Sentara RMH Fall 2020 Magazine

SENTARA RMH Magazine

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Advancing Our Mission Sentara RMH Celebrates 10 Years of Growth

PLUS: Seasonal Flu or COVID-19?

Sentara Sleep Center Combats Sleep Disorders | Help for Varicose Veins and Spider Veins

PRESIDENT’S LETTER

2020 SENTARA RMH BOARD Joseph Funkhouser II | Chair

Jerry Benson, PhD | Vice Chair Devon Anders Morris Fendley, MD C. Wayne Gates, MD Jonathan S. Davis, MPH, FACHE Terrie Edwards Michael Gentry Douglas Moyer

SENTARA RMH ADMINISTRATORS

Douglas Moyer President

Richard Haushalter Vice President of Administration

Donna Hahn, DNP, RN, NEA-BC Vice President of Acute Care/CNE

Anthony Bruno, MD, MBA Vice President of Medical Affairs

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

SENTARA RMH MAGAZINE EDITORS

Jenn Downs Neil Mowbray CONTRIBUTORS

Luanne Austin Charles Culbertson Preston Knight Lisa Smith Jennifer L. Stover

2020:

An Exceptional Year

A

s we approach the end of 2020 and I reflect back on the past several months, I certainly do think that “exceptional” is an appropriate way to categorize the year—both for Sentara RMH and our community as a whole. I don’t feel I’m off-base by saying that, for most of us, the COVID-19 pandemic has been top of mind since March, when we first began seeing cases in our community and hospital. We’re all well aware of the disruption the pandemic has brought to our everyday lives, homes and places of work. However, it also has been a time to see people truly come together to work for the best possible outcomes in an unfortunate situation. Our collective response to the coronavirus—both as a hospital and a community—has been exceptional. Together, we’ve come a long way over the past nine months and learned a lot about courage, perseverance and helping others.

On various occasions this year, I have stated how proud I am of the way the Sentara RMH team has risen to the COVID-19 challenge, and of how our community has supported the hospital throughout the pandemic. I know it sounds as though I’m a broken record in some ways, but I really can’t say enough how honored I am to serve along each member of the Sentara RMH team and how grateful I am to everyone in the community for your ongoing generosity and support.

This year is exceptional for the hospital and the community in another way as well, because in June Sentara RMH reached its 10-year milestone of providing service at our new hospital and health campus. We originally had planned a large community celebration at the hospital to mark our 10th anniversary, but those plans had to be relinquished due to the virus. Rest assured, however, that our commitment to our mission remains firm, even in spite of COVID-19, and we look forward to continuing to improve the health and wellness of our community for decades to come.

Beginning on page 24, you can read how the hospital has advanced over the past decade by expanding the level of care we provide—through new infrastructure, new services and an ongoing commitment to providing the award-winning, nationally recognized care our community expects from us.

It has been a tough year, but in this season of being thankful, we certainly still have many things to be grateful for at Sentara RMH. I am especially thankful that we continue to provide safe, effective care, even amidst the pandemic. We’ve grown in many ways as an organization and as individuals since those early weeks in March when the virus struck.

As we head into the winter months, when we could see increases in cases yet again, I am confident that we will remain vigilant and able to protect ourselves and those who come to us seeking care. You can read more about all of the precautions we are taking to keep you safe beginning on page 19.

As always, thank you for choosing Sentara RMH for your healthcare needs. I wish you and your family a wonderful holiday season.

Respectfully,

PHOTOGRAPHY

Luca DiCecco Tommy Thompson DESIGN

Picante Creative

Doug Moyer President, Sentara RMH Medical Center

Contents FA L L 2 0 2 0

19

Seasonal Flu or COVID-19?

PLRANG ArturFurmanek/stock.adobe.com

Preparing for Both Illnesses

24

28

Advancing Our Mission

Catching 40 Winks

Sentara RMH Celebrates 10 Years of Innovation

Sentara Sleep Center

Contents

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

3

New & Noteworthy

4

Physician’s Perspective

6

Treating Aneurysms in the Brain

On-Call Advice

9

Improve Health Every Day Women’s Health

11

14

Varicose Veins and Spider Veins Prostock-studio/stock.adobe.com

24

Calendar

17

Clinical Excellence

33

3D Mammography

Health Matters

36

Practice the Basics of Infection Prevention

La Salud Importa

37

Adopte las Medidas Básicas para la Prevención de Infecciones

17

COVID Corner

Calendar

38

Coping and Even Thriving During COVID-19

14

Philanthropy

41

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THE BEST MEDICIN E

BY MICHAEL CORDELL

Lessons Learned from

O

a Year in the House

K, 2020. You’ve got some explainin’ to do. Entering this year, I assumed it would be a great one, simply because the number 2020 had a numerical symmetry that connoted terrific things. And yes, most of my decisions are based on logic like that (but don’t act like you didn’t think the same thing).

Instead, for me 2020 turned out to be the Year of the House. I went out for takeout food on March 17, and I’m not sure I’ve left my house since, with the exception of walking up to my mailbox. Obviously that’s a bit of an exaggeration—after all, who gets mail anymore?

Each January, my wife and I create a photo book to memorialize the previous year. These photo books are normally filled with pictures of various trips, concerts, hikes, great dinners out, gatherings of family and friends, and all of the enjoyable things that fill our lives. It’s now looking like our 2020 photo book will be about two pages long, and most of our “memories” from this year will be pictures of our dog, Trolley.

Although I basically never changed out of my “2020 Happy New Year” sweatshirt, I nevertheless learned a number of important things this year, despite the lack of photographic evidence to document it.

• Healthcare workers truly are wondrous individuals.

Most every healthcare worker—regardless of his or her role—has raised the bar in response to the pandemic. In 2020, healthcare workers have been much like firefighters who fearlessly rush into burning buildings, with one important difference: for healthcare workers, bravely venturing into perilous circumstances has been a daily event this year. They have been truly heroic on a regular and repeating basis.

• Human interaction shouldn’t be taken for granted, even between total strangers. Once all of this has passed—and it will pass—I’m going to take a different view of the people who serve in restaurants, provide customer service in stores and assist me with my healthcare needs, among many others.

I actually miss these complete strangers, and once I’m back in a crowded restaurant and the waitperson comes to our table, I sense our relationship will feel different. I’ll likely even want to give them an unprovoked hug, although that’s probably illegal in most states. Perhaps just a knowing nod will be more appropriate. And a sizable tip.

• My mother was right after all: Wash your hands.

• Don’t take the truly important things for granted.

That’s a lesson we’re often given the opportunity to learn, and it usually doesn’t stick. But if any year has provided us with an extended period of time to step back and appreciate the things we have—and that we perhaps take for granted—it was this one. And by “truly important things,” I mean things like people, not toilet paper.

• At the same time, I also learned not to underestimate the value of having an ample supply of toilet paper.

So bring on 2021. I like that number! I like its sequential nature. I’ve got a good feeling about next year. I feel optimistic.

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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.

Azhar Ahmed, MD Emergency Medicine US Acute Care Solutions

John R. Finch, MD Hospital Medicine Sentara Hospital Medicine Physicians

Jedediah K. McMunn, MD Cardiovascular Disease Sentara Cardiology Specialists 540-689-7400

Matthew P. Cauchi, DO Interventional Cardiology Sentara Cardiology Specialists 540-689-7400

Kevin M. Fussell , MD Pulmonary Medicine Sentara Pulmonary & Critical Care Specialists 540-689-5600

Avery E. Michienzi, DO Emergency Medicine US Acute Care Solutions

Carrie E. Dean, FNP-C Allied Health Sentara Behavioral Health Specialists 540-564-5100

Zhijie Gao, MD Hematology/Oncology Hematology Oncology Associates 540-689-7000

Benjamin P. Persons, MD Rheumatology Sentara Rheumatology Specialists 540-689-5700

Natalie N. Detrich, FNP-C Allied Health Sentara Sleep Medicine Specialists 540-564-5500

James E. Lee Jr., DPM Podiatry Surgery Harrisonburg Foot and Ankle Clinic 540-434-2949

Brooke A. Runion, FNP-C Allied Health Sentara Rheumatology Specialists 540-689-5700

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

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Sentara Hospitals Recognized as Leaders in LGBTQ Healthcare Equality

Sentara RMH Medical Center Receives Honors for High-Quality Stroke and Diabetes Care Sentara RMH has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring that stroke patients receive the most appropriate treatment according to nationally recognized, researchbased guidelines established on the latest scientific evidence.

Sentara RMH also received two related recognitions. The first is the Target: Stroke Elite Award, given for meeting quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-busting medication tPA (tissue plasminogen activator). The second recognition is the Target: Type 2 Diabetes Honor Roll Award, given for meeting quality measures that address the special needs of cardiovascular patients who have diabetes, with more than 90% compliance for 12 consecutive months.

According to the American Heart Association/ American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds, and nearly 795,000 people suffer a new or recurrent stroke each year.

All 12 Sentara hospitals have earned Leader in LGBTQ Healthcare Equality status in the 2020 Healthcare Equality Index (HEI), a national LGBTQ benchmarking tool from the Human Rights Campaign. Leader status is HEI’s highest designation and can be attained only by earning a top score of 100 in the 2020 HEI survey.

Sentara’s hospital top scores place them in an exclusive group in Virginia—only four other facilities in the commonwealth hold Leader status. Sentara Albemarle Medical Center, located in Elizabeth City, N.C., joins 20 other facilities in North Carolina with Leader status.

“Sentara is a community leader, and everyone who enters a Sentara facility—whether for work, care or just to visit—should know they are welcome, safe and valued, and will receive the highest quality of care,” says Dana Beckton, chief diversity officer for Sentara Healthcare.

Follow Us on Facebook Be in the know and stay up to date with Sentara RMH by following us on Facebook. Hear from our experts and learn tips and information to help keep you and your family healthy.

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PHYSICI AN’S PERSPEC TIVE

Treating

Aneurysms in the Brain

By Mary E. (”Lee”) Jensen, MD, FS NIS, FACR

“Your scan shows that you have an aneurysm in your brain.”

T

hose are words that would strike fear in the hearts of most people, conjuring up images of a life-threatening, “ticking time bomb” aneurysm.

Cerebral aneurysms are weak spots in a blood vessel inside the brain. They swell slowly over time to resemble a berry on a branch— hence the name “berry aneurysm” by which the condition is known. Berry aneurysms account for 90 percent of all brain aneurysms, but in a small number of people, the aneurysm may look more spindle-shaped (fusiform aneurysm) or blisterlike (blister aneurysm).

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Although all aneurysms should be taken seriously, the presence of an aneurysm in a patient does not mean that it ultimately will cause trouble. In fact, about 2-3 percent of people have an intracranial aneurysm discovered on imaging studies done for other reasons. Most of these aneurysms are tiny and carry an extremely low risk of bleeding over the person’s lifetime. For these patients, simply checking on the aneurysm periodically using noninvasive

imaging, such as a special type of computed tomographic (CT) scan or magnetic resonance (MR) scan, is all that is necessary.

However, some aneurysms do grow large enough to rupture, causing bleeding around the brain, also known as subarachnoid hemorrhage. This type of bleeding, which affects about 1 in 10,000 persons each year in the United States, carries a significant risk of disability and/or death. Ruptured aneurysms require treatment, as do unruptured aneurysms that may be prone to rupture due to their size, shape, location in the brain, or patient factors such as an underlying disease that increases the risk of aneurysm formation.

Treating Brain Aneurysms In the past, cerebral aneurysms were typically treated using an open surgical method known as clipping. During this procedure, a neurosurgeon would remove a piece of skull, gently pull back the brain to expose the aneurysm, and place a special surgical clip across the neck of the aneurysm to exclude it from the normal brain artery.

Surgical clipping was the mainstay of aneurysm treatment until 1995, when tiny platinum coils called Guglielmi Detachable Coils (GDC), which are used to close off aneurysms from inside the artery, were approved by the U.S. Food and Drug Administration (FDA). This new technique was made possible by rapid advances in the miniaturization of catheters (long, thin, plastic tubes) and guidewires that could be navigated through the arteries with the

assistance of fluoroscopy, a type of real-time X-ray guidance.

The first step in aneurysm treatment is obtaining medical imaging, through a process known as angiography, to reveal the size, location and type of aneurysm in question. A common type of angiography is cardiac catheterization, which is used to study heart vessels. A similar technique, known as cerebral angiography, is used to study the vessels of the neck and brain.

Angiography involves the injection of X-ray contrast ("dye") through a catheter that has been pushed through a tiny incision made in an artery of the groin or wrist. The catheter is then navigated into the artery that needs to be investigated.

During the contrast injection, multiple X-ray pictures are taken of the contrast as it flows through the arteries and into the veins,

creating a “movie picture” of the person’s vessels.

If the coiling method is selected to treat the aneurysm, a specially trained neurointerventionalist uses an endovascular (”through the artery”) approach to enter the aneurysm and block it off from the inside with the GDC coils.

Using catheters and guidewires designed specifically for this treatment, the neurointerventionalist carefully inserts a whole series of coils inside the aneurysm, adding smaller coils inside the larger ones to create a “coil ball” that is similar in concept to those Russian dolls that are nested one inside the other. Using this technique, the aneurysm is blocked off progressively; once no more coils can be placed, the catheters are removed and the tiny incision is closed.

Not all aneurysms are amenable to simple coiling, however.

In an aneurysm with a wide neck, keeping the coil ball within the berry formation may require the assistance of a stent, which is a flexible, perforated metallic tube used to cover the neck of the aneurysm. The stent acts as a barrier to keep the coils from escaping into the parent artery, where they could potentially block blood flow and lead to a stroke.

Selecting the Appropriate Treatment In some situations, open surgery is a better treatment option for the patient. When a ruptured aneurysm has caused significant bleeding into the brain tissue, open surgery allows the neurosurgeon to clip the aneurysm and remove the blood clot at the same time. In other sentara.com

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PHYSICI AN’S PERSPEC T I V E

ANEURYSM COILING A

B

C

A paraophthalmic aneurysm treated by endosaccular occlusion with coils Friday, October 4, 19

A. Angiogram showing an intracranial aneurysm (arrows) prior to treatment B. Picture of a GDC coil C. No filling of the aneurysm (arrows) is seen after the coiling procedure

situations, the aneurysm may not be accessible by endovascular means, or may involve important arterial branches that need to be reconstructed using clips instead of coils or stents. In these situations, the neurointerventionalist and neurosurgeon work together to decide on the best treatment approach for the patient.

In fusiform or blister aneurysms, the entire wall of the blood vessel is diseased and requires reconstruction. To treat this condition, modern devices called flow diverters, which are finely woven tubes made of metallic mesh, are placed in the affected part of the vessel. Then, over the course of several months, the inner lining of the blood vessel slowly grows over the device, incorporating the flow diverter into the wall itself. The lengthy healing process allows small arteries that arise from the diseased segment to remain open. However, due to the extended amount of time required to achieve aneurysmal healing in this way, these devices usually are not suitable for ruptured aneurysms.

Aneurysm Treatment Guidelines I wish to reiterate that aneurysms need to be treated only if they are ruptured, are causing symptoms, or have dangerous features such as a large size or an irregular dome. Aneurysms also should be treated if they are associated with certain diseases or family traits that increase their risk of rupture.

