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SENTARA RMH S U M M E R 2 0 21

Magazine

We Are SENTARA RMH Team Members Share Why They Do What They Do PLUS: Robotic Surgery Comes to Sentara RMH

Fighting Food Insecurity | Behavioral Health lmpacts of COVID

PRESIDENT’S LETTER

2021 SENTARA RMH BOARD Joseph Funkhouser II | Chair

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

I Couldn’t Be More Proud …

s our community reopens and we embark on the road to recovery, I wanted to take a moment to reflect on the past 16 months and recognize the incredible work of our entire team. Their resolve, dedication and sacrifice is beyond admirable, and unbelievable work has been accomplished. If there was one way to sum up my feelings, it

would be to say thank you, and that I couldn’t be more proud. From setting up our first COVID-19 testing clinic last April, to releasing a COVID patient this March who had been in our care for 110 days, the last year has been among the most challenging on record for those working in health care. Nurses, doctors, hospital staff, emergency responders and so many more have selflessly stepped up to provide compassionate care amid intense uncertainty. You can read more on page 6 about what it was like to work through the pandemic from the perspective of two of our oncology providers. At the same time, I would also like to say how grateful and humbled we are by the tremendous support shown by our community over the past year. These difficult times have brought our community closer together and shown the best in us all. We’ve also found new ways of working together to benefit our neighbors SENTARA RMH ADMINISTRATORS

Douglas Moyer President

Donna Hahn, DNP, RN, NEA-BC

(see story on page 38), and that’s what is most important. Now, with more than half of Americans fully vaccinated, the outlook ahead is promising. As we begin to turn the corner on this pandemic, I also wanted to take a moment to recognize some milestones our hospital has reached along the way. At the core of our success is our caring and dedicated

Vice President of Acute Care/CNE

staff. Thanks to their tireless efforts and continued excellence, Sentara RMH recently was named one

Rita A. Bunch, MPH, FACHE

of IBM Watson’s Top 100 Hospitals in 2021, and has been included as one of IBM Watson’s Top 50

Vice President of Operations

Cardiovascular Hospitals for two consecutive years. Additionally, we recently launched robotic surgery at Sentara RMH (see story on page 19); we

SENTARA RMH MAGAZINE EDITORS

Jenn Downs Debra Thompson CONTRIBUTORS

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

adapted procedures to continue to provide vital behavioral health services despite the pandemic (see story on page 29); and we are excited to continue to help people heal, and allow them to get back to doing the things they enjoy and love. At the end of the day, our mission is to improve health every day. We cannot do that without our incredible team. We are honored to be your community hospital, and we are grateful for the enduring support shown to our team during these difficult times. We are truly privileged to serve such an incredibly tight-knit community. Respectfully,

PHOTOGRAPHY

Luca DiCecco Andrew Shurtleff Tommy Thompson DESIGN

Picante Creative

Doug Moyer President, Sentara RMH Medical Center

Contents SUMMER 2021

“Dr. Da Vinci” Robotic Surgery Comes to Sentara RMH

We Are Sentara RMH Strong

Behavioral Health Impacts of COVID

Making It Through the Pandemic—Together

Contents

SUMMER 2021

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

New & Noteworthy

Physician’s Perspective On-Call Advice

Improve Health Every Day Eat Well, Live Well

Grilling for Good Health

Calendar

Active Living

Sports Medicine Gets Athletes Back in the Game

Health Matters

Take Care of Anemia

La Salud Importa

Cuidarse de la Anemia

Sentara in the Community

Fighting Food Insecurity

Calendar

Philanthropy

THE BEST MEDICINE BY MICHAEL CORDELL

More Than Just a Walk in the Park

hey say everyone has a special talent. Some people are great at building things, while others can cook amazing culinary dishes. Some individuals sing like a bird, and others can sit at a piano and play any song by ear. At first, I had trouble identifying my special talent. For example, to say that I’m not a particularly handy person is as accurate as saying that I’m not nine feet tall, and when it comes to cooking skills, I can’t even make microwave popcorn. On the musical side, the one person who’s ever told me that I sing like a bird was referring to a turkey buzzard—and if I tried playing a piano by ear, it would sound the same as if I tried playing it using my ear. Then I remembered something I’ve always done extraordinarily well: I am amazing at coming up with excuses not to exercise. That’s not a small feat. If I could strengthen my heart, lower my blood pressure, sleep better, think better, move better, focus better, live longer and experience less pain simply by exercising 30-45 minutes, three to four times a week, then obviously I had to be creative to come up with reasons not to do so. And creative I was. I didn’t run because my knees sometimes hurt. I didn’t swim because I didn’t want to get wet, and I didn’t lift weights because they were heavy. I didn’t know how half of the machines in the fitness center worked, and the other half looked scary. I was afraid my resistance band might snap me like a wet bath towel. Now I’m not saying my special talent was a positive one, just as people who irritate everyone around them at work by constantly humming or whistling shouldn’t brag about their special talent. I’m just saying it’s what I was good at. Then I learned about the health benefits of walking, which shares many of the same benefits

as other types of exercising, such as maintaining a healthy weight; preventing or controlling health conditions like heart disease, high blood pressure and type 2 diabetes; strengthening bones and muscles; improving balance; and a host of others. Try as I might, I couldn’t come up with a truly good excuse not to walk. I couldn’t even come up with a meager excuse. I didn’t need special clothing or equipment to take a walk, and it was something I had learned how to do many years ago. In fact, it was something I was already doing every day. Not only that, but if I wasn’t able to walk 30-45 minutes at a time, I could still achieve some health benefits by walking in smaller chunks throughout the day. So I started walking, and it turned out to be as easy as it sounds. And not only am I improving my overall health, but walking also can yield some unexpected benefits. I use my walking time as an opportunity to listen to podcasts, so I’m learning new things in the process. Granted, I only listen to podcasts that focus exclusively on knock-knock jokes, but you might choose something different (although, why?). I also reconnect with neighbors on my walks, explore new parts of town and find myself relaxing as I spend more time in nature. I used to see nature simply as that space that existed outside my house or car windows, but it turns out there’s more to it. Who knew? So now I’m back to trying to figure out what my special talent is—since, again, they say everybody has one. Maybe mine is proving that there are exceptions to every rule.

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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. Noeen Arshad, DDS Pediatric Dentistry All Smiles Harrisonburg 540-432-1300

Jordan A. Hunter, DO Hospital Medicine Sentara Hospital Medicine Physicians

Jessica A. Stevens, DO Hospital Medicine Sentara Hospital Medicine Physicians

Lauren E. Eary, PA-C Allied Health Sentara Pulmonary & Critical Care Specialists 540-689-5600

Shiry R. Hunter, DO Hospital Medicine Sentara Hospital Medicine Physicians

Jennifer M. Writsel, PA-C Allied Health Blue Ridge Urological Associates, PC 540-689-5900

Kelli L. Frana, CRNA Allied Health SMG Anesthesia Specialists, LLC

Laura R. Lowe, NP-C Allied Health Sentara Hospital Medicine Physicians

Sentara RMH Medical Center Named to the

Fortune/IBM Watson Health 100 Top Hospitals® List

Sentara RMH Medical Center has been named to the Fortune/ IBM Watson Health 100 Top Hospitals list, a recognition that demonstrates Sentara RMH’s ongoing commitment to prioritize patient-centered care. “This recognition is thanks to the tireless work of every member of our team, be it nurses, providers, or those who work in roles behind the scenes to help care for our patients,” says Doug Moyer, Sentara RMH president. “It is an especially meaningful achievement to receive after the challenging year we spent navigating a global pandemic.” According to IBM Watson Health, the hospitals included on the Fortune/ IBM Watson Health 100 Top Hospitals

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list had better results on key clinical and operational performance indicators, as compared to similar hospitals. These indicators include survival rates, patient complications, healthcare-associated infections, 30-day mortality and 30-day hospitalwide readmission rates, length of stay, throughput in emergency departments, inpatient expenses, profitability, and ratings from patients. This year’s ranking of top hospitals also introduces a measure of hospitals’ contributions to community health, with a focus on equity. For the ranking, hospitals were surveyed across three components: 1) assessing hospital contributions to community health as a provider of critical services for community health and preventive care; 2) identifying ways in which hospitals contribute to community health as a community partner, teaming up with local organizations to implement critical programs; and 3) focusing on ways in which hospitals promote community health through their practices as anchor

Fetal Echocardiography Now Available in Harrisonburg Cathy Slusher, MD, as well as ultrasound techs Melanie Turner and Beth Orndorff, from Harrisonburg OBGYN, have completed specialized advanced training to perform fetal echocardiograms at their office. A fetal echocardiogram, or “fetal echo,” is a specialized ultrasound of a baby’s heart and surrounding structures that is performed before birth. Used to assess the anatomy and functioning of the fetal heart, the fetal echo is typically performed during gestational weeks 22-24. Fetal situations that would prompt such a study include suspicious findings on the routine fetal ultrasound evaluation that occurs around week 20, fetal heart rhythm abnormalities, chromosomal abnormalities, abnormal swelling of the fetus and other conditions.

institutions supporting local economic and social progress. “Being a partner with others in our community has always been important to us,” notes Moyer. “Developing good health care doesn’t happen in a bubble, and we continue to look for ways in which we can partner with others in the community to continue to improve the health of our neighbors.” Sentara Healthcare also has been named one of the Top 15 Health Systems in the nation for 2021 by IBM Watson Health. This is the second time Sentara has received this honor, which highlights top-performing health systems with excellent clinical outcomes, operational efficiencies and patient experience. For more information, visit www.100tophospitals.com.

Sentara RMH Now Offers 3T MRI for Detecting Prostate Cancer In the United States, prostate cancer is the most common cancer in men and the second-most common cause of cancer-related death in men. It is estimated that approximately one in six men will be diagnosed with prostate cancer at some point. Fortunately, most men are diagnosed with prostate cancer at an early stage, before the disease has spread to other parts of the body. Although a prostate-specific antigen (PSA) blood test or physical exam can suggest a potential problem with the prostate, those tests won’t tell the entire story. In many situations, advanced imaging of the prostate is necessary to determine whether an abnormal finding is due to cancer or a benign cause. To provide that kind of state-of-the-art imaging, Sentara RMH now offers 3T magnetic resonance imaging (MRI). Generating twice the magnetic field strength as that of a standard 1.5T MRI, the new technology can obtain extremely detailed images of the prostate gland without the need for an endorectal coil. With this improved image detail comes the ability to diagnose very small cancers within the prostate gland, improving early detection of prostate cancer and boosting the potential for cure of a patient’s disease. “Sentara RMH is the only hospital along the I-81 corridor from Roanoke to Winchester that provides 3T MRI,” notes Sentara RMH radiologist Matthew Blurton, MD. “That puts us on the forefront of prostate imaging and intervention, with the ability to perform advanced prostate MRI, as well as image-guided biopsies of prostate lesions.” For more information on 3T MRI prostate testing, call your clinician or Sentara RMH Medical Center at 540-689-4969. sentara.com

PHYS ICIAN’S PERSPEC TIVE

CANCER TREATMENT IN THE TIME OF

COVID

ithout question, 2020 was one of the most memorable years of my career. When the COVID-19 pandemic began to unfold in the spring, as caregivers we had By Heather Morgan, MD many questions and few answers Radiation Oncologist, Sentara RMH regarding how best to protect Hahn Cancer Center our patients and each other. We received new information about the virus almost daily, and as we learned more about what we needed to do to keep everyone safe, Sentara RMH continually updated its policies and protocols. The hospital’s infectious disease physician, Parag Patel, MD, visited the Hahn Cancer Center to analyze our unique issues and provide us with tailored recommendations to help keep our patients safe. Following Dr. Patel’s guidance, we spaced chairs further apart, removed magazines in waiting areas, and sanitized chairs and rooms after each patient visit. We also offered to postpone routine post-treatment follow-ups or convert them to phone or video conference (we did not, however, alter new patient appointments and follow-ups with concerns). Under the new protocols, patients had to come in unaccompanied unless they had memory issues, and this change proved to be the most difficult challenge for patients and physicians alike. Although patients naturally experience anxiety with a cancer diagnosis, coming to the Cancer Center with no support person in the midst of a pandemic was a very difficult experience for some. Having a support person present can be valuable for both patients and caregivers, since family members provide an extra set of ears to help the patient recall details, and often think of good

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questions to ask during appointments. With that in mind, I would do my best to provide extra support during these visits, often having family on speakerphone or talking with them separately at a later time. For patients who were already receiving daily radiation treatment, we spaced appointments out to avoid crowding in the small waiting area

near the machines, as well as to allow enough time to sterilize the treatment table and all other surfaces between appointments. We did not interrupt any ongoing radiation treatment, but we were able to postpone a few patients who had slow-growing cancers or could control their cancers with hormonal therapy in the interim. However, we could not safely postpone the vast majority of our patients without increasing the risk of their cancer worsening. For this reason, we had to prepare for the inevitable circumstance of having to treat a patient who had contracted COVID-19. Our plan was to treat the patient at the end of the day if they were in the midst of treatment, provided they were in stable condition. One such Cancer Center patient I recall was hospitalized with COVID-19 in the midst of treatment, which we were able to resume after a short break, while he recovered from the virus. Thankfully, he then completed his course and was discharged to a rehab facility—although he had missed one important ceremonial moment of his treatment. In our center, patients who have completed treatment have the option of ringing a bell three times to commemorate their milestone. The patient had missed that opportunity, but when he returned for his two-month follow-up, he was able to ring the bell to celebrate his victory over both COVID-19 and cancer. I am proud of the fact that, even in the midst of a pandemic, our Cancer Center persevered to provide the best possible care and outcomes for patients. On another note, a worrisome pattern began to emerge. By the fall, although we had learned to adapt to life in the pandemic, I began to notice an increasing number of new patients with advanced cancer, with a common theme: diagnosis had been delayed due to COVID. Often such delays were due to patients’ fear of going to the doctor to report symptoms during the height

of the pandemic. Unfortunately, a similar pattern has been reported nationwide, and it has been heartbreaking to see patients come in with cancers that, due to a delay in diagnosis, now require more aggressive treatment or can no longer be cured. In light of this trend, if I could get one message out to our community members, I would urge them not to postpone cancer screening or ignore worrisome symptoms— due to COVID-related concerns or any other reason. Physician offices and hospitals are now well prepared to keep patients safe during their evaluations, and earlier detection of a cancer generally results in a better chance of cure with less aggressive treatment. If you are due for a screening or have concerns about your health, be sure to see your physician as soon as possible.

