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SENTARA RMH
S U M M E R 2 0 16
Standing Tall
Magazine
Ralph Sampson Sr. Wins Cancer Battle
A Message From Sentara RMH
Board Chair Ann Homan
N
SENTARA RMH
MEDICAL CENTER
PRESIDENT
Jim Krauss
EDITORS
Michael Cordell
Jenn Downs
Neil Mowbray
CONTRIBUTORS
Luanne Austin
Erin Bascom
Karen Doss Bowman
PHOTOGRAPHY
Luca DiCecco
Mike Miriello
Andrew Shurtleff
Tommy Thompson
DESIGN
Picante Creative
ormally, this is the spot in our magazine for comments by the hospital president, Jim
Krauss. As Jim noted in his letter in the last issue of the Sentara RMH Magazine, he
has announced his retirement and will soon be stepping down as president.
As chair of the Sentara RMH Board of Directors and a member of the Sentara Healthcare
Board of Directors, I have had the pleasure of working closely with Jim. In our last issue, we
included an in-depth look at his tenure with us. His vision, forward-thinking mindset and
strategic outlook were instrumental in getting us where we are today.
Jim came to us in 2000 as chief operating officer with an initial task of carrying
out a master facility plan update. After promotion to president and chief executive
officer in 2007, and having spent 10 years on the plan, Jim opened the doors to
the new and current hospital location in 2010. Here’s a quick look at some of his
other achievements:
• He spearheaded our foray into tertiary service with the addition of
open-heart surgery.
• We formed our own medical group in 2010, and today Sentara RMH Medical
Group consists of 145 providers.
• In 2013, Jim prioritized women’s care, moving to consolidate our women’s
health services onto the new hospital campus in the Sentara RMH Funkhouser
Women’s Center.
• Earlier this year, we opened the new Sentara RMH Orthopedics Center and
two new primary care offices.
• And finally, in May we celebrated the fifth anniversary of our merger with Sentara Healthcare, a strategic decision for which Jim had the foresight to advocate.
In addition to his accomplishments within Sentara RMH, Jim also has contributed his time
and talents to our community’s nonprofit organizations and regional educational institutions.
He has assembled quite a track record, and the board and I thank Jim for his exemplary service,
as well as his family for their support. We wish him well in his retirement and future endeavors.
Paramount to all of us is selecting Jim’s successor. To that end, Sentara has launched a
national search and also accepted applications from within our organization. We are interviewing several qualified candidates and are committed to hiring a leader who best fits the Sentara
values, the Sentara RMH community and our local healthcare needs. If all goes well, we expect
to name our new president by the fourth quarter of this year.
In addition to welcoming a new hospital president, we can expect to continue experiencing
change at an exponential rate. Healthcare leaders work daily to balance the promise of new
technology, the demands of new healthcare legislation, and other potential challenges and
opportunities that arise. We joined the Sentara Healthcare system in 2011, and today Sentara
RMH is better positioned to provide more expeditiously the facilities, technology and clinical
expertise our community expects and deserves.
Collaboration and partnership are an effective formula for improving health, and that
observation certainly applies to our primary partnership, which is with you, the members of our
local community. A community hospital is defined by the people who use it and the people who
deliver the care provided there. Sentara Healthcare and the Sentara RMH Board are thoroughly
committed to providing the safest, highest-quality health care possible.
Ann Homan
Board Chair, Sentara RMH Board of Directors
Contents
SUMMER 2 016
27
Helping Hands
Specialized Hand Surgery
32
36
A Second Chance at Life
Standing Tall
Man Survives Cardiac Arrest,
Has Bypass Heart Surgery
Ralph Sampson Sr.
Wins Cancer Battle
Contents
SUMMER 2016
14
D E P A R T M E N T S
A Message From the Board Chair
Inside front cover
3
New & Noteworthy 4
The Best Medicine
Physician’s Perspective
6
Advances in Vascular Surgery
On-Call Advice
9
Improve Health Every Day
Eat Well, Live Well
14
Clinical Excellence
18
11
Probiotics: What They Are and
Where You Can Find Them
Pharmacies: New Technology,
Safer Medication
Active Living
22
Walk for Your Life!
25
Aging Well 41
Calendar
46
CT for Lung Cancer Screening
18
Health Matters
44
Protect Yourself From Skin Cancer
La Salud Importa
45
Protéjase del Cáncer de Piel
Women’s Health
25
Calendar
46
A Sacred Birth for Every Baby
Sentara in the Community
50
Celebrating Five Years as Sentara
Free Clinic
57
25 Years of Service to the Community
Philanthropy
2 |
SUMMER 2016
60
THE BEST MEDICIN E
BY MICHAEL CORDELL
Take a
Walk on
the Mild
Side
NE OF OUR FIRST
milestones as a baby
is taking our first step.
Prior to that we are still
stumbling and bumbling, as unsteady as a
person can be—which,
coincidentally, also describes me
on a Monday morning. But a
baby finally takes his or her first
step, and then a second, at which
point the proud parents will go
online to find a baby Fitbit, so
they can immediately start tracking their child’s steps.
After a while, walking simply
becomes one of those things we
do. And given the fact that we
master it at a very young age, it’s
easy to take walking for granted
and overlook its value in achieving
better health. Sometimes we reach
the point where we don’t even
walk unless we absolutely have to
transport ourselves from point
A to point B. In my case, point A
used to be the sofa, and point B
was the refrigerator (although, in
my defense, I then had to make
the walk back to the sofa).
More and more these days,
though, doctors and researchers
are stressing the benefits one can
achieve simply by going for a walk
(see article, page 22)
Part of my own personal
challenge in trying to get fit was
thinking that I needed to go from
doing nothing to working out
hard every day, throwing myself
into exercise like a rock star into
a mosh pit. The downside was
that I would last about five minutes before deciding I couldn’t
do it, at which point I’d return to
doing nothing.
I have since adopted the old
adage: “little by little wins the
race.” In fact, you shouldn’t even
worry about winning the race: just
being in the race is what’s important. Maybe each day you walk a
little farther or a little faster. Or
maybe not. As long as you’re out
there making an effort, that’s what
really counts— especially at first.
A lot of articles recommend
walking 10,000 steps a day, which
is a terrific ultimate goal—but
what if your starting point is 5,000
steps, or 1,000? What if it’s five?
If you’re currently only walking
two steps a day, then five is a start.
Don’t let a number that may
seem unrealistic discourage you
from at least getting started.
Experts say you should walk at
a slow enough pace to be able to
carry on a conversation comfort-
ably (although when I walk with
friends, they often tell me that my
goal should be to walk fast enough
that I can’t carry on a conversation). I want to ask them if they’re
trying to tell me I’m boring, but
I’m often too winded to ask.
We need to recognize that
not everyone lives in a Mountain
Dew commercial, riding mountain
bikes along rugged trails, scaling
rock walls and paragliding off
cliffs. You rarely see anyone in
those commercials taking a walk
around the neighborhood, so
it’s easy to feel that if you’re not
sweating blood, then it’s not worth
it—but that’s not the case.
So if you’re not sure what your
first step toward getting in better
shape should be, consider literally
taking a first step. Take a walk, perhaps with a friend or loved one.
Or try listening to music while you
walk. Or listening to nature. Or to
yourself. That last option may not
be great for me, since apparently
my friends don’t think I’m all that
interesting, but others may actually
benefit from trying it.
You may find that walking
ends up being one small step for
mankind, and one giant leap toward achieving better health.
sentara.com
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3
new&
noteworthy
Sentara RMH Medical
Center is pleased
to welcome the
following new
providers to the
hospital community.
To get connected with one of our
providers, or for more information on any caregiver at Sentara
RMH, please call 1-800-SENTARA.
The physician referral line is a free
service that can help you find a provider who fits your individual needs.
More information can also be found
at www.sentara.com.
Jon B. Barlow III, PA-C
Allied Health
Harrisonburg Emergency
Physicians
Johanne Durbin, PA-C
Allied Health
Harrisonburg Emergency
Physicians
William S. Leighton, DO
Anesthesiology
Harrisonburg Physicians
for Anesthesiology
Corinne R. Replogle, MD
Family Medicine
Harrisonburg Community
Health Center
4 |
SUMMER 2016
Sentara RMH congratulates the Class of 2016—seated, from left: Justin Chittum, Michael
Bronez, Lyndsey Grove and Melissa Vasbinder, and standing, from left: Sarah Smith,
Craig Burkholder, Emily Swenson, Spencer Turner, Charity Doll and Hunter Reed.
Sentara RMH School of Radiologic
Technology Celebrates a Half-Century
of Excellence
The Sentara RMH School of Radiologic Technology held its
annual graduation ceremony Friday, May 6, at Blue Ridge Community College. The event marked the 50th annual graduation
held since the school received initial accreditation in 1966.
More than 360 students have graduated from the program,
and about 90 percent of current Sentara RMH Radiology
Department employees are graduates of the school.
Over the years the school has maintained the highest levels of academic and professional excellence. Graduates’ overall
scores on board examinations have always been higher than
the national average on any given year, and since 1993 the
school’s graduates have maintained a 100 percent first-time
pass rate on the American Registry of Radiologic Technologists
registry examination.
“As a group, our combined score is nearly always in the top
18 percent of radiologic technology programs nationwide,”
says Russell Crank, MS, RT(R), a 1992 graduate of the school
who currently serves as its program director.
Local Art Show Seeks to
Raise Stroke Awareness
The Strokes of Distinction art show is a
collaboration among Sentara RMH, the
Arts Council of the Valley, local artists, and
stroke survivors and their care partners.
The displayed artworks depict each artist’s
interpretation of his or her conversation
with stroke survivors and their care partners
about what it means to live with stroke and
be a stroke survivor. The exhibit is a unique
way to help enhance stroke awareness and
provide education.
Strokes of Distinction opens Friday, July
1, 5-8 p.m., at the Smith House Galleries, 311
South Main St., Harrisonburg. The exhibit
will be open Monday-Friday, 9 a.m.-5 p.m.,
through July 28.
Learn more about the Arts Council of the
Valley at www.valleyarts.org.
“Bluebird”
Artist: Piper Groves
Mixed media (monoprint with pencil and wax)
One of the artworks on display with the Strokes of Distinction exhibit
Sentara RMH Histotechnology School Receives Accreditation
Now in its third year, the Sentara RMH
School of Histotechnology (HTL) has
been awarded accreditation by the
National Accrediting Agency for Clinical
Laboratory Sciences. The accreditation
is granted for five years, after which time
it must be renewed.
Histology is the branch of science
dedicated to the study of cell structures
and how cells form tissues and organs.
Histotechnology focuses on the detection
and treatment of disease processes that
lead to cellular and tissue abnormalities.
The Sentara RMH HTL program is a oneyear school that includes six months of lectures
and student labs, followed by six months of rotations through hospital laboratories at Sentara
Norfolk General, Sentara Martha Jefferson,
Sentara Williamsburg and Sentara RMH. Applicants must have a bachelor’s degree, with a
minimum of 12 hours of academic credit each
in chemistry and biology.
Sentara RMH is the only hospital in the
Sentara system that has an HTL school, and
the school is one of only two hospital-based
HTL programs in the country.
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5
PHYSICI AN’S PERSPEC TIVE
Advances in
Vascular Surgery
ascular surgery is a medical specialty that treats
diseases of the vascular system—the arteries and
veins— throughout most of the body, except for those
of the heart and brain. Vascular problems of the heart are
treated by interventional cardiologists and cardiothoracic
surgeons, and neurosurgeons or interventional
neuroradiologists treat vascular problems within the brain.
6 |
SUMMER 2016
By Gregory Montgomery, MD,
Sentara RMH Vascular Surgery
Vascular surgeons treat conditions primarily in
the aorta, the largest artery in the body that carries blood from the heart; the carotid arteries
in the neck that carry blood to the brain; and
the arteries and veins of the lower extremities.
In my 30 years of practice in Harrisonburg,
I’ve witnessed dramatic changes in the field
of vascular surgery, and I am pleased to say
that Sentara RMH has done an excellent job
keeping up with those changes. For example,
last year, we upgraded our interventional angiography suite to include new, state-of-the-art
equipment. This year, we’ll be opening a new
hybrid operating room (OR) suite—combining
angiography equipment with OR capabilities—
to perform more complex vascular procedures.
Increasing Specialization of Vascular Surgery
Over the last decade, as a result of increasing
specialization within vascular surgery, a fundamental change has occurred in the way vascular
surgeons are trained.
The first vascular procedures were performed in the United States in the early 1950s.
Back then, vascular surgery was a core part of
residency training for general surgery. In the
mid-1970s, vascular surgery fellowships were
developed to provide additional training for
surgeons after they completed their general
surgery residency.
More recently, since the advent of endovascular (“inside the vessel,” or catheter-based)
procedures in the 1990s, vascular surgeons have
undergone a distinct five-year training program, with minimal general surgery exposure.
I started with Harrisonburg Surgical Associates in 1985, after completing a one-year
vascular fellowship at Eastern Virginia Medical
School in Norfolk. I performed both general
and vascular surgery there, which was typical
for a community-based hospital. I still had a
lot to learn, however, and my partners, general
surgeons Eugene Lareau, MD; Eugene Harper,
MD; and Elmer Kennel, MD, became my new
mentors. In 2010, the vascular surgeons separated from Harrisonburg Surgical Associates to
form Valley Vascular Associates, largely because
we could no longer recruit young surgeons
who would do both general and vascular surgery, due to the increased specialization that
had been occurring within vascular surgery.
Improvements in Diagnostic Procedures
Diagnostic testing has undergone dramatic
changes as well, not only in the volume of
tests performed, but also in recent advances
in diagnostic technology.
In 1985, our noninvasive vascular lab consisted of one technologist performing anklebrachial index tests, or ABIs. ABIs involve taking the patient’s blood pressure at the ankles,
which provides a quick indication of possible
peripheral artery disease, or blockages in
the arteries of the lower extremities. We also
conducted indirect measurements of carotid
artery narrowing using suction cups on the
eyes! Today we have four vascular techs, and
duplex ultrasound imaging has revolutionized our ability to detect narrowings in the
arteries of the neck and extremities.
In the early days of vascular surgery, dye
studies of arteries, known as angiograms,
were conducted by inserting needles directly
through the back into the carotid arteries
or the aorta. In the 1970s, however, a new
technique was developed by Swedish radiologist Dr. Sven-Ivar Seldinger, using a wire and
catheter to access the femoral artery. This
new approach provided a distinct advantage,
allowing surgeons to access any major artery
inside the body. Today, computed tomography angiography and magnetic resonance angiography allow us to obtain detailed images
of these vessels without the need for arterial
puncture, an advance that has been especially
valuable for treating aneurysms.
Developments in Surgical Treatments
of Arteries
Like many other surgical specialties, vascular
surgery has undergone a fundamental paradigm shift to less invasive procedures, due
primarily to the rapid expansion of endovascular technologies.
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7
This advance has been most dramatic in the
treatment of abdominal aortic aneurysm. Until the
late 1990s, this life-saving operation was performed
only by open surgical repair, which required a
large incision in the patient’s abdomen. Although
still occasionally needed, the open surgery has now
largely been replaced by a minimally invasive endovascular technique in which the surgeon places
an aortic stent graft—a kind of metal scaffolding—inside the aneurysm to keep the aorta from
rupturing. This procedure is performed through
two small groin incisions and often requires only
an overnight stay in the hospital.
Treatment of peripheral arterial disease,
or blocked arteries in the legs, also has seen a
tremendous expansion of techniques. Prior to
1985, surgical bypass was carried out not only for
abdominal aortic
aneurysm, but
also for blocked
unchanged since its inception in the 1950s.
Endarterectomy, the cleaning out of plaque from
the carotid arteries, is still generally the safest
technique. Carotid artery stenting has a role for
patients at high risk for surgery and may have an
expanded role in the future.
