Sentara RMH Spring Summer 2023 Magazine

2023 SENTARA RMH BOARD

Joseph Funkhouser II | Chair

Jerry Benson, PhD | Vice Chair

Devon Anders

Arthur Dean II

Morris Fendley, MD

C. Wayne Gates, MD

SENTARA RMH ADMINISTRATORS

Douglas Moyer President

Gina Yost, MSN, RN, NEA-BC, CLSSBB Vice President, Chief Nursing Officer

Catherine Hughes, MBA, RD Vice President of Operations

Robert Garwood, MD Chief Medical Officer

SENTARA RMH MAGAZINE EDITORS

Alyssa Pacheco

Bob Grebe

CONTRIBUTORS

Jim Heffernan

Preston Knight

Lisa Richmon

PHOTOGRAPHY

Mary Grebe

Andrew Shurtleff

Tommy Thompson DESIGN

Picante Creative

PRESIDENT’S LETTER

Community Support Making a Lasting Impact

From its very beginning, Sentara RMH Medical Center has been a community hospital in every sense of the word. Looking back to 1912, the area’s first hospital building was funded in large part by the estate of William Leake. As he battled a life-threatening illness with no accessible health care close by, Mr. Leake experienced firsthand the need for quality medical services in Harrisonburg, Rockingham County and the Shenandoah Valley. Countless community-supported upgrades were to follow over the next hundred or so years, including the historic move into our current state-of-the-art facility in 2010. And since that time, we have been able to continue to grow both in size and in the scope of the lifesaving services we provide.

The community’s donations to the RMH Foundation, both large and small, have an incredible impact on our hospital and are crucial to our ability to provide the highest level of care possible. As a not-for-profit organization, we rely on community generosity to help fund and invest in the latest medical technologies, as well as upgraded facilities.

In this edition of Sentara RMH magazine, you can read an article on page 41 celebrating the 15th anniversary of the White Rose Giving Circle, a women-led group that pulls together its financial resources and makes a remarkable impact on the quality of care here at the hospital. White Rose started with 22 members and since has grown to 80 women, who each contribute a $500 membership gift each year. Together, their collective funding over the years has supported 115 projects totaling more than $500,000.

And White Rose is just one example of our community’s incredible generosity. On pages 44-48 you’ll find a listing of hundreds of “Friends of the RMH Foundation,” some of whom have contributed for more than 30 consecutive years! How incredible is that? It’s also encouraging to see how many new donors have been added to the list. Every one of our supporters should know that their financial gifts help provide lifesaving equipment and technology, life-changing programs in the

community, and training for staff on the latest treatment techniques.

Through the RMH Foundation, 100% of your gift stays local in your community, 100% is put to your desired purpose, and 100% is stewarded by a board of directors made up of your neighbors and friends—volunteer leaders who live and work here in the Shenandoah Valley. Some donors choose to contribute to the Sentara RMH Hahn Cancer Center or the Heart and Vascular Center. Others offer financial support to our hospice program or the Institute for Nursing Excellence and Innovation. Many give to the RMH Foundation Priority Fund, which helps bring the latest high-tech equipment, clinical advances and compassionate programs to our community for everyone who needs them.

Each year, one out of every two people in our community will need care at Sentara RMH—in fact, we treat more than 70,000 patients annually in our Emergency Department alone. Our hard-working team members remain as committed to providing exceptional care today as we have for the past 100-plus years, and it is through the community’s continued commitment to philanthropic support of the RMH Foundation and Sentara RMH Medical Center that we are able to do so.

What will the hospital look like 100 years from now? What innovative, lifesaving technologies will be found inside our doors then? Although we cannot see into the future, we can be certain that our hospital will still benefit from the strong support of this community, and that our staff will continue its commitment to providing the best possible care for this community.

With gratitude,

Doug Moyer President, Sentara RMH Medical Center

Doug Moyer President, Sentara RMH Medical Center

17 Sentara Cares

33 Active Living Feeling Stressed? Talk with Your Primary Care Physician.

36 Health Matters Think You Might Be Having A Heart Attack? Call 911 Right Away!

37 La Salud Importa ¿Piensa que puede ser un ataque cardíaco? ¡Llame al 911 inmediatamente!

38 Sentara in the Community Home Health Care and the Rewards of Connecting with Patients

41 Philanthropy

Clear Out the Winter Cobwebs and Get Moving!

Each year, I’m always surprised to find myself moved to partake in some spring cleaning. I say “surprised” because I never get the urge to do summer, fall or winter cleaning. But then again, what better time to do spring cleaning than, you know, spring, when I’m finally out of my winter doldrums and looking to start fresh.

There are four types of spring cleaning. The first is deep-dive cleaning: tackling blinds, baseboards, behind the refrigerator and the other areas we usually neglect, mainly because they’re a pain to clean. I know next to nothing about that type of spring cleaning, so I won’t be touching on it here. It’s sort of like winning the lottery: I know it can happen, but it’s not something I’ve ever personally experienced.

The second type involves easier cleaning, such as stovetops, refrigerator shelves, the dishwasher filter, etc. Once again, I can’t speak to this sort of cleaning (see above re: winning the lottery), so you’ll have to turn on the Google machine to learn more about it. Maybe there’s a TikTok video that can help make this sort of cleaning seem fun (well, “fun” might be optimistic, but I suppose it’s a possibility, and I’m not willing to take that chance).

The third type focuses on getting rid of clutter: magazines and coupons and pens that accumulate like kudzu, the invasive plant that spreads little by little until one day you discover your house has been engulfed by it. For example, more and more things keep appearing in my medicine cabinet, to the point where it’s now like a jack-in-the-box— except with my cabinet, I never know which item is going to jump out when I open its door. But, again,

I’m probably not the best person to talk about this level of cleaning.

That leaves the fourth type of spring cleaning, which I refer to as personal cleaning—and by that, I don’t mean I only take a shower in the spring (if you are someone who takes the term “April showers” literally, you might want to rethink that). What I mean by personal cleaning is making a fresh start on improving one’s health. It’s like a New Year’s resolution, only without the hangover.

I often find that after winter, I have added a few pounds in preparation for a long hibernation that never took place. After all, if I had truly hibernated, I wouldn’t have eaten as much food. So with this type of spring cleaning, I try to eat better, get outside more and introduce a bit of exercise into my daily routine.

Just as cleaning your house doesn’t mean cleaning every single thing (trust me, I know), and reducing clutter doesn’t mean getting rid of everything you own, focusing on your physical and mental well-being doesn’t mean having to exercise every day for an hour or eating nothing but tofu. Walking 10 minutes a day is great if you haven’t been exercising at all. And if you’re already walking 10 minutes, try going for 20 minutes. Likewise, cutting out junk food, say, two days a week is better than eating junk food every day.

The invigorating feeling you experience during beautiful spring days is a sign that your body wants to live its best life—so take a step forward, even if it’s literally just taking a step forward. See what you can do while spring is in the air to make a small change or two; these types of incremental changes can really add up, just as wiping off the stovetop after each meal preparation makes it easier to keep it clean.

Not that I would know anything about that.

new & noteworthy

Sentara RMH Medical Center is pleased to welcome the following new providers into the hospital community.

Jenelle Alderfer, NP Family Medicine

Sentara Timber Way Health Center (540) 901-0800

Patricia N. Caldwell, PA-C Cardiology

Sentara Cardiology Specialists

(540) 689-7400

Stephanie O. Findley, NP-C Orthopedic Surgery

Hess Orthopaedics & Sports Medicine

(540) 434-1664

Kenneth L. Hyden, Jr., DO Emergency Medicine

USACS Sentara RMH Medical Center (540) 689-1414

Gaurav Nayyar, MD Pediatrics

Bluestone Pediatrics (540) 437-4800

Yoo T. Suh, MD Gastroenterology

Sentara Gastroenterology Specialists

(540) 689-5800

Jessica M. Thomas, NP-C Cardiology

Sentara Cardiology Specialists (540) 689-7400

To get connected with one of our providers, or for more information on any caregiver at Sentara RMH, please call 1-800-SENTARA.

Dr. Jordan Hill Honored with 2023 Golden Stethoscope Award

Jordan Hill, DO, of Sentara Timber Way Health Center, has been named the recipient of the 15th annual Sentara RMH Golden Stethoscope Award, which recognizes outstanding physicians on the Sentara RMH medical staff who demonstrate excellence in patient care, customer service, communication and teamwork.

“Considering how fortunate we are to have so many outstanding physicians locally, I am greatly honored to be recognized by my co-workers and peers for this award,” says Dr. Hill. “This recognition would certainly not be possible without the help of a team of incredible nurses and support staff. I am blessed beyond measure.”

Dr. Hill, who grew up in the Shenandoah Valley and joined Sentara Timber Way in 2010, received more

than 20 nominations this year. A common theme in those submissions was Dr. Hill’s ability to connect with his patients on a personal level. He was also described as “caring and compassionate” and “a great mentor and co-worker.”

“In working with Dr. Hill for more than 10 years, I have found him to be very focused on providing exceptional care to the community,” says Sue Miller, Sentara Timber Way Health Center practice manager. “He puts his patients’ needs first and works closely with them to improve their quality of life.”

“Not only is he a wonderful physician, but he is also a leader in our clinic,” Miller adds. “He gives great feedback to staff and is always willing to provide guidance to help develop a more knowledgeable team. In addition, he continually seeks out innovative ways

to provide care and improve outcomes for patients. He is very deserving of the Golden Stethoscope Award.”

With more than 400 physicians on the medical staff, Sentara RMH received 115 Golden Stethoscope Award submissions nominating 46 individuals this year. All hospital team members, as well as staff in local independent medical practices, are eligible to submit nominations.

“This year, we are honored to recognize Dr. Hill’s exceptional commitment to our community,” says Robert Garwood, MD, medical director of general and bariatric surgery at Sentara RMH Medical Center. “He not only exhibits a great deal of respect, care and regard for his patients, but also for his co-workers. He always takes the time to be courteous while teaching and instructing his team members, and he excels in the areas of communication, teamwork, patient care and lending a personal touch in customer service — exactly the types of qualities the Golden Stethoscope Award is intended to recognize.”

Jordan Hill, DO

Sentara RMH Medical Center Introduces Visitor Badging System

Sentara RMH Medical Center has launched a new visitor badging system (VBS) designed to enhance safety and security for patients, visitors and staff. With the VBS, which is part of a systemwide rollout across all 12 Sentara Health hospitals, visitors will be asked to:

• Lock firearms, knives and other weapons in their vehicles before entering Sentara RMH.

• Show photo identification at the reception area.

Tell receptionists their destination in the building.

• Have a photo taken for printing on a visitor badge that is to be worn visibly at all times.

“We’re trying to strike a balance between being a welcoming place and being a safe place,” says Stephen Hollowell, Sentara system director of security. “Knowing who is in the building

helps keep our patients, visitors and colleagues safer.”

The VBS includes a digital camera at reception for taking visitor photos on the spot.

“It’s really important to increase safety for everyone on our campus,” adds Catherine Hughes, vice president of operations for Sentara RMH. “That includes our visitors and our staff. This will be a very quick and simple check-in process. We’ll log the information into the system, and then we’ll issue the visitor a badge that is valid for 24 hours.”

