Sentara Martha Jefferson Hospital Spring 2021 Magazine

Sentara Marthamagazıne Jefferson S P R I N G 2 0 21

Fighting the Pandemic

COVID Vaccine Rollout at Sentara Martha Jefferson

PLUS: Bariatric Surgery Leads to Healthier Lives Treating Vertigo with Physical Therapy | Maternity Support Services

LETTER FROM THE BOARD CHAIR

2021 SENTARA MARTHA JEFFERSON BOARD Carol Hurt | Chair

Bill Achenbach Lillian BeVier John Ligush, MD Lawrence Martin E. Ray Murphy Bernie Boone Michael Gentry Douglas Moyer

SENTARA MARTHA JEFFERSON ADMINISTRATORS

Amy Black, DNP, RN, NEA-BC Interim President

Johnsa Morris, MHA, MBA, RN, NEA-BC Vice President, Chief Nurse Executive

Paul Tesoriere, MD Vice President of Medical Affairs

SENTARA MARTHA JEFFERSON MAGAZINE EDITORS

Jenn Downs Neil Mowbray CONTRIBUTORS

Luanne Austin Karen Doss Bowman Lisa Smith Jennifer L. Stover

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A Time of Transition and a Heartfelt Thanks

or the past six years, Sentara Martha Jefferson President Jonathan Davis has authored this letter, which opens each issue of the hospital’s health and wellness magazine. On March 1, however, Jonathan stepped down from that position to join FirstHealth of the Carolinas, a nonprofit health system in North Carolina. As chair of the Sentara Martha Jefferson Hospital Board of Directors, it has been my pleasure to work closely with Jonathan during his tenure at the hospital. I have truly appreciated the unwavering dedication and remarkable energy with which he carried out the organization’s mission.

Among his many accomplishments, Jonathan led the hospital in growing the breadth of services offered, facilitated development of Sentara Martha Jefferson’s regional stroke and neurosurgery services, and played a critical role in developing the hospital’s clinical education scholarship fund and the Caregiver Center to support families during their healthcare journeys. He also exhibited strong commitment to the community by serving in leadership roles on multiple community boards. You can read more about Jonathan in the Philanthropy section of this magazine, beginning on page 45. His influence and welcoming, warm personality will truly be missed by all of us who knew and worked with him.

A formal search is underway to select Jonathan’s successor. Until that time, Amy Black, DNP, RN, NEA-BC, will serve as interim hospital president. Amy has been an invaluable member of the Sentara Martha Jefferson team since 2002, serving as chief nurse executive until 2015, when she became chief operating officer. It was under her leadership that the hospital achieved its first Magnet® designation, an honor that Sentara Martha Jefferson has since maintained.

Amy’s dedication to Sentara Martha Jefferson, and to the community it serves, is evident. She has served on the Charlottesville Free Clinic Board of Directors and is currently on the boards of directors for The Women’s Initiative and PT@ACAC. Amy’s focus on enhancing the Caring Tradition and providing safe, high-quality care has not wavered, and patients and their families can be assured of a seamless continuity of care as we move through this period of transition.

On another note, I would like to thank all of our Sentara Martha Jefferson team members for their ongoing dedication, resilience and courage in providing care through the challenges of the COVID-19 pandemic. Their commitment to our hospital’s mission and values has been exemplary. I also extend thanks to you, the members of the communities we serve, for your ongoing support of our caregiving team—through your well wishes and kind messages of hope, your in-kind donations to the hospital, and your financial support.

As the COVID-19 vaccines are made available to ever-widening segments of the public, our hope is that we will begin to see a significant lessening of the effects of the virus among our communities and families. Until we get this pandemic behind us, please continue to exercise vigilance and practice the safety measures our health experts are recommending.

Yours in health,

PHOTOGRAPHY

Luca DiCecco Sara Morris Andrew Shurtleff DESIGN

Picante Creative

Carol Hurt Chair, Sentara Martha Jefferson Board of Directors

Contents S P R I N G 2 0 21

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Maternity Support Services Helping New Parents Navigate Life with Baby 24

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Weight, Lifted

Fighting the Pandemic

Bariatric Surgery Leads to Healthier Lives

COVID Vaccine Rollout at Sentara Martha Jefferson Hospital

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Contents

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

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New & Noteworthy

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Physician’s Perspective

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Treating Brain Tumors

On-Call Advice COVID Corner

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Are the COVID-19 Vaccines Safe?

Women’s Health

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14

Benign Breast Conditions

Calendar

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Clinical Excellence

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Treating Vertigo with Physical Therapy

Health Matters

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Keep Watch on Your Blood Pressure

La Salud Importa

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Controle la Presión Arterial

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Eat Well, Live Well

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Eating Well to Help Control Chronic Kidney Disease

Calendar

Philanthropy

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THE BEST MEDICINE

BY MICHAEL CORDELL

’ve learned from experience recently that when it comes to the news, there is often a dramatic difference between facts and stories. Although both can be true, how I react to news headlines can impact my life—and usually not for the better.

For example, I once read a news story about a person taking a shower who saw a snake slither up from his bathtub drain. My immediate takeaway was to no longer take showers, as I had no interest having a snake join me in the tub.

Instead, I started spraying myself down outside each morning with the hose.

Another news story told of a person who was walking down a sidewalk to get milk when he was killed by a falling tree branch. After reading that story, I came to the obvious conclusion that I needed to start walking down the middle of the street, given that most falling tree branches wouldn’t reach that far.

News stories even resulted in my regrettable decision about our family pet. Uncertain about what type of animal to get, I turned on the Google machine and read about a rabid dog that had bitten its owner, a cat that had blinded a woman while playfully clawing at her, and a house that had burned down after an aquarium broke and short-circuited the refrigerator. That’s a long way of explaining why I now own a sloth, which I named Fido. There were no online stories about sloths causing problems—I now realize that’s because no one has been dumb enough to have a sloth as a family pet.

So after getting hypothermia from hosing myself outside in the winter, constantly dodging honking cars while walking in the street, and standing on a tabletop screaming while a hostile Fido snarled at me (sloths have fangs!), I decided to rethink my strategy of basing life decisions on news stories.

It turns out that stories often make the news because they are unusual. Newspapers don’t sell a lot of copies with headlines like “Man Walks to Store for Milk, Chooses 2%” or “Local Resident Takes Shower, Fails to Rinse and Repeat.”

So while all of those stories I read technically may have been true, they weren’t the best basis for decision-making.

Another problem with getting information online is that you can generally find whatever kind of story you want to find.

If you don’t want to eat your vegetables, the Daily Mail has an article proclaiming “Eating Vegetables Can Seriously Damage Your Health.” If you’d rather eat candy, Candy Club’s website offers a piece titled “The Surprising Health Benefits of Candy.”

But finding the answer you want is different from finding the best answer.

My point—to the degree my prattling ever has a point—is now that COVID-19 vaccines are becoming available, I’ll be turning off the Google machine and consulting with my doctor for the best medical advice. I’m doing so because my doctor is smart, is someone I trust, and keeps current on facts-based news (not stories). When I ask him whether or not I should take the vaccine, he’s won’t say, “Well, I read this story about this one person in Alaska who … .” Instead, we’ll talk about what’s best for me.

I’m also willing to wager that my doctor has never owned a sloth (see above: my doctor is smart). Although my experience with one would probably make a good story.

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All the News That Fits

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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.

Elaine Allen, DPM Podiatric Foot & Ankle Surgery Elaine Allen, DPM, LLC Crozet Foot & Ankle 434-242-8550

Linnea R. Goodman, MD Reproductive Medicine and Endocrinology Virginia Fertility & IVF 434-654-8520

Kimberly St. Jean, MD Palliative Care Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580

Deveryn Bailey, NP Hospital Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580

Amy K. Lansing, PA-C Hospital Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580

Mary C. Taylor, MD OB/GYN Surgery Jefferson OB-GYN 434-977-4488

Brent Cochran, PA-C Emergency Medicine US Acute Care Solutions 434-654-7150

Peter Nock, DO Hospital Medicine Sentara Martha Jefferson Inpatient Services 434-654-7580

Valerie Tulenko, CRNA Anesthesiology Sentara Anesthesiology Specialists

Sentara Opens New Primary Care Clinic in Waynesboro provide access to quality medical In January, Sentara Primary Care,

formerly Sentara Waynesboro Internal Medicine, began seeing patients in its new location.

The new clinic offers walk-in and sameday care for minor illnesses and injuries, and physicals for patients 18 and older.

Sentara Primary Care is conveniently located at 760 Town Center Drive, Suite 760A, beside Physical Therapy at acac, where patients can receive rehab care for a wide range of needs.

“We are thrilled to offer this new model of primary care for the Waynesboro community,” says Dr. Bruce Clemons, Executive Director, Primary Care, for the Blue Ridge. “With people’s increasingly busy schedules, it’s important to us to

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care as conveniently as possible.”

Two providers are staffing Sentara Primary Care: David Herring, MD, formerly with Sentara Waynesboro Internal Medicine, who will continue to see his internal medicine patients in the new clinic, and Angela Honeycutt, NP, who will offer walk-in care services.

Patients can either walk-in, call ahead to make an appointment, or reserve a time online at SentaraPrimaryCareandTherapy.com.

“Sentara Waynesboro Internal Medicine has been the medical home to many in this community for years, and it is exciting for us to make the transition to this new model during the move to our new

location,” says Kelly Graves, Practice Manager of the clinic. “We continue to serve patients ages 18 and older for their wellness, chronic disease care, and acute care needs. Our goal continues to be to provide the best possible care to our community with providers who treat your individual needs. Our patients are our family.”

Sentara Primary Care is open Monday– Friday, 8 a.m.–5 p.m. The phone number is 540-941-2400.

Jonathan Davis Steps Down as Sentara Martha Jefferson Hospital President Jonathan Davis, former president of Sentara Martha Jefferson Hospital, has stepped down after six years of service to the Charlottesville community to join FirstHealth of the Carolinas, a non-profit health system in North Carolina. His last day was March 1, 2021.

In his six years with Sentara, Davis led the hospital in many innovative expansions. Among them were the opening of the neurointerventional service line and the addition of a helipad outside the Emergency Department, permitting Sentara Martha Jefferson to serve as a leading-edge stroke center for central Virginia and the Harrisonburg area. Sentara Martha Jefferson also added advanced gastrointestinal services and expanded its surgical services, especially for cancer surgery, during Davis’ tenure.

“I truly appreciate the unwavering dedication and remarkable energy Jonathan brought to carry out the hospital’s mission and to further the Caring Tradition,” says Carol Hurt, Board chair of Sentara Martha Jefferson Hospital. “He will be deeply missed both professionally and personally at Sentara Martha Jefferson Hospital and throughout the community.”

In addition to his dedication to Sentara Martha Jefferson, Davis also served in leadership positions on multiple community boards including the United Way, Boys & Girls Club of Central VA, The Center and the Charlottesville Regional Chamber of Commerce.

“I extend my gratitude to Jonathan for his

many contributions to Sentara and the community he served,” says Paul Gaden, President, Western Region, for Sentara. “He is an engaged, compassionate servant-leader who works tirelessly for the community and members of the team. I wish him and his family all the best as he embarks on this new and exciting endeavor.”

Speaking of his tenure as president, Davis says, “I feel fortunate to be among the many leaders who have contributed to the success of Sentara Martha Jefferson so that our patients and families can safely find their way to receive the best care. I take with me one of the greatest gifts of my career; I have seen great care delivered and connected personally with so many caregivers. With family still in town, I look forward to seeing those efforts continue. The Martha Jefferson Caring Tradition is stronger than ever.”

A formal search process is underway for Davis’s successor. Amy Black, DNP, RN, NEABC is serving as interim president. Black joined the Martha Jefferson Hospital team in 2002, serving as Chief Nurse Executive until 2015 when she assumed the role of Chief Amy Black, DNP, RN, NEA-BC Operating Officer. sentara.com

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PHYS ICIAN’S PERSPEC TIVE

Treating BRAIN TUMORS in the 21st Century

The discovery of a brain mass can be a frightening and confusing experience for a patient. The presentation of symptoms and diagnostic workup are often nuanced and can be fraught with anxiety and uncertainty for patients and their loved ones. Thanks to recent advances, however, we now have more options and technology than ever before for effectively treating and managing brain tumors.

