President, Sentara RMH Medical Center
As we wrap up 2022, I would like to reflect on our accomplishments this year at Sentara RMH and thank all of our team members for their dedication to our mission: to improve health every day.
That dedication is continually on display inside our hospital walls with the exceptional, award-winning care we provide, as well as the incredible compassion and emotional comfort given to our patients—many of whom are going through the most frightening moments of their lives.
become more accessible, right here at home.
Joseph Funkhouser II | Chair
Jerry Benson, PhD | Vice Chair
Devon Anders
Arthur Dean II
Morris Fendley, MD
C. Wayne Gates, MD
Douglas Moyer President
Donna Hahn, DNP, RN, NEA-BC Vice President, Chief Nursing Officer
Catherine Hughes, MBA, RD Vice President of Operations
Robert Garwood, MD Chief Medical Officer
EDITORS
Alyssa Pacheco Bob Grebe
CONTRIBUTORS
Luanne Austin
Preston Knight
Lisa Smith
Jennifer L. Stover
Andrew Shurtleff
Tommy Thompson DESIGN Picante Creative
Two such patients, Nora Malinowski and Ingrid Shipp, recently received treatment for breast cancer at Sentara RMH from Dr. Emily Turzanski and her staff. Nora was initially frightened following her diagnosis in April 2021. Thankfully, as you’ll see on page 19, she found hope and reassurance from the care she received.
Ingrid, who had gone five years without getting a mammogram, discovered a lump in her breast due to an innocent yet fortunate accident. Following her treatment, she spoke about her appreciation for the “woman-to-woman relationship” she had with Dr. Turzanski. Today, both Nora and Ingrid are doing well, appreciative for the compassionate, high-quality care they received at Sentara RMH.
Another reason I am proud of Sentara RMH has to do with the services and specialized treatments we provide—treatments that, not so long ago, patients would had to have traveled out of our region to receive. On page 6, for example, Dr. Matthew Cauchi explains a cardiological condition known as mitral valve regurgitation, which affects millions of people in our country. Typically caused by wear and tear to the heart, this condition can now be treated locally at Sentara RMH through a number of new and revolutionary catheter-based interventions. As we bring new techniques and technologies to our hospital, advanced treatment options
Our team’s dedication to our mission is frequently on display out in our community as well. If you have visited any of the local fairs or cultural events around the Valley recently, you’ve likely encountered volunteers from Sentara RMH staffing our community outreach booths. These events are about more than exposure and goodwill, however; they also allow our team members to provide crucial—and sometimes timely— health screenings.
Many of you may know Chaz Haywood, clerk of the circuit court for Rockingham County and the city of Harrisonburg. As you will see on page 23, when Chaz visited the Sentara RMH booth at the Rockingham County Fair this summer, a routine screening revealed his blood pressure to be dangerously high. Thanks to that quick visit to our booth, he went to his primary care doctor, who prescribed medication to regulate his blood pressure and help protect his overall health.
And in yet another recent success story, this fall Sentara provided more than $5 million in grants to nearly 100 agencies in Virginia and Eastern North Carolina. Locally, 12 community partners received more than $518,000 (you can find the list of recipients on page 17).
Finally, I would like to wish you all a safe, joyous and healthy holiday season and once again thank you, our community, for your continued trust and support of Sentara RMH.
Respectfuly, Doug Moyer President, Sentara RMH Medical Center
DougCuring with Kindness Breast cancer patients reflect on treatment at Sentara RMH
23 Bringing Health Care on the Road Screenings at events throughout the year help improve the health of community members
Rising to the Occasion
Hospital teams recount efforts to respond to increased demands during COVID
My previous column, which provided summer health tips, was a huge success—and by “huge success,” I mean nobody threatened to sue me after following my advice. So I thought I would now share my wisdom related to the upcoming winter months and the holiday season.
Let’s start with the topic of food. Tip #1: When you sit down to eat your big holiday meal, try not to take the names of the dishes literally. Take stuffing, for example. Unless you’re a taxidermist working on yourself, it’s not an invitation to literally stuff your body full of this tasty treat, despite the temptation to do so. And please, if there are peas on the table, do not take this as a literal directive.
Which brings us to New Year’s Eve and tip #2. For many, the top health risk on Dec. 31 isn’t foodrelated, but drink-related. Many people assume the physical laws of the human body don’t apply on holidays and assume it’s not possible to drink too much on New Year’s Eve—because, you know, it’s New Year’s Eve. But I’m here to tell you, alcohol is not known for keeping a calendar. Even if it did, it would probably forget what day it was—since, you know, it’s alcohol.
Now, I’m not one who tends to overimbibe. A wild night for me, in fact, is two glasses of wine. One New Year’s Eve, however, I ate at a restaurant where they paired a cocktail with each course of dinner. That would have been fine if I were at my favorite fast-food chicken place, since a chicken dinner is just one course (or, at least, it comes in one box). But this restaurant had so many courses that after I drank the accompanying cocktails, I walked down a flight of steps in the restaurant and literally couldn’t figure out how to get back up.
Steps are pretty straightforward and rarely require an instruction manual, but for whatever reason, I was completely befuddled. I tried calling out, “but it’s New Year’s Eve,” and that’s when I realized that the alcohol didn’t care.
Moving from culinary concerns to weather, winter often brings with it a snowfall or two (or several). When the forecast calls for a lot of heavy snow, I often shovel my driveway when it’s only partially covered, even if it’s still snowing. My neighbors laugh at me as I’m shoveling while the flakes are still coming down—but when the heavy stuff is over, the remaining accumulation is much more manageable for me, whereas they’re now stuck dealing with dangerously heavy piles. Personally, I would rather shovel the equivalent of two light snowfalls than struggle with one that could injure my back. So who’s laughing now, neighbors? (Actually, they probably still are, because I usually fall down while shoveling, and not because I’ve been drinking.)
Which brings me to the topic of black ice. The ninja of weather risks, black ice can be right in front of you, and you won’t even know it’s there. It may not technically know karate, but black ice can throw you to the ground quicker than Bruce Lee in combat with Humpty Dumpty. Since you don’t want to have doctors trying to put you back together again, remember that if it has been below freezing outside, be extra careful where you step. You know the saying, “Dance like no one is watching”? My advice with black ice is to walk like your neighbors are watching. Because they always are.
Have a wonderful—and safe—winter!
Sentara RMH Medical Center is pleased to welcome the following new providers into the hospital community.
Ahmad K. Abdul Ali, DO
General Surgery
Sentara Surgery Specialists (540) 689-5800
Leodegario Alonso, PA-C
Family Medicine
Sentara South Main Health Center (540) 564-7300
Erica L. Formato, MD
Family Practice
Staunton Primary Care and Therapy Services (540) 437-7920
Giorgio L. Guiulfo, MD
Colorectal & General Surgery
Sentara Surgery Specialists (540) 689-5800
Tynessa W. Hazelwood, PA-C
Cardiology
Sentara Cardiology Specialists (540) 689-7400
Kristin A. Hom, DO
Pulmonary Medicine
Sentara Pulmonary and Critical Care Management (540) 689-5600
To get connected with one of our providers, or for more information on any caregiver at Sentara RMH, please call 1-800-SENTARA.
Grace Krouse, PA-C
Emergency Medicine US Acute Care Solutions
Gina N. Legalluppi, PA-C
Orthopedic Surgery
Sentara Orthopedics & Sports Medicine Specialists (540) 689-5500
Stephen G. Legg, MD
Urology
Blue Ridge Urological, PC (540) 689-5900
Matthew R. Risendal, DO
Urology
Blue Ridge Urological, PC (540) 689-5900
Sarah Rydock, PA
Gastroenterology
Sentara Gastroenterology Specialists (540) 564-5800
Bryce C. Simes, DO
Internal Medicine
Sentara East Market Street Health Center (540) 564-5666
Mark D. MacKay, MD Family Practice
Sentara Timber Way Health Center (540) 901-0800
Mario E. Montalvo, DO Pulmonary Medicine
Sentara Pulmonary and Critical Care Management (540) 689-5600
Parth A. Patel, DO
Anesthesiology
SMG Anesthesia Specialists, LLC (757) 363-6230
Mark S. Peterson, PA-C
Palliative Care
Sentara Palliative Care Specialists (540) 564-5600
Mekaela K. Smith, DO Family Practice
Sentara Integrative Medicine Physicians (540) 564-5400
Jeremiah Stinson, PA-C Emergency Medicine US Acute Care Solutions
Kristina M. Wessels, MD Anesthesiology
SMG Anesthesia Specialists, LLC (757) 363-6230
Sentara RMH has been recognized with the American Heart Association/American Stroke Association’s Get With the Guidelines®–Stroke Gold Plus/Target: Stroke Honor Roll Elite/Target: Type 2 Diabetes Honor Roll Award. This honor demonstrates the commitment of Sentara RMH team members to ensuring that stroke patients receive the most appropriate treatment, according to nationally recognized, research-based guidelines using the latest scientific evidence. It takes passionate and highly dedicated teammates to achieve such levels of recognition. Congratulations—and thank you—to all of our Sentara RMH team members!
In August, Sentara Medical Group expanded its regional impact by opening Sentara Primary Care & Therapy Center at 103 Community Way in Staunton, Va.
Sentara RMH Medical Center has received Platinum recognition by the American College of Cardiology’s NCDR Chest Pain–MI Registry Performance Achievement Award for 2022. Seven Sentara Healthcare hospitals received the Platinum Award—the highest achievement, which is bestowed upon just 240 hospitals nationwide. This is the fifth-consecutive year the American College of Cardiology has recognized Sentara RMH’s commitment to and success in implementing a higher standard of care for heart attack patients.
The new 11,000-square-foot clinic was established to offer quick, convenient care for patients 5 and older, providing primary care services, walk-in care for minor illnesses and injuries, physical therapy, and X-ray services—all together in a centralized location.
“We are excited about the new facility, and to be able to provide expanded services to the Staunton area,” says Kurt Hofelich, vice president of ambulatory services for Sentara Medical Group. “We hope the new facility makes health care more convenient and allows people access to the services they need, without having to leave the community.”
Staunton native Erica Formato, MD, began seeing patients at the new location on Monday, Aug. 22. Patients can either walk in, call ahead to make an appointment or reserve a time online at SentaraPrimaryCareAndTherapy.com.
“Sentara’s mission to improve health every day extends to the entire community we serve,” says Doug Moyer, president of Sentara RMH Medical Center. “Staunton residents have long been a part of that community, and we are honored to continue to find ways to meet their healthcare needs. With this new practice, we are now able to provide the same highquality care for minor injuries and illnesses at a more accessible location.”
The heart is essentially a series of tubes, chambers and doors that separate very different and synergistically functional compartments. Each of these parts can fail, unfortunately, resulting in various symptoms that can range from the subtle, taking weeks or months to manifest, to the severe, which can play out over a matter of hours or days. In the case of the heart’s four valves—its “doors”—problems can arise when they leak and fail to close (regurgitation) or have difficulty opening (stenosis). Much of the research of the past decade has focused on the two doors on the left side of the heart, the aortic and mitral valves. When these valves are dysfunctional, an increase in pressure inside the chambers of the heart can occur, which can then translate back into the lungs, resulting in shortness of breath, swelling in the legs, early fatigue and reduced exercise tolerance.
Most importantly, if these conditions are left untreated, they can result in irreversible cardiac damage, multiorgan complications and even death. For the past two decades, NORMAL REGURGITATION
much of our focus in the structural heart field has been on the aortic valve, especially with the advent of transcatheter aortic valve replacement (TAVR), a minimally invasive treatment option that is now the standard of care for patients with aortic stenosis. However, the mitral valve recently has seen a surge in research interest, as more and more technologies and devices are being made available through clinical trials. The Sentara Heart Hospital in Norfolk, Va., has been at the center of many of these clinical trials, serving as an invaluable contributor to national research since the inception of the structural heart and valve intervention field.
