carilion clinic living

Inspiring better health.

Carilion Clinic

SPRING 2015

in this issueCOSMETIC CENTER TO OPEN 9A NEW TREATMENT FOR HEART FAILURE 10HOW HOSPICE CARE UNITED A FAMILY 12STAND-UP PADDLE BOARDING TAKES OFF 19

Diabetes: Are You at Risk?Through diet and regular walks through her neighborhood, Linda Waltz of Roanoke brought her blood sugar under control.

Dedicated to Caring for Women

At Carilion Clinic, we provide the comprehensive services you need for specialized gynecological care. We offer complete outpatient and inpatient care for a wide variety of gynecologic conditions at several locations in Roanoke.

800-422-8482 | CarilionClinic.org

» Incontinence

» Gynecologic cancer

» Infertility

» Genetic counseling

» Endometriosis

» Menopause

SPECIALIZED SERVICES TO MEET YOUR NEEDS

WE CAN HELP WITH:

Give us a call today and let us help you.

Dec 2014 Living Womens Services ad.indd 1 12/22/14 11:34 AM

Are you at risk for diabetes? This disease is reaching epidemic proportions in our country, but many who have it aren’t aware of the damage being done to their bodies. Our cover story profiles one courageous woman who tackled her diabetes and through exercise and diet was able to get her blood sugar under control. Read the account of her success—and about all you and your family can do to keep this disease at bay.

We also have news about a treatment for heart failure that promises to be a game changer. Called CardioMEMs, it is a wireless sensor implanted in a patient’s pulmonary artery to remotely monitor the heart. Carilion is the first in Virginia and the Carolinas to offer the treatment, which clinical trials have shown significantly reduces hospital readmissions. Eight people in our region have received it so far.

Our patients at Carilion Roanoke Memorial Hospital also have a new tool to help them get better. Through our GetWellNetwork, recently introduced in hospital rooms, patients can watch videos on TV monitors that help them understand their conditions, medications, hospital services, and more. The network will eventually be available at other Carilion hospitals and outpatient facilities.

With spring comes the chance to get back outdoors. And one of the loveliest and most rejuvenating spots in our region has to be Woodpecker Ridge in Botetourt County. The birds, wildlife, forest trails, and scenic vistas all combine to make it a perfect day-trip getaway. Reading our story will make you want to lace up your hiking shoes and pack a picnic lunch!

WARM REGARDS,

NANCY HOWELL AGEEPRESIDENT AND CEOCARILION CLINIC

PRESIDENT’S MESSAGE

AN INVITATION FROM THE PRESIDENTIf you live in the Roanoke Valley, the Rockbridge area, or Giles County, Carilion Clinic and community partners invite you to take part in a survey. The survey will assess the community’s health care needs and help determine barriers and access to care. Please take the survey online at surveymonkey.com/s/2015CHNA or by phone at 888-964-6620 through April 30, 2015.

CARILION CLINICPRESIDENT AND CEO Nancy Howell Agee

CARILION CLINIC 1906 BELLEVIEW AVE.P.O. BOX 13367ROANOKE, VA 24033540-981-7000

CARILION CLINIC LIVING IS PRODUCED BY MARKETING, RESEARCH AND COMMUNICATIONS:

VICE PRESIDENT Shirley Holland

SENIOR DIRECTOR, COMMUNICATIONS Mike Dame

EDITOR Maureen Robb

LEAD DESIGNER David Porter

DESIGNERS Taryn Anderson, Nicholas Buehring

CONTRIBUTING WRITERS Karen Doss Bowman, Allison Buth, Karen A. Chase, Su Clauson-Wicker, Jay Conley, Sarah Cox, Bruce Ingram, Dan Radmacher, Dan Smith, Erica Stacy, Randolph Walker, Alison Weaver

PHOTOGRAPHERS Darryle Arnold, Jared Ladia

PRINTING Chocklett Press

CARILIONCLINIC.ORG | 800-422-8482

Carilion Clinic is a not-for-profit health care organization based in Roanoke, Va. Through our comprehensive network of hospitals, primary and specialty physician practices, and other complementary services, we work together to provide quality care close to home for nearly 1 million Virginians. With an enduring commitment to the health of our region, we also seek to advance care through medical education and research to help our community stay healthy and inspire our region to grow stronger.

Copyright 2015 by Carilion Clinic. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Carilion Clinic. Articles in this publication are written by journalists or authors who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional advisor. All editorial rights reserved. Opinions expressed herein may or may not reflect the views of Carilion Clinic.

If you would like to be added to or removed from the mailing list for Carilion Clinic Living, please call 800-422-8482, email us at [email protected], or write to us at Marketing, Research and Communications, 213 McClanahan St., Roanoke, VA 24014.

Bruce Ingram is an English teacher at Lord Botetourt High School in Daleville. He is the author of five books on fishing, and his articles on the outdoors have appeared in Outdoor Life, Virginia Wildlife, and many other magazines.

Karen A. Chase is an award-winning novelist who has also written for Virginia publications such as The Richmond Times-Dispatch. She is writing a historical novel about the Declaration of Independence. She lives in Richmond.

Sarah Beth Jones blogs about personal devel-opment, was an op-ed columnist for the Greens-boro News & Record, and has written for publi-cations including Valley Business FRONT, Mother Earth News online, and Today’s Woman maga-zine. She lives in Floyd.

Dan Smith is an award-winning journal-ist and photographer, an essayist on public radio, and a member of the Virginia Communi-cations Hall of Fame. He is the author of a novel and several nonfiction books.

Alison Weaver is a freelance writer based in Roanoke. Her work has appeared in Valley Business Front, The Roanoke Times, Good Housekeeping, Woman’s Day, Redbook, and Seventeen.

Randolph Walker is a writer and musician in Roanoke. Formerly a staff writer with The Roanoke Times, his work has appeared in many publications including Virginia Living, Valley Business Front, and The Roanoker.

OUR CONTRIBUTORS

2 SPRING 2015 | CarilionClinic.org

20

24

10 16features5 GETTING WELL A new program helps patients.

9 COSMETIC PROCEDURES A cosmetic center will soon open.

10 HEART FAILURE A new implant saves lives.

12 HOSPICE A family expresses thanks for end-of-life care.

14 AUTOIMMUNE DISORDERS There are new treatment options.

16 DIABETES You can take steps to prevent this condition.

19 SPORTS Stand-up paddle boarding takes off.

20 RECREATION Enjoy nature at Woodpecker Ridge.

23 PATIENT CARE Awards recognize outstanding care.

24 HEALING Pets help hospitalized patients heal.

departments1 PRESIDENT’S MESSAGE Diabetes is reaching epidemic levels.

4 SUPERFOODS Enjoy kale in all kinds of dishes.

6 HEALTH NEWS Research findings that can improve your life.

22 IN YOUR COMMUNITY Making a difference in western Virginia.

25 NEW PROVIDERS New physicians and advanced care providers.

28 RECIPE What’s for breakfast? Blueberry-Oatmeal Cakes.

CONTENTS

CarilionClinic.org | SPRING 2015 3

Superfoods: KaleAre you looking for a versatile veggie that tastes great and is incredibly good for you?

Look no farther than kale.You can munch it raw as a snack, toss it with fruit or other vegetables for salads,

shred it in soups, or sauté it as a side dish for dinner. It also pairs well with a variety of herbs and spices.

Best of all, kale is loaded with nutrients. It is chock full of vitamins A, C, and K, has can-cer-fighting flavonoids, and acts as an anti-inflammatory. It contains minerals such as potassium, iron, and copper.

Along with its dark-leafy-green goodness comes fiber that keeps you full and helps regulate your blood sugar. Add calcium and protein to the mix, and you have a vegetable that meets many nutritional needs.

In the Middle Ages, kale was a common vegetable in Europe and Asia. Lately it has become such a nu-tritional darling in the U.S. that it is popping up in restaurants and has spawned a number of cookbooks.

Two of the latest are Kale, Glorious Kale and Let Them Eat Kale! Available in the grocery store and at farmers’ markets, kale is also easy to grow in your own back

yard. And it comes in a number of varieties and colors, including pink and purple. With a small in-vestment of time and money, you could reap a colorful bonanza every summer.

Still need more ideas for how to eat kale? Why not try:» Topping your pizza

» Tossing with pasta» Mixing in smoothies

» Grinding into pesto» Baking yummy kale chips.

Your friends and family will thank you!

SUPERFOODS


It takes only a trip or two on an airplane to become familiar with the pre-flight routine where flight attendants run through safety procedures. But for inexperienced fliers, it’s exactly the kind of infor-mation that empowers them.

“We want patients to have similar expectations,” says Andrew Kellam, Carilion Clinic’s interactive patient sys-tem manager. “We want patients to walk into the hospital expecting to learn and be involved in their care so they can have the best outcomes possible.”

