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Sentara Marthamagazıne Jefferson FA L L 2 0 2 1

Making a

Comeback

Orthopedics and Sports Medicine PLUS: Surviving and Thriving After Cancer Surgery Vanquishing Painful Varicose Veins | Sentara Hospital to Home

LETTER FROM THE PRESIDENT

SENTARA MARTHA JEFFERSON BOARD Carol Hurt | Chair

Lillian BeVier John Ligush, MD Josh Fisher, MD Lawrence Martin E. Ray Murphy Michael Gentry Douglas Moyer Paul Gaden

SENTARA MARTHA JEFFERSON ADMINISTRATORS

Paul Gaden Interim President

Johnsa Morris, MHA, MBA, RN, NEA-BC Vice President of Patient Care & Chief Nursing Officer

Paul Tesoriere, MD Vice President, Chief Medical Officer

SENTARA MARTHA JEFFERSON MAGAZINE EDITORS

Jenn Downs Alyssa Pacheco Debra Thompson

Forging Ahead for the Health of Our Community

t’s hard to believe that we’re coming up on two years from the time COVID-19 first made its appearance in our world. Since then, as we’ve traveled the uncharted waters of dealing with a global pandemic, I have truly been amazed by the outstanding work of our caregivers. From the beginning, through many twists and turns and ups and downs, our team members have remained calm and kept focused on providing the best possible care for our patients. As we near Thanksgiving, there’s no better time to say THANK YOU and express my appreciation for the hard work that EVERY member of our team has contributed. Additionally, a big thank-you goes out to each and every one of you for your ongoing trust and support of your community hospital. We’ve truly felt the benefits of your kindness, and as you’ll read on page 44, we’ve even been able to launch new resiliency programs, thanks to philanthropic community support through the Martha Jefferson Hospital Foundation’s COVID-19 Emergency Response Fund. While I’d like to be able to share better news about the pandemic, unfortunately COVID is still with us—and, in fact, just last month our hospital saw the highest number of hospitalized COVID patients since the crisis began. We do have a way to fight back, however, through widespread vaccination. If you have not yet been vaccinated, please consider doing so as soon as possible. If we can all pull together and maximize our community vaccination rate, we will be closer to stopping this virus. Additionally, as we head into the flu season, protecting ourselves and each other from the flu becomes increasingly important. If you haven’t already done so, please carve out some time from your busy schedule to get your flu shot. Despite the pandemic’s many challenges, the team at Sentara Martha Jefferson has never lost focus on our mission: helping patients heal and feel better. As you’ll read on page 19, our sports medicine program has stayed busy, helping athletes at all levels recover from injury and get back to doing what they love. Additionally, as you’ll read starting on page 24, many inspiring stories shared by grateful patients have come out of our cancer center in recent months. Finally, as many of you know, we are currently searching for the next president to lead this wonderful organization, and we hope to identify our new president by the end of this year. While I know the process has taken longer than expected, it was important to us to make sure we made the right decision and found the best fit for Sentara Martha Jefferson— and for this community. Best wishes for a safe, healthy, happy holiday season.

CONTRIBUTORS

Luanne Austin Karen Doss Bowman Lisa Smith Jennifer L. Stover PHOTOGRAPHY

Andrew Shurtleff Tommy Thompson DESIGN

Picante Creative

Paul Gaden Sentara Healthcare Regional President, Western Region

Contents FA L L 2 0 21

Returning Stroke Patients to the Rhythm of Life

Orthopedics and Sports Medicine

Surviving and Thriving

Making a Comeback

After Cancer Surgery

Contents

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14 D E P A R T M E N T S President’s Letter Inside front cover The Best Medicine

New & Noteworthy

Physician’s Perspective On-Call Advice

Improve Health Every Day Eat Well, Live Well Calendar

Aging Well

Vanquishing Painful Varicose Veins

Health Matters

Foot Care for People with Diabetes

La Salud Importa

Cuidado de los Pies para Personas con Diabetes

Sentara in the Community

New Sentara Program Offers “Hospital at Home” Care for Some Patients

Caring Tradition

Calendar

THE BEST MEDICINE BY MICHAEL CORDELL

To Get Healthy,

Speed Isn’t Everything

hen I was young, a car’s “zero-to-60” time was essential information for me. If you told me you bought a new car, that’s the first question I’d ask. I’d scoff if your car hit 60 miles per hour in 5.4 seconds, and I knew of a model that could do it in 5.1 seconds. Yet somehow, I can’t remember an occasion when I actually needed to get from zero to 60 as fast as possible. Cutting two seconds off my trip to get a haircut wouldn’t make me look any less dorky. And getting to work quickly was definitely never my goal, which is why I commuted to work on a riding lawn mower, weather permitting. Part of this has to do with our collective obsession with speed. In my opinion, Nike’s slogan shouldn’t be “Just Do It”—it should be “Just Do It As Fast As You Can.” And it’s not just time we focus on—it’s giving it our all. We want to go for broke, knock ourselves out, pull out all the stops. We don’t want to leave anything on the table. But when it comes to getting in shape, this sort of thinking can be detrimental. In the past, when I’ve decided to start exercising, I’ve committed to working out hard for at least an hour, if not longer, every day. If I went on a diet, I wanted to lose 10 pounds the first month, and I wouldn’t have objected to losing 20. The problem with this approach is that it usually doesn’t work, at least not over the long run. For example, I’d quickly burn out from trying to do too much exercise too soon, so I’d quit. Or I’d realize that food actually isn’t overrated, and I’d want some as soon as possible.

We tend to underestimate the power of incremental change. If you’re just starting to exercise, instead of buying a set of weights, a treadmill and a rowing machine, try going for a 10-minute walk. Walk up a flight of stairs—or even half a flight, if that’s all you can do. Then, before long, add a little to that: five more minutes walking or one more flight of steps. Gradually you’ll build up your capabilities, and then you can start looking at things like weights or other equipment—but first, establish the habit. As for diets, start by cutting back a little on unhealthy foods. Maybe it’s a struggle to do that every day at first, but try eating healthy two or three days a week, and then build on that. Don’t worry about starving yourself or eating a bowl of Styrofoam peanuts for lunch— just eat a little better, then keep doing a little better over time (the key phrase here being “over time”). As Maya Angelou said: “Do the best you can until you know better. Then when you know better, do better.” So try not to focus solely on how quickly you can lose weight or run a marathon. Instead of losing 10 pounds in a month, maybe you’ll lose two pounds. If you do that consistently, in a year you’ll have lost 24 pounds! As for me, several years ago, I went from not being able to run a quarter-mile to completing a half-marathon because each time I went out to train, I ran a couple of mailboxes farther in my subdivision. It took quite a while, but I got there. Granted, my zero-to-60 time wasn’t something I could measure, but sometimes speed isn’t everything.

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new& noteworthy Sentara Martha Jefferson is pleased to welcome the following new providers into the hospital community. To get connected with one of our providers, or for more information on any caregiver at Sentara Martha Jefferson, please call 1-800-SENTARA. Abdallah S. Abdelrazeq, MD Hospitalist Sentara Martha Jefferson Inpatient Services 434-654-7580

Keith D. Jackson, DMD Oral Surgery Central VA Oral & Facial Surgeons, PLC 434-973-3348

Whitney P. McClincy, MD Family Practice Sentara Forest Lakes Family Medicine 434-654-4600

Caitlyn S. Buller, DO Hospitalist Sentara Martha Jefferson Inpatient Services 434-654-7580

Joseph M. Koes, MD Emergency Medicine US Acute Care Solutions 434-654-7150

Shyaun Rafii, DPM Podiatric Foot & Ankle Surgery Virginia Foot & Ankle Surgical Associates 434-977-8040

Garrett E. Ghent, MD Emergency Medicine US Acute Care Solutions 434-654-7150

Evan J. Kraus, MD OB/GYN Jefferson OB/GYN 434-977-4488

Kenia M. Sosa, CRNA Anesthesiology Sentara Anesthesiology Specialists

Scott Goldberg, MD Family Practice Sentara Spring Creek Family Medicine 434-654-8900

Lisa A. Mathison, CRNA Anesthesiology SMG Anesthesia

John D. Wolfe, Jr., MD Medical Imaging/Radiology Charlottesville Radiology 434-654-7114

Megan Hart, PA Emergency Medicine US Acute Care Solutions 434-654-7150

Michael S. McClincy, MD Family Practice Sentara Martha Jefferson Family Medicine 434-654-1950

Allison W. Yeaman, MD Family Practice Sentara Forest Lakes Family Medicine 434-654-4600

To get connected with one of our providers, please call 1-800-SENTARA.

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Sentara Martha Jefferson Hospital Named

10th-Best Hospital Martha Jefferson Hospital Foundation In the Pink Tennis Tournament On Sept. 17th and 18th, more than 200 men, women and juniors turned our city into a sea of pink and raised more than $30,000 to fight breast cancer and support women’s health. All of the funds raised support Marianne’s Room, which provides free wigs and scarves to cancer patients in our community, as well as other patient services offered through the Phillips Cancer Center at Sentara Martha Jefferson Hospital. In the Pink is sponsored by The Women’s Committee of the Martha Jefferson Hospital Foundation.

Martha Jefferson Hospital Foundation

Celebrates 2021 Martha’s Market On Oct. 23, The Women’s Committee of the Martha Jefferson Hospital Foundation hosted the 28th annual Martha’s Market at two locations: the IX Art Park and the Downtown Mall in Charlottesville. This fun and free shopping experience boasted new ways to bring our community together with dozens of specialty vendors set up alongside the Farmer’s Market at IX Art Park. In addition, a new partnership with the Downtown Business Alliance connected Downtown Mall merchants and restaurants to the yearly event. Attendees shopped with a purpose, knowing that 15% of all purchases support breast cancer treatment and health programs for women in our community.

in Virginia by U.S. News & World Report Sentara Martha Jefferson Hospital has tied for the 10th-best hospital in Virginia, up two spots from last year, in the 2021 edition of the U.S. News & World Report rankings. “I am pleased to see Sentara Martha Jefferson Hospital rise to one of the 10 best hospitals in Virginia this year,” says Paul Gaden, interim president of Sentara Martha Jefferson. “Such recognition highlights the dedicated work of every member of our team, showcasing our long-standing commitment to improving health every day. We consistently aim to provide high-quality health care for our community, and this honor highlights those efforts.” In addition to its state ranking, Sentara Martha Jefferson is also recognized as “high performing”— meaning it ranks in the top 10% nationally—in its adult neurology and neurosurgery specialty. “Achieving this honor takes extensive devotion from the entire hospital team,” says Frank Jargowsky, Sentara Martha Jefferson director of quality and patient safety. “We want to thank our patients and their families for their confidence in our care, and we are committed to continually striving for new heights in excellence and providing high-quality health care for our community.” sentara.com

PHYS ICIAN’S PERSPEC TIVE

Remembering Dr. Nicholas Brandt “He taught us that our time on this earth is best invested in service to others and that it is an honor to give that service.” Dr. Nicholas Brandt, a beloved physician with the Sentara Martha Jefferson Hospitalist Service, died suddenly on Sept. 3, 2021. His passing was news for which none of us was prepared and that we are still trying to comprehend, and it put the spotlight on what all of us know to be true: Life is fragile. 6 |

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When death comes to someone close, it forces us to reflect on the impact that remains: how he touched each of our lives and the legacy he leaves behind. The impact of Nick’s death on the entire hospital staff was immediate. In the days since, many of us have gathered to share our common grief over a life cut short, while reflecting on the amazing man and physician he was. During these conversations, words that kept popping up included: genuine, gracious, thoughtful, respectful, beloved, approachable, compassionate and “a ray of sunshine.” An amazing human. One of a kind. The absolute best. That smile. Nick started his career as a staff physician for the Indian Health Service on the Navajo Indian Reservation in Chinle, Ariz., where he served as the internal medicine division chief for three years. Occasionally, Nick would talk about his time there and how it shaped his professional career.