Sentara RMH Family Birthplace Honored with “High Performing” Rating

Sentara RMH Medical Center is ranked among the best hospitals in Virginia for maternity care in the “uncomplicated pregnancy” category, according to the latest U.S. News and World Report survey. Only 12 Virginia hospitals, including seven Sentara

Sentara RMH Medical Center is Recognized as a Leader in Maternity Care

“We are very thankful for this recognition,” says Sabrina Shiflett, director of patient care services at Sentara RMH. “It’s really all about patient safety and providing high-quality care.”

We want to thank our care team for

Sentara RMH Medical Center is honored to be recognized as a leader in Maternity Care by U.S. News & World Report. This designation recognizes our commitment and success in providing safe and comprehensive maternity services.

Looking Forward and Ever Striving to

Improve Health Care

Over the past three decades, I have witnessed many changes in health care that have impacted the profession of nursing. I have also experienced defining moments in my career that have shaped my core values and inspired me to continue the pursuit of nursing excellence.

Early in my career, I learned the importance of structure and process in advancing professional development, quality of care and clinical practice standards. After securing a solid foundation in critical care clinical skills, I transitioned to the hospital’s Emergency Department and later to the Postanesthesia Care Unit, where I was selected to lead the implementation of a new electronic documentation system. Following the very successful outcome of the project, I was asked to serve as clinical coordinator for the hospital-wide electronic health record conversion the following year.

From that point, I spent seven years working as a clinical analyst, assisting with the design and implementation of advanced

By Gina Yost Chief Nursing Officer, Sentara RMH

technology to improve the quality, safety and efficiency of clinical workflow and patient care. Several key projects I facilitated during that time included implementing electronic medication administration records, bar code blood transfusion administration records, computerized physician order entry and electronic prescription management—all of which required major transformations in clinical processes and workflow. Seeing how these changes advanced the safety and quality of patient care was incredibly rewarding. This evolution in health information technology led to advancements in obtaining meaningful and actionable data, and at this

My Foundation as a Nursing Leader

point, I transitioned into a role analyzing and interpreting clinical data in the hospital’s Quality and Safety Department. Accessing this new data spurred the use of quality frameworks and led to further improvements in the safety and effectiveness of patient care. And those developments, in turn, influenced changes in hospital reimbursement models by incorporating pay-for-performance and tying reimbursement to data-driven outcomes, best practices and patient satisfaction.

As my career continued to progress, I decided to advance my skill set by becoming certified as a Lean Six Sigma Black Belt. The training for Lean Six Sigma, which is a data-driven methodology to reduce variation, enhance efficiency and improve the quality of care, helped me gain the skills I needed to lead complex process-improvement projects throughout the hospital. With this newly acquired expertise, I assisted with opening an admission transition unit and with the redesign of patient flow in our Emergency Department—both projects that were designed to improve patient experience and ensure timely, highquality care.

My work with process improvement eventually led to an opportunity to become the hospital’s director of surgical services. While in this role, I facilitated multiple projects to advance surgical technology, including the implementation of 4K video technology to improve endoscopic image quality, narrow-band imaging to improve visualization and detection of bladder tumors, and the launch of our first robotic surgery program at Sentara RMH.

Valuable Lessons Learned and the Path Ahead

So, what have I gleaned from my professional experiences, and how will I use that knowledge going forward? One of the most valuable lessons I have learned during my career has been the importance of relationships and teamwork in the achievement of shared goals. While seeing the

end results of projects and initiatives has certainly been rewarding, I have found even greater satisfaction leading teams and fostering collaborative relationships—helping to develop highperforming teams that harness shared strengths, knowledge and resources to bring forth meaningful change within a complex healthcare system.

The COVID-19 pandemic has also highlighted another key takeaway from my experiences: the need for teamwork, innovation and creativity in health care. The disruption and change that occurred in our field during the pandemic required organizations to learn how to adapt and respond dynamically to new and evolving situations. Innovation and creativity allow organizations to create, promote and implement novel ideas and strategies to remain resilient and quickly adapt to changes, and I intend to continue fostering those values going forward.

Looking to the future in my new role as a senior leader at Sentara RMH, I will strive to utilize the transformational leadership skills I have gained throughout my career to effectively lead practice initiatives that result in continued improvement in patient care. In today’s healthcare environment, leaders must possess innovative thinking and rapid problem-solving skills to address the many issues of the current healthcare system and accept the challenge of achieving the so-called

“One of the most valuable lessons I have learned during my career has been the importance of relationships and teamwork in the achievement of shared goals.”

“quadruple aim” in health care: improving population health, elevating the patient experience, reducing costs of care, and boosting care team well-being.

One of my first steps as chief nursing officer will be to engage nursing leaders and staff in the development of a synergistic nursing strategic plan that renews our mission, vision and values, and provides a roadmap to reach our goals.

Fostering authentic, compassionate patient care should also be a core value at the center of what we do as healthcare professionals. This type of care goes beyond nursing skills and knowledge, incorporating a relational connection with patients on a foundation of dignity and respect. Doing so allows us to understand our patients’ values and preferences and engage them in their care on a level that creates positive experiences and improved outcomes.

As a nursing leader, I will also work to create an environment that cultivates effective group dynamics and empowers nurses to

collaborate effectively with other healthcare disciplines to positively impact patient outcomes. Through effective collaboration, we can foster innovative partnerships and successful interprofessional teams, both of which are essential elements for developing the solutions needed to transform health care.

As I move forward in my role as chief nursing officer, I am truly enthusiastic about the opportunity to serve the staff and patients in our community, and I believe the future of nursing at Sentara RMH is bright.

Gina Yost was named chief nursing officer for Sentara RMH Medical Center in February 2023, following the retirement of Donna Hahn.

Are heartburn and acid indigestion the same thing?

Although both conditions involve discomfort and feature symptoms that tend to overlap, leading many people to use the terms interchangeably, heartburn and acid indigestion occur in distinct areas of the body.

Acid indigestion usually describes feelings of discomfort in the stomach or abdomen that can occur with eating. Sometimes called a sour or upset stomach, symptoms may include burning stomach pain, belching, bloating, abdominal fullness, nausea and vomiting. This condition typically occurs when the stomach is stimulated to produce acid or when the mucous lining of the stomach fails to protect it from acid or other irritating substances, such as aspirin or ibuprofen. Symptoms also may result from eating too much or too quickly, eating high-fat foods, or eating during high-stress situations.

Unlike acid indigestion, heartburn refers to burning sensations or feelings of pressure in the upper abdomen and chest. And although heartburn can be a symptom of acid indigestion, it occurs when stomach acid leaks into the lower esophagus and burns the esophageal lining—often brought on by bending over, lying down, or eating certain spicy or acidic foods.

As a side note, while heartburn pain can feel like one of the classic symptoms of heart disease, heartburn doesn’t actually have anything to do with the heart. Occasional acid indigestion and heartburn are usually relieved by self-treatment with over-the-counter medications. Avoiding alcohol and carbonated beverages and refraining from smoking also may help relieve symptoms. However, acid indigestion and heartburn may be signs of a more serious problem, such as a stomach ulcer or gastroesophageal reflux disease (also known as GERD)—particularly if symptoms last longer than two weeks.

You should see your healthcare provider if you experience acid indigestion or heartburn fairly often.

Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions

What causes dry eyes?

Is this a condition I should be concerned about?

Dry eyes occur when you don’t produce enough tears, or when the tears produced by your eyes evaporate too quickly.

Decreased tear production can be related to the use of certain medications, such as antihistamines, decongestants, antidepressants, and high blood pressure or birth control medications. Various medical conditions, including diabetes, thyroid problems, lupus, rheumatoid arthritis and inflammation of the tear ducts, also can cause decreased tear production.

Many older people experience dry eyes, since tear production tends to diminish after age 50. In addition, women tend to be more affected by the condition, due to hormonal changes resulting from pregnancy, menopause and the use of birth control pills.

Increased tear evaporation can occur when people fail to blink as often as they normally do. Less-frequent blinking is typical for some people when concentrating on tasks like reading or working at a computer monitor. Environmental factors such as dry air, ambient smoke and wind also can contribute to increased evaporation. As well, certain anatomical problems with the eyelids, or an imbalance in the composition of the tears themselves can lead to greater tear evaporation.

Thankfully, dry eyes are often less of a danger and more of a nuisance, making daily activities like reading or computer work more challenging. However, tears help protect the eyes from infection, so decreased tear production or increased evaporation can cause a person to be more at risk for an eye infection. Severe cases of dryness may lead to problems like inflammation of the eyes or corneal damage.

Occasional or mild cases of dry eyes often can be relieved using over-the-counter “artificial tears” or lubricating eye drops. Avoid drops that claim to reduce redness, however—they can actually cause additional eye irritation in people with dry eyes. If the problem persists, or if you have extremely dry eyes, see your eye doctor.

Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions

Consider Gentle Exercise to Help Relieve Chronic Stiffness and Pain

Gentle stretching is one of the most beneficial types of exercise to help relieve chronic pain. Stretching can also improve your blood circulation, flexibility and range of motion.

Arthritic joints often feel better when they undergo regular movement, so engaging in gentle exercises can help keep you from stiffening up. For example, try bending and straightening your legs for 20 repetitions, three times per day or more, while sitting in a chair.

Gentle strength training with weight machines, dumbbells or even your own body weight improves circulation, muscle tone and strength. Regular strength training also boosts your metabolism, helping you burn calories more efficiently for better weight management. In addition, weight loss can help relieve stress on joints and ease joint pain.

Cardiovascular exercise is beneficial for a strong heart and lungs. If you fear that running or jogging might be too strenuous or painful, try walking or swimming—both are gentler on the joints.

Besides the many physical benefits regular exercise provides, such as improved circulation, enhanced muscle tone and greater strength, it also helps improve your mood, thanks to the release of natural endorphins—the “feel-good hormones”—into your bloodstream.

Physical therapy can be another good way to reduce chronic pain and stiffness. For guidance on the best gentle exercises for your needs, talk to your physician or a physical therapist.

Tips for Communicating with Your Healthcare Professional

Effective communication with healthcare providers is essential for your health and peace of mind. Here are some suggestions for making your next office visit more effective and efficient.

• Jot down notes your personal health and health history. Include aches and pains, allergies, sleep problems, diet and exercise habits, and anything else you think may affect your health.

• Make a list of any questions or health concerns you may have before seeing your provider.

• Keep an updated list of all prescription and over-the-counter medications, as well as any herbal or other supplements you may take, along with the dosage and frequency of each. Take this list with you each time you go to the doctor.

• Bring a pen and notepad to your appointment, and take notes on what the doctor and office staff tell you.

• Ask questions of the doctor and office staff, especially if you don’t understand something.

• Bring your health insurance cards and any other documents you think you may need for your visit.

Kids and Caffeine

To date, the U.S. Food and Drug Administration has offered no recommendations for how much caffeine children can safely ingest. However, many health experts urge that children under 12 should not drink coffee or other highly caffeinated beverages, and should limit caffeine intake through soda and hot chocolate to no more than 45 milligrams (mg) per day. For adolescents, the American Academy of Pediatrics recommends no more than 100 mg of caffeine per day.

As a stimulant, caffeine affects the central nervous system and may interfere with sleep—which can be a problem for children and adolescents, who typically need more sleep than adults. In adults and children alike, however, caffeine increases blood pressure and heart rate and can result in “the jitters,” interfere with concentration and cause headaches. These effects can occur in children with even less intake of caffeine than would be needed for adults.