Interactive in Kellam’s title is not just a description; it’s the guiding focus of Carilion Roanoke Memorial Hospital’s new patient care system, the GetWell-Network (GWN).

Newly installed in patient rooms, the GWN might not look much different from a standard TV at first glance. Be-hind its simple exterior, though, are two care-changing functions.

First is an extensive entertainment package, including on-demand Hol-lywood movies, online arcade games, soothing relaxation audios and visuals, and full access to the Internet.

“It really helps to have a distraction

while receiving treatment,” says Mandy Allen, R.N., of the Pediatric Intensive Care Unit. “It helps take away some of the worry and discomfort of lying in bed.”

Second is a 700-video library designed to educate patients and their families about every aspect of their illness and care.

“There are videos about getting X-rays, MRIs, and other procedures that show pictures of the machines, which I think helps reduce the anxiety levels in ways that we couldn’t when it was up to nurses to just describe to patients what to ex-pect,” says Allen.

“Imagine someone just telling you about your newly diagnosed heart con-dition,” says Kellam. “Now imagine also watching a video with an animated pic-

ture of the heart that shows you visually what’s happening. It really stimulates your ability to remember both informa-tion about your diagnosis and how to better care for yourself once you return home.”

The system includes an option for patients to offer real-time feedback to hospital staff, giving nurses and nurse managers a boost from the positive feedback, and an opportunity to resolve issues immediately if problems are re-ported.

Over the next two years, Kellam hopes to not only expand the system to other Carilion hospitals and every outpatient facility, but also to add more features. These will include an electronic white-board in the hospital to display messages along with photos and bios of every member of a patient’s care team, and access to all prescribed videos from any computer through a patient’s MyChart account.

“Our goal is to influence health care change in our community,” says Kellam. “We want patients and their families to engage with us so that together we can make the best care decisions possible, resulting in better outcomes.”

New Network Empowers Patients

“It really stimulates your ability to remember both information about your diagnosis and how to better care for yourself...”

— ANDREW KELLAM; INTERACTIVE PATIENT SYSTEM MANAGER

MEDICAL NEWS


Does Your Child’s School Stock a Life-Saving Drug?

Contact Lens Misuse Causes Eye Infections

A Single Blood Test for Cancer?

Too Many Adults over 45 Lack Muscle Strength

Less than 25 percent of adults over 45 have enough muscle strength to sustain good health, according to a new study. They are advised to take up strength training, which can involve sit-ups, push-ups, lifting weights, yoga, elastic bands, or weight machines. Learn more at bit.ly/muscle-guidelines.

Scientists are moving closer to developing a single blood test for many cancers. They have identified more than 800 markers in the blood of cancer patients and are optimistic that a blood test can be created. Such a new approach to detect cancer early would save many lives, researchers said. For added information, go to bit.ly/cancer-test.

Almost a million Americans suffer eye infections each year after wearing their contact lenses too long, or not cleaning them well, according to a new report by the U.S. Centers for Disease Control and Prevention. Sleeping with lenses on, or letting them get wet while in the shower or swimming, significantly raised the risk of infection. See more study results at bit.ly/contacts-misuse.

Many states are passing laws allowing or requiring schools to stock epinephrine in case a child suffers a severe allergic reaction. The drug is the main treatment for anaphylaxis, which can cause trouble breathing, throat swelling, and a plunge in blood pressure — or even lead to death. The laws are intended to help children with severe food or drug allergies. For more information, go to bit.ly/allergic-reactions.

HEALTH NEWS


Are Babies from Green Neighborhoods Healthier?

Obesity Linked to ‘Silent’ Heart Damage

Hand Dryers in Restrooms May Spread Germs

Do You Grind Your Teeth?

Women from leafy, green neighborhoods have fewer premature or underweight babies, a new study suggests. After analyzing data from 64,000 births, researchers found that mothers who lived in areas with trees, grass, and plants were 20 percent less likely to have very preterm babies, or those born before 30 weeks. Find out more at bit.ly/green-neighborhoods.

Obesity may cause heart damage that produces no symptoms, researchers found. In a study of more than 9,500 people aged 53 to 75, heart damage was also seen in those who didn’t have such risk factors as high cholesterol, diabetes, or high blood pressure. For more information, go to bit.ly/silent-damage.

Warm-air dryers in restrooms may spread more germs than paper towels, according to a new study by British researchers. When they measured bacteria in the air around the dryers, they found more germs than around the paper dispensers. The bacteria also lasted 15 minutes after the dryers were used. See more study findings at bit.ly/hand-dryer-germs.

An estimated 40 million Americans grind their teeth — some so severely that they break dental fillings or otherwise damage their teeth. Morning headaches and facial pain have even been linked to teeth grinding. Stress, along with other psychological and physical causes, has been identified as a culprit. For suggestions on how to deal with the condition, go to bit.ly/grinding-teeth.


CARILION DIRECT Our physician referral and health information service is here to help. Call us at 540-266-6000 or 800-422-8482, or email us at [email protected].

PUBLICATIONSPick up a copy of Carilion Clinic Living at magazine racks throughout our facilities, or access the digital edition at CarilionClinic.org/living, where you can also read past issues. For health tips and news about upcoming health screenings events, subscribe to Living’s monthly e-newsletter at CarilionClinic.org/living.

RESOURCES TO KEEP YOU HEALTHY

“WELL SAID” SPEAKER’S BUREAUIf you’d like a speaker on a health topic for your community group or workplace, call 540-266-6561 or visit CarilionClinic.org/speakers.

SUPPORT GROUPS Support groups are available for a wide range of health needs, including gynecologic and breast cancer. Learn more at CarilionClinic.org/support.

COMMUNITY HEALTH SCREENINGSHealth screenings are available at little or no cost. Call 540-266-6000 or 800-422-8482, or email us at [email protected].

CHILDREN’S HEALTH For the latest news and perspectives on children’s health care, read Close to Home, a blog by Alice Ackerman, M.D., chair of the Department of Pediatrics at Carilion Clinic. Visit CarilionClinic.org/blogs/ackerman.

NEWS BLOGKeep up with the latest news, photos, videos, and more at Carilion Clinic’s newsroom. CarilionClinic.org/blogs/newsblog.

SOCIAL MEDIAStay connected to Carilion Clinic through social media:

facebook.com/carilionclinictwitter.com/carilionclinicyoutube.com/carilionclinic google.com/+carilionclinicpinterest.com/carilionclinic

MOBILE RESOURCESStay connected with our mobile apps, available for iPhone and Android:

Carilion Clinic Mobile Health Resource – Use our interactive symptom checker to access the most relevant information in our digital health library, then connect with Carilion services by using the search feature to find Carilion health care providers, hospitals, and urgent care locations near you.

MyChart – Access your medical record, request an appointment or prescription refill, and stay in touch with your doctor, all while on the go. If you are interested in MyChart, speak with your doctor.WEBSITE TAILORED FOR YOU

Check out these features at CarilionClinic.org: » Easy-to-use physician/provider finder » Interactive maps to help you find your way to

our locations » Health and wellness content, including an A-Z

library » A community health education and events

calendar

GIVING TO CARILION CLINIC FOUNDATION Be part of improving the health and vitality of communities in western Virginia. Make a gift at CarilionFoundation.org.

RESOURCES


A cosmetic center will open in March in Roanoke.

The new Carilion Clinic Cosmetic Center, located on Rosalind Avenue, will be headed by Kurtis E. Moyer, M.D., Carilion’s chief of plastic and reconstruc-tive surgery. Dr. Moyer will practice there along with Mark Schoemann, M.D., and Mark E. Feldmann, M.D.

“We’ve all been trained within the last five to ten years, allowing us to be well-versed on the most up-to-date proce-dures,” says Dr. Moyer.

The three surgeons are trained in all types of surgical and non-surgical cos-metic procedures, including:

» Abdominoplasty (tummy tuck) » Blepharoplasty (eyelid surgery) » Body contouring (after gastric bypass

surgery or significant weight loss) » Breast augmentation » Breast reduction » Brow lift » Breast reduction for men » Breast lift » Injections (Botox and fillers) » Liposuction

» Ear surgery » Rhinoplasty (nose reshaping) » Face lift

The center will also provide spa-level treatments by a medical esthetician, Gina Hunt. These will include laser therapies, micro-dermabrasion, and chemical peels. Medical-grade, skin-care products such

as Obagi and SkinMedica will be available as well.

“It is unusual to find a practice that can offer this level of comprehensive cos-metic care under one roof in southwest Virginia,” says Dr. Moyer.

The 5,700-square-foot center will have a soothing, spa-like atmosphere, and when it is completed, the public will be in-vited to an open house.

