Sentara Martha Jefferson Spring Summer 2023 Magazine

SPRING/SUMMER 2023

Healing On the

Fly

Hope and Support for Cancer Survivors

PLUS: Home Health Care and the Rewards of Connecting with Patients Breathing Easier with Help from the Health and Wellness Center

PRESIDENT’S

LETTER

Working Together to Serve Our Community Rita Bunch President, Sentara Martha Jefferson Hospital

SENTARA MARTHA JEFFERSON BOARD Carol Hurt | Chair Lillian BeVier Robert Broermann Rita Bunch, President Joshua Fischer, MD Peggy Echols Paul Gaden John Ligush, MD Lawrence Martin Douglas Moyer E. Ray Murphy SENTARA MARTHA JEFFERSON ADMINISTRATORS Rita A. Bunch, MPH, FACHE President Michele Carroll, MHA Vice President, Chief Operating Officer Johnsa Morris, MHA, MBA, RN, NEA-BC Vice President of Patient Care & Chief Nursing Officer Kimberly Skelly Executive Director, Martha Jefferson Hospital Foundation Paul Tesoriere, MD , FHM, FACP Vice President, Chief Medical Officer SENTARA MARTHA JEFFERSON MAGAZINE EDITOR Alyssa Pacheco CONTRIBUTORS Luanne Austin Jim Heffernan Sara Kaplaniak Lisa Richmon Jennifer Stover PHOTOGRAPHY Andrew Shurtleff Theresa N. White DESIGN Picante Creative

A

s the warm weather approaches and we enter the spring and summer months, I’d like to take a moment to express my gratitude to every team member at Sentara Martha Jefferson Hospital for the excellent care they provide to our community daily. Their unwavering dedication to providing high-quality medical care, while embodying the ideals of the Sentara Martha Jefferson Caring Tradition, is remarkable.

Over the course of my first year as hospital president, I had the opportunity to meet with many of you along the way during events such as listening tours in our surrounding counties, Chamber of Commerce meetings, various happenings hosted by local nonprofits, and Martha Jefferson Hospital Foundation events like Martha’s Market. No matter where I encounter individuals in our community, I am met with enthusiasm and good dialogue about our town and the exciting things happening at Sentara Martha Jefferson.

As you’ll read on page 4, we’ve accomplished much in the last year. From welcoming Sentara Breast Surgery Specialists to the Sentara family to building our new Outpatient Care Center, we have expanded many offerings in our community. The new center, built in the same neighborhood as the old Martha Jefferson Hospital, holds a very special place in our hearts. While a lot has changed since the hospital moved to Pantops from the Downtown area, what hasn’t changed is our ongoing commitment to providing accessible, convenient, expert medical care to our community—and we are thrilled to bring this additional access back to the center of town.

You’ll also read firsthand accounts of our team members and their dedication to delivering the best possible outcomes for our patients, while working exceptionally well together to improve the health and well-being of our community. On page 19, you’ll learn more about our rectal cancer team members and how they collaborate to provide our patients with the care they need, from initial consultation to planning and treatment, follow-up appointments, and beyond. And on page 28, we share an account from our Family Birthplace unit that serves as another great example of teamwork from our dedicated caregivers, who work hard every day to help mothers realize their ideal birth plans and have safe and healthy delivery experiences.

Another exciting development announced earlier this year is the partnership we have established with UVA Children’s that will, through a true team approach, enhance and expand pediatric neurodevelopmental and behavioral health care in Central Virginia. By proactively providing this service, this collaboration will enable children and families to receive care in a supportive, caring environment.

I am also pleased to welcome Michele Carroll, our new vice president of operations, to the Sentara Martha Jefferson family. Michele brings a wealth of experience and knowledge to her role, and we are thrilled to have her on our team.

And as always, I would like to thank the community for their ongoing support of Sentara Martha Jefferson Hospital. We are honored to be your community hospital, and we look forward to continuing to work together to make a positive impact on the lives of those we serve.

Rita Bunch

President, Sentara Martha Jefferson Hospital

CONTENTS SPRING/SUMMER 2023

Features

19

A Team Approach to Rectal Cancer Treatment When it comes to fighting cancer, nothing is more important than having a dedicated team of healthcare professionals by your side

24

Breathing Easier Health and Wellness Center improves quality of life

19 28

Circle of Support Sentara Martha Jefferson supports mothers in realizing their ideal birth plans

CONTENTS

Departments 6

11

17 Sentara Cares 33 Active Living

Feeling Stressed? Talk with Your Primary Care Physician.

36 Health Matters

Think You Might Be Having A Heart Attack?

Call 911 Right Away!

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

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

President’s Letter Inside front cover

3 The Best Medicine

41 Caring Tradition

4 New & Noteworthy

36

6 Provider’s Perspective 9 On-Call Advice 11 Improve Health Every Day 14 Eat Well, Live Well

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SPRING/SUMMER 2023

38

BY MICHAEL CORDELL

THE BEST

MEDICINE

Clear Out the Winter Cobwebs and Get Moving!

E

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

There are four types of spring cleaning. The first is deep-dive cleaning: tackling blinds, baseboards, behind the refrigerator and the other areas we usually neglect, mainly because they’re a pain to clean.

I know next to nothing about that type of spring cleaning, so I won’t be touching on it here. It’s sort of like winning the lottery: I know it can happen, but it’s not something I’ve ever personally experienced.

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

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

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

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

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

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

Likewise, cutting out junk food, say, two days a week is better than eating junk food every day.

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

Not that I would know anything about that.

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new &

noteworthy Sentara Martha Jefferson DAISY Nurses Announced for 2022 Sentara Martha Jefferson is pleased to recognize a select group of nurses with the prestigious DAISY® nursing award. A national recognition program, DAISY is among the highest accolades in the nursing profession. According to the DAISY Foundation website, DAISYs honor the “superhuman” work nurses do for patients and their families. This program is made possible with gifts from our community to the Martha Jefferson Hospital Foundation.

2022 DAISY Nurses:

Brenda Backe, RN (W2) Colby Hill, MSN, RN, CNL (PACU) Megan Phillips, RN (Obs) Kathryn Murray, MSN, RN (W3) Brittney Gilmore, BSN, RN (C1) Lucy Brescia, RN (ICU) Shaela Shifflett, BSN, RN (C3) Lauren Sink, BSN, RN (C2) Shantay Mitchell, BSN, RN (FSED) Kunga Deyang, BSN, RN (C1) May Ann Fernando, RN (C1) Debbie Brown, BSN, RN (C2)

2022 DAISY Team of the Year: Wendel 1 (ICU) Team

2022 Sentara Martha Jefferson Nurse Leader of the Year: Tiffany Fick, BSN, RN (ICU)

2022 Sentara System-wide Nurse Leader of the Year: Michelle Harper, MSN, MBA, RN, CMGT-BC

Sentara Martha Jefferson Hospital Family Birthplace Honored With “High Performing” Rating

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Sentara Martha Jefferson is ranked among the best hospitals in Virginia for maternity care in the “uncomplicated pregnancy” category, according to the latest U.S. News & World Report survey. Only 12 Virginia hospitals, including seven Sentara facilities, earned this designation, which recognizes Sentara’s commitment to and success in providing safe, comprehensive maternity care to expecting families.

The annual maternity care rankings are designed to assist expecting parents, in consultation with their doctors, in making informed decisions about where to receive care.

To compile the 2022-2023 rankings, U.S. News evaluated data from nearly 650 hospitals across the country. Fewer than 300 hospitals received a “high performing” designation in maternity care, the highest rating awarded by the survey.

Sentara Breast Surgery Specialists Practice Opens in Charlottesville In January 2023, Sentara Breast Surgery Specialists, now led by Linda Sommers, MD, and Kimberly Suppes, MD, joined Sentara Medical Group, expanding access to convenient, high-quality breast care in the Charlottesville area.

“We are so pleased to have Dr. Sommers and Dr. Suppes join the Sentara Medical Group family,” says Ellen Burke, regional director, operations, for Sentara Medical Group– Charlottesville. “This expansion of our services, which couples their expertise with that of our existing care team, will greatly benefit our community.”

In what can be a frightening and uncertain time for patients going through treatment and recovery, the

New Outpatient Care Center The Sentara Martha Jefferson Outpatient Care Center, located at 920 East High St. in Charlottesville, opened in November 2022. In addition to providing imaging and laboratory services and housing an infusion center, the new facility has extra capacity for new services, as need arises.

Sentara Martha Jefferson Family Medicine has also moved to this location, and Velocity Urgent Care has opened within the building.

“We are excited to offer this level of access to healthcare

Sentara Breast Surgery Specialists

services all in one place,” says Bruce Clemons, MD, FACP,

team offers warm, compassionate

executive director of primary care services for the Sentara

care, supported by the most

Blue Ridge Region. “Providing individuals with convenient

up-to-date technology, for the best possible outcomes.

access to high-quality medical care is vital to our mission, and offering this many services in one location is part of Sentara’s model for the future.”

Best Wishes to Chief Operating Officer Amy Black After dedicating more than 40 years to health care and serving as a vital member of the Sentara Martha Jefferson team for more than 20 years, Amy Black, DNP, RN, NEA-BC, retired from the hospital on Jan. 31, 2023.

Amy kept the Caring Tradition front and center in everything she did at the hospital—whether working with patients, community members or staff—and acted faithfully as a leader, mentor, confidant and friend. Thank you to Amy for her years of dedication, passion, mentorship and genuine inspiration.

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PROVIDER’S

PERSPECTIVE

Sentara Martha Jefferson Offers New, More Effective

Endoscopic Techniques Third-Space Endoscopy

T

he capabilities of interventional gastrointestinal (GI) endoscopy have significantly evolved over the past decade. Although endoscopy traditionally had been confined to inside the GI tract, recent advances in scope design and device development have enabled interventional endoscopists to

access both outside and within the walls of the GI tract. Access outside of the GI tract within the peritoneal cavity (referred to as “second space”) is currently a developing field.

The ability to access the space within the walls of the GI tract (referred to as “third space”) has until recently been carried out via endoscopic submucosal dissection (ESD), a technique that

Alan Brijbassie, MD, MBBS, FACG, FASGE Division of Advanced Therapeutic Endoscopy Sentara Martha Jefferson Hospital

involves the injection of fluid to expand the submucosal space of the GI wall, followed by careful freehand dissection in the submucosal plane using electrosurgical knives. ESD has been established in Asian countries as the standard of care for the management of superficial cancers throughout the GI tract, with increased uptake in Western countries over recent years.

Third-space endoscopy, a newer technique born out of ESD techniques, was initially utilized for the management of achalasia, a rare swallowing disorder.

However, applications for thirdspace endoscopy procedures have broadened recently and are now being used for other indications, such as subepithelial tumors, refractory gastroparesis and Zenker’s diverticulum.

Esophageal Per Oral Endoscopic Myotomy (E-POEM)

With achalasia, which affects approximately 8-12 people per 100,000, the muscles in the esophagus do not work properly in moving swallowed food into the 6 |

SPRING/SUMMER 2023

stomach, and the ring of muscle at the bottom end of the esophagus (known as the lower esophageal sphincter) is unable to relax to let food into the stomach. Symptoms of achalasia can include difficulty swallowing, food “hanging up” in the esophagus, regurgitation of food, chest discomfort and weight loss. Treatments for the condition aim to facilitate passage of food from the esophagus into the stomach by loosening the muscles involved in this process.

Traditionally such treatments had

involved surgical incision of these muscle fibers (known as a Heller myotomy), large-bore esophageal dilation and injection of Botox.

However, the endoscopic management of achalasia has advanced with the introduction of per oral endoscopic myotomy (POEM). Esophageal POEM (E-POEM), the most studied of the third-space endoscopy procedures currently being performed, involves submucosal injection, mucosal incision, tunneling within the submucosa, myotomy of the

involved muscle fibers and then closure of the mucosal incision.

Since its inception more than a decade ago, more than 7,000 POEM cases have been reported worldwide, with multiple reviews and analyses illustrating a good safety profile and excellent shortto midterm clinical outcomes.

More recently, a study examining 10-year POEM outcomes confirmed a clinical success rate of greater than 90% at five- to nineyear follow-up, with an excellent safety profile.

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PROVIDER’S PERSPECTIVE

small prospective studies from the United States and Europe reported clinical success rates of 45% and 65%, respectively, at 36-month follow-up. Favorable candidates are those individuals with diabetic gastroparesis, those who had an early diagnosis, and symptomatic individuals with nausea and vomiting.