As we continue to make strides in medicine, survival and meaningful outcomes for these patients continue to improve.

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By Osmond C. Wu, MD, Sentara Martha Jefferson Neurosciences

Intracranial tumors—abnormal masses of tissue that grow unchecked in the brain, no longer subject to the mechanisms that typically control normal cell growth— can be broadly grouped as primary versus metastatic.

Primary brain tumors, which are lesions that originate from brain tissue or from nearby areas surrounding the brain, can be malignant (cancerous) or benign (noncancerous). Although benign tumors generally grow less quickly, they still can result in neurologic dysfunction caused by brain compression, cerebral edema or the obstruction of cerebrospinal fluid outflow.

Most brain tumors are metastatic lesions, meaning that they arise from cancer cells originating in another part of the body and traveling to the brain. Metastatic brain tumors can occur in 10–30% of adults with systemic cancer. Certain types of cancer, such as lung and breast cancer, are more prone to metastatic spread to the brain. By definition, metastatic lesions to the brain are considered malignant.

Brain Tumor Symptoms

Varying based on the location of a brain tumor and its surrounding structures, symptoms can include headaches, weakness on one side of the body, confusion and memory loss, changes in personality, seizures, difficulty using and understanding language, nausea and vomiting, vision changes, hearing loss, or difficulty with balance.

Occasionally, the patient may have no obvious symptoms. Asymptomatic tumors are often found incidentally on routine oncology screenings or on cranial imaging performed for other reasons, such as head trauma.

Managing Brain Tumors

Techniques for managing intracranial tumors can vary, depending on the type of lesion and the location of the mass. Certain tumors, such as meningiomas (tumors that form in the tissue surrounding the brain), can be slow-growing and, if asymptomatic, may be monitored with MRI imaging taken at specific time intervals to check for tumor growth.

When needed, brain tumor treatment typically consists of surgery, radiation and chemotherapeutic agents—or some combination of the three. A multidisciplinary approach involving neurosurgery, medical oncology and radiation oncology allows for a comprehensive treatment plan, and is proven to improve outcomes for the patient.

Surgical Treatment Options

The goal of the neurosurgeon is typically to achieve maximal, safe tumor resection—to remove as much of the brain tumor as possible without worsening neurologic function. Surgery is typically accomplished through the skull by a craniotomy, a surgical procedure in which a portion of the skull is temporarily removed to access the brain.

Occasionally, due to the location of a lesion, a biopsy to obtain tissue diagnosis is recommended, either before or in lieu of a craniotomy. This can be performed using a less invasive procedure called a stereotactic brain biopsy.

Some lesions are actually best

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treated without resection, and a stereotactic brain biopsy enables tumor diagnosis without the more involved craniotomy procedure.

Technology for cranial surgery has advanced substantially over the past few decades.

3D navigation systems have been developed and refined, allowing the neurosurgeon to locate the tumor accurately and precisely, as well as to better understand the orientation of the mass and vital surrounding structures in the brain. These systems can aid in tumor resection while minimizing impact to the surrounding brain tissue, as well as permit stereotactic biopsies of tumors through very small incisions.

Tumors are sometimes located within or near areas of the brain that are essential for movement or language. In such cases, techniques such as intraoperative motor and/or language mapping can assist in determining whether an entire tumor, or certain portions of a tumor, can be safely resected. Intraoperative language mapping is performed on a conscious patient (awake craniotomy) in order to map the anatomy vital to language function, optimize tumor resection and help preserve critical neurological functions.

Another concern involves the development of vasculature, or blood vessels, around a tumor, raising the chance of increased blood loss during surgical resection. In these cases, surgeons can use neurointerventional radiology techniques to enter the blood vessels of the brain and block off those vessels that are supplying blood to a tumor.

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Treating Brain Tumors with Radiation Radiation therapy utilizes highenergy radiation to control and kill cancer cells, thus decreasing the size of a brain tumor. Techniques range from whole-brain radiation to stereotactic radiosurgery, which uses multiple beams to target a tumor and limit injury to normal tissue.

Radiation can be used in different scenarios, including cases where a tumor cannot be surgically resected. It is also frequently used as an adjunct after surgical tumor resection to control recurrence of the tumor.

Recently, there has been more evidence supporting the use of stereotactic radiosurgery for metastatic tumors prior to surgery, potentially decreasing the risk of harming healthy surrounding brain tissue. Such preoperative treatment also may decrease incidence of leptomeningeal disease, a condition that occurs when cancer cells migrate into the cerebrospinal fluid that bathes the brain and spinal cord.

Systemic Therapies Systemic therapies such as chemotherapy and immunotherapy are often used in addition to the aforementioned treatments. The brain is a privileged space in the body, however, and the blood-brain

barrier can impede the effectiveness of systemic therapies.

In certain situations, intrathecal treatment, in which chemotherapeutic agents are injected directly into the cerebrospinal fluid space, can be beneficial.

Neurosurgery and Neurosciences at Sentara Martha Jefferson Hospital The diagnosis of a brain tumor is an often unexpected and frightening experience for the patient. Our team of neurosurgeons, neurologists and neurointerventional radiologists is highly trained and skilled in diagnosing and treating a comprehensive range of neurological conditions—from common problems like traumatic brain injuries to highly complex brain tumors. We collaborate closely with medical oncologists, radiation oncologists and rehabilitation specialists to provide patients with safe, effective and comprehensive treatment options for optimal outcomes and improved quality of life.

To learn more about Sentara Martha Jefferson Neurosciences, visit Sentara.com or call 434-654-8960.

ON-CALL ADVICE

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

What is an underactive thyroid, what causes it and how is it treated?

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Early symptoms of hypothyroidism like fatigue are often overlooked, but as the patient’s metabolism continues to slow, additional symptoms may appear, including sluggishness; increased sensitivity to cold; constipation; pale, dry skin and brittle nails; hoarse voice; elevated cholesterol levels; unexplained weight gain; muscle aches, tenderness and stiffness; heavier-than-normal periods; and depression. Untreated hypothyroidism can lead to joint pain, obesity, infertility and heart disease.

Various conditions may result in hypothyroidism. In some cases, certain autoimmune diseases may cause the immune system to produce antibodies that attack the thyroid. More rarely, a disorder of the pituitary gland—often the result of a benign brain tumor—can cause the condition. Also, some people are born with thyroid disease.

Certain medications also may cause hypothyroidism—for example, lithium, which is used in treating psychiatric disorders, and amiodarone, which is used to treat irregular heart rhythms.

Other potential causes include radiation therapy, thyroid surgery, pituitary gland disorder, pregnancy, iodine deficiency, and having a parent or grandparent with autoimmune disease.

Hypothyroidism affects people of all ages, but women over age 50 are most commonly affected.

The condition is diagnosed by measuring thyroid hormone levels in the blood.

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underactive thyroid, also known as hypothyroidism, is a condition in which the thyroid gland does not produce enough thyroid hormones. The thyroid, which lies below the voice box on the trachea (the “windpipe”), produces hormones that help regulate the body’s metabolism.

Doctors recommend that middle-aged women be screened for hypothyroidism during routine physicals. Some doctors also recommend testing pregnant women or women who are thinking of becoming pregnant. Men are more likely to develop hypothyroidism after age 60, so men in that age group should be screened regularly.

Although there is no cure for hypothyroidism, typically the condition is treated with hormone replacement therapy, using the synthetic thyroid hormone levothyroxine. This is an oral medication that must be taken for the rest of a person’s life. However, with proper management under a physician’s care, hypothyroidism generally does not interfere with the ability to enjoy a happy, fulfilling lifestyle. sentara.com

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ON- C ALL A DVICE

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

What is shingles, and why do some people continue to have pain after shingles goes away?

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After a person has had chickenpox, the varicella-zoster virus lies inactive in certain nerves close to the spinal cord. For some unknown reason, this virus can reactivate later in life in the form of shingles. Shingles can occur at any age, but it’s more common in elderly people and in those with weakened immune systems.

When a person gets shingles, a red rash generally appears first, followed by small, itching blisters that burst, ooze and then crust over. The primary symptom of shingles is pain, which may begin even before the rash appears, and may be accompanied by sensations of burning, itching, tingling or numbness. Symptoms are usually confined to a small area and are virtually always located only on one side of the body.

Shingles usually goes away by itself in two to three weeks, but prompt treatment with antiviral medications can reduce the severity and duration of symptoms.

If pain and burning continue after the rash and blisters have gone away, this condition is called postherpetic neuralgia (the word neuralgia means “nerve pain”). This neuralgia, which results from nerve damage caused by the outbreak of shingles, has symptoms resembling those of shingles and may include pain, itching, numbness and weakness.

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iStock.com/Ivan-balvan

hingles is a painful, blistering skin rash caused by the varicellazoster virus, the same virus that causes chickenpox. Unfortunately, after the rash and blisters of shingles have gone away, the associated nerve pain sometimes continues.

There is no cure for postherpetic neuralgia, and the pain may last months or years. Use of certain prescription medications, however, may help provide temporary relief.

People who think they may be developing shingles—that is, they experience pain or burning with a rash or small blisters on one side of the body—should see their physician right away.

Starting antiviral medication within 72 hours of developing shingles helps reduce the severity of shingles symptoms and lessens the risk of developing postherpetic neuralgia.

People who are 50 and older should ask their doctor about whether Shingrix, the shingles vaccine, is appropriate for them.

COVID CORNER

Are the COVID-19 Vaccines Safe?

In spite of the many rumors, unfounded claims and myths you may have heard or read, the COVID-19 vaccines are indeed safe.

The U.S. Food and Drug Administration (FDA) has rigorous standards and procedures in place to ensure the safety of any vaccine, and clinical trials must show COVID-19 vaccines are safe and effective before they are used. People of different ages, races and ethnicities, as well as those with different medical conditions, have participated in these large-scale trials.

The Pfizer and Moderna vaccines were studied in placebo-controlled trails in nearly 90,000 patients to establish their safety and efficacy. Thousands of healthcare workers have been vaccinated in the weeks since these vaccines were launched, and there have been few adverse effects. The FDA and the Centers for Disease Control and Prevention (CDC) continue to monitor the safety of all COVID-19 vaccines.

How are the Vaccines Administered?

Both the Pfizer and Moderna COVID-19 vaccines are delivered via injection into the arm, just like a flu shot. Both vaccines require two doses: an initial dose and then a repeat vaccination 3-4 weeks later.

Are There Side Effects?

Some people may experience mild symptoms, including muscle pain at the injection site, fever, headache or fatigue. These symptoms, which actually signal that your immune system is responding properly to the vaccines, usually go away on their own within a few days. Very few serious side effects have been reported. sentara.com

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Concern has been raised about how quickly the COVID-19 vaccines were developed. The COVID-19 vaccines are based on messenger RNA (mRNA) vaccine technology, which has been studied for more than a decade. Although this technology was perfected with the SARS-1 and MERS virus outbreaks starting in the early 2000s, those coronaviruses were short-lived and had limited spread, so there was no opportunity to test or implement the associated vaccines. Since then, pharmaceutical companies have had the vaccine technology ready to apply to any new virus outbreaks, such as COVID-19.

Although profitability and financial risk are often deterrents for pharmaceutical companies to developing new vaccines, those factors weren’t relevant in the case of the COVID-19 vaccines. In 2020, the U.S. government actually prepaid multiple pharmaceutical companies to manufacture potential COVID-19 vaccine candidates, removing any financial risk to the companies and accelerating the development process.

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Too Quick?

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COVID CORNER

Myths vs. Facts: MYTH: “I don’t have to wear a mask if I get the vaccine.”

FACT: You must still wear a mask. It is still not clear if one can carry the virus and spread it to others, even if vaccinated.

MYTH: “There is a microchip in the vaccine.”

FACT: There is no “tagging” or any metal in the vaccine—a microchip is too large to be embedded in the vaccine.

MYTH: “My DNA will be changed.”

FACT: The mRNA vaccines from Pfizer and Moderna have no impact on human DNA.