“I’m a big believer in education,” says Dr. Moyer. “We strive to teach our pa-tients about procedures, and all their options. We will do the same thing with our new facility. Carilion is recognized as a pillar of service to the community, and everything about our new cosmetic cen-ter has that idea behind it.” To learn about additional cosmetic surgery procedures available, schedule a consulta-tion, or make an appointment, call 540-853-0510.

Dr. Kurtis E. Moyer

Cosmetic Center

to Open

WHAT IS COSMETIC SURGERY?

There are two types of plastic surgery: cosmetic surgery and reconstructive surgery. Cosmetic surgery is an elective procedure designed to surgically enhance a physical feature. Reconstructive surgery is a procedure that restores or corrects both function and physical features of a part of the body.Carilion Clinic’s team of experienced plastic surgeons performs both types of surgery and is committed to using the safest approach to achieve the best possible results for each patient.

MEDICAL NEWS


Hazel Johnson made medical history last year.

Johnson, 74, of Stewartsville, was the first of eight people in Virginia to receive an implant that monitors the condition of heart failure patients. “My monitor lets the doctors know about any prob-lems before they become serious, and that can keep me from having a heart attack or a stroke,” Johnson says.

Carilion Clinic is the first medical center in Virginia and the Carolinas to provide the treatment, which monitors patients from home.

The wireless im-plant, a sensor called the CardioMEMS HF System, is about the size of a paper clip. It can be implanted in the pulmonary artery

during a minimally invasive, non-surgical procedure to monitor artery pressure.

The device that transmits the data is embedded in a small pillow, and patients lie against the pillow for about 20 sec-onds each day to send their readings to Carilion’s Heart Failure Clinic. Nurses there monitor the readings, alert for signs of worsening heart failure.

Traditionally, patients have had to make frequent office visits and have their conditions monitored by indirect mea-sures, such as blood pressure or fluctua-tions in weight.

LIVING WITH HEART FAILUREAn estimated five million Americans

live with heart failure, a condition in which the heart is still working but no longer pumping or filling as well as it once did. Patients are often hospitalized, have a reduced quality of life, and face a

higher risk of death. “Heart failure is the No. 1 reason for

readmission to hospitals,” says Stephen G. Phillips, M.D., director of the Heart Failure Clinic in Roanoke. “It accounts for $40 billion a year in medical costs, and two-thirds of that is for inpatient treatment.” Each heart failure patient is hospitalized on an average of once or twice a year, he says.

“Regular monitoring is where treat-ment is going,” says Dr. Phillips. “We don’t need to see the patients in person as frequently. The cost saving is win-win.”

In a clinical trial, the CardioMEMS sensor reduced the rate of heart failure hospitalizations at six months by 28 per-cent. There was a 37 percent reduction in hospitalizations during and after 15 months.

A BREAKTHROUGH IN TREATING HEART FAILURE A BREAKTHROUGH IN TREATING HEART FAILURE

By Dan Smith

Remote Monitoring a Reality

Dr. Stephen G. Phillips

MEDICAL NEWS


NEW TECHNOLOGY“It is the most amazing technology I’ve

seen in years,” says Jason Foerst, M.D., the interventional cardiologist who im-planted the sensor in the eight Virginia patients. “This just blows our minds.”

“Many of our patients live three to four hours away from Roanoke, so the remote monitoring is less expensive and much more convenient,” says Dr. Foerst. “The monitoring nurses are aware of the fluc-tuations in pressure well before the pa-tient is aware of heart failure symptoms like weight gain and shortness of breath.”

“In one or two cases already, if we had

not had the device, we would have waited for a follow-up visit and the patient’s condition would have worsened,” says Meena Shah, R.N., clinical coordinator

at the Heart Failure Clinic and one of the nurses who monitors patients. “Because we had the device, we were able to nip a potential problem in the bud.”

Since Carilion ranks in the top

three of Virginia hospitals in the number of heart disease patients treated, the po-tential impact on patients is huge.

Johnson, who lives 20 miles from Ro-anoke, says her monitor saves her from making office visits two or three times a week. “It saves time, gas, and doctors fees,” she says. “I’m delighted with it.”

So are Carilion physicians. “This tech-nology represents an important step in our comprehensive approach to heart failure management,” says David Sane, M.D., chief of cardiology.

“It’s the beginning of a new era in heart monitoring,” says Dr. Foerst. For more information, go to bit.ly/hf- monitor. To watch Hazel Johnson’s patient story, go to CarilionClinic.org/heart.

Dr. Jason Foerst

Hazel Johnson, a Carilion Clinic patient, is monitored daily from her home more than 20 miles away from her physician’s office in Roanoke.

“It is the most amazing technology I’ve seen in years.”

— JASON FOERST, M.D., INTERVENTIONAL CARDIOLOGIST

NEW PROGRAMS AID RECOVERY

Two new programs at Carilion Roanoke Memorial Hospital are also helping heart failure patients.

The GetWellNetwork provides TV monitors and educational videos in hospital rooms so all patients can learn about their conditions, med-ications, and hospital services. The network is expected to eventually be available at other Carilion hospitals.

“The focus is on information peo-ple can understand—delivered in layman’s terms,” says Kathleen Baudreau, senior director of nursing quality and improvement. “We need to communicate in a form and a for-mat that it is useful,” she says. “It is all about patient engagement.”

Before they go home, heart failure patients can learn specifically what is wrong with their hearts, what medi-cations they need, how those medica-tions act, and what follow-up care is needed at home, says Andrew Kellam, Carilion’s interactive patient care sys-tem manager.

A new pharmacy program, mean-while, is helping patients to take their meds. Carilion’s pharmacy can now deliver prescriptions to patients’ rooms as they prepare to leave the hospital.

“Patients don’t always buy their needed prescriptions,” says Chad Alvarez, senior director of Carilion’s retail pharmacy systems. “It could mean an extra stop on the way home that they don’t want to make.”

In the past, 30 to 40 percent of pre-scriptions weren’t filled, he says.

“There is no charge for the in-room service, and medication prices are fully competitive,” Alvarez says. “In-surance co-pays are also the same as they would be elsewhere.”

For more information on the GetWell-Network, see the story on page 5.


MEDICAL NEWS

For many, hospice is associated with the end of a person’s life. But for two sisters faced with their mother’s devastat-ing illness, it also proved to be a life enhancer.

“I’m a firm believer that we had Mom three months longer because of hospice,” says Beth Croy Tanner.

It was May 2013 when Betty Croy, 81, was diagnosed with Stage IV lung cancer. She’d noticed that she was often tired, was losing weight, and had a nagging dry cough that never went away.

Beth and her sister, Barbara Croy Vesely, describe their mother as a humble “farm girl” who had lots of friends. She was a faithful member of her church in Pearisburg and sold Avon products for over 40 years.

“Mom loved sweets, so we knew something was wrong when she began losing weight,” says Barbara.

When Betty received her diagnosis, chemotherapy was presented as a treatment option. Barbara and Beth told their

mother that they would support her in whatever course of treatment she chose.

At first, Betty decided to forego chemotherapy and instead began taking a prescription drug to ease her pain. But she ex-perienced serious adverse side effects. Low-dose chemotherapy became the next option, but before she could begin, she fell and broke her leg.

Betty then spent 20 days at Carilion Giles Community Hospi-tal recovering from leg surgery in December 2013. “She had no complications and no pain,” says Beth.

On Dec. 30, Betty went to live with Beth and her family in their Pearisburg home (Barbara lives in Memphis, Tenn.). It was also the first day that Carilion Clinic Hospice came to care for Betty.

“At that point, we’d never had to experience anything like this,” says Beth. “Signing over care to hospice was an unknown to us.”

At End of Life Making the Most of Every Day By Karen Dillon


AN INDIVIDUAL CARE PLANThe first two weeks were busy at Beth’s

home. The hospice team made sure that the equipment needed to care for Betty was properly delivered and that she had her medications.

“Once it settled down, those people became my family,” says Beth.

Hospice caretakers created an individ-ualized care plan for Betty that included stress relief techniques to keep her com-fortable and relaxed. The care provided kept their mother alert, mobile, and as

independent as she could be, the sisters say.

Beth and Bar-bara also felt empowered to care for their mother due to the support they got from hospice staff. Having

never gone through a prolonged illness, they admitted they didn’t know what to expect and had many questions.

“Hospice equipped us and trained us enough that when faced with a difficult situation, we knew what to do,” says Barbara. “And if we really tripped up, they were always a phone call away,” says Beth.

As Betty’s health slowly deteriorated, Beth kept a journal so she could remem-ber her mother’s final days. In the last two weeks of Betty Croy’s life, Beth and

Barbara prepared for the service that would be a celebration of her life.