These days, vascular surgeons are uniquely
trained to offer the most appropriate approach,
surgical or endovascular, for each patient.
Surgical Treatment of Veins
Vein surgery has also seen dramatic change.
The days of “vein stripping” have now largely
been replaced by a procedure done in the office
under local anesthesia. A catheter is advanced
up the leg to the groin, and the saphenous
vein is ablated (closed) by thermal energy. Not
infrequently, bulging varicose veins can also be
treated at the same time, in a procedure known
as microphlebectomy.
Patients who come to Sentara RMH needing vascular surgery services
can rest assured that they will receive the safest, highest-quality care
available—care that is based on the latest technological advances
and with the patient’s best interests in mind.
arteries in the abdomen or thighs. I
had gained experience in my training to expand the scope of these
bypasses down to the vessels in the feet, as well as
arteries leading to the kidney and intestines.
In the late 1980s, radiologist Sherry Morris,
MD, introduced to RMH a procedure known
as balloon angioplasty of the vessels, which has
revolutionized our treatment of peripheral arterial disease. Under local anesthesia, a catheter is
advanced into a blocked segment of artery. We
then open the blockage using a balloon or stent,
or with an atherectomy device, a kind of “RotoRooter” for arteries—all without the need for
surgical bypass.
In addition, if an artery (or vein) clots off,
we can now place a catheter inside the vessel to
remove the clot without the need for an operation.
Carotid artery surgery has largely remained
8 |
SUMMER 2016
A Bright Future
I have had the privilege of practicing surgery
during a time of incredible change. The minimally invasive revolution has affected all surgical
specialties, including vascular surgery services.
This shift has fundamentally improved our
patients’ experience, and has been professionally challenging and exciting for us as physicians.
I look forward to the new changes ahead.
More important, however, patients who
come to Sentara RMH needing vascular surgery
services can rest assured that they will receive the
safest, highest-quality care available—care that is
based on the latest technological advances and
with the patient’s best interests in mind.
•
Gregory Montgomery, MD, is on staff with Sentara
RMH Vascular Surgery. He joined the Sentara RMH
medical staff in 1985.
ON-CALL ADVICE
Where Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH
Medical Center answer your health and wellness questions
Can you talk about
minimally invasive
heart surgery?
By Jerome McDonald, MD
inimally invasive heart surgery refers to procedures by which the cardiothoracic
surgeon operates on the heart through small incisions in the chest. Unlike open-heart
surgery, which requires a large incision, minimally invasive heart surgery does not
require the cardiac surgeon to cut through the sternum (breastbone). Instead, the
surgeon operates between the ribs.
Minimally invasive techniques also can be used for
some thoracic (chest) surgeries,
including certain operations on
the lungs.
The advantages of performing minimally invasive heart or
thoracic surgery include the
following:
• Less trauma to the body
• Less blood loss and less likelihood for the need of a blood
transfusion
• Generally less pain
• Very little scarring, as opposed to the large “zipper”
scar that open-heart surgery
patients typically have
• Reduced risk of infection
• Quicker recovery times and
generally shorter postoperative hospital stays
• Usually a quicker return to
work and daily life activities
Patients who are good candidates for minimally invasive
cardiac surgery generally are
those who require only a single
process, such as a valve replacement or a single coronary
artery bypass. Depending on
individual circumstances, it is
occasionally possible to do more
than one coronary artery bypass
in a minimally invasive setting.
Unfortunately, however, the
cardiac surgeon is frequently
required to address more than
just one issue—when that is
case, open-heart surgery is the
preferred option.
As highly trained specialists,
the cardiothoracic surgeons at
Sentara RMH Medical Center
are skilled at assessing each individual patient and selecting the
best surgical option to meet his
or her specific needs.
•
Jerome McDonald, MD, medical
director of Sentara RMH Cardiothoracic Surgery, specializes in adult cardiac, thoracic and minimally invasive
cardiothoracic surgery. He joined the
Sentara RMH medical staff in 2013.
sentara.com
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9
ON-CALL ADVICE
brain
aneurysm
What is a
and how is the condition treated?
By John Gaughen, MD
brain aneurysm is a weakness or bulge in the wall of an artery that supplies blood to
the brain—a condition that, while relatively uncommon, can be deadly. According to
estimates, approximately 2 percent of people in the United States have an unruptured
brain aneurysm. Some may live a lifetime with the condition without any ill effects, but
an aneurysm that does rupture is fatal about 40 percent of the time.
Patients frequently are
unaware that they have
a brain aneurysm. Some
symptoms, however, may
provide clues to patients
and doctors alike, such as
a headache in one spot,
pain above or behind the
eye, dilated pupils, blurry
or double vision, and
slurred speech. Sometimes
aneurysms are found as a
result of imaging studies,
such as computed tomography (CT) or magnetic
resonance imaging (MRI)
scans, that a patient may
have done for unrelated reasons.
Most aneurysms develop after
the age of 40, but they are most
prevalent in people ages 35-60.
Patients with a family history of
brain aneurysms should be sure
to inform their physicians, as
they are more likely to have an
aneurysm than people without
such a history. Women are about
50 percent more likely to suffer a
brain aneurysm than men.
Although there are several
risk factors for brain aneurysm
and subsequent rupture that
10 |
SUMMER 2016
patients can’t control, a few risks
are related to lifestyle. Some
aneurysms develop due to hardening of the arteries, and high
blood pressure and smoking both
increase a person’s chance of experiencing a ruptured aneurysm.
Many aneurysms don’t
require surgical treatment, needing only careful monitoring by a
physician. When a rupture does
occur, however, immediate intervention is needed.
At Sentara Martha Jefferson,
which launched its Neurointer-
ventional Surgery Department in late 2015, doctors
access an aneurysm for
treatment through blood
vessels, ultimately getting inside the aneurysm
and inserting metal coils.
These coils are like small,
medical-grade Slinkies
that can form different
shapes, with the goals of
filling the aneurysm completely and preventing
further damage.
While this type of
brain surgery is minimally
invasive, leaving patients
with just a small incision about
the size of a paper cut in the
groin area, the procedure is extremely complex and does come
with significant risks. For this reason, doctors must be judicious in
treating unruptured aneurysms,
weighing the risk of potential
surgical complications against
the risk of leaving the condition
untreated.
•
John Gaughen, MD, is on
staff with Sentara Martha Jefferson
Medical & Surgical Associates.
IMPROVE HEALTH EVERY DAY
For a Longer Life,
Lose the Belly Fat
A study recently published in the Annals of Internal Medicine
has found that persons with central obesity, popularly known as
a “pot belly” or “beer belly,” even if they are slim in other parts of
their bodies, are at significantly higher risk of early death than
those who are simply obese or overweight throughout their body.
The study, based on 15,000 participants, found that men with
flabby middles have twice the risk of early death, while the risk for
women is 1.5 times as high. Prior research had found that having
a pot belly increases a person’s risk of Type 2 diabetes, heart
disease, stroke and other chronic health problems, but this is the
first study of central obesity to look at mortality.
So how to lose that unsightly “spare tire” around your middle?
Follow a balanced, healthy diet like the Mediterranean diet,
which focuses mostly on healthy fruits, vegetables, whole grains
and unsaturated fats. Also be sure to get plenty of fiber.
n
Reduce the amount of carbohydrates you eat in the form of
breads, pasta, potatoes and baked goods. Avoid all beverages
that include added sugar, such as sodas, juices and sports drinks.
n
n Limit your meat consumption to two to three times a week,
favoring poultry, fish and lean cuts of red meat.
Exercise to boost your metabolism. Get at least 30 minutes of
cardio exercise most days of the week. This can take the form of
walking, running, jogging, swimming, dancing, doing yard work,
climbing stairs, rowing, bicycling—any activity that raises your
heart rate can be beneficial. About twice a week, engage in some
form of resistance training to build muscle mass.
n
Get enough sleep and reduce the amount of stress in
your life.
n
These guidelines are essential for obtaining and maintaining a healthy
weight and overall well-being, says Sentara RMH bariatric surgeon
Robert Garwood, MD. “But sometimes these strategies alone are not
quite enough to help someone achieve his or her weight-loss goals,”
he says. “In those situations, bariatric surgery, such as laparoscopic
sleeve gastrectomy, offers an additional avenue for achieving a healthy
weight and reducing the risk of weight-associated illness.”
sentara.com
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11
I M PROVE HEALTH EVERY DAY
Five Ways to Keep Regular
Is constipation a problem? Before resorting to laxatives,
try the following:
1
Increase your fiber intake. Many plant foods are high in fiber.
Especially good sources include acorn squash, bananas, beans,
berries, broccoli, cabbage, greens, sweet potatoes and unrefined
whole grains.
2
Increase your fluid intake. Consuming extra fiber requires more
fluids to help move that fiber through your digestive system. Choose
water to avoid the calories in sugary drinks.
3
Eat prunes and probiotic yogurt daily. The sorbitol in prune juice
and whole prunes is a natural laxative, and prunes also contain fiber.
Probiotic yogurt helps maintain the “good” bacteria in your digestive
tract that keep you regular.
4
Get moving. Increasing your activity level with regular walking,
jogging or other activity helps move food through your colon
more quickly.
5
Don’t put off going to the bathroom. Habitually ignoring the urge
to have a bowel movement can cause constipation. Try to establish
a regular bathroom routine.
Ticks and
Lyme Disease
According to the Centers for Disease
Control and Prevention, every
year about 300,000 people in the
United States are diagnosed with
Lyme disease, a bacterial infection
spread by the bite of Ixodes (deer)
ticks, which live in wooded, bushy
and grassy areas. The symptoms of
Lyme disease are similar to those
of fibromyalgia, chronic fatigue
syndrome, multiple sclerosis and
even depression.
Prevent Carpal Tunnel
Carpal tunnel syndrome, characterized by pain,
weakness and numbness in the wrists, hands and
fingers, can occur with repetitive or forceful use
of the upper extremities. People who type or click
a computer mouse for much of the day, or those
who use vibrating equipment such as saws, are
especially at risk. To avoid carpal tunnel syndrome,
try the following:
•
Take frequent breaks. Alternate tasks when
you can, or take frequent breaks of two to
three minutes to gently stretch or bend your
hands and wrists.
•
Vary your technique. If possible, relax your
grip or reduce the force with which you use
your hands or wrists. Avoid frequently bending
your wrists all the way. Change positions.
•
Observe good posture and body
mechanics. This is especially important for
people who work on a computer keyboard.
•
Follow ergonomic guidelines. Ask your
supervisor about an ergonomic assessment
or guidelines for your workplace or job. Use
ergonomically designed office furniture
and keyboards.
“Carpal tunnel syndrome is one of the
more common conditions I treat,” says Michael
Potter, MD, with Sentara Martha Jefferson
Orthopedics. “Many patients will respond
to splinting, activity modification or other
conservative treatments—but in severe
cases, outpatient surgery may be required to
decompress the median nerve.”
When outdoors, protect
yourself from ticks by avoiding
the areas where they live, if
possible. When working in bushy
or woody areas, wear long pants
and long sleeves for protection.
Apply to exposed skin an insect
repellent that contains DEET,
picaridin or lemon eucalyptus
oil. Check yourself frequently
for ticks, and pay attention to
your feet and lower legs, as well
as your hair and scalp. Wash
your clothes in hot water after
removing them.
Pick off any ticks you find
crawling on your clothing or
skin. Remove any attached or
embedded ticks carefully, using
fine-tipped tweezers. Make sure
not to leave any part of the tick’s
jaws or head attached.
“If you do find an attached
tick, don’t panic,” advises Keri
Hall, MD, MS, infectious disease
physician with Sentara Martha
Jefferson Hospital. “Most tickborne infections, including Lyme
disease, require the tick to be
attached for at least 48 hours
for a person to become infected.
If you develop a fever or a rash
within two weeks of the tick
bite, see your physician, who can
determine whether or not you
have Lyme disease.”
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13
EAT WELL , LIVE WELL
Probiotics:
What They Are and Where
You Can Find Them
By Sarah Novelly, MS, RDN
Probiotics have been making a name for themselves recently in the
headlines, with claims that they promote healthy digestion and support a
strong immune system. So what exactly are probiotics? Are they really useful?
And, if so, can you simply take a pill to reap their benefits?
What Are Probiotics?
Probiotics are live bacteria and yeasts, two of the
most common strands of which are Lactobacillus and
Bifidobacterium. These micro-organisms are considered beneficial because they help maintain a healthy
balance between “good” bacteria and “bad” bacte-
14 |
SUMMER 2016
ria in the gut (the colon or large intestine). They
accomplish this balance by decreasing the amount
of bad bacteria, which can cause inflammation, and
increasing the amount of good bacteria, which can
be lost, for example, during a course of antibiotics.
• Miso—a paste of soybeans, sea salt and
koji (a mold starter)
• Tempeh—fermented soybean cake that
can serve as a meat substitute
• Sauerkraut—the Western form of kimchi
• Sour pickles
Incorporating these foods into your diet
not only will provide you with healthy bacteria, but also will supply vitamins, minerals,
fiber and other nutrients.
To get the most benefit out of your probiotic foods, eat them in the state in which
you purchase them. Heating probiotics, particularly for long periods or at high temperatures, may kill off the good bacteria.
Who Can Benefit From Probiotics?
You do not need probiotics in order to be
healthy, but these friendly bacteria are particularly notable for promoting digestive health.
Scientific research provides strong evidence that
probiotics are beneficial for either treating or
preventing conditions such as diarrhea and eczema, as well as urinary tract infections and yeast
infections in women.
Research to learn about additional advantages of probiotics is ongoing. Promising evidence suggests that probiotics may be helpful
in treating irritable bowel disease, tooth decay,
childhood respiratory infections and allergies.
Probiotics also may help boost the immune system. These findings make sense, since research
has shown that 70-80 percent of our immune
system’s effectiveness comes from the gut.
Which Foods Contain Probiotics?
Yogurt is probably the most well-known probiotic, but many other foods are equally worthy of
our attention. Healthy probiotic bacteria can be
found in a variety of foods, including:
• Buttermilk
• Kefir—a yogurt-based drink
• Kimchi—Korean fermented vegetables,
often eaten as a condiment or side dish
• Kombucha—a drink of fermented,
sweetened tea
What About Probiotic Supplements?
You can find probiotic supplements in your
drugstore. While they will not provide the
extra nutrition that probiotic foods offer,
supplements can be a convenient alternative
for some people.
If you are thinking about taking these
supplements, talk with your healthcare provider first—and before you purchase probiotic supplements, make sure they are from a
reputable manufacturer.
Whenever you’re able, however, choose
probiotic foods instead of supplements to
receive more significant nutritional benefits.
Tips for Adding Probiotic
Foods to Your Diet
•
•
•
•
•
Pack a yogurt for workday snacks,
or to have with lunch.
Top your sandwich or grilled meats
with sauerkraut.
Include miso as a flavoring in soups,
or garnish steak or fish with this
savory paste.
Add a pickle or two with sandwiches.
Chop pickled vegetables and mix
with tuna or chicken salad for
added flavor.
sentara.com
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15
E AT WELL , LIVE W ELL
Give Your Probiotics a Boost!
Incorporate foods known as prebiotics—
such as leeks, asparagus, bananas, garlic,
onions, wheat, oats and soybeans—into
your diet. Not only are these foods rich in
vitamins, minerals and fiber, but they also
promote the growth of probiotic bacteria in
the gut. Prebiotics act as a type of fertilizer,
creating an environment in which probiotic
bacteria can thrive.
Miso Dressing
Use this dressing on cooked
vegetable salads, spinach salads, tofu
and noodle salads, or eat it stirred
into a simple bowl of rice. Miso
dressing will keep for up to one week
in the refrigerator.