The most common heart valve abnormality, mitral valve regurgitation, affects more than 2% of the world’s population. The prime reason for valve dysfunction, valve degeneration due to “wear and tear,” only increases with age—confirming the old adage, “the more it moves, the more likely it is to break.” Lying between the upper and lower chambers on the left side of the heart, the mitral valve consists of two leaflets inside a fibrous, saddle-shaped support structure that originates in the atrium, the upper chamber. The leaflets are tethered like a parachute to the bottom chamber, the ventricle, through two large muscles that move and flex with the pumping of the heart, opening and closing like a fish mouth. Mitral regurgitation can either be classified as degenerative (a problem with the valve leaflets) or functional (problems with other aspects of the heart that cause the mitral valve to be unable to retain its normal configuration).
Diagnosing mitral valve regurgitation first requires recognizing that the problem may exist in a patient, typically through detecting a heart murmur or other abnormal heart sounds. However, directly visualizing a leaking valve with a transthoracic echocardiogram is the best screening test, as it allows for evaluation of the origin and severity of a leak, as well as any collateral damage that may have taken place. Once the problem has been identified, a variety of other testing, including labs, advanced imaging, cardiac catheterization and exercise stress testing, can help determine whether the problem needs to be fixed and what the best way to fix it might be. While medications can be used to lessen symptoms, the only way to truly deal with a valve that fails to close properly is to either replace or repair the door. While this typically involves open heart surgery, historically there have been few options for patients—including the elderly and those with complex comorbidities—deemed too high-risk for surgery.
Over the past decade, however, catheter-based interventions have been developed and made commercially available in the United States to fill this treatment gap and improve quality of life for high-risk patients. These procedures include:
• TAVR for native and previously replaced surgical valves (valve-in-valve TAVR)
• transcatheter mitral valve replacement (TMVR) in patients with prior surgical replacement
• minimally invasive electrosurgical procedures like the LAMPOON, BASILICA and transcaval access techniques
• closure of selected adult congenital heart defects
• alcohol septal ablation for hypertrophic cardiomyopathy
• implantable cardiopulmonary sensors that allow for remote monitoring in heart failure patients
• closure of the left atrial appendage in patients with atrial fibrillation who cannot take blood thinners
• and, in the case of mitral valve regurgitation, transcatheter edge-to-edge repair (TEER)
All of these procedures, except for TEER, are currently available at Sentara RMH. These revolutionary technologies have been used to treat tens of thousands of patients worldwide, with overwhelming success—and they are only a few of the revolutionary treatment options that will become available over the next decade.
Since these technologies have so far been primarily centered in large university hospital systems, many patients unfortunately have been forced to leave their communities in search of treatment options. However, over the past two years—and in the midst of a crippling global pandemic—Sentara RMH physicians and staff have pushed to expand our services and offer TEER as a local option to treat patients with mitral regurgitation. Thanks to the commitment and collaboration of the Sentara RMH Structural Heart and Valve team, general cardiology and advanced cardiac imaging divisions, as well as our cardiothoracic surgery and cardiac anesthesia teams, TEER will be available at our hospital beginning in winter 2022.
Despite its cutting-edge nature, TEER actually mimics an old surgical procedure that uses a single stitch through the center of the fish mouth of a leaking valve, reducing it to two smaller holes. This effectively reduces the severity of the leak, lowering the pressure within the heart and lungs and making symptoms more manageable. Performed through a vein in the leg, similar to a heart catheterization, the procedure involves creating a small hole in the heart’s top chambers to allow access to the mitral valve on the left side of the heart. Then a small, clip-like device is positioned below the valve, and two gripper arms grab each leaflet, pulling them together and thereby reducing the leak. One or more clipping devices can be deployed to optimize results, based on the size, shape and residual leak seen
after each deployment. After the procedure, the vein in the leg is closed with a small stitch. Patients typically stay one night in the hospital before being discharged, with an expected recovery time of three to five days. The most important determinant of success in this situation is selecting the right patients for the procedure, which makes the multidisciplinary Heart Team at Sentara RMH more crucial than ever. Currently, TEER is approved for patients at high or prohibitive risk for surgical repair and/or replacement, which remains the gold standard and is considered the most durable and reproducible option for treating certain types of mitral regurgitation. However, since surgery is not considered a viable option for individuals with functional regurgitation, where the valve leaflets are effectively innocent bystanders, TEER is the only FDA-approved treatment in such cases.
Adding TEER to our available services has been a mission of our Heart and Valve team since I arrived at Sentara RMH two years ago. By adding minimally invasive treatment for mitral valve disease to our arsenal, we will have the full complement of commercially approved advanced structural heart procedures to treat our neighbors, friends and family—without leaving the place we call home. Our mission as a multidisciplinary division of cardiology and cardiothoracic surgery is to keep advancing available technology, and we believe these advancements will have an enormous positive impact on the community we serve.
Our mission as a multidisciplinary division of cardiology and cardiothoracic surgery is to keep advancing available technology, and we believe these advancements will have an enormous positive impact on the community we serve.
Diverticulitis refers to inflamma tion or infection of the small pouch-like recesses, called diverticula, that can form in the digestive tract— especially in the lining of the colon, the lower portion of the large intestine. No one knows why these marble-sized pouches form, but a low-fiber diet may be one cause. Lack of fiber makes the colon work harder to eliminate waste, and this may cause diverticula to form in weak areas of the colon wall. Most people form diverticula at some point—especially after middle age—and most of the time they cause no serious problems.
The cause of diverticulitis is not fully understood, either, but doctors think the condition may arise from bacteria caught in pouches that happen to tear. Risk factors associated with a higher incidence of diverticulitis include age; obesity; lack of exercise; a low-fiber diet; smoking; and taking certain medications like ibuprofen, naproxen, steroids and opioids.
Diverticulitis can be very painful. Typical symptoms include persistent abdominal pain— especially in the lower left side—which may get
worse with movement; rectal bleeding; bloating; abdominal tenderness; constipation or, less commonly, diarrhea; nausea or vomiting; loss of appetite; and fever or chills. Diagnosis is typically based upon a history of symptoms, as well as blood tests and X-rays or computed tomography
Treatment depends upon the severity of the condition. Mild cases usually can be treated with rest, diet modifications, antibiotics and over-the-counter pain medications. In the majority of mild cases treated by these means, symptoms are successfully resolved.
Severe cases may lead to complications that include blockage of the colon; abscess, or the collection of pus in the diverticula; and peritonitis, or rupture of a diverticulum that releases its toxic contents into the abdominal cavity. Peritonitis is a medical emergency that requires immediate attention. Severe cases of diverticulitis may be treated by the insertion of a drainage tube in the case of an abscess, or by surgery if there is blockage, or if there is presence or significant risk of peritonitis.
The best way to avoid diverticulitis is to exercise regularly, eat a high-fiber diet and drink plenty of fluids to help your body handle the increased fiber intake.
Laryngitis is an inflammation of the larynx, the “voice box” that contains the vocal cords. It can be either acute (of short duration), or chronic (of long duration). Laryngitis typically results in a change of vocal quality, often described as hoarseness or a weak voice. Associated symptoms can include dry throat, cough, a tickling sensation that leads to repeated clearing of the throat, and/or a sore throat.
cords and experience laryngitis. Voice changes also may be caused by benign or malignant growths on the vocal cords. Frequently effective self-treatment measures for acute laryngitis include the following: Rest your voice and avoid talking as much as possible to give the inflammation a
Avoid smoking or drinking alcohol or caffeine, since those agents can dry out and
Drink plenty of water and use a humidifier to maintain moisture and lubrication in
Cover your mouth with a scarf or mask when going out in extremely cold weather. Moisten your throat by sucking on lozenges
A healthcare provider should be seen in cases where there is difficulty swallowing or breathing, or if you develop a high fever with laryngitis. Voice change that persists for longer than 3 weeks should be evaluated by a physician to determine the underlying cause.
Winter weather can present serious challenges and dangers to travelers. Avoiding dangerous driving conditions is always a good policy, so as much as possible, stay off the roads when the weather is bad or predicted to be dangerous. If you must venture out, be extra cautious and follow these safe driving tips.
• Know your route and keep informed on road conditions and the weather forecast.
• Travel with a fully charged cell phone, and keep family or friends advised of your route, as well as your departure time and estimated arrival time.
• Keep your tires properly inflated, and keep your gas tank at least half-full to avoid frozen gas lines.
• Do not use cruise control when driving in slippery conditions (heavy rain, ice or snow).
• Keep blankets and extra jackets, gloves and head coverings in your vehicle during cold weather, in case you get delayed or stranded in the cold.
• Take extra snacks, drinks and any necessary medications in your vehicle when traveling in winter.
• Keep a working flashlight and extra batteries in your vehicle at all times, along with a good ice scraper, snow brush and can of lock deicer.
• Take a bag of cat litter in your vehicle for use in gaining traction if your wheels start spinning on ice or packed snow.
• Drive slowly, and keep an eye on other vehicles around you.
• Accelerate and slow down slowly and evenly. When on slippery roads, give yourself plenty of room and time to slow down and stop.
• If you start to skid, don’t hit your brakes—instead, gently steer the vehicle in the direction you want to go.
• To conserve gasoline, run the engine just long enough to remove the chill.
• Stay with your vehicle, rather than trying to walk in deep or blowing snow— your vehicle can provide shelter and make it easier for you to be spotted. Tie a colored piece of cloth around your antenna or place it in your window to help make you more visible.
• Make sure your exhaust pipe is not clogged with snow, ice or mud, and keep something in the vehicle that will allow you to unclog the exhaust pipe, if needed.
You may know that our bodies need calcium to maintain strong bones and teeth, but did you know that calcium also helps our nerves transmit messages throughout the body and helps our blood clot? Since the body loses calcium every day through perspiration, urination and other means—and because the body can’t make its own calcium—we need to replace the calcium we lose each day by eating calcium-rich foods.
1,000 mg per day: Women 50 and younger Men 70 and younger
Salmon Sardines Shrimp Soybeans Spinach
Most people probably think of dairy products as good food sources of calcium, but you can also get this essential mineral by regularly eating these calcium-rich foods: Broccoli Collard greens Figs, dried Kale Okra Oranges
1,200 mg per day: Women 51 and older Men 71 and older
Also be sure also to get plenty of vitamin D each day. The body needs vitamin D to help it absorb calcium.
Here are six things you can do to lower high blood pressure or avoid it altogether:
• Lose weight.
• Get regular physical activity— at least 30 minutes most days of the week.
• Don’t smoke.
• Reduce your sodium (salt) intake.
• Drink alcohol in moderation, or not at all.
• Take blood pressure medication, if prescribed, as your doctor indicates. If you have high blood pressure, make sure you take care of it. Not doing so can lead to heart disease, stroke, kidney failure and other serious problems.
As the temperature outside gets colder, we tend to crank up the heat in our homes. But heaters remove moisture from the air, causing our skin to get dry. To prevent dry skin, fine lines and wrinkles, the American Academy of Dermatology recommends a modified skin care routine during colder weather:
Baths and showers. Limit baths and showers to 5-10 minutes, and use warm water rather than hot. Wash with a gentle, fragrancefree cleanser, and lightly blot skin with a towel to dry.
Moisturize immediately. Applying a moisturizer will trap much-needed moisture to help soothe dry skin.
Wear gloves. The hands often are the first place dry skin appears, so be sure to wear gloves while going outside in the winter, performing tasks that may require hands to get wet, and exposing hands to chemicals and greases.
Humidify. During winter the humidity in the air drops, and using a humidifier puts moisture back into the air, helping to fight against dry skin. A simple remedy? Vaseline is an excellent moisturizer, and one of the most economical. It should be applied regularly after a warm bath or shower. And for dry, cracked hands or feet, apply Vaseline liberally before bed and cover with white cotton gloves or socks.
If, despite your best efforts, your dry winter skin doesn’t start to feel better, see a dermatologist, as you may require a prescription ointment or cream. A dermatologist can examine your skin and explore treatment options with you.
Do you have to become a vegetarian or vegan to benefit from plant-based eating?
Of course not! Introducing a plant-based diet merely means increasing your intake of whole grains, cereals and cereal products, fruits, vegetables, legumes, nuts, and seeds while trying to limit intake of animal products like meat, fish and dairy.
BY SHILA RAJBAHAK, RDNFor starters, a plant-based diet rich in fruits, vegetables and whole grains can help you increase your fiber intake, which in turn can help improve cholesterol levels by increasing high-density lipids (HDL or “good” cholesterol) and lowering lowdensity lipid levels (LDL or “bad” cholesterol). Additionally, the naturally low cholesterol content of plant foods contributes to a reduction in overall dietary cholesterol intake.
