Sentara Marthamagazıne Jefferson SPRING 2020
Stronger Than Ever
Athletes Return to the Sports They Love
PLUS: Cancer Survivors Continue Recovery through Exercise Brainlab: GPS for the Brain | Sentara in the Blue Ridge
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PRESIDENT’S LETTER
Celebrating Sentara Martha Jefferson
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SENTARA MARTHA JEFFERSON HOSPITAL PRESIDENT
Jonathan Davis, FACHE Editors
Jenn Downs Neil Mowbray Contributors
Luanne Austin Karen Doss Bowman Lisa Smith Jennifer L. Stover Photography
Luca DiCecco Andrew Shurtleff Tommy Thompson Design
Picante Creative
appy spring! As we embark on a new season, it is always a great opportunity to reflect on our most recent successes and anticipate what is ahead. I am pleased to say that there is a lot to celebrate at Sentara Martha Jefferson!
First, as you will read more about on page 5, we were recently awarded five stars by the Centers for Medicare & Medicaid Services (CMS). This rating, which is the highest a hospital can achieve from CMS, recognizes our ongoing commitment to safe, high-quality care for our patients. Additionally, I am pleased to share that our neurosurgeons are now using new leading-edge technology to track and treat brain tumors, an innovation you can read more about starting on page 19. Essentially a type of “GPS for the brain,” this advanced technique provides a map of the brain so doctors can deliver a safer, minimally invasive experience with superior outcomes. Finally, as you will learn starting on page 41, we are welcoming a new leader to the helm of the Martha Jefferson Hospital Foundation. I am thankful for all the Foundation has done for the hospital and for our community over the years, and I am excited about the Foundation’s future. In addition to celebrating our successes, I’m also looking forward to what’s coming in the next few months. In April, we will be opening a family medicine practice inside The Center at Belvedere. The Center is a community hub with both outdoor and indoor spaces for healthy aging programs and partnerships, and we are pleased to be a part of the project and expand access to much-needed services in our community. Sentara Family Medicine at Belvedere will accept walk-ins, and will also have extended and weekend hours to meet the healthcare needs that always seem to arise on the off-hours. As the weather warms up and the winter hibernation ends, we are also looking forward to being WITH our community, IN our community. Keeping people healthy involves so much more than simply providing care inside the walls of our facilities. Education, prevention and self-care are key pieces of a person’s overall health picture, so we are glad to be able to interact with many in the community through a variety of upcoming events. For starters, the fourth annual Women, Wine & Wellness event is set for April 22 at the Paramount. The focus this year will be on breast health, and women of all ages are invited to attend for a fun night out! We also hope to see many of you downtown at Fridays After Five, where our teams will be sharing health information throughout the season—and having some fun, of course. And finally, Sunsets with Sentara will continue this year on the hospital grounds. Our first event is June 17, and we hope to see many of you there for an evening of music, relaxation and a beautiful sunset. Thank you for your continued dedication to your community hospital. We strive to improve health every day, and we couldn’t do it without your support.
Warm regards,
Jonathan Davis, FACHE President, Sentara Martha Jefferson Hospital
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Contents SPRING 2020
24
30
Stronger than Ever
Cancer Rehab
Athletes Return to the Sports They Love
Recovery Through Exercise
19
What Lies Beneath Brainlab for Brain Surgery
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Contents
SPRING 2020
38 D E P A R T M E N T S President’s Letter Inside front cover The Best Medicine
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New & Noteworthy
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Physician’s Perspective
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Schwartz Rounds to Reinforce Our Culture of Compassion
On-Call Advice
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Improve Health Every Day Aging Well
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14
Building Muscle after Age 50
Calendar
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Sentara in the Community
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Health Matters
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Calendar
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Signs and Symptoms of Stroke
La Salud Importa
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Las señales y síntomas del accidente cerebrovascular
Eat Well, Live Well
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Budget-Friendly Healthy Eating
Philanthropy
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Sentara’s Commitment to the Blue Ridge Region
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THE BEST MEDICIN E BY MICHAEL CORDELL
My Career in Health Care
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hirty-seven years after getting my master’s degree in hospital administration and entering the wild and woolly world of health care, I’m retiring. That word still catches me off guard—retirement is something a grandparent does, not me. I’m still a kid. Or at least a kid at heart. Well, OK, it’s a pretty old heart, but still … It’s a fluke I even went into healthcare administration. I was studying journalism at the University of Nebraska and was considering getting a master’s degree in playwriting, so I could make big bucks writing plays for local theater groups. That seemed like a solid plan. To put myself through school, I got a part-time job at my university’s student health center, and I absolutely loved it. To this day I can’t explain what it was about that job, but being in a setting filled with truly caring professionals helping others immediately resonated with me. After working there for a couple of years, I changed career paths: I wanted to work in health care. I knew I wasn’t bright enough to be a nurse or a doctor or a lab tech, so I decided to go into management. I attended the University of Missouri’s health administration program. It was a challenging adjustment, both for me and the school. My brain was wired differently from many of my classmates, most of whom had undergraduate degrees in business. One time we had to draw a decision tree in a planning class. My decision tree had branches and squirrels and leaves and nuts. My professor was quite angry; he wasn’t sure if I was being insolent or an idiot (apparently he thought it was an either/or situation). Somehow I graduated and ended up in Virginia. Since my undergraduate start at a student
health center, I’ve worked at two academic medical centers and three community hospitals, including Sentara Martha Jefferson Hospital and Sentara RMH Medical Center, as well as a local hospice organization. There are too many experiences to sum up in a letter like this, but some of my key career observations include the following: • Most everyone in health care cares. There is definitely a wide range of personalities in a hospital, which can make for interesting work dynamics, but people are there for the right reason: to serve those in need. When everyone in health care remembers that, we can do amazing things. • The challenge of running a place that absolutely never closes is striking. When Martha Jefferson and RMH opened their new hospitals a few years ago, I was struck by the fact that once their front doors were unlocked, they would always be open. Not just 24/7/365, but quite possibly for the next 50 or 60 years. Always. Open. It’s a marvel. • The range of care and the magnitude of activities that take place in a hospital every single day are also stunning. Every day, under one roof, babies are born, surgeries are performed, emergency care is delivered, cancer treatments are conducted, diseases are diagnosed, lives are saved, lives are lost, families are consoled, and people are fed, cleaned and cared for—and that only represents probably 15% of what takes place in a hospital. Every day. • Decision trees don’t have squirrels in them. Sometimes I think about how different my life would be if I hadn’t taken that job at the student health center. I’d be living in some other part of the country, with different friends, a different wife and a different career to look back on. I’m glad I took that job. It’s been a good run.
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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 Hospital, please call 1-800-SENTARA. More information can also be found at Sentara.com. C. Todd Borchers, NP Hospital Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580
Norman R. Dube, NP-C Hospital Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580
Barbara L. Royston, CNM Obstetrics and Gynecology Jefferson OB/GYN 434-977-4488
David Calhoun, MD Sleep Medicine Sentara Martha Jefferson Medical & Surgical Associates 434-654-5260
Kurtis Elward, MD Family Medicine Sentara Family Medicine at Albemarle Square 434-654-2830
Kara A. Sims, PA-C Emergency Medicine US Acute Care Solutions 434-654-7150
Brooke Csaky, PA Emergency Medicine US Acute Care Solutions 434-654-7150
Kevin McCarthy, MD Internal Medicine Sentara Martha Jefferson Blue Ridge Internal Medicine 434-654-4550
Timothy S. Snow, MD General Surgery, Bariatric Surgery Sentara Martha Jefferson Medical & Surgical Associates 434-654-5260
Andrew J. DeNardo, MD Neurointerventional Radiology Sentara Martha Jefferson Neurosciences 434-654-8960
Rita D. Page, MD Ophthalmology Blue Ridge Ophthalmology 434-295-3227
To get connected with one of our providers, please call 1-800-SENTARA.
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SPRING 2020
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Arthur Bender Award Recipient
Sentara Martha Jefferson Receives Five-Star Rating from CMS Hospital Compare
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In a recent update of its quality-of-care website Hospital Compare, the Centers for Medicare & Medicaid Services (CMS) assigned five stars to Sentara Martha Jefferson Hospital in its Overall Hospital Quality Star Ratings. A five-star rating is the highest quality score CMS awards to a healthcare facility. Based on the most up-to-date quality information available, the Overall Hospital rating includes 64 quality measures that cover the type of routine care patients receive for problems like heart attack and pneumonia, as well as quality measures that focus on infection control, the value of care and unplanned hospital visits. “We focus on improving our quality and patient safety every day at Sentara Martha Jefferson,” says Paul Tesoriere, MD, vice president of medical affairs for the hospital. “Each morning, leadership from around the hospital participates in a safety huddle to identify problems, focus on safety issues of the day, and get updates on our performance with quality and patient satisfaction metrics. Our priorities align well with the items CMS is measuring, and this rating is a reflection of those efforts.” Hospital Compare is a website maintained by CMS to help patients and their families learn about the quality of hospitals in their area, compare healthcare facilities and ask questions about services provided, so they can find the care that is right for them. “We’re very grateful for this recognition by CMS, but we realize it takes constant attention not only to sustain success but also to achieve our real goal, which is to improve our patient care and safety every day," says Dr. Tesoriere.
Congratulations to Paige Perriello, MD, of Pediatric Associates of Charlottesville, for being selected as the 2019 recipient of the annual Sentara Martha Jefferson Hospital Arthur Bender Quality Award. A member of the Sentara Martha Jefferson Hospital medical staff since 2008, Dr. Perriello has served as a section chief of pediatrics, working closely with her colleagues to improve communication and streamline care. She is devoted to her patients and colleagues, and spends time advocating for public safety on the local and state levels. Dr. Perriello also volunteers at her children’s school and even coaches one of the school’s sports teams. She has received the Best in Charlottesville Award many times, as voted on by patients in the community. Dr. Perriello served as a member on the Sentara Martha Jefferson Medical Executive Committee and the Performance Improvement Committee. She also serves on the board of the Virginia Chapter of the American Academy of Pediatrics and the board of the US Lacrosse Sports Science and Safety Committee. Each year, the Arthur Bender Quality Award is given to a Sentara Martha Jefferson medical staff physician who has provided outstanding service to the community by improving the quality of care delivered at the hospital. Nominations for the award are solicited from the medical staff and hospital staff, and the recipient is selected by the nine members of the Medical Executive Committee.