When aneurysms are found incidentally, a person’s best course of action is to consult with a doctor who routinely sees aneurysm patients. If endovascular treatment is recommended, most patients can have surgery one day and be discharged the next. Follow-up appointments consist of MR angiography (MRA) and an office visit on a yearly basis for three years, or longer if necessary. Tiny aneurysms can be followed with MRA every two or three years, as needed.

While having a cerebral aneurysm may sound scary and is understandably a cause for concern, patients and their families can take heart in the fact that today we have powerful diagnostic and treatment options that enable us to provide safe, effective, life-saving care.

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Working at the Frontiers of Aneurysm Treatment In 1990, the world’s first patient to be treated with Guglielmi Detachable Coils (GDC) underwent the procedure at the University of California, Los Angeles (UCLA), where the device was developed by Guido Guglielmi, MD, and Fernando Vinuela, MD. Lee Jensen, MD, was a member of the team that treated the first four patients with GDC coils.

In 1991, Dr. Jensen joined Jacques Dion, MD—another UCLA physician who was her mentor and part of the GDC team—at the University of Virginia (UVA).

“UVA was one of only 20 sites in the world that was asked to participate in the U.S. Food and Drug Administration (FDA) trial, which approved the GDC coil for use in patients with ruptured aneurysms who were too sick to have open surgery,” says Dr. Jensen.

Over the next 10 years, Dr. Jensen helped design and evaluate numerous “improved” coils, intended to make aneurysm treatment safer, faster and more durable. In addition, she trained physicians from all over the world on how to use the coil, as well as other devices that were developed later, such as intracranial stents used to assist in the coiling of wide-neck aneurysms.

In 2019, Dr. Jensen joined Blue Ridge Area Interventional Neuroradiology, which practices at Sentara Martha Jefferson Neurosciences and sees patients from across central Virginia, including stroke and other neurointerventional patients from Sentara RMH Medical Center.

Because of the effectiveness and safety profile of the endovascular approach to the treatment of cerebral aneurysms, the FDA ultimately approved the coil for use in all aneurysm patients who meet the criteria for having the coil procedure.

Today, most patients are offered coiling—or in some cases, another technique called flow diversion— as the first-line treatment for their aneurysm.

ON-CALL ADVICE

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

Are heartburn and acid indigestion the same thing?

A

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

Acid indigestion usually describes feelings of discomfort in the stomach or abdomen that can occur with eating.

Sometimes called sour or upset stomach, symptoms may include burning stomach pain, belching, bloating, abdominal fullness, nausea or vomiting. This condition typically occurs when the stomach is stimulated to produce acid, or when the mucous lining of the stomach fails to protect it from acid or other irritating substances, such as aspirin or ibuprofen. Symptoms also may result from eating too much or too quickly, from eating highfat foods, or from eating during high-stress situations.

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

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

certain spicy or acidic foods. As a side note, while this pain can feel like one of the classic symptoms of heart disease, heartburn actually doesn’t have anything to do with the heart.

Occasional episodes of acid indigestion and heartburn usu-

ally are relieved by self-treatment with over-the-counter medications. Avoiding alcohol and carbonated beverages and refraining from smoking also may help to relieve symptoms. However, acid indigestion and heartburn may be signs of a more serious problem like a stomach ulcer or gastroesophageal reflux disease (GERD)—particularly if symptoms last longer than two weeks.

If you experience acid indigestion or heartburn fairly often, see your healthcare provider.

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ON-CALL ADVICE

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

L

aryngitis is an inflammation of the larynx, the “voice box” that contains the vocal cords. It can be either acute (of short duration), or chronic (of long duration).

Laryngitis typically results in a change of vocal quality, often described as hoarseness or a weak voice. Associated symptoms can include dry throat, cough, a tickling sensation that leads to repeated clearing of the throat, and/ or a sore throat.

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What is laryngitis, and what causes it?

What treatments are recommended?

Acute laryngitis can result from viral or bacterial infection, such as the common cold, flu, bronchitis or pneumonia. Chronic laryngitis may result from continuous irritation of the larynx brought on by heavy smoking, excessive alcohol consumption or gastrointestinal issues like acid reflux. People who constantly use their voice also can irritate their vocal cords and experience laryngitis. Voice changes also may be caused by benign or malignant growths on the a7880ss/stock.adobe.com vocal cords.

Frequently effective self-treatment measures for acute laryngitis include the following: • Rest your voice and avoid talking as much as possible to give the inflammation a chance to subside.

• Avoid smoking or drinking alcohol or caffeine, since those agents can dry out and irritate the vocal cords.

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• Drink plenty of water and use a humidifier to maintain moisture and lubrication in the throat.

• Cover your mouth with a scarf or mask when going out in extremely cold weather.

• Moisten your throat by sucking on lozenges or gargling with saltwater.

A healthcare provider should be seen in cases where there is difficulty swallowing or breathing, or if you develop a high fever with laryngitis. Voice change that persists for longer than 3 weeks should be evaluated by a physician to determine the underlying cause.

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IMPROVE HEALTH EVERY DAY

FLU SHOTS

Are Even More Important This Year With the COVID-19 pandemic still among us, and given the medical complexities the disease can produce, getting your flu shot early this year is crucial. Since many flu symptoms are similar to those of COVID-19, getting a flu vaccination could help prevent potential confusion about any symptoms you may experience in the coming months. Also, preventing flu will help save lives and preserve precious healthcare resources.

People can get the flu and COVID-19 at the same time, according to the Centers for Disease Control and Prevention, and both illnesses can quickly become life threatening. Research shows that flu vaccines reduce the risk of having a more serious case of flu, and also result in fewer hospitalizations and deaths.

So, getting the flu vaccination this fall is more important than ever. If you haven’t yet had your flu shot, talk to your healthcare provider.

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I MPROVE HEALTH EVE RY DAY

TEMPERATURES

RISING:

Understanding

FEVER

Tips for a Great

Night’s Sleep

Getting enough sleep is essential for your good health and wellbeing. Adults usually need about seven to nine hours of sleep each night, and people over 65 need seven to eight hours per night. Babies, young children and teens, however, need even more sleep to enable proper growth and development.

Continual sleep deprivation can weaken your immune system, reduce your mental sharpness, affect your performance in school or on the job, and make you more susceptible to accidents.

If you have trouble getting a good night’s sleep, consider these tips: • Avoid eating heavy meals and drinking alcohol or caffeine for at least two to three hours before bedtime.

• Avoid sleeping with the TV, radio or other electronic devices on in your room.

• Limit naps to 10-15 minutes in the early afternoon, and avoid napping too close to bedtime.

• Get regular physical activity for at least 30 minutes per day most days of the week—but not right before going to bed.

• Maintain a regular sleep schedule by going to bed and getting up around the same time.

• Keep your bedroom dark and cool while you are sleeping.

• Make sure your mattress and pillow are comfortable and conducive to restful sleep.

• Before going to bed, practice meditation, prayer or deep breathing; take a relaxing bath or shower; or engage in some other relaxation technique to help you calm down from the day’s activities.

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Is a temperature of 99.9 degrees a fever?

When does a baby’s temperature reach the danger point?

Fevers are the body’s way of fighting off infection. Just as we heat water to sterilize it, the body heats up to kill germs.

The average body temperature in adults ranges from 97-99 degrees. Clinically, a temperature is considered a fever when it reaches 100.4 degrees or above in adults and children.

In babies three months old and younger, a temperature of more than 100.4 degrees should be treated as a medical emergency because it could indicate the presence of sepsis, a severe, potentially lifethreatening infection.

In otherwise healthy adults and older children, you can try treating a fever with

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Consider Gentle Exercise to

Help Relieve Chronic Stiffness and Pain

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home remedies first. Take medications like acetaminophen and ibuprofen, or try other remedies like cool compresses or a cool bath. If the fever does not go away within 48-72 hours, or if it keeps rising within that time to above 103 degrees, seek medical help.

Adults and older children should see their medical provider if they have a fever with a serious underlying medical condition, a new rash, pain with urination, a surgical procedure in the last 14 days or a weakened immune system. Also see the doctor if your fever comes and goes for up to a week or more, even if the temperature is not high. Any time a temperature is of concern—particularly in infants and younger children—see your physician.

During the COVID-19 pandemic, a temperature of 100.4 degrees or higher may be a sign of coronavirus infection. If you think you may have been exposed to the COVID-19 virus, or if you have other respiratory symptoms or a loss of taste with your fever, call your healthcare provider for advice about the need for testing.

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

Arthritic joints often feel better when they undergo regular movement, so engaging in gentle exercises can help keep you from stiffening up.

While sitting in a chair, try bending and straightening your legs for 20 repetitions, three times per day or more.

Gentle strength training with weight machines, dumbbells or even just your own body weight improves circulation, muscle tone and strength. Regular strength training also boosts your metabolism, helping you burn calories more efficiently for better Syda Productions/stock.adobe.com weight management. Weight loss can help relieve the stress on joints and possibly help ease joint pain.

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

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

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

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WOMEN’S HEALTH

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VEINS

Vexing You? What You Can Do about Varicose and Spider Veins Varicose veins and spider veins—those red, purple and blue lines and webs visible just below the surface of the skin—can be an unsightly nuisance. Or worse.

While the biggest threat posed by most such veins is cosmetic, varicose veins can potentially turn into an issue that requires medical treatment.

Lewis V. Owens, MD, a vascular surgeon at Sentara Martha Jefferson Hospital, explains why veins can develop problems.

“Arteries take blood away from the heart, while veins return blood to the heart,” he says. “Arteries are usually more efficient because they have a robust pump: the heart. Veins don’t have that powerful pump and have to work against the force of gravity, so they can become dilated, weak and inflamed.”

Veins also have valves, he adds, which can become a source of problems.

Similar in appearance to varicose veins, spider veins carry less potential for harm. Somewhat hereditary in nature, according to Dr. Owens, spider veins

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develop due to inadequacies in the elastic tissue of the small valves that primarily function in veins to keep blood moving back toward the heart.

“The valves go up the legs like a stepladder,” says Dr. Owens. “But if the valves get leaky or incompetent, veins can get bumpy and inflamed.”

Spider veins are common, affecting about 25 percent of the adult population.

What Causes These Problems?

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“There are many theories about causes,” says Christine Ou, MD, a vascular surgeon at Sentara RMH Medical Center.

“Previously we thought females more frequently developed varicose veins, but now we know that men get them quite often, too.”

Dr. Owens notes that although men are just as prone to varicose veins as women, more women come in for treatment.

“They’re more of a cosmetic problem than anything else,” Dr. Owens adds, “so we treat them for aesthetic purposes.

Women, in particular, often don’t like the way spider veins look.”

People at risk for varicose veins include those who are overweight or pregnant, and people like teachers, hair stylists and nurses whose professions require them to stand for prolonged periods of time, according to Dr. Ou.

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Age can be another factor contributing to weakening of the veins, as can hormones and sitting for long periods of time.

Varicose veins may start off looking similar to spider veins, but worsen over time. They can start to itch, burn and swell, and may cause sensations of heaviness in the legs.

As varicose veins worsen, bumps and bulges may emerge under the skin and lead to additional problems. In some cases, the skin may break down, allowing damaged or weak veins to erupt into a venous ulcer that looks like a wound. Bulging veins also may result in thrombosis (blood clotting) in surface veins. Another condition that can arise is phlebitis, in which the veins become inflamed and may block blood flow.

To Treat or Not to Treat?

While many problems with varicose veins probably don’t need to be treated, the condition can become a nuisance when veins become uncomfortable, itchy or swollen.

There are three general approaches to addressing varicose veins, according to Dr. Owens.

“First, you can do nothing—but the condition will progress,” he says. “Second, you can take some conservative measures, including exercising, losing weight, wearing compression stockings and elevating the legs.”

Weight loss and exercise may help relieve varicose veins by improving blood circulation, he explains. Compression stockings can help by assisting the pumping action of the veins in the calf muscles. Elevating the legs can facilitate blood flow upward from the ankles.

“The veins work against gravity,” says Dr. Owens, “so elevating the legs and exercising help augment the pumping action in the calf muscles.”

“I’m pretty conservative in treating varicose veins because all that most patients need is compression and elevation,” Dr. Ou says. “However, for a number of reasons, sentara.com

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W O MEN’S HEALTH

some people can’t tolerate those measures.”

Elderly people, for instance, often have difficulty in getting compression stockings on and off, so Dr. Ou often explores other conservative options with them.

Doing nothing or taking conservative measures is appropriate for most patients.

However, for those who experience significant discomfort, bleeding, open sores or superficial thrombosis, Dr. Owens says medical treatment—the third option—may be necessary.

Treating Spider and Varicose Veins To treat spider veins, cosmetic sclerotherapy is usually the most effective option. During this outpatient procedure, a special sclerosing solution is injected into the spider vein. The needles used are extremely thin—the size of a human hair—so the injection is well tolerated by nearly all patients. The solution causes the vein to collapse, and the body starts absorbing the vein until it eventually disappears.

The blood is then redirected to healthy veins, leading to improved circulation.

“It’s not the ‘fountain of youth,’ but sclerotherapy does a good job with spider veins,” says Dr. Owens.

Topical laser treatments are another option for spider veins, but that technique is much more expensive.

As for varicose veins, about 25 percent of patients require treatment, according to Dr. Ou. Since patients differ in terms of symptoms, expectations and goals, there’s no one “right” way to treat everyone, and there are

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many treatment options, Dr. Ou adds. Fortunately, since surface veins are not as important to blood flow as deep veins, procedures generally do not affect circulation.

Before undergoing more aggressive treatment, patients with varicose veins will have a physiologic ultrasound to assess valve function for leaking or incompetent valves. Then patients will be asked to wear compression socks for several months. If this conservative approach fails, other options will be considered.

Endovenous (“inside the vein”) laser treatment is a widely used procedure that offers excellent outcomes with a low complication rate, says Dr. Ou. During this procedure, which takes about 60 minutes and is performed in a clinical setting under local anesthesia, the physician heats the inside of the valve-incompetent vein, which causes it to seal shut and gradually disappear.

Another treatment for varicose veins is transilluminated powered phlebectomy, a minimally invasive technique in which the vascular surgeon

uses two small tubes called cannulas. The tubes are inserted through a minimal number of tiny puncture sites to localize and directly visualize varicosities (the areas of bulging) and assist in their complete removal. This is a useful technique for patients who are not candidates for endovenous catheter therapies.

Although these and other treatments can be very effective, people with a genetic predisposition to valve insufficiency can expect to have recurring problems, says Dr. Owens.

“If you’re born with valve problems, you can never take care of it 100 percent,” he cautions. “There will likely be ongoing issues.”

For this reason, most patients who undergo surgery for varicose veins return for further treatment within two to five years.

“Thankfully, however, these vein conditions are rarely life threatening,” points out Dr. Ou. “Whether through conservative measures or more advanced techniques, patients with these issues can achieve reduced symptoms, improved cosmetic appearance and enhanced quality of life.”

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 Teen Pregnancy Support Group (virtual group) • New Moms Ask a Nurse Support Group (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. sentara.com

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calendar

Vascular Screening For people 50 and older with known cardiovascular disease or risk factors (high blood pressure, diabetes, smoking or high cholesterol), Sentara RMH Heart and Vascular Center’s vascular screening checks for vascular disease that can lead to stroke, abdominal aortic aneurysm (AAA) and peripheral artery disease. Appointments are available on Monday and Tuesday mornings: 8:15 and 9 a.m.; advanced registration is required. To learn more, go to Sentara.com. To register, call 1-800-SENTARA. A physician referral is not required.