What impressed me most about Nick was his mental clarity and ability to quickly synthesize the clinical picture of complex patients. His clinical acumen was surpassed only by his talent for connecting with patients and families. He truly seemed to relish getting to know his patients and embodied the ethos of the 20th-century physician Dr. William Osler, who said, ’It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.’ Nick was that kind of physician and person.” —Dr. Lee Litvinas

He once said to me, “Really, all most patients need is to feel like someone is listening.” Anyone who had observed Nick interact with his patients could see this was one of his greatest gifts. He believed that his patients made him a better doctor. He had a way of being clear and honest with those in his care, while also serving as a calming and compassionate presence. His patients had his full attention. He was humble in his excellence, and when someone would

comment on how smart he was, he would inevitably say, “My wife is the smart one!” He spoke of his wife, Sharon Meth, also a Sentara physician, with such admiration and respect. He would discuss in wonder how she managed to be amazing both as a physician and a mother, without missing a beat. In a prime location on his desk was his annual calendar of family photos on full display, hoping whoever might be passing by would ask about his twins, whom he spoke about with pride. He was a true family man.

I always hoped Nick would be working if a family member or I were hospitalized. His desk was next to mine, and he always lit up the room when he walked in. Whether it be discussing a patient’s concerns or the concerns of the world at large, his empathy always shone through. I loved to pause at his desk on the first of every month, when his calendar would be changed to show another happy photo of the family of which he was so deservedly proud.” —Dr. Clara Eden sentara.com

Nick was a wonderfully calm and level-headed physician, a keenly smart and funny colleague, and a kind, caring and dear friend. I miss him terribly.” —Dr. Mike Longo

As a leader, Nick made each one of us feel important, no matter our role. He always took the time to stop and talk about life events, our families, how our day was going—and, of course, UVA basketball. Many nurses spoke with him about their career plans, and they always had Nick’s full support. He was even known to write professional recommendations for staff, when asked. He wanted everyone to grow and achieve the greatness he saw in them. We learned by his example that even the smallest gesture could have significant meaning. Shift changes were always entertaining when Nick was around. He would lighten the mood the moment he entered the office with his Thermos and bright blue running shoes. None of us ever saw him angry or frustrated, even on the worst of days. It was impossible to walk through our department without passing Nick, who sat at an oversized desk in the center of the office, as if he were holding

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court. He was always available and willing to talk about whatever was on our minds, and somehow he always had the answer. Nick always knew just what to do and just what to say, and he said it perfectly. Even the very best of words cannot pay tribute to or truly capture the loss we feel. Nick is irreplaceable. He represented the best in all of us. By example, he taught us to be kind. He taught us to be thoughtful. He taught us that our time on this earth is best invested in service to others and that it is an honor to give that service. He truly brought out the best in everyone. As medical providers, we see death every day. But when it occurs so close to home, it has a way of changing everything we’ve grown to believe. The Hospitalist Service is a family, and Nick was our brother. He was our leader who never judged— instead, he inspired us. He lived what we all strive to be as providers: compassionate, funny, warm, selfless, calm and level-headed. He could bring humor to almost any situation, especially at the end of a stressful day. Our time with Nick was too short, but all of our lives are better for having had him in them. Sentara Martha Jefferson lost one of the best people ever to walk our hospital campus. It is now up to each of us to carry on his legacy of kindness, goodness and service. Nick, we will miss you every day. Our time with you was our

privilege, and we will strive to honor your memory with the example you set for each of us. Fly high, my friend. Caroline Brand, NP, on behalf of the Hospitalist Service

And when great souls die, after a period peace blooms, slowly and always irregularly. Spaces fill with a kind of soothing electric vibration. Our senses, restored, never to be the same, whisper to us. They existed. They existed. We can be. Be and be better. For they existed. —Maya Angelou

Sentara Martha Jefferson Hospital honors all team members we have loved and lost.

ON-CALL ADVICE

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

What is Seasonal

Affective Disorder? Seasonal Affective Disorder (SAD), also known as the “winter blues,” is a type of seasonal depression that occurs at about the same time each year. Symptoms typically start in the fall and continue through the winter months, due to less sunlight and shorter days. However, SAD also can occur in the spring or early summer months. Symptoms of SAD tend to be mild at first, but can become more severe as the seasons progress. Individuals experiencing SAD may notice that they: • feel sad or depressed most of the day • feel sluggish or irritable • have lost interest in activities they once enjoyed • have low energy and trouble sleeping • have experienced changes in appetite or weight • have difficulty concentrating • have withdrawn from social interactions SAD is extremely common, with more than 3 million cases per year in the United States, and can last several months or years. Occurring more often in

women than in men and typically beginning in young adulthood, SAD is experienced more often by those living in northern areas, due to shorter winter daylight hours. The condition can run in families and is more common in people who have experienced other mental illnesses. If you are experiencing any of the common symptoms of SAD, see a healthcare provider to discuss treatment options and get evaluated for other potential underlying issues. Treatments for SAD vary greatly, and you may need a combination of treatments to get the best results. Your healthcare provider will be able to discuss which treatments are best for you. A few common remedies include:

• Light therapy: Keeping your house well lit and sitting closer to bright windows at home and work can help. • Talk therapy • Medication • Vitamin D: You can increase vitamin D levels in the body via exposure to natural sunlight or through a supplement. • Meditation • Yoga • Practicing music or art therapy Not much research has been conducted to determine whether SAD is preventable. However, if you find a solution that works for your symptoms, starting those therapies or treatments before the beginning of the fall season might help reduce the overall effects of SAD. sentara.com

ON- C ALL A DVICE

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

What is Nonalcoholic

Fatty Liver Disease?

Nonalcoholic fatty liver disease (NAFLD), a condition in which the liver has become fatty without an excessive intake of alcohol, is now the most common chronic form of liver disease. Fatty liver develops when your body produces too much fat or doesn’t metabolize fat efficiently, causing an accumulation over time. In people who don’t drink an excess of alcohol, the cause of NAFLD isn’t totally clear. However, there are a few known risk factors for the disease: • Being overweight and obese • Type 2 diabetes • High cholesterol and triglycerides • Polycystic ovary syndrome • Sleep apnea • Certain genes To diagnose fatty liver, your doctor will review your medical history, perform an exam, run lab work on your liver enzymes, and conduct an ultrasound or computed tomography (CT) scan. NAFLD is sometimes called a “silent” liver disease, since many people who have it don’t experience any noticeable effects. However, symptoms may include:

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Abdominal pain Yellow skin and eyes Mental confusion Fatigue Weakness Nausea, weight loss or loss of appetite • Swelling in the abdomen and legs When NAFLD goes unchecked, it can lead to cirrhosis of the liver, and then liver failure or liver cancer. The condition does tend to worsen over time, so if you are diagnosed with NAFLD, be sure to follow your doctor’s treatment plan, which can help reverse the effects of the disease. The best way to avoid or reverse NAFLD is to maintain a healthy weight, limit alcohol consumption, exercise regularly and properly take any prescribed medications. • • • • • •

When you meet with your healthcare provider to discuss NAFLD, here are a few important questions to ask: • How much damage has my liver suffered? • How long will it take to reverse the liver damage? • Can you connect me with a nutritionist to learn more about eating healthy? • What is a healthy weight for me? • Based on my lifestyle and medications, do you see anything that is contributing to fatty liver disease? • What signs and symptoms of complications should I watch out for? If you are diagnosed with NAFLD, be sure to take it seriously. Modest weight loss, regular exercise and a healthy diet can help your liver function efficiently and effectively.

IMPROVE HEALTH EVERY DAY

THREE REASONS TO

GET OUTDOORS For many of us, screen time and indoor activities drastically interfere with our time outdoors. However, the documented physical and mental health benefits of being outdoors provide compelling reasons to head outside. Here's why:

Spending time outside also lowers levels of the stress hormone cortisol. A University of Michigan study asked participants to “take a nature pill” by going outside 10 minutes or more at least three times a week. Cortisol levels were measured before and after spending time outside. The data revealed that a 20-minute nature experience was enough to reduce cortisol levels significantly.

1 Improves cardiovascular health and immunity

3 Boosts concentration and creativity

Being outdoors lends itself to exercising, improving your heart health, weight, blood pressure, and even cholesterol levels. While you're outside, your body makes vitamin D when your skin is exposed to the sun, which: • Fights off invading bacteria and viruses • Strengthens bones • Helps your nerves carry messages between your brain and body

Being outdoors calms our brain, reducing our frenetic pace and slowing our minds. We can get a fresh perspective if we take a step away from our indoor lives and let the sun, sights and smells seep in. The great outdoors can improve your health mentally and physically. Just step outside and enjoy all that Mother Nature offers.

2 Reduces stress and improves mood Exposure to sunlight boosts serotonin, which helps to regulate our mood naturally, making us feel calmer and happier.

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I M PROVE HEA LTH EVE RY DAY

What to Expect at Your First Mammogram Mammograms are the most effective screening tool available for the early detection of many types of breast cancer. While the process is simple and fast, some can have anxiety around getting their screening, especially if it’s their first. What happens during a mammogram? The mammography technologist will review your history, explain the exam, and answer any questions you might have. They may place adhesive markers on your nipples, scars, and moles to identify these areas on the images. Your technician will position your breast by lifting breast tissue onto the machine and lowering a plastic compression paddle. You will need to stay still for a few seconds during the imaging process.

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Compression, slightly uncomfortable yet necessary, spreads out the breast tissue and reduces overlapping tissue areas, allowing the radiologist to "see through" areas of dense tissue. Two views of each breast are taken, and the whole process takes 15-20 minutes. Mammograms are a vital tool in keeping you healthy. Speak with your provider if you have concerns about receiving a mammogram. Here are a few tips to improve your mammogram experience:

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Try not to schedule your appointment for the week before your period to avoid tender and swollen breasts.

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Let the technologist know if you have breast implants because they will have to take additional images.

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Don't use anything on your underarms the day of your appointment. The ingredients can appear in the images.

The Importance of Stretching in Cold Weather

Alcohol Overuse Can Lead to“Holiday Heart” and Other Cardiac Issues Holiday celebrations often bring people together. These gatherings sometimes lead to higher alcohol consumption—whether due to the happiness we experience at an office party or from seeing out-of-town relatives, or to the stress that can result from these interactions. This increase in alcohol consumption is not without risks, particularly to the heart, so we should all use caution as we navigate this holiday season. "Holiday Heart" is a term used to describe a spike in arrhythmias that occur around weekends and holidays associated with binge drinking. Research has found a 15 percent increase in heart attack risk during these same periods. It has been found that the risks of alcohol consumption on heart conditions are not limited to rhythm disturbances, but include risk of plaque rupture, heart attack, and by extension, the possibility of heart failure. There is a risk of heart failure itself — in the absence of prior heart attack — that can be brought about by excessive alcohol intake. While this is most often associated with prolonged high alcohol intake (excessive daily drinking), it can also be induced by episodes of bingeing, leading to acute heart failure and hospitalization. In summary, alcohol consumption during stressful times increases the risk of cardiac issues and events. Alcohol consumption is best kept at moderate levels to minimize risk. So, if you want to toast the holidays, do so—but with common sense and caution.