Betty Croy passed away on May 28, 2014. While still grieving, the sisters find comfort in the care she received and are thankful for the time they had with her.

ENHANCING HER FINAL DAYSBeth and Barbara say they will forever

cherish the quality time hospice allowed them to have with their mother. “Because of the care hospice provided and because they monitored Mom’s pain, she was able to stay relatively coherent until the very end,” says Barbara. “Mom was dying with dignity.”

After Betty’s death, the sisters wrote a letter to the editor of the Virginian Leader, Giles County’s local newspaper, recognizing Carilion Clinic Hospice for the care it provided.

“They taught us to be what Mom needed us to be on the difficult days,” the sisters wrote. “They told us the im-portance of holding her hand because it showed Mom that she would not face death alone. Hospice eased our fears of death and showed us the way to be phys-ically and emotionally present with our mother during her final days with us.”

Beth has since been inspired to share her family’s experience with others. “What I learned from hospice was just amazing,” she says. “I can’t even begin to wrap my head around what would have happened without hospice.”

Barbara adds: “Hospice does not mean

a death warrant. Instead it prepares you for the journey — for what’s going to happen.”Carilion Clinic Hospice has offices in Roa-noke, the New River Valley, and Franklin County. For more information, visit Carilion-Clinic.org/Hospice or call 800-964-9300.

WHAT IS HOSPICE?Hospice professionals provide expert pain and symptom management, caregiver education, and emotional and spiritual support for the patient and family. Typically patients who enter hospice early live longer and better.

The hospice team consists of physi-cians, nurses, social workers, health aides, volunteers, chaplains, and be-reavement counselors who take the time to get to know patients and their loved ones.

Whether patients live in a private resi-dence, a nursing home, or an assisted living facility, hospice care allows them to spend their last days in com-fort surrounded by family and friends.

That is the mission of Carilion Clinic Hospice, says Aubrey Knight, M.D., a Carilion specialist in geriatrics and palliative medicine. “The goal is to provide specialized care for that indi-vidual in order to allow them to spend their last days with family where they want to be—at home,” he says.

Left: Barbara Croy Vesely (at left) and her sister, Beth

Croy Tanner, hold photos of their mother, Betty Croy.

L to R: Betty Croy; Betty with Barbara and Beth.

Betty Croy


MEDICAL NEWS

“Being a rheumatologist is like being a detective at times,” says Shanthi Dhaduvai, M.D. “Each patient presents a challenging puzzle of symptoms and it’s our job as physicians to figure out what the problem is.”

Rheumatology is a subspecialty of internal medicine dedicated to diagnos-ing and treating disorders of the bones, joints, and muscles, often caused by au-toimmune diseases.

“Many people don’t really know what rheumatology is,” notes Adegbenga Bankole, M.D., Carilion Clinic’s chief of rheumatology. “Sometimes they know that we treat arthritis, but they might not realize that we treat all types of auto-immune or auto-inflammatory ailments, such as gout, lupus, and scleroderma.”

The body’s immune system detects and destroys harmful viruses and bacteria by creating antibodies. However, sometimes the system goes haywire and begins attacking healthy cells. “We don’t know for sure what causes that switch to be tripped, but research indicates that it’s partly genetic and partly due to environ-mental causes,” Dr. Bankole explains.

Autoimmune disorders can cause a

wide range of symptoms that at first might appear to be unrelated. “No two people have the same symptoms, de-pending on which organs are affected,” he says. “Lupus, for example, means very different things to different people. Cold toes, mouth sores, painful breathing, rashes, eye problems, and unexplained fevers can all be symptoms of lupus.”

Detecting the cause of such diverse symptoms can require a variety of blood tests, X-rays, MRIs, biopsies, and electro-physiological testing, but “the most im-portant tools doctors have are our eyes and ears,” Dr. Dhaduvai says. “We take very careful patient histories, listening to every detail, and do comprehensive exams.”

Dr. Bankole says that many patients come in convinced that they have a cer-tain disease based on a blood test alone. “Fifteen to 20 percent of the population would have positive blood tests if you randomly tested them,” he says. “That’s why we have to look at all of the clues to make a diagnosis.”

Carilion’s rheumatology department provides laboratory, imaging, and infu-sion services on-site. “It’s like one-stop

By Alison Weaver

Is It an Autoimmune Disease? ADVANCES IMPROVE TREATMENTS


shopping for our patients,” says Dr. Bankole. “We’re one of only a few fa-cilities in the region that incorporate research, medical education, and clinical services in a single location.

“Because autoimmune diseases can af-fect so many different parts of the body, we work with a team of specialists that might include orthopaedists, neurolo-gists, occupational and physical thera-pists, dermatologists, and dietitians.”

In addition to Dr. Bankole and Dr. Dhaduvai, Carilion’s rheumatology department includes Robert Johnson, M.D., and John Pendleton, M.D., both of whom have more than 20 years’ experi-ence. “They don’t just have two decades of clinical experience,” Dr. Bankole says. “They have 20+ years of being at the fore-front of research and new treatments.”

Jeff Croteau, M.D., Carl Henderson, D.O., and nurse practitioner Sandy Sandridge-Moser are more recent arrivals in the department. “We are committed to recruiting the best candidates who share our enthusiasm for teaching medical residents and conducting research,” Dr. Bankole says.

MAJOR ADVANCEMENTS“Over the past 15 to 20 years, there’s

been a dramatic change in our ability to treat autoimmune disorders,” Dr. Dhaduvai says, ”primarily due to new medications called biologics.”

These biological drugs, which have been available only since 1998, are genetically engineered medicines that mimic natu-rally occurring proteins in the body. “Bi-ologics are given to lessen inflammation and can target very specific areas,” Dr. Bankole says. “They are usually used in conjunction with traditional medicines such as prednisone, and they’re most often delivered by injection or IV. Be-cause they can have significant side ef-fects, they’re not for mild symptoms that can be managed other ways.”

Both doctors emphasize that biologics do not cure autoimmune diseases. “We can’t reverse the damage that’s already been done, but we can control the symp-toms and stop the progression,” Dr. Bankole says.

“The new medications are one reason I wanted to go into the field of rheumatol-ogy; they allow us to really help people,” Dr. Dhaduvai says. “When I hear some-one use the term ‘crippling arthritis,’ it surprises me. Arthritis is no longer a crip-pling, disfiguring disease if it’s treated early on.”

PREVENTIONDr. Bankole has two pieces of advice for

helping prevent autoimmune diseases: take care of your teeth and quit smoking.

“People are really surprised to hear that keeping your teeth and gums healthy can go a long way toward preventing disease,” he notes. “The mouth contains many types of bacteria, some helpful and some harmful. Mouth ulcers or bleeding gums can allow bacteria to enter the blood-stream and spread rapidly throughout the body. You wouldn’t ignore a bleeding eye; don’t ignore bleeding gums.”

Evidence continues to mount that smoking cigarettes increases the risk of developing autoimmune disorders, in-cluding rheumatoid arthritis, lupus, and Grave’s hyperthyroidism. In fact, accord-ing to the U.S. Department of Health and Human Services, smoking doubles the risk of developing rheumatoid arthritis.

“We’ve known for a long time that smoking increases inflammation in the body and weakens the immunity sys-tem,” Dr. Bankole says. “More and more research is showing the link between cigarettes and the onset of autoimmune diseases.” For more information, go to CarilionClinic.org/rheumatology.

L to R: Dr. Shanthi Dhaduvai and Dr. Adegbenga Bankole

say autoimmune disorders can cause a wide range of

symptoms that at first might appear to be unrelated.


COVER STORY

DIABETES: Which Future Will You Choose?

Diabetes can sneak up on you. Ask Linda Waltz.

Waltz, now 65, was admitted to Carilion Roanoke Memorial Hospi-tal in 2013 for an unrelated health issue. Routine blood tests were done. Waltz was stunned when her providers told her she was diabetic. Her blood sugar level was 455 mil-ligrams per deciliter. (Normal on a fasting blood glucose test is between 70 and 100 mg.)


“You could have knocked me over with a feather,” she says.

Once she got over the shock, the Roa-noke resident got down to business. She started attending diabetes education classes. She learned about the A1C, a test

that measures average blood sugar level. Normal is less than 5.7 percent.

“My A1C was 8.2,” Waltz says. “I

started a diet and I’m down to 5.4, and I’ve lost about 47 pounds through walk-ing and diet. I eat a lot of fruits and veg-etables. I’ve cut out salt as much as I can. I’ve cut out white sugar completely and white bread.” Under the management of her primary care physician, Waltz has been able to cut her medication in half, and she only tests her sugar once a week.

Waltz is living (and walking) proof that diabetes can be successfully con-trolled. And for people whose blood sugar is still in the healthy range, or even slightly ele-vated, diabetes can actually be pre-vented.