Getting Through

COVID, Getting BACK to NORMAL

rior to early 2020, the most feared two-syllable word starting with C was cancer—and then the term COVID entered both our world and our vocabulary. At the Hahn Cancer Center, we’re used to dealing with the former, but dealing with both diseases simultaneously required a new strategy. Delivery of traditional oncology care is normally loaded with personal interactions: clinic visits,

By Mary Helen Witt, MD Medical Oncologist/ Hematologist, Sentara RMH Hahn Cancer Center

sentara.com

PHYS ICIA N ’ S PERSPEC T IV E

treatments that can last for hours, visits for lab work, surgery, imaging, support and educational classes—all of which are opportunities for virus transmission. Cancer patients in general are especially vulnerable to infection, and COVID added yet another threat. Those with lung cancer and hematologic malignancies have proven to be at the highest risk for complications from COVID infection. Although telemedicine became an option for many practices, the majority of our Cancer Center patients require in-person care. We had some tough decisions to make during the pandemic, but the goal remained essentially the same: maximizing care for our cancer patients by minimizing interruptions in lifesaving and life-prolonging treatments—now, however, while keeping patients and staff safe from COVID. In response to the crisis, we were put in the uncomfortable position of having to decide which cancer patients needed immediate treatment, and which ones could delay treatment without compromising outcomes. For example, utilization of oral hormone pills allowed some women with lower-risk breast cancer to postpone surgery safely. Patients with chronic malignancies that had multiple, equally effective treatment options often chose an oral agent or a regimen that minimized visits to the Cancer Center. As an added complication, more recently we have had to consider the timing of treatments that could lower a patient’s immune response and impact the efficacy of COVID vaccinations. Although isolation and separation are already part of a typical cancer diagnosis and journey, during the pandemic we had to limit the number of people passing through the Cancer Center on a daily basis. This led to the requirement that patients come to appointments and treatments alone. Early on in the pandemic, as I entered an exam room, I often found myself worried about the absence of the typically ever-present caregiver. Then I would remember why the patient was alone and be relieved that the support person was probably just waiting in the car and not sick at home or in the hospital. Several provisions were made to facilitate communication with patients, including allowing a visitor to accompany patients being seen for the first time with a new diagnosis of cancer. An extra set of ears is crucial during that visit, and many family members participated in such consultations via speakerphone. Still, communication has been more challenging during COVID, since we humans rely on many forms of nonverbal cues, including body language and facial expressions, for information. In that respect, masks and goggles haven’t helped, either—but we

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have managed to muddle through as best we could. With the pandemic now appearing to be easing, I look forward to handshakes, hugs and seeing each other’s faces again. While COVID has disrupted lives in countless ways, one area of collateral damage that may lead to long-term harm is the disruption of cancer screenings like mammograms and colonoscopies. Thankfully, screening exams were only halted for a few months, and extra precautions have been implemented in the meantime to ensure safety during these visits. So, while many of us plan long-overdue vacations, I encourage everyone to get any necessary screening exams back on their calendars as well. For those with cancer, despite all the necessary changes, we at the Cancer Center remain dedicated to continuing to provide the best and safest treatment possible.

Supporting Cancer Patients and their Families

The Sentara RMH Hahn Cancer Center offers a variety of support services in both face-to-face and virtual settings for patients and their families. These include: • Cancer Treatment Class: To inform new patients about what to expect during treatment, and support services offered • Women’s Stage IV (breast cancer) support group: twice monthly via Zoom • One-hour Zoom chair yoga class: every Wednesday for cancer patients, survivors, and caregivers • Facing Forward: Life After Cancer Treatment: for cancer patients who have completed treatment; quarterly via Zoom • Clinical dietitian Robin Atwood, MS, RDN, CSO: available for nutrition counseling • Social worker Maxine Jean-Louis, MSW, LCSW: available to provide counseling services and assist patients in coordinating supportive care To learn more, contact Maxine Jean-Louis at 540-689-7065 or mgjeanlo@sentara.com.

ON-CALL ADVICE

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

What is lupus? Lupus, also known as systemic lupus erythematosus, is a type of chronic autoimmune disorder in which the body’s immune system attacks its own healthy tissues or organs. The resulting inflammation may damage the joints, skin, blood cells, kidneys or other organs. No one fully understands why lupus and other autoimmune responses occur. Symptoms of the condition vary from person to person, and often come and go. Most people with lupus experience joint pain, often with stiffness, swelling or arthritis; mild to severe fatigue; and a skin rash that may get worse in sunlight. About half of

those with such a rash develop a characteristic “butterfly rash” across the nose and both cheeks. Fever that cannot be traced to another cause also may be present. Other symptoms may occur as well, depending on which organs are affected. Diagnosis typically is based on the presence of several characteristic symptoms and may be confirmed by tests to check for inflammation in the body, including blood or antibody tests, urinalysis, X-rays and biopsy. No cure for lupus currently exists, so the goal of treatment is to control symptoms and minimize organ damage. Treatment varies by person and depends on the organs affected and how severely symptoms are interfering with the individual’s daily activities. In milder

SYMPTOMS

cases, doctors may prescribe anti-inflammatory and pain medications to treat muscular or joint pain or swelling, antimalarial medications to treat pain and fatigue, and corticosteroid creams for skin rash. More severe cases may require medications to suppress the immune system. Most people with lupus have the mild form, with occasional symptom flare-ups. If left untreated, lupus can lead to complications such as blood clots, destruction of red blood cells, low blood platelets, inflammation of blood vessels, and fluid around the heart or in the lungs. Having lupus also raises a person’s risk of having a heart attack or stroke. People living with lupus should see their doctor regularly, avoid getting too much exposure to sunlight, stay current with immunizations, engage regularly in heart-healthy physical activity, and eat a balanced, healthy diet. sentara.com

ON- C ALL A DVICE

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

What are blood clots, and why are they dangerous? A clot is a clump of blood cells and other blood components that forms in the blood. In response to an injured artery or vein, clot formation is normal, helping to stop bleeding and promote healing. After such a wound heals and the clot is no longer needed, the body releases chemicals to dissolve the clot. Sometimes inappropriate clotting can take place, however, obstructing normal blood flow. In some cases, clots form in one part of the body and then migrate to another area, where they can cause harm. These dangerous clots may form for a variety of reasons, including due to surgery or trauma; in response to plaque, a fatty substance that builds up gradually inside arteries; or due to health problems like heart disease or high blood pressure. Factors that increase a person’s risk of forming dangerous clots include smoking, obesity, prolonged lack of physical activity, advanced age, some forms of hormone therapy and certain genetic factors. Common symptoms of blood clots include pain and swelling, with other varying

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effects throughout the body. For instance, clots in the legs often make it painful to walk, while clots in the lungs may produce chest pain and shortness of breath. In some cases, a potentially life-threatening condition known as pulmonary embolism occurs when a blood clot travels to a lung and blocks the flow of blood. When a clot blocks a coronary artery, the result may be angina (chest pain) or a heart attack. When a clot blocks a carotid artery, which supplies blood to the brain, or blocks a vessel inside the brain, it may cause a stroke. Clots in the kidney may lead to high blood pressure or kidney failure.

Medications for preventing the formation of blood clots include anticoagulants (“blood thinners”) such as warfarin, heparin, apixaban (Eliquis®) and rivaroxaban (Xarelto®). In addition, so-called “clot buster” medications can be used to dissolve clots. In serious cases, doctors may perform a minimally invasive catheter-based procedure that involves inserting a long, thin tube into an affected blood vessel to remove a clot. Occasionally, a more extensive procedure known as a thrombectomy may be performed to remove a clot. People can lower their risk of developing blood clots by eating a healthy diet, maintaining a healthy weight, staying physically active and not smoking.

IMPROVE HEALTH EVERY DAY

i l o C . E t s n i a g A Be on Guard One of the most common sources of foodborne illness is a bacteria named Escherichia coli, or E. coli for short. Certain types of E. coli make a toxin that can cause diarrhea, urinary tract infections, respiratory problems and other serious illnesses. Some people, including children, pregnant women, older adults and individuals with weakened immune systems, are at higher risk for contracting a foodborne illness. The best way to protect yourself from E. coli infection is to follow strict hygiene recommendations and observe safe practices when preparing food.

When preparing food, follow these guidelines:

• •

Wash fruits and vegetables under running water before use Cook meats thoroughly, using a food thermometer to ensure the meat reaches an internal temperature suitable for killing E. coli and other bacteria (most meat packaging will list the appropriate internal temperature)

The most important hygiene practice is to wash your hands thoroughly in the following situations:

• • • •

Before and after handling food— especially raw meats, vegetables and fruits After using the bathroom or changing diapers After touching animals or objects that animals use, such as food bowls, pet toys and beds Before preparing and feeding bottles or foods to an infant or toddler, or touching anything that goes into a child’s mouth

If soap and water are not available, use an alcohol-based hand sanitizer.

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I M PROVE HEA LTH EVE RY DAY

SUNSCREEN SMARTS If you’re going out in the sun for any length of time, be sure to apply sunscreen to all exposed areas of your body to protect your skin from the sun’s damaging ultraviolet UVA and UVB rays. Not all sunscreens are created equal, so be sure to choose your sunscreen based upon factors other than its fragrance or degree of greasiness. Using any sunscreen is better than using no sunscreen at all, but for the best protection, experts recommend using a sunscreen with the following characteristics: •

Broad-spectrum coverage, protecting you from both UVA and UVB rays

•

Resistance to water and perspiration, if you will be going in the water or will be exposed to high temperatures that promote perspiration

•

A sun protection factor (SPF) of 30 or higher

Put on your sunscreen about 15 minutes before going out in the sun. Reapply sunscreen according to the label’s directions or at least every two hours—and more frequently if you go in the water or are sweating. Even water-resistant sunscreens can begin to break down when exposed to water or perspiration, and in such cases should be reapplied after about 40 minutes.

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COVID Vaccine and

Mammograms Since the initial rollout of the COVID-19 vaccines in late 2020, the public has been advised that the vaccines may cause certain mild symptoms that mimic some of the symptoms of full-scale virus infection, such as slight fever, headache and fatigue. These symptoms are a sign that the vaccine is “working,” and they typically go away on their own within a few days. Recently, breast health experts have noted an additional symptom of COVID-19 vaccination: swollen lymph nodes under the same arm in which patients received their injection. This is an additional normal response by the immune system, and similar swelling often occurs in women who get the flu shot. Like the other postvaccination symptoms, swollen lymph nodes are an indication that the immune system is preparing itself to fend off any future COVID-19 infection. According to the Centers for Disease Control and Prevention, swollen lymph nodes that occur following COVID-19 vaccination typically go away on their own within a few days to a few weeks. However, breast health experts point out that swollen lymph nodes under the arm also can be a sign of breast cancer.

If such swelling doesn’t go away within a few weeks, or if it continues to get bigger, see your healthcare provider. Should women who have received the COVID-19 vaccine delay getting a mammogram? Many breast-screening experts suggest that women may delay having a regular annual screening mammogram for four to six weeks following COVID-19 vaccination (after the second shot, if the vaccine requires two doses). However, women who have other symptoms of breast cancer, who have a known breast cancer or who have been previously treated for breast cancer should not delay having a mammogram—even if it is scheduled for right after a COVID-19 vaccination. If you have questions about mammograms and the COVID-19 vaccines, be sure to speak with your physician.

Does Acid Reflux Cause Cancer? Acid reflux occurs when stomach acid enters the lower esophagus, where it does not belong, and where it may cause indigestion, heartburn or other feelings of discomfort that seem to come from the chest or upper abdomen. While nearly everyone has occasional episodes of acid reflux, symptoms also can be long-term or chronic—a condition known as gastroesophageal reflux disease (GERD). People with GERD have a somewhat increased risk of developing cancer of the esophagus; however, GERD is very common, and the vast majority of people who have it will not develop esophageal cancer. GERD can lead to esophageal cancer by causing what is known as Barrett’s esophagus, a condition in which the squamous cells that line the interior of the esophagus are transformed into gland cells. Gland cells, which are more resistant to stomach acid, are similar to the cells that line the inside of the stomach. People with Barrett’s esophagus typically have had GERD for a long time, and they are at significantly higher risk of developing esophageal cancer (about 1 in 400). Still, the majority of people with Barrett’s esophagus do not develop cancer from the condition. If you suffer from persistent acid reflux, talk to your doctor. Effective treatments are available. sentara.com

Gforrilling Good Health EAT WELL , LIVE WELL

By Robin Atwood, MS, RDN, CSO Sentara RMH Medical Center

It’s that time of year again when the weather is good for grilling outside. You may already know that choosing grilled foods over fried foods generally reduces the calorie density of food—but to make your grilled food choices healthy, you will want to look at how you are grilling as well as what you are grilling.

