Sentara RMH Spring 2020 Magazine

SENTARA RMH Magazine

SPRING 2020

Faster Care

Revamping Processes in the Emergency Department PLUS: Minimally Invasive, Minimally Scarring Breast Surgery New Procedure for Treating Afib | Sentara in the Blue Ridge

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PRESIDENT’S LETTER

A Long Tradition of Excellence

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SENTARA RMH MEDICAL CENTER PRESIDENT

Doug Moyer Editors

Jenn Downs Neil Mowbray Contributors

Luanne Austin Karen Bowman Preston Knight Lisa Smith Jennifer L. Stover Photography

Luca DiCecco Andrew Shurtleff Tommy Thompson Design

n June, Sentara RMH Medical Center will celebrate its 10th year of caring for our community in our current facility. I wasn’t here when the new RMH hospital and health campus opened, but I have learned that “move day” on June 22, 2010, was uneventful, thanks to more than a year’s worth of intense planning and practice leading up to the move. On that day, RMH transitioned 95 patients to the new facility without causing any harm or unforeseen disruptions in care. And since my arrival to Sentara RMH more than three years ago, I’ve witnessed firsthand this same dedication to providing safe, high-quality care to our patients and their families. This community should expect no less from its hospital.

The Sentara RMH commitment to building on our long tradition of excellence— stretching back over more than a century—is why we are always striving to improve the quality of the care we offer. One recent example of that commitment was the installation of the Varian Truebeam® linear accelerator in the Hahn Cancer Center in late 2019.This best-in-class technology for providing radiation therapy was made possible in part because of our hospital’s commitment to excellence, but also largely thanks to financial support from many community members. We are all so grateful for our community’s life-saving generosity.

In this issue of Sentara RMH Magazine, you will find other concrete examples of how the hospital continues to bring advanced, innovative and patient-centered care to our community. In the past year, we have started offering a new technology called the WATCHMAN™ Implant, which helps reduce the potential risks of stroke for atrial fibrillation patients who cannot tolerate the long-term effects of blood-thinning medications (see article on page 29). On page 24, you can learn about Dr. Shannon Tierney, a breast surgeon who joined our team last year. Dr.Tierney offers minimally invasive and minimally scarring breast surgery to her patients, making a significant difference in the lives of many women facing breast cancer treatment. Beginning on page 19, you can also learn how the Sentara RMH Emergency Department has redesigned its space and reworked many of its processes to improve its efficacy, including faster patient care.

In addition to these new technologies and service advancements, the daily work of our staff, and their commitment to patient-centered care, shouldn’t be overlooked. For example, as an added safety measure for patients, members of our team double-check each other when administering crucial medications. Employees are also empowered to express any trepidations they may have about a patient’s care, and can even temporarily halt care when concerns arise.This empowerment is embraced in our operating rooms and in all of our settings, and best practices identified at Sentara RMH or at other Sentara hospitals are frequently shared and replicated across the Sentara Healthcare system. No matter what their position, all employees play important roles in ensuring the best and safest care for all of our patients, and I couldn’t be more proud of the Sentara RMH team.

In closing, as we celebrate the success we’ve seen over the past 10 years, I’d like to extend a special invitation to you and your family. On Saturday, June 27, Sentara RMH will be hosting a community event at the hospital to celebrate our 10th anniversary, during which we will provide important health screenings, share the latest information on the services we offer and have some family fun! Watch for more information as we get closer to the date—I hope to see you there!

Thank you for choosing Sentara RMH for your healthcare needs,

Picante Creative

Doug Moyer President, Sentara RMH Medical Center

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Contents SPRING 2020

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Breast Surgery without a Trace Minimally Invasive, Minimally Scarring

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Faster Care

A WATCHMAN for the Heart

Sentara RMH Revamps Emergency Department

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A New Way to Reduce Stroke Risk

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Contents

SPRING 2020

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

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New & Noteworthy

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Physician’s Perspective

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Strong as Ever: Heart Care at Sentara RMH

On-Call Advice

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Improve Health Every Day Aging Well

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Building Muscle after Age 50

Calendar

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Sentara in the Community

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Health Matters

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Signs and Symptoms of Stroke

La Salud Importa 17

Calendar

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Sentara’s Commitment to the Blue Ridge Region

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Las señales y síntomas del accidente cerebrovascular

Eat Well, Live Well

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Budget-Friendly Healthy Eating

Philanthropy

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THE BEST MEDICIN E

BY MICHAEL CORDELL

My Career in Health Care

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hirty-seven years after getting my master’s degree in hospital administration and entering the wild and woolly world of health care, I’m retiring. That word still catches me off guard—retirement is something a grandparent does, not me. I’m still a kid. Or at least a kid at heart. Well, OK, it’s a pretty old heart, but still …

It’s a fluke I even went into healthcare administration. I was studying journalism at the University of Nebraska and was considering getting a master’s degree in playwriting, so I could make big bucks writing plays for local theater groups. That seemed like a solid plan.

To put myself through school, I got a part-time job at my university’s student health center, and I absolutely loved it. To this day I can’t explain what it was about that job, but being in a setting filled with truly caring professionals helping others immediately resonated with me. After working there for a couple of years, I changed career paths: I wanted to work in health care. I knew I wasn’t bright enough to be a nurse or a doctor or a lab tech, so I decided to go into management.

I attended the University of Missouri’s health administration program. It was a challenging adjustment, both for me and the school. My brain was wired differently from many of my classmates, most of whom had undergraduate degrees in business. One time we had to draw a decision tree in a planning class. My decision tree had branches and squirrels and leaves and nuts. My professor was quite angry; he wasn’t sure if I was being insolent or an idiot (apparently he thought it was an either/or situation).

Somehow I graduated and ended up in Virginia. Since my undergraduate start at a student

health center, I’ve worked at two academic medical centers and three community hospitals, including Sentara Martha Jefferson Hospital and Sentara RMH Medical Center, as well as a local hospice organization. There are too many experiences to sum up in a letter like this, but some of my key career observations include the following: • Most everyone in health care cares. There is definitely a wide range of personalities in a hospital, which can make for interesting work dynamics, but people are there for the right reason: to serve those in need. When everyone in health care remembers that, we can do amazing things.

• The challenge of running a place that absolutely never closes is striking. When Martha Jefferson and RMH opened their new hospitals a few years ago, I was struck by the fact that once their front doors were unlocked, they would always be open. Not just 24/7/365, but quite possibly for the next 50 or 60 years. Always.

Open. It’s a marvel.

• The range of care and the magnitude of activities that take place in a hospital every single day are also stunning. Every day, under one roof, babies are born, surgeries are performed, emergency care is delivered, cancer treatments are conducted, diseases are diagnosed, lives are saved, lives are lost, families are consoled, and people are fed, cleaned and cared for—and that only represents probably 15% of what takes place in a hospital. Every day.

• Decision trees don’t have squirrels in them.

Sometimes I think about how different my life would be if I hadn’t taken that job at the student health center. I’d be living in some other part of the country, with different friends, a different wife and a different career to look back on.

I’m glad I took that job. It’s been a good run.

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new& noteworthy Sentara 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. The physician referral line is a free service that can help you find a provider who fits your individual needs. More information can also be found at www.sentara.com.

Jeffrey B. Adler, MD Emergency Medicine US Acute Care Solutions

Blake L. Brown, PA-C Allied Health Sentara Cardiology Specialists 540-689-7400

Elaine A. Clancey, NP Allied Health Sentara Cardiology Specialists 540-689-7400

Trudy M. Colaw, FNP-C Allied Health Sentara Hospital Medicine Physicians

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Hunter Hensley, PA-C Allied Health Sentara Orthopedic & Sports Medicine Specialists

Katelyn Ray, FNP-C Allied Health Sentara Palliative Care Specialists

540-689-5500

540-564-5600

Miranda N. Hinkle, PA-C Allied Health Sentara Vascular Surgery Specialists

Nina Smith, MD Wound Care Sentara Wound Healing Center

540-689-5800

540-689-2100

Robert A. Lancey, MD Cardiothoracic Surgery Sentara Cardiothoracic Surgery Specialists

Frances R. Vitalis, NP-C Allied Health Sentara Wound Healing Center

540-689-5555

540-689-2100

Katy C. Lopez-Vasquez, MD Family Medicine Rockingham Family Physicians

Martha Williams, PA-C Allied Health Sentara Hospital Medicine Physicians

540-433-3344

Jennifer R. Derby, DO Family Medicine Sentara Timber Way Health Center

Jessica A. Yoder, MD Family Medicine Sentara South Main Health Center

540-901-0800

540-564-7300

SPRING 2020

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Meet Dr. Anthony Bruno, Our New Vice President of Medical Affairs In December, Sentara RMH welcomed Anthony Bruno, MD, MBA, CPE, as the hospital’s new vice president of medical affairs (VPMA).

Before taking this new role with Sentara, Dr. Bruno served as VPMA and chief medical officer at Wayne UNC Health Care in Goldsboro, N.C. Prior to that position, he practiced for nearly 21 years as an orthopedic surgeon in Pennsylvania.

Dr. Bruno brings extensive experience and a proven record of success in the medical field and is a valuable addition to the Sentara RMH team.

Dr. Bruno earned his MD degree from the Pennsylvania State University College of Medicine. He completed his training in general surgery at the University of Massachusetts and Penn State, as well as an orthopedic surgery residency and an orthopedic research fellowship at Penn State. He is boardcertified in orthopedic surgery, and also holds an MBA from the University of Tennessee.

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Sentara Neurointerventional Clinic Expands Service at Sentara RMH

To meet growing patient demand, the Neurointerventional Clinic at Sentara RMH has expanded its service from one day per month to a weekly clinic that sees patients at the Sentara Evelyn Byrd Health Center in Harrisonburg. The clinic is staffed by interventional neuroradiologists based at Sentara Martha Jefferson Hospital’s Neurosciences Center in Charlottesville: Dr. Lee Jensen, Dr. John Gaughen and Dr. Andrew DeNardo.

Interventional neuroradiologists treat a wide variety of problems involving the blood vessels of the brain and neck, including stroke, brain aneurysms, carotid artery stenosis (narrowing) and intracranial stenosis (narrowing of the vessels in the brain). About half of the neurointerventional patients seen at Sentara RMH have come through the Emergency Department, many of them with symptoms of stroke. A quick-transport system, which includes ambulance and medical helicopter service, transfers appropriate patients to Sentara Martha Jefferson for neurointerventional procedures like mechanical thrombectomy, a process for removing stroke-inducing blood clots from arteries in the brain or neck. The clinic offered at Sentara RMH provides follow-up care for these patients, as well as for patients referred to the clinic for other needs.

The Neurointerventional Clinic at Sentara RMH offers a 24/7 line for physicians to reach neurointerventional providers with both emergent and nonemergent patient needs.

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PHYSICI AN’S PERSPEC TIVE

Strong as Ever

Heart Care at Sentara RMH

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By Yuriy Zhukov, MD, Sentara Cardiothoracic Surgery Specialists

SPRING 2020

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“Just keep breathing.”

That’s a bit of advice I occasionally give patients who are going through a tough time.

Focusing on this most basic element of respiration seems to help reduce anxiety in many stressful circumstances, and it’s advice I also use myself. In the operating room, for instance, when I’m placing a challenging stitch or dealing with a complex heart valve case, I sometimes tell myself to just keep breathing. And then I take that deep breath and keep operating.

A chief resident I knew, who was a few years ahead of me when I was training at the Mayo Clinic, had a different mantra— but one that works just as well.

When things got tough, Dr. Said would keep saying: “Don’t give up!” I can still hear that chant in my head.

Challenges and Enhancements Although my training at the Mayo Clinic prepared me to handle even the most challenging aspects of cardiothoracic surgery, many things still arise in carrying out my everyday duties that can only be learned on the job.

Since joining the Sentara RMH cardiothoracic team almost two years ago, things have changed significantly in that short time. Probably the most challenging adjustment occurred when several colleagues left our program. At that point, finding ourselves with fewer team members, Dr. Said’s advice became especially relevant.

Through perseverance, I’m pleased to report that we were soon able to recruit multiple talented new team members and get them trained and oriented to our processes and expectations.

And in spite of the personnel changes, the mission of our cardiothoracic team—to provide the safest, highest-quality heart care

possible—hasn’t wavered one bit.

In addition to adding new providers, in 2019 we advanced the breadth and depth of the cardiothoracic surgery program at Sentara RMH. Last year, 200 patients received a new lease on life by having their hearts mended in our operating room, and many more received treatment to open blocked coronary arteries and address other cardiac issues in our Catheterization Lab. In addition, dozens of patients improved their chances of surviving lung cancer, thanks to the safe, effective thoracic surgeries our team performed.

Earning National Recognition In late 2019, Sentara RMH was recognized by IBM Watson Health as one of the top 50 cardiovascular hospitals of 2020!

The IBM Watson list also includes St. Mary’s Hospital at the Mayo Clinic, so it’s nice to find myself in familiar company!

As I ask myself just how we managed to impress the all-knowing IBM Watson Health team and receive this important, impressive national recognition, I keep concluding the same thing: We are fortunate to be surrounded by a group of fantastic colleagues and friends who made this progress possible. Gifted physicians, compassionate and skilled nurses, and sentara.com

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PHYSICI AN’S PE R S P E C T I V E

Award-Winning Heart Care at Sentara RMH Sentara RMH Cardiovascular Services recently received two prestigious national awards for excellence in heart care.

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IBM Watson Health has included Sentara RMH among its 50 Top Cardiovascular Hospitals for 2020.

This top-50 designation is part of the Watson Health 100 Top Hospitals® national benchmark series. Being named a 50 Top Cardiovascular Hospitals winner means that Sentara RMH outperforms its peers on measures that include inpatient and extended outcomes, clinical processes, and efficiency and cost for common cardiovascular conditions and cardiac interventions.

Sentara RMH also has received the American College of Cardiology’s NCDR Chest Pain–MI Registry Platinum Performance Achievement Award for 2019, and is one of only 225 hospitals nationwide to receive this award. The platinum award recognizes Sentara RMH’s commitment to, and success in implementing, a higher standard of care for heart attack patients, and also signifies that Sentara RMH has reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/ American Heart Association’s clinical guidelines.

one of the hardest working operating room teams I’ve known should receive much of the credit. In addition— and most important—the trust and support of this community is vital to our ongoing success and continued growth. Without the trust of our patients to come to Sentara RMH for their heart care, we would have no reason to be here.

A Multidisciplinary Approach

Meet Dr. Yuriy Zhukov Yuriy Zhukov, MD, is medical director of Sentara Cardiothoracic Surgery Specialists.

His clinical interests include adult cardiac surgery, structural heart disease, mitral valve repair, transcatheter aortic valve replacement, surgical treatment of atrial fibrillation, coronary revascularization and hypertrophic cardiomyopathy.

Dr. Zhukov graduated from the Indiana

Our cardiothoracic surgery University School of Medicine and program and the other heart completed his general surgery residency and a fellowship in cardiothoracic surgery care programs at Sentara at the Mayo Clinic. He is board-certified in RMH are as strong as ever general surgery and cardiothoracic surgery. because of the multidisciIn his spare time, Dr. Zhukov is a private plinary approach we take. pilot and enjoys skydiving.

To improve our level of care, in recent years we have developed an ever-closer collaboration among the Cardiology, Pulmonary Critical Care, and Cardiothoracic Surgery departments, and our patients have been the greatest beneficiaries of these efforts.

Even though this collaborative, multidisciplinary approach is receiving increased emphasis in modern medicine, it’s actually not really that novel. In fact, its importance was recognized many years ago

by Dr. Will Mayo, one of the principle founders of the Mayo Clinic.

“As we grow in learning, we more justly appreciate our dependence upon each other,” Dr. Will wrote. “The sum-total of medical knowledge is now so great and wide-spreading that it would be futile for one man to attempt to acquire, or for any one man to assume that he has, even a good working knowledge of any large part of the whole. The very necessities of the case are driving practitioners into cooperation. The best interest of the patient is the only interest to be considered, and in order that the sick may have the benefit of advancing knowledge, union of forces is necessary.” [emphasis added] Without learning from the past, it is much harder to affect the future. As we move forward, I am certain we will have many new lessons to learn here at Sentara RMH, and that new challenges and changes in providing health care will continue to arise. But in the face of all that, I believe the lessons I learned at the Mayo Clinic will remain unchanged: Don’t give up!

