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PLUS: State of Local Healthcare | High Blood Pressure Redefined | Too Young to Talk about Senior Living? Think Again! january • february 2018 ourhealthrichmond.com

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TABLE OF CONTENTS JANUARY • FEBRUARY 2018

12 THE PULSE

| KEEPING THE PULSE ON HEALTHCARE

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

12 – NEW PEOPLE, PLACES & ANNOUNCEMENTS 15 – HIGH BLOOD PRESSURE REDEFINED: WHAT SHOULD YOU KNOW?

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THE CHECK-UP

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PASSION MEETS POSSIBILITY

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BREAKING THE SILENCE: ORGAN TRANSPLANTATION

| LOCAL HEALTH & MEDICINE

18 – VOLUNTEER SPOTLIGHT: GETTING A RUNNING START

Respected Virginia physician finds an ally in his quest to care for senior patients

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

20 – Q&A ON HEALTH

24 STATE OF HEALTHCARE IN GREATER RICHMOND A look at the healthcare landscape in the Greater Richmond area for 2018.

WHAT’S NEW WITH YOU?

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KEEPING YOUR HEALTH IN THE GAME OF LIFE Patients share how local healthcare professionals enabled them to overcome their personal health challenges.

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TABLE OF CONTENTS JANUARY • FEBRUARY 2018

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CHILDREN & TEENS

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| YOUTH HEALTH

56 – DON’T PASS THE BREAD: WHY IS CELIAC DISEASE ON THE RISE IN KIDS?

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AGING WELL

| LOCAL FOODS & RECIPES

61 – GET PUMPED: HEART HEALTHY TIPS 62 – COOL CUCUMBER DIP

| THE SCOOP ON SENIOR HEALTH

63 – SALMON WITH CILANTRO PESTO

58 – MOVIN’ ON UP: WHEN AND HOW SHOULD SENIORS GO ABOUT CHOOSING A RETIREMENT COMMUNITY? 60 – MYTH: HOME CARE WILL TAKE AWAY MY INDEPENDENCE.

NUTRITION

64 – PINEAPPLE UPSIDE-DOWN CAKE

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MISSION

| PREVENTION

65 – SATISFYING HUNGER AND IMPROVING HEALTH

JOIN THE OURHEALTH COMMUNITY ON SOCIAL MEDIA We want to hear from you! Don’t forget to tag us, #OurHealthRVA

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JANUARY • FEBRUARY 2018

OURHEALTH’S EXCLUSIVE MEDIA PARTNER

PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION CHIEF DESIGNER GRAPHIC DESIGNER MEDIA EDITOR DIGITAL CONTENT MANAGER DIGITAL MEDIA STRATEGY ACCOUNTING MANAGER

McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Karrie Pridemore Tori Meador Elissa Einhorn Lisa Spinelli Dalton Holody Laura Bower

CONTRIBUTING RICHMOND MEDICAL EXPERTS

Mike Armstrong, MD Quinn K. Lippmann, MD, MPH Katie Skiff, NP Stephanie Smith, MD, FAAP

CONTRIBUTING PROFESSIONAL Kathleen Baker, RYT 200 EXPERTS & WRITERS Catherine Brown Brandy Centolanza Susan Dubuque Holly Ford Sloan Lindsey Michelle McLees Rick Piester Brandon Shuletta ADVERTISING AND MARKETING Cindy Morris-Scruggs Senior Media Account Executive P: 804.300.0650 F: 540.387.6483 cmscruggs@ourhealthvirginia.com SUBSCRIPTIONS Subscriptions are $19.95 per year. To receive OurHealth Richmond via U.S. Mail, please contact Jenny Hungate at jenny@ourhealthvirginia.com

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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 © 2018 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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THE PULSE

ANNOUNCEMENTS

HEALTHCARE RECOGNITIONS

MEDARVA FOUNDATION ACCEPTING PROPOSALS FOR 2018 GRANTS

BON SECOURS ST. FRANCIS MEDICAL CENTER and BON SECOURS ST. MARY’S HOSPITAL have been selected as a Top General Hospital for 2017 by The Leapfrog Group, an independent hospital watchdog organization.

The MEDARVA Foundation – which funds grants for programs and organizations that aim to enhance the health and well-being of individuals and families – is now accepting applications for its 2018 grant program. For more than six decades, MEDARVA Healthcare has been impacting the Greater Richmond community by providing charity care and services to individuals and multiple organizations. Nonprofits and other organizations that help with access to care and target improving the health of individuals and families within the communities they serve are encouraged to apply.

APPLICATION DEADLINE IS FEBRUARY 1, 2018. For more information, visit www.medarva.com/grant.

More than 1,800 hospitals reported safety and quality information to The Leapfrog Group. Only four hospitals in Virginia received the Top General Hospital recognition for 2017. To qualify for the Top Hospitals distinction, hospitals must submit a Leapfrog Hospital Survey. The selection of Top Hospitals 2017 is based on surveys from nearly 1,900 hospitals. To see the full list of institutions honored as 2017 Top Hospitals, visit www.leapfroggroup.org/tophospitals.

HCA VIRGINIA’S HENRICO DOCTORS’ HOSPITAL has earned the prestigious Five-Star rating from the Centers for Medicare and Medicaid Services’ Hospital Compare program. This distinction recognizes Henrico Doctors’ Hospitals for its superior performance in providing high-quality patient care and outcomes. Only eight hospitals in Virginia received five stars and Henrico Doctors’ Hospitals is the only community hospital organization to earn the Five-Star CMS rating in Central Virginia. According to CMS, hospitals with five stars are considered to have an above average quality rating when measuring overall patient outcomes and experiences. To view Henrico Doctors’ Hospitals results and others, visit www.medicare.gov/hospitalcompare.

Luisa Caparoula, DO Primary Health Group – Ironbridge Chester | 804.217.8990 www.phg-ironbridge.com

Salim Zulfiquar, MD

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

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Margaret Villers, MD, MSCR

Commonwealth Perinatal Services Richmond | 804.289.4972 www.Commonwealth perinatal.com

Dawncherrie Walker, MD Primary Health Group – Short Pump Richmond | 804.217.9091 www.phg-shortpump.com


THE P ULSE |

OPENINGS

New People and Places

MEDARVA HEALTHCARE, the parent company of Stony Point Surgery Center, has opened its second independent ambulatory surgery center in West Creek Medical Park in Goochland County. It is 6,600 square feet and has two operating rooms. MEDARVA WEST CREEK SURGERY CENTER has received the Centers for Medicare and Medicaid Services accreditation; therefore, it will be able to accept Medicare and Medicaid covered patients. Similar to Stony Point Surgery Center, surgeons and patients will be able to utilize the new location for outpatient surgeries such as: eye and cataract, ENT, gastro, facial and plastic surgery, orthopedics, gynecology and colonoscopies. Conveniently accessible by three major interstates: Route 288, I-64 and I-295, the West Creek Medical Park provides surrounding communities with high-quality, low cost medical services in a comforting environment.

In mid-February the SARAH CANNON CANCER INSTITUTE AT HENRICO DOCTORS’ HOSPITAL will officially open its doors to the residents of Central Virginia. The 98,500 square foot facility will provide the latest technology and cancer services such as patient navigation, genetic counseling, nutrition counseling and support groups under one roof. For more information visit www.henricodoctors. com/service/cancer-care.

www.OurHealthRichmond.com

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THE PULSE | High Blood Pressure Redefined THE P ULSE | High Blood Pressure Redefined

Q&A HIGH BLOOD PRESSURE REDEFINED What should you know? words | MICHELLE MCLEES

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

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

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

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

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

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

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

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

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THE PULSE

Robert M. Carey, MD

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

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

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

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

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

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THE CHECKUP | Volunteer Spotlight

Getting a Running Start Richmond runner of 40 years enjoys training other runners for the Richmond Marathon words | BRANDY CENTOLANZA

“While some people get up and grab a cup of coffee in the mornings, I get up and go for a run,” says Don Garber. “Running has just always been a part of my life.” Garber has been a runner for forty years. For the past sixteen, he’s helmed the Sports Backers Marathon Training team, helping average Janes and Joes achieve their goal of crossing that finish line after 26.2 miles. “I started out as just another guy running on the street,” Garber says. “Now I am helping people get off the couch and run.” It was Sports Backers that approached Garber about creating the team, which started with about a hundred people and has since grown to more than a thousand. As head coach, Garber preps runners for training, plans schedules and routes, and recruits other coaches for the cause. He now has seventy other coaches helping him. The team trains every year from late May until the Richmond Marathon in November. “I had a friend help me with my first marathon, so I know the benefits of having people support you as you train,” he says. Garber played lacrosse at the College of William & Mary and then took up running. He’s now raced in forty marathons, clocking in more than 30,000 miles. 18

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“My first marathon was on October 18, 1987, here in Richmond,” Garber says. “I have run the big marathons, including Boston, New York, and the Marine Corps in Washington, DC. But the most memorable ones have been where I’ve run with friends or in a real scenic place. Scenic ones I’ve done include Shiprock, New Mexico, which was all on the Navaho Indian Reservation with super cool views; Helena, Montana; Anchorage, Alaska; and St. George, Utah. I’ve also recently done a few small ones that are on very scenic trails in Kansas, Missouri, and Iowa.” Garber is a commercial contractor. He’s also active with the Richmond Road Runners and in the arts, volunteering for both the Virginia Repertory Theatre and Richmond CenterStage. “I am a firm believer in giving back to the community and helping others,” he says. For six months of the year, he does just that with the Sports Backers Marathon Training Team. “It’s a lot of fun,” he says. “It’s very satisfying watching someone who never saw themselves as a runner finish the marathon. It’s just such a reward to see people accomplish something they never thought possible and knowing that you helped contribute to that. It warms my heart.”

ON THE WEB

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

What affect can an undiagnosed ADHD condition have on an adult’s work performance? Most people think Attention-Deficit Hyperactivity Disorder (ADHD) is just for kids. Though it’s called adult ADHD, symptoms start in early childhood and continue into adulthood. About 4 to 5 percent of U.S. adults have adult ADHD.

Businesses find that employees with untreated ADHD have an estimated revenue loss of approximately $4,336 per worker per year.

– Stephanie Smith, MD, FAAP

While many kids with ADHD outgrow it, many adults with ADHD aren’t aware they have it — they just know that work and everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize; leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or frequently interrupting others to mood swings and outbursts of anger. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. It is important to learn how to manage stress, eat right, and get enough sleep regularly so that your body is best equipped to handle challenges. Workplace interventions include: clearly posting daily schedules, breaking assignments into smaller chunks, making lists of daily tasks and using a daily planners.

