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SENTARA RMH Magazine

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Listen to Your Heart The Lesser-Known Dangers of Cardiovascular Disease in Women

PLUS: Battling Brain Cancer with Grace and Gratitude Vanquishing Painful Varicose Veins | Sentara Hospital to Home

PRESIDENT’S LETTER

2021 SENTARA RMH BOARD Joseph Funkhouser II | Chair

Jerry Benson, PhD | Vice Chair Devon Anders Arthur Dean II Terrie Edwards, CVP Morris Fendley, MD Paul Gaden C. Wayne Gates, MD

SENTARA RMH ADMINISTRATORS

Douglas Moyer President

Donna Hahn, DNP, RN, NEA-BC Vice President, Chief Nursing Officer

Rita A. Bunch, MPH, FACHE Vice President of Operations

Robert Garwood, MD Chief Medical Officer

SENTARA RMH MAGAZINE EDITORS

Jenn Downs Alyssa Pacheco Debra Thompson CONTRIBUTORS

Luanne Austin Jim Bishop Jim Heffernan Preston Knight Lisa Smith Jennifer L. Stover

Providing Exceptional Care in Challenging Times

s we approach the end of what has been a tumultuous and uncertain year for our community, I wanted to update you all on some exciting developments at Sentara RMH and remind you of the importance of remaining vigilant and safe during the holiday season. First and foremost, I am excited to announce that Sentara RMH has recently welcomed many new providers to our family and the Shenandoah Valley. Just to name a few, Drs. Stephen Ernst, Thomas Krisztinicz, Erwin Secretov and Mark Williams have joined us as orthopedic surgeons. Additionally, Dr. Sophia Leung will serve as an orthopedic hand and upper extremity surgeon, and Dr. Trent Mazer joins us as a family medicine physician. See page 4 for a complete listing of all new Sentara RMH providers—we are excited to welcome each of these talented individuals to our team! On a more serious note, I would be remiss not to acknowledge the recent spike in COVID-19 cases throughout Virginia and in our area over the past few months. The recent surge is a harsh reminder that, unfortunately, the pandemic is not yet behind us. To help patients stay safe, Sentara recently launched an online dashboard containing detailed, up-to-date information about the volume of COVID patients at each Sentara hospital. You can view the dashboard by visiting sentara.com and clicking on the COVID banner at the top of the page. With the holidays approaching, taking precautions against COVID and flu will help keep your loved ones safe. While COVID vaccination rates continue to climb, we urge all eligible unvaccinated community members to get vaccinated. Should you have any questions or concerns regarding the COVID vaccine, please contact a member of the Sentara staff, or visit sentara.com/vaccine for more information. We also ask each of you to get your flu shot as soon as possible. The combined threat of COVID and flu season presents yet another obstacle to our path to recovery and a return to normalcy, and we hope to eliminate this hurdle with increased access to vaccinations. Finally, I want to publicly recognize and thank the employees who have been responsible for providing incredible care to our community over the past year and a half. As our community continues to combat the pandemic, I am extremely grateful for the commitment of ALL Sentara team members in continuing to provide exceptional care in the face of adversity. The wonderful work of our caregivers touches the lives of our patients every day, and I am truly thankful for their perseverance and professionalism. You can read about the healthcare journeys of two Sentara RMH patients on pages 19 and 29. As always, we are honored to care for the valley community and are humbled by the support we have been shown during these difficult times. Thank you for trusting us with your care. I wish everyone a joyful, safe, healthy holiday season. Respectfully,

PHOTOGRAPHY

Andrew Shurtleff Tommy Thompson DESIGN

Picante Creative

Doug Moyer President, Sentara RMH Medical Center

Contents FA L L 2 0 21

You're Having a Baby! Now What? Sentara RMH Community Health Programs Are Here to Help 19

Listen to Your Heart

Batting Brain Cancer

The Lesser-Known Dangers of Cardiovascular Disease in Women

With Grace and Gratitude

Contents

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

New & Noteworthy

Physician’s Perspective On-Call Advice

Improve Health Every Day Eat Well, Live Well Calendar

Aging Well

Vanquishing Painful Varicose Veins

Health Matters

Foot Care for People with Diabetes

La Salud Importa

Cuidado de los pies para personas con diabetes

Sentara in the Community

New Sentara Program Offers 'Hospital at Home' Care for Some Patients

17 Calendar

Philanthropy

THE BEST MEDICINE BY MICHAEL CORDELL

To Get Healthy,

Speed Isn’t Everything

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

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

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new& noteworthy Sentara RMH Medical Center is pleased to welcome the following new providers into the hospital community. To get connected with one of our providers, or for more information on any caregiver at Sentara RMH, please call 1-800-SENTARA.

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Shahab M. Ehtesham, MD Internal Medicine Sentara East Market Street Health Center 540-564-5666

Adrienne Koch, DO Internal Medicine Sentara East Rockingham Health Center 540-713-4100

Justin Roberts, MD Anesthesiology SMG Anesthesia Specialists, LLC

Stephen Ernst, MD Orthopedic Surgery Sentara Orthopedic & Sports Medicine Specialists 540-689-5500

Sophia Leung, MD Orthopedic Hand Surgery Sentara Orthopedic & Sports Medicine Specialists 540-689-5500

Benjamin Ruth, MD Cardiology Sentara Cardiology Specialists 540-689-7400

Carla Gibbs, MD Family Medicine Sentara South Main Health Center 540-564-7300

Derek Matt, DO Anesthesiology SMG Anesthesia Specialists, LLC

Erwin Secretov, MD Orthopedic Surgery Sentara Orthopedic & Sports Medicine Specialists 540-689-5500

David S. Gish, MD Radiology Rockingham Radiologists Ltd.

Trent W. Mazer, MD Family Medicine Sentara South Main Health Center 540-564-7300

Mohamed A. Sultan, MD Allied Health Sentara Gastroenterology Specialists 540-564-5800

Jessica M. Goldstein, CRNA Allied Health SMG Anesthesia Specialists, LLC

Banafsheh Motazedi, MD Endocrinology Sentara Endocrinology Specialists 540-689-4300

Jacob Whyte, DO Anesthesiology SMG Anesthesia Specialists, LLC

Lidiya Gutnikova, MD Internal Medicine Sentara East Market Health Center 540-564-5666

Mitchell C. Palmer, PA-C Allied Health Sentara Cardiothoracic Surgery Specialists 540-689-5555

Mark Williams, DO Orthopedic Surgery Sentara Orthopedic & Sports Medicine Specialists 540-689-5500

Thomas I. Krisztinicz, MD Orthopedic Surgery Sentara Back and Neck Specialists 540-689-4500

Stacy W. Quinn, DO Family Medicine Sentara South Main Health Center 540-564-7300

Sentara RMH Medical Center Named

Ninth-Best Hospital

Sentara RMH Receives Gold-Level Certification from Harrisonburg-Rockingham Living Wage Campaign Recently, Sentara RMH Medical Center received gold-level certification recognition from the Harrisonburg-Rockingham Living Wage Campaign, which recognizes businesses paying a fair wage to their employees. Ramona Sanders, a steering committee member with the HarrisonburgRockingham Living Wage Campaign, presented the certification to Doug Moyer, Sentara RMH Medical Center president.

Hundreds Receive Free Health Screenings at Rockingham County Fair Annually, Sentara RMH team members volunteer their time at the Rockingham County Fair to meet with fairgoers and provide hundreds of free health screenings. This year, team members provided 790 blood pressure screenings, 100 cholesterol screenings, 96 glucose tests

and 75 A1C tests over the course of six nights at the fair. Sentara RMH team members also handed out approximately 7,000 bottles of water, 3,000 tote bags, 4,000 Band-Aid kits, and lots of Frisbees and sunglasses for our littlest visitors.

in Virginia in 2021 Edition of U.S. News & World Report’s Top Hospitals

“Sentara RMH’s rise to being named one of the top 10 best hospitals in Virginia this year is a testament to our long-standing commitment to improving health every day,” says Doug Moyer, president of Sentara RMH. “The steadfast work of every member of our team, aiming to provide consistent, high-quality health care for our community, showcases the ongoing dedication of everyone at the hospital, and this honor highlights those efforts.” In addition to its state ranking, Sentara RMH is also recognized as high-performing in its pulmonology and lung surgery specialty. “Earning this honor takes tremendous commitment by the entire Sentara RMH team,” says Paul Gaden, Sentara corporate vice president of the Blue Ridge region. “We value the trust of our patients and families in our community and will continue our commitment to being the healthcare choice of the community we serve.”

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PHYS ICIAN’S PERSPEC TIVE

The Importance of

A GOOD NIGHT’S SLEEP

… and Why You Might Not Be Getting One Getting a good night’s sleep is essential to helping the body and mind function optimally, and By Fouzia Siddiqui, MD, FAAN a continual lack of sleep can have significant health consequences. Unfortunately, sleep is often not taken seriously as a factor in good health, and many people regularly sacrifice hours of sleep in order to get through the demands of their busy schedules.

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Approximately 50-70 million U.S. adults have a sleep disorder, the most common of which are obstructive sleep apnea and insomnia. In addition to interfering with daily activities (about 40% report unintentionally falling asleep during the day), sleep deprivation and sleep disorders can have substantial short-term and long-term effects on our brains.

Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a potentially serious sleep disorder in which breathing repeatedly stops and starts. The estimated prevalence rates of OSA have increased substantially over the last two decades, most likely due to our nation’s obesity epidemic. It is now estimated that 26% of adults in the U.S. between the ages of 30 and 70 years experience sleep apnea. The physical effects of OSA on the body include hypertension, worsening diabetes, heart failure, heart disease, stroke and other vascular issues. OSA also affects our brains, causing various sleep disturbances throughout the night that deprive the brain of oxygen and preclude the brain from getting to the restorative stages of sleep (deep sleep and REM sleep). As a result, people with OSA often experience symptoms such as short attention span, reduced short-term recall, irritability and mental exhaustion. In terms of long-term effects, OSA can result in detrimental changes in brain matter and neurons, which can in turn lead to memory loss and alter neurotransmitter levels in the brain. In one study, researchers at the University of California, Los Angeles, compared the mammillary bodies— structures in the brain that are important in memory storage—of several adults suffering from sleep apnea with those of healthy people. They found that the mammillary bodies in the troubled sleepers were nearly 20% smaller than in their untroubled counterparts. Furthermore, multiple studies have discovered a decrease in both gray and white matter in the brains of subjects with OSA. A neuroimaging study published in

the journal Sleep found that participants with severe, untreated sleep apnea had a significant reduction in white matter fiber integrity in multiple brain areas, which was accompanied by impairments to cognition, mood and daytime alertness. According to the American Academy of Sleep Medicine, a few studies have evaluated the effects of continuous positive airway pressure (CPAP) therapy on several subjects who had seen significant damage to their brain matter. After a year of CPAP treatment, these patients’ white matter was almost completely restored, while their gray matter saw substantial improvement after just three months. This is in line with other studies that have confirmed that CPAP treatment, when used regularly, can almost completely alleviate the symptoms and effects of sleep apnea.

Insomnia Another very common sleep disorder in the developed world is insomnia, which involves difficulty falling asleep, staying asleep and not feeling refreshed during the daytime, and generally occurs at least three times a week for one month. Short-term insomnia is reported by about 30% of the population, and chronic insomnia by 10%. According to a recent Johns Hopkins study, people with insomnia exhibited more neuronal excitability, which is defined as sentara.com

PHYS ICIA N ’ S PERSPEC T IV E

the propensity of a neuron in the brain to generate an output signal from a given input signal. These findings indicate that “insomnia is not a nighttime disorder. It’s a 24-hour brain condition, like a light switch that is always on.” All this neural activity can have long-lasting effects on a person’s body, including poor short-term and long-term memory, reduced concentration, reduced attention span, mood irritability, and mental exhaustion. In short, insomnia leaves the brain exhausted and unable to perform the duties necessary to keep us happy, healthy and productive. A study at the University of California, San Francisco, found an association between poor sleep quality and reduced gray matter in the frontal lobes of Gulf War veterans. The frontal lobe helps control important neurological processes, such as

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working task memory and executive function. The study revealed that poorer sleep quality, such as that among patients with chronic insomnia, is associated with reduced total cortical and regional frontal lobe matter volumes, resulting in cognitive deficits in attention, executive function and nonverbal memory.

Take Control of Your Sleep With so many negative health effects of poor sleep quality on the body and brain, getting the

recommended number of daily hours of sleep is essential. You can improve sleep quality by developing consistent routines at bedtime and creating a healthy sleep environment—for instance, by keeping the bedroom free of electronics and free of arguments; dimming lights; and keeping the room at a cool, comfortable temperature. If you have any symptoms of a sleep disorder, be sure to talk to your doctor about available treatments.

ON-CALL ADVICE

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

What is Seasonal

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

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

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

ON- C ALL A DVICE

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

What is Nonalcoholic

Fatty Liver Disease?

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

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

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

IMPROVE HEALTH EVERY DAY

THREE REASONS TO

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

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

1 Improves cardiovascular health and immunity

3 Boosts concentration and creativity

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

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

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

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I M PROVE HEA LTH EVE RY DAY

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

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

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

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

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

The Importance of Stretching in Cold Weather

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

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

• • • • •

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

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

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EAT WELL , LIVE WELL

Fall Flavor PROFILES

By Patricia Tyndale, RD Sentara Martha Jefferson Hospital

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

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

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

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

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

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

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

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EAT WELL, LIVE WELL

What Is It About Fall?

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

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

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

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

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

calendar Unless otherwise noted, call 1-800-SENTARA for more information and to register. Classes are also listed on Sentara.com. We have coded our classes and events as follows: AR Advance registration required NR No advance registration required FREE No fee

Behavioral Health Life Recovery Intensive Outpatient Program A program for those with alcohol or substance abuse issues. Sessions will focus on education about substance abuse, relapse prevention and strategies for managing difficult emotions that accompany substance abuse. Meets Mondays, Tuesdays and Thursdays, 4-7 p.m. For more information, call 540-564-5100. Cancer Sentara RMH Hahn Cancer Center offers a number of classes and support groups—many of them free of charge—for cancer patients, cancer survivors and caregivers. To learn more, visit Sentara.com or call 540-689-7065. Chronic Pain Chronic Pain Self-Management Classes Learn techniques for how to cope with chronic pain and how to communicate with healthcare professionals, family and friends, as well as appropriate exercise and nutrition information. Call 540-820-8567 to learn more. FREE

Diabetes Caring for Your Diabetes Class Series Covers medications, monitoring, reducing risks, staying active, healthy eating and more. Medicare and most insurance plans cover a portion of the cost. Virtual and in-person class options available. To register, call 1-800-SENTARA. AR Grief and Loss Grief: 1 to 1 Grief can follow death, marriage breakup, chronic illness, job change or retirement. Talk with someone trained to help you understand how your grief can affect you. For an appointment, call 540-564-5118. Seniors Sentara RMH Senior Advantage Affordable, fun educational and social events for adults 55 and “better.” Call 540-564-7001 or visit Sentara.com to learn more. Support Groups A variety of support groups—most of them free of charge—are provided by Sentara RMH or affiliated groups in the community. Among them are the following: • Bariatric Support Group • Breastfeeding Support Group • Cardiac Device Support Group • Hand-in-Hand Resource Mothers Program (virtual support group offered for teen mothers) • New Moms Ask a Nurse—Partnering with Postpartum Support Virginia (Zoom meeting) This is a partial listing. To learn more about these and other support groups offered in the Sentara RMH service area, visit Sentara.com.

Sentara RMH Medical Center offers a variety of classes and seminars throughout the year. For a complete list and more details, visit Sentara.com. Many events meet virtually. COVID-19 safety precautions are in place at all in-person events and appointments. sentara.com

calendar

Women’s Services Mammography Van Schedule Call 540-689-6000 or 800-277-1021 to schedule your mammogram at the following locations: Nov. 15 • Elkton Area Community Center Nov. 16 • Walmart, Timberville Nov. 17 • Highland Medical Center, Monterey Nov. 19 • South River Medical Clinic, Grottoes Nov. 22 • Walmart, Luray Nov. 24 • Sentara RMH East Rockingham Health Center Nov. 29 • Perdue, Bridgewater Nov. 30 • Bridgewater Retirement Community Dec. 1 • Montevideo Middle School Dec. 3 • Virginia Mennonite Retirement Community

Sentara RMH Wellness Center 2500 Wellness Dr., Harrisonburg So much more than a gym, we’re the perfect fit for your lifestyle, with classes and activities for all ages and life stages. Find your perfect fit with group fitness classes, including yoga, aqua, fitness, indoor cycling, Bodypump, a dedicated Pilates equipment studio, a functional training and recovery area, two indoor pools, indoor track, and child care for our youngest members! Stop in for a visit and experience for yourself why you should become a member of the Sentara RMH Wellness Center, or call 540-564-5685 for more information. Lifeguard Certification Classes For ages 16 and older. Call 540-564-5698.

Dec. 6 • Sentara RMH Mt. Jackson Medical Center Dec. 7 • Sentara RMH Timber Way Health Center, Broadway Dec. 9 • Bridgewater Health Center Dec. 14 • Mt. Solon Pentecostal Church Dec. 15 • Elkton Area Community Center Dec. 17 • Carilion Family Medicine Dec. 20 • Grottoes Food Lion Dec. 21 • Sentara RMH East Rockingham Health Center

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Heart Disease

Women and

Lisa Walsh, a national sales manager for WHSV-TV, was between Zoom meetings at home on Feb. 12, 2021, when she began to feel anxious. The feeling didn’t make sense to her at the time, since she wasn’t nervous or stressed about anything in particular that day. “Then my arms started to hurt, but I kept working,” says Walsh, 52, of Harrisonburg. “I felt tired, so I cut out of a meeting early and thought I’d take a 10-minute nap, which isn’t something I normally do. Suddenly I felt sweaty and dizzy. I looked at my face in the mirror—it was white, and I had no life in me.”

Take Heed and Make Time to Take Care of Your Heart

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specializing in women’s heart health at Sentara RMH. “The textbook symptoms—such as crushing chest pain, like an elephant is sitting on your chest—aren’t necessarily what women experience,” explains Dr. Tajouri, who joined Sentara in 2018. “Women are more likely to feel tired, dizzy, lightheaded and nauseous, or have indigestion and trouble sleeping.” Often, women experience three or more of these symptoms leading up to a heart attack, according to Dr. Tajouri. Sometimes these symptoms can linger for days to months before a woman experiences a heart attack. “Some of the symptoms can be subtle or silent, so they tend to get brushed aside,” Dr. Tajouri adds. “We need to empower women to know the risk factors and recognize the symptoms—especially as they get older.” Heart disease is the leading cause of death for both men and women. In fact, more women die from heart disease than from all cancers combined, Dr. Tajouri notes. While women and men face similar risk factors, heart disease generally becomes more concerning 7-10 years later for women than men—particularly after they enter menopause.