Ingredients
2 rounded tablespoons white or yellow
miso (available in the Asian section of
your market)
2 tablespoons seasoned rice vinegar, or
1 tablespoon rice vinegar and 1 tablespoon
fresh lime juice
½ teaspoon grated fresh ginger
1 garlic clove, minced or put through a press
Pinch of cayenne
2 tablespoons dark sesame oil
2 tablespoons peanut oil or grapeseed oil
2 tablespoons plain low-fat yogurt
Overnight
Oatmeal
Make it the night before, then enjoy
as a quick grab-and-go breakfast.
Ingredients
1 container (6 oz.) of yogurt
¼ cup uncooked old-fashioned or
quick-cooking oats
¼ cup fruit (optional)
Preparation
In a container with a tight-fitting cover,
mix the yogurt and uncooked oats. Stir in
the desired fruit. Cover the mixture and
refrigerate for at least 8 hours—but no
longer than 3 days—before eating.
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SUMMER 2016
Preparation
Combine the miso and vinegar (or vinegar
and lime juice) in a small bowl and whisk
together. Add the remaining ingredients and
whisk until combined (you can also mix this in
a blender). Toss with the salad of your choice.
Tzatziki
Enjoy this delicious cucumber
and yogurt dip at a warmweather barbecue or, for a healthy
snack, pack it for dipping fresh
vegetables, such as broccoli
florets, bell pepper strips, snow
peas and carrot sticks.
Ingredients
Preparation
1 tablespoon olive oil, plus extra for
pita chips
1. Whisk the olive oil, vinegar, garlic
and yogurt together. Season with salt
and pepper. Fold the cucumber and
mint into the mixture. Cover and
refrigerate until chilled.
1 teaspoon vinegar
1 tablespoon chopped garlic
1 cup Greek yogurt
1 medium cucumber, peeled and
small-diced
2 teaspoons finely chopped fresh mint
Salt
Freshly ground black pepper
Kalamata olives
2. Preheat oven to 400°F. Place pita
wedges on baking sheets and brush
with olive oil. Bake until crisp, about
10 minutes. Cool. Serve tzatziki dip
with baked pita wedges and olives.
Note: You can make the pita chips one
day ahead. Store them in an airtight container at room temperature.
6 pita breads, cut horizontally in half,
then cut into wedges
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17
CLINICAL EXCELLENCE
New Technology,
Safer Medication
Pharmacy Advances Bring
Major Benefits for Sentara
Patients and Caregivers
Each year, the pharmacies at Sentara Martha
Jefferson Hospital and Sentara RMH Medical
Center distribute millions of doses of medication
to inpatients, as well as to those who come
for outpatient procedures. These medications
come in all forms—from tablets, capsules and
liquids to inhalers, patches and intravenous (IV)
infusions—and making sure each patient gets
the right medication in the right dose and at the
right time is crucial for maintaining safety and
achieving successful outcomes.
T
he highly trained pharmacy staff at each Sentara
facility is involved in every aspect of the medication use
process—from the time a drug comes in from the manufacturer until it is administered to the patient. Sentara’s
clinical pharmacists are also integral members of each
patient’s interdisciplinary healthcare team, serving as
consultants for nurses and physicians in cases that involve
complex drug dosing and monitoring.
“Achieving medication safety during a patient’s stay is
a cooperative effort among the patient, the care providers
and the support staff at Sentara Martha Jefferson,” says Michael Van Ornum, RPh, RN, BCPS, the hospital’s medication safety officer. “Our pharmacy plays a significant role
in ensuring the safe delivery of medication to care providers, as well as providing expert guidance and oversight for
complex or high-risk treatments.”
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SUMMER 2016
The pharmacy robot at Sentara
Martha Jefferson. Sentara RMH
has a similar robot.
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19
C L INICAL EXCELLENCE
Recent technological advances have had a
significant impact on the way medications are
prescribed, distributed and administered. Following are just a few of the upgrades that are helping
to improve care at Sentara Martha Jefferson and
Sentara RMH.
Electronic Health Record System
Having easy access to accurate, up-to-the-minute
patient information is paramount to quality
healthcare, so the electronic health record systems
in use at Sentara Martha Jefferson and Sentara
RMH provide a solid foundation for the safe
administration of medications. Containing a full
medical record for each patient, these electronic
systems help to expand the clinical role of the
pharmacist in medication decision-making. Once
a physician prescribes a medication through the
system, the pharmacist can verify whether that
medication is the best choice, or whether it might
potentially cause a problem for the patient. The
pharmacist also may be able to recommend another medication that would be more appropriate
for a patient’s specific circumstances.
“The integrated electronic health record
system of double-checks makes a big difference
in helping to keep our patients safe,” says Laura
Adkins, PharmD, BCPS, Sentara RMH clinical
pharmacy manager.
Bar Code Scanning
From the time a medication is received from a
wholesaler and entered into inventory, to the moment when that medication is administered to a
20 |
SUMMER 2016
“This verification process helps
confirm that it’s the right patient,
the right drug, the right dose at
the right time,” Adkins says.
patient, the drug is scanned at multiple points along
the way. This tracking system allows pharmacists to
monitor the hospital’s drug supply closely and easily
perform inventory audits, supporting a safer, more
secure medication supply line.
Most important, studies have shown that bar
code scanning also significantly reduces errors in the
administration of medications to patients. Anytime
a patient receives a dose of medication, the administering nurse scans both the patient’s wristband bar
code—which is linked to the patient’s electronic
health record—and the medication bar code.
“This verification process helps confirm that it’s
the right patient, the right drug, the right dose at the
right time,” Adkins says.
Automated Dispensing Cabinets
Secure machines known as automated dispensing
cabinets, which contain controlled substances such
as Percocet, as well as medications dispensed on
an “as-needed” basis, are located in all patient care
areas throughout Sentara Martha Jefferson and
Sentara RMH. These machines offer “true unit dose
dispensing,” providing only the smallest dose of the
medication needed by a patient at a particular time.
Before a nurse or other authorized provider can
access these medications, they must go through a
strict accounting system that tracks where each dose
will be dispensed. Additionally, bar code scanning is used during dispensing to verify strength
and dosing, further reducing the possibility of
medication errors.
Robotic Dispensing Systems
Certainly futuristic but far from science fiction,
robots are active around the clock at Sentara
Martha Jefferson and Sentara RMH to assist with
the dispensing of medications, working each
night to pull the needed patient medications for
the next 24 hours.
Guided by bar codes, these robots use
information received from each patient’s electronic health record to gather the medications
ordered. A robot then drops each patient’s dose
into an envelope, which a pharmacy technician
delivers the next morning to a locked medication cabinet in the patient’s room, for administration by the nurses.
At Sentara RMH, plans are also in place to
acquire a robot to assist with the prescriptionfilling process in the outpatient pharmacy.
Smart Infusion Pumps
For patients who need IV medications or nutrition, smart infusion pumps are used to help ensure that providers deliver the appropriate dose.
These computerized smart pumps are equipped
with a full drug library that has been aligned with
Sentara’s guidelines for specific medications.
Once the care provider sets the pump for the
drug to be administered, the software applies the
upper and lower dose limits for that medication,
and will sound an alarm if an error is detected.
“The smart pumps have caught several errors,” says Van Ornum. “These aren’t knowledgebased errors, but rather human-input errors. If
you’ve ever dialed a phone number incorrectly,
you can understand how this kind of error could
happen—however, such mistakes can be deadly
to a patient who is depending on receiving the
appropriate dose of a medication. These pumps
catch those types of errors and make our IV
therapies safer.”
Implementing the Latest Technologies
Medical technology is always changing, improving the ways hospitals deliver drugs, and Sentara strives to stay at the forefront of the latest
advances, providing safe, quality care for every
patient. The state-of-the-art pharmacy advances
in which Sentara Martha Jefferson and Sentara
RMH have invested are all helping to improve
efficiency and lower costs, at the same time reducing errors and improving patient outcomes.
“We’re always looking at new technology on
the market to help us improve safety,” Adkins
says. “And we continually work with multidisciplinary teams and watch for developments in
the healthcare industry regarding specific safety
protocols and procedures we can implement—
any improvements we can make to help keep
our patients safe.”
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21
AC TIVE LIVING
WALK for
Your Life!
Stroll Your Way to Better Health and Well-Being
re you convinced that you need to be more active, but aren’t sure how to
begin? Or do you lack the interest or skills to take up tennis, basketball, squash,
dancing or other organized activities? If so, try walking. This low-impact exercise
is easy on the joints and great for improving your cardiovascular health. It’s also
an enjoyable way to burn calories.
“The great thing about
walking is that almost everybody
can do it,” says Laura Bartley,
MS, ACSM-CEP, clinical fitness
coordinator for the Sentara RMH
Wellness Center. “Other than a
good pair of walking shoes, you
don’t need any special equipment
or uniform, and you don’t have
to join a club or gym to walk. You
don’t even have to worry, as an
athlete does, about improving
your technique—you just have to
start walking.”
“Walking also can help you
burn calories, aiding in weight
maintenance, weight loss and
prevention of weight regain.
And adding increased steps daily
has been linked to a reduction
in certain health problems like
hypertension, heart disease and
Type 2 diabetes.”
Regular walking, like other
forms of exercise, is also a proven
way to help reduce stress and
improve one’s overall sense of
well-being.
A Great Way to Improve
General Health and
Well-Being
Walking to Burn Body Fat
The benefits derived from a regular routine of walking spill over
into daily life, notes Cathy Roy,
PhD, an exercise physiologist with
Sentara Martha Jefferson Health
& Wellness.
“Walking can improve your
cardiovascular health, making it
easier to perform all the other
activities of daily life,” Roy says.
22 |
SUMMER 2016
Carrying excess weight in the
form of subcutaneous fat on
the hips, thighs and buttocks
increases the amount of stress
placed on our joints—causing
them to wear out sooner—and
requires the heart to work harder
than necessary to pump blood.
Another kind of fat, known as
abdominal visceral fat, or “belly
fat,” significantly raises a person’s
risk for heart disease, stroke and
diabetes. The good news for
people with excess body fat is
that walking can help.
Abdominal visceral fat is
highly sensitive to many of the
hormones we release by exercising,” says Roy. “These hormones
can assist in breaking down and
utilizing the visceral fat as energy.
In other words, compared to subcutaneous fat on the hips, thighs
and buttocks, belly fat responds
swiftly to aerobic exercise.”
People who want to “walk
away” their body fat should aim to
walk at least 30 minutes a day for
four or five days a week—if not
every day—and should maintain
a pace at which their heart rate
is around 120 beats per minute,
according to Bartley.
“You should be able to hold
a conversation while walking at
that pace, but not be able to sing
a song,” Bartley says.
Worried that walking won’t be
enough exercise to help you trim
down? It turns out that walking is
Safety First
• Drink 6-8 fluid ounces of water every
15-20 minutes to stay hydrated (drink
Gatorade or some other glucose drink,
if exercising more than an hour).
• In cold temperatures, dress in layers.
• Wear sunscreen, if walking in the sun.
• If walking outdoors, go with a friend
or in a small group, if you can, and
take along a cell phone, in case of any
unforeseen circumstances.
A Few Words on Technique
• Don’t let your feet shuffle or drag
on the ground—clear the ground
completely with each step.
• Stand upright, with your head up and
shoulders back and relaxed.
• Walking should not hurt. Stop if
you are experiencing chest, joint or
muscular pain; dizziness; or significant
shortness of breath.
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23
AC TIVE LIVING
actually more effective for losing
belly fat than doing multiple sets
of abdominal exercises.
“Muscular endurance exercises that specifically target your abs,
such as crunches and situps, will
only help tone your abdominal
muscles,” says Roy, “but they will
not help you lose belly fat.”
It’s essential for people to
understand, she adds, that the
only way to lose body fat—especially belly fat—is by burning
more calories than you consume.
“In other words, calories out must
exceed calories in,” Roy says. “A
regular walking routine, along
Going for 10,000
Steps a Day
Research has shown that walking 10,000 steps
each day will help you lose around 500 calories
per day. If you do this every day and maintain
an appropriate, consistent calorie intake, you
should lose one pound of body weight per
week (there about are 3,500 calories in one
pound of fat).
Purchase a pedometer or use a
smartphone app to count your steps, including
all those steps you take throughout the day as
you go about your daily activities and work.
24 |
SUMMER 2016
with a well-balanced diet, can be a
very effective strategy.”
Both Bartley and Roy point
out that people who can exercise
longer than 30 minutes—say, 4560 minutes most days—are going
to lose body fat more readily.
Walking for Cardiovascular
Health
For those who aren’t overweight
and don’t have a lot of excess
body fat, but who may not be in
the best of shape, walking can
definitely help improve the functioning of the heart, lungs and
circulatory system.
“You’re going to get cardiovascular benefits if you just keep
your heart rate at 120 beats per
minute and walk for 30 minutes,”
says Bartley. “If you really want
to improve your cardiovascular
health, though, you should go up
to about 60-80 percent of your
maximum heart rate.”
To find your maximum heart
rate, subtract your age from 220,
Bartley advises. Then walk for an
interval of several minutes at that
higher pace to achieve 60-80 percent of that maximum number.
Then slow it down to let yourself
rest. Then repeat with another
interval at a higher pace.
Challenging your body with
something it’s not used to—
known as the overload principle—is the key to improving your
fitness, Roy adds.
“To build stamina and improve fitness, try walking up and
down hills, or raising the incline
of your treadmill,” she says. “Combining hill walking with regular
flat-terrain walking is another
form of interval training.”
Get Moving
Roy and Bartley offer some practical advice to those who are ready
to start walking for fitness and
weight loss. First, make sure to
wear clothing that’s easy to move
around in and comfortable for
activities that may cause you to
sweat. And be sure to wear bright
clothing—you can’t be too noticeable, particularly if you’re walking
along a street.
Appropriate shoes are particularly important for effective
walking. Be sure to wear comfortable walking shoes that provide
good arch and ankle support.
If you’re new to exercise, start
slowly. At first, walk only short
distances at a slower pace. Then
gradually, over several weeks,
increase the pace and intensity.
Whether you’re new to walking or a longtime walker, you
should dedicate the first five minutes of each session to warming
up. Doing this allows your heart
rate, blood pressure, breathing
and body temperature to increase
gradually, says Roy, and this can
help prevent injury. At the end of
your walking session, take several
minutes to slow your pace, allowing your breathing and pulse to
return to normal.
“Failure to cool down properly may cause blood pooling,
leading to dizziness or lightheadedness,” says Roy. “After cooling
down, at the end of your walk,
it’s also a good idea to do a few
stretching exercises.”
If you’re too busy to walk
30-60 minutes at a time, break up
your walks into shorter sessions of
10-20 minutes, a few times a day.
“If you walk at all, you’re
burning calories, which can aid in
weight loss,” says Bartley. “You’re
also helping to improve your cardiovascular fitness, overall health
and well-being. And the more
walking you do, the more benefits
you will reap.”
calendar
Unless otherwise noted, call 1-800-SENTARA for more information and to register.
Classes are also listed on Sentara.com. We have coded our classes and events as follows:
Advance registration required
AR NR
No advance registration required
FREE No fee
Behavioral Health
Square One. For adults concerned about their alcohol or
drug use. All levels of change are supported; quitting is not
required to join. Call 540-564-5960 or 877-294-5731.
Cancer
Personal Health and Wellness
Heart Check. A heart disease screening for women and
men. $50 fee includes lab work, one-on-one consultation,
education and goal setting. Call 540-689-6000 to learn more
and to schedule. AR
Sentara RMH Hahn Cancer Center offers a number of classes
and support groups, many of them free of charge, for cancer
patients, cancer survivors and caregivers. To learn more, visit
Sentara.com or call 540-689-7065.
Vascular Screenings. Detect artery blockages that can
Diabetes
Caring for Your Diabetes Class Series. Covers medica-
Seniors
Sentara RMH Senior Advantage. Affordable, fun
lead to debilitating leg pain with walking, stroke or death.