Dec. 14—Mount Solon Pentecostal Church Dec. 15—Elkton Area Community Center Dec. 16—Pleasant View, Timberville Dec. 17—Cargill, Timberville Dec. 18—Grottoes Food Lion Dec. 29—Walmart, Luray Jan. 8—Rockingham County Schools, Harrisonburg Jan. 12—Coors, Elkton Jan. 14—Whitewave, Mount Crawford May 5—Broadway High School

Women’s Services Mammography Van Schedule Call 540-689-6000 or 800-277-1021 to schedule your mammogram at the following locations:

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.

Nov. 24, Dec. 21, Dec. 30—Sentara East Rockingham Health Center, Elkton Nov. 30—Georges, Harrisonburg Dec. 1—Cub Run Elementary School, Penn Laird Dec. 2—Montevideo Middle School Dec. 3—Virginia Mennonite Retirement Center, Harrisonburg Dec. 4, Dec. 22—Sentara Mount Jackson Health Center Dec. 7, Dec. 23—Sentara Timber Way Health Center, Broadway Dec. 8—Munsey Medical Center, Staunton Dec. 9—Bridgewater Health Center Dec. 10—Dairymen Specialty, Harrisonburg Dec. 11—Carilion Family Medicine, Weyers Cave

Sentara RMH Wellness Center 2500 Wellness Dr., Harrisonburg

Lifeguard Certification Classes For ages 16 and older. Call 540-564-5698.

Sentara RMH Medical Center offers a variety of classes and seminars throughout the year.

For a complete list and more details, visit Sentara.com.

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Seasonal Flu or COVID-19?

Sentara RMH Infectious Disease Team Prepares for Both Illnesses When the COVID-19 pandemic took root in March, Sentara RMH Medical Center, much like hospitals all across the world, worked tirelessly to understand the new strain of coronavirus and plan for the impact it would have on patients, healthcare workers, the hospital and surrounding communities. sentara.com

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This fall and winter, Sentara RMH will face yet another challenge: treating coronavirus and seasonal flu cases at the same time. Since both are respiratory viruses with similar symptoms, distinguishing between the two could be challenging for both patients and caregivers. Depending on the diagnosis, treatment likely will take different paths.

With more than six months of experience in and data from treating COVID-19 patients, infectious disease experts at the hospital are confident in their strategies for handling both the flu and coronavirus effectively.

“The difficult part of the pandemic was that when we started seeing cases, we didn’t know much about the virus,” says Parag Patel, MD, an infectious disease specialist at Sentara RMH. “We didn’t know how it behaved, how it spread, what kind of symptoms it produced and what kind of testing we needed to do. There were so many unanswered questions to address in a short period of time.”

With new medical data shared frequently not just within the Sentara Healthcare system, but throughout the world, Dr. Patel is confident they have the systems and protocols in place to tackle both illnesses.

“Compared to last year, the flu season will be more challenging due to COVID-19,” Dr. Patel says. “But hopefully we will have more medications available for the coronavirus.

Having plenty of personal protective equipment on hand will help, too.”

Notable Differences Flu season typically peaks each year in January or February. So when doctors first started diagnosing patients at Sentara RMH with COVID-19 in March, they were still seeing a small amount of seasonal flu, according to Becky Brubaker, Sentara RMH infection control practitioner.

Fever, body aches, cough, headache, sore throat, and runny or stuffy nose are all symptoms shared by the two viruses, as well as by the common cold. One of

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• Incubation period: Symptoms appear one to two days after exposure with the flu. With COVID, the average time for symptoms to appear after exposure is five days, but this period can range from two to 14 days. People also can spread COVID-19 to more people and for a longer period than is the case with the flu.

• Asymptomatic cases: As many as 80% of patients diagnosed with COVID-19 have a mild case, or do not experience symptoms at all, Dr. Patel says. With the flu, most patients experience the telltale signs.

• Taste/smell: Many people diagnosed with COVID-19 experience a loss of taste or smell. In fact, loss of taste and smell was the leading indicator of COVID-19 in a U.S. and British study involving 2.6 million people who reported symptoms on a smartphone app. Flu typically does not cause this loss.

• Populations affected: Severe cases of COVID-19 have developed primarily in the elderly, people with

compromised immune systems and those with other health problems. Children have had much milder cases overall, Dr. Patel says. That’s not true of the flu, which affects younger age groups more often.

• Superspreading: Although the flu is a contagious illness, it doesn’t have the same “superspreader” tendencies as the coronavirus.

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the most significant differences between COVID-19 and the flu, however, is how quickly flu symptoms appear.

“With the flu, you can feel OK one minute, and the next moment you have developed a fever and feel terrible,” Brubaker says. “You’ve got a temperature of 102, you’re feeling bad and you’re wondering what in the world is going on— because when you got up in the morning, you felt fine.”

With a COVID-19 infection, patients tend to feel symptomatic more gradually.

Other differences between COVID-19 and the flu include:

How Do These Viruses Spread?

Both the seasonal flu and the coronavirus are spread through droplets in the air.

“These droplets get injected into the air when infected people sneeze, cough or talk,” Brubaker explains. “Then others can inhale them, or the droplets can get deposited on the mucous membranes in our mouth, nose or eyes some other way, such as by touch.”

With the flu, researchers know for sure that people also can become infected by touching an object that someone has just sentara.com

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sneezed or coughed on, and then touching their own nose, mouth or eyes.

Although experts believe COVID-19 can spread via objects as well, it’s actually transmitted primarily from person to person, according to the Centers for Disease Control and Prevention.

However, COVID-19 is more contagious than the flu, according to Dr. Patel.

“With the flu, each person can pass it on to one or two people,” he says.

“With COVID, you can spread it to two to three people. So that’s almost double the rate of spreading.”

COVID-19 is also more deadly for certain patient populations, in part because with a new virus, people have no built-up immunities to fight it. What makes COVID-19 so challenging to treat is that it has mutated and can attach to the lung surface, causing inflammation, Dr. Patel says.

The mortality rate for people who contract the flu is 0.2%, Dr. Patel says. Right now, statistics show the mortality rate for COVID-19 at 2-3%. Due to the high number of unreported asymptomatic cases, that number will drop, but likely will remain higher than the mortality rate for the flu, he adds.

Living in a “hot spot” with a relatively high infection rate increases a person’s chance of contracting the coronavirus, Dr. Patel notes.

“We’ve gotten accustomed to running errands and going to work even when we feel bad,” Brubaker says. “Now we’re being asked to stay home when we don’t feel well, and that should help stop the spread of the flu, too.”

Unlike during the H1N1 “swine flu” outbreak in 2009, today people can more easily avoid crowded places like stores and workplaces, thanks to increased options for online shopping, curbside pickup and working from home.

“I’m hoping all these steps will lead to a reduction in flu cases this year,” Brubaker says.

Flu Vaccine Key to Staying Healthy Of course, the No. 1 defense against flu is the annual flu vaccine.

“Whether it protects you from getting the flu entirely or lowers the severity of symptoms, the vaccine definitely reduces hospitalizations and deaths from flu-related illnesses every year,” says Brubaker.

During the 2019–2020 flu season, the Slowing the Spread flu virus infected 11,964 people in Virginia, of Both Viruses according to the Virginia Department of The good news is that the Health. Each flu season, the vaccination is precautions people are taking to modified to combat the strains of the virus slow the spread of COVID-19— researchers predict will be in circulation. such as wearing a covering over After receiving the flu vaccine, it takes xtock/stock.adobe.com the nose and mouth, practicing about two weeks for antibodies to develop in social distancing, avoiding large crowds, the body that can fight off a flu infection. That’s why and frequently washing hands with soap and doctors recommend getting vaccinated well before water—also can limit the flu from spreading. the virus is active in your area.

Another precaution people are taking “It’s important to put a flu shot reminder on more often now, likely due to the COVID-19 your calendar, just as you do for a seasonal event,” pandemic, is staying home when they feel sick.

Brubaker says.

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How Sentara RMH Hospital is Keeping You Safe Flu patients also can benefit from antiviral medications like Tamiflu that can shorten the duration of illness, health experts say. Similar medicines for coronavirus are still under development.

COVID Care While researchers are working tirelessly to develop a vaccine for COVID-19, Dr. Patel says the knowledge healthcare teams have gained from treating coronavirus patients has improved the effectiveness of care.

At the beginning of the pandemic, screening policies, instructions for isolating patients and guidelines for treating patients changed every few days as hospitals made adjustments. Now hospitals have standard procedures in place that have been developed and tested over time.

Medications used to treat COVID-19 patients also have evolved as the pandemic progressed. That knowledge will make a difference in the readiness of healthcare teams to face the concurrent flu and COVID season, Dr. Patel adds.

“I’m hopeful we’ll have a mild seasonal flu season,” Brubaker says. “And if we can get a safe, effective coronavirus vaccine by wintertime, we should be looking pretty good. Time will tell, but I’m optimistic.”

Everyone entering the hospital—staff, patients and visitors—is screened for COVID-19 with a temperature check.

Staff, patients and visitors must wear a mask that covers the nose and mouth.

In the Emergency Department, patients suspected of having COVID-19 are immediately separated from other patients.

If you have a surgery scheduled, you’ll likely be required to take a COVID-19 screening test to prepare for surgery.

Fewer chairs are available in waiting rooms, and magazines have been removed to avoid transmission via high-touch objects Housekeeping uses enhanced cleaning protocols recommended by the Centers for Disease Control and Prevention for cleaning and disinfecting high-touch surfaces in patient rooms and common areas.

Besides using disinfectant products, the hospital also uses ultraviolet light disinfectant technology.

To reduce congregating traffic in the cafeteria, fewer tables are now open for seating, and more graband-go food options are available.

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Advancing Our Mission Structural Heart Surgery

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Sentara RMH Celebrates

Open House Ribbon Ceremony

years of Innovation on New Hospital Campus

O

n June 22, 2010, RMH staff members experienced a real sense that “we’ve arrived” as they safely moved 95 patients from the old hospital in Harrisonburg to the new state-of-the-art hospital, billed as a “destination for health and wellness,” on an expansive 254-acre campus just outside the city limits. The years of construction and months of planning for a safe patient move had finally come to fruition. RMH was securely positioned in its new home, ready to begin “a second century of service,” words hospital leaders frequently repeated when explaining the decision to relocate. Landlocked between a century-old residential community and James Madison University, the original location had no room for expansion. However, with a rapidly growing local community, RMH was looking for effective, patient-centered ways to grow its services to meet increasing demand.

Today, the first decade of that second century has just ended, and it has been anything but static. Over the past 10 years we’ve seen the addition of new buildings, new partnerships and new healthcare services as the rule, not the exception. And through it all, Sentara RMH has remained true to its promise and mission of improving health every day.

New Buildings, Smart Design

Wound Healing Center

During a June 2010 open house, community members lauded the new hospital as a breathtakingly beautiful facility, with its large windows, gorgeous views, warm interior colors, private patient rooms with large restrooms, and beautiful artwork. Sixteen days later, William Blodgett, the first patient to be moved to the new facility, commented that he thought he was being transported to a new hospital. “I didn’t sentara.com

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Electrophysiology

know I was going to the Astor,” he said. “This room is as fine as any you would find in any hotel.”

But the intention of the new hospital was not merely to impress.

“It was all carefully planned to provide a calm, soothing environment that promotes healing,” says Donna Hahn, DNP, chief nurse executive at Sentara RMH. “In addition, the layouts and locations of various departments inside the hospital were intended to support and enhance the efficient delivery of care to our patients.”

Three years later, in 2013, the Sentara RMH Funkhouser Women’s Center opened, incorporating the same aesthetic and design goals to support the hospital’s healing mission. The new center brought together an array of women’s health services, including mammography and the breast surgery clinic; bone density screening; and the Image Recovery® Center, an integral part of the services Sentara RMH offers to cancer patients—especially women—who are dealing with hair loss, scarring and other appearancealtering treatments.

A third building, the outpatient Orthopedic and Advanced Imaging Center, opened on the health campus in January 2016 as a “destination center” where patients can get all their orthopedic, sports medicine, outpatient imaging, hand, spine and rehab services under one roof.

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Merging with Sentara Healthcare

“The Advanced Imaging and Orthopedic Center, like the other buildings on campus, was designed and built with efficiency in mind,” says Tom Weber, MD, an orthopedic sports medicine specialist who practices in the building. “Its design supports our mission of providing care that is centered on patients’ needs, as well as convenience for patients and staff.”

Celebrating a New Partnership and 100 Years of Service

Just months after moving to its new location, RMH announced its plans to merge with Sentara Healthcare, an innovative, community-focused, not-for-profit organization founded in 1888 in Norfolk. In May 2011, RMH became the ninth hospital to join the Sentara system.

A primary theme of the centennial celebration was the long tradition of healthcare excellence that had been practiced at the hospital since its founding. This tradition included the RMH School of Nursing, which opened with the hospital in 1912 and quickly established a statewide and regional reputation for producing excellent nurses.

Later, the RMH School of Radiologic Technology and the School of Medical Technology were opened, soon achieving similar reputations for excellence.

“Clearly, the partnership between Sentara and RMH represented the merger of two established providers of innovative, safe, high-quality care, with similar missions and commitments to serving the local community,” says Doug Moyer, president of Sentara RMH. “RMH has been privileged to adopt many evidencebased best practices from our sister Sentara hospitals, and we’ve also contributed several to the entire system. We enjoy the shared expertise of multiple hospital administration teams, nursing teams and medical groups, helping us to ensure that we remain innovators in health care.”

Sentara RMH was able to open the Funkhouser Women’s Center and the Advanced Imaging and Orthopedic Center more quickly, Moyer adds, thanks in part to funding contributed

by Sentara Healthcare.

New Services, New Capabilities

A month after the new hospital opened, Robert VerNooy, MD, who had recently joined the medical staff, performed the first electrophysiology procedure at Sentara RMH in one of the hospital’s four new cardiac intervention suites. Electrophysiology is a cardiology subspecialty that corrects irregular heart rhythms like atrial fibrillation, one of the most common heart arrhythmias.

Another significant advance in local cardiac care occurred in 2016, when Sentara RMH Heart and Vascular Services started its structural

heart program. Structural heart disease includes conditions—such as atrial septal defect, atrial stenosis (narrowing of the atrial valve) and leaky heart valves—that compromise the integrity of the heart’s valves or chambers, notes Stan Holland, MS, RRT, FAARC, director of the cardiovascular service line.

“With the addition of these two subspecialties, Sentara RMH offers procedures locally that mostly only hospitals in larger urban areas are able to provide,” adds Holland.

In 2013, the Sentara RMH Wound Healing Center began seeing patients with chronic, difficult-to-heal or nonhealing wounds, such as diabetic foot ulcers, arterial and venous ulcers, pressure ulcers, and wounds following surgery or cancer treatment. The new center featured two hyperbaric oxygen therapy chambers to facilitate the healing process of certain chronic wounds.

“This was the first dedicated wound care center in our area,” says Tamlyn Ogden, director of the Wound Healing Center. “A valuable resource where local providers can refer patients with difficult wounds for advanced therapy, the Wound Healing Center uses a holistic approach in treating patients and their underlying conditions, helping to prevent amputations and permanent disabilities.”

Additional services that have been added over the past decade include genetic counseling and testing for cancer patients, low-dose CT scans to screen for lung cancer, 3D mammography in the Funkhouser Women’s Center and, in partnership with Sentara Martha Jefferson, neurointerventional services for stroke patients.