Walsh, who was home alone, called 911. Emergency crews arrived rapidly and realized she was having a heart attack. They rushed her to Sentara RMH Medical Center while communicating with the waiting medical team about her condition. “This was not the typical heart attack you read about,” says Walsh. “My heart didn’t hurt. I wasn’t grabbing my chest.”

Heart Attack Symptoms More Subtle in Women Walsh’s heart attack symptoms are more common for women than men, explains Tanya Tajouri, MD, a cardiologist

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“Menopause and changing hormone levels trigger weight gain,” Dr. Tajouri explains. “Women can be especially at risk if they have a larger waist or midsection. Also, around menopause, blood pressure often goes up, and cholesterol can change with a drop in estrogen.”

Heart Attack Treatment and Aftermath Genetic high cholesterol played a significant role in Walsh’s heart attack. Discovering that her right coronary artery was fully blocked, doctors placed a stent in the artery to open and support it. The established goal for opening a blocked artery once the patient shows up in the emergency room—known as door-toballoon time—is 90 minutes, as set by the American College of Cardiology. At Sentara RMH, impressively, the average door-to-balloon time is just 52 minutes. “The whole treatment team worked swiftly and explained every step,” Walsh recalls. “They coordinated my care from the moment I got in the ambulance. Within a couple of hours of my heart attack at home, I was already recovering in my hospital room.” Doctors told Walsh that a few months after she recovered from her stent procedure, she would need open-heart surgery to unblock the left anterior descending artery (LAD), which typically supplies blood to more than half of the heart. A blockage in the beginning of the LAD is often called the “widowmaker” because it stops blood flow to the left side of the heart. Without oxygenated blood, the heart muscle dies within minutes. As Walsh researched where to have her open-heart surgery, she looked at many options throughout the region. She wanted to be sure that her surgeon was highly skilled and experienced, and also to feel confident that the chest scar would be as inconspicuous as possible. When she met with Sentara RMH cardiothoracic surgeon Yuriy Zhukov, MD, she

Dr. “Zhukov promised me he’d do everything he could to make the scar as small as possible, and that is exactly what he did.”

knew she had found the right surgeon and the right hospital. The fact that she found what she needed so close to home was even more reassuring. “I was impressed with Dr. Zhukov’s encouraging, approachable manner and his impeccable credentials,” says Walsh, whose open-heart surgery took place in April. “Dr. Zhukov promised me he’d do everything he could to make the scar as small as possible, and that is exactly what he did.” Walsh also appreciated how kind and thorough Dr. Zhukov and the entire care team were during her postsurgical recovery in the hospital. When she got home, Walsh relied on her son, Ryan, 21, and dear friends and family for support during her early recovery. She is also grateful for the support and encouragement of her colleagues at WHSV.

Heart-Healthy Changes and Self-Care Dr. Tajouri monitored Walsh’s health and recovery following her surgery, and Walsh’s providers continue to keep tabs on her cholesterol levels. She now focuses on getting more exercise and eating even healthier than before. sentara.com

Heart disease risk factors for men and women: • Diabetes •

Eating diets high in processed foods, sodium, saturated fat, sugar and cholesterol

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Family history of early heart disease

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High blood pressure

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High body mass index (BMI): A BMI of 25-30 is considered overweight. A BMI over 30 is considered obese.

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High cholesterol

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Sedentary lifestyle: Doctors recommend 20-30 minutes of exercise a day, most days. This exercise doesn’t have to be strenuous—you just need to get your heart rate up. Pick something that you enjoy, so you will stick to it.

• Smoking

Risk factors for women: For women, diabetes, mental stress, depression, obesity and smoking are higher risk factors than for men. Women are also affected by:

Heart Attack Symptoms in Women

• Menopause •

Polycystic ovarian syndrome

As with men, the most common heart attack symptom in women is chest pain or discomfort.

•

Pregnancy complications such as high blood pressure, pre-eclampsia, gestational diabetes, preterm delivery and having a baby weighing in the lowest 10th percentile

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The age they started menstruating, if before 10 years old or after 17 years

But women are more likely than men to experience some other common symptoms, including: •

Arm pain

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Back pain

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Cold sweats

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Difficulty sleeping

• Dizziness/lightheadedness •

Feeling anxious

•

Jaw pain

• Nausea/vomiting/indigestion •

Shortness of breath

Call 911 immediately if you are concerned that you may be experiencing a heart attack. Do not drive yourself to the hospital.

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Nine out of 10 women have at least one risk factor for heart disease or stroke. Even if a risk factor is under control with medication, it is still considered a risk factor. The good news is that 80% of heart disease and strokes can be prevented through lifestyle changes.

Dr. Tajouri sees many women who are so busy managing work and home life, they can’t find time to concentrate on their own health. “As women, we are so focused on taking care of everyone else and making sure everything is in order, we often let our own health care fall to the bottom of the list,” Dr. Tajouri says. “Women also tend to minimize symptoms. In fact, for a lot of women, the first sign of heart disease is a heart attack.” Had she not been home alone, Walsh says she likely would have ignored her symptoms and not called 911, to avoid bothering her family and friends. “I know if someone had been with me at home, I would have said, ‘I’m OK. I’ll just go lay down,’” she says. “If I had done that, I likely would have died.” Treatments for heart attacks are most effective when given within one hour of the onset of a heart attack, according to Dr. Tajouri. Walsh’s prompt treatment minimized the damage to her heart muscle and saved her life. After a heart attack, women are also less likely than men to follow up with cardiac rehab, possibly due to family obligations. For that reason, Dr. Tajouri advises providers and family members to make sure follow-up care is a priority.

Take Heed of Symptoms and See Your Doctor Dr. Tajouri urges women of all ages to pay attention to changes in their health. Women may be self-conscious about seeing a doctor and gathering their weight, blood pressure, cholesterol and other important information. However, checking

these vital numbers regularly is essential to working toward better heart health. “Please set any hesitancy aside and know that your health is important to you and your family,” Dr. Tajouri says. “The good news is that 80% of heart disease and strokes can be prevented through lifestyle changes alone.” Walsh is grateful for Dr. Tajouri’s care and advice, and appreciates how positive, reassuring and sympathetic she has been. “When you notice changes in your health and energy, it’s worth going to the doctor,” Walsh says. “If I had gone for regular checkups, I would have known more about my high cholesterol and been put on medication to control it. I also have very minimal heart damage because I got to the hospital right away during my heart attack. Be sure to listen to your body and get help when you need it.”

Heart disease and COVID-19 Patients with underlying heart disease experience an increased risk of complications with COVID-19. Even after they have recovered from the virus, they can still experience palpitations, increased heart rate, shortness of breath with activity and atypical chest pain, according to Dr. Tajouri.

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You’re Having a

Baby!

Now what? Sentara RMH Community Health Programs Help New Parents Thrive

A new baby can bring joy and excitement, but for teenage mothers and first-time parents, it can also bring stress and anxiety, as anticipation gives way to sleepless nights, countless feedings and diaper changes, and worries about developmental milestones. Luckily, three Sentara RMH Community Health programs are here to help. 24 |

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★ Hand in Hand Resource Mothers Program The Hand in Hand Resource Mothers Program provides teenage mothers with support, guidance and encouragement, both during and after their pregnancies. “We’re here to advocate for you,” says Olivia Brown, team coordinator. Once enrolled, program participants are assigned a case manager, or resource mother, who serves as a mentor. “During pregnancy, we want to make sure they’re getting good prenatal care, without which the baby is at higher risk of being born prematurely, as well as low birth weight and stillbirth,” says Brown. “We want to see healthy birth outcomes and positive bonding between mother and child.” Since many teens who become pregnant are still in high school and may be living with their parents, one of the goals of Hand in Hand is to help them with the transition to motherhood. “That’s a lot of responsibility to take on very quickly—especially if it’s not

something you’ve planned for,” Brown says. “We want the girls to feel confident in their new roles as mothers. A lot of them come in very fearful—they’re dealing with a lot of changes, emotionally and physically. Our resource mothers walk with them through all of these changes. We’re going to praise and affirm them in all of the really good things they’re doing, and let them know their lives aren’t over just because they got pregnant.” After the baby arrives, Hand in Hand resource mothers continue to provide services, including home visits, support groups and community resources to help new mothers continue their journeys. Home visits start with assessing the baby’s development, followed by a conversation with the mother about what to expect as the child grows and learns. “We do activities and crafts, we introduce developmentally appropriate toys, and we encourage a lot of mother-child interaction,” Brown says. The Harrisonburg Hand in Hand support group meets on the fourth Monday of each month, giving teen moms—and dads—a forum to engage in discussions with their peers about the challenges they’re facing during pregnancy and parenthood. The support group also involves activities sentara.com

“We want the girls to feel confident in their new roles as mothers.” ★

and guest speakers on a wide range of topics, including home safety and how to install a car seat properly. Since early on in the coronavirus pandemic, the group has been meeting virtually. Hand in Hand also works to make sure young mothers have bottles, diapers, clothes and other necessities for their babies. In addition, the group coordinates rides to and from doctor appointments and, if necessary, helps them find employment and childcare options.