Fruits and vegetables are also abundant in antioxidants, which are thought to protect cells against harmful substances known as free radicals that can play a role in causing cancer and heart disease. Plant-based eating also can help with weight management. In addition, studies have shown that vegetarians generally have higher intake than nonvegetarians of vitamins A, C and E, as well as thiamine, riboflavin, folate, calcium, magnesium and iron.
To help improve heart health, the American Heart Association encourages adopting a Mediterranean-style diet, which is abundant in minimally processed plant-based foods such as
fresh fruits and vegetables, nuts and whole grains; rich in monounsaturated fat from olive oil; lower in saturated fat, meats, dairy products, sugary sweets and processed foods; and higher in fish and other seafood. Review of multiple studies from 2019 has shown better cardiovascular health outcomes from Mediterranean and plant-based diets, including reduced rates of coronary heart disease, ischemic stroke and overall cardiovascular disease.
Get creative with fruits and vegetables:
• Use fresh fruit as a topping on oatmeal or as a side with toast or pancakes.
• Eat fresh vegetables as a snack or in a salad.
• Use fresh vegetables like spinach and fresh or frozen fruits to prepare a smoothie, and top with nuts and seeds.
Explore different ways to prepare vegetable dishes:
• Boiling and simmering: Make vegetable soups and broth to eat during the colder months.
• Steaming is one of the best cooking methods for preserving nutrients, as it leads to less loss of the water-soluble B vitamins. Steam vegetables like broccoli, spinach, lettuce, corn and green beans to accompany your meal.
• Microwaving is an easy and convenient way to cook vegetables when you’re short on time. Choose a microwavable frozen vegetable bag without sauce, to keep sodium levels down.
• Grilling and broiling: While grilling meat in your backyard or on a camping trip, throw in vegetables like zucchini, tomatoes and peppers—rather than packaged foods like chips—to serve as sides.
• Roasting and baking: Roast vegetables when you don’t have much time to prepare. Throw chopped vegetables of your choice on a baking sheet with plant oil (olive or canola) and spices, and let the oven do the work.
• Stir-frying: Taking less time and using less fat, stir-frying is better for heart health than other methods like deep frying. Use a small amount of plant oil to stir-fry with vegetables, meat and a starch of your choice.
Spices and aromatics: The American Heart Association recommends consuming no more than 2,300 milligrams of sodium per day. Instead of salt, use seasonings like garlic powder, onion powder, lemon juice and pepper to flavor vegetables and make them more appetizing. Freshly minced garlic, chopped onions, celery, tomatoes, carrots, mushrooms, parsley, thyme and cilantro also can help enhance flavor without sodium.
Meatless Mondays: Setting aside a day each week to have meatless meals is a great way to eat more fresh vegetables. On these days (Monday or any other day you prefer), you can also use meat substitutes like tofu, chickpeas and seitan (made of wheat gluten) to increase your protein intake.
Alternatives to Dairy Instead of whole milk, dietitians advise using 2% or 1% milk for better heart health. In addition, there’s a wide selection of plant-based milk products available that naturally have lower cholesterol levels and are great alternatives for those who are lactose intolerant. Here’s a quick overview of some plant-based milk options:
• Soy milk: Highest in protein among all alternatives to cow’s milk
• Oat milk: Good fiber content but low in protein
• Rice milk: Comparable in calories to cow’s milk but rich in carbohydrates
• Almond milk: Lower in calories but higher in fiber than cow’s milk
• Coconut milk: Low in calories but rich in saturated fat
Ingredients
2 tablespoons olive oil
1 large onion, chopped
4 garlic cloves
9 ounces cremini mushrooms, sliced 1 tablespoon flour
1 teaspoon thyme
2 teaspoons Dijon mustard
½ teaspoon black pepper
4 cups vegetable stock
1 teaspoon lemon juice
8 ounces uncooked rotini pasta
Fresh parsley
1. Heat the olive oil in a pot on medium-high heat, then add the onions and garlic. Saute for 2 minutes.
2. Add the mushrooms and saute for 5-6 minutes until the mushrooms are golden brown.
3. Add in the flour, thyme, Dijon pepper, vegetable stock and lemon juice. Mix everything together and bring the mixture to a boil.
4. Add the pasta, cover the pot and cook on medium-low heat for 8-10 minutes until the pasta is cooked through.
5. Top with fresh parsley and serve immediately.
Nutrition:
Serving size: ¼ of recipe. Calories 269, fat: 9 grams, carbohydrates: 38 grams, fiber: 2 grams, protein: 10 grams
2 tablespoons extra-virgin olive oil
1 large yellow onion, chopped ½ teaspoon sea salt
1 (3-pound) butternut squash, peeled, seeded and cubed
3 garlic cloves, chopped 1 tablespoon chopped fresh sage ½ tablespoon minced fresh rosemary 1 teaspoon grated fresh ginger 3-4 cups vegetable broth
Freshly ground black pepper Chopped parsley
Directions
1. Heat the oil in a large pot over medium heat. Add the onion, salt and black pepper to taste. Saute until soft, 5-8 minutes.
2. Add the squash and cook until it begins to soften, stirring occasionally for 8-10 minutes.
3. Add the garlic, sage, rosemary and ginger. Stir and cook for 1 minute, until fragrant. Then add 3 cups of vegetable broth. Bring to a boil, cover and reduce heat to simmer. Cook until squash is tender, 20-30 minutes.
4. Let cool slightly and pour soup in a blender, working in batches as necessary. Blend until smooth. If soup is too thick, you can add an additional 1 cup of vegetable broth.
5. Top with parsley and serve.
Nutrition:
Serving size: 1 cup. Calories: 80, fat: 3 grams, carbohydrates 11 grams, fiber: 2 grams, protein: 3.5 grams.
Like regular cow’s milk, plant-based milk can be consumed plain or added to coffee, smoothies and other recipes. While each type of plant-based milk has its own advantages, soy milk can be a good choice if you’re concerned about not getting enough protein in your diet.
While we’re on the topic of soy and soy milk, I would also like to address some myths and misconceptions about the consumption of soy products. Many people believe—mistakenly—that soy isoflavones have harmful health impacts, including thyroid and breast cancer. However, studies have shown that there is no cause-andeffect link between eating foods like soy milk, tofu, or edamame and getting breast cancer. On the contrary, research has shown that, since soy is high in both protein and fiber, consuming soy products actually can help prevent breast cancer and can have benefits for women with breast cancer.
Working more plant-based foods into your diet isn’t as challenging as you might think! Going totally vegetarian or vegan isn’t necessarily to take advantage of the benefits of a plant-based diet—making just a few small changes to the types of foods you eat can make a big difference and help lead to a lifetime of health benefits. To get you started on the road to healthier eating, try the delicious plant-based recipes on the left.
As an organization, we’re driven to improve health every day. And while we meet that mission through the healthcare services we provide to our patients and the coverage we provide to our health plan members, we know that truly improving health every day requires a much deeper commitment within our communities.
Through our grassroots partnerships with organizations throughout Virginia and Eastern North Carolina, we work to:
• Ensure greater access to behavioral health services for children, families and adults.
• Secure consistent, equitable access to nutritious food.
• Support targeted training for skilled careers in high-demand fields.
• Develop emergency and scattered housing solutions.
• Eliminate barriers to care and strengthen the cultural fabric of our communities.
entara held two grant cycles in 2022, providing investments to organizations working to advance health equity and create healthier communities. Most recently, 12 organizations in the Harrisonburg area received funding totaling more than $518,000. These investments expand on Sentara’s long-standing commitment to address social determinants of health and promote equitable access to care in traditionally underserved communities—efforts strengthened through numerous grassroots partnerships with community and faith-based organizations.
“Addressing the most pressing needs of our communities and improving overall health and wellness are the foundation of our mission at Sentara,” says Sherry Norquist, MSN-RN, Sentara director of community engagement and impact. “We are hopeful that through our ongoing investments and collaboration with community partners and faith-based leaders who share our mission, together we will continue to create opportunities to advance health equity and eliminate disparities in the communities where we live, work and play.”
Sentara prioritizes funding for community partners and initiatives that align with our primary focus areas. The 12 local community partners receiving funding from the fall 2022 Sentara Cares grant cycle include:
AVA Care of Harrisonburg
Blue Ridge Community College Educational Foundation Inc.
Blue Ridge Free Clinic
Bridge of Hope Harrisonburg-Rockingham
Central Valley Habitat for Humanity Foundation for Rehabilitation Equipment and Endowment (FREE) of Harrisonburg
Our Community Place Shenandoah Housing Corporation Shenandoah LGBTQ Center
The Arc of Harrisonburg and Rockingham
The Community Foundation of Harrisonburg and Rockingham County
The Sentara Cares program strives to foster sustainable community partnerships around social determinants of health—specifically housing, food security, behavioral health services, skilled career training and equitable access to care—and we cannot do this work alone.
Our 2023 grant cycles will be open in February for the spring session and June for the fall session. Visit SentaraCares.com to learn more.
Ingrid Shipp was having a pretend sword fight with her son-in-law when she leaned in as he tapped her with his sword. That silly moment in September 2021 may have saved her life. Examining the resulting bruise later that day, she felt the lump. »
“I decided to get a mammogram and was advised to get the lump biopsied,” says Shipp, 66, a poultry farmer in the Melrose area of Rockingham County.
The biopsy showed it was cancerous. “A very small, stage 1 tumor,” Shipp says. But no matter how small it was, she was alarmed by the news. She hadn’t been screened in five years.
“I didn’t have any relatives who’d had breast cancer and didn’t know anyone who had cancer like mine,” she says.
Upon meeting the breast surgeon at Sentara RMH Medical Center, Emily J. Turzanski, DO, Shipp felt it was “a very woman-towoman relationship,” which put her at ease. Dr. Turzanski was confident that Shipp could be cured.
“Dr. Turzanski helped put the cancer in perspective,” Shipp remembers. “Instead of being front and center of my life, she helped me put it in the back seat.”
In April 2021, Nora Malinowski began to suspect a problem with her breasts, so she made an appointment for a mammogram, but the results came out clear. Then, when she went for her annual mammogram in October, she was diagnosed with an aggressive breast cancer.
“I was so scared that first day at the hospital,” says Malinowski, 46, of Harrisonburg. “But everyone was so nice and so patient, and treated me so well.”
“From the moment we walked in the door, Dr. Turzanski and Nora took to each other like sisters,” recalls her husband, Sean. “She told Nora, ‘I’m going to cure you.’”
Malinowski took those words to heart, reminding herself daily of the doctor’s assurances.
“I was panicked, but she explained everything to me,” she says. “She gave me hope.”
To slow down the aggressive growth of the tumor, which had spread to the lymph nodes, Dr. Turzanski and the SRMH medical team decided to treat Malinowski with chemotherapy first.
By April 2022, Malinowski was ready for surgery, and Dr. Turzanski performed a lumpectomy. Afterward, the doctor gave Malinowski the good news that she was cancer-free.
Dr. Turzanski says that most women, upon receiving a diagnosis of breast cancer, become afraid and even terrified.
“My team and I work hard to help them through these intense emotions, taking it one day at a time as they battle breast cancer,” she says.
A practicing surgeon for nine years, Dr. Turzanski came to Sentara RMH in 2019. During her prior training in general surgery, she says she had excellent mentors who were breast surgeons. They encouraged her to continue doing breast surgery while working as a full-time general surgeon.
“I feel that I was called to be come a surgeon, and that it was God’s plan for my life,” Dr. Turzanski says.
That plan began to take a slightly different direction during the COVID-19 pandemic.
“With changes that came with the pandemic, it was necessary for me to take on even more of a focus in breast surgery, to help meet the community’s needs,” Dr. Turzanski explains. As a result, she shifted her entire practice to breast oncology surgery, supporting patients with both benign and malignant breast disease.
Dr. Turzanski also provides a number of other breast procedures, including performing surgical biopsies, draining breast infections, placing mediports for chemotherapy recipients, and placing catheter and balloon devices into the breast for patients who need radiation therapy.