MYTH: “I will contract COVID-19 if I get the vaccine.”

FACT: These vaccines are not made from live or attenuated virus.

Instead, they “teach” the immune system to find and destroy the virus “spike protein,” which is how the virus attaches to human cells and infects the host. The mRNA is rapidly destroyed by the cell, leaving no permanent trace.

MYTH: “The vaccine uses fetal tissue.”

FACT: The mRNA COVID-19 vaccines produced by Pfizer and Moderna do not require the use of any fetal cell cultures as part of the manufacturing process.

MYTH: “The virus has mutated, so what is the point of getting the vaccine?” santima.studio/ stock.adobe.com

FACT: Most viruses mutate over time. Even with mutations, the spike protein used to attach to human cells is the same. Scientists are confident that the COVID-19 vaccines will be effective against virus mutations.

MYTH: “I already had COVID, so I don’t need the vaccine.”

FACT: It is unclear how long your natural immunity will last after

having COVID-19, so you still need to receive the vaccine to prevent future infection.

MYTH: “Once I get the vaccine, I’ll have lifelong immunity.”

FACT: It’s too early in the use and study of the COVID-19 vaccines to know how long they will be effective.

MYTH: “The vaccine will give me Bell’s palsy.”

FACT: Four patients who received the vaccine in clinical trials

developed Bell’s palsy. There is no evidence this was related to the vaccine, and because the trials were so large, the occurrence rate was similar to what would be expected in the general population.

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Can I get the vaccine if I’m pregnant or want to become pregnant, or if I’m breastfeeding?

A now-blocked Facebook post that went viral claimed the coronavirus vaccine could cause infertility, incorrectly suggesting that the vaccine teaches the body to attack a protein involved in placental development. In reality, the protein the vaccine spurs the body to make and attack bears little resemblance to the one in the placenta.

Both American College of Gynecology and Society for Maternal Fetal Medicine recommend the mRNA vaccine during pregnancy, after a discussion between the doctor and the patient on its benefits. Researchers believe there is minimal risk to a fetus, or to a breastfeeding infant.

Should I Get the Vaccine?

Experts believe getting a COVID-19 vaccine may keep you from getting seriously ill, even if you do get COVID-19. Vaccinations protect you by creating an antibody response without your having to experience illness. The vaccine also may protect people around you— particularly those at increased risk for severe illness from COVID-19.

Only you can decide if you should get the COVID-19 vaccine. If you have concerns or questions, talk to your healthcare provider. You can also review the vaccine information provided at Sentara.com.

This information was compiled by Sentara clinical experts through a thorough review of trusted medical sources, including the New England Journal of Medicine, the Society of Maternal Fetal Medicine, the National Center for Biotechnology Information, the CDC and others.

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WOMEN’S HEALTH

BENIGN

BREAST

CONDITIONS At some point in their lives, many women will experience a benign breast condition, a category that includes unusual growths or other changes in breast tissue. As the name implies, benign breast conditions are noncancerous. However, any change in the breasts could be a sign of cancer, so it’s important to see a doctor if you notice a difference in your breasts.

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condition, according to Emily Turzanski, DO, a breast surgeon with Sentara Breast Surgery Specialists in Harrisonburg, include the following: • Unusual growths or lumps • Pain or swelling • Thick, dry or red skin • Fluid discharge • Itchy or warm skin Many of these conditions don’t require treatment, and it's normal to experience one or more of them over the course of your life, says Lynn Dengel, MD, MSc, a surgical oncologist at Virginia Breast Care in Charlottesville. However, if you experience discomfort or pain, or simply want a benign lump or cyst removed, a breast surgeon can help.

Types of Benign Breast Conditions Some of the most common types of benign breast conditions include the following.

Cysts

Breast cysts, which are fluid-filled sacs typically found in women of childbearing age or in the years leading up to menopause, may feel round and rubbery. They often appear suddenly and may go away on their own. Although cysts may not require any treatment, a doctor may use a thin needle to drain (aspirate) a cyst if it is large or painful.

Fibroadenomas

Fibroadenomas of the breast are round, rubberyfeeling lumps. They can occur at any age but are most common in women in their 20s and 30s. Hormonal changes, including those that occur during pregnancy, can cause fibroadenomas to grow over time—or they may shrink or disappear completely.

A breast surgeon may recommend a watch-andwait approach with fibroadenomas that don’t cause pain or produce uncomfortable symptoms. If a fibroadenoma increases in size or is painful, a breast surgeon may recommend a procedure to remove the affected breast tissue.

Clogged milk ducts

Breastfeeding mothers can get clogged or plugged milk ducts that prevent the flow of breast milk.

Clogged ducts present as hard, often painful lumps. Women approaching menopause may also develop a form of clogged ducts called duct ecta-

sia. Treatment typically involves the use of warm compresses or antibiotics. If symptoms don’t improve, in some cases a breast surgeon may remove the affected duct.

Mastitis

Mastitis is an inflammation of the breast tissue that primarily affects breastfeeding women. Symptoms include swelling, pain, warmth and redness.

Mastitis also can result in an infection, accompanied by fever and chills. The condition is typically treated with antibiotics, pain relievers, massage and cool compresses. If an abscess forms, it can be drained as an outpatient procedure. Lactation consultants also can help provide support and techniques for mothers who are struggling with breastfeeding while coping with mastitis.

Mastitis also can affect menopausal women who aren’t breastfeeding—especially those who smoke or have diabetes. Compresses, good hydration and antibiotics may be used to treat mastitis at this stage of life.

Diagnosing and Treating Benign Breast Conditions Many women discover benign breast conditions while examining their own breasts, notes Dr. Turzanski.

“Women may find a lump or change in their breasts, or their primary care doctor or OB/ GYN may find a lump during an annual exam,” she says. “Cysts, fibroadenomas and clogged milk ducts can all feel like a lump in the breast.”

Breast surgeons can diagnose benign breast conditions with a core needle biopsy, adds Dr. Dengel. During this procedure, the doctor uses ultrasound imaging to guide the placement of a hollow tube that is used to extract a sample of breast tissue for evaluation. Due to the advancement of breast care in recent years, many diagnostics and treatments now can be performed in a doctor’s office.

“We can perform many more tests in our office today, without a trip to the operating room,” says Dr. Dengel. “If I feel a mass, I can put my ultrasound probe right on the mass and evaluate it.”

Seeing a Breast Surgeon Breast surgeons like Dr. Turzanski and Dr. Dengel specialize in treating noncancerous

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he most common signs of a benign breast

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W O M E N’S HEA LT H

When to See a Doctor Normal hormone fluctuations affect breast tissue and can cause breast tenderness, pain and other changes, but a doctor should look at any differences that last longer than two weeks—some signs of a benign breast condition are also similar to signs of breast cancer. See your family doctor or OB/GYN if you notice a lump that: • Lasts longer than two weeks • Doesn’t go away after your menstrual cycle • Is accompanied by a fever or infection

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Screening Mammogram versus Breast Ultrasound A mammogram is an X-ray of your entire breast. All women over the age of 40 should get an annual screening mammogram to look for signs of breast cancer.

A breast ultrasound uses sound waves to examine a specific part of the breast. A breast ultrasound is typically used either to evaluate findings from a mammogram or assess a symptom such as discomfort or a lump.

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“Plenty of people will have a benign breast lump removed for a number of reasons, including anxiety or a family history of breast cancer,” she says. “Some people may want a breast lump removed so it doesn’t mask other findings on a mammogram or breast exam.”

Know Your Breasts Both physicians emphasize the need for women to be aware of any changes in their breasts. The best way to do this is by performing regular monthly breast self-examinations at home. Regular examinations will help you notice changes in your breasts.

In addition, all women should get an annual breast exam from their primary care provider or OB/GYN. These exams should start once a woman reaches puberty and continue throughout her life.

Sentara Breast Surgeons “Although we’re talking in Charlottesville and here about noncancerous Harrisonburg breast conditions, starting Virginia Breast Care around age 40 most women 595 Martha Jefferson Drive, also should have an annual Suite 320 mammogram to screen for Charlottesville, VA 22911 cancer,” concludes Dr. Tur434-984-6121 zanski. “Younger women with Sentara Breast Surgery risk factors for breast cancer Specialists should talk to their physician 2275 Health Campus Drive about when they should begin Harrisonburg, VA 22801 having mammograms.”

540-689-4800

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breast conditions, as well as breast cancer. Primary care providers and OB/ GYNs manage many breast conditions in their offices, but they may refer certain patients to a breast surgeon for additional assessment or treatment.

Patients over age 40 who receive regular mammograms may see a breast surgeon if they require a second opinion or need a breast ultrasound. Younger patients not receiving regular mammograms due to their age may see a breast specialist for ultrasound imaging and diagnosis. Patients also may see a breast surgeon if they’re experiencing anxiety about their symptoms or want a second opinion.

“These benign conditions still can provoke anxiety for many women,” says Dr. Dengel. “They may want reassurance or want us to remove the lump or aspirate it to make it go away.”

Each patient’s case is unique, notes Dr. Turzanski.

calendar

Sentara Martha Jefferson Hospital is pleased to provide a variety of health education opportunities to community members. Highlights of the spring 2021 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 May 27, July 22, Sept. 23, Nov. 18, 1-3 p.m.

This free seminar discusses specific types of bariatric surgery and whether those options might be right for you. Monthly in-person seminars will be held on the dates above in the Kessler Conference Room, Sentara Martha Jefferson Outpatient Care Center. COVID-19 safety precautions will be observed. A free online seminar is also available at Sentara.com/weightlosssurgery.

Joint Camp: A Complete Guide to Preparing for Knee and Hip Surgery Details on Sentara.com. Call Connie Summy, BSN, RN, ONC, at 434-654-8338 to obtain the Sentara Martha Jefferson Joint Camp video link.

VIRTUAL CLASS: 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!

Advance Care Planning Assistance If you desire assistance completing your advance care plan, please call 434-654-8407.

We can answer your questions and assist you via telephone or Zoom. In-person classes will resume when it is safe to gather.

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

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

VIRTUAL SUPPORT GROUP: Empty Arms, Full Hearts Held the third Thursday of each month, 7-8:30 p.m.

For parents of deceased infants; find space and time to share with other parents who are going through the same experiences. Currently meeting by Zoom. To request the meeting link, please contact Tammy James at 434-654-5597.

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

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VIRTUAL Cancer Support Groups Various cancer support groups are offered: • Coping with Breast Cancer • Living with Cancer (for new patients) • Establishing a New Normal (cancer survivorship)

Sentara Martha Jefferson offers a variety of other classes and seminars, including the following:

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

Welcome to Motherhood Support Group (virtual) Parenting Support Group for Survival (virtual) Most classes are free. For a complete list of classes, support groups and seminars at Sentara Martha Jefferson Hospital, please visit www.sentara.com.

Registration for all classes is required unless otherwise noted.

To register, call 1-800-SENTARA (1-800-736-8272).

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Maternity Support Services

Helping New Parents Navigate Life With Baby Mothers and babies—along with all of our patients—deserve the very best care. That’s why Sentara Martha Jefferson Hospital features a number of specialized maternity offerings, including a state-of-the-art Family Birthing Center, expert breastfeeding guidance, and a variety of classes and support groups. Together, these services help families feel prepared for baby’s arrival and support them during pregnancy, through a safe delivery and beyond.

Getting Ready for Baby with Prenatal Education Classes

The Sentara Martha Jefferson Birthing Center offers a variety of prenatal education classes to help parents prepare for their new arrival, covering topics from what to expect during childbirth to how to care for your newborn.

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To keep everyone safe during the COVID-19 pandemic, most prenatal classes are currently being offered in a virtual format. While you can always find the latest updates on class offerings on the hospital’s website at sentara.com, current classes include the following: Virtual classes and tours: • Preparation for Childbirth • Understanding Birth (a self-paced virtual class) • Breastfeeding classes (free) • Basics in Baby Care (free) • Childbirth Refresher • Tour for Expectant Parents (free, with virtual questionand-answer session) In-person class: • Family and Friends CPR (currently offered in small groups, with social distancing and other safety practices in place)

Help for Moms Who Need Extra Support

New moms who need some additional help can request services from the Sentara Martha Jefferson’s Maternity Case Management team (a healthcare provider also may refer patients to the program).