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Grilled Chicken Fajitas Ingredients

How to Grill Healthfully One major tip for healthy grilling is simple: Don’t burn the meat, poultry (chicken and turkey), and seafood. Although there isn’t clear evidence that grilling animal products directly increases cancer risk, experts at the American Institute of Cancer Research (AICR) warn that charring meat, poultry and seafood while cooking at high temperatures in the presence of smoke forms substances called polycyclic aromatic hydrocarbons (PAHs) and heterocyclic amines (HCAs), which can cause changes in our DNA that may lead to cancer. To avoid formation of PAHs and HCAs: • Marinate meat, poultry and fish in an acidic marinade (containing vinegar, lemon juice, orange juice or wine, along with herbs and spices). Studies show that marinating in this type of marinade for at least 30 minutes prior to grilling can decrease the formation of HCAs by as much as 90%. • Choose lean cuts of meat and trim excess fat before grilling. Potentially cancer-causing PAHs form in the smoke when fat from meat, poultry or fish drips onto the heat source. That PAH-filled smoke then coats your food. • Cook at a lower temperature and flip meat frequently to reduce charring. • Avoid flare-ups and keep juice from dripping into the fire. Cover the grill with aluminum foil and puncture the foil with tiny holes. • Trim off any charred flesh before eating. • Precook food. Cook meat, poultry or fish in the oven or microwave for 2-5 minutes, then finish cooking on the grill. Less grill time means less exposure to potentially cancer-causing substances. • Choose gas over wood or charcoal. You will have more flame and flare-ups with wood and charcoal, which can increase charring and smoke contact with meat, creating both PAHs and HCAs.

6 boneless, skinless chicken breasts (about 6 ounces each) ½ cup canola oil ¼ cup red wine vinegar 1/3 cup lime juice ¼ cup finely chopped onion 2 cloves garlic, minced 1 teaspoon sugar 1 teaspoon dried oregano leaves ½ teaspoon salt ½ teaspoon pepper ¼ teaspoon ground cumin 12 flour tortillas (8-inch) 6 cups shredded lettuce 2 cups chopped tomato 3 ripe avocados, peeled, seeded and sliced 2 cups of your favorite salsa

Directions 1.

For the marinade, whisk together oil, vinegar, lime juice, onion, garlic, sugar, oregano, salt, pepper and cumin in a shallow, nonmetal container.

One at a time, place each chicken breast on a cutting board, place a sheet of plastic wrap over chicken and pound to an even ½-inch thickness.

Add chicken to the marinade, turning to coat each side, then cover and refrigerate for 4 hours, turning occasionally.

Prepare grill for direct cooking over medium heat (350-450 degrees F).

Wrap 6 tortillas each in 2 foil packets.

Remove chicken from marinade, discard marinade and place chicken on the grill. Grill with lid closed until chicken is no longer pink and a meat thermometer reads 165 degrees F. This should take 6-8 minutes, turning once. At the same time, warm the tortilla packets over direct heat for 2-4 minutes, turning once.

Place chicken on a clean cutting board and slice crosswise into ¼-inch strips. Transfer to a clean bowl or plate and serve with the warmed tortillas, lettuce, tomato, avocado and salsa.

What to Grill for Good Health Limit processed meats such as hot dogs, sausages, bratwurst and bacon. According to the AICR, even small amounts of processed meats, if eaten regularly, can increase your risk for colorectal and stomach cancer. sentara.com

E AT WE LL , LIVE WEL L

Grilled Summer Vegetables Serves 4 Ingredients 4 ounces baby bella mushrooms 1 eggplant 1 zucchini 1 yellow squash 1 onion 1 bunch thick asparagus 1 red bell pepper 2 tablespoons extra-virgin olive oil 1 tablespoon kosher salt 1 tablespoon freshly ground black pepper 2 tablespoons fresh basil, chopped ¼ cup balsamic vinegar reduction or your favorite salad dressing

Directions 1.

Preheat the grill to medium heat (350-450 degrees F).

Chop the mushrooms in half. Trim the ends of the eggplant, zucchini, yellow squash and onion, and cut into slices of 1/3-inch to ½-inch. Seed the red bell pepper and cut into quarters. Trim the asparagus ends.

Drizzle the vegetables with olive oil and sprinkle evenly with salt and pepper. Place the vegetables in a grill basket or grill pan and grill with the lid closed until tender and lightly charred all over—about 8-10 minutes for the bell peppers, onion and mushroom, and 5-7 minutes for the yellow squash, zucchini, eggplant and asparagus.

Sprinkle with fresh basil and drizzle with balsamic vinegar reduction or a dressing of your choice. Serve warm, cold or at room temperature.

Limit red meat. Diets high in red meat increase your risk of colorectal cancer. The AICR recommends limiting red meat to 12-18 ounces of cooked red meat (beef, pork, lamb or venison) per week. Choose to grill poultry and seafood more often. Fish such as salmon and tuna contain omega-3 fatty acids, which have been shown to decrease inflammation in the body, promote heart health and possibly benefit brain health as well. Grill plant-based foods such as veggie burgers, fruits and marinated vegetables. Grilling fruits and vegetables produces no HCAs or PAHs and poses no potential cancer risks. In fact, diets high in plant foods are associated with reduced risk of several cancers.

Safe Grilling According to the Centers for Disease Control and Prevention (CDC), food poisoning cases rise in the summer months, when warm temperatures increase the growth rate of bacteria in our foods. Be mindful of the following CDC food safety principles when planning to grill: When shopping for meat, poultry or seafood, add them to your cart last, keep them separated from other foods and keep them chilled/refrigerated below 40 degrees Fahrenheit until ready to grill. Wash your hands before and after handling raw meat, poultry and seafood. It is also important to wash your work surfaces, grill and utensils before and after cooking meat, poultry and seafood. Use a food thermometer to check that your grilled foods reach an internal temperature that will kill any foodborne pathogens: •

Beef, pork, lamb, veal, fish: 145 degrees F

•

Hamburger and other ground meats: 160 degrees F

•

Poultry: 165 degrees F

After grilling, discard any marinades or sauces that have touched raw juices of meat, fish or poultry. Use a clean plate to serve the grilled food. Refrigerate or freeze any leftover grilled meats, fish or poultry within 2 hours of cooking—or within 1 hour of cooking, if the air temperature is above 90 degrees F.

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

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

calendar

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 Tuesday mornings at 8:15, 9:00, 9:45, 10:30 and 11:15 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: Aug. 5 • South River Medical Clinic, Grottoes Aug. 6 • Sentara RMH East Rockingham Health Center Aug. 11 • Sentara RMH Timber Way Health Center, Broadway Aug. 12 • Walmart, Luray Aug. 16 • Bridgewater Health Center Aug. 26 • Sentara RMH Timber Way Health Center, Broadway Aug. 27 • Carilion Family Medicine, Weyers Cave Aug. 30 • Mamma Mia Italian Restaurant, Shenandoah Aug. 31 • Sentara RMH East Rockingham Health Center Sept. 2 • Virginia Mennonite Retirement Community Sept. 8 • Walmart, Timberville Sept. 9 • Walmart, Luray Sept. 10 • Elkton Area Community Center Sept. 13 • Grottoes Food Lion Sept. 14 • Bridgewater Health Center Sept. 15 • Staunton City High School Sept. 16 • Farmers & Merchants Bank, Timberville Sept. 17 • Sentara RMH Mount Jackson Medical Center Sept. 20 • HCHC Elkton Sept. 21 • Sentara RMH Timber Way Health Center, Broadway Sept. 22 • Waynesboro Constitution Park Sept. 23 • Harrisonburg Health & Rehabilitation Center Sept. 24 • Skyview Springs, Luray Sept. 30 • Sentara RMH East Rockingham Health Center Oct. 2 • Briery Branch Church of the Brethren Oct. 6 • New Market Community Center

Oct. 7 • Rockingham County Administration Building, Harrisonburg Oct. 12 • Gypsy Hill Park, Staunton Oct. 13 • Elkton Area Community Center Oct. 15 • Sentara RMH Timber Way Health Center, Broadway Oct. 19 • Bridgewater Health Center Oct. 20 • Sentara RMH East Rockingham Health Center Oct. 22 • Carilion Family Medicine Oct. 25 • Highland Medical Center Oct. 27 • Ed Good Memorial Park, Stanley Oct. 28 • Virginia Mennonite Retirement Community Oct. 29 • Sentara RMH East Rockingham Health Center Nov. 1 • Mamma Mia Italian Restaurant, Shenandoah Nov. 3 • Sentara RMH Timber Way Health Center, Broadway Nov. 4 • EMCO Enterprises Inc, Luray Nov. 8 • Turner Ashby High School Nov. 9 • HCHC Stone Port Nov. 10 • Daikin Applied, Verona Nov. 11 • Bridgewater Health Center Nov. 12 • New Market Community Center Nov. 15 • Elkton Area Community Center Nov. 16 • Walmart, Timberville Nov. 17 • Highland Medical Center, Monterey Nov. 19 • South River Medical Clinic, Grottoes Nov. 22 • Walmart, Luray Nov. 24 • Sentara RMH East Rockingham Health Center Nov. 29 • Perdue, Bridgewater Nov. 30 • Bridgewater Retirement Community

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

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Dr. da Vinci

”

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ROBOTIC SURGERY Comes to Sentara RMH

In the not-too-distant past, the only way to perform many operations—especially those in the abdominal or pelvic areas—was for the surgeon to make a large incision. Without doing so, he or she couldn’t effectively see or access the target area. Patients undergoing this traditional type of “open” procedure could reasonably expect to be in the hospital for several days—or perhaps even longer, depending on the severity of the surgery. sentara.com

That’s no longer the case at Sentara RMH Medical Center, thanks to two significant medical advancements over the years: laparoscopy (also known as “keyhole” surgery) and, more recently, medical robotics. While laparoscopy has been used for years at Sentara RMH, the da Vinci robotic surgical system is new to the medical center, now enabling minimally

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invasive surgery to be employed in complex procedures more than ever before.

Doctor da Vinci?

Yes, that’s actually a robot standing there in the operating room, its long, delicate “fingers” waiting patiently to perform the most intricate of procedures. However, the robot doesn’t really

operate on you—at least, not independently. That function is still within the purview of the surgeon. But with the da Vinci surgical system, Sentara RMH’s skilled surgeons can accomplish a wider range of surgeries with a higher degree of accuracy and fewer, smaller and less-debilitating impacts. “It’s important for people to know that the surgeon is still doing the job,” says Robert Garwood, MD, Sentara RMH Medical Center’s chief of surgery. “The robot doesn’t do anything on its own—it simply helps the surgeon do a better job.” According to Dr. Garwood, any urological, gynecological or general surgical procedure the surgeons at Sentara RMH can do laparoscopically now can be performed using the robot, allowing the surgeon “to accomplish things inside the human body laparoscopically that we couldn’t do before.”

He adds that the robot can be used for “procedures as simple as hernia repair and gallbladder surgery, and for more complex surgeries like removing a cancerous colon, performing bariatric surgery or repairing a hiatal hernia.” Dr. Garwood explains that the da Vinci system has three components: an ergonomic surgeon’s console, a patientside cart with four interactive robotic arms, and a sophisticated vision system. Once the surgeon is comfortably seated at the console, he or she can control every aspect of the laparoscopic surgery. Using images provided by two offset cameras, the surgeon can see the surgical field in remarkably clear, three-dimensional, high-definition detail. Each of the surgeon’s hands slips into a master controller that is not unlike a virtual-reality glove; these controllers precisely translate the surgeon’s hand movements to the four robotic arms on the patient cart. “The system uses computer processors that make very precise movements possible,” explains Dr. Garwood. “These processors also perform millions of safety checks over the course of a procedure, ensuring that every surgical maneuver is under the direct control of the surgeon, and that there is no independent movement of the robot.” The da Vinci’s arms and the wide range of surgical accessories they can accommodate are designed with a patented “wristed architecture,” which provides the surgeon with a fluid range of motion even greater than that of the human hand. Foot pedals on the console provide additional control and allow the surgeon to perform a variety of additional surgical tasks, such as cauterization. “The da Vinci system enables surgeons at Sentara RMH to provide care with the most advanced components and technology available, giving patients a better outcome,” says Dr. Garwood. “It also allows the hospital

to recruit surgeons who are skilled in this technology and who want to bring enhanced technology here, further expanding our ability to deliver high-quality, technically advanced health care to this community.” Although the da Vinci system is a recent arrival, robotic technology is nothing new to Sentara RMH. The hospital first invested in robotics 18 years ago with a $1 million pharmacy robot that could hold and dispense 12,000 units of prescribed medications. The medical center’s ongoing investment in technolBenefits of Robotic Surgery ogy—this time with the da Vinci surgical system— Shorter procedure time and continues to provide less time under anesthesia, a streamlined medical reducing both risk and cost experience that benefits to the patient. everyone—the hospital, Less pain. Incisions are smaller, the operating room team surgical trauma is reduced, and, most importantly, and patients may not need the patient. extraordinary pain medication Dr. Garwood, who following the procedure. calls the da Vinci system Quicker recovery time. “the next step in miniPatients get back to normal mally invasive surgery,” more quickly, and a stay in the hospital following also pointed to a bright the procedure may not and exciting future for be necessary. this type of surgical Less risk of scarring. system. One day, he said, it may even be possible to Less bleeding during operate remotely, with the the procedure. surgeon and console in

• • •

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one location, and the patient and robot in another. “We’re not there yet,” he says, “but it’s not impossible. With technology advancing the way it is, it could happen sooner rather than later.”