Stephanie Smith, MD, FAAP Focus MD – Richmond Mechanicsville | 804.723.4668 www.focus-md.com/richmond

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I’m worried mom may be experiencing dementia. What are early signs and symptoms I should be on the lookout for? A common sign in the early stages of dementia is short term memory loss. This may be observed as someone who forgets to pay a bill, a date with a friend or a medical appointment. These lapses in memory can often disrupt this person’s daily life. Confusion is also prevalent. This may be seen in the failure to recognize someone he/she has known for years. This has the potential to lead to isolation in an attempt to avoid an uncomfortable situation. Communication difficulties often go hand-in-hand with confusion. One may have difficulty expressing themselves due to the inability to remember the proper word to use. It may become a struggle to follow a conversation or story and in turn, become frustrating for the individual. Mood changes are often identified, especially depression and moodiness. Loss of interest is also noted as it is difficult for those who have been active and independent all their lives to lose their ability to manage their affairs and social calendar.

Sloan Lindsey, Assisted Living Administrator Westminister Canterbury Richmond Richmond | 804.264.6000 www.wcrichmond.org

What can be done if I experience urine leakage? There are many things that can be done if you are experiencing urinary leakage. First thing to understand that this is a medical condition that should be accurately diagnosed and treated. Although very common, it can be debilitating, and patients have many options. We start with the most conservative treatments and work from there. Many nonsurgical options are available that were not years ago. People shouldn’t be embarrassed to come seek help.

Quinn K. Lippmann, MD, MPH Virginia Urology Richmond | 804.330.9105 www.uro.com


THE C HEC K UP | Q&A on Health


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

To reduce exposure to viruses during the winter months, wash or sanitize your hands often – especially before and after eating, drinking, touching your face, or shaking hands.

– Mike Armstrong, MD

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Why do sinus conditions seem to be more common in the winter months? Sinusitis is an inflammatory condition of the air-containing spaces that surround the nose and eyes. Sinus inflammation is most often triggered by exposure to allergens and viruses. While allergies are most commonly associated with the spring bloom and fall ragweed season, the incidence of colds and influenza peak between December and March. This seasonal incidence is attributed to increased interpersonal contact as people move indoors during cooler weather, and as children expose each other to viruses during the fall semester. Most physicians recommend against using antibiotics during the early phase of viral infections. However, if upper respiratory symptoms persist longer than 10 days, or worsen after the first week, then it is likely that a bacterial infection is spreading into the sinuses. Antibiotics and nasal steroids may shorten the course of the illness. A specialty examination by an otolaryngologist (ear nose and throat specialist) is recommended for patients who have sinusitis more than 3 times each year or lasting longer than 3 months.

Mike Armstrong, MD Richmond ENT Richmond | 804.622.3782 www.RichmondENT.com

OurHealth | The Resource for Healthy Living in Greater Richmond

Should I see my family care provider when suffering from cold symptoms? A family care provider is the ideal place for evaluating your cold symptoms. A primary care provider will be able to evaluate trends in your sick symptoms and help come up with preventive strategies. They will also make sure that you are not given a medication that will interact with any chronic care conditions, such as diabetes or hypertension. In my practice, I frequently see patients with recurrent sinusitis. I have been able to help them identify triggers and early intervention strategies that have helped reduce how often they are on antibiotics. If I did not see them regularly this would have been harder to do.

Katie Skiff, NP

Bon Secours Canal Crossing Internal Medicine Richmond | 804.298.3460 www.bonsecours.com

Can yoga help me lose weight? Yoga postures build strength and stamina, however, attention to the present moment, or mindfulness, is a key part of this ancient practice that may result in weight loss. When we carry this awareness into our daily lives, and pay attention to what and when we eat, we become attuned to our needs. This may lead us to the realization that instead of food, our body craves a walk, or a glass of water. We may develop the awareness to begin to eat only when hungry, to consume less and enjoy our food more. Attention to breath and body in a consistent yoga practice allows us to lower the stress hormone, cortisol. High levels of cortisol are associated with insulin resistance and weight gain. With a regular yoga practice, students learn to respond to stress with mindful breathing. Of course, participating in more intense practices such as power yoga and hot yoga may shed weight, a Hatha yoga practice, with a focus on breath and mindfulness, reinforces positive changes in mind and body.

Kathleen Baker, RYT 200

Owner, Glenmore Yoga & Wellness Center Richmond | 804.741.5267 www.glenmoreyoga.com


THE P ULSE | Q&A on Health

www.OurHealthRichmond.com

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STATE OF

HEALTHCARE IN RICHMOND words | BRANDON SHULLEETA

Across the nation, the 2018 version of the health industry is focused on efficiency — tapping into the latest medical advancements and cutting-edge technology — while the timeless idea of top medical professionals finding better ways to help people with the most pressing health-related issues still remains at the forefront. Such is the case for Richmond, where robots are becoming more prominent in the healthcare industry, for example, and medical professionals are experimenting with new methods for fighting the opioid epidemic.

DOCTORS TEAMING WITH ROBOTS FOR PRECISION Robots saw expanded roles in 2017, continuing a trend that has been ongoing for the past several years, while the use of robots is set to further advance this year. Among the advantages of robots is their ability, with surgeons’ guidance, to make more precise and minute incisions during surgeries than what a human hand could achieve. Robots can also be used for placing cameras in surgery sites, and those camera images then give surgeons a clearer, more magnified picture of the operation site than what the human eye could see without that technology.

HCA VIRGINIA ADVANCING ROBOTICS PROGRAM Marijan Gospodnetic, MD an OB/GYN with Richmond Women’s Specialists, said he was the first to perform a robotic surgery at Johnston-Willis Hospital about five years ago and has since performed more than 400. “It has revolutionized the recovery time from surgery and has helped us do cases with ... minimally-invasive surgery which before we could not do,” Dr. Gospodnetic says. Dr. Gospodnetic says that while the surgery itself might be a bit more time-consuming with a robot, the patient’s recovery time is typically shorter. “The advantage is definitely in favor of the patient. The surgery may be a little longer in time spent on the operating table, but recovery time is drastically reduced. Most of these patients are able to leave the hospital within 12 to 24 hours, some even within six to eight hours,” Dr. Gospodnetic says.

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FEATURES

Dr. Gospodnetic says robotic surgery requires extensive practice. “One cannot possibly be a good robotic surgeon with a small number of cases per year. It requires constant practice and updating of the technique,” he says. The HCA Virginia Institute of Robotic Surgery is a 10-facility organization that spans Central, Northern and Southwest Virginia. HCA performs more robotic-assisted surgeries than any other health system in the state, according to its website, with more than 21,000 such procedures having been performed by 186 surgeons and $38 million having been invested in the program. For prostate, gynecological and cardiac repair, the Virginia Institute of Robotic Surgery uses the da Vinci Robotic Surgery System to make tiny incisions (much smaller than with traditional surgery) to insert miniature instruments and a high-definition 3-D camera inside the patient. This gives the surgeon a magnified, high-resolution 3-D image of the surgical site, and the surgeon is then able to tap into the robot technology to make precise movements when performing surgeries. HCA locations in Virginia include Chippenham, Henrico Doctors’, Johnston-Willis and Retreat Doctors’ hospitals and Spotsylvania Regional Medical Center.

The hospital is training more surgeons on the procedure and technology. Globus Medical’s ExcelsiusGPS technology is designed to be safer and more accurate than traditional methods. It minimizes radiation exposure and shortens recovery time, according to Bon Secours. “Overall, patients who undergo a minimally invasive surgery may benefit from less postoperative pain, smaller incisions and minimal scars, a shorter hospitalization and faster recovery time,” Barr says. ExcelsiusGPS is not Bon Secours’ first crack at robotics. Like HCA Virginia, Bon Secours has been using the da Vinci Robotic Surgery System for years. However, Bon Secours believes ExcelsiusGPS allows for advancements in its robotics program. ExcelsiusGPS combines both robotic guidance and navigation. The robotic guidance provides a pathway for the surgeon, while navigation provides feedback and visualization of the patient’s anatomy.

LOCAL MEDICAL PROFESSIONALS TACKLING OPIOID EPIDEMIC HEAD-ON The opioid epidemic is hitting new highs nationally, and specifically in Virginia.

BON SECOURS HAS A NEW SPINAL SURGERY ROBOT

President Donald Trump declared the opioid crisis a public health emergency last year.

Richmond’s first minimally invasive spine surgery using the ExcelsiusGPS was successfully performed in November at Bon Secours St. Mary’s Hospital – making it one of four hospitals in the country to offer this technology.

Meanwhile, Virginia saw opioid overdose deaths hit an all-time high of 1,138 in 2016, according to a Virginia Department of Health report.

“We are excited that St. Mary’s is the first hospital to introduce this new technology to our spine surgery program and to our community,” Francine Barr, the CEO of Bon Secours St. Mary’s Hospital, says. “Patients in the Richmond area now have the most innovative options when it comes to spinal surgery choices.”

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OurHealth | The Resource for Healthy Living in Greater Richmond

While state figures for deaths last year have not been compiled yet, opioid fatalities were projected to jump to 1,169 in 2017, according to state health department report last year — more than double that of a decade earlier when opioid deaths were 515 in 2007. With drug overdose deaths now the No. 1 leader in unnatural deaths in Virginia, ahead of car crashes and gun-related deaths, efforts


FEATUR ES |

VCU FIGHTING OPIOID EPIDEMIC VCU is among the institutions focused on helping prevent overdose patients from relapsing.

State of Local Healthcare

to combat the problem are on the rise, including in Central Virginia, where Virginia Commonwealth University has made itself a leader in that effort. Francine Barr CEO of Bon Secours St. Mary’s Hospital in Richmond.

VCU announced in December 2017 that it would lead an 18-month clinical trial to test SUBLOCADE, a monthly injection that helps patients battle the addiction. “The main goal of the research is to develop a new treatment paradigm for patients after an overdose,” F. Gerard Moeller, MD, professor of psychiatry, pharmacology and toxicology, and neurology at VCU School of Medicine said in a prepared statement when the trial was announced in December.

Marijan Gospodnetic,MD An OB/GYN with Richmond Women’s Specialists, an affiliate of HCA Virginia in Richmond.

Dr. Moeller, who is also the director of the VCU Institute for Drug and Alcohol Studies, will serve as principal investigator on the trial. The injections would be used on patients in combination with ongoing addiction treatments and support, according to the university. VCU released a six-year plan last year that points to 2013 data showing more than 40,000 adults in the Medicaid program in Virginia have a substance abuse disorder. More than half of Medicaid enrollees with serious mental illness also have a substance abuse disorder. VCU and VCU Health have made strides to fight this epidemic through research, education, training and interventional programs.

