carilion clinic living

Carilion Clinic

e Joy of Walking

Inspiring Better Health | CarilionClinic.org | Spring 2013

Is Your Child Getting enough Sleep?

The Latest in Joint Replacementand Heart Surgery

HEALING ARTSPROGRAM DEBUTS

ABOUT THIS SMALL.

CarilionClinic.org/daVinci | 800-422-8482

Less than half an inch. That’s the length of incisions

when you’re talking about the da Vinci® Surgical

System. With that small cut, surgeons at Carilion can

accomplish big things, and offer you less discomfort

and a shorter recovery. It’s a revolutionary approach

to care, and only Carilion offers it here. Ask your

doctor about da Vinci. You may have less to talk

about than you ever imagined.

The da Vinci Surgical System is available at:• Carilion Roanoke Memorial Hospital• AND NOW at Carilion New River Valley Medical Center

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CarilionClinic.org | SPRING 2013 1

Carilion Clinic

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SPRING 2013 FEATURES

DEPARTMENTS

Carilion Clinic

�e Joy of Walking

Inspiring Better Health | CarilionClinic.org | Spring 2013

Is Your Child Getting enough Sleep?

The Latest in Joint Replacementand Heart Surgery

HEALING ARTSPROGRAM DEBUTS

On Our CoverKatie Howey, a grad studentat Virginia Tech, walksWillow, her 8-month-oldGoldendoodle, on theRoanoke River Greenway.

President’s Message3 Walking benefits mind and body.

Healthy Lifestyles4 Tips from Carilion Clinic medical professionals.

In Your Community6 Making a difference in western Virginia.

New Providers24 New physicians across our region.

Better Living28 Your health calendar.

Child Safety5 Many kids don’t get enough sleep.

Pregnancy8 New alternatives for childbirth.

Innovations10 Healing arts program is launched.

Joint Replacements12 e newest options.

Heart Disease14 Specialty care close to home.

Activity16 Walking for fun and fitness.

Neighborhoods20 Wasena has more to offer.

Quality Care22 Awards recognize strides in health care.

Retail Pharmacies23 How they can help you.

Advanced Care27 Epilepsy monitoring unit opens.

2 SPRING 2013 | CarilionClinic.org

CARILION CLINICPReSIDeNT AND CeONancy Howell Agee

CARILION CLINIC 1906 BeLLeVIew AVe.P.O. BOx 13367ROANOke, VA 24033540-981-7000

CARILION CLINIC LIVINg IS PRODuCeD BYSTRATegIC DeVeLOPMeNT:

VICe PReSIDeNT Of STRATegIC DeVeLOPMeNT Shirley Holland

SeNIOR DIReCTOR, MARkeTINgMike Dame

eDITOR Maureen Robb

LeAD DeSIgNeRDavid Porter

DeSIgNeRTaryn Anderson

CONTRIBuTINg wRITeRSKaren Doss Bowman, Allison Buth, Su Clauson-Wicker,Jay Conley, Rich Ellis, Laura Markowski, Otesa Middleton Miles, Erica Stacy, Randolph Walker,Alison Weaver

PHOTOgRAPHeRDarryle Arnold

CONTRIBuTINg PHOTOgRAPHeRSMarino Colmano, Sam Dean

PRINTINgChocklett Press

CARILIONCLINIC.ORg | 800-422-8482

Carilion Clinic is a not-for-profit health care organization servingnearly one million people in Virginia through a multi-specialty physi-cian group, advanced primary care practices, hospitals, and outpatientcenters. Led by clinical teams with a shared philosophy that puts thepatient first, Carilion is committed to improving outcomes for every pa-tient while advancing the quality of care through medical education andresearch.

Copyright 2012 by Carilion Clinic. No part of this publication may be reproduced ortransmitted in any form or by any means without written permission from CarilionClinic. Articles in this publication are written by journalists or authors who strive topresent reliable, up-to-date health information. However, personal decisions re-garding health, finance, exercise and other matters should be made only after con-sultation with the reader's physician or professional advisor. All editorial rightsreserved. Opinions expressed herein may or may not reflect the views of CarilionClinic.

If you would like to be added to or removed from the mailing list for Carilion ClinicLiving, please call 800-422-8482, email us at [email protected], or write to usat Strategic Development, 213 McClanahan St., Roanoke, VA 24014.

Karen Doss Bowman is awriter who contributesto health care publica-tions, including the University of Virginia’sVim & Vigor. A native ofBassett, Va., she nowlives in Bridgewater.

Marino Colmano is anaward-winning photog-rapher whose work hasappeared in magazines,art exhibitions, and setpieces in film and televi-sion. He has also directeddocumentaries and shortfilms. His studio is inBlacksburg.

Sam Dean, a former pho-tographer for TheRoanoke Times, has beenpublished in The NewYork Times, The Washing-ton Post, Time and Peoplemagazines, and otherpublications. He has wonmany state and nationalawards.

Rich Ellis has written formany Roanoke Valleypublications, includingOur Healthmagazine.Nationally, he writes forArchitectural Salvage &Antique Lumber News.

Randolph Walker is awriter and musician inRoanoke. Formerly astaff writer with TheRoanoke Times, his workhas appeared in manypublications includingVirginia Living, ValleyBusiness Front, and TheRoanoker.

Alison Weaver is a free-lance writer based inRoanoke. Her work hasappeared in Valley Busi-ness Front, The RoanokeTimes, Good Housekeep-ing, Woman’s Day, Red-book, and Seventeenmagazine.

Our Contributors

President’s MessageHave you taken a good walk lately? If so, you probably came away feeling re-

freshed and invigorated. Happily, more people are discovering the joys of walking—and the physical and mental benefits that come with it. Randolph Walker’s articletakes a look at local residents whose lives have been transformed by this simple ac-tivity—and the many ways you can incorporate walkinginto your daily life. I can’t wait to lace up my own walkingshoes!

Is your child getting enough sleep? That’s a challengingquestion for many parents, who struggle to help their kidsstrike a balance in the evening between homework,sports, and family life. Unfortunately we’ve all heard aboutteens who sleep with their cell phones, and who wake upto receive and answer texts. Jay Conley explores the latestresearch on how much sleep kids are getting—and howit may affect their health.

We also profile several patients who have a new leaseon life due to advanced treatments for heart disease. Oneof these, Vickie Hoffler of Vinton, is a heroine who person-alizes inspiration. A year ago, Vickie was the first patient toreceive a mechanical heart pump at Carilion. It kept heralive and thriving until she was able to have a heart trans-plant a few months ago at UVA. I hope you’ll read herstory of courage.

Improving the quality of health care is our ongoing priority. Each year, we work tocut down on infections, reduce costs, and improve patient care in every way. Onpage 22, we’re proud to tell you about the 2012 Carilion Clinic Quality Awards, whichrecognize the achievements of our medical professionals. We thank all the recipientsfor their dedication and commitment to patient care!

wARM RegARDS,

NANCY HOweLL AgeePReSIDeNT AND CeOCARILION CLINIC


Nancy Howell Agee speaks at ferrum College,where she recently served as executive in residence.— Photo courtesy of ferrum College


Start Small when Making LifestyleChanges Break up significant lifestyle changes

into smaller, more manageable goals. Ifyou need to change your diet, start byeliminating soft drinks. If you want tostart an exercise program, walk or climbthe stairs for five minutes a day. If youneed to lose weight, focus on the first 10

pounds. en, when you have achieved the smaller goal, youwill be ready to tackle a larger one.

— Catherine G. Rea, M. D. Carilion Clinic Family Medicine, Blue Ridge

Create Balance in Your Life It is often difficult to give equal time

to professional, family, andrecreational activities. But time awayfrom work is essential to both our men-tal and physical health. Budget time todo the things you enjoy. Also, try to stayin shape, especially if you enjoy outdooractivities like skiing, water sports, or

mountain biking. Nothing’s worse than ending your ski trip inthe first aid hut. Invest time and effort in keeping fit duringthe other 50 weeks of the year, so you can enjoy your twoweeks on the mountain, river, or hiking trail.

