verve - fall/winter 2010-11

Fall 2010 / Winter 2011

Sally Field

Battling a Silent Disease

A community service of

Beyond the Limits of the Human Hand

www.CarilionClinic.org/davinci

The human hand is truly amazing: Fingers that bend and grip;precise touch and feel; fluid movement.

Imagine all of that being enhanced in the operating room. That’swhat the da Vinci Surgical System does. It takes the skill of asurgeon’s hand and elevates it to a higher level of performance.

That’s why the surgeries our doctors perform using da Vinci aremore precise. And because they are less invasive, the surgeriesprovide a faster recovery time, giving patients the upper hand on getting back to their life.

Surgeries performed with da Vinci include:• Urologic• Gynecologic• Cardiac• General

For more information about da Vinci surgery at CarilionRoanoke Memorial Hospital, call Carilion Clinic at 540-266-6000.

The da Vinci Surgical Systemoffers Dennis Scribner, M.D.,greater precision forcomplex procedures.

da Vinci Surgical System: less invasive, more precise, faster recovery

1Fall 2010 / Winter 2011

10

20

EducationNew medical school opens

5Sports InjuriesSports medicine clinic expands

Local Authors

Sally FieldHer fight against osteoporosis

These medical professionalsalso write

16

President and CEO .......................... Edward G. Murphy, M.D.Chief Operating Officer, Carilion Clinic and President, Carilion Clinic Hospital Division .... Nancy Howell AgeeVice President of

Strategic Development ............... Shirley HollandMedia Relations Director................. Eric Earnhart

verve:Editor................................................ Maureen RobbDesign .............................................. Gordon GarrettPhotography .................................... Darryle ArnoldPrinting............................................. Chocklett Press

Contributing WritersMary Brewer, Allison Buth, Shanna Flowers, Meredith Hite,

Kate Jones, Gail Nordhaus, Matthew Sams

www.CarilionClinic.org540-266-6000 or 800-422-8482

Carilion Clinic is a health care organization with more than600 physicians in a multi-specialty group practice and

eight not-for-profit hospitals.

verve is published quarterly byCarilion Clinic

1906 Belleview Ave.P.O. Box 13367

Roanoke, VA 24033540-981-7000

Copyright 2010 by Carilion Clinic. No part of this publication may bereproduced or transmitted in any form or by any means without writ-ten permission from Carilion Clinic. Articles in this publication arewritten by journalists or authors who strive to present reliable, up-to-date health information. However, personal decisions regardinghealth, finance, exercise and other matters should be made only afterconsultation with the reader's physician or professional advisor. Alleditorial rights reserved. Opinions expressed herein may or may notreflect the views of Carilion Clinic.

Departments

3 Letter

5 Sports Medicine

7 Technology

8 Cardiac Care

10 Education

12 Pregnancy

14 Chronic Conditions

16 Community

19 Elderly Care

24 Facilities

26 Interdisciplinary Care

28 Women’s Health

30 New Physicians

32 Excursions

34 Food

2 Fall 2010 / Winter 2011


f you’ve been to Riverside Center in Roanoke lately, you may have seensome of our new medical students on their way to class. Our 42 students—30 men and 12 women—have come from around the country to obtaintheir M.D. degrees at the new Virginia Tech Carilion School of Medicine.

Academically, they are among the best in the nation, with an average MedicalCollege Admission Test Score of 33, vs. the national average of 30. We tell youmore about the school and its innovative curriculum on page 10.

In this issue, we also take a look at Carilion Clinic’s expanded sports med-icine program for student-athletes and adults; a new, invisible hearing aid thatcan be worn 24/7; and our cutting-edge maternal-fetal medicine practice. Andwe’re pleased to report that our Heart Alert program, which fast-tracks heartattack victims to life-saving care, has celebrated a milestone: saving its 1,000thpatient.

For those of you who enjoy contemporary fiction, turn to page 16 to readabout a Roanoke-based nurse and author, Gina Holmes, whose debut novelwas published this year to wide acclaim. We also profile best-selling novelistHarry Kraus M.D., a Lexington surgeon, and John Ingram Walker, M.D. of theNew River Valley, whose latest highly regarded book on mental health is nowout.

You also may not know about some of the adventurous railway excursionsnow being offered across our region. Whether you’d like to take a day trip inmountainous West Virginia and watch Bald Eagles soar, or you’d enjoy a jauntdown to Danville and back, a variety of passenger trips are available.

Our cover story features none other than Sally Field, who has grown up inthe national spotlight and is now a youthful-looking 64. Recently, Field hasbeen sharing her story about her fight against osteoporosis—and has becomea leading spokesperson on the subject. Read about her life, award-winningcareer, and mission to save others from her own debilitating disease.

I

verveletter

Ed Murphy, M.D.President and CEOCarilion Clinic

welcome

Resources to Keep You HealthyNurse LineCarilion Clinic’s physician referral and health information service is here to help. Call us at 540-266-6000 or 800-422-8482, or e-mail us at [email protected].

“Well Said” Speaker’s BureauIf you’d like a speaker on a health topic for your community group, call 540-224-4961. For a speaker at your workplace, call 540-224-4967. Or visit www.CarilionClinic.org/speakers.

Community Health ScreeningsHealth screenings throughout the community are available at little or no cost. Call 540-266-6000 or 800-422-8482, or e-mail us at [email protected].

New, Improved WebsiteCheck out these features at www.CarilionClinic.org: • An easy-to-use physician database with multiple search criteria• Interactive maps to help patients find their way to our locations• Multimedia health and wellness content, including an A-Z library• A community health education and events calendar

News BlogKeep up with the latest news, photos, videos and more at Carilion Clinic’s news blog. Visit newsblog.CarilionClinic.org.

Social MediaStay connected with us through Facebook, Twitter, YouTube and LinkedIn:www.facebook.com/carilionclinicwww.twitter.com/carilionclinicwww.youtube.com/carilionclinicwww.linkedin.com/companies/carilion-clinic

PublicationsPick up a copy of verve, Carilion Clinic’s health and lifestyle magazine, at a magazinerack or grocery store near you. Or read past issues of verve and the Carilion ClinicReport at www.CarilionClinic.org/publications. For health tips and news abouthealth events, check out our e-newsletter, Carilion Clinic Living, atwww.CarilionClinic.org/living.

Support Groups Support groups are available for a wide range of health and emotional needs, including gynecologic cancer, breast cancer and perinatal loss. Learn more at www.CarilionClinic.org/support.

Health Information CentersComputer stations with health information are available at Carilion Clinic’s 3Riverside building at the corner of South Jefferson Street and Reserve Avenue inRoanoke. Check out the audio library, video library, clinical wizards, health newsand interactive tools.


In any given week, millions of Americans compete in sports.And whether they are playing tennis, baseball, or football, theyoften get hurt.

To treat athletic injuries, Carilion Clinic has expanded itssports clinic and its sports medicine program. The sports clinic,which is open on Saturday mornings during the fall season,aims to treat and prevent sports injuries in local athletes.Student athletes who suffer practice or game-related injuriescan either walk in or have their trainers call ahead for an ap-pointment.

Sports clinic physicians are also working with local teams toprovide better preventive care. The clinic’s doctors are nowworking with trainers for the Virginia Military Institute, SalemRed Sox, Ferrum College, and most of the region’s high schoolteams. Clinic physicians also provide sideline care and on-siteinitial evaluations of athletes.

“We like to work directly with the trainers at local schoolsand make ourselves available to themwhen they need us,” says orthopaedicsurgeon Christopher John, M.D. Thesports clinic also works with an ath-lete’s primary care physician to providecare tailored to a particular athlete.

“We see a wide range of sportsinjuries—from head to toe,” Dr. Johnsays. “More than anything, though, wesee shoulder, elbow, knee, and ankleproblems.”

The sports clinic, created by Roanoke Orthopaedic Center(ROC) 10 years ago, has been expanded since ROC mergedwith Carilion Bone and Joint last April to form Carilion Clinic –Orthopaedics.

The merger has also allowed Carilion Clinic – Orthopaedicsto expand its overall sports medicine program in many ways.The practice now has expedited access to an advanced 3 TeslaMRI system and the availability of a dedicated musculoskele-tal radiologist for consultation.

Other benefits of the merger include giving patients access

to more orthopaedic subspecialties; coordination of carebetween the sports clinic’s two offices in Roanoke and RockyMount; and enhanced physical therapy programs. Athletesalso now have access to multi-disciplinary assessment and carefor concussions and related injuries.

Three of the orthopaedic surgeons in the practice arelocated in Roanoke: Christopher John, M.D.; Thomas K. Miller,M.D.; and Brent Johnson, M.D. Another, Robert Cassidy, M.D.,practices in Rocky Mount. The sports medicine practice alsohas physician assistants with an interest in sports medicine,two of whom are certified athletic trainers.

The physicians also treat a variety of injuries in active adultswho injure themselves while running, hiking, bicycling, or play-ing sports. “We perform reconstructive shoulder surgery andrepair rotator cuff tears for people of all ages,” Dr. John says.

“Our goal is to offer preventive, diagnostic, non-surgical,and when needed, surgical services,” he says. “We’re here for alltypes of athletes—of any age.”

For more information, call Carilion Clinic – Orthopaedics at 540-776-0200 in Roanoke or 540-489-4541 in Rocky Mount.

By Meredith Hite

Christopher John, M.D.

Carilion Clinic Expands Sports Medicine Program

New research shows that concussions among football players is agreater problem than previously thought, leading to problems laterin life.

Helping patients face life-limiting illnessPartners in Care is a specially designed program that allows our staff to provide support and comfort topatients early in the course of a serious illness. Trained in the management of physical, emotional andspiritual needs of patients, our staff can also provide valuable information about hospice options andhelp patients stay involved in their treatment plans.