For ages 50 and older with risk factors for, or a history of,
heart and vascular disease. $50. AR
tions, monitoring, reducing risks, staying active, healthy
eating and more. Medicare and most insurance plans cover
a portion of the cost. AR
educational and social events for adults 55 and “better.” Call
540-433-4231 or visit Sentara.com to learn more.
Grief and Loss
Grief: 1 to 1. Grief can follow death, marriage breakup,
A variety of support groups, most of them free of charge,
are provided by Sentara RMH or affiliated groups in the
community. Among them are the following:
chronic illness, job change or retirement. Talk with someone
trained to help you understand how your grief can affect
you. For an appointment, call 540-564-5118. No charge for
the first two sessions.
Life Seekers. A dinner meeting for those wishing to con-
nect socially with others who have experienced a loss. Cost
of meal. NR
Parenting
Parenting Education and Support (PEAS). Tuesdays,
Sept. 6-Dec. 13, 6:30-8:30 p.m., Lucy Simms Educational Center, 620 Simms Ave., Harrisonburg. Dinner served 6-6:25 p.m.
Dinner and child care provided to participants at no charge.
Call 540-564-7006 for more information.
Support Groups
•
•
•
•
•
•
•
•
•
Bariatric Support Group
Breastfeeding Support Group
Cardiac Device Support Group
Diabetes Support Groups (adult and pediatric)
Grandparenting Education and Support (GrandPEAS)
Grief and Loss Support Groups
Mended Hearts Support Group
New Moms Ask a Nurse Support Group
Pregnant and Parenting Teen Support Group
This is a partial listing. To learn more about these and other
support groups offered in the Sentara RMH service area, call
1-800-SENTARA.
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25
calendar
Women’s Services
Mammography Van Schedule. Call 540-689-6800
or 800-277-1021 to schedule your mammogram at the
following locations:
July 14 • Cargill Distribution Center
July 15, Sept. 23 • Carilion Family Medicine, Keezletown
July 18, Oct. 7 • Elkton Area Community Center
July 19 • Montebello
July 20 • Luray Walmart
July 21, Aug. 25 • Pilgrim’s Pride
July 25, Aug. 29, Sept. 26, Oct. 12, Oct. 24 • East Rockingham
Health Center
July 26, Oct. 1 • Plains District Community Center
July 28, Aug. 15, Aug. 31, Sept. 12, Oct. 28 • Timber Way
Health Center
Aug. 9, Sept. 27 • Highland Medical Center
Aug. 10, Oct. 11 • Bridgewater Retirement
Aug. 13 • Briery Branch Church of the Brethren
Aug. 19, Oct. 18 • Shenandoah Grocery
Aug. 24, Oct. 13 • Virginia Mennonite Retirement Community
Aug. 30 • Waynesboro (at Constitution Park across from
Waynesboro First Aid Crew)
Sept. 1 • RR Donnelley
Sept. 8 • Grottoes Food Lion
Sept. 14 • Page County Administration
Sept. 20 • Harrisonburg Health & Rehab
Oct. 3 • New Market Community Center
Oct. 4 • Rockingham County Administration
Oct. 10 • Perdue
Oct. 19, Oct. 31 • EMCO
Oct. 21 • Ed Good Memorial Park, Stanley
Oct. 25 • Turner Ashby High School
Oct. 26 • Dick Myers Chrysler Dodge
Oct. 27 • Graham Packaging
Sentara RMH Wellness Center
Offering state-of-the-art fitness equipment; group fitness and Pilates classes; warm-water pools, whirlpool
and sauna; nutrition, CPR and first aid classes; child care;
and more. Call 540-564-5685 for membership details.
Progressive Exercise Program (ProEx). $60 for a
60-day introductory Wellness Center membership and
customized program to meet your medical needs and fitness goals. Ask your healthcare provider if you’re a ProEx
candidate; if so, call 540-564-5693.
Full Lipid Profile. Screening includes cholesterol,
Sentara RMH Medical Center offers a variety
of classes and seminars throughout the year.
For a complete list and more details, visit
Sentara.com. To register for an event,
call 1-800-SENTARA, unless otherwise noted.
HDL, LDL, triglycerides and glucose. $20 members,
$25 nonmembers. For appointments call 540-564-5696.
AQUATIC PROGRAMS
Group Swim Lessons. For all ages. Call 540-564-7200.
Private and Semiprivate Swim Lessons. Ages 3
and older, all skill levels. Call 540-433-4347.
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SUMMER 2016
Helping
HANDS
Sentara RMH Orthopedics and
Sports Medicine Now Offers
Specialized Hand Surgery
When Sophia Leung, MD, came on as the first hand
surgeon for Sentara RMH Orthopedics and Sports
Medicine in September 2015, patient referrals were
already awaiting her arrival.
“I came here hoping to ease into my new practice with some
straightforward surgeries, but there was no easing,” she says with
a laugh.
Dr. Leung, who specializes in orthopedic surgery, is fellowship-trained in hand and upper extremity surgery, which deals
with various problems of the hand, wrist and elbow. These kinds
of issues include trauma-induced injuries like fractures and tendon and ligament damage, nerve-compression syndromes, and degenerative and overuse problems
such as arthritis and tendinitis.
“This type of surgery takes patience and
a steady set of hands,” she says. “Most of
the procedures I perform are done under
loupe magnification, so they’re on a much
smaller scale than the general orthopedic
work I do. Everything is smaller, from the
anatomy I work on to the implants I place.”
Getting an Athlete Back
to the Ball Field
Dr. Leung’s first patient was Joseph Hamby
of Grottoes, Va. Hamby had injured his
hand in August 2015 during his first play of the
football season with the Spotswood High School team.
Joseph Hamby
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27
Sophia Leung, MD
Hand Treatments
at Sentara RMH
Sentara RMH hand surgeon Sophia Leung, MD,
treats—both surgically and nonsurgically—
a wide range of problems involving the hands
and upper extremities. Some of the common
conditions she deals with include:
• arthritis at the base of the thumb and wrist
• cubital tunnel syndrome, or damage to the
ulnar nerve (also known as “the funny bone”),
which can cause numbness or pain in the
ring and small fingers, forearm pain,
or weakness in the hand
• ganglion cysts, which are fluid-filled masses
that occur in the hands or wrists, typically
near joints or tendons
• hand and wrist fractures
• tendinitis of the wrist and elbow
• trigger finger, a condition in which a finger
gets stuck in a bent position
The most common hand surgery Dr. Leung
performs is carpal tunnel release, which can
help relieve the pain and weakness associated
with carpal tunnel syndrome. Carpal tunnel
syndrome refers to weakness, tingling, numbness
or pain in the hand and forearm that can occur
with pressure on the median nerve in the wrist.
The condition affects about 1 percent of the
general population and up to 5 percent of
the working population. Fortunately, in cases
where nonsurgical treatments fail to relieve the
symptoms of carpal tunnel syndrome, surgical
treatment has a high rate of success, if performed
early enough after the onset of symptoms.
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SUMMER 2016
“The hand hurt, but I didn’t think much of it until after
the second game,” says Hamby, now 17. “It was still swollen,
and the pain was getting worse.”
Hamby finally had X-rays taken in September and
was told to wrap his hand. Then, Sentara RMH physician
Thomas Weber, MD, contacted Dr. Leung, his soon-to-be
colleague at Sentara RMH Orthopedics and Sports Medicine. He sent her Hamby’s X-rays and asked her if she could
help him treat Hamby, as the injury was fairly complex and
already two weeks old.
“When I looked at Joseph’s scans, I knew it was a bad injury,” recalls Dr. Leung. “If you’re not a hand or orthopedic
surgeon, you wouldn’t necessarily appreciate the severity of
this kind of fracture, because it can be very subtle on X-rays.”
Dr. Leung saw Hamby on a Monday. Upon examination,
she discovered that half of Hamby’s ring finger joint was
crushed, and the entire joint was partially dislocated. Because the joint had been in that position for several weeks,
Hamby was in significant pain and could no longer bend the
finger. Dr. Leung scheduled his surgery for four days later,
on Friday, Sept. 18.
“The surgery for this injury is uncommon because this
type of injury is uncommon—especially in a teenager,” comments Dr. Leung. “Most people wouldn’t have tolerated the
pain from this fracture for so long, but Joseph is a tough
kid and a dedicated athlete. He certainly didn’t want to be
benched from playing over a finger injury, a sentiment that
is common among young athletes.”
The goal of treatment for this type of joint injury involves repairing the fracture, if possible, and reducing the
joint. But, as Dr. Leung points out, X-rays can only reveal
so much.
“No matter what the treatment is,” she states, “any injury to this particular joint can result in a permanently stiff
and swollen finger, which is especially challenging when
treating a 16-year-old athlete with plans for playing beyond
high school. I had to assess the severity of his joint damage
in the operating room before determining the best course
of action.”
Once Hamby’s finger was opened, Dr. Leung saw that,
due the condition of the joint, there was no way to repair
it. She sent a nurse to the waiting room to inform Hamby’s
mother, Bonnie Stephenson, that the joint would need
to be replaced, and that the surgery would not likely be a
quick fix.
During the next three hours, Dr. Leung performed a
hemi-hamate arthroplasty, a procedure in which a small
piece of the hamate bone in the wrist is used to replace the
damaged proximal interphalangeal (PIP) joint.
“We have many bones in our wrists, and the hamate
bone happens to have the same shape as the PIP joint,”
Bringing an Artist Back
to Her Easel
A watercolor artist, Carol Lawson, of Elkton,
Va., had been attending an art demonstration in Staunton when she set something
down and felt a sharp pain shoot through her
index finger.
“The finger drooped, and I couldn’t use
it anymore,” says Lawson, 72, a retired lab
technician.
At first she didn’t do anything about it.
“As you age, aches and pains come and go, so
I don’t always run to the doctor,” she remarks.
About six months later, however, a lump
appeared on the top of her hand. Diagnosing
the condition as a ganglion cyst, her physician
recommended waiting to see if the problem
resolved itself. In the meantime, Lawson
didn’t do much painting. Then, in May 2015,
as she was painting during an art workshop,
she experienced severe pain in her hand. She
had a magnetic resonance imaging (MRI)
scan, which showed that she had tenosynovitis, inflammation of the tendon and the
sheath that surrounds it. Lawson’s physician
told her surgery was her only option and
referred her to Dr. Leung.
Initially, Lawson was hesitant about having
an operation, but she overcame her reservations and went to see Dr. Leung.
“She was able to answer all of my questions,” says Lawson. “She told me she had
“The hand
hurt, but
I didn’t
think much
of it until
after the
second
game.”
notes Dr. Leung. “With the insertion of the
bone, he now effectively has a new joint.”
Following his surgery, Hamby’s finger was
put in a splint and wrapped. Dr. Leung sent
him to a Sentara RMH hand therapist right
away to initiate movement in the joint.
“Stiffness is the worst outcome from this
injury, and unfortunately it’s an outcome
that is very common,” says Dr. Leung. “Hand
therapists play an integral role in most of my
postoperative treatment plans—especially
after trauma.”
Hamby found the hand therapy to be
particularly challenging. “It was the tiny movements I had to perform that really hurt,” he
recalls. “But it was kind of like stretching—
it got better as the therapy continued.”
Carol Lawson
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29
performed many types of surgeries during her
residency and fellowship training, so she knew all
the latest technologies and procedures.”
The inflammatory tissue in the back of
Lawson’s hand weakened the tendon, according
to Dr. Leung. Due to the hand’s repetitive daily
use, the weakened tendon had rubbed against
the bone beneath, and eventually the weakened
30 |
SUMMER 2016
tendon had ruptured.
Using hand models and diagrams, Dr. Leung
explained to Lawson what was going on in her hand
and outlined her goals for surgery: to get rid of the
inflammation and repair the tendon. After cleaning out the inflammation and damaged tissue, she
performed a tendon transfer.
“I transferred the ruptured tendon to the
adjacent, functioning tendon, so now her hand is relying
on that functional tendon to do the work for both fingers,”
says Dr. Leung. “Now her finger is straight and functional.”
Successful Outcomes, Happy Patients
Lawson is quite happy with the outcome of her hand surgery. In addition to getting back to painting, she spends
a lot of time on her computer, conducting genealogical
research online and entering the results of that research
into her records. Before her surgery, the computer work
was getting difficult; now she can type without a problem.
“I really appreciate the excellent work Dr. Leung did,”
says Lawson. “The surgery was innovative and successful.”
As for Hamby, he ended up missing the rest of the
football season—but it was the baseball season he was
especially concerned about. Baseball practice began right
before his school’s winter holiday break.
“I was worried I wouldn’t be able to bend my finger,
and that it wouldn’t heal in time for me to be able to play
baseball,” says Hamby. “It was sore the first few times
I swung the bat, but it got better.”
As of this writing, Hamby is hoping to play with the
Richmond Braves this summer. He has aspirations of playing college baseball, and maybe beyond.
“What Dr. Leung did was pretty impressive,” he says.
“She made sure the scar wasn’t going to be in contact
with the baseball, so it wouldn’t affect my throwing. We’re
really happy with the results.”
Meeting a Common Need for the Area
Hand surgery seems to be in high demand in Harrisonburg, Dr. Leung notes. She thinks such demand may
be due in part to the many manufacturing and farming
jobs in the area, as well as many other jobs that require
physically demanding labor. There are also many school
athletes in the area who, like Hamby, can sustain sportsrelated hand injuries.
“There’s definitely no shortage of work for me to do
here,” she adds. “Getting patients back to their normal
activities as quickly and effectively as possible—whether
it’s a job, a sport or a hobby—is one of the most rewarding
parts of my job.”
Need a Hand Specialist?
Call the Sentara RMH Orthopedic and Sports
Medicine Center at 540-689-5500.
Orthopedic and Sports
Medicine Services
at Sentara RMH
At Sentara RMH, our number-one
priority is helping our patients get
back to their everyday activities.
With rehab and sports performance
services onsite, as well as
specialty-trained musculoskeletal
radiologists using the latest imaging
technologies, our qualified team
will provide you with expert
diagnosis and treatment, quickly
and effectively.
Concussion Care
In our concussion clinic, patients
can meet with a sports medicine
family practice physician and
physical therapist for expert
diagnosis and treatment.
Joint Services
We offer one of the most
comprehensive, quality-focused
joint programs in the Shenandoah
Valley, providing a wide range of
conservative and surgical treatments
for problems involving the shoulders,
hips and knees.
Spine Services
Our team of experienced surgeons
and specially trained nurses,
therapists and technicians
provide seamless, coordinated,
compassionate care in the areas of
cervical laminectomy, lumbar fusion,
cervical discectomy and fusion, and
lumbar microdiscectomy.
Sports Medicine
Our sports medicine team consists
of physical therapists, exercise
physiologists and certified athletic
trainers who work with primary care
physicians and orthopedic surgeons
to treat athletes of all ages.
To learn more, go to Sentara.com
or call 1-800-SENTARA.
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31
A SECOND CHANCE AT LIFE
Harrisonburg Man Survives Cardiac Arrest,
Undergoes Quadruple Bypass Heart Surgery
For Harrisonburg resident Mike Lam,
every day is a gift.
A little more than two years ago,
Mike suffered cardiac arrest. Suddenly
and without warning, his heart
stopped working.
“By all accounts, I should have
died on May 3, 2014,” Mike says. “I’m
already living on borrowed time. To
say ‘somebody’ was looking out for
me is an understatement.”
32 |
SUMMER 2016
The day before his cardiac arrest, Mike and his
wife, Kathy, drove to Pennsylvania for a visit. It
was Kentucky Derby weekend, and their friends
wanted to show them around State College, home
of Penn State University. The Lams and their
friends spent Friday evening together, and the
next morning they had breakfast downtown before
heading to a winery in the countryside. After that,
the group came back into town and went to an
Irish pub for lunch.
Mike ordered some drinks, and that was the
last thing he remembers before the cardiac arrest.
“I slumped behind my wife, who was seated
beside me,” Mike says. “Our friends thought I was
just messing around, kissing on her back, until
they saw that I was blue.”