Sentara Family Medicine at Albemarle Square is Moving! Beginning March 30, Sentara Family Medicine at Albemarle Square will begin seeing patients in its new clinic at The Center at Belvedere, located at 540 Belvedere Blvd., Suite 100, in Charlottesville. The practice name will change to Sentara Family Medicine at Belvedere, and office hours will be Monday-Friday, 7:30 a.m.-6 p.m. And on April 11, the practice will begin seeing patients on Saturdays, 8 a.m.-1 p.m. The new clinic will offer easier access, more parking and a cafe for patients. To contact Sentara Family Medicine at Belvedere, call 434-654-2830.
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PHYSICI AN’S PERSPEC TIVE
Reinforcing Our Culture of
Compassion
Crystal By Lee Dickson, Litvinas, MD Internal Medicine, Hospitalist
Schwartz Rounds Come to Sentara Martha Jefferson
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SPRING 2020
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Inspired by Boston attorney Ken Schwartz, who died of lung cancer at the age of 40 in 1995, the Schwartz Center for Compassionate Healthcare was created more than 20 years ago in an effort to “put compassion at the heart of healthcare through programs, education and advocacy,” according to the organization’s website. In his writings, Schwartz noted that what made the “unbearable bearable” during his own personal healthcare experience was the compassion shown to him by his doctors, nurses and other health professionals. Since then, Schwartz’s vision has helped create a powerful movement within contemporary health care, in part through the Schwartz Rounds program, which “offers healthcare providers a regularly scheduled time during their fast-paced work lives to openly and honestly discuss the social and emotional issues they face in caring for patients and families.” Schwartz Rounds programs
are now up and running in more than 550 healthcare organizations in the United States, Canada, the United Kingdom, Ireland, Australia and New Zealand—and thanks to generous community philanthropy provided through the Martha Jefferson Hospital Foundation, Schwartz Rounds are now taking place at our hospital as well. After more than a year of planning and preparation, Sentara Martha Jefferson launched its first Schwartz Rounds in September 2019 to an interactive audience of nurses, allied health professionals, physicians and representatives from administration. The topic for the inaugural session, “When Compassion and Safety Collide,” focused on how best to help patients, families and hospital staff navigate the challenges of disruptive patient behaviors, which can range from confusion and agitation to actions bordering on physical violence directed toward staff or a patient’s loved ones. The session engendered heartfelt sharing and, at times, intense, emotion-packed discussion. Our second Schwartz Rounds, which took place in November, focused on working with patients who have advanced cancer. The discussion centered on how best to support patients, families and medical staff when treatment shifts from curative therapies to palliation and, eventually, end-of-life care.
A Safe Place for Sharing I became involved in the Schwartz Rounds project at Sentara Martha Jefferson when sentara.com
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PHYSICI AN’S PE R S P E C T I V E
Peggy Bishop, ANP-BC, ACHPN, Palliative Care Service Team coordinator, asked hospital chaplain Tammy James, RN, MDiv, BCC, and myself if we would like to assist in getting the initiative up and running. Having been a hospital-based physician for nearly all of my 25 years in health care, I felt there was a clear need for healthcare workers to talk about many of the tough situations we often face. Professionals in our field often keep strong emotions bottled up inside them, even to the point where they’re unable to share with family or friends. Although the topics covered in Schwartz Rounds can be difficult to confront, as healthcare workers we face many such scenarios on a daily basis—so getting our shared experiences out in the open is key. With that in mind, these forums provide a safe place to share, giving staff an opportunity to reflect upon their own responses to challenging situations, hear the perspectives of others, and learn how more effectively to remain compassionate in the midst of frustration, fatigue and emotionally weighty situations. The discussions also help staff members connect with a larger network of support—not only for each other, but also for the patients and families we have the privilege of caring for during critical times in their lives.
Benefiting Caregivers and Patients The format of the Schwartz Rounds is fairly straightforward. After the session topic is introduced, a small panel—usually made up of a physician, a nurse, an allied health professional and others who can provide perspective—will give a summary of their personal experiences regarding
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the topic. The remaining time, which accounts for the greatest portion of each session, is open for all those in attendance to engage in discussion and share their perspectives. Based on survey responses, the first two Schwartz Rounds at Sentara Martha Jefferson appear to have been well received. Below are a few of the written comments staff members in attendance submitted on their postsession surveys: • “This is a great forum for all staff to share and commiserate together, to know we are not alone in our feelings.” • “I have a better understanding of the doctor-patient relationship and end-of-life care.” • “Find support in coworkers.” • “Always meet patients where they are.” • “I am more aware of my colleague’s views.” • “Understand that everyone (staff, family, patient) has a story.” Nationwide evaluation of Schwartz Rounds reveals that the program improves teamwork and staff retention, reduces caregiver stress and isolation, and helps cut down on burnout. At Sentara Martha Jefferson, the program gives us another tool not only to care for our patients and their families, but also to care for one another as we strive to communicate effectively with, support and work alongside one another. Going forward into 2020, Sentara Martha Jefferson plans to host a Schwartz Rounds every other month (a planning committee staffed from multiple frontline services in the hospital is charged with selecting the topics). Participants likely will leave not only with a stronger sense of community, but also with enhanced understanding and compassion for our patients and our colleagues “in the trenches” who strive every day to provide the best possible health care.
SPRING 2020
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ON-CALL ADVICE
Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions
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What is sepsis?
epsis is a potentially life-threatening complication arising from infection in the body. The condition occurs when the body attempts to fight an infection by releasing chemicals into the bloodstream that cause an overwhelming inflammatory response throughout the body. This inflammation can lead to tissue damage, organ failure and death. Typical signs that sepsis is starting to occur include rapid heart rate and breathing, fever, chills, or disorientation—particularly if any of these signs is accompanied by a known or suspected infection. As sepsis becomes more severe, the affected person typically experiences one or more signs of organ failure, such as decreased urine production, decreased platelet count, sudden changes in mental status, abnormal respiration or circulatory problems. People who go into septic shock often exhibit dangerously low blood pressure that does not respond readily to fluid-replacement therapy. Diagnosing sepsis can be difficult because many of its symptoms also occur with other illnesses. Blood tests; analysis of other bodily fluids such as urine, sputum and wound secretions; and imaging studies such as ultrasound, CT or MRI may be used to pinpoint the type and source of the infection that is causing the sepsis. Treatment typically involves use of broad-spectrum antibiotics
to fight infection, vasopressors to raise blood pressure, and other medications such as corticosteroids and insulin. Supportive therapy may include oxygen and large amounts of intravenous fluids. In some cases, patients may require respirators or dialysis. Sepsis is most common and most dangerous in older people, those with compromised or
suppressed immune systems, and people with wounds or burns. It often occurs in hospitalized patients—particularly those in intensive care units who may have breathing tubes or intravenous catheters. Most people with early or mild sepsis recover, but the death rate of those with septic shock is approximately 40-50 percent. As the U.S. population ages, healthcare providers are seeing an increasing incidence of sepsis, and with that in mind, hospitals are working to implement effective preventive measures and to raise awareness among providers to help ensure that effective treatment begins in the early, milder stages of the disease.
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ON-CALL ADVIC E
Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions
What is venous stasis disease? Is there a cure?
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enous stasis, also known as chronic venous insufficiency (CVI) is a condition in which the veins in the lower legs don’t work properly. In healthy veins, small valves in the vessels open and close to help blood in the legs return to the heart. The walls of veins also work with the valves to help circulate blood. But if the valves and walls fail to work properly, blood can pool in the lower legs—a condition known as stasis— and result in a number of chronic problems.
CVI is more common in people over age 50, and women are more likely to develop CVI than men. Smoking also can increase a person’s risk of developing CVI. Damage to the valves and vessel walls can result from aging, sedentary lifestyle, sitting or standing for long periods of time, obesity, high blood pressure, heart or kidney failure, varicose veins, or frequent pregnancies. Clots occurring in
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the deep veins of the legs also can cause CVI. Early symptoms of CVI include swelling in the lower extremities, especially around the ankles, and feelings of heaviness in the legs when walking or standing. As the condition progresses, symptoms may include itching and burning; yellow, red or brown discoloration of skin below the knees; pain; and sores that develop on the lower legs, especially around the ankles and shins, that ooze fluid or look scaly or crusty. Unfortunately, there is no cure for CVI. Treatment aims to improve circulation in the legs through the use of compression stockings, which aid in circulation and help reduce swelling that leads to
skin changes; doing exercises such as walking that cause the leg muscles to contract, helping push blood back toward the heart; and periodically and regularly elevating the legs above the heart. In some cases, surgery can help correct venous insufficiency in the legs. Medications can be prescribed to treat pain, itching and swelling in the legs. People can avoid developing venous insufficiency by eating a healthy diet, having an active lifestyle, maintaining a healthy weight and avoiding smoking. It is also advisable to avoid sitting or standing for long periods of time without movement, and to wear clothing that does not constrict circulation in the lower extremities.
SPRING 2020
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IMPROVE HEALTH EVERY DAY
Clearing Up Myths About
Scabies
Scabies is an infestation of the skin by microscopic mites called Sarcoptes scabiei, which burrow into the top layers of a person’s skin and lay eggs. The activity of these tiny mites typically causes a severe itch and rash in the area of infestation. The condition can be confused initially with mosquito bites or acne, but the severe itch—especially at night—is a characteristic indicator of scabies infestation. Contrary to common belief, scabies is not a result of poor hygiene, and the infestation can occur in people who bathe daily. Another misconception is the fear that scabies is highly contagious. Although the condition is contagious to some degree, prolonged skin-to-skin contact is typically required for the mites to crawl from one person to another. According to experts, it is much less likely for scabies mites to infect a person from casual contact, such as a handshake or touching a garment worn by someone with scabies. In addition, unlike mosquitoes and fleas, scabies mites cannot fly or jump from one person to another. If you suspect an itch with rash might be scabies, check with your physician. Treatment with creams, ointments or oral medications will kill the mites and their eggs.
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IMPROVE HEALT H E V E RY DAY
The Hidden Dangers of
Osteopenia and Osteoporosis
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Our bones are at their densest when we are around age 30. Unfortunately, as we age, bone loss can set in if the body makes less new bone tissue than the old bone it absorbs. If bone loss occurs, our bones become thinner, weaker and less dense than normal. This condition is called osteopenia, which is a middle stage between healthy, strong, dense bones and full-blown osteoporosis, a condition of weak, brittle, porous bones that are prone to fracture. Both conditions result in part from a lack of adequate calcium intake as we age. Typically occurring in people after age 50, osteopenia is more common in women, probably because the hormonal changes that occur after menopause can raise a woman’s risk of developing bone loss. Men with low testosterone levels are also at higher risk for bone loss. There are no early symptoms of bone loss, and often a person does not know his or her bones are fragile until a fracture occurs. However, bone scans can indicate if a person’s bone density is lower than normal. Bone loss can be slowed and managed with proper diet, exercise and medications, if appropriate. If you are middle aged or older and concerned about bone loss, talk to your healthcare provider and ask about the appropriateness of having a bone density scan.