★ Healthy Families of the Blue Ridge Another Sentara RMH Community Health program, Healthy Families of the Blue Ridge, provides education and support services for first-time parents who are considered to be “at risk.” Part of a nationwide network, the free, voluntary program is designed to teach parents about their baby’s health and development, and to help prepare the child for school. First-time parents living in Augusta, Bath, Highland and Rockingham counties and the cities of Harrisonburg, Staunton and Waynesboro may apply to the program before their baby is born, or up to three

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months after the birth. Couples are usually referred by their obstetrician during prenatal care or at the hospital following delivery. “Usually, these parents are really receptive to support,” says Brooke Garcia, program coordinator.

After an application has been submitted, a Healthy Families staff member will contact the parents to schedule an intake assessment that considers their backgrounds—including how they were raised—and their expectations for parenting. If the program seems to be a good fit for their needs, a family support worker will begin meeting with them regularly. “Even if they don’t qualify for the program, we can help set them up with resources in the community,” Garcia says. Like Hand in Hand, the Healthy Families home visitation program has shifted to virtual instruction during the pandemic, which Garcia says has actually benefited working families in the region. “It provides some flexibility that we didn’t have before,” she notes. Healthy Families home visits focus on caring for the baby, what to expect as the baby grows, communicating with the baby, and creating a healthy environment in which he or she can develop and learn. These visits can begin during pregnancy, with the option to continue them through the child’s fifth birthday, or until the child starts school. Garcia says new parents sometimes fall into the trap of not talking to their baby enough, or not recognizing cues and responding to their needs. “A lot of what we do involves getting first-time parents to understand, for instance, that when their baby is opening the cabinet door to the pots and pans, he or she is just curious and exhibiting problem-solving skills. With this information, parents come to realize that such behavior isn’t ‘bad.’ They learn to encourage it as a way for their baby to explore and learn safely.” In addition to home visits, Healthy Families of the Blue Ridge provides parent socials, a toy lending library, child development information and other sources of support.

★

“Even if they don’t qualify for the program, we can help set them up with resources in the community.”

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★ New Moms Ask a Nurse Support Group For the past decade, Reba Brunk has been running the New Moms Ask a Nurse Support Group at Sentara RMH Medical Center. Designed for moms and babies 12 months or younger, this free group meets on Wednesdays, 1:30-3 p.m., at the Sentara RMH Atrium in Harrisonburg. A maternal/baby care nurse for more than 40 years, Brunk is also a mother of four, grandmother of 15 and great-grandmother of four. She appreciates the opportunity to pass on her knowledge and offer support to new moms. “It’s helpful for new mothers to know they have someone to talk to,” Brunk says. “These women are often exhausted and sometimes don’t know where to turn for help.”

★

“It’s helpful for new mothers to know they have someone to talk to.”

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Among the topics the group discusses are breastfeeding, burping, calming techniques and swaddling. Brunk also teaches parents the Dunstan baby language to help them interpret the sounds their babies make. Brunk says the group, which has been meeting virtually due to the coronavirus, varies in size from week to week. All mothers, including those whose babies were not born at Sentara RMH, are welcome to attend.

BATTLING BRAIN CANCER with Grace and Gratitude In all of his 76 years, Jim Bishop had never had a serious medical issue requiring hospitalization.

A few days later, Jim went for a haircut. While he was out, Anna got a phone call from the hairdresser. “She said, ‘There’s something wrong with your husband,’” Anna recalls. Anna suspected Jim may have had a stroke and told him he needed to get checked out at the Sentara RMH Emergency Department (ED). “I firmly resisted—I felt fine,” Jim says.

This past spring, that changed. In May, his wife, Anna, noticed him behaving oddly. For one thing, after decades of line dancing, Jim was having trouble with his steps during an intermediate-level class they were taking together. “It’s all about memorizing the step sequence and rhythm—something I had never had a problem with before,” says Jim, who lives in Harrisonburg. So, the couple switched to an easier class. The second clue about Jim’s condition was stranger. One night at 3 a.m., Anna was awakened by Jim, who was up and in the shower. He said he had to meet his friend Sam at the church to get information for publicity he was working on. She reminded him what time it was and that Sam was away. “He argued with me about it, but I finally got him back to bed,” she says. The next morning, Jim drove to the church, only to find that Sam was indeed out of town. Photos for this article provided by Jim Bishop

Kind and Compassionate Care Amidst a Drastic Diagnosis At the ED, Jim’s initial tests came out normal. Then the attending physician ordered a CT scan. And there it was: a mass in Jim’s brain. He was sent immediately by ambulance to Sentara Martha Jefferson Hospital for more tests and possible surgery. After Jim had an MRI, the neurosurgeon, David Slottje, MD, told him the tumor, called a glioblastoma, in the frontal lobe of Jim’s brain was operable. Two other lesions, however, were more concerning.

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Jim underwent surgery on May 20 to remove the tumor. The next morning, he was a bit surprised to wake up in the hospital’s Intensive Care Unit. “What am I doing here?” he wondered. He spent five days—including his 76th birthday—in recovery at the hospital, before being released to home. In early June, Jim and Anna met with Dr. Slottje to discuss a treatment plan for the mass and the other lesions on Jim’s brain, which were aggressive and, due to their locations, inoperable. “We were so impressed with the surgeon,” says Jim, whose confusion had mostly cleared by this time. “He kept apologizing for what had happened to me.” Erika Struble, MD, an oncologist at Sentara Martha Jefferson, determined that Jim would need six weeks, five days per week, of radiation treatment. He also had to start taking a daily chemotherapy regimen in pill form. Fortunately, though Dr. Struble continued to monitor his case, she was able to refer his care to Heather Morgan, MD, a radiation oncologist at the Sentara RMH

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Hahn Cancer Center. Dr. Morgan developed his radiation treatment plan and managed his treatments, which kept the Bishops from having to drive to and from Charlottesville each day. “This cooperative attitude between the hospitals really helped lower our stress level,” Jim says. “We had a wonderful feeling of support and caring from the staff at Sentara RMH and Sentara Martha Jefferson.” Dr. Struble was impressed with Jim’s positive energy and active lifestyle, which includes walking on a treadmill, swimming and line dancing. Jim recalls: “She encouraged me to stay active, telling me, ‘We’re going to treat this cancer, but we want you to keep being Jim.’” Dr. Morgan took Jim’s good health into account when developing his treatment plan. “His energy level and activity level weren’t typical for his age, and I felt he could tolerate a longer, six-week treatment regimen, as opposed to the three-week regimen we normally offer older patients with the same type of brain tumor,” she explains. “Indeed, he breezed through the treatments, and his upbeat approach to life didn’t waver at any point.”

Staying Active, Positive and Grateful On the day Jim finished his radiation treatments, the Hahn Cancer Center staff rang “the bell,” and Jim had pictures taken with his caregivers. “The six weeks of treatment went faster than expected, thanks in large part to the Sentara RMH staff, who went out of their way to display care, concern and empathy,” he says. “It made a world of difference.” Since he had several weeks before the next phase of treatment would begin, he took

seriously Dr. Struble’s orders to stay active. He and Anna went on vacation to Topsail Beach in North Carolina, and he continued to take part in activities with his friends and grandchildren. Upon his return from vacation, Jim had an MRI, followed by consultations with Drs. Morgan and Slottje. The treatments thus far had exceeded their expectations. However, since the cancer was so aggressive, the physicians wanted to put him on a stronger chemotherapy drug. Jim attributes his good response to the treatments to the care he’s received—not only at the hospitals, but also from friends, family and fellow church members. Many trips to the hospital and to the Wellness Center at Virginia Mennonite Retirement Community were provided by friends. People also brought meals, sent cards and offered prayers. “He has a strong support system, which is very important,” Dr. Morgan says. Jim believes his faith, positive attitude and sense of humor have seen him through some dark days. He’s thankful for the many years of good health he’s enjoyed, and for the caregiving he has received from Anna, his wife of 54 years.

He’s also grateful for all of the things he has been able to do throughout this life, including working in communications for 40 years at Eastern Mennonite University, writing his long-standing “Bishop’s Mantle” column in the Daily News-Record, hosting a popular radio show and practicing photography. He also was a regular contributor to the RMH magazine for about 10 years. His debut column, which appeared in the summer 2006 issue, included an account of his first colonoscopy at RMH. “The article received considerable positive reader response,” Jim says, which led to an invitation to write a humor-tinged onepage essay on general wellness themes for each issue. “I thoroughly enjoyed my relationship with the publication.” As for what’s to come, Jim is taking it one day at a time. He feels that any time and ability a person has after age 70 is a bonus. Today, he’s living life to the fullest.

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Braindrops Keep Fallin’ on my Head Jim’s Perspective

Some five months after my unexpected encounter with the neurosurgeon’s knife, I remain alive and kickin’, grateful for many simple pleasures amid the upheaval of an unpredictable schedule.

maintain an active lifestyle, a positive attitude and the slightly warped Bishop humor (it runs in my family), all of which I believe have contributed to positive reports from my oncologists and neurosurgeon.

