specialized lab,” Dr. Parisi concludes. After all, a sleep study can be a small price to pay for years of wedded bliss. EXPERT CONTRIBUTOR Richard A. Parisi, MD, FAASM, Sleep Disorders Center of Richmond. Dr. Parisi is certified by the American Board of Internal Medicine with subspecialties in Pulmonary Disease and Sleep Medicine.

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Richmond Nov/Dec 2017