That’s saying something, because diabetes can be a formidable or even devastating foe. Uncontrolled, it can damage the eyes, feet, nerves, and kid-neys and lead to heart attack and stroke.

In people with diabetes, the body cannot regulate the amount of sugar in the blood. Normally, blood sugar is con-trolled by insulin, a hormone produced by the pancreas. In type 1 diabetes, most often seen in children and teens, the

IT’S AN EPIDEMICDiabetes affects 29 million Ameri-cans, or 9.3 percent of the popula-tion, according to the U.S. Centers for Disease Control and Prevention. Another 86 million, or more than one in three adults, have prediabetes.

Type 2 diabetes is the most com-mon form of the disease. Symptoms include frequent urination, un-usual thirst, fatigue, blurred vision, wounds that are hard to heal, and numbness in the hands or feet.

Some people don’t experience symptoms until their blood glucose levels have been high for some time.

The good news is: diabetes is preventable.

STUDY SEEKS PARTICIPANTSWhen you come to a fork in the road, know your choices.

If you’re prediabetic, one fork leads to diabetes. The other leads to healthy blood sugar. Sarah Wall wants to help you avoid the road with the “Diabe-tes” signpost.

Wall is project manager for diaBEAT-it, a research study by Carilion Clinic and Virginia Tech. She is recruiting partici-pants through fall of 2015.

“We are working with Carilion Clin-ic’s family practice clinics to identify participants who might be at risk for type 2 diabetes or be classified as prediabetic in the hopes that we can help them avoid developing type 2 diabetes,” she says.

“We ask our participants to wear an accelerometer that tracks their physi-cal activity for seven days,” says Wall. “And then we ask some questions about lifestyle, eating habits, social connections and support, things that can contribute to someone’s success in being able to lose weight and stick with the plan.”

DiaBEAT-it does not involve medica-tion. It’s a behavioral and educational intervention based on the Diabetes Prevention Program, a national study that identified lifestyle choices as being more effective at preventing diabetes than medication.

If you’re interested, check with your doctor first. “We don’t take anybody who has diabetes,” Wall says. Then contact the study team at 540-857-6668 or 540-857-6066. They will screen you over the phone to deter-mine eligibility.

L to R: Linda Waltz eats more fruits and vegetables as part of a diet designed to help control her diabetes. Kate Jones, a Car-ilion Clinic registered dietitian and diabetes educator, com-pares the nutritional values ofpopular breakfast foods.

Dr. Erica Reynolds

DIABETES: Which Future Will You Choose?

By Randolph Walker


COVER STORY

body makes little or no insulin. In type 2 diabetes, which is much more common, the body makes insulin but does not re-spond correctly to it.

“In the past we mostly saw type 2 diabetes in adults,” says pediatric endo-crinologist Erica Reynolds, M.D. “But with increasing rates of obesity, we’re now seeing a lot of type 2 diabetes in teenagers. We also see a lot of kids that don’t have full-blown type 2 diabetes yet, but they might have borderline or prediabetes with risk of developing type 2 diabetes down the road.”

“Frequent urina-tion, blurred vision, fatigue, and exces-sive thirst are red flags,” says endocri-nologist Demetrios Herodotou, M.D. “Even if you don’t have symptoms, you should ask yourself: Are you predisposed because of your family history? Are you overweight? Do you have a relatively sedentary lifestyle, unhealthy nutrition? If the answer is yes, you have to be on the alert. You should not go for a year without having a fasting glucose level or an A1C.”

Diabetes can be diagnosed and treated at the patient’s medical home. All Caril-ion primary care practices have adopted the medical home model, says Wanda Bowman, Carilion’s senior care coordina-tor in the New River Valley. “The medical home concept is a more comprehensive approach to patient care that has the pa-tient as the focus,” she says.

“A key part of the medical home is the

care coordinator,” Bowman says. “Re-peatedly, we hear success stories from care coordinators about patients whose diabetic testing results have improved drastically, and who are losing weight and improving their overall health through healthy food choices and exer-cise.”

Diabetes education classes have also helped many. “We’re helping folks to un-derstand their diabetes better and giving them the tools to help them manage it so they don’t have to deal with long-term complications down the road,” says Kate Jones, a Carilion registered dietitian and diabetes educator.

Jones would like people to adopt healthy habits early, before diabe-tes has started. “If they make lifestyle changes, become more active, change eating habits, lose a modest amount of weight, it is very much possible to delay or even prevent the development of type 2 di-abetes,” she says. Jones recommends exercising at least 150 minutes per week, which breaks down to between 20 and 30 minutes each day.

It may be a cliché, but Waltz is finding that eating an apple a day (and other fruits and veggies, plus exercise) really does keep the doctor away—or at least reduces her medical visits.

“You have to have the mindset that it’s not a death sentence,” she says, “but you do have to control it.”

BARIATRIC SURGERY: MORE THAN WEIGHT LOSS

How important is treatment of obe-sity? Important enough for Carilion Clinic to establish an accredited bariat-ric center based at 3 Riverside Circle in Roanoke.

To receive the distinction of being named a comprehensive bariatric center, Carilion Roanoke Memorial Hospital and all program providers underwent a rigorous evaluation by outside experts in weight-loss surgery.

Carilion’s surgeons must perform a certain number of procedures each year, show high-quality outcomes, and participate in quality improve-ment projects. Its team includes a bariatric nurse practitioner, a bariatric coordinator, three surgeons, a medical bariatrician, bariatric nurses, a dieti-tian, and a psychologist.

In addition to weight loss, bariatric surgery can either cure or improve related diseases including diabetes, cardiovascular disease, obstructive sleep apnea, gastroesophageal reflux disease, and osteoarthritis.

Procedures performed at Roanoke Memorial include gastric bypass, sleeve gastrectomy, and gastric banding. “All of the procedures are done laparoscopically through small incisions, which has eliminated a lot of the long recovery period,” says Kinga Powers, M.D., director of the Carilion Bariatric Program. Gastric banding is also offered at Carilion New River Val-ley Medical Center.

Carilion’s bariatric center is accred-ited by the Metabolic and Bariatric Surgery Accreditation and Quality Im-provement Program of the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery.

To learn more about surgical weight loss, call Carilion Direct at 540-266-6000 to register for a bariatric information session. Many insurers cover bariatric surgery.

RESOURCESCarilionclinic.org/diabetes-endocri-nology

bit.ly/cc-diabetes-support

bit.ly/cc-healthy-living

Dr. Kinga Powers

Dr. Demetrios Herodotou

“With increasing rates of obesity, we’re now seeing a lot of type 2 diabetes in teenagers.”

— ERICA REYNOLDS, M.D., PEDIATRIC ENDOCRINOLOGIST


Imagine standing on a large surfboard. Now add one long oar capped with a curved paddle. Welcome to stand-up pad-dle boarding (SUP).

Though some trace SUP back to the 1930s, its modern incarnation picked up steam around 2005 when Hawaiian surfers began using an oar to take them farther out into the ocean. An aid to surfing soon became a sport unto itself when those same surfers noticed that SUP worked a different array of muscles and gave them a fresh perspective on the ocean with which they already felt such a soulful kinship.

Unlike surfing, SUP has a minimal learning curve and can be practiced as anything from a slow, meditative move-ment to a high-speed thrill ride.

“It’s a great way to be on the water and see the scenery,” says Janet Crawford, a Roanoke-based professional coach. “You can go as fast as you want, as slow as you want. You can take a break, sit down and paddle on your knees, or just sit down and rest. No matter what age you are, you can paddle board.”

Pete Eshelman, director of outdoor branding for the Roanoke Regional Partnership, agrees, saying, “Most of the people I know [who SUP] are in their

mid-30s to mid-40s, but the core demo-graphic are people in their mid-20s to mid-30s.”

Eshelman was a white-water paddler until he and his wife started their fam-ily. The intensity of the sport led him to look for an alternative that still offered outdoor adventure. “A river that would be less thrilling in a kayak, like Class 2 water, is more exciting on an SUP,” he says, referring to river rapids that even newbies to white-water paddling could maneuver.

For others, the health benefits of SUP draw them in. The instability of the board activates core muscles while the paddling works the upper body, and all in a low-impact package. Add the aerobic workout and the often peaceful scen-ery and SUP can also provide notable stress-reduction benefits.

Some have even taken the fitness com-ponent further, fusing SUP with other sports including yoga.

“Our SUP yoga classes have been filling faster than we can add boards,” says Pat-rick Boas, outdoor education coordinator for Roanoke City Parks and Recreation. “Some things are easier on a paddle board than on the ground, like a handstand. I guess it has to do with the way the board

stabilizes your body. Of course, people do fall but most of the time they pop out of the water with a big smile on their face.”