Now is the Time

Another area surgeon skilled in performing surgeries with the da Vinci system at Sentara RMH is Brian Stisser, MD, a urologist with Blue Ridge Urological Associates. Even though Dr. Stisser’s experience with robotic surgery goes back nearly 20 years, he says the everimproving technology and resulting boons to medicine never cease to amaze him. “This type of surgery seems so advanced, yet it’s actually very similar to open surgery, from a mental standpoint,” notes Dr. Stisser. “Once you get over the mental hump that it’s not truly your hand in there doing the procedure—and you see that the instrument is really doing exactly what you want it to do—it becomes almost like open surgery, except better. It’s almost as if you’re miniaturized inside the human body and doing the

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sort of fantastic things people only used to write about in science fiction.” Surgeons must, of course, have training in order to use robotic surgical systems like da Vinci. Dr. Stisser says many physicians have received training within the last 10-15 years as part of their residencies. But for those who didn’t receive robotic surgical training that way, he says there are a variety of new training programs throughout the country—programs that are turning experienced doctors with certain skill sets into imminently qualified experts. Dr. Stisser points out that now really is the time for robotic surgery, noting that more than

90 percent of prostate cancer surgeries are currently performed through robotic assistance, and that the numbers for other types of surgeries are constantly rising. If you’re still asking yourself why any hospital would use a robotic system, Dr. Stisser has an answer for you. “It’s about precision. If you look at robotic data compared to standard laparoscopic data and open surgical data, you will see improved outcomes for the patient,” he says. “When you perform surgery on someone, obviously you’re trying to correct the pathology, whether that’s oncological or some sort of a lifestyle issue. Those outcomes are improved.” “But then you see the improvements in the specific outcomes we use as metrics in the operating room: blood loss, how much pain the patient experiences and how long the patient had to stay in the hospital after robotic surgery,” he adds. “Those improved outcomes

are pretty magical enhancements for both the patient and the hospital.” Dr. Stisser commended Sentara RMH for “being introspective enough to realize that they have to reinvest to fully be able to address the needs of the community.” “They realized that now was the right time, and that we had the right mix of people involved in the organization,” he says. “I’m proud to be part of that as well—to be able to say that now is our time.”

Applications for Robotic Surgery The da Vinci robot can be used to perform any urological, gynecological or general surgical procedure that is normally done laparoscopically. It can be used for procedures as simple as inguinal hernia repair or gallbladder surgery, or more complex surgeries like removing a cancerous colon, performing bariatric surgery or repairing a hiatal hernia. Surgeons must be specially trained to perform robotic surgeries, and more and more are now getting this special training. Currently at Sentara RMH, four surgeons are trained in robotic surgery. In addition to Dr. Garwood and Dr. Stisser, Justin Deaton, DO, and Bryan Maxwell, DO, of Shenandoah Women‘s Healthcare, perform a number of gynecological procedures using the da Vinci. These procedures include hysterectomies for various conditions, such as heavy or irregular menstrual cycles; uterine prolapse, pelvic pain and fibroids; ovarian surgery for cysts and removal of fallopian tubes; and various procedures for endometriosis.

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We Are

Sentara RMH

STRONG 24 |

Hospital Caregivers Share Their Experiences of Making It Through the Pandemic—Together

SUMMER 2021

Keeping Things Clean, Staying Safe Shirley Koontz, a team leader in Envi-

ronmental Services at Sentara RMH, unabashedly loves her job and the team with whom she works. Seeing staff pull together through the COVID pandemic, to care for each other and hospital patients, made her affection grow even stronger. “Our motto is ‘patients first,’” says Koontz, who’s been at Sentara RMH for nine years. “What we do is for patients and for our own safety.” Although that commitment to safety has always been paramount, the responsibilities of the Environmental Services team changed dramatically, and safety became even more crucial, when the pandemic arrived in early 2020. “At first, we were scared about it,” recalls Koontz, who supervises more than 25 employees, creates work schedules and gets the second-shift staff members started on their workday. “Then we realized that to Sentara, our safety also came first.” In response to the emerging COVID crisis, staff received information on cleaning and safety protocols to protect each other, themselves and patients. Koontz says her crew banded together as a team like they’d never done before. That team also expanded to include staff from other departments who stepped up to help with the extra required room cleaning. Facing new uncertainties and protocols, the team members looked out for one another. “We all had to check each other to make sure we were dressed properly, wearing our personal protective equipment (PPE) correctly and doing everything right,” she said. “We didn’t want anyone to get exposed.”

Shirley Koontz

Though COVID cases are finally dropping in this area, her team has not let down its guard. Environmental Services is still following all the COVID protocols regarding cleaning, masking up and wearing eye protection. “It’s a relief that there are not as many cases now, and now that we have a better understanding of what’s required to stay safe, it’s not so scary,” Koontz notes. Going through what has certainly been the worst of times together has reinforced Koontz’s belief that Sentara RMH staff members really respect and care for each other. sentara.com

“I’m proud to work for Sentara RMH,” she says. “Someday I’ll retire from here.”

Reconnecting with a Love for Patient Care Andrea Harris-Bivins has worked

at Sentara RMH for 15 years. As an Emergency Department (ED) technician, she performs all the protocols for checking in patients and getting them started in the ED. From a young age, Harris-Bivins knew she wanted to work in an emergency room. “It’s the highlight of my life,” she says. “I feel good taking care of patients.” Like many people, when COVID first began infecting people across the United States, she thought it would be over within a few months. But the pandemic persisted, and everyone—especially healthcare professionals—had to adapt. Harris-Bivins says the Sentara RMH hospital staff, particularly those on the front lines with patients, were told they needed to take care of themselves first. After all, if they became ill, they would not be able to help themselves, their families or their patients. “We had to stay away from our friends and family,” she says. “It tested my faith, really, because I still had to go take care of people when it was hard even to take care of myself.” As was the case at many healthcare facilities, Sentara RMH front-line staff were offered the opportunity to stay in local hotels, rather than going home to their families, to reduce the chances of COVID transmission and help them stay healthy. By doing so, HarrisBivins knew she was doing the right thing—but she, like many others, ached for her family and struggled

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Andrea Harris-Bivins

with her inability to take care of them. While she was living at the hotel, for instance, her husband had to undergo shoulder surgery, and during that time she wasn’t able to be home to care for him. However, staying at the hotel allowed Harris-Bivins to work more hours, so she was spending more time with her co-workers, and they all helped bear each other’s struggles. “Before COVID, you’d come in to work and say, ‘Hello, how’s your day going?’” she says, noting that the question often would be asked more out of politeness than true concern. “Now we’re genuinely concerned about each other. I’ve cultivated some beautiful relationships with my co-workers, and I’m proud to be part of a great team of individuals.” Not long ago, Harris-Bivins had the opportunity to experience the hospital as a patient

herself, when she was diagnosed with breast cancer and subsequently went through surgery and radiation treatment. She says that experience not only made her grateful for her compassionate co-workers, but also reawakened her compassion for her patients. “You think to yourself, ‘I’m doing a great job,’ but sometimes along the way we lose ourselves,” she says. “This was an eye-opener for me. It helped me to revisit that love that used to burn so heavy inside me. Now I’m back to that again. It’s helped me to understand what people are going through.” Harris-Bivins appreciates the sense of community she feels both inside and outside the hospital walls. Before coming to Harrisonburg, she worked in several big city hospitals. “In those places, when I had a patient, I never saw them again,” she says. “But here, I can be in the supermarket and see someone I took care of at the hospital.” “Once while shopping, a woman approached me and said, ‘Do you remember you took care of me?’ I really appreciated that.” During the pandemic, Harris-Bivins was touched by the love shown to healthcare workers by people in the community, whether it was by driving around the campus loop road honking their car horns, posting encouraging posters around the campus and in hospital hallways, donating much-needed PPE, or providing food and snacks for staff. “Working in a community-based hospital, we care about our community members, and they care about us,” she says. “Our team members often remember our patients after they’ve been discharged, wondering how they are doing. We really do care about the people we take care of.”

Pitching in Wherever Needed Sentara RMH’s lead hospitalist, Russ Ford, MD, has always been struck by the “remarkable friendliness” he found when he joined the hospital over a decade ago. During the pandemic, he was equally struck by the “all-in environment” the staff demonstrated. “It was really great,” he says. Dr. Ford is part of a team of about two dozen doctors, registered nurses and physician assistants who provide care for most of the hospital’s patients. When it was apparent that COVID patients were going to be a top priority and that sentara.com

elective procedures—surgeries, imaging and lab services, consults, and anything else nonemergent—would be canceled, it left many of the staff with little to do. Having previously worked in a larger medical system in Delaware during the 2008-2009 recession, Dr. Ford recalls: “During that time, all hospitals had to adapt economically, which came at a cost to employees. It became more of a business and less employee-friendly.” Russ Ford, MD

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With the onset of COVID, however, the response at Sentara RMH was quite distinct. Dr. Ford was impressed that, rather than initiating massive layoffs, as many businesses had to do, Sentara RMH found ways to keep staff engaged. Team members were redeployed throughout the hospital to perform tasks that were necessary to address and weather the pandemic crisis. For instance, physical therapists were not allowed to provide hands-on care during the pandemic, so instead they supported staff in the COVID isolation units, making sure PPE carts were stocked and assisting caregivers with donning and removing PPE. Dubbed “PPE buddies,” these staff members were deployed on every unit that cared for COVID patients. “It was kind of cool to be working in the hospital then, because I got to work with people I normally wouldn’t have seen,” Dr. Ford says. Other staff members were deployed at hospital entrances to screen employees, patients and visitors for potential COVID infections. While the staff was working well together as a team, they also felt the pain being experienced by patients and their families. When the hospital was not allowing visitors, the nurses did their best to facilitate interactive video calls with patients’ families. “It was a very difficult situation for patients,” Dr. Ford relates. “The staff here is very compassionate. We couldn’t do anything about the isolation, except assist with phone and video calls.” All in all, Sentara RMH cared for about 1,300 COVID patients over the course of the pandemic, while also looking out for one another. That caring environment continues today, and safety protocols remain in place, even though COVID numbers have plummeted recently. Even before COVID, Dr. Ford felt Sentara RMH was a “fantastic” environment to work in, with “outstanding clinicians, and phenomenal nursing and ancillary services.” Now that the crisis seems to be waning, he says: “I think our hospital adapted really well, and I’m proud to have been a part of that. We came out of the pandemic even stronger than we were before. Sentara RMH is a great place to work.”

Behavioral Health Impacts of COVID

t the peak of the pandemic in 2020, while healthcare providers at Sentara RMH were dealing with the physical impacts of COVID-19, the hospital’s behavioral health providers were giving care to those struggling with its impacts on mental health, due to the prolonged need for isolation from friends, family and neighbors.

Today, as the pandemic recedes and the numbers of those physically sickened by COVID continue to drop, the same cannot be said, unfortunately, of those dealing with the pandemic’s resulting mental health concerns. According to Luanne Bender Long, PhD, LPC, clinical manager of Outpatient Behavioral Health at Sentara RMH, statistics have revealed pandemic-related increases in depression, anxiety sentara.com

and substance abuse due to mandatory social isolation. “Research showed there was a 100% increase in mental health concerns, including suicide ideation, anxiety, depression, obsessive-compulsive disorder and substance abuse,” she explains. While this increase may be alarming, many people are seeking and receiving help for their issues, according to Tena Bibb, MSN, RN, director of Behavioral Health Services at Sentara RMH. She wants the community to know that Sentara RMH can offer them the help they need through a full continuum of care that includes inpatient services, as well as a wide variety of outpatient programs and counseling services. “Sentara RMH Behavioral Health Services is committed to addressing the mental health needs of the community,” Bibb emphasizes. “We will always explore ways to overcome barriers—COVID or whatever else may come—to meet our clients where they are.” Bibb noted that many patients whose mental health had been stable for years became destabilized not only by the isolation and loneliness that came with COVID, but also by the disruption of the routines that had given them a sense of control over their lives.

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Likewise, many alcohol and substance abusers who had been substance-free for a long time experienced difficulties due to isolation and a loss of contact with their support systems. In addition, behavioral health providers began seeing a surge of new patients struggling with alcohol and substance abuse brought on by various factors related to COVID. Throughout the pandemic, Behavioral Health Services offered virtual counseling and therapy sessions, but not everyone had access to or felt comfortable with the online format. “We offer outpatient services, individual counseling sessions, partial hospitalization programs and an intensive outpatient program for substance abuse—all of which are now back up and running at full speed,” Bibb says. Often, she adds, behavioral health care begins when a patient comes to the Emergency Department, where he or she sees a member of the Psychiatric Emergency Team (PET). “We’re now seeing a lot of the effects of social isolation and loneliness,” says Bibb. “People were fearful during the pandemic and often would not seek services until their needs became critical. At that point, many people came to the Emergency Department, where they were seen virtually by members of our PET. Once a patient is assessed and admitted to our inpatient unit, we can get them stabilized, then create a comprehensive plan for them to follow upon discharge.” That discharge plan, which is up to the patient to follow, may include contacting Behavioral Health Services for medication follow-up, participation in an outpatient behavioral health program, or counseling services through Sentara

Addressing Mental Wellness for Staff During COVID RMH or other community resources. Importantly, now that COVID restrictions have eased, these patients are able to once again reach out to their “safety nets”—families, neighbors and community members—for additional support.