Stretching before and after exercise, no matter the time of year, is very beneficial. During the colder months, because your muscles contract to conserve heat, stretching can help to increase flexibility and range of motion to keep you limber. Before you go out for your walk or run, practice some dynamic stretches to get the blood flowing to your muscles. However, never stretch to the point of pain. Dynamic stretches include:

• • • • •

Arm Circles Shoulder Rolls Hip Circles Leg pendulums (swinging each leg back and forth or side-to-side 10-12 times) Lunges, or walking lunges, with a twist

After exercising, static stretching can help decrease your heart rate and allow your body to cool down. Hold each stretch 60-90 seconds while breathing comfortably. Whether before or after exercise, stretching should be controlled movement, so don’t bounce, which could cause injury.

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EAT WELL , LIVE WELL

Fall Flavor PROFILES

By Patricia Tyndale, RD Sentara Martha Jefferson Hospital

hen we think of fall, what often comes to mind is the start of a new school year, cooler temperatures and the changing of the leaves. But what about the food? Not the all-things-pumpkin-spice craze, but the layering of flavors that fall brings. My favorite foods for this time of year include sweet potatoes, Brussels sprouts, beets, squash, pears and apples mixed with the smell of sage, rosemary, cinnamon and nutmeg. So many tastes come to mind in the fall that are sweet, tart and even savory. Let’s take a closer look at some of the flavors that make fall such a welcoming time of year.

Vegetables There are many creative ways to use fall vegetables in cooking. Don’t get me wrong—decorating with pumpkins in the fall is fun, but I also enjoy making pumpkin soup with added spices or roasting the seeds after carving Halloween pumpkins. I also enjoy beets at this time of year, although they can be an intimidating root vegetable for some. Many people opt for canned or jarred beets because they are unsure of how to cook fresh beets. Simply roasting them in the oven and adding them to your favorite cold dish or salad is simple, flavorful and very healthy. The parsnip is another vegetable I find is not used very often, due to its intimidation factor. Parsnips can be roasted whole or pureed to bring out their natural sweet flavor, making them a great fall side dish.

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Fruits Who doesn’t love a delicious apple pie or fruit crisp this time of year? With the addition of rhubarb or fresh cranberries, any dish can be made into a perfect dessert or a nice treat over the holidays. Some of my favorite fruit dishes include figs and pears, both of which bring out the sweet flavors of fall.

Spices Although nutmeg and cinnamon can be used year-round, their scents are reminiscent of what I enjoy most about fall flavors. Both spices go great in oatmeal, hot cocoa and many fall soups. Have you ever made a soup dish and wondered if something was missing? I certainly have, and I find this problem easy to fix just by opening the spice cabinet and trying different flavor

combinations. Other spices I enjoy include cumin, curry, cloves and ginger.

Herbs While salt remains the most common way people add flavor to foods, it’s not always the healthiest. Herbs are a wonderful way to add interest without the salt, and fall is a great time of year for herbs. Some herbs I use in fall include sage, rosemary, parsley and mint. I tend to use fresh herbs for many dishes. However, dried herbs, although more potent, are a great backup for flavoring vegetables and meats when fresh herbs aren’t available. Herbs also provide great texture. I enjoy adding thinly sliced sage leaves to chicken or adding a bunch of thyme (stems included) to many of my soup and stew recipes.

Perfect Pairings Here are some easy ways to pair foods for great fall flavors: • Add nutmeg and cinnamon to sweet potatoes or soup. • Brussels sprouts, cranberries, pecans and butternut squash make wonderful weeknight or holiday sides. • Make a salad with beets and goat cheese for great texture and flavor. • Add nuts such as pecans, pistachios or walnuts to any dish for a nice crunch. • Sauteed kale or beet greens are a great side dish for any fall-inspired meal. • Bake apples and rhubarb together for a great sweet-tart combination.

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EAT WELL, LIVE WELL

What Is It About Fall?

Pumpkin spice has its place in many drinks and foods, but it isn’t the only flavor that reminds me of this time of year. I particularly enjoy how fall foods, herbs and spices taste when combined for better textures, flavors and smells. I enjoy the balance that arises when pairing spicy and savory foods or salty and sweet combinations. One of the biggest reasons people don’t experiment with many vegetables, herbs and spices is that they don’t know how to prepare or pair foods in the right way. Roasting any vegetable with herbs brings out its depth of flavor, and adding different spices can elevate any soup dish. The best thing about exploring different flavors is that you can find new and exciting ways to make healthy foods taste great. Try the accompanying recipes to further explore the delicious tastes of fall!

Roasted Beet, Goat Cheese and Fennel Salad Ingredients 2 large beets ½ teaspoon salt, divided ½ teaspoon ground black pepper, divided 2 medium fennel bulbs, cored and very thinly sliced 8 cups torn butterhead (Boston or bibb) lettuce ¼ cup chopped walnuts, toasted 4 ounces crumbled goat cheese 2 tablespoons snipped fresh chives Lemon Vinaigrette 3 tablespoons lemon juice 1 tablespoon finely chopped shallot 1½ teaspoons Dijon-style mustard ½ teaspoon finely grated lemon zest ½ teaspoon honey 1/3 cup olive oil

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Directions Step 1: Preheat oven to 400 degrees F (200 degrees C). Directions Step 1: Preheat oven to 400 degrees F. Step 2: Prepare the lemon vinaigrette. In a medium bowl, whisk together lemon juice, shallot, mustard, lemon zest and honey. In a steady stream, slowly whisk in 1/3 cup olive oil. Makes 2/3 cup. Step 3: Scrub the beets. Wrap each beet in foil and place on a baking sheet. Bake 1½ hours or until a knife can be easily inserted into the beets. Cool 20 minutes or until able to handle. Remove and discard foil. Trim off stem and root ends of roasted beets. Peel and cut into 1-inch pieces. Step 4: In a medium bowl, combine beets, ¼ teaspoon salt, ¼ teaspoon pepper and 3 tablespoons of the vinaigrette. Step 5: In another medium bowl, combine fennel, ¼ teaspoon salt, ¼ teaspoon pepper and 3 tablespoons of the vinaigrette. Step 6: Line eight salad plates with lettuce and drizzle with remaining vinaigrette. Layer with beets, walnuts, fennel, goat cheese and chives.

Roasted Acorn Squash Soup Ingredients 2 acorn squash, halved and seeded Water, as needed 3 tablespoons unsalted butter 1 large sweet onion, chopped 1 large carrot, peeled and chopped 1 clove garlic, minced 3½ cups low-sodium chicken stock ¼ cup half-and-half ½ teaspoon ground nutmeg ½ teaspoon ground cinnamon 1 pinch salt and ground black pepper to taste

Step 2: Put squash, cut side down, into a baking dish. Pour enough water into the baking dish to cover the bottom. Step 3: Bake in preheated oven until the flesh of the squash is easily pricked with a fork, about 45 minutes. Remove from oven and allow to cool until squash can be handled. Scoop flesh into a bowl and set aside. Step 4: Melt butter in a pot over medium-high heat. Cook onion, carrot and garlic in melted butter until soft, 5-7 minutes. Pour chicken stock into the pot and add the squash. Step 5: Bring the mixture to a simmer and cook for 20 minutes. Step 6: Pour mixture into a blender, no more than half full. Cover and hold lid down; pulse a few times before leaving on to blend. Puree in batches until smooth, then return to pot. Step 7: Stir half-and-half, nutmeg and cinnamon through the blended soup; season with salt and pepper. Thin the soup with water, if desired. Recipes supplied by Allrecipes.com

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Sentara Martha Jefferson Hospital is pleased to provide a variety of health education opportunities to community members. Highlights of the winter 2021/2022 offerings are listed below. A full list of classes, support groups and seminars can be found by visiting Sentara.com or calling 1-800-SENTARA (1-800-736-8272).

About Bariatric Surgery: An Information Session for Those Seeking Lifelong Weight Management Nov. 18, Jan. 27, March 24, 1-3 p.m. This free seminar discusses specific types of bariatric surgery and whether those options might be right for you. In-person seminars will be held on the dates above in the Kessler Conference Room, Sentara Martha Jefferson Outpatient Care Center. COVID-19 safety precautions will be observed. A free online seminar is also available at Sentara.com/weightlosssurgery.

Advance Care Planning Assistance If you desire assistance completing your advance care plan, please call 434-654-8407. We can answer your questions and assist you via telephone or Zoom.

VIRTUAL SUPPORT GROUP: Out of the Blues—Postpartum Support Meets the second and fourth Thursdays of each month, 10:30 a.m.-noon.

Details on Sentara.com. Call Tiffany Townsend, BSN, RN, at 434-654-8338 to obtain the Sentara Martha Jefferson Joint Camp video link.

Even if this is not your first baby, sometimes the work of caring for your family can be overwhelming and bring unexpected stress, worry and sadness. If you need a place to talk, we are here for you. Feel free to bring your baby and connect with others who may be experiencing similar challenges. For more information, or to be added to the email list to receive a link to join, call 434-654-4415.

VIRTUAL CLASS: Preparation for Childbirth

VIRTUAL SUPPORT GROUP: Empty Arms, Full Hearts

* Call 1-800-SENTARA or visit SentaraMJHMaternity.com for dates and times. Classes are conducted by a certified childbirth instructor, and topics include understanding and managing the different stages of labor through relaxation, labor positions and breathing techniques, medication options, and Caesarean birth. Early registration is encouraged!

Held the third Thursday of each month, 7-8:30 p.m. For parents of deceased infants; find space and time to share with other parents who are going through the same experiences. Currently meeting by Zoom. To request the meeting link, please contact Tammy James at 434-654-5597.

Joint Camp: A Complete Guide to Preparing for Knee and Hip Surgery

Registration for all classes is required unless otherwise noted. To register, call 1-800-SENTARA.

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VIRTUAL Cancer Support Groups Various cancer support groups are offered: • Coping with Breast Cancer • Living with Cancer (for new patients) • Establishing a New Normal (cancer survivorship) Please contact Tammy James at 434-654-5597 to explore which group best fits your needs.

Sentara Star Hill Health Center A Free Wellness Center Focused on Chronic Disease Prevention and Management located at the Jefferson School City Center, 233 4th St. NW, second floor, Charlottesville Currently, because of the COVID-19 pandemic, we are not holding our drop-in sessions, but we are seeing patients and offering the community the opportunity to schedule appointments to have their blood pressure, blood sugar and weight checked. We are also conducting virtual group sessions and virtual cooking classes, and connecting community members to resources and services that provide mental and physical wellness. All services are free and open to the public. For information or to schedule an appointment, call 434-984-6220.

Sentara Martha Jefferson offers a variety of other classes and seminars, including the following: Basics in Baby Care Breastfeeding Welcome to Motherhood Support Group (virtual) Parenting Support Group for Survival (virtual) Most classes are free. For a complete list of classes, support groups and seminars at Sentara Martha Jefferson Hospital, please visit www.sentara.com.