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Finding cancer at its earliest stages is one of the most important factors in its successful treatment and cure. Unfortunately, there are no effective screening methods for early detection of pancreatic cancer, according to the American Cancer Society, and because the pancreas lies deep within the body, pancreatic tumors often are not discovered until they are quite large and advanced. Pancreatic cancer also may not produce any signs or symptoms until it reaches an advanced stage or spreads to other organs. However, a number of risk factors are known to be significant in the development of cancer in the pancreas, and some of these risks can be controlled:
Risk Factors for
PANCREATIC CANCER
• Smoking—one of the most important risk factors for pancreatic and other types of cancer
• Obesity—carrying extra weight around the waistline is also a risk factor, even if the person is not obese
• Chronic inflammation of the pancreas (pancreatitis)—often associated with excessive alcohol use and smoking
• Diabetes—the relationship between diabetes and pancreatic cancer is complex, but having diabetes can increase a person’s risk Risk factors that cannot be controlled include the following:
• Age—most patients with pancreatic cancer are over age 65
• Family history—pancreatic cancer seems to run in some families
• Gender—men are at higher risk than women
• Race—African Americans are at slightly higher risk than whites About 1.6 percent of men and women in the United States will be diagnosed with pancreatic cancer at some point during their lifetime, according to the National Cancer Institute. However, having one or even several of these risk factors does not mean a person will develop cancer. You can significantly reduce your risk by not smoking, maintaining a healthy weight, exercising and properly managing diabetes.
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AG ING WELL
Muscle BUILDING AND MAINTAINING MUSCLE AFTER AGE 50
Up!
or many people, one serious consequence of aging is frailty, marked most noticeably by loss of muscle tone, strength and mass, as well as stiff joints with decreased mobility. The condition often also results in weak, fragile bones that are more prone to fracture during a fall—an increasingly likely risk as people age. But is it possible to stave off some of these effects of aging, and maintain or even build muscle mass, improve mobility, and strengthen bones as we move into our fifth, sixth and seventh decades of life? Is it inevitable that our bodies will lose muscle as we age? 14 |
“The answer is yes—and no,” says Benjamin Mwanika, DO, of Sentara RMH Orthopedic and Sports Medicine. “There’s the old adage that you lose it if you don’t use it, and that’s certainly true. The more inactive you are, the less muscle mass you’re going to build and retain. But that’s no less true when you’re 20 or 30, than when you’re 60 or 70.” The general tendency of muscle is to atrophy if it’s not used, Dr. Mwanika explains, and this kind of “disuse
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atrophy” is especially present in older people, who tend to be less active— often due to orthopedic or other physical problems they may have. Another condition known as sarcopenia (“lack of flesh”) refers to muscle loss resulting from certain metabolic or physiological deficits that occur as we age, according to Clark Baumbusch, MD, with Sentara Martha Jefferson Sports Medicine. These deficits include lower levels of growth hormone and, in men, decreased testosterone levels, beginning typically after age 30. The good news, both physicians agree, is that with strength training and proper diet, most people can slow down or even halt the processes responsible for loss of muscle mass and tone. Thankfully, according to Dr. Mwanika, there isn’t really an age at which it becomes impossible to build muscle mass. “It’s not likely that you’re going to build a ‘beach body’ when you’re 60 or 70, but most people can improve their muscle tone and even build muscle at any age,” he says. “However, the focus in older people should be on contributing to their overall health, rather than the aesthetics of bodybuilding.”
Why Build or Maintain Muscle as We Age? While muscle makes it possible for us to move, strong muscles also serve an important preventive function. “People with significantly decreased muscle mass tend to have higher fall risk,” says Dr. Baumbusch. “And that’s one of the single most concerning things in elderly people: falls leading to skeletal fracture. Building or maintaining muscle tone and mass helps you maintain good balance. And if you do fall, having more muscle mass decreases your chance of having a traumatic injury.” sentara.com
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AG ING WELL
There is also evidence, he continues, that circulating growth hormones are present in higher quantities in people with greater skeletal muscle mass. Strength training to build muscle seems to help the body secrete more hormones like testosterone, which in turn contributes to increased muscle growth, setting up a kind of positive feedback cycle. In addition, having greater skeletal muscle mass helps boost the metabolism, causing more calories to be burned—even when we’re resting. Strength training benefits more than just muscles, however. The resistance that weightbearing exercise places on our bones helps keep them strong and contributes to growth of new bone tissue, Dr. Mwanika says. Stronger muscles also help stabilize our joints, making us less prone to joint injuries.
Strength Training Tips
Dr. Mwanika says he advises his patients who are 40 and older and are interested in strength training to proceed using common sense. “You’re not likely to bench press the same weight at 65 or 70 that you did in high school or college, especially if you’re coming back to strength training after years of nonparticipation,” says Dr. Mwanika. “Trying to lift too much weight can lead to ruptured muscles or tendons.” He generally recommends using lighter weights and doing 3 to 5 sets of 12 to 15 repetitions per set, with a 60-second rest between sets. Older adults also should give muscles sufficient time to recover. “Following a strength training schedule of one day on, one day
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off is probably right for most people,” he adds. Although lifting weights is an obvious way to build and tone muscle, it certainly isn’t the only way. Any type of resistance that regularly requires muscles to work can do the trick. “There are multiple studies showing, for example, that doing resistance exercise on a stationary bike for 45 minutes, three days a week, will increase the mass of the quadriceps muscles over time,” says Dr. Baumbusch. He also recommends adding some cardio exercise to any strength training routine to help improve the heart’s ability to circulate blood. “Improved circulation resulting from cardio training will help pull lactic acid, one of the byproducts of exercise, from muscle tissue, helping you recover more quickly after strength training,” says Dr. Baumbusch.
Safety First
People who have been away from exercise for a long time should check with their physician before starting a strength training routine, particularly if they have any medical or musculoskeletal problems that might pose a risk of injury. It’s also a good idea, says Dr. Mwanika, for those coming back to strength training to
consult with an athletic trainer, fitness coach, physical therapist or sports medicine specialist to help them find an exercise program that’s right for them. While it is possible to lift weights at home, joining a gym can have multiple advantages, including a wide range of exercise options and trained staff who can help members safely learn the exercise movements while maintaining proper form. “Particularly if they have any orthopedic problems, like a weak rotator cuff or arthritis in the hip or knees, they should check with a professional who can help them modify the exercises to find what works best for them,” Dr. Baumbusch says. Warming up with light cardio exercise and stretching for five to 10 minutes helps prepare the body for exercise, he adds. Following a heavy workout, doing a cooldown of light cardio and stretching for five to 10 minutes also helps clear the body of lactic acid and allows heart rate, body temperature and respiration to return to normal. While there are huge health benefits to be gained from building and maintaining muscle, both physicians emphasize that it’s also important to find workout activities that are enjoyable, so that exercise doesn’t become just another chore— which can lead to burnout. Any activity, however, is better than no activity, and that’s true at any phase of life. “Whatever your age, exercising and building strength can have important health benefits and help prevent injury,” says Dr. Mwanika. “It’s never too late to get those muscles working.”
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calendar Sentara Martha Jefferson Hospital is pleased to provide a variety of health education opportunities to community members. Highlights of the spring 2020 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 March 18, April 23, May 28, June 25, July 23 1-3 p.m. This free seminar discusses specific types of bariatric surgery and whether those options might be right for you. A free online seminar is also available at Sentara.com/weightlosssurgery.
Joint Camp: A Complete Guide to Preparing for Knee and Hip Surgery Details on Sentara.com. Call 1-800-SENTARA for dates and times.
Joint Pain: When is Enough, Enough? Tuesday, May 19, 6-7 p.m. Sentara Martha Jefferson Outpatient Care Center at Pantops Kessler Conference Room 595 Martha Jefferson Drive, Charlottesville Is joint pain keeping you from the things you like to do? Join board-certified orthopedic surgeon Dr. Megan Swanson for a discussion on causes of chronic hip and knee pain and the treatment options available to you. This is a free seminar, but registration is required. To register, call 1-800-SENTARA (1-800-736-8272).
Preparation for Childbirth * 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 due to limited space—classes fill quickly! An online Preparation for Childbirth class is also available.
Advance Care Planning Assistance Class meets on the first Thursday at 10 a.m. and the fourth Thursday at 3 p.m., Phillips Cancer Center Conference Room, 3rd floor of Sentara Martha Jefferson Hospital As part of routine health care, we encourage everyone over the age of 18 to complete an advance directive. An advance directive designates who will make health decisions for you if you cannot speak for yourself. It informs your care team of your choices for future medical care. During our class, we will answer your questions about advance care planning, will assist you with completing an advance directive, and will file your completed advance directive with the U.S. Living Will Registry. We will also submit it to medical records to be included in your electronic medical record so your care team will have access to the document. Please register by calling Tammy James at 434-654-5597.
Out of the Blues—A Postpartum Support Group Meets the second and fourth Thursdays of each month, 10:30 a.m.-noon. Sentara Martha Jefferson Outpatient Care Center, Community Education Room 595 Martha Jefferson Drive, Suite 330 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, please call 434-654-4415.
Registration for all classes is required unless otherwise noted. To register, call 1-800-SENTARA.
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Empty Arms, Full Hearts Support Group 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. To learn more, please contact Tammy James at 434-654-5597.
Sentara Martha Jefferson offers a variety of other classes and seminars, including the following:
Cancer Support Groups Various cancer support groups are offered. Please contact Tammy James at 434-654-5597 to explore which group best fits your needs.
Basics in Baby Care
Sentara Star Hill Health Center
Breastfeeding
A free wellness center located at the Jefferson School City Center, 233 4th St. NW, second floor, Charlottesville
Calming the Chaos
The center helps children, adults and families set goals for weight control and overall wellness, track their progress, and manage chronic diseases like high blood pressure and diabetes. Programs include free cooking classes, stress reduction and wellness sessions. In partnership with the Women’s Initiative and Common Ground Healing Arts, Drop-in Wellness Tuesdays are held from 9 a.m.-noon, offering blood pressure and blood sugar screenings, acupuncture and other wellness services. All services are free and open to the public. To schedule an appointment, call 434-984-6220.
Sunsets with Sentara Wednesdays, June 17 and July 15, 5:30 p.m. (rain dates: June 18 and July 16)
Sunsets
Relax on the lawn at Sentara Martha Jefferson with your family and friends while enjoying the sunset and live music provided by local bands. Refreshments will be available for purchase from local food trucks, wineries, cideries and breweries.