This kind of maternity support comes in many forms.

For example, moms with certain medical conditions may need specialized support for a safe delivery. And in some cases, support may be customized for a mother who has survived sexual abuse and is scared to have prenatal care or give birth.

“In such a situation, we can customize care for the mother to minimize any further trauma and support her in the best way possible,” says Laura Salvatierra, BSN, RN, CCE, team coordinator of Maternity Education Programs.

Providing support also includes being aware of any cultural differences or religious beliefs that might affect the ways in which expecting parents approach pregnancy and childbirth, and developing plans to best match these needs, adds Salvatierra.

Members of the Maternity Case Management team—which includes obstetricians, pediatricians, nurses, pharmacists and other providers—collaborate regularly to develop individual care plans for each expecting mom who needs support. The team also ensures that the Birthing Center staff is fully prepared in advance of an admission.

“Our support program is pretty phenomenal, and I don’t think this level of service is offered in most hospitals,” says Salvatierra.

Family Birthing Center

The Sentara Martha Jefferson Birthing Center has been designed with the safety and comfort of families and babies in mind. Private, oversized labor-and-delivery rooms offer

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plenty of space for expectant moms to move around, while also comfortably accommodating a birthing partner. Rooms also include Jacuzzi tubs with showers.

Postpartum rooms have been designed to provide a calm, healing environment. Expectant parents also enjoy convenient covered parking.

Maternity Nursing Care

The maternity providers at Sentara Martha Jefferson know how important high-quality care is to expectant parents, and our warm, welcoming maternity staff is specially trained to do everything possible to support a unique birthing experience. The Birthing Center team also strives to maintain nationally recommended nurse/patient ratios—which means every mom in active labor has a labor nurse who is focused on her individual birth experience.

“We’re incredibly proud of the maternity services we provide,” says Jennifer Wray, MSN, RN, NE-BC, manager of the Obstetrics service line. “It makes such a difference for our laboring patients to feel that consistent level of support.”

The Golden Hour

Studies show that the first hour after birth, often referred to as the “golden hour,” is an ideal time for bonding. At Sentara Martha Jefferson, many new moms spend up to two hours experiencing uninterrupted skin-to-skin contact with their newborn after delivery, as long as mom and baby are both doing well.

Although this precious skinto-skin time is a relatively new focus at many hospitals, the staff at Sentara Martha Jefferson has been encouraging the practice for 15 years. According to Wray, golden hour time has a positive impact on maternal-newborn bonding,

Keeping Up the Caring Tradition During the Pandemic

While the pandemic has brought some temporary changes to maternity care at the hospital—among them, mask requirements and restrictions on visitors—families still receive the same high level of care for which the maternity

unit has been known historically.

“Our outcomes and patient satisfaction rates demonstrate that our Caring Tradition has not changed despite the challenges of COVID-19,” says Wray. “We’ve continued to provide our patients the safe and supported birthing experience they seek.”

Since last spring, the team has prioritized the safety of all

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maternal and newborn vital signs, and breastfeeding success.

Low C-Section Rates

While Sentara Martha Jefferson’s labor and delivery team supports each mother’s desire and ability to have a healthy vaginal delivery, the hospital also has a dedicated maternity surgical team to deliver babies via cesarean section, when that is the best option for the safety of both mom and baby.

Sentara Martha Jefferson Hospital’s C-section rate of 27% currently is well below the national average of 32%, according to Wray.

Newborn Nursery and Special Care Nursery

Bonding with a baby after birth is special, and the staff at the Family Birthing Center supports 24/7 rooming in for healthy moms and babies. The center also offers a fully staffed Newborn Nursery as an option for moms who may need brief periods of rest and recovery time after delivery. In addition, the center has a state-of-the-art Special Care Nursery staff, with neonatal nurses who provide care for babies born after 34 weeks who need extra care or monitoring.

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patients, while maintaining a special birth experience for every family. As part of this commitment, Sentara Martha Jefferson has created a separate area to care for COVID-positive mothers and their babies. The hospital also has supported mothers who choose to go home early, in cases where it’s safe for them to do so.

The Transition Home

Returning home with a new baby can be both wonderful and challenging. To help support parents during this time, the Sentara Martha Jefferson team follows up with a phone call to every mom who leaves the hospital.

“We want to make sure the mother is transitioning well to being home and has the support she needs,” explains Salvatierra.

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“We can talk about any issues she’s having and check on her physical and emotional recovery, as well as breastfeeding health.”

During these calls, the team also inquires about the baby’s health, ensures that follow-up appointments are scheduled, and connects moms with any needed community resources, such as postpartum doulas and psychiatric help.

Support Groups for Parents

Parenthood is special, but it certainly can be challenging as well. For parents navigating these complexities, talking to others who understand can be helpful.

With this in mind, the Sentara Martha Jefferson Family Birthing Center offers several parenting support groups (all currently meeting online only):

• Welcome to Motherhood: This group offers a place for moms to meet new friends and share the joys and struggles of motherhood.

It also includes a private Facebook group.

• Out of the Blues—a Postpartum Support Group: Intended for moms experiencing unexpected sadness, stress or worry after the birth of their babies, this group is run by other moms who have experienced postpartum depression or anxiety.

• Parenting Support for Survival: This group offers practical advice for all parents, including tips for eating, sleeping and returning to work. Local experts participate in each session.

• Empty Arms, Full Hearts: This group offers bereavement support for anyone who has experienced a miscarriage, stillbirth or loss of a baby.

• Sentara Martha Jefferson Motherhood Facebook page: This private page serves as a gathering place for all of our mothers.

Breastfeeding Support

Sentara Martha Jefferson’s breastfeeding rates are still above the national average, despite the challenges presented by the pandemic. International boardcertified lactation consultants offer support seven days a week, and each family receives at least one visit from a lactation consultant while in the hospital.

“At Sentara Martha Jefferson, we’re passionate about providing quality care to our moms, so they

can feel empowered to take care of their baby,” says lactation consultant Allyson Michaels, MSN, RN, IBCLC. “Our breastfeeding program has been in place for more than 25 years.”

Lactation consultants also offer in-person or telehealth visits for mothers who need extra support after they’ve left the hospital.

In addition, lactation consultants: • Support the unique needs of moms whose babies are in the Special Care Nursery • Work with mothers whose babies stay in the hospital after the mother is discharged • Help breastfeeding moms who are admitted to other departments in the hospital • Facilitate rental of hospitalgrade pumps and assist mothers in getting pumps approved by insurance • Refer mothers to complementary care, including support groups, chiropractors and private practices According to Michaels, the lactation consultants and maternity nurses at Sentara Martha Jefferson love helping mothers have successful breastfeeding experiences.

“It is a real privilege to work with new families,” she says.

“There’s nothing like seeing a mom smile when things go right.”

Need breastfeeding support?

Call us at 434-654-8440.

Learn more or sign up for a class or support group!

Visit sentaramjhmaternity.com.

Honoring Babies Born at Sentara Martha Jefferson Hospital The Baby Wall at Sentara Martha Jefferson is a special way to celebrate or remember a child, while also supporting the Martha Jefferson Hospital Foundation’s Mother-Baby Fund.

Located in the third-floor lobby outside of the Mother-Baby Unit, the Baby Wall features three kinds of sea turtles that can be inscribed with a child’s name and birthdate. Gifts support the Mother-Baby Unit and Newborn Nursery, funding projects such as soft rocking chairs for parents and bottle warmers for premature infants.

Family or friends may purchase a turtle at any point during a child’s life.

The wall honors children born at the current hospital and at our former location on Locust Avenue.

To purchase a turtle on the Baby Wall, visit mjhfoundation.org/ donate-babywall or call Kimberly Skelly, Executive Director of the MJH Foundation at 434-654-8258. Featured above are Skelly's sons ages 9 and 12, who were born at Sentara Martha Jefferson Hospital and have turtles of their own.

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Weight, Lifted

Bariatric Surgery Leads to Healthier Lives Obesity has reached epidemic levels in the United States, with more than 70% of American adults now classified as obese or overweight, according to the Centers for Disease Control and Prevention (CDC). erhaps not surprisingly, a CDC report released in November 2020 revealed that 17% of adults over the age of 24 are currently following some sort of special diet—most commonly a weight-loss or low-calorie diet.

Even with the many diet plans out there, however, losing weight can be challenging. In fact, studies show that nearly 90% of dieting programs fail on their own to help people maintain healthy weight loss in the long term. For some individuals, weight-loss surgery (also known as bariatric surgery) can be an effective alternative to help achieve and maintain a healthy weight.

At Sentara Martha Jefferson Hospital, our dedicated Bariatric Program team partners with patients during every step of their weight-loss journey, from preparation for surgery, to recovery, to establishing and maintaining lifelong

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Mandy Feagan

healthy habits. Below, three recent Sentara Martha Jefferson Hospital bariatric surgery patients share their success stories.

Revision Surgery Boosts Weight Loss When the COVID-19 pandemic caused schools across the country to transition to online learning at home last year, Mandy Feagan often joined in her 8-year-old daughter’s elementary classroom “wiggle breaks”—they were a fun way for her to stay active following weight-loss surgery at Sentara Martha Jefferson.

“The teacher would have the kids get up out of their chairs and do silly dances or other movements, and I’d join my daughter to add a little bit of exercise to my daily routine,” says Feagan, 40, of Forest, Va. For nearly 25 years, Feagan had struggled to lose weight. Having watched family members deal with health problems like high blood pressure and diabetes, she was concerned about her own long-term outlook.

“Mostly, I was worried about being around for my daughter,” says Feagan, a certified tumor registrar for Himagine Solutions.

Feagan initially had undergone gastric lap band surgery in 2009, but the procedure proved ineffective and led to complications, including acid reflux and difficulty swallowing. Although a popular technique at one time, gastric banding surgery has declined in use nationally over the past decade, as a result of such postsurgical complications. Sentara Martha Jefferson no longer offers the procedure.

In April 2019, a surgeon removed Feagan’s lap band, and two months later she began a six-month program for gastric bypass surgery at Sentara Martha Jefferson. These preoperative visits, required for all patients preparing for

weight-loss surgery, include monthly weight checks and consultations with a dietitian.

“It was nice to be able to develop a relationship with the team members at Sentara Martha Jefferson,” Feagan says. “They encouraged me, answered all my questions and provided me with a cohesive plan to help me complete my weight-loss journey.”

Timothy Snow, DO, of Sentara Martha Jefferson Medical & Surgical Associates, performed Feagan’s gastric bypass surgery in December 2019. The procedure involves creating a new, smaller pouch out of the patient’s stomach. Then the small intestine is divided, and the upper portion is attached to this new stomach pouch. This rerouting enables food to pass directly into those cavities and then into the middle section of the small intestines.

“This procedure not only limits how much a person can eat, but also the amount of food and nutrients that can be absorbed by the body,” notes Dr. Snow.

At her first preoperative consult in June 2019, Feagan weighed 236 pounds. By November 2020, her weight was down to 163.

“My experiences at Sentara Martha Jefferson—from the very first surgery in 2009 to the most recent one in 2019—have been very positive,” says Feagan, who also is grateful for the support of her husband, Brian, and daughter, Charlotte. “I have been so impressed with everyone at the hospital— they are fantastic and really encouraging.

And now my energy level is so much greater than before!” sentara.com

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Shelley Shifflett

Weight Loss Restores Confidence and Joy For Shelley Shifflett, weight control has been a constant struggle since the birth of her first child 19 years ago. Since that time, she has tried a number of popular weight-loss plans, including the South Beach Diet, Atkins Diet and Weight Watchers. Nothing seemed to work for her, however, so in June 2019 she began her own journey toward weight-loss surgery.

“I just got tired of looking at myself in the mirror and being unhappy with what I saw,” says Shifflett, 47, of Zion Crossroads.

“And not being able to keep up with my 4-year-old daughter was distressing. I want to be around longer for my kids.”