Always provide the best patient-centered care possible.

And just keep breathing …

SPRING 2020

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ON-CALL ADVICE

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

S

What is sepsis?

epsis is a potentially life-threatening complication arising from infection in the body.

The condition occurs when the body attempts to fight an infection by releasing chemicals into the bloodstream that cause an overwhelming inflammatory response throughout the body. This inflammation can lead to tissue damage, organ failure and death.

Typical signs that sepsis is starting to occur include rapid heart rate and breathing, fever, chills, or disorientation—particularly if any of these signs is accompanied by a known or suspected infection. As sepsis becomes more severe, the affected person typically experiences one or more signs of organ failure, such as decreased urine production, decreased platelet count, sudden changes in mental status, abnormal respiration or circulatory problems. People who go into septic shock often exhibit dangerously low blood pressure that does not respond readily to fluid-replacement therapy.

Diagnosing sepsis can be difficult because many of its symptoms also occur with other illnesses. Blood tests; analysis of other bodily fluids such as urine, sputum and wound secretions; and imaging studies such as ultrasound, CT or MRI may be used to pinpoint the type and source of the infection that is causing the sepsis.

Treatment typically involves use of broad-spectrum antibiotics

to fight infection, vasopressors to raise blood pressure, and other medications such as corticosteroids and insulin. Supportive therapy may include oxygen and large amounts of intravenous fluids. In some cases, patients may require respirators or dialysis.

Sepsis is most common and most dangerous in older people, those with compromised or

suppressed immune systems, and people with wounds or burns.

It often occurs in hospitalized patients—particularly those in intensive care units who may have breathing tubes or intravenous catheters.

Most people with early or mild sepsis recover, but the death rate of those with septic shock is approximately 40-50 percent. As the U.S. population ages, healthcare providers are seeing an increasing incidence of sepsis, and with that in mind, hospitals are working to implement effective preventive measures and to raise awareness among providers to help ensure that effective treatment begins in the early, milder stages of the disease.

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ON-CALL ADVIC E

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

What is venous stasis disease?

Is there a cure?

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enous stasis, also known as chronic venous insufficiency (CVI) is a condition in which the veins in the lower legs don’t work properly. In healthy veins, small valves in the vessels open and close to help blood in the legs return to the heart.

The walls of veins also work with the valves to help circulate blood. But if the valves and walls fail to work properly, blood can pool in the lower legs—a condition known as stasis— and result in a number of chronic problems.

CVI is more common in people over age 50, and women are more likely to develop CVI than men. Smoking also can increase a person’s risk of developing CVI. Damage to the valves and vessel walls can result from aging, sedentary lifestyle, sitting or standing for long periods of time, obesity, high blood pressure, heart or kidney failure, varicose veins, or frequent pregnancies. Clots occurring in

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the deep veins of the legs also can cause CVI. Early symptoms of CVI include swelling in the lower extremities, especially around the ankles, and feelings of heaviness in the legs when walking or standing. As the condition progresses, symptoms may include itching and burning; yellow, red or brown discoloration of skin below the knees; pain; and sores that develop on the lower legs, especially around the ankles and shins, that ooze fluid or look scaly or crusty.

Unfortunately, there is no cure for CVI. Treatment aims to improve circulation in the legs through the use of compression stockings, which aid in circulation and help reduce swelling that leads to

skin changes; doing exercises such as walking that cause the leg muscles to contract, helping push blood back toward the heart; and periodically and regularly elevating the legs above the heart. In some cases, surgery can help correct venous insufficiency in the legs.

Medications can be prescribed to treat pain, itching and swelling in the legs.

People can avoid developing venous insufficiency by eating a healthy diet, having an active lifestyle, maintaining a healthy weight and avoiding smoking. It is also advisable to avoid sitting or standing for long periods of time without movement, and to wear clothing that does not constrict circulation in the lower extremities.

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IMPROVE HEALTH EVERY DAY

Clearing Up Myths About

Scabies

Scabies is an infestation of the skin by microscopic mites called Sarcoptes scabiei, which burrow into the top layers of a person’s skin and lay eggs. The activity of these tiny mites typically causes a severe itch and rash in the area of infestation.

The condition can be confused initially with mosquito bites or acne, but the severe itch—especially at night—is a characteristic indicator of scabies infestation.

Contrary to common belief, scabies is not a result of poor hygiene, and the infestation can occur in people who bathe daily. Another misconception is the fear that scabies is highly contagious. Although the condition is contagious to some degree, prolonged skin-to-skin contact is typically required for the mites to crawl from one person to another. According to experts, it is much less likely for scabies mites to infect a person from casual contact, such as a handshake or touching a garment worn by someone with scabies. In addition, unlike mosquitoes and fleas, scabies mites cannot fly or jump from one person to another. If you suspect an itch with rash might be scabies, check with your physician. Treatment with creams, ointments or oral medications will kill the mites and their eggs.

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IMPROVE HEALT H E V E RY DAY

The Hidden Dangers of

Osteopenia and Osteoporosis

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Our bones are at their densest when we are around age 30. Unfortunately, as we age, bone loss can set in if the body makes less new bone tissue than the old bone it absorbs. If bone loss occurs, our bones become thinner, weaker and less dense than normal. This condition is called osteopenia, which is a middle stage between healthy, strong, dense bones and full-blown osteoporosis, a condition of weak, brittle, porous bones that are prone to fracture. Both conditions result in part from a lack of adequate calcium intake as we age.

Typically occurring in people after age 50, osteopenia is more common in women, probably because the hormonal changes that occur after menopause can raise a woman’s risk of developing bone loss. Men with low testosterone levels are also at higher risk for bone loss. There are no early symptoms of bone loss, and often a person does not know his or her bones are fragile until a fracture occurs. However, bone scans can indicate if a person’s bone density is lower than normal.

Bone loss can be slowed and managed with proper diet, exercise and medications, if appropriate. If you are middle aged or older and concerned about bone loss, talk to your healthcare provider and ask about the appropriateness of having a bone density scan.

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Finding cancer at its earliest stages is one of the most important factors in its successful treatment and cure. Unfortunately, there are no effective screening methods for early detection of pancreatic cancer, according to the American Cancer Society, and because the pancreas lies deep within the body, pancreatic tumors often are not discovered until they are quite large and advanced. Pancreatic cancer also may not produce any signs or symptoms until it reaches an advanced stage or spreads to other organs.

However, a number of risk factors are known to be significant in the development of cancer in the pancreas, and some of these risks can be controlled:

Risk Factors for

PANCREATIC CANCER

• Smoking—one of the most important risk factors for pancreatic and other types of cancer

• Obesity—carrying extra weight around the waistline is also a risk factor, even if the person is not obese

• Chronic inflammation of the pancreas (pancreatitis)—often associated with excessive alcohol use and smoking

• Diabetes—the relationship between diabetes and pancreatic cancer is complex, but having diabetes can increase a person’s risk Risk factors that cannot be controlled include the following:

• Age—most patients with pancreatic cancer are over age 65

• Family history—pancreatic cancer seems to run in some families

• Gender—men are at higher risk than women

• Race—African Americans are at slightly higher risk than whites About 1.6 percent of men and women in the United States will be diagnosed with pancreatic cancer at some point during their lifetime, according to the National Cancer Institute. However, having one or even several of these risk factors does not mean a person will develop cancer. You can significantly reduce your risk by not smoking, maintaining a healthy weight, exercising and properly managing diabetes.

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AG ING WELL

Muscle BUILDING AND MAINTAINING MUSCLE AFTER AGE 50

Up!

or many people, one serious consequence of aging is frailty, marked most noticeably by loss of muscle tone, strength and mass, as well as stiff joints with decreased mobility.

The condition often also results in weak, fragile bones that are more prone to fracture during a fall—an increasingly likely risk as people age. But is it possible to stave off some of these effects of aging, and maintain or even build muscle mass, improve mobility, and strengthen bones as we move into our fifth, sixth and seventh decades of life? Is it inevitable that our bodies will lose muscle as we age?

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“The answer is yes—and no,” says Benjamin Mwanika, DO, of Sentara RMH Orthopedic and Sports Medicine.

“There’s the old adage that you lose it if you don’t use it, and that’s certainly true. The more inactive you are, the less muscle mass you’re going to build and retain. But that’s no less true when you’re 20 or 30, than when you’re 60 or 70.”

The general tendency of muscle is to atrophy if it’s not used, Dr. Mwanika explains, and this kind of “disuse

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atrophy” is especially present in older people, who tend to be less active— often due to orthopedic or other physical problems they may have.

Another condition known as sarcopenia (“lack of flesh”) refers to muscle loss resulting from certain metabolic or physiological deficits that occur as we age, according to Clark Baumbusch, MD, with Sentara Martha Jefferson Sports Medicine. These deficits include lower levels of growth hormone and, in men, decreased testosterone levels, beginning typically after age 30.

The good news, both physicians agree, is that with strength training and proper diet, most people can slow down or even halt the processes responsible for loss of muscle mass and tone.

Thankfully, according to Dr. Mwanika, there isn’t really an age at which it becomes impossible to build muscle mass.

“It’s not likely that you’re going to build a ‘beach body’ when you’re 60 or 70, but most people can improve their muscle tone and even build muscle at any age,” he says. “However, the focus in older people should be on contributing to their overall health, rather than the aesthetics of bodybuilding.”

Why Build or Maintain Muscle as We Age? While muscle makes it possible for us to move, strong muscles also serve an important preventive function.

“People with significantly decreased muscle mass tend to have higher fall risk,” says Dr. Baumbusch.

“And that’s one of the single most concerning things in elderly people: falls leading to skeletal fracture.

Building or maintaining muscle tone and mass helps you maintain good balance. And if you do fall, having more muscle mass decreases your chance of having a traumatic injury.” sentara.com

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AG ING WELL

There is also evidence, he continues, that circulating growth hormones are present in higher quantities in people with greater skeletal muscle mass. Strength training to build muscle seems to help the body secrete more hormones like testosterone, which in turn contributes to increased muscle growth, setting up a kind of positive feedback cycle. In addition, having greater skeletal muscle mass helps boost the metabolism, causing more calories to be burned—even when we’re resting.

Strength training benefits more than just muscles, however.

The resistance that weightbearing exercise places on our bones helps keep them strong and contributes to growth of new bone tissue, Dr. Mwanika says. Stronger muscles also help stabilize our joints, making us less prone to joint injuries.

Strength Training Tips

Dr. Mwanika says he advises his patients who are 40 and older and are interested in strength training to proceed using common sense.

“You’re not likely to bench press the same weight at 65 or 70 that you did in high school or college, especially if you’re coming back to strength training after years of nonparticipation,” says Dr. Mwanika. “Trying to lift too much weight can lead to ruptured muscles or tendons.”

He generally recommends using lighter weights and doing 3 to 5 sets of 12 to 15 repetitions per set, with a 60-second rest between sets. Older adults also should give muscles sufficient time to recover.

“Following a strength training schedule of one day on, one day

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off is probably right for most people,” he adds.

Although lifting weights is an obvious way to build and tone muscle, it certainly isn’t the only way. Any type of resistance that regularly requires muscles to work can do the trick.

“There are multiple studies showing, for example, that doing resistance exercise on a stationary bike for 45 minutes, three days a week, will increase the mass of the quadriceps muscles over time,” says Dr. Baumbusch.

He also recommends adding some cardio exercise to any strength training routine to help improve the heart’s ability to circulate blood.

“Improved circulation resulting from cardio training will help pull lactic acid, one of the byproducts of exercise, from muscle tissue, helping you recover more quickly after strength training,” says Dr. Baumbusch.

Safety First

People who have been away from exercise for a long time should check with their physician before starting a strength training routine, particularly if they have any medical or musculoskeletal problems that might pose a risk of injury.

It’s also a good idea, says Dr. Mwanika, for those coming back to strength training to

consult with an athletic trainer, fitness coach, physical therapist or sports medicine specialist to help them find an exercise program that’s right for them.

While it is possible to lift weights at home, joining a gym can have multiple advantages, including a wide range of exercise options and trained staff who can help members safely learn the exercise movements while maintaining proper form.

“Particularly if they have any orthopedic problems, like a weak rotator cuff or arthritis in the hip or knees, they should check with a professional who can help them modify the exercises to find what works best for them,” Dr. Baumbusch says.

Warming up with light cardio exercise and stretching for five to 10 minutes helps prepare the body for exercise, he adds.

Following a heavy workout, doing a cooldown of light cardio and stretching for five to 10 minutes also helps clear the body of lactic acid and allows heart rate, body temperature and respiration to return to normal.

While there are huge health benefits to be gained from building and maintaining muscle, both physicians emphasize that it’s also important to find workout activities that are enjoyable, so that exercise doesn’t become just another chore— which can lead to burnout. Any activity, however, is better than no activity, and that’s true at any phase of life.

“Whatever your age, exercising and building strength can have important health benefits and help prevent injury,” says Dr. Mwanika. “It’s never too late to get those muscles working.”

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calendar

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. 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 • Diabetes Support Groups (adult and pediatric) • Hand-in-Hand Resource Mothers Teen Pregnancy Support Group • Mended Hearts Support Group • New Moms Ask a Nurse Support Group 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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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 Tuesdays, 8:15 a.m. 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.

Women’s Services Mammography Van Schedule Call 540-689-6000 or 800-277-1021 to schedule your mammogram at the following locations: March 13, June 22 • Elkton Area Community Center March 16, May 14 • Sentara Mount Jackson Health Center March 18, April 16, May 11, June 17 • Bridgewater Health Center March 19, May 13, July 14 • Grottoes Food Lion March 23, May 15, July 10 • Walmart, Timberville March 25 • Virginia Poultry Growers, Hinton March 26 • Munsey Medical Center, Staunton March 27, June 26 • Carilion Family Medicine, Weyers Cave March 30 • EMU March 31, May 1, May 18, June 12, July 2 • Sentara East Rockingham Health Center, Elkton April 1 • Shenandoah Valley Electric, Rockingham April 7 • Cargill, Timberville April 8 • EMU April 14, May 28, June 15, June 29 • Sentara Timber Way Health Center April 15 • Bowman Andros, Mount Jackson April 20, May 4, July 9 • Highland Medical Center, Monterey April 21 • Stone Spring Elementary School April 22 • Harrisonburg Parks and Recreation Center April 23 • Thomas Harrison Middle School April 24 • J. Frank Hillyard Middle School April 27 • Mamma Mia Italian Restaurant, Shenandoah April 28 • F&M Bank, Timberville April 29 • Pleasant Valley Elementary School

April 30, July 1 • Harrisonburg Community Health Center May 5 • Shenandoah National Park, Luray May 6 • Wilbur S. Pence Middle School May 7 • Broadway High School May 12 • Skyview Springs, Luray May 19 • Virginia Mennonite Retirement Center, Harrisonburg May 20 • Plains Elementary School May 21 • Gypsy Hill Park, Staunton June 1 • Eastern Mennonite High School June 2, June 9, June 16, June 23 • Cargill, Dayton June 3 • Fulks Run Elementary School June 4, June 19 • Marshalls, Bridgewater June 13 • Shenandoah Valley Electric Cooperative Health and Wellness Fair June 30 • Bridgewater Retirement Center July 7 • Lantz Construction, Broadway July 13 • Community Health Center (Shen Elk Plaza), Elkton July 15 • New Market Community Center

Sentara RMH Wellness Center 2500 Wellness Dr., Harrisonburg Offering state-of-the-art fitness equipment; group fitness and Pilates classes; warm-water pools, whirlpool and sauna; nutrition, CPR and first aid classes; child care; and more. Call 540-564-5685 for membership details.

Progressive Exercise Program (ProEx). $60 for a 60-day introductory Wellness Center membership and customized program to help you meet your medical needs and fitness goals. Ask your healthcare provider if you’re a ProEx candidate; if so, call 540-564-5626.

Aquatic Programs Group Swim Lessons. For infants to school-age children. Call 540-564-5521.

Private and Semiprivate Swim Lessons.