Women, Wine & Wellness Wednesday, April 22, 6-8:30 p.m., The Paramount Theater The Sentara Martha Jefferson Cancer Care Center will be hosting our fourth annual Women, Wine & Wellness event at the Paramount on April 22. Grab a friend and join us for wine, light hors d’oeuvres, and candid conversation with our physician experts and breast cancer survivors. Our speaker lineup this year includes: • •
Dani Antol—co-owner, Rock, Paper, Scissors Elizabeth McClanahan—former justice of the Supreme Court of Virginia
Attendance is free, but registration is required. Please call 1-800-SENTARA or register online at Sentara.com.
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Heart to Heart Support Group Sibling Tours Taking Control (stress management) Welcome to Motherhood Support Group Welcome to Parenthood Support Group 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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By Karen Doss Bowman
What Lies Beneath Brainlab Maps Out Even the Most Complex Brain Tumors For years, Catherine Perkins experienced frequent headaches. Doctors believed the ongoing pain was the result of stress from the long hours she dedicated each week to the horse breeding and training business she and her husband owned, as well as to her job as manager of a Dollar General store. sentara.com
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ne evening in August 2019, Perkins began showing signs of confusion, speaking incoherently and losing consciousness. As her condition worsened over the next several days, her husband, Dennis, called 911 and had her transported to Sentara Martha Jefferson Hospital via ambulance. A CAT scan revealed that Perkins had a benign brain tumor called a meningioma. “I was definitely surprised to learn that I had a brain tumor,” says Perkins, 59. “It was scary news, but I felt I was in good hands at Sentara Martha Jefferson.”
Catherine Perkins
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Not Cancer, Yet Potentially Fatal The majority of meningiomas are noncancerous, and they account for about one-third of all brain tumors, according to the American Brain Tumor Association. Unlike many brain tumors, meningiomas do not arise from brain tissue, but instead grow from the thin layers of tissue surrounding the brain and spinal cord. Perkins’ tumor was extremely large, according to neurosurgeon David Slottje, MD. The mass was located in her right frontal and temporal lobes, extending down to, and putting pressure on, her brainstem. “It was a benign tumor, meaning it wasn’t cancer— but that didn’t mean it could be left untreated,” Dr. Slottje says. “With these masses, it's a bit like real estate: it’s all about location, location, location. Cathie’s tumor was in a very bad location, and it was quite enormous.” The tumor was wrapped around or putting pressure on the critical arteries supplying blood to Perkins’ brain, including the left and right carotid arteries, the right middle cerebral artery and the right anterior cerebral artery, explains Dr. Slottje. It also completely encased the right optic nerve and was growing into the optic canal. Additionally, a small portion of the mass had grown adjacent to the basilar artery along the brainstem and was pushing against the pituitary gland. For many patients with smaller meningiomas or growths not impinging on critical areas within the brain, radiation or a watch-and-see approach are the only necessary interventions—surgery is usually
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Dr. David Slottje
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AN IMPORTANT PART OF BRAIN TUMOR SURGERY IS RECOGNIZING WHAT CAN BE REMOVED SAFELY AND WHAT CAN'T BE.” MEET THE DOCTOR
David F. Slottje, MD Sentara Martha Jefferson Hospital is committed to providing the most advanced services available to patients in need of brain or spine care. With the expansion of the Department of Neurosciences, the hospital welcomed neurosurgeon David F. Slottje, MD, to the medical team in summer 2019. A New York native, Dr. Slottje brings expertise in several new procedures, including the treatment of brain tumors and vascular lesions. Fellowship trained in neurocritical care, he is focused on clinical areas such as neuro-oncology and cerebrovascular disorders. A graduate of Weill Cornell Medical College, Dr. Slottje completed his residency at Rutgers University and a fellowship at Thomas Jefferson University. “The diagnosis of a brain or spine disease is a source of tremendous personal stress for individuals and families,” says Dr. Slottje. “I’m committed to learning about my patients as complete individuals, and not just as they’re defined by their medical condition alone. It’s my role to educate my patients about their illness, and then we can work together to formulate and enact a personalized treatment plan that best suits their needs.” Dr. Slottje’s wife, Rebecca Burke, MD, is a hospitalist at Sentara Martha Jefferson. A native of the Charlottesville area, Dr. Burke also serves as the associate medical director for Hospice of the Piedmont.
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reserved for larger growths that are causing symptoms. In Perkins’ case, since her brain was swelling, she would need life-saving surgery to remove or reduce the size of the tumor. First, however, Dr. Slottje prescribed steroid medications to reduce the swelling and stabilize her condition. “Even though this was a benign mass that had grown slowly over many years, we couldn’t allow it to continue growing, because eventually the swelling would overwhelm the steroid therapy,” Dr. Slottje says. “That would only increase the severe neurologic deficits she was experiencing and eventually cause death. Even though it was a high-risk procedure, we recommended that she have surgery to remove as much of the meningioma as possible, since it had basically wrapped around most of the most critical blood vessels and structures of the brain. Cathie’s tumor was far too big to be treated with radiation, and she was already intensely symptomatic from it. Surgery was really the only option for her.”
Visualizing Targeted Areas for Surgery Sentara Martha Jefferson’s Neurosciences Department uses Brainlab, a navigational computer tool that generates 3D images of the brain’s structures, precisely mapping out the location of even the most complex tumors. The platform, which resembles GPS technology, enhances surgical planning and navigation for improved patient
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safety and better outcomes. In addition to mapping brain tumors, Brainlab can be used to assist in the treatment of arteriovenous malformations—a tangle of blood vessels in the brain that can cause life-threatening complications—and other conditions affecting the brain. “This technology allowed me to plan a route of attack for the surgery to remove as much of the mass as possible without harming Cathie,” adds Dr. Slottje, who was assisted during the 10-hour procedure by neurosurgeon Jacob Young, MD. Sentara Martha Jefferson installed an upgraded version of Brainlab last summer, adding the ability to map out different brain segments in relation to different anatomical sections. “That function was very useful with this case,” Dr. Slottje says. “For example, looking at Cathie’s MRI scan alone, it appeared that her tumor was situated next to the optic nerve—when, in fact, the growth encased the nerve. I learned this from the Brainlab reconstructions of the tumor showing the different parts of the anatomy, and that was a crucial piece of information to have going into the surgery.” Today, about 5% of the tumor remains in Perkins’ brain, since it was intertwined with critical structures and arteries in the brain. If this remaining portion shows any signs of growth, it will be treated with targeted radiation, likely preventing further growth and providing control of the tumor for decades. “An important part of brain tumor surgery is recognizing what can be removed safely and what can't be,” says Dr. Slottje. “It’s a constant struggle and tension between the desire to provide a cure and the need to avoid harming the patient. I made a calculated decision before the procedure to leave that portion of the tumor alone.”
illness,” Dr. Slottje says. “There is nothing more rewarding than gaining the trust of a patient and their family and helping them get back to the person they were before they were sick. Perkins is grateful for the care she received at Sentara Martha Jefferson. “Dr. Slottje and the rest of the medical team took good care of me,” Perkins says, adding that Dr. Slottje even called her at home several days after she left the hospital just to check on her. “Everybody at Sentara Martha Jefferson was so nice to me, and they really catered to me. This was the most dangerous surgery I've ever had, but everything went well in the hospital, and I recovered extremely quickly. I'm a fighter. I always have been, and always will be. I did what I had to do to recover, and the hospital did what they needed to do to help me recover. Thankfully, everything turned out well.”
Back to Life Since her surgery in August, Perkins has done remarkably well. She’s enjoyed getting back to an active lifestyle, including artistic pursuits such as crafting, crocheting and jewelry making. “It’s wonderful to see Cathie doing so well after recently facing a life-threatening sentara.com
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Coming Back STRONGER
THAN EVER
With Proper Injury Care, Athletes Return to the Sports They Love
T
he orthopedic surgeons at the Sentara Sports Medicine Center at Sentara Martha Jefferson Hospital understand the needs of athletes. They have experience caring for athletes at all levels— from weekend warriors to professional athletes—and they use their in-depth knowledge to find the best treatments for each patient’s unique injury, prevent future complications and improve athletes’ long-term health.
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A Cyclist’s Return from a Collarbone Break Sid Crocker likes to challenge himself physi-
Sid Crocker
cally with mountain biking, kayaking, backpacking and other activities. In 2018, he took his new mountain bike out on some rough terrain with a friend at Observatory Hill in Charlottesville. While attempting to jump the bike over a rock, he flew over his handlebars and landed on his right shoulder. At the moment of impact, he felt a crack in his collarbone with severe, sharp pain. After a long hike back to his truck, Crocker went to the Sentara Martha Jefferson Emergency Department to get an X-ray, which confirmed his suspicion: His collarbone was fractured in multiple places and severely displaced.
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It was amazing to get back on the bike and continue to do things I like."
A nursing supervisor who has worked at Sentara Martha Jefferson for 11 years, Crocker searched for treatment options that would allow him to return to his outdoor activities. He met with Sentara Martha Jefferson orthopedic shoulder and sports surgeon Stephen B. Gunther, MD, who recommended surgery.
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Using a highly technical minimally invasive procedure, Dr. Gunther inserted a titanium rod inside Crocker’s shoulder bone. The procedure realigned the fractured fragments, stabilized the bone and allowed full healing. Crocker had the procedure at Sentara’s Outpatient Surgery Center at Pantops. “It was great,” he says. “The nurses were fantastic. I know some of them, and they were all interested in why I was there having surgery.” The recovery period tested him, since he had to keep his right shoulder in a sling to reduce movement and promote healing. “It was hard not to be able to exercise or cook and prepare meals,” he recalls. “Life was certainly challenging, living in a sling and not doing much with my right side.” Crocker, who is 40, noticed that his body didn’t heal as fast as it used to during his youth, even though he’s an athlete and eats a healthy diet. “I felt like I should have bounced back quickly, but I’m not 20 years old anymore,” he admits. Five months after his April 2018 surgery, Dr. Gunther gave Crocker the all-clear to return to his favorite activities. To celebrate, Crocker went on a whitewater rafting trip in West Virginia. He also returned to mountain biking at the scene of his injury at Observatory Hill, where he is still hoping to master that jump. “Cycling and kayaking are integral to my life and my happiness,” Crocker says. “It was amazing to get back on the bike and continue to do things I like. Dr. Gunther is an excellent surgeon who gives you straightforward answers. The outcomes have been nothing but amazing.”