“I am so happy to now be completely focused on this specialty,” she says. “I can’t imagine doing anything else.”
As it turned out, Shipp would have to have a lumpectomy, followed by several weeks of radiation.
“Dr. Turzanski was so reassuring, comforting and knowledgeable,” Shipp says. “She was good about telling me what was going to happen next, and she was always confident that it would be OK.”
As a matter of fact, Shipp even felt comfortable enough to ask Dr. Turzanski to time the surgery and treatments to fit in with the demands of her poultry business.
“I told her we were doing a longer-thanusual clean-out of the chicken houses that fall, which would give me a break from the day-today work,” Shipp says.
The scheduling worked out, and Shipp underwent surgery, followed by three weeks of radiation treatment. The whole experience was more pleasant than she had anticipated.
“All the nurses at Sentara RMH were so caring when I went in for radiation,” Shipp says.
Later, however, she developed a chronic seroma, also known as a chronic postoperative fluid collection, that required a second surgery to resolve.
“After that, I was fine,” she notes. “I just have a small scar under my armpit now.”
For her part, Malinowski’s experience turned out to come with some life-changing surprises.
The youngest of 17 children, Malinowski came to the United States from Mexico in 1993. With all of her extended family in Mexico, she had only her husband and two grown daughters to support her through her struggle with cancer.
“The support from Dr. Turzanski and the hospital staff meant everything to me,” she says.
Becoming a U.S. citizen has always been important to her, so she decided to study for her citizenship exam while undergoing chemotherapy treatments.
Between the end of chemo and the surgery, her lawyer called to say she was eligible take the exam. Dr. Turzanski even wrote a letter of endorsement for her.
She took the exam, passed with flying colors, and participated in the citizenship ceremony the same day.
During her treatments, Malinowski’s faith in God grew stronger.
“Through cancer, God revealed to me the true significance of what it means to live,” she says. “Now, I’m aware of what’s important in life—all the little things I took for granted.”
Dr. Turzanski is quick to point out that she’s just one provider on a skilled a team of specialists who care for breast cancer patients at Sentara RMH. She works closely with medical oncologists, radiation oncologists, radiologists,
pathologists, physician extenders, nurses, navigators, schedulers, mammogram technologists and others to help provide the best possible outcomes.
“I truly would be nothing without these amazing people who surround me at the Funkhouser Women’s Center and the Hahn Cancer Center,” she says. “They are all a blessing to work with each and every day as we come together to care for our patients.”
According to Dr. Turzanski, supporting patients with empathy and kindness is right up there with providing medical treatments in terms of importance.
“There are no small actions in this role,” she says. “Interacting with patients with a smile, encouragement, enthusiasm that they can do what is needed, and even a warm embrace during those difficult moments—all that goes a long way.”
“The support from Dr. Turzanski and the hospital staff meant everything to me”
Screenings at events throughout the year help improve the health of community members
Part of fulfilling our mission at Sentara RMH to improve health every day often involves taking health care outside the walls of our hospital and clinics to meet people where they are. »
Such outreach efforts might take place outside a school or retail store, where women can get mammograms through our Sentara mobile mammography van, or at a church or community center, where people can receive flu and COVID vaccines more conveniently.
“Being active in our community is a vital part of fulfilling our mission,” says Doug Moyer, Sentara RMH president. “We enjoy being a part of fairs, cultural festivals, athletic events like walks and runs, and other celebrations that bring people together.”
Hundreds of volunteers from numerous Sentara RMH departments fan out to community events throughout the area to make it possible for the hospital to participate. Such events include Best.Weekend. Ever., hosted by Harrisonburg Downtown Renaissance; the Augusta and Rockingham county fairs; and the Harrisonburg Hispanic Festival. By offering screenings in these venues, Sentara RMH team members hope to positively influence the health of community members.
Determining which events to attend involves a collaborative effort among various hospital groups.
“Our senior leadership team reviews every request,” adds Moyer, “and we try to support as many as possible—whether that’s providing free screenings, organizing a team for a fundraising walk or simply making a monetary donation.”
Sentara’s Center for Diversity and Inclusion and Cultural Competency (DE&I) team also receives many requests to participate in events. The team works closely with the hospital’s marketing and administration teams to provide support at these events.
Being active in our community is a vital part of fulfilling our mission
Sentara RMH volunteers dress up event booths with posters, tablecloths, brochures, kids’ activities and lots of exciting giveaways (such as pens, stress balls, sunglasses and water bottles).
However, these festive booths do more than just offer trinkets—their primary mission is to provide educational materials and health screenings, especially to those who may not regularly see a primary care provider.
“For many people, these screenings serve as their yearly checkup,” explains Gladys X. Zito, language services coordinator at Sentara RMH. “Many people depend on them.”
Screenings offered at community events might include:
• Blood pressure
• Cholesterol
• Diabetes, using a pinprick of blood to check current blood sugar levels
• A1C, which tracks average blood sugar levels, rather than the immediate number shown by a regular diabetes test. This test may be used for
those whose diabetes tests show elevated glucose levels.
One of the goals of the DE&I team is to reach out and engage the diverse communities Sentara RMH serves.
“Someone new to the country may not understand how the health system works here or how to access health care,” explains Zito, who is also responsible for organizing logistics and volunteer recruitment for the cultural events. “That’s why meeting people where they are in their daily lives is so important to us.”
In addition to attending culturally focused events like the Hispanic festival this year, Sentara RMH enlisted the help of the hospital medical interpreters at the Rockingham County Fair. A Spanish-speaking interpreter was present at the booth during each shift, ensuring that the local Latino population would be able to get answers to health-related questions.
Sentara RMH community event organizers rely on hundreds of volunteers to staff events.
“I volunteer at community events often,” remarks Anne M. Snow, a registered nurse at the Sentara RMH Heart and Vascular Center and Cardiac Catheterization Lab. “It’s a great way to meet new people, and it allows me the opportunity to showcase our hospital—and especially the Heart and Vascular Department.”
Clinical staff team members, who volunteer to check blood pressure and blood sugar levels, make up a large portion of Sentara’s event volunteers. Nurses from Optima Health also pitch in to check cholesterol levels.
This year at the Rockingham County Fair, volunteers performed
more than 870 blood pressure checks and gave out 6,000 bottles of water to fairgoers.
“The Rockingham County Fair is by far the largest community event we attend,” says Sarah Wichael, customer development advisor and coordinator of the Sentara booth at the Rockingham County Fair. “More than 100 staff volunteers work at our booth during the week, offering more than a thousand free health screenings and fun items to take home. It’s really a favorite time of year for us at Sentara RMH.”
Chaz Haywood, clerk of the circuit court for Rockingham County and the city of Harrisonburg, was one of this year's county fair participants who received a blood pressure reading—and it couldn’t have come at a better time. For about 20 years, Haywood has been setting up a city and county court display at the Rockingham County Fair in the same exhibit hall as the Sentara booth, and he regularly gets his blood pressure checked there.
Due to short staffing at work, the week of this year’s fair he had worked about 80 hours, between his job and volunteering.
“I walked over to the booth to get a blood pressure reading the first day at the fair,” recalls Haywood. “When they took the reading, I saw the two nurses look at each other quickly, and I thought, ’Uh-oh.’ My pressure was 157/114, and it was still high when they took it a second time. My body was more stressed than I had realized.”
The next day Haywood made an appointment at his primary care practice, where his doctor prescribed medication right away
to regulate his blood pressure. Four weeks later, at a follow-up visit, his doctor was still concerned about the readings and added a second medication.
While high blood pressure is hereditary in his family, Haywood ultimately realized that the stress and long hours involved in his job had taken priority over his health. Now he makes a point to schedule time for both exercise and rest during his busy workweeks.
He’s grateful that Sentara RMH reaches out to help improve the health of community members.
“They are being neighborly and accessible by providing these screenings,” he adds. “I would highly encourage everyone to take advantage of them—no matter how much you may think you don’t need them.”
After hearing of stories like Haywood’s, Sentara RMH staff find helping out at community events to be truly gratifying.
“I’ve been volunteering the whole six years I’ve been with Sentara,” remarks Veronica Wright, a licensed practical nurse at Sentara Orthopedics and Sports Medicine. “I enjoy volunteering because I enjoy interacting with the community. I feel that these events help people learn about Sentara RMH and give us opportunities to help keep the health of community members on track.”
For more information on upcoming community events, please check the Sentara RMH Medical Center Facebook page.
hen the federal government authorized the use of monoclonal antibodies (mAbs) to treat COVID-19 in December 2020, few other options for battling the disease existed (although the first vaccine was administered that month, the shots wouldn’t be widely available until spring 2021). To take advantage of mAbs, hospitals rushed to determine how to get the new treatment to the people who needed it most.
Toward this end, a systemwide effort at Sentara ultimately saved lives and reduced hospitalizations. Smaller local teams at 10 sites, including Sentara RMH Medical Center, created new processes, collaborating to get the program up and running in a short time frame and dedicating time and energy to caring for their communities during a challenging period. Thanks to the team’s agility, ingenuity and perseverance, mAbs treatments began within just two weeks of the government’s emergency use authorization.
At Sentara RMH, the outpatient infusion center and inpatient pharmacy teams worked together to plan, adjust schedules and determine the best way to deliver the mAbs treatments to as many patients as possible—and both units were vital to the success of the initiative. Typically, the Inpatient Pharmacy has a full workload preparing and dispensing medications for hospitalized patients, as well as those in the Infusion Center, Emergency Department and Outpatient Surgery unit. The Infusion Center, for its part, normally keeps busy caring for patients in need of intravenous (IV) therapy. While the teams were preparing and administering the surge of additional mAbs treatments—mainly to the immunocompromised and elderly— they had to keep pace with their usual workloads as well.
To effectively deliver mAbs while continuing to treat regular patients, the Infusion Center team decided to increase its hours.
The Inpatient Pharmacy team followed suit, adapting its workflow to accommodate the elevated demand. To maximize safety, the
infusion center staff also developed processes to keep mAbs patients separate from regular patients. At times, the team would even go outside the hospital to the vehicles of regular patients to administer care, to keep inside rooms available for mAbs administration.
“The staff made a commitment that they were not going to miss one patient order,” says Jill Byrd, RN, manager of the Infusion Center. “They would stay here till midnight to make sure all the work got done.” Byrd credits the success of her team’s efforts to their high level of dedication, adding that the eight-nurse team decided on its own to work the extra hours needed to run the mAbs clinic. “I would come back from meetings, and they would already have decided how to divide the work to get all COVID patients in and out that evening.” As a result, the Infusion Center often treated double its typical number of patients on a given day.
The pharmacy, which is open 24 hours a day to serve patients throughout the hospital, had to mix and dispense the mAbs for each patient. They also needed to track inventory, review orders and regularly report data to the Virginia Department of Health, which required continual reporting on doses administered, current stock and other data. Unlike typical medications, mAbs were distributed by the government. “The inventory management and reporting required for these medications were
unprecedented,” says Dr. Laura E. Adkins, pharmacy manager.
As a result, the pharmacy team’s workload increased significantly. “There was a lot of teamwork,” says Adkins. “Pharmacists with other roles would jump in and help with the order-verification queue. Technicians worked to ensure that we could accommodate patients in the treatment center and simultaneously take care of other patients in the hospital. We adjusted our workload to meet those demands and mix medications for all of those patients.”
In recognition of its innovative problem-solving skills in preparing
for and administering mAbs, the COVID-19 Monoclonal Antibodies team was honored in July with the CEO award—the highest a Sentara team can receive—which includes a trophy and monetary award. The CEO Award recognizes teams that have overcome significant barriers and risen up to serve as role models for the entire Sentara family. The team was recognized for the following:
• Collaborating to create clinical criteria for mAbs treatment
• Designing workflows to screen, prioritize and treat patients
Our bodies make antibodies to fight off infections, but we don’t always have antibodies that can fight off new viruses like SARSCoV-2, the virus that causes COVID-19. Monoclonal antibodies (mAbs), which are designed to fight off specific infections like COVID-19, are administered through an intravenous infusion.
Approved in December 2020 to help fight COVID-19, before vaccines were widely available, mAbs are typically used to treat people at high risk of getting serious symptoms from COVID-19.