F. Gerard Moeller, MD Professor of psychiatry, pharmacology and toxicology, and neurology at VCU School of Medicine in Richmond.

The university is researching chemical entities to treat substance abuse disorders using a 5-year, $1.9 million grant from the National Institutes of Health. In addition to seminars and other interventional programs, VCU and VCU Health launched a multidisciplinary pilot project last year to help pregnant women with substance abuse disorders overcome their addiction and prepare them for motherhood. EXPERT CONTRIBUTORS Francine Barr is the CEO of Bon Secours St. Mary’s Hospital in Richmond. Marijan Gospodnetic, MD is an OB/GYN with Richmond Women’s Specialists, an affiliate of HCA Virginia in Richmond. F. Gerard Moeller, MD is professor of psychiatry, pharmacology and toxicology, and neurology at VCU School of Medicine in Richmond.

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WHAT’S NEW WITH YOU?

PULMONARY ASSOCIATES OF RICHMOND, INC. 804.320.4243 | www.paraccess.com

LOCATIONS BOULDERS | 1000 Boulders Parkway, Suite 200 CENTER POINTE | 1 Park West Circle, Suite 301 COLONY CROSSING | 2354 Colony Crossing Place MECHANICSVILLE | 7497 Right Flank Road, Suite 520

STAFF ADDITIONS

SANTA ROSA | 1603 Santa Rosa Road, Suite 101

EMILY J. GILBERT, RN, AGACNP-BC

Santa Rosa Office

Emily worked as a RN on the oncology and intensive care units at Henrico Doctors’ Hospital for eight years prior to joining PAR as a Nurse Practitioner.

ANNOUNCING NEW LOCATION CENTER POINTE | 1 Park West Circle We recognize the importance of quality healthcare that is easily accessible. That’s one of the reasons we’ve opened our fifth location in the Great Richmond Area! Our new Center Pointe Pulmonary Clinic is dedicated to offering you top pulmonary care! Drs. Cecilia Bergh and Katherine Price also offer WALK-IN clinic hours at this location!

TARA L. ORTIZ, MS, RN, AGACNP-BC, CCRN

Santa Rosa Office

Tara joined Pulmonary Associates of Richmond as a Nurse Practitioner in 2016 and works in the Henrico Doctors’ Hospital-Forest and Santa Rosa locations.

KATHERINE M. PRICE, MD

Center Point Office

COPD CLINIC

Dr. Price is board certified in Pulmonary and Critical Care. She practices at our Center Pointe Office and at St. Francis Hospital. Her clinical interests are general pulmonary and critical care medicine.

Pulmonary Associates of Richmond offers the only COPD Clinic in the area. Chronic obstructive pulmonary disease (COPD) is a lung disease caused by chronic inflammation and irritation of the airways that can cause shortness of breath, cough, and wheezing. The COPD Clinic at Pulmonary Associates of Richmond is designed to work with patients that have recently been hospitalized or had a COPD flare up to: • • • •

optimize and manage breathing medications, prevent readmittance to the hospital, connect patients to other resources, such as exercise programs or home health services, to support wellness, ensure patients have ongoing follow-up and testing as needed

In the COPD Clinic we offer longer appointment times to ensure that patients and family members have the education about COPD that they need.

MEGAN ZOLTY, MS, BSN, FNP-C

Santa Rosa Office

In the COPD Clinic, Megan sees patients that have recently been hospitalized for a flare up of COPD. Megan also works in our Sleep Clinic helping patients with Sleep Apnea and other sleep disorders.

NUTRITION COUNSELING Pulmonary Associates is pleased to now offer nutrition counseling in our Boulders Parkway location. Our certified health coach and integrative nutrition counselor, April Williams, MS, can help guide our patients to a healthier diet and lifestyle.

WALK-IN PULMONARY CLINIC In order to better serve our existing patients, we offer special Walk-In pulmonary clinic hours in three of our locations: Boulders, Center Pointe, and Santa Rosa. Walk-In clinic hours are for already established patients that may have a flare up of COPD, Asthma, shortness of breath, or other breathing related illnesses. Patients are treated on a first come first serve basis by one of our highly trained advanced practice clinicians. Please visit www.paraccess.com for more details about our walk-in pulmonary clinic.

COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA Our Sleep Clinic not only treats patients with sleep disorders, but also those who suffer from cognitive behavioral sleep related issues. Our cognitive behavioral therapy program uses techniques to address the mental factors associated with insomnia. Treatment may include regular visits with a clinician for a series of sleep assessments, completion of a sleep diary, and guiding you through sessions to help change the way you sleep. Sleep Clinic services are offered at our Boulders and Santa Rosa locations.

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www.OurHealthRichmond.com

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WHAT’S NEW WITH YOU?

VIRGINIA FAMILY DENTISTRY www.vadentist.com

UNDER CONSTRUCTION

OUR NEWEST LOCATION HUGUENOT PEDIATRIC & ORTHODONTIC SPECIALTY CENTER (Opening Spring 2018)

NEW KENT | 2700 Pocahontas Trail | Quinton | 804.932.4537

NEW PROVIDERS

VIRGINIA FAMILY DENTISTRY

DANIELLE M. MCCORMACK, DDS, MSD Periodontist

Construction of our new Short Pump location was completed in May and the West End general dentists moved into their new location. The existing location on Three Chopt Road underwent extensive renovations to transform into VFD’s first Orthodontic and Pediatric Specialty Center.

Chester & Midlothian | 288 Locations

Pediatrics will be a continued focus for the practice in future years. In an effort to create more kid-friendly spaces, we have begun expansion on the Atlee building to create a dedicated pediatric wing. Construction is also underway across the street from our Huguenot location to build our second Pediatric and Orthodontic Specialty Center. Once construction is complete, we will have 4 dedicated spaces for pediatrics in the West End, Ironbridge, Atlee, and Huguenot offices. Dr. Vicki Tibbs and her team joined VFD in October, creating our first location in New Kent located right off Route 60 near the Bottoms Bridge exit. Dr. Tibbs brings over 30 years of experience to the practice and an active involvement in the dental education community. The VFD Dental Lab has continued to grow in CAD CAM dentistry in 2017. The lab added a 3D printer to create surgical guides to aid with placing dental implants. We also have added three additional intra-oral scanners to the practice to reduce the need for traditional impressions during crown and bridge procedures. After struggling with arthritis in her hands for years, we were saddened to announce the retirement of Dr. Kit Sullivan in August this year. Another big retirement announcement came from VFD’s founder, Dr. W. Baxter Perkinson, Jr. At the end of 2017 Dr. Perkinson hung up the handpiece and retired from practicing dentistry. He will still be involved with VFD in other ways – and be on the lookout for him on our seminar circuit.

DANIEL J. BARTLING, DDS Endodontist Tri-Cities & Midlothian | 288 Locations

JEN M. TRAN, DDS General Dentist Short Pump Location

ERIN SHARKEY, DDS, FICOI General Dentist Ironbridge Location

ETHAN PURYEAR, DDS, MS Pediatric Dentist Ironbridge & Huguenot Locations

VICKI L. TIBBS, DDS General Dentist New Kent Location

WITH 14 LOCATIONS AROUND CENTRAL VIRGINIA, THERE’S SURE TO BE A VIRGINIA FAMILY DENTISTRY OFFICE CONVENIENT TO YOUR HOME OR WORKPLACE.

2018 SEMINAR SCHEDULE FEBRUARY 21 – Invisalign - Midlothian/288

MAY 16 – Adult Orthodontics – Short Pump

FEBRUARY 28 – Dental Implant – Patterson/Parham

JUNE 13 – Dental Implants – Short Pump

MARCH 13 – Dental Implants – Tri-Cities

SEPTEMBER 25 – Dental Implants – Ironbridge

APRIL 17 – Dental Implants – Midlothian/288

OCTOBER 3 – General Dentistry – Short Pump

APRIL 30 – Pediatrics & Orthodontics – Short Pump

NOVEMBER 6 – Dental Implants – Huguenot

For more information about our seminar schedule or to register, please visit www.vadentist.com/seminars.

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FEATUR ES | Whatâ&#x20AC;&#x2122;s New with You?

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www.OurHealthRichmond.com


Passion Meets Possibility Respected Virginia physician finds an ally in his quest to care for senior patients words | HOLLY FORD

Every day, Virginians see the people who are hurt the most by the shortcomings of our healthcare system. They are the retired teacher at church, struggling to manage the effects of diabetes and heart disease; the man standing beside you at the market who had to choose between cab fare, asthma medication, and food for his family; and maybe even the person looking back at you from the mirror. Daniel McCarter, MD, has dedicated his career to ensuring that at-risk patients like these arenâ&#x20AC;&#x2122;t left behind. In ChenMed, he has found an ally and an approach to caring for the chronically ill, poor, and elderly that has proven not only successful but rewarding. Dr. McCarter is using his extensive experience as a physician, healthcare administrator, and industry innovator to enhance the ChenMed model of care in his new role as chief medical officer of the JenCare Senior Medical Center in Richmond.

What Is ChenMed? ChenMed honors seniors with affordable VIP care that delivers better health. James Chen, MD, PhD, founded the organization after a personal experience with illness and hospitalization. A value-based care pioneer, he began by revolutionizing his successful South Florida medical practice, and then he and his family set out to create Americaâ&#x20AC;&#x2122;s leading primary care provider, transforming care for the neediest populations. Together they created a collaborative total care model led by primary care physicians. ChenMed doctors practice medicine 32

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the way it was meant to be practiced: with more face-to-face physician interaction with every patient, and with more compassion and accountability. The premise is not new, but what is unique is ChenMed’s physician-led business structure, its full-accountability culture, and the solid framework of smart, patient-first practices that have helped this care model gain traction in a seemingly static healthcare environment. ChenMed has grown by more than 420% since 2013 and now operates more than 40 medical centers in six states, including Virginia, where JenCare is a provider of choice in greater Richmond and Tidewater. The company consistently outperforms quality measures reported by the Centers for Medicaid and Medicare Services, and patient satisfaction levels are very high. For example, on a standardized CMS survey of 11,000 providers (for the 90-day period ending Nov 27, 2017) all the JenCare Richmond centers beat the U.S. Top Box average for “Provider – Overall Rating”; 80% outshone the average for “Timeliness of appointment for check-up or routine care”; and 72% surpassed the average for “Provider knew important medical history.” “I have been very interested in providing high-value care throughout my 30-year career,” says Dr. McCarter. “JenCare is taking this approach one step further by elevating the role of primary care providers, encouraging relationship-building and the full accountability needed to help middle- to low-income seniors enjoy more healthy days.”