COVID Brought Change When the COVID lockdown mandates first began in March 2020, Behavioral Health, like other departments at the hospital, had to make a number of changes to provide services safely. Suspending services at such a critical time was definitely not an option. “It didn’t seem right to discontinue mental health services, especially when depression, anxiety and substance abuse were increasing as the pandemic progressed,” says Long. Bibb adds that COVID protocols affected a number of aspects of behavioral health care—everything from patient assessments in the Emergency Department to inpatient unit operations and the delivery of outpatient services. “We did everything we could to give patients a face-to-face experience, since we were not able to offer in-person sessions with counselors and physicians,” she says. “To improve access, we started doing PET assessments and inpatient therapy via telehealth and Zoom, and we began to offer sessions by telephone.” For most of the counseling staff and psychiatric team, the client load increased many times over. “We’ve seen an increase in anxiety and depression,” says Danita Adamson, manager of Outpatient Behavioral Health Specialists. “Isolation has taken its toll on everyone—existing

Sentara has long had an Employee Assistance Program (EAP) to help employees and their families deal with mental health concerns. Under the program, staff members can schedule individual appointments—virtual or in person— with outpatient therapists. Recognizing the unique challenges staff faced in caring for COVID patients, as well as dealing with the pandemic’s impact on team members’ own families, counselors reached out to fellow employees—particularly during the most intense time of the pandemic. “For six weeks starting in June 2020, we collaborated with the Psychiatric Emergency Team and Inpatient Behavioral Health and had someone available to meet face to face with hospital employees from 7 a.m. to 7 p.m., Monday through Friday, and on call over the weekend,” says Luanne Bender Long, PhD, LPC, clinical manager of Outpatient Behavioral Health at Sentara RMH. “My director, Tena Bibb, and I visited several departments to check in on employees and introduce what we were doing.” Those departments included the Emergency Department, Critical Care Unit, nursing units providing dedicated COVID care, and other clinical and nonclinical support areas. Long notes that weekly articles written by an outpatient therapist on COVID-related topics, such as stress and working, parenting, self-care, and the like, were also made available to employees. In addition, team members received weekly COVID updates from Donna Hahn, chief nursing executive, that included reminders about how to access EAP services.

patients and new referrals are all dealing with it.” For Sentara RMH mental health providers like Syed “Ali” Rizvi, MD, the pandemic’s impact on his existing patients was clear. Many patients receiving psychiatric treatment for any of a variety of conditions—such as bipolar disorder, schizophrenia, depression, mood disorders, anxiety, panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder, eating disorders and attention deficit disorders—struggled with the impacts of the pandemic. “COVID stress worsened their symptoms,” Dr. Rizvi says.

Counseling to Address Feelings of Loss Since the onset of the pandemic, behavioral health counselors at Sentara RMH have been dealing with another troubling response to COVID-19, known as disenfranchised grief. Also referred to as hidden grief or sorrow, this term refers to any type of grief that goes unacknowledged or unvalidated by society. Often minimized or misunderstood by others, disenfranchised grief can be particularly hard to process and work through. “Nancy Shomo, our certified grief counselor, says disenfranchised grief occurs when we lose something: the death sentara.com

of a goal or a future hope—any type of expectation,” Long notes. “COVID-19 stripped us of life the way we expected it to be, so many of us were basically stuck in a state of disenfranchised grief because we didn’t know when the pandemic was going to end.” It’s the ambiguity surrounding the pandemic that seems to be the most stressful factor for many people, according to Long. “On top of dealing with job losses and kids who were not able to attend school in person, people have been confused by mixed messages in the media about issues like masks and vaccine effectiveness,” she observes. “Everyone just wants to know when the pandemic will be over and when they can resume their normal lives.” “We’ve been addressing so much of that kind of loss,” Long continues. “We’re trying to work with people around the ambiguity, but some people do not do well with not knowing.”

Getting Services Back to Normal Behavioral Health services at Sentara RMH are now largely back to normal operations, Bibb notes. The PET team in the Emergency Department, which processes 40% of inpatient behavioral health admissions, is back to doing assessments face to face, rather than by Zoom. “There is something to be said for having the individual in the room with you,” Bibb says. “When doing telehealth assessments, you may not see an individual’s body language or certain facial expressions, and you might miss pertinent information for individuals seeking behavioral health services.” The Inpatient Behavioral Health Unit is once again offering family sessions, its music therapy program and other face-to-face services. Outpatient Behavioral Health services are also back to full, in-person capacity. Although the department’s move from University Boulevard to Elizabeth Street in

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downtown Harrisonburg in August 2020 did temporarily interfere with the staff’s ability to schedule appointments, it also expanded the department’s capacity. “The move made it safer for patients, in terms of COVID, and also gave us room to grow,” Adamson says. “The new location is a welcoming, clean space with lots of natural light.” With the full array of behavioral health services available in the community, no one needs to suffer alone, Bibb stresses. “There are plenty of support resources out there for patients in need,” she says. “And as a community, as we move from isolation and loneliness back to normal after COVID, there is great reason for hope for better times ahead.”

Comprehensive Behavioral Health Services The Sentara RMH Behavioral Health inpatient unit works diligently to stabilize patients and then to discharge them with a comprehensive plan, based on the expertise of the Outpatient Behavioral Health Services team. This team includes experts in the following areas: •

Counseling for individuals of all needs

•

Testing and assessment

•

Partial hospitalization programs

•

Intensive outpatient and life-recovery programs

•

Bereavement services

Family counseling and couples counseling are also offered, along with the Employee Assistance Program for Sentara RMH employees and their families. For more information about Sentara RMH Outpatient Behavioral Health Services, call 540-564-5104. To reach Sentara RMH Behavioral Health Specialists, call 540-564-5100. If you or a loved one is in crisis, call 540-434-1766, or contact the National Suicide Hotline at 800-273-8255.

AC TIVE LIVING

Getting Back in the Game

Sports Medicine Physicians Tailor Treatments to Athletes’ Goals Sports medicine specialists have an in-depth understanding of athletic injuries, as well as the associated treatment and recovery process. The professionals at Sentara RMH Medical Center and Sentara Martha Jefferson Hospital work with individual athletes to understand their unique goals and needs and guide them to the best treatment path for their situation. “Our primary focus is to restore function and get the athlete moving again,” says orthopedics and sports medicine specialist Thomas S. Weber, MD, of Sentara Orthopedic & Sports Medicine Specialists. “Depending on the situation, we are able to use either surgical or nonsurgical techniques— or a combination of the two—to get athletes back in the game.”

Successful Surgery and a Newfound Career Path

Luke Bailey

Surgery, combined with a year of rehabilitation, helped Luke Bailey get back on the football field—and gave him a focus for his future. During a football scrimmage at Wilson Memorial High School in Fishersville in August 2018, Bailey tore his anterior cruciate ligament (ACL). “I went in to make a tackle,” says the 18-year-old. “I was hit from an awkward angle and went down and twisted my knee.” A sophomore at the time, Bailey didn’t immediately realize the severity of his injury. To assess the situation, he first went to South River Rehabilitation & Performance in Stuarts Draft, sentara.com

AC TI VE LIVIN G

and was then referred to Clark Baumbusch, MD, an orthopedic surgeon at the Sentara Sports Medicine Center. “Dr. Baumbusch knew it was an ACL tear right away,” Bailey recalls. “He scheduled me for surgery before he even had the MRI scan done.” Dr. Baumbusch built a new ACL using a portion of Bailey’s patella (kneecap) tendon. “It’s probably the most common approach for someone who is a contact athlete, and it’s a wellestablished surgical technique,” he explains, noting that each person’s situation is different, and that ACL surgery should be tailored to a patient’s specific injury, goals and expectations. For Bailey, the surgery itself was a breeze. “The whole process was really easy,” he recalls. “I was very comfortable. Everyone I encountered made me comfortable and helped me relax.” His recovery was a long process, however, which is typical with ACL surgery. He started physical therapy the day after surgery, but otherwise spent the first week resting in bed. He then saw Dr. Baumbusch regularly for follow-up care. For the first month, Bailey went to physical therapy five days a week and then tapered to three or four days a week for the next year. Rehab following ACL surgery has evolved in recent years, with an emphasis now on getting people moving and bearing weight immediately after surgery. But rehab also focuses on tailoring a program to the needs and healing

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level of each patient. “Luke was a pleasure to work with,” says Dr. Baumbusch. “I tell my patients that recovery is dependent on several variables: the ability of your surgeon to fix your problem, the ability of your therapist to understand and manage rehab, and the dedication the patient has to get better. When those stars align, the sky’s the limit.” The length of a rehab program depends on each patient’s goals. Bailey transitioned to athletic performance training in the final months of rehab to ensure that he was fully ready for a new season of football. “His goals were to get back to competition and contact sports at a high level,” notes Dr. Baumbusch. “That’s a pretty lofty goal, and in those situations the rehab can last a year.” Rehab and sports conditioning helped prepare Bailey for a return to the competition he loved. “I was in a better place than before the ACL tear,” Bailey says. “I would recommend Dr. Baumbusch 100%. He was awesome and very personable. Every time we went to the clinic, it was always upbeat and cheerful, even though the reason we were there wasn’t fun.” Bailey continued playing at tackle and middle linebacker during his junior and senior years, and also wrestled for Wilson Memorial. “I’ve had zero problems with my ACL,” he says. He’s also a competitive powerlifter and plans to continue lifting while he attends James Madison University in the fall. Somewhat unexpectedly, his injury and rehabilitation process also led him to explore a new career: He now plans to major in kinesiology, with a focus in exercise science.

“My injury is what made me want to go into this career,” he explains. “I was able to see the different aspects of physical therapy and athletic performance training. Ever since then, I’ve wanted to be a strength and conditioning coach.”

A Wrist Break and a Return to the Court Ben Bellamy’s sophomore basket-

ball season at Eastern Mennonite High School in Harrisonburg was cut short in February 2021 by an injury during a state playoff game on his home court. “I went in for a layup near the end of the fourth quarter,” says the sophomore shooting guard. “I jumped up, and a kid went under me and took out my legs.” Bellamy, 17, tried to catch himself on the way down, but all of his body weight landed on his left wrist. “I had never had a broken bone before, but it really hurt, so I figured something bad had happened. I remember thinking how I wouldn’t be able to finish the year and how it would affect my travel basketball season. I was hoping it was just a small sprain.” The athletic trainer covering the game that night, who happened to work at Sentara Orthopedic & Sports Medicine Specialists at Sentara RMH, contacted Dr. Weber to get Bellamy an appointment the following morning. “One great thing about our department is we have employees throughout the region serving as athletic trainers at games,” says Dr. Weber. “This allows us to get people prompt and accurate care, and also save the time and cost of a trip to the emergency room or urgent care.” The next day, X-rays showed that Bellamy had fractured his

Ben Bellamy

wrist. “Dr. Weber was really straight up and didn’t sugarcoat anything,” says Bellamy. “He told me it was going to be six to eight weeks before I’d be back. He was really cool. He knew I was sad, but he was trying to make everything better. He made the process a lot smoother.” Bellamy needed a cast for four weeks and a wrist brace for two weeks after that, but he didn’t require physical therapy. According to Dr. Weber, younger athletes typically don’t need surgery or physical therapy for a wrist break. “These younger patients with wrist fractures tend to bounce back very well,” he says. Dr. Weber did give Bellamy some exercises to perform to strengthen his wrist and get him ready for travel basketball. The exercises included squeezing a stress ball throughout the day to improve Bellamy’s hand strength while he wore the brace. “Once his bone was ready to go, he wanted to play,” Dr. Weber says. “We had him do aggressive therapy, which younger athletes can handle because their bones tolerate it well. We had him back on the court as soon as that cast came off.” Bellamy returned to play most of his travel basketball season in the spring and plans to play Injured? See a Sentara with another travel Sports Medicine Doctor! team this summer. In Harrisonburg: Then, he hopes, it’s Sentara Orthopedic & back to high school Sports Medicine Specialists competition. (East Market Street and Elkton locations) “I thought I was 540-689-5500 going to be out for two months, but it In Charlottesville: was thankfully only Sentara Sports Medicine Center at Sentara about six weeks,” he Martha Jefferson says. “I feel better (Pantops and than ever. I feel Proffit Road locations) really good.” 434-654-5575 sentara.com

HEALTH MATTERS

Take Care of

Anemia

nemia is a common blood disorder in which a person’s red blood cell count is lower than normal, which means less oxygen than normal is being transported through the circulatory system to the body’s tissues and organs. Anemia can occur either because the body makes too few red blood cells, or because the body loses or destroys them faster than it makes new red blood cells. There are many types of anemia, some of which are mild, and others that can be serious or even life-threatening. In addition, anemia can be a temporary or long-term condition.

Symptoms Initially, a person with anemia may not notice that anything is wrong. As the condition worsens, however, so do symptoms. Fatigue is the primary symptom of most types of anemia, but the condition also can cause other symptoms like: • Shortness of breath • Irregular heartbeat • Weakness or dizziness • Cognitive problems • Numbness or coldness in the arms and legs • Pale skin

Types of Anemia The most common types include the following: • Iron-deficiency anemia affects one in five women, nearly half of all pregnant women and about 3% of men in the United States. • Vitamin-deficiency anemia can result from a diet that is deficient in key nutrients—especially folate and vitamin B12, which are needed to produce an adequate amount of red blood cells. • Blood loss anemia can be caused by gastrointestinal conditions like ulcers or gastritis (inflammation of the stomach), or by overusing certain over-the-counter oral pain medications or certain anticoagulant medications that can cause or aggravate ulcers or gastritis. Very frequent and heavy periods also can sometimes cause anemia.

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•

Aplastic anemia: This life-threatening type of anemia results from a decline in the bone marrow’s ability to produce red blood cells. The condition is typically caused by radiation therapy, chemotherapy, pregnancy or lupus. • Anemia resulting from chronic disease: Certain diseases like cancer, bone marrow disease, Crohn’s disease, rheumatoid arthritis and other chronic inflammatory diseases can reduce red blood cell production.

Risk Factors Your chances of developing anemia are greater if you have any of the following conditions: • Alcohol abuse: Excessive alcohol consumption can interfere with red blood cell production. • Diabetes: This chronic condition also can reduce blood cell production. • Family history: If anemia runs in your family, you are at greater risk. • Pregnancy increases a woman’s risk for developing iron-deficiency anemia. • Vegetarian/vegan diet: If you follow a vegetarian or vegan diet, make sure you get sufficient iron to support red blood cell production. If you have symptoms of anemia or suspect you may have the condition, see your physician. Even if your anemia is not severe, you can improve your quality of life by treating this common blood disorder.