Registration for all classes is required unless otherwise noted. To register, call 1-800-SENTARA (1-800-736-8272).

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orthopedics and

SPORTS MEDICINE

Making a Comeback

Many people will experience musculoskeletal injury or pain at some point in their lives. The team of specialists at Sentara Martha Jefferson Orthopedics and Sports Medicine treats a wide variety of patients— from high-performance athletes to people who just like to go for walks around the block. Whether you have a sports injury, chronic arthritis or another condition, numerous treatment options are available, from physical therapy to the latest surgical techniques. sentara.com

Persistence Pays Off Hard work and a successful surgery

helped Orange County High School basketball player Joseph “JJ” MacDonald come back from a recent knee injury. The point guard/shooting guard was playing with a friend in early December 2020, getting ready for his upcoming season. He warmed up and stretched before playing and was feeling great after a few games, but at one point, after dunking a ball and landing hard, he could feel his knee twisting and dislocating. “I heard a weird little snap in my knee,” he recalls. He didn’t think it was anything serious, however, because he wasn’t in much pain. His friend helped him get up, and he walked to the car on his own. MacDonald’s coach recommended that he see Matthew J. Panzarella, MD, an

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orthopedic surgeon at Sentara Martha Jefferson Orthopedics and Sports Medicine in Charlottesville. After an examination, Dr. Panzarella told MacDonald he had torn his anterior cruciate ligament (ACL), the band that connects the thighbone to the shinbone. The snap he’d felt is a telltale sign of an ACL tear. He had also torn his meniscus, a piece of cartilage between the shin bone and thigh bone that acts like a shock absorber for the knee. MacDonald, 17, had outpatient surgery just eight days after his first appointment. Dr. Panzarella used small incisions to access the knee, replacing the torn ligament with tendon from another part of MacDonald’s knee. “The surgery went great,” MacDonald says. “The doctors and nurses at Sentara Martha Jefferson were amazing. It was the best experience I could’ve had.” A few weeks after surgery, MacDonald started physical therapy with Orange County athletic trainer Jenna Fincham. Persistence paid off when it came to rehab. “I had to retrain all those muscles, and it was a lot of work to get there—but I feel amazing,” MacDonald says. “My knee is really strong.” The professionalism of the sports medicine team at Sentara Martha Jefferson impressed MacDonald’s mother, Nicole Hartzfeld. Whenever the family or Fincham had questions, they could contact Dr. Panzarella or Sentara Martha Jefferson athletic trainer John J. Walker. “They often would get an answer for us within minutes,” Hartzfeld says. After getting cleared to play basketball again in late June, MacDonald is looking forward to

his upcoming senior season. “I’m absolutely expecting to be ready,” he says, noting that the time off and the perseverance required for his recovery have sharpened him mentally. “I know how far I’ve come. To any athlete or nonathlete going through an injury like this, I would say: Keep pushing, stay levelheaded and try not to get overwhelmed. At Sentara Martha Jefferson, they’re going to take care of you and treat you right.” Dr. Panzarella says MacDonald’s tenacity paid off. “He’s a

great kid, and he worked hard. Hopefully he’ll have a long athletic career ahead of him.” MacDonald’s mother agrees. “The surgery went well, and his recovery was faster than we expected. JJ and his entire support team— his surgeon, doctor, trainers, basketball coach and everyone else involved—had such determination,” she says. “We’re grateful and blessed that he’ll be able to push forward and continue his dreams.” sentara.com

Grateful and Amazed Julie Pate loves to run. The

mom of two has competed in multiple half-marathons and one full marathon. Staying healthy is important to her because she wants to avoid diabetes and other conditions that run in her family. However, running eventually took a toll on her body. “Being a runner has been part of my identity for the past decade,” says Pate, 42. “I spent so much time running and never took a break. I didn’t listen to my body.” In late 2020, she started feeling soreness in her right hip when walking up and down stairs and when sitting in a car. She tried massages but couldn’t find relief. Then one day she had trouble walking back to her car after what should have been an easy run, and she knew she needed help. Tests at Sentara RMH near her home in Harrisonburg showed a problem in her hip: a tear in her labrum, which is a ring of cartilage that surrounds the hip socket, cushioning the hip and providing stability. Pate also had a hip impingement, a condition in which the ball of the hip pinches against the cup of the hip. Doctors at Sentara RMH recommended that Pate see Dr. Panzarella. “It was a Friday,” she recalls. ”Dr. Panzarella called me himself that evening and had me booked for an appointment on Monday morning.” Pate appreciated that Dr. Panzarella also serves as a team doctor for area schools. “I loved that he works with sports teams and treats athletes,” she says. “Even though

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I’m a mom, he was looking at me as another one of his athletes.” Several weeks later, Dr. Panzarella performed a hip arthroscopy (also known as a hip scope), a minimally invasive outpatient procedure that can be used to treat an impingement, torn labrum and other hip conditions. Dr. Panzarella used a small camera to see inside the hip joint, and special surgical instruments to perform the procedure. Initially, Pate wasn’t even sure she would go through with the surgery—she was worried about recovery and didn’t want to be inactive for a long time. From the perspective of an athletic trainer, Walker spoke with her about the pros and cons of surgery. “He was amazing,” Pate says. “I had a million questions, and he talked with me for about an hour. I went from being in tears to laughing and feeling happy—and seeing the benefits of surgery.” Pate used crutches for eight weeks after surgery (sharing the experience along with her husband, Josh who has cerebral palsy). She also spent three months working with a physical therapist and a personal trainer to work on her upper-body strength. Recovery was challenging mentally, emotionally and physically, but her support system of family and friends helped her get through it. She asked friends to send her inspirational

Bible verses so she could read them during low moments. “I would tell anyone that has to go through this to make sure you have support,” she says. “The best part of it for me was having a strong support group. My husband, kids, friends, trainers, physical therapists—everyone had encouraging words for me.” In September—just eight months after her procedure—Pate ran a half-marathon. She now alternates her exercise time between running and SPORTS MEDICINE strength training, and DOCTORS is thankful for the healthcare providers The orthopedic specialists who helped her get at Sentara Martha Jefferson back to doing what Orthopedics and Sports she loves. “All the Medicine treat athletes— staff made me feel and anyone else—with so at ease—from musculoskeletal injuries the nurses to the or issues. anesthesiologists,” Sentara Martha Jefferson she says. “Every single Orthopedics and person I encountered Sports Medicine Locations at Pantops during the process and Proffit Road added value, and Phone: 434-654-5575 I’m just so grateful for that.” sentara.com

Surviving and Thriving After

CANCER SURGERY Surgery is often the best option for treating many types of cancer, and in some cases can completely remove a patient’s cancer. Many patients also benefit from chemotherapy and radiation before and/ or after surgery. Whatever the specific diagnosis may be, the cancer team at Sentara Martha Jefferson Hospital works tirelessly to provide expert treatment in a caring environment. ‘Out of This World’ Care When Patricia Gore started feeling a little tired in the fall of 2015, she assumed it was just a part of getting older. Luckily, Gore, now 80, had an appointment scheduled with her primary care provider the day after her symptoms began. To help pinpoint the problem, Lindsay D. Friesen, MD, at Sentara Blue Ridge Internal Medicine, ordered blood work, which showed that Gore was extremely anemic. A colonoscopy the next day revealed she had stage 4 colon cancer. Anemia, which occurs due to a low red blood cell count, is a symptom of colon cancer. Tumors in the colorectal tract often bleed, and this blood loss can lead to anemia. However, many people with colon cancer don’t even notice such blood loss because their stools look normal. Although Gore had been getting regular screenings, her colon cancer had developed at some point after her previous exam. “Dr. Friesen saved my life with that blood work,” Gore says. 24 |

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Patricia and her husband, Earl, live in Spring Creek in Louisa County. When the couple moved back to the Charlottesville area from Houston, Texas, they chose Sentara Martha Jefferson for its caring staff, convenient location and beautiful facilities. A few weeks after the colonoscopy, colorectal surgeon Zachary A. Gregg, MD, removed a 1-foot section of Gore’s colon. Although he was able to perform part of the surgery using laparoscopy, which allowed him to operate without making large incisions, he ultimately used a traditional open procedure to remove the cancer. “The tumor was big and inflamed, and it was stuck to her abdominal wall, so we had to make sure we could remove everything well and safely,” Dr. Gregg says.

Gore started chemotherapy after her colon surgery, but her cancer markers increased. Hematologist Jefferson “Mark” Pritchard, MD, then ordered a scan, which showed the cancer had spread to Gore’s liver. Surgeon Nicholas A. Spinelli, MD,

Colon Cancer Screening A screening test can find precancerous polyps and also can catch cancer early, when it’s easier to treat. Follow these colon cancer screening guidelines: • Everyone should get regular colorectal cancer screenings between ages 45 and 75. • If you’re over 75, ask your doctor if you need a screening. • If you have certain risk factors, you may need screening before age 45. Source: Centers for Disease Control and Prevention

performed another surgery to remove the liver tumor. “The doctors did a wonderful job,” Gore says. “I wrote them thank-you notes because I thought they were so good. They were such caring doctors.” After the surgeries, Gore underwent 18 months of chemotherapy, first through infusion and later in pill form. “I had a really great caretaker,” she says of Earl. “He was the world’s best helper when I couldn’t do anything but lie on the sofa during chemo.” “The chemotherapy was strong stuff,” she adds, “but I’m a positive person—and so far, so good.” Gore now gets regular checkups every six months, and her cancer markers remain very low. “With colon cancer—even with metastatic disease—there is still a possibility of a cure,” notes Dr. Gregg. “If there is a low tumor burden and it has only spread to minimal sites outside the colon, those areas can be removed. With a combination of removal and chemotherapy, we can get cures.” Although Gore gave up tennis following a recent knee replacement, she is planning to take up pickleball soon. She also takes regular walks around her neighborhood and enjoys spending time with her three sons and their families. She recently enjoyed a trip with 21 family members to the Outer Banks, where she walked three to four miles on the beach most days. “It was fabulous, and I’m so thankful I can still do that,” she says. She’s also thankful for the team of doctors, nurses and other providers who cared for her throughout her treatment. “My nurses were out of this world,” she says, “and I’m very grateful to my doctors for doing such a good job.” sentara.com

Doctors Dedicated ‘Beyond the Call of Duty’ When he was in his 50s, Steve Burrill started having trouble burping. While he felt the urge to belch, he could not expel the air. He wasn’t surprised because his father had a similar problem around the same age. But the problem kept getting worse. Over the years, swallowing became difficult, and a prescription antacid didn’t help. In late February 2021, tests revealed that Burrill, 60, had stage 2a esophageal cancer. Fortunately, the cancer was discovered before it reached beyond Burrill’s esophagus, which is the tube that connects the throat to the stomach. The standard treatment for esophageal cancer is chemotherapy and radiation, followed by surgery. The plan was for Burrill to have six weeks of chemotherapy and 28 days of radiation at Sentara Martha Jefferson. However, he developed fevers as a reaction to the treatment, and his final week

of chemo was canceled. Nevertheless, treatment had shrunk the tumor considerably. During one fever episode, Burrill and his wife, Virginia, went to the Outpatient Care Center at Proffit Road, north of Charlottesville. The Burrills moved to Louisa County more than 20 years ago and plan to stay there, due to its proximity to Sentara Martha Jefferson facilities. “I’m always so impressed with the care at Sentara Martha Jefferson,” Burrill says. “Even the professional care I received at the satellite emergency room reassured us that we made the right decision.”