Source: U.S. Department of Health & Human Services
• Creating isolated workspaces to deliver mAbs safely, while continuing to treat other patients
• Developing new online referral forms to replace paper forms and help streamline care More importantly, the team’s real-world impact during the pandemic was substantial. As of March 2022, 6,150 Sentara patients had been treated with mAbs, which helped the health system avoid an estimated 439 hospital admissions and 21 deaths.
“The Infusion Center nurses are an amazing group of caregivers,” says Byrd. “We did what we did to take care of the community, because every admission we could prevent helped to free up beds for other patients.”
Adkins says there are lessons to be learned from the quick decision-making and diligence required of everyone working on the project. “The teamwork and the agility we had to demonstrate to pull this off certainly serve as lessons that we will carry forward in everything we do,” she notes.
The federal government no longer covers the cost of mAbs, and most private insurance doesn’t cover the treatment. For those reasons, today the Infusion Center sees fewer patients seeking this kind of treatment.
Byrd says she’s glad she had the opportunity to treat patients during the pandemic. “I feel like we made a huge difference in the community during a very dark time. I really do,” she says. “I felt so strongly about it, and I think the staff did, too. We felt like we made a huge impact on the hospital as caregivers were struggling in the Emergency Department and with inpatients.”
“I was very impressed with and very proud of the team for pulling together,” adds Adkins. “I am amazed by the treatment center staff here at Sentara RMH and their outside-the-box thinking to figure out ways to safely offer monoclonal antibodies to more patients, while keeping our non-COVID patients safe. It’s just an awe-inspiring feat.”
An emergency use authorization (EUA) is a tool the U.S. Food and Drug Administration (FDA) can employ during health emergencies to make drugs, tests, devices and vaccines available more quickly to protect public health and safety. The FDA has granted a number of EUAs to respond to the COVID-19 pandemic. Previously, the FDA granted EUAs for Ebola, avian flu and other illnesses.
Source: U.S. Food and Drug Administration
Are you or your doctor concerned that cancer might run in your family? Or do you currently have cancer and would like to understand your risk for other cancers, as well as help your family members learn about their own cancer risks? If so, you could be a good candidate for genetic counseling.
Trained in both genetics and psychological counseling, genetic counselors can help patients understand genetic conditions, as well as talk them through any emotional impacts that may arise from the findings in their genetic profiles.
Paul Kwon, MS, LCGC, who has worked as a genetic counselor for both Sentara RMH Medical Center and Sentara Martha Jefferson
Hospital since June 2022, serves as an invaluable resource for patients when making decisions about their health.
“I really love working in this field,” he says. “I’m interested in helping patients understand how their family history affects their cancer risks.”
Kwon didn’t start out in genetic counseling, however. After earning his bachelor’s degree in biology at the University of Richmond, he first worked in vaccine development. However, he ultimately wanted to interact more with patients, so he began shadowing genetic counselors and found the specialty enjoyable. Kwon then returned to
school to get his graduate degree in counseling at Virginia Commonwealth University.
Today, Kwon works as a healthcare provider alongside primary care providers, oncologists and other physicians in the cancer field. When a physician recognizes that a patient’s personal or family history of cancer may point to certain higher-risk “red flags,” the patient is often referred to Kwon.
Based in Richmond, Va., Kwon’s clinic typically has a full slate of patients, providing services via telemedicine four days per week.
Many physicians try to keep an eye out for general types of red flags that might indicate a patient who is at high risk for certain types of cancer, or whose cancer is hereditary. Such warning signs include:
• Early-onset cancer (i.e., most types of cancer occurring before age 50)
• A strong family history of cancer
• Multiple primary cancers (i.e., separate instances of primary cancer)
Genetic counseling, which usually occurs over several sessions, involves gathering information from the patient, educating the patient and discussing genetic testing results. Kwon starts by learning about the patient’s personal and family history.
“For instance, if I’m seeing a patient in her 50s with breast cancer, I would start from her children’s generation, then her siblings, her parents, and her
grandparents on either side,” Kwon explains. “We would go over the cancer histories of each relative, including aunts and uncles, and then cousins. The process does take some time.”
After gathering all this information, Kwon looks for specific types of patterns of cancer in the family history—patterns that may indicate the presence of particular conditions. He also assesses whether the patient’s cancer might be hereditary.
“Notably, only about 5-10% of cancer cases are hereditary,” he says.
If Kwon sees evidence of certain types of cancer in a patient’s family history, but the patient doesn’t have cancer, he discusses whether the patient might be at an increased risk and what can be done to mitigate that risk.
“I’ll talk with them about their family history, talk about hereditary cancer in general and then discuss any red flags I see in their history,” he explains.
Once Kwon has covered the topic of risk factors thoroughly with patients, he then talks with them about whether or not they would like to pursue genetic testing to receive more information about their individual cancer risks, and potentially about cancer risk factors for family members.
As a side note, data generated by this kind of genetic testing is protected by law and must conform to regulations established in the Genetic Information Nondiscrimination Act (GINA). This federal legislation, enacted in 2008, protects individuals against discrimination based on their personal genetic information, as it applies to health insurance (with a few exceptions) and employment. These protections are intended to encourage Americans to take advantage of genetic testing as part of their medical care.
For patients who opt to go ahead with the testing, the process usually involves a simple blood draw. Once results are returned, Kwon schedules another appointment to discuss the patient’s specific profile and determine any needed next steps.
“I think I’m good at explaining things in such a way that my patients understand,” he says. “I want them to understand what it all means.”
With his counseling degree, Kwon also can help patients deal with the emotional aspects of receiving difficult information. He takes the time to answer any questions and reassures the patient
that he will work with their caregiving team to ensure the best possible cancer treatment and surveillance management.
“Depending on the patient, there can be a sense of guilt, sadness or other natural emotional reactions,” he says. “I do my best to discuss any feelings or thoughts the patient may have during post-testing counseling and remind them they’re not at fault for their genetic profile.”
While genetic counseling can have a significant impact on an individual patient’s outcomes, it can also play a larger role in the overall health of the patient’s family.
If the patient has an inherited cancer risk, Kwon will write a letter for the patient to share with family members, if desired.
“In such cases, it’s crucial for the rest of the family to receive genetic testing,” Kwon says.
For instance, if a patient presents with a personal and/or family history of breast or ovarian cancer, Kwon talks with them about BRCA1 and BRCA2, two well-known genes linked to increased risk for breast cancer and other related types of cancer. (He notes that there are also many other genes associated with increased risk for breast and ovarian cancers.)
“If a disease-causing mutation is in a family’s BRCA gene, I can clarify whether the patient and his or her family are at risk for other types of cancers,” Kwon says. “In these cases, women in the family might have an increased risk for breast cancer and ovarian cancer, and men in the family might have an increased risk for prostate cancer, pancreatic cancer and melanoma.”
For patients and family members, being armed with information about specific risk factors can lead to positive health impacts down the road.
“If we find a disease-causing mutation in one of the BRCA genes, for instance, we can make medical management recommendations,” Kwon says.
Ultimately, patients and family members must decide which, if any, genetic testing options are right for them.
“Genetic counseling is all about patient education,” Kwon adds. “The information we provide gives patients power to make informed decisions, be proactive with their health and lead the best possible lives.”
“I’m interested in helping patients understand how their family history affects their cancer risks.”
— Paul Kwon, MS, LCGC
Cancer of the colon and rectum (colorectal cancer) is one of the leading causes of cancer death among men and women in the United States, according to the American Cancer Society. The organization estimates that more than 106,180 new cases of colon cancer and more than 44,850 new cases of rectal cancer will be diagnosed in the U.S. in 2022.
Colorectal cancer usually starts as a polyp, or small growth, in the lining of the colon or rectum. Although not all polyps are cancerous, over time some of them can develop into cancer. The key to successful treatment is to catch the colon or rectal cancer in its earliest stages—or, better still, to screen for and remove any polyps.
In its earliest stages, colorectal cancer usually produces no symptoms. At more advanced stages, colorectal cancer can cause abdominal discomfort and cramps; blood in the stool; and changes in bowel habits, such as frequent constipation or diarrhea that may last several days.
Risk factors for colorectal cancer include the following:
• Age
• Diet high in red meat and fat
• Family history of colorectal cancer
• Lack of physical activity/sedentary lifestyle
• Obesity
• Smoking
A number of colorectal cancer screening tests are available. Your healthcare provider can help you decide which method is best for you.
Colonoscopy is an outpatient screening procedure that allows the physician to examine the lining of the large intestine and rectum directly. Using a thin, flexible tube with a small camera and light on the end, the doctor looks for changes and growths like polyps. If any suspicious growth is found, the physician usually can remove it during the colonoscopy procedure, and the growth is then examined for the presence of cancer.
The patient is placed in a lightly sedated state during the colonoscopy, which lasts about 30-60 minutes. Most patients are asked to take it easy for the remainder of the day on which the colonoscopy is performed, and are able to return to normal activities the day after their procedure.
The American Cancer Society generally recommends that people should have their first colonoscopy at age 45 and then repeat it about every 10 years. For African Americans, the recommended starting age is 40. If you have a personal history of cancer or a family history of colorectal cancer, your doctor may recommend you have a colonoscopy more frequently than every 10 years.
If you are 45 or older (40 for African Americans), or if you are younger but have risk factors for colorectal cancer, ask your doctor about colonoscopy and the other screening tests.
El cáncer de colon y recto (cáncer colorrectal) es una de las principales causas de muerte por cáncer entre hombres y mujeres en los Estados Unidos, según la Sociedad Americana contra el Cáncer. La organización estima que se diagnosticarán más de 106 180 nuevos casos de cáncer de colon y más de 44 850 nuevos casos de cáncer rectal en Estados Unidos en 2022.
El cáncer colorrectal generalmente comienza como un pólipo, o crecimiento pequeño, en el revestimiento del colon o recto. Aunque no todos los pólipos son cancerosos, con el tiempo algunos de ellos pueden convertirse en cáncer. La clave para un tratamiento exitoso es detectar el cáncer de colon o recto en sus primeras etapas o, mejor aún, detectar y eliminar cualquier pólipo.
En sus primeras etapas, el cáncer colorrectal generalmente no produce síntomas. En etapas más avanzadas, el cáncer colorrectal puede causar
molestias abdominales y calambres, sangre en las heces y cambios en los hábitos intestinales, como estreñimiento frecuente o diarrea que puede durar varios días.
de riesgo
Los factores de riesgo para el cáncer colorrectal incluyen los siguientes:
• Edad
• Dieta rica en carne roja y grasa
• Antecedentes familiares de cáncer colorrectal
• Falta de actividad física/estilo de vida sedentario
• Obesidad
• Tabaquismo
Hay varios exámenes de detección del cáncer colorrectal disponibles. Su proveedor de atención médica puede ayudarle a decidir qué método es mejor para usted.
La colonoscopia es un procedimiento de detección ambulatorio que permite al médico examinar el revestimiento del intestino grueso y el recto directamente. Usando un tubo delgado y flexible con una pequeña cámara y luz en el extremo, el médico busca cambios y crecimientos como pólipos. Si se encuentra algún crecimiento sospechoso, el médico generalmente puede extirparlo durante el procedimiento de colonoscopia y luego se examina el crecimiento para detectar la presencia de cáncer.
Se coloca al paciente en un estado ligeramente sedado durante la colonoscopia, que dura entre 30 y 60 minutos. A la mayoría de los pacientes se les pide que no realicen esfuerzos durante el resto del día en que se realiza la colonoscopia y pueden volver a las actividades normales al día siguiente.
La Sociedad Americana contra el Cáncer generalmente recomienda que las personas se realicen su primera colonoscopia a los 45 años y que luego la repitan cada 10 años. Para los afroamericanos, la edad de inicio recomendada es a los 40 años. Si tiene antecedentes personales de cáncer o antecedentes familiares de cáncer colorrectal, el médico puede recomendarle que se realice una colonoscopia con una frecuencia mayor a 10 años.
Si tiene 45 años o más (40 para los afroamericanos), o si es más joven pero tiene factores de riesgo de cáncer colorrectal, consulte con su médico sobre la colonoscopia y otros exámenes de detección.