This unanticipated episode, as well as my 76th birthday on May 22, have brought these observations to the fore: •

•

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With this in mind, so to speak, I stumble on, seeking to follow several of these Ten Commandments for seniors (Moses had the first tablet that was connected to a cloud):

A reminder of the ephemeral nature of material riches versus a strong faith in God; a loving, supportive extended family; and many years of relatively good health. The importance of maintaining a positive approach and sense of humor through it all, despite the “down days.” I’m finding that laughter is the best medicine (as long as the doctors don’t charge extra for it). I’ve received a multitude of appreciative responses to the upbeat attitude I’ve sought to maintain toward my bout with brain cancer, the fearful foe that is no respecter of persons, regardless of health, gender or religious persuasion.

I have largely enjoyed, including freelance writing and photography; deejaying; and time to write a rough draft of my own obituary/ epitaph and funeral service plans. •

The serendipitous discovery that I am loved and have made a difference in the lives of many over the years. People have told me that explicitly, thanking me for my newspaper columns and my steady smile, regardless of any anxiety I may have been experiencing. Any time and ability given to me past age 70 is a bonus. For me, among those bonuses are the opportunity to do work

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•

Renewed appreciation and love for my spouse, Anna, as my primary support person through this medical saga. She quickly became my principal caregiver as my ordeal unfolded, taking notes at medical consultations, keeping tabs on the many chemo pills I ingested, and answering and replying to countless texts (which nearly short-circuited the system). Gratitude for few major side effects from my first intensive six-week round of radiation and chemotherapy. I’ve been able to

•

Talk to yourself. There are times when you need expert advice (and everyone’s welcome to my opinion).

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“In style” clothes are the ones that still fit.

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Age 76 might be the new 40, but 9 p.m. is the new midnight.

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The biggest lie I tell myself is, “I don’t need to write that down. I’ll remember it.”

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Lately I’ve noticed that people my age seem so much older than me.

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“On time” is when I get there.

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Growing old should have taken longer.

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When someone asks what I did over the weekend, I squint and ask, “Why, what did you hear?”

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I still haven’t learned to act my age, and I hope I never will.

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And one more: “One for the road” means using the bathroom before you leave the house.

Sorry if I made you flush.

AGING WELL

Vanquishing

Painful

VARICOSE VEINS

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

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

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

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AG I NG WEL L

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

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

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

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

•

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

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

Varicose Vein Prevention •

Exercise: Walking 20-30 minutes every

•

Limit sitting and standing:

•

Toe ups and calf stretches: From a

•

Watch your weight: Although weight

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

sentara.com

HEALTH MATTERS

FOOT CARE

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

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

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

LA SALUD IMPORTA

Cuidado de los

PIES para personas con diabetes

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

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

SENTA R A IN THE COMMUNITY

New Sentara Program Offers

‘Hospital at Home’

Care for Some Patients Imagine this.

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

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

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

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

SE NTA R A IN THE COM MU N IT Y

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

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

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

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

PHILANTHROPY

On-site Pharmacy

Delivers Higher Level of

Care to Cancer Patients As a clinical oncology pharmacy specialist,

John Moore, PharmD, offers a friendly and reassuring presence to patients at the Sentara RMH Hahn Cancer Center. “I get great gratification out of being able to interact with patients on a daily basis and talk with them face to face,” says Moore, who manages the Cancer Center’s onsite pharmacy. “Those who haven’t been to the Cancer Center don’t understand the benefits of having our pharmacy on the premises. It’s a huge, huge advantage.” Not all cancer centers are fortunate to have a pharmacy within their walls, Moore notes. This is but one example of the Hahn Cancer Center’s extraordinary commitment to its patients—a commitment sustained by the community’s continued generosity through gifts to the RMH Foundation. Unfortunately, there’s hardly a family in our community that hasn’t been affected by cancer. In fact, visits to the Cancer Center have grown by 17% in the past two years alone, prompting the need for renovations after

a decade in operation. The RMH Foundation has committed $1.4 million of the total project cost and seeks the generosity of donors to see the renovation project through. Although the facility’s footprint itself will not expand with the upgrades, the number of chairs at the Infusion Center will grow by 50%, from 18 to 27, to accommodate those needing chemotherapy, blood infusions or other intravenous therapy. Other enhancements will include the addition of two exam rooms to the Medical Oncology Clinic and important safety updates to the on-site pharmacy to keep it compliant with new regulations. Moore is thankful the opportunity arose for him to be part of the on-site pharmacy when the Hahn Cancer Center opened, along with the new hospital, in 2010. He oversees the preparation of chemotherapy w w w.S uppor tRMH.org

PHI LA N THROPY

and biotherapy medications along with Jamey Groff, PharmD, a fellow clinical oncology pharmacy specialist. “What’s unique is that we treat patients the same day as the physicians,” Moore says. “Visiting patients chairside, we can build relationships and trust. We help explain side effects. We assist doctors and nurses. There’s a real added benefit toward that patient relationship by having us here as an integral part of the team.” Sherrill Glanzer, the RMH Foundation’s special gifts director, says the pharmacists’ constant interactions with patients are “invaluable” when providing treatments. By being present at the Cancer Center, pharmacists can adjust medication dosages on the spot, monitor for any potential issues with allergies, answer patients’ questions, and deliver medications more quickly and efficiently. “It’s real-time treatment,” Moore says. The convenience of having a pharmacy on-site also saves patients time and prevents the need for trips to multiple facilities, Moore notes. “It should be a standard of care for pharmacies to be in cancer centers,” Moore says. “It gives patients a lot of comfort to see and talk with the people who understand and prepare the treatments they are receiving.” For the Hahn Cancer Center to continue its tradition of delivering compassionate, high-tech care to people in the Shenandoah Valley, the community will again need to answer the call for support. “We are always very grateful to our community for being generous in supporting cancer care,” Moore says. To support the RMH Foundation’s fundraising efforts for the Hahn Cancer Center renovation, please visit supportrmh.org/donate or contact the Foundation at 540-689-8545.

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“Birds of a Feather”

…Give Together

The premise is straightforward: Plastic flamingos are not something you’d expect to see at a hospital. Perhaps for that reason, at Sentara RMH Medical Center, the skinny-legged, long-necked pink creatures make the best possible mascot to attract attention and encourage charitable giving among employees and volunteers.

“People who like flamingos really like flamingos,” says Janet Wendelken, senior development consultant for the RMH Foundation. “They get noticed and just make people smile.” Each August, 180 flamingos arrive on the hospital campus to signify the launch of the Employee and Volunteer Gifts Campaign, a Foundation-led effort to give employees and volunteers the opportunity to support the hospital. The first such campaign was held in 1975. Gifts made to the RMH Foundation from the campaign and the community helped fund equipment and programs totaling $524,000 in 2020. Among such purchases, the campaign helped acquire two stretchers for the Emergency Department (ED), at a cost of more than $22,000. The stretchers help ED staff to be better prepared for any situation. Corie Shifflett, a radiology manager at Sentara RMH, is currently co-chairing her second consecutive campaign. “I’ve

P H I L A NT HROP Y

always believed that you give back to see others prosper,” says Shifflett, who will celebrate 20 years of Sentara RMH employment in January 2022. “It’s great to have an organization that’s able to help team members out in times of need.” To raise awareness of the annual campaign, the plastic flamingos show up in all kinds of places around the hospital. Some gather in groups to create heart shapes in the grass. Large flamingos are spray-painted around the hospital grounds, and a pair of large flamingo floats find a home in the hospital pond just off the patio behind the Mountain View Café. About 50 departments are represented on the campaign committee, Wendelken notes. Marsha Wetzel, a customer service representative in the business office, just finished her first campaign. “I was very honored to be asked to be a department representative,” Wetzel says. “We have an amazing group of employees who work so hard, and they want to look out for each other, as well as the hospital.” One special aspect of the employee campaign, Wendelken notes, is that “it allows for giving to the Employee Relief Fund to support our co-workers.”

And for many committee members, the most heartwarming part of the campaign comes when the fund can help a fellow employee in need. Each year, Wendelken shares the story of a different Sentara RMH co-worker who has needed help in years past. For the 2021 campaign, she highlighted the tale of an employee whose husband was sick for about 11 months, and who traveled every day to visit him in hospitals in Richmond and Charlottesville. Thanks to the Employee Relief Fund, this employee was able to apply for and receive assistance to pay for gas, car repairs and other related expenses. “This campaign is a wonderful way to support our own team here,” says Wendelken. Since 2013, when Wendelken started overseeing the employee and volunteer gifts campaign, more than 270 employees have received help through the Employee Relief Fund. And by taking care of their own “flock,” Sentara RMH employees prove they are serious about being in the profession of caring for the community. “The campaign is a great way to do a full circle—helping both the hospital and our own team members,” Shifflett says.

Rollover Your IRA for Good By taking a distribution from your IRA this year, you will likely pay more in taxes and may even reach a higher tax bracket. Rolling over part of your IRA “required minimum distribution” or “RMD” to a charity like the RMH Foundation can help reduce your tax bill while supporting our mission of elevating health care in our community.

Double the Benefits!