Gastric Per Oral Endoscopic Myotomy (G-POEM)

Gastroparesis occurs when there is delayed gastric emptying, which means the stomach takes too long to empty its contents. One of the most typical culprits for gastroparesis is diabetes, with high blood sugars damaging the stomach nerves over time. Medications are another common cause. However, in some instances, no discernible etiology can be found, with such cases referred to as idiopathic.

Similar to E-POEM, G-POEM uses the principles of third-space endoscopy and follows the same procedural steps (mucosal incision, submucosal tunneling, myotomy and closure of the mucosal incision. A mucosal incision is generally performed in the stomach proximal to the level of the pylorus, which serves as the gateway between the stomach and the small intestine. Submucosal tunneling is then initiated and continued until identification of the pyloric muscle. Once the pylorus is identified, a myotomy is performed. Upon completion of the myotomy, mucosal closure is performed. The rates of clinical success at one year and adverse events were 61% and 8%, respectively. A few studies have recently reported long-term outcomes of G-POEM in patients with refractory gastroparesis. Two 8 |

SPRING/SUMMER 2023

Zenker’s Per Oral Endoscopic Myotomy (Z-POEM)

Zenker’s diverticulum is an esophageal pouch that develops in the upper esophagus and can be associated with debilitating dysphagia (difficulty swallowing) and regurgitation of food. The diagnosis can be made by swallow evaluation tests such as a barium esophagram, video-fluoroscopic swallow study, fiber-optic endoscopic evaluation of swallowing and transnasal esophagoscopy.

This condition is usually managed by an endoscopic division of the septum between the esophageal and diverticular lumen.

An endoscopic approach with Z-POEM is preferred over surgical treatment, as the former is associated with fewer complications, shorter procedure duration and shorter length of hospital stay. The submucosal tunneling technique has recently been utilized to safely divide the septum with a concomitant reduced risk of perforation.

Submucosal Tunneling Endoscopic Resection (STER)

Subepithelial lesions of the GI tract, defined as tumors arising from within the wall of the GI tract, are usually benign and discovered incidentally—although some may have malignant potential, including GI stromal tumors and neuroendocrine tumors. In the past, the primary method for re-

secting these lesions was via surgery, which can be associated with high morbidity. Submucosal tunneling endoscopic resection (STER) is another prime example of an application of third-space endoscopy, in which a submucosal tunnel is created to provide a working space for the dissection of the subepithelial lesion.

Once the lesion has been completely excised, it is then extracted through the tunnel, followed by closure of the initial mucosal incision to restore luminal integrity.

Other Indications for Third-Space Endoscopy

Submucosal tunneling has also been explored for other indications, such as the management of complete occlusion of the esophageal lumen after chemoradiation, per-rectal endoscopic myotomy for Hirschsprung disease or internal anal sphincter achalasia, and transesophageal mediastinoscopy. Since these instances have been restricted to isolated case reports and animal studies, further evaluation is required prior to more comprehensive clinical application.

Third-Space Endoscopy at Sentara Martha Jefferson Hospital

Third-space endoscopy traditionally has been performed at tertiary and quaternary academic centers, with only a handful of institutions within Virginia currently offering this novel service. By providing the expertise and ability to offer these cutting-edge procedures, Sentara Martha Jefferson is heralding a new era geared toward improving the overall health of our community. Our approach has been built and maintained around the patient-centered and personalized Caring Tradition, enabling us to guide our patients in selecting the options that best meet their needs.

ON-CALL

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

Are heartburn and

acid indigestion

the same thing?

A

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

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

Symptoms also may result from eating too much or too quickly, eating high-fat foods, or eating during high-stress situations.

Unlike acid indigestion, heartburn refers to burning sensations or feelings of pressure in the upper abdomen and chest.

And although heartburn can be a symptom of acid indigestion, it occurs when stomach acid leaks into the lower esophagus and burns the esophageal lining—often brought on by bending over, lying down, or eating certain spicy or acidic foods.

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

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

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ON-CALL ADVICE

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

What causes

dry eyes?

D

Is this a condition I should be concerned about?

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

Decreased tear production can be related to the use of certain medications, such as antihistamines, decongestants, antidepressants, and high blood pressure or birth control medications.

Various medical conditions, including diabetes, thyroid problems, lupus, rheumatoid arthritis and inflammation of the tear ducts, also can cause decreased tear production.

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

Increased tear evaporation can occur when people fail to blink as often as they normally do. Less-frequent blinking is typical for some people when concentrating on tasks like reading or working at a computer monitor.

Environmental factors such as dry air, ambient smoke and wind also can contribute to increased evaporation.

As well, certain anatomical problems with the eyelids, or an imbalance in the composition of the tears themselves can lead to greater tear evaporation.

Thankfully, dry eyes are often less of a danger and more of a nuisance, making daily activities like reading or computer work more challenging.

However, tears help protect the eyes from infection, so decreased tear production or increased evaporation can cause a person to be more at risk for an eye infection. Severe cases of dryness may lead to problems like inflammation of the eyes or corneal damage.

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

IMPROVE HEALTH

EVERY DAY

Tips for

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

•

Jot down notes about your personal health and health history.

Include aches and pains, allergies, sleep problems, diet and exercise habits, and anything else you think may affect your health.

•

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

•

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

•

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

•

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

•

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

Consider Gentle Exercise to

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

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

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

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

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

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

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IMPROVE HEALTH EVERY DAY

Kids and Caffeine

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

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

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

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

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Caffeine amounts in common beverages: Chocolate milk (8 fl. oz.): 5 mg Coca-Cola (12 fl. oz.): 39 mg Coffee, brewed (8 fl. oz.): 163 mg Coffee, instant (8 fl. oz.): 57 mg Coke Zero (12 fl. oz.): 34 mg Hot chocolate/hot cocoa (8 fl. oz.): 5 mg Lipton Iced Tea (20 fl. oz.): 48 mg McDonald’s iced coffee (12 fl. oz.): 120 mg McDonald’s sweet tea (32 fl. oz.): 100 mg Monster Energy (16 fl. oz.): 160 mg Mountain Dew (12 fl. oz.): 55 mg Snapple, peach (16 fl. oz.): 37 mg Starbucks Frappuccino (13.7 fl. oz.): 110 mg

IMPROVE HEALTH EVERY DAY

Treating Minor Burns at Home

If you experience a minor or seconddegree burn, home treatment is usually all you need for the burn to heal on its own. In general, follow this advice: • First, cool the burn. If possible, run cool tap water over the burned area for 10-20 minutes. If the burn is on the face or body, gently apply cool compresses.

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

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

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

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

• Do not break open any blisters that form.

• If a blister has not broken open, no bandage is needed.

If a blister bursts, loosely bandage the area, and change the bandage when it becomes soiled.

• If a bandage becomes stuck to burned skin, soak the bandage in lukewarm water to help loosen it.

If you have any concerns or questions about a burn’s severity, or if it becomes infected, see your doctor.

Don't Forget the Sunscreen!

With spring and summer on the way and the days growing longer, many of us will be spending more time outdoors. When you or your family members go outside, don't forget to put sunscreen on areas of the body that are exposed to the sun's harmful ultraviolet rays. Select a broad-spectrum sunscreen that protects against both UVA and UVB rays, has a sun protection factor (SPF) of 30 or higher, and is waterresistant. Even if you don't plan on going in the water, perspiration can reduce the effectiveness of sunscreens that aren't water-resistant.

Apply sunscreen to dry skin about 15 minutes before going outside and reapply about every 2 hours- or immediately after swimming or sweating­—following the directions on the bottle.

Also, use lip balm with an SPF of at least 15 to protect the lips from the sun's harmful rays. sentara.com

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EAT WELL,

LIVE WELL

DASH Away High Blood Pressure

BY Rita P. Smith, RD

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

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

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

Healthy Habits for a Healthy Heart

Healthy Weight: Excess body weight puts stress

on the heart, so it’s important to maintain a healthy 14 | S P R I N G / S U M M E R 2 0 2 3

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

Physical Activity: Regular physical activity can

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

Relieve Stress: Chronic stress releases hormones in

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

No Smoking: Quit all forms of tobacco.

Drink in Moderation: If you choose to drink

alcohol, women should have no more than one drink per day, and men no more than two.

Eat Well to Be Well: Enjoy a healthful diet such as

the DASH (Dietary Approaches to Stop Hypertension) diet, which includes a wide variety of colorful and nourishing foods.

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

The DASH diet includes the following healthful foods: Daily: • Fruits: at least 4 servings (a serving is ½ cup or one medium piece of fruit) • Vegetables: at least 2 cups • Whole grains: multigrain breads and cereals, whole-wheat or multigrain pasta, brown rice, oats, barley, quinoa • Lean protein: fish, poultry without the skin, small portions of red meat • Dairy: fat-free or low-fat milk, yogurt, cheeses • Healthy oils: olive, grapeseed, canola, sunflower, safflower, avocado Weekly: • Nuts, nut butters and seeds: 4-5 servings • Legumes or dried beans and peas: 4-5 servings While a healthful diet goes a long way toward keeping your heart healthy, there are also a few foods to avoid or limit because they contain high

amounts of sodium, added sugar and saturated fats.

All of these can significantly raise your blood pressure if not consumed in moderation.

Reducing your sodium intake typically implies reducing your salt usage, since salt is 40% sodium.

However, convenience and processed foods are the biggest culprits, supplying 70% of the sodium in the average American diet.

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

To reduce sodium, added sugar and saturated fat, the DASH diet recommends limiting the following: • Processed meats: bacon, sausage, deli meats, hot dogs • Full-fat dairy: whole milk products, butter • Tropical oils: coconut, palm, palm kernel • Sugar-sweetened beverages: soda, sweetened fruit drinks, sweet tea • Sweets and desserts: cake, pie, cookies, ice cream, candy Tips to Lower Your Intake of Dietary Sodium: • Replace the salt shaker with your own homemade blends of herbs and spices. Bring on the pepper, thyme, garlic powder and nutmeg!

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

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

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

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Cobb Salad with Avocado Prep time: 15 minutes Makes 4 servings

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

1 cup frozen whole-kernel corn 1 cup shredded carrots

Whole-Wheat Couscous with Almonds and Raisins

2 Roma tomatoes, rinsed and cut into wedges 1 ripe avocado, peeled and sliced 1 cup frozen green peas, thawed 1 can (6 ounces) white albacore tuna packed in water, drained

Prep time: 20 minutes Cook time: 5 minutes Makes 4 servings

Dressing

Ingredients

1 tablespoon fresh lime juice

1¼ cups no-salt chicken or vegetable broth

1 tablespoon honey

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

1 tablespoon water

1 cup whole-wheat couscous

Directions

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

2 tablespoons fresh lemon juice

1 tablespoon minced fresh parsley 1 tablespoon vegetable oil

1.

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

2.

Meanwhile, evenly divide the greens among four salad plates.

Top the greens with grated carrots, tomato wedges, avocado slices, green peas and flaked tuna. When the roasted corn is ready, add that as well.

3.

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

4.

Top each salad with dressing and enjoy!

1 tablespoon fresh orange zest Directions 1.

2.

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

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

3.

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

4.

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

Serve immediately.

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Tips to Lower Your Intake of Added Sugar: • Sweeten beverages with frozen berries or orange slices.

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

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

Tips to Lower Your Intake of Saturated Fat: • Replace all or part of butter or stick margarine with a soft oil spread; vegetable oils such as canola, corn or grapeseed; or mashed avocado.

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

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

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

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

SENTARA

CARES

Sentara Health Invests Nearly $4 Million in Healthcare CareerDevelopment Programs In response to the medical staff shortages currently straining the U.S. healthcare system, Sentara Health is launching two new pipeline-development programs to support students pursuing healthcare careers.

Through a nearly $4 million investment in the Sentara Scholars and Project CHOICE programs, Sentara is working to create pathways for young students toward their desired healthcare careers, while also positively impacting economics and health equity outcomes in their communities.

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

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SENTARA CARES

Project CHOICE

Sentara Scholars Partners:

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

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

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

ACCESS College Foundation Centura College College of the Albemarle Foundation Eastern Mennonite University Elizabeth City State University George Mason University Foundation, Inc. Hampton Roads Community Foundation James Madison University Medical College of Virginia Foundation Norfolk State University Foundation Old Dominion University Educational Foundation Sentara College of Health Sciences Virginia Foundation for Community College Education Virginia Foundation for Independent Colleges Virginia Ready Initiative (VA Ready) Virginia State University Virginia Union University Virginia Wesleyan University Western Governors University

Project CHOICE Partners: Christopher Newport University Eastern Virginia Medical School Hampton University Hearts4Progress James Madison University Ole School Alumni Group Norfolk State University Old Dominion University On the Road Collaborative Scholars Latino Initiative The Giveback Foundation (GVBK)

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A Team Approach To Rectal Cancer Treatment When it comes to fighting cancer, nothing is more important than having a dedicated team of healthcare professionals by your side. That’s exactly what patients with rectal cancer can expect at Sentara Martha Jefferson Hospital Cancer Center.