Parents should encourage their children to drink primarily milk, water and fruit juices with no added sugar.

Also, children should never be allowed to partake in so-called “energy drinks,” which often contain significantly more caffeine than regular soda and coffee.

Caffeine amounts in common beverages:

Chocolate milk (8 fl. oz.): 5 mg

Coca-Cola (12 fl. oz.): 39 mg

Coffee, brewed (8 fl. oz.): 163 mg

Coffee, instant (8 fl. oz.): 57 mg

Coke Zero (12 fl. oz.): 34 mg

Hot chocolate/hot cocoa (8 fl. oz.): 5 mg

Lipton Iced Tea (20 fl. oz.): 48 mg

McDonald’s iced coffee (12 fl. oz.): 120 mg

McDonald’s sweet tea (32 fl. oz.): 100 mg

Monster Energy (16 fl. oz.): 160 mg

Mountain Dew (12 fl. oz.): 55 mg

Snapple, peach (16 fl. oz.): 37 mg

Starbucks Frappuccino (13.7 fl. oz.): 110 mg

Treating Minor Burns at Home

If you experience a minor or seconddegree burn, home treatment is usually all you need for the burn to heal on its own. In general, follow this advice:

• First, cool the burn. If possible, run cool tap water over the burned area for 10-20 minutes. If the burn is on the face or body, gently apply cool compresses.

• Do not apply ice, ice water or butter to the burn—these substances can cause additional tissue damage.

• Remove any jewelry or clothing in the affected area, particularly if there’s a chance of swelling.

• To avoid infection, wash your hands before handling the burn, and try not to touch the burned skin directly.

• If you need to clean the burn, gently wash the area with cool water and pat dry with gauze or a clean cloth. Do not rub.

• Do not break open any blisters that form.

• If a blister has not broken open, no bandage is needed. If a blister bursts, loosely bandage the area, and change the bandage when it becomes soiled.

• If a bandage becomes stuck to burned skin, soak the bandage in lukewarm water to help loosen it. If you have any concerns or questions about a burn’s severity, or if it becomes infected, see your doctor.

Don't Forget the Sunscreen!

With spring and summer on the way and the days growing longer, many of us will be spending more time outdoors. When you or your family members go outside, don't forget to put sunscreen on areas of the body that are exposed to the sun's harmful ultraviolet rays. Select a broad-spectrum sunscreen that protects against both UVA and UVB rays, has a sun protection factor (SPF) of 30 or higher, and is waterresistant. Even if you don't plan on going in the water, perspiration can reduce the effectiveness of sunscreens that aren't water-resistant. Apply sunscreen to dry skin about 15 minutes before going outside and reapply about every 2 hours- or immediately after swimming or sweating—following the directions on the bottle. Also, use lip balm with an SPF of at least 15 to protect the lips from the sun's harmful rays.

DASH Away

High Blood Pressure

BY Rita P. Smith, RD

Hypertension, a condition more commonly known as high blood pressure, is often called a “silent killer” because it provides no warning signs and can be deadly if left untreated. Sustained high blood pressure puts tremendous stress on the cardiovascular system, often leading to heart attacks, strokes, heart failure and kidney disease.

More than 100 million adults in the United States—almost half of the adult population—have high blood pressure. So it’s no surprise that medications to reduce blood pressure are among this country’s most widely prescribed drugs.

The good news is that hypertension is both preventable and treatable, often without medications. Healthful lifestyle choices can bring high blood pressure back down into the normal range and even reduce your risk of developing high blood pressure in the first place.

Healthy Habits for a Healthy Heart Healthy Weight: Excess body weight puts stress on the heart, so it’s important to maintain a healthy

weight. If that currently seems like an unrealistic goal, keep in mind that every little bit helps—even losing 10 pounds can help lower blood pressure.

Physical Activity: Regular physical activity can improve blood flow through the arteries, help manage body weight and reduce stress. The American Heart Association suggests 150 minutes per week of moderate-intensity exercise—that’s about 30 minutes per day, five days per week. Enjoy walking, hiking, swimming, biking or another aerobic exercise. Call a friend or listen to a podcast while you get your body moving!

Relieve Stress: Chronic stress releases hormones in the body, which can increase your blood pressure. So pay close attention to how you feel and participate in stress-relieving activities daily. These could include spending time in nature, meditating, journaling, taking a short catnap, chatting with a loved one, creating art or engaging in other hobbies you enjoy.

No Smoking: Quit all forms of tobacco.

Drink in Moderation: If you choose to drink alcohol, women should have no more than one drink per day, and men no more than two.

Eat Well to Be Well: Enjoy a healthful diet such as the DASH (Dietary Approaches to Stop Hypertension) diet, which includes a wide variety of colorful and nourishing foods.

The DASH diet isn’t a fad diet. In fact, it was originally developed based on the results of a multicenter study sponsored by the National Heart, Lung, and Blood Institute that demonstrated how eating a well-balanced, healthy diet can lower high blood pressure without medication. The study found that generous daily servings of healthful, less-processed foods offered the most benefits for heart health.

The DASH diet includes the following healthful foods:

Daily:

• Fruits: at least 4 servings (a serving is ½ cup or one medium piece of fruit)

• Vegetables: at least 2 cups

• Whole grains: multigrain breads and cereals, whole-wheat or multigrain pasta, brown rice, oats, barley, quinoa

• Lean protein: fish, poultry without the skin, small portions of red meat

• Dairy: fat-free or low-fat milk, yogurt, cheeses

• Healthy oils: olive, grapeseed, canola, sunflower, safflower, avocado

Weekly:

• Nuts, nut butters and seeds: 4-5 servings

• Legumes or dried beans and peas: 4-5 servings

While a healthful diet goes a long way toward keeping your heart healthy, there are also a few foods to avoid or limit because they contain high

amounts of sodium, added sugar and saturated fats. All of these can significantly raise your blood pressure if not consumed in moderation.

Reducing your sodium intake typically implies reducing your salt usage, since salt is 40% sodium. However, convenience and processed foods are the biggest culprits, supplying 70% of the sodium in the average American diet.

Check out the Nutrition Facts label on food packages—you might be surprised at how much sodium, added sugar and saturated fat can be found in just a single serving. These labels can help you compare products to find those with lower amounts of these undesirable ingredients.

To reduce sodium, added sugar and saturated fat, the DASH diet recommends limiting the following:

• Processed meats: bacon, sausage, deli meats, hot dogs

• Full-fat dairy: whole milk products, butter

• Tropical oils: coconut, palm, palm kernel

• Sugar-sweetened beverages: soda, sweetened fruit drinks, sweet tea

• Sweets and desserts: cake, pie, cookies, ice cream, candy

Tips to Lower Your Intake of Dietary Sodium:

• Replace the salt shaker with your own homemade blends of herbs and spices. Bring on the pepper, thyme, garlic powder and nutmeg!

• Toss vegetable salads with olive oil and balsamic vinegar or other homemade blends. Commercial salad dressings can be especially high in sodium.

• Make more meals from scratch. Frozen dinners, canned soups and packaged dishes can contain more than 1,000 milligrams of sodium per serving! (Bonus tip: There are lots of meals you can make ahead of time and then freeze, giving you your very own homemade convenience foods without the added sodium.)

• Fresh and frozen vegetables are very low in sodium, but canned vegetables often contain added salt. Be sure to drain the liquid from the can and rinse the vegetables to get rid of that extra salt.

Whole-Wheat Couscous with Almonds and Raisins

Prep time: 20 minutes

Cook time: 5 minutes

Makes 4 servings

Ingredients

1¼ cups no-salt chicken or vegetable broth

3 tablespoons raisins (or other dried fruit, such as cranberries or diced apricots)

1 cup whole-wheat couscous

1 tablespoon chopped fresh mint or 1 teaspoon dried mint (or other herbs such as thyme or rosemary)

1 tablespoon sliced almonds, toasted

1 tablespoon fresh orange zest

Directions

1. In a medium saucepan, bring the broth to a boil over high heat. Stir in couscous and raisins. Return to a boil, cover and remove from heat.

2. Let the couscous stand for 5 minutes in a covered saucepan, or until all broth has been absorbed.

3. Meanwhile, toast the almonds in a 400-degree oven until golden brown.

4. Fluff couscous with a fork. Stir in mint, almonds and orange zest. Serve immediately.

Cobb Salad with Avocado

Prep time: 15 minutes

Makes 4 servings

Ingredients

4 cups assorted greens (such as leaf or Romaine lettuce, arugula, baby spinach, etc.)

1 cup frozen whole-kernel corn

1 cup shredded carrots

2 Roma tomatoes, rinsed and cut into wedges

1 ripe avocado, peeled and sliced

1 cup frozen green peas, thawed

1 can (6 ounces) white albacore tuna packed in water, drained

Dressing

2 tablespoons fresh lemon juice

1 tablespoon fresh lime juice

1 tablespoon honey

1 tablespoon minced fresh parsley

1 tablespoon water

1 tablespoon vegetable oil

Directions

1. Spread corn on a baking sheet and roast in a 400-degree oven for 7 minutes.

2. Meanwhile, evenly divide the greens among four salad plates. Top the greens with grated carrots, tomato wedges, avocado slices, green peas and flaked tuna. When the roasted corn is ready, add that as well.

3. In a small Mason jar, combine all dressing ingredients. Shake well to combine.

4. Top each salad with dressing

Tips to Lower Your Intake of Added Sugar:

• Sweeten beverages with frozen berries or orange slices.

• Mash up very ripe berries and spread on whole-grain toast or an English muffin.

• Reduce the sugar in baking recipes by one-third and add ½ teaspoon of vanilla extract instead.

Tips to Lower Your Intake of Saturated Fat:

• Replace all or part of butter or stick margarine with a soft oil spread; vegetable oils such as canola, corn or grapeseed; or mashed avocado.

• Replace all or part of the butter or shortening in recipes for muffins, quick bread and pancakes with baby-fruit or natural applesauce, mashed banana, or vegetable oils.

• Add extra diced vegetables, such as mushrooms and cauliflower, and reduce the ground beef in chili and spaghetti sauce.

DASH your way to good blood pressure control with a variety of healthful foods, regular exercise such as walking, and meaningful ways to lower daily stress.

Rita P. Smith, MS, RD, a Registered Dietitian with Sentara Martha Jefferson Hospital, has more than 45 years of experience in the field of nutrition and disease prevention.

Sentara Health Invests Nearly $4 Million in Healthcare CareerDevelopment Programs

In response to the medical staff shortages currently straining the U.S. healthcare system, Sentara Health is launching two new pipeline-development programs to support students pursuing healthcare careers. Through a nearly $4 million investment in the Sentara Scholars and Project CHOICE programs, Sentara is working to create pathways for young students toward their desired healthcare careers, while also positively impacting economics and health equity outcomes in their communities.

Sentara Scholars

Sentara is investing more than $3 million in Sentara Scholars, an initiative designed to provide financial support to students in healthcare-related education programs, easing financial barriers to student enrollment and retention. Available to selected students through partnerships with academic institutions and nonprofit organizations throughout Virginia and North Carolina, recipients will be chosen according to a combination of merit- and need-based criteria.