LA SALUD IMPORTA

Cuidarse de la

anemia

a anemia es un trastorno sanguíneo común en el cual el recuento de glóbulos rojos de una persona es inferior al normal, lo que significa que se está transportando menos oxígeno de lo normal a los tejidos y órganos del cuerpo a través del sistema circulatorio. Síntomas Inicialmente, una persona con anemia puede que no note que algo anda mal. Sin embargo, a medida que la afección empeora, también lo hacen los síntomas. La fatiga es el síntoma principal de la mayoría de los tipos de anemia, pero la afección también puede causar otros síntomas como: • dificultad para respirar • ritmo cardíaco irregular • debilidad o mareos • problemas cognitivos • entumecimiento o frialdad en los brazos y las piernas • piel pálida

• Anemia aplásica: Este tipo de anemia, potencialmente mortal, es el resultado de una disminución en la capacidad de la médula ósea para producir glóbulos rojos. La afección suele deberse a la radioterapia, la quimioterapia, el embarazo o el lupus. • Anemia resultante de una enfermedad crónica: Algunas enfermedades como el cáncer, la enfermedad de la médula ósea, la enfermedad de Crohn, la artritis reumatoide y otras enfermedades inflamatorias crónicas pueden reducir la producción de glóbulos rojos.

Tipos de anemia

Las posibilidades de manifestar anemia son mayores si se dan alguna de las siguientes condiciones: • Abuso de alcohol: El consumo excesivo de alcohol puede interferir con la producción de glóbulos rojos. • Diabetes: Esta afección crónica también puede reducir la producción de células sanguíneas. • Antecedentes familiares: Si la anemia está presente en su familia, su riesgo es mayor. • El embarazo aumenta el riesgo de una mujer de manifestar anemia por deficiencia de hierro. • Dieta vegetariana/vegana: Si sigue una dieta vegetariana o vegana, asegúrese de consumir suficiente hierro para facilitar la producción de glóbulos rojos. Si tiene síntomas de anemia o sospecha que puede tenerla, consulte a su médico. Incluso si la anemia no es grave, puede mejorar su calidad de vida tratando este trastorno sanguíneo común.

Los tipos más comunes incluyen los siguientes: • La anemia por deficiencia de hierro afecta a una de cada cinco mujeres, casi la mitad de todas las mujeres embarazadas y alrededor del 3% de los hombres en los Estados Unidos. • La anemia por deficiencia de vitaminas puede ser el resultado de una dieta deficiente en nutrientes clave, especialmente el folato y la vitamina B12, que son necesarios para producir una cantidad adecuada de glóbulos rojos. • La anemia por pérdida de sangre puede deberse a afecciones gastrointestinales como las úlceras o la gastritis (inflamación del estómago), o por el uso excesivo de ciertos analgésicos orales de venta libre o algunas medicaciones anticoagulantes que pueden causar o agravar las úlceras o la gastritis. Los periodos menstruales muy frecuentes y abundantes también a veces pueden causar anemia.

Factores de riesgo

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SENTA R A IN THE COMMUNITY

Sentara Hospitals Create Innovative Programs to

Help Fight

Food Insecurity When the pandemic began to roll through Virginia in 2020, job loss, illness and quarantines limited the ability of many people to fill their refrigerators and pantries at home. To compound that situation, with school out, many children weren’t receiving the meals they normally would get in an in-person school setting. In fact, about 450,000 students in Virginia rely on free or reduced-price meals during the school day. As a result, the share of people experiencing hunger and food insecurity in Virginia rose from about 10% in February 2020 to 22% in June 2020, according to the Federation of Virginia Food Banks. The U.S. Department of Agriculture defines food insecurity as a lack of

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consistent access to enough food for an active, healthy life. “When COVID hit, we noticed quickly that a lot of people needed food,” recalls Jackie Martin, director of community benefit for Sentara Martha Jefferson Hospital. “The Local Food Hub worked quickly with us to help solve this problem.”

Fresh Produce, Healthy Options The Local Food Hub works with Virginia farmers to bring fresh food to the tables of Virginians. For the past five years, the organization has worked with Martin and her team—Seirra Winn, Diana Webb and Setour Dillard— at the Sentara Starr Hill Health Center to provide free, fresh produce to patients. During the growing season, the Local Food Hub usually delivers 100 fresh-produce bags to the clinic for distribution every Wednesday. Fifty of those bags would go to patients, while clients of other Jefferson School City Center tenants would receive the remaining 50 bags. During the early stages of the pandemic, the Starr Hill clinic team began running out of bags, so the Local Food Hub quickly increased distribution to 220 bags to help satisfy needs. “We are currently distributing bags every other week and have yet to see a decrease in need,” Martin explains.

five-day supply of heart-healthy, low-sodium, shelf-stable items, including cereal, rice, and canned vegetables and fruit. Sentara gave $500,000 to the $2.6 million We Care initiative— but the commitment didn’t stop with donating funds. “We engaged staff to help pack those boxes, since it was a Sentara partnership,” explains Patra Reed, Blue Ridge regional director of integrated care management and Sentara RMH Medical Center director of community health services. “Our senior leadership teams from Sentara RMH and Sentara Martha Jefferson, along with a group of staff nurses, helped pack boxes at the Blue Ridge Area Food Bank.” Both Sentara Martha Jefferson and Sentara RMH also received We Care boxes from the Blue Ridge Area Food Bank to distribute to patients in need. To see how they could assist hospital patients who needed help obtaining food, coordinators

at the Blue Ridge Area Food Bank contacted the RMH Foundation. Sentara RMH developed a program to provide identified patients with a box weighing up to 20 pounds and containing staple foods like peanut butter, kidney beans, long-grain rice, navy beans, dried fruit, shredded wheat and vegetable soup. To reach patients needing assistance, staff provided boxes at the Sentara RMH Emergency Department, Cancer Center and physician practices, as well as through the Continuum Case Management program, which visits patients at home. Case managers identified patients who would have difficulty purchasing food due to COVIDrelated circumstances, including: • Patients waiting for COVID test results • COVID-positive patients quarantining at home • Patients discharged from the hospital after being treated for COVID

Food Bank Partnership Last July, Sentara Healthcare, Optima Health, Truist, the commonwealth of Virginia and the Federation of Virginia Food Banks joined forces to provide free food boxes statewide. The 20-pound We Care boxes were filled with a

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SE NTA R A IN T HE COMMU N IT Y

• Any patient discharged for whom food access was difficult, due to COVID-related reasons “Many of our elderly patients being discharged didn’t feel comfortable going to the grocery store or even going out in public, whether they were being treated for COVID or any other condition,” recalls Reed. “The boxes provided them with some muchneeded supplies to help get them through a tough time.”

Taking Boxes to the Community To reach out directly to the community, Martin and her team at Sentara Martha Jefferson decided to deliver We Care boxes to people in their neighborhoods. “We selected specific sites, and the Blue Ridge Food Bank worked with us to expand our food access program,” Martin says. “Beginning in February 2021, our team began distributing food boxes either directly to recipients

or by giving them to community leaders for distribution, recognizing that people might be more comfortable accessing the food from people they know.” Another strategy Sentara Martha Jefferson used to get We Care food boxes out to the community was to have them available at vaccine events. “What I liked about this program is that we didn’t have to ask people for a lot of personal information,” Martin explains. “The Food Bank only required the ages of people in their

households—no names. You shouldn’t have to give your life story to get a box of food.” In 2021, Sentara Martha Jefferson and Sentara RMH will continue to provide food boxes to patients and families, as needed, and will partner closely with local food pantries to assess ongoing needs. “We knew that a lot of people were food insecure before the pandemic, but COVID really made us see the need,” Martin says. “The food boxes have been so helpful.”

Sentara Cares: A Multifaceted Approach to Improving Community Health The overall health of a community requires more than access to health care. The Sentara Cares program is a comprehensive approach to addressing the key aspects that determine overall community health. The program focuses on five pillars: • Community engagement • Housing • Skilled careers • Food security • Behavioral health Sentara Healthcare has consistently recognized its role in corporate social responsibility, and the Sentara Cares program creates a formula that can be applied systemwide. “Sentara, historically, has been very philanthropic with multiple partners, but the goal here was to be more strategic about

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improving the health of the population at large, versus focusing on individual programs in each of our regions,” says Sherry Norquist, director of corporate social responsibility for Sentara. Every three years, Sentara hospitals are required to submit a community health needs assessment that identifies and suggests ways to improve health, including what’s known as the social determinants of health: the conditions in the environments where people are born, live, learn, work, play, worship and age. Sentara Cares builds on these assessments. “Beyond providing traditional health care, Sentara is addressing many of our communities’ needs, especially those needs that cannot necessarily be

treated inside the walls of the healthcare facility,” Norquist explains. “Creating healthier communities requires finding solutions that address health where it starts—at home.”

PHILANTHROPY

Playing the Role of

Lifesaver

Gift Leads to Purchase of Oxygen Sensors to Enhance Care for COVID Patients

Chris Ellis poses a

rhetorical question that could easily double as the end of a fiery locker room speech to motivate his team. “If you don’t step up and help out during a time of a crisis,” he says earnestly, “when are you going to do it?” Ellis, a Harrisonburg-based market president for Truist Bank (formerly BB&T), answered his own question a year ago as COVID-19 placed added stress w w w.S uppor tRMH.org

on the entire community—most notably on frontline healthcare workers. That’s when his company’s charitable arm, the Truist Foundation, made a $10,000 gift to the RMH Foundation’s Crisis Response Fund. The contribution led to the purchase of additional oxygen sensors, allowing for better care at Sentara RMH Medical Center. For Ellis’ team at Truist, the expression of such community support builds pride in their employer. But the impact goes far beyond company walls. “COVID has been the biggest worldwide crisis during my lifetime,” Ellis says. “We know what Sentara RMH has gone through, and supporting them and their frontline workers was important to us. Everybody has a part to play. This was just part of ours.”

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“

This gift made it possible for us to purchase the equipment to monitor a patient’s oxygen levels at the same time.”

Around-the-Clock Impact The RMH Foundation, the fundraising arm of Sentara RMH, created the Crisis Response Fund in response to the COVID-19 pandemic, allowing healthcare workers an opportunity to fill in gaps and support patients’ needs. The Truist gift came at the height of the crisis. Due to the respiratory nature of the infection, it was “clearly imperative” that patients’ oxygen levels be monitored at all times, says Jenay Mason, director of Patient Care Services. “In order to provide this crucial service, we needed to add the ability to monitor patients’ oxygen levels to our existing 24hour monitoring system, which previously only monitored heart rhythm,” she says. “This gift made it possible for us to purchase the equipment to monitor a patient’s oxygen levels at the same time.” This technology enabled Sentara staff to be informed more quickly of significant changes in a COVID patient’s oxygen level, which would then trigger additional treatments, Mason notes. Unbeknownst to Ellis and his Truist team when they made the gift, the parts they would play in the pandemic would be as lifesavers. “As healthcare providers, we are thankful for the support of our community for such critical equipment,” Mason says. “As members of the community served by this hospital, we are grateful for the technology that enabled lifesaving interventions.” Cory Davies, executive director of the RMH Foundation, calls Truist a “true community partner.” “The generosity of the Truist Foundation toward the RMH Foundation’s Crisis Response Fund helped equip our frontline caregivers with the tools they needed to provide exceptional care,” he

says. “On behalf of our staff and our patients, we are deeply grateful.”

On a Mission to Improve Quality of Life It should come as no surprise that Sentara RMH would benefit from the Truist Foundation’s efforts, as the charitable group’s stated mission aligns perfectly with Sentara RMH ideals. On its website, Truist, which has contributed tens of millions of dollars nationwide, states: “All people and communities should have an equal opportunity to thrive. Through our partnership with innovative organizations and a focus on four key areas, the communities we serve have a chance for a better quality of life.” The foundation has four pillars it believes every community needs: leadership development, economic mobility, thriving communities and educational equity. To Ellis, there’s a common denominator among those four pillars. “You don’t have any of those four things without health,” he says. “Without health and the ability to move freely in society, you just don’t have those things.” Locally, the Truist Foundation’s charitable efforts are overseen by a small committee, which approved more than $750,000 in gifts

back to the Shenandoah Valley in 2020, including responding to COVID-related needs. Organizations throughout the Interstate 81/U.S. 29 corridor benefited from these gifts. “It’s an enjoyable part of the job, to give back like that,” Ellis says. “We try to be very active in the community. Supporting Sentara RMH certainly was something that fit with our goals.” Ellis knows personally how important a well-equipped medical facility, as well as a caring and highly-trained staff, are to a community during “ordinary” times. He’s been a patient at the Center for Orthopedics and Sports Medicine, as well as a member of the Sentara RMH Wellness Center. “I’ve always had good experiences with Sentara RMH,” he says. That personal experience further underscores his appreciation for the support the Truist Foundation could provide to the Sentara RMH staff during the most extraordinary of times. “It’s all about playing your part,” Ellis says. For more information on the RMH Foundation and ways you can support your local hospital, please visit www.supportrmh.org.