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Among the center’s rectal cancer physicians are oncologist Andrew M. Romano, MD; colorectal surgeon Zachary A. Gregg, MD; and radiation oncologist Sylvia S. Hendrix, MD, who collaborate closely to provide patients with individualized care.

The team also includes specialists and a rectal care nurse navigator, who offer comprehensive patient support at every step of the treatment journey, from diagnosis to recovery. In addition, a dedicated rectal cancer tumor board reviews cases to help ensure that treatment plans progress as intended.

Rectal Cancer Treatment Treatment for rectal cancer typically involves a course of radiation and chemotherapy prior to surgery to remove the cancer. The treatment regimen, which varies based on the stage of the cancer, can involve a month of radiation therapy in combination with an anti-cancer chemotherapy drug, followed by several months of intravenous chemotherapy. This combination therapy, overseen

by Drs. Romano and Hendrix, works to shrink the cancer before surgery.

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do well with the regimen. “We don’t see a lot of nausea; fatigue is the most common side effect,” says Dr. Romano. “We’ve come a long way with medications to help prevent nausea.”

During surgery, Dr. Gregg removes the cancer, along with other areas, such as the rectum and lymph nodes, as necessary. He then creates an ileostomy, which is a surgical opening in the abdomen that

navigator, social workers, a registered dietician, an oncology pharmacist and massage therapists. Social workers and financial navigators work closely to provide transportation and housing assistance, gas cards, and help with paying bills. And for rectal cancer patients who have problems eating or who require specialized diets, a registered dietician works with them to develop personalized meal plans and meal supplements, depending on individual needs.

The Sentara Martha Jefferson Cancer Center also has an outpatient palliative care program— the first of its kind in the Sentara system—to help patients with symptom management and quality-of-life issues. The program is designed to support patients through their treatment journey, addressing the physical, emotional and spiritual needs of patients and their families.

Helping Patients Get the Care They Need One recent Sentara Martha Jefferson patient who faced transportation challenges received assistance from the Martha Jefferson Hospital Foundation.

The patient, who required radiation treatments daily and chemotherapy once a week, lived far away from both the hospital and a friend who was acting as their caregiver, creating difficulties in traveling diverts waste from the bowels into an attached pouch, to give the body time to heal from surgery and radiation. A home health nurse visits patients with pouches to help ease the process. “There can be little bumps in the road, so having someone working with you and making sure you’re doing things right makes for an easier transition,” says Dr. Gregg. During a second surgery several months later, Dr. Gregg removes the ileostomy and reconnects the bowel to restore normal bowel function.

Rectal Patient Support Services A dedicated rectal cancer nurse navigator plays a crucial role in helping patients understand their diagnoses and guiding them through their treatment plans. Case managers, clinic nurses and infusion nurses take over once patients have an established care plan. In addition, case managers can help patients who need to apply for medical leave from work and can assist with obtaining equipment such as wheelchairs and walkers.

Other support services patients can access during their treatment journey include a financial

Colorectal Cancer Symptoms and Risk Factors People with early-stage colorectal cancer often have no symptoms. Symptoms of advanced stages of colorectal cancer may include: • • •

Abdominal discomfort and cramps Blood in the stool Changes in bowel habits, including constipation or diarrhea

Risk factors for colorectal cancer include: • • • • •

Diet high in red meat and fat Family history of colorectal cancer Lack of physical activity Obesity Smoking

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Sentara Martha Jefferson Earns National Accreditation for Rectal Cancer Treatment Sentara Martha Jefferson earned accreditation from the National Accreditation Program for Rectal Cancer (NAPRC) in November 2022.

This three-year accreditation from the American College of Surgeons Commission on Cancer recognizes the hospital’s commitment to the highest standards of care for rectal cancer. NAPRC-accredited programs undergo a site visit every three years.

The voluntary accreditation program evaluates rectal cancer programs for their clinical services, quality improvement and program management.

“We succeeded on our first application,” says oncologist Andrew M. Romano, MD, of Sentara Martha Jefferson Hematology and Medical Oncology Associates. “I think that reflects the excellent care we provide these patients, and how coordinated and comprehensive the care is.”

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for treatments. To help ease the burden, the Martha Jefferson Hospital Foundation collaborated carefully with the medical team to provide transportation support.

“There was a lot of coordination involved in making sure all of those appointments were aligned in a way that was helpful for the patient,” says LaDonna Winegar, manager of patient care services at the cancer center. “We understand the stresses our patients undergo and do our best to make things easier for them.”

Rectal Cancer Tumor Board The rectal cancer tumor board at the cancer center meets biweekly, as do tumor boards for other diseases like breast cancer. These multidisciplinary teams include surgeons, radiation oncologists and other specialists, who collaborate to develop the best treatment plan for each patient. The board reviews cases and care plans, incorporating the latest information to refine treatments as needed. “We try to bring as many specialists into the room as we possibly can to give the patient the best outcome,” says Winegar.

Colonoscopies Save Lives While cancer treatments continue to advance, cancers of the rectum and colon (colorectal cancers) are among the leading causes of death in the United States.

The best defense against these diseases involves getting regular colonoscopies. A colonoscopy is an outpatient procedure that allows a doctor to examine the inside of the rectum and colon using a tiny camera. During the procedure, the patient is sedated and doesn’t feel any pain.

Although rates of colorectal cancer are rising—especially in younger people—catching cancer earlier on with a colonoscopy increases the chances for a cure. “We can often limit side effects and treatment time when the cancer is caught early,” says Zachary A. Gregg, MD, a colorectal surgeon at Sentara Martha Jefferson Medical & Surgical Associates.

The American Cancer Society recommends people get their first colonoscopy at age 45 (age 40 for African Americans) and repeat the procedure every 10 years. If you have a personal or family history of colorectal cancer, you may need a colonoscopy earlier.

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Breathing

EASIER In the winter of 2013, Clayton Glass

thought he had come down with a bad cold. When he woke up the next morning, however, he was having difficulty breathing.

A visit to the Sentara Martha Jefferson Hospital Emergency Department, followed by 10 days of hospitalization, led to a diagnosis of emphysema and stage 4 chronic obstructive pulmonary disease (COPD). Symptoms of COPD, which is a type of 24 |

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progressive lung disease that leads to long-term respiratory problems, include cough and shortness of breath.

Nine years, four doctors and many treatments after the initial diagnosis, Glass was dependent on an oxygen tank 24 hours a day. His doctor informed him that a lung transplant was the only remaining medical option for improving his condition.

Sentara Martha Jefferson Health & Wellness Center improves quality of life for lung and heart patients “I couldn’t even walk the length of my small ranch house without stopping to catch my breath,” says Glass, 69, of Scottsville. To cope with his worsening symptoms, in April 2021 Glass was referred to the rehabilitation program at the Sentara Martha Jefferson Health & Wellness Center, where therapists worked with him over the course of 36 sessions to prepare his body for the transplant.

On Dec. 15, 2022, Glass underwent a lengthy double lung transplant. When he woke up after the procedure,

he no longer needed an oxygen tank to breathe properly. “For the first time in years, I felt great,” he recalls.

A week after his hospital release following the transplant, Glass began a second round of pulmonary rehabilitation at the center. Following an initial assessment, he started going to the center for one hour three times per week. “It’s like going to the gym to work out,” he says.

The center’s three-month rehab program, which supports patients who are at risk for or recovering from cardiovascular disease, lung disease and cancer, includes monitored exercise and education to optimize health and recovery.

Each patient at the center goes through an individualized treatment plan, according to Alice Racine, RRT-ACCS. The aim of pulmonary rehab, she says, is to strengthen the muscles patients use to breathe, as well as educate patients on strategies to help them better manage shortness of breath.

“We look at many different factors—lung function, lab results and a physical assessment—in order to prescribe the appropriate level of exercise for each patient,” says Racine.

“We measure shortness of breath and give the patient a timed walk test while we monitor vital signs, supplying supplemental oxygen when needed.”

After weeks of diligently working his rehab program, Glass was able to walk the half-mile round trip to collect his mail each day. Now he’s able to be active on his rural property, working on projects in his shop, riding his four-wheeler and fishing in his creek. He figures he walks at least a mile per day.

“Before, it was like having asthma 24/7,” he says. “Now there’s no more tightness. Even when I do get winded, I only need to stop for a moment to catch my breath.”

Racine adds that pulmonary rehab isn’t capable of curing lung disease, and is instead aimed at strengthening the heart muscle. “We give patients ways to improve their ability to engage in daily activities,” she explains.

Although Glass leads a somewhat solitary life, he has enjoyed the social aspects of being at the center three times a week, even starting friendships with some of the other patients. “I don’t like going out much, but I do like going to rehab,” he says. “The staff there is great.” sentara.com

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“A lot of our patients feel like they can’t leave the house or go out with their friends, due to their disease process and their oxygen equipment,” says Ashley D. Easter, RRT-ACCS, who also works at the center. “Coming here and realizing they can do those things helps their mental health tremendously.”

“Patients find camaraderie and encouragement here, seeing other patients on oxygen or with similar limitations who are able to exercise,” adds Racine.

The pulmonary rehab staff treats a range of conditions, including COPD, lung cancer, lung transplant, asthma and bronchiectasis. After completing the rehab program, patients repeat the initial assessments in order to see how they’ve progressed.

“Our goal is to help improve their lives,” Racine says.

Helping Cardiac Patients Get Back to Health

Jonathan Bartels has also experienced life-changing benefits from treatment at the Sentara Martha Jefferson Hospital Health & Wellness Center.

Bartels, 55, of Charlottesville, became aware of the severity of his heart problem a few years ago while tiring very quickly trying to catch a bus. Realizing he needed to get more exercise, he wanted to start in the safest way possible. Due to his cardiac history, he thought he should visit his cardiologist before beginning an exercise regimen.

During a stress test, Bartels experienced polymorphic ventricular tachycardia, a potentially fatal condition that causes a rapid heart rate from the lower chambers of the heart. Noticing the tachycardia, technicians stopped the test immediately. Bartels then underwent a cardiac catheterization, a cardiac MRI and other tests in an attempt to determine the cause, but results were inconclusive. He told his doctor he still wanted to exercise to improve his health.

“I thought my condition might be due to weakness in my heart caused by inactivity for so many years, so my doctor and I agreed that I should pursue cardiac rehab,” he says. Bartels began the center’s three-month program in October 2022.

“Since I was a bit different from other patients, I was able to push myself a little more,” Bartels says. “But I still started with a nice, easy pace and gradually progressed to more strenuous exercises.”

Diagnoses and procedures that may qualify a patient for cardiac rehab include heart attack, heart failure, stable angina, stenting, coronary artery bypass surgery, and heart valve repair or replacement. Experiencing arrhythmia alone, however, does not necessarily mean a person needs cardiac rehab.

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and other vitals were checked during each visit.

Center staff showed him how to use all the different types of workout equipment, and he wore a cardiac monitor while exercising.

“We monitored Jonathan’s heart rhythm during exercise and exertion to look for abnormal changes,” says Ashley Hamlett, M.Ed., a clinical exercise physiologist at the center.

When a new cardiac patient comes to the center, the staff asks about his or her personal goals, taking into account the patient’s medical status, exercise history and comfort in a gym setting.

“When creating an exercise program, the patient’s personal goals are important in helping us determine the best way to structure rehab,” Hamlett adds. “We find out which activities they’d like to get back to, what hobbies they enjoy, and what their physical requirements are at work and at home.”

Like Glass, Bartels had a great experience with the center’s staff and other patients. “I felt like I was being protected while I exercised,” he says. “I knew I was being watched, so I felt very safe.”

On days when he wasn’t feeling well or was just having a hard time, people at the center often reached out to cheer him up.

“Over time I developed a rapport with a lot of the other participants,” Bartels says.

“We ended up connecting and supporting and inspiring each other to continue to move forward.”

After his rehab program, Bartels was able to move more easily and walk longer distances, and his heart arrhythmias decreased. “I also learned to recognize the warning signs, apply techniques to slow myself down when needed and then continue to move forward,” he adds. Now he’s able to take regular walks, work out at a local gym and go hiking with his son.