— J. Randy Howell, D.H.Sc., Certified Physician AssistantCarilion Clinic Emergency Department, Roanoke

Tips from our Medical Professionals

Make Sleep a PriorityMy health tip is to get at least seven to

eight hours of sleep a night. Our bodiesneed a good night’s sleep to functionproperly. Cells need sleep to regenerate.A good night’s sleep can also help pre-vent overeating, improve your mood andmotivation, and generally help you to feelbetter. So be disciplined. Turn off the TV

and make it to bed on time and see how you feel!— Joy Badillo, Nurse Practitioner

Carilion Clinic Family and Obstetric Medicine, Christiansburg

Avoid Colds and flu Year-Roundere are many ways to prevent gettingrun down by colds and flu. Hand washingis most important in preventing thespread of harmful germs. Getting ade-quate sleep helps to keep your immunesystem strong. Exercising regularly anddrinking adequate fluids also enhancesthe immune system. Avoid smoking.

Smoking is an irritant that increases susceptibility to cold andflu viruses. And remember, you can contract colds and flu allyear long—so don’t let your guard down.

— Jennifer Adkins, M.S., Certified Physician AssistantCarilion Clinic Family Medicine, Brambleton

Don’t Misuse Antibiotics Antibiotics are still often prescribed

unnecessarily for viral respiratory infec-tions. is is alarming as it can lead toantibiotic resistance and also develop-ment of “superbugs.” Part of this is dueto patient expectations. Some patientshave taken antibiotics for viral respira-tory infections and gotten better, even

though they would have improved without medication. Mostof the time, symptomatic treatment is all that is needed. Rest,adequate hydration, and using natural remedies such as vita-min C can be very helpful.

— Jeremy A. Llavore, M.D.Carilion Clinic Family and Internal Medicine, Boones Mill

know the Signs of a ConcussionConcussions can occur with a fall or a

biking or motor vehicle accident—notjust a sports injury. Concussions are alsounder-reported because there may be nooutward signs or symptoms. Be on thelookout for one or more of the follow-ing: headache, fogginess, moodiness,nausea/vomiting, and irritability. Loss of

consciousness may not occur. If you suspect a concussion,please seek immediate medical treatment.

— April Nichols, Physical erapy AssistantCarilion Clinic Outpatient erapy – Roanoke AthleticClub

HEALTHY LIFESTYLES


Does your child go to bed with a cell phone—and wake upat all hours to text or read new messages?If so, you’re not alone. Sleep researchers say that many children are

scrimping on sleep due to this and other distractions. And that it canaffect their grades and health.School-age children have more distractions than ever preventing

them from getting needed shut-eye, according to the National SleepFoundation. Aside from homework, sports, and other extracurricularactivities, they can have trouble turning off the TV, smartphone, andInternet. Combine that with early classes, and the window of timeavailable for sleep seems to keep shrinking. Drowsiness or fatigue are also leading causes in at least 100,000

traffic accidents annually, and drivers age 25 or younger are involvedin the majority of accidents where drivers fall asleep, says the Na-tional Sleep Foundation.“Even if you get into bed at 10 o’clock and you have to be up at 6,

you’re only getting 8 hours of sleep in the best of worlds if you sleptthe whole time,” says Helene A. Emsellem, M.D., a neurologist andmedical director of e Center for Sleep & Wake Disorders in ChevyChase, Md. “We feel the adolescent population is sleep deprived ingeneral.”A recent study from UCLA, published last August in the journal

Child Development, indicates that when teens stay up late to study, theextra time studying not only doesn’t compensate for the lack of sleep,it has a negative effect on their grades.“I think the real implication here is don’t sacrifice one for the

other,” says Andrew Fuligni, a UCLA professor of developmental psy-chology who worked on the study. “If you have extra academic de-mands, you need to fulfill them, but don’t sacrifice sleep to fulfillthem.”Another new study, however, indicates that kids may be getting

enough rest. is study, conducted at UCLA and published in theArchives of Pediatrics & Adolescent Medicine last November, collecteddata on 1,500 to 2,800 children from 1997 to 2007. It indicated thatthey got the recommended amount of age-appropriate sleep.Researchers based their findings on parents’ reports of their chil-

dren’s sleep habits.How much sleep do children need? It depends on their age. e U.S.

Centers for Disease Control and Prevention recommends that kidsages 5 to 10 get 10 to 11 hours of sleep, and adolescents ages 10 to 17get 81⁄2 to 91⁄4 hours.One thing we do know: Getting enough sleep is critical to learning,

says Dr. Emsellem.

Are Kids Gettingenough Sleep? By Jay Conley

Once again, Carilion Roanoke Memorial Hospital and Carilion New RiverValley Medical Center received Consumer Choice Awards, placing themamong the best in the country. e awards, from National ResearchCorp., are based on a national survey of more than 250,000 households.ey are given to hospitals ranked the highest in their market for overallquality, doctors, nurses, and image/reputation. Carilion Roanoke Memo-rial Hospital has received the award for nine consecutive years; CarilionNew River Valley Medical Center for three.

Dr. Carol M.gilbert HonoredIn honor of trauma surgeon Carol M.Gilbert, M.D., Carilion Clinic has es-tablished an award in her name. eCarol M. Gilbert Lectureship will beheld annually, featuring a specialguest speaker. Dr. Gilbert was recog-nized for her contributions as a men-tor to medical students and residentsand for her leadership in emergencymedical services and search and res-cue operations. Pictured: Dr. Gilbertwith Christopher C. Baker, M.D.,chair of surgery at Carilion.

DRAGON BOAT RACE BENEFITS CHARITYe first dragon boat race at Smith Mountain Lake washeld to benefit the Presbyterian Community Center. Caril-ion Clinic and VelocityCare, two of the main sponsors, en-tered one of the nine teams that raced; more than $10, 000was raised. e Pan American Dragon Boat Associationprovided all boats and pre-race practice sessions.

IN YOUR COMMUNITY


CARILION HOSPITALSRANKED MOST-PREFERRED

Cardiac Lab Recognizede cardiac catheterization lab at Carilion Roanoke Memorial Hospital is the first in Virginia, and one of only 10 nationwide, to earn accreditationfrom ACE (Accreditation for Cardiovascular Excellence).ACE’s mission is to ensure high-quality patient care andto promote patient safety in facilities where invasivecardiac and endovascular procedures are performed.

SCAN TO WATCHA DRAGON BOATRACE IN ACTION!

»


CARILION CLINIC PROVIDESOVER $131 MILLION IN COMMUNITY BENEFITere are many ways an organization can give back to thecommunity. Some pay taxes to support the cost of govern-ment services. As a tax-exempt organization, Carilion Clinicgives back in other ways. In 2011, Carilion Clinic provided $131.1 million in com-

munity benefit. is meant that for every dollar of tax ex-emption, Carilion gave nearly $5 back to the community.is included an average of more than $292,000 in uncom-pensated care each day. Community benefit, as defined bythe IRS, includes community outreach such as free healthscreenings and community programs, and investments ineducation to train new physicians and medical professionals.

Dr. Sidney MallenbaumHeads Task ForceSidney Mallenbaum, M.D., was electedco-chair of the Virginia Stroke SystemsTask Force for a two-year term. e taskforce’s purpose is to improve stroke careand access to care for stroke victimsacross Virginia. Dr. Mallenbaum is med-ical director of the stroke unit at Carilion Clinic and associateprofessor of neurology at the Virginia Tech Carilion School ofMedicine.

TRAUMA CENTER RECERTIFIEDCarilion Clinic’s Level I Trauma Center received its three-yearrecertification by the Virginia Department of Health. e cen-ter, at Carilion Roanoke Memorial Hospital, is one of only fiveLevel I trauma centers in the state — the highest designationawarded. e trauma center has been certified since 1983.

COMMUNITY BENEFIT$131.1 MILLION

TAX EXEMPTION$28.3 MILLION

UNCOMPENSATED CARE:$106.7 MILLION(CHARITY CARE: $65.4M)

EDUCATION:$20.4 MILLIONCOMMUNITY OUTREACH:$3.3 MILLIONRESEARCH:$.7 MILLION

$131.1 MILLIONTOTAL

COMMUNITY BENEFIT

Children’s Hospital Awarded grantCarilion Clinic Children’s Hospital received a $36,252grant from Kohl’s Department Stores to provide freeportable cribs to families in need in Roanoke and Lynch-burg. e grant, through the company’s Kohl’s Cares pro-gram, will support a new initiative, Kohl’s Infant SafeSleep. e No. 1 killer of infants is suffocation due to anunsafe sleep environment. For more information, go toCarilionClinic.org/kiss.