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A Volleyball Player’s Comeback from Knee Injury An on-court collision with a volleyball teammate left Maggie Butters with a knee injury during her junior year of high school. While playing with her club team in February 2019, Butters dislocated her knee and tore her medial patellofemoral ligament (MPFL), which is located on the inside of the knee and holds the kneecap in place. She also damaged the cartilage under her kneecap. “The top half of my leg went one way, and the bottom half went the other,” she says. “I couldn’t put weight on it or straighten it.” Butters went to Sentara Martha Jefferson orthopedic surgeon Matthew J. Panzarella, MD, for treatment. “When I went in for the first appointment, Dr. Panzarella was very nice and very welcoming,” says Butters. “He really made me feel right at home. I knew I could trust him with fixing my knee. He gave me a lot of information, and I know a lot about the knee now.” Through reconstruction surgery, Dr. Panzarella replaced Butters’ injured MPFL with part of her hamstring tendon, stabilizing her knee and helping to prevent future joint damage. Following the procedure, four months of physical therapy helped strengthen
Maggie Butters
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Butters’ knee. She also used an electrical muscle stimulator at home to stimulate the nerve muscles in her quadriceps and help her move again. “Rehab is super important in these cases,” says Dr. Panzarella. “Surgery is half of it, but rehab is the other half, and Maggie was a superstar at working to get her strength back.” The injury and recovery helped push Butters to be her best on the volleyball court. After struggling to get playing time in previous seasons, she was a team captain at Madison County High School during her senior year and helped lead the team all the way to the state semifinals. She earned firstteam all-district and all-region honors, first-team all-Central Virginia honors, and second-team allstate honors. Butters has committed to play volleyball beginning in fall 2020 at Franciscan University of Steubenville, where she plans to major in nursing. “I feel like this is kind of a comeback story,” she says. “Even though I had this injury, it was just something to make me come back stronger and get that position on the court. I’ve grown a lot from this experience. I can’t thank Dr. Panzarella enough for everything he did for me.”
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Back on the Football Field After Meniscus Surgery Noah Robinson injured his right knee in offseason training during his junior year at Louisa County High School. The 17-year-old wide receiver tore his lateral meniscus, which is a critical cushion for the knee and a protector for the knee’s cartilage. Standard care for such an injury used to involve removing the damaged tissue, which often caused long-term damage to the knee. To preserve the meniscus and its critical cushioning using a more modern procedure, Sentara Martha Jefferson orthopedic surgeon Clark Baumbusch, MD, performed a partial lateral meniscectomy with a lateral meniscus repair on Robinson’s knee. Dr. Baumbusch used this minimally invasive technique to suture the tear and anchor the meniscus to the bone. “Dr. Baumbusch is very knowledgeable,” Robinson says. “He had done the operation many times before, so I felt comfortable with him.” Robinson had to stay off his feet for a month after the procedure to give his knee time to heal, and then he did six months of physical therapy to get back his strength and mobility. Although the procedure requires a longer recovery time than a meniscus removal, Dr. Baumbusch says that extra time is worth it. “As sports surgeons, we aren’t just worried about next season—we’re worried about three seasons from now,” Dr. Baumbusch explains. “It’s important to fix these problems correctly, so that the knee is stabile and healthy for decades to come.” The surgery and Robinson’s hard work paid off. After missing the first half of his senior season at Louisa, Robinson returned to the field, earning first-team all-district and first-team all-region honors in 2019. Dr. Baumbusch even checked in with Robinson via text messages after his games. “Dr. Baumbusch is a really cool guy,” says Robinson. After graduating from high school early, Robinson signed to play football with Old Dominion University. He started his college classes and football team meetings in January 2020, with a knee he feels is ready for college football. “I feel 100 percent,” he says.
Noah Robinson
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FINISHING THE M
Fight Cancer Survivors Continue Recovery Through Exercise
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onths after completing radiation treatments and chemotherapy for stage 3 esophageal cancer in 2018, Richard Wagner was declared cancer-free by his medical team at the Sentara Martha Jefferson Cancer Center. While the news was definitely worth celebrating, Wagner knew the struggle to regain a sense of normalcy in his life would continue. The disease and powerful chemotherapy drugs took a toll on Wagner’s body, causing adverse effects such as poor muscle tone and weakness, hearing loss, and balance problems. He also developed shingles in the midst of his therapy and was 30 pounds underweight by the time his treatments ended. “I had the best treatments and the best medical team possible, and I was cancer-free—but the battle was not over,” says Wagner, 83, who now lives near Charlottesville after a long, distinguished career as a CBS News correspondent
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based in various parts of the world. “It was comforting to know I wasn’t going to die of cancer and its related ailments, but I wasn’t home free at all. I was generally in bad physical shape from the cancer, which is such an evil disease, as well as the aftereffects of chemotherapy.” One of Wagner’s doctors told him about Sentara Martha Jefferson’s Cancer Rehab and Renewal Program, which is designed to help cancer survivors as well as patients who are still undergoing treatment reclaim their lives and establish healthy habits. Wagner jumped at the chance to enroll. “This program seemed to be exactly what I needed to restore a good quality of life and get back to the activities I enjoy,” he says.
Taking Back Control It’s not uncommon for cancer patients to feel generally powerless over their bodies and lives as a whole. In addition to the physical issues Wagner experienced, cancer treatments may cause patients to become extremely fatigued, lose joint flexibility and mobility, and suffer a general decline in fitness. Cancer Rehab and Renewal can help patients reestablish a sense of control as they work to regain independence, become stronger and feel better overall. “After treatment, patients are happy to have their cancer resolved, but they often encounter a whole other group of issues as well,” says Michele Howe, PT CLT-LAN, one of the program’s directors and session leaders. “We work closely with each participant
and tailor the exercise program for their needs. Ultimately, they gain a sense of empowerment and confidence in their ability to raise their fitness and daily functioning to a higher level. They really feel like they are taking back their bodies and their lives.” The 12-week exercise program, which was first offered in April 2018, is customized for each individual’s unique needs. Following an initial assessment, a cancer exercise specialist guides each participant through three group or individual exercise sessions a week, offering access to a variety of gym equipment, a walking/jogging track, resistance devices and therapy tools to gradually improve mobility and cardiorespiratory fitness. The sessions, which are free, are offered at the Sentara Martha Jefferson
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Health and Wellness Center. Participants need a doctor’s referral to enroll. “The rehab program is a good starting point for patients to help rebuild the sense of self that can be lost when going through a serious illness like cancer,” says clinical exercise specialist Tracey Hill, who co-directs the program and leads sessions. In addition to group and individual exercise, participants are invited to attend group coaching sessions on topics such as daily living activities, lymphedema (blockage in the lymphatic system following lymph node removal or other cancer treatment), scar management, energy conservation and stress management.
Staying Fit Boosts Recovery Research shows that many cancer patients have better outcomes when they participate in some type of fitness program while undergoing treatment, according to Howe. And once they are finished with treatments, these individuals tend to bounce back quickly to their baseline fitness level. Michelle Edwards, 57, began the cancer rehab program in August 2019, in the midst of chemotherapy treatments for breast cancer. The customization of the sessions allowed her to continue with fitness efforts even during times when she was not feeling well. When she was too weak for strength training workouts, for example, she focused on stretching. In December, she took a hiatus from the program to recover from her lumpectomy. Once she resumed exercising in January, however, she recovered quickly, thanks to the rehab training she had begun the previous summer.
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“I didn’t have a strong exercise regimen before my cancer diagnosis, but this program put me on the path toward doing something good for myself,” says Edwards, a training consultant for Booz Allen Hamilton. “Even on days when I felt bad from chemo treatments, just having someone to say, ‘It’s okay—just do what you’re able to do, and don’t push it,’ was motivating. It also gave me a reason to get out of the house for something besides chemotherapy.” Her exercise group also became an important part of her support network, giving her an outlet for sharing concerns and triumphs with other cancer survivors. “I started from a good place emotionally because I have a strong support system of family and friends,” says Edwards, who was able to take a cruise on the Danube River with her husband, Wayne, and her mother in the midst of treatments. “I’m not normally one to be drawn to support groups, but the ladies I worked out with every week almost became an organic support group, even though it was not structured as such. We had similar
diagnoses, similar treatments and many of the same doctors. In the course of exercising together, we shared our experiences and encouraged each other.”
Finding a New Normal Since completing the Cancer Rehab and Renewal Program last year, Wagner believes his balance and strength have improved, though he still uses a cane. Overall, he’s feeling better. “I found Michelle and Tracey wonderfully knowledgeable about what had to be done to restore my physical abilities,” says Wagner, who in March celebrated 30 years of marriage to his “forever Valentine,” Donna Lewis-Wagner. “The benefit of cancer rehab is that it helps you address what’s left after you’re pronounced cancer-free, when you realize that the struggle is not over. My physical condition has improved as a result of this program, and it’s helped to keep me motivated. I’m grateful that Sentara Martha Jefferson offers this program, which should be an essential part of anyone’s overall cancer care.”
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SENTA R A IN THE CO MMUNITY
Sentara’s
Dedicated Commitment
to the Blue Ridge Region Since Its Earliest Days, Sentara Healthcare Has Stayed True to Local Communities Among the wreckage of destroyed shipyards and charred buildings, the people of Norfolk, Va., set out to rebuild after the conclusion of the American Civil War in 1865. As part of the recovery effort, the Norfolk Women’s Christian Association pitched the idea of a hospital.
Local physicians and civic leaders agreed with the need to establish a local healthcare facility, donating $5,000 for a down payment on a Spanish-style house. The 25-bed Retreat for the Sick opened in 1888, planting the roots of what would later grow into Sentara Healthcare. Now, 132 years later, Sentara Healthcare spans Virginia and northeastern North Carolina, with 12 acute care hospitals and more than 300 sites of care. The network includes two hospitals with outpatient care clinics in the Blue Ridge region: Sentara RMH Medical Center in Harrisonburg and Sentara Martha Jefferson Hospital in Charlottesville.
Sentara’s first home: the Norfolk Retreat for the Sick, constructed in 1888 on the corner of Holt and Reilly Streets.