For a smooth transition from one program to another, choose Carilion Clinic Home Care and our Partners in Care program.

For more information or to make a referral, please call 800-964-9300 orvisit www.carilionclinic.org/Carilion/HomeCare.

A patient must qualify for home health services to be eligible. All services are provided under the care of a physician.

Partners in Care

Fall 2010 / Winter 2011 7

Hearing aids often get mixed re-views from their users.

They can’t be worn in the showeror while sleeping, and their batteriesneed frequent replacement. Some are alsolarge and clunky or can amplify backgroundnoises—interfering with the sounds a user wants tohear.

But now a new type of hearing aid, which is invisibleand can be worn for months at a time, has been devel-oped. The Lyric, created by InSound Medical, Inc. ofNewark, California, is worn inside the ear canal, and doc-tors say it produces more natural hearing because of itsproximity to the eardrum.

Recently, hearing specialists at Carilion Clinic began of-fering the Lyric to patients. It is not available elsewhere inthe region; in fact, Carilion Clinic Otolaryngology washandpicked to provide the Lyric, along with about 200other medical practices across the country.

“Carilion Clinic was chosen to distribute the devicebecause of its perfect clinic setting,” says LillianBeasley Beahm, Au.D., Carilion Clinic Otolaryngol-ogy. “We have readily available support, space, andequipment and we also operate on a patient-centeredcare model.”

Developed by physicians and audiologists, the Lyricis unique due to its incredibly small size. But only50 percent of the patients who want it canactually wear it. If a patient’s ear canal istoo narrow or shallow, the device will

not fit. However, InSound Medicalis expected to release an even

smaller version of the Lyric in 2011that will fit a larger percentage of pa-

tients.The Lyric is also unique because it can

stay in the ear for long periods of time. Referred to asan “extended-wear device,” it can be worn continuouslyfor up to four months. When its battery dies, patients re-ceive a new device. Most patients subscribe to the Lyric ona yearly basis and are guaranteed eight devices per year.

“The Lyric eliminates many of the hassles of typicalhearing aid devices,” says Dr. Beahm. “Users can talk onthe phone comfortably, shower with it in, etc. It truly is agame-changer for us.”

Patients are also enthusiastic. Joseph Vipperman, 70,says he is enjoying better hearing in general, as well as on

the phone. And he is pleased to not have to rememberwhere he put his hearing aids, or to have to re-

move them for activities like gardening, whenthey could get wet from the sprinkler sys-tem.

“I am enjoying greatly improved hearingability and rediscovering sounds such asbacon sizzling,” he says. “I can even hear my

dog licking!”

Carilion Clinic Otolaryngology is locatedat 1 Riverside Circle in Roanoke. Formore information, call 540-581-0232.

Loving Your Hearing Aid

Introducing the First Invisible Hearing Device

By Matthew Sams

Half of all baby boomers in the U.S.are thought to be experiencing some

degree of hearing loss.

On May 16, Norma Anderson was on an uneventful drivehome from Greensboro with her family—until she reachedFranklin County. On U.S. Route 220, Anderson, 58, suffered aheart attack.

Her daughter and the driver of the car, Tara Williams, sawAnderson pass out and immediately pulled over. “I got out andstarted jumping up and down trying to get help,” says Williams.“Then a car stopped and a woman ran up. She gave my momCPR until others arrived.”

That woman was Shannon Barber, a nuclear medicine tech-nologist at Carilion Clinic. Although she’d been certified in CPRfor 18 years, Barber had yet to put her skills to use.

“My husband and I were traveling out of town to pick upour children when we saw the vehicle pulled over with frantic-looking passengers,” says Barber. “We decided to turn aroundand head back to their location.”

“I asked what was wrong and was told something had hap-pened to their mother. Ms. Anderson at that point was in herseat, unresponsive with no palpable pulse. Her daughtersquickly lowered her out of the van onto the ground, where Ibegan CPR.”

Williams, meanwhile, called 911. “I didn’t know where wewere exactly,” Williams says. “I told them we were somewhereon 220 near a bridge.”

8 Fall 2010 / Winter 2011

By Allison Buth

Coordinated Response Saves Franklin County Heart Attack Victim

Saving a LifeCarilion Clinic

Life-Guard 10 helicopter.

Heart Alert patient Norma Anderson was interviewed on the Blue Ridge PBS program HealthQuest. She was also shown riding inthe same Life-Guard helicopter that flew her to care during her ordeal.

With only this to go on, Franklin County police and EMSproviders in Carilion Clinic’s Heart Alert program begansearching for them.

Police Sergeant Dan Hale and Deputy Brian Garland werethe first to arrive. “I saw an unresponsive woman on theground,” Hale says, “so I quickly got out the portable defibril-lator in my car and used it on her. As soon as I shocked her, sheregained consciousness.”

(It was the first time Franklin County police had saved any-one with an automated external defibrillator.)

But Anderson wasn’t out of the woods yet. She again losther pulse, and Sgt. Hale had to use the defibrillator a few moretimes.

When the EMS specialists arrived, they rushed Anderson toCarilion Franklin Memorial Hospital in Rocky Mount, wherephysicians were able to stabilize her.

Carilion Clinic’s Life-Guard 10 helicopter was then called,and it sped Anderson to Carilion Roanoke Memorial Hospital.

There cardiologist Alan McLuckie, M.D. of Heart of VirginiaCardiology cleared her blockage, and the hospital’s Catheter-ization Laboratory provided support and follow-up.

Anderson was placed on a ventilator for three days, andshe remained in the hospital for nearly two weeks.

Commemorating Her Survival During the summer, everyone who helped save Anderson

met to commemorate her recovery. The EMS crew, Sgt. Hale,the dispatcher on duty, the Life-Guard 10 crew—to name afew—gathered and acknowledged the quick responses thathad led to her life being saved.

Anderson was overwhelmed—and couldn’t hold back hertears of joy. “I can't thank everyone enough,” she kept repeat-ing as she hugged one person after another.

To this day, Anderson says she remembers nothing abouther heart attack or its immediate aftermath.

“It was nice to meet her,” Sgt. Hale says. “We salute at a lotof funerals, but this was a good time, where we could smileand meet a person.”

Barber, who performed the CPR, was also touched. “Out oftragedy comes new life, new friendships, and new begin-nings,” she says.

Every 34 seconds, someone in the U.S. has a heart attack,according to the American Heart Association. But tens ofthousands do survive each year—and return to work andenjoy a normal life.

That has been the case for Anderson.


A Heart AlertMilestone

Earlier this year, Carilion Clinicreached a milestone—its 1,000th HeartAlert patient was saved.

The Heart Alert program, which fast-tracks heart attack victims to life-savingcare, bypasses lengthy routines and coordinates care between EMSproviders, physicians, and heart careprofessionals. It allows for a simultane-ous and comprehensive response byboth local ambulance crews and Caril-ion Clinic medical teams as a heart attack victim is en route to the hospital.

As a result, medical care is faster—and a patient suffers less heart damage.

Nationwide, the speed with which ahospital performs a heart-saving proce-dure is critical and is clocked from themoment a patient is rushed through ahospital’s doors. This interval is knownas “door-to-balloon time,” and the national standard set by the AmericanCollege of Cardiology is 90 minutes orless.

Carilion Clinic’s average responsetime for patients fast-tracked throughits Heart Alert program is about 30minutes faster than the national standard.

Carilion Clinic’s average response time for patients fast-tracked through its Heart Alert

program is about 30 minutes faster than the national standard.

10 Fall 2010 / Winter 2011

By Maureen Robb

The new medical school is located at Riverside Center in downtown Roanoke.

The Virginia Tech Carilion School of Medicine, a world-classmedical education center, has opened in Roanoke.

An innovative school with a leadership focus, it is the firstnew medical school in Virginia awarding an M.D. degreesince 1973. It is also the fifth medical school in the state.

The VTC School of Medicine, which welcomed its inaugu-ral class in August, will help alleviate a shortage of physiciansnationwide. The United States is expected to face a shortfallof at least 125,000 doctors by 2025, according to the Associ-ation of American Medical Colleges.

A unique public/private partnership between CarilionClinic and Virginia Tech, the school is located at CarilionClinic’s Riverside Center, near Carilion Roanoke MemorialHospital. It shares the Riverside campus with two CarilionClinic outpatient facilities, with over 10 physician specialtiesrepresented.

The proximity of the school to these physicians is bydesign: medical students will work in small groups to learnfrom patient cases. Classes will also be small, with only 42students.

Physicians and the researchers at the new Virginia TechCarilion Research Institute will also take the process one stepfurther by working together to potentially develop bettercare. In doing so, they will bridge a traditional divide be-tween their two fields—and expand the frontiers of medical

education and research.In addition, VTC School of Medicine will train its medical

students in research methods, and they will conduct theirown original research. Only two other schools in the nationoperate on this model: Harvard Medical School and theCleveland Clinic’s Lerner College of Medicine.

The VTC School of Medicine will accordingly make animportant contribution to the limited pool of doctors whodo active medical research—less than 2 percent. Moreimportantly, its graduates will be adept at using research intheir daily practice of medicine, thereby improving the qual-ity of care for their patients.

“Our students will be inspired by collaboration and dis-covery, and patients will reap the benefits,” says VTC Schoolof Medicine President and Founding Dean Cynda Ann John-son, M.D., M.B.A.

The combined economic impact of the school andresearch institute is forecast to be $40 million annually. Everydollar spent by a medical school or teaching hospital createsan additional $1.30 in economic activity, according to theAssociation of American Medical Colleges.

For more information, go to www.vtc.vt.edu/ andwww.me2md.vtc.vt.edu/.