Bartels and Glass were both willing to go the distance with their programs, believing that, in the end, they would have improved quality of life. “Clayton has been my most successful lung transplant patient,” Racine says.

“He’s put in the work.”

Sometimes physicians and nurse practitioners don’t get as much time with patients as they’d like. At the Sentara Martha Jefferson Hospital Health & Wellness Center, however, staff can spend much more time with patients—a major factor in the success of both the cardio and pulmonary programs.

“That’s the advantage of cardiac rehab,” says Hamlett. “We see them three times a week for three months, so we really get to know patients from both the clinical and personal perspectives and form good relationships. The extra time also allows us to communicate with a patient’s medical team to address any clinical changes after a heart event.”

Those close relationships also help the center’s staff keep patients committed to their rehab programs.

“We truly care about our patients,” Racine says. “If we don’t see them for one of their scheduled appointments, we call them. If we aren’t able to reach them, we call a family member.

We want to help them stay on track with rehab, but we also want to show them we really do care.”

Pritikin Rehab

In November 2022, the Sentara Martha Jefferson Health & Wellness Center began offering a new type of cardiac rehabilitation program known as Pritikin Intensive Cardiac Rehab, which offers new strategies for heart patients who qualify, including both exercise and education at every visit. “It can be really scary to go through a cardiac event, so our goal is to give patients the confidence to get back into their everyday activities without fear,” says Ashley Hamlett, M.Ed., a clinical exercise physiologist at the center.

For one hour, three days per week for up to 12 weeks, patients participate in a custom-tailored exercise program that is closely monitored by the staff.

The educational part of the program includes workshops, cooking classes and in-depth videos. “It’s a lot more heavily focused on education,” Hamlett says. “So far we’re seeing a lot of people make changes—more so than we have seen with traditional cardiac rehab.”

Patients in Pritikin rehab learn to prepare heart-healthy meals, read nutrition labels and make balanced choices when dining out—all while managing weight. They also learn strategies for managing stress and anxiety, improving communication skills, and setting effective goals.

Conditions and procedures that might qualify patients for Pritikin rehab include heart attack, coronary artery bypass surgery, stable angina, chronic heart failure, stenting or angioplasty, heart or heart-lung transplant, and heart valve repair or replacement. “We can’t always prevent cardiac events from occurring, but we can provide patients with tools to reduce the risk of recurrence,” Hamlett says.

Circle

of support Sentara Martha Jefferson supports mothers in realizing their ideal birth plans

Like all expectant mothers, Amy Plopper ultimately just wanted to have another healthy baby her second time around. Having gone through a difficult experience with her firstborn, though, she was also hoping her new baby would arrive with as little medical intervention as possible—and she was well aware that things didn’t always go as planned.

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Before she even went into true labor with her first child, her doctor discovered a potentially serious problem with the placement of the placenta. To protect the baby, Plopper underwent an emergency caesarean section, and the baby was then transferred to the neonatal intensive care unit at a nearby hospital.

“The whole experience was so traumatic,” recalls Plopper. “I had pictured being able to hold my baby immediately after she was born.

Instead, she was whisked away to receive care, and we were separated for a week.”

In spite of an unexpectedly frightening start, baby Sonora, now 3, recovered. But for her second child, Amy was hoping for a different birth story—and thanks to her team of caring and competent professionals at Sentara Martha

Jefferson Hospital, that story has a happy ending.

Striving for the Safest Birth Plan

Aiming to increase the odds of achieving a more positive childbirth experience, Plopper worked with a therapist to help her mentally separate the approaching pregnancy from the previous one, and she brought in a doula for additional support before, during and after childbirth.

Plopper also worked with her OB-GYN to explore the possibility of having a vaginal birth after caesarean (VBAC). While both VBACs and repeat caesareans have higher risks than first-time vaginal births, the National Institutes of Health reports that VBAC can be a safe and viable option for many women, with a reported success rate of 60-80%.

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“Of utmost importance is that everyone works as a team to have a safe delivery for the mom and baby,” says Jennifer Wray, clinical manager of Sentara Martha Jefferson’s Family Birthing Center, Women’s Services and Maternity Community Education Programs. “At Sentara Martha Jefferson, we come together as a group to help provide the birth experience the mother desires.”

According to Wray, the overall caesarean rate at Sentara Martha Jefferson is about 26%, which is well below the national average and, in her words, “a testament to the team’s dedication to providing attentive, bedside support to our maternity patients.” She also attributes the low rate to the hospital’s one-to-one nurse-to-patient ratio for women in active labor and a shared commitment among labor and delivery staff and physicians to approaching birth as a natural process that is not to be rushed, rather than as a medical procedure.

Fortunately for Plopper, her OB-GYN confirmed that she would be an excellent candidate for VBAC. “I wanted to know what childbirth felt like—even the labor pains,” explains Plopper.

“So we decided to move forward with the plan, in hopes of having that skin-to-skin moment after our baby was born.”

Leaning on Her Circle of Support

When the big day finally came, circumstances were already different. Plopper’s second

baby was arriving past the due date, whereas Sonora had been delivered three weeks early.

Wanting minimal medical intervention, Plopper relied on the birthing center’s whirlpool tub and yoga ball for pain relief while labor progressed. The hospital’s labor and delivery team regularly monitored her and her baby for any signs of distress. At certain points, when Plopper would become emotional or exhausted, her doula would bring her focus back to the “circle of support” that was present in the room.

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Murray, MSN, RN, who was working in the labor and delivery room that day. “Together, everyone created a collaborative and respectful environment. It couldn’t have gone any better.”

All’s Well That Ends Well

“Together, everyone created a collaborative and respectful environment.

It couldn’t have gone any better.”

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of labor,” says Shannon McElroy, who works independently as a doula and also as a pediatric oncology nurse at an area hospital. “I was glad to play that role for Amy, but I was just one of many in the room who were encouraging and respectful of her feelings.”

Eventually, Plopper agreed to some extra medical help to move the process along and prepare for giving birth. After that, things moved quickly.

“When it came time to push, I felt like I must be the greatest pusher in the world, based on how enthusiastically everyone cheered for me,” says Plopper.

After many hours of laboring and an hour or so of pushing, she got her long-desired moment.

Weeping with happy tears, she held her baby, a daughter named Lyra, skin to skin.

“I remember welcoming Lyra with a phenomenal team in the room,” says Kathryn

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Plopper’s labor and delivery story represents the type of experience Wray wishes for every mother-to-be at Sentara Martha Jefferson. She is quick to note, however, that this supportive environment doesn’t end with the birth of a baby, but continues into the “fourth trimester,” during which mother and child continue to go through significant changes as they adjust to life together. This approach made a big difference for Plopper as she transitioned into breastfeeding.

“Similar to the apprehension I felt prior to having Lyra was not knowing what to expect with nursing, since I had started off having to pump breast milk for my firstborn,” she says, adding that she appreciated the support she received after leaving the hospital. “We worked with a lactation consultant through our pediatrician and received follow-up support from the hospital’s childbirth education coordinator. Thanks to my wonderful team of caregivers, things have gone very well.”

Now back to work, Plopper still plans to write personal thank-you notes to every person who was present in her labor and delivery room that day. Grateful beyond measure, she appreciates the circle of support that helped her safely deliver a healthy baby—this time more aligned with the experience she had been hoping for.

“We take this journey together with the patient,” says Wray. ”The mother is an informed partner, and we want her to feel heard. Amy’s birth experience was the perfect version of that.”

ACTIVE

LIVING

Feeling

Stressed?

Talk with your primary care physician

W

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

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

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

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ACTIVE LIVING

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

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

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

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

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

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

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

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

The Effects of Stress on the Body

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

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

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

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

can be especially noticeable in the brain, leading to prayer, journaling and meditation,” he adds. “I issues with regular body function and processing. would also include minimizing the background noise Stress also causes mitochondrial DNA to leak into in our lives, which means setting limits on phone the blood, which can lead to chronic diseases like use and taking breaks from television, social media hypertension and diabetes. Additionally, stress can and the internet—all of which can be very disrupspeed up the aging process of cells, increasing the tive. This layer also includes formal therapy with risk of heart disease and certain cancers. licensed social workers, clinical psychologists and Chronic stress, a state of feeling anxious or other mental health experts, which can be incredibly overwhelmed for a prolonged period of time, beneficial in helping people manage stress.” affects the body’s immune system and appetite and The top level of the pyramid, Dr. Volkema says, can lead to various mood disorders and sleep issues. represents medication. “I always tell my patients However, stress can manifest in myriad ways. that the bottom two layers need to be addressed first.

“People often think of symptoms of stress as Otherwise, medication is, at best, just a Band-Aid.” anxiousness, sadness or worry,” says Dr. Volkema.

While medication shouldn’t necessarily be “But it could also be trouble sleeping. It could be a first step, dietary supplements like ashwachest pain or feeling like you’re having trouble gandha and magnesium have been shown to breathing. It could be abdominal pain. Some help relieve stress and anxiety. people develop rashes or feel shaky. So it can “Ashwagandha is a plant-derived be quite challenging for patients and their supplement that helps your body better Medication physicians to separate stress from other cope with stress,” Dr. Smith says. “It possible causes of symptoms.” also can be helpful for symptoms like When it comes to reducing stress anxiety and depression.”

Self-work levels, prevention is key.

Magnesium can help you relax Dr. Smith says that in addition to by stimulating the production of diet, sleep and exercise, her practice melatonin and serotonin, which preaches the value of daily can boost your mood and help mindfulness and meditation to you sleep. help reduce stress and anxiety.

Although not approved by “For five to 10 minutes a day, at work or prior the U.S. Food and Drug Administration for treating to going to bed, close your eyes and focus on your anxiety, beta-blockers have been shown to reduce breathing,” she explains. “It’s a simple technique some of its physical symptoms, such as trembling and takes just a few minutes, but it can help you and sweating. lower stress and bring your body down into that relaxation stage.”

Back to Basics A number of smartphone apps, including HeadDr. Smith says that ultimately, managing stress space, Breathe and Calm, are also available to help involves getting back to the basics of self-care: provide timeouts from the stresses of everyday life. eating well, being active, getting restful sleep and Dr. Volkema employs a pyramid-type model in minimizing distractions. his practice for dealing with stress.

“I think people need to be easier on themThe bottom layer of the pyramid represents selves,” Dr. Volkema adds. “A lot of times when lifestyle, which includes things like movement people come into my office for stress, or if they’re at and rest; what we consume (diet, medications and a crucial moment in life, they’re being really hard supplements); relationships; and passions. “Those on themselves. I think people need to be a little four factors are so incredibly important for overall more forgiving toward themselves.” health,” he explains. “But they also minimize the “We’re all dealing with some form of stress,” effects of chronic stress, depression and anxiety, Dr. Smith says. “But if it becomes so significant and they can make it easier to be resilient when that people aren’t able to do the things they want acute stressors do arise.” to do, or they’re not able to be happy or complete The second layer of the pyramid represents selftheir work, I would encourage them to visit their work. “This is the stuff we know we should do but primary care physician. We have options available rarely prioritize, including deep-breathing exercises, to help.”

Lifestyle

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HEALTH

MATTERS

Think You Might Be Having a

HEART ATTACK?

Call 911 Right Away.

H

eart attack is one of the most common causes of preventable death in the United States.

According to the Centers for Disease Control and Prevention, someone in the U.S. has a heart attack on average every 40 seconds—that’s almost 800,000 people each year. Heart disease affects both men and women, and more women die each year from heart attack than from breast cancer.

With so many people affected by heart attack, it’s important to recognize one when it occurs and seek medical help immediately.

Know the Signs and Symptoms

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

The “classic”signs of heart attack in men and in some women include: • Chest discomfort, which may feel like pressure, squeezing, fullness or pain, especially under the breastbone (sternum) • Discomfort in other areas of the upper body, including one or both arms, the back, the neck, or the jaw • Shortness of breath, especially due to physical exertion; may occur with or without chest discomfort • Sweating • Nausea (with or without vomiting) • Cold, clammy skin In some women, the signs of heart attack can be less distinct and may include the following: 36 | S P R I N G / S U M M E R 2 0 2 3

• Fatigue • Nausea (with or without vomiting) • Sudden onset of shortness of breath, with or without chest pain or discomfort • A generalized feeling that “something isn’t right” • Confusion (especially in older women)

Call 911 Immediately!

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

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

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

What Causes a Heart Attack?