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After a period of rest to allow Burrill’s body to recover from the chemo and radiation, thoracic surgeon Christopher D. Willms, MD, performed an esophagectomy in June to remove the middle and lower sections of Burrill’s esophagus and the top portion of his stomach. He also removed nearby lymph nodes. Dr. Willms then stretched part of Burrill’s stomach to create a new tube and connected it to the remaining portion of the esophagus. The procedure was performed using minimally invasive techniques that can help reduce pain and speed recovery.

During the surgery, Dr. Willms was able to see into Burrill’s chest cavity using a small camera inserted between the ribs. Not every hospital offers a minimally invasive approach for esophageal cancer, Dr. Willms explains. “Most people do incredibly well with this approach,” he says. “Our numbers are better than the national average for prognosis after treatment. We have a good team taking care of them and low complication rates.” Nationwide, the average length of a hospital stay after esophageal cancer surgery is 12-14 days, but Sentara Martha Jefferson’s average is only about eight days. “Dr. Willms spent an hour with us at the first appointment and walked us through all the milestones. He took his time to explain everything,” Burrill says. “They take cancer seriously at Sentara Martha Jefferson. They knew we were scared and

took the time to explain it to our satisfaction and comfort. My wife said it felt like I was Dr. Willms’ favorite patient during the whole process.” Burrill spent eight days in the hospital following surgery, including two days in the Intensive Care Unit, where he was up and walking a little on the first day. Tests confirmed that Dr. Willms had successfully removed all of the cancer. Burrill’s hematologist/oncologist, James E. Boyer, MD, recommended that Burrill follow up surgery with a year of immunotherapy with the drug nivolumab. After several years of use in treating lung cancer, melanoma and several other cancers, nivolumab was approved for use in treating esophageal cancer by the U.S. Food and Drug Administration in May 2021. In fact, Burrill was the first patient with esophageal cancer to get the newly

approved treatment at Sentara Martha Jefferson. It was a happy Fourth of July for the entire family, with Burrill home and feeling better in time to celebrate with his son’s family, who had flown in from California. He now walks about 2,000 steps a day and hopes to increase his steps and add in weightlifting soon. While Burrill currently has to eat six small meals a day and can’t drink fluids with his meals, Dr. Willms expects him to be back to a near-normal diet soon. Burrill and his wife are now planning a camping trip, during which he’ll spend time walking his dog, fishing and resting before he returns to work. A retired U.S. Army warrant officer who now works for the Marine Corps Systems Command at Marine Corps Base Quantico, Burrill says the doctors at Sentara Martha Jefferson are “dedicated beyond the call of duty.” “I think I went to the right place,” he adds.

Contact Us Call us for more information about cancer care at Sentara Martha Jefferson Hospital: 434-654-7009 1-888-652-6663 (toll-free)

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Returning

Stroke

Patients to the 28 |

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Rhythm of

At Sentara Martha Jefferson, our nationally recognized experts in the hospital’s stroke program specialize in using minimally invasive techniques to provide the best treatment possible. Thanks to new developments in stroke care, many patients now can recover fully and return to the lives they love. After Stroke, a New Chapter of ’Amazing Experiences’

Life

A lifelong musician who played professionally for many years, Rick Eldridge is back to doing music gigs after suffering two separate strokes. In July 2020, Rick, 63, and his wife, Anita, moved from Northern Virginia to Harrisonburg. Two days after the move, Anita noticed a change in Rick when he woke from an evening nap. Knowing the signs of stroke from spending years working with her mother at a caregiver facility, Anita acted quickly to evaluate her husband’s condition. “I went through the stroke protocol with him, and he failed it,” Anita says. “Within two minutes, I called 911.” At the time, Rick could walk and wasn’t in any pain, but he couldn’t communicate with Anita. “When you ask simple questions and the patient can’t answer, you know something is going on in the communication part of the brain,” Anita says. Rick had suffered an ischemic stroke due to a blood clot that was blocking an artery in his brain. An ambulance took him to Sentara RMH, where he was given a clot-busting medication, and he was then transferred to Sentara Martha Jefferson Hospital for further treatment. The two sister hospitals regularly and carefully coordinate care for stroke patients, and anyone who needs a neurointervention procedure is transported to Sentara Martha Jefferson. John R. Gaughen, MD, a neurointerventionalist at Sentara Martha Jefferson, performed a mechanical thrombectomy, a minimally invasive procedure during which instruments are guided into a blocked artery to remove a clot. A newer treatment option, thrombectomy can be offered up to 24 hours after the onset of a stroke and has a higher success rate than medication. “We’ve seen enormous improvements with thrombectomy in patients who suffer ischemic stroke,” says Dr. Gaughen, the hospital’s

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Rick Eldridge

director of neurointerventional surgery. “With more aggressive treatment, many patients like Mr. Eldridge get better.” Rick was up and playing the piano in the hospital lobby within just 24 hours. Several months later, however, a second stroke affected his ability to play music and perform mentally intensive work. At that point Rick decided to retire from his work as an insurance agent and focus on rehabilitation, including speech therapy and strengthening his right arm. “I can’t play strong and quick like I used to, but it’s a whole lot better than before,” says Rick. “After the second stroke, at first I couldn’t play at all. As a lifelong piano player, that was devastating—but I worked at it, and it’s gotten a lot better.” Before the stroke, Rick knew thousands of songs by heart. Now he can remember the tunes, but not all of the song names or lyrics—though his recall tends to improve, the more he plays. Rick and Anita soon hope to set off in their specially outfitted van and travel coast to coast, visiting friends and family and performing music along the way. “We have a bucket list of places we want to perform in every state,” Anita says. “We’re going to take our dog with us and accumulate some amazing experiences.”

A ‘Shockingly Positive Recovery’ Emily Gary woke up feeling sick one morning in early

July 2021. She couldn’t stop vomiting and thought she might have food poisoning or a stomach bug. Her son decided to stay home from work and take his mother to the Emergency Department at Sentara Martha Jefferson.

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After a CT scan showed Gary, 54, had suffered a hemorrhagic stroke caused by an aneurysm, she was sent to the hospital’s Intensive Care Unit (ICU). Hemorrhagic strokes due to brain aneurysms are rare and incredibly complex to treat, according to Dr. Gaughen. These types of strokes occur when an artery inside the brain leaks blood or breaks open, which in turn puts pressure on brain cells. Dr. Gaughen treated Gary with a newer technique known as flow diversion. During this endovascular procedure, the surgeon places a tiny stent inside the blood vessel feeding the aneurysm. This diverts the blood flow away from the aneurysm, which then shrivels up and goes away. Flow diversion is safer than other treatments that involve going into the aneurysm itself, such as packing the aneurysm with coils or clipping the aneurysm. Gary’s aneurysm was very weak and wouldn’t have responded well to those options, Dr. Gaughen notes. Patients with a hemorrhagic aneurysm require careful monitoring for two to three weeks. This type of neurocritical care and specialized treatment includes determining the right medications, monitoring for seizures and addressing electrolyte imbalances. “Cerebrovascular vasospasm,

Sentara Martha Jefferson Stroke Program Recognized by U.S. News & World Report The U.S. News & World Report 2021-22 Best Hospitals guide recently recognized the neurosciences program at Sentara Martha Jefferson Hospital. The hospital is rated as “high performing” for adult neurology and neurosurgery, meaning it ranks in the top 10% nationally. One of only four institutions in Virginia recognized for adult neurology and neurosurgery, Sentara Martha Jefferson is also ranked as high performing—the highest rating possible—for stroke care.

Types of Stroke

There are three main types of stroke:

or bleeds, are more likely in younger people and women,” Dr. Gaughen says. “We were really concerned about that possibility with Emily, but we were able to treat her condition successfully with medications and fluid management.” Gary remembers little from her 16-day ICU stay, but she knows her three sons were there watching over her. She does remember the care and professionalism of the providers at Sentara Martha Jefferson, including Dr. Gaughen; interventional radiologist Mary E. Jensen, MD; and Genevieve F. Harway, NP. “I never felt like they were rushing away or had something else they had to do,” Gary recalls. “They explained everything, and they would come back and explain it again because they knew I might not remember it the first time. I felt really safe in their hands. They were kind, accessible and skillful.”

Ischemic stroke

• Occurs when there’s a blockage in an artery supplying the brain • Blockage is often caused by blood clots • 87% of all strokes are ischemic

Hemorrhagic stroke

• Occurs when an artery in the brain leaks blood or breaks open, putting too much pressure on brain cells • Causes include aneurysm and high blood pressure • Less common and often harder to treat

Transient ischemic attack

• Also called a mini-stroke • Blood flow is only blocked for a short time • Could be a warning sign for future stroke Source: Centers for Disease Control and Prevention

Emily Gary and sons.

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After transitioning to a regular hospital room for three more days, Gary returned to her home in Batesville. Although she does have some issues with her lower left field of vision, which can happen when the pathway between the eyes and brain is damaged during a stroke, she’s back to going on morning runs, and she recently studied for and passed her licensed clinical social worker exam. She did take time off from her job as a therapist at the Secure Child Program in Charlottesville, but she hopes to return to seeing clients soon.

A bass player and singer in an Americana band called Cry Babies, she also hosts radio station WTJU’s “Something New” program, during which she plays new folk releases. Gary recently went to a friend’s birthday party and had the opportunity to sing. “It felt fairly remarkable to be two months out from an aneurysm and hopping up on stage and singing,” she says. “I’m outrageously lucky. I will always be grateful to my neurointerventionalist team at Sentara Martha Jefferson. It seems like I had a shockingly positive recovery.”

Stroke Successes The high level of stroke treatment available at Sentara Martha Jefferson is uncommon at small hospitals, Dr. Gaughen notes. Success stories like those of Emily Gary and Rick Eldridge make all that extra effort worthwhile. “That visible improvement in patient outcomes is what drives our aggressiveness in building such a strong stroke program at Sentara Martha Jefferson,” Dr. Gaughen says. “To offer a service like this, staff has to be available at all times to treat very sick patients very quickly. There’s a lot of heavy lifting by a lot of dedicated staff members, but it’s also a very rewarding service.”

Get in Touch with Sentara Martha Jefferson Neurosciences At Sentara Martha Jefferson, we offer expert care for stroke, epilepsy, neuromuscular disorders, cerebrovascular disease and spine disorders. Our team includes neurosurgeons, neurointerventional radiologists and neurologists, along with nurses and other healthcare providers, who offer expert treatment in a caring, empathetic environment. To contact us or refer a patient, call 434-654-8960.

BE FAST to Save Brain Cells

With stroke, every second counts—each moment without treatment means lost brain cells.

Know these signs of stroke:

B = Balance Is there a sudden loss of balance?

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E = Eyes

Has the person lost vision in one or both eyes?

F = Face

Does one side of the face droop or look uneven?

A = Arm

S = Speech

T = Time

Is one arm weak or numb?

Is speech slurred or strange?

If you see any of these signs, call 911 immediately!