Two restaurant patrons saw what happened
and rushed over to help. Assessing Mike, they
found he had no pulse and wasn’t breathing, so
they immediately started cardiopulmonary resuscitation (CPR). Mike later learned their names:
Kris Keeler, a local dental office worker, and Adam
Burkholder, a Penn State student. The two worked
to try to get Mike’s heart beating again for about
12 minutes before State College police officers,
the first responders on the scene, arrived.
Fortunately, the Penn State and State College
police departments carry automatic external defibrillators (AEDs) in their vehicles. These portable
devices are used to diagnose and treat life-threatening irregular heart rhythms and to restart a
heart that has stopped beating. The officers on the
scene shocked Mike twice before they got a pulse.
Meanwhile, Kathy and the Lams’ seven
friends were in complete disbelief.
“It all happened so fast that I didn’t realize
what was going on until I heard the words, ‘We
don’t have a pulse,’” recalls Kathy. “Then the seriousness of the situation hit me, and I just went numb.”
Once Mike’s heart was restarted, emergency
medical services (EMS) workers, who also had
arrived on the scene, transported him to the
hospital. On the way, Mike started to wake up,
but he was incoherent. The EMS workers told
Kathy, who was also in the ambulance, to be
prepared, because her husband likely would have
mental deficiencies as a result of the event—if he
survived at all.
“The Luckiest Man
in Pennsylvania”
Mike recalls nothing of the incident until the
point when he woke up in the emergency room.
The doctor there asked him: “Mike, do you know
where you are? Do you know what happened?”
When Mike told him he didn’t have a clue,
the doctor replied: “You’re the luckiest man in
Pennsylvania. You’ve suffered a cardiac arrest,
and most people don’t come back from that.”
According to Mike, he remained “pretty
much out of it” through the rest of that weekend.
On Monday he was taken for a heart catheterization, so doctors could try to find out what had
caused his heart to stop.
Following the catheterization his physician
told him, “You have both an ‘electrical’ problem
and a ‘plumbing’ problem in your heart. On the
electrical side—the cause of your cardiac arrest—we’re not sure what happened. But on the
plumbing side we found four areas of near-100
percent blockage in your coronary arteries.”
The news came as a complete surprise to
Mike and Kathy. Prior to his cardiac arrest, Mike
had experienced no heart problems. He knew he
was overweight and had high blood pressure and
high cholesterol, but he had never experienced
chest pain, neck pain or any of the other classic
symptoms of heart disease.
His doctors told him he was not a good
candidate for bypass surgery, even though he had
significant disease in his coronary arteries.
Shortly after the cardiac arrest, word had
gotten back to Mike’s family and friends in Harrisonburg. One of them, a former heart surgery
patient himself who had undergone six-way
bypass surgery at Sentara RMH, called Mike in
the hospital and said: “Mike, you need to come
back here and see Dr. McDonald, the surgeon I
had. He’s one of the best.”
Mike had heard of Jerome McDonald,
MD, FACS, medical director of Sentara RMH
Cardiothoracic Surgery Services, earlier through
that same friend. So the Lams decided to return
to Harrisonburg to consult with Dr. McDonald.
Before Mike left Pennsylvania, however, his cardiologists implanted a permanent defibrillator, a
device to help ensure that his heart wouldn’t stop
beating again, in his chest.
“
I slumped
behind my
wife, who
was seated
beside me,”
Mike says.
“Our friends
thought I was
just messing
around,
kissing on her
back, until
they saw that
I was blue.
“
A Weekend With Friends Goes Wrong
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33
“I used to be a red meat and potatoes
guy,” Mike says. “Now I eat a lot of fish,
and I may have a salad or a bowl of soup
for lunch. I also exercise regularly.”
“I Can Fix You”
Ten days after his cardiac arrest, Mike met with
Dr. McDonald.
“I’ll never forget it,” Mike recalls. “He came into
the office, sat down and said, ‘Your films are a little
unclear, but I can fix you. I’m going to go in there,
see what I can see, and fix you.’”
The Lams were relieved that even though Mike
had been deemed a poor candidate for cardiac bypass
surgery, Dr. McDonald was willing to operate. Kathy
notes that Dr. McDonald “simply exuded confidence” during their first meeting. They both knew
Mike was in good hands.
“I admit that when I looked at his images, he
appeared to be in the bottom 15 percent of patients
in terms of the quality of his coronary vessels,” says
Dr. McDonald. “Medical imaging gives you some
guidance, but I would never exclude someone from
surgery solely because their vessels didn’t look great.”
Open-heart surgery was scheduled for the following Thursday. During the operation, Dr. McDonald did four bypasses around the areas of greatest
blockage. Due to the extensive nature of Mike’s
disease, Dr. McDonald believes there may also have
HEART ATTACK OR CARDIAC ARREST?
Cardiac arrest and heart attack are two separate
problems that people often confuse.
A heart attack occurs when a coronary artery
supplying blood to the heart tissue becomes blocked by
a buildup of plaque inside the vessel. Such a blockage
restricts or diminishes blood flow to the heart tissue,
which begins to die due to a lack of oxygen.
A cardiac arrest, on the other hand, occurs due to
a sudden interference in the heart’s rhythmic beating.
The heart suddenly stops, the person collapses and
passes out, and blood circulation stops.
The difference between the two conditions is often
described as the difference between a “plumbing”
problem (heart attack) and an “electrical” problem
(cardiac arrest). Both conditions require prompt medical
attention, but for a person who has suffered cardiac
arrest, death is a certainty unless intervention—via CPR
or the use of an AED—is started within minutes.
34 |
SUMMER 2016
been other smaller blockages. Like Mike’s cardiologists in Pennsylvania, Dr. McDonald doesn’t know
what caused the electrical problem that stopped
Mike’s heart, but he thinks the extensive blockage
could have been a contributing factor.
Mike did very well during the postsurgery
recovery period. He did exactly as his nurses and
physicians told him, and his compliance paid off.
“I had the operation on a Thursday, and I walked
out of the hospital on Sunday morning,” he says.
Mike followed up with Dr. McDonald a week
after the operation, and six weeks after surgery he
began cardiac rehabilitation in the Sentara RMH
Heart and Vascular Center. During the rehab
program, Mike worked to build up his strength
and learn a new way of life. He began a weight-loss
regimen and started learning about healthier eating
habits, the value of regular exercise and other hearthealthy lifestyle choices.
“I used to be a red meat and potatoes guy,” he
says. “Now I eat a lot of fish, and I may have a salad
Sentara RMH Cardiothoracic Surgery Program
Rated Among the Best in the Nation
or a bowl of soup for lunch. I also exercise regularly.”
Mike still has the defibrillator to regulate his
heart rhythm, but his lifestyle choices are paying
off. He has lost about 60 pounds since the time of
his surgery.
The Angels of State College
Six weeks after his surgery, the Lams returned to
State College and revisited the pub where Mike’s
cardiac arrest had occurred. When the bartender
came to take their drink order, Mike asked him:
“Six or seven weeks ago, didn’t you guys have an
emergency situation in here?” The bartender answered: “Oh, yeah—he died.” And Mike responded: “I don’t think so—I’m that guy.” The bartender
couldn’t believe it, and began making phone calls.
“All kinds of people started coming into the
restaurant to see for themselves,” Mike says.
On that and subsequent visits, Mike got to
meet and thank the people he calls “the angels
of State College” who saved his life. At a State
College Police Department awards ceremony, he
and Kathy heard the police report read aloud that
stated the dire circumstances of his situation: the
lack of respiration, the blue coloring of his skin
and eyes, and the statement that read: “Patron
dead on the floor.”
“It was pretty intense, what they were telling
us,” Mike reflects.
The Society for Thoracic Surgeons (STS) has rated the Sentara RMH
cardiac surgery program among the top programs in the country.
For aortic valve replacement surgery, Sentara RMH was awarded
three stars (the top rating) for the past three years, putting the program
in the top 7.4 percent of participating hospitals for valve replacement.
For coronary artery bypass surgery, Sentara RMH received two stars and
is rated in the top 15 percent nationally.
The rankings are based on the STS National Database, which
contains 5.9 million patient records and rates 90 percent of heart
surgery programs in the nation. The STS collects more than 1,000 data
points on every heart patient undergoing surgery in those participating
hospitals. The results are risk-adjusted for patient history, risk of certain
complications, and other factors that determine how sick a patient is at
the time of surgery. The STS ratings are considered the most accurate
and trustworthy available.
“We have excellent outcomes, as depicted by our STS numbers,”
says Jerome McDonald, MD, FACS, medical director of Sentara RMH
Cardiothoracic Surgery Services. “Our data show that our patients
consistently do better than what is expected nationally. People who
come to Sentara RMH for cardiac surgery can rest assured that we’re as
good as any other program in terms of quality, safety and low risk for
complications.”
A Second Chance at Life
Mike and Kathy recognize that the cardiac arrest, as
frightening as it was, had a positive effect. The event
uncovered the advanced coronary artery disease
Mike had—a condition that almost certainly would
have resulted in a life-threatening heart attack at
some point.
Since then, the couple has started traveling
more often to enjoy the additional time they have
together. So far they have been to Greece and
Mexico, and they’re planning a trip to Costa Rica
next year. They appreciate the fact that not only
did Mike survive, but he also didn’t experience any
mental deficiency, as had been projected by the
EMS workers.
Kathy notes the providential way in which
things seemed to fall into place to keep her husband alive.
“Just prior to this incident, we had been miles
away out in the country,” she says. “If the cardiac
arrest had happened out there, none of us could
have helped him because none of us knew CPR at
the time—although now we all do. And when it
Mike Lam with the police
officers who saved his life:
from left, Officer Amanda
Estep, Officer Jordan Pieniazek,
Chief Thomas King, and, far
right, Lieutenant Mark Argiro
happened in the restaurant, there just happened to be two
patrons there who did know CPR and started working on
Mike quickly. And the police who got there first just happened to have an AED in their car.”
The Lams are also thankful that they just happened to
have access to a cardiac surgeon with the skill and confidence to “fix” Mike.
“I got a second chance,” he says, “and I’m still trying
to figure out why.”
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35
STA
Ralph Sampson Sr.
Wins Cancer Battle
36 |
SUMMER 2016
TANDING
In May 2014, when Ralph Sampson Sr., of
Harrisonburg, began to experience severe
abdominal pain, he went to the Sentara
RMH Emergency Department, where it was
discovered he had a large hernia on his
right side, a smaller hernia on his left side
and some prostate problems. The prostate
issue turned out to be cancer. Though
that news was unwelcome, with excellent
medical care, his strong faith, and the
support of his family and friends,
Sampson Sr.’s journey to healing had
begun—not, however, without some
bumps in the road.
“They called me, so I came
home, and we started dealing
with the process,” says Ralph
Sampson Jr., who grew
up in Harrisonburg and
recently moved back
to Virginia.
His father, now 80, was
admitted to the hospital.
Sampson Jr., along with
his mother and two sisters,
helped his father with asking
questions, weighing treatment
options and making informed
healthcare decisions.
The first issue that needed immediate attention was Sampson Sr.’s
prostate problems, which were affecting his ability to urinate. At the
end of May, Marcus Morra, MD,
a urologist at Sentara RMH, performed a transurethral section of
his prostate.
“The procedure is similar
to coring out an apple,” says Dr.
Morra. “Upon follow-up, he was
able to urinate.”
Addressing a Series
of Health Issues
Tissue from that surgery was sent
to a pathologist, who confirmed
the presence of cancer. Dr. Morra
referred Sampson Sr. to the Sentara
RMH Hahn Cancer Center’s Radiation
Oncology Department. There, Heather
Morgan, MD, agreed that the cancer
could be treated with radiation, in combination with hormonal manipulation—
but not until after Sampson Sr.’s hernia
surgery, which had already been scheduled.
“Medication was used to reduce his
testosterone levels,” says Dr. Morra. “His
situation was a little different because of
the hernias, so the medication served as
an initial course of treatment, before the
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37
lung. His family now sees the fainting episode
as providential.
“We were blessed to have that happen because at that point, we didn’t know anything
about the lung,” says Sampson Jr. “My dad
had had pneumonia the year before, and
at that point no spot showed up on his
X-rays—so the spot must have appeared
within that ensuing year.”
With this new information, the Sampsons had to decide what to do next.
“After seeing a few physicians at Sentara
RMH, I decided to get a second opinion,”
says Sampson Jr. He took his father to another
medical facility, where a biopsy revealed that the
spot on the left lobe of his left lung was cancerous. The doctors recommended chemotherapy,
followed by surgery, so Sampson Sr. underwent
chemotherapy treatments every three weeks for
12 weeks, ending on Dec. 26, 2014.
Working Together
more definitive radiation therapy treatment
could begin.”
In June, Sampson Sr. underwent surgery
for the right hernia as an outpatient. The
surgery went well, but that night, as Sampson
Jr. was helping his father to his bedroom,
Sampson Sr. fainted.
“We didn’t know whether it was a heart
attack, a seizure, a stroke or what,” recalls
Sampson Jr. “He was coherent, but he wasn’t
all there.”
The family called 911, and the Harrisonburg Rescue Squad transported Sampson Sr.
to Sentara RMH. As it turned out, the fainting
was caused by dehydration.
In the process of trying to diagnose what
had happened, however, X-rays were taken—
and that’s when doctors discovered something unexpected: a spot on Sampson Sr.’s
38 |
SUMMER 2016
During this period, Sampson Sr.’s family was
taking good care of him. As a professional
athlete, Sampson Jr. had a strong interest
and background in nutrition and exercise,
as did his younger sister. With advice from
a Sentara RMH nutritionist, they began to
make healthy changes to Sampson Sr.’s diet,
and they started him on light exercise.
“We took a team approach,” says Sampson Jr. “My sister Joyce transferred her job
to Bridgewater, Va., to be closer. She helped
mom with cooking and everything. My other
sister, Valerie, made nutritious juice concoctions for Dad.” He adds, jokingly: “He may
not have liked some of them.”
Sampson Sr. had a tendency to get dehydrated, so his co-workers with the City of
Harrisonburg frequently reminded him to
drink water throughout the day.
“At the time he didn’t like drinking water,” says Sampson Jr. “Now he does. Everyone played a role in helping him maintain
his health, and those efforts helped me realize how important those people are to him.”
Sampson Sr. also received a lot of inspiration from his friends at work.
“They ask how I’m doing every morning,
or they’ll say something to make me laugh,”
he says. “We care about each other and about
what happens in each other’s lives.”
Sampson Jr. took charge of tracking
his father’s medical procedures. In order to understand what was happening,
he made charts that included every doctor appointment, every blood pressure
reading and every shot, putting it all
into a spreadsheet. He also kept track of
insurance information.
“I had everything in my hands,”
says Sampson Jr. “We were dealing with
doctors here and in Charlottesville. As
a caregiver, I just had to understand the
process in order to help make decisions.”
In the meantime, even while he was
getting chemotherapy treatments, Sampson Sr. was following his daily routine of
eating breakfast at L&S Diner, going to
work, spending time with his friends and
going to church. His son gives him tickets to University of Virginia basketball
games, which he would also enjoy attending with a few close buddies.
“In the process of going through it
all, I just leaned back because I believe
in God, my family, my kids and my
wife,” says Sampson Sr. “And my son,
I’m blessed with him—he means a lot
to me. And through the spirit of Christ
in my life, He gave me the strength to
keep going.”
Remarkably, Sampson Sr. took
off only two days of work during his
treatment, toward the end of his
chemotherapy.
“He’s a very strong man, and very
dedicated to what he thinks life should
be,” notes Sampson Jr.
A month after his last chemotherapy treatment, Sampson Sr. had surgery
to remove the left lobe of his left lung.
Following two months of recovery, he
returned to work and prepared for the
next stage of his journey.
Back to the Prostate
“Then we still had to tackle the prostate,” says Sampson Jr. “But we had to
deal with the other hernia first.”