As a freshman at Orange County High School (OCHS) in Orange, Va., Bree Squiers was thrilled to earn a spot on the varsity volleyball team—not just because she’s passionate about the sport, but also because her older sister, Brooke, was on the team.
Unfortunately, Bree’s season came to a heartbreaking halt after an accident during her first week of practice.
“I was going up for the ball, and my sister dove for it at the same time, sliding into both of my legs,” Bree recalls. “I heard a loud pop when she hit me, and I fell to the ground.”
OCHS athletic trainer Jenna Fincham swiftly scooped Bree off the ground, with the help of her coach and manager, and examined Bree’s knee. Suspecting that Bree had sprained a major knee ligament during the collision, Fincham called Bree’s mom, Suzie, to give her the news and offer advice for follow-up care.
“When parents aren’t sure what the next steps should be, I offer to reach out to Sentara Martha Jefferson for orthopedic care,” says Fincham, who
has been an athletic trainer at OCHS for more than seven years. “I have good rapport and a direct line of contact with the athletic trainers at Sentara Martha Jefferson.”
Fincham contacted John Walker, an athletic trainer at Sentara Martha Jefferson Orthopedics and Sports Medicine, asking for his help in facilitating an appointment with sports medicine and orthopedic surgeon Matthew Panzarella, MD. Before considering surgery, Dr. Panzarella recommended holding off for a few weeks to see how Bree’s knee healed.
Thousands of students in the Blue Ridge region participating in a wide range of activities, from youth recreational leagues through college sports teams, benefit from the support of athletic trainers at Sentara Martha Jefferson Hospital and Sentara RMH Medical Center.
While collegiate and high school teams often have an orthopedic surgeon and athletic trainer on the sidelines for high-contact games, you can also find athletic trainers at practices for a wide range of high school sports. The trainers often oversee multiple practices and games, focusing on sports with the highest risk of injuries.
“Athletic trainers provide care on the spot, first assessing an injury and then providing initial treatment,” explains Scott Powers, a certified athletic trainer and the athletic trainer program coordinator at Sentara RMH. “After an athlete has seen an orthopedic physician and, if needed, had surgery, we also help the athlete rehabilitate so they can get back on the field.”
For athletes with more serious injuries, rehab may mean coming to a clinic, but athletic trainers
try to make the process as convenient. In less severe cases, they can guide students with a rehab program at school while their team is practicing.
“For some students, getting to appointments after school is tough,” Walker notes. “Working with athletic trainers at school is more convenient, and they can still get a high level of treatment.”
Several schools in Central Virginia, including OCHS, employ athletic trainers through their school district budgets rather than contracting out with a healthcare system. Walker’s goal is to build partnerships with those trainers to help provide a conduit to care.
He also hopes to offer seminars focusing on “prehab,” which would cover tips for coaches, athletic trainers and athletes to help them warm up properly and improve form, thereby reducing the chances of getting hurt.
Right now, Sentara Martha Jefferson has two full-time athletic trainers, including Walker, who works at the sports medicine clinic. The athletic trainers meet with patients to perform initial assessments before Dr. Panzarella sees them.
Sentara RMH employs 13 full-time athletic trainers: four in the orthopedic clinic, six in high schools, and three in the James Madison University (JMU) recreational sports program. Powers has expanded the athletic training program during his six years in the position.
Recently, the Sentara RMH athletic trainer team helped coordinate an appointment for Zechariah Stuhlmiller, a 9th-grade varsity football player at Broadway High School in Rockingham County.
“We were doing hitting drills, and I got hit high from behind,” recalls the freshman defensive back,
known as “Z” by his friends and family. “My cleat got stuck in the ground, and my knee twisted as I came down. The coach called our athletic trainer to check on me right away.”
Knowing there’s an athletic trainer nearby is comforting to athletes’ parents.
“It’s definitely given me peace of mind and made the process easier,” says Z’s dad, Jason Stuhlmiller, who has coached baseball at the high school and collegiate levels. “The athletic trainer got in touch with orthopedics, and we were able to get an appointment the next day.”
Thomas Weber, MD, co-medical director for the Sentara RMH Orthopedics and Sports Medicine program, determined that Z had strained his medial collateral ligament. Z was able to rehab with the athletic trainer at school and get back on the field a couple weeks later.
High school athletic trainers attend meetings at the beginning of each sports season to make sure parents know they are available for questions or concerns about an injury.
“When Bree and her siblings went to practices, it was comforting knowing Jenna would be there,” says Suzie Squiers. “As a parent, you want to know someone is there for your child, and Jenna absolutely was that.”
For young adults at college, dealing with an injury experienced while working out, playing intramurals
or participating in other activities on campus can be daunting.
Thankfully, JMU students can rely on the advice of Sentara RMH athletic trainers, who staff a full-service athletic training room at the university’s recreation center, which is open to all JMU students.
“We see a lot of 18- and 19-year-olds making healthcare decisions for the first time,” Powers explains. “They need counseling and guidance. They need to know if they should see a doctor, and that’s what we do with our evaluations.”
JMU students can see the athletic trainers free of charge for an initial assessment. If indicated, the athletic trainer will recommend that the student seek follow-up care with a physician. Students can also return and rehab for free.
Powers recalls a case in which a student took a fall while skateboarding. When the student came in to get checked for a concussion, he reported experiencing considerable neck pain. The athletic trainer on duty referred him to Sentara RMH, and X-rays revealed two cervical fractures. In such cases, having an athletic trainer on hand can help students get the treatment they need more quickly and conveniently, potentially helping them avoid more serious injury.
Seeing students back on the field following an injury is rewarding for athletic trainers.
“We’re certainly on the athlete’s side,” Walker says. “We want them to stay in the field, and it’s our job to help them get back out there as soon as possible.”
A few months after her accident on the volleyball court, Bree had surgery to reconstruct the major ligament that keeps the kneecap in place. However, COVID school shutdowns and a subsequent snowboarding injury delayed her return to the court. Now a senior, Bree serves as a team captain and has aspirations of becoming an orthopedic surgeon.
“Jenna’s work as our athletic trainer has had a positive impact on our entire team,” Bree remarks. “She’s been like a mom to us, and we truly appreciate all she’s done. I hope to make a difference like that someday, too.”
While everyone has different ways of coping with grief, realizing that you’re not alone can be an important part of the grieving process.
Thankfully, children and teens in the Shenandoah Valley now have a new way to heal after the loss of a loved one.
Camp Lighthouse, a two-day camp hosted by Sentara Hospice Services where kids can express grief with one another in a safe space,
debuted in early October at Brethren Woods Camp and Retreat Center in Rockingham County. Founded in the Hampton Roads area in 2006, the camp came to the Valley this year, largely thanks to the generosity of community supporters like Nathan Ziegel and Truist Bank, the major local sponsor.
“This event is near and dear to my heart,” says Ziegel, the bank’s Mid-Valley market president. When I hear people say that kids have it easier these days, I’m on the other side—I actually think kids have it
more difficult regarding grief management, and in terms of having a shoulder to lean on. Camp Lighthouse just felt like such a good thing. These kids are able to spend time with peers who have gone through the same types of experiences.”
Chris Ellis, a senior vice president with Truist, learned of the camp from Cory Davies, executive director of the RMH Foundation, through his seat on the foundation board. Wanting to get involved in a service project with his 16-year-old daughter, Addison, Ellis found Camp Lighthouse to be an ideal cause to support. Addison, who then became the unofficial local champion for the camp, was inspired to help others, given her own experiences with grief following the death of her paternal grandfather in 2015, when she was just 9 years old.
“The first time I dealt with grief was when my grandfather passed away,” Addison says. “I am very appreciative of all those who were willing to contribute to Camp Lighthouse. The staff at Sentara RMH was very flexible and advised me as I prepared the letter to solicit patrons. I had the opportunity to participate in donor meetings as we raised money for a good cause.”
Ellis says simply, “She’s a good kid.”
At Camp Lighthouse, which is open to children in grades K-12 (who, during the camp’s activities, are divided into age-appropriate groups), trained professionals and volunteers help the children and their families explore grief-related issues and begin healing. Parents, grandparents and guardians participate in their own activities, as they learn to cope with loss while guiding their children through the process.
There’s also plenty of fun during the two-day event, as camp attendees take part in team-building games, crafts and other outdoor activities. Maintaining a balance between smiles and difficult emotions is valuable in helping the camp achieve its mission.
“Camp Lighthouse helps participants normalize feelings associated with death and dying, as well as validates campers on their own grief journey,” Addison wrote in her letter to potential donors. “We want children to feel a sense of community and be able to say, ‘Now I know I’m not the only one feeling like this.’”
The Camp Lighthouse name comes from a real-life story of a former Sentara Hospice patient named Cheryl, who had a 14-year-old daughter. During her time in hospice care, Cheryl shared with her hospice nurse her dream of making a quilt for her daughter’s wedding. In fact, she used the last of her energy to design the quilt.
“She died knowing the volunteers would finish what she had started,” Addison wrote. “The design Cheryl picked out for the quilt was of a huge lighthouse. As a result of this work,
the Sentara hospice staff developed Camp Lighthouse to help children deal with grief.”
A camp to bring children together has great value, Ellis says—especially following the COVID-19 pandemic, when it was more challenging for people to get together—and even often made it impossible for family members to say goodbye to a dying loved one.
Camp Lighthouse is facilitated by trained professionals and volunteers from Sentara Hospice Services, Sentara Home Care Services, Sentara Healthcare and the community—all of whom strive to provide a safe environment for the children.
“As a foundation member and as a patient, I’ve been extremely impressed at the Sentara RMH team’s level of expertise and the amount of care they have in
wanting to help people,” Ellis says. “I don’t think they sing their own praises as much as they should.”
For Truist’s part, the chance to sponsor Camp Lighthouse fit in very well with the bank’s mission. Financial support for events like this is only part of the equation.
“We want to give back to help grow the community,” Ziegel says. “This is one of those events that help children become better citizens of the community and learn there are others like them. I hope the friendships they make there go far beyond the camp.”
If you’d like to help with future camps, donations and volunteers are welcome. Your financial support will help with the cost of a camper’s stay, including meals and art supplies, as well as additional training for volunteers. Your help in making this camp a success will serve to sustain the program for years to come.
Visit www.sentara.com/ camplighthouse for more information.
Life is one long road trip, and no matter where you are, we can help you on your journey. We have tools and ideas to save you money, while providing for the people and causes most important to you—causes like the RMH Foundation. Your expression of philanthropy makes a difference to local patients and supports the RMH Foundation’s mission of elevating health care in our community.
No matter how far you are into your life’s journey, it is never too late to update your plan. You decide on your destination based on your own values and priorities, and we can help you get there.
For more information, please visit https://sentara.giftlegacy.com. We look forward to helping you plan your future!
Sentara RMH Medical Center is so grateful to have the support of generous community members. We express this gratitude and recognize the contributions our donors make through the President’s Forum, the William Leake Society, 1910 Cornerstone Club and the White Rose Giving Circle. These exclusive giving circles are our way to honor our most generous partners who show they care about having the best medical services available in our community. Finally, to recognize your loyalty over the years, we are placing the number of consecutive years you have supported the RMH Foundation next to your name. Thank you for your support!
Totals represent cumulative amounts given in 2022.