Shifflett began the six-month preoperative regimen in June 2019, weighing

in at 327 pounds. By the time she went in for gastric sleeve surgery (also known as a sleeve gastrectomy) in December 2019, her weight was down slightly to 319.

Lane Ritter, MD, of Sentara Martha Jefferson Medical & Surgical Associates, performed the minimally invasive procedure, which involves reducing the size of the stomach by approximately 75 percent and creating a new pouch about the size and shape of a banana. This reduction restricts the amount of food the patient can eat at one time.

“Shelley went through the required preoperative medical workup, including an upper endoscopy,” Dr. Ritter explains. “This imaging test involves using a scope that goes down the esophagus and looks around in the stomach for abnormalities or signs of long-term acid reflux. There were no signs of ongoing problems, so Shelley was a good candidate for the gastric sleeve procedure. The outcomes of a sleeve gastrectomy are comparable to those of a gastric bypass, without the small added risks that go along with the more involved bypass procedure.”

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By December 2020, Shifflett’s weight was down to 217 pounds, and she was able to stop taking medication for high blood pressure.

Previously an avid runner as a teenager, Shifflett is now back to running four to six miles each day.

She has done numerous races since her surgery, including the Jingle All the Way Virtual 5K and the Surf-nSanta 5 Miler in Virginia Beach, and is currently training for the Princess Marathon at Walt Disney World in February 2022.

Shifflett appreciates the support given to her by the Sentara Martha Jefferson bariatric surgery team, noting that the whole process has been life-changing for her.

“It’s been awesome,” says Shifflett, who also is grateful for the encouragement from her husband, Joe, and her two children. “The biggest impact on my life is that I now have so much more energy. I’m so much happier than I was before.”

The greatest joy has been realizing that I’m able to lead a more active lifestyle without worrying that my body is going to sabotage me.”

— Benjamin Cole

first preoperative consultation, he weighed 367 pounds.

“I took steps toward bariatric surgery once I decided with all my heart and soul that I could commit myself to the lifestyle changes I would need to make,” says Cole, an actor who toured two seasons with National Players of Olney, Md. “Everyone on the bariatric surgery team at Sentara Martha Jefferson was so wonderful and supportive of my efforts. I felt like they cared about me personally.”

Benjamin Cole

A New Life After Losing Nearly 200 Pounds Benjamin Cole has an adventurous spirit—but for most of his life, obesity limited the types of activities he could enjoy.

“That instinct for adventure has always been there, but for as long as I can remember, it was curbed by the limitations of what my body was physically capable of doing,” says Cole, 30, of Charlottesville. “I would often think that if I tried to do something physical, my body might let me down—and then I’d be miserable.”

In June 2019, Cole decided to pursue gastric sleeve surgery at Sentara Martha Jefferson. At his sentara.com

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Martha Jefferson Foundation Donors Fund Helpful Weight-Loss App For patients undergoing weight-loss surgery, making a commitment to nutritional and lifestyle changes can be daunting. Sentara Martha Jefferson Hospital’s customized smartphone app, Baritastic, helps to ease that process by providing a way for patients to keep track of calories, nutrition and exercise each day. Patients also may use the app to connect with the Sentara Martha Jefferson Bariatric Program and keep track of follow-up appointments and support groups.

By the day of his gastric sleeve surgery in January 2020, Cole had lost more than 100 pounds. As of December 2020, Cole weighed 180 pounds, for a total loss of 187 pounds—more than half his previous body weight.

“Even before his surgery, Ben persisted in making the nutritional and lifestyle changes necessary to sustain weight loss for the long term,” says Dr. Snow. “Thanks to his efforts, he is setting himself up for better health in the future.”

With newfound energy and confidence, Cole now enjoys a variety of outdoor activities. He recently completed an externship at the Wildlife Center of Virginia, working as part of the Our Award-Winning center’s wildlife rehabilitation Program team and assisting with day-toSentara Martha Jefferson Hospital’s day care of the animals.

Bariatric Care Center is accredited “That was incredibly physias a Comprehensive Center cal work—the type of thing I under the Metabolic and Bariatric couldn’t have done a year ago,” Surgery Accreditation and Quality Cole says. “This whole weight-loss Improvement Program (MBSAQIP®), indicating our excellence in patient experience has been transformaoutcomes and long-term success. tional. The greatest joy has been Additionally, Anthem Blue Cross realizing that I’m able to lead Blue Shield has bestowed upon a more active lifestyle without our program the Blue Distinction® worrying that my body is going to Center+ for Bariatric Surgery sabotage me. Those are the modesignation. ments when I feel happiest about Interested in weight-loss surgery? this decision—when I’m experiFor more information, encing the gift of having a body call 434-654-5260. that does what I want it to do.”

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The app was made possible through generous donations to the Martha Jefferson Hospital Foundation from the Doloris C. and John B. Thomas Endowed Fund for the Prevention and Treatment of Obesity, established by Jim Thomas and his late wife, Doloris. The couple donated in memory of Jim’s brother, Barry, who struggled with obesity for decades until the disease finally took his life.

After Doloris died in 2014, Jim made an additional gift to the Martha Jefferson Hospital Foundation in her memory and added her name to the fund.

“As patients track their nutrition, exercise and weight loss through the Baritastic app, they can begin to implement healthy habits that are sustainable for the long-term,” says Gina Mitchell, PA-C, coordinator for the Sentara Martha Jefferson Bariatric Program. ”This is a meaningful way for Jim Thomas to honor the memory of his loved ones.”

Ben Cole, 30, of Charlottesville, started using Baritastic in June 2019, when he began the preoperative process for gastric sleeve surgery. He has continued using the app since his procedure in January 2020, now having lost a total of 190 pounds.

“A lot of the nutritional information is already available within the app, so it’s very easy to keep track of everything you’re consuming,” Cole says. ”It’s an intuitive tool, and it helped make my weight-loss journey much easier.”

COVID

vaccine Rollout

How Sentara Martha Jefferson Delivered This Precious Cargo to Help Fight the Pandemic

As some of the first COVID-19 vaccines began to reach people

around the world, Sentara Healthcare took an early leadership role to distribute some of the first doses to healthcare workers, hospital staff and community members in Virginia.

Months before the first vaccines were delivered to Sentara Norfolk General Hospital, a systemwide coronavirus task force at Sentara developed intricate plans to transport the extremely temperature-sensitive Pfizer vaccine to hospitals across the healthcare system. The first shipment of Pfizer vaccines arrived in Norfolk just before Christmas.

The Pfizer and Moderna vaccines—the first COVID vaccines approved for use in the United States—have been revolutionary, both in terms of how quickly they were developed and in their use of “messenger RNA” technology to enable the body’s immune system to recognize and fight the coronavirus.

“The scientific community expended an incredible amount of time and effort to make sure a safe and effective vaccine was sentara.com

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delivered to combat this pandemic,” says Andrea Chapman, an infection control practitioner at Sentara Martha Jefferson Hospital. “The timeline from start to completion is remarkable, and a testament to scientific innovation and fortitude.”

For Sentara team members, the vaccines represent hope and progress during a pandemic that has changed so much about our way of life.

“After months of seeing the worst cases of COVID patients, I was more than ready to help us move closer to the end of the pandemic by getting vaccinated,” says Sara Morris, RN, an intensive

care nurse at Sentara Martha Jefferson. “I decided this vaccine was important not only for my own health, but also for the health of my family and community.”

Planning for the Vaccines’ Arrival Besides implementing a “hub and spoke” shipping plan across the healthcare system, the

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Sentara coronavirus task force also worked with hospitals to ensure they had the right equipment to store the highly sensitive Pfizer vaccine, which must be kept between -112 degrees Fahrenheit and -76 degrees F. The Moderna vaccine also must stay frozen, between -13 degrees F and 5 degrees F. Since a medical-grade freezer can accommodate that range, the Moderna vaccines are shipped directly to hospitals, explains Jamin Engel, regional director of pharmacy for the Sentara Western Region.

If packed in dry ice, the Pfizer vaccine can be stored

temporarily in its shipping container—but the preferred option is to keep it in an ultracold freezer.

Sentara RMH Medical Center had an available ultracold freezer, so it transferred one to Sentara Martha Jefferson in preparation for receiving the vaccines. The pharmacy also had to make plans to handle the dry ice used for temporary storage and shipping of the Pfizer vaccine.

Regardless of the storage method or the brand of vaccine received, each vaccine requires extensive monitoring of storage temperatures.

The Pfizer shipping container, for example, contains a GPS-monitored, wireless-connected device for temperature recording.

“Whichever vaccine came first, we were going to be ready for it,” says Engel. “At times like these, it’s good to be part of a healthcare system—we put our heads together, looked at what equipment was out there and figured out how to distribute the vaccine safely.”

Doug Paige, Sentara Martha Jefferson pharmacy manager, helped create the pipeline to ship the vaccine to Sentara hospitals in the Blue Ridge Region. Shipments traveled from Norfolk to Sentara Martha Jefferson, which was established as the regional storage hub. From there, vaccines were sent to Sentara RMH, Sentara Halifax Regional Medical Center and Sentara Northern Virginia Medical Center.

To assist in community vaccination efforts, Paige also helped coordinate shipments of some of Sentara’s supply to various Virginia Department of Health clinics.

“Planning has been complex, and other patients of course also need our attention and treatment, but these vaccines are a light at the end of the tunnel,” Paige says. “It’s been exciting to be a part of the rollout, and it’s been a complete team effort.”

Setting Up Vaccine Clinics Employee Health teams worked on the logistics of setting up vaccine clinics at Sentara hospitals. The first vaccines arrived at Sentara Martha Jefferson on Dec. 16.

The department educated hospital employees about the vaccines—which are voluntary, not mandatory. When setting up the vaccine schedule, planners had to take into consideration different shifts and workdays, as well as the shelf life of the Pfizer vaccine once it leaves the ultracold freezer.

“We are optimizing our vaccination clinic times,” Chapman says. “Overall, people are excited to have the opportunity to protect themselves and those around them.

The vaccines are bringing a sense of hope that as a community and a nation, we’re taking one step closer to stopping the spread of COVID-19.”

Sentara Martha Jefferson set up the vaccine clinic next to the pharmacy, so moving the vaccine from the ultracold freezer to the clinic’s refrigerator went quickly.

“Once you take it out of the freezer and put it into a refrigerator, you can’t return it to the freezer, and you have five days to use the vaccine,” Paige explains. “We have to be good stewards of the vaccine, which requires careful coordination with employee health vaccination appointments—and even finding eligible employees to help fill canceled appointments, to minimize the risk of wasting vaccines.”

The first vaccines arrived at Sentara Martha Jefferson on Dec. 16.

In addition to the five-day time frame, the clinic has six hours once a vial is diluted with saline and the vaccine is pulled into syringes, whether they are at room temperature or in a refrigerator.

These time constraints require an extraordinarily efficient, well-run clinic. After checking in for the appointment, the staff member receives the vaccine, then goes to a waiting area for 15 minutes to be monitored for any side effects.

Paige notes that resourceful pharmacy staff at Sentara and across the country quickly discovered that they could use a specialty syringe to extract six doses out of each Pfizer vial, rather than the five doses initially anticipated by the manufacturer.

This allows providers to get the most out of each vial and enables more people to be vaccinated with a limited supply.

Among the First to Get the Vaccine ICU nurse Sara Morris has been taking care of COVID-19

patients since the beginning of the pandemic.

“There was a lot we didn’t know, and we had to prepare ourselves quickly,” Morris recalls. “That included hands-on training on how to take personal protective equipment on and off, how to preserve supplies, and how to transport patients.”

Before deciding to get the vaccine, Morris spoke to physicians and studied information Sentara provided on the vaccines’ safety. As a wife and mother to five children, she was grateful to receive her first dose of the Pfizer vaccine on Dec. 21 and her second dose on Jan. 13.

As reported in the clinical trials, some initial recipients of the COVID vaccine have reported mild side effects. After the first dose of the vaccine, many people report soreness at the injection site. After the second dose, some people experience fatigue, headache, muscle pain, chills, joint pain and fever, according to the U.S. Food and Drug Administration (FDA).