As Sampson Sr. recovered from
surgery and treatments, his family began
A month
after his last
chemotherapy
treatment,
Sampson Sr.
had surgery
to remove the
left lobe of
his left lung.
Following two
months of
recovery, he
returned to
work and
prepared for
the next stage
of his journey.
mapping out a strategy to address the
remaining health issues. He had a
complete physical and had a cataract
removed. Then, in August 2015, about
a year after his first hernia operation,
Sampson Sr. underwent surgery on the
second hernia. He saw Dr. Morra and Dr.
Morgan again, and in November began
eight weeks of daily radiation treatments
for the prostate cancer. Dr. Morgan says
Sampson Jr. accompanied his dad to
most of his weekly check-ins with her.
“When I asked how he was feeling,
he would always say ‘Great!’” she recalls.
“So I’d turn to his son and say, ‘Is this
true?’ That’s pretty much how it went.”
The fatigue that often results from
radiation depends a lot on the patient’s
level of fitness, Dr. Morgan says. She
cites studies that show how patients who
exercise experience much less fatigue
than those who don’t, so she emphasizes
the importance of regular exercise with
her patients.
“He just breezed through radiation,” Dr. Morgan says. “You can’t keep
him down.”
Sampson Sr.’s job keeps him moving,
plus he was working out with weights at
home. Sampson Jr. took charge of planning his father’s physical activity.
“His son gave him very good advice
on nutrition and exercise, which makes
such a difference,” Dr. Morgan says.
“Many people don’t have those social
resources.”
Sampson Sr.’s friendly nature made
Dr. Morgan feel very much like a part of
his care team. But then, she cares about
all of her patients.
“I’m a cheerleader as well as a
doctor,” she says.
All Clear
Sampson Sr. last saw Dr. Morra for a
checkup in March 2016.
“From our standpoint, he was doing well,” Dr. Morra says. “He has clearly
benefited from all aspects of his medical treatments, and he has always been
grateful for our efforts on his behalf.”
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Cancer Care at Sentara RMH
At the Sentara RMH Hahn Cancer Center, our goal is to provide patients with the most
innovative, comprehensive care possible. Our highly skilled physicians and specialists
use advanced technology and treatment to better understand cancer, detect it earlier
and treat the disease effectively. Our areas of specialization include:
Breast cancer
Colorectal cancer
Head and neck cancer
Lung cancer
Prostate cancer
To learn more, visit Sentara.com or call 1-800-SENTARA.
Sampson Sr. says he feels good. He takes no
medications, just a few vitamins, and he’s keeping up
with his new, improved diet and exercise schedule.
He plans to retire soon, but he has no plans to sit in a
rocking chair—instead, he wants to do more volunteer work at the Boys and Girls Clubs of Harrisonburg. As a trained watercolor artist, he wants to teach
painting to the young people there.
“They need help,” says Sampson Sr. “Some kids
don’t receive love from their parents at home. I had
love from my parents, and we showed love to our kids.”
Painting, he says, helps him “more than Advil.”
Sampson Sr. also studied voice for more than
two years. He sings gospel music at weddings and
funerals, and plans to continue. He relies on singing
to help with his physical strength and to keep his
mind focused.
“When you lie around thinking about yourself
… well, you just feel better when you’re doing other
things,” he remarks.
As for Sampson Jr., he says he learned a lot over the
past two years.
“I’d never dealt with anyone this close to me having
medical problems,” he says. “I must have asked the doctors about 50 million questions.”
Relatives of Sampson Jr., including a cousin who’s
had a stroke, are now calling on him to accompany
them to doctor visits.
“I find it interesting, from a healthcare standpoint,
to learn how to keep people healthy,” he says.
Sampson Jr. plans to make sure his father goes for
follow-up appointments with Dr. Morra, his primary
care physician and other doctors involved in his care.
He has become an advocate of regular checkups and
healthcare screenings.
“I’m not my dad, so I’m not feeling what he’s feeling,” says Sampson Jr. “The only way I can tell is for him
to get things checked on a regular basis. If you don’t get
things checked, you might have multiple issues to deal
with down the road.”
Gift to Establish the
Ralph L. Sampson Sr. Hope Fund
In gratitude for the effective cancer treatment his father received while a
patient at the Sentara RMH Hahn Cancer Center, Ralph Sampson Jr. has made
a $50,000 gift to the RMH Foundation. The gift will establish the Ralph L.
Sampson Sr. Hope Fund. The Hope Fund will provide assistance to patients with
a cancer diagnosis who need financial help in obtaining their treatments.
Specifically, the Hope Fund will help provide preventive screenings for
those without insurance to pay for them, medications for cancer patients when
they leave the hospital who cannot afford them, and transportation for those
individuals who require cancer treatment but have no means of getting to the
Hahn Cancer Center.
“We are so grateful for the Sampson family’s generosity,” commented
Cory Davies, RMH Foundation Executive Director. “This thoughtful gift
will enable a strategic approach to bring hope and healing to those in our
community who need it most.”
Those who wish to contribute to the Ralph L. Sampson Sr. Hope Fund
may contact the RMH Foundation at 540-564-7222 or visit us online at www.
SupportRMH.org.
AG ING WELL
Lung Cancer
CT Screening
Saves Lives
Early Detection Is Key to a Positive Outcome
Charlotte
Hoover
bout eight years ago, after
being a smoker for nearly three
decades, Charlotte Hoover finally
kicked the smoking habit. A
little over a year ago, when she began
experiencing shortness of breath, she
attributed the problem to her chronic
obstructive pulmonary disease (COPD).
When she mentioned the symptom
to her family doctor, however, her
physician suspected that something
else might be causing the problem.
Aware of Charlotte’s history as a smoker,
her doctor recommended that she have
a lung cancer screening at Sentara RMH
Medical Center.
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41
AG ING WELL
In early 2015, Charlotte went
to Sentara RMH for a low-dose
computed tomography (CT)
scan lung screening. The scan
revealed a small spot on her right
lung, and Charlotte was diagnosed with stage 2 lung cancer.
She underwent surgery to remove
the nodule in April 2015 and
subsequently underwent four
months of chemotherapy. She is
now living cancer-free.
“It was kind of surreal when
they called and said I had cancer,” says Charlotte, 67, of Mt.
Clinton. “I was impressed with
Sentara RMH. They jumped on it
right away, and they’re still monitoring me. I’m just thankful the
disease was caught early, before it
metastasized and spread to other
organs. I definitely recommend
that current or former smokers
get the screening—it was very
simple and wasn’t stressful at all.”
Both hospitals in the Sentara
Blue Ridge Region, RMH and
Martha Jefferson, offer low-dose
CT scan lung screening for the
early detection of lung cancer—
the best hope for successful treatment and survival of the disease.
Sentara RMH began offering
lung cancer screening two years
ago, and Sentara Martha Jefferson has been offering the service
for more than a decade, performing more lung cancer screenings
than any of the 11 other hospitals
in the Sentara Healthcare system.
The Best Prevention for Lung
Cancer: Don’t Smoke!
Smoking raises your risk for lung
cancer and numerous other
health problems. The best way to
prevent lung cancer is never to start
smoking—or to quit, if you do smoke.
Cigarettes and other tobacco products can be
highly addictive. If you’re struggling to quit, talk to
your doctor or visit www.sentara.com for smokingcessation information.
CT lung scan
showing cancer
(arrows)
The Deadliest Cancer
According to the American Cancer Society (ACS), lung cancer is
the leading cause of cancer-related
deaths in the United States, claiming more lives each year than
breast, prostate and colon cancer
combined. Over the next year,
nearly 250,000 Americans will be
diagnosed with lung cancer, and
nearly 160,000 of those diagnosed
will die from the disease.
Most patients do not experience the symptoms of lung
cancer—persistent cough, shortness of breath or coughing up
blood—until the disease has progressed to advanced stages. However, the prognosis for patients
like Charlotte who are diagnosed
at an early stage is good.
“By the time lung cancer
manifests itself, it typically
will have grown and spread to
the point where it can be very
difficult, if not impossible, to
treat,” says Sentara RMH radiologist Matthew Blurton, MD.
“In fact, eight out of 10 lung
cancers are diagnosed at this late
stage—that’s why lung cancer is
considered by most experts to
be one of the deadliest forms of
cancer. Our goal with lung cancer
screening is to find tumors early,
while they are still small, before
they cause symptoms and begin
to spread. Finding them early
significantly increases the chance
for a complete cure.”
ACS guidelines recommend
lung cancer screenings for patients
between the ages of 55 and 74 who
are current or former smokers with
a 30-pack-year smoking history
(meaning, for example, that they
smoked one pack a day for 30 years
or two packs a day for 15 years).
The guidelines are based on
the National Lung Screening Trial,
which followed more than 50,000
smokers and former smokers. The
study found that patients who were
screened with a low-dose CT scan
reduced their risk of death from
lung cancer by 20 percent.
“These screenings are going
to make a big difference in our
communities,” says Sentara Martha Jefferson radiologist Jonathan
Ciambotti, MD. “If you look at all
cancer survival rates over the last
20 years, medical science has made
progress in treatments, particularly
for breast, prostate and colon cancers. The one cancer we have not
had any effect on over the last 20
years, despite our advances in chemotherapy and other treatments, is
lung cancer. Lung cancer mortality
has not changed in more than 20
years, but this one inexpensive test
will have a dramatic positive effect.”
For Dr. Blurton, being able to
offer lung cancer screenings brings
personal satisfaction.
Getting the Screening
“Lung cancer affects us all,
either directly or indirectly,” says
Dr. Blurton. “In the U.S. alone,
more than 400 people die every
day from lung cancer. My own
grandfather died of lung cancer 25 years ago. This is a personal fight for all of us. Although
screening doesn’t guarantee that
a patient won’t die of lung cancer,
it will significantly improve his or
her chance for survival. The more
patients we scan, the more lives
we will save. It’s a great service for
the community.”
A Simple, Safe Test
The low-dose CT lung cancer
screening scan takes about 10 seconds, and patients can expect the
whole process—from registration
through completion of the test—
to take 15-20 minutes. Results are
typically available within five business days. If any abnormalities are
detected, the patient’s physician
will discuss next steps for additional testing or treatments.
“From the patient’s perspective, the screening test is the
easiest thing he or she will ever
have done in a healthcare facility,” says Dr. Ciambotti. “You go
into the hospital, lie down on
the CT table, hold your breath
for about 15 seconds, and then
you’re done. There are no
needles, and there’s no prodding. It’s that simple.”
Patient safety is a high priority at all Sentara facilities, so
both Sentara RMH and Sentara
Martha Jefferson administer the
screenings using a minimal dose
of radiation. Radiation exposure
is measured in units called millisieverts, Dr. Ciambotti explains.
A regular CT scan of the chest
exposes the body to about 5 millisieverts, while the low-dose CT
screenings use 0.5-1 millisieverts
of radiation.
“The guidelines call for less
than 3 millisieverts, and most of
our patients receive less than
1 millisievert,” Dr. Ciambotti
adds. “So the radiation exposure
is minimal, and well below the
national guidelines.”
Many insurance companies cover low-dose
CT screening at no cost to the patient. Many
healthcare insurers and Medicare, however, may
have their own eligibility guidelines, in addition
to those of the American Cancer Society. If you are
interested in the screening, start by consulting
your primary care doctor. Embracing Life
For more information or to schedule a low-dose CT
lung cancer screening, contact:
For 40 years, Charles Hoffman,
of Charlottesville, smoked about
one pack of cigarettes a day. He
finally quit in the early 2000s and
at the time was still feeling great.
Based on Hoffman’s long smoking history, however, his primary
care doctor recommended that
Hoffman have the low-dose CT
scan lung cancer screening at
Sentara Martha Jefferson.
Even though Hoffman had
no symptoms of lung cancer,
he agreed to go through with
the screening. The CT scan,
performed in December 2015,
showed nodules on one portion
of his lung, and in January 2016
he was diagnosed with stage 1
lung cancer.
“I had no cough, nothing to
tell me I had a problem,” Hoffman says. “The news hit me like
a ton of bricks. I never thought
I would have cancer.”
A few weeks after his diagnoCharles Hoffman
• Sentara Martha Jefferson Hospital in
Charlottesville, at 434-654-4487
• Sentara RMH Medical Center in Harrisonburg,
at 844-327-5939
sis, Hoffman underwent surgery
to remove two tumors and a small
portion of his lung. Thanks to
the success of the procedure, he
needed no further treatments and
is now cancer-free. He and his wife
are looking forward to celebrating
their 50th wedding anniversary later
this year.
“The operation went well, and
my recovery is going great,” says
Hoffman, who can’t wait to rejoin
his hiking group in the near future.
“I recommend that anyone who was
a previous smoker get checked out.
I feel blessed that the screening
program was available to detect my
lung cancer early, enabling me to
be completely cured.”
HEALTH MATTERS
Protect Yourself from
Skin Cancer
Identifying Skin Cancer
kin cancer is the most
common form of cancer, yet it’s one many
people don’t take seriously enough, especially when
they go out into the sun.
Skin cancer affects people
of all ages and skin types. The
risk of skin cancer rises with age,
but young people also get skin
cancer. People with light skin are
more at risk, but skin cancer also
occurs in people with darker skin,
including African Americans.
About one in five Americans will
develop skin cancer in their lifetime, according to the American
Academy of Dermatology.
The major risk for developing skin cancer is exposure to the
ultraviolet (UV) rays of sunlight,
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SUMMER 2016
tanning beds and sunlamps. The
UV rays damage the DNA in skin
cells, and this damage can result
in cancer. The more a person is
exposed to UV radiation—no
matter what the source—the
higher the risk for skin cancer.
Prevention Tips
•
Avoid the sun between 10
a.m. and 4 p.m.
• Don’t use tanning beds or
sunlamps.
• Use sunscreen with an SPF
(sun protection factor) of
15 or higher; apply 30 minutes before going in the sun,
and reapply according to
directions.
• Wear long sleeves, long
pants and a hat when you’re
exposed to sun for longer
periods.
Skin cancer can have various
colors, sizes and shapes. The
most common types are basal cell
cancer, squamous cell cancer, and
melanoma.
Basal cell cancers and
squamous cell cancers typically
occur in parts of the body that
receive a lot of sun, such as the
neck, arms, face and head, but
they can be found on any part of
the body. They typically appear
as new spots, bumps or patches
on the skin, or as a sore that will
not heal.
Common sites for melanoma
include the legs, chest and back.
In people with dark skin, melanoma often appears on the palms
of the hands, the soles of the feet
or under the nails. Melanoma
typically appears as a new spot on
the skin or as an already existing spot, or mole, that begins to
change in color, size or shape. A
new spot that looks different from
other spots on the skin should be
watched carefully.
Stay Watchful
Skin cancer is highly curable if it’s
caught early, when the cancer is
small and has not spread.
The American Academy
of Dermatology recommends
monthly self-examinations of your
skin to check for new or changing spots. Report any suspicious
or concerning changes to your
doctor. In addition, have a dermatologist examine your skin at least
once a year.
LA SALUD IMPORTA
Protéjase del
cáncer de piel
l cáncer de piel es la
forma más común de
cáncer, pero no son
muchas las personas
que lo toman en serio,
especialmente cuando
exponen al sol.
El cáncer de piel afecta a personas de todas las edades y tipos
de piel. El riesgo de cáncer de
piel aumenta con la edad, pero
las personas jóvenes también
pueden padecer de cáncer de
piel. Las personas de piel clara
tienen mayor riesgo, pero las
personas de piel más oscura también pueden padecer de cáncer
de piel, incluso los americanos
africanos. Según la Academia
Americana de Dermatología,
aproximadamente uno de cada
cinco estadounidenses desarrollará cáncer de piel en su vida.