MEDICAL NEWS

Luckily for Gibbs, Carilion New River Valley Medical Centerhas three master’s-degree certified nurse-midwives on thehospital’s staff. Gibbs met with both a physician and midwifeKris Conrad during her pregnancy, and delivered baby Kyle atthe hospital’s “e Birthplace.” Midwives Conrad and MattieBerry were on duty.“Kris and Mattie were wonderfully supportive throughout,”

Gibbs says. “ey explained the facts and let me decide manythings. I was so involved this time.”Since September, e Birthplace has offered midwife serv-

ices 24/7. Patients can choose whether to deliver with a physi-cian or a midwife, and almost 20 percent request midwives.“We’re in partnership with our clients,” Conrad says. “We

support their autonomy as well as their health.”

New Alternatives

By Su Clauson-wicker

FOR EXPECTING PARENTS

Sarah Gibbs, a permaculture garden designer,likes to do things naturally. But at 42, shewanted to deliver her second child in a hospital,as she had her first. Gibbs wanted medical ex-pertise, but she craved more control over herbirth experience.

Top: Midwife Sherrie Doss holds newborn Aubrei Stump.Bottom: Midwife Mattie Berry listens to fetal heart tones asshe examines Aubrei’s mother, Tristi DeBord.


Easing Labor

Women beginning labor areadvised to soak in a warm tub.The water’s buoyancy lifts thebaby’s weight off the mother’sback and relieves contractions. Now women have the labor tuboption at Carilion RoanokeMemorial Hospital, where thetub was installed last fall.(Patients undergo labor in thetub, but do not deliver in it.) “I was thrilled that theyinstalled the tub at RoanokeMemorial weeks before mydelivery,” says Laura Godfrey ofRoanoke. “I went from 5 cm tofully dilated and pushing in anhour. I didn't need painmedication.”Andrea Cobb, M.D., whopractices at Carilion Clinic’sobstetrics and gynecologypractice in Salem, recommendsthe tub for women foregoingepidurals. “Tension prolongslabor,” she says. “When awoman relaxes in the tub, herbody proceeds naturally.”

e midwives also enjoy a collaborative relationship with physicians. “ecare we give is complementary,” says Conrad. “We each have strengths to offer,and the care we provide as a group gives women many options to meet theirneeds.”“We encourage all patients—even those requesting a midwife for labor—to

see both a physician and midwife during their prenatal care,” adds Berry.“ere is always a possibility that a physician may need to be involved in thelabor or birth.“What makes our practice so unique is that we share patients together, pro-

viding the most well-rounded maternity care possible.”Patients who choose a midwife for delivery can also ask for an epidural to re-

lieve their pain. While many prefer to go through labor naturally with a mid-wife, it isn’t required. “Midwives also provide continuous labor support, which has been shown to

decrease interventions in labor,” says Sherrie Doss, who in 2007 was the firstmidwife to join the hospital’s staff. Doss and Conrad have doctorates in nursing in addition to their master’s de-

grees. “It’s unique to guarantee midwife availability,” says Patrice M. Weiss, M.D.,

chair of Carilion Clinic’s Department of Obstetrics and Gynecology. “We offerthis to even high-risk patients, such as diabetics, because e Birthplace is in ahospital with OB/GYN availability to do a Caesarean section very quickly, if inthe unlikely event this is needed.”e Birthplace has won the coveted five-star rating in patient satisfaction

three times from Professional Research Consultants, Inc. e Birthplace teamoffers family-centered care in homelike rooms with sleep sofas, refrigerators,televisions, and massage therapy for patients. “We’re here to offer families the best possible birth experience,” says Dr.

Weiss. Laura godfrey holds her daughter, Avery,at the labor tub.

L to R: Midwives kris Conrad, Mattie Berry, and Sherrie Doss.


MEDICAL NEWS

HEALING ARTS PROGRAM DEBUTSBy Rich Ellis

Artas

Medicine

Soon there will be a new form of treat-ment available in the region—one thatdoesn’t involve medication or even over-sight by a physician or nurse.A healing arts program that incorporates the literary,

visual, and performing arts is being launched by CarilionClinic.Named after the highly regarded Roanoke thoracic

surgeon, e Dr. Robert L.A. Keeley Healing Arts Pro-gram will create inspiring and restorative environmentsfor patients, visitors, and caregivers. (Dr. Keeley, 91, ismedical liaison for nursing services at Carilion RoanokeMemorial Hospital.) “We’re beginning with a pilot project to introduce

journaling in several units at the hospital,” says MarieWebb, senior director of community outreach for Caril-ion. “We’ll distribute journals and pens to patients whoare often hospitalized for a longer period of time, such asoncology and cardiac surgery patients.“Patients want to express their feelings,” Webb says.

“Journaling gives them that opportunity. Some patientsmay choose to create their own life map or tree of life intheir journal.”Writing in a journal can also help patients ease their

transition from the hospital to home by letting themwrite down questions about their care, along with theircaregivers’ instructions.

A Healing environmentAs part of the program, a healing garden will be

planted near the Roanoke River Greenway in partner-ship with the City of Roanoke. “We’re creating a small


garden near Roanoke Memorial between the greenway and the river,” says DanielDart, landscape designer for Roanoke’s Parks and Recreation department.“It will have benches and a swing surrounded by aromatic plants like rose-

mary, thyme, and butterfly bushes, as well as paved areas. We’re trying to cre-ate a secluded garden that’s sequestered from the rest of the world toencourage the healing process.” e garden is expected to open this spring or summer; a ceremony will be

held to dedicate it in honor of Dr. Keeley.

A Community CollaborationCarilion is developing the healing arts program in collaboration with mem-

bers of the local arts community. A steering committee is developing a list ofpotential offerings, cultivating partnerships, identifying volunteer resources,and recommending artists and works. “is is something I’ve been interested in for a while,” says Susan Jennings,

arts and culture coordinator for the City of Roanoke and a committee member. “One important aspect of the program is that it’s not just for patients but

also for health care professionals. Involvement in the arts promotes healing aswell as stress relief, and with health care being so stressful, this can help.”rough her interaction with the Roanoke Arts Commission, Jennings is

also spreading the word about the healing arts program and seeking ideas fromothers in the art community. Integrating arts with the healing process isn’t a new idea at Carilion.

Roanoke Memorial already offers recorded music therapy and guided imageryfor cardiac patients, live performances and arts and crafts projects in the pedi-atric unit, and expressive arts therapy for adult and pediatric patients in the be-havioral health unit.Live bluegrass music performances are also staged weekly by volunteers in

the outpatient oncology waiting room, and other live performances take placein the hospital’s lobby. An art wall displays paintings by local artists that areavailable for purchase. e formalization of the healing arts program, though, will greatly expand

patients’ access to art as part of the healing process. Now that’s powerful medicine.

e Carilion Clinic Foundation is raising fundson behalf of the healing arts program. For moreinformation about the program, and how youcan support it, call 540-224-5398 or go to CarilionFoundation.org.

Boosting the Healing Process

Healing arts programs createhealing environments thatsupport a patient’s mental andemotional recovery. Studiesshow that art can reduceanxiety, lower blood pressureand stress hormone levels,enhance sleep patterns andalertness, and raise painthresholds and mood. Some hospitals around thecountry, including the MayoClinic and Cleveland Clinic, nowhave healing arts programs.In support of its new program,Carilion Clinic received a $25,000grant from Epic Systems Corp.The grant, which will lay thefoundation for the program, willpay for art materials for use bypatients and their families atCarilion Roanoke MemorialHospital.The funds may also be used tocreate public art spaces withinthe hospital.


MEDICAL NEWS

As a cardiothoracic surgeon, Paul Frantz,M.D., doesn’t enter into surgery lightly. But once the degenerative arthritis in his left

hip began keeping him from doing the outdooractivities he enjoyed most—such as skiing andhiking—he knew it was time to consider a hip replacement. “I was walking with a limp and was in pain,”

says Dr. Frantz, Carilion Clinic’s director of car-diac services. “It was progressively getting worse,and when I had difficulty doing the things Iwanted to do, I decided to schedule the surgery.”His hip replacement was done through the

anterior approach—a relatively new technique.Joseph Moskal, M.D., section chief of ortho-paedics, introduced it to the region nearly fouryears ago, and since then, he and his colleagueshave performed more than 1,000 of these proce-dures at Carilion.

Enjoying Life after a Hip

Replacement By Karen Doss Bowman

Minimally Invasive Surgery

Minimally invasive surgery has manyadvantages, including smallerincisions, less discomfort and bloodloss, shorter hospitalization andrehabilitation, and a quicker return towork. The surgical team at Carilion Clinicperforms a number of minimallyinvasive, laparoscopic or endoscopicprocedures, including partial andtotal hip, knee, and anklereplacement surgeries.