Ages 3 and older, all skill levels.

Call 540-564-5521.

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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Sentara RMH Revamps Emergency Department to Save Patients Time

Faster CARE

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In the past, patients with minor conditions such as ear pain or a sinus infection might have found themselves waiting for hours in a crowded emergency department (ED) waiting room, growing more frustrated as they watched more seriously ill patients receive attention more promptly.

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Sentara RMH Medical Center has taken steps to help prevent that type of situation with its newly redesigned ED, which separates acute patients from those who are considered to be nonacute (generally defined as patients who do not require constant monitoring and who are likely to be discharged quickly). With the recent changes, these two groups of patients no longer will be competing for the same bed space.

“In the past, sometimes we’d have numerous patients in the waiting room, on top of a full department and overflow unit,” says Brandy Sollenberger, clinical nurse manager for the ED at Sentara RMH. “In those cases, some patients might have had to wait six to eight hours, which was far from ideal.”

The redesign, which began in July 2019, is based on the concept of vertical care—also known as focused care—which helps streamline patient flow through the ED with a different physical setup and a new set of procedures. The goal of the new system is to release nonacute vertical care patients within two hours, and admit acute care patients to the hospital, if needed, within four hours.

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Before the vertical care system was fully implemented at Sentara RMH, the median time patients spent in the ED from check-in to departure was three hours. Following the redesign, that time has dropped by more than 25%, to 2.2 hours.

How Does Vertical Care Work?

When entering the ED, all patients are now seen by an intake nurse, who asks them about their chief complaint, takes their pulse and oxygen saturation level, and decides whether the patient should go to vertical/focused care or acute care, according to Gina Yost, process improvement manager at Sentara RMH. While patients are speaking to the intake nurse, which generally takes less than two minutes, they’re also being registered. Within 26 minutes of arrival, on average, vertical care patients are then brought back to a private exam room to speak with a care provider (physician, physician assistant or nurse practitioner) along with the intake nurse—another time-saving feature of the new process.

“We want patients to have to tell their story only once, not over and over to several different providers,” says Yost. “With the new parallel workflow, the patient only has to explain their symptoms one time.”

The provider will order imaging, labs or other tests, as needed, from the vertical care room. For patients with easily treatable illnesses, such as a sinus infection, the provider can order their prescriptions and discharge them right away, adds Sollenberger.

Another feature of the new system that helps save patients time is alluded to right in its name. To speed up care, vertical care patients literally stay vertical and don’t have to lie on a gurney or change into a hospital gown while waiting. Instead, they remain in street clothes. After seeing a provider, patients who require further testing may be taken to one of the eight recliners in the vertical care waiting room, where they are monitored by a team of nurses. For patient privacy, each recliner is separated from the others by a partition. Depending upon needed testing, the patient might also go to another small waiting room, where he or she would be called by a lab technician or imaging tech.

For sicker patients who may require more privacy, the vertical care area also includes four procedure rooms.

Improving Efficiency and Patient Care For the past five years, Sentara has been working to increase ED efficiency systemwide. As part of that effort, according to Yost, Sentara staff visited Kaiser Permanente in California to learn about the “Kaiser model,” which is aimed at reducing length of stay and optimizing workflow in the ED. Sentara Leigh Hospital in Norfolk was the first Sentara facility to implement the new model, followed by other hospitals in the Sentara system.

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guidelines while the supporting physical infrastructure was being constructed.

“When we were finally able to complete the renovation and move to the new vertical care area, we saw improvements almost instantly,” says Marcus Almarode, director of emergency and critical care at Sentara RMH. “Since then, the new system has greatly improved staff efficiency and the patient process.”

Although the new system can be a bit unfamiliar to patients at first, the intake nurse helps prevent any confusion by thoroughly explaining the process to newly arrived patients, Almarode says. Word of mouth from other patients also is helping to ease the transition.

“The days of long, inconvenient waits in the Sentara RMH ED are largely over,” adds Almarode. “Now, when patients are in the waiting room, they’re actually waiting for testing or lab results.

In terms of getting patients the care they need in a timely manner, the new vertical care system has been a huge improvement for both patients and caregivers.”

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What Separates Vertical Care from Acute Care?

Conditions considered for focused care: •

Abdominal pain

•

Ear pain without hearing loss

•

Eye complaints without vision changes

•

Skin conditions, such as eczema

•

Strains, sprains and minor fractures

•

Superficial burns, not including facial burns

•

Upper respiratory infections without shortness of breath

•

Urinary tract infections without fever or other pain

Generally, patients are eligible for vertical care if they are: •

Between the ages of three months and 75 years

•

Can walk on their own and do not need a wheelchair to get back to the ED for treatment

Conditions referred to acute care include: •

Abnormal vital signs

•

Alcohol-related illnesses

•

Cardiac conditions requiring monitoring

•

Head injuries

•

Psychiatric complaints

•

Sepsis

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Breast Surgery WITHOUT A TRACE

New Technique Uses Minimally Invasive Approach to Hide Scars 24 |

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Poland’s Treatment Journey A few days after Poland’s mammogram, an ultrasound at the Women’s Center revealed a mass in her breast.

The radiologist arranged for Poland to get a biopsy later that day.

The call came two days later when she was at work at Generations Crossing in Harrisonburg. A nurse colleague accompanied her to a quiet room, where she learned her diagnosis of stage 1 invasive cancer.

“That was a shock,” says Poland. “I had no clue.

There was no history of breast cancer in my family.”

During that call, a breast cancer patient navigator at the Women’s Center talked with Poland about what her next steps should be. First up was an appointment with the breast care surgeon, Dr. Tierney. Later she would consult with an oncologist, a genetic counselor, a dietitian and a family therapist.

Dr. Tierney told Poland that removing her tumor would require a partial mastectomy—what most people call a lumpectomy.

Glennette Poland

uring her annual physical examination in November 2019, Glennette Poland’s nurse practitioner found something in Poland’s breast that concerned her.

“Feel this,” she said to Poland, 62, who lives in Mount Jackson.

“I had to push really hard to feel it,” says Poland, “but it was there.”

Poland was afraid—she’d had thyroid cancer six years previously. Although she had beaten the cancer, she didn’t care to repeat the experience.

“The hardest part about the diagnosis was telling my husband and kids, because of the previous cancer,” Poland says. “It was hard for them. At that point, I didn’t know what stage it was—just that it was cancer.”

As it turned out, Poland’s experience with breast cancer was much less difficult than she feared, thanks to the care and expertise of her surgeon, Shannon Tierney, MD, and the staff at Sentara RMH Funkhouser Women’s Center. sentara.com

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“She took her time with me, showing me drawings of everything,” Poland says. “She’s such a compassionate person.”

When Poland met with the genetic counselor, she learned that her surprise at the diagnosis was well founded—there was no genetic cause for her cancer.

Poland’s procedure was scheduled for Dec. 4. Since it was an invasive-type cancer, she was also scheduled for chemotherapy and radiation treatment.

A few days before surgery, a radiologist inserted a radar device called a Savi Scout into Poland’s breast, so the surgeon would be able to locate the tumor easily in the operating room.

“Using the device helps to shorten the surgery,” explains Dr. Tierney, “which is much nicer for patients.”

Just before the operation, the anesthesiologist asked Poland if she would like to listen to music. Poland responded that she liked the Doobie Brothers. And just like that, as she was taken into surgery, Poland was listening to her favorite band.

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The surgery took almost three hours, during which Dr. Tierney also removed three lymph nodes. All were clear of cancer.

One of the most interesting aspects of Poland’s surgery was the technique Dr. Tierney used, known as minimally invasive surgery with a hidden-scar approach. In this technique, the surgeon makes the incision around the patient’s areola. Remarkably, no visible scar remains after the incision heals.

Poland was very pleased with the care she received at the Women’s Center, as well as the outcome of her procedure.

“I can’t say enough about how kind, caring and supportive they all are,” she says.

Hidden Scars Minimally invasive surgery involves smaller incisions, so it’s generally considered safer than open surgery. Patients often recover more quickly, spend less time in the hospital and feel more comfortable while they heal.

Using minimally invasive breast surgery, Dr. Tierney uses smaller incisions and specialized instruments to minimize external scarring, as well as oncoplastic approaches to rearrange the breast tissue to repair defects or dents.

About 95% of Dr. Tierney’s lumpectomy and biopsy patients are eligible for minimally invasive surgery using the hidden-scar approach, Dr. Tierney says. The only patients who aren’t eligible are those who have had prior surgery in the breast area, or whose cancers are close to the skin surface.

“Even the size of the tumor doesn’t matter quite as much, because oncoplastic surgery is so much better than it used to be,” Dr. Tierney notes.

“As long as the cancer is in only one place and the breast is large enough in relation to the tumor, we can take advantage of this new approach.”

In addition to hiding scars along the edge of the areola, surgeons also can locate them out of sight under the breast or in the armpit, where the patient already may be getting lymph nodes removed.

“I had an elderly patient who initially told me she wasn’t concerned about scarring,” recalls Dr. Tierney. “After her surgery, however, she was actually very pleased that she had no scarring.”

Dr. Tierney says she finds it fulfilling to offer such options to women here in the Valley. Before she started her practice at Sentara RMH in August

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2019, she worked for 10 years at a large hospital system in Seattle where there was little opportunity for employing new surgical techniques.

Another Patient’s Experience with the Hidden-Scar Approach Sandra Dean learned she had breast cancer following a routine mammogram last July.

By the end of the month, she had been to the Sentara RMH Imaging Center for a diagnostic mammogram, had a biopsy, been diagnosed with stage 1 breast cancer and been scheduled for surgery.

Dean was one of Dr. Tierney’s first patients at Sentara RMH.

Sandra Dean

Meet Dr. Shannon Tierney Sentara RMH breast surgeon Shannon Tierney, MD, MS, FACS, is a graduate of the Washington University School of Medicine in St. Louis, Mo. After completing her general surgery residency at the University of Virginia School of Medicine, she completed a fellowship in breast surgery at the Memorial Sloan Kettering Center. A fellow of the American College of Surgeons and board-certified in general surgery, Dr. Tierney joined the Sentara RMH medical staff in 2019.

In her spare time, Dr. Tierney enjoys spending time with her family, cooking, reading and traveling.

“Dr. Tierney said she was going to use a new type of minimally invasive surgery on me,” says Dean, 73.

Like Poland, Dean had a tiny radar device implanted in her breast, so the surgeon would know exactly where to find the tumor. As is usually the case, her partial mastectomy was performed as outpatient surgery, so Dean was back home resting later the same day.

After her surgery, however, Dean began experiencing a buildup of fluid. She called the Women’s Center, only to learn that Dr. Tierney had already left for the day.

“But a little while later, I got a call,” Dean says. “They told me Dr. Tierney had come back in to drain the fluid.

She was very accommodating.”

After she recovered from the surgery, Dean began radiation treatments in October. When she got on the table to prepare for her first treatment, the nurse was unable to see the scar from her breast surgery.

“It’s just at the edge of the areola, so it blends right in,” Dean says. sentara.com

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Why Get Your

mammogram

at Sentara RMH?

Dean says her total experience at Sentara RMH was very satisfying.

“Everyone at the Funkhouser Women’s Center— from the receptionist to the technicians—was so pleasant,” she says. “Their positive attitudes helped me feel less anxious.”

Dean is happy with her results and recovery. Since her surgery, she has continued with her ballroom dancing classes.

“I didn’t miss one week,” she says.

Patient-Centered Breast Care Dr. Tierney offers Sentara RMH patients a range of treatments for breast cancer. After hearing their options, patients get to choose what’s best for them based on their priorities, lifestyle, insurance, finances and what “feels right to them,” Dr. Tierney says.

If a woman is fearful of a particular treatment, such as radiation, Dr. Tierney usually can offer another option. And for women who fear that lumpectomy will cause a defect in their breast, minimally invasive surgery with the hidden-scar approach can help alleviate those concerns.

“I want these women to be able to look at themselves years later in a dressing room and not even remember they had breast surgery,” says Dr. Tierney. “With the hidden-scar approach, there’s no constant reminder of what they went through.”

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Breast care surgeon Shannon Tierney, MD, says the most important thing a woman can do for her breast health is to get regular screening mammograms—particularly at the Sentara RMH Funkhouser Women’s Center.

“There are definitely advantages to getting mammograms done here at the Women’s Center,” she says.

The main benefit is having a team of familiar, fellowship-trained breast radiologists reading patients’ mammograms consistently from year to year, as well as their ability to perform any needed diagnostic studies and biopsies. Caregivers at the Women’s Center also have the ability to compare mammograms with ultrasound, MRI or scintimammography to look for correlations.

“If diagnostic imaging and/or biopsies are needed, scheduling can be quick and easy, since our radiologists already will have read the patient’s screening mammogram,” notes Dr. Tierney.

That can add several days to the process, she says.

Finally, having the breast surgeon, nurse practitioners and radiologists on hand means they can consult together quickly regarding best practices for the management or treatment of questionable lesions.

“My office is right there at the Women’s Center,” says Dr. Tierney, “so if they need to run down the hall to ask me about something, I’m available.”

Both 2D and 3D digital mammography services are offered at the Funkhouser Women’s Center and on the Mobile Health Services Van. Sentara RMH also offers a High-Risk Breast Program aimed at identifying and educating women who may be at greater risk for developing breast cancer.

For more information, visit Sentara.com/Harrisonburg.

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John Brown

J

ohn Brown of McGaheysville had been taking warfarin, a medication used to thin the blood, for more than 25 years before he began experiencing any serious side effects.

Then last July, he showed up at the Sentara RMH Emergency Department with major bleeding in his intestines. He spent the next five days in the hospital while caregivers got the bleeding under control.

A watchman for the

heart A New Way to Reduce Stroke Risk in Patients with Atrial Fibrillation

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“To be considered for the WATCHMAN Device, Afib patients have to have a good reason—like the intestinal bleeding Mr. Brown experienced—not to be on a blood thinner.”

Image courtesy of Boston Scientific Corporation.

Brown, 82, had been taking warfarin due to a condition called atrial fibrillation (Afib), an abnormal heart rhythm that can lead to the pooling and clotting of blood inside the heart. When such a clot moves outside the heart and travels to the brain, the result can be a stroke. Warfarin helps reduce the risk of blood clot formation and therefore reduces the risk of stroke.

So Brown needed another option to control his Afib, since continuing to take warfarin over a long period of time could have put him at risk for further bleeding.

After conducting tests with Brown in the hospital’s Heart and Vascular Center, Sentara RMH electrophysiologist

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Alan Johnson, MD, determined Brown was eligible for an electrophysiology procedure to implant a device known as the WATCHMAN™.

“To be considered for the WATCHMAN Implant, Afib patients have to have a good reason—like the intestinal bleeding Mr. Brown experienced—not to be on a blood thinner,” says Dr. Johnson. “For patients who have complications due to these medications, the WATCHMAN offers a safe, effective alternative.”

During the procedure, the WATCHMAN, a small device made of thin wire and mesh, is implanted in the heart to close off the left atrial appendage (LAA), a small, sac-like extension in the wall of the

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left atrium, one of the four chambers in the heart.

The LAA has no known purpose, but stroke-causing clots originating in the heart most often come from the LAA. After the device is implanted, heart tissue will grow over the WATCHMAN, completely closing off the LAA and preventing any blood clots from escaping from that area.

“The WATCHMAN offers a reduction in stroke risk comparable to that of warfarin, while helping the patient avoid the risk of bleeding associated with long-term warfarin use,” explains Dr. Johnson.

Noninvasive Procedure, Quick Recovery

The WATCHMAN™ Device (Courtesy of Boston Scientific)

frequency sound waves (ultrasound) to make detailed pictures of the heart. Brown’s TEE showed no leaks around the WATCHMAN Implant, so Dr. Johnson gave him the all-clear to discontinue the warfarin.

“Now I’m just taking aspirin and Plavix,” says Brown, a retired building inspector for the city of Harrisonburg.

If it weren’t for the WATCHMAN procedure, Brown would have had two other options, according to Dr. Johnson. One such option is AtriClip surgery, which involves a small surgical procedure to access the LAA through an incision between the ribs. It is typically performed at Sentara RMH in collaboration with one of the cardiothoracic surgeons in appropriately selected patients.