Award Winning, Nationally Recognized Health Care

In December 2014, Sentara RMH received the highest recognition

years

possible for the nursing profession when the American Nurses Credentialing Center (ANCC) announced that the hospital’s nursing team had been awarded Magnet® designation for its sus-

Accreditation Program of the American College of Surgeons.

In 2019, the Wound Healing Center received national recognition as a Healogics® Center of Excellence. And

Orthopedic and Advanced Imaging Center

tained excellence in nursing care.

The designation was granted for four years, during which time Sentara RMH was closely monitored for continued compliance with ANCC standards. In June 2019, Sentara RMH received its second Magnet designation.

“A Magnet hospital is one that has met the very specific and high standards of the ANCC, and Magnet status recognizes the entire hospital for its excellent care,” says Hahn. “It is a validation of the superior quality of our care and of the positive impact that care has on our patients and their families—and only 9% of U.S. healthcare facilities have achieved this recognition.”

In addition to Magnet recognition, Sentara RMH was designated as a Primary Stroke Center

by DNV, a healthcare accrediting agency, in 2012. That same year, the hospital’s bariatric weight loss program received Center of Excellence accreditation from the Bariatric Surgery Center Network

in recent years, the hospital’s heart care team and stroke care team have received Get With the Guidelines® achievement awards from the American Heart Association/American Stroke Association for the excellent care they provide.

Looking Ahead

If the founders of the original Rockingham Memorial Hospital could see the Sentara RMH of today, there is much that would astound them—our minimally invasive surgery, our advanced medical imaging, our targeted cancer treatment and our lifesaving heart care. But they would certainly find familiar the hospital’s commitment to providing safe, compassionate care to those in need.

As the 21st century unfolds, Sentara RMH is well positioned to add to its accomplishments and continue to meet the community’s growing healthcare needs. sentara.com

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40 WINKS

How the Sentara Sleep Center Combats Sleep Disorders Aaron Figgins thought he was a good sleeper.

This hard-working farmer from Mt. Crawford seldom, if ever, awoke in the middle of the night and usually got seven or eight hours of sleep per night—essential for a man engaged in hard physical labor. So if he was sleeping soundly, why was he unbearably tired throughout the day?

Figgins, 32, first suspected that he wasn’t, in fact, such a good sleeper when his wife began waking him up in the middle of the night.

Rude Awakening “She could tell that I wasn’t breathing,” he says. “I’d just stop breathing altogether, and she would have to wake me up to get me going again.”

But the days were the worst. Figgins was perfectly exhausted all day long.

“I would get up in the morning after having slept for eight hours, and it felt as if I hadn’t slept a bit,” he recalls. “It was as if I hadn’t gone to bed at all. I would drag all day long. In the afternoons, when I had to drive between farms, it was almost impossible to stay awake. In fact, I know I fell asleep at the wheel several times. That worried me—plus the fact that I operated tractors and heavy equipment all day. I could easily have had a fatal accident.”

“My livelihood depends on my driving,” he continues. “If I can’t stay awake and drive, I can’t work. I had to figure it out.”

Figgins’ doctor referred him to the Sleep Center at Sentara RMH Medical Center—a state-of-the-art facility accredited by the American Academy of Sleep Medicine that provides evaluation, diagnosis and treatment of disorders that occur during sleep, as well as disorders that affect alertness. In late May 2020, Figgins checked into the center for his overnight sleep evaluation by a team of board-certified sleep medicine physicians and technologists.

“They hooked me up to a series of monitors, and I went to sleep,” Figgins says. “The problem revealed itself very quickly. The monitors showed I stopped breathing 31 times an hour, and the diagnosis was severe obstructive sleep apnea.”

According to the Mayo Clinic, obstructive sleep apnea (OSA) occurs when the muscles of the throat intermittently relax and block the airway during sleep. One of the noticeable warning signs of OSA is snoring; another is not breathing normally during sleep.

Fouzia Siddiqui, MD, FAAN, medical director of the Sleep Center, says there are several causes of OSA, including a person’s anatomical features, the positioning of the person’s neck, the size of the tonsils and size of the tongue. sentara.com

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exhaustion and excessive tiredness during the day can lead to inactivity, which contributes to obesity and weight gain.

A Breath of Fresh Air With 31 instances of sleep disruption per hour at night, Figgins’ case was severe enough that no other option than the “gold standard”—the continuous positive airway pressure (CPAP) machine—was considered as a treatment. The CPAP produces a continuous, pressure-controlled flow of air that travels through a hose and into a mask worn by the sleeper.

The air keeps the sleeper’s airway open throughout the night, thereby eliminating snoring and instances of breathing cessation.

Figgins bought his CPAP locally and began using it in early June, with instructions to use it at least four hours per night. He says sleeping with the CPAP took some getting used to, but eventually he was using it throughout the night and getting as many as seven hours of good sleep.

“I have noticed a huge difference,” he says. “I used to wake up in the morning with a headache. My headaches have just about disappeared. I can now work throughout the day, all day long, and I don’t get tired. Best of all, I’m no longer sleepy on the road.”

Figgins’ wife is also happy with his improved situation. “She can now get some sleep and not have to worry about me,” he says.

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“Some of these factors are genetically determined,” notes Dr. Siddiqui. “The next most common cause of OSA is being overweight and obesity. Obesity can lead to a narrowing of the upper airway and subsequently contribute to OSA. Alcohol and sedatives also can cause the upper airway to relax and collapse, causing apneas.”

Dr. Siddiqui also cites cigarette smoking, nasal congestion and certain medical problems like hypothyroidism and acromegaly as additional causes of OSA. “Some families are predisposed to obstructive sleep apnea just due to their facial structures,” she says. “Patients who have recently had strokes also have a higher chance of developing OSA.” Figgins’ decision to seek medical attention was definitely the right thing to do, she says. Ignoring sleep apnea can have severe— even fatal—consequences.

“Sleep apnea is an independent risk factor for stroke,” she adds. “Other cardiovascular conditions associated with OSA include coronary artery disease, congestive heart failure, atrial fibrillation and hypertension. OSA also can contribute to metabolic syndrome and can worsen diabetes.”

But that’s not all. Dr. Siddiqui says multiple disruptions of sleep at night and poor quality of sleep can cause problems with short-term memory and lack of attention and focus during the daytime. The feeling of

THE DARK SIDE OF sleep

Tracy Kimble lifted his head from

his school desk and shook off the effects of a deep sleep. The classroom was empty.

He looked at the clock on the wall—many hours had passed. Kimble panicked at first, but he quickly discovered that he had been “pranked” by his fellow high school senior classmates. They had set the clock forward and then sneaked out of the classroom, leaving Kimble alone and asleep at his desk.

It was meant to be a good-natured joke, since Kimble was famous for taking naps at his desk and other places throughout the day. But it wasn’t really funny.

Rather than simply catching a few winks throughout the day, he was suffering from a chronic, severe, incurable sleep disorder known as narcolepsy.

Narcolepsy is characterized by overwhelming daytime drowsiness and sudden attacks of sleep, explains Dr. Siddiqui.

People with narcolepsy often find it difficult, if not impossible, to stay awake for long periods, regardless of the circumstances. Worse yet, sufferers can experience a sudden loss of muscle tone (cataplexy), sleep paralysis (the inability to move or speak when falling asleep or waking up), and hallucinations.

“I don’t know how long I’ve had it,” says Kimble, a West Virginia native who moved to Harrisonburg at the age of 18 to work at Sentara RMH. “I’m guessing I’ve had it my whole life, since there are so many pictures of me growing up in which I’m asleep.”

Kimble says he thought his bouts with drowsiness as an adult were the result of “burning the candle at both ends”—that is, going to school while holding down a job.

So when he got kicked out of some college classes for sleeping, and was unable to hear his alarm going off in the morning, he chalked it up to an overly busy lifestyle.

But in 2010, at age 23, Kimble went to his primary care physician for a different problem. When the doctor entered the examination room, Kimble was half asleep.

The doctor started probing and asking questions, which ultimately led to a sleep study at the Sentara Sleep Center.

“The study was easy to do at night,” says Kimble.

“You just go to sleep and they monitor you all night long. But they also did a different type of sleep test the following day. They’d make me stay awake for two hours, then hook me up to the monitors and let me take a 20-minute nap. They’d keep me awake for two more hours, then let me take another nap. And so on.

I took five naps in all, and each time I fell asleep within five minutes, and went into REM (rapid eye movement) sleep three times.”

Kimble was quickly diagnosed with narcolepsy.

While there is no known cure, there are treatments— sentara.com

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A BETTER NIGHT’S SLEEP

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The Sentara Sleep Center provides evaluation, diagnosis and treatment of these and other disorders that occur during sleep, as well as those that affect alertness. Sleep studies are conducted in a comfortable, state-of-the-art facility centrally located in Harrisonburg. For more information, visit Sentara.com or contact the Sentara Sleep Center at 540-564-5500.

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and Kimble was eager to find the one that was right for him. As a cardiac interventional technologist at Sentara RMH, his duties keep him busy assisting physicians and operating equipment during many different procedures, so being sharp and alert is essential.

“So is getting to work on time,” he says with a laugh.

At first, he was prescribed amphetamines to keep him awake during the day. That worked for a while but became less effective over time. Now he takes a medication at night that puts him into a deep sleep for several hours.

He sets an alarm to get up at 2 a.m. to take a second dose that helps him stay asleep for the rest of the night. He takes yet another medication to help him stay awake during the day.

“My life is absolutely better than it was,” says Kimble, who is married and has one child and another on the way.

“I don’t know what I would have done or where I would have been without the sleep test and the medications.

I didn’t know how bad I felt until I found out what was wrong and got treatment for it.”

Other common sleep disorders include insomnia, restless leg syndrome, periodic limb movement disorder, REM sleep behavior disorder, advanced sleep phase syndrome and delayed sleep phase syndrome. It is estimated that one in three Americans suffers from some form of sleep disorder or lack of sufficient sleep.

CLINICAL EXCELLENCE

3D

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MAMMOGRAPHY Leading-Edge Breast Cancer Screening Technology Saves Lives

If you haven’t heard about threedimensional (3D) mammography yet, read on! Also known as tomosynthesis, 3D breast imaging is the most upto-date breast screening technology available to women today.

“Tomosynthesis takes multiple images of each breast,” says Emily Ritchie, MD, a radiologist and women’s imaging specialist with Sentara RMH Medical Center. “As a result, it provides a more accurate study than traditional imaging techniques.”

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CLINICAL EXCELLENCE

That greater accuracy means patients don’t need to be called back for additional imaging— and possibly biopsies—as often as with two-dimensional (2D) imaging.

“That’s a huge advantage when it comes to patients’ time and anxiety levels,” Dr. Ritchie adds.

Multiple studies have demonstrated the superiority of tomosynthesis over 2D mammography. One study showed a 38% drop in recall rates and an 11% drop in biopsy rates.

Cancer detection is also better with 3D mammography. In addition to seeing cancer more easily, 3D mammograms also allow radiologists to spot tumors sooner than ever before. Early detection, of course, is especially effective in treating breast cancer.

“There’s about a 20-30% relative increase in accurate cancer detection,” says C. Scott Pease, MD, a radiologist at Sentara Martha Jefferson Hospital. “So 3D mammography offers fewer false positive exams and seems better at finding cancers than 2D imaging alone.”

In fact, 3D tomosynthesis has been one of the most significant advances in the field since mammography was first used to screen women for breast cancer in 1969.

How Tomosynthesis Works A standard 2D mammogram consists of flat X-ray pictures of each breast taken at two different positions, yielding two images for each breast.

Digital 3D breast tomosynthesis, on the other hand, provides hundreds of additional images, giving radiologists 3D views into the breast tissues that aren’t possible with a 2D mammogram.

During a tomosynthesis exam, lowdose X-ray exposures are taken during a brief compression of the breast, as the X-ray source moves incrementally around the breast.

“The technique produces scans that almost look like a short movie,” says Dr. Pease. “Viewing breast tissue in this way reduces ‘artifacts’ caused by normal tissue overlap, which helps reduce recall rates and false alarms.”

The 3D exam also allows radiologists to better detect certain early tissue changes associated with breast cancer—particularly architectural distortions of the breast tissue.

From the patient’s perspective, the 3D and 2D procedures are actually very similar, except that during

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tomosynthesis the machine moves to capture more images, and the procedure takes one to two seconds longer. A tomosynthesis scan also requires more time for a radiologist to review, Dr. Pease notes.

Sentara Martha Jefferson has offered tomography since 2014, and Sentara RMH has had the technology since the winter of 2015.

Approximately 70-80% of Sentara RMH patients opt for 3D mammography, according to Dr. Ritchie, and most women opt for it at Sentara Martha Jefferson, too.

When it was first introduced, 3D mammography wasn’t accepted by some insurance companies, and it was only partially covered by others.

“Now, almost all insurance companies are on board,” says Dr. Ritchie.

Medicare and many insurance providers cover the full cost of 3D mammography; other insurance providers cover most of the cost but leave a portion for the patient to pay, she adds.

Who Benefits from 3D Mammography?

“All women can benefit from having a tomosynthesis exam,” says Dr. Ritchie. “We strongly recommend it for women who have previously had breast cancer.”

Tomosynthesis may be particularly beneficial for women who are at high risk of developing

breast cancer, including those with dense breast tissue or a family history of breast cancer.

Being high-risk means that a woman’s chance of developing breast cancer is greater than average, but it does not mean she will definitely get cancer, Dr. Pease notes.

When a woman knows she is at high risk, she can make more informed decisions about her health care, including screenings and prevention methods.

Both Sentara RMH and Sentara Martha Jefferson offer high-risk breast programs aimed at giving women the tools they need to make these important decisions. Depending on a woman’s particular needs, these tools may include more frequent examinations and adding other imaging technologies, such as MRI or ultrasound.

Why Choose Sentara?

For women who opt to get their mammograms done at Sentara RMH or Sentara Martha Jefferson, there are many advantages.

“Our compassionate mammography technologists really strive to perform the best imaging,” says Dr. Pease. “I’m always impressed by our staff’s professionalism—their desire to do their best and adapt to new technologies.”

Quality audits at Sentara Martha Jefferson have bested published national data by the Breast Cancer Surveillance Consortium and compare well to those of published academic papers, he adds.

Both Sentara hospitals use current Hologic tomosynthesis equipment that features radiation dose-reduction techniques.

The staff and equipment comply with quality measures established by the American College of Radiology and the U.S. Food and Drug Administration.

Getting mammograms done at the same location, year after year, adds consistency, says Dr. Ritchie, enabling radiology teams to compare mammograms with ultrasound or MRI images to look for correlations. If callback imaging or biopsies are needed, scheduling can be done quickly and easily.

“When outside imaging centers do the mammograms, Sentara radiologists must request the previous images and reports to review, which can add time to the process,” she explains.

Another advantage is having the patient’s entire breast care team in one place, allowing radiologists, breast surgeons and nurse practitioners to consult together easily about the best treatment options.

At Sentara RMH, both 2D and 3D digital mammography services are available at the Funkhouser Women’s Center and on the Mobile Health Services Van. At Sentara Martha Jefferson, the same mammography services are available at the Outpatient Centers at Proffitt Road and Pantops, and at the Health Services Center at Spring Creek.

Mammogram Screening is Safe—Even During the Pandemic dima_oris/stock.adobe.com

With all of the COVID-19 safety protocols in place at Sentara RMH Medical Center and Sentara Martha Jefferson Hospital, there is no reason to postpone, procrastinate or delay when it comes to getting your annual mammogram.