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

LA SALUD

IMPORTA

¿Piensa que puede ser un

ATAQUE CARDÍACO? ¡Llame al 911 inmediatamente!

E

l ataque cardíaco es una de las causas más comunes de muerte que puede prevenirse en los Estados Unidos. De acuerdo con los Centros para el Control y Prevención de Enfer-medades, una persona sufre un ataque cardíaco en los Estados Unidos cada 40 segundos.

Eso es alrededor de 800,000 personas cada año.

Las enfermedades cardíacas afectan tanto hombres como mujeres y cada año mueren más mujeres por ataques al corazón que por cáncer de mama.

Con tantas personas afecta-das, resulta importante reconocer el momento en que se presenta un ataque cardíaco y buscar asistencia médica de manera inmediata

Reconozca las señales y los síntomas

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

Las señales “típicas” de un ataque cardíaco en hombres y mujeres incluyen: • Molestias en el pecho, las cuales pueden sentirse como presión y tensión, sensación de llenura o dolor especialmente en el área bajo el esternón.

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

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

• Sudor • Náusea (con o sin vómito) • Piel fría y húmeda En algunas mujeres los síntomas de un ataque cardíaco no son tan distintos y pueden incluir algunos de los siguientes:

• Fatiga • Náusea (con o sin vómito) • Sensación repentina de dificultad para respirar, en presencia o ausencia de alguna molestia o dolor en el pecho.

• Una sensación generalizada de que “algo no está bien” • Confusión (especialmente en mujeres mayores)

Llame inmediatamente al 911

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

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

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

¿Qué causa un ataque cardíaco?

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

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37

SENTARA

IN THE COMMUNITY

HOME HEALTH CARE and the Rewards of Connecting with Patients

38 | S P R I N G / S U M M E R 2 0 2 3

S

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

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

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

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

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

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

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

Seeing the joy on her face made it so worth it.

Autonomy is empowering.”

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

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

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39

SENTARA IN THE COMMUNITY

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

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

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

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

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

Cook’s innate sense of caretaker empathy was likely handed down to her. “My grandmother loved going into patients’ homes and caring for them,” she says.

“That love sparked my own interest in home health.

When it comes to family, patients and even strangers, she loves taking care of people and making sure everyone’s needs are met. Even though she’s retired now, anytime you need anything, she’s still the first person you want to call.”

Working in a home health setting allows Cook to see how her patients live, rather than just focusing on an illness or cluster of health challenges. “As a home 40 | S P R I N G / S U M M E R 2 0 2 3

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

Knowing her patients well also helps Cook provide better guidance.

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

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

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

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

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

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

CARING

Healing

TRADITION

On the

Fly

Misti O’Neal was coming off an exceptionally tough year when she found herself, fly rod in hand, pursuing trout in Moormans River. During that year, she had faced a breast cancer diagnosis, a lumpectomy and radiation treatments, as well as the unexpected loss of her sister.

“I was feeling overwhelmed,” O’Neal says, recalling that she initially resisted the invitation to join the Spring Fly Fling, an annual weekend retreat to help support women cancer survivors. She wavered on going all the way up until the day of the event, but ultimately decided to attend.

“It ended up being exactly what I needed,” she says.

In many ways, O’Neal’s experience embodies the power of the Spring Fly Fling, which celebrated its 15th anniversary in March 2023. The “Bug Slinger Warrior Sisterhood™,” as the retreat-goers call themselves, now numbers more than 150 women, many of whom return to the retreat annually as alumni, inspired to give back and help others on their cancer journeys.

“It’s a really powerful experience,” says Susan Kreiner, who attended the 2018 Spring Fly Fling. At the time, she was undergoing a series of reconstructive

Celebrating 15 years of hope and support for cancer survivors at the Spring Fly Fling Misti O’Neal discovered a passion for fly-fishing at this year’s retreat.

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41

CARING TRADITION

Retreat attendee Martha Robeson learns fly fishing from Mark Andrews, Spring Fly Fling leader and co-founder.

surgeries following breast cancer diagnosis and treatment. Now she volunteers for The Women’s Committee of the Martha Jefferson Hospital Foundation, which provides leadership support for the retreat. “We were all so different— but when you stripped it down, we were going through the same thing.

Someone would tell a story, and I’d break down while they were talking because I would think, ‘I totally understand that.’”

To facilitate connections among participants, the retreat is purposefully short on medical experiences and long on unstructured time to relax. “The women have spent so much time dealing with doctors and appointments,” says Mark Andrews, founder and executive director of Therapeutic Adventures Inc., a nonprofit organization that provides adaptive outdoor experiences. “We wanted to give them some time away from all that, where they could 42 |

SPRING/SUMMER 2023

Princess Perry learns fly-tying from the experts at the Thomas Jefferson Trout Unlimited Chapter.

“Witnessing the strength of these women and listening to their stories made me feel hopeful and made me want to do more for others.”

—Misti O’Neal, 2023 retreat participant

focus on learning something new and having fun.” Andrews and his wife, Teresa, along with James “Chubby” Damron, president of the Thomas Jefferson Chapter of Trout Unlimited (TJTU), are the architects of the retreat.

This year, the retreat kicked off with a St. Patrick’s Day party on Friday night, complete with silly headbands and party hats.

On Saturday, the women paired up with expert fly-fishing guides from TJTU to learn about fishing

and fly tying. They shared a special potluck lunch with retreat alumni, and later the participants enjoyed an evening of music and gourmet food prepared by Teresa Andrews and the couple’s son, Zach, the executive chef at the Spoon & Spindle in Orange, Va. All participants received roses and gift bags. They then spent Sunday fishing or relaxing before heading home.

Andrews and Damron lead a community of volunteers who are inspired to provide a therapeutic, five-star fly-fishing retreat for the women, free of charge.

Therapeutic Adventures, TJTU, Sentara Martha Jefferson Hospital and The Women’s Committee provide funding and volunteer support. Crozet’s Montfair Resort Farm rents space for the event at a deep discount, Shenandoah Joe Coffee Roasters supplies coffee, and a local vintner provides fine wine from his private cellar.

CARING TRADITION

For this year’s retreat, 33 volunteers, many with clinical and adaptive guiding expertise, donated a combined 377 hours of service. “They do so much to make the women feel special,” says Andrews. “Their love is a big part of what makes the retreat so healing.”

On Saturday night, Neli Ramirez was among the volunteers serving an exquisite meal of salmon, pork tenderloin, broccolini and a Norwegian chocolate cake she provided. Sunday she led a yoga class. It had been 10 years since Ramirez attended the retreat, but she still remembers how the camaraderie helped her regain her confidence after her breast cancer treatment.

“I had lost my ability to have fun,” she says, recalling how emotionally fraught the simple act of removing her hat felt at the start of her retreat. “But when you are in such a relaxed, supportive and accepting environment— with music, good food, a cozy fireplace and even some silliness—you can’t help but experience joy.”

That was certainly the case for O’Neal, whose initial shyness at this year’s retreat quickly gave way to enthusiasm. “I caught the fly-fishing bug,” she laughs. “On the first day I caught the most fish, and on the last day I caught the biggest fish. I even went out one morning when it was only 29 degrees. I could have stayed there all day.”

Of course, not all participants discover a passion for angling, which is why the menu of activities also includes nature walks, kayaking, yoga and massage. Opportunities to rest, read and cultivate new friendships are also encouraged.

Past retreat participant Neli Ramirez (front) now gives back as a yoga instructor.

“The retreat has become something really magical,” says Andrews. “The women often start off reserved, but by the second day they’re walking hand in hand to the lodge, laughing and supporting one another.”

That type of camaraderie has kept volunteers like Donna Westermann coming back for more than a decade. A passionate fly angler, adaptive guide and oncology nurse practitioner, Westermann has known for years about the therapeutic benefits of casting a fly rod, spending time outdoors and learning new skills. When she underwent her own breast cancer journey several years ago, however, those benefits got more personal. Donna kept coming to the retreat, choosing to stay on as a guide rather than as a participant. Giving back in that way felt healing.

Kreiner, too, understands the retreat’s transformative power. “When you go through something like this and your body is torn apart, you’re not the same person you were— it makes you humble. Attending the retreat opened my heart.”

Images courtesy of retreat alumna and longtime volunteer retreat photographer Theresa White.

To join The Women’s Committee in supporting the Spring Fly Fling and other women’s health programs in our community, contact TWCchair@gmail.com, call 434-654-8258 or visit mjhfoundation.org.

A St. Patrick’s Day party on Friday night set the tone for this year’s retreat. mjhfoundation.org |

43

CARING

TRADITION

Thank you!

Martha Jefferson Hospital Foundation extends our most heartfelt thanks to all the individuals, foundations and corporations whose generous support in 2022 made possible compassionate, lifesaving care for our patients and families, while improving the health of our community. Your generosity is reaching across our region to lessen the impacts of chronic disease and support healthier lifestyles, while continuing our commitment to delivering the highest-quality patient experience to all who enter our doors. We promise that 100% of your support always stays right here to directly benefit the health of our local friends and families in our neighborhoods and towns. Thank you for your support!

Martha Jefferson Society $100,000+

Maurice G. Burnett * The August Heid Trust The Manning Family Foundation, Paul and Diane Manning Anonymous

$25,000 - $99,999

Tessa G. Ader Wendy Brown The Joseph and Robert Cornell Memorial Foundation Richard B. Gilliam, Sr., The Richard and Leslie Gilliam Foundation Bebe Heiner, The Heiner Family Fund of CACF Carol and Blake Hurt Mr. and Mrs. Donald A. King, Jr. Mr. and Mrs. Howard M. Long Brian and Jean Mandeville Susie Morris Mildred R. Pickett Foundation Rhoback LLC Mrs. H. Gordon Smyth *, Smyth Fund for Nursing at Martha Jefferson Hospital of CACF Truist Bank Anonymous

$10,000 - $24,999

Mr. Charles W. Axten and Ms. Katherine L. Rhyne John and Sandy * Beard and Family Rich and Roxanne Booth, The Rimora Foundation The Family of Nicholas Brandt, MD in His Loving Memory Charlottesville Radio Group The Culbertson Foundation, Alan, Sharon, Elizabeth and Jennifer Culbertson The Dairy Market Don Danilek, The Danilek Family Trust

Keith Frazee and Carole Frazee, The Keith and Carole Frazee Family Fund Brenda and Curtis Hathaway Mr. and Mrs. W. Peter Henderson, The Whitney and Anne Stone Foundation Estate of Frederic A. Hertz Innovaccer Brian H. and Barbara T. Kennedy Byrd and Mary Leavell Elizabeth and Joe LeVaca NBC29, WVIR-TV Jane Patterson Trust Margaret L. Porter Trust Erwin E. Schaeffer Trust Dr. and Mrs. Tripp Stewart Lee Stinchfield, The Margaret and Frank Stinchfield Foundation Mr. and Mrs. William A. Stuart III, The Whitney and Anne Stone Foundation Ellen and David Turner Umansky Toyota / Mercedes-Benz of Charlottesville Anonymous

$5,000 - $9,999

Elizabeth and Greg Allen David and Carolyn Beach, David and Carolyn Beach Charitable Fund of CACF Debra Bryant and Larry Groves Elizabeth J. Callan Virginia B. Cenedella Jeanne and John Chamales Daisy Foundation of Silicon Valley Community Foundation Jim and Betsy Greene David and Carolyn Grow Anne and Thad Jones The Laing Family Trust Sheila H. McCarthy Lawrence J. and Lynn W. Martin Network for Good / Greyson and Ariana Williams Oakwood Foundation Perry Foundation

Mr. and Mrs. David Pollak, Jr., Pollak Family Fund of CACF Misty and Jon Roberts Cynthia and Jim Stultz, Stultz Foundation James J. Thomas and Family Tiger Fuel Company Mr. and Mrs. David J. Wood, Jr., The Whitney and Anne Stone Foundation Anonymous

$1,000 - $4,999

Bill and Carolyn Achenbach American Cancer Society Mark and Kris Andersen Mr. and Mrs. James E. Atkinson Drs. David and Lori Balaban Ms. Myra L. Beal Mrs. Rodney F. Beckwith Lillian and Michael BeVier Richard and Diana Beyer Amy and Richard Black Kathleen and Daniel Bowman Jim Boyer Mr. Vincent J. Bozza Mr. and Mrs. Mark E. Brown, Mark and Mary Brown Charitable Fund Jane* and Peter Buchanan Rita Bunch Rosemary Burns Caspari Mille and Rip Cathcart Didi and Peter Chapin Charlottesville Radiology, Ltd. David and Betsy Chesler Mr. and Mrs. Adam Childers Crystal Chu Mr. and Mrs. Arthur Wm. Clinger, Jr. The Community Foundation Harrisonburg and Rockingham County The Counterpoint Foundation Dr. Douglas and Jayne Cox, Cox Chiropractic Clinic Matthew Jonathan Cutler Family Giving Account Mrs. Joan M. Daly