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SENTA R A IN TH E C O M M U N I T Y
centers on the hospital campus—both of which were constructed thanks in part to access to low-cost capital provided by Sentara, which allowed new construction to move forward. Sentara Martha Jefferson has experienced similar growth and benefits by partnering with a larger healthThe Power of Collaboration care system focused on innovations in care. Modern Healthcare magazine has ranked Sentara one “Navigating the ever-changing delivery systems in of the nation’s top integrated healthcare systems for health care is a difficult yet important journey, “says more than a decade. That consistent level of success is Jonathan Davis, president of Sentara Martha Jefferson likely due, in part, to the close ties among caregivers Hospital. “Sentara serves as both a catalyst for change at the system’s diverse facilities, through which leaders in our industry and as an incubator for cutting-edge at all 12 Sentara hospitals collaborate and combine reimprovements in care processes. We have been able to sources to help ensure efficient, state-of-the-art patient face the many industry headwinds and accelerate our care across the network. quality of care today and into the future because of As Sentara RMH and Sentara Martha Jefferson our Sentara family. I’m excited about the approach their respective 10th andirection in which Sentara Martha Jefferniversaries of joining Sentara, each Sentara at a Glance son is headed, given our focus on clinical hospital’s president reflects on the excellence and meeting the ever-changing positive changes that have taken healthcare needs of our community.” place since joining the network. OUR MISSION Over the past 10 years, Sentara “Being part of a large, innovaWe improve health Martha Jefferson has introduced many new tive healthcare system like Sentara services, including neurointerventional raevery day brings many benefits to Sentara diology, advanced gastroenterology services RMH—clinically, financially and in and advanced colorectal cancer services. VALUES terms of effective management,” The hospital also has opened its freestandsays Doug Moyer, president of Sen- People, quality, patient safety, ing emergency department north of town. tara RMH. “We can draw from the service and integrity These services, which provide great value expertise of the system’s multiple to the community, were made possible hospitals, sharing best practices in VISION in part due to Sentara Martha Jefferson’s the care we provide and getting partnership with a larger healthcare system, multiple perspectives from hospiTo be the healthcare Davis adds. tal leaders throughout the system. choice of the As a not-for-profit healthcare system, Sentara’s focus is on patients and local communities, with a primary goal to improve health every day by focusing on quality, patient safety, service and integrity.
We’re also able to lower our costs because of the economies of scale we achieve by purchasing supplies and equipment in larger volumes.” Concrete examples of how Sentara RMH and its community have benefited from partnership with Sentara include the Funkhouser Women’s Center and the Orthopedic and Advanced Imaging
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communities we serve
Giving Back Each Sentara hospital is firmly rooted in its respective community, and giving back to the local areas Sentara serves is essential to our mission. In the Blue Ridge Region, the Martha Jefferson Hospital and RMH foundations have directed millions of dollars in donations that stay exclusively within their local communities.
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Likewise, at Sentara RMH, the hospital has been able to expand its services and outreach thanks to the efforts of foundation board members and donors. “Donors in our community help improve and save the lives of our patients in countless ways,” says Cory Davies, executive director of the RMH Foundation. “They are heroes in every sense of the word, and we are so grateful for the impact their generosity has on the care our patients receive.” “The foundation is a conduit between caring and generous community members and programs and services we wouldn’t be able to provide through operations support alone,” says Ray Mishler, vice president of the Martha Jefferson Hospital Foundation. “Our donors are the heart and soul of Martha Jefferson’s Caring Tradition.”
COMMITTED TO THE COMMUNITY In the Charlottesville area and Shenandoah Valley, the Martha Jefferson Hospital Foundation and RMH Foundation have directed millions of dollars in donations to their local communities. Some recent examples include:
Martha Jefferson Hospital Foundation
Sentara By The Numbers As a not-for-profit healthcare system, we serve patients across Virginia and northeastern North Carolina with:
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Free clinical breast exams and mammograms for more than 100 women annually
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Scholarships to local community college students to develop entry-level employees interested in building careers at Sentara Martha Jefferson
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Up to $20,000 each in financial support for more than 100 nurses to return to school for an advanced degree, benefiting their careers and professional development, as well as improving the overall quality of bedside patient care
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Continuing the Martha Jefferson Caring Tradition through funding for palliative care, cancer survivorship programs, and nursing resiliency initiatives.
12 hospitals 300+ sites of care 1,000+ physicians and
advanced practice clinicians
RMH Foundation
2,741 beds
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Approximately 280 free mammograms provided annually to underinsured/uninsured women
3,800 medical staff providers
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$159,000 in scholarships awarded to nurses enrolled in Bachelor of Science in Nursing programs while also working at Sentara RMH
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Nearly $650,000 in donations to provide new cardiac monitors for each rescue squad throughout Rockingham County, helping to ensure that patients suffering a heart attack will get the timely, life-saving care they need
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More than $19,000 in medication assistance to help patients fighting cancer in the Shenandoah Valley
28,000 team members 500,000 people served by Optima Health, our health plan in Ohio, North Carolina and Virginia
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HEALTH MATTERS
Know the Signs and Symptoms of
Stroke
A stroke is a “brain attack” that can take two generally distinct forms. Most strokes occur when a blood clot lodges in an artery and blocks blood flow to some part of the brain. Another variety of stroke occurs when a blood vessel in the brain ruptures, causing bleeding into the brain. Regardless of the type, however, a stroke is an urgent medical emergency. When brain cells are deprived of oxygen-rich blood during a stroke, they die, leading to permanent brain damage that can result in disability or even death. According to the American Stroke Association, stroke is the fifth-leading cause of death in the United States and a leading cause of disability—so it’s important to learn the signs and symptoms of stroke and to seek immediate medical help when those signs are present.
Signs and Symptoms of Stroke: ALWAYS SUDDEN Anyone can have a stroke— regardless of age, race or gender. However, nearly three-quarters of all strokes occur in people over the age of 65, and the risk of having a stroke more than doubles each decade after age 55. The most common signs and symptoms include the following: • Sudden numbness or weakness of the face, or an arm or leg on one side of the body • Sudden confusion, or difficulty speaking or understanding • Sudden vision changes in one or both eyes
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• Sudden difficulty with walking, dizziness, or loss of coordination or balance • Sudden, severe headache for no known reason If any one of these five symptoms is recognized, call 911 immediately.
The Importance of a Quick Response When a stroke occurs, every second counts—and the countdown begins at the onset of symptoms. The longer the time before treatment begins, the greater the number of brain cells that die. The acute treatment window for a stroke is 24 hours, but the sooner you seek emergency care,
the better off you or your loved one will be. Even if initial stroke symptoms go away, however, always call 911. Often these “mini-strokes,” also known as transient ischemic attacks (TIAs), are warning signs that a more severe stroke is likely to occur. Within about two weeks, 40% of persons having a TIA will go on to suffer a full stroke. Seeking immediate medical care for any stroke symptoms offers the best chance of recovery, or in the case of a TIA, of avoiding a more severe stroke.
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LA SALUD IMPORTA
Conozca las señales y síntomas del
accidente cerebrovascular Un accidente cerebrovascular es un “ataque cerebral” que puede producirse de dos formas generalmente distintas. La mayoría de los accidentes cerebrovasculares ocurren cuando un coágulo de sangre se aloja en una arteria y bloquea el flujo sanguíneo hacia alguna parte del cerebro. Otra tipo de accidente cerebrovascular ocurre cuando un vaso sanguíneo en el cerebro se rompe y causa sangrado en el cerebro. Sin embargo, independientemente del tipo, un accidente cerebrovascular es una emergencia médica urgente. Cuando las células cerebrales se ven privadas de sangre rica en oxígeno durante un accidente cerebrovascular, mueren, lo que conduce a un daño cerebral permanente que puede resultar en una discapacidad o incluso la muerte. Según la Asociación Americana de Accidentes Cerebrovasculares, el ataque cerebrovascular es la quinta causa de muerte en los Estados Unidos y una de las principales causas de discapacidad, por lo que es importante conocer los signos y síntomas del accidente cerebrovascular y buscar ayuda médica inmediata cuando esos signos están presentes.
Señales y síntomas del accidente cerebrovascular: SIEMPRE ES REPENTINO Cualquier persona puede tener un accidente cerebrovascular, independientemente de su edad, raza o sexo. Sin embargo, casi tres cuartas
partes de todos los accidentes cerebrovasculares ocurren en personas mayores de 65 años y el riesgo de tener un accidente cerebrovascular se duplica cada diez años después de los 55 años. Los signos y síntomas más comunes incluyen los siguientes: • Entumecimiento repentino o debilidad de la cara, un brazo, pierna o en un lado del cuerpo • Confusión repentina o dificultad para hablar o entender • Cambios repentinos en la visión en uno o ambos ojos • Dificultad repentina para caminar, mareos o pérdida de coordinación o equilibrio • Dolor de cabeza repentino e intenso sin razón conocida
Si reconoce alguno de estos síntomas, llame al 911 inmediatamente.
La importancia de una respuesta rápida Cuando se produce un accidente cerebrovascular, cada segundo cuenta y la cuenta regresiva comienza cuando aparecen los síntomas. Cuanto más tiempo transcurra antes de que comience el tratamiento, mayor será la cantidad de células cerebrales que mueren. La ventana de tratamiento agudo para un accidente cerebrovascular es de 24 horas, pero cuanto antes busque atención de emergencia, mejor será para usted o su ser querido. Incluso si los síntomas iniciales del accidente cerebrovascular desaparecen, siempre llame al 911. A menudo, estos “miniaccidentes cerebrovasculares”, también conocidos como ataques isquémicos transitorios (AIT), son signos de advertencia de que es probable que ocurra un accidente cerebrovascular más grave. Dos semanas después, el 40% de las personas que tienen un AIT sufrirán un accidente cerebrovascular completo. Buscar atención médica inmediata ante cualquier síntoma de accidente cerebrovascular ofrece la mejor posibilidad de recuperación, o en el caso de un AIT, de evitar un accidente cerebrovascular más grave. sentara.com
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EAT WELL , LIVE WELL
A BudgetFriendly
Pantry List
By Patricia Tyndale, RD Sentara Martha Jefferson Hospital
for Healthy Eating fter the bustle of the winter holidays, spring is a great time to take a closer look at your pantry and focus on stocking your shelves with healthier food options. But first, it’s a good idea to ask yourself a few questions:
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What do you see when you open your cabinets, refrigerator or freezer?
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What are some staple foods you buy during every grocery store trip?
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Are these staple foods generally considered healthy or unhealthy?
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Does your budget keep you from buying healthier options?
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Unfortunately, we don’t always make our food choices based on the desire to eat healthy. Often, financial factors and cultural practices may play a bigger role in the foods we buy and eat. We often hear that “fresh is best.” However, given certain factors, it may not always be ideal for consumers to buy fresh foods. Knowing which foods are both healthy and convenient might help change the way we shop. For instance, while dried beans are loaded with vitamins, minerals and fiber and are a great source of protein, canned beans still can provide a healthy alternative. When beans from a can are rinsed, dried, and stored in the refrigerator, they provide great health benefits when added to soups and stews, used as a topping for salads, or eaten as a side dish. Let’s take a closer look at some other healthy food choices.