AGING WELL

Vanquishing

Painful

VARICOSE VEINS

ogether, our veins and arteries make up an intricate, coordinated system that takes blood to and from the heart and lungs. In order to function properly, the valves in our leg veins must work against gravity, moving blood upward to the heart and lungs and keeping blood from traveling down toward the feet. When leg veins suffer damage or change due to age or genetic predisposition, those valves can fail to work correctly, leading to a condition known as venous insufficiency. In such cases, blood pools in the legs, leading to bulging, painful varicose veins. “Gravity is the reason people develop symptoms from varicose veins,” explains Tara Balint, MD, a vascular surgeon at Sentara RMH Medical Center. “When we sit or stand for too long, gravity pulls blood flow toward the feet when the leg veins dilate.” More common in women than in men, varicose veins are often hereditary. However, they also can be caused by pregnancy, weight gain, aging, and frequently standing or sitting for extended periods. “People with varicose veins can experience burning, itching, skin discoloration and leg swelling,” says Lewis Owens, MD, a vascular surgeon with Sentara Martha Jefferson Hospital. “With those types of symptoms, we’ll often

come up with a treatment plan to help alleviate the condition.”

Traffic Jam Leads to Long-Term Vein Issues Vein issues began for Sharon Archer, of Massanutten, Va., back in 2009. During a drive from California to their home in Nevada, Sharon and her husband, Steve, ended up in an eight-hour traffic jam. “The day after we got back, my ankle and leg were so swollen,” recalls Sharon, 69. “We went to the hospital, and it turned out I had a massive blood clot in my left leg that was completely blocking blood vessels.”

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AG I NG WEL L

Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, commonly in the lower leg, thigh or pelvis. The most serious complication of DVT can occur when part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage known as a pulmonary embolism. Thankfully, Sharon’s clot dissolved with medication—but the blockage had caused scarring and damage to the veins in her leg, so they could no longer pump blood efficiently. The pooling blood had led to varicose veins and swelling in her ankles.

Diagnosing Vein Conditions Dr. Balint advises patients to see a vascular specialist if they have pain and swelling that is uncomfortable and disruptive, or if they would like to remove varicose veins for cosmetic reasons. In most cases, varicose veins do not pose a serious health threat. After a physical examination of the affected veins, a specialist can order a venous insufficiency ultrasound exam to determine the extent of the vein damage. “The exam, which takes about an hour on each leg, looks at vein valves and blood flow, as well as how long the valves in the veins stay open,” Dr. Balint says. “Ultimately, the test tells us what kind of treatment plan we should pursue.” Vascular doctors rate vein damage in a classification system called a CEAP (clinical, etiological, anatomical and pathophysiological) score, which ranges on the low end from spider veins, which are broken capillaries on the surface, to severe cases of bleeding skin ulcers caused by chronic venous insufficiency.

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Treating Varicose Veins Home treatments for varicose veins include leg elevation and compression to relieve pressure on the veins, Dr. Balint explains: • Elevation: In this technique, the person lies down on a bed or couch so that the toes are above the nose. However, this is a temporary solution to relieve pain, since blood can begin to pool again upon when the person returns to a standing position. • Compression: Compression stockings for vein issues—which aren’t the same as diabetic compression stockings—exert more compression on the foot, and the compression gradually decreases up the calf. Usually, insurance companies will ask patients to wear compression stockings for a couple of months to see how well they control the problem, according to Dr. Balint. If they don’t provide adequate relief, doctors will look for other causes for the leg pain, such as nerves, muscles, bones and joints. If a vein procedure turns out to be the best course of action, doctors can use minimally invasive techniques, including endovenous ablation and sclerotherapy, or surgical options: • Endovenous ablation: A minimally invasive procedure that uses heat to close veins. “We put a catheter inside the veins, and it releases thermal energy that closes veins from the inside,” explains Dr. Owens. “When the veins close, less blood pools, and blood flow improves.”

Treatment for venous ulcers includes cleaning and applying a dressing to the wound regularly. Patients will need to wear compression socks to improve circulation and speed up healing. Doctors also may prescribe an antibacterial topical ointment and an oral antibiotic to prevent infection. For more information on varicose veins and other vascular concerns, please contact Sentara Martha Jefferson Vascular & Vein Center in Charlottesville at 434-654-1700, or Sentara Vascular Surgery Specialists in Harrisonburg at 540-689-5800.

•

Sclerotherapy: Instead of heat, this minimally invasive technique relies on chemicals to close veins. “We can use a medicine that glues the veins shut, or a foam-type medicine that irritates the inner lining of the veins and causes them to close,” Dr. Owens says. • Surgical solutions: When minimally invasive techniques aren’t effective, doctors can turn to surgical solutions, including vein stripping and phlebectomy. During vein stripping, the surgeon removes the longest vein in the leg, which runs from the foot up the thigh, through small incisions. During a phlebectomy, the surgeon removes veins near the skin’s surface through small incisions. Fortunately, for Sharon, a patient of Dr. Balint, the minimally invasive endovenous ablation and sclerotherapy treatments dealt with her varicose veins successfully. “Almost all of them are gone now,” Sharon notes. “I have one more treatment to go, but I am already back in sandals and am not in pain. My results have been fantastic.”

More Serious Varicose Veins The most severe cases of venous insufficiency can lead to bleeding skin ulcers. When blood pools in the veins of the lower leg, fluid can leak out. Symptoms include: • Dark red, purple, brown, hardened skin • Itching and tingling • Shallow sores with surrounding skin that may be shiny, tight, and warm or hot • Leg pain

Varicose Vein Prevention •

Exercise: Walking 20-30 minutes every

•

Limit sitting and standing:

•

Toe ups and calf stretches: From a

•

Watch your weight: Although weight

day is a great way to prevent varicose veins, since walking engages all vein systems in the leg: deep, superficial and connecting. Walking is an excellent way to improve your blood flow. Wearing compression socks while walking is even more effective. Get up every hour and take a short walk. standing or sitting position, lift your heels to flex your calves. Then lower your feet, plant your heels and raise your toes. gain doesn’t cause varicose veins, it can make the condition worse.

sentara.com

HEALTH MATTERS

FOOT CARE

for People with Diabetes By Julie Pierantoni, MSN, RN, CDCES Sentara RMH Medical Center

ost of us probably take our feet for granted and rarely give them a second thought. For someone with diabetes, however, proper foot care is key to preventing complications, including the possible loss of toes or even the feet themselves. Sustained high blood glucose (over 150) can cause a condition known as neuropathy, which involves nerve and blood vessel damage, especially in the smaller nerves and blood vessels of the feet (and sometimes the hands). Early neuropathy may have no symptoms at all, but later symptoms can include burning, tingling, numbness, foot ulcers and increased sensitivity to touch. Getting an annual foot exam by your medical provider is essential. The provider will check for early nerve damage with a monofilament, which is essentially a stiff piece of fishing line. While you may still have feeling in your feet, the monofilament detects early loss of their protective sensation. For a couple of reasons, people with diabetes are at higher risk of infection, and even minor foot injuries can lead to serious problems. First, germs inside a wound feed on glucose, which tends to be elevated in diabetics. Second, a blood glucose level above 200 paralyzes the white blood cells that defend against infections. To help prevent infections, people with diabetes should keep blood glucose levels below 150 and examine their feet daily for cracks, wounds, redness or blisters. If possible, use a mirror to view the bottom of your feet, or ask a family member to help. As well, since foot callouses can often have hidden damage

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underneath, it’s important to see a podiatrist regularly to keep callouses trimmed. Here are some more tips to help with proper foot care: • Wear well-fitting shoes at all times—even indoors. Look inside and remove any debris before putting them on. • Avoid soaking feet in hot water. Prolonged soaking removes moisture from the skin, increasing the risk of cracks and allowing germs in. Instead, wash feet in warm water, then dry thoroughly. • Keep feet dry, especially between the toes. Avoid using creams between toes, which may cause moisture retention. • Cut toenails straight across. The best time to trim toenails is after a bath or shower, when they are softer. If toenails are thickened or challenging to reach, have a professional trim them. • Avoid “bathroom surgery” (using sharp instruments on toes or feet). Instead, see a podiatrist, who has special tools for care, to have corns, callouses and toenails trimmed. • Pedicures are not recommended for people whose glucose is elevated, or who have neuropathy or poor circulation. • Avoid smoking and excessive alcohol intake. Smoking constricts the blood vessels, which over time decreases blood flow and can lead to poor healing in case of a foot injury. Excessive alcohol intake causes nerve damage and can worsen neuropathy. Keeping your blood glucose at safe levels and talking with your healthcare team regularly—especially if you develop cracks, wounds or redness on your feet— will help prevent foot issues.

LA SALUD IMPORTA

Cuidado de los

PIES para personas con diabetes

odo el mundo quiere conservar los pies «de origen». Para alguien con diabetes, el cuidado de los pies es fundamental para prevenir complicaciones, incluida la posible pérdida de los dedos de los pies o los pies. La glucosa en la sangre alta sostenida (más de 150) puede dañar los nervios y vasos sanguíneos, especialmente los nervios más pequeños y los vasos sanguíneos de los pies (y a veces de las manos). Esta afección se llama neuropatía. La neuropatía temprana puede no presentar síntomas, pero los síntomas posteriores pueden incluir ardor, hormigueo, entumecimiento, aumento de la sensibilidad al tacto y úlceras en los pies. Es esencial que su proveedor médico le realice un examen anual de los pies. El proveedor comprobará si hay daños tempranos en los nervios con un monofilamento (un trozo de hilo de pescar rígido). Si bien es posible que aún pueda «sentir», el monofilamento detecta la pérdida temprana de la sensación protectora de los pies. Una lesión menor puede pasar desapercibida, pero los gérmenes se alimentan de la glucosa y las personas con diabetes tienen un mayor riesgo de infección. La glucosa en la sangre superior a 200 paraliza los glóbulos blancos, que se defienden contra las infec-

ciones, por lo que mantener la glucosa en la sangre a menos de 150 ayuda a prevenir infecciones. Las personas con diabetes deben examinarse los pies diariamente para detectar grietas, heridas, enrojecimiento o ampollas. Use un espejo para verse la planta de los pies o pídale a un familiar que lo examine. Con frecuencia los callos pueden tener daños ocultos debajo, por lo que es importante ver a un podólogo para mantener los callos recortados. Le presentamos algunos consejos para ayudarlo: • Use zapatos que le queden cómodos en todo momento, incluso en interiores. Mire adentro antes de ponérselos y elimine lo que pueda estar en el interior. • Evite remojarse los pies en agua caliente. El remojo prolongado elimina la humedad de la piel, aumentando el riesgo de grietas y permitiendo la entrada de gérmenes. En su lugar, lávese los pies en agua tibia; luego séquelos bien. • Mantenga los pies secos, especialmente entre los dedos de los pies. Evite el uso de cremas entre los dedos de los pies, que pueden retener la humedad. • Corte las uñas de los pies en línea recta. El mejor momento para cortarse las uñas de los pies es después de un baño o una ducha porque están más suaves. Si las uñas de los pies están engrosadas o le cuesta alcanzarlas, pida a un profesional que se las corte. • Evite la «cirugía de baño» (usar instrumentos afilados en los dedos de los pies o los pies). Consulte a un podólogo, que tiene herramientas especiales para el cuidado, para que le corte las uñas de los pies y le recorte las durezas y los callos. • No se recomienda ver a un pedicuro a las personas cuya glucosa está por encima del objetivo o que tienen mala circulación o neuropatía. Evite fumar y beber alcohol en exceso. Fumar contrae los vasos sanguíneos. Con el tiempo, esto disminuye el flujo sanguíneo, lo que conduce a una mala curación si se produce una lesión en el pie. Beber alcohol en exceso también daña los nervios y puede empeorar la neuropatía. Mantener la glucosa en la sangre en niveles seguros y hablar con su equipo de atención médica regularmente, especialmente si tiene grietas, heridas y enrojecimiento en los pies, ayudará a prevenir problemas en los pies. sentara.com

SENTA R A IN THE COMMUNITY

New Sentara Program Offers

‘Hospital at Home’

Care for Some Patients Imagine this.