Medical School Opens


Carilion Clinic has welcomed 70 new medical doctors toits residency and fellowship programs this year—a recordnumber.

The arrival of these new graduates reflects Carilion Clinic’sstrong role in training physicians. Carilion has provided med-ical education for over 60 years, and an estimated 80 percentof the doctors in southwest Virginia have received trainingthrough its educational programs.

(After graduating from medical school, doctors spendthree to seven more years training in their specialty.)

The 70 new doctors come from seven countries and 24U.S. states, and more than 40 medical schools. They will studyunder the auspices of Carilion Clinic’s Graduate Medical Ed-ucation Program within the Office of Academic Affairs. Thisoffice in turn will help facilitate the clinical rotations for thenew Virginia Tech Carilion School of Medicine.

Seven residency programs are offered: family medicine,internal medicine, obstetrics and gynecology, neurosurgery,psychiatry, general surgery, and transitional year. Two otherresidency programs in emergency medicine and pediatrics

are being considered. Fellowships are offered in six specialties: geriatric medi-

cine, geriatric psychiatry, pulmonary medicine, infectiousdisease, addiction psychiatry, and child and adolescent psy-chiatry. The number of annual fellowships awarded hasgrown from two to six in recent years, and expansion of thefellowship program will continue. Applications are nowbeing considered for fellowships in cardiovascular medicine,critical care, and surgical critical care.

Carilion Clinic’s transition to the clinic model has height-ened its already strong emphasis on education, says DanielP. Harrington, M.D., vice president of academic affairs. “With-out the conversion to the clinic model and development of the new medical school, we would not have had the oppor-tunity to expand our education programs so substantially,”he says.

“The new medical school truly defines Carilion Clinic asan academic medical center with a superb faculty and serv-ices and facilities that other hospitals in the region simplycannot offer.”

Carilion Clinic resident physicians (L to R) Christopher Wood, D.O.,

Christopher Morley, M.D., andSuchet Kaur, M.D. check on patient

Kenneth Senter. After graduatingfrom medical school, doctors spend

three to seven more years trainingin their specialty. During this time,

they are known as resident physicians, or residents.

Carilion Clinic Expands Residency and Fellowship Programs An estimated 80 percent of the doctors in southwest Virginia have received training through Carilion educational programs.By Matthew Sams

12 Fall 2010 / Winter 2011

When Melissa Wright was nine weeks pregnant, shewas told she had a rare blood disorder that could kill herbaby.

Wright, 28, learned she was “Kell-positive,” whichmeant she had a marker on her red blood cells that causedher to produce atypical antibodies. “As my baby was de-veloping her own red blood cells, mine were killingthem,” she says. “The doctors told me, ‘You could have adead baby before your pregnancy reaches 20 weeks.’ ”

Her goal became to keep the baby alive until the 20-week mark, when doctors might be able to do bloodtransfusions. (Babies younger than that can’t toleratethem.) Wright says she was “scared beyond belief.”

Luckily she had access to the maternal-fetal medicinespecialists at Carilion Clinic, who spelled out her risks—and the state-of-the-art resources they had to combatthem.

Wright made it to 20 weeks, and began going in forweekly ultrasound monitoring to determine if the baby

was anemic. If so, the doctors were prepared to performa blood transfusion in utero—possibly every two to threeweeks until birth. Wright was also told that severely ane-mic babies can develop congestive heart failure.

Sure enough, she needed two transfusions: one at 26weeks and another at 28 weeks. And because such trans-fusions are high-risk—doctors enter a needle into theuterus and aim to hit a 6-mm blood vessel without thebaby moving—Wright had to be prepped each time for apossible emergency delivery.

“I was numbed from the chest down and my abdomenwas shaved in case I needed a Cesarean section,” she says.“The surgical team stood by in the same room, ready toact at a moment’s notice.”

It was upon admission for the third transfusion that herdoctors decided to deliver—the baby was too anemic toundergo the procedure—and Bailey Wright came into theworld two months premature. She was rushed into Caril-ion Clinic’s Neonatal Intensive Care Unit, or NICU.

By Maureen Robb

Overcoming High Risk in PregnanciesWhen Mother and Child Need Cutting-Edge Care

Melissa Wright and her daughter Bailey.


Then Wright—who happens to be a Roanoke Memoriallabor and delivery nurse—faced another ordeal. Bailey, at3 pounds and 14 ounces, stayed in the NICU for almost amonth. She had two IVs in her at all times and receivedround-the-clock, highly specialized care designed to buildher immune system so she could begin to produce her ownhealthy blood cells. Otherwise doctors would have to drainall her blood and transfuse her.

Thankfully, Bailey never needed that final transfusion,and she is now a thriving 9-month-old. “The NICU and thedoctors did everything possible for her,” says Wright. “Myhusband and I told them: ‘You’re heroes. You saved herlife. Twenty years ago, she would have died.’ ”

Wright’s story is one of the many successful outcomes atCarilion Clinic’s NICU in association with the Clinic’smaternal-fetal medicine practice. And while many high-riskexpectant mothers in southwest Virginia used to be referredto the University of Virginia Hospital in Charlottesville, theynow have access to the most advanced technology andmedical care close to home.

The Carilion Clinic NICU, the largest in the region, is lo-cated within Carilion Clinic Children’s Hospital in Roanokeand cares for about 600 babies each year. Infants born asearly as 16 weeks premature are cared for in this Level IIIfacility (the highest designation given by the VirginiaDepartment of Health).

Eighteen hospitals in southwest Virginia send motherswith complicated pregnancies to Roanoke Memorial, the re-gional perinatal referral center. They also send critically illbabies to the NICU for life-saving technology. Often theyask Carilion Clinic’s highly trained neonatal transport teamto perform the delicate transport process.

As for Wright and her daughter Bailey, both are doingwell. Says Wright proudly: “My daughter is as healthy asany other baby now.”

For more information, talk to your obstetrician or call 540-985-9985.

Specialized Care forHigh-Risk Pregnancies

When a pregnancy is deemed high-risk, a physician may refer expectantmothers to a maternal-fetal medicinespecialist. Reasons for referral may include a woman’s age, family history,or personal history of miscarriages orstillbirth.

For women in southwest Virginiawho need such specialized care, Carilion Clinic provides the largest maternal-fetal medicine program inthe region. With three physician specialists and certified genetic counselors, Carilion Clinic’s teamworks closely with a patient’s obstetrician, the staff of the NeonatalIntensive Care Unit, and other medicalspecialists to provide full-spectrumcare.

The field of maternal-fetal medi-cine, which has grown significantly inrecent years, includes obstetricianswho specialize in the diagnosis, treatment, and ongoing care of high-risk expectant mothers and their unborn babies.

When It’s Hard to

14 Fall 2010 / Winter 2011

Are you often breathless? Do you have a chroniccough? Do you wheeze or feel a tightness in yourchest when you’re performing activities that neverused to give you trouble?

“These are not normal signs of aging,” says JoseM. Goyos, D.O. of Carilion Clinic Pulmonary Medi-cine. “If you are an adult in your 60s, 70s, or 80s andexperiencing these symptoms, you want to get testedfor COPD. This is especially true if you are a currentor former smoker, or spent a lot of time around peo-ple who smoke.”

COPD stands for Chronic Obstructive PulmonaryDisease, a term used to describe a number of lungdiseases that make it hard to breathe and that can getworse over time. They include chronic bronchitis, em-physema, and refractory asthma.

What many do not realize is that COPD is thefourth leading cause of death in the United States. By2020, it is expected to be the third leading cause. TheNational Heart, Lung and Blood Institute estimatesthat 12 million Americans have been diagnosed withCOPD, and that another 12 million are undiagnosedor developing the disease.

“Younger people are getting diagnosed all thetime,” says Dr. Goyos. “Yes, it’s people smoking, butit’s also more awareness of the disease.”

While smoking is the main cause of COPD, expo-sure to second-hand smoke is also a significant cause.

“We are seeing people with COPD in our pulmonaryclinic who never smoked,” Dr. Goyos says. “Many arewomen who were around fathers, brothers, and hus-bands who smoked.”

Other important causes are occupational dust andchemicals, while air pollution and genetic factors canalso cause or contribute to some cases of COPD.

There is no cure, but treatments are available tohelp manage symptoms. At Carilion Clinic, for in-stance, the pulmonary clinic has nine board-certifiedpulmonologists who provide a full spectrum of treat-ments. These can include bronchodilators, drugs thatrelax muscles in the airways and improve breathing.Other COPD patients require supplemental oxygen—either all day, while sleeping, or at both times.

“We also offer pulmonary rehabilitation that in-cludes exercises that increase exercise tolerance anddecrease shortness of breath and other symptoms,”says Dr. Goyos. Training in optimal breathing strate-gies is provided as well.

“We offer hope,” Dr. Goyos says. “The people whosee us really feel a very significant difference after pul-monary rehab. We hear it all the time.”

In conjunction with the Carilion Clinic Sleep Cen-ter, the pulmonologists may also do sleep testing. “Inmore severe cases of COPD, we may elect to do asleep study in order to evaluate for the presence ofsleep apnea (disrupted breathing during sleep),” Dr.

COPD Is the Fourth Leading Cause of Death in the U.S.

By Mary Brewer


Goyos says. “There is a higher incidence of this dis-ease in patients with more severe COPD. This canbe effectively treated.”

If you have symptoms, start by seeing your pri-mary care physician to talk about taking a spirom-etry test to determine the health of your lungs. Thisis an easy, painless test that requires you to blowinto a machine that can detect changes in andmeasure your breathing ability.

Even those without symptoms but who are atrisk can benefit. Spirometry tests are recommendedfor all smokers older than 45, all former smokers,people exposed to significant second-hand smokeor workplace irritants, or anyone with a family his-tory of COPD.