Surgeons trained inthe anteriorapproach technique:John Mann, M.D.Joseph Moskal, M.D.Michael Wolfe, M.D.


Reclaiming Her Life

For Susan Marchon, a new hip has recharged her life.In June, Marchon underwent anterior hip replacement surgery onher deteriorated right hip. With her painsignificantly reduced, she is able to keep upwith the demands of daily life. “It was the best thing I ever did,” saysMarchon, the executive director of the NewRiver Valley Alcohol Safety Action Program.“It’s been a miracle. I feel like I have my lifeback.”Marchon, who also had back surgery in2011, had read about the anterior approachand knew she wanted to take that route.Joseph Moskal, M.D., section chief of orthopaedics at CarilionClinic, performed the procedure. When she got home, Marchon discovered that everyday tasks wereoften the hardest. Wanting to help others, she created a brochurepacked with advice on everything from how to put oncompression stockings and going to the bathroom to organizingyour home before surgery. “These are the things I needed to be as independent as I possiblycould during my recovery,” she says. Marchon is grateful for the care she received and oftenrecommends Dr. Moskal to others. “I’m a Dr. Moskal groupie,” shejokes. “If anyone I know has hip issues, I refer them to him.”

Ankle Replacement

Ankle replacement surgery isnow available at Carilion Clinicfor patients with severelydamaged ankle joints causedby end-stage arthritis ortraumatic injury. The rareprocedure, offered by just afew surgeons in Virginia,provides an alternative toankle fusion surgery andpreserves ankle motion.The surgery involves replacingdamaged bone in the anklejoint with artificial prosthetics.“This procedure providespatients with an option ofmaintaining joint motionwhile decreasing their pain,”says Carilion Clinic podiatrist J.Randolph Clements, D.P.M.,who performs the procedurein tandem with orthopaedicsurgeon Thomas E. Shuler,M.D. “If you can preserve themotion at the ankle joint, thenit helps prevent other jointsaround the ankle fromwearing out.”Though Drs. Clements andShuler see many patients withdebilitating conditions of theankle joint, few qualify for theprocedure. The typicalcandidate is over age 50 andnot obese, with no footdeformities or nerve damagefrom diabetes.

e computer-guided procedure in-volves making a small incision on thefront (anterior) of the hip. Unlike thetraditional approach to hip replacement,this method does not require the cuttingor detachment of muscles and tendons.at means patients can expect less painand a quicker recovery. ere is also a re-duced risk of dislocating the joint.Dr. Frantz, whose wife, Susan, had

traditional hip replacement surgery inPittsburgh nearly a decade ago, believesthe anterior approach is superior. “I had heard about it and read that re-

covery was faster,” he says. “Having beeninvolved in my wife’s care after her sur-gery, I knew I wanted to try for a lesspainful course.”He was out of the hospital within a

few days of surgery and was walkingwithout help soon after. He’s been pleased with his results.

“I’m back to my full range of activitywith no limitations, except running isn’trecommended after a hip replacement,”says Dr. Frantz, who regularly bikes,hikes, and works out on his ellipticaltraining machine. “It took a while to getback the full range of motion I once had,but this surgery has made all the differ-ence in the world.” e surgeons on the joint replace-

ment team recommend that patientstalk to their doctors to discuss potentialalternatives to surgery. ey also advisepatients to exhaust all other options,such as modifying their activities, get-ting more rest, and using appropriate

medications. ey believe that surgery isalways the last option, but that for thosewho need it, the prognosis with the an-terior approach is excellent.Dr. Frantz agrees. “e speed of re-

covery with this muscle-sparing ap-proach was amazing.”


SPECIALTY CARE

Heart disease is complex, andtreating it successfully requiresspecialized knowledge. In the Roanoke Valley, Carilion Clinic

offers three unique programs to patientswith severe heart conditions. All have received a strong response

from patients, many of whom previouslywould have had to travel outside the re-gion for such care. Here are three oftheir stories.

Heart failure Clinic“e program has two main goals—

to care for patients with severe heartfailure who require vigilant follow-up,and to provide easy access for patientsrecently discharged from the hospital forheart failure,” says Carilion cardiologistStephen Phillips, M.D. Heart failure patients typically have

high hospital readmission rates. By see-ing patients within a week after dis-charge, the heart failure clinic caneducate them about their medications

and provide follow-up treatments thatimprove their quality of life.Some patients with advanced heart

failure can benefit from an innovationknown as a left-ventricular assist device

(LVAD) —a mechanical heart pump thathelps pump blood throughout the bodywhen a patient’s heart is too weak to doso. “Our objective is to stay on the frontedge of evolving science for advanced

New Options for Ailing Hearts

By Allison Buth

Heart patient Vickie Hoffler and her husband, Charlie.


treatment of heart failure,” says Carilioncardiothoracic surgeon W. Scott Arnold,M.D. “One of those treatments is theLVAD.” A year ago, Dr. Arnold implanted the

first LVAD at Carilion in patient VickieHoffler of Vinton, who arrived at thehospital in dire condition. “Once Vickieproved that she was going to survive,we put in the implantable device,” hesays. “At that point, we didn’t know if

she would have it indefinitely or justuntil she received a heart transplant.”Recently Hoffler did undergo a

heart transplant, but the LVAD kepther thriving until she received hernew heart. “I am so thankful this im-plant was available and I was able toget it,” she says. “At that time, it wasmy only option.”

Heart Valve Centere heart valve center is available to

patients with severe aortic stenosis, ornarrowing of the heart’s aortic valve,which obstructs blood flow. One new treatment available to such

patients is transcatheter aortic valve im-plantation (TAVI). During the minimallyinvasive procedure, an artificial heartvalve is implanted by passing it throughan artery in the leg up to the heart usinga tube, or catheter. Special imagingequipment helps guide the valve intoplace.TAVI was recently approved by the

FDA as a treatment for high-risk pa-tients and those who are not candidatesfor traditional open heart surgery. It isonly available in about 200 medical cen-ters nationwide. Interventional cardiologist Jason Fo-

erst, M.D., brought the ground-breakingprocedure to Carilion after training for

nearly a year in Germany. “Physiciansand patients often think that the elderlypopulation is too old for surgery,” hesays. “But TAVI is typically offered to pa-tients who are 80 to 90.”Patient Ruby Poore, 86, was referred

to Dr. Foerst by Richard Konstance,M.D. “I was not a candidate for open

heart surgery,”she says. “WhenI found out I wasa candidate forTAVI, I prayed alot about it. Iwanted to livefor my son,grandchildren,and great grand-son who will beborn in thespring.”

Prior to TAVI, she was in a lot of pain,wheezing and frequently out of breath.“I feel very lucky,” says Poore, of

Roanoke. “I can get around now to cookand clean a little. I sleep better now be-cause I breathe better, and I have in-creased stamina. TAVI gave me a newlease on life.”

Center for Atrial fibrillation (A-fib) “A-fib is very common—the most

common arrhythmia in the U.S., infact—but with complex symptoms,”says cardiac electrophysiologist CarlMusser, M.D. “We’re unique in that wehave experts devoted to treat this.” Within the program, doctors diag-

nose, treat, and manage electrophysiol-ogy disorders and provide cardiacablation for a-fib.Patient Susan Hinchee of Roanoke,

for instance, was treated with cryoabla-tion—a minimally invasive techniquethat uses coolant to freeze affected tis-

sue around the pulmonary vein to blockirregular electrical signals.“Susan’s heart was having a hard time

falling back into a normal rhythm afterit went into a-fib,” says Dr. Musser.“ere was a six- or seven-second delaywhere blood wasn’t pumping to herheart, causing dizziness. We put in apacemaker to alleviate that problem. epacemaker provided a safer recovery op-tion for her, and we can forever monitor

her overall arrhythmia through thepacemaker, which is very helpful.”“I can’t say enough about Dr. Musser

and his team,” says Hinchee. “I feel won-derful, absolutely wonderful. I don’thave any symptoms, and I can do what Iwant. I can exercise again, and I now feelhow I felt before I had a-fib.”

For more information on these specialtycare programs, visit carilionclinic.org/heart,or call 540-266-6000 or 800-422-8482.

Ruby Poore

Susan Hinchee


Across our region, more peopleare going for a walk.And whether it’s by themselves or

with friends, family, or a group, they’rediscovering the physical and mental joysof walking.It’s one of the best forms of exercise.