$1,000,000 and above
The Community Foundation of Harrisonburg and Rockingham County (20)
$100,000-$999,999
The Fred O. Funkhouser Charitable Foundation, Inc. (26)
Estate of Linda L. Rinaca (1)
George C., Jr. and Gretchen Welch Trust (1)
$25,000-$99,999
Pat Messner (35)
$5,000-$24,999
Ameriprise Financial Services, Inc. (4)
Bob Wade Subaru (9)
Frances Ann Byers (3)
Paul S. and Sherry B. Cline (11)
Eddie R. and Catherine Coffey (25)
Dick Myers Chrysler, Dodge, Jeep, Ram, Fiat (3)
Christopher A. and Trina L. Ellis (1)
Harry F. and Margaret M. Flippo Foundation of the Community Foundation of Harrisonburg and Rockingham Cty. (5)
Cardinal Dental Specialties (8)
Drs. Brooke and Will Goodwin (8)
Donna S. Hahn (16)
Dr. Charles H. and Mary Henderson (17)
James and Frances Mason (3)
Herman and Janet Mason Families Fund of the Community Foundation of Harrisonburg and Rockingham Cty. (14)
Garry and Nancy Nichols Family Charitable Fund, a Donor Advised Fund of The U.S. Charitable Gift Trust (14)
Helen W. Shickel (21)
Mark and Kendra Shickel and Ephesians 2 Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (2)
Shickel Corporation Colossians 3:17 Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (2)
Larry W. Showalter (5)
William G. and Hope Shank Stoner (17)
The U.S. Charitable Gift Trust (6)
Theta Iota Chapter of Alpha Phi James Madison University (6)
Truist Bank, Harrisonburg (1)
Wayne and Joyce Wright (22)
$1,000-$4,999
Marcus B. Almarode (10) Alpha Phi Foundation (2)
Devon C. and Teresa B. Anders (13)
Anonymous Donor The Community Foundation of Harrisonburg and Rockingham Cty. (1)
Anonymous Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (1)
Drs. A. Jerry Benson and Martha K. Ross (11)
Tena M. Bibb (14)
Debra H. and Dale L. Bontrager (2)
Auburn A. and Ruth D. Boyers (41)
Louise R. Burtner (10)
Bonnie C. Caplinger (4)
LuAnn L. Clark (25)
Dr. Bruce Clemons (2)
Cassey Cook (2)
Crosslink Community Church (3)
Cory and Donielle Davies (15)
The Davies Family (15)
Andrea Dono (1)
Edward Jones Investments (3)
Fidelity Charitable Gift Fund (15)
Cindy Fike, Deb Payton and Ken Heatwole (1)
Fraternal Order of Eagles New Market Auxiliary #4264 (4)
Sherrill Glanzer (21)
Donna Gochenour (7)
Chasity H. Godshall (14)
Dr. David C. and Amelia M. Hall (12)
Elizabeth Harnsberger Trust (11)
Richard and Julie Haushalter (23)
John R. and Mary Ann Heatwole (4)
Interchange Group (13)
Judith D. Jenkins (6)
Tedd H. and Lora W. Jett (33)
Eldon F. Layman (1)
Terry and Judy LePera (25)
Dr. Sophia S. Leung (1)
Robert J. Lynch (7)
Jason and Hilary Moore (4)
New Market Rotary Club (9)
Rebecca M. Nicely (14)
Chris and Sarah Orem (4)
Thomas D. and Jennifer L. Rea (8)
Thomas H. Rice (8)
Rockingham Insurance Company (5)
Schwab Charitable Fund (3)
Robert S. and Patricia M. Scott (4)
Sentara Healthcare Matching Gift (1)
Shenandoah University (2)
Mary and Jim Sherman (10)
Corie B. Shifflett (19)
Richard L. and Patricia N. Shoemaker (8)
Anita L. Smootz (6)
Brandy Sollenberger (7)
Barbara B. Stoltzfus (24)
Lynn and Diane Trobaugh (15)
Tropical Smoothie Cafe (1)
Phillip and Christina Updike (9)
Dr. David H. and Janet T. Wendelken (10)
Whetzel Family Irrevocable Trust (2)
Richard L. and Pamela B. Wilkins (35)
LTC Charles D. Young, US Army Retired (5)
$100-$999
Laura E. Adkins (9)
Elizabeth Alderfer (2)
David E. and Gloria W. Alger (1)
Lori Alger (3)
Leodegario Alonso (5)
Marsha G. Andes (3)
Larry Andrick (1)
Megan Angel (1)
Jane Armstrong (6)
Robin R. Atwood (13)
AXOX Clearing (1)
Andrea Baker (4)
Edward J., Jr. and Ellen D. Baldwin (1)
Edith J. Banks (8)
Hope N. Barb (3)
Tamela J. Bare (3)
William Barkley (1)
Natalie R. Bass (7)
Sam L. Batton (7)
Richard and Cathy Baugh (1)
Jennifer B. Baugher (6)
Valerie Beales (1)
Erin Beeker (6)
James T., Sr. and Barbara R. Begoon (19)
Joanne L. Bell (7)
Thomas L. Bellamy (7)
Holly G. Berry (14)
Kenneth G. and Linda R. Berry (13)
Zelda Blackwell (3)
Blakemore Florist (1)
Rhonda Blosser (1)
Lisa W. Bottenfield (1)
Deirdre Bowyer (2)
Nancy R. Bradfield (14)
Linda H. Bradley (2)
Loretta F. Bradley (10)
Sherry L. Braithwaite (7)
Susan Breeden (1)
Justin Brenneis (2)
Emmett H. and Leola C. Brooks (7)
Jamie L. Brown (1)
David and Teresa Bruce (7)
Patricia A. Brunk (15)
Deborah E. Bullis (26)
Rodney E. Bussard (2)
Carrie Bynaker (1)
Tammy M. Byrd (25)
Reva Susan Veramessa (4)
Sallie Campbell (4)
Lyle Scott Cassell (2)
Diana J. Catlett (7)
Bruce F. Cave (1)
Kajsa Champ (1) Susan Chelgren (7)
William W. Chestnut (9)
Lee E. Clapper, Sr. (10)
Susan E. Clark (13)
Katherine Clausen (1)
Randy S. Clem (6)
Brenda J. Cline (2)
Pamela F. Collins (9)
MariaElena Coscia (1)
Patricia S. Costie (12)
Gloria B. Craun (1)
Christy L. Crawford (1)
Dana Crittenden (7)
Tina Crum (6)
Jeffrey D. and Faye B. Curl (1)
Kimberly J. Curry (10)
Vanessa Custer (4)
Linda A. Davis (1)
Jill Delawder (5)
Shirley L. Dellinger (19)
Marie B. Dofflemeyer (1)
Ellen R. Dotas (4)
Jennifer S. Dove (4)
Penny Driediger (1)
Eileen E. Dubberstein (2)
Sonya S. Eberly (21)
Jessica C. Edwards (16)
Anne M. Ekdahl (11)
Tami Reid Eppard (16)
Phyllis C. Eskridge (8)
Fear2Freedom (1)
Fred and Michele Fielding (1)
Carol Ann Fields (4)
Carla Foerster (1)
Larry A. and Linda J. Fogle (15)
Susan Foltz (2)
Forrest L. Frazier (20) Courtney G. French (2)
Byron Fulk, PA-C (4) Wolfgang G. Fundinger (1)
Jason A. Funkhouser (3)
Lelia Lightner Galvin (3) Donna Garber (1)
Patsy K. Garber (6) Wesley S. Garber (2) Michael A. and Carolyn S. Gardner (6) Karen J. Garrison (8) Chad M. Gathers (8)
Tracey A. Gentry (10)
Walter G. Gerner (8)
Sara E. Gingerich (13)
Donna and Bob Golson (1)
Jamey C. Groff (1)
Jeff Guinn (1) Rebecca Haggan (1)
Olivia Haimani (7)
Herman W. and Rosemary G. Hale (11)
Tamela Hall (1) Marianne F. Halterman (5)
Jarman L. Hammer (9) Dana Harlow (8) Janis L. Harrington (1)
Harrisonburg Department of Public Transportation (1)
Kenneth T. Haskell III (15) Betty Hassler (5) Rachel Hayes (1) Wilma F. Hedrick (10) Denise A. Hensley (11) Robert E. and Gail L. Hess (6) Cary Hevener (18)
Lillan B. Hilbert (1) Sherrel J. Hissong (14) Angela H. Hoak (15)
Tina B. Hodge (3)
Thomas J., III and Virginia C. Holden (5)
Stan and Joni Holland (32) Amanda S. Holt (4)
Dena Hoover (2) Terri M. Horst (1)
Ronald M. and Linda C. B. Hotinger (6)
Anita Housden (1)
Kathleen and John Houseman (1)
Tyler Dashiell Huddle (9)
Charlinda W. Huffman (30) Genevieve W. Huffman (2)
Holly Huffman (1)
Catherine H. Hughes (1)
David O. and Catherine H. Hughes (1)
Donna Hurst (2)
Lynetta Hutchinson (5)
Alesia M. Israel (5)
James J. Iverson (2) Yvonne Jarrels (2) Rebecca S. Jessie (22)
Ronald P. and Julianne Jilinski (15)
Tammy R. Johnson (1) Carmen Jones (1)
J. S. Parker Jones, IV and Diana L. Jones (3)
Susan K. Justice (6)
Elizabeth A. Kaestner (2) Caroline H. Ketler (1)
Deborah B. Kile, DNP, RN, NE-BD (21)
Terry D. King (1)
Jason Kirby (6)
Teresa M. Kite (9) K. Michael and Susan C. Kline (2) Gene E. and Ann H. Knicely (3) Katherine H. Knicely (14)
Lorrie Koontz (7)
Julie F. Kramer (34)
Jim and Vicki Krauss (23) Dorothy L. Kreider (2) Troy E. Kurtz (8)
Letitia E. Lam (6)
Gary and Shelia Lam (35)
Dana Lambert (2)
Melissa Lambert (2) Sandra L. Leap (4)
Donna E. Lear (26)
Karen R. Lee (1)
Robert J. and Carolyn J. Leiston (15)
Cathy Leitner (9) James and Jane Lewis (1) Tommy M. Lilly (10)
Donal E. Loker (5) Cynthia S. Lowe (14)
Vunly Luangrarj (7)
Donna Lucas (1)
Aimee B. Lyle (17)
H. L., Jr. and Mildred R. Maiden (5)
Noella Manns (1)
Laura S. Mapp (29)
Christine M. Marshall (17) Courtney Martin (3) Robin L. Martin (20)
Martorana Family Donor Advised Fund of The Community Foundation of Harrisonburg and Rockingham Cty. (1)
Peggy G. Mason (30)
Cheryl Matthews (4)
Philip H. Maxwell (35)
Rebecca C. McCutcheon (4)
Deborah M. McDonald (1)
Ellen S. McDonald (11)
Mary Sue McDonald (1)
Catherine M. McGowan (2)
Grady McGuire and Friends at LMI (1)
Linda T. McIntyre (20)
Drs. David K. and Charlette E. McQuilkin (8)
Dr. Simeon Melaku (1)
Colonel William P. and Frances A. Menefee (4)
Odessa F. Merica (12)
Jana R. Miller (25)
Lisa Miller (1)
Rhonda R. Miller (4)
Catherine Mills (1)
Alison K. Minnick (6)
Leslie E. Mohler (20)
Sherry L. Mongold (11)
Howard R. and Cheryl J. Montaigne (1)
Stacey R. Morris (26)
Donald L. and Marie I. Moyer (3)
Donald R. and Nancy M. Myers (4)
Foelke D. Nair (29)
National MS Society, Virginia and West Virginia (1)
Steve A. Nelson (22)
New York Life Insurance Company (18)
Darlene L. Newman (9)
Richard and Sue Orem (3)
Charles V. Oster (26)
Alyssa Pacheco (2)
Mitchell Palmer (1)
Emily A. Parker (1)
Meghan A. Patterson (14)
Kristin H. Payne (15)
Sharon L. Peale (1)
Julie A. Pierantoni (4)
Richard G. and Annie L Pierce (11)
Shannon M. Pitsenbarger (10)
Virginia Pope (1)
Judith A. Potepan-McCarty (24)
Richard M. Powell (15)
Lisa C. Price (1)
Marshall and Gloria B. Price (23)
John E. and Jean L. Ralston (1)
Jeff A. Ramsey (1)
Robert J. and Virginia G. Ravera (2)
Dennis and Mary Jane Rawley (5)
Patra H. Reed (9)
Steven Rehkemper (7)
Eleanor S. Rexrode (22)
Andrea L. Rhodes (1)
Salinda F. Rhodes (4)
Susan W. Ribelin (30)
James B. Richardson, Jr. (14)
Dr. Alexander V. Rilling (1)
Natalie S. Rinaca (35)
Paul and Laura Riner (2)
Amber E. Rinker (16)
Beth Robbie (18)
Lori A. Roberts (10)
Amy J. Rogowski (9)
Susan E. Rozmus (18)
Cynthia V. Ryman (1)
Karen Sager (5)
Sarah Samuels-Thornton (6)
Kelli N. Schroeder (18)
Kathryn K. Scripture (19)
Donald W. Seese (9)
Lyman G. Seese, Jr. (1)
John H. and Faye T. Sellers (17)