For smokers, the most important step is to quitsmoking. Smokers are also advised to guard againstflu and pneumonia, which can be prevented withvaccines.

Left untreated, COPD may quickly worsen. Butwith proper diagnosis and treatment, COPD symp-toms can be controlled. “The progression of the dis-ease may also be delayed,” says Dr. Goyos.

Carilion Clinic Pulmonary Medicine is located at2001 Crystal Spring Ave. in Roanoke and 2900Lamb Circle in Christiansburg. For more informa-tion, talk to your doctor or call 540-985-8505 inRoanoke or 540-693-4860 in Christiansburg.

Possible Causes of COPDSmoking

Exposure to second-hand smokeOccupational dust and chemicals

Air pollutionGenetic factors

Breathe

16

They’re Medical Professionals— and Authors


Gina Holmes became anurse in order to helpothers and to make a dif-ference in the world. Thesame impulse has guidedher writing career.

Her debut novel, Cross-ing Oceans, was pub-lished earlier this year towide acclaim. Holmesdescribes it as the story“of a dyingy o u n gmother whomust return

home to face the ghosts of her past, andtransition her daughter into the arms of a fa-ther who didn’t even know she existed.”

Best-selling author Tess Gerritson hascalled the book “an uplifting and inspiringtale that reminds us to live every day as ifit’s our last.” Another reviewer has praisedit as a story of “choices and consequences”that explores every human emotion.

Holmes, a nurse at Carilion RoanokeMemorial Hospital, never set out to writewhat is often called women’s fiction.Growing up in New Jersey, she had al-ways read suspense novels and thoughtthat was what she should write.

In her 20s and early 30s, she spent 10 years writingfour thrillers—and looking for a publisher. “I had fleetingmoments of despair along the way, especially when Icame close to getting a contract and then saw it fallthrough,” she says.

Eventually she began reading outside the suspensegenre. “I read some amazing novels, and it was like an-other world opened up,” Holmes says. “I decided I nolonger wanted to write thrillers, but stories that wouldchange lives the way these books had changed mine.”

Her agent told her that while her thrillers were good,Crossing Oceans seemed to be written more in her truevoice. Holmes, now 39, agreed. “That was a turning pointfor me, and the right advice,” she says. “I’m now writingwhat comes naturally, and I love it.”

Along the way, she founded a literary blog, Novel Jour-ney, which has featured interviews with such

popular authors as Dean Koontz andNicholas Sparks. She has also written abouther favorite books, which include JaneEyre, The Catcher in the Rye, Jonathan Liv-ingston Seagull, Lord of the Flies, Memoirs ofa Geisha, and The Secret Life of Bees.

She is often asked if Crossing Oceans isautobiographical. “Every character—goodand bad—is drawn from parts of me,” shesays. But as Holmes wrote the story, she alsodiscovered that her characters took on a lifeof their own.

Holmes, who lives with her husband andtwo sons in the Roanoke Valley, is now atwork on her next book. “I have a burning de-sire to tell good stories,” she says.

For more information, go to www.ginaholmes.com/.

Roanoke Nurse Writes Contemporary Fiction

Gina Holmes

The cover of Holmes’ first novel,Crossing Oceans.


They’re Medical Professionals— and Authors By Maureen Robb

(continued on page 18)

“Life is about keepingyour eyes on yourdream,” says author andphysician John IngramWalker, M. D.

Dr. Walker, who is di-rector of Psychiatric Edu-cation at Carilion ClinicSaint Albans Hospital,ought to know. He is theauthor of 13 books andmany articles about psy-chiatry and the behav-ioral medicine field.

His most recent book isComplete Mental Health: The Go-to Guide for Cliniciansand Patients, published in April by W.W. Norton & Co. Ithas been praised for its warm, inviting style that appealsto both the medical professional and lay person, and itbalances research with personal insights, clinical anec-dotes, and practical tips.

“Research shows that 50 to 70 percent of people visit-ing a primary care physician have a mental health issuethat is contributing to their presenting problem,” Dr.Walker says. “Yet most doctors receive only a few weeksof psychiatric training.”

“I wrote Complete Mental Health to fill that educationalgap by empowering physicians and other health profes-sionals to quickly recognize, diagnose, and treat a broadspectrum of psychiatric disorders,” he says. “And I wantedpatients to have a better understanding of their illnesses,so I wrote the book with them in mind too.”

Locally, Dr. Walker has also acquired a following as theinspirational author of the newsletter LifeWorks, publishedby Saint Albans Hospital. In its pages, he takes on prob-lems that prevent us from living our lives to the fullest.He counsels readers to not waste time on unimportanttasks but to make time for priorities.

“We spend all our time on insignificant things and haveno time left for the activities that will achieve our dreams,”he wrote in a recent issue. “A well-used time managementrule says, ‘Success depends on what you neglect,’ ” hepoints out.

He advises making a daily list of the things you wantto accomplish, and tackling them in order of importance.“If you can’t finish them all, so be it,” he says.

For his own part, Dr. Walker enjoys the act of writing.“Writing helps me organize my thoughts,” he notes.“Sometimes I don’t know what I am thinking until I readwhat I write.”

Dr. Walker came to Carilion Clinic two years ago fromCollege Station, Texas, where he was the behavioralhealth unit medical director for St. Joseph Regional HealthSystem. He had formerly been a professor of psychiatry atDuke University and the University of Texas Health andScience Center–San Antonio.

He and his wife had been looking for a place to livethat would allow them to be closer to their children andgrandchildren. “We enjoy the small town charm and theacademic amenities that the New River Valley offers,” hesays. “I am especially pleased to be with Carilion Clinic, aninnovative health care organization that will be a modelfor the next generation’s medical care.”

New River Valley Doctor Is a Mental Health Expert

John Ingram Walker, M.D.

18 Fall 2010 / Winter 2011

(continued from page 17)

Harry Kraus, M.D.began writing his firstnovel during his surgicaltraining at the VeteransAdministration Hospital inLexington, Kentucky. Al-though he was practicingmedicine up to 80 hours aweek—and raising twoyoung sons with hiswife— Dr. Kraus couldn’tignore the urge to write.

He has since succeededin both careers—surgeonand author—and has

published 12 contemporary inspirational novels and threenonfiction books on faith. And he is now practicing inLexington, Virginia, at Carilion Stonewall Jackson Hospi-tal, while on sabbatical from his post as a missionary sur-geon at Kijabe Hospital in Kenya.

Dr. Kraus’ experience as a writer has certainly beenatypical. He studied biology and chemistry in college, thenreceived his M.D. degree from the Medical College of Vir-ginia. The longest thing he’d ever written before becom-ing a novelist was a college term paper. “My onlypreparation for a writing career was a love of reading,”he says.

He also didn’t attempt to learn the craft of fiction untilafter he’d published four novels. “I would not recommendthis to others,” he says. “I may have had a natural talentfor plotting, but my initial success probably stunted mygrowth as a writer. I could have progressed faster if I’dstudied the craft.”

Dr. Kraus does believe that writing and performing sur-gery complement one another. He likes the variety of hissurgical cases, and particularly enjoys performing ad-vanced laparoscopic surgery. Many of his plots are drawnfrom his medical cases.

His latest best-selling novel is The Six-Liter Club, pub-lished by Simon & Schuster. It tells the story of Dr. CamilleWeller, the first black female doctor at the Medical Col-lege of Virginia, who manages to save a patient who haslost six liters of blood.

She is, however, plagued by flashbacks from her child-hood in the Congo that hamper her ability to work. Her

faith is also threatened.This African dimension reflects Dr. Kraus’ long tenure

as a missionary surgeon in East Africa, and he says he isfascinated by the opportunity to combine medicine withChristian ministry.

He is currently working on the second book in a three-book contract for David C. Cook publishers. “It is anothercontemporary novel with a realistic medical stripe,” hesays.

Dr. Kraus and his wife Kris—whom he describes as themodel for the inspiring female characters in his books—live in Harrisonburg; they now have three sons. Dr. Krauswill be working in Lexington until next May, when he willbe moving back to East Africa to continue his surgicalwork among the Somali people.

For the time being, he is enjoying living and workingin Virginia. “I love Lexington because it is a friendly, col-lege town with salt-of-the-earth people,” he says.

For more information, visit www.harrykraus.com.

Lexington Surgeon Draws onMissionary Experience

Harry Kraus, M.D.

They’re Medical Professionals— and Authors

African zebras and flamingos photographed by Dr. Kraus.


In our society, where almost two out of three Americans areoverweight, shedding pounds is a goal for many. But being thindoesn’t always mean optimal health—especially when you’re older.

Sadly, many older adults and caregivers are unfamiliar withanorexia in aging, and the health problems associated with it. Thesecan include protein-energy malnutrition, functional and cognitivedecline, acute illness, and even death. Older adults with anorexiaare also at significantly higher risk for fall-related injuries.

As we age, our chances of experiencing unintended weight lossactually increase. But anorexia in the elderly is different fromanorexic disorders found among younger people.

Elder anorexia is defined by involuntary weight-loss caused byphysiologic changes in aging body systems. It is caused in part bychanges in the brain that alter older adults’ ability to perceivehunger and adequately regulate food intake.

Deterioration of the hypothalamus and other regions of thebrain prevents hormones and neurotransmitters associated withhunger from properly signaling the need to eat, so older persons donot feel hungry as often and eat less. Over time, the process causescontinual weight loss.

Several other physiologic conditions can also contribute toanorexia in aging. These include poor-fitting dentures, loose or miss-ing teeth, and other dental problems that make eating difficult orembarrassing. Sores, infections, and other painful conditions in themouth can have the same effect.