An Estate Planning Quiz Are you certain that your current estate plan is up to date? Take this brief quiz to see where you stand. 1. Do you have a will or living trust to direct the distribution of your property? Yes n No n 2. Is the makeup of your family the same as when you last reviewed your plans? Yes n No n 3. Do you live in the same state as when you last updated your will or other plans? Yes n No n 4. Is the person you have named to settle your affairs still able and willing to serve? Yes n No n 5. Has the value of your assets remained the same since you last reviewed your plans? Yes n No n 6. Are all the people and charities important to you mentioned in your plans? Yes n No n

Your score 1. If you answered No to any of the above questions, you may need to review your plans. Professional advisors and attorneys who specialize in such matters can offer advice and help to coordinate various parts of your plan. To receive the FREE brochure “37 Things People ‘Know’ About Wills That Aren’t Really So,” w wor w .540-689-8549. S u p p o r t R M H . o r g | 43 please contact Sarah Orem at seorem@sentara.com

friends of the

RMH Foundation Gifts received from Jan. 1 to April 30, 2021 entara RMH Medical Center is so grateful to have the support of generous community members. We express this gratitude and recognize the contributions our donors make through the President’s Forum, the William Leake Society, the 1910 Cornerstone Club and the White Rose Giving Circle. These exclusive giving circles are our way to honor our most generous partners who show they care about having the best medical services available in our community. Finally, to recognize your loyalty over the years, we are placing 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 2021. President’s Forum

William Leake Society

$100,000 and above

$1,000–$4,999

Diane C. Davis (29)

Anonymous Fund of The Community Foundation of Harrisonburg and Rockingham County (1) Carolyn and Gerald Beam (2) Drs. A. Jerry Benson and Martha K. Ross (10) Helen Breeden (2) Craig M. and Melanie Brimhall (3) Francis M. and Alice S. Bruce (3) Crosslink Community Church (2) The Davies Family (14) Colonel and Mrs. Peter F. Dieck (4) Douglas and Gayle Driver (6) Farmers and Merchants Bank (8) Dr. Steve and Kathy Gardner and the Pass Through Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (2) Cardinal Dental Specialists (7) Brooke Goodwin (7) Amelia Michon Hall (11) Harrisonburg Kiwanis Club, Inc. (2) George and Cary Hevener (17) Impact Assets (2) Integrity Insurance Group (2) Richard C. and Mona D. Johnson (33) LD&B Insurance Agency (3) Robin L. Martin (19) Rennie Mitchell McAllister (3) Ann and Neal Menefee (28) Drs. David and Heather Morgan (5) Dr. Harold F. III and Donna S. Reilly (15) Rise Church UMF Community (2) John and Carol Rosenberger (8) John and Faye Sellers (16) Shenandoah Valley Bicycle Coalition (1) Mary Sherman (9) Barbara B. Stoltzfus (23)

$25,000–$99,999 Mary Doris Joecks and Family (1) Herman and Janet Mason Family (13) Eleanor Page Price (3) The Community Foundation of Harrisonburg and Rockingham Cty. (19)

$5,000–$24,999 DuPont Community Credit Union (4) John R. and Mary Ann Heatwole (3) Dr. Charles H. and Mary Henderson (16) James and Frances Mason and Herman and Janet Mason Families Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (2) Calvin R. Nichols Jr. (5) Charles Oster (25) Dewayne C. Rhodes (2) Schwab Charitable Fund (3) Sentara RMH Volunteer Auxiliary (40) Shenandoah Automotive Service Center (5) Mr. and Mrs. Mark Shickel and Ephesians 2 Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (1) Shickel Corporation - Colossians 3:17 Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (1) The Robert H. Strickler and Lorraine W. Strickler Foundation (9) The US Charitable Gift Trust (5) Lynn and Diane Trobaugh (14)

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SUMMER 2021

David O. and Elizabeth A. Swingle (12) Paula L. Thompson (1) Holly Thorne and F&M Bank Community Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (8) Phillip and Christina Updike (8) Dr. David and Janet Wendelken (9) Whetzel Family Irrevocable Trust (1) Janet Estep Whetzel Family (1) Richard L. and Pamela B. Wilkins (34)

1910 Cornerstone Club $100–$999 Robert E. and Linda L. Alley (4) Cliff and Amanda Alt (1) Dr. Steven G. and Patricia A. Alvis (2) Devon and Teresa Anders (12) Ervin L. and Ann Noffsinger Anderson (8) Paul Baker (1) Edith J. Banks (7) Edgar L. Barnard Jr. (15) Karen Barnes (2) John G. Barr (5) Sam L. Batton (6) Dennis and Darlene Baugh (1) Joanne L. Bell (6) Douglas L. Berry (1) Kenneth G. and Linda R. Berry (12) Bethany United Methodist Church Adult Mission Team (1) Bethel United Church of Christ Women’s Fellowship (1) Adam and Christy Blagg (7) Dennis P. and Janet E. Boffo (4) John F. and Elsie L. Bowers (5) Lawrence D., Jr. and Linda K. Bowers (2) Larry O. and Paula C. Bowman (3) Catherine E. Boyd (1) Nancy R. Bradfield (13)

Alfred and Delma Brenneman (5) Rosemary O. Brenner (2) Broadway Timberville Ruritan Club (1) Emmett H. and Leola C. Brooks (6) Jacquelyn K. Brooks (1) Ernest P. Burger (1) David L. and Elizabeth B. Burkholder (5) Owen R. and Judy M. Burkholder (2) Christine W. Burner (14) Nancy E. Camp (3) William B. Carper Sr. (40) Dr. Dale A. Carroll and Dr. Merrily McGowan (2) Brenda D. Cave (10) Cedar Stone Spa (1) Anne Terese Colao (1) Belinda ’Dawn’ Cooper (2) Glenn and Leslie Crawford (6) Cross Keys Mill Creek Ruritan Club (1) Crossroads Cafe & Catering, LLC (1) Crossroads Mennonite Church (2) Dennis A. and Martha C. Cummins (8) Lowell R. and Alta A. Davis (2) Dayton Tavern, LLC (1) Dayton United Methodist Church (1) Curtis and Marcy Dean (1) Dennis and Lou Dellinger (2) Kay C. Divincenzo (1) Dominion Energy Charitable Foundation (9) Dave D. and Patricia H. Dungan (6) Edward Jones Investments (6) Janet S. Einstein (15) Elkton Ruritan Club (1) Emmanuel Episcopal Church (1) Donald M. and Joyce Y. Evers (1) Fidelity Charitable Gift Fund (14) Carol Ann Fields (3) Dale Flaten (1) Gregory V. and Elizabeth Lea Flynn (1) Larry A. and Linda J. Fogle (14) Donald E. Forren (3) Lewis and Arleen Forsheit (1) Richard L. and Diana L. Forsythe (1) Bibb Y. and Dolly Sease Frazier and B. Y. Frazier Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (1) Forrest L. Frazier (19) Charles J. Frye (3) William E. and Rita F. Fulk (3) Claude M. and Kathleen T. Gantt (1) Michael A. and Carolyn S. Gardner (5) Dr. Linford K. and Rebecca L. Gehman (2) Sherrill Glanzer (20) J. R. and Cheryl Good (1) Richard and Joan Goodrich (3) Karen Wood Grizzard (6) Marilyn Guntner (2) Joshua P. Hale (5) Richard and Julie Haushalter (22) Sheri Heatwole and Friends (1) Evelyn S. Hedrick (11) Robert E. and Gail L. Hess (5)

Shelvy K. Hinkle (1) Charles R. Sr. and Constance E. Hoover (1) William R. Hudelson (12) Philip D. and Sue L. Hutchinson (1) Richard E. and Linda H. Jacobs (2) Judy Jenkins (5) Ronald P. and Julianne Jilinski (14) Robert F. Jochen V., MD (6) J. Robert and Patricia C. Johnson (3) Flora L. Kagey (14) Sharon L. Kiracofe (15) K. Michael and Susan C. Kline (1) Katherine H. Knicely (13) Steve and Cindy Lamb (11) Peggy H. Landis (1) Robert J. and Carolyn J. Leiston (14) Leitner Law Group, PLC (8) Leonardo DRS (1) Howard Lind (1) Linville-Edom Ruritan Club (1) Charles E. and Cynthia A. Litten (13) Horst and Deborah Locher (3) Barry L. and Mardia B. Long (1) LPL Financial Foundation (2) Laura S. Mapp (28) Philip H. Maxwell (34) Ronald T. and Louise M. McCoy (1) Thomas L. and Barbara W. Melby Charitable Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (1) Marie Menard (2) Col. William P. and Frances A. Menefee (3) Pat Messner (34) Mervyl L. and Linda H. Miller (4) Robert E. Miller, Jr. (3) Sherry L. Mongold (10) Dr. and Mrs. Jason R. Moore Mountain View Fellowship Church of the Brethren (1) Susan K. Moyers (2) Mt. Olive Brethren Church (1) Daniel J. and Alyce U. Nardi (4) Rotary Club of New Market, VA (8) Roy A. and Karen A. Norville (2) Kelly and Leo O’Donnell (1) Chris and Sarah Orem (3) Park View Federal Credit Union (2) Park View Mennonite Church (1) Pershing - Pro Equities, Inc. (1) John R. and Virginia H. Phalen (10) Richard G. and Annie L. Pierce (10) Steve and Deb Proctor (2) S. Walton Propst (4) Rick and Joy Pulley (1) Dewain H. and Joyce W. Rahe (1) A. Kenneth and Mildred L. Ranck (6) Thomas D. and Jennifer L. Rea (7) David and Elizabeth P. Reedy (2) Nelson L. and Janet W. Reinsch (1) Raymond E. and Naomi W. Ressler (1) Eleanor S. Rexrode (21)

Lisa Rhodes and Bobby Stroop (1) Lourdes Rhodes (6) James B. Richardson, Jr. (13) Michael L. and Roxanne M. Rider (1) Marjorie T. Ridgway (5) Paul and Laura Riner (1) Mark E. and Barbara C. Roberts (2) Verna A. Rodes (2) John Rogers (1) Wayne and Joan Ruck (4) Sangerville Church of the Brethren (1) Laurence and Evelyn Sauder (16) Al P. and Phyllis S. Saufley (7) Garland R. and Denise L. Sawyer (2) Ralph L. and Ann W. Sebrell (11) Lucy J. Seymour (12) David W. Shaffer Jr. (5) John C. Shank (1) Shenandoah Valley Printing (1) Shepherd of the Valley Lutheran Church (3) Charles C. Shiflet Jr. (2) Hazel K. Shirk (1) James M. and Carol S. Showalter (23) Larry Showalter (4) Christine Simmons (1) Delbert D. Slater (14) Ilene N. Smith (39) Sons of the Confederate Veterans, Inc. (1) John Sponaugle Family, Sarah Ward, Laura Begoon and Pam Sponaugle (1) Virginia J. Steeber (15) David E. and Esther Yoder Stenson (2) Roy H. Stetler III (5) William G. and Hope Shank Stoner (16) Esther J. Strawderman (14) Richard L. and Joyce K. Strawderman (14) John and Mary Strickler (1) Rodney and Ruth Stultz (13) Bill and Carolyn Taylor (1) Juanita M. Taylor (39) Linda L. Taylor (13) Debra D. Thompson (32) James M. Tongue (4) Truck and Equipment Corporation (1) Sherwin and Sandy Tusing (40) James M. and Grace T. UpDyke (1) Keith J. Vanbenschoten (1) Dan C. and Kathleen Vance (1) John A. Via (1) Jill Wade (2) Coworkers of Ann Wall (1) John M. and Martha S. Watkins (4) Watt, Tieder, Hoffar & Fitzgerald LLP (1) James R. and Susan C. Weaver (2) Wallace W. and Mary Alice Weaver (10) Weiler Orthodontics (1) Henry G. Jr. and Ferne M. Wenger (14) Linda B. West (3) Patricia T. Wichael (5) Mr. David and Dr. Karen Wigginton (4) Roberta (Robbie) and Robert K. Wilkins (14)

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friends of the

RMH Foundation John R. Wilkinson (3) Brenda R. Williams (1) Garland J. and Shelvy Williams (11) Kathleen M. Williar (6) Mary Ann and Roger Winegard (2) LTC Charles V., USA (RET) and Stephanie S. Wollerton (2) Robbie Jean Zirkle (14)

White Rose Giving Circle $500 Violet Allain “A Little Bit of Good Giving Circle” (2) Teresa B. Anders (12) Ann J. Bird (4) Linda Heatwole Bland (9) Jennifer M. Bolt (6) Sharon S. Bowers (11) Nancy B. Bradfield (30) Rita Bunch (2) Maryjane Chewning (7) Sherry B. Cline (24) Phyllis Y. Coulter (10) Diane C. Davis (29) Lynn Diveley (14) Sallie E. Funkhouser (16) Zanette Hahn (6) Cary Hevener (17) Louise Otto Hostetter (14) Mona D. Johnson (33) Dawn F. Kern (6) Victoria Krauss (22) S. E. Kruck (3) Twilla M. Lambert (6) Elisabeth M. Lawson (6) Brenda J. Lenhart (21) Jo Ann S. Liskey (9) Sharon Menefee (3) Rebecca W. Morris (32) Debra L. Mowery (3) Lori B. Moyer (5) Alyce U. Nardi (4) Gloria B. Price (22) Carrie Rash (4) Donna S. Reilly (15) Martha K. Ross (10) Shirley M. Shimp (6) Elayne Smith (1) Ilene N. Smith (39) Barbara B. Stoltzfus (23) Hope Shank Stoner (16) Debra D. Thompson (32) Diane E. Trobaugh (14) Sallye Trobaugh (8) Christina Updike (8) Nancy Hopkins Voorhees (14) Susan C. Weaver (2) Teresa Boshart Yoder (1) Shirley B. Yoder (1)