100%

of JenCare centers in Richmond beat the U.S. Top Box average for “Provider - overall rating”

80%

of JenCare centers outshine the U.S. Top Box average for “Timeliness of appointment for check-up or routine care.”

Quality > Quantity For a medical practice born of a desire to provide more compassionate care, it is no surprise that relationship-building is paramount at the 26 JenCare Senior Medical Centers, Chen Senior Medical Centers, and five Dedicated Senior Medical Centers that serve Medicare beneficiaries in markets. All ChenMed centers give seniors industry-leading access to doctors, including walk-in appointments. “We honor our patients by giving them the face time they need and the attention they deserve,” says Dr. McCarter. “Instead of an unwieldy panel exceeding 2,000 patients, which is typical in

72%

of JenCare centers surpass the U.S. Top Box average for “Provider knew important medical history.” www.OurHealthRichmond.com

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FEATURES

a fee-for-service model, our physicians each effectively serve about 400 seniors. With about one-fifth as many patients, our goal is to see each of our patients every month.” This quality time adds up to greater participation and higher satisfaction among patients, not to mention improved outcomes. “Our physicians keep earning trust,” Dr. McCarter relates. “It’s how we connect with patients that’s truly empowering, and our collaborative approach helps seniors live healthier lives.”

WITH ABOUT

ONE-FIFTH

as many patients, as in a typical fee-for-service model, our goal is to see each of our patients every month.

Elevating the Role of PCPs At JenCare, the primary care provider is the patient’s primary point of contact and the “quarterback” of their total care team. Armed with a comprehensive understanding of each patient’s health history, concerns, and preferences, the PCP is a champion for all of the patient’s needs and is on point to coordinate care year-round. Each PCP at JenCare has a network of support staff and specialists on site. From nephrologists, psychiatrists, and cardiologists to acupuncturists and podiatrists, a great depth of services is readily available at each clinic, so patients have easy access to comprehensive care and PCPs have a collaborative, supportive environment in which to practice. “We give all of our providers the tools they need to do well,” explains Dr. McCarter. These include a custom electronic medical record system tailored to the needs of the JenCare physician. “We don’t need the long progress reports that other practices need for billing. Our EMR is designed to help us collect brief notes and pull out the data we need, which means our doctors have more time to care for the patient.”

Empowering the Patient The typical JenCare patient is over the age of 65, middle- to low-income, with multiple chronic conditions. This patient population has historically been responsible for nearly half the nation’s healthcare spending, and as a result they are seen as a burden by many healthcare providers. Yet JenCare tailors its services and chooses locations specifically to attract these patients. This is because, first and foremost, JenCare providers care about and respect seniors. Second, JenCare leaders also have faith that they can shift the trajectory by uniting their team behind a common goal: keeping these patients out of the hospital. A critical component of this effort is making it easier for patients to participate in their care and comply with doctors’ orders.

The concierge-level perks offered at JenCare include: On-site prescriptions within 15 minutes Transportation to and from clinic visits On-site screenings for common conditions 24/7 access to an on-call provider

Daniel McCarter, MD

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“JenCare invests about four times more on primary care than other medical practices do,” explains Dr. McCarter. This formula seems to be working: JenCare and other ChenMed

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FEATUR ES | Passion Meets Possibility

patients average 28% fewer inpatient hospital admissions and 25.7% fewer inpatient hospital days than CMS patients treated by traditional fee-for-service providers.

To Grow, Adapt If a patient needs to be hospitalized, JenCare care teams are accountable. Meetings are held three times a week at each location to discuss patients who have been hospitalized, how this could have been avoided, and how the team will manage them after they are discharged. This commitment to ongoing quality-of-care reviews, sharing of best practices, and collaboration, are hallmarks. What’s more, the company’s leadership team consistently monitors patient and staff satisfaction, focusing on maintaining the core values and company culture that are vital to achieving better health outcomes. Right now, that means actively recruiting like-minded primary care providers. “Substantial organic growth resulting from happy patients referring in family members and friends, means our company likely will double in size during the next five years,” notes Dr. McCarter. Doctors who wish to practice medicine as it was intended to be practiced are encouraged to apply. “Whether you are looking for a forever job or an opportunity to learn and move into a leadership role, this is a great opportunity for those who are interested in shaping the future of healthcare.” For patients seeking better healthcare in the Richmond area, JenCare may be the right fit. “Any Medicare-eligible patient who wants a close relationship with his or her provider and who is willing to be an active participant in improving personal health should consider JenCare,” concludes Dr. McCarter.

To learn more about JenCare Senior Medical Center, visit JenCareMed.com.

EXPERT CONTRIBUTOR Daniel McCarter, MD is the market chief medical officer for JenCare Richmond at ChenMed.

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More at ourhealthrichmond.com

www.OurHealthRichmond.com

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FEATUR ES |

Organ Transplantation words | SUSAN DUBUQUE

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

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

barely walk downstairs to the kitchen, and she texted her roommate to bring her a glass of water. “My roommates were pretty freaked out by how sick I was. I was throwing up blood, so they called my parents. When my friends said my skin looked like ‘cookie dough’ — yellow and doughy — my mom told them to take me to the hospital emergency room immediately.” Bethany’s roommates drove her to LewisGale Hospital in Montgomery. “I really don’t remember much about being in the ER,” she recounts. “I was pretty much out of it. I felt like I was drunk. I had no sense of balance and couldn’t think straight. The doctors initially thought it was a drug overdose.” After an evaluation and a battery of tests, the physicians realized what they were really dealing with: Bethany’s liver was failing. Friday morning, she was airlifted to VCU Health’s VCU Medical Center. At 2 a.m., Scott and Cricket Sandone received a call from the emergency department in Roanoke telling them of their daughter’s hospitalization. “At 5:30 a.m., they called again,” Scott says, “and we knew Bethany was being taken to Richmond.” The family arrived a few hours after the medivac helicopter, having made the drive from Downington, Pennsylvania, in record time. Todd Stravitz, MD, FACP, a VCU Health hepatologist (liver specialist) determined that Bethany had acute liver failure. By Saturday morning, her condition showed no sign of improvement, and she was placed on the national waiting list for a transplant. Patients on this list can wait for months or years for a liver, but Bethany didn’t have the luxury of time. Her life was hanging in the balance, so she was moved to the top of the list for the region. Within hours, a good match was located in Memphis, Tennessee. But serious complications still threatened Bethany’s transplantation surgery. Her liver failure had produced an increase in ammonia in her body, which had led to swelling of the brain. She suffered a small bleed when a catheter was placed in her brain to monitor the pressure. She needed emergency kidney dialysis to help manage her fluid levels and remove the toxins www.OurHealthRichmond.com

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Breaking the Silence: Organ Transplantation

Breaking the Silence:


FEATURES

that were poisoning her system. But the ICU team worked relentlessly to ensure that Bethany survived the arduous surgery to replace her failed liver. In the early hours of Sunday, December 4, Amit Sharma, MD, a VCU Health transplant surgeon, started the eight-hour operation. The organ had been donated by a 55-year-old man from Tennessee who had died in a car accident. One life was sadly ended, but thanks to this generous gift, another one was saved. For two days after the surgery, Bethany floated in and out of consciousness, but her sassy personality and quick wit still shone through. As she was coming out of anesthesia, her doctor came into the room to check on her and Bethany quipped, “Have no fear, Sharma’s here.” That slogan was posted on her whiteboard for the remainder of her stay, and after her discharge, Bethany gave Dr. Sharma a framed copy of it that he proudly displays in his home. “When I first woke up in the ICU after surgery, my mom and dad and sisters, Chelsea and Hollie, were there. I thought I was in the hospital in Pennsylvania,” recalls Bethany. “And I didn’t realize that I had surgery. When the doctor first told me I had a liver transplant, I was in a stupor from the surgery and half-dreaming. My brain was so fuzzy I actually thought Dr. Sharma printed a 3-D liver for me and that we were going to be famous and do a TED Talk together. My doctor got a real kick out of that one.”

No matter where she is, Bethany is never out of touch with the team at VCU Health. “I check in with Shawn Fenner, my transplant coordinator, regularly. He wants to know how I’m feeling and if my medications are all doing their jobs. I also have a hotline I can call 24/7 if I have any concerns or problems. And I can always email Dr. Sharma directly.” - Cricket Sandone

On December 13, she was discharged — an astonishing nine days after receiving her new liver. “We have a video of Bethany walking out

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For three days, Bethany and her parents stayed at the Doorways, a facility that provides hotel-type accommodations for patients at local hospitals and their families. Then they moved into a two-bedroom apartment nearby while Bethany recuperated. “We needed to be close by so I could see my doctor frequently,” says Bethany. “They wanted to make sure my new liver was functioning as it should.” Bethany had blood drawn and saw her surgeon first twice a week, then once a week, then every other week until January 31, when she could finally return home to Pennsylvania. But she would have to keep coming back to VCU Health for at least a year after her transplant.

From that point on, Bethany seemed to recover at warp speed, the way only a healthy 20-something can. Dr. Sharma encouraged walking and prescribed breathing exercises, so Bethany did laps around the hospital floors, toting her IV pole, tubes, bags, and all.

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of the hospital, a sight we prayed that we would see,” says Scott. “The whole experience was surreal. When we were in the hospital in the thick of it, I felt like I was watching a movie — as if this kind of thing couldn’t possibly be happening to me, to our family.”

Medication is now a big part of Bethany’s life. “When I first got out of the hospital I was taking 17 pills in the morning and 13 at night. Now I take 11 in the morning and 8 at night.” And she takes every single one happily, knowing that her life-saving medications protect her from infections and organ rejection. Today, as Bethany continues to heal, she is looking to the future and is eager to get back to school. She will take a few online courses this summer and then return to Virginia Tech in January 2018 to complete her degree in environmental science. “I foresee a long, healthy life ahead for Bethany,” predicts Dr. Sharma.