Dr, Johnson, assisted by electrophysiologist Robert VerNooy, MD, performed Brown’s WATCHMAN Implant in December 2019. The procedure is often performed by two physicians. After inserting a thin, hollow tube known as a catheter into a vein in Brown’s leg and guiding it through the venous system to Brown’s heart and the LAA, they used the catheter to implant the WATCHMAN Implant.

“When we insert the device, initially it’s compressed and folded,” Dr. Johnson says. “Then when we back out the catheter, the WATCHMAN unfolds into place.”

In the weeks following the procedure, Brown’s body created layers of heart cells over the WATCHMAN Implant. In the meantime, he continued to take warfarin to prevent blood clotting.

“To be eligible for the WATCHMAN procedure, the patient has to be able to tolerate warfarin for 45 days afterward, while new tissue grows over the device,” adds Dr. Johnson.

In late January, Brown was back in the Heart and Vascular “To be eligible for Center undergoing a test to check for leaks around the device. the WATCHMAN “According to guidelines and procedure, the the manufacturer’s recommendapatient has to be tions, we always re-evaluate with able to tolerate transesophageal echocardiograwarfarin for 45 days phy (TEE) after the procedure,” Dr. Johnson says. “This allows us to afterward, while transition the patient off warfarin.” new tissue grows TEE is a special type of over the device.” echocardiogram that uses high-

Dr. Alan Johnson

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“The WATCHMAN procedure is a lot less invasive—and has a much shorter recovery period—than AtriClip surgery,” Dr. Johnson notes.

Without the WATCHMAN, Brown’s other option would have been to eliminate the use of blood thinners, which would have increased his risk of stroke.

“The WATCHMAN doesn’t necessarily make you feel any better, but it does prevent clots from migrating out of one of the most risky areas in patients with atrial fibrillation,” Dr. Johnson says.

Brown will continue taking Plavix with as-

pirin for six months after the procedure to keep his blood thin—the normal course of action for nearly all WATCHMAN patients. After that, Dr. Johnson is confident Brown will only need to take aspirin regularly to keep his blood thin.

“He’s on the classic trajectory, headed for aspirin-only therapy,” he adds.

Reflecting on his experience, Brown is pleased with how well his WATCHMAN procedure went.

“Everything involving the WATCHMAN procedure went really well,” says Brown. “I’m feeling very good about it.”

What is Electrophysiology?

W

hile many people are familiar with the heart’s pumping action that circulates blood through the body, perhaps less well known is the intricate electrical system that regulates the heart’s rhythmic beat. When something goes wrong with the heart’s electrical system, a heart-rhythm specialist known as an electrophysiologist—a subspecialist in the field of cardiology—may be called on to fix the problem.

Sentara RMH currently has two electrophysiologists on staff. Robert VerNooy, MD, who founded the electrophysiology (EP) program at Sentara RMH, has been at the hospital since 2010. Alan Johnson, MD, joined the EP team in August 2019. Together, the two specialists offer a full spectrum of EP services, including cardiac ablations (procedures that remove or alter heart tissue to correct an irregular heart rhythm), the implantation of various cardiac devices to regulate a patient’s heart rhythms and the new WATCHMAN Implant procedure.

Dr. VerNooy began performing the WATCHMAN procedure at Sentara RMH in April 2019. Both physicians provide the WATCHMAN Implant procedure and accept referrals.

Understanding Cardiac Arrhythmias An irregular heart rhythm, or arrhythmia, occurs when the heart’s rhythm is too fast, too slow, or irregular in some other way. There are several common types of arrhythmias: • Atrial fibrillation (Afib) is one of the most common types, occurring when the atria (upper chambers of the heart) beat irregularly or quiver, instead of beating normally.

• Premature or extra beats are also very common. People with this condition may feel a fluttering or skipping sensation in the chest.

• Bradycardia is an abnormally slow heart rate.

• Tachycardia is a very fast heart rate.

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•

Ventricular fibrillation (VF) is the most serious type of arrhythmia, potentially leading to cardiac arrest and death. During VF, the ventricles (lower chambers) quiver, preventing the heart from pumping blood adequately.

Both fellowship-trained in electrophysiology, Dr. VerNooy and Dr. Johnson diagnose and treat all these types of heart arrhythmias in the EP lab, which is equipped with advanced cardiac diagnostic equipment.

“We can evaluate lightheadedness, slow or racing heartbeat, and shortness of breath—all possible symptoms of heart arrhythmia,” Dr. VerNooy says. “Heart arrhythmia symptoms that cannot be controlled with medication may be greatly helped by an EP procedure.”

Dr. Robert VerNooy, left, and Dr. Alan Johnson in the EP lab.

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SENTA R A IN THE CO MMUNITY

Sentara’s

Dedicated Commitment

to the Blue Ridge Region Since Its Earliest Days, Sentara Healthcare Has Stayed True to Local Communities Among the wreckage of destroyed shipyards and charred buildings, the people of Norfolk, Va., set out to rebuild after the conclusion of the American Civil War in 1865. As part of the recovery effort, the Norfolk Women’s Christian Association pitched the idea of a hospital.

Local physicians and civic leaders agreed with the need to establish a local healthcare facility, donating $5,000 for a down payment on a Spanish-style house. The 25-bed Retreat for the Sick opened in 1888, planting the roots of what would later grow into Sentara Healthcare.

Now, 132 years later, Sentara Healthcare spans Virginia and northeastern North Carolina, with 12 acute care hospitals and more than 300 sites of care. The network includes two hospitals with outpatient care clinics in the Blue Ridge region: Sentara RMH Medical Center in Harrisonburg and Sentara Martha Jefferson Hospital in Charlottesville.

Sentara’s first home: the Norfolk Retreat for the Sick, constructed in 1888 on the corner of Holt and Reilly Streets.

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SENTA R A IN TH E C O M M U N I T Y

centers on the hospital campus—both of which were constructed thanks in part to access to low-cost capital provided by Sentara, which allowed new construction to move forward.

Sentara Martha Jefferson has experienced similar growth and benefits by partnering with a larger healthThe Power of Collaboration care system focused on innovations in care.

Modern Healthcare magazine has ranked Sentara one “Navigating the ever-changing delivery systems in of the nation’s top integrated healthcare systems for health care is a difficult yet important journey, “says more than a decade. That consistent level of success is Jonathan Davis, president of Sentara Martha Jefferson likely due, in part, to the close ties among caregivers Hospital. “Sentara serves as both a catalyst for change at the system’s diverse facilities, through which leaders in our industry and as an incubator for cutting-edge at all 12 Sentara hospitals collaborate and combine reimprovements in care processes. We have been able to sources to help ensure efficient, state-of-the-art patient face the many industry headwinds and accelerate our care across the network. quality of care today and into the future because of As Sentara RMH and Sentara Martha Jefferson our Sentara family. I’m excited about the approach their respective 10th andirection in which Sentara Martha Jefferniversaries of joining Sentara, each Sentara at a Glance son is headed, given our focus on clinical hospital’s president reflects on the excellence and meeting the ever-changing positive changes that have taken healthcare needs of our community.” place since joining the network.

OUR MISSION Over the past 10 years, Sentara “Being part of a large, innovaWe improve health Martha Jefferson has introduced many new tive healthcare system like Sentara services, including neurointerventional raevery day brings many benefits to Sentara diology, advanced gastroenterology services RMH—clinically, financially and in and advanced colorectal cancer services.

VALUES terms of effective management,” The hospital also has opened its freestandsays Doug Moyer, president of Sen- People, quality, patient safety, ing emergency department north of town. tara RMH. “We can draw from the service and integrity These services, which provide great value expertise of the system’s multiple to the community, were made possible hospitals, sharing best practices in VISION in part due to Sentara Martha Jefferson’s the care we provide and getting partnership with a larger healthcare system, multiple perspectives from hospiTo be the healthcare Davis adds. tal leaders throughout the system. choice of the As a not-for-profit healthcare system, Sentara’s focus is on patients and local communities, with a primary goal to improve health every day by focusing on quality, patient safety, service and integrity.

We’re also able to lower our costs because of the economies of scale we achieve by purchasing supplies and equipment in larger volumes.”

Concrete examples of how Sentara RMH and its community have benefited from partnership with Sentara include the Funkhouser Women’s Center and the Orthopedic and Advanced Imaging

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communities we serve

Giving Back Each Sentara hospital is firmly rooted in its respective community, and giving back to the local areas Sentara serves is essential to our mission. In the Blue Ridge Region, the Martha Jefferson Hospital and RMH foundations have directed millions of dollars in donations that stay exclusively within their local communities.

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Likewise, at Sentara RMH, the hospital has been able to expand its services and outreach thanks to the efforts of foundation board members and donors.

“Donors in our community help improve and save the lives of our patients in countless ways,” says Cory Davies, executive director of the RMH Foundation. “They are heroes in every sense of the word, and we are so grateful for the impact their generosity has on the care our patients receive.”

“The foundation is a conduit between caring and generous community members and programs and services we wouldn’t be able to provide through operations support alone,” says Ray Mishler, vice president of the Martha Jefferson Hospital Foundation. “Our donors are the heart and soul of Martha Jefferson’s Caring Tradition.”

COMMITTED TO THE COMMUNITY In the Charlottesville area and Shenandoah Valley, the Martha Jefferson Hospital Foundation and RMH Foundation have directed millions of dollars in donations to their local communities. Some recent examples include:

Martha Jefferson Hospital Foundation

Sentara By The Numbers As a not-for-profit healthcare system, we serve patients across Virginia and northeastern North Carolina with:

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Free clinical breast exams and mammograms for more than 100 women annually

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Scholarships to local community college students to develop entry-level employees interested in building careers at Sentara Martha Jefferson

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Up to $20,000 each in financial support for more than 100 nurses to return to school for an advanced degree, benefiting their careers and professional development, as well as improving the overall quality of bedside patient care

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Continuing the Martha Jefferson Caring Tradition through funding for palliative care, cancer survivorship programs, and nursing resiliency initiatives.

12 hospitals 300+ sites of care 1,000+ physicians and

advanced practice clinicians

RMH Foundation

2,741 beds

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Approximately 280 free mammograms provided annually to underinsured/uninsured women

3,800 medical staff providers

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$159,000 in scholarships awarded to nurses enrolled in Bachelor of Science in Nursing programs while also working at Sentara RMH

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Nearly $650,000 in donations to provide new cardiac monitors for each rescue squad throughout Rockingham County, helping to ensure that patients suffering a heart attack will get the timely, life-saving care they need

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More than $19,000 in medication assistance to help patients fighting cancer in the Shenandoah Valley

28,000 team members 500,000 people served by Optima Health, our health plan in Ohio, North Carolina and Virginia

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HEALTH MATTERS

Know the Signs and Symptoms of

Stroke

A stroke is a “brain attack” that can take two generally distinct forms.

Most strokes occur when a blood clot lodges in an artery and blocks blood flow to some part of the brain.

Another variety of stroke occurs when a blood vessel in the brain ruptures, causing bleeding into the brain.

Regardless of the type, however, a stroke is an urgent medical emergency. When brain cells are deprived of oxygen-rich blood during a stroke, they die, leading to permanent brain damage that can result in disability or even death.

According to the American Stroke Association, stroke is the fifth-leading cause of death in the United States and a leading cause of disability—so it’s important to learn the signs and symptoms of stroke and to seek immediate medical help when those signs are present.

Signs and Symptoms of Stroke: ALWAYS SUDDEN Anyone can have a stroke— regardless of age, race or gender.

However, nearly three-quarters of all strokes occur in people over the age of 65, and the risk of having a stroke more than doubles each decade after age 55.

The most common signs and symptoms include the following: • Sudden numbness or weakness of the face, or an arm or leg on one side of the body • Sudden confusion, or difficulty speaking or understanding • Sudden vision changes in one or both eyes

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• Sudden difficulty with walking, dizziness, or loss of coordination or balance • Sudden, severe headache for no known reason If any one of these five symptoms is recognized, call 911 immediately.

The Importance of a Quick Response When a stroke occurs, every second counts—and the countdown begins at the onset of symptoms. The longer the time before treatment begins, the greater the number of brain cells that die. The acute treatment window for a stroke is 24 hours, but the sooner you seek emergency care,

the better off you or your loved one will be.

Even if initial stroke symptoms go away, however, always call 911. Often these “mini-strokes,” also known as transient ischemic attacks (TIAs), are warning signs that a more severe stroke is likely to occur.

Within about two weeks, 40% of persons having a TIA will go on to suffer a full stroke. Seeking immediate medical care for any stroke symptoms offers the best chance of recovery, or in the case of a TIA, of avoiding a more severe stroke.

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LA SALUD IMPORTA

Conozca las señales y síntomas del

accidente cerebrovascular Un accidente cerebrovascular es un “ataque cerebral” que puede producirse de dos formas generalmente distintas. La mayoría de los accidentes cerebrovasculares ocurren cuando un coágulo de sangre se aloja en una arteria y bloquea el flujo sanguíneo hacia alguna parte del cerebro. Otra tipo de accidente cerebrovascular ocurre cuando un vaso sanguíneo en el cerebro se rompe y causa sangrado en el cerebro.

Sin embargo, independientemente del tipo, un accidente cerebrovascular es una emergencia médica urgente. Cuando las células cerebrales se ven privadas de sangre rica en oxígeno durante un accidente cerebrovascular, mueren, lo que conduce a un daño cerebral permanente que puede resultar en una discapacidad o incluso la muerte.

Según la Asociación Americana de Accidentes Cerebrovasculares, el ataque cerebrovascular es la quinta causa de muerte en los Estados Unidos y una de las principales causas de discapacidad, por lo que es importante conocer los signos y síntomas del accidente cerebrovascular y buscar ayuda médica inmediata cuando esos signos están presentes.

Señales y síntomas del accidente cerebrovascular: SIEMPRE ES REPENTINO Cualquier persona puede tener un accidente cerebrovascular, independientemente de su edad, raza o sexo. Sin embargo, casi tres cuartas

partes de todos los accidentes cerebrovasculares ocurren en personas mayores de 65 años y el riesgo de tener un accidente cerebrovascular se duplica cada diez años después de los 55 años.

Los signos y síntomas más comunes incluyen los siguientes: • Entumecimiento repentino o debilidad de la cara, un brazo, pierna o en un lado del cuerpo • Confusión repentina o dificultad para hablar o entender • Cambios repentinos en la visión en uno o ambos ojos • Dificultad repentina para caminar, mareos o pérdida de coordinación o equilibrio • Dolor de cabeza repentino e intenso sin razón conocida

Si reconoce alguno de estos síntomas, llame al 911 inmediatamente.

La importancia de una respuesta rápida Cuando se produce un accidente cerebrovascular, cada segundo cuenta y la cuenta regresiva comienza cuando aparecen los síntomas. Cuanto más tiempo transcurra antes de que comience el tratamiento, mayor será la cantidad de células cerebrales que mueren.

La ventana de tratamiento agudo para un accidente cerebrovascular es de 24 horas, pero cuanto antes busque atención de emergencia, mejor será para usted o su ser querido.

Incluso si los síntomas iniciales del accidente cerebrovascular desaparecen, siempre llame al 911. A menudo, estos “miniaccidentes cerebrovasculares”, también conocidos como ataques isquémicos transitorios (AIT), son signos de advertencia de que es probable que ocurra un accidente cerebrovascular más grave. Dos semanas después, el 40% de las personas que tienen un AIT sufrirán un accidente cerebrovascular completo. Buscar atención médica inmediata ante cualquier síntoma de accidente cerebrovascular ofrece la mejor posibilidad de recuperación, o en el caso de un AIT, de evitar un accidente cerebrovascular más grave. sentara.com

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EAT WELL , LIVE WELL

A BudgetFriendly

Pantry List

By Patricia Tyndale, RD Sentara Martha Jefferson Hospital

for Healthy Eating fter the bustle of the winter holidays, spring is a great time to take a closer look at your pantry and focus on stocking your shelves with healthier food options. But first, it’s a good idea to ask yourself a few questions:

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What do you see when you open your cabinets, refrigerator or freezer?

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What are some staple foods you buy during every grocery store trip?