Sentara RMH Medical Group Admin Staff (1)
Lucy J. Seymour (13)
Emily I. Sherrill (7)
Brandy Shifflett (2)
Denise Dean Shifflett (3)
Lori Ann Shifflett (4)
Sabrina D. Shiflett (25)
Shirley A. Shirron (22)
Mark C., Jr. and Dorothy S. Showalter (1)
Elwood and Barbara Shrader (3)
Kari F. Shrader (4)
Nelson and Linda Simmons (11)
Terry G. and Victoria G. Slaubaugh (2)
Linda Joan Slota (2)
Jennifer Smiley-Gill (2)
Ilene N. Smith (40)
Joanna Smith (1)
Julie M. Smith (20)
Marcia G. Smith (3)
Tamara L. Smith (2)
Anne M. Snow (11)
Jaclyn Snyder (1)
Barbara R. Somers (2)
Beth E. Sorrells (2)
Caroline M. Spiers (11)
Sammye B. Sponaugle (10)
Gloria Stout (2)
Richard L. and Joyce K. Strawderman (15) Rodney and Ruth Stultz (14)
Katherine Stum (2) Leslie A. Sullivan (6)
Frank M. Summers (4) Sunnyside Communities (1) Juanita M. Taylor (40)
Robert W. and Jeanne C. Taylor (1)
William L. Taylor (17) Emma C. Terry (1) Kimberly N. Teter (14) Tanya M. Thompson (1) Elaina J. Tinnell (1)
Brent Holsinger and Laura Toni-Holsinger (3) Kathy L. Toth (10)
Gregory S. and Ann B. Trobaugh (12)
Tonya R. Turner (4) Janette R. Tusing (7) Sandy and Sherwin Tusing (41) Deborah E. Tysinger (19) Utterback family (1) Carolyn S. Van Dyck (6) Elizabeth Marie VanMeter (1) Ann E. VanPelt (1) Frank H. and Tara M. Vetting (4) VIP Recognition, LLC (1) Stephen L. Vogen (18) Sarah and Matt Von Schuch (1) Wylie E. and Diane Walton (30) Sarah Ward (7) Laura A. Watson (12) Merv and Marlene Webb (40) Marsha Wetzel (2) Dawn R. Whetzel (15) Malinda Whitfield (3) Denise A. Whitman (19) Sarah H. Wichael (4) Mr. David and Dr. Karen Wigginton (5)
Katy Wilson (10)
Robert L. and Nancy B. Wiskeman (1)
Megan Yeager (2) Carol A. Yetzer (1) Claudia Yoder (1) Gina F. Yost (13)
Christal M. Yowell (5) Heidi A. Zander (31)
Julianne Zerkle (1) Katherine M. Zimmerman (3)
$500
Maryjane Chewning (8) Debra Douglas (1)
Patsy K. Garber (8) Sherrill Glanzer (21) Ruby K. Hostetler (5) Catherine H. Hughes (1) In memory of Susan Layman
Jo Ann S. Liskey (10) Ruth Lorson (9) Jill McGlaughlin (6) Jacqueline L. Walline (11)
Marlene Webb (40)
Nichole M. Whatley (1) Denise A. Whitman (19) Shirley B. Yoder (2)
$25 to $99
Joseph and Jane Alderfer (1)
Lorena F. Anderson (1) Jerry O. Andes (14) Anonymous Patient (1) Teresa Arey (4) Jean Anne Armstrong (15) Karen Barnes (3) Donna D. Beach (1) Joseph M. Beahm (25) Cathy L. Beall (1)
Howard E., Sr. and Elizabeth F. Beall (2) George W. Bell (2)
Ray R. and Edna C. Bishop (1) Joyce R. Blosser (11)
Brenda Bly (1) Jill Bowman (6) Judy E. Bowman (1) Kari Bowman (5) Sally H. Brown (3)
Steve C. and Marian B. Buckwalter (3)
Thomas L., Jr. and Carroll P. Buskirk (5)
Susan D. Cabell (11)
Della D. Cable (1) Cynthia D. Campbell (10) Jeffery Carr (1)
Chanda J. Carrier (10) Patricia Carroll (9)
Annette Cashatt (2)
Jillene K. Cavallo (1) Kathryn L. Cheeks (3)
Rebecca Chester (2)
Richard G. and Claudia J. Childs (7)
Sherry D. Clegg (18)
Fern H. Cline (1)
Penny C. Cline (9)
Julie Cochrane (1)
Jennifer L. Coleman (1)
Crystal Collins (7)
Clara Jean Comer (7)
Emanuel B. Conley Jr. (9)
Jacqueline Dault (2)
Frederick A. and Alice H. Davino (4)
Debra K. Deavers (1)
David L. and Mary E. DeFilipps (1)
Bunita Delawder (1)
Colonel and Mrs. Peter F. Dieck (5)
Andrea M. Dove (6)
Rebecca Dove (1)
Gary L. and Brenda H. Driver (5)
Tom and Kathy Dunham (8)
Laurie R. Dye (17)
Richard and Miriam Eichlin (1)
Elim Boutique, Inc. (1)
Samuel Ellingson (7)
Ron Elliott (2)
Rollin L. and Betty M. Eutsler (1)
Angela C. Fann (1)
John W., Jr. and Dana N. Fenner (1)
Kathi and Winn Fields (1)
David R. and Debbie B. Fordham (1)
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Margaret Furr (4)
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Indira Gandhi (1)
N. Brooke Garcia (1)
Hermilo Garcia-Hurtado (2)
Robert F. Geary, Jr. (1)
Karen R. Gerard and Matthew C. Bingay (1)
E. Richard and Wanda L. Good (1)
Ramniklal J. and Vijayaben R. Goradia (3)
Clifton Greer (3)
Alma C. Hale-Cooper (3)
Dr. James A. and Sue M. Haley (1)
Tammy Harman (1)
Melissa Harmon (1)
Leslie Harris (7)
Dianne Hautanen (3)
Julia H. Hawse (23)
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Lindsi Hedrick (1)
Nancy Hernandez (2)
Brent and Karen Holl (5)
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Nancy B. Huffman (1)
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Anna F. Jefferies (1)
Robert R. Jefferson (1)
Julie O. Jones (1)
Karen Jordan (15)
Justine Kabesha (1)
Gary A. Kardos (19)
Sarah Karnes (18)
Cassandra King (3)
Paul F. and Mary J. King (1)
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Erin Knapik (1)
Sabrina H. Knight (9)
Frances Knott (1)
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Jenny Loraine Caston, Mother Lloyd A. Caston
Loretta Clapper Lee E. Clapper, Sr. Joe Coakley
Robert L. and Nancy B. Wiskeman
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Dawn Crawford Christy L. Crawford
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Linda A. Davis
Richard C. and Helen K. Davis
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Sunnyside Communities
Judith Ann Destefano
Virginia Pope
Dr. Aubrey and Mrs. Pauline Cook Duffer
Judith D. Roop
Hampton Walker Foley Mabel Anna Foley
Nancy Jean Fundinger
Aileen P. Bertoia
Anita H. Brechtel
Linda and Randy Combs
Paul T. and Ruth A. Fekete
Fred and Michele Fielding
Herbert Slade and Susanna Finn
Wolfgang G. Fundinger
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Celia M. Mitchell
Terry L. and Linda Morris
Donald R. and Nancy M. Myers
Louisa S. Painter
George and Glenda Stickley
William G. and Hope Shank Stoner
Eileen Waterhouse
Hahn Cancer Center Staff and Nurses
Mike and Tami Plaugher
D. Dean Hunsberger
John R. and Mary Ann Heatwole
Anita Kiracofe Heatwole by her children
Cindy Fike, Deb Payton and Ken Heatwole
Glenna Margaret House
Lillan B. Hilbert
Dorothy Huffman
Genevieve W. Huffman
Roy W. and Judith A. Matlick
Sharon Kay Jahde-Barkley
William Barkley
Ruth Bowman Jarrells Yvonne Jarrels
Harry R. Laatz
Marianne Laatz
In memory of wife, Susan Layman
Eldon F. Layman
Julia Long Orville L. and Betty H. Long
Robert Douglas McCall
Robert M., Jr. and Donna S. Golson
Alan Meilinger Kathleen and John Houseman
Joy Ellen Michael Collins-Hughes VFW, Post 3136
Louise ‘Dot’ Moomaw Otis L, Jr. and Crena M. Ryman
Margene Mitchell Moore George and Cary Hevener
Lois M. Oster Charles V. Oster
Dorothy V. Price and Evelyn V. Stultz Rodney and Ruth Stultz
Elva H. Ratliff
Lloyd E. and Joan H. Heatwole Larry L. and Donna B. Newberry Kenneth E. and Janice B. Ryman
Robert Rhan Mary E. Rhan
Michael Roadcap Michael J. and Heather L. Gigliotti
Wanda White Roadcap, Class of 1965 Linda B. Scrogham
Brenda L. Rosenberger Ernest L., Jr. and Barbara B. Mongold
Michael Eugene Ruckman, Jr. Drs. Brooke and Will Goodwin Cardinal Dental Specialists
J. Wilson Ryman Cynthia V. Ryman
Gilbert and Carolyne Schuckman Susan L. Schuckman
Lyman and Rosemary Seese Donald W. Seese Lyman G. Seese, Jr.
Carolyn Shifflett Nelson and Linda Simmons
Erik Carl Shifflett Denise Dean Shifflett
Earl Everette Shirkey Friends at LMI R. Allen and Susan N. Miller India R. Strickler
Jenell Elaine Counts Sipos Harrisonburg Department of Public Transportation
Debbie K. Smith Everett L. Smith
Thomas Scott Stephens
Edward J., Jr. and Ellen D. Baldwin Donald R. and Nancy M. Myers
Jeff A. Ramsey
Benny C. Stout
Gloria Stout
Diana Cline Summers Frank M. Summers
June Thompson Paul A. and Elizabeth Cole Hart
Charles Tuller Sandra K. Tuller
Anne H. Vance William and Suzanne Vance Phyllis Lee Zimmerman Wampler Barbara R. Page
Polly Wean Foelke D. Nair Dr. Gene L. Yoder Mary Sue McDonald
Betty W. Browning Jeffrey D. and Faye B. Curl
Ted and Cindy Bryan Darlene L. Newman
Elizabeth E. (Betty) Herman Durrett Lillan B. Hilbert
Personnel at the Funkhouser Women’s Center Utterback family
Gloria Golladay Green Lillan B. Hilbert
Gayle Hastings, in gratitude for my care Caroline H. Ketler
In Honor of Nurses, 4th Floor, who cared for me on the night of February 17 Walter G. Byrd
Michael Wade Hoover, for saving his life Thomas W. and Jane M. Hoover
Mary Ellen Houser Kyger Lillan B. Hilbert
Don and Nancy Lemish Denise A. Whitman Dr. Ben Mwanika Christopher A. and Trina L. Ellis
Nurses Robert E. and Gail L. Hess Nurse, Ann Royer Bill and June Nabers
Sentara RMH Nurses Lareth L. May
Lottie Anderson Showalter Ralph J. and Linda F. Rhodes
Francie Suter Terry G. and Victoria G. Slaubaugh
Diane Trobaugh Laura G. Price
Jean Ann Turner Ronald M. and Linda C. B. Hotinger
Tina and Phil Updike James B. Richardson, Jr. Janet T. Wendelken Drs. David K. and Charlette E. McQuilkin
Salinda has been a nurse with Sentara RMH Medical Center for nearly 40 years. Every day, she demonstrates a true passion to caring for her community.
“What makes me proud is the fact that we have everything here. We have the people and technology here. Sentara makes a huge difference in this community, but it’s us that make the facility what it is and the services we provide.”
For the team at Sentara RMH Medical Center, our work is not just our job, it is our passion.
Hear more of Salinda’s story at Sentara.com/RMHpeople.
At Sentara Pulmonary & Critical Care Specialists, our team of experts is dedicated to ensuring you’re breathing well and living well. Our team includes highly-trained pulmonologists, respiratory therapists, and nurses who provide care to patients of all ages. Our team is on call 24 hours a day, 7 days a week.