Similarly, chemical and structural changes in the gastrointestinaltract can create problems such as pain, bloating, and diarrhea thatnegatively affect appetite, nutrient absorption, and weight man-agement. Older adults’ ability to taste their favorite foods oftendeclines as well as they lose some of their sense of smell (whichaccounts for approximately 70% of taste).

Fortunately, early intervention and support from care providerscan help offset many of these problems. Visits by friends and fam-ily can ward off the social causes of anorexia in elders—such as iso-lation and loneliness. Other causes like depression and cognitiveimpairment should be assessed by a physician.

Registered nutritionists and dieticians can also provide tips onhow to compensate for losses in appetite, taste, and interest incooking and eating.

So the next time you encounter ads for weight loss programsdirected at older adults, realize that weight management in laterlife can be a complex issue.

Darrell Kirtland Shomaker is an assistant professor and director of thehumanities and social sciences program at Jefferson College of HealthSciences. He is in the doctoral program in adult development and agingat Virginia Tech. He can be reached at [email protected].

For more information, contact the Carilion Clinic Center for HealthyAging and its Geriatric Assessment Clinic in Roanoke at 540-981-7653.

By Darrell Kirtland Shomaker

Preventing Anorexia in the Elderly

“I was raised to sense what someone wanted me to be and tobe that kind of person. It took me a long time not to judge myselfthrough someone else’s eyes.”

This may seem like a surprising assertion by two-time AcademyAward winner Sally Field—an icon to audiences of all ages. Butshe has never flinched from the truth.

After winning fame as the bubbly Gidget—the quintessentialCalifornia surfer girl—Field went on to tackle diverse and ever-more challenging roles over the course of her career: Norma Rae,a feisty union organizer; Sybil, a young woman afflicted by multi-ple personality disorder; and matriarch Nora Walker on the dramaBrothers & Sisters, to name a few. Field has always been determinedto make the most of her talent.

“I must go to what desperately frightens me—the chance of fail-ure,” she said after being typecast as The Flying Nun.

Proving HerselfSally Field, 64, was born in Pasadena, California, to an actress

mother and a military officer father. Her first television role, as the1960s-era Gidget, delighted viewers and soon led to The FlyingNun.

Yet even as she became a household name, Field yearned tobreak free of her typecasting and to grow as an actress. She even-tually began studying with celebrated acting teacher Lee Strasberg,who had helped Marilyn Monroe extend her own acting range.

The roles that followed included the lead in the 1976 TV movieSybil and the co-starring role in Smokey and the Bandit, with BurtReynolds. After she portrayed Norma Rae—for which she won herfirst Oscar in 1979—Field cemented her reputation as a dramaticactress and went on to other challenging roles. She earned her sec-ond Academy Award in 1984 for Places in the Heart, in which sheplayed a widow beset by obstacles as she strove to support herchildren on a Depression-era cotton farm.

It was in accepting this Oscar that Field uttered what hasbecome an often parodied—and misquoted—statement. Her actualwords in her acceptance speech were not, “You like me, you reallylike me!” but: “I haven’t had an orthodox career, and I’ve wantedmore than anything to have your respect. The first time I didn’t feelit, but this time I feel it, and I can’t deny the fact you like me, rightnow, you like me!” With good humor, Field has even on occasionparodied her own purported comment.

20 Fall 2010 / Winter 2011

By Maureen Robb

Battling a Silent Disease

Sally Field

Fall 2010 / Winter 2011 21

Field’s ensuing film roles included those in Murphy’sRomance, Steel Magnolias, Mrs. Doubtfire, Forrest Gump,Not without My Daughter, and Where the Heart Is.

She has also triumphed in numerous television roles,winning three Emmy Awards. One was for her recurringrole on ER; another was for her portrayal of Nora Walkeron Brothers & Sisters.

In the 1990s, Field expanded her repertoire by direct-ing the television movie The Christmas Tree. She laterwent on to direct the film Beautiful and an episode ofFrom the Earth to the Moon, the critically acclaimed TVmini-series.

Family Ties Field’s marriage to construction contractor Steven

Craig, from 1968 to 1975, produced two sons: Eli Craig, aproducer and actor, and Peter Craig, a novelist. Field laterbecame romantically involved with Burt Reynolds andco-starred in several movies with him. From 1984 to 1993,she was married to film producer Alan Greisman and hadanother son, Sam.

In 1988, she and her family suffered a crash in theircharter plane on takeoff. Thankfully, they all incurred onlyminor injuries.

Combating OsteoporosisWhen Field was diagnosed with osteoporosis several

years ago, at the age of 58, she was initially surprised. Shehad no symptoms. She had also been vigilant about herhealth.

“I always watched my diet,” she says. “I always ate lotsof leafy greens. I took my vitamin D…I never smoked.”She even exercised regularly. “I’ve always worked out be-cause I’m an actor, and I have to stay fit,” she says. “It’salways been a big part of my life.” Field thought she haddone everything right.

But “there does come a time when your genetic pre-disposition is going to kick in,” she says, noting that shefit the profile for women at risk: she was over 50, small-framed and thin, and Caucasian. She had also watchedher grandmother grow hunched over due to weakenedbones.

What Is Osteoporosis?Osteoporosis is an often silent diseasethat causes bones to become weakand brittle. It often goes undetected,and about 80 percent of those affected are women. It is estimated to cause about 1.5 million fractures annually.

Ten million Americans are believed to have the disease, and almost 34 million more are thought to have lowbone mass, increasing their risk for osteoporosis, according to the National Osteoporosis Foundation.

For more information, go to the National Osteoporosis Foundation’s website at www.nof.org/.

(continued on page 22)

22 Fall 2010 / Winter 2011

Risk Factors for Osteoporosis Include:

• Age

• Gender (female)

• Ethnicity (Caucasians and Asians)

• Family history

• Poor nutrition (low calcium intake)

• Physical inactivity

• Tobacco and alcohol use

• Certain medications (diuretics, corticosteroids,

blood thinners, anti-seizure medications)

When Field was diagnosed, she assumed a new role inlife: that of an osteoporosis activist. And she is tacklingthis new role with her typical determination.

She has spoken with the media in countless interviewsabout what she terms a huge health threat to warn otherwomen that they, too, might be vulnerable. “Women needto go in armed with information that this disease—bonehealth issue—actually exists,” she says. “They could verywell be at risk.”

“They should go in and ask for a bone density test,and if they are at risk, they can discuss with their healthcare practitioner the options,” she says. “There are veryeffective treatments for osteoporosis.”

Field has also teamed up with pharmaceutical firmRoche Therapeutics Inc. to spread the word. In their jointcampaign and website, Rally with Sally for Bone Health,Field speaks out on how to prevent and deal with osteo-porosis. She also offers bone-healthy workouts, questionsto ask your doctor, tips on eating right, and a bone healthquiz.

She has even taken her quest to Washington, whereshe attended a briefing on the disease with members ofCongress.

The good news, Field says, is that osteoporosis can beprevented or delayed through diet and exercise. The keysare a balanced diet and weight-bearing exercise such aswalking, jogging, or dancing.

Although Field herself looks younger than her years—and retains her youthful enthusiasm and energy—she hasa message for other women. Aging well isn’t only aboutlooking good, she says: it’s about feeling good, and stay-ing healthy.

Battling a Silent Disease (continued from page 21)

Sally Field in a scene from the television drama Brothers & Sisters.

Photos courtesy of ABC.


Stroke Program Awarded National CertificationThe Stroke Program of Carilion Roanoke Memorial Hospital has received

the Gold Seal of Approval from the Joint Commission as a Primary Stroke Center.

This certification recognizes stroke centers that make ex-ceptional efforts to foster better outcomes for stroke care. Italso signifies that Roanoke Memorial is in compliance withthe highest standards for treating strokes, and that it has thecritical elements to achieve long-term success in improving

outcomes.To become a Primary Stroke Center, a hospital must meet stringent

response criteria. “Studies have consistently shown that stroke victims treatedat Primary Stroke Center hospitals have shorter hospital stays and better out-comes from their strokes,” says Sidney Mallenbaum, M.D., medical directorof Carilion Clinic’s Stroke Unit.This Gold Seal of Approval is the second awarded to Carilion Clinic. The

Joint Commission earlier granted the Inpatient Orthopaedic Unit at RoanokeMemorial a Gold Seal for total hip and knee replacement.

Carilion Clinic Ranks as a National Leader in ElectronicMedical Records Systems

With the conversion of Bedford Memorial Hospital to the Epic electronicmedical records (EMR) system, Carilion Clinic continues to rank as a national leader in implementing EMR systems. Carilion Clinic is now theonly multi-hospital health system in Virginia, North Carolina, West Virginia,Maryland, and the District of Columbia to have all of its hospitals live on asingle integrated EMR system for clinical care, orders, and finances.

Over 100 physician practices are live as well, with about 30 more prac-tices to be added. Three Carilion Clinic hospitals have also been ranked inthe top 2.5 percent of all U.S. hospitals for their use of EMR systems: CarilionRoanoke Memorial Hospital, Carilion New River Valley Medical Center, andCarilion Franklin Memorial Hospital. These three hospitals are certified atStage 6 by the Healthcare Information and Management Systems Society,which grades hospitals on the scope of their adoption of EMR systems on ascale of Stage 1 to Stage 7. All seven Carilion Clinic hospitals are expected toachieve Stage 6 proficiency in the near future.

Carilion Clinic Partners with Radford University in Doctorate Program

Carilion Clinic and its affiliate Jefferson College of Health Scienceshave formed a partnership with Radford University to base Radford’s newdoctorate of physical therapy program in Roanoke. The program will betaught at Carilion Roanoke Community Hospital and will share space,services, and resources with Jefferson College of Health Sciences.