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Are these staple foods generally considered healthy or unhealthy?

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Does your budget keep you from buying healthier options?

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Unfortunately, we don’t always make our food choices based on the desire to eat healthy. Often, financial factors and cultural practices may play a bigger role in the foods we buy and eat.

We often hear that “fresh is best.”

However, given certain factors, it may not always be ideal for consumers to buy fresh foods. Knowing which foods are both healthy and convenient might help change the way we shop. For instance, while dried beans are loaded with vitamins, minerals and fiber and are a great source of protein, canned beans still can provide a healthy alternative. When beans from a can are rinsed, dried, and stored in the refrigerator, they provide great health benefits when added to soups and stews, used as a topping for salads, or eaten as a side dish. Let’s take a closer look at some other healthy food choices.

Best Shelf-Stable Foods Have you considered cleaning out your cabinets of unhealthy foods? For starters, check for high-sodium foods, sugary snack foods such as baked goods and other sweets, sugary cereals, and sweetened beverages like juice and soda.

Many of these processed, packaged foods are calorically dense but offer very few beneficial nutrients. Instead, stock canned foods that have low levels of salt, snack foods with limited amounts of added sugars, and low-calorie beverages such as flavored waters.

Here are some healthy foods to keep on hand: •

Lower-sugar cereal (less than 8 grams per serving)

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Steel-cut and old-fashioned oats

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Whole-wheat and whole-grain breads and crackers

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Wild rice, quinoa, barley, whole-wheat couscous

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Canned vegetables and soups that contain no added sodium or reduced sodium

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Olive oil and cooking spray

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Canned chicken, tuna and salmon (packed in water)

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Nuts and seeds

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Natural peanut butter or other nut butters

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Dried and canned beans and lentils

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Unsweetened applesauce and fruit cups packed in juice

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Popcorn and whole-wheat pretzels

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Graham crackers

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Sugar-free pudding and gelatin

What About Perishable Foods?

Foods that have to be stored in the refrigerator are often pricier, don’t last very long and can use up most of your food budget. To save on the cost of these items, buy them when they’re on sale, or purchase more store-brand items. With fresh produce, you can often save by buying fruits and vegetables that are in season. Another helpful tip is to review store ads before you shop and make a meal plan for the week based on which items are on sale.

Some common nutrient-rich foods to buy weekly are low-fat dairy items such as milk, cheese and yogurt. Consuming dairy regularly can be beneficial, since it’s loaded with essential nutrients, including

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EAT WELL , LIVE W E L L

vitamin D, calcium and protein. When selecting yogurt, however, be sure to choose varieties with less added sugar.

Eggs are another high-quality, economical protein source that are ideal to keep on hand for a variety of meals. Other nutrient-dense foods to keep in the fridge include vegetables like broccoli, cabbage, green beans and spinach. Purchasing frozen vegetables can increase the variety of foods you consume and help you save money when shopping. In addition, many frozen vegetables are preserved at their peak without added salt, making them a healthy, convenient alternative to fresh vegetables. Frozen fruits offer many of the same benefits as fresh fruits, but be sure to avoid frozen fruits that contain added sugar.

Common perishable items to buy regularly include: • Low-fat yogurt, milk and cottage cheese • Part-skim mozzarella, parmesan and feta cheese • Baby carrots, cucumbers and celery • Lean proteins, including eggs, fish and poultry • Frozen fruit or yogurt bars • Frozen mixed vegetables, broccoli and spinach • Frozen strawberries, blueberries, blackberries and raspberries

Don’t Sacrifice Healthy Options for the Sake of Convenience With the seemingly steady rise in grocery prices, it can be challenging to stay within budget and still manage to have a variety of well-balanced, healthy foods on hand. However, it is generally more costeffective and beneficial for your health to cook most of your meals at home and cut down on or eliminate processed and packaged foods.

When visiting your local market or grocery store, think more about shopping for foods that are both healthy and within your budget, rather than foods that simply offer mere convenience.

Choose items that contain little or no added salt and sugar, and avoid unhealthy saturated and trans fats. Plan your meals for the week and make your list accordingly, and enjoy the savings in cost and benefits to your health!

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Chunky Marinara with Pasta and Seared Chicken Serves 6 Ingredients 4 cloves sliced garlic (or 2 teaspoons jarred, minced garlic) 2 tablespoons chopped, fresh basil (or 2 teaspoons dried basil) 2 tablespoons fresh oregano (or 2 teaspoons dried oregano) 28 ounces canned, low-sodium, diced tomatoes (undrained) 1/2 teaspoon black pepper 2 tablespoons chopped, fresh parsley Nonstick cooking spray 10 ounces whole-wheat pasta (spaghetti, penne, rotini, elbow, etc.)

1 pound chicken tenderloins Grated fat-free parmesan or mozzarella (optional)

Preparation 1.

Prepare pasta according to package directions.

2.

Preheat oven to 350 degrees. Spray a 9-by-13-inch casserole dish with cooking spray. Lay tenderloins in dish, evenly spaced.

3.

Lightly spray chicken with cooking spray.

4.

Bake for 25 minutes, flipping over halfway through the baking time.

5.

Spray saucepan with cooking spray and heat over medium heat. Add garlic and cook 3 minutes.

6.

Add all remaining ingredients, except the parsley.

Bring to a boil, cover and reduce to simmer for 12-15 minutes.

7.

Spoon pasta onto plate and top with marinara and chicken. Sprinkle with grated fat-free parmesan or grated mozzarella (optional).

8.

Top with parsley.

Per serving: 287 calories, 2.5 grams fat, 108 milligrams sodium, 43 grams carbohydrates, 7 grams fiber and 24 grams protein. Cost: $2.05 per serving. Recipe from the American Heart Association (recipes.heart.org).

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PHILANTHROPY Mary Louse Leake

Leaving a

Legacy The opportunity to leave behind a lasting impression on the world after we’re gone makes for a warm and fuzzy feeling inside.

Mary Louise Leake gets this sensation. As current foundation board chair for Blue Ridge Community College and a longtime volunteer for other organizations, the Waynesboro resident has always enjoyed giving back to her community.

Leake says she is also motivated to do so because she has no children and few family members.

When she established a will and trust several years ago, an important question was how she could give back when she was gone. For her, the perfect answer was to make the RMH Foundation, the fundraising arm of Sentara RMH Medical Center, the largest beneficiary of her estate.

Sentara RMH Benefits from Those Who Plan Ahead to Give Back

“It isn’t pleasant to think of your own death, but it’s inevitable,” Leake says. “I have enjoyed a healthy, fulfilling life and want to help impart those qualities when my life is over. You want your gift to make a difference and have meaning. It always makes you feel good to be able to help someone else.”

Getting Connected Leake currently serves as a member of the RMH Foundation Board, her latest foray into volunteerism after a career in education at Stuarts Draft High School and working at Hollister Inc., a healthcare product manufacturer in Stuarts Draft. Born in Clifton Forge, Va., and moving w w w.S uppor tRMH.org

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with her family to Harrisonburg at age 6, then-Rockingham Memorial Hospital was her hometown medical facility.

Leake’s parents both died at RMH—her mother at age 47 and her father at 91. She says they both received “excellent care” from the hospital, which would later prompt her to donate $100 to the RMH Foundation, earmarked toward hospice in appreciation for the services her father had received.

That simple act sparked a domino effect that has benefited, and will surely continue to benefit, an untold number of lives. A few days after Leake made her donation, Cory Davies, executive director of the Foundation, called her to thank her for her contribution and to invite her to consider further involvement in the organization.

“He didn’t know me from Adam,” Leake says. “For someone to call and thank me, that was really special to me.”

That initial involvement has turned into “many rewarding twists and turns,” she adds.

Since then, Leake has fundraised for the opening of the Funkhouser Women’s Center and served on the linear accelerator campaign committee to bring an advanced piece of cancertreatment equipment to the Hahn Cancer Center. She also provides a nursing scholarship and currently sits on the Legacy Leadership Council, a group that encourages legacy giving.

Leake’s biggest gift of all, however, is yet to come.

“Walking the Talk” For anyone considering the RMH Foundation as part of his or her estate planning, Leake emphasizes that no gift is too small, noting that it’s the act of giving—not the value of the gift— that matters.

“Believe me, a philanthropist or legacy giver does not have to be wealthy,” she says. “Those of us who care deeply for our community—and the amazing, state-of-the-art medical care Sentara RMH provides—can join our gifts together. You don’t need to be a millionaire to do it.”

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The Value of

Legacy Giving Do you want to make an important difference after you’ve lived a full, productive life? The RMH Foundation invites community members to participate in its Legacy Giving program, which encourages donors to make gifts through their estates.

The hospital started because of a generous William G. Leake bequest left more than 100 years ago by William Glodomore Leake, a distant relative of Mary Louise Leake, featured in the accompanying article.

A Harrisonburg businessman, William Leake suffered a cut on his foot that required medical attention. Unfortunately, during that era there was no medical facility within miles, and by the time he received the care he needed, the infection in his foot left him seriously ill.

It wasn’t too late, however, for Leake to take action to help future generations. He left his bequest with the expressed intent that it be used to build Rockingham Memorial Hospital.

“Mr. Leake wanted to guarantee that when others fall ill or are injured, they can get the care they need when they need it most,” says Cory Davies, executive director of the RMH Foundation. “Figuratively, he planted the seed for the tree under which we sit today.”

The need for health care is no less vital today than it was a century ago. As the Shenandoah Valley population grows and the healthcare landscape rapidly changes, Sentara RMH must expand its services and grow to meet increasing need.

Could you be the next William Leake? Or perhaps the next David Cupp, who, through a bequest, provided funding that enabled the construction of the hospital’s hybrid operating room, where minimally invasive heart and vascular procedures are now performed.

Or maybe you can be an anonymous donor, such as the one who made a $250,000 gift through his estate that helped the Hahn Cancer Center acquire a new state-of-the-art linear accelerator, used to provide radiation therapy to cancer patients.

“Mr. Leake’s gift was visionary then, as were those of the countless others who have donated to the RMH Foundation since,” Davies says. “Indeed, from Mr. Leake’s gift to the present day, our donors’ generosity has saved countless lives and built Sentara RMH into the healthcare provider it is today.”

For more information, please contact the RMH Foundation at 540-689-8545.

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Leake’s belief in the people who work at Sentara RMH gives her confidence that her gift will be used properly. The advancements the hospital has made since its origins near downtown Harrisonburg—including the implementation of a robotic pharmacy that guarantees the timeliness and accuracy of medications distributed to patients—truly impress her.

Leake says she has never once been asked to give money to the RMH Foundation. Instead, people like Davies have cared more about developing a relationship with her.

“That made me want to give,” Leake says. “At Sentara RMH, they ‘walk the talk.’ I believe in the philosophy and mission of the hospital and have no fear that it will diminish in the future. That’s why I’m leaving my gift unrestricted, knowing it will be used where it is needed most.

“It’s all about relationships, and my connection with Sentara RMH and the RMH Foundation is very special,” she adds. “Sentara RMH is still my hospital, and it will be for many years to come.”

Will you be our long-term partner?

A legacy gift is a meaningful way to partner with organizations and support causes you care passionately about, like having world-class health care close to home. Sentara RMH Medical Center is here to provide the care our community requires, and donors are essential to making this possible. Indeed, donors who support the RMH Foundation through their will or estate plan help people in this community meet some of their most fundamental needs: to be well physically and mentally. Isn’t that what we all hope for?

Making a beneficiary designation to the RMH Foundation is as easy as filling out a form, which can be modified or revoked at any point during your lifetime. And, in most cases, you do not need to amend your will or trust, thus saving legal fees.

Our community is quickly growing, and the healthcare landscape is rapidly changing. The only constant is the indelible importance of philanthropic support and the life-saving impact it has in the care our community receives. Please consider supporting the RMH Foundation through your estate today.

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.

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.

The best way to contact me is by:

E-mail

Mail

Telephone

NAME

ADDRESS

CIT Y STATE ZIP

PHONE

EMAIL

All inquiries treated with complete confidentiality.

OUR 100% PROMISE 100% of your gift

stays local

100% of your gift

is put to your desired purpose

100% of your gift

strengthens the care you and your loved ones receive

This information is not intended as tax, legal or financial advice. Consult your personal financial advisor for information specific to your situation.

Mail to: Cory Davies, Executive Director, RMH Foundation, 2010 Health Campus Drive, Harrisonburg, VA 22801

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friends

of the RMH Foundation Gifts received from Aug. 1–Dec. 31, 2019 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 2019.

President’s Forum $100,000 and above Robert O and Maxine Burkholder (1) The Fred O. Funkhouser Charitable Foundation Inc. (23) Sentara RMH Volunteer Auxiliary (38)

$25,000–$99,999 Michael D. and Mary B. Davis (1) Everence Foundation Inc. (3) Fidelity Charitable Gift Fund (10) Lantz Construction Company (2) Jerry and Becky Morris (30) The Community Foundation of Harrisonburg and Rockingham County (17) Mr. Jodie E. Wampler (34)

$5,000–$24,999 Dr. Donna Amenta (8) Devon C. and Teresa B. Anders (10) Bank of the James (4) Estate of Charles Conrad Byers (1) MJ Chewning (5) Paul S. and Sherry B. Cline Fund of The Community Foundation of Harrisonburg and Rockingham County (22) Eddie R. and Catherine Coffey (22) Joseph K. II and Sallie Funkhouser (14) Drs. William and Brooke Goodwin (5) Dr. David C. and Amelia M. Hall (9) Orden L. and Reba R. Harman Pass Through Fund of The Community Foundation of Harrisonburg and Rockingham County (12) Elizabeth Harnsberger Trust (8) Vivian Harrison Trust (1) Dr. William I. and Lynda D. Lee (13) Daniel R. Lynn and Rosemary P. Mitchell (1) Beverly T. MacLeod (6) Travis F. and Kara A. Marshall (10) McDonald’s and Boxley Family (6) Kathy Moran and Marcie Harris (10) Drs. David and Heather Morgan (3) Charles V. and Lois M. Oster (23) W. Marshall and Gloria B. Price (20) Douglas M. and Vickie K. Rawley (3) Rockingham Insurance (2) RunSignUp (5) Select Aerospace Industries Inc. (3) Twila and Larry Showalter Cancer Fund of The Community Foundation of Harrisonburg & Rockingham County (2)

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Eula M. Showalter Donor Advised Fund (1) Karl D. and Barbara B. Stoltzfus (21) William G. and Hope Shank Stoner (14) The Robert H. Strickler and Lorraine W. Strickler Foundation (7) Lynn and Diane Trobaugh (12) Dr. T. Keith and Terri Vest (4) Linda B. West (1) Denise A. Whitman (16) N. Paige and Ann C. Will (6) Dwight and Sheryl Wyse Donor Advised Fund of The Community Foundation of Harrisonburg and Rockingham County (8)

William Leake Society $1,000–$4,999 David O. Banks (2) Drs. A. Jerry Benson and Martha K. Ross (8) Auburn A. and Ruth D. Boyers (38) Steve and Chris Bradshaw (1) Estate of Ethel L. Burkholder (1) James H. and Judith H. Butler (1) Dr. William F. and Susan Cale (6) Ruby J. Callahan (11) William B. Sr. and Phyllis W. Carper (38) Dr. Henry H. Chang (17) Dean and Sandra Clatterbuck (2) Community Foundation for a greater Richmond (1) Thomas F. Constable Jr. (20) Louise Dolly Cook (3) D’Earcy P. III and Bettye C. Davis (4) Mensel and Linda Dean (30) Dominion Energy Charitable Foundation (7) L. Kathryn Evans (20) F & M Bank Community Fund of The Community Foundation of Harrisonburg and Rockingham County (2) Farmers and Merchants Bank (6) Friends of Valley Charities (10) Dr. C. Wayne and Donna Gates (6) Sherrill Glanzer (18) Dr. Eugene J. Harper (1) Harrisonburg OB-GYN Associates, PC (5) W. Wallace and Carolyn L. Hatcher Fund of The Community Foundation of Harrisonburg and Rockingham County (2) John R. and Mary Ann Heatwole (1) George and Cary Hevener (15) George W. II and Ann E. C. Homan (18) Dr. Debra Horst and Mr. Mark Horst (1) Larion J. and Ruby K. Hostetler (2)