Al exponerse a los rayos
ultravioletas (UV) del sol, a las
camas de bronceado y lámparas
solares, aumenta el riesgo de
desarrollar cáncer de piel. Los
rayos UV dañan el ADN de las
células de la piel, y este daño puede resultar en cáncer. Cuanto
más una persona se exponga a
la radiación UV, no importa la
fuente, mayor será el riesgo de
cáncer de piel.
Sugerencias de prevención
• Evite exponerse al sol desde
las 10:00 a.m. a las 4:00 p.m.
• No use camas de bronceado
o lámparas solares.
• Use protector solar con un
FPS (factor de protección
solar) de 15 o más; aplicarlo
30 minutos antes de salir al
sol y vuelva a aplicar según
las indicaciones.
• Vístase con camisas manga
larga, pantalones largos y
un sombrero, cuando deba
exponerse al sol por períodos largos.
Identificación del cáncer de piel
El cáncer de piel puede tener
varios colores, tamaños y formas.
Los tipos más comunes son el
cáncer basocelular, escamocelular y melanoma.
Los cánceres de células
basales y los cánceres de células
escamosas aparecen usualmente
en las partes del cuerpo que
reciben mucho sol, como el
cuello, los brazos, la cara y la
cabeza, pero puede encontrarse
en cualquier parte del cuerpo.
Usualmente, aparecen como
manchas nuevas, protuberancias
o manchas en la piel, o como
una úlcera que no se cura.
Los sitios comunes para el
melanoma incluyen las piernas,
el pecho y la espalda. En personas con piel oscura, el melanoma aparece a menudo en las
palmas de las manos, las plantas
de los pies o debajo de las uñas.
Por lo general, el melanoma
aparece como una mancha
nueva o que ya existía en la piel,
o como un lunar, que comienza
a cambiar de color, tamaño o
forma. Una mancha nueva que
se ve diferente de otras manchas
en la piel debe ser vigilada cuidadosamente.
Manténgase atento
Si se detecta a tiempo, el cáncer
de piel es fácilmente curable
cuando el cáncer es pequeño y
no se ha diseminado.
La Academia Americana de
Dermatología recomienda el
autoexamen mensual de la piel
para detectar manchas nuevas o
cambiantes. Reporte a su médico cualquier cambio sospechoso
o preocupante. Además, vea
a un dermatólogo para que le
examine la piel al menos una
vez al año.
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WOMEN’S HEALTH
F
A Sacred Birth
for Every Baby
or new parents-to-be, awaiting the birth of a child can bring about all sorts of emotions,
accompanied by countless questions and a need to plan for the future—both short- and
long-term. One of the most crucial decisions to be made is the type of birth the motherto-be and her partner want. Understanding the importance this decision has for most
expectant women, the birthing teams at both Sentara Martha Jefferson Hospital and
Sentara RMH Medical Center aspire to create an exceptional birthing experience for every
patient from the very beginning.
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SUMMER 2016
IT’S AN HONOR
Childbirth Education
AND A PRIVILEGE
TO BE ABLE TO
Since preparing for childbirth is
SHARE ONE OF THE
such an important part of each new
MOST MEMORABLE
parent’s journey, Sentara Martha
EVENTS IN LIFE WITH
Jefferson and Sentara RMH offer a
variety of birth-related classes.
FAMILIES IN OUR
At Sentara Martha Jefferson,
COMMUNITY.
available classes include Preparation
for Childbirth, Basics in Baby Care,
and Family Care. The classes are led
by qualified instructors, and some are held in
group sessions, allowing expectant parents to
connect with others who may share some of
their questions and concerns.
Randi Derden, a recent patient at the
Sentara Martha Jefferson Labor and Delivery unit, found the Preparation for Childbirth class she attended to be tremendously
helpful. “It made me feel empowered and
prepared, instead of anxious and scared,”
Derden says. “After taking the class, I felt
mentally ready for childbirth.”
Similar classes are offered at Sentara
RMH, and both hospitals offer tours of the
birthing rooms, enabling expectant parents
to familiarize themselves with where they will
be throughout the labor and delivery process. Also, an annual Family Fair organized
by the Sentara RMH Family Birthplace gives
expectant parents an opportunity to see up
close the amenities and programs offered at
Sentara RMH to support women, infants and
new families.
“We understand how life-changing having
a baby is,” says Sabrina Shiflett, RN, director
of the Sentara RMH Family Birthplace. “It’s
an honor and a privilege to be able to share
one of the most memorable events in life
with families in our community.”
By participating in these programs,
parents can feel less apprehensive about, and
more in control of, their birthing experience.
“Our goal is to provide parents with
the birthing experience they desire,
which can be different for every patient,”
says Shiflett. “Our exceptional nurses
and physicians aim to accommodate
birth preferences as much as possible.”
It’s very important to the staff
members of both hospitals to make the
birthing experience one that’s both
individualized and sacred, each and
every time.
Individualized Care
Since births don’t necessarily follow a predetermined formula, the birthing teams at Sentara Martha Jefferson and Sentara RMH provide
individualized care, based on the status of the
mother when she arrives for the birth.
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WOMEN’S HEALTH
“Every birth is sacred, and we respect that sacredness,” says Mary Ann Lucia, labor and delivery
clinical manager at Sentara Martha Jefferson. “It’s
not just another birth—it’s their birth.”
Both birthing centers offer personalized labor
support to every patient, based on individual
medical needs and specific requests. Amenities
such as birthing balls, Jacuzzis, warm lighting and
temperature control offer “special touches” to
help comfort expectant parents during the delivery process.
Women who are at low risk for complications
are encouraged to eat, drink and be mobile during labor. Each hospital embraces a low-intervention birthing philosophy for low-risk women. If
medical intervention becomes necessary during
labor and delivery, the staff tries to maintain as
much of a sense as normalcy as possible.
“My nurses and doctors were so supportive
and understanding throughout the whole process,” recalls Derden. “I never felt pressured to
make a certain decision—they always made me
feel comfortable and in control.”
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SUMMER 2016
Skin to Skin
One thing that can make a birth special
is the immediate skin-to-skin contact a
mother and her baby experience. Evidence shows that babies who are stable at
birth, when placed on their mother’s skin
and left there for at least one to two hours,
display signs of a positive, natural physiological transition that benefits their heart
rate, blood sugar and temperature.
“The goal is to place the baby on the
mom for skin-to-skin contact for at least
one hour, known as ‘the golden hour,’”
says Sharon Fickley, staff development
educator at Sentara Martha Jefferson.
“This contact is beneficial as babies
move through their natural transition
from womb to world. We’ve also worked
diligently to make skin-to-skin contact a
practice in the operating room for our
cesarean births, whenever possible.”
Currently, babies delivered via cesarean birth are placed on their mother’s skin
for 15 minutes, if both mother and baby
are stable. “For women giving cesarean
birth, we still acknowledge and embrace
that they are giving birth,” says Fickley.
“They’re not just having a surgical procedure—it’s still their birth.”
Both hospitals also support exclusive
breast milk feeding, offering continuous
lactation support for breastfeeding mothers through full-time lactation consultants
and a wide range of educational and training opportunities.
OUR TEAMS
An Extraordinary Experience
ARE FOCUSED
Through educational programs, amenities and superior care, Sentara Martha
Jefferson and Sentara RMH are devoted
to ensuring that the birthing experience
is both personalized and sacred for every
patient.
“We want to help women look back on
their labor with satisfaction and know that
giving birth is the most amazing thing that
will ever happen to them,” says Fickley.
“Our teams are focused on providing a
ON PROVIDING
A NURTURING
ENVIRONMENT
FOR
EXPECTANT
PARENTS
AND THEIR
FAMILIES.”
nurturing environment for expectant
parents and their families.”
Reflecting on her own labor and
delivery experience, Derden notes, “It
was exactly the way I wanted it to be,
a special experience that I reflect on
often. Having a healthy baby is the ultimate aim, of course, but all the added
touches helped to make my birthing
experience even more special.”
For additional information about
birthing services offered at Sentara
Martha Jefferson or Sentara RMH,
visit www.sentara.com or call
1-800-SENTARA.
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49
SENTA R A IN THE COMMUNITY
Celebrating Five Years
as Sentara
Reflecting on the Benefits of Being
Part of Something Bigger
Sentara Martha Jefferson
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SUMMER 2016
Sentara RMH
Anniversaries are a time to celebrate and
to reflect on where we’ve come from and
where we’re headed. This past May and June,
Sentara RMH Medical Center in Harrisonburg
and Sentara Martha Jefferson Hospital in
Charlottesville reached, respectively, their
five-year anniversaries since partnering
with Sentara Healthcare.
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51
SENTA R A IN THE COM M U N I T Y
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SUMMER 2016
or both hospitals, those
five years have been a period of
extensive change, new process
implementation and enhanced
collaboration. Now that the
integration of the Blue Ridge
Region’s two hospitals into the Sentara
system is nearing completion, however,
team members at Sentara RMH and
Sentara Martha Jefferson are looking
forward to achieving even greater
enhancements in patient care—not only
together within the region, but also with
their sister hospitals across the system.
The Impact of the Merger on Nurses
and Patient Care
Before joining Sentara, each Blue Ridge Region hospital already had a long history of providing safe, efficient, high-quality health care
for its patients. During their past five years as
Sentara hospitals, Sentara Martha Jefferson
and Sentara RMH have strengthened and
enhanced their traditions of excellent patient
care, as their staffs have worked diligently with
Sentara to integrate each hospital fully within
the system.
“Sentara has the same focus on safety and
quality that Sentara RMH had before integration,” says Patra Reed, MSN, RN, CNML,
director of clinical excellence and patient
transitions for Sentara RMH. “Our integration
with Sentara has helped us continue striving
for improved patient outcomes. We now have
many sister hospitals—including our closest
sister, Sentara Martha Jefferson—with whom
we can share best practices, solve problems,
and focus together on achieving top-level quality care and outcomes.”
This collaboration among Sentara hospitals has been especially fruitful for nurses.
“The camaraderie, networking and sharing
among peers has created a synergy that has
produced very meaningful results,” says Abby
Denby, MSN, RN, NE-BC, director of patient
care services at Sentara Martha Jefferson.
“We’re able to use best practices from other
Sentara hospitals, and that has helped us implement ongoing clinical quality improvements.
For instance, recently Sentara Martha Jefferson received a top-level score of ‘A’ from the
Leapfrog Group for the hospital’s patient safety
initiatives. We also received our third Magnet
designation, and Sentara RMH received its first
Magnet designation.”
The Blue Ridge Region hospitals have
adopted a number of patient care best practices
from other Sentara hospitals, with promising
results. One such practice is complex case
review, a process in which caregivers analyze
and plan the transition of care for patients
with complex health issues who are transitioning from the hospital to home, or to a nursing
home or assisted-living facility. A second practice is conducting simulations during nursing
orientation, during which new nurses—especially those hired right out of school and those
transitioning into a new area of nursing—are
able to practice certain nursing skills in a simulated patient-care environment before working
with real patients.
“Simulation helps our nurses coalesce as a
team, as newer nurses, or those transitioning
into a new area of nursing practice, are mentored by their peers,” says Reed.
Another important way in which Blue
Ridge Region nurses benefit from the integration with Sentara is through enhanced opportunities to further their nursing education.
Both Sentara Martha Jefferson and Sentara
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SENTA R A IN THE COM M U N I T Y
RMH have always put a premium on nursing
education, but in today’s healthcare environment, continuing education and specialized
training are more important than ever for
achieving successful patient outcomes. With
Sentara’s support, the Blue Ridge hospitals
enjoy even greater opportunities for tuition
reimbursement to help nurses return to
school, as well as enhanced programs to
assist with specialty training and nursing
certifications.
“Opportunities for nurses to take advantage of continuing education and professional
development courses have increased significantly for staff of the Blue Ridge Region, due
to the vast offerings from the Sentara system,”
says Denby.
One of the newest educational opportunities for Blue Ridge nurses is the recent
development and implementation, with
support from Sentara, of a nurse residency
program for new registered nurse graduates.
Nurse residency programs provide novice
nurses with additional mentoring to transition
them from “textbook nursing” to the level of
professional competence hospitals need from
nurses practicing at the bedside.
“Having highly educated and highly
skilled nurses is key to enhanced patient
outcomes and safer, more effective care,”
adds Denby. “The premium our Blue Ridge
hospitals place on hiring and retaining highly
educated, skilled nurses aligns us squarely
with Sentara’s commitment to providing safe,
high-quality care.”
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SUMMER 2016
Sharing Goes Both Ways
Clinical benefits and enhancements also flow
from the Blue Ridge hospitals to the larger
Sentara system. One best practice that originated in the Blue Ridge Region is a bedside
scanning process for blood transfusions and
the collection of lab specimens. These products are labeled with bar codes and scanned
at the patient’s bedside, then checked against
the patient’s identification bar code and
medical records to ensure that patients are
receiving the appropriate blood type and the
correct lab results—not those intended for
another patient.
Another Blue Ridge best practice now
making a life-saving difference across the
system is the treatment of central lines, which
are special catheters or tubes inserted into
the body to access the venous system. Central
lines are placed in patients for a number of
reasons, including monitoring cardiac output
or providing medications directly into the
blood stream. A potential problem, however,
is that central lines increase the risk of infection, and central line-associated bloodstream
infections, or CLABSIs, are serious complications that can prolong a patient’s hospital stay
or result in death.
“Because Sentara RMH and Sentara Martha Jefferson had some of the lowest CLABSI
rates within the system, their processes for
handling central lines have been adopted
throughout all Sentara hospitals,” says Reed.
“What has made our affiliation so ideal is
that we share the same values, dedication and
“OUR FOCUS HAS
ALWAYS BEEN—
AND ALWAYS WILL
BE—ON DOING
WHAT’S BEST FOR
OUR PATIENTS.
commitment to quality and excellence,” says
Howard Kern, president and CEO of Sentara
Healthcare. “The value proposition from being
a part of Sentara is that we can learn from each
other and share best practices. This is integral
to providing quality care for our patients. Our
Blue Ridge hospitals have provided great clinical quality for many years, and we knew there
would be plenty of opportunity to exchange
best practices and learn across our system.”
Further Reasons to Celebrate
Integration with Sentara also has meant that
Sentara RMH and Sentara Martha Jefferson
are able to enjoy the benefits of Epic, a highly
rated clinical documentation system that captures, stores and retrieves all patient information, whether generated during a hospital visit
or in a Sentara outpatient setting. Were it not
for integration with Sentara, neither hospital
would have been able to have access to Epic.
“The Epic business model does not
include smaller, independent hospitals,” says
Tami Duggan, ambulatory product manager
for Sentara Blue Ridge. “Epic is widely regarded as the best clinical documentation system in
health care today, and Sentara has developed
robust functionality using Epic tools. By virtue
of being part of a large, integrated healthcare
system, the hospitals and medical group practices are able to take advantage of having one
Epic medical record for each patient.”
A Magnet for Excellent Care
The American Nurses Credentialing Center (ANCC), a subsidiary of the
American Nurses Association, promotes nursing excellence through its
credentialing and other accreditation programs. Chief among these is the
ANCC’s Magnet Recognition Program®, which recognizes hospitals for
quality patient care, nursing excellence and innovations in professional
nursing practice. Magnet status is granted for a period of four years, after
which the designation must be renewed.
“Magnet designation is the highest, most prestigious credential a
healthcare organization can achieve for nursing excellence and quality
patient care,” says Lesley Cook, MSN, RN, NE-BC, regional director of nursing
excellence and the Magnet Program director for both Sentara Martha
Jefferson and Sentara RMH.
Sentara Martha Jefferson had already achieved its initial Magnet designation before integrating with Sentara, and the hospital has applied for its
third redesignation in 2016, Cook notes. Likewise, Sentara RMH had already
begun its “Magnet journey” before integrating with Sentara, achieving its
first Magnet designation in December 2014. Six of the 12 Sentara hospitals
currently have Magnet status.