Project CHOICE

Sentara also is investing more than $775,000 in Project CHOICE in an effort to support careers in health care that provide opportunities for improvements in community economics and equity. Through this program, Sentara is partnering with existing educational systems to provide exposure, experience and immersion toward clinical and nonclinical healthcare pathway choices. Sentara’s funding through Project CHOICE is currently impacting approximately 500 students across 10 organizations and academic institutions.

“Sentara Scholars and Project CHOICE are testaments to our commitment to building a stronger healthcare pipeline and advancing health equity through collaboration with educational institutions,” says Becky Sawyer, Sentara executive vice president and chief people officer. “By reducing the financial burden on students from disadvantaged socioeconomic backgrounds, offering stronger mentorship and training opportunities, and removing barriers to higher-paying and more meaningful careers, we are investing in the future of health care and empowering the next generation of professionals.”

Sentara Scholars and Project CHOICE include Sentara-led educational programs, grants and opportunities for middle, high school and highereducation students. Many of these programs focus on attracting minorities and other underrepresented groups to help build the diverse healthcare workforce of the future. Examples of Sentara Scholars and Project CHOICE initiatives include scholarships, pre-medical and medical student engagement, health career camps, and the Sentara Health Professionals High School Partnership.

Sentara Scholars Partners: ACCESS College Foundation

Centura College

College of the Albemarle Foundation

Eastern Mennonite University

Elizabeth City State University

George Mason University Foundation, Inc.

Hampton Roads Community Foundation

James Madison University

Medical College of Virginia Foundation

Norfolk State University Foundation

Old Dominion University Educational Foundation

Sentara College of Health Sciences

Virginia Foundation for Community College Education

Virginia Foundation for Independent Colleges

Virginia Ready Initiative (VA Ready)

Virginia State University

Virginia Union University

Virginia Wesleyan University

Western Governors University

Project CHOICE Partners:

Christopher Newport University

Eastern Virginia Medical School

Hampton University

Hearts4Progress

James Madison University Ole School Alumni Group

Norfolk State University

Old Dominion University

On the Road Collaborative

Scholars Latino Initiative

The Giveback Foundation (GVBK)

New Monitoring Technology Provides Another Layer of

PATIENT SAFETY

It’s 8:40 a.m. on a Monday, and a group of nurses, administrators and team leaders from a wide variety of Sentara RMH Medical Center departments have packed into a conference room for the daily “safety huddle” meeting.

RPM system helps keep more vulnerable Sentara RMH patients from harm

Each such gathering, regardless of the day, begins with the same quote: “Together we are passionate about keeping our patients safe, by ensuring we first do no harm.”

However, even with that safety-conscious mantra in mind, how can caregivers ensure that patients don’t inadvertently cause harm to themselves while in the hospital?

On each floor of the hospital, members of the clinical staff are expected to visit patients at least once per hour. Those individual encounters can last from 10 minutes to an hour, depending upon the needs and condition of a particular patient. With each visit, the clinical staff addresses the “five P’s”: pain, potty, position, possession and preference:

• Pain: Are they in pain?

• Potty: Do they need to use the restroom?

• Position: Is the patient in a comfortable position, or do they need to be repositioned in the bed to avoid laying in one spot, causing potential skin breakdown?

• Possession: Is there something in their possession—a handbag or reading glasses, for example—but not within reach of the bed?

• Preference: Does the patient have any preferences (e.g., they may prefer a fresh glass of water or need assistance working the television)?

The point of these hourly visits is to check on the patient’s health, and for those who require assistance, to make sure they do not attempt to get up independently.

But what about those times when a nurse or clinical staff member isn’t present in a patient’s room?

That’s where the value of Sentara’s new Remote Patient Monitoring (RPM) system becomes evident. Essentially a camera on wheels, the device offers an extra set of eyes on patients who are most in need of extra attention.

“We hope this system will give patients’ families greater peace of mind,” says Charlene Bridges, Sentara Health’s director of resource allocation, who is supervising the rollout. “This is especially important for patients with dementia and other conditions that affect behavior. Knowing someone is looking after their loved ones around the clock to prevent harm might help ease their minds about potential safety issues.”

Cameras included in the monitoring system will be assigned based on nursing assessment, using a fall-risk scoring tool, care team notes and assessment of a patient’s ability to follow verbal cues.

“We use this system with patients we know are at risk of falling due to confusion, or because they may not remember to ring their nurse-call for assistance before getting up—whether that’s just to stretch their legs or to go to the restroom,” says Jill Delawder, director of patient care services for Sentara RMH Medical Center. “Those are the patients this system focuses on.”

Once consent to use the monitoring system is given by the patient or the patient’s family, a nurse will call Sentara technicians at a facility in Williamsburg, Va. Together, the team will then go over the relevant needs for that specific patient, discussing why the camera will be used and what technicians will be watching for.

“They are going to explain the rationale for the patient’s need for continuous observation,” says Delawder. “For instance: ’This patient is at high risk for fall, and someone cannot be there to consistently redirect them. We are going to need you to help support this patient.’”

The high-resolution cameras used in the system also can be used to monitor for certain physical conditions, such as choking, difficulty breathing, pain or other issues that need immediate intervention. In addition, technicians are able to observe real-time interactions among patients, family members and hospital staff to aid in communication and continuity of care.

The RPM device also features two-way audio, enabling the technician and patient to speak to each other, with the additional capability of using different languages, when needed. Sentara’s staff of trained technicians watch the monitoring cameras around the clock. To maintain patient privacy, the system is limited to live observation and does not record any activity.

“The system provides assistance to our current staff, but it’s also a huge patient safety initiative,” Delawder explains. “Helping keep patients from falling, breaking bones and experiencing additional complications while in the hospital is our main priority. We are trying to prevent patient harm, whatever that looks like. It could involve preventing them from manipulating medical equipment such as intravenous

(IV) lines, urinary catheters and drains. It could also help keep patients from getting up independently, touching other equipment in the room or causing harm to themselves in other ways.”

Important to note, the monitoring system is fully intended to enhance the quality of patient care as an extra safeguard, not as a replacement for other types of care.

“These cameras are not a substitute for our nursing staff, safety partners or in-person sitters,” adds Donna Wilmoth, chief nursing officer at Sentara Williamsburg Regional Medical Center. “Instead, the RPM system adds one more layer of awareness to our patient safety protocols.”

Sentara Health is in the process of deploying 108 remote cameras in its 12 hospitals to provide 24-hour monitoring of at-risk patients. The investment follows a pilot program at two Sentara hospitals that demonstrated the technology’s value in preventing patient harm.

“Our pilot showed a significant reduction in falls through remote verbal intervention—for instance, asking patients to wait for assistance before walking to the bathroom,” says Wilmoth. “We were also able, through verbal contact and immediate telephone calls to nurses on the floors, to prevent patients from pulling out IV lines and doing other harmful things.”

Launched at Sentara RMH Medical Center in February 2023, the program is still in its beginning stages at the hospital.

“Our hope is that, in the future, we can utilize the system with a wider variety of patients,” says Delawder. “We would like to start off small, focusing on patients who are at risk for falls, and later with, for example, patients who may be confused at bedtime or are just lonely in the hospital.”

Given the multitude of reasons a person might be hospitalized, having remote monitoring in place adds a layer of security for clinical staff as well.

“A patient may be a little bit confused because they’re ill, they’re in the hospital and they’re not thinking clearly,” adds Delawder. “It could be that they are having withdrawal from some type of drug or alcohol. Or they might have delirium or dementia from acute and chronic issues. They may have restraints for some type of medical device protection. It could be that we have them here on a temporary detainment order and they are at risk for running. The possibilities are endless. Whatever the case may be, with the RPM system in place, the caregiving team has another tool standing by to help keep patients from inadvertently harming themselves—and that’s a good thing for everyone involved.”

We would like to start off small, focusing on patients who are at risk for falls, and later with, for example, patients who may be confused at bedtime or are just lonely in the hospital.

Living with

Lymphedema

MANAGING PAIN THROUGH A NEW ROUTINE

Due to recent changes in her health, Sherrie Morris has had to make some lifestyle adjustments to stay ahead of her condition. Following a breast cancer diagnosis in December 2020, surgeons removed two cancerous masses and six lymph nodes near her right armpit, after which she was to begin radiation treatments in February 2021.

However, Morris began having trouble raising her right arm and started feeling pain in the area. Caregivers explained that she was experiencing lymphedema, a condition that causes swelling of the arm, breast, neck or leg due to an obstruction in the lymphatic system and a resulting accumulation of fluid. The lymphatic system, a part of the body’s immune system made up of about 800 lymph nodes in the neck, armpits, thorax, abdomen and groin, helps fight infections and other diseases.

Sherrie Morris

Enlargement and removal of lymph nodes, such as from cancer surgery, are the most common causes of lymphedema. In fact, approximately 30% of women who have undergone breast cancer treatment develop complications associated with lymphedema—sometimes up to several years after treatment.

When Morris learned she was experiencing lymphedema, she began to see Linda Larson, then a lymphedema specialist with Sentara. Together, Morris and Larson came up with a treatment plan.

“Linda was wonderful,” says Morris. “She told me not to be surprised that I would need to come back for additional treatments, and that this condition was going to be a part of my life for some time.”

Morris appreciated the upfront honesty from Larson, who retired in 2022.

“Pain wears you out,” continues Morris. ”You don’t sleep well, and when it’s bad enough, some days it’s hard just to get going. Linda could always tell how I felt from my facial expressions, even though I tried to stay positive.”

If lymphedema goes untreated, swelling and discomfort can increase around the affected area. In addition, a person’s risk of infection rises significantly because fluid buildup prevents circulation of white blood cells in the body.

‘You Can Live Your Life’

Although lymphedema is a chronic condition, it can be managed with proper treatment, and many people with lymphedema are able to lead active, normal lifestyles. For Morris, slow, gentle stretching proved to be an effective technique for treatment, which continues today under the guidance of Wrenda Trent, an occupational therapist with Sentara.

“Opening the lymphatic system means creating more places for the fluid to move,” says Trent. “The goal for Sherrie, as for all my patients, is for her to learn the proper techniques and make them part of her daily routine, to stay ahead of the swelling.”

The gentle stretch massage, for example, starts by making a C shape with the fingers,

leaving an opening for the fluid to move out. Morris does this for about 20 min utes every morning at various points on her body, including her arm and neck.

“The lymphatic system is right under the skin, where muscle is deeper,” Morris says. “Massages work with more pressure to relieve those knots.”

A second component of treatment involves the use of compression garments. In Morris’ case, after she completes a regular schedule of therapy, she will return to Trent every six months to receive a new set of garments to help with fluid movement away from the affected area.

While compression has been painful at times and Morris has questioned her tolerance for the garments, she appreciates the care and honesty in the treatment she has received, and she has come to accept that the garments and daily massaging will be part of her life going forward.

“I’m honest with patients from the first day about how treatment is going to be uncomfortable, but also that they’ll be so grateful if they stick with therapy,” adds Trent. “With

the right routine, you can live your life pretty much as normal. If the pain gets worse, you might not be able to get out of bed or hold your hand over your head—so keeping up with therapy is really important.”

Lymphedema patients must stay committed to those routines to keep swelling and pain down over the long term. Morris, who recognizes she is fighting an extended battle against lymphedema, has been successful so far in making the needed lifestyle adjustments.