“We always put our patients’ safety first,” says Emily Ritchie, MD, a radiologist at Sentara RMH. “Our team strongly believes that part of patient safety is making sure everyone has access to health care, even in a pandemic.”

The protocols being practiced at both hospitals meet or exceed the guidelines for COVID-19 in healthcare settings, including those recommended by the Centers for Disease Control and Prevention, the World Health Organization, and the U.S. Food and Drug Administration.

Patients are prescreened for COVID-19 before their appointments—and, in fact, anyone entering the hospital or clinic is screened with a no-touch thermometer for possible COVID-19 symptoms.

Physical distance is required in the waiting rooms, and the number of patients in the office at any one time is limited. Hand sanitizer and masks are provided to all patients and guests.

All staff members wear masks and other necessary protective equipment. Imaging technicians wear masks, sterile gloves and other protective equipment. All surfaces and equipment are wiped down between patients.

Common areas are also cleaned regularly between each use, with a focus on high-touch surfaces such as chair armrests, doorknobs, hand scanners and pens.

Both hospitals provide their staff members with detailed checklists of cleaning requirements so that nothing is overlooked.

“Breast cancer can be a deadly disease, but it’s usually curable when caught early by a screening mammogram,” says Dr. Ritchie. “So ensuring that our patients have safe access to our life-saving services during the pandemic is our top priority.” sentara.com

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Practice the Basics of

Infection Prevention

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HEALTH MATTERS

I

nfectious diseases spread through a variety of means. Respiratory diseases like COVID-19, influenza (flu) and the common cold spread via droplets of saliva or mucus that contain germs. An infected person expels the droplets into the air by sneezing, coughing or talking. If someone else is in close contact with the infected person and inhales these droplets, he or she also can become infected.

Germs, including respiratory viruses and gastrointestinal bacteria, can be spread by contact as well.

Hands can become contaminated by touching an infected person’s skin or body fluids, or by touching a surface that contains the germs. The germs can then enter the body through the mouth, eyes or nose via contact with unwashed hands.

Many infectious diseases also can spread through contaminated food or water. However, COVID-19, influenza and other respiratory diseases cannot spread this way.

• Rinse thoroughly under running water. Use a clean towel or paper towel to dry your hands. Use the towel—not your freshly washed hands—to turn off the faucet.

Wash your hands frequently, especially at these times: • After using the bathroom • After blowing your nose, sneezing or coughing • After handling pets or cleaning up after them • Before preparing food or eating • Before and after visiting or caring for a sick person • Whenever your hands are visibly soiled When soap and water are not readily available, or when your hands are not visibly soiled, you can use alcohol-based sanitizer. Make sure the sanitizer gets between your fingers, around your nails and on the backs of your hands.

Appropriate Hand-Washing

Other Infection Prevention Practices

One of the most effective ways to stop the spread of germs is frequent, thorough hand-washing.

Multiple times a day, our hands touch surfaces and objects that are also touched by many other people.

Each touch is an opportunity to pick up germs and spread them to yourself and others.

• Clean frequently touched surfaces with a disinfecting product that kills bacteria and viruses.

• Cover your cough or sneeze using a tissue. If one is not available, sneeze or cough into your bent elbow.

• When you are sick, stay home.

• Practice social distancing as recommended by the Centers for Disease Control and Prevention, as well as other public health officials.

• Thoroughly clean surfaces and utensils that come in contact with raw meat or raw fruit or vegetables.

To wash your hands effectively, do this: • Wet your hands thoroughly with warm or cold water and apply soap.

• Rub your hands together to create a good lather.

Scrub the palms and backs of your hands, between your fingers, around your nails, and on your wrists. Continue scrubbing for 20 seconds (you can sing or hum “Happy Birthday” twice or count slowly to 20).

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Although we don’t need to live in fear of the germs that surround us, it does pay to remember and regularly practice these tips for simple infection prevention and control.

LA SALUD IMPORTA

Adopte las medidas básicas para la

prevención de infecciones

L

as enfermedades infecciosas se propagan a través de diversos medios.

Las enfermedades respiratorias, como la COVID-19, la gripe y el resfriado común, se propagan a través de las gotas de saliva o del moco que contienen gérmenes. Una persona infectada expulsa gotas al aire al estornudar, toser o hablar. Si otra persona está en contacto estrecho con la persona infectada e inhala esas gotas, también puede infectarse.

Los gérmenes, incluidos los virus respiratorios y las bacterias gastrointestinales, también pueden propagarse por contacto. Las manos pueden contaminarse al tocar la piel o los líquidos corporales de una persona infectada, o al tocar una superficie que contiene gérmenes. Luego, dichos gérmenes pueden ingresar al cuerpo a través de la boca, los ojos o la nariz cuando nos tocamos estas zonas del cuerpo con las manos sucias.

Muchas enfermedades infecciosas también pueden propagarse a través de alimentos o agua contaminados.

Sin embargo, la COVID-19, la gripe y otras enfermedades respiratorias no pueden propagarse de esta manera.

Lavado adecuado de manos Una de las formas más eficaces de detener la propagación de gérmenes es el lavado de manos frecuente y minucioso. Varias veces al día, las manos tocan superficies y objetos que muchas otras personas también tocan.

Cada vez que se toca algo se corre el riesgo de recoger gérmenes y propagarlos a usted mismo y a los demás.

Para lavarse las manos eficazmente, haga lo siguiente: • Mójese bien las manos con agua cálida o fría, y aplique jabón.

• Frótese las manos hasta que se forme buena espuma.

Frote las palmas y los dorsos de las manos, entre los dedos, alrededor de las uñas y las muñecas. Continúe frotándose las manos durante 20 segundos (puede cantar o tararear el “Feliz Cumpleaños” dos veces o contar lentamente hasta 20).

• Enjuáguese bien las manos con agua corriente. Use una toalla limpia de tela o de papel para secarse las manos. Use la toalla, no las manos recién lavadas, para cerrar el grifo.

Lávese las manos de manera frecuente, en particular, en los siguientes momentos: • Después de ir al baño • Después de sonarse la nariz, toser o estornudar • Después de tocar mascotas o de limpiar lo que ensuciaron • Antes de preparar alimentos o de comer • Antes y después de visitar o de cuidar a una persona enferma • Siempre que las manos estén visiblemente sucias Cuando no haya agua y jabón disponibles, o cuando las manos no estén visiblemente sucias, puede usar un desinfectante a base de alcohol. Asegúrese de colocarse desinfectante entre los dedos, alrededor de las uñas y en los dorsos de las manos.

Otras medidas para la prevención de infecciones • Limpie las superficies de mucho contacto con un producto desinfectante que mate bacterias y virus.

• Al toser o estornudar, cúbrase con un pañuelo de papel. Si no tiene uno a mano, estornude o vectorfusionart/stock.adobe.com tosa en el pliegue del codo.

• Quédese en casa cuando esté enfermo.

• Ponga en práctica el distanciamiento físico según lo recomendado por los Centros para el Control y la Prevención de Enfermedades, así como por otros funcionarios de salud pública.

• Limpie a fondo las superficies y los utensilios que entran en contacto con carne, frutas o verduras crudas.

Aunque no tenemos que vivir con miedo a los gérmenes que nos rodean, vale la pena recordar y poner en práctica regularmente estos consejos para la prevención y el control de infecciones.

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COVID CORNER

Coping

AND

EVEN

Thriving DURING

COVID-19

Since arriving in the United States in early 2020, the COVID-19 pandemic truly has turned our world upside down. Many thousands have lost their lives, while countless others have lost their livelihoods.

In light of this new reality, experiencing feelings of grief, anger, fear, anxiety, weariness and cynicism is quite understandable and normal.

Even if you haven’t been directly affected by the virus, you’ve likely felt its impact on your life.

The ways we move about, educate our kids and do our jobs have changed rapidly, and now even something as mundane as a trip to the grocery store can be a cause for anxiety and stress.

“Adapting to a global pandemic can be unsettling and challenging, since none of us has been through anything like this before,” says Luanne Bender Long, PhD, LPC, LMFT, clinical manager at Sentara RMH Behavioral Health. “COVID-19 has resulted

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Get Reliable Information Since COVID-19 is a new disease, the medical community is learning more about it on a continual basis—which, in turn, means information about the pandemic in the media has changed frequently. As a result, you may find a lot of confusing and conflicting news out there.

When evaluating such information, ask yourself what facts a story states and what biases the media outlet or reporter may have, and make sure you get information about COVID-19 from reliable sources, says Tammy James, RN, MDiv, chaplain at Sentara Martha Jefferson Hospital. She suggests these websites for the latest information about testing, safety and more: • Centers for Disease Control and Prevention (CDC): https://www.cdc.gov

•

World Health Organization (WHO): https://www.who.int

Get Regular Exercise and Eat a Healthy Diet

tasty treat, turning to “comfort food” in times of stress isn’t healthy in the long run.

Stay Connected

Although many of us are hunkering down at home these days in order to stay safe, getting out of the house regularly—done in a safe manner—can have real benefits. In fact, something as simple as going for a 30-minute walk each day can boost your mood and improve your health.

Be sure to drink enough water while exercising, though, since dehydration can lead to headaches and irritability.

Also, try to resist the urge to overeat when you’re feeling stressed or anxious. Similar to alcohol and drug use, “emotional eating” is often used as a form of self medication, according to Bender Long.

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in the loss of our sense of predictability, control and justice, and has seriously challenged the belief that we can protect ourselves and our families.”

And although we can’t wish COVID-19 away, we can take some steps to make our lives a little better during this stressful and unusual time.

It’s okay to acknowledge your sadness over the loss of human connection. Cry when you need to, lament your losses and then move forward.

Also, you’ll likely feel less isolated if you stay in touch with friends and family. Try to connect with loved ones through social media, video chat meetings, texts and phone calls. “You can even mail letters and cards to loved ones,” says James. “It’s a great way to stay in touch, and it’s fun to get ‘real’ mail back.

Get your kids or grandkids involved in the letter writing!”

Be Kind to Yourself Find healthy ways to lower your stress level and relax: • Read or listen to a podcast • Find a new hobby or pick up an old one again • Plant a garden • Practice yoga • Foster or adopt a pet And if social media causes you to feel stress, scroll past negative posts and comments, or avoid social media altogether. sentara.com

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Practice Gratitude

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Reflect upon the positive things that have come out of this time, and try to appreciate the growth in resiliency you may have experienced.

Consider keeping a gratitude journal, writing down what you’re thankful for and your successes each day. Looking back through the journal at a later time can be inspiring and encouraging.

“Ask yourself what you’ve gone through and succeeded at in the past,” says Bender Long.

“Use that as a guide to say, ‘I can do this.’”

Take Time for Yourself

Don’t Forget: We’re All in This Together

With many schools and offices closed, families and loved ones are spending a lot more time together at home these days, Bender Long notes. “That can be challenging, even if there’s a lot of love,” she says.

Set boundaries and take regular time to be alone, if you need it. “It’s not selfish to take time for yourself—it’s actually good for your mental well-being,” Bender Long adds. “Time to yourself could mean taking a bath with the door locked, going for a drive or simply spending some time alone in your bedroom.”

Even when you’re feeling alone, know that many others are feeling very much the same these days.

“One would hope that this pandemic will draw us together in our shared humanity,” says James. “We are all in this together and need one another to get through this.

If we stop to hear each other and stop making assumptions about each other, we can see the hearts of our fellow citizens and truly know them.”

We will get through this together, says Bender Long.

“We need each other to do this, knowing that on the other side, we’re still going to be a community and family,” she concludes. “We can do this.”

Your spiritual beliefs can give you a sense of inner peace and help you worry less about external issues. Prayer and meditation can help decrease anxiety and fear and lead to a greater sense of well-being.

“When people meditate, they become centered in the present moment,” explains James. “Meditation helps keep the mind from worrying or obsessing about things beyond one’s control.”

If your place of worship isn’t open or you’re staying home for safety reasons, consider attending virtual worship services. If your church, synagogue or mosque doesn’t offer virtual services, there are plenty that do. James also suggests attending virtual services of other faith traditions to broaden your horizons.

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Gain Strength from Spiritual Beliefs

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EAT WELL , LIVE W ELL

NEED HELP? Get help if you or someone you love is struggling or abusing alcohol or drugs.

Call or visit online: • Sentara RMH Behavioral Health Specialists: 540-564-5104 • Region Ten mental health services: 434-972-1800 • National Suicide Prevention Hotline: 800-273-8255 • Move2Health Equity: move2healthequity.org/ covid19 • Local resources, podcasts and updates to help decrease stress and promote healthy living

HOLIDAY TRADITIONS Thanksgiving, Hanukkah, Christmas and Kwanzaa all may look different this year. Family gatherings may be smaller or even canceled, and many of us may need to avoid traveling.

Get creative with your holidays, says Luanne Bender Long, PhD, LPC, LMFT, clinical manager at Sentara RMH Behavioral Health.

That may mean connecting with loved ones via Zoom, FaceTime or another video chat platform. It could involve wearing masks and practicing social distancing at gatherings. Try creating new traditions if the old ones won’t work this year.

Smaller gatherings of 6–8 people may be safer, but be sure to check the number of COVID-19 cases in your area before making any plans.

PHILANTHROPY

Bill and Jean Madren

Generous to the End … and

Beyond

Couple’s Estate Gift Shows Commitment to Care

When Bill and Jean Madren committed to something, it was for the long haul.

For starters, they were together for 67 years, abiding by the ultimate pledge to each other. This was more than enough time for both to make significant contributions to their community neighbors in Elkton, from Bill’s generosity toward youth by funding the construction of basketball courts and playground w w w.S uppor tRMH.org

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A Gift to Heal Tomorrow Legacy giving through estates has made a transformational impact on the care delivered at Sentara RMH. The Madrens’ legacy gift is designated for the Hahn Cancer Center, according to Cory Davies, executive director of the RMH Foundation. Such contributions have improved and enhanced care at the Hahn Cancer Center recently in two very meaningful ways. First, philanthropic giving has enabled the purchase of a new linear accelerator, which provides radiation therapy treatments to cancer patients. Second, these gifts help to expand the reach of the Hope

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renovations, to Jean’s background in education, which sparked the creation of scholarships in their names at Spotswood High School and East Rockingham High School.

Jean’s sense of commitment to community even extended to her fight against cancer. First diagnosed with breast cancer in 1982, and then with cervical cancer in 1992, she refused to let her condition keep her from completing a 40-year academic career with Harrisonburg and Rockingham County public schools, after which she finally retired in 1996.

In 2006 Jean was found to have bone cancer, which led to a painful life until her death on Jan. 25, 2014, according to her obituary. Bill died on the same date four years later.

The Madrens’ commitment to their community could have ended there. In some respects, however, it was just beginning.

The care Jean received from the Hahn Cancer Center at Sentara RMH Medical Center inspired the couple to leave a generous gift to the RMH Foundation through their estate—an expression of their desire to help others receive the same high-quality treatment.

“They always lived in the local community,” says Erica Martin, Bill’s niece and co-executor of the couple’s estate. “RMH was their hospital. They received years of good care there, and their gift continues to help people in our area.”

Fund, which has assisted patients in various ways since its founding in 2016. The fund supports preventive screenings to detect cancer sooner, medication assistance and the meeting of other unexpected needs.