Best Shelf-Stable Foods Have you considered cleaning out your cabinets of unhealthy foods? For starters, check for high-sodium foods, sugary snack foods such as baked goods and other sweets, sugary cereals, and sweetened beverages like juice and soda. Many of these processed, packaged foods are calorically dense but offer very few beneficial nutrients. Instead, stock canned foods that have low levels of salt, snack foods with limited amounts of added sugars, and low-calorie beverages such as flavored waters. Here are some healthy foods to keep on hand: •
Lower-sugar cereal (less than 8 grams per serving)
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Steel-cut and old-fashioned oats
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Whole-wheat and whole-grain breads and crackers
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Wild rice, quinoa, barley, whole-wheat couscous
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Canned vegetables and soups that contain no added sodium or reduced sodium
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Olive oil and cooking spray
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Canned chicken, tuna and salmon (packed in water)
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Nuts and seeds
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Natural peanut butter or other nut butters
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Dried and canned beans and lentils
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Unsweetened applesauce and fruit cups packed in juice
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Popcorn and whole-wheat pretzels
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Graham crackers
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Sugar-free pudding and gelatin
What About Perishable Foods? Foods that have to be stored in the refrigerator are often pricier, don’t last very long and can use up most of your food budget. To save on the cost of these items, buy them when they’re on sale, or purchase more store-brand items. With fresh produce, you can often save by buying fruits and vegetables that are in season. Another helpful tip is to review store ads before you shop and make a meal plan for the week based on which items are on sale. Some common nutrient-rich foods to buy weekly are low-fat dairy items such as milk, cheese and yogurt. Consuming dairy regularly can be beneficial, since it’s loaded with essential nutrients, including
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EAT WELL , LIVE W E L L
vitamin D, calcium and protein. When selecting yogurt, however, be sure to choose varieties with less added sugar. Eggs are another high-quality, economical protein source that are ideal to keep on hand for a variety of meals. Other nutrient-dense foods to keep in the fridge include vegetables like broccoli, cabbage, green beans and spinach. Purchasing frozen vegetables can increase the variety of foods you consume and help you save money when shopping. In addition, many frozen vegetables are preserved at their peak without added salt, making them a healthy, convenient alternative to fresh vegetables. Frozen fruits offer many of the same benefits as fresh fruits, but be sure to avoid frozen fruits that contain added sugar. Common perishable items to buy regularly include: • Low-fat yogurt, milk and cottage cheese • Part-skim mozzarella, parmesan and feta cheese • Baby carrots, cucumbers and celery • Lean proteins, including eggs, fish and poultry • Frozen fruit or yogurt bars • Frozen mixed vegetables, broccoli and spinach • Frozen strawberries, blueberries, blackberries and raspberries
Don’t Sacrifice Healthy Options for the Sake of Convenience With the seemingly steady rise in grocery prices, it can be challenging to stay within budget and still manage to have a variety of well-balanced, healthy foods on hand. However, it is generally more costeffective and beneficial for your health to cook most of your meals at home and cut down on or eliminate processed and packaged foods. When visiting your local market or grocery store, think more about shopping for foods that are both healthy and within your budget, rather than foods that simply offer mere convenience. Choose items that contain little or no added salt and sugar, and avoid unhealthy saturated and trans fats. Plan your meals for the week and make your list accordingly, and enjoy the savings in cost and benefits to your health!
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Chunky Marinara with Pasta and Seared Chicken Serves 6 Ingredients 4 cloves sliced garlic (or 2 teaspoons jarred, minced garlic) 2 tablespoons chopped, fresh basil (or 2 teaspoons dried basil) 2 tablespoons fresh oregano (or 2 teaspoons dried oregano) 28 ounces canned, low-sodium, diced tomatoes (undrained) 1/2 teaspoon black pepper 2 tablespoons chopped, fresh parsley Nonstick cooking spray 10 ounces whole-wheat pasta (spaghetti, penne, rotini, elbow, etc.) 1 pound chicken tenderloins Grated fat-free parmesan or mozzarella (optional)
Preparation 1.
Prepare pasta according to package directions.
2.
Preheat oven to 350 degrees. Spray a 9-by-13-inch casserole dish with cooking spray. Lay tenderloins in dish, evenly spaced.
3.
Lightly spray chicken with cooking spray.
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Bake for 25 minutes, flipping over halfway through the baking time.
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Spray saucepan with cooking spray and heat over medium heat. Add garlic and cook 3 minutes.
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Add all remaining ingredients, except the parsley. Bring to a boil, cover and reduce to simmer for 12-15 minutes.
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Spoon pasta onto plate and top with marinara and chicken. Sprinkle with grated fat-free parmesan or grated mozzarella (optional).
8.
Top with parsley.
Per serving: 287 calories, 2.5 grams fat, 108 milligrams sodium, 43 grams carbohydrates, 7 grams fiber and 24 grams protein. Cost: $2.05 per serving. Recipe from the American Heart Association (recipes.heart.org).
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PHILANTHROPY
Ray with Katy Kreienbaum
Celebrating the Past,
Moving Forward Carol Hurt and Ray Mishler
Martha Jefferson Hospital Foundation Builds on Earlier Successes Toward a Promising Future
Elizabeth LeVaca and Ray
Since joining Sentara Martha Jefferson Hospital in 1989, Ray Mishler has been a “first-call kind of guy” for Bill Achenbach, the first chair of the Martha Jefferson Hospital Foundation Board. With a strong working knowledge of operations throughout the entire organization, Mishler has become one of the first people Achenbach turns to for information or guidance on just about any hospitalrelated concern. “Ray knows all about the nuts and bolts of what makes the hospital work,” says Achenbach, who has volunteered on numerous Sentara Martha Jefferson committees and boards for the last 27 years, including serving as chair
Ray with Abby Denby
of the Hospital and Health Services boards. “Development was always his bailiwick, but a good development director has to understand the workings of the entire institution, from the bricks and mortar and the glamorous stuff in the surgical suites to the cafeteria workers mjhfoundation.org
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Construction site tour of the new hospital on Pantops Mountain
and the nurses on the night shift. Ray knows the hospital—and the people in it—extremely well.” Described as cheerful and optimistic, with a tendency to whistle as he strolls the hospital halls on the way to a meeting, Mishler retires on March 31, leaving behind a legacy of extraordinary accomplishments that will positively impact the hospital for years to come.
An Era of Growth When Mishler joined Sentara Martha Jefferson as vice president for development, he hit the ground running. Tapping into the energy and enthusiasm of hospital leaders and volunteers who envisioned a significant expansion of services, Mishler guided the launch of a $5 million capital campaign to build the Cardwell Center, the hospital’s first dedicated outpatient center, which opened in 1992. That same year, the Cancer Care Center was created with $2 million in community support. Mishler’s philanthropic leadership has been an essential element of numerous milestones over the last 30 years, including construction of the new Martha Jefferson Hospital on Pantops Mountain; establishment of the Haden Nursing Institute, a nationally recognized model that supports nursing education and professional development; and raising $3.5 million annually for
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cancer care, palliative care and many other patient care programs. “Ray has strengthened Sentara Martha Jefferson Hospital through his extraordinary abilities to create and nurture relationships in our community,” says Sentara Martha Jefferson President Jonathan Davis. “His character is built around servant leadership in our community and through the Foundation, supporting some of the most significant and transformational successes in Sentara Martha Jefferson’s history. Ray has made the hospital and our community stronger. He is genuinely proud of the work we do at the hospital, believes in our cause passionately, and is humble and trustworthy in his stewardship of gifts.”
The Path to Development Mishler came to Charlottesville in 1977 after graduating from Windham College in Putney, Vt. After working for the United Way and Offender Aid and Restoration—where he met his wife, Pat Smith—Mishler served as executive director of the Central Virginia Chapter of the American Red Cross and director for development at UVA Children’s Medical Center. Upon his arrival at Sentara Martha Jefferson, Mishler joined a dedicated group of volunteer leaders working to establish a professional and sustainable fundraising program to support
the hospital’s commitment to delivering the highest level of care. Their efforts ultimately led to the creation of the Martha Jefferson Hospital Foundation in 2002. “Martha Jefferson’s Caring Tradition was as strong then as it is now, serving as a ‘guiding star’ for how we were to build and grow in service to the community,” says Mishler, whose two adult children, Evan and Erin, were born at the downtown Martha Jefferson location. “Our generous community of donors saw that as well and helped to make these goals a reality. There were then—and still are—a myriad of places where these people could invest their philanthropic resources, but they have a special connection with what we do at Sentara Martha Jefferson to support our staff, help grow our capabilities, and tenderly and thoughtfully provide comfort and aid our patients and their families.” Under Mishler’s leadership, Sentara Martha Jefferson has established services and programs that go beyond the basics of quality hospital care. For example, the Palliative Care Medicine Program, funded almost entirely through
“
Ray’s leadership has been essential to the success of countless major initiatives, from the opening of the Cardwell Center on Locust Avenue to the creation of our beautiful new hospital on Pantops Mountain. The community’s philanthropic support during Ray’s tenure has helped make our beloved Sentara Martha Jefferson Hospital stronger and we are so fortunate that he will remain a part of our community and the Martha Jefferson family. We look forward to working with Kimberly Skelly to build on Ray’s remarkable legacy and the Foundation’s continued commitment to the Caring Tradition." — Katy Kreienbaum, Chair, Martha Jefferson Foundation Board of Trustees
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philanthropy, improves quality of life for patients with serious or complex illnesses, providing guidance to help them and their loved ones make critical healthcare decisions. The HighRisk Breast Cancer Program empowers patients by helping them manage their risk of developing breast cancer, and the Cancer Survivorship Program guides patients who have ended treatment with a personalized care plan that includes ongoing monitoring and preventive measures. Each year, the Foundation raises approximately $200,000 to support women’s health services, through Women’s Committee events like the In The Pink Tennis Tournament and Martha’s Market. “Ray has always been remarkably prepared for and highly engaged in all tasks, routine or great,” says former Sentara Martha Jefferson President Jim Haden. “He has innumerable positive characteristics, but his goodwill, sincerity and follow-through made so much of what he did successful. He played a crucial role in the construction of the new Martha Jefferson Hospital at Pantops, for example. There were so many people involved in various aspects of the capital campaign for that project, but Ray’s leadership— particularly in guiding Foundation board members and other community leaders through the envisioning sessions for capital campaign planning and execution—was truly instrumental in the successful realization of that dream.”