The three-year program will admit 25 students per year for a total of75 students at full enrollment. It will also build on a historical relation-ship between Carilion Clinic and Radford in nursing education and willset the stage for future opportunities to collaborate.

News Notes&Carilion Clinic MedicareHealth Plan Expands

Carilion Clinic Medicare Health Plan has announced the expansion of the plan’s servicearea to include Buena Vista. The plan’s servicearea for 2011 now includes: Bedford, Lexing-ton, Radford, Roanoke, Salem, and the coun-ties of Bedford, Botetourt, Craig, Floyd,Franklin, Giles, Montgomery, and Roanoke.

For 2011, the plan offers one Health Main-tenance Organization (HMO) and three differ-ent HMO-Point-of-Service (POS) coverageoptions with a range of benefits, including options with low and no monthly premiums.HMO members must use Carilion ClinicMedicare Health Plan providers, while HMO-POS members can choose to use out-of-net-work providers with increased out-of-pocketexpenses. All plan options include prescriptiondrug coverage.

The Carilion Clinic Medicare Health Planhas also announced that its four Medicare Advantage plans will be offered though localinsurance brokers and agents for the first time.The health plan’s own sales staff will also sellthese, and a series of sales seminars is sched-uled for the fall.

The Medicare Annual Enrollment Period—when eligible individuals can join a MedicareAdvantage plan, switch to another plan, or goback to Original Medicare—begins on Nov. 15and continues through Dec. 31, 2010 for coverage beginning on Jan. 1, 2011. Thosewho are turning 65 or who have other specialcircumstances may be able to join before the annual enrollment period opens.

To find out if you are eligible, or for moreinformation, call 1-800-332-1625 from 8 a.m.to 8 p.m., seven days a week. The CarilionClinic Medicare Health Plan is a Medicare Advantage organization with a Medicare con-tract and a Medicare-approved Part D sponsor.

24 Fall 2010 / Winter 2011

Injuries, strokes, and other medical problems can cause perma-nent damage—and force you to change how you live. That is whyrehabilitation is so important. Rehab therapists can help you relearnhow to do simple daily tasks.

To give patients every chance for a full recovery, Carilion Clinichas expanded its inpatient rehabilitation center to provide the mostadvanced rehab technology and medical expertise. The new rehabcenter has also been relocated to the 7th floor of Carilion RoanokeCommunity Hospital and is almost triple the size of the previouscenter.

“We went from a 12-bed unit where patients shared rooms to onewith 34 private rooms and one of the most therapeutic viewsaround,” says Stimis Smith, unit director of Carilion Clinic’s PhysicalMedicine and Rehabilitation. The center’s panoramic view overlooksdowntown Roanoke, Mill Mountain, and the Roanoke Valley.

“One patient joked that he wanted to come back for his nextvacation,” says Smith.

The rehab center, the most comprehensive in southwest Virginia,is designed for those who need a short stay with intensive physical,occupational, or speech therapy services. All staff members are ded-icated professionals who have a passion for rehabilitation and ex-pertise in helping patients recover from all types of injuries, illnesses,and surgeries.

By Meredith Hite

The Carilion Clinic inpatient rehabilitation center provides intensive physical, occupational, and speech therapy services. Individual therapy sessions are designed to maximize each patient’s recovery.

When an Injury Requires RehabCarilion Clinic’s

rehab center is the

most comprehensive

in southwest

Virginia.

When an Injury Requires RehabEveryone on the staff is focused on helping patients regain

independence by teaching them new ways to perform dailytasks such as getting dressed, bathing, eating, cooking, andcleaning. “Our emphasis is on health, wellness, and teaching pa-tients how to help themselves,” says Dan Gaskell, rehabilitationmanager.

The rehab staff includes doctors and nurses and physical,occupational, and speech therapists. Individual therapy sessionsare developed to maximize each patient’s recovery, and therapysessions are tailored to a patient’s lifestyle and hobbies.

Therapists are skilled in a variety of therapeutic approaches,including neuropsychology, therapeutic recreation, and pet ther-apy. They also utilize every means at their disposal to helppatients recover. Kitchen cabinets, for instance, are outfitted withevery type of knob imaginable, allowing patients to practiceopening doors and drawers like they have at home.

Carilion Clinic’s rehab center is fully accredited by the nationalJoint Commission, which accredits health care providers andprograms in the United States. This year also marks the 25thanniversary of Carilion Clinic’s rehab program.

For more information, or for a guided tour, please call 540-985-8550.


26 Fall 2010 / Winter 2011

Fighting Lung Cancer

Brice Towle, a retired physician’s assistant from Texas,thought he had contracted bronchitis last March. But hewent to see his primary care physician, just to be sure.

After a chest X-ray, Towle learned that he had a masson his lung, and before he knew it, he was meeting withDavid Wyatt, M.D., a cardiothoracic surgeon at CarilionClinic.

“I was surprised that I was able to see Dr. Wyatt onlya couple of days after I saw my primary care physician,”Towle says. “At that point, we didn’t know if the mass wascancerous or not.”

Dr. Wyatt told Towle that his case would be evaluatedby a thoracic oncology team whose members—all spe-cialists in different areas of medicine—focus on lung can-cer. The team at Carilion Clinic meets weekly to evaluateindividual patient cases from an interdisciplinary point ofview, with each physician applying his or her specializedexpertise to the case at hand.

The thoracic oncology team works to improve access,timeliness of care, and outcomes and is an example ofhow physicians are working together to benefit patients.The team includes Carilion and non-Carilion physicians,and its size varies, depending on the cases being re-viewed.

After the team reviewed Towle’s case, Dr. Wyatt toldTowle he needed to see a pulmonologist for a bron-choscopy and a biopsy. Within days, Towle saw ChristianButcher, M.D., a Carilion Clinic pulmonologist. The biopsyrevealed that Towle’s lung mass was indeed a canceroustumor.

The thoracic oncology team’s next step was to ensurethat a thyroid mass also discovered by Towle’s primarycare physician was of less concern than his lung tumor. Aseries of biopsies and other imaging studies were obtained

to correctly identify the stage of the lung and thyroid massin order to recommend treatment.

Only days later, Towle returned to Dr. Wyatt for anupdate on the results. “I referred Mr. Towle to one of ourear, nose, and throat physicians to get a biopsy of thethyroid,” says Dr. Wyatt. “The results of that biopsydemonstrated a lower-grade cancer, giving the lung can-cer priority for treatment.”

Towle then underwent surgery to remove his lungtumor.

Treating Lung CancerReceiving a cancer diagnosis is never easy. Receiving

a lung cancer diagnosis is all the more daunting, as lungcancer is the leading cause of cancer death in the UnitedStates among both men and women. In fact, lung cancerclaims more lives each year than colon, prostate, ovarian,lymph, and breast cancers combined.

There is also a high incidence of lung cancer in south-west Virginia. And with people living longer and babyboomers aging, lung cancer diagnoses are expected to in-crease.

“Treating lung cancer requires many sub-specialtiesand a lot of coordination,” says David A. Buck, M.D., aradiation oncologist with Blue Ridge Cancer Care. As aresult, the thoracic oncology team was created to providesuch interdisciplinary care.

“Many sub-specialists like me noticed that we wereseeing new patients with lung cancer, and we feltuncomfortable with them having to wait longer than nec-essary to receive treatment,” says Dr. Buck.

The thoracic oncology team at Carilion Clinic consistsof sub-specialists in pulmonology, medical oncology, car-diothoracic surgery, radiation oncology, pathology, radi-

A Team Improves CareBy Allison Buth

According to the AmericanLung Association, the following symptoms can be indicators of lung cancer:

• A cough that doesn't go away andgets worse over time

• Constant chest pain • Coughing up blood • Shortness of breath, or wheezing • Loss of weight and loss of appetite • Frequent lung infections, such asbronchitis or pneumonia


ology, and interventional radiology. They meet weekly todiscuss and review patients with suspected or diagnosedlung cancer.

“The team discusses how to best treat patients, maxi-mize outcomes, and weigh risks versus benefits,” saysMichael Boyd, M.D., an interventional pulmonologist withCarilion Clinic. “We provide a pathway for patients so lesstime passes before their diagnosis and treatment.”

“All the sub-specialists need to work together collabo-ratively for a program like this to be successful,” says Dr.Buck. “The relationship we have with Carilion Clinic isunique.”

A Successful Outcome Less than one month after Towle’s initial visit to his pri-

mary care physician, Dr. Wyatt had good news for him:pathology reports confirmed that his surgery was success-ful and that his lung cancer was in an earlier stage that car-ries a good prognosis. The thoracic oncology team thenrecommended four rounds of chemotherapy at Blue RidgeCancer Care as a precaution, due to the size of the tumorremoved. Plans have been made for treatment of the thy-roid cancer as well.

“Everyone I saw was excellent and very professional,”says Towle of his course of treatment. “The staff was superthe whole way through. I really don’t have enough nicethings to say about everyone that’s helped me.”

“I’d like the people I worked with in Texas to comehere and see the type of care Carilion provides.”

For more information, talk to your doctor, or call 540-985-8505.

Members of thethoracic oncologyteam review a patient case.

28 Fall 2010 / Winter 2011

Breast screening could save your life—or that of some-one you love.

Yet the Carilion Clinic Breast Care Center estimates thatonly 34 percent of the region’s eligible women getscreened for breast cancer each year. This statistic hasbeen stable for many years, despite the fact that a cutting-edge breast care program exists right here.

The quality of the program is among the best in thecountry—offering advanced technology and breast careexperts in surgery, radiology, pathology, and medical andradiation oncology. These specialists also collaborate on aregular basis to provide a multi-disciplinary approach andcomprehensive, high-quality care.