An IRA charitable rollover gift can benefit both you and our patients! Contact your IRA administrator to get started with your gift. While you will not receive an income tax deduction, you will not pay taxes on distributions made to us. Please inform us of your plans so we can put your gift to use where it matters the most to you. For more information, please contact Sarah Orem at SEOrem@sentara.com or 540/689-8549 w w w.S uppor tRMH.org

friends

of the RMH Foundation

Gifts received from May 1 to Aug. 31, 2021

Sentara RMH Medical Center is so grateful to have the support of generous community members. We express this gratitude and recognize the contributions our donors make through the President’s Forum, the William Leake Society, the 1910 Cornerstone Club and the White Rose Giving Circle. These exclusive giving circles are our way to honor our most generous partners who show they care about having the best medical services available in our community. Finally, to recognize your loyalty over the years, we are placing the number of consecutive years you have supported the RMH Foundation next to your name. Thank you for your support! Totals represent cumulative amounts given in 2021. President’s Forum $100,000 and above The Fred O. Funkhouser Charitable Foundation, Inc. (25)

$25,000-$99,999 Howard N., Jr. and Zanette S. Hahn (8) The Community Foundation of Harrisonburg and Rockingham County (19) Bonnie Wampler (1)

$5,000-$24,999 Helen Breeden (2) Paul and Sherry Cline Fund of the Community Foundation of Harrisonburg and Rockingham County (10) Eddie R. and Catherine Coffey (24) DuPont Community Credit Union (4) Harry F. and Margaret M. Flippo Foundation of the Community Foundation of Harrisonburg and Rockingham County (4) Donna S. Hahn (15) Dr. Charles H. and Mary Henderson (16) Hollister, Incorporated (1) Pat Messner (34) Garry and Nancy Nichols Family Charitable Fund, a Donor Advised Fund of The U.S. Charitable Gift Trust (13) Charles V. Oster (25) Schwab Charitable Fund (3) Sentara RMH Volunteer Auxiliary (40) Larry W. Showalter and the Twila and Larry Showalter Cancer Fund of The Community Foundation of Harrisonburg and Rockingham County (4)

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The U.S. Charitable Gift Trust (5) Lynn and Diane Trobaugh (14) Denise A. Whitman (18) Drs. Yuriy Zhukov and Tanya Tajouri (1)

William Leake Society $1,000-$4,999 Marcus B. Almarode (9) Alpha Phi Foundation (1) Tena M. Bibb (13) Auburn A. and Ruth D. Boyers (40) Rita Bunch (2) Thomas G, Jr. and Nellie B. Camp (3) Maryjane Chewning (7) Chick-fil-A (1) LuAnn L. Clark (24) Dr. Bruce Clemons (1) Colonel and Mrs. Peter F. Dieck (4) Dominion Energy Charitable Foundation (9) Everence Foundation, Inc. (13) Fidelity Charitable Gift Fund (10) Fraternal Order of Eagles New Market Auxiliary 4264 (3) Donna Gochenour (6) Chasity H. Godshall (13) Dr. David C. and Amelia M. Hall (11) Elizabeth Harnsberger Trust (10) Harrisonburg Downtown Renaissance (1) Sheri Heatwole and Friends (1) Ollie Heatwole Trust (2) Stan and Joni Holland (31) Integrity Insurance Group (2) Judy Jenkins (5) Tedd H. and Lora W. Jett (32)

Terry and Judy LePera (24) Beverly T. MacLeod (8) William R. Madren Trust Agreement (3) Edgar L. Miller (15) Drs. David and Heather Morgan (5) Thomas D. and Jennifer L. Rea (7) Thomas H. Rice (7) Dr. Edward Sandy and Pamela Grimm (5) Shenandoah University (1) Corie B. Shifflett (18) Richard L. and Patricia N. Shoemaker (7) Sullivan Cotter (1) Theta Iota Chapter of Alpha Phi James Madison University (5) Richard H. Torovsky Jr. (5) Janet Estep Whetzel Family (1) Robert S. Wildman (6) Kelli L. Zahn (9)

1910 Cornerstone Club $100-$999 Robert L. and Karma C. Adams (14) Laura E. Adkins (8) John C. and Mary E. Albert (1) Phyllis Albrite (7) Elizabeth Alderfer (1) Lori Alger (2) Ruth K. Alger (2) Leodegario Alonso (4) Phyllis A. Anderson (5) Anonymous for Employee Gifts Campaign (1) Emily Baker (2) Tamela J. Bare (2) Natalie R. Bass (6)

Jennifer B. Baugher (5) Erin Beeker (5) James T., Sr. and Barbara R. Begoon (18) Thomas L. Bellamy (6) Jennifer G. Bennett (8) Holly G. Berry (13) Blue Ridge Christian School (1) Colleen R. Bolander (3) Martha F. Bradfield (4) Nancy R. Bradfield (13) Linda H. Bradley (1) Loretta F. Bradley (9) Sherry L. Braithwaite (6) Abigail Breeden (4) Linda V. Breeden (2) Justin Brenneis (1) Rosemary O. Brenner (11) Carol J. Brooks (17) Donna and Pat Browne (1) Deborah E. Bullis (25) Donna E. Burch (2) Christine W. Burner (14) Judith F. Buskirk (3) Rodney E. Bussard (1) Julia L. Bynaker (5) Tammy M. Byrd (24) Sallie Campbell (3) Bonnie C. Caplinger (3) William B. Carper, Sr. (40) Lyle Scott Cassell (1) Lloyd A. Caston (1) Diana J. Catlett (6) Brenda D. Cave (10) Susan Chelgren (6) Lee E. Clapper Sr. (9) Susan E. Clark (12) Randy S. Clem (5) Brenda J. Cline (1) Comfort Inn and Suites (1) Emanuel B. Conley Jr. (8) Cassey Cook (1) Patricia S. Costie (11) Dana Crittenden (6) Alesia Cruey (4) Tina Crum (5) Deborah J. Cubbage (3) Dale L. and Sandra S. Cupp (3) Kimberly J. Curry (9) Vanessa Custer (3) Gary W. and Teresa B. Day (3) Desiree S. Dean (3) Jill Delawder (4) Dennis and Lou Dellinger (2) Donna Dispanet (1) Jerry A. Dollens-Herron (1) Jennifer S. Dove (3) Tom and Kathy Dunham (7) John J. Early (1) Frank S. Earman Jr. (9) East Coast Construction, Inc. (1) Sonya S. Eberly (20)

Jessica C. Edwards (15) Anne M. Ekdahl (10) Tami Reid Eppard (15) Dr. J. Robert and Rosalie Hartman Eshleman (5) Jackie Estes (6) Beverly S. Eye (31) Carol Ann Fields (3) Susan Foltz (1) Courtney G. French (1) Charles J. Frye (3) Byron Fulk, PA-C (3) Jason A. Funkhouser (2) Wesley S. Garber (1) Lois J. Garrett (1) Karen J. Garrison (7) Chad M. Gathers (7) Tracey A. Gentry (9) Kristy Gilliam (6) Sara E. Gingerich (12) Sherrill Glanzer (20) Harry C., Jr. and Patricia K. Glenn (4) Linda S. Gnewikow (1) Herman W. and Rosemary G. Hale (10) Marianne F. Halterman (4) Jarman L. Hammer (8) Robert L. and Faye C. Hansbrough (8) Dana Harlow (7) Kenneth T. Haskell III (14) Betty Hassler (4) Katherine Hawk (1) Joyce Coryell Hedrick (2) Wilma F. Hedrick (9) Irais Hermosillo (1) Cynthia L. Hill (8) Angela H. Hoak (14) Jeff L. and Susan H. Holsinger (36) Lanny W. and Shirley S. Holsinger (1) Amanda S. Holt (3) Dena Hoover (1) Tyler Dashiell Huddle (8) Bruce R. and Doris Jean Huffman (2) Charlinda W. Huffman (29) Donna Hurst (1) Buddy G. Hutchens (2) Lynetta Hutchinson (4) James J. Iverson (1) Anne Jernigan (1) Rebecca S. Jessie (21) JMU Phi Sigma Sigma Sorority (1) J. S. Parker Jones, IV and Diana L. Jones (2) Susan K. Justice (5) Gauhar Khurshid (1) Deborah B. Kile, DNP, RN, NE-BD (20) Jason Kirby (5) Gene E. and Ann H. Knicely (2) Sabrina H. Knight (8) Lorrie Koontz (6) Mary H. Kratz (1) Troy E. Kurtz (7) Carlissa J. Lam (1) Deanna D. Lam (11)

Letitia E. Lam (5) Mary E. Lam (3) Gary and Sheila Lam (34) Arnold L. and Elaine H. Lambert (1) Dana Lambert (1) Robin Lambert (3) Tina M. Lambert (11) Donna E. Lear (25) Eugene C. and Sherry M. Leffel (1) Junior L. Lineaweaver (5) Jo Ann S. Liskey (9) Lowe’s of Waynesboro (1) Aimee B. Lyle (16) Robert J. Lynch (6) Clarence J. Maday (7) Nancy M. Mandeville (8) Christine M. Marshall (16) Courtney Martin (2) June Martin (4) Peggy G. Mason (29) Cheryl Matthews (3) Brenda J. McCurdy (1) Ellen S. McDonald (10) Catherine M. McGowan (1) Linda T. McIntyre (19) Drs. David K. and Charlette E. McQuilkin (7) Sandra F. Meadows (18) Col. William P. and Frances A. Menefee (3) Odessa F. Merica (11) Jana R. Miller (24) Janice K. Miller (8) Stephanie Miller (1) Alison K. Minnick (5) Jill Moffett (1) Leslie E. Mohler (19) Sherry L. Mongold (10) Montezuma Church of the Brethren (1) Stacey R. Morris (25) Melinda D. Mowbray (1) Douglas J. and Yvette M. Munnikhuysen (9) Donald R. and Nancy M. Myers (3) Steve A. Nelson (21) Margaret L. Neustadt (1) Rebecca M. Nicely (13) Evelyn Ola (1) Marketia Palmer (3) Jane Parker (6) Meghan A. Patterson (13) Debra R. Pattison (10) Kristin H. Payne (14) Anthony F. Pestilli (1) Julie A. Pierantoni (3) Shannon M. Pitsenbarger (9) Alene Wright Pittman (1) Judith A. Potepan-McCarty (23) F. L. Proctor, Jr. (3) Robert J. and Virginia G. Ravera (1) Patra H. Reed (8) Steven Rehkemper (6) Renaissance Charitable Foundation, Inc. (1) Eleanor S. Rexrode (21)