Though an SUP can cost anywhere from $600 to $1,200 and up, many shops in Roanoke and at Smith Mountain Lake and Claytor Lake offer rentals at a fraction of the price. Classes are also available, including summer classes at Claytor and Smith Mountain Lakes by Blacksburg-based SUP manufacturer Stride, and winter classes in Roanoke at the Gator Aquatic Center.

Whether it’s to take a slow, peaceful paddle; try some yoga; or shoot the rap-ids, Boas encourages everyone to give it a try. “Go in with an open mind and posi-tive attitude and you’ll go far.”The 3rd Annual Smith Mountain Lake SUP Race was also held last year.

RESOURCESbit.ly/roanoke-paddle

claytorlakewatersports.com

smwake.com

hfhboats.com

roanokeoutside.com

IT’S TAKING OFF

STAN

D-UP

Paddle Boarding By Sarah Beth Jones

REGIONAL INTEREST


The afternoon was extremely hot, but as my wife Elaine and I drove up the Botetourt County mountainside to the Woodpecker Ridge Nature Center, we could feel the air growing cooler.

Pausing at the entrance, where trees envelop a narrow lane, we heard a pile-ated woodpecker drumming on a hard-wood—announcing to other males of his species that he was on duty and in charge of this particular woodlot.

Woodpecker Ridge, a 108-acre nature preserve just outside of Troutville, is one of the best places in our region to enjoy nature. Verdant trails meander through hardwood forests, pond habitats, and butterfly gardens, offering glimpses of birds and wildlife.

Wood ducks call one pond on the property home, while a cattail pond is frequented by green herons and red-winged blackbirds. The woodlands and brush are habitats for the pileated woodpecker, great horned owl, red-tailed hawk, scarlet tanager, and other birds. Feeding stations attract many species of songbirds and ruby-throated humming-birds.

At an elevation of 1,644 feet, Wood-pecker Ridge also commands fine views, and many visitors enjoy the

hawk-watching platform, where broad-winged hawks can be seen sweeping through the valley.

“I’ve been there many times the past 25 years, and it’s a wonderful place,” says Kent Davis, president of the Roanoke Valley Bird Club. “Visitors don’t have to be bird watchers to enjoy coming. The wildflower gardens, ponds, fields, for-ested knoll, and hawk-watching platform with a great view of the Roanoke Valley add to the experience. Woodpecker Ridge is a wonderful place to get outside and bring a picnic lunch.”

WANDERING THE PRESERVE After driving down the shady drive-

way, Elaine and I met owners Barry and Teresa Kinzie at the visitor’s center, where detailed maps of the property are available. Nearly four miles of trails dot the landscape, and Barry shepherded us down a pathway leading to a mature hardwood forest consisting of white and red oaks, ashes, poplars, and red maples.

“This is where I go to hear wood thrushes in the morning,” said Barry. “There’s no better sound in nature.” He also said that in early summer, he can hear or see 30 species of songbirds be-tween 7 and 8 a.m.

Barry explained why he has thinned

his mature oak/hickory forest and left a number of dead trees standing. “Many people get upset when landowners cut trees, but by cutting certain trees and leaving others, I create a better wildlife habitat so that a greater variety of song-birds can live here,” he said.

“You see that standing dead tree? Woodpeckers, titmice, and chickadees are all cavity nesters and they need old snags like that one to raise their young. Cutting down some trees also gives the remaining ones more room to grow and to produce more food for wildlife. I’ve cut down the ashes and poplars around this oak so that it can get more sunlight and produce more acorns.”

We walked to a knoll at the highest point on the Kinzie property. Earlier Barry had predicted that butterflies would be there to greet us, and sure enough, some Red Admiral butterflies flitted about.

“For mating purposes, butterflies often congregate at the highest point in an area, especially if it is in sunlight,” Barry said. “This is also a divide for the James and Roanoke river watersheds.”

We then headed for a man-made bog that Kinzie’s friend Bill Opengari of Montgomery County created a number of years ago. A green frog, also known

A LOCAL OASIS By Bruce Ingram

WOODPECKER RIDGE

REGIONAL INTEREST


as a banjo frog because of the “notes” in his mating song, sounded off. Barry said he has tallied as many as seven different species of frogs in the small pool at one time.

Another stop was at a spruce grove that Barry planted several decades ago. “This is a unique, very cool habitat,” he said. “Magnolia warblers will stop here on their way northward to breed, and purple finches and crossbills will visit come winter.”

PROTECTING THE LANDThe Kinzies placed the Woodpecker

Ridge property under a conservation easement in 2010, thus forever protect-ing the land from development. They also created an easement to open the land to the public.

“I wanted to share my feelings about nature; that’s why all this exists,” Barry

said. “To give people a chance to come here and relax either in the morning or after work and commune with nature is very meaningful to me.

“Our land sort of evolved from a place that we and members of the Roanoke Valley Bird Club could go to enjoy bird watching to a place where we wanted other folks to gain that same enjoyment,” he added. Kinzie credits members of the club for helping him build and maintain trails and determine bird-feeding stations.

“We feel it is very important to protect rural land for the future,” he said. “And we also feel that people should have places where they can walk for exer-cise and be a part of nature. Coming to Woodpecker Ridge is very good for a per-son’s mental and physical health.”

Kinzie also gives credit to Genevieve Goss, a former volunteer at Wood-

pecker Ridge and now the Upper James Program Manager for the Valley Con-servation Council, a land trust, for en-couraging the couple to go the easement route.

Goss, in turn, says: “Woodpecker Ridge Nature Center wouldn’t exist with-out Barry and Teresa’s love of nature and their generosity in sharing it with others. They’ve protected an oasis of habitat for wildlife and an oasis of peace for walkers.”

Clockwise: The entrance to Woodpecker Ridge; a box turtle basks in the sun; the hawk-watching platform has a view of the Roanoke Valley; one of many toads that live in the ponds; a pipevine swallowtail caterpillar feeds on a leaf; pileated wood-peckers are among the many birds you might see at Woodpecker Ridge.

RESOURCESWoodpecker Ridge: bit.ly/birding-wildlife

roanokevalleybirdclub.com

valleyconservation.org

virginiaoutdoorsfoundation.org


IN YOUR COMMUNITY

The Roanoke Athletic Club (RAC), Botetourt Athletic Club, and RAC Xpress have a new focus—wellness. The clubs will emphasize functional training, which strengthens the core muscles to improve balance, coordination, and endurance. It is designed to condition the body for everyday activities without stress.

“We will be offering programs with a clinical emphasis, like those for pre- and post-surgery patients, to members and non-members alike,” says Bud Grey, who as Carilion Clinic’s vice president of wellness directs the centers. “Some of it has to do with the aging of the population. We are not just a gym.”

The RAC had a complete physical makeover late last year, which included creating a 2,400-square-foot room for functional training and “assist changing rooms” with private showers and grab bars in the showers. The assist changing rooms will serve the elderly as well as parents with young children.

In keeping with the new focus, the clubs also have new names: Carilion Wellness-Roanoke; Carilion Wellness-Botetourt; and Carilion Wellness-Downtown. The Botetourt and downtown facilities will get new logos but are not undergoing renovations at this point.

ATHLETIC CLUBS SHIFT FOCUS TO WELLNESS

Carilion Roanoke Memorial Hospital and Carilion Tazewell Community Hospital were named “Top Performers on Key Quality Measures” by The Joint Commission, which accredits U.S. hospitals. Roanoke Memorial was recognized for heart attack, heart failure, pneumonia, and surgical care and Tazewell Community was recognized for pneumonia care. Only about a third of the country’s hospitals earned this distinction.

CARILION HOSPITALS ARE ‘TOP PERFORMERS’

In 2013, Carilion Clinic provided $138.8 million in community benefit. This included $111 million in uncompensated care; $4.2 million in community outreach such as free health screenings and community programs; $1.3 million in research; and $22.3 million in investments in education to train new physicians and medical professionals.

CARILION PROVIDES OVER $138 MILLION IN COMMUNITY BENEFIT

When winter weather strikes, visit CarilionClinic.org before heading to your doctor’s appointment. A red banner will appear at the top of the home page when snow and ice make it too dangerous for travel. Click on the banner for a detailed list of closings and delays. If there’s no banner, your doctor’s office is on its normal schedule.

SNOW AND ICE IN THE FORECAST? CHECK BEFORE YOUR DOCTOR’S APPOINTMENT

$22.3 MILLION EDUCATION

$1.3 MILLION RESEARCH

$4.2 MILLION COMMUNITY OUTREACH

$111 MILLION UNCOMPENSATED CARE

$138.8 MILLION COMMUNITY BENEFIT


Patient care is paramount at Carilion Clinic. To recognize the contributions of our exceptional doctors and medical professionals, we recently an-nounced Carilion’s 2014 Quality Awards.