Mr. and Mrs. Bill Dannemann Debbie and John Desmond Mr. and Mrs. Edward G. Dinwiddie, Anna M. Day Foundation Mr. James C. Dunstan* and Mrs. Julia S. Dunstan, Dunstan Fund of CACF Jo Anne Ebersold Mr. and Mrs. John T. Echols Mr. and Mrs. Franklin S. Edmonds, Jr. Dr. Robert Elliot Catherine T. Eudailey Joe and Robyn Evans Mr. and Mrs. J. G. Ferguson First Citizens Bank Paul and Bess Flick Barbara and Dick Fontaine Mr. Thomas A. Garrison Mr. and Mrs. Howard S. Gentry Ginnie and Peter Gillen Ms. Margaret G. Gossweiler GovSmart, Inc. Erik Greenbaum, Greenbaum Family Charitable Fund Alex and Karen Grunsfeld Jacquelin Jeffress Guter Jim and Sue Haden Will Hammond Hantzmon Wiebel, LLP Dana and Peter Harris Mrs. Margaret H. Hart Dr. David M. Heilbronner and Ms. Lynn Valentine Mr.* and Mrs. Frederic A. Hertz Mr. and Mrs. Chris Holden Bo and LizBet Hopkins Richard and Susan Howard-Smith Randy and Lisa Huffman, Huffman Family Fund Ms. Martha I. (Patsy) Hunt Elizabeth A. Hyatt Jack Brown’s Burgers Ms. Jane Johansen Janet Stone Jones Foundation Mr. Michael H. Kaminski Dr. William S. Knight and Dr. Sarah E. Knight * indicates deceased

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SPRING/SUMMER 2023

Katy and Tony Kreienbaum Mr. Doug Larimer Tom and Delia Laux Mary Ann Leeper Mr. and Mrs. Thomas Likowski Mark and Anne Logan Bill and Judy Lynch Mr. Earle A. MacKenzie Len and Grace Mailloux Martin Marietta Dr. James I. Masloff Mr. and Mrs. Robert V. McGlothlin, Jr. Meanwhile Back on the Farm Mark and Karyl-Leigh Megaw Mr. and Mrs. John Merrill Miller Financial Group, LCC Robert and Lisa Moorefield Karen M. Moran and B. Wistar Morris, Karen Moran and Wistar Morris Family Fund of CACF Ray and Thelma Murphy Dan and Maureen Murray Lang Murray Stewart and Patty Nelson Rob and Paula Newcomb Jeep and Cathy Newman The Nook Northwestern Mutual Financial Network Mr. and Mrs. Richard L. Nunley Dr. and Mrs. William A. Orr Mr. and Mrs. Dennis Palmgren, Wrightson Ramsing Foundation Inc. Sandra C. Palumbo F. Troost and Kathryn B. Parker Mrs. Virginia S. Payne Paul and Cynthia Pearce Pepsi-Cola Bottling Company of Central Virginia Drs. Barbara T. and John H. Post Fund, Dr. John H. Post III and Dr. Barbara T. Post Mr. and Mrs. Matthew Powers Mr. and Mrs. Richard Randolph Alan Y. Roberts Joanne B. Robinson Victor and Janice Rosenberg Patricia and Glenn Rowe Jeanne S. Runkle Mrs. Judith Schmitt Sentara Health Mr. Dennis B. Sigloh and Rev. Jane E. Sigloh, Jane E. and Dennis Sigloh Fund of CACF Kimberly and Don Skelly Jane-Ashley and Peter Skinner Suzanne Hilton Smith and Mahon T. Smith, III * Mr. Phillip Snow and Dr. Doris Snow Mr. and Mrs. Scott C. Solak Charles and Julie Stamm John and Helen Steele Jeff Strider Nelson and Christina Teague Mr. and Mrs. Michael W. Terry Bryan and Jane Thomas Ms. Charlotte G. Tieken and Mr. Charles J. Stick Mr. * and Mrs. G. McNeir Tilman, Tilman Family Fund of CACF Ting Internet T & N Printing, Inc. Bob and Terry Valiga Hatsy and Scott Vallar

Dr. and Mrs. White McKenzie Wallenborn Ms. Winifred Wegmann and Mr. George W. Sampson William Monroe High School Blair K. Williamson S. L. Williamson Company, Inc. Stirling and Jane Williamson Dr. and Mrs. Christopher P. Zazakos, Jr. Anonymous

Friends of the Martha Jefferson Hospital Foundation $500-$999

Mr. and Mrs. Brandt R. Allen As You Like It Barbara C. Aulebach-Ross and John S. Ross, Jr. Bridgid & Bess Mr. and Mrs. Frederic M. Bryant III Nancy and Peter Brooks Caldesign Antony* and Edith Champ Mr. and Mrs. Connor Childress Mr. and Mrs. Carroll R. Chisholm Mr. Samuel S. Clark III Mr. Thomas Cole Mr. and Mrs. J. Daniel Crigler Crutchfield Corporation Michael and Jan Cubbage Mr. and Mrs. James C. Dorschel Elizabeth A. Duris Erin McDermott Jewelry Mr. and Mrs. Peter M. Grant Marguerite Hancher Peter and Lauretta Harbilas Lynda and Roy Harrill Mr. and Mrs. Robert L. Haught Mr. and Mrs. Edward Hutchinson Mr. and Mrs. Charles Johnson Kekst CNC Mrs. Lois M. Keller Ms. Susan Klees Mr. and Mrs. William Koch III Liza Byrd Boutique Madison Joe Lindsay W. Marshall and L. Courtenay Beebe, M.D. Randi and Scott Marshall Ms. Diane McCallum Susan F. McNeely Ms. Elizabeth D. Merrill Minda’s Boutique Daisy and David Moga Mr. David Ogens One Little World Mr. and Mrs. Donald M. Pamenter Cindy Petrie Pour la Maison Dr. Lane A. Ritter Rock Paper Scissors Dennis and Ann Rooker Mr. William Rowe Ms. Virginia C. Roy Mr. and Mrs. Bruce W. Saunders Prof. Merry Sebelik Shenanigans Spiekermann Family

Kent and Erika Struble Dr. and Mrs. Paul J. Tesoriere Mr. and Mrs. Mark Tonacci Waccamaw Pearls Mac Walker William H. Wetsel Middle School Ms. Julie A. Wheaton Yves Delorme

$100-$499

Ms. Nancy Aamot 2nd Act Books Agents In Style Luxury Consignment Boutique Dr. Keiko Aikawa Albemarle Cannabis Co. Allied Concrete Mr. and Mrs. Hugh D. Ames Samantha Andres Mr. Maurice Apprey Ashlee Tyler & Co. Mr. and Mrs. Eric Ask Dr. and Mrs. Fletcher C. Askew Marcia Aulebach-Lagomarsino Fax and Andrea Ayres Mr. James D. Ballif Mr. Jordan G. Barr Ms. Mary Barrick Ms. Christine P. Barth Mrs. and Mr. Virginia Barton Mrs. Judy Barton Mr. and Mrs. A. Terrell Baskerville Bay Head Home Mr. and Mrs. Michael P. Beck Mr. and Mrs. Harry Bell Mr. and Mrs. James N. Bell IV Mr. and Mrs. Steven D. Bell Bellavance Ink Mr. Jonathan Belmares Carol A. Berge Mr. James Bernhardt, DDS and Mrs. Olivia Bernhardt, RN Prof. Silvia Blemker Mr. Charles M. Boldt Mr. Donald Boothe deK. and Connie Bowen Mr. and Mrs. Donald Bowman Ms. Alexandra Bracey Joan M. Brakman Brazos Tacos Ms. Eden H. Brent Mr. and Mrs. Lee S. Briscoe Mr. Theodore Bruning Mr. Mike Bruscia Mr. Forest N. Bryant, Jr. Mr. and Mrs. Jim Burns Mrs. Mary Anne Burns Michael and Dianne Burris Frank and Joyce Butros Susan Cabell Mains Mrs. Terri Cady Ms. Qian Cai Cakes by Jen Duncan W. and Susan J. Campbell Mr. and Mrs. Lloyd H. Canada Ms. Joan Carlson Betsy Carrier Mrs. Jan R. Carroll Mr. Randolph Carter, Jr. Michelle M. Caruso-Cabrera Mr. and Mrs. D. Warren Cash Sam Caughron M.D. and Cyndy Caughron

Central Virginia Flower Co. Sheila Chambers Dr. and Mrs. Bradford Chervin Mr. and Mrs. Neelan Choksi John Christen Mrs. Jay L. Chronister Carol and Steve Clarke Mr. and Mrs. Roy D. Coffey Mr. Fred Collier Color Street Mary V. Connell Dr. and Mrs. Brian Conway Mr. and Mrs. Kent Couling Mr. and Mrs. Fred M. Councill Mr. George Coupar Peter J. and Barbara T. Cover Ms. Elizabeth M. Cranmer Mr. Jon Craver Mr. and Mrs. David J. Crickenberger Mary Laurence Crook Mr. R. Andrew Cueva Mr. and Mrs. Mike Davis Mrs. Barbara D. Davis Ms. Kim Davis Ms. Gwynne B. Daye Ms. Alexandra de Guzman Mr. and Mrs. Carl P. Deacon Ms. Cheryl DeAngelis Mrs. Jeanette F. Deavers Greta Dershimer Mr. Luca DiCecco Mr. and Mrs. Christopher S. DiVita Mr. and Mrs. James Dixon DOE Club 389 Mr. Mark Donnelly Ms. Dalton L. Dorne Mr. Michael Dorsch Mr. and Mrs. Edward Dubuisson Mr. and Mrs. E. Alexander Dudley Earl and Louise Dudley Jacqueline Dugery Mr. and Mrs. A. Scott Duncan Mr. and Dr. Thomas A. Eagleson Mr. and Mrs. Peter Easter Clara Eden, M.D. Mr. and Mrs. Chris Edwards Mr. and Mrs. Michael D. Egidi Lawrence R. and Vicky C. Eicher Mr. Jimmy Engel Joan F. Fadden Mr. Roscoe Faris Mr. William L. Farmer Jo Ann Farrell Ms. Caroline Faulconer Saul Mr. and Mrs. Stewart J. Ferguson Jim and Betsy Fernald Ronald F. and Judith A. Fertile Drs. Josh and Renee Fischer Nancy Fischer Ms. Lathia Flannagan Ms. Susan Folley Mr. Ashland Fortune Mr. and Mrs. C. Shane Foster Mrs. Dorothy J. Fowler Meg and Don Franco French Boutique Mr. and Mrs. J. F. Gaffney Brian Gallagher Dr. Adrina Garbooshian-Huggins Dr. and Mrs. John N. Gardner Mr. and Mrs. James P. Gelatt Ms. Caroline Gentile Mr. and Mrs. Trevor Gibson

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Tarpley and Scott Gillespie Ms. Nancy L. Gillies Ms. Charlotte Gillum Ginger and Pickles Kimberly Glass Mr. Gilbert D. Glennie, Ph.D. and Mrs. Elizabeth Word-Glennie Dr. and Mrs. Allan Gold Good Girl Millie Cards Goose & Willow Mr. and Ms. Earl R. Gore Mr. William Gray Jane K. Greenberg John and Arden Gresh Ms. Hattie Grundland Ms. Tracy Gulledge Mr. and Mrs. Fred Gunnels Warren Haden Carol L. Haig Mr. John F. Hallstead Ms. Karen Ham Wanda D. Hamlin Mr. Trevor J. Hancock Margaret S. Handelsman Mr. and Mrs. Chris Hapgood Mr. and Mrs. R. Franklin Hardy Mr. and Mrs. William W. Harlowe Mr. and Mrs. John W. Haun Bob and Kedra Hauser Lt. Col. John R. Hayes, Jr. Mr. and Mrs. Stanley S. Hazen Ms. Regina Healy Heirloom Home Dr. John and Ilse C. Hendrix Dr. John D. Hendrix, Jr. and Dr. Sylvia S. Hendrix Herb Angel Dave and Bonnie Hetrick Ms. Courtney Heyward Mrs. Dabney Hibbert Mrs. L. E. Hill Dr. Douglas E. Himberger Mr. Daniel M. Hoadley Mr. C. R. Bruce Hobbs, Jr. Mr. and Mrs. Dennis H. Hogberg Mrs. Nancy A. Holland Ms. Elizabeth Hollen Mr. and Mrs. Drew Holzwarth Steve Hoover and Lisa Wittenborn Mr. and Mrs. James E. Horn Mr. and Mrs. James M. Hubbard Mrs. Kathy Huddleston Ms. Gail Hudson Mr. and Mrs. Benjamin Hurt Mr. and Mrs. Walter D. Hussey Howard and Linda Imhoff Indo Chic Imports Mrs. Patricia V. Irby Ms. Judy D. Jenkins Katherine P. Jenkins Mr. and Mrs. Charles H. Jenkins J. McLaughlin Gloria and Greg Johnson Bethany Johnson Mrs. Linda C. Jordan JST Art & Design Dr. Alexandra Kadl Mr. William A. Kahn Ms. Beverly Kaminsky Lindy Kastendike Aileen and Jim * Kelly Ms. Grace Kelly Christine S. Kennedy