The Hahn Cancer Center provides about 15,000 treatments per year, according to Davies. Without support from people like the Madrens through the RMH Foundation, these patients would face more difficult financial challenges and wouldn’t necessarily have access to the latest diagnostic and treatment technology.

The fact that the couple left a gift through their estate shows their ongoing commitment to their community. Davies says the Foundation encourages gifts through estates because, with legacy giving, “your kindness today heals tomorrow.”

“When you choose to leave a gift like this to the hospital, that compassionate, kind act establishes a legacy of good health for the community for years to come,” Davies adds.

No Glory Necessary Martin says Bill Madren was more like a grandfather than an uncle to her, due to the wide age gap between them. The Madrens didn’t have any children and largely kept to themselves.

“When they had each other,” Martin says, “they didn’t need anybody else.”

The couple enjoyed photography, gemstone collecting, gem cutting and making jewelry, according to Bill’s obituary.

With the newest linear accelerator, patients will have access to the advanced care they need locally, instead of having to travel out of the area for treatment.

A native of Alamance County, N.C., he moved with his family to Elkton in time to meet Jean, an area native, at Elkton High School.

He became business manager for the local Chevrolet dealer, Hensley Sales and Service, and retired in 1996, the same year his wife finished working as a guidance counselor at Spotswood High School.

Bill was a member of the Elkton volunteer fire and rescue squad companies, both of which also have benefited from his estate. Funds also were directed to Elkton United Methodist Church and Bethel United Church of Christ.

Sentara RMH and the American Cancer Society represented the other primary causes the couple singled out for estate gifts.

“Leaving money to the Hahn Cancer Center was a big part of what they wanted to do with their estate,” Martin says. “Both are well known in the Elkton community for the work they did.”

After Jean died, Bill supported an array of causes, including the establishment of scholarships for high school seniors interested in the arts or education, as well as the funding of a reading room that now bears Jean’s name at

East Rockingham High School.

He also stepped up to meet a fundraising goal to furnish basketball courts in Elkton.

“He really was generous in that way,” Martin says, “but he didn’t want any of the glory.”

Recognition does not need to be a motivating factor to make a legacy gift to the RMH Foundation, either. “You just need to care about the people around you and have a desire to see future generations get the best medical care possible,” says Davies. “Such commitments can have positive impacts on the community for decades to come.”

Thanks to their generous gifts, the Madrens’ legacy lives on.

“Bill and Jean were very generous both in their lives and after their deaths,” Martin says.

For more information on how to make an estate gift to the RMH Foundation, contact Cory Davies at crdavies@sentara. com or visit rhcc.plannedgiving.org. Davies says the RMH Foundation also recommends consulting with an attorney or wealth adviser before making a gift.

Legacy Gift—“Your Kindness Today Heals Tomorrow” To learn more A legacy gift is a meaningful way to partner with Sentara RMH Medical Center in providing lifesaving, high-quality care in our community. Learn more by visiting www.supportrmh.org/kindness-todayheals-tomorrow/. Or, fill out the form below and mail it to: RMH Foundation, 2010 Health Campus Drive, Harrisonburg, VA 22801.

I’d like to know more!

Please send me information on how to name the RMH Foundation as a beneficiary of a retirement account, insurance policy or other estate plan. n n

I would like information about the benefits of making a gift of stock.

I have already named the RMH Foundation as a beneficiary of a retirement account, insurance policy or other estate plan. Please contact me about my gift. n

The best way to contact me is by: n E-mail

n

Mail

n

Telephone

NAME

ADDRESS

CIT Y STATE ZIP

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All inquiries treated with complete confidentiality. This information is not intended as tax, legal or financial advice. Consult your personal financial advisor for information specific to your situation.

friends of the

RMH Foundation Gifts received from Jan. 1 to July 31, 2020 entara RMH Medical Center is 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 next to your name the number of consecutive years you have supported the RMH Foundation. Thank you for your support!

Totals represent cumulative amounts given in 2020.

President’s Forum $100,000 and above Harman Realty (1) Sentara RMH Volunteer Auxiliary (39)

$25,000–$99,999 Diane C. Davis (28) James Madison University Engineering Class and Friends (1) William R. Madren Trust Agreement (2) Earl L. Shirkey Jr. Trust (1)

$5,000–$24,999 Devon C. and Teresa B. Anders (11) Ball Corporation (1) Blue Ridge Bank (5) Bob Wade Subaru (7) Barbara Z. Buhl (2) Frances Ann Byers (1) Eleanor M. Campbell (11) Paul and Sherry Cline Fund of the Community Foundation of Harrisonburg and Rockingham County (9) Eddie R. and Catherine Coffey (23) Covenant Presbyterian Church Group (1) DuPont Community Credit Union (3) Harry F.and Margaret M. Flippo Foundation of the Community Foundation of Harrisonburg and Rockingham County (3) Harrisonburg Makers Help (1) Bob Alexander, Laura Atkins, Kim Bowmaster, Holly Buchanan Hans Burkholder, Jamie Calcagno-Roach, Kathleen Conery Dan Easley, Geoffray Estes, Charles Fairchild, Rebecca Field Carrie Gray, Jeff Guinn, Jamie Haag, Bill Harner, Julie Hatfield Kevin Hegg, Shelly Hokanson, Adrienne Hooker, Sara Horst Carlson Jenkins, Daniel Kvitko, Holly Labbe-Cole, Anneke Lamb Nicholas Lamb, Laura Lambert, Joe Lipscomb, Matt Loflin Emma and Zoey Loflin, Kristen Loflin, December Lorimer Vanessa Manson, Tanya Monger, Stephanie Nelson Bethany Nowviskie, Art Pekun, Keenan Rowe, Amy RusselYun Grover Saunders, Seth Shantz, Julie Sorge-Way, Eric Stauffer Mike Stoltzfus, Laura Taalman, Amanda Thompson, David Wang, Oscar Wang, Patty Watson, Heidi Yoder, Nathan Cooper, Jay Veenis Dr. Charles H. and Mary Henderson (38) Dr. Alden L. and Louise Otto Hostetter (13) InterChange (1) Carolyn Henry Joseph Charitable Trust (9) John D. Kinkead Trust (1) David and Emily Larson and the Spark Adoption Grant of The Community Foundation of Harrisonburg and Rockingham County (1) Macado’s of Harrisonburg (1) Herman and Janet Mason Family Fund of The Community Foundation of Harrisonburg and Rockingham County (12) Garry R. and Nancy B. Nichols and Nichols Family Charitable Fund, a Donor Advised Fund of The U.S. Charitable Gift Trust (12) Charles V. Oster (24) W. Marshall and Gloria B. Price (21) Douglas M. and Vickie K. Rawley (4) Riner Rentals (2) Barbara R. Somers (1)

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The Robert H. Strickler and Lorraine W. Strickler Foundation (8) Louise Brenneman Tardy (1) The Community Foundation of Harrisonburg and Rockingham County (18) The US Charitable Gift Trust (4) Theta Iota Chapter of Alpha Phi James Madison University (4) N. Paige and Ann C. Will (7) Wayne and Joyce Wright (20)

William Leake Society $1,000–$4,999 Michael and Violet Allain (1) Ameriprise Financial Services Inc. (2) Judy Anderson (1) Cindy Barnett (1) Daniel B. and Susan Weiss Behrend (1) Drs. A. Jerry Benson and Martha K. Ross (9) Auburn A. and Ruth D. Boyers (39) Chester L. and Nancy B. Bradfield Pass-Through Fund of the Community Foundation & Rockingham County (29) Craig M. and Melanie Brimhall (2) Francis M. and Alice S. Bruce (2) Rita Bunch (1) Sharon Carr and Friends, Debbie Ream, Rebecca Arthur, Lou Kirkendall (1) Crosslink Community Church (1) Crossroads Mennonite Church (1) Cup Cake Company (1) Nancy Dauer (1) Cory R. and Donielle Davies (13) Domino’s (1) Dynamic Aviation Group Inc. (1) Linda Elliott (1) Everence Foundation Inc. (4) Farmers and Merchants Bank (7) Fidelity Charitable Gift Fund (10) Funkhouser Real Estate Group (1) Dr. and Mrs. Steven E. Gardner Family Fund of The Community Foundation of Harrisonburg and Rockingham County (1) Donna Gochenour (5) Chasity H. Godshall (12) Grace Covenant Church (1) Donna S. Hahn and Doug Hahn (14) Elizabeth Harnsberger Trust (9) Harrisonburg Elks Lodge #450 (1) Harrisonburg Kiwanis Club Inc. (1) Harrisonburg Rotary Club Charitable Foundation Inc. (1) Richard and Julie Haushalter (21) John R. and Mary Ann Heatwole (2) Ollie Heatwole Trust (1) George and Cary Hevener (16) Hokkaido Japanese Resturant (1) Home Depot Harrisonburg (1) Robert P. and Eloise B. Hostetler (8) Impact Assets (1) Insurance Center of Harrisonburg and Erie Insurance/ Mike Rodes (1) Judith D. Jenkins (4) Tedd H. and Lora W. Jett (31) Richard C. and Mona D. Johnson (32) Ken Copeland Family Dentistry (5) Lantz Construction Company (3)

Cathy Jackson Leitner, PLC (7) Terry and Judy LePera (23) Jo Ann S. Liskey (8) Maestro, LLC (1) James and Frances Mason (1) Barry and Eileen McEneely (1) Edgar L. and Carmen Strite Miller (14) Robert and Janie Mullett (1) Calvin R. Nichols Jr., Charitable Fund, a Donor Advised Fund of the U.S. Charitable Gift Trust (4) Otterbein United Methodist Church (2) Janice L. Pence (9) Eleanor Page Price (2) Dennis and Mary Jane Rawley (3) Thomas D. and Jennifer L. Rea (6) Lourdes Rhodes (5) E. John III and Carol H. Rosenberger (7) Dr. Edward Sandy and Pamela Grimm (4) Al P. and Phyllis S. Saufley (6) Schwab Charitable Fund (3) John H. and Faye T. Sellers (15) James R. and Mary C. Sherman (8) Corie B. Shifflett (17) Richard L. and Patricia N. Shoemaker (6) Silverback Distillery (1) Pamela Sponaugle (1) Karl D. and Barbara B. Stoltzfus (22) Juanita M. Taylor (38) The GE Foundation (3) Shannon Tierney, MD, MS, FACS (1) Lynn and Diane Trobaugh (13) Sallye Trobaugh (7) Tropical Smoothie Cafe (1) Phillip and Christina Updike (7) Nancy Hopkins Voorhees (13) Merv and Marlene Webb (38) Dr. David H. and Janet T. Wendelken (8) Richard L. and Pamela B. Wilkins (33)

1910 Cornerstone Club $100–$999 5 Star Nutrition, Harrisonburg (1) Pamela Adams (1) Robert L. and Karma C. Adams (13) Laura E. Adkins (7) Elizabeth Adornato (1) Atheer Al kawaz (1) Raed Alaziz (1) Raymond and Susan Albers (1) Sarah H. Albrecht (1) Phyllis Albrite (6) Violet Allain (A Little Bit of Good Giving Circle)(1) Robert E. and Linda L. Alley (3) Dr. Steven G. and Patricia A. Alvis (1) Ervin L. and Ann Noffsinger Anderson (7) Larry Andrick (2) Anonymous Crisis Reponse (1) Arcangelo Arecchi (1) Warren J. and Janet M. Armentrout (1) Jane Armstrong (4) Dennis Arthur (1) Gail Arthur (1) Suzanne Arthur (1) Katie Auville (1) Bonnie Ayers (1) Janet Baggott (1)

Tim Ball (1) Deborah L. Bandalos (1) Hope N. Barb (1) Carole Barber (1) Larry Barber (1) Edgar L. Barnard Jr. (14) David A. and Karen L. Barnes (1) John G. Barr (4) Dr. Lou G. Bartram (1) Sam L. Batton (5) Beachy Arehart, PLLC (1) Gerald W. and Carolyn L. Beam (1) Fred W. and Lois E. Beaufait (1) James T. Sr. and Barbara R. Begoon (17) Joanne L. Bell (5) Richard M. and Lenora Y. Bell (1) Belmont Community Ruritan Club (1) James O. and Joyce R. Benedict (1) Kenneth G. and Linda R. Berry (11) Ginnie Beyerler (1) Roger L. and Sonja A. Bible (13) Bible Holiness Church (1) Kathy G. Billhimer (2) Sandra Blade (1) Dr. Andrew B. Blay (1) William E. and Allene R. Blessing (7) Dennis P. and Janet E. Boffo (3) Fred and Susan Bosserman (1) James E. Bowers (1) John F. and Elsie L. Bowers (4) Lawrence D. Jr. and Linda K. Bowers (1) James O. and Sylvia K. Bowman (2) Larry O. and Paula C. Bowman (2) Martha F. Bradfield (3) Nancy R. Bradfield (12) Donald R. Jr. and Brenda S. Bradley (1) Matt and Marianne Branigan (7) James B. Branner (7) Helen Breeden (1) Jen and Ben Breeden (1) Judith K. Breeden (2) Victoria E. Breen (1) Barbara Brennan (1) Rosemary O. Brenner (1) Bridgewater Church of the Brethren, Dwynn, Kajsa, Mary Beth (1) Brookdate Senior Linving Inc., Harrisonburg (1) Carol J. Brooks (16) Emmett H. and Leola C. Brooks (5) Martha Brooks (1) Larry Brown (1) Richard T. Brown (1) Erma R. Brubaker (1) Raymond Bruce (1) Patricia A. Brunk (13) Steve C. and Marian B. Buckwalter (1) Betsy Bugg (1) Henry F. and Catherine S. Buhl (9) Reese Bull and Pamela Patrick (1) Donna Burch (1) Jason Burch (1) Melvin and Edith Burger (1) David L. and Elizabeth B. Burkholder (4) Lois C. Burkholder (2) Owen R. and Judy M. Burkholder (1) Rodney J. and Joyce G. Burkholder (1) Christine W. Burner (13) Gary and Linda Burner (1) Merrie Burruss (1) Dr. Leslie Burt (1)