Awards Recognize Outstanding Patient Care

PALADIN AWARD Brenda Gilliam, R.N., unit director for Presurgical Testing in Roanoke, for 35 years of compassion serving as an advocate for our patients and for quality care.

PROVIDER EXCELLENCE AWARDS RESIDENT Matthew Roby, D.O., resident, Internal Medicine, Virginia Tech Carilion School of MedicineADVANCED CLINICAL PRACTITIONER Portia Tomlinson, P.A.-C., physician assistant, NeurosurgeryPHYSICIANS Mary Beth Sweet, M.D., physician, Carilion Family Practice - Roanoke Salem

QUALITY AWARDS The Creating a Culture of Quiet team from Carilion Stonewall Jackson Hospital worked to provide a quieter environment at night to help patients rest and heal.The team that worked on the project, Is Safe Care Possible? Mitigating the Risk of Inpatient Suicides in Medical Hospitals, found ways to reduce the risk of harm for suicidal patients.The Collaborative Heparin Project team found ways to reduce medication errors related to anticoagulant medications.The Reducing First-Birth Cesarean Sections team worked to lower the Cesarean section rate for babies born at Carilion Roanoke Memorial Hospital.

VALUES AWARDS Commitment: Vascular ICU Leadership team, Carilion Roanoke Memorial Hospital. Team members were recognized for their work to eradicate central-line infections and ventilator-associated pneumonia on their unit.Curiosity: Timothy Salyer, R.N., Emergency Department, Carilion Roanoke Memorial Hospital. Tim developed, teaches, and tracks the ultrasound-guided IV program within the department.CommUNITY: Vascular Progressive Care Unit Community Outreach team, Carilion Roanoke Memorial Hospital. This team was recognized for service to patients, the community, and to fellow employees. Compassion: Amanda Kitchner, Carilion Clinic Cardiology – Christiansburg. Amanda, a medical office associate, was recognized for the way she connects with patients and for ensuring they get the care they need.Courage: Joe Castiglioni, Communications. Joe, a videographer, filmed a video series documenting his weight-loss journey through one of Carilion’s FIT Rx programs.Learn more about these award recipients and their achievements by visiting CarilionClinic.org/Shine2014.

Nancy Howell Agee, Carilion Clinic president and CEO, and Brenda Gilliam, R.N., Paladin Award recipient.

L to R: Melina Perdue, executive vice president, Carilion Clinic, and the members of the Vascu-lar Progressive Care Unit Community Outreach team: Alicia Broughman; Carla Hazelwood; Cecile Dietrich; Cynthia Gillespie; Tony Derossi; Evelyn Rubongoya; and Andrea Steuart.


Five-year-old Alex Lakes lay in pedi-atric intensive care looking tired, his eyes half closed, his mother close by. When Ellie, a white Golden Doodle, gently placed her paws on Alex’s bed and rested her head on them, looking at Alex, he opened his eyes wide and smiled. He wasn’t yet ready to pet her, but he leaned toward the dog.

Ellie is one of 10 gentle and friendly certified dogs participating in Carilion Clinic’s Pet Pals program. For 14 years, volunteers from the community have taken their dogs to visit patients at Car-ilion Roanoke Memorial or Community Hospitals.

“The first thing you notice is the smiles,” says Linda Perdue, a Pet Pal vol-unteer who coordinates the visits. “Ev-erybody smiles: the patients, the staff, the doctors. Everybody.”

Pet Pals dogs include a golden re-triever, a St. Bernard mix, a Yorkshire terrier, and a black Labrador. All are certified by Pet Partners, the nation’s largest non-profit registering organiza-tion of therapy animals. Pet Partners

runs them through a battery of tests that re-create some of the situations they will encounter in the hospital: people in wheelchairs and walkers, toys on the floor, people being loud or arguing. “It is a high standard that Carilion demands,” says Perdue.

Four more dogs are awaiting certifica-tion to join the program.

Perdue accompanies the owners and their pets, who take turns visiting Roa-noke Memorial most days of the week for a couple of hours.

HEALING PROPERTIESPets are said to have been used in pa-

tient therapy for more than 150 years, and one study has found that heart at-tack patients with pets live longer than those without. Another study found that petting your dog can lower your blood pressure.

Carilion physicians often put in special requests for Pet Pals visits. “They are en-thusiastic about it,” Perdue says.

When Ellie eventually stepped into

17-year-old Cristin Parsons’ room, Cris-tin immediately sat up on the edge of her bed, smiled, and reached out to touch her. Cristin was only minutes from being released from the hospital following sur-gery and was in some pain, but the dog seemed to ease that.

“This is so awesome,” Cristin said. “She’s pretty.” Cristin has two small poo-dles at home.

“Ellie gets all this attention, which she loves, then goes home and sleeps the rest of the day,” says her owner, Neely Con-ner, who works at Carilion as manager of the Employee Assistance Program. She is one of two Carilion employees who vol-unteer their dogs for Pet Pals.

Perdue is delighted that people are starting to recognize and understand the program. “The owners are so proud to be involved in this, and they have to take on some expense to become evaluated and certified,” she says. “There are a lot of warm fuzzy moments.” For more information about the Pet Pals program, call 540-981-7819.

Healing with Pets Long-Standing Program More Popular than Ever A Staff Report

MEDICAL NEWS

Clockwise: Alex Lakes lights up when he gets a hospital visit from Ellie, a Pet Pals dog; Cristin Parsons pets Ellie; Gabriel Scott holds Ellie close.


Ralph Caldroney, M.D. Internal MedicineMedical Degree: Medical College of VirginiaResidency: Medical University of South CarolinaFellowship: Critical Care Medicine, University of Florida108 Houston St., Suite A, Lexington, VA 24450540-463-2181

Kevin Combs, D.O. Emergency Medicine; Internal MedicineMedical Degree: Pikeville College School of Osteopathic Medicine Residency: Norton Community Hospital141 Ben Bolt Ave., Tazewell, VA 24651276-988-8850

Thomas Hamilton, M.D. Family MedicineMedical Degree: University of Minnesota Medical SchoolResidency: Richland Memorial Hospital2252 Magnolia Ave., Buena Vista, VA 24416540-261-7421

Jill Devlin, D.O. Obstetrics and GynecologyMedical Degree: Edward Via Virginia College of Osteopathic MedicineResidency: Maine Medical Center2900 Lamb Circle, Suite 202, Christiansburg, Va 24073540-731-4578

Kevin Griffin, M.D. Urology Medical Degree: University of Texas Health Science Center at San AntonioResidency: University of Texas Health Science Center at San Antonio120 Akers Farm Road, Christiansburg, VA 24074540-382-3440

Violet Fernandes, M.D. Pediatric Hematology and Oncology Medical Degree: Drexel University College of MedicineResidency: Jefferson Medical College/Alfred I. DuPont Hospital for ChildrenFellowship: Pediatric Hematology Oncology, Children’s National Medical Center1906 Belleview Ave., 4 North, Roanoke, VA 24014540-981-7376

Ryan Harris, D.O. Orthopaedic Surgery Medical Degree: West Virginia School of Osteopathic MedicineResidency: Pinnacle Health Hospital Fellowship: Adult Reconstruction and Total Joint, Carilion Clinic – Virginia Tech Carilion School of Medicine 2900 Lamb Circle, Suite L-760, Christiansburg, VA 24073540-731-2436

Judy Chun, M.D. UrologyMedical Degree: University of Iowa Carver College of MedicineResidency: University of North Carolina at Chapel Hill120 Akers Farm Road, Christiansburg, VA 24073 540-382-3440

Sean Burke, M.D. Neurology Medical Degree: University of MarylandResidency: Penn State College of MedicineFellowships: Neuromuscular, Penn State University; Multiple Sclerosis, University of Maryland; Neurophysiology, Allegheny General Hospital3 Riverside Circle, Roanoke, VA 24016540-224-5170

Farrell C. Adkins, M.D. General Surgery and Colorectal SurgeryMedical Degree: West Virginia University School of MedicineResidency: West Virginia UniversityFellowship: Colorectal Surgery, Cleveland Clinic Florida3 Riverside Circle, Roanoke, VA 24016540-224-5170

NEW PROVIDERS


Mark Joseph, M.D. Cardiothoracic SurgeryMedical Degree: University of Oklahoma College of MedicineResidency: University of North CarolinaFellowships: Cardiothoracic Surgery and Critical Care/Trauma, University of North Carolina at Chapel Hill2001 Crystal Spring Ave., Suite 201, Roanoke, VA 24014540-853-0100

William King, M.D. UrologyMedical Degree: University of Virginia School of MedicineResidency: Bowman Gray School of MedicineFellowship: Urology Research, Bowman Gray School of Medicine120 Akers Farm Road, Christiansburg, VA 24073540-382-3440