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SPRING/SUMMER 2023

Dr. Nora Kern Ms. Donna Kerpelman Mr. and Mrs. Michael Kerrigan Mr. and Mr. Michael Kesselman Dr. and Mrs. Bradley Kesser Ila Kimata Vicki Kimberling Mr. and Mrs. Stephen J. Korfanty Ann L. Kostick Mr. and Mrs. Wayne Koyanik Penny and Rick Krell Dr. and Mrs. Sidney Kriger Shirley Krohn* Ms. Debra Lafond Mr. and Mrs. Brian F. LaFontaine Ms. Sherry Lake Mrs. Richard P. Lalley Mr. Charles R. Lam Brenda F. Langdon Jen and Daniel LaPlume Mrs. Sue Lauf and Mr. Bruce Becker David Lea Mr. and Mrs. Edward Leary Marijo and Joel Lecker Mr. and Mrs. Gary D. Lee Mr. Francis Lee Mr. Mark Leffers Mr. Robert L. Leininger Mrs. Jill Lerner Mr. and Mrs. A. Reenst Lesemann Mr. and Mrs. Jerome Liebman Ms. Kelly Lindauer The Little Flower Field James (Jeb) and Jill Livingood Local Food Hub, Inc. Mr. and Mrs. Charles E. Loftin Mr. and Mrs. Dennis C. Longwell Mr. Scott R. Lounsbury Patricia O. Lowry Low Ultraviolet (L.U.V.) Lucy Clare Spooner Studios Mr. and Mrs. Peter Lueders Miss Patricia Lynch Robert and Letty MacDonald Mr. and Mrs. Robert N. MacGovern Joanne and Peter Mackey Magpie Knits Ms. Ann O. Mahan Ms. Merrily Main DArpino Nancy F. Maloy Mr. and Mrs. Arthur Markos Mr. Russell Marks Dr. Christine A. Marshall Ms. Andrea L. Massey and Mr. Jason Grigg Mrs. Daniel S. Mawyer Mrs. Jeannette May Mr. and Mrs. Mark McCarron Mr. and Mrs. John T. McCauley, Jr. Dr. Bruce McClelland Michael and Alice McCorry Mr. Lee McCraw-Leavitt Mr. Richard McdKern Dr. and Mrs. Eugene D. McGahren III Gary C. McGee Meena Creations Ms. Sarah Merck Ms. Mary S. Meyer Ms. Denise F. Michie Mr. James L. Millner Ray R. Mishler and Patricia L. Smith Louise and Mike Monticello Ms. Margaret W. Moon

Evan Mooney Maggie Moore Mr. Robert K. Moore Ms. Sue C. Morley Judy and Jeffrey Morton Charlotte A. Morris Dr. and Mrs. David L. Morris Mr. Joseph F. Morrissette Judy and Jeffrey Morton Alexandra Moses Mpulse Boutique Ms. Eleanor K. Muller Liz Nabi Mrs. Ronnie L. Neal Mrs. Brenda Nichols Cheryl Norman Nosetta Handbags Mr. Eric Oliver Organic Impression Mr. and Mrs. Jay Osborne Ms. Karen Overman Ms. Jamie Owed Ms. Ruth Pachman Mr. George H. Parry Mr. and Mrs. Robert F. Payne Judith S. Pease Rebecca P. Pence Ms. Elizabeth Perdue Mr. and Mrs. Richard L. Perry Richard and Linda Pietrzak Pink Lotus, LLC Mr. and Mrs. Jerald E. Pinto L. F. and Frances G. Ponton Mr. and Mrs. Homer G. Ponton Mr. Mark Post Mike and Karen Powell Mrs. Willistine Pritchett Ms. Patricia H. Purcell Ronda Puryear Patricia Ramsey Mr. and Mrs. Mark Randall Red Root & Co. Ms. Allison Reed Peter and Peggy Rice Mr. and Mrs. Hansford L. Riordan Mr. Michael P. Roberts Mr. Dale Robinson and Mrs. Vicki Andreae Rock, Paper, No Scissors Mr. David W. Rodwell Mr. and Mrs. Jackson Rossi Patty and Dick Rousseau Mr. and Mrs. Donald S. Rudd Ms. Joan E. Rudel Ms. Sheila J. Ryan Ms. Susan Saliba Dr. Kristin Saltonstall Ellen and Stuart Saltzman Mr. and Mrs. Bryan Sanderson Mr. and Mrs. Eugene D. Sandridge Mr. John S. Santic Mr. and Mrs. Brad Sauer Saunders Brothers Mr. and Mrs. Peter W. Schare Ms. Sandra L. Schmidt Mr. Frederick W. Schneider Robin Durkin Ms. Rhea Schwartz Ms. Tracy Senf Mr. Richard A. Severin Maddie Sewani Mr. and Mrs. Matthew P. Shapiro Shaylynn’s Soothing Teethers

Mr. George Sheets Julia Lewis Shields Mr. and Mrs. Archie Shifflett Marjorie Shifflett Mr. and Mrs. Ken Shimberg Dr. Brian M. Showalter and Ms. Danielle Pambianco Janet and Michael Silvester Ward and Sallie Sims Ms. Linda J. Slota Mrs. Melinda Smale Gail and Jim Smith Mr. and Mrs. Clyde Smith Mr. Craig D. Smith SMJH Oncology Nursing Staff Kathy and Fred Smyth Mr. Harold R. Spainhour Mr. and Mrs. Steven C. Sperry Ms. Jackie Spitler Mr. John C. A. Stagg Mr. and Mrs. John A. Stalfort II Gineane and Sean Stalfort Preston and Diane Stallings Mrs. Ann Steckler Stone Fox Beauty Project Ms. Merrill P. Strange Mr. Phillip C. Strange Mr. and Mrs. Robert J. Stubin Adm. and Mrs. Paul F. Sullivan Patrick and Ruth Sullivan Mr. and Mrs. Mack C. Sumpter, Jr. Dr. and Mrs. Mark Sussman Beth and Adam Swartout Ms. Jody Sweeney Thomas J. and Sigrid Sweitzer Ms. Amy W. Taggart Dickie and Louise Tayloe TD Capital Management LLC Mr. Sanfjord Teu Three Chopt Ruritan Club Mr. and Mrs. David Thurston C. Bruce and Lois S. Till Mr. Frank Tinsley Mr. and Mrs. David C. Tobin Robert Todd and Catherine Snowden Charitable Fund Tori Leigh Studio Mr. and Mrs. Ed Traille Mr. and Mrs. Wade M. Tremblay Dr. Nathaniel and Rachel Tricker Mr. and Mrs. Douglas F. Trout Mr. James Trueheart Mr. Robert W. Trybus, Sr. and Ms. Beverly J. Hovencamp Dr. Sheila Van Cuyk Mr. Theo van Groll and Mrs. Charlotte P. Black-van Groll Ms. Doris Van Vleet Mr. and Mrs. Michael J. Vassallo Mr. and Mrs. Thomas C. Vaughan Lanie Veckman Verde Candles Ms. Genevieve Verlaak Mr. and Mrs. Richard P. Vinal Mr. and Mrs. Michael R. Vincel, Jr. Vitae Spirits Distillery LLC Ms. Mary Wagoner Mr. James P. Waite III Ms. Mary E. Walker Mr. Steve Walker Mrs. Susan Wall Ms. Mavis Waller and Mr. Eric Adderly Mr. John V. Ward

Bertram L. Warren, Jr., M.D. Mr. Robert A. Watson Bill and Charlotte Weathersby Ms. Susan T. Webb Ms. Diana Webb Carolyn Weber Weft and Wool Deborah Weintraub Mr. and Mrs. Dean J. Wentz Mr. and Mrs. John H. Wheeler Mr. and Mrs. Charles A. White III Ms. Bernadette A. Whitlock Mr. and Mrs. Randy Whitlow Ms. Andrea Wilder Mr. and Mrs. J. Harvie Wilkinson III Mr. and Mrs. David W. Williams J. Page and Peggy W. Williams Ms. Teresa Willis Mr. and Mrs. Jeffrey C. Wilson Mr. Gregory Winston Dr. Cleome J. Winters Mrs. Birgit Winther Mr. Hugh R. Wood Wriley and Lee Wood Elizabeth H. Woodard Ms. Loring Woodriff Ms. Beverly B. Woolfolk Suzanne S. Word Mr. and Mrs. Peter H. Wray Ms. Rebecca Wright Yenta + Posha Barbara Walsh Yoder Jeff Young Ms. Melissa Zeller and Mr. Philip Kangas Mr. and Mrs. Walter M. Zirkle III Anonymous (5)

Leone Ciporin Ms. Sarah Lloyd

Kathryn R. Kreienbaum Ms. Allison Rachels

Dr. Russell C. Sawyer Mr. Kelley Sims

Brent P. Cochran Anne K. Vest

Dr. Daniel A. Landes Anonymous

Dr. Alexander A. Schult Mr. and Mrs. Lalit C. Parmar

Dr. Charles J. E. Cole Mr. Gary Kiev

Dr. John Ligush, Jr. Mrs. Willistine Pritchett

Dr. Mohammad H. Shakhatreh Mr. Maurice Apprey

Dr. Anthony Crimaldi II Dr. Douglas and Jayne Cox, Cox Chiropractic Clinic Mr. Frederick W. Schneider Mr. and Mrs. Jeffrey C. Wilson

Dr. J. Devon Lowdon Mrs. Richard P. Lalley Mr. and Mrs. Bruce W. Saunders

Dr. Linda M. Sommers Ms. Nancy L. Gillies

MJH Cancer Care Center Nancy F. Maloy Mr. Harold R. Spainhour

Katie Spero Ms. Diana Webb

MJH ED Staff Mrs. Willistine Pritchett

Dr. Erika P. Struble Mr. and Mrs. J. Daniel Crigler Mr. and Mrs. Dale R. Gamache Mr. Harold R. Spainhour

Dr. Lynn Dengel Mr. and Mrs. Dennis H. Hogberg

MJH Hospital Staff Debbie and John Desmond Mr. and Mrs. William H. Shifflett

Dr. Megan A. Swanson Mr. and Mrs. J. Daniel Crigler Mrs. Joyce F. Shiflett

Setour A. Dillard Kimberly and Don Skelly

MJH ICU Staff Mrs. Willistine Pritchett

Alyssa & James Walsh Cindy Petrie

Dr. Gregory H. Doull Mr. John S. Santic

MJH Infusion Center Ms. Linda J. Slota

Dr. Gregory Wiaterek Mrs. Joyce M. Massowd

Dr. John Z. Edwards Rebbeca Marshall Mrs. Melinda Smale

MJH Radiation Oncology Dept.

Adm. and Mrs. Paul F. Sullivan

Julie Williams Ms. Julie Williams

Dr. Kevin R. McConnell Mr. Willie Jones Mr. and Mrs. Charles E. Loftin Mr. and Mrs. Frederick W. Payne

Blair K. Williamson Martin Marietta

Patricia Fairfax Donald Fairfax

Dr. Erin McLoughlin Sylvia Dovel Mr. and Mrs. Dennis H. Hogberg

Kelly Woolford Mr. Phillip Snow and Dr. Doris Snow William Monroe High School

Charleene R. Frazier Ed Koch

Megan & Trevor Nash-Keller Cindy Petrie

Dr. Lindsay D. Friesen Mike and Karen Powell

Tammy Neher Malaney Neher

Honorary Gifts

Dr. Adam Goldberg Mr. and Mrs. Charles W. Jones

Dr. Kelly A. Owens Ms. Susan Folley

Dr. Francis B. Ansa Dr. Harold Bare, Sr.