FEATUR ES | Breaking the Silence: Organ Transplantation

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

When Bethany reflects on her experience, she is matter-of-fact, telling the story with little drama or emotion. It happened. It was bad. Now it’s time to move on to the next chapter of my life. For her mom, though, it’s a different story altogether — one of unimaginable terror of the kind that can only be aroused when one’s child’s is threatened. “We got through this thanks to continual prayer from our family and circle of friends and the team at VCU Health who did everything possible to save our daughter,” says Cricket. “The way they worked together, never giving up, was nothing short of amazing.” Through this ordeal, the Sandones gained a new perspective on organ transplantation. “Before this, I never gave organ donations a second thought,” says Scott. “I checked the box on my license because I thought it was a good thing to do. ‘What the heck, if I no longer need an organ, why not share it with someone who does?’ But it wasn’t real. Now I get it.” They also came to appreciate how many people are affected by transplants. “I always thought this type of surgery was rare,” remarks Cricket, “something that happens to one in a million people.” But this past April, she learned otherwise. Bethany’s sister, Hollie, a nurse at the Children’s Hospital of Philadelphia, organized a team of co-workers to participate in the Gift of Life Donor Dash — a fun run to raise awareness of transplantation. The team’s theme was “Miracles Do Happen — Walking for Wob.” Wob is Bethany’s nickname. “I was stunned by the thousands of people — organ donors, recipients and family members — whose lives have been touched by transplants.” But perhaps the biggest surprise was the fact that Bethany was among them — alive, thriving, smiling and able to walk a mile, thanks to the selfless gift of an organ donor from Tennessee.

When it comes to healthcare, knowledge is power. So let’s learn more about organ transplantation — how many people are affected, the medical conditions that can require it, and the services available here in Virginia.

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

If you think organ transplantation is a rarity, or you assume that no one in your family will ever need a transplant, read on. The facts will astound you. More than 116,500 people in the United States are on the waiting list for a life-saving organ transplant. Even so, only 33,611 transplants were performed in the country last year. Every day, www.OurHealthRichmond.com

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FEATURES

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

twenty people die while waiting for an organ, another person is added to the waiting list every 10 minutes. One day, that person could be you or a loved one.

What organs can be transplanted? Most people are familiar with heart, kidney, and liver transplants, but you may be surprised to learn that the pancreas, intestines, and even hands and faces can be transplanted as well. Around 80 percent of the people on the list are waiting for a kidney, 12 percent for a liver, 3.4 percent for a heart, 1.2 percent for a lung, and 2.5 percent for another organ.

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

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

What is a living donor? About 40 percent of donated organs come from living donors — typically a relative or friend of the patient. With so many patients on the waiting lists, a living donor can shorten wait times significantly and produce better outcomes. “Organ donation is one of the most selfless acts one human being can do for another,” says Lisa Matthias, RN, director of the Virginia Transplant Center at Henrico Doctors’ Hospital. “Living donation allows the donor to see the impact their gift can have on someone in need. Kidney paired donation (KPD) is a program that matches incompatible pairs with other incompatible pairs throughout the country so that recipients receive from someone they are compatible with and donors give to someone they are compatible with. Kidney paired donation has allowed willing, suitable donors to be compatible donors.”

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FEATUR ES | Breaking the Silence: Organ Transplantation

Some living donors are Good Samaritan or altruistic donors — people like Christoffer Friend, who donated a kidney to an unknown recipient. Christoffer was confident that donating an organ would be safe, and he felt empowered and grateful to be able to save a life in this way. We could make a huge dent in the waiting list if more people considered organ donation, either living or deceased. In the U.S., 95 percent of adults say they support organ donations, yet only 54 percent actually sign up as donors by checking the box on their driver’s licenses or visiting www.donatelifevirginia.org

Where do I start if I need a transplant or want to donate an organ? Richmond is fortunate to have two transplant programs. The Virginia Transplant Center was established in 1990 and offers kidney transplants. It is located in HCA Virginia’s Henrico Doctors’ Hospital. To learn more, contact: Virginia Transplant Center at Henrico Doctors’ Hospital Professional Office Building, Suite 303 1602 Skipwith Road | Richmond, VA 23229 804.289.4941, or toll-free, 877.626.4581 henricodoctors.com/service/transplant-services VCU Health’s Hume-Lee Transplant Center was one of the first organ transplant centers in the country and is celebrating its sixtieth anniversary this year. Hume-Lee performs kidney, liver, pancreas, and islet cell auto-transplants. VCU Health’s Pauley Heart Center performs heart transplants too. VCU Health Hume-Lee Transplant Center Gateway Building, Seventh Floor 1200 East Marshall Street Richmond, VA 23219 804.828.4104, or toll-free, 800.762.6161, ext. 4104 vcuhealth.org/transplant VCU Health Pauley Heart Center 1200 East Marshall Street Richmond, VA 23219 804.828.4571 | vcuhealth.org/pauley EXPERT CONTRIBUTOR Lisa Matthias, RN with Virginia Transplant Center at Henrico Doctors’ Hospital

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

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FEATUR ES | Keeping Your Health in the Game of Life

words | CATHERINE BROWN

We all know what we are supposed to do to ensure a long, healthy life: eat healthy foods and exercise daily while refraining from smoking and overindulgence in alcohol and sweets. It seems so easy, but sometimes life just gets in the way. We find ourselves working long hours and unable to find time to shop for and prepare healthy meals. Or we just don’t have the time, energy or money to join a gym and exercise regularly. And doctors’ appointments? Who has the time to take off work or schedule a babysitter to keep up with regular visits to primary care physicians, dermatologists, and dentists? Unfortunately, not making time to incorporate a healthy diet, regular exercise and routine medical visits can lead to a multitude of health challenges, including diabetes, high blood pressure, heart disease and even cancer. These conditions can profoundly impact our lives— and the lives of our loved ones—if we aren’t proactive about being healthy. Some of us may do all the right things in childhood and adulthood. Maybe we stay physically fit but end up with a debilitating disease because of genetics or just plain old bad luck. If that happens, are we doomed to suffer the rest of our lives? With the right mentality, we can mediate the impact health challenges have over our lives. We can manage— and even possibly reverse—difficult health conditions by improving our habits, consulting with knowledgeable medical providers, educating ourselves and maintaining a positive outlook. To be able to manage health conditions, however, we need to be proactive about sharing concerns with doctors and undergoing routine screenings done. Omer Khalid, MD, Gastroenterologist with Gastrointestinal Specialists, Inc., emphasizes the importance of making the time for tests that ultimately can save our lives: “Don’t put off moments with your family because you want to put off having screening done.” In this article, several patients from the Richmond area have shared their experiences coping with health issues and getting back on track. Many of their medical providers have also shared their insights into overcoming health challenges.

www.OurHealthRichmond.com

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FEATURES | Aortic Dissection & Obesity

HEALTH CONDITION

Aortic Dissection ISSUES GORDON EXPERIENCED Pain in his chest and leg

MEDICAL PROVIDER

Jill Melia, RN Cardiac surgery program nurse at Bon Secours St. Mary’s Hospital

Gordon Burks AGE 58

A

lthough he does love ice cream, Gordon Burks has worked hard all his life to eat healthfully and exercise regularly. As he has learned, though, you can’t pick your family. Burks’ mother experienced four heart attacks, and he has always worried that he would develop heart disease. One day last February, Burks was working at home and having a difficult phone conversation with his boss. He had run three miles that morning and had been feeling good. Suddenly, though, he felt like someone had put a knife into his chest, and he felt excruciating pain in his right leg. Because he knew the signs of heart distress, he called an ambulance, and in five minutes it arrived and took him to St. Mary’s Hospital. “Calling the ambulance was the right thing to do,” says Jill Melia, RN, a cardiac surgery program nurse at St. Mary’s who was part of the team that worked on Burks. “Too many people think they can drive themselves,” Melia says, “but important diagnoses and treatment happen in that ambulance ride.” Melia also encourages patients to visit the hospital right away

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if they have any concerns about heart trouble. “Don’t delay coming because you think it might just be heartburn,” she says. “We’re happy to send you home if it is, but we want to treat you earlier if it is something more serious.” When Burks arrived at St. Mary’s, cardiovascular surgeon Steven Fiser, MD performed a CT scan and found that he had suffered a type 1 aortic dissection, meaning that the entire length of his aorta, the largest artery in the body, was peeling apart. The team at St. Mary’s performed a root repair, inserted a mechanical valve, and carried out a femoral bypass. Following some complications resulting from the temporary loss of airflow to his organs, Burks stayed in the hospital almost a month before going home and returning to normal. During his stay, one of the team members told him something that stuck with him: “Don’t feel sorry for yourself that you stayed in shape and this happened; it’s because you’re in shape that you got through this.”


FEATUR ES |

HEALTH CONDITION

Keeping Your Health in the Game of Life

Obesity ISSUES MELISSA EXPERIENCED Dissatisfaction with her inability to do things she wanted to do

MEDICAL PROVIDER

Gretchen Aquilina, DO BEFORE

AFTER

Bariatric Surgeon, VCU Health

Melissa Burton AGE 32

I

n 2014, 29-year-old Melissa Burton was dissatisfied with her life. She was not facing any serious health challenges, but she felt limited in what she could do. She couldn’t ride a roller coaster with her child, for instance, and she couldn’t participate in the ropes course with the youth group she led. Most importantly, she wanted to avoid major health problems, like diabetes, and to provide an example of living healthfully and attaining goals. Burton consulted Gretchen Aquilina, DO, a bariatric surgeon with VCU Health, and decided to undergo a gastric bypass. By following the team’s guidelines and restrictions, she lost 161 pounds within a year after the surgery. “I am not a new person, because I still have the same struggles and joys,” she says, “but I am a healthier version of myself in smaller clothes.” Burton’s life has changed dramatically. “When you stop eating bread and sugar,” she says, “your whole life changes. You find will-power you never knew you had and learn things about yourself that were covered up by the weight and your

dependence on food.” Dr. Aquilina recounts Melissa telling her that after the surgery, if she was making cupcakes for her kids and got icing on her finger, she would wash it off instead of licking it off. “It’s this dedication and attention to the details of her diet and lifestyle that have made Melissa so successful,” Dr. Aquilina says. Since the surgery, Burton has written a sugar-free cookbook, and she helps others by leading seminars on sugar-free living. She also caters meals and prepares meal kits for people who don’t have the time to eat healthfully otherwise. “This isn’t an easy fix,” she reminds people, “but it can be a life-saving opportunity for someone who is willing to take it seriously and really change who they want to become.” Dr. Aquilina reinforces the significance of changing one’s relationship with food. “A person can live their life without smoking, or drinking, or gambling, or any other number of activities,” she says, “but a person can’t get away from food. We need food every day, and because of this, successful patients need to change their relationship and mindset towards food.”