“Sherrie’s been an absolutely beautiful patient,” says Trent. “She’s committed to doing whatever she can do to keep this under control.”

Although there’s no cure for lymphedema, Trent adds, no one has died from the condition. The risk of infection from its effects, however, should be taken seriously.

Swelling alone should raise an alarm to seek treatment. Without proper intervention, the condition could, for example, cause one leg to grow to be three times the size of the other, leaving a person immobile.

To avoid these worst-case scenarios well before they settle in, Trent advises people—especially those who have undergone cancer treatment— to see a physician about swelling or heaviness in the arms or legs. Fatigue also might present as a symptom.

Since people are at higher risk for developing lymphedema after cancer treatment, these patients should perform regular arm inspections to watch for early signs of the condition.

If you develop lymphedema, request a referral from your doctor to see a certified lymphedema therapist, who will provide you with education and an individualized treatment plan to help manage your condition.

“By doing my part, I feel I have more control over my condition,” Morris says. “If you have lymphedema, there could be better days ahead— if you take the proper steps.”

Morris is grateful for the care she has received at Sentara.

The whole Sentara team was awesome,” she adds. “They were kind, caring and well informed, and they took their time with me and wanted to help me as much as possible. I’m in such a better place with my lymphedema now.”

PEERS Pulmonary

Arriving at a hospital as a new doctor can be a tough transition. Fitting into an existing team, with its own established workflow and practices, can be a difficult adjustment as well—even for a seasoned medical professional.

Thankfully, for Kristin Hom, DO, and Mario Montalvo, DO, who joined the pulmonary critical care team at Sentara RMH Medical Center during the summer of 2022, their “new kid in town” experiences have gone well. The transition has been so smooth, they say, because the team welcomed them with open arms, and because they had each other to lean on right from the beginning.

Two Peas in the Pulmonary Pod

Although Dr. Montalvo was new to Sentara RMH, he wasn’t a newcomer to Harrisonburg. In fact, he and his wife are both graduates of James Madison University and volunteered with the Harrisonburg Rescue Squad as undergrads. Dr. Hom also had prior ties to the Shenandoah Valley, since her husband studied at Bridgewater College.

Dr. Montalvo joined the hospital staff two weeks before Dr. Hom, but they actually met for the first time virtually months prior, thanks to a connection through a mutual friend. That introduction gave them a chance to get to know each other, and a friendship was built from there.

“It was wonderful,” recalls Dr. Hom. “It was great having a really good friend and a co-worker in the same level of training, and being new providers at the same time was really helpful. We were experiencing all of this together, so we didn’t feel alone. Even with all the newness of coming on board, someone else was experiencing the same growing pains I was going through.”

“It was neat to move into our offices right next to each other,” Dr. Montalvo adds. “Being in the same place professionally, it was nice to commiserate with somebody else during the

first few months of attending life—which is a transition all its own.”

Dr. Hom describes her relationship with Dr. Montalvo as “thick as thieves.”

“I couldn’t do this job without him,” she says. “He will patiently toss around ideas with me when I feel stuck—and if I’m ever in a sticky situation where I need backup, he’s always the first to arrive.”

Taking the Next Step from Fellowship to Attending

The journey to becoming a physician is a long, challenging, strenuous path. The education and instruction required to earn attending physician status include medical school, residency and fellowship training in a specialty. And even

“We have this unspoken rule that if one of us needs help, the other will always be there,” notes Dr. Hom.

when a doctor reaches that level of achievement, the learning doesn’t stop there.

“Being a newly practicing attending physician has been both exciting and humbling,” says Dr. Montalvo. “Even after nearly a decade of practicing medicine in various stages of training, I continue to learn something new each day.”

The Critical Care Unit (CCU) can be a demanding place to practice medicine. According to Dr. Montalvo, it takes a healthy dose of daily self-scrutiny to ensure the best possible patient care.

Dr. Hom agrees. “Being a new attending physician, I have to come to work prepared to be humbled by whatever the day holds,” she says. “I know I will be humbled, and I know I will learn.”

The unfortunate reality of the CCU is that not all patients receiving care will recover, which can lead to some difficult days for caregivers. Fortunately, Drs. Hom and Montalvo know they’re not alone in bearing the emotional load that goes along with their work.

“We have this unspoken rule that if one of us needs help, the other will always be there,” notes Dr. Hom. “I had a rough week of cases in the CCU recently and sent out an SOS to Mario. He showed up immediately and helped me out. Thankfully, we’re all in this together—it’s a true team effort.”

Accordingly, both doctors are quick to point out that the success of care provided in the CCU comes from the entire caregiving team.

Sentara Pulmonary & Critical Care Specialists provides expert assessment, diagnosis and treatment for pulmonary and neurological conditions on an individual basis. Our caregivers treat patients with conditions such as lung disease, asthma, bronchitis, cystic fibrosis, lung cancer, emphysema and congestive heart failure, and we also offer pulmonary rehabilitation to increase quality of life for our patients.

Services may be performed in inpatient or outpatient settings. Our team members work in various areas of Sentara RMH Medical Center, including the Emergency Department, Critical Care Unit and several hospital floors.

“It helps to work alongside the fantastic bedside nurses in the Sentara RMH CCU,” says Dr. Montalvo. “They will quickly point out when something isn’t quite right with the patient or with our treatment plan. I appreciate them more than I can ever express. The nurses are truly the backbone of the CCU.”

Mentors Make a Difference

Drs. Hom and Montalvo consider themselves fortunate to work on the pulmonary critical care team with Drs. Aklilu Degene and Earl King, who each have decades of experience. The new providers appreciate the continued education and direction they receive from their more seasoned colleagues.

“They’ve treated us as equals from the start,” says Dr. Hom. “Their mentorship and guidance was a big reason I came to Sentara RMH. They’re brilliant!”

Dr. Montalvo feels the same way. “One of my biggest draws for coming to practice pulmonary medicine at Sentara RMH was being able to work

alongside mentors I can lean on and continue to learn from. Pulmonary medicine is a nuanced and complex field of medicine, so it helps to have mentors whose vast experience I can draw on to make sure I am doing the very best for our patients.”

The professional relationship among pulmonary critical care team members has had a deep personal impact on them as well.

“What I’ve enjoyed just as much as their mentorship—and gleaning as much knowledge as I possibly can from them—is their friendship,” says Dr. Hom.

“Drs. Degene and King are the kindest, biggest-hearted, warmest people you’ll ever meet,” she adds. “They welcome new ideas and are so open to new medical literature and incorporating new guidelines into our practice. They always encourage me to keep learning and keep reading, and to never be afraid to ask questions.”

That admiration among the team is a two-way street.

“Drs. Hom and Montalvo have been great additions to our team,” says Dr. King. “Bringing a new skill set of navigational bronchoscopy and pleural procedures, they have hit the ground running and are a huge asset to the pulmonary critical care team. I could not ask for better partners to work with.”

Dr. Hom calls the pulmonary team a family. “That sounds nauseatingly cheesy, but it’s true,” she says. “I couldn’t be more grateful to all my colleagues across positions and specialties. I’ve felt so supported by my co-workers, and I really lucked out in coming to work at Sentara RMH.”

Feeling Stressed?

Talk with your primary care physician

When it comes to managing stress, the old adage is true: An ounce of prevention is worth a pound of cure. But whatever your stress level happens to be, you can likely benefit from a visit to your primary care team.

Consisting of physicians, physician assistants and nurse practitioners, your primary care team is your long-term partner in health care. They help you to identify and manage chronic illness, treat common medical conditions, and achieve your highest level of wellness through preventive care and routine health screenings.

“Having a good rapport with patients over time, not just here and there, really builds trust,” says Mekaela Smith,

DO, of Sentara Integrative Medicine Physicians in Harrisonburg. “You can then work with your patients as a team. A lot of times, I’m not telling a patient what to do—instead, I’m offering recommendations and trying to engage them in taking ownership of their health. Ultimately, they’re the ones who will have to make changes to improve their health.”

Kevin Volkema, DO, a primary care physician at Sentara Martha Jefferson Family Medicine, shares a similar sentiment. “I really value prevention,” he says. “I like focusing on the big picture and talking about how a patient’s lifestyle and decisions are interconnected when it comes to their health.”

Recently, stress has become an increasingly common topic during primary care visits.

“A lot of patients report feeling pretty burned out, whether it’s due to work stress or issues at home,” Dr. Smith says. “And in the past couple of years, with all the issues related to the COVID-19 pandemic on top of countless other daily life factors, stress definitely seems to have gotten worse among patients.”

Dr. Volkema says he rarely goes a day without one of his patients reporting feeling stressed.

“Many times, it’s due to acute stressors like relationships, financial concerns or the death of a loved one,” he says. “But for some people, the cumulative demands of life have just reached a breaking point.”

Drs. Smith and Volkema report seeing a dramatic uptick lately in stress, anxiety and depression in patients of all ages—but especially among young people.

“I think the combination of the pandemic, social media and everything else has caused a kind of stress epidemic,” adds Dr. Volkema.

The Effects of Stress on the Body

As a natural human response to challenges and threats in our lives, stress affects everyone to some degree.

As the body perceives stress, the adrenal glands produce the hormone cortisol and release it into the bloodstream. Often called the “stress hormone,” cortisol causes an increase in heart rate and blood pressure.

Left unchecked, stress can upset day-to-day functioning and, over time, lead to health problems.

According to Dr. Smith, stress impacts us at a cellular level, causing damage to mitochondria, the powerhouse centers of our cells. This type of damage

can be especially noticeable in the brain, leading to issues with regular body function and processing. Stress also causes mitochondrial DNA to leak into the blood, which can lead to chronic diseases like hypertension and diabetes. Additionally, stress can speed up the aging process of cells, increasing the risk of heart disease and certain cancers.

Chronic stress, a state of feeling anxious or overwhelmed for a prolonged period of time, affects the body’s immune system and appetite and can lead to various mood disorders and sleep issues.

However, stress can manifest in myriad ways.

“People often think of symptoms of stress as anxiousness, sadness or worry,” says Dr. Volkema. “But it could also be trouble sleeping. It could be chest pain or feeling like you’re having trouble breathing. It could be abdominal pain. Some people develop rashes or feel shaky. So it can be quite challenging for patients and their physicians to separate stress from other possible causes of symptoms.”

When it comes to reducing stress levels, prevention is key.

Dr. Smith says that in addition to diet, sleep and exercise, her practice preaches the value of daily mindfulness and meditation to help reduce stress and anxiety.

“For five to 10 minutes a day, at work or prior to going to bed, close your eyes and focus on your breathing,” she explains. “It’s a simple technique and takes just a few minutes, but it can help you lower stress and bring your body down into that relaxation stage.”

A number of smartphone apps, including Headspace, Breathe and Calm, are also available to help provide timeouts from the stresses of everyday life.

Dr. Volkema employs a pyramid-type model in his practice for dealing with stress.

The bottom layer of the pyramid represents lifestyle, which includes things like movement and rest; what we consume (diet, medications and supplements); relationships; and passions. “Those four factors are so incredibly important for overall health,” he explains. “But they also minimize the effects of chronic stress, depression and anxiety, and they can make it easier to be resilient when acute stressors do arise.”