“This means the immune system is responding to the vaccine and is working to build immunity,” says Chapman. sentara.com

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Annie Brown, who works in the Environmental Health Services Department at Sentara Martha Jefferson, has seen her responsibilities increase since the pandemic began, with an enormous emphasis on disinfecting and keeping surfaces clean.

“You have to wipe down anything people touch,” says Brown. “I was one of the first in my department to get the vaccine. The first dose made my arm sore for a couple of days, but I didn’t experience any side effects after the second.”

Receiving the vaccines has been a relief and a positive experience for Jaidy Polania, who works as a buyer for Sentara Martha Jefferson. She says that during her vaccination, she was too excited to feel any pain from the needle prick.

“There are so many reasons I wanted to get the vaccine,” Polania says. “I want to keep myself healthy. I also want to encourage people in the Latino community to get the vaccine as soon as it’s available for them.”

Building Herd Immunity As the FDA approves more vaccines and a higher percentage of the population is immunized, the country will inch closer to herd immunity, according to the Centers for Disease Control and Prevention. Once that threshold is reached, the disease won’t be able to spread as easily from person to person, due to the high numbers who will have been vaccinated or already will have had the disease. At the current time, since herd immunity varies by disease, experts do not know what threshold is needed to control COVID-19.

In the meantime, health experts advise everyone to continue wearing masks, observing social distancing and practicing good hand hygiene. New treatments likely also will emerge to combat the virus.

“Vaccines are not going to be a quick solution because it will take some months to roll them out to get a sufficient proportion of the population immunized,” points out Chapman. “In the meantime, we need to focus on COVIDprevention strategies and be vigilant to do what we know is effective in preventing the spread of this disease.”

To learn more about COVID-19 vaccine safety, see the article that begins on page 11.

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How Does the COVID-19 Vaccine Work?

Most vaccines trigger an immune response by using a weakened or inactivated version of a given virus, which imitates an infection. With this method, the next time the body runs into that virus, it knows how to fight it.

Unlike traditional vaccines, the coronavirus vaccines do not use a weakened or inactive virus to spark an immune response. Instead, they use messenger RNA (mRNA) to target the “spike proteins” that enable the coronavirus to latch onto and infect healthy cells. The mRNA technology instructs our cells to make a piece of the spike protein that is unique to the COVID-19 virus. Since only part of the protein is made, it triggers an immune response without harming the vaccinated person, according to the Centers for Disease Control and Prevention (CDC).

With this method, the body views the spike proteins as invaders and builds antibodies against them. Later, if a vaccinated person encounters the actual virus, the body will recognize the spike proteins and respond accordingly to destroy them.

Both the Pfizer and Moderna vaccines, which require two doses each, are about 95 percent effective in fighting the COVID-19 virus, says Andrea Chapman, infection control practitioner at Sentara Martha Jefferson Hospital. Although both vaccines appear to provide limited (and potentially only short-term) protection after the first dose, a second dose is required to achieve the maximum benefit.

“It takes up to two weeks after the second shot for your immune system to fully respond to the vaccine and provide protection against COVID,” she explains.

Other pharmaceutical companies are manufacturing additional types of vaccines— some requiring only one dose—to join in the fight against COVID.

CLINICAL EXCELLENCE

TREATING

Not long ago, a man in his mid-80s came to the Physical, Occupational and Speech Therapy Outpatient Clinic at Sentara Martha Jefferson Hospital complaining of dizziness. He walked slowly, hesitantly.

VERTIGO WITH PHYSICAL THERAPY

“Normally, he was a pretty functional, strong guy,” says Anne Knox, PT, MSPT, GCS, a physical therapist who specializes in vestibular and balance disorders. “He would help his church with building projects and did a lot of woodworking and yard work.

But then he had a sudden onset of vertigo, with nausea and other problems.”

After checking him over, Knox diagnosed the man with benign paroxysmal positional vertigo (BPPV), one of the most common types of vertigo.

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C LIN ICA L E XC E L LEN CE

Those who suffer from vertigo experience a spinning sensation and feel as if their visual field is moving. The condition also may come with lightheadedness, dizziness, nausea and a loss of balance. Episodes are brought on by changes in head position, such as bending over, looking up or down, and turning the head quickly in any direction. Fortunately, once diagnosed, BPPV and most other forms of vertigo are highly treatable.

Most inner ear disorders are grouped together under the general category of dizziness by those who are not trained in vestibular therapy. As such, they often go undiagnosed.

“What’s interesting about vertigo is that, although it’s so common, it’s poorly understood by healthcare practitioners,” Knox says.

A Problem of the Inner Ear BPPV is a disorder of the body’s vestibular system, which is part of the inner ear.

“The vestibular system is responsible for our sense of hearing, and for providing our brain with information about motion, head position and space,” says Jeb Brittle, MPT, a physical therapist at Sentara RMH. This information allows us to keep our balance, stabilize our head and body during movement, and maintain posture.

“When you have trouble with your vestibular system, you can have difficulty with balance, dizziness and walking,” Brittle says.

The two main causes of vertigo that Knox and Brittle see in their clinics are BPPV and vestibular neuritis, which is an inflammation in the inner ear.

BPPV occurs when debris has collected within a part of the inner ear. This debris,

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formally known as otoconia and sometimes referred to as “ear rocks,” is made up of small crystals of calcium carbonate. With head movement, the displaced otoconia shift, sending false signals to the brain and causing the eyes to move in a specific pattern known as nystagmus. This eye twitching makes it seem like the room is spinning, Knox explains.

In addition to dizziness, symptoms of BPPV include lightheadedness, nausea, vomiting and blurred vision. Episodes of BPPV symptoms tend to last about 10-60 seconds.

Vestibular neuritis can be caused by an infection or inflammation in the inner ear, says Brittle. Its symptoms can be mild or severe, ranging from subtle dizziness to a violent spinning sensation (vertigo), as well as nausea, vomiting, unsteadiness and imbalance, difficulty with vision, impaired concentration, and severe disorientation.

Symptoms of vestibular neuritis usually come on suddenly, with severe dizziness starting abruptly during routine daily activities. In some people, the symptoms are present upon awakening in the morning. This sudden onset can be frightening.

“The symptoms can last for two to three days,” Brittle says. “They may be so severe that they affect a person’s ability to stand up or walk.”

As for medications, the most common one prescribed for dizziness is meclizine. However, explains Knox, meclizine actually suppresses the vestibular system, when the ideal solution is to get the system to work better.

“In the acute phase of vertigo, meclizine can help,” says Knox. “But when you’re trying to recover, you want the vestibular system working.”

Who Gets Vertigo and Why

Treating Vertigo When patients come for physical therapy for vestibular disorders, they’re often stressed— not only by their condition, but by the effort it often takes to get the condition diagnosed and treated.

“Physical therapy is really highly effective at treating vertigo, with 80-90% success,” says Brittle.

During treatment for BPPV and vestibular neuritis, a physical therapist guides the patient through certain exercises. The most common therapy for BPPV is known as the Epley maneuver.

“With that maneuver, we’re trying to get those crystals back into the part of the ear where they belong,” Brittle says. “Typically, in just one or two visits, patients with vertigo are cured.”

When physical therapists can’t figure out where a patient’s symptoms are coming from, they still can try to find ways to help them adapt.

“We look at the big picture,” Knox says.

“We can make recommendations that will make the person’s life better. They really appreciate that.”

Dizziness is the second-most common complaint heard in doctors’ offices, according to the National Institutes of Health.

For individuals over age 70, dizziness is actually the No. 1 medical complaint. Although very common, acute or chronic problems with equilibrium can limit a person’s everyday living. So it’s crucial for elderly persons with a vestibular balance disorder to be treated, says Brittle.

“When the elderly lose their sense of balance, they often become scared they will fall and break a hip—so instead, they just sit,” he adds. “And when they do get up, they go real slow, take a step and stop.”

That lack of movement can cause older individuals to deteriorate and lose muscle strength, which in turn further contributes to their lack of balance.

“It’s kind of a snowball effect for the elderly,” Brittle says. “Generally, if someone in their 30s or 40s gets vertigo, they make the best of it and get back to work because they can’t afford to be off. They really just retrain themselves to adjust to a new sense of balance.”

Knox notes that treating older people can sometimes be multilayered. Her patient mentioned above—the man in his mid-80s with BPPV—also had arthritis in his neck, so he wasn’t able to do the therapy exercise Knox prescribed.

To work around that problem, she used a special table that moved the man’s whole body to accomplish the maneuver.

Although the BPPV quickly cleared up, the man still had a balance problem.

“COVID restrictions had made him less fit,” she says.

“His quality of life had changed.”

So Knox worked with him on his gait.

“Gait speed is very important,” says Need physical Knox. “Faster walking is correlated with therapy to treat good health.” vertigo? Talk to In addition, the man had cervicogenic your doctor (a dizziness—another type of vertigo—so he referral is needed), got dizzy whenever he looked up. Knox then call: advised him to stay off ladders. The patient In Charlottesville: was more than happy with his therapy, 434-654-8333 which had restored his quality of life.

In Harrisonburg: 540-689-4999 “By the time he left,” Knox says, “he was feeling like Superman.” sentara.com

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HEALTH MATTERS

Keep Watch on

H

igh blood pressure, also known as hypertension, is sometimes called “the silent killer” because it usually causes no noticeable symptoms, and many people don’t realize they have hypertension until it results in other health problems.

Left untreated, high blood pressure can lead to heart attack, heart failure, stroke, kidney failure and eye damage.

The best way to know if you have high blood pressure is to have your pressure checked regularly by your healthcare provider. You also can regularly check your blood pressure yourself, either at a pharmacy equipped with a blood pressure machine or using a home blood pressure monitor.

What the Numbers Mean Two numbers are used to record blood pressure.

Systolic pressure, the higher of the two numbers, indicates the pressure your blood exerts in your arteries with each heartbeat. Diastolic pressure, the lower number, indicates the pressure your blood exerts between heartbeats.

Here is what the numbers mean, according to the American Heart Association:

Upper Number (Systolic Pressure)

Normal Elevated High Blood Pressure/Stage 1 High Blood Pressure/Stage 2 Hypertensive Crisis (Consult your doctor immediately)

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Less than 120 120–129 130–139 140 or higher Higher than 180

and and or or and/or

Andrey Popov/stock.adobe.com

Your Blood Pressure Who is at Risk?

Risk factors for hypertension include the following: • Age: You’re more likely to have hypertension as you age.

• Race: Blacks tend to get hypertension at an earlier age.

• Family history: Hypertension tends to run in families.

Other risks for hypertension include being overweight or obese, having a sedentary lifestyle, stress, smoking, excessive alcohol consumption, and having too much sodium (salt) in your diet. In addition, nearly 60 percent of people with diabetes have hypertension.

How Do I Keep My Levels Normal?

The easiest way to keep your blood pressure normal is to get regular exercise, reduce stress, maintain a healthy weight and eat a healthy, low-sodium diet.

Don’t smoke, and don’t drink alcohol in excess.

What if I Find Out that I Have High Blood Pressure?

A slightly elevated blood pressure reading may simply require a lifestyle change, such as losing weight, reducing stress, changing diet or increasing your physical activity. If Lower Number your pressure gets too high, how(Diastolic Pressure) ever, your doctor may recommend blood pressure medication in addiLess than 80 tion to lifestyle changes.

Less than 80 If you have high blood pres80–89 sure, be sure to see your doctor for regular checkups.

90 or higher

Higher than 120

LA SALUD IMPORTA

Controle la

L

presión arterial

Si no se trata, la presión arterial alta puede provocar ataques cardíacos, insuficiencias cardíacas, accidentes cerebrovasculares, insuficiencias renales y daños oculares.

La mejor manera de saber si usted tiene presión arterial alta es que su proveedor de atención médica le controle la presión de manera regular. También puede controlar la presión arterial usted mismo regularmente: la mayoría de las farmacias ofrecen una máquina que puede controlar la presión arterial con precisión y también tienen dispositivos de control domésticos.

El significado de los valores Se utilizan dos valores para registrar la presión arterial. La presión sistólica es el valor más alto de los dos e indica la presión que ejerce la sangre en las arterias con cada latido del corazón. La presión diastólica es el valor más bajo e indica la presión que ejerce la sangre entre los latidos del corazón.