IDM Trucking Inc. (14) Tedd H. and Lora W. Jett (30) Richard C. and Mona D. Johnson (31) Glen E. and Sandra H. Kauffman (1) Dr. Elmer E. and Marianne Kennel (5) Dr. Jeffery B. Kesecker, DDS, PLC (1) Earl D. King, MD (1) Larson Wealth Management, LLC (2) Elisabeth M. Lawson (4) Mary Louise Leake (11) John Douglas Light (21) Earle A. and Glenna B. MacKenzie (5) Rennie M. McAllister Charitable Fund at Schwab Charitable (2) T. Carter Jr. and Connie G. Melton (1) Jim and Pat Messner (32) Dr. Marcus N. and Jodi G. Morra (13) Nielsen Builders Inc. (3) Carolyn B. Pence (13) Janice L. Pence (8) Virginia Frances Plecker and the Plecker Family Fund of The Community Foundation of Harrisonburg and Rockingham County (5) Eleanor Page Price (1) Michael D. and Tina R. M. Purdy (1) Thomas D. and Jennifer L. Rea (5) Robert and Sarah Rees (8) Rockingham Cooperative Inc. (12) Janice F. and Rick Scaglione (20) Robert S. and Patricia M. Scott (1) Dr. Robert H. Jr. and Mary Sease and the R and M Fund of The Community Foundation of Harrisonburg and Rockingham County (13) John H. and Faye T. Sellers (14) Sentara RMH Student Stipend (1) Shenandoah Women’s Healthcare (3) Helen W. Shickel (18) T. Edgar and Zizi C. Sipe (11) Marvin T. and Sarah A. Slabaugh (7) Steven KIA (1) Dr. John M. and Doris S. Stone (6) D. O. and E. A. Swingle (10) Anonymous Fund of The Community Foundation of Harrisonburg and Rockingham County (1) The Rotary Club of New Market (6) Theta Iota Chapter of Alpha Phi James Madison University (3) Richard H. Torovsky Jr. (3) Frank H. and Tara M. Vetting (1) John A. Washam (2) Merv and Marlene Webb (37) Dale E. and Waneta R. Wegner (12) Dr. David H. and Janet T. Wendelken (7) Richard L. and Pamela B. Wilkins (32) Wayne and Joyce Wright (19)

1910 Cornerstone Club $100-$999 Jacquelyn J. Addison (1) Mary L. Addy (2) Ricky and Sharon Adkins (1) James R. Alpine (3) American Legion Post 278 Charitable Fund of The Community Foundation of Harrisonburg & Rockingham County (1) Chad and Donna Anthony (1) Robert P. Armbruster (1) Timothy R. and Phyllis C. Armentrout (3) Sandra G. Baker (8) Edward J. Jr. and Ellen D. Baldwin (5) Cynthia M. Banks (8) Edgar L. Barnard Jr. (13) John G. Barr (3) Sam L. Batton (4) Richard A. and Cathy D. Baugh (1) Samuel C. and Kathryn J. Beck (2) James T. Sr. and Barbara R. Begoon (16) Joanne L. Bell (4) Douglas L. Berry (1) Kenneth G. and Linda R. Berry (10) Kathy G. Billhimer (1) William E. and Allene R. Blessing (6) Mary S. Bolt (2) John F. and Elsie L. Bowers (3) Nancy R. Bradfield (11) Matt and Marianne Branigan (6) Ellen C. Branner (10) James B. Branner (6) Lanny L. and Phyllis B. Branner (4) Judith K. Breeden (1) Broadway High School Volley Ball Team (1) Linda Brooke (1) Carol J. Brooks (15) Emmett H. and Leola C. Brooks (4) Larry E. Brown (6) Derek G. and Karen S. Brownsword (1) Harold D. and Fay K. Brubaker (2) Patricia A. Brunk (12) Barbara Z. Buhl (1) Henry F. and Catherine S. Buhl (8) Mary E. Bunch (6) Martin J. and Elizabeth J. Bundrick (2) Amy E. Burke (21) Bruce B. and Norma S. Burkholder (6) Christine W. Burner (12) J. Michael and Dianne H. Burris (1) Gregory G. and Pollyanna A. Bush (12) Samuel G. Butler (3) Margaret T. Byers (7)

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Edward A. and Flora H. Byrd (5) Elizabeth J. Calabria (1) Marguerite E. Cale (1) Gary V. and Lesa R. Calleo (10) Thomas G. Camp Jr. (1) Jay L. Campbell (1) A. Fontaine and Martha J. Canada (8) Thomas F. and Janice R. Carroll (1) Brenda D. Cave (8) Paul R. and Becky A. Christophel (11) Lee E. Clapper Sr. (7) Michael W. Comer (1) Russell J. Jr. and Delores A. Comer (2) Commonwealth Dog Obedience Training Club (1) Consumers Auto Warehouse (1) Jo Cooper (1) Eugene A. and June S. Counts (1) Robert Counts (1) Gloria B. Craun (1) Charlton K. and Sarah J. Crider (10) Anita M. Cross (2) Patricia Cubbage (1) Cathy Cupp (2) Custom Systems USA Region 2 Executive Team (1) Maria and Jeff Daly (1) Phillip E. and Wilma R. Davis (2) Gary W. and Teresa B. Day (1) Shirley L. Dellinger (16) Colonel and Mrs. Peter F. Dieck (2) Robert F. and Linda W. Dinsmore (3) Jim and Caroll Douglas (4) Phillip B. DuBose (1) Tom and Kathy Dunham (5) John F. and Nancy B. Dunne (1) Karl P. Esser (1) Joseph J. and Rose Marie Estock (1) Anne G. Farmer (1) First Choice Home Health Services, LLC (2) William M. and Grace A. Florence (9) Larry A. and Linda J. Fogle (12) Mary E. Foley (1) Lewis and Arleen Forsheit (1) Alva J. Frederick (2) Marie K. Frey (3) David and Rachel N. Frye (1) Frye Marketing Inc. (1) Cathy Fulk (1) Susan A. Fulk (1) Peter G. and Nancy J. Fundinger (2) Curtis W. Funkhouser Sr. (2) Susan S. Gallaher (2) Edward R. and Nancy K. Gallalee (1) Douglas and Lila Gardner (1) Norma J. Gardner (10) Robert A. and Portia B. Gibson (1) Tommy and Betsy Heatwole Glendye (7) J. D. and Rebecca F. Glick (22) Paige Webb Godoy (1) Bobby W. Gooden II (3) Susan J. Gosney (3) Grand Home Furnishings (4) John F. and Joann Grubbs (1) Mae B. Guthrie (12) Herman W. and Rosemary G. Hale (8) Gary W. and Joy S. Halterman (1) Marianne F. Halterman (2) Harrisonburg and Bridgewater 24/7 Fitness (1) Harrisonburg Department of Public Transportation (1) Harrisonburg Family and Cosmetic Dentistry (1) Richard W. Hatch (1) Robert A. and Marlene A. Hazzard (7) Dr. John T. Hearn and Jan Hearn (17) Norma J. Heath (4) Doris B. Heatwole (1) Robert E. and Gail L. Hess (3) William E. “Ike” Himelright (2) James H. and Lois Hinegardner (2) Shelvy K. Hinkle (1) William R. and Barbara H. Hite (11) Thomas J. III and Virginia C. Holden (2) Elizabeth Ann Homan (1) Linda S. Hoover (1) Robert E. and Betty W. Hoover (19) Leila P. Hopkins (4) Ronald M. and Linda C. B. Hotinger (3) Dwight E. and Carolyn R. Houff (12) Kern L. and Chanda C. Houff (1) Howard Houghton (1) Debra Howe (3) Harold E. Huber (1) Lois B. Huffer (1) Russell E. Jr. and Lillian C. Huffman (4)

David M. Hughes (9) Delores D. Hulvey (23) Ann Gerding Hurley (2) Jean Y. Hylton (1) James Construction Company (1) James M. Armentrout Construction (1) Shelvy M. Jenkins (29) Ronald P. and Julianne Jilinski (12) Dr. Robert F. Jochen V.M.D. (4) J. Robert and Patricia C. Johnson (1) Kevin W. and Cosette P. Johnson (2) Horace E. Jr. and Sally G. Jones (11) Sue Ludington Jones (3) Flora L. Kagey (12) Hazel K. Karnes (1) Kenco Trucks and Equipment (1) Charlotte H. Kenney (2) Garnic and Hilda Kidwell (1) Lorraine L. Kimble (2) Lois Ann King (1) Sharon L. Kiracofe (13) Joseph R. and Sharon J. Kisamore (8) Leroy and Juanita Kiser (4) Libby Kistler (1) Alan L. and Patricia W. Knicely (14) Paul G. and Mary N. Kniss (1) Frances M. Kray, DDS (2) Donald W. and Alice B. Krech (1) Joseph C. and Carol A. Kudless (7) Billy and Betty Kuykendall (8) Elizabeth L. Kyger (3) Letitia E. Lam (3) Steve and Cindy Lamb (9) Arnold L. and Elaine H. Lambert (1) Joan H. Lambert (1) Bill and Joan Layman (14) LD&B Insurance Agency (1) Jerry O. and Daisy D. Leake (11) Eugene C. and Sherry M. Leffel (2) Tim and Twila Lehman (5) Robert J. and Carolyn J. Leiston (12) Cathy Jackson Leitner, PLC (6) Robert C. and Jeri J. Lewis (5) Carl G. and Arnesa F. Lind (18) Junior L. Lineaweaver (3) Charles E. and Cynthia A. Litten (11) Donal E. Loker (2) Wayne L. and Ann Payne Long (14) Wilbur J. and Ann S. Long (14) Wayne J. and Geraldine S. Lowe (1) Robyn R. Ludwig (10) David M. Lynch (4) Laura S. Mapp (26) David A. and Karin E. Mars (5) Helen Sue Marshall (1) Kathleen W. Marshall (6) Donald L. and Betty L. Martin (1) R. Larry Martin (2) Peggy G. Mason (27) Roger E. and Cheryl Yoder Mast (3) Philip H. Maxwell (32) Stephen F. May (1) Joan C. McGlaughlin (10) John J. Jr. and Marcia Blay McGrath (2) Calvin E. and Sandra F. Meadows (2) Donna F. Meadows (8) Melrose Church of the Brethren (1) Ann and Neal Menefee (26) Emory and Bechwith Merryman (2) Charles W. Michael (3) Jack and Judy Miller (2) Kyle L. Miller (1) Mabel V. Miller (6) Thelma H. Miller (9) MillerCoors Shenandoah Brewery (2) Mooreland Farms (1) Margie L. Moore (13) Shelia A. Moorman (7) Richard R. J. Morin (14) Deland F. and Phyllis S. Morris (1) Dr. A. Glenn and Linda M. Morrison (2) John W. and Mary D. Morsch (3) Donald Taft Nair (12) Foelke D. Nair (26) Thomas A. Nardi (3) John N. and Linda E. Neff Charitable Fund of The Community Foundation of Harrisonburg and Rockingham County (3) Randolph G. and Beverley Z. Nelson (11) Darlene L. Newman (6) Esther M. Nizer (1) Chris and Sarah Orem (1) OTF 8:45 Wolf Pack (1)

Christine J. Ou (1) Etha Jane Parker (4) David V. and Claudia A. Pascarella (5) Bonnie L. Paul (3) Pearls Spa120-High Tech (1) Owen C. Pence (7) John R. and Virginia H. Phalen (8) Orlando A. and Eloise E. Pinneri (7) Butch Proctor (1) Bobby E. Prophet (20) S. Walton Propst (2) John E. and Jean L. Ralston (1) Robert J. and Virginia G. Ravera (2) Jonathan and Melissa Rawley and Family (1) Roxanne Rhodes (2) Sharon Rice, Jan Hopkins, Gail Huber and Denny Gordon (1) James B. Richardson Jr. (11) Riddleberger Brothers Inc. (1) Philip F. and Sheila F. Riley (9) Frances E. Ritchie (21) M. Hope Ritchie (1) Audrey A. Roadcap (1) Cathy Y. Roadcap (12) Roger D. Roadcap (12) Ronald W. and Mary Ellen Rohrbaugh (9) Ralph S. Rohrer (3) Wayne and Joan Ruck (2) Amy L. Rush (1) Robert and Deborah A. Ryder (1) Nelson L. Rynes (1) Bryan W. and Peggy S. Sandridge (2) LeVerle H. Sappington (1) Noralyn J. Schulte (2) Joyce M. Schumacher (19) Ralph L. and Ann W. Sebrell (9) Donald W. Seese (6) Sentara RMH Business Office Employees (1) Sentara RMH Nursing Leadership Team (1) Lucy J. Seymour (10) Estate of Joseph Ervin Shafer (11) David W. Shaffer Jr. (3) Ronald and Janice Shanholtzer (4) John C. Shank (2) Shenandoah Automotive Service Center (3) Shenandoah Valley Baseball (1) Edward L. and Marsha M. Shenk (2) Dr. Jonathan D. and Sheryl L. Shenk (6) Mark and Kendra Shickel and the Ephesians 2 Fund of The Community Foundation of Harrisonburg and Rockingham County (1) Larry and Dawn Shifflett (1) Mark A. Shifflett and Rebecca R. Hill-Shifflett (1) William J. Shilling (1) Alton K. and Helen W. Shipe (7) Melissa Shipe (1) Shirley D. Shipe (4) Goldie T. Showalter (9) James M. and Carol S. Showalter (21) Paul F. and Wanda L. Showalter (4) Shyam P. and Rameshwari P. Shrestha (2) Nelson and Linda Simmons (8) Skyline Middle School Builders Club (1) Fred A. and Brenda V. Smiley (3) Detra Shell Smith (8) Glenn, Terri, Wes and Jake Smith (7) Ilene N. Smith (37) Jason T. and Nicole B. Smith (1) John D. Smith (1) Sandra Kay Smith (1) Lawrence E. and Carolyn D. Smoot (16) Joseph Solesky and Ray Parker (2) David E. and Marilyn S. Solomon (5) Chanda G. Sponaugle (1) Ralph C. and June T. Steger (1) Roy H. Stetler III (3) Barbara K. Stickley (2) John D. and Toni H. Stone (16) Ronald W. and Lynne F. Stover (1) William L. and Louise K. Stover (8) William E. and Heidi B. Strang (1) Alfred L. Strawderman (4) Esther J. Strawderman (12) Richard L. and Joyce K. Strawderman (12) Judith S. Strickler (1) Richard P. Strickler (3) Lisa Stroupe-Kephart (2) Rodney and Ruth Stultz (11) Dennis R. and Cathy J. Stuter (11) Style Encore Harrisonburg (2) Elizabeth Sullivan and Edward Gallalee III (1) F. M. Summers (1)

Marian B. Suter (6) Sara Jean Trimble Sutherland (1) Tactical and Survival Specialties (1) Juanita M. Taylor (37) Kennneth Lee Thomas Jr. and J. Faye Hoover-Thomas (7) Debra D. Thompson (30) Connie Thompson-Bodkin and Terry Bodkin (1) Reverend James M. and Judith A. Tongue (2) Jacqueline G. Towers (30) Gilbert S. Trelawny (19) Donald D. Turner (32) Mary Miller Turner (1) Turner Ashby Athletic Booster Club (1) Janette R. Tusing (4) United Way of South Hampton Roads (1) John A. Via (2) Barbara R. Vought (9) Janice W. Wade (6) Wayne E. Waggy (5) Jacqueline L. Walline (8) Wylie E. and Diane Walton (27) Bonnie Lou Wampler (6) Rick and Joyce Wampler (20) Tom Ward and and Susan Steele-Ward (1) David A. and Diane L. Warren (1) John M. and Martha S. Watkins (2) Grace B. Watt (20) Wallace W. and Mary Alice Weaver (8) Jake and Mary Lou Wenger (1) Wayne B. and Mary Sue Wenger (19) Homer and Janice Whetzel (3) David E. White and Peggy W. Nagel (3) John P. Jr. and Jo Ann Widener (15) Mr. David and Dr. Karen Wigginton (2) Judith and Robert Wildman (4) Roberta (Robbie) and Robert K. Wilkins (12) John R. Wilkinson (1) Louie Z. Will (7) Kathleen M. Williar (4) Waller H. Wilson (5) Linda T. Wilt (10) O. Walton Jr. and Judith W. Wine (1) Gladys B. Wonderley (2) Nell C. Wright (7) Richard S. and Margaret M. Wurst (4) Frederick B. Wynn (6) Matilda M. Yoder (11) Richard L. and Jeanelle G. Yoder (25) LTC Charles D. Young (2) Robbie Jean Zirkle (12)