On-site are four dedicated breast imagers (physicians)who specialize in mammography, ultrasound, and MRI.All mammograms are read on-site by board-certified radi-ologists. The center also has a dedicated breast surgeonand a nurse navigator, who acts as a patient educator andadvocate, empowering patients to make informed deci-sions.

This interdisciplinary team meets weekly to reviewevery breast cancer diagnosis to determine the best courseof treatment. Team members also review all benign find-ings.

New Federal GuidelinesIn 2009, the U.S. Preventative Services Task Force re-

vised its guidelines for breast screenings. It reversed its

recommendation that women in their 40s get routineannual mammograms and said that women ages 50-74should cut back their exams to one every other year.

“When new guidelines come out, physicians shouldlook critically and scientificallyat those recommendations,”says Roxanne Davenport, M.D.,surgeon at the Carilion ClinicBreast Care Center. The centerin turn decided to do further re-search to evaluate the new fed-eral guidelines.

After intensive research andanalysis, the breast center foundthat replacing yearly examswith screening every two yearsover age 50 would result in in-

creased death rates from breast cancer. Before mammo-grams became widespread in the mid-80s, womentypically came in with advanced forms of breast cancer,says Dr. Davenport.

The high death rate from breast cancer had also beenunchanged for 50 years, she says. But by the early 90s,death rates had declined by 30 percent with the help ofscreening mammography.

“We feel that the new recommendations are a stepbackwards,” Dr. Davenport says. “We diagnose about onenew breast cancer in a 40-to-49-year-old woman each

Breast Care:

By Allison Buth

Roxanne Davenport, M.D.

World-class Expertise in Western VirginiaWhen Quality of Care Counts


week at the breast center, and thereis a greater than 90 percent chancethat if a breast cancer should de-velop in a woman, annual screeningwould detect it before the patientwould find it. We recommend an-nual screening mammography forwomen age 40 and over.”

The new federal guidelines statethat temporary harm may result fromhaving annual mammograms, suchas emotional anxiety, possible biop-sies, and higher costs. But the breastcenter contends that every woman has a certain risk fordeveloping breast cancer and that the benefit of screeningfar outweighs these potential factors.

A Focus on QualityScreening is the first important step to ensure good

breast health, but for those with a cancer diagnosis, con-sistency in the way a breast center delivers care is alsoparamount. At the Carilion Clinic Breast Care Center, con-sistency has been a core focus and has led to improvedoutcomes.

Take the re-excision rate—the percentage of womendiagnosed with cancer who’ve had surgery but who haveto go back for a second surgery. Recent literature reportsnational re-excision rates of 20 to 60 percent for breast

surgery patients. At the CarilionClinic Breast Care Center, however,the re-excision rate is only 6.7 per-cent, well below national statistics.

The breast care center attributesthis lower rate to its comprehensiveapproach to care before, during, andafter surgery. Its pre-operative plan-ning includes imaging (mammo-gram, ultrasound, and MRI) and acase review by the interdisciplinaryteam. During surgery, the use ofspecimen radiography allows the

radiologist and surgeon to see precisely what tissue needsto be removed. And post-operatively, the team uses ad-vanced technology to look for residual cancer.

As a result, fewer deaths occur, and women suffer lessemotional harm. Better cosmetic results are also reported,and added costs are prevented.

This focus on quality is reflected in every procedure atthe breast care center—where everyone is dedicated tomaking a difference in the fight against breast cancer.

The Carilion Clinic Breast Care Center is located at 1211South Jefferson Street in Roanoke. For more information,call 540-985-9885 or visit www.carilionclinic.org/Caril-ion/Breast+Care+Center.

World-class Expertise in Western Virginia

Mammograms are an important part of a breast care program.

30 Fall 2010 / Winter 2011

Timothy C. Ball, M.D., Ph.D.CardiologyEducation: Medical University of South CarolinaResidency: Wake Forest University Baptist Medical CenterFellowships: Critical Care Medicine, Wake Forest University BaptistMedical CenterCardiology, Dartmouth-Hitchcock Medical CenterInterventional Cardiology, Dartmouth-Hitchcock Medical Center 127 McClanahan St., Roanoke, VA 24014540-982-8204

Joann G. Journigan, M.D.CardiologyEducation: Vanderbilt University School of MedicineResidency: Vanderbilt UniversityFellowship: Cardiology, Emory University 127 McClanahan St., Roanoke, VA 24014540-982-8204

M. Ayoub Mirza, M.D.CardiologyEducation: Kashmir UniversityResidency: Geisinger Medical CenterFellowships: Cardiology, University of VirginiaInterventional Cardiology, University of Virginia 127 McClanahan St., Roanoke, VA 24014540-982-8204

Carl W. Musser, Jr., M.D.CardiologyEducation: Wake Forest University Baptist Medical CenterResidency: Mayo Clinic College of MedicineFellowships: Cardiology, Dartmouth-Hitchcock Medical Center Cardiac Electrophysiology, Dartmouth-Hitchcock Medical Center 127 McClanahan St., Roanoke, VA 24014540-982-8204

Keel E. Coleman, D.O.Emergency Medicine Education: University of New England College of OsteopathicMedicineResidency: Virginia Commonwealth University Health Systems 1906 Belleview Ave., Roanoke, VA 24014540-981-7000

Stepheny D. Berry, M.D.Trauma and Critical Care Surgery Education: University of Kansas School of MedicineResidency: Henry Ford Health SystemFellowship: Trauma and Surgical Critical Care, University ofTennessee at Memphis 3 Riverside Circle, Roanoke, VA 24016540-224-5170

Thomas H. Bishop, M.D.Radiology Education: University of North Carolina School of Medicine-Chapel HillResidency: University of North Carolina Hospitals Program Fellowship: Vascular/Interventional Radiology, University of North Carolina 1906 Belleview Ave., Roanoke, VA 24014540-981-7083

Daniel R. Karolyi, M.D., Ph.D.RadiologyEducation: Medical College of GeorgiaResidency: Emory UniversityFellowship: Body MRI, Emory University 1906 Belleview Ave., Roanoke, VA 24014540-981-7122

John W. Steffe, Jr., M.D.RadiologyEducation: Medical College of VirginiaResidency: Medical College of Virginia Fellowship: Musculoskeletal Radiology, Medical College of Virginia 1906 Belleview Ave., Roanoke, VA 24014540-981-7122

James T. Wilson, III M.D.Pediatric NeurologyEducation: Medical College of VirginiaResidency: Medical College of VirginiaFellowships: Child Neurology, University of MinnesotaElectroencephalography, Medical College of Virginia 102 Highland Ave., Suite 104, Roanoke, VA 24013540-985-8147

New Physicians Carilion Clinic

Department of Medicine

Department of Emergency Medicine

Department of Radiology

Department of Surgery

Department of Pediatrics


Jamie L. Jennell, M.D.Obstetrics and GynecologySpecialty: Obstetrics and Gynecology Education: Virginia Commonwealth UniversityResidency: Wake Forest University Baptist Medical Center 1997 S. Main St., Suite 704, Blacksburg, VA 24060540-961-1058

Richard D. Kauffman, D.O.Family MedicineEducation: Midwestern University, ChicagoCollege of Osteopathic MedicineResidency: MacNeal Hospital, University of

Chicago Family Medicine Program3707 Brambleton Ave., Roanoke, VA 24018540-725-7800

Jo-Anne A. Llavore , M.D.Family Medicine Education: University of Santo TomasResidency: Carilion Clinic Family Medicine Residency Program 3369 Colonial Ave., Roanoke, VA 24018540-772-0555

Arlene S. McCain, M.D.Family MedicineEducation: Eastern Virginia Medical SchoolResidency: Eastern Virginia Medical School, Portsmouth FamilyResidency Program 200 High St., Bridgewater, VA 22812540-828-2634

Nationally Praised PhysiciansJoin Carilion Clinic

Department of Obstetrics and Gynecology

Department of Primary Care and Regional Medicine

For more information or to find a physician go to:www.CarilionClinic.org or call: 540-266-6000 or 800-442-8482.

Two nationally prominent physicians, surgeonChristopher Baker, M.D. and emergency physicianJohn H. Burton, M.D., have joined Carilion Clinic. Eachwill play a pivotal role in improving patient care at the

physician-led Clinic. Dr. Baker, a trauma surgeon, will be

the new chair of the Department ofSurgery for Carilion Clinic and theVTC School of Medicine. Mostrecently he has been the IsidoreCohn, Jr. Professor and chair of theLouisiana State University

Department of Surgery in New Orleans. He receivedhis M.D. from Harvard Medical School and completedhis surgical training at the University of California atSan Francisco, where he had a National Institutes ofHealth-funded research fellowship.

He has also taught at Yale University, the Universityof North Carolina School of Medicineand Harvard Medical School. He willjoin the Clinic on November 1.

Dr. Burton is the new chair of theDepartment of Emergency Medicine.He comes to Carilion Clinic fromAlbany Medical College, Albany, NewYork, where he was interim chair of

the Department of Emergency Medicine and vicechair for the medical college’s academic affairs. Hereceived his M.D. from the University of North CarolinaSchool of Medicine-Chapel Hill and completed hisresidency at the University of Pittsburgh.

Dr. Baker

Dr. Burton

32 Fall 2010 / Winter 2011

Taking the TrainPulitzer Prize-winning poet Edna St. Vincent Millay

wrote her ode to trains almost 100 years ago, but herwords still speak to many aspiring travelers today.

If you, too, enjoy rail travel—or have always yearnedto try it—a regional rail excursion may be just the ticket.Railways offer scenic day trips in both Virginia and WestVirginia.