Your loved one is not well, lying in bed. A nurse comes in to take vitals, such as heart rate, oxygen and blood pressure. An intravenous line administers antibiotics. A moment later, the doctor does his daily check-in. He asks how your loved one is feeling today, confers with the nurse and checks to make sure the patient is eating well. Does that sound like your loved one is in the hospital? Actually, they’re at home. The new service, known as Sentara Hospital to Home, is part of one of the newest trends in medicine—a trend that is resulting in happier, healthier patients. Modeled after the Hospital at Home® program launched by Johns Hopkins Schools of Medicine and Public Health in 2012, the new home care delivery model was pioneered last year at Sentara Norfolk General Hospital. The program provides hospital-level care at home and operates under Sentara To Home, the existing hospital pharmacy transition program. The COVID-19 crisis provided the impetus to pilot the program at Sentara Norfolk General. During the height of the pandemic, many hospitals across the nation reached full or near-full

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capacity, and the resources— including staff—required to treat the massive influx of COVID patients, along with non-COVID patients, were often stretched thin. In response, hospitals began to look for innovative ways to ensure the safest, highest-quality care for all patients, while maximizing resources. “People started using their imaginations to find solutions,” says Russ Ford, MD, lead hospitalist at Sentara RMH. “Doctors started seeing hospital patients remotely using interactive video equipment, in order to increase appointment availability and provide better service.” This innovation soon raised another question: If doctors could see patients remotely in the hospital, why couldn’t the patient be somewhere else, like at home? “That was the start of it,” Dr. Ford says. “Since there were challenges with resources in the hospital, Dr. Colin Findlay (clinical chief for Sentara Medical Group’s hospitalist program) began pushing for the Sentara Hospital to Home initiative.” As it turns out, the new care delivery model not only improves patient satisfaction, but also has been found to reduce costs and improve outcomes for acute-level care. Sentara Hospital to Home can be a great alternative for certain patients who need acute care and are stable enough to be safely monitored from home. It’s a good fit for conditions that offer well-defined treatment plans, such as congestive heart failure, chronic obstructive pulmonary disease and deep vein thrombosis. Even though these patients are at home, they’re in constant contact with healthcare provid-

ers through biometric monitoring via telehealth technologies, home visits and video visits. Some healthcare professionals now see this kind of program as the model of the future.

Implementing in the Blue Ridge Region After the success of the Sentara Hospital to Home program in Norfolk, Sentara Martha Jefferson Hospital and Sentara RMH began offering eligible patients the option of being cared for at home. “We actually already had the technology to take care of people at home, with appropriate monitoring and visits from a home nursing service,” says Dr. Ford. The needs of COVID patients—including oxygen and anti-inflammatory steroids— could be supplied at home, and they were the first patients to be offered the service. The model worked so well, Dr. Ford notes, that as COVID hospitalizations started to wane, Sentara doctors began looking at it for other conditions, such as congestive heart failure and infections. “The care provided through Sentara Hospital to Home is equivalent to the care we provide in the hospital,” says Will Knight, MD, lead hospitalist at Sentara Martha Jefferson. sentara.com

SE NTA R A IN THE COM MU N IT Y

Here’s how it works. During a daily nursing visit, a home health nurse examines the patient and facilitates a video interaction between the patient and doctor. The patient, visiting nurse and doctor agree on the time for the visit. When the nurse arrives at the patient’s home, he or she notifies the doctor with a call or text. If the doctor isn’t quite ready, the nurse begins the patient assessment. When the doctor appears online, the nurse uses a handheld device or tablet to initiate the video call. The nurse reports the patient’s vitals, and the doctor talks with the patient. In some cases, the doctor also may ask the nurse to direct the camera for more specific examination—for instance, in the case of heart failure, at the patient’s lower limbs. “The nurse can tell me about the swelling in the legs and how the lungs sound,” Dr. Knight says. “I can tell if the patient is breathing comfortably. I can see that visually.” Dr. Knight adds that he can also make other requests as needed. In one case, he asked the patient to stand up so he could check his blood oxygen saturation while in that orientation. “I can do everything I normally do, with the help of the video feed and the nurse,” he says.

Working Together to Achieve Success To succeed, the Sentara Hospital to Home delivery model requires multiple partners working together. Sentara Medical Group and Sentara Home Care Services are the hospital-based partners. A vendor supplies remote monitoring devices to collect a patient’s oxygen saturation, heart rate, blood pressure and other pertinent vitals in real time. Additionally, emergency medicine physicians watch the monitors remotely, so if a patient is having trouble, the hospital is contacted and a new plan of care is created. The patients, of course, also must be willing partners in their own home care. Patients are selected for the program carefully, based in part on whether they can be cared for

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safely at home, as well as on their willingness to do so. “The patients have been appreciative,” Dr. Knight says. “They want to be at home, so they’ve been very enthusiastic about this model of care.” Dr. Ford says that for some patients, being at home facilitates recovery. “The hospital is an alien environment—the sights and sounds can feel bizarre to patients,” he says. “A lot of people don’t sleep well in the hospital, and they need to sleep in order to heal.” As well, at-home patients often look forward to daily visits from the nurse and doctor. “A lot of these patients see us as visitors, and our older patients seem to like visitors,” Dr. Ford notes. “It’s a nice benefit of receiving care in an at-home setting.”

The Future of Patient Care The length of a typical Sentara Hospital to Home care stint is currently about two to three days. “Once the patient is able to be at home without daily monitoring, care is turned back over to his or her primary care provider,” Dr. Ford says. Though the program’s preliminary participant numbers are small to date, they already suggest that the home care delivery model is reducing readmission rates. “This model can actually be better for the patient, because if their condition changes, we can provide treatment before a visit to the Emergency Department becomes necessary,” Dr. Ford says. It’s the proverbial win-win situation. “Sentara Hospital to Home frees up inpatient beds for sicker patients and costs less than inpatient admissions,” Dr. Findlay says. “Patients often feel safer and more comfortable at home, and their families can be there to support them.” Adds Dr. Ford: “It does them a world of good.”

CA RING TR ADI TION

BRING

Cheer Phillips Cancer Center volunteer Diane de Launay

ON THE

Sentara Martha Jefferson Hospital Volunteers Serve With Joy

More than a decade ago, Diane de Launay found her calling for life after retirement while supporting a friend who was going through cancer treatments at Sentara Martha Jefferson Hospital’s former campus. During those treatment sessions, de Launay often found herself pitching in to ensure that other patients had warm blankets or someone to talk to. “The more I helped out, the more I realized this was something I wanted to do after retiring,” says de Launay, a former insurance agent. “This has been good for me, and it means a lot to me to know I’ve done something good for someone else.” mjhfoundation.org

A Lifetime of Giving Nancy Maine Retires After 61 Years of Volunteer Service

Since 1960, Charlottesville resident Nancy Maine has touched thousands of lives with her warm smile and kind words as a Sentara Martha Jefferson Hospital volunteer. After an extraordinary 61 years of service, she retired in July at age 93. An integral part of the Martha Jefferson family, Maine has served in a variety of hospitality roles, including at the front desk of the Phillips Cancer Center for the past decade. As the first person to greet anxious patients and families, she took care to listen and help them feel safe and welcome. “Nancy has embodied our Caring Tradition through her heart, spirit and dedication to the hospital and the community she served,” says Renee Dinwiddie, manager for volunteer and guest services. “Saying ’thank you’ can’t possibly express the gratitude we feel for Nancy and her service.” For her part, Maine has enjoyed giving back, as she puts it, “out of gratitude for the good things life has done for me.” She looks forward to having more time for her daily walks, as well as spending time with her three sons and 12 grandchildren, but she will miss her Martha Jefferson family. “I love all the people I worked with at Martha Jefferson,” she says. “It’s just a caring community.”

Thank you, Nancy! Grateful doctors, nurses and friends at Sentara Martha Jefferson presented Nancy Maine with nearly 70 cards to celebrate her 61 years of volunteer service.

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Volunteers can be found in almost every area of Sentara Martha Jefferson, greeting guests, escorting patients, visiting with inpatients, providing warm blankets, fluffing pillows, delivering newspapers and flowers, or serving on councils and teams that strive to improve the patient experience. These volunteers bring positive attitudes, enthusiasm and energy to their service to others. A volunteer at the Phillips Cancer Center’s Infusion Center for more than 10 years, de Launay devotes two mornings a week to helping people during their treatments, doing anything from taking lunch orders to holding a hand to provide comfort. “Diane, and other volunteers like her, bring so much to the patient experience in the Cancer Center,” says LaDonna Winegar, patient care services manager at the Infusion Center. “They help us make the Caring Tradition real, from greeting people warmly at the door to bringing food and blankets for patients receiving chemotherapy.” For her part, de Launay says she usually goes home from her volunteer shifts feeling better than when she started, despite the inevitable sad moments. “I always leave feeling like I’ve helped somebody,” she says. “Maybe I made them smile or laugh. It’s a rewarding experience.” With the hospital now facing critical staffing challenges, seasoned volunteers like de Launay also serve as an invaluable resource in supporting professional staff, training newer volunteers and helping to stretch hospital resources. “Our staff satisfaction is higher with the volunteers around as well,” says Winegar. “We missed them every day during the COVID pandemic!” By doing work that would otherwise be carried out by paid staff, volunteers can save the hospital as much as $1.5 million annually in a typical year. Even in 2020, when COVID forced the hospital to send most volunteers home early in the year, their service still resulted in nearly $700,000 in savings. The compassion volunteers bring to their work makes all the difference for worried patients and families navigating an unfamiliar place. “Our volunteers are that friendly face,” says Renee Dinwiddie, manager for volunteer and guest services. “Even with face masks, you can see the kindness in their eyes and hear the warmth in their voices.” Jay McClellan agrees. After a career in the pharmaceutical industry, he began serving as a patient support volunteer 16 years ago. Once a week, he rounds on the patients and families in his assigned units, attending to their needs and providing a listening ear.

“If they have a concern, I hear them out and try to figure out how to resolve it,” says McClellan, who also represents the community as part of Sentara Martha Jefferson’s Patient and Family Advisory Council, which helps patients and hospital administrators support the hospital in establishing priorities around patient services. “It says a lot to me about Sentara Martha Jefferson that the hospital takes these extra steps to ensure that patients receive the best care possible,” he adds. The appreciation is mutual. “Our volunteers exemplify the connection between the hospital and our community,” says Dinwiddie. “They are amazing, and we are fortunate to have them.”

We Need Your Help! Sentara Martha Jefferson Hospital welcomes community members ages 18 and up to serve as hospital volunteers in a wide variety of roles. Your service will truly make a difference in the lives of patients, families and our hospital staff. For more information, contact Renee Dinwiddie, manager for volunteer and guest services, at rmwalker@sentara.com.