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FEATURES | Protruding Ears

Emma Carson PSEUDONYM | AGE 14

E

mma Carson was born with protruding ears, and for years she suffered from bullying by other kids and even hurtful comments from adults. “I had to deal with a lot of bullying,” she says, “and I was called a lot of names.” Emma was so affected by the comments that her mother, Sarah, worried incessantly about her. “I worried my daughter would do the unimaginable,” she says. “That is a parent’s worst nightmare.” Emma struggled with her self-confidence and self-image. “I didn’t think I was pretty,” she says. “I started to get angry with people, and I felt like everyone was laughing at me.” This year, Sarah took Emma to see cosmetic surgeon Joseph Niamtu, III, DMD, who performed an otoplasty. Dr. Niamtu explains, “The procedure involves removing excess cartilage and reconstructing the delicate anatomy of the normal ear. The combination of these surgical procedures allows the protruding ear to set back in a more normal position.” Since the procedure, Emma’s life has changed dramatically. She now feels comfortable wearing her hair up, and she doesn’t worry as much about the way she looks. “I LOVE how my ears are,” Emma says. “People look at me now instead of my ears.” According to Dr. Niamtu, “The transformation resulting from an otoplasty is always immediate and amazing. The day after surgery when the bandages are removed and the patient sees their ears in a normal position for the first time ever, the whole room often tears up. It is an extremely emotional moment for most people.” Dr. Niamtu adds that the procedure immediately boosts the patient’s confidence, as it has for Emma. For Sarah, the procedure has assuaged some worry. “I couldn’t be happier for her,” she says. “Emma looks in the mirror and just smiles.” 46

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HEALTH CONDITION

Protruding Ears ISSUES EMMA EXPERIENCED Bullying and low self-esteem

MEDICAL PROVIDER

Joe Niamtu, III, DMD


FEATUR ES | Keeping Your Health in the Game of Life

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FEATURES | Bladder Cancer FEATUR ES |

HEALTH CONDITION

Keeping Your Health in the Game of Life

Bladder Cancer ISSUES MONICA EXPERIENCED None leading to bladder cancer diagnosis

MEDICAL PROVIDER

Michael E. Franks, MD Virginia Urology

Monica Cox AGE 43

W

hen Monica Cox was 30 years old, her physician felt something unusual during her annual pap smear and ordered an ultrasound. That led to further testing of her bladder and ultimately a diagnosis of bladder cancer. “After digesting the news, I was an emotional roller coaster,” says Cox. “I had never even heard of non-invasive bladder cancer.” She immediately started researching and found the Bladder Cancer Advocacy Network, which became an important resource for her and her family. Cox’s medical provider, Michael Franks, MD, of Virginia Urology, says that Cox’s case was unusual because she is African American and doesn’t smoke. Smokers are twice as likely as non-smokers to get bladder cancer, and Caucasians are twice as likely as African Americans. The risk also increases as people age. To fight Cox’s cancer, Dr. Franks treated her with Mitomycin-C, an anti-cancer chemotherapy drug, and with Bladder 2.1, a multivitamin and mineral supplement designed to support a healthy bladder lining. Fortunately,

Cox did not lose her bladder as some patients do, although it is weakened. Dr. Franks relates that when Cox developed cancer, she was determined to take charge of her situation. She wanted to help not just herself but others going through the same diagnosis. She became a volunteer with BCAN and is organizing the Walk for Bladder Cancer, which will take place in Richmond the first Saturday in May. The awareness and advocacy BCAN provides are invaluable, and Virginia Urology supports the group by participating in the walk. Cox has made many changes in response to her cancer, like eliminating caffeinated beverages, avoiding chemicals, and eating more healthfully, but perhaps the most profound change has occurred because of her involvement with BCAN. “Through this annual walk,” she says, “I have met some amazing survivors and caregivers, who are my extended family!” Although she originally viewed her diagnosis as negative, she says now that a lot of positive things have come from her journey.

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FEATURES | Traumatic Brain Injury

HEALTH CONDITION

Traumatic Brain Injury ISSUES JAE EXPERIENCED Cognitive, attentional, neurological, and sensory abnormalities

MEDICAL PROVIDER

Gregory O’Shanick, MD Medical Director of the Center for Neurorehabilitation Services

Jae Felder AGE 61

B

efore 2010, Jae Felder wrote poetry and worked as an event planner. Then a fall down her apartment stairs left her with a traumatic brain injury and what Gregory O’Shanick, MD, Medical Director of the Center for Neurorehabilitation Services, describes as “cognitive, attentional, neurological and sensory abnormalities.” Felder also experienced post-traumatic amnesia and had trouble retaining information, had trouble communicating with others, and often became angry and frustrated. At times, she withdrew and avoided talking to people for fear she would say the wrong thing. Dr. O’Shanick and his team performed a thorough neurological exam and MRI to rule out tumor and stroke and conducted nutritional testing before starting Felder on a treatment plan. Once other conditions were ruled out, Felder began seeing a physical therapist to work on her balance, a speech therapist to help her communicate, and an occupational therapist to help her develop organizational strategies so she could live in her home independently.

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The treatment was challenging at times, but Felder worked hard and appreciated that Dr. O’Shanick and his team let her work at her own pace. Throughout her treatment, Felder slept restoratively, ate nutritiously, stayed well-hydrated, and exercised regularly. Dr. O’Shanick describes these four things as the “foundation upon which any therapy has to be built, accounting for 65 to 70 percent of concussion recovery.” Two other factors contributed to Felder’s success: she worked hard to understand her condition and develop strategies to self-manage; and she had the support of her grown daughters, who helped her cope with the sadness and frustration she felt at the changes resulting from her injury. Now, seven years later, Felder is writing poetry again and planning a conference for the spring. “I’ve come a long way,” she says. “I don’t let the injury be my life.”


FEATUR ES | Keeping Your Health in the Game of Life

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FEATURES | Saddle Nose & Pelvic Floor Dysfunction

HEALTH CONDITION

Saddle Nose ISSUES HOLLY EXPERIENCED Trouble breathing, dissatisfaction with appearance

MEDICAL PROVIDER

Alan Burke, MD Facial Plastic and Reconstructive Surgeon with Virginia Ear, Nose & Throat

Holly Harris AGE 54

H

olly Harris has come a long way in twenty years. In 1995, she was homeless in New York City and addicted to heroin. But from that low point, she was able to move back to Richmond, where she lived with her parents and recovered in their guest room. “My parents saved my life,” she says. After her recovery, Harris got her life back on track. She found a good job with health benefits and was able to live a normal life. But the deformities in her nose caused by her drug use kept her from feeling confident. Alan Burke, MD, a facial plastic and reconstructive surgeon, with Virginia ENT, explains: “Her saddle nose was disfiguring apart from her inability to breathe through her nose. The disfigurement is markedly stigmatizing, creating a spiral of loss of confidence, stature, self-worth, etcetera.” Harris first met Dr. Burke in 2002. She related her story, and he assured her that they could repair her nose and help her feel good about herself again. To do so, he performed a “functional and reconstructive and aesthetic septorhinoplasty to restore form and function.” As he explains it, “This involved borrowing rib and ear cartilage to restructure her nose; the rib was used to reconstruct the bridge of her nose, and the ear cartilage was used to brace the nostril and nasal tip anatomy.”

BEFORE

Burke explains the benefits to Harris of having her nose repaired: “Restoring her old nose helps her mind, her ego, her place in society, her place in the workforce, her airway and her sinus function. . . . It helps restore her as a more whole person.” Harris is grateful for Dr. Burke’s willingness to help her, and even credits him with aiding her along her path to recovery. “Dr. Burke will always be a paramount figure in my recovery,” she says, “for correcting my appearance and giving me confidence to carry on with a healthy lifestyle.” 52

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AFTER


FEATUR ES |

HEALTH CONDITION

Keeping Your Health in the Game of Life

Pelvic Floor Dysfunction ISSUES JANINA EXPERIENCED Urinary leakage, back pain

MEDICAL PROVIDER

Cora Huitt, PT, DPT, MACT, BCB-PMD, IF Women’s Health Physical Therapy and Men’s Pelvic Health

Janina King-Poulin AGE 37

W

hen Janina King-Poulin had her first baby almost four years ago, she knew her body would go through changes. But she never anticipated they would be so drastic. “It seemed as though my body had fallen apart,” she said. “I started experiencing debilitating lower back pain and started leaking with any physical activity or when I laughed.” King-Poulin had always been active before her pregnancy and was frustrated at being unable to exercise. King-Poulin assumed these changes were normal and struggled through each day because she lacked confidence and felt broken. Then one day while she was listening to an NPR program, someone started talking about pelvic floor physical therapy. She was excited because she finally felt like there was a solution to her problems. Afterward, King-Poulin consulted a pelvic floor physical therapist in New York, where she used to live. Later, when she was pregnant with her second child, she started seeing Cora Huitt, PT, DPT, MACT, BCB-PMD, IF, at Women’s Health Physical Therapy and Men’s Pelvic Health, for back pain and pelvic floor weakness.

After her pregnancy, Dr. Huitt treated King-Poulin for diastasis, or separation of the abdominal muscles, and hypotonus of the pelvic floor related to urinary incontinence. As a result of her months of therapy, King-Poulin no longer has urinary leakage and experiences less back pain. She reaped many other benefits from the therapy too. “It brought back a me I didn’t know could exist now that I’m a mother,” she says. “I have renewed confidence and energy, and I’m armed with facts about my own body.” Her newly gained knowledge of how her body works has been empowering. Because so many women experience incontinence, bowel problems, back and pelvic pain, and sexual dysfunction after pregnancy, Dr. Huitt says that she and her colleagues recommend Postpartum Strong, “a from-the-inside-out screening for all pregnant women that addresses all musculoskeletal structures at six months and at six weeks post-birth.” King-Poulin feels that she underwent so much stress because so few women talk about pelvic floor issues. She hopes to change that. “I want people to put it out there so people know there is a solution,” she says. “You don’t have to walk around in shame and pain.” www.OurHealthRichmond.com

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FEATURES | Cancerous Polyp in Colon

HEALTH CONDITION

Cancerous Polyp in Colon ISSUES DAVID EXPERIENCED None leading to the colonoscopy; and the cancerous polyp was removed

MEDICAL PROVIDER

Omer Khalid, MD Gastroenterologist, Gastrointestinal Specialists, Inc.