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friends of the RMH Foundation Pamela Rexrode (10) Salinda F. Rhodes (3) Douglas G. Riley (2) Natalie S. Rinaca (34) Amber E. Rinker (15) RMH School of Nursing Class of 1971 (1) Beth Robbie (17) Charles W. and Patsy C. Rodeffer (3) John E. Rodes (11) Patricia D. Rodgers (14) Amy J. Rogowski (8) Ann S. Royer (14) Susan E. Rozmus (17) Melissa Ruddle Lambert (1) Jacquelyn Rufo (1) RunSignUp (7) Connie W. Ryan (3) Karen Sager (4) Winifred Salyards (2) Sarah Samuels-Thornton (5) Michael S. Scholfield, MD (2) Kathy Price Schroeder (18) Kelli N. Schroeder (17) Sierra Schwertz (Bigler) (2) Kathryn K. Scripture (18) Donald W. Seese (8) Emily I. Sherrill (6) Brandy Shifflett (1) Denise Dean Shifflett (2) Sabrina D. Shiflett (24) Ann M. Showalter (1) Elwood and Barbara Shrader (2) Kari F. Shrader (3) Terry G. and Vickie G. Slaubaugh (1) Linda Joan Slota (1) Jennifer Smiley-Gill (1) Ilene N. Smith (39) John D. Smith (3) Julie M. Smith (19) Marsha Smith (2) Tamara L. Smith (1) Tamerau C. Smith (1) Victor J., II and Cheryl B. Smith (13) Kara B. Smoker (17) Anita L. Smootz (5) Anne M. Snow (10) Brandy Sollenberger (6) Beth E. Sorrells (1) Caroline M. Spiers (10) Sammye B. Sponaugle (9) James K. and Ruth Y. Stauffer (4) Barbara K. Steele (14) Barbara K. Stickley (4) Katherine Stum (1) Ruby Styer (1) Leslie A. Sullivan (5) Ina Swartz (1) Rebecca Strickler Tate (1) Kimberly N. Teter (13) Kathy L. Toth (9) Jacqueline G. Towers (32)

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Debra R. Townsend (11) Pamela K. Tullos (14) Tonya R. Turner (3) Sherwin and Sandy Tusing (40) Marie Tyrrell (2) Carolyn S. Van Dyck (5) Stephen L. Vogen (17) Karen M. Walters (1) Sarah Ward (6) David A. and Diane L. Warren (3) Laura A. Watson (11) Merv and Marlene Webb (39) Western Governors University (1) Marsha Wetzel (1) Malinda Whitfield (2) Sarah H. Wichael (3) Rebecca Wickline and Juanita Brady (1) Katy Wilson (9) Megan Yeager (1) Helen C. Young (21) Heidi A. Zander (30) Katherine M. Zimmerman (2)

White Rose Giving Circle $500 Maryjane Chewning (7) Lou Dellinger (2) Patsy K. Garber (6) Juanita H. Gibson (5) Sherrill Glanzer (20) Brooke D. Goodwin (7) Pamela Grimm (5) Amelia M. Hall (11) Mary Henderson (16) Ann E. C. Homan (20) Ruby K. Hostetler (4) Mary Louise Leake (13) Cathy Jackson Leitner, P.L.C. (8) Beverly T. MacLeod (8) Kara A. Marshall (12) Edgar L. Miller (15) In memory of Carmen Strite Miller Margaret (Peggy) M. Miller (23) Nancy B. Nichols (13) Patricia N. Shoemaker (7) Velleda M. Vernooy (1) Susan C. Weaver (2) Valerie S. Weaver (9) Denise A. Whitman (18) Dr. Karen Wigginton (4)

Annual Support $25-$99 340 Grocery Quick Stop (1) Raed Alaziz (2) Abdulwahhab Altumah (2) Roy C. Anderson (2) Jerry O. Andes (13)

Marsha G. Andes (2) Bonnie L. Andrade (2) Pamela Armentrout (1) Jennifer Arnold (5) Robin R. Atwood (12) Andrea Baker (3) Joseph M. Beahm (24) George W. Bell (1) Rebecca Benahmed (4) Jeffrey L. and Beth A. Berg (2) Ralph N. Bergdoll (5) Danny L. and Gracie M. Berry (6) Zelda Blackwell (2) Robert W. and Elaine Taylor Blakey (2) William E. and Allene R. Blessing (8) Joyce R. Blosser (10) Terry L. Bodkin and Connie Thompson-Bodkin (6) Sharon Botkin (3) Jill Bowman (5) Kari Bowman (4) Deirdre Bowyer (1) Douglas C. Bradley (2) Rodney A. and Patricia D. Branson (8) Diana Gray (2) Diana Brittle (3) Jeb W. Brittle (1) Melanie Burgess (6) Kelly Burke (1) Teresa R. Burkholder (3) Thomas L., Jr. and Carroll P. Buskirk (4) Susan D. Cabell (10) Cynthia D. Campbell (9) Chanda J. Carrier (9) Barry and Patricia Carroll (8) Annette Cashatt (1) Kathryn L. Cheeks (2) Rebecca Chester (1) William W. Chestnut (8) Richard G. and Claudia J. Childs (6) Sherry D. Clegg (17) William Click (1) Penny C. Cline (8) Jackson P. Comer (1) James A. and Karen B. Costie (1) Charles A. Darcus (4) Jacqueline Dault (1) Thomas C. and Doreen D. DeVore (2) Ellen R. Dotas (3) Jennifer M. Downs (1) Juanita A. Durrett (14) Laurie R. Dye (16) Samuel Ellingson (6) Ron Elliott (1) William and Patricia Emerick (1) Samantha L. Emrich (3) Shawnna S. Erdos (6) Joyce E. Fields-Clark (2) Dina Fix (1) James S. and Ann B. Flora (1) Ray H. and Ruth C. Floyd (3) Sarah Fritz (1)

Catana W. Fulk (1) Margaret Fulk (2) Margaret Furr (3) Lelia L. Galvin (2) Hermilo Garcia-Hurtado (1) Michael A. and Carolyn S. Gardner (5) Dr. Linford K. and Rebecca L. Gehman (2) Jean Gerber (1) Dana L. Gibson (9) Daniel W. and Bette M. Goodson (14) Emily Green (1) Olivia Haimani (6) Robert M. Hammer (1) Emily Harper (4) Brittany Harris (1) Leslie Harris (6) Dianne Hautanen (2) Glenna Hertzler (1) Amy Hess (2) Robert S. and Dorothy M. Hiner (2) Sherrel J. Hissong (13) Brent Holl (4) Tom and Breck Hook (6) Brenda B. Hoops (14) Reuben W. Horst (2) Dewitte M. and Edna R. Hosaflook (1) Robert P. and Eloise B. Hostetler (9) Michael L. and Rose Ann Houliston (1) Patricia P. Hubbard (1) Robert Z. and Judith Huffman (1) R. Fleming and Sharon W. Jones (3) Karen Jordan (14) Elizabeth A. Kaestner (1) Philip C. Kanagy (1) Gary A. Kardos (18) Leanne Karnes (17) Larry F. and Judith Kertcher (4) Cassandra King (2) Stashia M. Kline (2) Richard A. and Barbra J. Knupp (7) Lindsey Lang (3) Kenneth O. Larson (3) Linda Larson (1) Brandy Lash (1) Gloria S. Lawson (2) John P. and Barbara Moyer Lehman (15) Angelique Y. Liskey (11) Karen T. Loker (1) Barbara L. Long (24) Harry E. and Virginia L. Long (15) Orville L. and Betty H. Long (2) Teresa L. Louden (6) Jennifer S. Lough (4) Cyndee S. Lowe (13) Carol A. Lowry (24) Luray Caverns (1) William S. and Sally A. Martin (4) Inirides J. Mattson (1) Joyce E. Maust (1) Teressa Mcclure (2) Mable S. McCullough (2)