A continuación, presentamos el significado de los valores según la Asociación Estadounidense del Corazón:

Valor superior (Presión sistólica)

Normal Elevada Presión arterial alta/etapa 1 Presión arterial alta/etapa 2 Crisis hipertensiva

Menos de 120 120-129 130-139 140 o más Más de 180

y y o o o

lenetsnikolai/stock.adobe.com

a presión arterial alta, también conocida como hipertensión, a veces se denomina factor de muerte silencioso porque normalmente no presenta síntomas visibles, y muchas personas no saben que la tienen hasta que causa otros problemas de salud.

¿Quiénes están en riesgo?

Los factores de riesgo incluyen los siguientes: • Edad: Es más probable que padezca hipertensión a medida que envejece.

• Raza: Las personas de color suelen tener hipertensión a una edad más temprana.

• Antecedentes familiares: La hipertensión suele ser hereditaria.

Otros riesgos relacionados con la hipertensión incluyen el sobrepeso o la obesidad, el sedentarismo, el estrés, el tabaquismo, el consumo excesivo de alcohol y el exceso de sodio (sal) en la dieta. Además, casi el 60 por ciento de las personas con diabetes tienen hipertensión.

¿Cómo mantengo los niveles normales?

La manera más sencilla de mantener la presión arterial en un nivel normal es hacer ejercicio con regularidad, reducir el estrés, mantener un peso saludable y tener una dieta saludable y baja en sodio. No fume y no beba alcohol en exceso.

¿Qué sucede si descubro que tengo presión arterial alta?

Una medición de la presión arterial ligeramente elevada puede simplemente requerir un cambio en el estilo de vida, por ejemplo, perder peso, reducir el estrés, cambiar la dieta o Valor inferior aumentar la actividad física. Sin em(Presión diastólica) bargo, si la presión es demasiado alta, el médico puede recomendarle mediMenos de 80 cación para la presión arterial además Menos de 80 de los cambios en el estilo de vida.

80-89 Si tiene presión arterial alta, asegúrese de realizarse controles médi90 o más cos regulares.

Más de 120

(Consulte con el médico de inmediato).

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Eating Well to

By Patricia Tyndale, RD Sentara Martha Jefferson Hospital

Help Control

Chronic Kidney Disease

ur kidneys serve several vital roles in the body, including eliminating waste, filtering the blood and helping to maintain fluid balance in the body.

When kidney function is compromised, chronic kidney disease (CKD) can develop, often due to chronic conditions like diabetes and hypertension (high blood pressure).

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Based on my experience, CKD seems to be one of the least understood chronic conditions among patients. For starters, many patients have little awareness of the different stages of the disease or what recommendations they should follow. If you receive a CKD diagnosis, your healthcare provider may

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EAT WELL , LIVE WELL

Apple Cranberry Walnut Salad Ingredients 2 cups red seedless grapes, each grape sliced in half 21/3 cups walnut halves, chopped into pea-size pieces 1¼ cups (6-ounce package) Ocean Spray Craisins® Pomegranate Juice Infused Dried Cranberries

recommend that you consult with a dietitian to help you gain a better understanding of the role nutrition plays in preventing the progression of CKD. By following a healthy lifestyle, including a diet that includes plenty of fruits and vegetables and few processed foods, you can slow the progression of CKD and improve your outcome.

Here are a few factors to consider regarding nutrition and CKD.

4 stalks celery, chopped into ¼-inch pieces 7 medium-sized Gala apples, skin on 1 bottle (8 fluid ounces) Maple Grove Farms Fat-Free Cranberry Balsamic Dressing

Directions 1. Rinse the cluster of red grapes and separate from the stem. Use a paring knife to slice each grape in half. Place sliced grapes in an extra large mixing bowl.

Sodium Excessive sodium (salt) intake can lead to serious outcomes for people with compromised kidney function.

Since sodium contributes to fluid retention, it also can raise blood pressure, which can further reduce kidney function in those with CKD. Typically, sodium is present in high quantities in many restaurant foods and in most processed and packaged items in grocery stores. In fact, a single restaurant dish may contain 3,000 milligrams of sodium or more, while the U.S. Food and Drug Administration’s recommended sodium intake for an entire day is less than 2,300 mg. When eating out, you can reduce your sodium intake by checking nutrition information beforehand; asking for sauces, dressings and other condiments to be served on the side; consuming smaller portions; and sharing meals.

A better option, though, is to eat out less frequently and make more meals at home—using fresh ingredients, rather than packaged, frozen or prepared items. Substitute the high-sodium foods you usually consume with reduced-salt or salt-free products. And instead of seasoned salts, use garlic, onions and herbs to flavor meals.

Together, these steps can help reduce your sodium intake to 500 mg or less for a single meal.

You can also reduce your sodium intake by buying frozen vegetables without sodium, as well as not having the saltshaker present at the table during mealtimes.

2.

Chop the walnuts into pea-sized pieces. Add the chopped nuts to the bowl with the grapes.

3.

Add the bag of dried cranberries to the mixture.

4.

Rinse, clean and chop the celery into ¼-inch pieces, and add to the mixture.

5.

Rinse the apples, slice them in half vertically and core them. Slice into wedges, and then chop the wedges into bite-sized pieces. Add the chopped apple pieces to the mixture.

6.

Pour the bottle of cranberry dressing over the entire mixture. Stir the ingredients, making sure the dressing is incorporated and covers all of the ingredients. Chill and serve.

Plant-based diets have been a focus in the media recently for their ability to prevent certain cancers, as well as heart disease, diabetes and other conditions. As with many healthy-eating recommendations, eating more fruits and vegetables also is beneficial for kidney health.

Fruits, vegetables and foods from other plant sources are packed with vital nutrients, and may even be effective in delaying the progression of CKD.

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Plant-Based Eating

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E AT WE LL , LIVE WEL L

sveta_zarzamora/stock.adobe.com

If you are among the millions of adults who suffer from CKD, or if you have a loved one who has CKD, you can learn more about how to maintain kidney health by consulting with a registered dietitian, in addition to your other healthcare providers. Other helpful resources include the National Kidney Foundation (www.kidney.org) and the American Kidney Fund (www.kidneyfund.org).

One very effective way to prevent development of CKD and other health conditions is to manage your weight. In addition to helping prevent diabetes, heart disease, high blood pressure and many cancers, maintaining a healthy weight also can help prevent worsening kidney function.

Simple strategies for better weight management include focusing on more nutrientdense foods, such as fiber-rich grains and lean proteins. These foods create a feeling of satiety (fullness) that can help with portion control.

Engaging in regular physical activity also can be beneficial for weight management.

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Weight Management

Chicken Fajitas Ingredients 2 chicken breasts (about 12 ounces) 6 tablespoons grated 2% Mexican cheese blend ½ teaspoon onion powder

Potassium and Phosphorous Levels

1 teaspoon garlic powder

Following a low-sodium diet is a standard recommendation for CKD, even in its earlier stages, but what about other dietary modifications? Potassium and phosphorus are two minerals that build up in the blood when the kidneys can no longer excrete them in adequate amounts. For many CKD patients, elevated phosphorus levels (known as hyperphosphatemia) in later stages can be controlled with a phosphorus binder. CKD patients with elevated potassium levels (known as hyperkalemia) should follow a low-potassium diet. Regular visits with your nephrologist will help to monitor these levels.

1 teaspoon ground black pepper

SPRING 2021

½ yellow onion, sliced and cut into strips 1 bell pepper, cut into strips 6 small corn tortillas

Directions 1.

Cook chicken until 165°F. Let cool, then cut.

2.

Cook onion until translucent, and cook bell pepper until browned.

3.

Toss chicken and vegetables with onion powder, garlic powder and black pepper.

4.

Add chicken and cooked vegetables to tortilla.

5.

Top with shredded cheese.

PHILANTHROPY

Caring FOR THE

Caregivers

B

urnout can be a serious issue for healthcare professionals even in the best of times, and COVID-19 has only heightened this reality by magnifying existing challenges in the lives and careers of healthcare providers. Add to this the pandemic’s unprecedented psychological impact on all of us—the fear, isolation and distrust—and it’s easy to understand the increased need in today’s world to support the emotional health and wellness of the Sentara Martha Jefferson Hospital team.

Through the COVID-19 Emergency Response Fund, the Martha Jefferson Hospital Foundation is increasingly focusing on new and innovative ways to boost staff resilience and wellness during these unprecedented times. Although Sentara Martha Jefferson has been investing in staff resiliency efforts for years, COVID-19 has underscored and amplified existing stressors and challenges, which aren’t likely to disappear when the pandemic is over.

We thank the community for its support and are pleased to share a few examples of how your generosity is helping to make life better for the healthcare heroes at Sentara Martha Jefferson.

The Power of Place and Beauty to Heal and Promote Wellness Recognizing the constant, busy work pace of our teams, gifts to the COVID-19 Emergency Response Fund are making possible the creation of dedicated, intentional spaces for staff in which to meet and private, meditative spaces in which to rest. While all Sentara Martha Jefferson units have break rooms, mjhfoundation.org

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those spaces are primarily communal and intended as places to eat and find refreshment. True resiliency spaces, conveniently located and easily accessible for our frontline team, are still needed.

Thanks to a generous gift from The Joseph and Robert Cornell Memorial Foundation, one such space is now being created. With the working title of “Heroes’ Garden,” a rooftop located between the Intensive Care Unit and Cornell 1—the units where some of our most critically ill patients are treated—will provide a dedicated space for staff to retreat for rest and private meditation.

The plan for this garden was included in the original landscape designs for the new hospital created nearly 10 years ago by renowned landscape design firm Nelson Byrd and Woltz, which designed all of the gardens in and around the new campus.

Until now, however, funding has not been available to build out this beautiful space. As our caregivers continue to grapple with the stress and uncertainty of COVID-19, we give special thanks to The Joseph and Robert Cornell Memorial Foundation for its continued dedication to the hospital and our team, especially at this most challenging of times.

Farm-Sourced Food For Everyone To promote wellness and help ensure that all employees have access to healthy food, the Foundation recently established

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veggies, dairy and other yummy surprises were a highlight of my week. I loved learning more about our local growers, trying new things and making healthy meals for my family. With thanks, Andrea Chapman, Infection Disease Preventionist

Unmasked Affection

a partnership with Local Food Hub, a Charlottesville-based organization that strives to achieve equitable access to fresh food, among other goals. Every Friday throughout the summer of 2020, this “Fresh Farmacy” program delivered 100 bags of fresh, locally grown produce directly to the hospital for our staff. Using philanthropic support to underwrite the program, staff members were eligible to purchase the produce on a “pay what you can” basis. Bags brimming with fresh vegetables and fruits, eggs, jams, and even locally grown and ground cornmeal, valued at $35, could be purchased for as little at $5—enabling access to all staff, regardless of economic circumstances. The program continued in October to celebrate the fall harvest, in November for Thanksgiving and in December for the holidays. Altogether, more than 2,000 bags of fresh, healthy food were provided.

“My sincere thanks to the Martha Jefferson Hospital Foundation for support of the weekly farm-share bags. Those delicious bags of fruits,

One year ago, very few people in our area owned a face mask, and now masks have almost become a fashion statement!

To protect our team inside and outside the hospital, Rhoback generously donated more than 2,600 face masks, which were distributed to staff and volunteers.

Customized with the Martha Jefferson Hospital Foundation logo, these masks quickly became the crowd favorite among our team. Special thanks to Rhoback, a locally founded and locally operated Charlottesville company, for its generous support.

PHILANTHROPY

Finding

Beauty

in the FACE OF ADVERSITY

Inspiration from the Front Lines

M

eet Sara Morris, BSN, RN, RN-BC, a Sentara Martha Jefferson Hospital veteran of 17 years and a trusted member of the Intensive Care Unit (ICU).

Normally, Morris uses her gift for photography to capture memories of her children. However, as she and her ICU colleagues faced the long marathon of fighting COVID-19 on the front lines, she started bringing her camera to work. Since late 2020, Morris has been documenting the brave faces of the Sentara Martha Jefferson ICU. “Art can be a positive outlet for a person’s feelings, and taking

photos has been a good way for me to deal with the pandemic,” says Morris, a mom of five children between the ages of 2 and 14. “Starting this photographic journey to document the faces of my colleagues has helped me process what we’re going through. It’s been a difficult time for all of us.”