It can be adapted to any fitness level.So it’s no surprise that people of allages are re-discovering an activitythat can be free and easy — or organ-ized and vigorous. ey’re also burn-ing calories, losing weight,improving their health, and reliev-ing stress while they do it. Take Linda Foster of Salem. It’s

hard to believe that this slenderretired nurse was almost 50pounds heavier a little over ayear ago. Foster signed up forthe Lose Big program atRoanoke County’s Green RidgeRecreation Center, where theprogram includes treadmilland track walking. “When Istarted, I couldn’t jog at all,”she says. “I could only walk.”She’s covered a lot ofground since then.Exercising at Green

Ridge is a family affair forAmy Maffe of Salem. Shecame first, then broughther father, Steve DeHavenof Roanoke County. De-Haven in turn got Amy’smom and grandfather tocome. DeHaven likes theflexibility of walking.“You can do it as hard asyou want,” he says. “You

JOY

Retired nurse Linda foster has lost almost 50pounds by walking.

By Randolph Walker

COVER STORY

can get a good warm-up, or get aggres-sive and do a good workout.”Outdoors, the Roanoke River Green-

way attracts many walkers—and theirdogs. Katie Howey, a grad student atVirginia Tech, is one. “I lead a generallyhectic life,” she says. “Between com-muting to Blacksburg, working on mythesis, and my job, it is hard to findtime to go to the gym. at is why I liketo walk. Walking is a physical and men-tal refresher. “During the week, I walk Willow [her

8-month-old Goldendoodle] on thegreenway regularly. On the weekendsmy boyfriend, Willow, and I take ad-vantage of the beautiful region we livein by hiking.” Roanoke residents Tom Johnson,

72, and Pat McMeekin, 63, can also beseen on the greenway with theirSheltie, Ruffian Ready, a.k.a. Ruffy.“He’s gone probably as much as eightmiles in one walk,” says McMeekin.“We carry water for him.”

Johnson, a former runner,switched to walking for healthreasons. He’s not the only one,according to Jim Humphrey,president of the Star CityStriders. “It’s mainly arunning club,” he says,“but we’re lookinginto how to inte-

grate walking into it some, recognizingthat walking is becoming more of a fac-tor and more people are doing it.ey’ve aged out or have hip issues sothey become walkers.” In November, the group’s Star City

Half Marathon included a 10K walk forthe first time.“A lot of the races are becoming walk

friendly,” says Blaine Lewis, co-ownerof Fleet Feet Sports in Roanoke. In theDrumstick Dash, held annually to ben-efit the Roanoke Rescue Mission, walk-ers outnumber runners almost two toone, he says.Group walking not your style? Op-

portunities abound for more solitaryjaunts. Buddy Johnson, 60, works atWalkabout Outfitter in Lexington.“Within a three-mile proximity of Lex-ington, you’ve got four different op-tions,” he says: Woods Creek Trail,Chessie Nature Trail, Brushy Hill Pre-serve, and Boxerwood Nature Center &Woodland Garden. Johnson says hewalks to get in shape for longer tripson the Appalachian Trail. In Roanoke, woodland wanderers

can explore the trails that wind invit-ingly through the 500 acres of parklandon and around Mill Mountain. NancyDye, chairperson of the city’s MillMountain Advisory Committee, liveson the old switchback road up the


Making It a Habit

Need a specific time and dayto get motivated? You’realways welcome to joinPhysicians on Foot, a freewalking program offered byCarilion Clinic. The groupmeets at 8:30 every Saturdaymorning. From April throughOctober, it meets on theRoanoke River Greenway nearCarilion Roanoke MemorialHospital; from Novemberthrough March, at TanglewoodMall.

“It helps to have a group towalk with. It gives you a placeand time to show up,” saysElizabeth Polk, M.D., a familymedicine physician whostarted the program and whooften walks with the group.“There’s no topic, the point isto get out and exercise.”

“It gets me out walking on aregular basis,” says StuartZaikov, 64. Zaikov says he wasintroduced to the greenwaythrough Physicians on Foot.

Carilion has also sponsoredStep by Step, a voluntary 12-week walking program for itsown employees. Each wasgiven a pedometer, with thegoal of walking 10,000 steps,or 30 minutes a day.

Carilion is also a sponsor ofmany running and walkingevents throughout the region.


mountain, closed to through-vehiclesbut open to bicyclists and walkers. “It’senjoyed by people of all ages,” she says.“We see older people walking up it,young couples with babies, and everyonein between.”Popular walking trails elsewhere in

the region include those along the Peaksof Otter in Bedford and in Explore Parkin Roanoke, and Huckleberry Trail inBlacksburg and Christiansburg. (See Re-sources on page 19 for more trail loca-tions.) Indoor tracks and treadmills with

heart rate monitors are also available atthe Roanoke and Botetourt AthleticClubs, as well as certified personal train-ers who can develop individualized pro-grams to help walkers gain strength andendurance.In addition, both clubs offer FIT Rx, a

60-day medical membership that in-cludes fitness consultations and weeklyone-on-one training sessions with a cer-tified personal trainer.

Health BenefitsWhether you’re walking solo or with

16,000 close friends in the DrumstickDash, you’re getting all sorts of benefits.“Walking is good because it is a car-

diovascular exercise,” says ElizabethPolk, M.D., a Carilion Clinic family medi-cine physician. “It also has a benefit forbone health. It’s a weight-bearing exer-cise, so it helps prevent osteoporosis.And it helps improve your mood andyour sleep. Plus it promotes weight loss,which helps manage and correct somechronic medical conditions like diabetesand high blood pressure and choles-terol.”How many calories are you burning?

Dr. Robert Grange of Virginia Tech’s De-partment of Human Nutrition, Foods,and Exercise suggests using an onlinewalking calorie calculator (see link in Re-sources). Enter your weight, the timeyou walked, and your estimated speed.Click “calculate” to find out how manycalories you burned.e benefits of walking aren’t just

physical. For group walkers, there’s a so-

As rock music blasts, threewomen and four men liftbarbells from a squattingposition.Then they set down theweights, race down a grassyslope, pivot, and charge backup.Welcome to CrossFit, a fitnessprogram with varied high-intensity activities, includingweight-lifting. It is oftenpracticed by law enforcementand military personnel to gainstrength, endurance, andflexibility. It has 4,500 affiliatedgyms worldwide, includingCrossFit Blacksburg, RoanokeValley CrossFit in Salem, andBrickhouse CrossFit in Roanoke.“It’s big in any metropolitanarea, and it’s starting to spreadto some of the more ruralregions,” says Tim Falke, co-owner of Roanoke Valley

CrossFit. His clients range in agefrom 14 to 65, with the averagestudent in his or her late 30s tomid 40s. Most work out four orfive days a week. The workouttakes less than an hour.At his first CrossFit workout, inAustin, Texas, Neil Stricklandwas paired with a 49-year-oldwoman. “She made it throughthe workout — I did not,” saysStrickland, 26. “I had a lot tolearn about fitness.”Strickland, a Salem resident, hasbeen practicing CrossFit for twoyears. “I’ve seen better resultsfrom this than anything else,” hesays.Marit Berntson, 49, of Roanoke,is another regular. “I need towork on my bone density andoverall strength and flexibility,”she says. “I had a child prettylate in life, and I want to be ableto keep up with him.”

CrossFit Takes Off

cial benefit as well, says Brad Kinkema,CEO and executive director of the Mar-tinsville-Henry County Family YMCA.His Y offers a free mid-day walking pro-gram called Activate tailored to seniorsand those with low incomes.“You see a lot of people meeting at the

same time,” says Kinkema. “It’s impor-tant for seniors to have social interac-tion as well, if they’re the only person athome.”

A National TrendWith advantages like these, it’s no

wonder that walking is growing in popu-larity. In 1994, the U.S. Department of

Transportation started encouragingurban planners to accommodate pedes-trians. Since then, “there has been meas-urable progress in improving conditionsfor bicycling and walking,” according to“e National Bicycling and WalkingStudy: 15-Year Status Report,” publishedby the department in 2010.In the National Health Interview Sur-

vey, the percentage of people who re-ported walking at least once for 10

minutes or more in the previous weekrose from 56 percent in 2005 to 62 per-cent in 2010. e South showed a largeincrease. Dr. Dianna Carroll, an epidemiologist

with Centers for Disease Control andPrevention, was one of the authors ofthe survey. Researchers didn’t know whywalking increased in the South, but itmight have been related to publicityabout obesity in the region, she says. Inany case, “we were happy to see it.”Another survey that addresses walk-

ing is the U.S. Census American Commu-nity Survey. From 2002 to 2008,workers who commute primarily bywalking increased slightly to 2.82 per-cent.In addition to getting exercise, walk-

ing commuters avoid paying for fuel andvehicle maintenance. “e nice thingabout walking is, it doesn’t require anyequipment or training except maybe apair of tennis shoes,” says Dr. Polk. However, if you’re the type who loves

gadgets and gear, there are stores forthat. Walkabout Outfitter in Roanokeand Lexington has quick-drying gar-

ments for summer and insulated onesfor winter. Fleet Feet Sports, with a loca-tion in Roanoke, specializes in fittingshoes for walking and other activities.One thing is clear: indoor or out-

door—alone or with a group—walkersare taking strides toward a better qualityof life.