The second layer of the pyramid represents selfwork. “This is the stuff we know we should do but rarely prioritize, including deep-breathing exercises,

prayer, journaling and meditation,” he adds. “I would also include minimizing the background noise in our lives, which means setting limits on phone use and taking breaks from television, social media and the internet—all of which can be very disruptive. This layer also includes formal therapy with licensed social workers, clinical psychologists and other mental health experts, which can be incredibly beneficial in helping people manage stress.”

The top level of the pyramid, Dr. Volkema says, represents medication. “I always tell my patients that the bottom two layers need to be addressed first. Otherwise, medication is, at best, just a Band-Aid.” While medication shouldn’t necessarily be a first step, dietary supplements like ashwagandha and magnesium have been shown to help relieve stress and anxiety.

“Ashwagandha is a plant-derived supplement that helps your body better cope with stress,” Dr. Smith says. “It also can be helpful for symptoms like anxiety and depression.”

Magnesium can help you relax by stimulating the production of melatonin and serotonin, which can boost your mood and help you sleep.

Although not approved by the U.S. Food and Drug Administration for treating anxiety, beta-blockers have been shown to reduce some of its physical symptoms, such as trembling and sweating.

Back to Basics

Dr. Smith says that ultimately, managing stress involves getting back to the basics of self-care: eating well, being active, getting restful sleep and minimizing distractions.

“I think people need to be easier on themselves,” Dr. Volkema adds. “A lot of times when people come into my office for stress, or if they’re at a crucial moment in life, they’re being really hard on themselves. I think people need to be a little more forgiving toward themselves.”

“We’re all dealing with some form of stress,” Dr. Smith says. “But if it becomes so significant that people aren’t able to do the things they want to do, or they’re not able to be happy or complete their work, I would encourage them to visit their primary care physician. We have options available to help.”

Think You Might Be Having a HEART ATTACK? Call 911 Right Away.

Heart attack is one of the most common causes of preventable death in the United States. According to the Centers for Disease Control and Prevention, someone in the U.S. has a heart attack on average every 40 seconds—that’s almost 800,000 people each year. Heart disease affects both men and women, and more women die each year from heart attack than from breast cancer. With so many people affected by heart attack, it’s important to recognize one when it occurs and seek medical help immediately.

Know the Signs and Symptoms

Your chances of surviving a heart attack with little or no damage to your heart depend on recognizing the signs and symptoms and calling 911 immediately if you are (or someone with you is) experiencing the following symptoms.

The “classic”signs of heart attack in men and in some women include:

• Chest discomfort, which may feel like pressure, squeezing, fullness or pain, especially under the breastbone (sternum)

• Discomfort in other areas of the upper body, including one or both arms, the back, the neck, or the jaw

• Shortness of breath, especially due to physical exertion; may occur with or without chest discomfort

• Sweating

• Nausea (with or without vomiting)

• Cold, clammy skin

In some women, the signs of heart attack can be less distinct and may include the following:

• Fatigue

• Nausea (with or without vomiting)

• Sudden onset of shortness of breath, with or without chest pain or discomfort

• A generalized feeling that “something isn’t right”

• Confusion (especially in older women)

Call 911 Immediately!

• This point can’t be emphasized enough: If you suspect that you or someone with you is having a heart attack, call 911 right away.

• DO NOT try to drive yourself or your family member to the hospital. An emergency response team can assess the patient on the way to the hospital and call ahead to let the hospital know they’re on their way in with a heart attack patient. With advance notice, the hospital’s emergency room staff and heart team will be waiting for the patient and can begin appropriate care right away.

• Not sure if it’s a heart attack? Call 911 anyway!

What Causes a Heart Attack?

Like all other parts of the body, the muscles that make up the heart rely on a constant supply of blood for oxygen and other nutrients. If one of the coronary arteries, the vessels that supply blood to the heart tissue, becomes blocked, a heart attack can occur. Heart tissue that is deprived of blood begins to die and, depending on the location and severity of a blockage, the person can suffer permanent heart damage or death. That’s why it’s important to seek medical attention right away when there’s even a suspicion that someone is having a heart attack.

¿Piensa que puede ser un ATAQUE CARDÍACO?

El ataque cardíaco es una de las causas más comunes de muerte que puede prevenirse en los Estados Unidos. De acuerdo con los Centros para el Control y Prevención de Enfer-medades, una persona sufre un ataque cardíaco en los Estados Unidos cada 40 segundos. Eso es alrededor de 800,000 personas cada año. Las enfermedades cardíacas afectan tanto hombres como mujeres y cada año mueren más mujeres por ataques al corazón que por cáncer de mama. Con tantas personas afecta-das, resulta importante reconocer el momento en que se presenta un ataque cardíaco y buscar asistencia médica de manera inmediata

Reconozca las señales y los síntomas

Sus posibilidades de sobrevivir a un ataque cardíaco, con un daño mínimo o nulo a su corazón, dependen tanto del reconocimiento de las señales y de los síntomas como de la llamada inmediata al 911, en el momento en que usted o alguien cercano experimenta estos síntomas. Las señales “típicas” de un ataque cardíaco en hombres y mujeres incluyen:

• Molestias en el pecho, las cuales pueden sentirse como presión y tensión, sensación de llenura o dolor especialmente en el área bajo el esternón.

• Molestias en otras áreas de la parte superior del cuerpo, como en uno o ambos brazos, la espalda, el cuello y mandíbula.

• Dificultad para respirar, que puede suceder antes, con o sin la presencia de molestias en el pecho, en especial cuando realiza algún esfuerzo.

• Sudor

• Náusea (con o sin vómito)

• Piel fría y húmeda

En algunas mujeres los síntomas de un ataque cardíaco no son tan distintos y pueden incluir algunos de los siguientes:

• Fatiga

• Náusea (con o sin vómito)

• Sensación repentina de dificultad para respirar, en presencia o ausencia de alguna molestia o dolor en el pecho.

• Una sensación generalizada de que “algo no está bien”

• Confusión (especialmente en mujeres mayores)

Llame inmediatamente al 911

• Es fundamental insistir: si sospecha que usted o una persona cercana está sufriendo un ataque cardíaco, llame al 911 de inmediato.

• NO intente conducir, ni llevar a un miembro de su familia al hospital. El equipo de respuestas de emergencias puede realizar la valoración del paciente camino al hospital y llamar con anticipación para comunicarles que llevan un paciente con un ataque cardíaco. Cuando el paciente llega, el personal de la sala de emergencias y el equipo de atención cardiológica estarán esperándolo para atenderlo y proporcionarle el cuidado adecuado.

• ¿No está seguro de que se trata de un ataque cardíaco? ¡Llame de todos modos al 911!

¿Qué causa un ataque cardíaco?

Así como otras partes del cuerpo, los músculos que conforman el corazón requieren de un suministro constante de sangre para proveer oxígeno y otros nutrientes. Si una de las arterias coronarias, que son los vasos que suministran la sangre al tejido muscular cardíaco, se obstruye, esto puede ocasionar un ataque cardíaco. El tejido muscular cardíaco que no recibe sangre comienza a morir. Según el lugar y la gravedad de la obstrucción, la persona puede sufrir un daño permanente en el corazón o morir. Esa es la razón por la que resulta importante buscar atención médica de forma inmediata en el momento en el que exista la sospecha de que una persona está sufriendo un ataque cardíaco.

¡Llame al 911 inmediatamente!

HOME HEALTH CARE and

the Rewards of Connecting

with Patients

Sentara Home Health Care offers an array of hospital-level care services—including physical therapy, occupational therapy, skilled nursing care and social work—that are designed to make it safe for patients to remain in their own homes after being discharged from the hospital. Delivered by a dedicated team of caregivers, Sentara’s home health services can help relieve the burden on patient family members and often eliminate the need for a nursing home or assisted living.

Jessica Stith, a physical therapist with Sentara Martha Jefferson Home Health Care, gained skills in the hospital setting that help her care for medically complex cases in the home. She values the many opportunities she has to spend time and build relationships with her patients.

“My home health care patients are usually very excited to see me when I visit,” says Stith, who works mostly with individuals in their 70s, 80s and 90s who have recently been discharged from the hospital—

many of whom live alone. “Physical therapy in the home fosters an element of social engagement and encouragement that is similar to gym-based personal training. Our patients work hard and want us to be proud of them when we come back to see how they’ve progressed. And while we can’t accept gifts of any kind, they often want to give us things, like tomatoes from the garden, out of gratitude.”

The home health care process may start, for instance, with a patient who has had a heart attack or an exacerbation of chronic obstructive pulmonary disease. After being bedbound in the hospital for days or weeks, individuals often lose the strength to perform many vital daily tasks. Once discharged, Stith works with them at home to rebuild their strength. However, education is also a central part of home health care services. That may involve, for example, teaching a patient with congestive heart failure how to identify the signs of weight gain due to fluids and to contact caregivers when needed—allowing the patient to receive prompt medication adjustment and avoid unnecessary hospital visits.

Home health care providers like Stith also help their patients feel hopeful and independent, which in turn improves their mental fortitude. “I don’t see it in myself, but people often tell me I have a calming presence around patients,” she says.

Baby Steps Can Be a Big Deal

In a home health care setting, significant milestones often come in the form of small improvements and gradual progress, and part of Stith’s work involves helping her patients regain their freedom and reduce dependence on family members. For instance, one patient regained her ability to walk a distance of five feet, four consecutive times, without a walker. “She was so excited,” Stith recalls. “It was the first time she didn’t have to use the walker in four months. Seeing the joy on her face made it so worth it. Autonomy is empowering.”

Another patient had been unable to safely walk a quarter-mile to get their mail, so Stith would walk with them, carrying a chair for the patient to take breaks along the way. Eventually the patient was able to make it the whole distance without resting, which was a huge source of satisfaction for Stith.

When she joined Sentara Home Health Care, Stith was impressed by Sentara’s comprehensive home health care orientation program. “This program is exceptional,” she notes. “As trainees, we go out with other physical therapists, nurses and

clinicians in all disciplines to experience how they work, individually and collectively. That experience gave me the confidence I needed to take care of patients in their homes. We know when to call the rescue squad and how to properly deal with a lot of other situations that may arise.”

Team stability and professionalism are further indicators of the strength of the Sentara Home Health Care program. Many of Stith’s co-workers, for instance, have been with the organization for 10-15 years—and Stith has seen many of them go above and beyond to selflessly help their patients on countless occasions.

In one such case, a therapist and his wife drove 40 minutes on a weekend to move furniture and secure padding for a woman who lives alone. Another has shoveled a driveway to ensure that helpers would have safe access. And for patients in rural settings with spotty cell service or no smartphone at all, Stith often uses her own phone to schedule and conduct important telehealth sessions.

“When you’ve been seeing someone on and off for 10 years, you know their kids, and they know a good bit about yours, too. With that level of trust, family members often turn to us to discuss difficult topics like hospice and palliative care, when the time comes.”

Following in Family Footsteps

Olivia Cook is a home health nurse with Sentara RMH Medical Center who aims to provide both empowerment and empathy to her patients. The granddaughter of a retired hospice nurse, Cook strives to approach every patient’s state of mind from his or her own perspective. “I always try to think about how I would want to be cared for,” says Cook. “Home health patients face a lot of unknowns and often feel vulnerable. Putting myself in the patient’s mindset allows me to gain their trust. That trust motivates them to take steps to manage their health, which is so rewarding for me.”