Morris joined Sentara Martha Jefferson in 2004, and since has worked primarily as a medical surgical nurse. After spending two years as a Cath Lab RN, she joined the ICU in September 2019.

When the third COVID-19 surge hit the area after Thanksgiving, Morris decided to honor

her colleagues through photographs. The pictures are not just of doctors and nurses—they include a wide range of team members, from Physical Therapy to Environmental Services and everyone in between.

Morris’ colleagues have been excited to share in her journey, and she sees these photos as a way to help boost morale during trying times.

“When you take pictures, you are putting memories into history. To me, that history is more solid than just relying on your memory.”

Shown here is a selection of Morris’ photos and, in her own words, what these pictures mean to her. mjhfoundation.org

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I want these pictures to tell our story.

By Sara Morris, BSN, RN, RN-BC

When we saw this virus coming, it was like waiting for a wave to crash ashore.

We were given the extraordinary task of keeping people alive from an unknown illness. When the rest of the world shut down, we continued to face our fears every time we walked through our hospital doors.

We continue to fight for these people minute by minute, hour by hour. It’s like a marathon at times, with no end in sight. We have seen death, life, hope, miracles. It’s been a long and sometimes arduous journey.

Throughout much of this pandemic, I had been keeping my gift of photography away from work as I fought in the trenches alongside my fellow nurses in the ICU. In our first hit from the pandemic, I created wooden plaques to help lift everyone’s spirits, but I started feeling like I needed to do something more personal.

Finally, as we hit a third surge, I decided that it was time to honor my co-workers with my gift of photography. I want these pictures to tell our story.

The faces of our ICU are filled with years of experience, youthfulness, and some just starting or getting out of

nursing school—all of us working with these patients day in and day out. Respiratory therapists are the wizards of the ventilators, sometimes changing settings several times a shift. As they change their settings, we tweak our life-saving drips. It is a yin-and-yang relationship. The doctors and nurse practitioners here are abreast of the most up-to-date recommendations and so receptive to input from the rest of the team. Our team runs like a smooth ship sailing through choppy waters.

If only people could see what our eyes have seen. As we wear our masks, we are faceless, unknown, the unsung. Throughout it all, we have clung to love, hope and faith. This is what keeps us coming back. We see people, not the virus. We listen, connect and learn as we navigate this storm. We are hopeful as we pioneer the first rounds of the vaccine.

Frontline worker after frontline worker, we voluntarily roll up our sleeves to protect our families, neighbors and communities. This is one part of our history we will never forget.

To see Morris’ blog and more photographs, visit tinyurl.com/ ssm-icu.

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PHILANTHROPY

A Fond

Farewell to JONATHAN DAVIS

O

n March 1, Sentara Martha Jefferson Hospital bid farewell to President Jonathan Davis, FACHE, who stepped down after six years of service to the Charlottesville community to join FirstHealth of the Carolinas, a nonprofit health system in North Carolina.

During his time at the helm of Sentara Martha Jefferson, Davis led market-share growth in orthopedics, neurology and cardiac services, while significantly expanding the hospital’s acute gastrointestinal, stroke and neurosurgery services.

Under his leadership, the Sentara Martha Jefferson stroke program earned designation as a Primary Stroke Center, achieving the nation’s first DNV-plus accreditation, and transitioned emergency and anesthesia services to larger practice groups. Most importantly, he guided the team to achieve numerous performance rankings in Leapfrog A+, Medicare 5-Star and year-over-year Sentara health system top results.

These accomplishments have paralleled his critical role in developing programs through the Martha Jefferson Hospital Foundation, such as the Center for Clinical Education to promote professional development scholarship opportunities for staff and the Caregiver Center to

support families in their healthcare journey.

Throughout his tenure, Davis has championed the work of the Foundation and worked closely with hospital leaders, donors and volunteers. Before his departure, we asked him to share some of his thoughts and perspective on the role of philanthropy in keeping community at the heart of Sentara Martha Jefferson Hospital.

MJH Foundation: What has been

the greatest impact of philanthropy during your time at Sentara Martha Jefferson?

Jonathan Davis: First, we’ve continued a tradition of connecting personally within our community. When people give their dollars to an organization, they do so because they feel connected to and passionate about the mission and purpose of that organization. I’ve enjoyed the opportunity to be accountable to our commitment for service, access and excellent outcomes.

Second, we’ve been able to grow and expand our priorities.

That includes the trajectory of strengthening the Haden Nursing Institute's scholarship programs, which enable our nurses to go back to school and earn advanced degrees. Programs like this create new professional opportunities, while also improving

patient outcomes. We also have strengthened and expanded our Palliative Care Program, which is one of the strongest within the Sentara system, thanks to the philanthropic support of our community. We’ve started new initiatives like the Caregiver Center to support our approach of caring for the needs of the whole family—not just the patient. The Caregiver Center is the only one in the Sentara system, and one of only 22 in the United States. These are examples of the margin of excellence that community support makes possible.

MJH Foundation: How do you

think the programs and services funded through philanthropy— such as the High-Risk Breast Program, and the Center for Cancer Survivorship Program—help to enhance our community? mjhfoundation.org

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Janet and Jonathan Davis

Jonathan Davis: Reimbursement changes in the healthcare industry have really pushed many hospitals to less personal, more transactional care—that is, carrying out the tasks of health care, conducting physical exams or prescribing medicines for a period of time.

Through the Martha Jefferson Hospital Foundation, Sentara Martha Jefferson can offer special services that express how much we really care about the patient as a person, and that includes their family. Sentara Martha Jefferson isn’t just going to treat patients for a diagnosis—we’re also going to hold their hand through the journey and take care of their family.

Our efforts to care for the whole person and families also extend to our staff and Sentara Martha Jefferson family. For instance, we show that we care about our community by investing in nursing and clinical education, which allows individuals to pursue their career goals here and ultimately give back to the local community.

MJH Foundation: How is the Martha Jefferson Hospital

Foundation unique among other hospitals throughout the nation?

Jonathan Davis: Across the Sentara system, we share clinical best practices and learn from one

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another. We learn how to deliver extraordinary care, streamline processes and improve clinical procedures. The Foundation allows us to fund local needs beyond the normal, necessary clinical services. Foundation support enables Sentara Martha Jefferson staff to explore other programs and services across the United States and bring new ideas to our community. The Caregiver Center is a great example. We had a Foundation board member who brought the idea to us from New York. We embraced this personal touch to caring, knowing that the services offered would enhance our ability to provide holistic care to our community.

The Foundation creates a feeling of personal connection, like home—it doesn’t feel institutional.

Over the years, we’ve created an aura that supports ownership and engagement from the community.

The leadership of our Foundation board and staff is a big part of that success. We aren’t doing our work behind closed doors; we’re really connecting and developing relationships in our community, bringing people together to be involved and engaged in our (community and hospital) future. In addition, our greatest gift is that we are afforded the opportunity to listen to what the community needs.

MJH Foundation: What accomplishment during these

six years are you most proud of?

Jonathan Davis: Rallying a team to create a high-performing organization. We have a team of leaders and physicians who are loyal, humble and committed to the values of our organization, and that is the core and fabric underneath everything we do and accomplish. Our values create a culture of excellence, and I am most proud of our team’s compassion, resilience, commitment and dedication to our patients. I have been honored to serve and foster those values so that we give our best to our patients. This fills my cup every day.

MJH Foundation: What does the Martha Jefferson

Caring Tradition mean to you?

Jonathan Davis: The Caring Tradition describes our singular outcome to compassionately care for all people. Community donors and volunteers give us gifts of time, dollars and ideas, which keep Sentara Martha Jefferson Hospital thriving and connected to the local community. As a team, we all are truly committed to improving health and wellness for the broader community. To me, that is what the Martha Jefferson Caring Tradition is all about.

PHILANTHROPY

KICKING OUT CANCER

A Local Boy’s Campaign to Save Lives and Inspire a Community of Caring

As goalkeeper for his soccer team, Brady Krysiewicz makes saves on the field to help his squad win. Off the field, he’s trying to help save as many lives as possible by promoting breast cancer awareness and fighting in the war against cancer. mjhfoundation.org

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Last fall, Brady raised more than $2,700 for the Phillips Cancer Center at Sentara Martha Jefferson Hospital through his campaign, “Keeper for a Cure.”

These funds are making possible essential cancer support programs, such as free wigs and scarves through Marianne’s Room and a new “cooling cap” chemotherapy treatment that reduces and even helps prevent hair loss.

“Our coach told us that we need to use our skills to be leaders on the field and off the field,” says 11-year-old Brady. “My dad told me about people in my family who had breast cancer, and I decided I wanted to help people in my community. So, I researched organizations that support breast cancer awareness, and we just kind of went from there.”

A fifth-grader, Brady says that although one of his aunts survived breast cancer, he had a great-aunt who succumbed to the disease.

“I’ve learned that there are some people who really, really need help in this world, and they need it way more than some of us, like me, who are very privileged,” Brady says. “I have a great family, a really amazing house to live in and one of the best sisters I could ask for. I also learned that I just like helping people.”

Brady’s parents, Heather and Anthony, have been 100% behind his fundraising campaigns, and are excited to see where he takes his initiative in the future.

“We’ve been blown away during these campaigns,” Heather says. “He first came up with the idea two seasons ago, and he has raised more than we ever thought he would. We’re so proud. We encourage him in whatever he decides to do and try to help make it happen as much as we can.”

Brady has more than 2,000 social media followers and hosts a podcast on which he has interviewed

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several professional goalkeepers, including Brad Stuver of Austin FC, Major League Soccer (MLS); Nicole Barnhart, two-time Olympic gold medalist and goalkeeper for Kansas City NWSL (National Women’s Soccer League); Matt Bersano of the San Jose Earthquakes (MLS); and Michelle Betos of Racing Louisville (NWSL).

Brady, who started playing soccer at age 3, aspires to play for the MLS and become a soccer coach.

“I’m hoping to retire with a soccer ball in my hands,” he says.

As to why he chose to help raise funds for the Phillips Cancer Center, Brady says: “They have great people working there.

Everybody is super nice, and the way they take care of their patients is so amazing.

When I got there and took the tour, the thing that stuck out to me the most is how the team takes care of their patients.”

Thanks for helping us, Brady. Kick on!

Learn more about the impact of philanthropic support on the lives of cancer patients in our community at mjhfoundation.org, and more about Brady’s next campaign at keeperforacure.org.

Gifts From Our Community Supporting Our Community Our 100 % Promise In the face of great challenges, community is our greatest strength. At the Martha Jefferson Hospital Foundation, we know and believe this, which is why our 100% promise to you is that 100% of every gift will be used to support local patients and their families, our hometown healthcare heroes, and those most at-risk in our community.

Please support the Martha Jefferson Caring Tradition and make a gift to show your: • Gratitude for our Doctors, Nurses, and Caring Staff • Compassion for Patients and their Families • Love for our Community Make a Gift Online at mjhfoundation.org or by phone at 434-654-8258.

“It is our aim to make this institution a blessing to this community.”

—Dr. J. Hamilton Browning, a Martha Jefferson Hospital Foundation, 1906

For information on including Martha Jefferson Hospital in your will and estate plans, email us at: mjh_foundation@sentara.com or call us at: 434-654-8258

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S E N TA R A OR T HOPE DIC S

NEW PLAYGROUND. NEW INJURIES. NEW RISKS IN OUR NEW NORMAL Staying safe at home doesn’t mean we’re safe from orthopedic injury. Even virtual yoga becomes hazardous with kids zooming through your Zen. If you find yourself injured after being at the bottom of a three-kid pileup, know that Sentara Orthopedics is here to care for all your new injuries in your new normal. Adhering to the strictest COVID protocols, we continue to bring you the highest quality care in the safest possible environment. Same-day appointments available.

Call 434-654-5575 to make an appointment, or visitsentara.com/orthopedics for more information.

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