White Rose Giving Circle $500 Teresa B. Anders (10) Linda Heatwole Bland (7) MJ Chewning (5) Gail Collins (1) Phyllis Yarrow Coulter (8) Sallie Funkhouser (14) Patsy K. Garber (5) Sherrill Glanzer (18) Amelia M. Hall (9) Cary Hevener (15) Ruby K. Hostetler (2) Mona D. Johnson (31) Susan J. Lawrence (3) Mary Louise Leake (11) Cathy Jackson Leitner, PLC (6) Ruth Lorson (6) Jill McGlaughlin (3) Alyce U. Nardi (2) Martha K. Ross (8) Doris S. Stone (6) Denise A. Whitman (16)

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of the RMH Foundation Annual Support $25-$99 Richard F. and Phyllis P. Albers (1) Steven J. and Susan Byrd Albright (1) Phyllis Albrite (5) John W. Alger Jr. (1) Richard S. and Alice H. Alley (1) Marlin P. and Margaret M. Alt (2) Vanessa Darlene Anderson (1) Herbert M. and Betty M. Aylor (2) Nancy W. Barr (3) Evelyn W. Basinger (16) Howard E. Sr. and Elizabeth F. Beall (1) Roger W. and Joan E. Bell (3) Wulf and Heide Berg (1) Ralph N. Bergdoll (3) Adam and Christina Blagg (5) Judith Adler Bland (3) Linda F. Bodkins abd Kathryn Grace Bodkins (1) Kenton Clemmer Bosserman (11) Norma C. Bowman (2) David J. Boyle (3) Roberta D. Branigan (4) Rodney A. and Patricia D. Branson (6) Shannon L. Brauchli (1) James S. Jr. and Shirley A. Breeden (2) Alfred and Delma Brenneman (3) Tommy E. Brooks (3) David and Teresa Bruce (4) Victoria Bryant (1) John D. and Sharon C. Bucher (4) Carol S. Burkholder (7) Lois C. Burkholder (1) Barbara L. Burner (1) Beverly S. Burrill-Hill (3) Thomas L. Jr. and Carroll P. Buskirk (2) Howard E. Sr. and Anne G. L. Byrd (1) Donald G. Jr. and Katherine L. Cabana (1) Edward W. Cale (2) Cynthia C. Campbell (11) Edgar L. Caplinger (2) Joseph P. and Akiko Carniglia (13) Barry and Patricia Carroll (6) Barbara M. Cavanaugh (1) Richard G. and Claudia J. Childs (4) Earl and Agnes Clarke (1) Patricia A. Clayton (1) Carolyn G. Cline (10) Kemper Price Cline (1) George W. and Sally M. Coffman (1) Clara Jean Comer (4) Jackson P. Comer (6) Harold Cook (8) William B. Jr. and Patricia A. Corley (2) Linda R. Covington (1) Randall L. Craig (3) Wayne and Betty Cupp (1) Barbara E. Currence (4) Warren E. Davis Jr. (2) David L. and Mary E. DeFilipps (3) William Dent (1) Nancy E. Deputy (1) L. D. Jr. and Patricia C. DeRamus (1) Millie Harman DeVall (2) Norman R. Downey Jr. (2) Gary L. and Brenda H. Driver (2) Dennis G. and Gayle P. Dupier (1) Juanita A. Durrett (12) Richard and Miriam Eichlin (1) Walter E. and Fonda M. Erdman (4) B. Earl and Cheryl K. Eshbach (7) Sharon Kay Fairhurst (1) Nancy Faulkner (2) Carol Ann Fields (1) Ray H. and Ruth C. Floyd (1) Gary L. and Jo-Jean R. Foltz (3) Charles E. and Deborah A. French (2) Charlotte A. French (1) Douglas P. and Peggy L. Fry (2) Dorothy L. Fulk (3) Mary S. Fuller (4) David M. and Brenda K. Funkhouser (1) Freda C. Garst (7) Danny H. and Cordia George (2) James M. Good (1) Kenneth I. and Betty Sue Good (1) Mary Martha Good (2)

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Richard K. and Edith H. Good (1) Verna Gosling (1) Alice M. Graves (3) John M. and Christie L. Greer (1) Lynn R. Grigg (2) Robert A. Guzzi (1) William Lee and Christine E. Hall (1) Carole Jo Harner (3) Betty I. Haslacker (1) Leonard E. and Rebecca P. Helmick (1) Burk and Linda Hershey (1) Robert L. Sr. and Connie S. Hofacker (12) Dennis W. and Shirley S. Hohenstein (2) Brent and Karen Holl (2) Mary A. Holler (1) Kurt D. and Elenore S. Lind Holsopple (1) Gregory C. and Melinda R. Homan (3) Sarah Sachiko Hori (5) Miriam Hostetter (1) Jay Hotchkiss and Kim Haines (20) Douglas L. and Julie T. Howdyshell (1) Debra S. Huffman (4) Jerry L. and Betty J. Huffman (1) Peter R. and Carol A. Hughes (1) Glen C. and Virginia Ann Hulvey (16) David S. and Patricia R. Hunter (1) Teresa A. Hunter (4) William J. Jr. and Catherine G. Hunter (11) Interstate Mufflers, LLC (1) Keith K. Jacob (1) Polly A. Jamison (5) Charles D. and Virginia S. Jones (9) Patricia S. Judd (2) Paul E. and Shirley K. Judd (1) David and Carolyn Kenee (1) Larry F. and Judith Kertcher (2) David R. and Teresa Wolfe King (2) Phyllis Ann Kisling (2) Betty Jane Knighton (3) Richard A. and Barbra J. Knupp (5) William A. and Carole H. Kreowski (2) Kenneth K. and Caroline B. Kump (3) Judy K. Miller Lalla (1) James V. and Lucretia M. Lane (1) Lydia Lapp (1) Steven and Nancy Lazarus (1) Sandra L. Leap (1) John P. and Barbara Moyer Lehman (13) Rich and Micheline Lehman (2) John W. and Beverly M. Leonard (7) Dorothy D. Logan (19) Harry E. and Virginia L. Long (13) Sandra P. Long (5) David M. and Gladys D. Longacre (8) Elizabeth Lopez (1) Teresa L. Louden (4) Kenneth L. and Diane Louderback (4) John T. Jr. and Joyce G. Lyon (2) Patricia Martin (3) Cornelia B. May (1) Rebecca C. McCutcheon (1) Harry F. McDorman (6) Leonard W. and Elaine N. McDorman (1) Challace and Mary Lou McMillin (3) Sally B. Meeth (4) Elmer W. and Violet J. Metzler (1) Steven M. and Dawn B. Michael (7) Charles E. and Bonnie S. Miller (5) Dawn Elizabeth Miller (1) Frances Sue Miller (2) Garry W. and Peggy R. Miller (1) George A. and Judy A. Miller (1) Mervyl L. and Linda H. Miller (2) Thomas and Sylvia Miller (2) Trovilla S. and Treva E. Miller (3) Ernest L. Jr. and Barbara B. Mongold (1) J. Robert and Marjorie B. Moore (3) Robert H. and Bonnie S. Moore (1) Michael A. and Julia A. Moretti (4) Odessa R. Moyers (11) Frank G. Mundy (3) Richard D. and Peggy S. Neff (1) Nestor and Nancy Neira (1) Epifania Nunez (7) Joseph T. O’Byrne (10) Arnold L. Osborne (11) Sue Overman (1) Francisco Cruz Pacheco (1) Daniel G. Packer (2) Lt. Col. Frank G. Padilla USAF (Ret.) (6) Larry S. and Mandy D. Pence (1) PEO Chapter BR (1)

Cdr. and Mrs. David J. Perault (5) John K. and Ruby K. Petersheim (2) Phyllis A. Peterson (8) Thomas A. and Daille G. Pettit (10) Kevin and Sivilay Phengsitthy (1) Charleen C. Pinnell (2) Nancy J. Pippen (1) Thomas W. and Tassie L. Pippert (8) Captain James R. and Alison J. Poplar (1) Lucretia M. Powell (2) Percy L. Prickett (1) Yvonne J. Prophet (1) Joseph E. and Gloria A. Randolph (2) Calvin Wall Redekop (1) Kathy A. Reichenbach-Stonesifer (1) Raymond E. and Naomi W. Ressler (1) Julia S. Rhodes (1) Marjorie T. Ridgway (3) Lynn F. Riner (2) Samuel E. and Donna Kay Ritchie (1) Drs. Arthur H. Jr. and Sylvia P. Rogers, Ph.D (4) John Rogers (1) Helen C. Rohrbaugh (18) Eric D. and Rosalynn S. Rohrer (1) Samuel J. and Julia D. Rohrer (9) Linda D. Rowe (1) Irene C. Ruddle (1) Joseph D. Rudmin (4) Keith B. and Jennifer R. Sampson (1) Ursula Schlegel (2) Richard B. Schneider (7) Phyllis Seekford (1) Heather Shai (2) Dr. Christopher N. and Norma M. Sheap (1) Keith W. Sheffer (2) Teresa Shenk-Stuart (1) Sheila Sally Shepherd (1) Cheryl Wynne Shifflett (8) Harry L. Shoemaker (10) Phyllis A. Showalter (1) Dr. Beverly P. Silver (10) Linda D. Simmers (1) Sandy S. Simmons (1) Regina Sinclair (1) Earl R. III and Sharon L. Smith (3) Joseph R. and Stephanie M. Smith (10) Victor J. II and Cheryl B. Smith (11) Wayne D. and Deborah L. Smoot (10) Jacob L. and Mary A. Spitler (3) Ira C. and Janice Spitzer (1) Marie C. Spitzer (10) James K. and Ruth Y. Stauffer (2) Michael R. and Faye L. Steele (2) Aaron and Becky Stoltzfus (2) Kathleen V. Stoneberger (10) Leonard S. and LaVonna C. Strickler (1) Gene A. and Elizabeth A. Stultz (2) Charles E. and Sandra S. Stumpf (2) Dr. Fred W. and Nancy C. Swartz (12) Dr. Asa R. and Jean F. Talbot (1) Mark W. and Sharon M. Taylor (1) Richard L. Thacker (1) Johnny L. and Anne Thompson (31) Tony and Susan Tomasello (4) Ronald P. and Ann D. Turnicky (2) Raymond W. Tusing (9) Janalee J. Tutwiler (1) Carolyn S. Van Dyck (3) Richard K. and Sherry R. VanPelt (10) Dr. Nando Visvalingam (3) Richard Wampler (3) Ursula H. Watson (1) Dona F. Weakley (1) T. B. and M. B. Webster (1) Earle P. and Debra B. Weekley (3) Carlyle Whitelow (8) Dr. Richard T. and Carolyn F. Wilfong (31) Leroy G. and June B. Williams (7) Laurie and Peter Yates (11) John D. and Janet G. Yeich (1) James D. and Mary A. Young (5) B. J. and Erma G. Zimmerman (4) Roy E. Jr. and Carolyn M. Zirk (4) Susan F. Zirkle (2) Totsie Ellen Zirkle (1)

Memorial Gifts Betty Jo Acker, Our Sister Garnic and Hilda Kidwell Rania Almond Henry H. Almond Jr. Dr. Roddy Amenta Jeffrey J. and Linda B. Reisner Lester Andes, My Husband Patricia M. Andes Susan Moore Arey Margie L. Moore Donald Armstrong Jan Miller Garfield E. Banks Sr. Edith J. Banks Lynn Barnard William W. and Margaret W. Anderson Chad and Donna Anthony Jo Cooper Scott A. and Dana M. Eichlin Elizabeth W. Hoover Howard Houghton Mark K. and Sheree L. Laurer Elisabeth M. Lawson William E. and Heidi B. Strang Wilson and Ruth Ann Troxell Tactical and Survival Specialties James and Audrey Barnhart Michael W. and Jean A. Click Sharon Barnhart Donald L. and Betty L. Martin Ann Barr John G. Barr David E. Batman Linda B. West Judith H. Bell George W. Bell George Billhimer Kathy G. Billhimer Janet W. Bollinger Lanny L. and Phyllis B. Branner Bernard L. Bolt Mary S. Bolt Ira B. and Ethel G. Boyers Pamela Boyers Arbogast Dr. Cecil D. Bradfield Nancy R. Bradfield Anna H. Branner James B. Branner Connie Brown Larry E. Brown Ray Brownfield Richard H. Torovsky Jr. Melvin Browning Richard L. and Pamela B. Wilkins Phillip H. Bulken Robert P. Armbruster Joan M. Buracker H. L. Jr. and Mildred R. Maiden John Marshall Burner Christine W. Burner Glenn, Terri, Wes and Jake Smith Nancy N. Butler Samuel G. Butler Dr. and Mrs. A. C. Byers Estate of Charles Conrad Byers Dr. and Mrs. F. L. Byers Estate of Charles Conrad Byers Jane Alane Byrd Edward A. and Flora H. Byrd John Calabria James H. and Judith H. Butler Henry H. Cale Marguerite E. Cale Dr. Donald M. Callahan Ruby J. Callahan

SPRING 2020

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All Those Touched by Cancer Cancer— God Bless Them David C. and Mary A. Zirkle

Eugene Coakley Nelson and Linda Simmons

Ruby Angeline Gallalee Linda Brooke James A. and Marilyn L. Estep Edward R. and Nancy K. Gallalee Denny and Maria Gordon Bonnie E. Guyer Joan H. Lambert Sharon Rice, Jan Hopkins, Gail Huber and Denny Gordon Elizabeth Sullivan and Edward Gallalee III

Gerald E. Collins Elma T. Collins

Boyd and Ada Garber Anne G. Farmer

Carroll Comer and Elwood Walton Wylie E. and Diane Walton

Derwood and Ruby Garber Anne G. Farmer

Arlene D. Conger and Ida T. Peters Charles J. and Linda W. Peters

Jill Hedrick Garrison Butch Proctor

Walter E. Counts Evelyn F. Aleshire Michael W. Comer Eugene A. and June S. Counts Robert Counts Stephen A. and Shirley L. Parsons Vickie L. Rule John M. and Marie A. Ryman OTF 8:45 Wolf Pack Special Fleet Service on behalf of Winston and Zach Counts Harrisonburg Department of Public Transportation Smith’s Tax Service

Sandra Gehr Derek G. and Karen S. Brownsword

William D. Craun Gloria B. Craun

Janet Glendye Tommy and Betsy Heatwole Glendye

Alice Cupp Cathy Cupp

Cecil Grove Cathy Cupp

Walt Daggert James H. and Judith H. Butler

Joyce Hall Debra Howe Garland E. and Susan S. Huffman Donald R. and JoAnn Kantner

Loretta Clapper Lee E. Clapper Sr. Collis Eugene Coakley Nelson and Linda Simmons

Robert George D’Angelo Martin J. and Elizabeth J. Bundrick Benjamin Cole Davis Gayle L. Davis Donald Dellinger Kathie W. Dellinger William Ray Dellinger Shirley L. Dellinger Pat Dotson Anne M. Dellinger Gary D. Dove Wanda L. Fry Ken Downey S. Edward Jr. and Betsy D. Craun Jackie Driskill William Y. and Janet S. Joseph Virginia T. Dunlap Edward J. Jr. and Ellen D. Baldwin Hilda S. Earhart Darwin C. and Kathryn E. Simmons Eldor, beloved Sentara RMH therapy dog Daniel R. Lynn and Rosemary P. Mitchell Arlen and Lula Eller Dean and Sandra Clatterbuck Cleo and Estelle Emswiler and Wayne Rankin Chuck and Faye Bowden Wallace S. Erdman Michael R. and Adina E. Bailey Yvonne H. Esser Karl P. Esser Clarence and Jane Ewing Elizabeth Ann Homan Leo Falconieri William B. and Margaret A. Zeh Ray Farmer Anne G. Farmer Norval E. D. Fishel Ralph M. and Evelyn P. Desarno Helen Foley Broadway High School Class of 1955 Ben and Betty Ann Fordney Richard A. and Cathy D. Baugh Elizabeth de Bie Frederick Alva J. Frederick

Wayne F. Geisert Gregory W. and Margaret S. Geisert Josephine Merryman Blankinship Gibbons Emory and Bechwith Merryman Lillie Mae Shifflett Gibson Harold R. and Betty L. Morris Barry M. and Teresa B. Shifflett Debra L. Shifflett Custom Systems USA Region 2 Executive Team Riddleberger Brothers Inc.