Karen K. McInteer (1) Gail W. McKinney (1) Jack G. and Virginia K. McKinney (1) Sharon McLaughlin (2) Sally B. Meeth (6) Marie Menard (2) Julia B. Mercer (3) Brooke Metzler (1) Raven Miller (1) Rhonda R. Miller (3) Elizabeth N. Mims (7) Kristal R. Mitchell (9) Heather Moneymaker (4) Sharon Morgan (6) Victor D. and Nina B. Moroz (1) Cynthia H. Moyer (5) Ginger J. Myers (1) Joleen K. Myers (3) Gary W. and Joan W. Neff (1) Nest Realty, Shenandoah Valley (2) Mr. and Mrs. Bernard A. Nies (2) Lisa Olshove (5) Sarah Orebaugh (3) Alyssa Pacheco (1) George E. and Betty L. Painter (5) Tammy D. Pence (10) John R. and Ruby K. Petersheim (4) Phyllis A. Peterson (10) Cynthia L. Phillips (3) Eileen B. Phillips (20) Charleen C. Pinnell (4) Eunice H. Pitsenbarger (23) Rick Poland (1) Bobby E. Prophet (22) Joan Pulliam (6) Wilbert E. Raines (12) Charles R. Raisner (2) Carter R. Ritchie (11) Danett Roach (6) Lori A. Roberts (9) Kimberly A. Roby (2) Janice M. Rosenow (1) Carol M. Sacra (25) Debra E. Saylor (8) Frank B. and Shirley S. Shakespeare (12) Rawley J. and Esther H. Shank (1) Nelson W. and Martha S. Sheets (5) Kostandina Shehu (6) Cynthia J. Shifflett (3) Douglas W. and Kathy K. Shifflett (2) Harvey E. and Joan F. Shifflett (2) Lisa F. Shifflett (1) Larry and Kay Shiflett (2) Harry L. Shoemaker (12) Bruce S. and Mary L. Short (2) Shyam P. and Rameshwari P. Shrestha (4) Dr. Beverly P. Silver (12) Valerie Simmers (6) Barbara A. Simmons (1) Regina Sinclair (1) Charles A. and Linda L. Smith (1)

Dean O. and Kay T. Smith (1) Kathy S. Smith (2) Rosemary Smith (14) Stephanie L. Spaid (4) Sue S. Stalcup (3) Shannon M. Stewart (8) Dwynn M. Stovall (13) Kenneth Szmagaj (2) Marta E. Szuba (9) Jennifer L. Taylor (1) Juanita M. Taylor (39) Nikki Taylor (4) William L. Taylor (16) Elizabeth Terrebonne (1) Rebecca M. Teter (3) The Merck Foundation (8) Carrie Thompson (6) Johnny L. and Anne Thompson (33) Deborah E. Tysinger (18) Valerie B. Ward (7) Dana Waters (1) Ceci D. Weaver (10) Rachel S. Wenger (1) Louise A. White (13) Peggy Nagel White (5) Sharon Whitfield (1) Carla Williams (10) Rhonda S. Wise (24) Melissa K. Wolfe (11) Kelly Wood (1) Jerry W. E. ’Pete’ Wright (7) Richard S. and Margaret M. Wurst (6) Matilda M. Yoder (13) Monica Zavalahurtado (4) Maxine W. Zirkle (6)

Memorial Gifts Jean Armentrout Ann Coakley Virginia A. Joseph Dr. Thomas R. and Cherylen A. Martin Nelson and Linda Simmons Ruth Batten, Hospice Volunteer Betty B. McGee Bernice Bowers Margot E. Allman-Smith Bennie M. and Cathy L. Cupp John F. Breeden Linda V. Breeden Loretta Clapper Lee E. Clapper Sr. Eugene Coakley Nelson and Linda Simmons Robert (Bob) Dellinger Sr. East Coast Construction, Inc.

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friends of the RMH Foundation George E. Gilmer Richard Ling

E. Virginia Reilly John J. Early

Robert P. Hall Douglas R. and Tammy F. Caudle Linda S. Gnewikow Lanny W. and Shirley S. Holsinger

Mr. and Mrs. Warren Rhodes Jimmy J. Sr. and Carolyn R. Sheffer

Charles L. Heatwole Doris B. Heatwole Gerard “Gerry” Ernest Jacques Curtis and Margery Kite Gene Jeffers Donna and Pat Browne Gary W. and Teresa B. Day Dr. and Mrs. Peter W. Squire

Maurice F. Ritchie Frances E. Ritchie Classmates, Lana Matheny Fulk, Barbara Plum Wine, Margaret Beck Morris and Mary Houser Kyger RMH School of Nursing Class of 1971 Sadie B. Rodes John E. Rodes

Patricia Kite Carter Myers

Leo Salyards Winifred Salyards

Rosalie Leake Eddie Ney and Margee Greenfield-Ney

Gil and Carolyne Schuckman Susan L. Schuckman

Elizabeth ’Libby’ Newman Lee Larry C. and Marsha S. Howdyshell Dr. Rufus C. and Elaine W. Huffman Beverly Peratino Alene Wright Pittman Delores Reid

Joyce Miller Schumacher Mike and Dawn Claypoole John J. Early Rebecca Strickler Tate

Donald R. Litten Madeline W. Litten Russell L. McCurdy Brenda J. McCurdy Dr. Robert M. McDonald Janice Simmers Rhodes Joyce S. Michael Charles W. Michael Paulette Mills Robert E. and Mary E. Rhan Louise ’Dot’ Moomaw John H. Koontz Stephen L. Nesselrodt The Jenkins Family Lois M. Oster Charles V. Oster Richard L. Parker Jane Parker Myrtle Propst S. Walton Propst Robert Lee Pultz Sr. John C. and Mary E. Albert F. L. Proctor Jr.

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Lyman and Rosemary Seese Donald W. Seese Erik Carl Shifflett Denise Dean Shifflett My Mom and Dad Tim and Zena Shifflett Ethel S. Smith Jeffrey Lee Sorrells Beth E. Sorrells Carmen Strite Miller Edgar L. Miller William G. Toth Beatrice R. Rolon Jean Ann Wall Anne Jernigan Ruby Pearlena Walters Karen M. Walters Judy Wildman Robert S. Wildman

Honor Gifts David Baker Buddy G. Hutchens Cancer Caregivers Colonel and Mrs. Peter F. Dieck Matthew P. Cauchi, DO Denise A. Whitman Dr. Matthew Cauchi and Dr. Alan Johnson Lois J. Garrett Dr. Morris J. Fendley Bruce Robin Toms Donnie Fulks Buddy G. Hutchens Richard Haushalter Merv and Marlene Webb My Sister, Maggie Kyger, 65th Birthday Nancy Mengebier Dailey Bonnie Miller Terry D. and Linda M. Looney Martha Ross and Jerry Benson Judith S. Strickler Sentara RMH 4 East Staff Barry and Patricia Carroll Sentara RMH All Emergency Department Staff Louise R. Burtner Sentara RMH, The whole staff Bonnie L. Andrade Bruce R. and Doris Jean Huffman Robert S. Wildman Amy Ball Steele Joyce M. Ham and Family Frances Sutert Terry G. and Vickie G. Slaubaugh Michael Suter Terry G. and Vickie G. Slaubaugh Dr. T. Keith Vest Howard E. Sr. and Elizabeth F. Beall

S E N TA R A O R T H O PE D I C & S P O R T S M E D I C I N E S PEC I A L I S T S

Stephen Ernst, MD Upper Extremity Orthopedic Surgeon

Thomas Krisztinicz, MD Spine Surgeon

Sophia Leung, MD

Orthopedic Hand Surgeon

Erwin Secretov, MD

Sports Medicine Surgeon

Mark Williams, DO

Adult Reconstructive and Total Joint Surgeon

MEET THE NEWEST MEMBERS OF THE ORTHOPEDIC TEAM Sentara Medical Group is pleased to welcome five surgeons to our orthopedic and spine care teams in Harrisonburg. These surgeons join Clark Baumbusch, MD, Joel Hess, MD, Benjamin Mwanika, DO, Thomas Weber, MD, and our team of physician assistants, nurses, athletic trainers, physical and occupational therapists to bring innovative surgical and non-surgical treatments for conditions affecting the bones, joints and muscles. From knee and hip replacements to fracture care and complex spine surgery, our experienced providers develop personalized treatment plans to help patients get back to doing what they love.

Sentara Orthopedic & Sports Medicine Specialists is Taking Every Safety Precaution By: • Providing personal protective equipment (PPE) to caregivers & patients • Screening providers & office staff • Ongoing cleaning & sanitizing of all areas • Pre-screening patients before arrival • Screening patients for fever & symptoms at the front door

To schedule your appointment, call 540-689-5500 (orthopedics) or 540-689-4500 (spine) | Sentara.com/harrisonburgorthopedics Sentara Orthopedic & Sports Medicine Specialists 2509 Pleasant Run Drive, Harrisonburg, VA 22801

NON-PROFIT U.S. POSTAGE PAID PERMIT NO. 19 BURLINGTON, VT

Sentara RMH Medical Center 2010 Health Campus Drive Harrisonburg, Virginia 22801 Sentara.com Change service requested

S E N TA R A R MH ME DI C A L CE N T E R

Ranked #9 in Virginia When our neighbors are healthy – we all win. Sentara considers it a privilege to provide highquality healthcare in our community. Sentara RMH Medical Center is honored to be recognized by U.S. News & World Report as a top hospital in Virginia. Thank you to all of the providers, nurses and clinical care teams at Sentara RMH Medical Center for your ongoing dedication to the patients and families you care for each day.

Providing high-quality care and keeping you safe at Sentara by: • Providing personal protective equipment (PPE) to caregivers & patients • Screening providers & office staff • Ongoing cleaning & sanitizing of all areas • Screening patients for fever & symptoms at the front door

sentara.com/USNewsHarrisonburg