David Saunders AGE 50

D

avid Saunders always looked after his health by scheduling routine physicals each year. Once, when his primary-care physician didn’t have any openings for several months, Saunders even switched doctors to one who could perform a physical right away. That decision turned out to be life-saving. Saunders’s new doctor checked him out thoroughly and insisted he have a colonoscopy. He knew he needed one when he turned fifty, but he wasn’t looking forward to it. It turned out, though, that the procedure wasn’t that big a deal. “People build it up to be more involved than it is,” Saunders says. The colonoscopy itself may not have been a big deal, but its findings were. His physician, Omer Khalid, MD with Gastrointestinal Specialists Inc. found several large polyps in Saunders’s colon, and the largest, more than a centimeter across, turned out to be cancerous. Fortunately for Saunders, the cancer had not spread into his blood vessels. “We saved him a great deal of trouble and heartache,” Khalid says. After Dr. Khalid found the cancerous polyp, Saunders learned that his first cousin had been diagnosed with colon cancer

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years before. Because of the stigma surrounding colon cancer and colonoscopies, Saunders never heard of it. Had he known this family secret, he would have been more active about having a colonoscopy, because patients with a genetic risk are encouraged to get screenings even earlier than age 50, as they are more likely than others to develop colon cancer. It’s fortunate that Saunders had the screening colonoscopy when he did. “If Dave had waited a year longer,” says Dr. Khalid, “he would be combating cancer. Once a polyp becomes cancerous, it often spreads quickly, and the common treatment for the patient is chemotherapy.” Saunders says that he used to be more reactive with his health; for instance, he went to see his doctor when he had a cold, and he visited the emergency department when he got a fish hook stuck in his finger. Now that he is 50 and has had a cancerous polyp removed, he takes a more proactive approach. “I think a lot more about my health and being around for my friends and family,” he says.

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GASTROINTESTINAL SPECIALISTS, INC. 804.285.8206 | f gastrova | www.gastrova.com

THE IMPORTANCE OF COLORECTAL SCREENING According to Omer Khalid, MD, a gastroenterologist with Gastrointestinal Specialists, Inc. (GSI), colon cancer is the third highest cause of cancerrelated death in the United States, responsible for more than 50,000 deaths in 2017. “Not only is colon cancer a major contributor to the total number of cancer related deaths, but sixty to seventy percent of colon cancer death can be avoided if screenings are conducted at the appropriate time,” he says. “In fact, The American Cancer Society reports that incidents of colon cancer are down 30% over the past ten years, a stat they attribute to the larger number of screening colonoscopies being performed.” The American Cancer Society and The American College of Gastroenterology recommend that everyone (except African-Americans) should have a screening colonoscopy at age 50. Under recently published guidelines, African Americans should receive screening at age 45. Furthermore, if a person has a family history of colon cancer, the screenings should begin earlier, at age 40 or 45. Colon cancer is a silent killer and manifests itself slowly over time. As such, colon cancer screenings are particularly important because they are used to detect pre-cancerous polyps, slow-growing lesions within the colon and/or intestinal tract, and thus prevent them from turning into cancer and spreading, causing further damage and/or loss of life. If a polyp is detected during colonoscopy, it is removed and then tested; additional testing may also be required, and follow-up colonoscopies will have to happen more frequently. If no polyp is detected, patients can often wait ten years before receiving another colonoscopy. Unlike other cancer screening tests, a colonoscopy is the only test that allows physicians to prevent, detect and treat colon cancer.

words | CATHERINE BROWN

The physicians at GSI find that patients often put off having a colonoscopy because they incorrectly assume that they do not need to undergo the test if they do not exhibit any abnormal symptoms. However, according to Dr. Khalid, by the time a patient does experience concerning symptoms and cancerous polyps are detected, it is often too late. “A patient will typically experience symptoms only after cancer has grown and spread,” he says. “Getting screened regularly, and at the appropriate ages, is the only way to rule out pre-cancerous or cancer polyps.” Dr. Khalid also believes too many patients avoid getting a screening colonoscopy because they think it will be uncomfortable or have been frightened by unfounded horror stories. “A colonoscopy is actually a very safe and painless procedure,” he says. “In fact, the physicians at GSI typically perform, in total, 50-70 colonoscopies each day. Honestly, the worst part of the procedure for the patient is properly preparing for it. However, it is nothing that we have not all had to do and should do.” GSI is the largest and one of the oldest gastrointestinal practice in central Virginia. Providing outreach and education to primary care physicians and others on the importance of early detection, GSI also works with AccessNow, (a program by the Richmond Academy of Medicine to provide services for the uninsured) and Hit Cancer Below the Belt (a Richmond-based non-profit whose mission is to educate people about the necessity of early colorectal cancer screening). In addition to screening for colorectal cancer, the providers at GSI also perform many other procedures and assist patients with a wide-range of gastrointestinal issues; from symptoms related to Irritable Bowl Syndrome (IBS) to Inflammatory Bowl Disease (IBD), which could include Ulcerative Colitis or Crohn’s disease.

THE AMERICAN CANCER SOCIETY REPORTS THAT INCIDENTS OF COLON CANCER ARE DOWN 30% OVER THE PAST TEN YEARS, A STAT THEY ATTRIBUTE TO THE LARGER NUMBER OF SCREENING COLONOSCOPIES BEING PERFORMED.”

SOME OF THE OTHER ADVANCED PROCEDURES PERFORMED BY GSI: EGD (Esophagogastroduodenoscopy) examines the upper part of the gastrointestinal tract for symptoms of acid reflux or when patients have trouble swallowing. ERCP (Endoscopic Retrograde Cholangiopancreatography) is used to study bile and pancreatic ducts for the treatment of gallstones or pancreatitis. EUS (Endoscopic Ultrasound) is used to image the pancreas, gallbladder and esophagus walls to look for cancers or cists. HALO, a radiofrequency ablation procedure, is performed for patients with Barrett’s Esophagus with dysplasia, a condition that is linked to chronic heartburn

Hemorrhoid Banding is another useful procedure that is used to treat the itching, burning and bleeding conditions often associated with hemorrhoids. This is a painless, non-invasive and non-surgical procedure that is conducted during a clinical visit that enables GSI physicians to safely remove internal hemorrhoids. PillCam is a tool that is used to examine the small intestine. In this procedure, the patient swallows a tiny camera, encapsulated within a small, regular-sized pill that they will later pass. The PillCam will transmit images of the GI tract that the physicians are able to study and deliver a diagnosis. Any of the above procedures offered by Gastrointestinal Specialists, including colorectal screening, can provide comfort and peace of mind.

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CHILDREN & TEENS

Don’t Pass the Bread WHY IS CELIAC DISEASE ON THE RISE IN KIDS? words | BRANDY CENTOLANZA

Celiac disease, a digestive disease that affects the small intestine, appears to be on the rise in children. What is the cause of this disease, and how does it impact the children who contract it? “When people with celiac disease eat gluten, a protein found in certain foods containing wheat, rye and barley, their bodies trigger an immune response that attacks the finger-like structures in the lining of the small intestine, called villi, where nutrient absorption takes place,” explains Jennifer Snow, MD, Medical Director of the Pediatric Intensive Care Unit at Henrico Doctors’ Hospital. “The damage is referred to as villous atrophy or flattening of the villi and can lead to gastrointestinal symptoms, poor absorption of nutrients and, in some cases, poor weight gain and malnutrition.”

JENNIFER SNOW, MD Medical Director of the Pediatric Intensive Care Unit at Henrico Doctors’ Hospital.

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While the exact cause of celiac disease is unknown, some research studies indicate that it could be hereditary, meaning that it only occurs in people with a particular set of genes and tends to run in families. Other studies suggest that there may be a link between respiratory infections in children and the development of the disease. “To develop celiac disease, you must eat gluten and have the specific genes,” Dr. Snow says. “Celiac disease may develop any time after wheat or other gluten-containing foods are introduced into the diet. In children, this is typically after six to nine months of age. It is unknown why some children develop the disease early on and others only after years of exposure to gluten. This suggests that other environmental triggers could be involved, and research indicates that additional environmental factors may contribute to the development of celiac disease. Possible triggers include gastrointestinal and respiratory infections.”

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CHILDREN & TEENS | Don’t Pass the Bread

Certain organizations, including the Celiac Disease Foundation (CDF) and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN), continue to study the disease and lead efforts to educate and advocate for people who have celiac disease.

“It is possible that certain viruses can stimulate the immune system in people who carry the celiac genes, which then contributes to the switch from tolerance to intolerance to gluten,” notes Snow. “Other studies are looking at the interaction of the gut microbiota — the microorganisms that live in the human digestive tract — and the immune systems in children who are genetically at risk for developing celiac disease.” - Jennifer Snow, MD

No matter how children develop the disease, it is important to stay on top of it. Children with celiac disease must adhere to a strict diet, eliminating all foods and drinks that contain gluten. “Speaking with a knowledgeable dietician can help parents and children learn which foods to avoid, which foods are safe, how to read food labels and how to adjust to a gluten-free lifestyle,” Dr. Snow says. “Children with celiac disease require regular visits with their care team to monitor their response to the diet, to assist with dietary compliance and to assure positive health outcomes. Children with celiac disease often have poor nutritional status, resulting in potential bone loss, vitamin and mineral deficiencies, growth problems and anemia. Celiac disease can also be associated with other autoimmune disorders. Routine follow-up care will include the assessment and monitoring of these potential issues.” EXPERT CONTRIBUTOR Jennifer Snow, MD, Medical Director of the Pediatric Intensive Care Unit at Henrico Doctors’ Hospital.

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AGING WELL

Movin’ On Up When and how should seniors go about choosing a retirement community? words | BRANDY CENTOLANZA

As people grow older, they must consider whether to remain in their homes or move into retirement communities. What should seniors keep in mind when deciding on downsizing and moving into an independent living community? And when should they make this major decision?

STACEY NANNERY The Director of Sales and Marketing at Westminister Canterbury Richmond.

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“It’s really never too early to start looking at options,” says Stacey Nannery, director of sales and marketing at Westminster Canterbury, a senior community in Richmond. Nannery suggests planning roughly five years in advance, as many communities have waiting lists. “The decision to move is a very emotional one,” she notes. “It is always best to plan ahead.” The minimum age for living at Westminster Canterbury is 62. Preparing in advance for a move makes it less stressful, as it gives seniors time to work out their finances and let go of the memories and possessions associated with their previous homes. Some people find it daunting to part with the lifestyle they’ve always known, and others feel they just aren’t ready to take the next step, but there are plenty of benefits to living in a retirement community. These include a safe and secure dwelling, not having to worry about household or lawn maintenance, and easier access to health care.