Robert L. Halterman Marianne F. Halterman Barbara Ann Hansbrough James P. Hansbrough Vivian Z.Harrison Steve and Chris Bradshaw Cathy Fulk

Nancy P. Hoppe Herman E. Hoppe

William B. MacLeod Beverly T. MacLeod

Donald and Robert Horne Gloria Horne

Pauline Z. Martin R. Larry Martin

Jo Ann Hottinger D. S. Hottinger

Raymond Martindale Jr. Miriam S. Martindale

William and Ann Houff Edmund and Deborah Price

Susan Mast Paul G. and Mary N. Kniss

Dr. Vida S. Huber Harold E. Huber

Sue and Wade Menefee Ann and Neal Menefee

Larry G. Huffman Lois B. Huffer

Lottie Mezak Thomas F. and Janice R. Carroll

Phyllis Long Hughes Wayne L. and Ann Payne Long

Joyce S. Michael Charles W. Michael

Robert Hurley Ann Gerding Hurley

Dawn Miller Phillip E. and Wilma R. Davis

Alvin L. Irwin Michael W. and Debra I. Davis

Ricky Lee Miller Kyle L. Miller

W. E. Jamison Polly A. Jamison

Paulette Mills Robert E. and Mary E. Rhan

Maynard Johnson Johnna L. Johnson

Helen M. Minzey Hampton W. and Mabel Anna Foley

Phyllis Johnson Roger Lee and Kay Riggleman

Stanley Lee Mitchell Rennie Mitchell McAllister

James B. Joyner Sr. Catherine W. Joyner

Winston and Betty Moore Patricia A. Mohler

Wayne Judd James H. and Judith H. Butler

Lawrence F. Moran Jr. Nancy L. Moran

Louise Keim Steve E. Keim

Phyllis J. Morin and Brenda Morin Bazinet Richard R. J. Morin

George Weldon Kenney Charlotte H. Kenney

Susan J. Morningstar Ruby M. Lineweaver

Daniel Keith King Terry D. King

Sam Morris Betty D. Morris

Lila June King Lewis and Arleen Forsheit Myrna M. Guion John D. Hahn Solomon P. and Ruby H. Hedrick Donald L. and Judith H. Hulvey

Virginia “Jenny Anne” Mowbray Jonathan and Melissa Rawley and Family

Sharla King Norman C. and Doris E. Benner

Bob Heath Norma J. Heath

Carson L. Kiracofe Sharon L. Kiracofe

Carol Heatwole Amy Wampole and Sandy Wampole

Gregory Scott Kuykendall Billy and Betty Kuykendall

Wayne and Wilson Heatwole Christine Miley

Harry R. Laatz Marianne Laatz

Charles L. Heatwole, my dear husband Doris B. Heatwole

Carolyn Jean Ratcliff Landes Richard and Sharon Soldan

John Held Ann R. Held

J. Steven Landes Frances E. Ritchie

Jeddie H. Hensley Shelvy M. Jenkins Robert L. and Patricia A. Taylor

Dr. George Lewis Lawson Elisabeth M. Lawson

John Steven Hensley Sr. Jo Anne Dean Paul and Elaine Hershey Glen E. and Sandra H. Kauffman Angela Hess Sandra A. Hess Gary L. Higgs Frances E. Ritchie Carol High Daneen A. Coakley Phyllis N. Himelright William E. “Ike” Himelright Harold Hinegardner and Jack Hinegardner William R. and Barbara H. Hite Donald W. Hinkle Shelvy K. Hinkle Ray and Margaret Holsinger Margaret A. Alexander Ellwood and Ernestine Hoover Anne G. Farmer Harold Hoover Anne G. Farmer Warren Hopkins Leila P. Hopkins

Susan Layman Lois Ann King Raymond F. and Naomi H. Leeth James L. Leeth Darla Faye Craft LePera Allen G. and Kaethe J. Schick Ninfa T. Lianez Emmanuel J. Lianez Ruth B. Life Mary Life Garrett LeRoy and Violet Lineweaver Sharon L. Kiracofe Donald R. Litten Madeline W. Litten Mabel Lohr Janet A. Waugerman Janet L. Long Carolyn Long Dickenson Leonard and Virginia Long George E. and Betty L. Painter Paul M. Longacre Nancy R. Heisey Tye Cobb Lytton Tyrus C. and Lita Z. Lytton

Stanley B. Moyer Jr. Lareth L. May Jeffery S. Moyers Wayne and Diane M. Stephens Bobby L. Myers Fay B. Myers John D. Myers Donna H. Robinson Rachel B. Myers Debra D. Thompson Sterling E. Nair Foelke D. Nair Ralph and Terry Newman Bettye S. Newman Vivian M. Nilsen Reverend K. Roy Nilsen Edward F. Norford Jr. Melrose Church of the Brethren Donna Faye Parady Lewis Parady Richard L. Parker Etha Jane Parker Hallie Bowman Pence Carolyn B. Pence Roger P. Pence Janice L. Pence Kimberly Harrison Prater Susan Diane Harrison Jesse and Dorothy Price Rodney and Ruth Stultz Page P. Price Eleanor Page Price Page P. and Ann S. Price Edmund and Deborah Price Arnold Propst S. Walton Propst Etha Mae Propst Leila P. Hopkins Lacy Rea Charles Steven Smith

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friends

of the RMH Foundation Christine Reeves Richard M. Reeves

Billie G. Strickler Richard P. Strickler

Barbara Buhl Gary W. and Teresa B. Day

Bonnie Miller Terry D. and Linda M. Looney

E. Virginia Reilly John J. Early

Robert Strickler Henry F. and Catherine S. Buhl

Louise Butler Lynn and Diane Trobaugh

Judy Miller Lynn and Diane Trobaugh

Robert S. Rhodes Lois M. Rhodes

Evelyn V. Stultz Rodney and Ruth Stultz

Dr. Kevin Casey and His Cardiac Team Robert P. Armbruster

Hunter Mitchell Ricky and Sharon Adkins

Mr. and Mrs. Russel (Lenna) Rhodes Dr. Richard T. and Carolyn F. Wilfong

Marie Sullivan Jason T. and Nicole B. Smith

The Cekada Family David V. and Claudia A. Pascarella

Ashley Payne Tommy and Betsy Heatwole Glendye

Alice Riddle Tom E. and Linda R. Sites

Diana Summers F. M. Summers

Crystal Collins Lynn and Diane Trobaugh

Linda Rhodes Tommy and Betsy Heatwole Glendye

Mahlon N. Rissler Gloria Rissler

Nelson E. Suter, my beloved husband Donna Suter

Cory Davies Lynn and Diane Trobaugh

Warren N. Riddle Jodi B. Riddle

Phyllis R. Roberts Frances E. Ritchie

Dr. G. G. Tanner Don A. and Carole T. Landes

Diane Davis Michael D. and Mary B. Davis

Debby Ritchie Lynn and Diane Trobaugh

Polly Rogers Paige Webb Godoy

Inge Taylor Colonel and Mrs. Peter F. Dieck

Rick Davis Michael D. and Mary B. Davis

Geraldine Rush Amy L. Rush

Clayton N.Towers Jacqueline G. Towers

Diane W. Ryman Deborah M. Barrick

Florence A. Trelawney Gilbert S. Trelawny

Ellen R. Dotas Eastern Mennonite University School of Grad & Prof Studies

Dr. Brian E. Robinson N. Paige and Ann C. Will Nell C. Wright

Gilbert G. Schuckman Susan L. Schuckman

Granvil, Gifford, Garnett and Wayne Turner J. E. and Vada T. May

Gary Scott Anita H. Brechtel

Wayne and Betty Turner Phillip W. and Joanna T. Thompson

Lyman and Rosemary Seese Donald W. Seese

Paula Jane Van Ryan David O. Banks

Wanda Sherman Joann Roadcap

Roy Waggy Tammy L. Oldman

Joseph W. Shifflett Drew and Carrie Covey H. L. Jr. and Mildred R. Maiden Family of Delmer Sellers Charles E. and Brenda K. Shifflett Larry and Dawn Shifflett

Phyllis Dove Wampler Mr. Jodie E. Wampler

Leon W. Shifflett Sandra Dean

John B. Watlington Jean S. Watlington

James E. Shirron Shriley A. Shirron

Norris Elwood Weaver Charles E. Cline Pat Long Etha Jane Parker Jean Reilly Marci J. Rockhold

My husband, Kay Showalter Goldie T. Showalter

George and Anna Whitmore Joseph S. and Annette W. Paxton

Twila D. Showalter Larry W. Showalter

Mr. and Mrs. Everett (Elva) Wilfong Dr. Richard T. and Carolyn F. Wilfong

My Mother, Katie Showalter Lloyd D. and Edna V. Brugger

Mildred Wilkinson John R. Wilkinson

Catherine S. Simmons Gayle E. and Hester S. Judy

Jack C. Will Louie Z. Will

Jean Siple Allen S. and Fonda M. Harlow Dayspring Church of the Nazarene Raymond G. Hand

Evelyn Willett Robert B. Jr. and Jeanne S. Minnich

Arvin W. Shipe Shirley D. Shipe

Betty M. Slifer and Fern H. Fix Robert E. and Martha M. Cook Arlie E. Smith Detra Shell Smith Eugene R. Smith II Linda G. Smith Lacey and Ethel Smith Shyrl R. and Betty M. Smith Wilson Smith Jr. Sandra Kay Smith Terry and Glenda Spitzer Patricia A. Spitzer Norma L. Sponaugle Chanda G. Sponaugle Mary Ann Stetler Roy H. Stetler III Dan Stickley Barbara K. Stickley Graham Stoneburner Susan S. Gallaher

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Dottie Warfield Tommy and Betsy Heatwole Glendye

Harriet J. Wilson George O. Wilson Jr. May Wimer, my Mother Alan L. and Patricia W. Knicely Dr. Jean F. Wine Joseph H. Meyerhoeffer John “Yogi” Wolfe Jay L. Campbell Frances E. Wyant Evelyn S. Hedrick Brenda M. Wynn Frederick B. Wynn John and Joyce Zigler Randolph G. and Beverley Z. Nelson Blair Zirkle Maxine W. Zirkle

Honor Gifts Sarah Albrecht Lynn and Diane Trobaugh

Margaret W. Strate Robert and Sarah Rees

Melvin L. Armentrout Timothy R. and Phyllis C. Armentrout

Elaine and Jay Strawderman Alfred L. Strawderman

Nancy Bradfield Lynn and Diane Trobaugh

Wayne A. Strawderman Esther J. Strawderman

Ted and Cindy Bryan Darlene L. Newman

Cheryl Dove Mabel F. Dove Mary Catherine Dove J. Brisco and Janet Dellinger Scott Eichlin Tommy and Betsy Heatwole Glendye Janice Eppard Melissa Shipe Doris A. Etter Debra D. Thompson Julie and Dave Fites Ralph C. and June T. Steger Chris Foster Tommy and Betsy Heatwole Glendye

Dr. Brian Robinson and Hahn Cancer Center Staff Sue Ludington Jones Deborah F. Kilby Ron Rose Lynn and Diane Trobaugh Sentara RMH 5 West Staff John C. Shank Sentara RMH Employees and Volunteers Donald L. and Ginger B. Usry Dr. George A. Roussel Dr. Marcus N. and Jodi G. Morra Bob Scott Russell A. Curro Ray L. Heatwole Pamela R. Mason Robert and Deborah A. Ryder

Funkhouser and Kistler families Libby Kistler

Bob Scott and the Central Office Instructional Staff for Rockingham County Schools Mark A. Shifflett and Rebecca R. Hill-Shifflett

Betty Ann Lewis Giuliano Arthur S. Giuliano

Teresa Shafer Estate of Joseph Ervin Shafer

Jodi Marie Gooden Bobby W. Gooden II

Pat Shoemaker Lynn and Diane Trobaugh

Donna Hahn Sentara RMH Nursing Leadership Team

David Solomon David E. and Marilyn S. Solomon

Betty Ruddle Heavner 85th Birthday Louise Dolly Cook

Steven J. Spart Mike and Dawn Claypoole

Naomi Heishman Wayne E. and Carolyn H. Miller

Linda Taylor Donald and Margie Zimmerman

Susan H. Holsinger J. Michael and Dianne H. Burris

Debra Thompson Lynn and Diane Trobaugh

Beth Hook Thomas A. L. and Breck H. Hook

Trevor and In memory of Maggi Lisa C. Williams

Brenda Hoops O. Walton Jr. and Judith W. Wine

Dr. Christine M. Urbanski Alison S. Hardwick Russell E. Jr. and Lillian C. Huffman

All Sentara RMH Hospice Volunteers Horace E. Jr. and Sally G. Jones Ruby Hostetler Sherrill Glanzer Spencer, Chester and Gretchen Hotinger Ronald M. and Linda C. B. Hotinger Lana and Robert Hurdle Ralph C. and June T. Steger Claire Janssen Walter W. and Claire R. Janssen Dr. Robert M. Kyger Roberta (Robbie) and Robert K. Wilkins Duane S. Lam Roger L. and Mary Frances Lam Jo Ann Liskey Lynn and Diane Trobaugh Jim Macarthur Janet L. Macarthur Kathy MacMillan Donald L. and Ginger B. Usry Kristopher Maul and Natalie Hensley Anna-Christy Carson

Mary Vann Larry R. and Linda V. May Janet T. Wendelken Marianne F. Halterman Denise Whitman Lynn and Diane Trobaugh Lisa Williams Harrisonburg and Bridgewater 24/7 Fitness Chris and Sarah Orem Teresa Shifflett Dr. Mary Helen Witt Kennneth Lee Thomas Jr. and J. Faye Hoover-Thomas Robbie Jean Zirkle Pete Wright Lynn and Diane Trobaugh Dr. Gene L. Yoder Dr. Marcus N. and Jodi G. Morra Susan Zucconi and the nurses at RMH who provided compassionate care for my wife Linda Light John Douglas Light

Barbara C. McHone J. Michael and Dianne H. Burris Pat Messner Lynn and Diane Trobaugh

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S E N TA R A E M E RG E N C Y DE PA R T M E N T

DON’T MISS LIFE’S SPECIAL MOMENTS “When mom fell on the day of my wedding, we were so worried.

We took her to the Sentara RMH Emergency Department where she was given the right treatment, by the right provider, in a short amount of time.”

At Sentara RMH, we’re continuously working on reducing our emergency room wait times, providing top quality medical care so you can get well and not miss any of life’s special moments.

For more information, visit sentara.com.

Follow us on Facebook and Twitter, @Sentara.com.

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Sentara RMH Medical Center 2010 Health Campus Drive Harrisonburg, Virginia 22801

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

Sentara.com Change service requested

S E N TA R A OR T HOJOIN T CE N T E R ®

WE CAN’T SLOW DOWN TIME . . .

BUT WE CAN GET YOU BACK TO ENJOYING IT. Time flies, and the grandkids grow so fast. We can’t stop the clock, but we can make sure you’re enjoying every moment.

At the Sentara OrthoJoint Center®, we look forward to getting you back to you.

SENTARA ORTHOJOINT CENTER® OFFERS PATIENTS: • A dedicated orthopedic patient navigator with you every step of the way.

• A dedicated orthopedic facility with onsite therapy and imaging • Private patient rooms in a state-of-the-art facility

Call 540-689-5500 to schedule. For more information, visit SentaraOrthopedics.com.

Follow us on Facebook and Twitter @SentaraRMH

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