Kelley Morel, M.D. OB/GYNMedical Degree: Louisiana State University Health Science Center School of MedicineResidency: Virginia Commonwealth University Health System102 Highland Ave., Suite 303, Roanoke, VA 24013540-985-9715

Sanjiva M. Lutchmedial, M.D. Pulmonology MedicineMedical Degree: University of West IndiesResidency: Carilion Clinic - Virginia Tech Carilion School of MedicineFellowship: Pulmonary and Critical Care Medicine, University of Vermont2900 Lamb Circle, Suite 7-700B, Christiansburg, VA 24073540-731-7450

James Allen Maxey, D.O. Family Medicine Medical Degree: Edward Via Virginia College of Osteopathic MedicineResidency: Riverside Regional Medical Center195 Maple Ave., Rocky Mount, VA 24151540-483-5168

David Luyimbazi, M.D. General Surgery Surgical/Oncology Medical Degree: New York Medical CollegeResidency: University of Connecticut School of MedicineFellowship: Surgical Oncology, City of Hope National Medical Center3 Riverside Circle, Roanoke, VA 24016540-224-5170

Thomas Morel, M.D. Palliative Medicine Medical Degree: Louisiana State University Health Science Center School of MedicineResidency: Virginia Commonwealth University Health SystemFellowship: Hospice & Palliative Medicine, Virginia Commonwealth University Health System 1906 Belleview Ave., Roanoke, VA 24014540-981-7515

Senaida Keating, M.D. Geriatric and Palliative CareMedical Degree: Spartan Health Sciences UniversityResidency: Carilion Clinic – Virginia Tech Carilion School of MedicineFellowships: Geriatrics Medicine and Hospice and Palliative Medicine, both at Carilion Clinic – Virginia Tech Carilion School of Medicine2001 Crystal Spring Ave., Roanoke, VA 24014540-981-7653

Gregory Howes, D.O. Neurosurgery Medical Degree: West Virginia School of Osteopathic MedicineResidency: Midwestern University Fellowship: Stanford University 3 Riverside Circle, Roanoke, VA 24016540-224-5170

Carl S. Henderson, D.O. RheumatologyMedical Degree: Rowan University School of Osteopathic MedicineResidency: University of Vermont at Fletcher Allen Healthcare Fellowship: Rheumatology, Duke University Health System3 Riverside Circle, Roanoke, VA 24016540-224-5170

NEW PROVIDERS


Christopher Pile, M.D. Palliative MedicineMedical Degree: Eastern Virginia Medical SchoolResidency: Riverside Hospital2001 Crystal Spring Ave., Suite 302, Roanoke, VA 24014540-981-7653

Shawn Safford, M.D. Pediatric SurgeryMedical Degree: University of Pennsylvania School of MedicineResidency: Duke University Medical CenterFellowship: Pediatric Surgery, Children’s Hospital of Philadelphia102 Highland Ave., Suite 404, Roanoke, VA540-985-9812

Christine Ullman, D.O. Family MedicineMedical Degree: Edward Via Virginia College of Osteopathic MedicineResidency: Lewis Gale - Montgomery118 Broad St., Dublin, VA 24084540-674-8805

Isaac Spence, D.O. Family MedicineMedical Degree: Edward Via Virginia College of Osteopathic MedicineResidency: Wake Forest University Baptist Medical Center901 Plantation Road, Blacksburg, VA 24060540-951-0352

Priscilla Tu, D.O. Family Medicine Medical Degree: Kirksville College of Osteopathic MedicineResidency: Carilion Clinic - Virginia Tech Carilion School of MedicineFellowship: Primary Care Sports Medicine, Duke University Medical Center1314 Peters Creek Rd., Roanoke, VA 24017540-562-5700

Shen-Li Tan, M.D. Interventional Cardiology Medical Degree: National University of SingaporeResidency: Mayo ClinicFellowships: Cardiology, Mayo Clinic; Interventional Cardiology, Mayo Clinic2900 Lamb Circle, Suite 301, Christiansburg, VA 24073540-731-7600

Wei Wei, M.D. General Surgery Medical Degree: Tongji Medical UniversityResidency: Carilion Clinic - Virginia Tech Carilion School of Medicine 2900 Lamb Circle, Suite 302, Christiansburg, VA 24073540-731-7600

Natalie Powell, D.M.D. DentistryMedical Degree: University of Pennsylvania School of Dental MedicineResidency: VA Medical Center, Washington, D.C.2017 S. Jefferson St., Roanoke, VA 24014540-981-7128

Biraj Patel, M.D. Interventional Neuroradiology Medical Degree: Virginia Commonwealth University School of MedicineResidency: University of Cincinnati Medical CenterFellowships: NeuroInterventional Surgery and Diagnostic Neuroradiology, Northwestern University; Neuroendovascular Surgery, University of Wisconsin Hospital and Clinics 127 McClanahan St., Suite 201, Roanoke, VA 24014540-981-8353

Scott Otallah, M.D. Pediatric NeurologyMedical Degree: University of Virginia School of MedicineResidency: University of VirginiaFellowship: Pediatric Neurology, University of Virginia102 Highland Ave., Suite 104, Roanoke, VA 24013540-985-8454


Did you know that blueberries are one of the best foods you can eat?

Loaded with antioxidants thought to protect against heart disease and cancer, they also have other nutrients that may lower blood pressure and keep blood vessels elastic.

These blue gems will help keep you healthy—and happy—throughout your day.

Add Blueberries to Your Breakfast!

PREPARATION1. Combine oats and milk in a large bowl. Cover and let soak in the refrigerator

until much of the liquid is absorbed—at least eight hours and up to 12 hours.

2. Preheat oven to 375°F. Coat a 12-cup nonstick muffin tin with cooking spray.

3. Stir egg, maple syrup, oil, vanilla, cinnamon, baking powder, and salt into the soaked oats until well combined. Divide the mixture among the muffin cups (about 1/4 cup each). Top each with 1 tablespoon blueberries.

4. Bake the oatmeal cakes until they spring back when touched, 25 to 30 minutes. Let cool in the pan for 10 minutes. Loosen and remove with a paring knife. Serve warm.

Per serving: 264 Calories; 9 g Fat: 1 g Sat., 4 g Mono.; 34 mg Cholesterol; 41 g Carbohydrates; 7 g Protein; 4 g Fiber; 219 mg Sodium; 277 mg Potassium

• 2 1/2 cups old-fashioned rolled oats• 1 1/2 cups low-fat milk• 1 large egg, lightly beaten• 1/3 cup pure maple syrup• 2 tablespoons canola oil• 1 teaspoon vanilla extract• 1 teaspoon ground cinnamon• 1 teaspoon baking powder• 1/4 teaspoon salt• 3/4 cup blueberries, fresh or frozen

BREAKFAST BLUEBERRY-OATMEAL CAKES6 SERVINGS

INGREDIENTS

RECIPE


We know how to treat patients

who can’t tell us where it hurts

Our staff of 350 pediatric professionals is specially trained to care for the unique needs of children

We make going to the doctor

less scary for you and your kids

Because tests, treatments, and facilities are tailored to fit your child

Carilion Clinic Children’s Hospital is the only dedicated hospital for children and adolescents in western Virginia. From allergy shots to stitches to cancer care, we know how to care for kids because it’s all we do!

CarilionClinic.org/kids | 800-422-8482VISIT OUR WEBSITE TO MEET OUR MASCOT, NED!

your children’s hospital What makes

special?

Dec 2014 Living CCCH Kids ad.indd 1 12/22/14 11:34 AM

CarilionClinic.org/MyChart | 800-422-8482

Close to your last pill and need a refill?

Want to help Mom keep up with her appointments and prescriptions?

Can’t remember when little Suzy needs her next booster shot?

Tired of waiting for test results to arrive in the mail?

MyChart —western Virginia’s first online health care management tool —offers 24/7 access to your health records. Request an appoint-ment, view lab results, refill a prescription and much more, all on your schedule. With more than 75,000 users, MyChart provides the tools you need to manage your health care.

WHY WAIT? GET ACTIVE ON MYCHART TODAY!

MyChart It!

Dec 2014 Living MyChart Questions_backcover.indd 1 1/12/15 2:10 PM

CARILION CLINICP.O. BOX 13727ROANOKE, VA 24036-3727

NON-PROFIT ORG. U.S. POSTAGE

PAID ROANOKE, VA

PERMIT NO. 247

Scan this code to sign up for the Carilion Clinic Living e-newsletter.

carilion clinic living - spring 2015

Documents

carilion clinic spring

womenat carilion clinic

carilion clinicpresident

carilion hospitals

hospital services

inpatient care

roanoke valley