Elizabeth T. Burtner (1) Louise R. Burtner (8) Gregory G. and Pollyanna A. Bush (13) Carroll E. and Billie M. Bushong (1) Wayne R. and Beverly S. Butterfield (1) Tammy M. Byrd (23) Dr. Paul C. and Paula T. Caldwell (1) Dr. William F. and Susan Cale (7) Nancy E. Camp (2) James C. and Adelaide J. Cannata (1) Drs. Earl and Karen Cannon (1) Dr. John Canter (1) Card My Yard (1) Mark R. and Carolyn E. Carderelli (1) William B. Sr. and Phyllis W. Carper (39) Ann Carr (1) Sharon Carr, Linda Monger, Lou Kirkendall and Rebecca Arthur (1) Larry Carroll (1) Cynthia Cartee (1) George F. III and Lucretia A. Carter (1) Joseph W. and Beverley W. Carver (1) Brenda D. Cave (9) CDW, IT Vendor (1) Cedar Run Church of the Brethren, Broadway (1) Dr. Ramesh Chalam (1) Harry L. and Marlene A. Chandler (1) Dr. G. Edward Jr. and Elizabeth S. Chappell (8) Richard Churchill (1) Nancy O. Cisick (1) Lee E. Clapper Sr. (8) Sandra Clatterbuck (3) John G. Clem (1) Randy S. Clem (4) Kyle Coleman (1) Emanuel B. Conley Jr. (7) Ellen Conner (1) Lesley A. Cook (16) Patricia S. Costie (10) Crystal Cota (1) Dane Cox (1) Glenn and Leslie Crawford (5) Linda Crawford (1) John Crim (1) J. Leo Crosier, M.D and Mrs. Virginia R. Crosier (1) Cross Keys Worship (1) Irene Cummings (1) Dennis A. and Martha C. Cummins (7) Dale L. and Sandra S. Cupp (2) Jeffrey D. and Faye B. Curl (2) Curtis Dean Family Dentistry (1) Michael T. Daly (1) Sue Daniels (1) Linda A. Davis (1) Lorraine Davis (1) Lowell R. and Alta A. Davis (1) Gary W. and Teresa B. Day (2) Mensel and Linda Dean (31) Patricia I. Deer (1) Wanda Delaney (1) Kenneth and Carla Delawder (1) Betty A. Deleeuwerk (1) Denton Family Charitable Foundation (3) Nancy E. Deputy (2) Donna L. Devier (1) Matthew Di Stefano (1) Agnes Dickerson (1) Col. and Mrs. Peter F. Dieck (3) Betty Diehl (1) Robert F. and Linda W. Dinsmore (4) Lynn and Dave Diveley (2) Charles and Betty Dixon (1) Janelle Donaldson and Ms. Sue Dean (1) Gay Donlan (1) Phil Douglas (1) Phillip B. DuBose (2) Dave D. and Patricia H. Dungan (5) John F. and Nancy B. Dunne (2) Charles Dutt (1) Janet L. Earhart (1) Eastern Mennonite University (1) Eastside Church (1) Paulette F. Eaton (1) Edward Jones Investments (3) Joyce Edwards (1) David H. and Diane C. Ehrenpreis (1) Janet S. Einstein (14) Steven and Terry Eiserman (1) Elkton Middle School (1) Chris Ellis (1) Ronald and Vickie Elyard (1) Tami Reid Eppard (14) Dr. J. Robert and Rosalie Hartman Eshleman (4) Joseph J. and Rose Marie Estock (2) Laura Evans (1) Douglas Eye (1) Farm Credit of Virginia, Verona Branch (1) John and Barbara Fast (1) Hal C. and Saundra Sue Ferguson (11) Carol Ann Fields (2) First Presbyterian Church (2) Kenneth E. Fisher (1) Amy Fitzgerald (1) Marsha FitzGerald (1) Edgar A. Flora (20) Theodore W. and Mary Beth M. Flory (6) Larry A. and Linda J. Fogle (13) Brenda Ford (1) Donald E. Forren (2)

Richard D. and Glenda S. Foust (1) Daniel F. and Debra W. Fraser (1) Fraternal Order of Eagles New Market Auxiliary 4264 (2) Forrest L. Frazier (18) Tiffany French (1) Charles J. Frye (2) David and Rachel N. Frye (1) Jason A. Funkhouser (1) Gwen Gainer (1) Mike Galang (1) Susan S. Gallaher (3) Charles D. and Bernice W. Garber (1) June Garber (1) Michael A. and Carolyn S. Gardner (4) Norma J. Gardner (11) Karen Garrison (1) Susan Gatling (1) Rick Gawlowski (1) GE Nail Spa (1) Dr. Linford K. and Rebecca L. Gehman (1) Steve Gillaspie (1) Janet K. Gillman (1) Girl Scout Troop 89, Grottoes (1) Girl Scouts Troop 368 (0) Sherrill Glanzer (19) Harry C. Jr. and Patricia K. Glenn (3) Asela Goebel (1) John Goff (1) Golden China Restaurant (1) Goodville Mutual Insurance Group (1) Drs. William and Brooke Goodwin (6) Joni Grady (1) Henry B. and Dorice M. Graham (1) Jessie Granier (1) Keith Grant (1) Pamela Gray (1) Bob Green (1) Norma L. Greenleaf (1) David Gregory (1) Russell T. and Mary Jane L. Gregory (1) Larry P. and Jannie M. Greiman (1) Karen Wood Grizzard (5) Marilyn and Peter Guntner (1) Joshua P. Hale and Hale Family Charitable Fund, a Donor Advised Fund of The U.S. Charitable Gift Trust (4) Alma C. Hale-Cooper (1) Dr. David C. and Amelia M. Hall (10) Tom and Ella Hall (1) Clive Hallman (1) Marianne F. Halterman (3) Russell and Carla Hamblin (1) Robert L. and Faye C. Hansbrough (7) Alison S. Hardwick (4) Orden L. and Reba R. Harman (13) Randy and Donna Harper (1) Harrisonburg Baptist Church (2) Joan Hartzler (1) Michael Harvey (1) Henry E. and Loretta Z. Hawkins (1) Stephen Hay (1) Robert A. and Marlene A. Hazzard (8) Paula Hearne (1) Michael Heatwole (1) Evelyn S. Hedrick (10) Mary Hedrick (1) Solomon P. and Ruby H. Hedrick (2) Paul Heisey (1) Jean Helmick (1) Judith N. Henneberger (13) Nancy and Joey Hepner (1) Heritage Estates, Harrisonburg (1) Robert E. and Gail L. Hess (4) Lillam B. Hilbert (12) James H. and Lois Hinegardner (3) Joel and Marsha Hinkle (1) Frank S. and Sherrel J. Hissong (12) James E. and Carole S. Hively (1) Delores H. Hoak (1) Dennis W. and Shirley S. Hohenstein (3) Eileen Hokanson (1) Thomas J. III and Virginia C. Holden and the Holden Family Fund of the Community Foundation of Harrisonburg and Rockingham County (3) Lynn Holtzman (1) Breck and Tom Hook (31) Sarah Sachiko Hori (6) Lorna Hospach (1) Ronald M. and Linda C. B. Hotinger (4) Kern L. and Chanda C. Houff (2) Susanne Houghland (1) Howard Houghton (2) Charlotte Hoyle (1) Lucy Hoyt (1) Larry Hubbard (1) William R. Hudelson (11) Susan Huffman (1) Lyle C. and Georgianne M. Hull (4) Ann Gerding Hurley (3) William Hugh and Barbara C. Hutchens (1) Kellie and Isaac Hutchison (1) Dr. Mac Hutson (1) Lucas Hutton (1) Elizabeth L. Ihle (1) Carol James (1) Marian C. Jameson (1) Robert and Joyce Jellum (1) Jimmy Johns (1) Dr. Robert F. Jochen VMD (5) Betsey H. Johnson (1)

J. Robert and Patricia C. Johnson (2) Lawrence G. and Julie B. Jolly (1) R. Fleming and Sharon W. Jones (2) Charlton Jordan (1) June E. Jordan (1) Joan E. Judd (1) Flora L. Kagey (13) Keezletown Methodist Church Relay for Life Team (1) Anne R. Kendrick (1) Dr. Jeffery B. Kesecker, DDS, PLC (2) Virgil “Rick” Keyton (1) Susan L. Kidd (1) Mary Kile (1) Deborah B. Kile, DNP, RN, NE-BD (19) Charles King (1) Robert King (1) Theresa King (1) Thomas L. and Rosemary S. King (1) Rick and Vickie Kinkead (1) Heather Kinkead-McLeod and -JMU Engineering (1) Heather Kirkrold (1) Sharon S. Kisamore (1) Camala Kite (1) Teresa M. Kite (7) Ian Knapp (1) Gene E. and Ann H. Knicely (1) Katherine H. Knicely (12) Melonie Knicely (1) Susan Koch (1) Lorrie Koontz (5) Jim and Vicki Krauss (21) Dr. Frances Kray (3) Joseph C. and Carol A. Kudless (8) Margaret Kwolek (1) Mari Kyle (1) Elly Lafkin (1) Letitia E. Lam (4) Gary and Sheila Lam (33) William O. III and Sharon A. Lam (1) Steve and Cindy Lamb (10) Twilla M. Lambert (5) Caitlin Landes (1) James V. and Lucretia M. Lane (2) Carol Lawson (1) Mary Louise Leake (12) Dr. William I. and Lynda D. Lee (14) Robert J. and Carolyn J. Leiston (13) Stacey Leitzel (1) Robert L. Lembright (1) Mr. Mark Leonard (1) Barbara J. Lewis (1) Life Care Center of New Market (1) Light of the World Church (1) Judith Ligon (1) Howard Lind and Naomi Kaiss (1) Howard Lind and Ruby Yoder (1) Junior L. Lineaweaver (4) Charles E. and Cynthia A. Litten (12) Edward and Phyllis Litton (1) Corri Loan and Julie Pate (1) Horst and Deborah Locher (2) Hillary Long (1) Wayne L. and Ann Payne Long (15) David M. and Gladys D. Longacre (9) William C. III and Beverly M Loomis (3) Teresa L. Louden (5) Joy Loving (1) Anthony and Jeanne Lubrano (3) Philip C. and Charlotte R. Lucas (1) Leslie E. and Judith A. Luginbuhl (1) Robert J. Lynch (5) Sybil Macgill (1) Ralph J. Magri (1) H. L. Jr. and Mildred R. Maiden (3) Hugh R. and Sydney B. Manley (1) Laura S. Mapp (27) JennaRose Mapstone (1) David A. and Karin E. Mars (6) Harold C. and Brenda H. Marshall (5) Don R. and Barbara J. Martin (1) Earl and Pat Hostetter Martin (1) John R. and Evelyn Jost Martin (33) Steve and Claire Martindale (1) Charles A. and Jill A. Martorana (1) Mashita Restaurant (1) Julien J. and Kathi E. Mason (1) Pamela R. Mason (2) Patricia A. Mason (1) Peggy G. Mason (28) Pamela Mason and her therapy dogs (1) Massanutten Chapter DAR (1) Monica Mathusek (1) Philip H. Maxwell (33) Maribeth May (1) Garry Maynor (1) William G. and Nancy F. Mccann (1) Rodney McCarter (1) G. Richard McClung Jr. and Susan H. McClung (1) Matthew C. McCoy (8) Ellen B. McDorman (3) McGaheysville Ruritan Club (1) Warren McKeen (1) Colonel Richard K. McNealy (16) Drs. David K. and Charlette E. McQuilkin (6) Michael Meffert (1) Ann and Neal Menefee (27) Colonel William P. and Frances A. Menefee (2) Mill Creek Church of the Brethren New Covenant Sunday School Class (1)

Craig M. and Lois Blanch Miller (1) Dwight E. Miller (4) Fern Miller (1) Janice K. Miller (7) John F. III and Judith A. Miller (3) Margaret (Peggy) M. Miller (22) Mervyl L. and Linda H. Miller (3) Karen and Mike Miller (1) Pauline G. Miller (1) Peggy Miller (1) Rodney Miner (1) Douglas Mitchem (1) Frederick Mone (1) Sherry L. Mongold (9) Dr. Gregory F. and Karen Montgomery (1) Montivideo Middle School (1) John E. Moore (15) John Robert Moore (1) Margie L. Moore (14) Moorefield Elementary School (1) Ann Morris (1) Terry Morris (1) Dr. A. Glenn and Linda M. Morrison (3) John W. Morrow and Alaina J. Henry (1) Douglas J. and Lori B. Moyer (4) Karen Moyers (1) Leonard Moyers (1) Eugene and Pam Moyers (1) Susan K. Moyers (1) Douglas J. and Yvette M. Munnikhuysen (8) Charles M. and Rebecca C. Munse (1) Danielle Murrie-Robinson (1) Kristen Myers (1) R. Wayne Myers (1) Peggy W. Nagel (1) Foelke D. Nair (27) Alan Neckowitz (1) Chip Neese (1) Georgia Nelson (1) Kevin and Jenifer Nesselrodt (1) Darlene L. Newman (7) James and Virginia Newman (1) Larry Newman (1) Kevin and Jerrica Nixon (1) Janis Norton (1) Ruth Oates (1) William and Jeannie O’Brien (1) Dan and Gail O’Donnell (27) Cody and Eugene Oliver (1) Chris and Sarah Orem (2) Rick and Sue Orem (1) Renee A. Ours (5) George and Ann Pace (2) Lt. Col. Frank G. Padilla USAF (Ret.) (7) Mobley Padilla (1) Park View Federal Credit Union Mortgage Department (1) Eugenia E. Parker (12) Jane Parker (5) Edward C. and Carol L. Parks (12) Stephen A. and Shirley L. Parsons (2) Charles Pascale (1) Joshua R. and Julia L. Pate (1) Deborah J. Pavay-Thompson (1) Elizabeth Pazur (1) Clement C. III and Carolyn S. Pearce (1) Edward and Beth Pease (1) Owen C. Pence (8) Tom Pender (1) Drs. Zack and Judith Perdue (1) Philip and Karen Perkins (1) Dany and Mary Perramond (1) Thomas A. and Daille G. Pettit (11) Richard A. and Judith A. Phillippi (1) Julie A. Pierantoni (2) Richard G. and Annie L Pierce (9) Debbie Pine (1) Carolyn Piner and Wes Conley (1) Orlando A. and Eloise E. Pinneri (8) Sheryl Powers (1) Deborah M. Proctor (1) Kenneth B. Jr. and Linda J. Propst (1) S. Walton Propst (3) Betty H. Puffenbarger (1) Qdoba Mexican Grill (1) R & G Services and Joshua Wilton House (1) John E. and Jean L. Ralston (2) A. Kenneth and Mildred L. Ranck (5) Mark Rankin (1) Tim Reamer (1) Patra H. Reed (7) David and Elizabeth P. Reedy (1) Kenneth and Phyllis Reeves (1) Dr. Harold F. III and Donna S. Reilly (14) William Reinhold (1) Barbara A. Reisner (1) Renaissance Charitable Foundation Inc. (1) David and Janet Reser (1) Eleanor S. Rexrode (20) Dewayne C. Rhodes (1) Janice Simmers Rhodes (1) Roxanne Rhodes (3) Susan L. Rhodes (1) James B. Richardson Jr. (12) Jay B. Richardson (1) Dr. Alexander V. Rilling (3) Lynn F. Riner (3) Deborah Ritchie (1) Jane W. Ritchie (1) Robbie Roberts (1)