The Roanoke chapter of the National Railway Histori-cal Society (NRHS), for instance, has partnered with Am-trak for the past two years to provide all-day excursionsin the fall. One of these leaves Roanoke and travels alongthe former Virginian Railway route through Moneta andStone Mountain, then turns south on the former SouthernRailway route to Danville. It returns via Lynchburg, For-est, and Bedford.

Another excursion takes passengers from Roanoke toBluefield, West Virginia and traverses spectacular moun-tains and valleys. This popular trip includes a climb upChristiansburg Mountain and a ride through the New RiverValley and the narrows of the New River. The train alsogoes through tunnels and over bridges.

Both of these excursions offer layovers and an oppor-tunity for dining and other activities.

The New River Train, meanwhile, offers trips throughthe New River Gorge in southern West Virginia each fall.These run along the former Chesapeake & Ohio main linefrom Huntington, West Virginia to Hinton, West Virginiaand feature gorgeous scenery in an area often called theGrand Canyon of the East. Passengers can also viewCharleston, Kanawha Falls, the New River Gorge Bridge,the Hawks Nest Dam, and historical coal mining towns.

These trips are sponsored by the Collis P. Huntington

Railroad Historical Society of Huntington, West Virginia. For those with a more urban bent, another excursion

this fall will take passengers to Washington, D.C. Spon-sored by the Botetourt County Department of Parks,Recreation and Tourism, it will bus local passengers toLynchburg, where they can board Amtrak. The train willthen go through Charlottesville, Culpeper, Manassas andother towns en route to Washington, where travelers willhave a 2 1⁄2-hour layover.

In addition, the Potomac Eagle Scenic Railroad in

By Gail Nordhaus

My heart is warm with the friends I make,

And better friends I'll not be knowing;

Yet there isn't a train I wouldn't take,

No matter where it's going.

— Edna St. Vincent Millay, from her poem “Travel”


Romney, West Virginia offers its own trips through themountains above the south branch of the Potomac River.What makes these trips particularly memorable are theBald Eagles that routinely soar along the route.

Potomac Eagle Scenic Railroad offers a number of tripsthroughout the fall, and they can be boarded at threelocations: Romney, West Virginia (west of Winchester,Virginia); Moorefield, West Virginia; and Petersburg, WestVirginia.

So when wanderlust overcomes you—or you just want

a fun weekend trip with the family—think about headingfor the nearest railway station.

Roanoke’s chapter of the NRHS, with 167 members, isdedicated to preserving the railroad history of westernVirginia. For more information on it and its trips, go tohttp://roanokenrhs.org/excursions.html. For informationon the West Virginia trips, go to www.newrivertrain.comand www.potomaceagle.info/trips.php. For BotetourtCounty trip information, call 540-473-8326.

A train crosses a bridge over Smith Mountain Lake in southwest Virginia. Photo courtesy of Norfolk Southern Corp.

34 Fall 2010 / Winter 2011

As the weather turns cooler, there’s nothingquite like a bowl of hot soup. We associate certainfoods with sensations or memories, and for many,soup is linked with feelings of comfort. Like a warmblanket, soup warms us up, physically and emotion-ally.

Soup conjures up feelings of security and being takencare of—chicken soup, anyone? And yes, there is an al-most magical quality about soup that envelops us whenwe’re feeling sick or down. It’s no surprise: nutritious in-gredients in a good soup sustain us. Fragrant steam helpsto decongest our noses and throats. A soup’s fluids helpto hydrate us and fight infection. Researchers now eventhink that certain substances in soup might help fight theinflammation associated with the common cold.

The versatility of soup also allows it to be enjoyed atany time—not just when one is ill. Soup can be a precur-sor to a meal or the meal itself. Thanks to the freeze-abil-ity of broth-based soups, they can be made in largebatches and frozen in single-serving containers, thenreheated whenever one needs a quick and easy meal.

Soup is also a great way to inject more veggies intoyour diet. Most soups call for some sort of veggies orbeans, and you can even freeze leftover vegetables andsave them for that next batch of soup. Although somesoups are made from fruits and served cold, we’ll focus onthe warm ones here.

While soup is generally a great addition to any diet, beaware of a few things if you’re trying to manage yourweight. First, there is potentially a big difference in calo-ries and fat when it comes to broth-based vs. cream-basedsoups. A cup of Manhattan Clam Chowder has 134 calo-ries and 3.4 grams of fat (2.1 grams saturated fat), whereasa cup of New England Clam Chowder can have 190 calo-ries and 10 grams of fat (2.5 grams saturated fat).

There is also potentially a big calorie difference be-

tweena cupand a bowlin a restaurant. Ionce ordered a bowl ofsoup as my main course, and it was actually more like atrough.

Speaking of portion sizes, research is constantly underway to try to discover the keys to weight management.Research does show that when given the choice, peopletend to want to eat more rather than less. (You mightknow what I’m talking about.)

When trying to “diet,” people tend to severely restricttheir food choices. All too often, people on diets loseweight in the short-term, then tire of the effort to maintaintheir weight loss. They give up altogether and put theweight back on.

Dr. Barbara Rolls, professor and researcher at Pennsyl-vania State University, has done a lot of research in thearea of food energy density (calories per volume) and itsimpact on weight management. She has found that eatinghigher-volume, lower-calorie foods (e.g., non-starchy veg-etables) leads to fewer calories consumed overall. Thus, ifyou add sliced tomatoes, lettuce, and onion to your sand-wich, thereby giving it more volume, it will look moresatisfying and help you to skip the cookie and eat fewercalories overall at that meal.

vervefood

Soup’s On! By Kate Jones


Similarly, foods with a proportionally high water con-tent (e.g., grapes vs. raisins) will seem more filling psy-chologically because we can eat a larger portion for thesame number of calories. This principle can be extendedto soups as well. Dr. Rolls found that people who includedbroth-based soup in a meal generally ate fewer calories atthat meal.

The same effect was not found when drinking a glassof water. It turns out that water is good for quenchingthirst, but not for filling us up. You can read more aboutit in Dr. Rolls’ book The Volumetrics Eating Plan.

Something else to consider is the sodium content. Mostsoups contain large amounts of sodium. The daily recom-mendation for sodium in the diet is no more than 2,300milligrams (mg), but some soups easily contain half of thator more per serving. If you’re buying canned soup, checkthe label and look for no more than 600 to 800 mg perserving if the soup will be the main part of your meal,especially if you have hypertension or high blood pres-sure.

If you want to make your own soup, even better. Thereare hundreds of enticing recipes to try. And who knows?You may enjoy it so much that it becomes a weekly ritual!

Here is an easy and nutritious recipe:

Gingered Butternut Squash Soup

1 small yellow onion 1 tablespoon butter1 butternut squash5 cups chicken stockFresh or powdered ginger 1⁄2 cup cream (optional)

Split the squash lengthwise and bake in a covered bak-ing dish at 350 degrees for about 50 minutes, or until soft.Scoop out the flesh and reserve it. Dice the onion andsauté it in a tablespoon of butter in a stock pot until soft.Stir in the squash and then the chicken stock and simmer.Add ginger, salt, and pepper to taste and puree. For aricher soup, stir in cream after pureeing.

For more delicious soup recipes, go towww.allrecipes.com, www.cooks.com, and www.foodnetwork.com.

Kate Jones is a Carilion Clinic registered dietitian andcertified diabetes educator.

36 vervetalk vervetalk

Tell us what gives you life + energy.

Whether it’s a home remedy, a family recipe, or justsomething that makes life worth living, share it with thereaders of verve. We would also love to hear your opin-ions in letters to the editor. After all, sharing things thatmatter is what makes us a community.

FoodShare your grandmother’s recipe or a new discovery

that keeps your family healthy and happy.

FitnessIf you’ve got a routine that’s anything but routine, tell

us about it and start the next fitness craze.

Parting shotsSend us your photos or artwork that you think reflects

our lives.

verveE-mail: [email protected]

Mail: 711 S. Jefferson St.Roanoke, VA 24016

Phone: 800-422-8482


Physicians on FootGet in stride by walking with a docThe doctors of Carilion Clinic are putting on their walking shoes and hitting the Greenway. Becausethe health of the Valley is so important to us, we encourage you to lace up your shoes and join ourweekly walking program. We’ll be with you every step of the way on the path toward a healthier you.

Location: Roanoke Valley GreenwayCorner of Hamilton Terrace and Belleview Avenue(In front of Carilion Roanoke Memorial Hospital)

When: 8:30 a.m., every SaturdayDuring inclement weather, call 540-981-7684.

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River’s EdgeSports Complex

CARILION ROANOKE MEMORIAL HOSPITAL

Starting Point

For more information, call 800-422-8482or visit www.CarilionClinic.org/walking.

Our Cardiac Team Shares a Single Goal

Cardiology

The physicians of Carilion Clinic – Cardiology on the steps of the Virginia Tech Carilion School of Medicine and Research Institute, where they will participate in researchprojects designed to improve patient care. Not pictured: Tim Ball, M.D., Ph.D., John Bushkar, M.D., Rod Savage, M.D., and Dhun H. Sethna, M.D.

Getting you back to your life and the ones you love

Carilion Clinic – Cardiology continues to be a leader in providing comprehensive cardiovascularservices in southwest Virginia. Our team of more than 20 cardiologists has the experience to handlevirtually any cardiovascular problem. We are one team sharing a single goal: getting you back toyour life and the ones you love.

To schedule an appointment at our offices conveniently located in Roanoke, Lexington, Westlake and Bedford, please call 540-982-8204.

To schedule an appointment at our offices conveniently located in the New River Valley, please call 540-731-7420.

For more information, please call Carilion Direct at 800-422-8482 or visit www.CarilionClinic.org/Carilion/Cardiology.

verve - fall/winter 2010-11

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