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SUMMER 2021

Annual Support $25–$99 Laura Adkins (8) Phyllis Albrite (7) Ameriprise Financial Services, Inc. (1) Jean Anne Armstrong (14) Thomas and Yvonne Barr (1) Darryl B. Bartley (2) Natalie R. Bass (6) Tracy Baughman (1) Nancy Beatty (1) Ralph N. Bergdoll (5) Patricia A. Brunk (14) Judy Bullis (1) Thomas L., Jr. and Carroll P. Buskirk (4) Cyrus G. and Barbara S. Buttram (1) Dr. Zachary and Kristen Collier (3) David R. B. Collins (1) Emanuel B. Conley Jr. (8) Randall L. Craig (5) Judy Ann Craun (2) Thomas N. and Joy H. Daggy (2) Frederick A. and Alice H. Davino (3) Gary L. and Brenda H. Driver (4) Eileen E. Dubberstein (1) Theresa Enke (1) B. Earl and Cheryl K. Eshbach (9) Joseph M. Evy (4) Glen O. and Barbara Sue Eye (4) Richard H. and Hazel K. Forbus (1) GE Nail Spa (2) The Gilmer Family Trust (1) Michael A. and Deborah W. Good (16) Rodney D. and Peggy C. Good (1) Daniel W. and Bette M. Goodson (14) Mae B. Guthrie (14) The Halterman Family (1) Carolyn A. Hartman (1) Martin T. Hartman (1) Harry E. and Mary Jane Hedlund (4) Robert S. and Dorothy M. Hiner (2) Mary A. Holler (3) Mattie L. Howell (2) Harold E. Huber (3) Lyle C. and Georgianne M. Hull (5) Richard A. and Linda J. Humbert (13) Polly A. Jamison (7) Jollett Springs Mobile Home Park (1) Lorraine L. Kimble (4) Faye R. Kingston (1) Orrin M. Jr. and Jane C. Kline (15) Larry W. and Janice L. Knicely (2) William A. and Carole H. Kreowski (4) Richard Lamma (1) Lydia Lapp (3) Cheryl Lindsay (1) Carroll T. Lisle (2) Dorothy D. Logan (21) John L. and Faye A. Lokey (2) Orville L. and Betty H. Long (2) Tim and Cristy Long (2)

David M. and Gladys D. Longacre (10) Carole Lovelace (1) Sharon and Rob Lovell (1) William B. and Mary Ludwick (2) H. L. Jr. and Mildred R. Maiden (4) Robert and Kathryn Manley (10) Va Marston (1) Lareth L. May (10) Juanita May (1) Patricia C. McGee (1) Elmer W. and Violet J. Metzler (3) Diane O. Mincey (12) Robert B. Jr. and Jeanne S. Minnich (26) Louis and Kathryn Mole (3) Ernest L. Jr. and Barbara B. Mongold (1) Richard G. Moore (1) Harold R. and Betty Lou Morris (3) Victor and Phyllis Morrison (2) Donald L. and Marie I. Moyer (2) James W. and Aldine M. Musser (2) Reverend K. Roy Nilsen (3) Epifania Nunez (9) Joan M. Painter (7) Eugenia E. Parker (13) Elizabeth Pazur (2) Richard Piepenbrink (1) Charles R. Raisner (2) Joseph E. and Gloria A. Randolph (1) Lawrence Emory and Sharon Elaine Ressler (1) Terry L. and Christine P. Richards (1) Martin J. Ritchie (2) Jimmy D. and Nancy J. Russell (3) Cora C. Scruggs (4) Orlin D. and Sandra F. Shank (1) William N. Shawger Jr. (6) Janet L. Sheffer (2) Bobby L. Shifflett (1) Harvey E. and Joan F. Shifflett (2) Mary K. Shipe (1) Harry L. Shoemaker (12) E. C. and Ruth C. Showalter (2) Paul F. and Wanda L. Showalter (6) Shyam P. and Rameshwari P. Shrestha (4) L. Ronald and Bonnie V. Smith (3) Victor J. II and Cheryl B. Smith (13) Billy D. and Sharon W. Smitherman (2) Lana Bennett Sours (1) Jayne M. Stargel (2) Tetyana and Pylyp Stryuts (1) Dorothy Mae Taylor (1) Patricia Thomale (1) P. Conner Thomas (1) Rachel Thomas (3) Jacqueline G. Towers (32) Janette R. Tusing (6) United Way of South Hampton Roads (3) Catherine E. Vann (2) Robert J. Vogel (2) Sarah H. Wichael (3) Rebecca Wicklline (1) Mario Williams (1) Michael L. and Brenda P. Witt (1)

Memorial Gifts All Babies Who Died of Cancer Hector Urbina Frances Armentrout Leroy B. Jr. and Mary Ellen Earhart G. Richard McClung Jr. and Susan H. McClung Charles C. Shiflet Jr. Ruth Batten Sam L. Batton Harriston United Methodist Church Robyn R. Ludwig Frank H. and Tara M. Vetting

Douglass Dye Dr. Lawrence W. and Barbara S. Roller

Kenneth Steeber Virginia J. Steeber

Robert Scott Edwards Wilbur W. and Mabel E. Brewer Frances S. Hood Rick and Joy Pulley

Benny Stout Gloria Stout

Janet Flaten Dale Flaten Dr. Joseph E. Gardner and Janet L. Gardner Dr. Steven E. and Kathryn J. Gardner Jim Glanzer Sherrill Glanzer

Ruth Batten, Hospice Volunteer Jill Wade

Donald W. Hinkle Shelvy K. Hinkle

Jennifer Barbour Biller Cliff and Amanda Alt Sandra Clatterbuck Monty H. and Lana W. Cox Patrice B. Doerries Lynda O. Estep Keith and Naoma P. Floyd Gregory V. and Elizabeth Lea Flynn Claude M. and Kathleen T. Gantt Kim Guthrie Scott A. and Beth M. Hinegardner Michael C. and Ann M. Jones K. Michael and Susan C. Kline Col. William P. and Frances A. Menefee Nelson L. and Janet W. Reinsch Jennifer Ryman John M. and Marie A. Ryman Jane Shumway Sons of the Confederate Veterans, Inc. Strasburg High School Dan C. and Kathleen Vance Watt, Tieder, Hoffar & Fitzgerald LLP Carolyn J. Watts and Kelly D. Justus

Paul Holdaway Howard M., Jr. and Rebecca S. Spurlock

Lois Blosser Jessica Septon Terri Berry Bowman C. Dennis Armentrout Dr. Cecil D. Bradfield Nancy R. Bradfield Betty Jo Cline Chester L. and Nancy B. Bradfield Jerry L. and Kaye G. Brunk Philip D. and Sue L. Hutchinson Sharon L. Kiracofe Mossy Creek Presbyterian Women of the Church Janice L. Pence Richard Davis Diane C. Davis

Sandra E. Hudelson William R. Hudelson Maynard Johnson Johnna Lee Johnson Janet Mae Jordan Horst and Deborah Locher Harold J. McCann Leonardo DRS Elizabeth Raines Michon Amelia Michon Hall Carmen Strite Miller William G. and Hope Shank Stoner

Doug Wager David L. and Tammy J. Jordan Horst and Deborah Locher Denis W. and Judith Ann Post Janet L. Wager Jean Ann Wall June T. Branner Anne Terese Colao Coworkers of Ann Wall: Michael Cowin, Eric Griffin, Greg Needham, Emanuel McGirt, Margot Clark, Ashley Gaskins and Donna Raynor Charles W. Sr. and Judith W. Hartman Emanuel and Dorothy McGirt Dewain H. and Joyce W. Rahe Larry A. and Patsy L. Will Liz Worley Heather Roberts Frances E. Wyant (Mother) Evelyn S. Hedrick

Honor Gifts All the Team at Sentara RMH Rich and Micheline Lehman Sarah Barnes Karen Barnes Melissa Bowman Heather Roberts

John Minnis, Jr. Jacquelyn K. Brooks Stan and Judy Gray

Dr. Harry S. Crawford III Roger L. and Mary Frances Lam

Stanley L. Mitchell Rennie Mitchell McAllister

Dr. Punkaj K. Dua Karen Wood Grizzard

Lois M. Oster Charles Oster

Dr. Scott Fowler Ramniklal J. and Vijayaben R. Goradia

Dorothy Price and Evelyn Stultz Rodney and Ruth Stultz

In honor of loved ones, Dillion and Elizabeth Good JR and Cheryl Good

Arnold Propst S. Walton Propst

Megan A. Grizzard Karen Wood Grizzard

James L Simmons Christine P. Simmons

Brandy Hallebaugh, NP, SRMH South Main Medical Center Susan L. Schuckman

Janet Smith Julia H. Hawse John Sponaugle Sam L. Batton Ricky L. and Cheryl G. Chandler Anza Evans

Nancy McSherry Henderson Bill and Carolyn Taylor Wanda Hollen, ER Nurse, Retired Terri Lynn Denton

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friends of the

RMH Foundation Joyce E. Horst, Nurse A. Kenneth and Mildred L. Ranck

Sentara RMH CCU Team Allen M. III and Susan L. Clague

Ayla Landis Hottel Carolyn T. Landis

Sentara RMH Critical Care Unit Team Ronald P. and Julianne Jilinski

Anil and Shaila Solanki Juanita M. Taylor Wallace W. and Mary Alice Weaver Louise A. White Garland J. and Shelvy Williams

Dr. Johnson, Dr. Rash and Sentara RMH Coronary Team Raymond F. and Sharon K. Schulte

Sentara RMH DaVinci Center Team and the whole staff Dr. Robert F. Jochen VMD

The whole staff, Sentara RMH, especially Dr. Ford Judith D. Roop

Paul Johnston, P.A., Sentara RMH South Main Street Sandra F. Morris

Sentara RMH East Rockingham Health Center and the whole staff Mr. and Mrs. Ed Long, Jr.

Deb Thompson, Retirement, Director and SRMH Volunteer Services Team Denise A. Whitman

Sentara RMH Emergency Department Michael A. and Carolyn S. Gardner

Deb Thompson, SRMH Volunteer Department, Happy Retirement Pamela R. Mason

Ray King Family Lewis and Arleen Forsheit Dana Landacre and SRMH Emergency Room Team Charles R. Sr. and Constance E. Hoover Dr. Timothy C. Landes, MD Mildred F. Branner

Deb Thompson’s Retirement Pat Messner

Sentara RMH Hahn Cancer Center Entire Staff Robbie Jean Zirkle

Diane E.Trobaugh Laura G. Price

Dr. David McLaughlin, all Nurses and Staff John and Mary Strickler

Sentara RMH Hahn Cancer Center Radiation Oncology Team Richard G. and Claudia J. Childs

Dr. Emily J. Turzanski, DO Eric P. and Lein T. Jenkins

Dr. Jason Moore, Sentara RMH Vascular Surgery Team and the whole staff Charles and Ruth Mullins

Sentara RMH Hahn Cancer Center Team Arthur E. Parente Esther J. Strawderman

Dr. Christine J. Ou John C. Shank

Sentara RMH Hahn Cancer Center Team and the whole staff Richard L. and Pamela B. Wilkins

Dr. Christine M. Urbanski Garry W. and Peggy R. Miller Charleen C. Pinnell S. Walton Propst Roberta (Robbie) and Robert K. Wilkins

Nancy Mandeville Susan K. Moyers

Amy Raynes, Nurse Clara Jean Comer Sarah and Stacey Rider Michael L. and Roxanne M. Rider Sandy Riner Paul and Laura Riner Dr. Edward Sandy James B. Richardson, Jr. Melissa Shawger, Sentara RMH X-ray Tech Christine W. Burner Amber L. Showalter James M. and Carol S. Showalter Twila Showalter Larry Showalter Sentara RMH 3rd Floor Team Charles N. and Sandra K. Tuller Sentara RMH 4 West Team Ilene N. Smith Sentara RMH Cardiology Specialists Team Owen R. and Judy M. Burkholder Sentara RMH Cardiology Team Patricia T. Wichael

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Sentara RMH Emergency Department Team Catherine E. Boyd Walter P. McNett

SUMMER 2021

Juanita Taylor Lynn and Diane Trobaugh Juanita Taylor 100th Birthday Pat Messner The whole staff, Sentara RMH John W. Alter Jr. Clive A. Babkirk Jr. Edith J. Banks Sally Brown John G. Clem Charles J. Frye Flora L. Kagey Lee and Brenda E. Knicely Sifet Korjenic Judy M. Lindamood Charles E. and Cynthia A. Litten Teresa L. Louden R. Larry Martin Wayne E. and Carolyn H. Miller Rick Poland Marjorie T. Ridgway John D. and Marilyn K. Ritchie Beatrice R. Rolon Rose Schuck David W. Shaffer Jr. Alton K. and Helen W. Shipe Hazel K. Shirk Delbert D. Slater

Dr. Christine Urbanski and Sentara RMH Oncology Team Roberta (Robbie) and Robert K. Wilkins Dr. VerNooy, nurse Jacquie and the whole staff, Sentara RMH Loren C. and Elaine E. Good Dr. Weldearegay, Dr. McDonald, Dr. McLaughlin, Sentara RMH Cardiology Surgery, Paula Lesca, RN., Christina Seto, RN, and George Dr. Ronald A. Campbell Elizabeth Worley Catherine Worley Dr. Yuriy Zhukov Allen M. III and Susan L. Clague

S E N TA R A S P O R T S M E D I CI N E

THE HOME TEAM ADVANTAGE There’s no better time to get back in the game.

The Sentara Sports Medicine team is a caring group of sports medicine physicians, surgeons, physical therapists, physician assistants and athletic trainers. If an injury sidelines you or your loved ones, come see us. Sports-related injuries | Concussions | Shoulder injuries | Rotator cuff injuries Total shoulder replacement | Arthroscopic surgery | Fracture care Carpal tunnel syndrome | Foot and ankle injuries

For appointments, call 540-689-5500 or visit Sentara.com Follow us on Facebook and Twitter, @SentaraRMH.

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

S E N TA R A R M H M E DI C A L CE N T E R

SENTARA RMH NAMED A FORTUNE/IBM WATSON TOP 100 HOSPITAL

For 109 years, Sentara RMH Medical Center has been dedicated to the health of our community. While healthcare is constantly evolving, one thing never changes: our commitment to serving you. IBM Watson Health has identified the top hospitals from a rigorous evaluation of 2,675 short-term, acute care, non-federal hospitals in the U.S. The annual list recognizes excellence in clinical outcomes, operational efficiency, patient experience, and financial health.

sentara.com Follow us on Facebook and Twitter, @SentaraRMH.