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friends of the

RMH Foundation Lori L. Robinson (1) Patricia L. Robinson (1) Marci J. Rockhold (2) Charles W. and Patsy C. Rodeffer (2) John E. Rodes (10) Verna A. Rodes (1) Ronald W. and Mary Ellen Rohrbaugh (10) Jennifer Rohrer (1) Thomas R. and Laura R. Rosazza (1) Lori and Lee Rosen (1) Gary Ruckman (1) Dawn Ruple (1) Jon Ryley for AW (1) S & R Auto Service, LLC (4) Pat Sacra (1) Winifred Salyards (1) Jacqueline Sammon (1) Jim Sanders (1) Lara E. Sapp (1) Laurence and Evelyn Sauder (15) William Saunders (1) Garland R. and Denise L. Sawyer (1) Janice Scanlan (1) Richard and Jean T. Schaeffer (1) Doris Schinke (1) Bradley L. and Jayne P. Schlabach (1) Richard Schlabach (1) Noralyn J. Schulte (3) Joyce M. Schumacher (20) Katherine Schwartz (1) Elizabeth V. Scott (1) Robert S. and Patricia M. Scott (2) Kathryn K. Scripture (17) Ralph L. and Ann W. Sebrell (10) Donald W. Seese (7) Select Sires (1) Elaine Senn (1) Sentara College of Health Sciences (1) Sentara RMH Infant Photo Commission (2) Lucy J. Seymour (11) David W. Shaffer Jr. (4) Frank B. and Shirley S. Shakespeare (11) Donald R. and Linda R. Shanholtzer (1) Ronald and Janice Shanholtzer (5) Jerry D. Shank (1) Oren W. and Janet S. Shank (1) Penny Sharpe (1) Joann Shaver (1) Sharon Shears (1) Robert Shehane (1) Dr. Jonathan D. and Sheryl L. Shenk (7) Shepherd of the Valley Lutheran Church (2) Page Shields (1) Denise Dean Shifflett (1) Lori Ann Shifflett (2) William J. Shilling (2) Richard L. and Shirley M. Shimp (5) Alton K. and Helen W. Shipe (8) Jennifer and Aaron Shirkey (2) Glennys Shouey (1) James M. and Carol S. Showalter (22) James R. and Lisa N. Showalter (1) Mark C. Jr. and Dorothy S. Showalter (1) Becky Shreckhise (1) Ryan Silver (1) Dennis F. and Judy R. Simmons (3) Simply Farm to Table/Katie Auville (1) T. Edgar and Zizi C. Sipe (12) Pattye L. Sites (1) Patricia Skeins (1) Marvin T. and Sarah A. Slabaugh (4) Fred A. and Brenda V. Smiley (4) Ilene N. Smith (38) Jack and Mary L. Smith (1) Jeff Smith (1) Victor J. II and Cheryl B. Smith (12) Wendy Smith and Janice Funk (1) Joanne Smith-Knauf (1) Debbie Snider (1) Gene C. and Josephine G. Snyder (1) Brandy Sollenberger (5) R. Allen Somers (1) Edward L. and Janet C. Sonifrank (1) Margaret G. Sparks (1) Rita M. Spitler (1) Neese and Alma Spitzer (2) Selah Sprinkel (1) Dr. Kimberly St. Jean and Mr. John Kwak (1) Sarah Stallard (1) Starbucks (1) Richard Stees (1) Linda Stenger (1) Mr. and Mrs. David E. Stenson (1) Roy H. Stetler III (4) Ramona Stevens (1) James E. and Kay B. Stilwell (1) Ron Stimers (1) Phillip C. Stone (1) Stanley T. Stone (19) Edna W. Stoner (1) William G. and Hope Shank Stoner (15) William L. and Louise K. Stover (9) Alfred L. Strawderman (5) Esther J. Strawderman (13) Richard L. and Joyce K. Strawderman (13) India R. Strickler (3)

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Memorial Gifts Leon Armentrout Donald L. and Ginger B. Usry Thomas Baggott Janet Baggott David E. Batman Linda B. West Mitch and Mark Baugher Victor and Phyllis Morrison Juanita Hopkins Voorhees Nancy Hopkins Voorhees Wilda Billhimer Jean’s Fellowship Bible Study Edward “Chip” Lee Boyers Dana Dewing Stephen O. and Barbara Dawn H. Fisher Darrell and Susan Hensley Barbara J. Snyder Dr. Cecil D. Bradfield Nancy R. Bradfield Peggy Bradford Jay and Connie Coffman Anna H. Branner James B. Branner E. Melvin Browning Jeffrey D. and Faye B. Curl J. Allen Brubaker Erma R. Brubaker Don W. Brunk Patricia A. Brunk Barbara Buhl Keith S. and Denise R. Atkins C. Ray and Patricia W. Barrier Henry F. and Catherine S. Buhl Gary W. and Teresa B. Day Bruce A. and Rebecca J. Kipps J. Robert and Marjorie B. Moore Louie Z. Will

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RMH Foundation Dr. L. Daniel Burtner Louise R. Burtner Tracy Carson Michael Carson Rena Cavicchi Michael and Violet Allain Richard West Dean Suter Clatterbuck M. E. Conner Dean Suter Clatterbuck Frances C. Gapp Peter R. and Carol A. Hughes Madeline L. Pimenta Charles W. and Patsy C. Rodeffer E. John III and Carol H. Rosenberger The Rotary Club of New Market Eugene Coakley Nelson and Linda Simmons Cornelia Coronel Jeff Smith Lia Coronel Officers and Employees of the Colonial Williamsburg Foundation Janet Crafford Mae M. Corral Mildred F. Branner Richard D. Davis Diane C. Davis Lewis T. Dean Homer and Janice Whetzel J. William Dellinger and Virginia R. Dellinger Shirley L. Dellinger Eleanore Kennedy DeMaio William G. and Hope Shank Stoner Heinz Dieck Col. and Mrs. Peter F. Dieck Mary K. Dove Norma C. Bowman Mary Katherine Dove Robert E. and M. Jean Driver Gladys and Browniie Driver Sharon S. Kisamore Roger Finan Sr. Pamela Barker and “Undecided Readers” Roger Finan Sr. Lesley Dexter Victoria Elaine Ford Woodrow W. and Linda R. Carr Lattisa M. Evelsizer Richard F. and Zona M. Fotter William Hugh and Barbara C. Hutchens Keezletown Methodist Church Relay For Life Team H. Paul and Betty Jo Obaugh Tammy S. Obaugh Edith Gallaher Susan S. Gallaher Ruby Angeline Gallalee Edward R. and Nancy K. Gallalee Dr. Joseph E. Gardner and Janet L. Gardner Dr. Steven E. and Kathryn J. Gardner George E. Gilmer Richard Churchill Kinley and Cheryl Comer Russell and Carla Hamblin Richard Ling Ron and Barbara Little R. Larry Martin Joseph ‘Bill’ Goheens Jr. Robert and Judith Wildman Robert L. Halterman Marianne F. Halterman Dr. and Mrs. John B. Harrington, my wife’s parents Frederick A. and Alice H. Davino Vivian and F. H. Harrison Robert and Kathryn Manley Ruth Heatwole Anne W. Nielsen John Steven Hensley Sr. Jo Anne Dean Violet Hensley Linda A. Davis Terry D. King Paul Herald Community Mission Church of the Brethren John W. Cummings Emily Hill Eddie Ney and Margee Greenfield-Ney Al P. and Phyllis S. Saufley James F. Hoak Delores H. Hoak Jonathan Hofstetter Mervyl L. and Linda H. Miller Joyce E. Horst A. Kenneth and Mildred L. Ranck

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Russell E. Huffman Jr. Allen and Nancy Barr Saint Michaels Church Council of Lay Life & Work Darwin C. and Kathryn E. Simmons Cathy Hughes Merv and Marlene Webb Robert Hurley Ann Gerding Hurley William Jamison Polly A. Jamison Janet Mae Jordan Ellen C. Branner Anne G. Farmer Horst and Deborah Locher Philip and Karen Perkins Patricia Sears Shoults Judith J. Spahr Truck Enterprises Inc. M. D. and Janet L. Wager Homer and Janice Whetzel Louie Z. Will Lila June King Leslie E. and Judith A. Luginbuhl John “Bobby” Robert Kite H. L. Jr. and Mildred R. Maiden Carson and Della Kline Madge K. Trobaugh Janet C. Kohen Andrew I. Kohen Rita Lanham K. Vera Blum Michael T. Daly Robert Lee Layman Kim, Mike, Matthew, Melody and Christopher Brantley Houston Dickenson Jr. Totsie Ellen Zirkle Majorie Hope Wichael Leake Fred W. and Lois E. Beaufait Teresa A. Gonzalez Dr. James Hoffmann Mary Louise Leake Karen and Mike Miller Jennifer and Aaron Shirkey Larry and Suzanne Thomas Judith K. Warren Robert Lubrano, our son Anthony and Jeanne Lubrano Paulette Mills Robert E. and Mary E. Rhan Susan J. Morningstar Ruby M. Lineweaver Victoria “Tori” Morris, RN E. A. Beckmeier Steven and Katy Wilson Bobby L. Myers Fay B. Myers Jeanette Nelson Ronnie B. Life Loyd B. Newman Jr. Shirley S. Newman Tillie Newman Lorraine Warren Strickler Vivian M. Nilsen Reverend K. Roy Nilsen Lois M. Oster Charles V. Oster Neese and Alma Spitzer Merv and Marlene Webb Denise A. Whitman Donna Faye Parady Lewis Parady Ray Parker Nancy M. Farrar Jarrett A. and Linda P. Nesselrodt Irene E. Parker Pathfinders Sunday School Class of West Side Baptist Church Lyndsay and Nick Von Ehrenhelm Westside Baptist Church Roger P. Pence and Hallie B. Pence Janice L. Pence Robert Eugene Pratt June E. Jordan Lois M. Rhodes and Shawn L. Rhodes West Side Baptist Church Page P. Price Eleanor Page Price Dorothy V. Price and Evelyn V. Stultz Rodney and Ruth Stultz Harry and Rick Rawley Dennis and Mary Jane Rawley Betty Brannon Rice Ann Rice Yager A. Jackson Ridder Linda R. Ridder

David Rodes Covenant Fellowship Warner Insurance Agency, LLC Wayne Hills Baptist Church Sadie B. Rodes John E. Rodes Arnauld Scafidi, MD J. Leo Crosier, M.D and Mrs. Virginia R. Crosier Mr. and Mrs. Rhodes & Mr. and Mrs. Jim Sheffer Jimmy J. Sr. and Carolyn R. Sheffer Erik Carl Shifflett Denise Dean Shifflett Charles “Bud” Somers III Nancy O. Cisick Mensel and Linda Dean Eleanor L. Garber James F. Logan Jr. and Carole S. Logan Eddie Ney and Margee Greenfield-Ney Martin J. Ritchie India R. Strickler James O. Stepp Janet S. Stepp Wayne A. Strawderman Esther J. Strawderman Ardath K. Sutherland Fred G. Sutherland Betty Swartz Robert B. Jr. and Jeanne S. Minnich Roseann Szmagaj Kenneth Szmagaj Jeanette Nina Taylor Matthew A. and Heather H. Diehl Donald Trobaugh Madge K. Trobaugh Larry Trobaugh Laura Evans William D. Koogler Family Elly Lafkin Susan and David Lawrence John F. III and Judith A. Miller Miller, Jameson & Brake, LLP James Morris and the Morris Family Park View Federal Credit Union Mortgage Department Lynn and Diane Trobaugh Eileen Waterhouse Chris and Cindy Whitelock Holly Tutwiler William R. and Barbara H. Hite Margaret Tysinger Carolyn T. Landis Danny Usry Jeffrey D. and Faye B. Curl Richard L. and Pamela B. Wilkins Jane Van Ryan Ronald P. and Julianne Jilinski Anne H. Vance William and Suzanne Vance Cecil L. Wampler Dorothy K. Wampler Charlie Bill Warren Dan and Gail O’Donnell Norris Elwood Weaver Lyn Simmons Weaver Anna T. Whitmore Kenny and Denise Sager Mildred Wilkinson John R. Wilkinson Jack C. Will Louie Z. Will Phillip Wilberger Long View Farm Homeowners Association Shirley Willis Todd Trivett Frances E. Wyant (Mother) Evelyn S. Hedrick Brenda M. Wynn Fredd Wynn

Honor Gifts All RMH Caregivers Philip H. Maxwell Timothy Bill, MD Shirley F. Hupp Jennifer Bruno John W. and Beverly M. Leonard Jennifer Bryant Randy and Donna Harper Christine Burner Denise Whitman Hope Clatterbuck Shelba J. Clatterbuck Christy Crawford and CCU Unit Staff Melonie Knicely

TMD - live strong good buddy!

Cory R. and Donielle Davies Brittany Davis Eastside Church Terri Denton Denton Family Charitable Foundation In appreciation to the Doctor, PAs, Nurses, Technicians and Others David A. and Karin E. Mars Front line doctors and nurses, and all staff keeping the patients safe Nancy R. Bradfield Mary Katherine Dove J. Brisco and Janet Dellinger Dr. Punkaj K. Dua Karen Wood Grizzard Barbara Dumler Roy and Karen Norville Dr. Morris J. Fendley William G. and Hope Shank Stoner Margaret Furr, RN William Reinhold Megan A. Grizzard Karen Wood Grizzard Jeff Guinn Gary and Judy Hall Brenda N. Hall Lorraine Warren Strickler Health Care Workers Jay B. Richardson Andrienne Hoover Cody and Eugene Oliver Ayla Hottel, Emergency Department Nurse India R. Strickler Fred and Alice Houff Kern L. and Chanda C. Houff James “Kip” Jenkins Joseph B. Jr and Kathryn H. Bowman Roger L. and Mary Frances Lam H. L. Jr. and Mildred R. Maiden Ken and June Monger Carolyn Piner and Wes Conley James B. Joyner, Minister Catherine W. Joyner Dr. Earl D. King Daniel B. and Susan Weiss Behrend Roger L. Lam Mary Frances Lam Mary Louise Leake Amy Kiger Alfred B. and Dottie S. Whitt Dr. Shawn M. Lepley Donna Tinsley Bud and Betty Long Orville L. and Betty H. Long The Incredible Medical Teams at RMH, Thank you!

Emily McCarty Denise Morin Norma L. Greenleaf Lowell Moyers, 80th Birthday March 21 Owen R. and Judy M. Burkholder Sarah Orem David A. and Karen L. Barnes Jessica Pultz India R. Strickler Dr. Brian E. Robinson John and Cindy Reeves Nelson and Linda Simmons William G. and Hope Shank Stoner Kyle Sampson Keith B. and Jennifer R. Sampson Linda Sue Shank Fern Miller Julia Shirkey, Jamin Engel and Ian Swartz Gary Ruckman Nancy Smith William E. Bray Jr. SRMH Emergency Department Staff Jane W. Ritchie Dr. T. Keith Vest Linda T. Wilt Brittney Villeda Merrie Burruss Janet T. Wendelken Drs. David K. and Charlette E. McQuilkin Dr. Duane S. White Roberta (Robbie) and Robert K. Wilkins Dr. Mary Helen Witt N. Paige and Ann C. Will Dr. Mary Helen Witt Robbie Jean Zirkle Jane Yokum retirement from Moorefield Elementary School Moorefield Elementary School Dr. George Zimmerman, DO Margaret Hahn

98.6°

You’re Safe at Sentara

Screening Everyone Who Enters Our Facilities

Masking Everyone Who Enters Our Facilities

Personal Protective Equipment (PPE) for All Clinicians & Staff

Ongoing, Robust Cleaning for Infection Prevention

Virtual Care Appointments When Appropriate

Ensuring Social Distancing

Limiting Visitors

COVID-19 Testing Before Some Tests & Procedures

In times of uncertainty, trust that Sentara is here to keep our community safe. We are following strict guidelines and have implemented extra safety measures to ensure you are safe while receiving the care you need. When it comes to your health, don’t wait to seek care.

You’re safe at Sentara.

To learn more about the precautions Sentara is taking to keep you safe, visit sentara.com/safe.

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

SENTARA RMH HEART & VASCULAR CENTER

AWARD-WINNING HEART CARE CLOSE TO HOME When you or a loved one are faced with heart or vascular problems, the Sentara RMH Heart & Vascular Center is here for you. Our award-winning team of expert cardiologists, vascular surgeons, nurses and staff provide a comprehensive program for our community.

We are now pleased to welcome Matthew Cauchi, DO, interventional structural cardiologist, and Jedidiah McMunn, MD, general cardiologist, to our growing team.

ABOVE: In 2019, Sentara RMH Medical Center was named one of the Top 50 Cardiovascular Hospitals by IBM Watson Health.

For more information, visit sentara.com.

Follow us on Facebook and Twitter, @SentaraRMH.