Skelly Comes Home As Mishler steps down from his position, Kimberly Skelly moves into the role of executive
director of the Foundation. Skelly brings to Sentara Martha Jefferson more than 20 years of fundraising experience, serving most recently as chief development officer for the National Trust for Historic Preservation. While at the National Trust, headquartered in Washington, D.C., she directed the $200 million Campaign for America’s National Treasures, the largest campaign in the organization’s history. Under her leadership, the campaign significantly exceeded its goal, with gifts totaling $300 million. Since joining the Martha Jefferson Hospital Foundation in January, Skelly has immersed herself in learning about the work of the hospital, meeting donors and volunteers, and envisioning how the Foundation can have the greatest community impact in the years ahead. “I’m focused on advancing the Foundation’s philanthropic priorities, and on finding new ways to inspire community members to be part of the hospital—not only when in need, but also in times of health and wellness,” Skelly says. “I believe the Foundation can play a role in promoting these values and bringing people together to find spiritual strength and physical renewal.” A Georgia native and graduate of Mary Baldwin College, Skelly also has led development efforts for local organizations such as James Madison’s Montpelier (a Historic Site of the National Trust), the Focused Ultrasound Foundation,
The Caring Tradition continues: Ray Mishler will retire in March, and Kimberly Skelly is the new Executive Director of the Martha Jefferson Hospital Foundation.
the University of Virginia Darden Graduate School of Business, the Virginia Museum of Fine Arts, and Elk Hill Farm Inc. For Skelly, who lived in Somerset from 2003 to 2016, joining the Foundation team feels like a homecoming. Her two children, Stokes and Compton, were born at Sentara Martha Jefferson, and she and her husband, Don, developed many friendships during their years in the area. She also has known Mishler for many years, having served with him on the Charlottesville Area Planned Giving Council. “Ray has been such an important part of the hospital and of the community,” Skelly says. “I’m very honored to be succeeding him as head of the Foundation and building on his accomplishments. I’m pleased to return to this community I love, and I’m committed to the Foundation’s promise that every dollar we raise stays in Charlottesville to positively impact the lives of people in our community.” mjhfoundation.org
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PHILANTHROPY
BUILDING A
Nursing CareerWith a Little Help
fter earning an associate degree in nursing in May 2015, Forrest Yoder began thinking about pursuing a more advanced Bachelor of Science in Nursing (BSN) degree— but it wasn't an easy decision to make. Hired in July 2015 as a “float nurse” to cover various departments at Sentara Martha Jefferson Hospital, Yoder and his wife, Rachel, had already started raising a family. He wasn't sure how to pay for—or find the time for—further college education. “I knew I had to get a bachelor's degree at some point,” says Yoder, 36, who earned his associate degree from Southside Virginia Community College. “The way the field is heading, I knew that if I wanted to perform at the top of my profession, getting that additional education was going to be critical.” Through a colleague, Yoder learned about the generous scholarships offered by the Haden Nursing Institute at Sentara Martha Jefferson. These awards cover up to 90 percent of the cost of earning a BSN degree, including tuition, fees and books. Established thanks to
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generous donors throughout the community, the Haden Institute and its nursing scholarships support Sentara Martha Jefferson’s strategic goal of having BSNs at the bedside by 2020. Studies show that when nurses attain advanced education, patient outcomes are improved and patient mortality rates decrease. By the time Yoder enrolled in the online RN to BSN Program at the University of Phoenix in spring 2017, his daughters, Ellie and Charlotte Kate, were both under age 2— so it seemed like a challenging time to start an intensive academic program. However, this particular program was ideal because it offered flexible scheduling that allowed him to continue working full time. Fourteen months later, Yoder finished the program, earning his BSN degree in August 2018. “The scholarship was such a blessing for me and my family,” he says. “It gave me the freedom to balance my studies, my full-time job and my family responsibilities. I didn’t have to worry about how in the world I was going to pay for my education.”
The Haden Institute for Nursing Excellence and Innovation was established in 2013 in support of our vision of nursing leadership, superior clinical outcomes, and exemplary patient care. Evidence demonstrating the relationship between advanced education and improved patient outcomes and reduced patient mortality is clear. Since establishing the Haden Nursing Institute in honor of Jim Haden (President and CEO of Sentara Martha Jefferson Hospital 1993 - 2014), more than 183 nurses have received scholarships enabling them to return to school and earn a fouryear college degree. Our goal is for at least 80% of all Sentara Martha Jefferson registered nurses to have baccalaureate level education. These scholarships are made possible with the generous philanthropic support of our community. Please consider a gift to the Martha Jefferson Foundation to make more opportunities like this possible. mjhfoundation.org
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Forrest Yoder
Nursing is actually a second career for Yoder. Before joining the team at Sentara Martha Jefferson, he was a foreman for 10 years at his father’s construction company, Yoder Construction. As a certified Class A Contractor, Master Licensed Plumber and Master Licensed Electrician, Yoder was able to apply his certifications toward some of his course requirements with the University of Phoenix, which helped shorten the time needed to complete his degree. Yoder and his family currently live in their “dream home,” which he built on farmland in Buckingham County. He sings with a gospel quartet and also is a part-time pastor at Oak Hill Mennonite Church. The Yoders recently expanded their family with the addition of
baby Hank, born in July 2019. He is grateful for the support the Martha Jefferson Hospital Foundation has provided for his nursing career. “The scholarship has definitely been a blessing, in large part because it has enabled me to do what I love to do,” he says. “Going from a construction career into nursing was a huge switch for me, but I feel like I have found my calling. The scholarship played a significant part in my career—without that support, it would have been really difficult to raise our young children and provide for them while pursuing a bachelor's degree. Being able to advance my education and not worry about financial constraints was a big relief. I truly appreciate all that the Martha Jefferson Hospital Foundation and the Haden Nursing Institute have done for me.” mjhfoundation.org
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PHILANTHROPY From left: Hunt MacMillan, Jonathan Davis, Mark Krebs, Peter Brooks and David Turner.
T
he 2019 Martha Jefferson Champion’s Cup was held May 13, 2019, at Glenmore Country Club. Event proceeds supported the Caregiver Center, a new program funded by the Martha Jefferson Hospital Foundation to help family caregivers cope by offering emotional support, assistance navigating the hospital and healthcare system, and referrals to community resources. Save the date! The 2020 Martha Jefferson Champion’s Cup will be held Monday, May 18.
Martha Jefferson Hospital Foundation:
A Community of M
Philanthropy
ark your calendar! The 2020 Sunsets with Sentara dates are set for June 17 and July 15, 2020. Community members are invited to relax on our lawn with their families while enjoying the sunset, live music, and refreshments from local food trucks, breweries and wineries. Proceeds from this family-friendly event support the Caregiver Center at Sentara Martha Jefferson Hospital.
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Sunsets with Sentara
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Martha’s Market
L
ast November, The Women’s Committee (TWC) of the Martha Jefferson Hospital Foundation celebrated its 26th year by going back to where it all started—the Boar’s Head Inn! Taking on a bold challenge, TWC Board members worked tirelessly to make the 2019 Martha’s Market, which took place at the Pavilion at the Boar’s Head, a memorable shopping experience. Moving the event to mid-November also enabled organizers to create a special and festive holiday shopping experience for our patrons. The event featured a smaller, more intimate venue; a more select group of high-quality local and regional vendors; and a few successful changes, such as the Sip n’ Shop shopping experience on Friday night and the Celebration of Hope Gala on Saturday night. Also on display was our Gallery of Hope—a collection of portraits of women who have battled breast cancer and were treated at Sentara Martha Jefferson Hospital.
From left: Danyelle Collins and Amy Nolasco enjoy the Celebration of Hope Gala with Sentara Martha Jefferson President Jonathan Davis.
Each portrait shared the story of a survivor’s individual journey with cancer. Attendance and sales at the event were fantastic, the volunteers and vendors were thrilled, and we remain committed to tweaking
this experience further to achieve the right balance for all. Vendors contribute 15 percent of every sale to benefit the fundraiser. Over the years, Martha’s Market has provided funds for a wide range of programs and services benefiting mjhfoundation.org
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PHILANTHROPY
women’s health care, including critical services to underinsured or uninsured women in our community through free biannual breast health screening days. Established in 1993 with a group of 16 women, TWC membership has grown to more than 260 members today. The committee continues to make a meaningful impact on programs at Sentara Martha Jefferson through its three annual fundraisers: Martha’s Market, the In the Pink Tennis Tournament and the Squash Cancer Tournament. Nearly $6 million has been raised through the success of these events to date, made possible through corporate and individual sponsorships, as well as the detailed planning and diligent efforts of the passionate volunteers who serve TWC. “In addition to the 17th year of In the Pink and the seventh year of Squash Cancer, 2019 was another hugely successful year for TWC,” says Amy Nolasco, TWC chair. “Our committee is so proud to continue to host these events, which fund many programs and services at Sentara Martha Jefferson. We are grateful for the amazing support we receive from our community—especially our sponsors, shoppers, and the many tennis and squash participants who help ensure the success of our events!” Save the date! The 2020 Martha's Market will be held November 20-22.
In the Pink Tennis
Save the date! The 2020 In the Pink Tennis will be held October 17.
The Women’s Committee welcomes new volunteers and encourages those interested to contact the committee’s membership chair at MembershipChairTWC@gmail.com or visit MJHFoundation.org/The-Womens-Committee for more information.
Wetsel Middle School, Madison County
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ach October, the Student Council Association at Wetsel Middle School in Madison County works to raise money in support of breast cancer awareness, research and treatment. For the last four years, the group has donated those funds to Sentara Martha Jefferson Hospital. At the end of the month, Wetsel students and staff held a “Turn Wetsel Pink Day” to celebrate their hard work and present Sentara Martha Jefferson with their donation. We are so grateful for Wetsel Middle School and the efforts of their passionate and dedicated students, which help us improve health in our community every day!
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HEALTHCARE AT Y O U R F I N G E R T I P S D O W N LOA D T H E S E N TA R A A P P T O DAY
Securely View Health Information
Review Test Results
Schedule Appointments
Access Virtual Care
Find a Provider
Learn more at Sentara.app
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Non-Profit Org. U.S. Postage
PAID Sentara Martha Jefferson Hospital
Sentara Martha Jefferson Hospital 500 Martha Jefferson Drive Charlottesville, VA 22911 Sentara.com Change service requested
S E N TA R A S P OR T S ME DICINE CE N T E R
WE CAN’T KEEP YOU CLEAN, BUT WE CAN GET YOU BACK ON THE COURSE The harder you race, the muddier you get— and you love it! Don’t let pain keep you off the course. The experts at the Sentara Sports Medicine Center will get you back to you.
SENTARA SPORTS MEDICINE CENTER OFFERS PATIENTS: • State-of-the-art facilities in Charlottesville and Harrisonburg with access to onsite physical therapy and imaging • Fellowship-trained surgeons for every joint and bone in your body
Sentara Martha Jefferson Orthopedics, Charlottesville | 434-654-5575 Sentara RMH Orthopedics, Harrisonburg | 540-689-5500 For more information, visit SentaraOrthopedics.com. Follow us on Facebook and Twitter, @SentaraRMH.
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