Resources

ROANOkeOuTSIDe.COM

OuTDOOR.ORg.VT.eDu

fRANkLINCOuNTYVA.gOV/PARkS

MARTINSVILLeYMCA.COM

CNYHIkINg.COM/BRP-PeAkSOfOTTeR

CARILIONCLINIC.ORg/wALkINg

STARCITYSTRIDeRS.COM

CARILIONfITNeSS.COM

Mill Mountain trails mapRVARC.ORg/MAPS/MILLMTNPARk.PDf

Roanoke Appalachian Trail ClubRATC.ORg

Walking Energy CalculatorexRx.NeT/CALCuLATORS/wALkRuNMeTS.HTML


Top: Linda foster works out on the treadmill at green RidgeRecreation Center. Right: Amy Maffe with her father, SteveDeHaven, at left, and her grandfather, Ray DeHaven.


More than 100 years after itsinception, one of Roanoke’sfirst suburbs is undergoing arenaissance.Wasena, a small neighborhood nes-

tled along the Roanoke River, is becom-ing a mecca for urban pioneers whocherish its dozens of acres of parkland,affordable housing, and proximity todowntown Roanoke.Residents, developers, and city offi-

cials all point to the river and its green-way as the catalysts for what JamesSettle, president of the Wasena Neigh-borhood Forum and a resident since1999, prefers to call a “rediscovery” ofthe area. “We’ve been here all along. It’sin the middle of everywhere you want tobe. It’s close to downtown, Grandin Vil-lage, South Roanoke, Towers ShoppingCenter, and the interstate.”Wasena dates to 1910, when farmer

George Howbert sold his acreage toWasena Land Company to be developedas a suburb. Designed to be affordable,lots could be purchased for a $2 downpayment and $2 per week. It was thefirst Roanoke neighborhood served by abus line because the original metalbridge was too unstable to support astreetcar.Most of Wasena’s 469 structures were

built before World War II and feature aneclectic mix of Colonial Revival, Crafts-man, and Tudor Revival homes. Another

REGIONAL INTEREST

HAVEy o u s e e n

LATELY?

By Alison Weaver


building surge after the war broughtsome of the first ranch-style homes tothe area.Sarah Hudson is a Wasena home-

owner who purchased there seven yearsago. “We got the most bang for our buckin Wasena in terms of location and costper square foot,” she says. Another hugedraw was Wasena Park and the RoanokeRiver Greenway that runs through it.According to Michael Clark, manager

of the city’s Parks and Recreation de-partment, some 20,000 people use thegreenway every month. “We feel that thegreenway is what’s driving the develop-ment in Wasena,” he says. It attracts cy-clists, walkers, joggers, and rollerbladersyear-round, as well as fishermen andbird-watchers. In addition to the appeal of the green-

way, the neighborhood’s designation in2011 as a state and national historic dis-trict is fueling development. Using stateand federal tax credits, developer EdWalker converted an old icehouse intoe River House, with 128 upscaleapartments. e building also housese Wasena City Tap Room restaurant,commercial space, and e River Rock, arock- and rope-climbing gym expectedto open in February.Brent Cochran, e River Rock’s man-

aging partner, hopes the facility will be“a gateway to getting people off theircouches. I picture people riding their

bikes along the greenway to the climbinggym.”To facilitate growth, the city created a

new zoning designation called an “urbanflex district” that encourages mixed-usedevelopment in what it terms “under-performing” industrial areas not suitedfor heavy industrial use.City Planning Administrator Chris

Chittum envisions the area along MainStreet becoming like Grandin Village orCrystal Spring, with coffee shops,restaurants, and small shops. “e piecesare in place for development to take off,”he says. “We want to open the area to alot of different kinds of uses.”Wasena Park and the greenway are al-

ready magnets for businesses catering tooutdoor enthusiasts. Last March, ChrisHeslin opened UnderDog Bikes next toVic omas Park, just over the pedes-trian bridge from Wasena Park in the ad-

jacent Mountain View neighborhood.Open throughout the year, UnderDogprovides rentals for greenway visitors.Wes Best, the owner of East Coasters

cycling shop, has purchased the quaintbuilding in Wasena that once housed theRoanoke Transportation Museum. Bestsays he first spied the long-vacant,boarded-up building in 1999. “I thought,‘Why is that cool building sitting thereempty?’ I’ve dreamed about buying itever since.”Best is shooting for an early spring

opening for the business, which willoffer bicycle sales and rentals and repairservices. He’s also finalizing plans tohave a café on site.“Wasena has always had so much to

offer,” says Settle. “And now it has evenmore.”

West End Revitalization

The City of Roanoke hastargeted an area across theriver from wasena for its nextconcentrated revitalizationeffort. funding from HuD andother sources will pump $2.5million a year into the westend, comprising portions ofthe Old Southwest, MountainView, and Hurt Parkneighborhoods known forhigh crime rates and lowhome ownership.The former Villa Sorrentorestaurant on PattersonAvenue will be the site of anurban mix of commercialspace, a community kitchen,meeting rooms, a branch offreedom first Credit union,and a pavilion. grants willalso be awarded toencourage construction ofnew owner-occupied single-family housing andrehabilitation of existingowner-occupied homes.

Left and upper right: The new wasenaCity Tap Room restaurant and TheRiver House, a converted icehousewith 128 apartments. Lower right: wesBest plans to open a bicycle shop andcafé in wasena.

REGIONAL INTEREST


Every year, Carilion Clinic works to cut down on infections,reduce costs, and otherwise improve the safety and qualityof health care. Carilion’s 2012 Quality Awards recognized such successes in many

areas of patient care. e MVP Award for the best overall project went to the Carilion

Roanoke Memorial Hospital team that reduced the Central Line-Associ-ated Blood Stream Infection (CLABSI) rate to zero for 12 consecutivemonths.Because they are associated with inserting a central vascular

catheter, proper insertion and care can cut the risk of CLABSI infec-tions.Carilion was able to reduce its infections by forming a quality team

that reviewed and instituted best practices. ese include choosing theoptimal catheter site, using an insertion checklist, and following stricthand hygiene.An estimated 250,000 or more CLABSI infections occur in U.S. hos-

pitals annually. According to the Centers for Disease Control and Pre-vention, these infections “result in thousands of deaths each year andbillions of dollars in added costs to the U.S. health care system, yetthese infections are preventable.” e Pioneer Award went to the Roanoke Memorial team that re-

duced cases of hospital-acquired pressure ulcers from 39 to two pa-tients in the 8 Mountain Intensive Care Unit and from 37 patients toseven patients in the 10 Mountain Intensive Care Unit. And more than$1.5 million in costs were avoided. e Enterprise Award was given to the Roanoke Memorial team that

improved the hospital’s processes for preventing such ulcers, resultingin a current rate of 1.3 percent, a significant improvement over the 7.9percent rate reported in 2009. A Roanoke Memorial team previously recognized for reducing venti-

lator-associated pneumonia won the Hold-the-Gains Award for cuttingthe incidence rate even further: from 1.29 percent to 0.5 percent. Teammembers potentially saved 71 lives and avoided costs of more than $5million.

IMPROVING QUALITY

QUALITY AWARDS RECOGNIZE STRIDES

S A V I N G L I V E S

Top: R. wayne gandee, M.D., executive vice presi-dent and chief medical officer of Carilion Clinic,presents the Provider excellence Award to gyne-cologist kaylene Logan, M.D., Residents and fel-lows Category winner.Middle: The team who won the Hold-the-gainsAward for cutting the number of ventilator-associ-ated pneumonia cases.Bottom: The team who won the MVP Award for re-ducing the Central Line-Associated Blood StreamInfection rate.