Cook’s innate sense of caretaker empathy was likely handed down to her. “My grandmother loved going into patients’ homes and caring for them,” she says. “That love sparked my own interest in home health. When it comes to family, patients and even strangers, she loves taking care of people and making sure everyone’s needs are met. Even though she’s retired now, anytime you need anything, she’s still the first person you want to call.”

Working in a home health setting allows Cook to see how her patients live, rather than just focusing on an illness or cluster of health challenges. “As a home

health nurse, my goal is to help patients invest in their own care and become their own advocates. I try to be proactive and often find myself advocating on their behalf. But knowledge is power, so the more the patient feels informed and involved in their own care, the better the outcome.”

Knowing her patients well also helps Cook provide better guidance.

“I just have to figure out what motivates each patient and set that as a goal,” she explains. “For one person, it’s the freedom to be more involved with their grandchildren. Another patient has a special event to attend. I want to get to the root of what’s holding them back and unpack all the factors that influence their health. That often means talking about their life, their family and everything in between.”

Sentara Home Health nurses often remark that while home health care is rarely easy work, it’s always fulfilling. Dealing with serious illness following a hospital discharge, patients are often highly motivated to work with home health workers to regain their independence and avoid dependence on family—so the progress patients make can be truly remarkable.

Tough as her job may be, Cook finds that there’s always a return on her investments.

“There are hard days,” she says. “But you see the impact you make, and that’s what you remember. For example, I might work with a patient one week and teach them about diet and how to manage their blood sugar. Then I go back the next week to see that they’ve actually taken steps to get their health under control.”

Cook tries to live up to her grandmother’s passion for taking care of people in their homes.

“There’s no other setting like home health, where you step into someone’s world, learn all you can and help them achieve goals—and for the time you’re there, it’s like you become part of their family.”

Collective Giving Creates a ‘Better Place’

For 15 years, a group of women known as the White Rose has been pooling its financial resources to make a significant impact on the quality of care delivered at Sentara RMH Medical Center. The RMH Foundation works with White Rose group members to support hospital projects and programs based on a yearly review of requests.

Through a coordinated, collective approach, members of the circle leverage their combined annual gifts to have an immediate impact on how the gifts are put to work.

“The circle is an inclusive entry point to understanding what is happening with healthcare philanthropy in the community,” says Mary-Kaye Slonaker, the foundation’s special gifts director. “Members are like-minded women from all backgrounds who collaborate to assume responsibility for leaving the world—in this case, Sentara RMH—a better place.”

More than 80 women currently participate in the program. While there are no plans for a grand celebration to mark the group’s 15th anniversary in 2023, it’s certainly an appropriate time to commemorate the White Rose and its member philanthropists. In addition to the anniversary, the group’s founder, Sherrill Glanzer, retired in March.

“Sherrill blazed a trail 15 years ago when she started this group, and it’s still going strong,” Slonaker says.

A Long List of Beneficiaries

Vicki Krauss was among the original set of 22 members recruited to the White Rose by Glanzer, sold on the group’s vision through her own prior experience in health care. Krauss worked in a hospital setting before coming to the area more than 20 years ago, when she started as a nurse practitioner in outpatient services.

“Being able to provide gifts to the hospital and help staff with medical needs really appealed to me,” Krauss recalls. “Having worked in a hospital setting, I knew the challenges involved in providing quality care. It’s remarkable what we’ve been able to achieve.”

Since its founding, the White Rose has funded more than 115 projects totaling more than $500,000, with a wide array of beneficiaries including cancer care, women’s health, hospice, behavioral health, community health education, and scholarships intended to address a nationwide

The White Rose Giving Circle has proven to have remarkable staying power.

$500,000 total giving

15 years in the community

$ 80+ female philanthropists

shortage of nurses and nursing faculty.

Among its many achievements, the White Rose has supported two-way radios and a vein finder for the Emergency Department, an intubation GlideScope to help with airway management for the Family Birthplace Center, and stair chairs for the Orthopedics Department. The list goes on and on.

The circle’s reach also applies to ancillary services, such as supporting speech and physical therapies.

“It’s just heartwarming what we can do,” Krauss says. “The past 15 years have flown by. They really have.”

Glanzer points to some shared characteristics among the group’s members, including compassion, generosity and an understanding of the value of combined giving.

“This community is extraordinarily blessed with strong, philanthropic women who want to be part of something that directly and positively affects the quality of health care in our community,” Krauss adds. “They also understand the value of collaboration.”

How the White Rose Works

Each year, Sentara RMH department directors and managers are asked to submit requests for proposals to the White Rose explaining their needs. Several of these requests are selected and brought before the members at the White Rose annual meeting, where members vote to select the projects that will receive funding.

At each White Rose meeting during the next calendar year, departments that receive funds are invited back to report on the impacts of the donations.

“In this way, group members are able to receive direct feedback on the fruits of their labor,” Glanzer explains. Participating women pay a $500 membership gift per year and

attend as many or as few of the four scheduled annual White Rose meetings as they desire. The spring meeting offers a chance to invite a friend, and in early summer, the president of Sentara RMH addresses the group. The group hosts a social event in late summer and holds its annual meeting in the fall.

“Your gift matters, whether you attend the informational meetings or not,” Glanzer notes.

The RMH Foundation sets aside money in its budget for administrative and operating expenses for the White Rose, ensuring that 100% of membership gifts go toward worthy projects at Sentara RMH. The foundation’s liaison attends meetings to provide information and guidance.

Annual membership can be given by an individual, gifted, or made in memory or in honor of a special woman someone wants to recognize. An annual membership recognition plaque is mounted in the hospital cafe’s overlook area.

Krauss loves to stumble upon conversations among her colleagues talking about the White Rose’s contributions.

“It’s a good feeling to know that projects are being funded

and then appreciated,” she says. “I am proud that I’ve been able to help improve healthcare delivery through the projects we’ve funded.”

Next Woman Up

Slonaker and Krauss often invite other women to join the White Rose—“planting seeds,” in essence, to help the circle of giving grow and continue to blossom.

“Philanthropy means ‘love of humanity,’ so anyone who loves humanity belongs in the White Rose community, regardless of age, wealth, where you live or where you are from,” Slonaker says. “The group offers purpose, impact, connection and joy.”

Krauss knows firsthand how the healthcare industry has changed since the White Rose’s inception, and the field stands to transform further in the next 15 years. Requests received by the Giving Circle often reflect the emerging needs of Sentara RMH.

The White Rose’s role in helping Sentara RMH grow and

expand its services may only get bigger as time goes on.

“The program works because the members have a desire to have quality medical care in the community,” Krauss says. “Sentara RMH is a wonderful hospital and provides many different services. The women of the White Rose are passionate about being able to stay local for medical needs and not having to travel an hour or two away. High-quality health care is available right here in our own backyard.”

For the next era of the White Rose, Slonaker hopes to guide the group to even greater achievements.

“There is a strong sense of community in the Valley, and the White Rose represents giving by community, for community and with community,” she says. “Community knows what community needs.”

Plan for Your Life’s Journey

Life is one long road trip, and no matter where you are, we can help you on your journey. We have tools and ideas to save you money, while providing for the people and causes most important to you—causes like the RMH Foundation. Your expression of philanthropy makes a difference to local patients and supports the RMH Foundation’s mission of elevating health care in our community.

No matter how far you are into your life’s journey, it is never too late to update your plan. You decide on your destination based on your own values and priorities, and we can help you get there.

For more information, please visit https://sentara.giftlegacy.com. We look forward to helping you plan your future!

“The program works because the members have a desire to have quality medical care in the community.”

of the RMH Foundation friends

Gifts received from May 1 to Sept. 15, 2022

Sentara RMH Medical Center is so grateful to have the support of generous community members. We express this gratitude and recognize the contributions our donors make through the President’s Forum, the William Leake Society, 1910 Cornerstone Club and the White Rose Giving Circle. These exclusive giving circles are our way to honor our most generous partners who show they care about having the best medical services available in our community. Finally, to recognize your loyalty over the years, we are placing the number of consecutive years you have supported the RMH Foundation next to your name. Thank you for your support!

Totals represent cumulative amounts given in 2022.

President’s Forum

$5,000 - $24,999

Dr. Donna Amenta (11)

Books-A-Million, Valley Mall (3)

Nancy R. Bradfield (15)

Eddie R. and Catherine Coffey (25)

Community Foundation for a Greater Richmond (1)

Elizabeth Harnsberger Trust (11)

Harrisonburg Kiwanis Club, Inc. (3)

John R. and Mary Ann Heatwole (4)

Dr. William I. and Lynda D. Lee (17)

Earle A. MacKenzie (8)

T. Carter, Jr. and Connie G. Melton (4)

Edgar L. and Char Miller (16)

Kathy Moran and Marcie Harris (13)

Douglas J. and Lori B. Moyer (7)

Douglas M. and Vickie K. Rawley (6)

Riner Rentals (4)

RunSignUp (8)

Schwab Charitable Fund (1)

Estate of Elizabeth L. Seiler (1)

Select Aerospace Industries, Inc. (6)

Helen W. Shickel (21)

Barbara B. Stoltzfus (25)

United Way of Greater Charlottesville (1)

Robert S. Wildman (7)

William Leake Society

$1,000 - $4,999

Mary L. Addy (5)

Dr. Stephen G. and Patricia A. Alvis (3)

Bisapaca LLC (1)

Matt and Marianne Branigan (9)

Rosemary O. Brenner (13)

Ruby J. Callahan (14)

Dr. Henry H. Chang (20)

Sandra Clatterbuck (5)

CommonWealth One Federal Credit Union (3)

Thomas F. Constable (23)

Benjamin Craig (3)

Bettye C. Davis (7)

Mensel and Linda Dean (33)

Bessie Cleo Didawick Trust (1)

Colonel and Mrs. Peter F. Dieck (6)

Everence Foundation, Inc. (1)

Rosemary and David Eyler (3)

Dr. C. Wayne and Donna Gates (2)

Sherrill Glanzer (22)

Hale Family Charitable Fund (1)

Dr. David C. and Amelia M. Hall (12)

Harrisonburg and Bridgewater 24/7 Fitness (2)

Harrisonburg Family and Cosmetic Dentistry (2)

Ollie Heatwole Trust (3)

George and Cary Hevener (19)

James and Connie Hillyard (7)

Glenn M. and Sandra K. Hodge (3)

Dwight E. and Carolyn R. Houff (1)

Kern L. and Chanda C. Houff (4)

IDM Trucking, Inc. (17)

Edward E. Jones (3)

Kerry Foods (1)

Elisabeth M. Lawson (8)

McDonald’s and Boxley Family (10)

Barry and Eileen McEneely (3)

Ann and Neal Menefee (29)

Dr. Jason R. and Hilary D. Moore (4)

Richard R. J. Morin (17)

Mulberry Hills Farm LLC (2)

Calvin R. Nichols, Jr. (6)

Nielsen Builders, Inc. (1)

Janice L. Pence (12)

Virginia Frances Plecker (6)

Laura R. Remington (1)

Bill Riner (1)

Rockingham Cooperative (15)

Janice F. and Rick Scaglione (23)

Sentara RMH Volunteer Auxiliary (42)

Shenandoah Oral and Facial Surgery (1)