Dr. Zachary Gregg Mr. and Mrs. David Pollak, Jr., Pollak Family Fund of CACF

Jennifer Pease Judith S. Pease

Jenn & Craig Barlund Cindy Petrie

James E. Haden Kathleen and Daniel Bowman

Dr. Clark Baumbusch Mr. and Mrs. J. Daniel Crigler

Sarah Heisey Mrs. Melinda Smale

Amy Black Lillian and Michael BeVier Michael and Dianne Burris The Culbertson Foundation, Alan, Sharon, Elizabeth and Jennifer Culbertson

Dr. Sylvia S. Hendrix Dr. Douglas and Jayne Cox, Cox Chiropractic Clinic Mr. and Mrs. Dennis H. Hogberg Adm. and Mrs. Paul F. Sullivan Anonymous

Dr. James E. Boyer Ms. Margaret G. Gossweiler Mrs. George Havenner Ms. Linda J. Slota Mr. and Mrs. Jeffrey C. Wilson

Dr. William R. Dandridge, Jr. Mr. and Mrs. William H. Arrington, Jr. Pamela Deemer Ms. Elizabeth S. Whitestone

Linda D. Estepp Mr. and Mrs. WIlliam T. Estepp John Fairfax Donald Fairfax

Dr. Leslie Hilding Mr. Randolph Carter, Jr. Tracey Hill Jo Anne Ebersold Robert and Letty Macdonald

Dr. Jefferson M. Prichard Dr. Harold Bare, Sr. Mr. Lucien Charette David Heilbronner and Lynn Valentine Ms. Phyllis Highland Mr. Kenneth Horst Anonymous Deborah R. Mr. and Mrs. Brian Nagel Tracey Reynolds Mr. and Mrs. Charles E. Loftin Dr. Daniel R. Ricciardi Yancey and Peggy Ford Charitable Fund

Corinne W. Burton Ms. Corinne Burton

Moonera Hussain Asila Lashkeri

Andrea Caldwell Robert and Virginia Barton

Dr. Katherine Kimbrell Ms. Peggy H. Bohannon

Dr. Andrew Romano Mr. Forest N. Bryant, Jr. Mrs. Barbara D. Davis Mr. and Mrs. Larry Entsminger Ms. Sandra L. Schmidt Mr. H. Robert Villwock* Mr. and Mrs. Randy Whitlow Anonymous

Dr. John M. Carl III Mr. Mark C. Greenfield

Lorie and Lisa Koch Mr. and Mrs. William Koch III

Charles Rotgin Dr. John and Mrs. Ilse C. Hendrix

Dr. Andrew S. Chang Mr. Charles Shores

Steve and Carol Koch Mr. and Mrs. William Koch III

Dr. Daniel W. Sawyer Anonymous

Dr. Alan Brijbassie Dr. Harold Bare, Sr. Mr. Donald Boothe

Ivora Hinton Ms. Branika Scott

Dr. Edward T. Wolanski Mrs. Laverne R. Baumgardner

Memorial Gifts William Alexander Taylor Chandler Valancee Avalos Mary Lena Taylor Russell T. Beal Ms. Myra L. Beal Jennifer Beckett Mr. Lee McCraw-Leavitt Rodney F. Beckwith Mrs. Rodney F. Beckwith Joyce Ann Benton Miss Karen T. Benton Irwin & Evelyn Bernhardt Mr. James Bernhardt, DDS and Mrs. Olivia Bernhardt, RN Daniel Boatwright SMJH Oncology Nursing Staff Danny A. Bowen Mr. Melvin L. Blincoe Dr. Nicholas Brandt Jim Boyer The Family of Nicholas Brandt, MD in His Loving Memory Deborah Weintraub Mary Brennan Mrs. Nancy A. Holland Brenda Brown Edna P. Wood-Jones Sue B. Brown Anonymous Jane Buchanan Peter Buchanan

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Anneliese Burgbacher Ms. Doris Van Vleet

Betsy R. Carr Mr. and Mrs. James Dixon Joan Fadden Mrs. Jill Schmid Patty A. Schmid Mr. and Mrs. John H. Wheeler

Mr. and Mrs. Fred M. Councill Peter J. and Barbara T. Cover Mary and Jim Holden Mrs. Daniel E. Horan Mr. and Mrs. Dennis C. Longwell Mr. and Mrs. Bill McGuinn Derry Miller Sandra C. Palumbo Ellen and Bob Pate Mr. and Mrs. David D. Plageman Mr. Alexander M. Rankin III Mr. and Mrs. Brad Sauer Bertram L. Warren, Jr. M.D. Ms. Gloria M. Wilson Suzanne S. Word

John G. Chestnutt Mr. and Mrs. Frank F. Fountain

William J. Hill Mrs. L. E. Hill

Donna H. Chewning Mr. and Mrs. Hansford L. Riordan

William & Anna Huggard Mr. James Bernhardt, DDS and Mrs. Olivia Bernhardt, RN

Gene Burleson Ms. Dabney Hibbert James E. Burns Rosemary Burns Walter H. Burton Ms. Corinne Burton

Joyce P. Craig The Counterpoint Foundation Carren Curtis Mr. and Mrs. Keith A. Curtis Jane T. Danilek Joan M. Brakman Elizabeth J. Callan Don Danilek, The Danilek Family Trust C. Bruce and Lois S. Till William F. Daly Mrs. Joan M. Daly Mark Day Ms. Grace Kelly Mr. and Mrs. David E. Richard Jerry G. Daye Ms. Gwynne B. Daye G. S. Dewey Lindsay W. Marshall and L. Courtenay Beebe, M.D.

Maddie A. Johnson Mr. and Mrs. David Thurston Aiden J. Kehoe William J. Kehoe James L. Kelly Aileen W. Kelly Thomas J. Kelly Chuck and Whitley Rotgin John F. Koonce Mr. Joseph F. Morrissette Linda Larimer Mr. Doug Larimer Charley Lepow Ginny Lepow Cathy Littleton Dickie and Louise Tayloe

Claudia Dodson Brenda F. Langdon

Richard Lounsbury Mr. Scott R. Lounsbury

Dorothy Doll Mr. and Mrs. Christopher S. DiVita

Albert G. Lowry Mr. and Mrs. Price Ketchiff

James C. Dunstan Julia Dunstan

Marion Marino Mr. and Mrs. James E. Horn

George W. Eudailey Mrs. George W. Eudailey, Jr.

Bruce E. Martin Mr. and Mrs. Michael Caplan Dr. John and Mrs. Ilse C. Hendrix

Gloria Fletcher Ms. Hattie Grundland Annie B. Fuller Anonymous Cassandra Hughes J. Garrison Mr. Thomas A. Garrison Florence M. Geyer Joan F. Fadden Daphne Glassman Mr. James L. Millner Elisabeth M. Greenbaum Greenbaum Family Charitable Fund Dr. and Mrs. David L. Morris

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Mr. and Mrs. Ben Hurt Ronny and Jo Anne Byram

Martha A. Martin Mr. and Mrs. Michael Caplan Ralph E. McGuire Mr. and Mrs. Ken Toler Noel Toler and Grace B. Toler Dr. Latham B. Murray Mr. Lee T. Stinchfield Frederick G. Newman Helen Newman Benjamin Orr Rebecca P. Pence Lloyd Parcell Ms. Alice L. Parcell

Marie C. Haden Warren Haden

William N. Payne Mrs. Virginia S. Payne

Betsey D. Hathaway Mrs. Wallace C. Bedell Mr. and Mrs. Steven D. Bell Ms. Wanna M. Blanton

Dr. Paige L. Powers Dr. Keiko Aikawa Mr. and Mrs. Eric Ask Ms. Mary Barrick

SPRING/SUMMER 2023

Dr. Kari Boucher Ms. Eden H. Brent Michelle M. Caruso-Cabrera Dr. and Mrs. Bradford Chervin Mr. and Mrs. Neelan Choksi Crystal Chu Mr. Thomas Cole Mary Laurence Crook Matthew Jonathan Cutler Family Giving Account Mr. Michael Dorsch Mrs. Ron Fischer Mrs. Sarah Fleming Ms. Renée Fuller Ms. Caroline Gentile Dr. and Mrs. Allan Gold Isy and Michele Goldwasser Ms. Andrea B. Goodman Alex and Karen Grunsfeld Ms. Karen Ham Dr. and Mrs. John D. Hendrix, Sr. Mr. Daniel M. Hoadley Kekst CNC Dr. Nora Kern Mr. and Mr. Michael Kesselman Dr. and Mrs. Bradley Kesser Dr. and Mrs. Sidney Kriger John Lanham, M.D. Mrs. Sue Lauf and Mr. Bruce Becker Mr. Francis Lee Ms. Linda L. Lester Joanne and Peter Mackey Dr. Christine A. Marshall Mr. Richard McdKern Dr. and Mrs. Eugene D. McGahren III Mr. Robert K. Moore Mr. Eric Oliver Ms. Ruth Pachman Ms. Jane Park Mr. and Mrs. Matthew Powers Dr. Lane A. Ritter Mr. Michael P. Roberts Dr. Kristin Saltonstall Mr. and Mrs. Bryan Sanderson Ms. Rhea Schwartz Prof. Merry Sebelik Maddie Sewani Mrs. Gail Sheldon Marjorie Shifflett Mr. and Mrs. Ken Shimberg Dr. Brian M. Showalter and Ms. Danielle Pambianco Mr. Craig D. Smith Ms. Anne Soh John and Helen Steele Kent and Erika Struble Dr. and Mrs. Mark Sussman Mr. Brian Sussman TD Capital Management LLC Robert Todd and Catherine Snowden Charitable Fund at Schwab Dr. Sheila Van Cuyk Mr. John V. Ward Mr. and Mrs. Irving N. Weiss Dr. Cleome J. Winters Mrs. Birgit Winther Anonymous Susan Prasad Carol A. Berge Ms. Barbara Olin Ms. Julie A. Wheaton

Marjorie B. Radford Polly Faulkner Peggy Robertson Misty and Jon Roberts Brenda Rogers Ms. Glena F. Cooper Janet A. Ross Ms. Mary C. Blackwell Steven Sahle Mr. and Mrs. Keith A. Curtis Elaine Grace Scharer Mr. and Mrs. F. C. Abell Fred Scarlata Ginnie and Peter Gillen Lillian R. Schafft Mr. and Mrs. Brian F. LaFontaine Richard Schmitt Mrs. Judith Schmitt Melvin Schwartz Mr. and Mrs. Ray Kunk Mr. Roger B. Kunk Ms. Renee Viverito John C. Shilan Tom and Karen Vaughan Charles E. Smith Ms. Brenda K. Melton Mahon T. Smith Janice S. Creasy Mrs. E. Louis Runkle Colleen Taylor Mrs. Jeannette May Doloris C. Thomas James J. Thomas and Family John B. Thomas Mr. and Mrs. James J. Thomas Catherine N. Thompkins Ms. Carmen Smith George M. Tilman Chuck and Whitley Rotgin Alfred P. Tosto Mr. Leonard Tosto William Washington Mr. and Mrs. David L. James Frederick L. Watson Chuck and Whitley Rotgin Ethel A. Webber Ms. Barbara Webber Gary Weber Carolyn Weber Jamie Wells Bob and Kedra Hauser Katherine West Mr. and Mrs. Cliff West John Wheatley Lindsay W. Marshall and L. Courtenay Beebe, M.D. Doris Young Ms. Natasha Banks John Young Cappy and Paul Grabowski

Make Compassion Last More than a Lifetime The heart of the Martha Jefferson Caring Tradition is all of us, caring for each other to improve the health of our community.

You can make this spirit of compassion part of your legacy by including the Martha Jefferson Hospital Foundation in your estate plan.

100% of your support will directly benefit life-saving programs for friends and families here at home, in our community.

For more information, contact the Martha Jefferson Hospital Foundation at 434-654-8258 or by email at mjh_foundation@sentara.com.

Or visit us online at mjhfoundation.planyourlegacy.org.

Non-Profit Org. U.S. Postage

PAID

Sentara Martha Jefferson Hospital 500 Martha Jefferson Drive Charlottesville, VA 22911

Sentara Martha Jefferson Hospital

Sentara.com Change service requested

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

We want to thank our care team for providing individualized, focused, holistic care to every patient choosing Sentara Martha Jefferson Hospital for their birth journey.

sentaramjhmaternity.com