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“Staying at home is certainly an option, but you need to consider the following: care coordination, the emotional strain on family, dependability, the potential for fraud, social isolation, and home maintenance, including utilities and taxes,” Nannery points out. Other things to consider are whether to rent or to buy; what type of floor plan you want; whether to live in a place with social activities, clubs, and events; what amenities you want, including meals and transportation; the accessibility of the community to stores, the library, the hospital, and other places around town; the proximity of your neighbors; and the health care and wellness services that are provided. Does the independent living community you want to move into also offer assisted living and nursing home options? How friendly and welcoming is the staff? Can you envision yourself living there? “Many of us have been planners all our lives, planning our careers, our home, our education,” says Nannery. “It’s also important to talk about our plans for future health care now, before we face a problem.” If the move itself is something you dread, it’s worth noting that some communities offer move-in incentives, providing seniors with turnkey services for downsizing, packing, and unpacking. Before you decide which community is the right fit for you, do your research. Speak with representatives and express your needs and wants. “Our job is to listen,” says Nannery. “Some people may have a misconception of what a retirement community is like. Visit a community, have a meal, take a tour, and talk with the residents. Often, a reality check helps dispel any hesitations.” EXPERT CONTRIBUTOR Stacey Nannery, director of sales and marketing at Westminster Canterbury, a senior community in Richmond.

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AGING WELL

Myth: HOME CARE WILL TAKE AWAY MY INDEPENDENCE FACT: Home care services offer an alternative to assisted living or nursing home care and help seniors live independently at home. words | OURHEALTH STAFF WRITER

What is home care or home health care? The answer is different for different people, and can be adapted to an individual person’s needs. For example, some seniors may only need weekly drives to the grocery store and light housekeeping help. Other seniors may need physical therapy or skilled nursing in addition to household help. Whatever assistance is needed, the goal is the same—to help seniors maintain independent living and the ability to stay in their home for as long as possible. It’s a reality of aging—freedom is compromised by declines in physical or mental health. Sometimes, a senior temporarily loses the ability to care for himself following an illness or surgery. Whatever the cause, as seniors lose the ability to self-care, they become reliant on friends and family members. If they don’t have family members or capable friends nearby, they risk having to relocate to a facility that can provide the necessary care. Home care is an alternative to relocation, and is often a cost-effective bridge to independence. It is well known that being in one’s own environment, among possessions and memories, is the best place to promote health and healing. Having to downsize and squeeze a lifetime into a new, smaller residence is not ideal. With a little support in the home in the form of therapy to promote strength, skilled nursing to help monitor medications, and personal care to assist with those tasks that have become more difficult, health can be regained and independence can be kept. How exactly is independence promoted? In some cases, a person is told they can no longer safely drive. A home care service can drive for them, making sure they still get haircuts, groceries, and to doctor’s appointments—even a picnic in the park if they wish. For those with compromised mobility, home health care trained providers will assist them in getting around to help minimize the risk of falling. For those who lose the ability to read because of poor eyesight or other limitations, a home health care worker reads to them so they don’t lose touch with the outside world. Home health care workers are compassionate caregivers who can provide both practical and emotional support in many ways. Home care seeks to reinstate and preserve independence–it provides solutions to grant the wishes of a senior citizen to continue living a full life in the place they already call home.

EXPERT CONTRIBUTOR Tina Bell with Care Advantage in Richmond.

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NUTRITION

Get Pumped

WITH

HEART HEALTHY EATING TIPS words | MICHELLE MCLEES

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

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

What to Keep:

1

CHOOSE WISELY, EVEN WITH HEALTHIER FOODS:

Ingredients and nutrient content can vary by brand and preparation.

2

COMPARE NUTRITION INFORMATION ON PACKAGE LABELS:

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

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

What to Moderate:

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

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

3

WATCH YOUR CALORIE INTAKE:

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

4

IF YOU WANT TO LOSE WEIGHT:

Consume fewer calories or burn more calories.

5

EAT REASONABLE PORTIONS:

6

EAT A WIDE VARIETY OF FOODS:

7

LOOK FOR THE HEART-CHECK MARK:

Often this is less than you are served.

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

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


NUTRITION

COOL CUCUMBER DIP SERVES 8 | Two tablespoons per serving Crushed toasted almonds provide crunch, and the just-right seasoning blend adds zing to this unusual dip. It’s convenient and stress-free for parties. You can make it up to four days in advance and serve it with colorful precut vegetables.

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

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

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

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

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

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

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

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

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

source: Livestrong

teaspoon salt-free extra-spicy seasoning blend

DIRECTIONS 1.

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

2.

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

3.

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

4. To serve, sprinkle with the reserved almonds.

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

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

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NUTR I TI O N |

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

INGREDIENTS CILANTRO PESTO 1/2 cup loosely packed fresh cilantro

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

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

3

tablespoons fat-free, low-sodium chicken broth

2

tablespoons sliced almonds

2

tablespoons shredded or grated Parmesan cheese

1

teaspoon salt-free garlic-herb seasoning blend

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

1/4 cup sliced almonds

HEALTH BENEFITS OF EATING MORE

DIRECTIONS

SALMON

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

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

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

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

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

1.

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

2.

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

3.

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

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

source: Livestrong

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

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Heart Health Recipes

SALMON WITH CILANTRO PESTO


NUTRITION

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

DIRECTIONS 1.

Preheat the oven to 350°F.

2.

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

3.

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

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

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

INGREDIENTS 1

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

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

cup all-purpose flour

1

teaspoon baking powder

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

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

medium ripe banana (peeled, chopped)

1

tablespoon canola oil

1

tablespoon water

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

2 large eggs

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

½ cup 1 percent buttermilk

7.

1

teaspoon vanilla extract

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

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

ON THE WEB

More at ourhealthrichmond.com


MISSION MI SSI O N | Satisfying Hunger and Improving Health

Satisfying Hunger and Improving Health A LOCAL ORGANIZATION FINDS A WAY TO ACCOMPLISH BOTH AND PAY IT FORWARD. words | TINA JOYCE

photos | HAL TYLER & SID KOERIN

Making health a priority often falls behind paying bills, caring for families or working. However, a few local residents will be given a chance to make improving their health a top priority this year. Last summer, 15 fortunate patients of Health Brigade, formerly known as the Fan Free Clinic, were selected to participate in a pilot health program called Food Farmacy. The program resulted in such positive outcomes that a second cohort of participants has been screened and will begin the program on January 18, 2018. Health Brigade, an organization that conducts approximately 5,700 medical visits each year, is seeing a growing number of patients suffering from diabetes. “In the past, a traditional food pantry tried to solve many of the needs of patients. Now, instead of simply trying to satisfy hunger, we are also trying to a improve health,” shares Johanna Gattuso, a registered nurse and Health Brigade consultant charged with clinical program development. The Food Farmacy is a program designed to assist patients who have an A1C of at least 7.5 and meet other screening requirements in learning to make healthier food choices to accompany their prescribed medications to control diabetes. Often, medications alone cannot combat the life-threatening disease; diet and exercise play an additional and vital role in patients’ treatment.

WHAT IS AN A1C TEST? According to the Mayo Clinic, the A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications.

www.OurHealthRichmond.com

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MISSION

The Food Farmacy is a 12-week program, meeting once a week in the evenings. The schedule alternates health coaching and cooking instruction each week to give participants a well-rounded, practical education. “It is truly empowering participants to make lifestyle changes,” notes Gattuso.

JOHANNA GATTUSO A registered nurse and Health Brigade consultant charged with clinical program development.

VIRGINIA PREMIER HEALTH PLAN Virginia Premier is a Managed Care Organization (MCO) that works to educate, encourage and empower its members toward the goal of healthy living. As a proud part of the Virginia Commonwealth University Health brand, Virginia Premier is the first and only university-based nonprofit MCO in the Commonwealth, serving nearly 200,000 members statewide. In addition to its Medicare and Medicaid plans, Virginia Premier provides third-party administrative services and runs the Virginia Premier Medical Home in Roanoke.

“VPHP has a long history of engagement with community partners so that we can support the health needs of our community. We’re excited to be part of this already successful program,” shares Carol Wilson, the Director of Disease Management for VPHP.

A generous pool of volunteers and supporters make the program possible. One local partner, Shalom Farms, donates fresh produce each week for participants. Patients walk away with a giant bag of fresh produce, spices, recipes, divided plates (to learn portion control) and their prescriptions stapled to the bag. This generous donation provides a handson approach to cooking. Participants are not simply hearing about recipes and the benefits of reading labels; they actually have the opportunity to prepare healthy, delicious meals. “Ya know, it’s cheaper to eat horrible than to eat healthy. I learned so much through the Food Farmacy. I was never a label reader until now, and I never thought I would eat vegetables,” acknowledges Jacqueline Anderson, a 2017 participant. Last year, the participants finishing the program had a 50/50 ratio of men to women. It is important to have the entire family support changes in eating habits for the household for the best long-term results. For those in the program, the average drop in A1C was 2 percent. The selection process is underway for 2018. Participants are selected through medical recommendations and must meet the following requirements: •

Being motivated to make a lifestyle changes

Having an A1C level over 7.5

Registering blood sugars levels in the high 200s

Having reliable transportation

Being an established Health Brigade patient

Being interested in learning more

Additional community partners are proudly supporting the initiative. VCU’s dietetic program sends interns to assist with Food Farmacy, and Virginia Premier Health Plan (VPHP) learned about the program because of their longstanding relationship with Health Brigade. Carol Wilson, the Director of Disease Management for VPHP, explains, “Our organizations are both focused on prevention and self-empowerment, and we were excited to learn about the Food Farmacy program. Food insecurity is a major social determinant of health, and we are focusing on this issue in all of the communities we serve across Virginia.” VPHP’s direct involvement includes providing supportive funding, especially to cover the expense of fresh foods over the winter months, providing transportation for participants to a grocery store for education about healthy shopping and giving assistance as needed with health education. Up to five VPHP members will be able to join the class. “VPHP has a long history of engagement with community partners so that we can support the health needs of our community. We’re excited to be part of this already successful program,” shares Wilson.

EXPERT CONTRIBUTORS Jacqueline Anderson, a 2017 participant of Food Farmacy. Johanna Gattuso, a registered nurse and Health Brigade consultant. Carol Wilson, the Director of Disease Management for Virginia Premier Health Plan.

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The vision and coordination of a specialized health program such as the Food Farmacy represents a community coming together to address a need by developing creative solutions to make a longterm impact on those it serves. The participants completing the program can utilize their newly acquired life skills and pay it forward by teaching others how to improve their own health.

ON THE WEB

More at ourhealthrichmond.com

OurHealth | The Resource for Healthy Living in Greater Richmond


OurHealth RVA Jan/Feb 2018  
OurHealth RVA Jan/Feb 2018  

Keeping Your Health in the Game of Life, plus Organ Transplantation, Health Brigade's Food Farmacy program, and Healthy Eats from the Americ...