James R. and Mary C. Sherman (10)

T. Edgar and Zizi C. Sipe (14)

Mrs. Doris S. Stone (10)

Robert Strickler (1)

David O. and Elizabeth A. Swingle (13)

The Community Foundation of Harrisonburg and Rockingham Cty. (2)

Richard H. Torovsky, Jr. (6)

Lynn and Diane Trobaugh (16)

John D. Wenger, DO (1)

White Horse OpCo, LLC (1)

Denise A. Whitman (20)

Priscilla Ann Whitmore Estate (1)

Ray M. and Ann H. Wine (2)

1910 Cornerstone Club

$100 - $999

2MD Fitness, LLC (1)

Frank K. Abel (3)

Richard D. and Louise H. Alderfer (1)

Margaret A. Alexander (19)

David E. and Gloria W. Alger (1)

Ameriprise Financial Services, Inc. (1)

Devon C. and Teresa B. Anders (13)

C. Dennis Armentrout (3)

Eldon W. and Sandra P. Armstrong (3)

Sandra G. Baker (3)

Cynthia M. Banks (11)

Edgar L. Barnard, Jr. (17)

David G. and Velva J. Barr (1)

Sam L. Batton (7)

Joanne L. Bell (7)

Drs. A. Jerry Benson and Martha K. Ross (12)

Ralph N. Bergdoll (7)

Blue Ridge Insurance Service, Inc. (2)

Terry L. Bodkin and Connie Thompson-Bodkin (8)

Fred and Susan Bosserman (3)

James O. and Sylvia K. Bowman (4)

Auburn A. and Ruth D. Boyers (41)

Ellen C. Branner (1)

Breast Cancer Awareness Month

Peer-to-Peer Funds (1)

Judith K. Breeden (4)

Jack J. and Mary T. Broaddus (1)

Carol J. Brooks (19)

Emmett H. and Leola C. Brooks (8)

Larry E. Brown (9)

Larry Brown (1)

Donald R., DDS and Jean C. Brown (1)

Harold D. and Fay K. Brubaker (5)

Ted and Cindy Bryan (2)

Henry F. and Catherine S. Buhl (11)

Donna E. Burch (3)

Jenny and Jared Burden (2)

Bruce B. and Norma S. Burkholder (9)

Christine W. Burner (15)

Margaret Burruss (1)

Gary V. and Lesa R. Calleo (13)

Jay L. Campbell (4)

A. Fontaine and Martha J. Canada (11)

William B. Carper, Sr. (41)

Maryjane and Carroll Chewning (9)

R. Bradley and Mary Ellen Chewning (11)

Sherry Clegg (1)

Randy S. Clem (7)

Daneen A. Coakley (1)

Community Foundation of the Central Blue Ridge (1)

Alisa D. Cook (1)

Raymond A. and Diane Y. Courchene (1)

Chad Covelli (1)

Jim Cunningham (1)

Bennie M. and Cathy L. Cupp (2)

Brian Davis (3)

Phillip E. and Wilma R. Davis (1)

Caitlin Daw (1)

Mary Day (1)

Mary Dayton (1)

Arthur Dean (2)

Arthur Dean (2)

John R. and Tina D. DeLapp (3)

Harry Lee, II and Louann S. DePoy (1)

Thomas C. DeVore (3)

Robert F. and Linda W. Dinsmore (6)

Lynn and Dave Diveley (5)

Dominion Energy Charitable Foundation (11)

Jim and Caroll Douglas (7)

Betty Bryan Dove (18)

Eileen E. Dubberstein (2)

W. Gary and Brenda S. Early (1)

Andrew Eckstrom (2)

Edward Jones Investments (3)

Steven D. and Theresa A. Eiserman (3)

Dr. J. Robert and Rosalie Hartman Eshleman (7)

Joseph J. and Rose Marie Estock (1)

Dr. James D. and Sheila D. Evans (3)

Donald M. and Joyce Y. Evers (2)

Anne G. Farmer (4)

Carol Ann Fields (4)

First Choice Home Health Services, LLC (1)

Lillie Ann Flora (1)

Larry A. and Linda J. Fogle (16)

Frackelton Family (1)

Forrest L. Frazier (21)

Charles J. Frye (4)

H. David and Rachel N. Frye (3)

Robert S. and Susan D. Fulk (1)

Susan A. Fulk (1)

William E. and Rita F. Fulk (5)

Peter G. Fundinger (5)

Lelia Lightner Galvin (4)

Douglas and Lila Gardner (4)

Norma J. Gardner (14)

Dr. Robert Garwood (2)

Dr. Linford K. and Rebecca L. Gehman (4)

Allison Gilbert (1)

Ronald W. and Velda J. Gilkeson (3)

Tommy and Betsy Heatwole

Glendye (10)

J. D. and Rebecca F. Glick (25)

Paige Webb Godoy (4)

Susan J. Gosney (6)

Henry B. and Dorice M. Graham (1)

Grand Home Furnishings of Harrisonburg (7)

Marianne F. Halterman (6)

Teresa Hanger (1)

Dr. Bill and Dorothy Harper (1)

Leo E. and Ruthanne J. Heatwole (1)

Evelyn S. Hedrick (13)

Joyce Coryell Hedrick (3)

Rodney E. Hildebrand (1)

William E. ‘Ike’ Himelright (5)

William R. and Barbara H. Hite (14)

Thomas J., III and Virginia C. Holden (5)

Brent Holsinger and Laura ToniHolsinger (3)

Ann Ewing Homan (20)

Robert E. and Betty W. Hoover (22)

Dr. Alden L. and Louise Otto Hostetter (16)

Michael L. and Rose Ann Houliston (2)

Lillian C. Huffman (7)

Peggy Hufford-Bohannon (1)

David M. Hughes (12)

Delores D. Hulvey (26)

Timothy J. and Anne E. Hutt (1)

Julie Ilg (1)

Yvonne Jarrels (2)

Tedd H. and Lora W. Jett (33)

Ronald P. and Julianne Jilinski (16)

Dr. Robert F. Jochen V.M.D. (8)

J. Robert and Patricia C. Johnson (5)

Kenworth Sales Company and Truck Enterprises, Inc. (1)

Dr. Charles E. and Dawn F. Kern (8)

LaDene King, MD (1)

Lois Ann King (1)

Libby Kiser (1)

Leroy and Juanita Kiser (1)

K. Michael and Susan C. Kline (2)

Richard L. and Allison H. Kline (1)

Alan L. and Patricia W. Knicely (17)

Gene E. and Ann H. Knicely (3)

Melonie Knicely (3)

Kay Knickrehm (2)

John H. Koontz (3)

Krispy Kreme (2)

Joseph C. and Carol A. Kudless (11)

Steve and Cindy Lamb (12)

Anita H. Landes (1)

Walter L. and Maria B. Landis (1)

Nancy J. Lantz (2)

Terry and Judy LePera (25)

Carl G. and Arnesa F. Lind (21)

John S. and Patsy V. Liskey (1)

Charles E. and Cynthia A. Litten (14)

Wayne L. Long (17)

Teresa L. Louden (8)

Wayne J. and Geraldine S. Lowe (4)

David M. Lynch (7)

Laura S. Mapp (30)

David A. Mars (8)

Kathleen W. Marshall (9)

Robin L. Martin (21)

Erma Brubaker Martin (3)

Roger E. and Cheryl Yoder Mast (1)

Philip H. Maxwell (36)

Helen G. May (1)

Joan C. McGlaughlin (13)

Dr. John and Beverly McGowan (1)

Donna F. Meadows (11)

Mr. Edgar Meyerhoeffer (1)

Charles W. Michael (6)

Pauline G. Miller (3)

Thelma H. Miller (12)

Fern Miller (1)

Gloria Miller (1)

Janice K. Miller (10)

John F., III and Judith A. Miller (5)

Robert B., Jr. and Jeanne S. Minnich (27)

Jane S. Mohr (1)

Melinda A. Monroe (1)

John E. Moore (18)

Margie L. Moore (16)

Dr. A. Glenn and Linda M. Morrison (1)

John W. Morrow and Alaina

J. Henry (3)

Randall L. and Eleanor M. Moyers (1)

C. Carter Myers (2)

John J., Jr. and Linda W. Myers (5)

Donald Taft Nair (1)

Foelke D. Nair (30)

John N. and Linda E. Neff (6)

Randolph G. and Beverley Z. Nelson (14)

Jenifer Nesselrodt (1)

Dwight W. and Betsy W. Newman (3)

Brian L. Nixon (1)

Charles V. Oster (27)

Michael Overman (1)

Lewis Parady (4)

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Patty Chapman

Douglas M. and Vickie K. Rawley

Ben Craig

Nicholas Swartz

Jesse Crawford

James R. and Mary C. Sherman

Ramona Crowe

Susan C. Threewitts

Linda Davis and Terry King

Anita H. Landes

Tyler Denby

Charlotte L. Stover

Judy Embrey

Donald R. and Karen R. Embrey

All Staff Members at Funkhouser’s Women’s Center for their care, kindness and expertise, thank you!

Judith D. Roop

Sherrill Glanzer

Dr. Alden L. and Louise

Otto Hostetter

William G. and Hope Shank Stoner

Denise A. Whitman

John R. and Mary Ann Heatwole

Mandi Glendye

Tommy and Betsy Heatwole Glendye

Corrie Lynn Green

Lynn and Diane Trobaugh

Roger and Judy von Seldeneck

Donna D. Williams

Denise A. Whitman

Dr. John and Beverly McGowan

Terry L. and Christine P. Richards

Patricia Hansbrough

Georgeanna H. Wymer

Brooke Hensley, Nurse, SRMH Emergency Department

John and Mary Strickler

Gloria Hildebrand

Rodney E. Hildebrand

Georgianne Kiser

Tommy and Betsy Heatwole Glendye

Joanne Kopp

Daniel and Kathleen Dvorak

Robert Kyler Foelke D. Nair

Ramona Leeth

Kay S. Leeth

Donald Lemish

Denise A. Whitman

Allen Litten

Debra D. Thompson

Barbara Loker, Home Health

Neil W. Mowbray

Jacqueline Painter

Mary Day

Sharon Quesenberry

Larry W. and Merietta A. Lambert

Barbara Ritchie

Tommy and Betsy Heatwole Glendye

Brian Robinson

John and Cindy Reeves

Dia Russell

Jimmy D. and Nancy J. Russell

Nancy Smith

William E. Bray, Jr.

Arthur Strunk, FNP-C

Jane S. Mohr

Diane Tesler

Barbara L. Randel

Diane Trobaugh

Laura G. Price

Sandy Tusing, Sherrill Glanzer and Janet Wendelken for wonderful service rendered

Merv and Marlene Webb

T. Keith Vest

Howard E., Sr. and Elizabeth F. Beall

Janet Wendelken

Ann Thompson-Haas

Benjamin Craig

Sandy Wenger

Mary H. Kratz

John D. Wenger, DO

Mark Williams

Charlotte L. Stover

JoAnne Wonderley

Pamela Sponaugle

Elizabeth Worley

Catherine Worley

Jerry ‘Pete’ Wright

David R. and Debbie B. Fordham

Yuriy Zhukov

Larry W. and Nancy A. Swisher

Karen Zirk

Roy E. Jr., and Carolyn M. Zirk