Your pharmacist does much more than justfill prescriptions.He or she is an integral part of your health care

team.Today’s pharmacists play new and vital roles in

patient care. ey play a critical role in preventingmedication errors and drug interactions. ey alsoadvise doctors on the best drug choices and workwith patients so they understand how to take theirmedications. Pharmacists are experts on the thousands of

medications available, and how they work in thebody. If he or she spots a problem, a quick call tothe prescribing physician can often prevent side ef-fects or health threats.A pharmacist also knows that medicines can

react adversely with some foods—or may not besafe for people with certain health issues.Pharmacists who graduate today receive four

years of education beyond their undergraduatestudies. Many who practice in health care systemscomplete another year of study or a two-year spe-cialist residency program. “We serve as counselors and advisors,” says

James Black, lead pharmacist for Carilion Clinic’sCrystal Spring pharmacy near Carilion RoanokeMemorial Hospital. “Our goal is to ensure that eachpatient understands how to take their medicinesand to determine any potential problems.”“It doesn’t matter if a medication is a miracle

drug,” he says. “If patients don’t take it the waythey’re supposed to, it won’t work. But when pa-tients understand how and why they are taking amedication, it can improve their quality of life, cuttheir time away from work, and reduce hospitaliza-tions.”Black and other pharmacists look at the whole

picture. Are patients taking other medications thatmay interact with a new prescription? Do they havefinancial challenges that could affect their ability toget refills?

Create a RelationshipEstablishing a relationship with a single phar-

macy also creates a safety net. It’s as important asselecting a family physician. A quality pharmacyshould offer guidance, information, and one-on-oneeducation. Look for Medication erapy Management, or

MTM, a new concept in pharmacy care that com-bines medication review with education, actionplans, and follow-up. “MTM offers the detailed in-structions and information necessary to empowerpatients to take care of their own health,” saysBlack. “When we customize care, and our patients un-

derstand why and how they are taking a medica-tion, the results are dramatic,” he says. “Our goalisn’t to simply count pills and measuremedicines. It’s simple. We care for people.”

Meet Today’s Pharmacist By Erica Stacy

LOOKING OUT FOR YOU:

Pharmacist JamesBlack helps patientJon Thomas.


Chinekwu Anyanwu, M.D.NeurologyEducation: University of NigeriaMedical Degree: University of Nigeria College of MedicineResidency: Neurology, Seton Hall University, New JerseyNeuroscience InstituteFellowship: Clinical Neurophysiology, Georgetown UniversityHospital3 Riverside Circle, Roanoke, VA 24016540-224-5170

Jonathan L. Gleason, M.D.UrogynecologyEducation: University of GeorgiaMedical Degree: Medical College of GeorgiaResidency: Obstetrics and Gynecology, Hospital of the Universityof PennsylvaniaFellowship: Female Pelvic Medicine and Reconstructive Surgery,University of Alabama at Birmingham101 Elm Ave., Roanoke, VA 24013540-985-4099

Allison Greenstein, D.O.Internal MedicineEducation: Florida Southern CollegeMedical Degree: Edward Via College of Osteopathic MedicineResidency: Internal Medicine, Bluefield Regional Medical Center2900 Lamb Circle, Christiansburg, VA 24073540-639-9071

Melanie D. Altizer, M.D.Obstetrics and GynecologyEducation: West Virginia UniversityMedical Degree: West Virginia University School of MedicineResidency: Family Medicine; Obstetrics and Gynecology, WestVirginia University School of Medicine902 S. Jefferson St., Roanoke, VA 24016540-985-9862

Joshua D. Farrar, M.D.Otolaryngology; Plastic andReconstructive SurgeryEducation: College of CharlestonMedical Degree: Medical University of South Carolina (MUSC)Residency: Otolaryngology/Head and Neck Surgery, MUSCFellowship: Plastic and Reconstructive Surgery, MUSC3 Riverside Circle, Roanoke, VA 24016540-224-5170

Mark E. Feldmann, Jr., M.D.Plastic and Reconstructive Surgery Education: Hampden-Sydney CollegeMedical Degree: Medical College of Virginia at VirginiaCommonwealth University (VCU)Residency: General Surgery, Medical University of South CarolinaFellowship: Plastic and Reconstructive Surgery, Medical Collegeof Virginia at VCU3 Riverside Circle, Roanoke, VA 24016540-224-5170

Ann Elizabeth Schleupner Austin, D.O.Internal MedicineEducation: Virginia TechMedical Degree: Edward Via College of Osteopathic MedicineResidency: Internal Medicine, New Hanover Regional MedicalCenter3 Riverside Circle, Roanoke, VA 24016540-224-5170

Twana H. Faraj, M.D. Internal Medicine Medical Degree: Salahaddin College of MedicineResidency: Internal Medicine, Roger Williams Medical Center1107A Brookdale St., Martinsville, VA 24112276-670-3300

Laura B. Cieraszynski, D.O.Family Medicine Education: University of KentuckyMedical Degree: Edward Via College of Osteopathic MedicineResidency: Family Medicine, Carilion Clinic - Virginia TechCarilion School of Medicine37 Laymantown Road, Troutville, VA 24175540-977-1436

Eric H. Bradburn D.O.General Surgery; Trauma/SurgicalCritical Care Education: North Central CollegeMedical Degree: Lake Erie College of Osteopathic MedicineResidency: General Surgery, Penn State Milton S. HersheyMedical CenterFellowship: Trauma and Critical Care, University of TennesseeHealth Science Center3 Riverside Circle, Roanoke, VA 24016540-224-5170

NEW PROVIDERS


Christian Klaus, D.O.Family MedicineEducation: University of North Carolina - CharlotteMedical Degree: Edward Via College of Osteopathic MedicineResidency: Family Medicine, Carilion Clinic - Virginia TechCarilion School of Medicine6415 Peters Creek Road, Roanoke, VA 24019540-265-5500

Michole C. Pineda, M.D.Child DevelopmentEducation: University of Santo Tomas Medical Degree: University of Santo TomasResidency: Pediatrics, Arnold Palmer Hospital for Children Fellowship: Developmental-Behavioral Pediatrics, University ofVirginia Children’s Hospital1030 S. Jefferson St., Roanoke, VA 24016540-224-4520

Robert J. Heineck, M.D.Obstetrics and GynecologyEducation: Virginia TechMedical Degree: University of South Carolina School ofMedicineResidency: OB/GYN, Carilion Clinic - Virginia Tech CarilionSchool of Medicine1997 S. Main St., Blacksburg, VA 24060540-961-1058

Chidinma Osefo, M.D. Family Medicine with ObstetricsEducation: University of Maryland College ParkMedical Degree: Howard University College of MedicineResidency: Family Medicine, Thomas Jefferson UniversityHospitalFellowship: Maternal Child Health, PCC Community WellnessCenter1314 Peters Creek Road, Roanoke, VA 24017540-562-5700

Vishal M. Patel, M.D.Radiology Education: University of Florida Medical Degree: University of Florida College of MedicineResidency: Diagnostic Radiology, University of Florida College ofMedicineFellowship: MRI-Predominant Body Imaging, NorthwesternUniversity Feinberg School of Medicine1906 Belleview Ave., Roanoke, VA 24014540-981-7122

Mitchell P. Kok, M.D.Diagnostic RadiologyEducation: Georgia Institute of TechnologyMedical Degree: Medical College of GeorgiaResidency: Madigan Army Medical CenterFellowship: Neuroradiology, University of Virginia1906 Belleview Ave., Roanoke, VA 24014540-981-7122

Jason V. Naldo, D.P.M.Podiatry Education: Virginia TechMedical Degree: Temple University School of PodiatricMedicineResidency: Podiatry, Inova Fairfax Hospital2900 Lamb Circle, Christiansburg, VA 24073540-731-2436

Kurtis E. Moyer, M.D.Section Chief, Plastic andReconstructive Surgery Education: Franklin and Marshall CollegeMedical Degree: Pennsylvania State College of Medicine,Milton S. Hershey Medical CenterResidency: General Surgery, Pennsylvania State College ofMedicine Fellowship: Plastic Surgery, Duke University Medical Center3 Riverside Circle, Roanoke, VA 24016540-224-5170

Hilton R. Lacy, M.D.Child and Adolescent Psychiatry Education: Hendrix CollegeMedical Degree: University of Arkansas College of MedicineResidency: General Psychiatry, University of Arkansas forMedical ServicesFellowship: Child and Adolescent Psychiatry, University ofVirginia Medical Center 2017 S. Jefferson St., Roanoke, VA 24014540-853-0900