Manager for Volunteer and Guest Services Renee Dinwiddie with patient support volunteer Jay McClellan

mjhfoundation.org

CA RING TR ADI TION

Peacein a

FINDING

PANDEMIC Community Support Cares for the Caregivers

Five-minute stretch and meditation breaks give nurses a chance to rest and relax.

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ell over a year into the COVID-19 pandemic, many of us are tired from all the changes the crisis has brought into our lives—but few are more worn down than our frontline healthcare teams. Doctors, nurses and clinicians have pushed through fear, exhaustion, frustration and uncertainty to treat thousands of people in our community.

Through it all, even as these hospital administrators. healthcare heroes have maintained Their only request was the highest standards of clinical exthat she develop the cellence, it’s no surprise that they are programming not just for struggling. According to the Nationnurses, but for all staff— al Academy of Medicine, as many as clinical and nonclinical. half of all professional caretakers are Empowered by comnow reporting severe signs of burnmunity support through out. Mental health needs related the Martha Jefferson to COVID-19 are quickly becoming Hospital Foundation, a large-scale public health crisis. A the Intentional Caring growing shortage of nurses nationCommittee has combined ally—and here at home—makes the training in mind-body situation even more challenging. Staff Resiliency Coordinator Esther Lozano Otis wellness practices—such Given the proven link between as exercise, healthy diet, staff well-being and clinical excellence, Sentara Martha relaxation and adequate sleep—with a suite Jefferson Hospital has made supporting our frontline of resources available at the hospital. Thanks healthcare providers a top priority. Thanks to philanto the program, features such as a roving thropic support from the community through the Mar“caring cart,” mindful movement sessions, tha Jefferson Hospital Foundation’s COVID-19 Emerearly morning outdoor walks around the hosgency Response Fund, we are making investments in our pital’s beautiful campus, and free virtual supteams that are unmatched at hospitals nationwide. port groups and chair massages have become popular mainstays for stressed-out staff. Making Time to Pause Patricia Scott, BSN, RN, RN-BC, Clin V, In June, Martha Jefferson became the first hospital in manages nursing teams who care for some of the Sentara system to hire a dedicated staff resiliency the hospital’s sickest patients. Over the past coordinator charged with creating programs to help year, Scott has made it a practice to provide frontline teams manage stress and fight burnout. team members with 15-minute breaks in Veteran Sentara Martha Jefferson obstetrics nurse Esther the reclining massage chair in the hospital’s Lozano Otis was chosen for the role, which builds on Caregiver Center. She also regularly brings her two years of leadership in creating a hospital-wide her staff together in the nurses’ station self-care program for nurses known as Intentional for five-minute meditation and stretch/ Caring—A Nurturing Tradition. yoga breaks. Lozano Otis brings to the work a passion for mind“These moments give them a little bit of body wellness that was forged early in life, when she and downtime and help them relax,” Scott says. her family unexpectedly found themselves in the role “And that gives them a little extra bump of of caregivers after her sister suffered a devastating brain energy.” She attributes the high retention injury in a car crash. To help them cope with their grief, rates in her units in part to the hospital’s Lozano Otis launched into a deep exploration of Eastern Intentional Caring initiative. and Western healing traditions. Today she holds a Bache“Resiliency and retention go together,” lor of Science in Nursing degree, as well as certifications in she says. “You’ve got to protect your employyoga, meditation and mindfulness-based stress reduction. ees when you’re going through hard times, Uniquely positioned to understand and address as we did during the pandemic. Giving them the urgent need for self-care among her nursing colthe time they need to rest their bodies and leagues, in 2018 Lozano Otis was inspired to create the minds helps build a stronger, more conIntentional Caring program, with the robust and ongonected team.” ing support of Chief Nursing Executive Johnsa Morris, Recognizing the power of these relatively Surgical Services Director Allison Crawford and other small interventions, Lozano Otis is creating mjhfoundation.org

an easily accessible program of free events, therapeutic services, educational classes and other resources in her new role. A staff survey launched in September, combined with patient experience data, will help create metrics and a suite of programming that responds to specific staff needs. “We’re giving our teams the tools to support their general well-being,” says Lozano Otis, noting that all of Sentara Martha Jefferson’s resiliency A rooftop serenity garden will provide a beautiful outdoor space for staff to rest and recharge. programming is designed as “opt-out” rather than “optin”—meaning that staff can rest and reflection. Recognizing the access services easily and without concern constant, busy work pace of our teams, such for potential stigma or the psychological spaces must be conveniently located and barriers of asking for support. To encourage easy to access. participation further, programs are offered Drawing on leadership support from during different shifts and in areas and units The Joseph and Robert Cornell Memorial where nurses are working. Foundation, as well as gifts from other longtime friends and the COVID-19 Serenity Now Emergency Response Fund, one Resiliency Lozano Otis is also leading the of the first of these spaces to be charge to develop “resiliency constructed is a staff resiliency garden and retention spaces” throughout the hospital— located on the rooftop between the go together,” quiet zones like the massage chair Intensive Care Unit and Cornell 1, says Clinical at the Caregiver Center, where where critically ill patients are treated. team members can retreat when Construction on the serenity garden Manager Patricia they need a moment to themselves, began this summer. When the project Scott. “You’ve or a place to connect and share is completed this fall, the garden got to protect support with their colleagues. will be the first purpose-built space Several years ago, the cardiac/ dedicated to the mental health of our your employees neurology unit retrofitted an frontline healthcare teams. when you’re existing break room to make it a Holistic health efforts like going through quieter, more peaceful space—with Intentional Caring have proven soft lighting, soothing colors and hard times, as we benefits in promoting staff retention, comfortable furniture—where a healthier workforce, and improved did during the nurses could eat or rest. Six months staff and patient satisfaction. pandemic. Giving Ultimately, Lozano Otis sees herself as after the new space opened, a survey found that 85 percent of the a champion for a cultural shift among them the time staff were using it as a welcome spot hospital staff. they need to to wind down and regroup. “My goal is to meld the two worlds rest their bodies Although the pandemic has of health and wellness, which don’t slowed down construction, plans always go hand in hand for healthcare and minds helps are underway to create more such workers,” she says. “We want to give build a stronger, spaces throughout the hospital, as our staff permission and resources to more connected take care of themselves.” well as private rooms for individual

team.

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CA RING TR ADI TION

Reducing Health Disparities and Improving Access to Care:

free

The Charlottesville Clinic Sentara Martha Jefferson provides

compassionate care for all who walk through our doors, and we reach outward to work toward greater health equity in our community. Every three years, we partner with colleagues at UVA Health and the Blue Ridge Health District to develop a Community Health Needs Assessment (CHNA), a comprehensive study of the most pressing issues in our community. Engaging more than 100 organizations and individuals, the most recent CHNA identified four priority areas:

• Reduce health disparities and improve access to care. • Promote healthy eating and active living. • Address mental health and substance abuse. • Foster a healthy and connected community for all ages. Our Community Benefits team collaborates closely with community healthcare partners to address these urgent needs. Over the next year, we will highlight a few of the partners and programs we work with to improve the overall health of our community.

“G

ood health is fundamental to securing housing, education and employment,” says Susan Sherman, executive director of the Charlottesville Free Clinic. “And there is an insatiable need in our community for the very basic foundation of access to care.”

The Charlottesville Free Clinic set up outdoor tents to see medical and dental patients during the pandemic last year.

Launched in 1992 by two medical residents, the Charlottesville Free Clinic offers free access to doctors and dentists, as well as no-cost prescriptions, to working uninsured and underinsured patients aged 18-64 in the greater Charlottesville community. The Free Clinic serves upwards of 2,300 patients annually. Many are gainfully employed in the service industries but have no private health insurance, Medicare or Medicaid; or have high-deductible insurance policies that consume more than 10% of their take-home pay. Government grants, corporate partnerships, events and private philanthropy fund the Free Clinic’s work, enabling

mjhfoundation.org

Clinic staff came out to show their gratitude to Sentara Martha Jefferson hospitalists, nurses and dental surgeons, who continue to volunteer their time through the pandemic.

The Charlottesville Free Clinic offers free access to dentists and doctors for working uninsured and underinsured patients in the greater Charlottesville community.

life-changing access to free prescription medications. That service alone saves many diabetic patients as much as $1,000 annually, given the cost of insulin. A true community effort, the Charlottesville Free Clinic staff is bolstered by hundreds of volunteer healthcare professionals from the area, who donate thousands of hours of service to Free Clinic patients, serve on the Free Clinic’s board and run lab work. The Free Clinic provides specialty care in many areas, including gynecology and psychiatry—and, thanks to their partnership with Sentara Martha Jefferson, can refer patients to Sentara Martha Jefferson providers for other

specialties, like cardiology and hematology. For their part, healthcare professionals who volunteer at the Free Clinic appreciate the opportunity to treat patients in need without worrying about billing and paperwork. This access to routine care also reduces the pressure on overburdened emergency rooms, saving Sentara Martha Jefferson tens of thousands of dollars annually. “We’re trying to be part of a paradigm shift, to let our neighbors know they don’t have to resort to the emergency room for nonemergent care,” says Sherman. “We can get them situated and stay with them as primary care providers and specialists. We can get them on the road to better health.”

Our mission to improve health every day drives everything we do to keep individuals, families and the community we serve healthy. We do this by establishing partnerships that create a positive impact in our communities. Through the support of the Martha Jefferson Hospital Foundation and the Sentara Healthier Community Fund, Sentara Martha Jefferson Hospital provides grant funding to community health partners like the Charlottesville Free Clinic and other free clinics located in the Blue Ridge Health District and surrounding counties. Find out more at sentaracares.com.

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Caring for the Community We Love 100% of every gift to the Martha Jefferson Hospital Foundation stays here locally to create opportunity and improve the health of patients and staff.

Make a Gift for Today

From free cancer screenings to nursing scholarships and emotional support for family members coping with a loved one’s illness, your generosity continues the Sentara Martha Jefferson Hospital Caring Tradition and provides an unmatched margin of excellence for our community.

be forgotten, as well as transformational changes that

Please consider a gift to continue strengthening the Caring Tradition for generations to come.

a lasting legacy through a named fund in honor of a

Visit mjhfoundation.org to make a gift. Gifts of all sizes help make possible small touches that will never benefit our whole community.

Make a Gift for Tomorrow Estate gifts to Sentara Martha Jefferson Hospital through a will, trust, retirement account or life insurance policy help sustain essential hospital programs while providing the opportunity to create loved one or family member.

For more information about making a gift to the Martha Jefferson Hospital Foundation, contact us: Call 434.654.8258 or email: mjh_foundation@sentara.com or visit our website: mjhfoundation.org

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Sentara Martha Jefferson Hospital

Sentara Martha Jefferson Hospital 500 Martha Jefferson Drive Charlottesville, VA 22911 Sentara.com Change service requested

SENTARA MARTHA JEFFERSON HOSPITAL

BEHIND EVERY PATIENT IS SOMEONE WHO CARES Behind every patient is… a loved one sitting by a bedside… a family member waiting at home… a care team member going above and beyond to ensure the patient AND their loved ones are supported. From our doctors and nurses to the team members behind the scenes, everyone at Sentara Martha Jefferson is focused on the big things that help patients heal, and the little things that provide extra comfort.

Sentara Martha Jefferson Hospital. Sentara Cares.

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