Michael S. Kolodney, M.D. Dermatology Education: Massachusetts Institute of TechnologyMedical Degree: Washington UniversityResidency: Dermatology and Internal Medicine, UCLA Schoolof MedicineFellowship: Dermatology Research, UCLA School of Medicine1 Riverside Circle, Roanoke, VA 24016540-581-0254

NEW PROVIDERS


Julia Sargent, D.O.Family MedicineEducation: Appalachian State UniversityMedical Degree: Edward Via College of Osteopathic MedicineResidency: Family Medicine, Self Regional Healthcare2829 Virginia Ave., Narrows, VA 24124540-726-7900

Guyton Register, M.D.PsychiatryEducation: Armstrong Atlantic State UniversityMedical Degree: Medical College of GeorgiaResidency: Internal Medicine and Psychiatry, East TennesseeState University2017 S. Jefferson St., Roanoke, VA 24014540-981-8025

J. Eric Vance, M.D. Child and Adolescent PsychiatryEducation: College of William and MaryMedical Degree: University of Virginia Medical SchoolResidency: Psychiatry and Child Psychiatry, Dartmouth MedicalSchool2017 S. Jefferson St., Roanoke, VA 24014540-853-0900

Christopher D. Wood, D.O.Geriatric Medicine Education: Virginia TechMedical Degree: West Virginia School of Osteopathic MedicineResidency: Internal Medicine, Carilion Clinic - Virginia Tech CarilionSchool of MedicineFellowship: Geriatric Medicine, Carilion Clinic2001 Crystal Spring Ave., Roanoke, VA 24014540-981-7653

Matthew Schumaecker, M.D.CardiologyEducation: Northwestern UniversityMedical Degree: McGill University Faculty of MedicineResidency: Internal Medicine, New York Presbyterian Hospital(Weill-Cornell Campus)Fellowship: Cardiovascular Disease, University of PittsburghMedical Center127 McClanahan St., Roanoke, VA 24014540-982-8204

Erik S. Storm, D.O.Radiology Education: North Carolina State UniversityMedical Degree: Philadelphia College of Osteopathic MedicineResidency: Diagnostic Radiology, Walter Reed Army MedicalCenterFellowship: Breast Imaging, Eastern Virginia Medical School1906 Belleview Ave., Roanoke, VA 24014540-981-7122

Richard R. Truxillo, D.O.Family Medicine Education: University of North Carolina - WilmingtonMedical Degree: West Virginia School of Osteopathic MedicineResidency: Family Medicine, Carilion Clinic - Virginia TechCarilion School of MedicineFellowship: Medical Informatics, Carilion Clinic1314 Peters Creek Road, Roanoke, VA 24017540-562-5700

Tejal Raju, M.D.Interventional Pain ManagementEducation: University of VirginiaMedical Degree: St. George’s University School of MedicineResidency: Anesthesiology, Cooper University HospitalFellowship: Pain Management, St. Luke’s - Roosevelt HospitalCenter3 Riverside Circle, Roanoke, VA 24016540-224-5170

Ashish Raju, M.D.Vascular SurgeryEducation: Lehigh UniversityMedical Degree: Drexel University College of MedicineResidency: General Surgery, Cooper University HospitalFellowship: Vascular and Endovascular Surgery, MontefioreMedical Center2900 Lamb Circle, Christiansburg, VA 24073540-731-7600


Epilepsy, a brain disorder, is marked by seizures or convul-sions. It can occur as a hereditary condition or can develop atany age due to a head injury, infections, brain disease, or othercauses. It affects almost 3 million Americans, and about 200,000

new cases are diagnosed each year, according to the EpilepsyFoundation of Virginia. One in 10 Americans has a seizureover his or her lifetime. A one-hour electroencephalogram (EEG), which measures

electrical activity in the brain, can help to diagnose epilepsy.But the test has limitations. A more accurate diagnosis can bemade during a three- to-five-day stay in an epilepsy monitor-ing unit. In the unit, three dozen tiny electrodes are attached to a pa-

tient’s skull to measure and record brain activity. A patient isalso continuously monitored by video. If a seizure occurs, thepatient or a family member who is always present pushes anevent button. It records when and where in the brain theseizure occurred and transmits the data to medical staff in anearby control room.Depending on the type of seizure, patients may be pre-

scribed anti-seizure medication, or referred for surgery.One doctor who has referred patients to the unit is neurolo-

gist Chinekwu Anyanwu, M.D. She recently joined Carilionafter completing her residency at New Jersey Neuroscience In-

stitute and a fellowship in neuro-physiology/epilepsy/EEG at George-town University Hospital.“e unit is designed to diagnose

different types of seizures and tohelp patients on multiple medica-tions whose epilepsy is uncontrolledor who make frequent ED visits,”says Dr. Anyanwu. “We also treat pa-tients with seizure-like activities, in-cluding dizziness, jerking, memorylosses, hallucinations, staring spells,

or sleep disorders.” In addition, the unit can do pre-surgical evaluations for re-

fractory seizures, or seizures not controlled by medication. ree beds at Roanoke Memorial have been designated as

the epilepsy monitoring unit. A day room with a refrigerator,microwave, and games is also available to give patients moremobility during their stay. Patients admitted to date have been from all age groups,

says Nikki Atkinson, respiratory and EEG director at CarilionRoanoke Memorial Hospital.

For more information, call 540-266-6000 or 800-422-8482.

EPILEPSY MONITORING UNIT OPENSBy Maureen Robb

The first epilepsy monitoring unit in the region has opened at Carilion Roanoke Memorial Hospital. The unit offersspecialized care to patients who would otherwise have to travel beyond western Virginia.

Dr. Chinekwu Anyanwu

EEG technologist Larissa Sellers monitors a patient by video and watches his brain activity.


BETTER LIVING

Your Calendar for Better HealthSPRING 2013

ATRIAL fIBRILLATION Speaker: Carl W. Musser, M.D.6 p.m.Carilion New River ValleyMedical Center, FiresideRoom

HeART fAILuRe Speaker: W. Scott Arnold, M.D.3 p.m.Trinity Ecumenical Church,Moneta

HeART VALVe DISeASeSpeakers: Jason Foerst, M.D,and Joseph Rowe III, M.D.6 p.m.South County Library,Roanoke

ReD HOT MAMAS: eVeRYTHINgYOu wANT TO kNOw ABOuT INTI-MACY, BefORe AND AfTeRMeNOPAuSe6 p.m.South County Library,RoanokeTo register, please call 800-422-8482.

feRTILITY SeMINARSpeaker: Robert Slackman,M.D.9 a.m. - noonSouth County Library,RoanokeTo register, please call 800-422-8482.

JOINT PAIN If you are 45 or older with hipor knee joint pain or limitedmotion, join us for free semi-nars on arthritis and optionsfor joint care. For more infor-mation, please call 800-422-8482.

HuNTINgTON’S DISeASe SuPPORTgROuP5:30 - 6:30 p.m.3 Riverside, Conference Room2D, RoanokeFor more information, pleasecall 800-422-8482.

wOMeN’S HeALTH uNIVeRSITYPatrice M. Weiss, M.D., will speak about emotional intelligence11:30 a.m. - 1:30 p.m.Fitzpatrick Hall at the Jefferson Center$15, includes lunchTo register, please call 800-422-8482.

PHYSICIANS ON fOOT8:30 a.m.Meet inside TanglewoodMall from Novemberthrough March and at thecorner of Hamilton Terraceand Belleview Avenue (infront of Carilion RoanokeMemorial Hospital) fromApril through October.Rain location: TanglewoodMallFor more information, pleasecall 800-422-8482 or visitCarilionClinic.org/walking.

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For more events, classes, and screenings, visit CarilionClinic.org/calendar or call 540-266-6000.

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Neurosurgery

At Carilion Clinic, we care for our neighbors in ways that optimize their health. It’s what we do eachday. Our neurosurgeons work as a team with each patient, using new techniques and innovativeminimally invasive treatments specific to their needs, to reduce recovery time and improve life.

Complex neurosurgical care for the brain, nervous system, and spine are all being performed atCarilion Roanoke Memorial Hospital.

Our team of specialists is focused on your health and committed to helping you get back to yourlife as quickly as possible.

Inspiring better health.™

CarilionClinic.org | 800-422-8482

Lisa Apfel, M.D.Zev elias, M.D.John fraser, M.D.Nicholas Qandah, D.O.gary Simonds, M.D.edgar weaver, Jr., M.D.

CARILION CLINICP.O. BOx 13727ROANOke, VA 24036-3727

NON-PROfIT ORg.u.S. POSTAge

PAIDROANOke, VA

PeRMIT NO. 247

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