“Magnet designation is very focused on outcomes, so we have to
achieve certain benchmarks and outcomes to maintain our status,” Cook
says. “Sentara is also very focused on outcomes and is always striving to
improve clinical performance, so Sentara’s culture of safety and quality
aligns very well with Magnet expectations.”
Cook notes that the performance-based, outcome-driven approach of
the Magnet program brings external prestige and wide-ranging internal
benefits, such as improved patient safety, higher nurse satisfaction and retention, and superior patient outcomes. “Patients can be assured that they will
receive the highest-quality care in a Magnet-designated hospital,” she says.
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55
SENTA R A IN THE COM M U N I T Y
Sentara RMH went live with
Epic in April, and Sentara Martha
Jefferson is scheduled to come
online with Epic in late September. Implementation of the system
at each hospital is the final stage
in completing the integration
process with Sentara.
Merging with Sentara also has given both
hospitals access to low-cost capital, enabling each
to expand infrastructure and bring on board new
services much sooner than would have been possible without Sentara’s financial assistance.
In terms of new infrastructure, Sentara
Martha Jefferson has been able to build a new,
free-standing emergency facility at Proffit Road
in Charlottesville, as well as a new helipad at the
main hospital on Pantops, helping to provide
greater regional access to its services. At Sentara
RMH, buildings constructed with the assistance of
Sentara capital include a new women’s center and
a new orthopedics and advanced imaging center,
both located on the main health campus, as well
as a new primary care facility in Timberville.
With regard to new services across the Blue
Ridge Region, both hospitals now offer 3-D mammography. In addition, Sentara Martha Jefferson
offers the advanced 3T magnetic resonance
imaging (MRI) system, which will also be coming to the new Sentara RMH orthopedic center. And Sentara Martha Jefferson has recently
added neurointerventional radiology services for
the treatment of brain aneurysm and stroke, a
service that will also benefit Sentara RMH stroke
patients, who can be airlifted to Sentara Martha
Jefferson for interventional treatment.
“The benefit of having an integrated delivery
system—doctor practices, ambulatory services,
hospitals, long-term care and a health plan—as
a part of the Sentara family is that we are able to
provide tangible value to the communities we
serve,” says Kern. “This value can be measured
as better quality of care, better patient/customer
experience and lower costs. Creating better access
to services for our patients and added healthcare
offerings helps us extend our mission to improve
health every day. In particular, I’m happy we’ve
been able to add more primary care, urgent and
emergency options, and provide a quicker means
of transportation for critical patients between
Sentara RMH and Sentara Martha Jefferson.
56 |
SUMMER 2016
I am also pleased to see the expansion of cardiac,
cancer and orthopedic service lines, as well as
expanded care for women.”
The Focus is Always on Patients
As both Blue Ridge Region hospitals celebrate
five years together as part of the larger Sentara
system, they can look to the future with greater
confidence, knowing they occupy a stronger,
more stable position in today’s challenging
healthcare environment. From a strictly business
and fiscal perspective, the merger of the two Blue
Ridge Region hospitals with Sentara made a lot of
sense. For example, both hospitals can now purchase supplies and medications in bulk with other
Sentara hospitals, enabling them to save on costs
via economies of scale. Those savings are then
passed on to patients or invested in new leadingedge technologies.
While those advantages are significant,
greater efficiency and cost savings are far from
the most important factors behind all the changes
that have taken place these past five years. Hospitals exist to care for patients, and the patients
served by Sentara Martha Jefferson and Sentara
RMH truly have gained the most from the mergers. Our focus has always been—and always will
be—on doing what’s best for our patients, and on
providing the safest, highest-quality care possible.
Sentara Healthcare at a Glance
Established in 1888, headquartered in Hampton, Va.
• Includes more than 27,000 staff members and more than
1,000 physicians and advanced practice clinicians
• Provided $335,510,000 in community benefits in 2015
• Was first in the nation to pioneer eICU®, a remote
monitoring system for intensive care
• Performed the first open-heart surgery and the first heart
and kidney transplants in the Hampton Roads area
Volunteers and
staff gather for a
daily huddle before
serving patients.
Compassionate Care.
Extraordinary People.
Harrisonburg-Rockingham Free Clinic Celebrates
a Quarter-Century of Community Service
For 25 years, the Free Clinic has been a haven for many residents of Harrisonburg
and Rockingham County. The clinic’s mission statement best describes its role in the
community: “to provide affordable, sustainable healthcare services for low-income and
uninsured adults, primarily through volunteer resources and community support.”
Located in the heart of downtown Harrisonburg, the
Free Clinic annually sees about 1,000 patients, provides more
than 4,500 healthcare appointments and dispenses more than
25,000 30-day prescriptions valued at $3.2 million.
All those services are made possible through generous
support from organizations and individuals throughout the
community. Because it is largely staffed by volunteers, the
Free Clinic is able to provide $7 in direct medical services for
every $1 it receives in contributions. More than 84 percent of
the Free Clinic’s funding comes from the community;
the other 16 percent is provided by the commonwealth
of Virginia. The Free Clinic receives no federal support
of any kind.
Partners in Health Care
One of the Free Clinic’s largest partners and benefactors over the years has been Sentara RMH and the
RMH Foundation.
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57
THE FREE CLINIC
AT A GLANCE
“The hospital has been a huge
contributor of in-kind services,” says
Keith Gnagey, executive director
of the Free Clinic. “Sentara RMH
provides lab testing and supplies, as
well as diagnostic testing and physical therapy services, just to name a
few. We absolutely could not offer the
services our patients need without the
hospital’s generous support. Thanks to
Sentara RMH support, many of our
chronically ill patients can be medically managed here, preventing many
unnecessary visits to the hospital’s
Emergency Department.”
Many of the medications the
Free Clinic dispenses through its
in-house pharmacy are donated by
drug companies. For some medications, however, the Sentara RMH
pharmacy allows the Free Clinic’s
pharmacy to make purchases through
the hospital, in order to take advantage of bulk-rate purchasing. The
clinic then submits a grant request to
the RMH Foundation to cover the
cost of those medications.
“We could not have done what
we have over the years, helping thousands of area residents, if it were not
for Sentara RMH,” Gnagey says.
58 |
SUMMER 2016
25 West Water St., Harrisonburg
540-433-5431
www.hrfreeclinic.org
Services Offered:
• Healthcare clinics
specializing in the treatment
of chronic illnesses like
arthritis, diabetes, heart
disease, high blood pressure
and respiratory disease
• On-site specialty
clinics, including ENT,
gastroenterology,
gynecology, nephrology and
rheumatology
• Behavioral health counseling
• Dental extraction referrals
A Community Commitment
by Sentara
Five years ago, when RMH partnered with Sentara Healthcare, Sentara leaders presented the Free Clinic
with a $500,000 donation during
the official signing ceremony at the
hospital, to signal Sentara’s support
for this vital community service.
The Free Clinic invested the money
through The Community Foundation and used the interest it drew
from that investment to fund major
information technology restructuring
at the clinic.
“That donation allowed us to
implement electronic health records
by providing the infrastructure needed,” explains Baker Garber, director
of development for the Free Clinic.
“The purchase of new computers and
portable workstations took us to a
whole new level in terms of our ability
to provide care. Moving to electronic
medical records also has allowed us
to open up additional appointment
times. We can even log in and get lab
results easily from Sentara RMH, and
we can run reports to see how well
patients are responding to their medical care. The infrastructure investment
has yielded huge improvements for
both our staff and our patients!”
Volunteers: the Heart
of the Free Clinic
Even with the community’s financial
and in-kind support, the work of the
Free Clinic would not be possible
without the generous and dedicated
volunteers. Although the clinic does
have a small number of paid staff
members, the majority of those who
provide clinical and nonclinical
services in the Free Clinic volunteer
their time and talents. Volunteers
include physicians, nurses, nurse
practitioners, nursing students, lab
techs, pharmacy staff, and clerical
and front office staff.
For the volunteers, knowing they’re making a difference is
payment enough. “The Free Clinic
provides me with the opportunity to
make a positive and healthy impact
on everyone who walks through the
doors,” says one volunteer. “Patients
often mention to me that it’s the
little things in life that count, and
having someone there to listen to
their needs and concerns means the
world to them. Providing patients
with community resources to help
them navigate their day-to-day lives
brings me great joy.”
In addition to those who provide
services in the clinic, 18 community
members volunteer time to serve on
the Free Clinic’s board of directors.
They provide oversight “for everything from clinical to financial to
resource development—and more,”
Gnagey says.
“Serving on the board of directors provides an opportunity to work
alongside dedicated volunteers and
staff in carrying out our mission, as
well as providing a direct avenue to
advocate for the work of the Free
Clinic in our community,” adds
Free Clinic Board member Barbara
Stoltzfus. “Every dollar received from
our generous donors provides not
only healthcare services, but also
hope for each patient we serve.”
Reflecting the Diversity
of the Community
About 40 patients can be seen at the
Free Clinic on a fully staffed day.
Patients are usually seen by appointment, although the clinic does leave
room in its schedule for call-ins.
The Free Clinic’s patients are as
diverse as the residents of Harrisonburg and Rockingham County—
“a real snapshot of the community,”
says Garber. In addition to Englishspeaking patients, the clinic sees a
sizable number who speak Spanish, and there are generally several
Spanish-speaking staff members on
hand to assist with interpretation.
Russian is the next-largest language
group among patients, but the clinic
also sees some who speak Kurdish,
Pakistani, Urdu, French, French
Creole, Korean and other languages.
With such a diverse clientele, having
medical interpreters available in so
many languages is quite a challenge.
“Arabic and other Middle
Eastern languages are where we
need the most help with interpreter
services,” says Garber. “We are hoping to install a telephone interpreter
service to help patients and providers communicate effectively. Having
that service would mean we would
never have to turn someone away
simply because of language barriers.
Of course, the service costs money,
and we recently received a grant
from the RMH Foundation to help
with funding.”
Looking Back … and Forward
The genesis of the Harrisonburg
Rockingham Free Clinic lies with
several parishioners of Blessed
Sacrament Catholic Church in Harrisonburg who became interested in
starting a free clinic in their hometown. The clinic, however, quickly
turned into a community project.
“The community’s commitment
to ensuring the availability of good,
local safety-net healthcare services
allowed us to take root, grow and
thrive,” says Gnagey.
In recent years, Gnagey points
out, the Free Clinic, like many local
primary care practices, has evolved
into more of a “medical home”
model. Under such a model, patients
aren’t simply “fixed” and then turned
loose, but instead partner long-term
with their healthcare providers for
ongoing medical needs.
“One of our volunteers said it
best,” Gnagey recalls. “‘We used to be
a group of volunteers finding what
we could from wherever we could,
and doing the best we could—and
we did good work. But today we’re a
medical practice.’”
Even though the Free Clinic
staff and volunteers are excited about
the clinic’s 25th anniversary in October, their sights are set firmly on the
future. To celebrate its first quartercentury and better position itself for
the future, the Free Clinic recently
rebranded itself with a new logo
and tagline: “Compassionate Care.
Extraordinary People.” Its name,
however, will remain the Free Clinic.
“Though much has changed in
a quarter-century, one constant is
the generous spectrum of volunteers,
partner organizations and donors who
provide resources to make health care
available to those in the community
who have limited options,” Gnagey
reflects. “As our staff gathers in a
‘huddle’ at the beginning of each
clinical day, we recognize ‘Mission
Moments,’ when compassionate care,
delivered by extraordinary people,
creates everyday miracles for patients
who are making journeys toward
improved health. We are grateful for
our generous community, which helps
us make those miracles happen.”
WHO CAN BE A
FREE CLINIC PATIENT?
To qualify as a Free Clinic patient,
a person must:
• be a resident of Harrisonburg City
or Rockingham County
• not have, or qualify for, any type
of medical insurance, including
Medicaid or Medicare
• have a gross household income,
before taxes, that is 200 percent or
less of federal poverty guidelines
(for example, $48,500 for a family of
four, or $23,540 for a single person)
• be a U.S. citizen or be in the
United States with permission
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59
PHILANTHROPY
A Passion for
Cancer Care
RMH Foundation Board Member
Amelia Hall is Helping to
Make a Difference
“Perhaps they are not stars in the sky,
but rather openings where our
loved ones shine down to let
us know they are happy.”
T
hat saying holds special meaning for
Amelia Hall and soothes her heart.
In June 1960, at age 7, Amelia
lost her mother, Elizabeth Raines
Michon, who was only 40, to
breast cancer. Amelia has a few
black-and-white photos of her
mother, and most of her memories from that
time are of her mother’s illness.
“I remember her being in bed a lot when
she was ill,” she says. “Back then, there really
weren’t many options for cancer treatment.
They didn’t have chemotherapy or radiation
therapy as we know them today, although
they did have a few medications, plus
surgery. My mom had a double mastectomy,
and she was given numerous experimental
drugs in an attempt to treat her disease.”
Given those early childhood experiences,
it’s not surprising that today Amelia has “an
absolute passion,” as she puts it, for supporting
cancer care and the Sentara RMH Hahn Cancer
60 |
Amelia Hall
SUMMER 2016
Amelia believes
telling the stories
of people who
have struggled
with cancer is what
touches people’s
hearts and prompts
them to take action.
Center. She attributes that
passion not only to her experience of growing up without her
mother, but also to the fact that
today physicians can do so much
more to detect, diagnose and
treat cancer.
Another motivating factor
for Amelia is the toll she has
seen cancer take in the lives of
those around her. Amelia has worked for nearly
25 years as the business manager in her husband’s
dental practice, David C. Hall DDS & Curtis G.
Dean DDS, in Harrisonburg. Over the years, they
have known several dentists and families whose
lives have been devastated by cancer. One of those
families was particularly close to the Halls.
Former Harrisonburg dentist Dr. George
Lawson lost his battle with cancer in 2000. His
children, Katie and Andrew, were 20 and 15,
respectively, when their dad passed away.
“They weren’t as young as I was when my
mother passed away, but I know it affected them
deeply,” says Amelia. “Katie, Andrew and our
children grew up together, and we’re still very
close. Watching this family deal with the pain of
losing their father and husband really touched my
heart. And just recently we lost Dr. Joe Greene
to cancer, which was a tragic loss to our regional
dental community.”
The Halls are committed to making a
difference through their support for the RMH
Foundation and the Hahn Cancer Center.
Amelia believes telling the stories of people
who have struggled with cancer is what touches
people’s hearts and prompts them to take action.
She also believes in the strength that comes when
people join together to make a difference.
“I recently shared my story in a letter to the
dental community,” she says. “My hope is that
Amelia with her
mother, Elizabeth
collectively we can make an impact, helping our
friends and families, as well as those whose stories
have touched our lives through our practices. If
everyone does a small part, together we can make a
huge difference.”
In addition to providing monetary support,
Amelia now serves on the RMH Foundation Advisory Board, a group of local community members
who oversee and direct the foundation’s fundraisw w w.S uppor tRMH.org
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61
Amelia and David Hall
ing efforts and charitable giving. Amelia
joined the advisory board late last year at
the invitation of Cory Davies, the foundation’s executive director.
“I consider it a real honor to serve
the RMH Foundation,” Amelia says. “As
someone who has worked in a local dental
practice for a quarter-century, I’m naturally
interested in health care in general, and
I think this foundation does an excellent
job of raising money to support all aspects
of care at the hospital. I had no idea how
important the foundation’s work was until I
joined. I’m hoping I can make a difference,
too, by serving on the board.”
Reflecting on her own efforts to support cancer care, Amelia notes that there’s
hardly a family or even an individual who
hasn’t been touched by cancer in some
way—either as a cancer patient or as the
relative, friend or co-worker of someone
battling the disease.
“My own story and the stories of others have really inspired me,” Amelia says.
“When you’re so directly touched by something, you want to do something to help. It
makes you more passionate about supporting the cause.”
If you would like to support cancer care
at the Hahn Cancer Center, contact the RMH
Foundation at 540-564-7222.
Do you have a question about planning your estate?
n
What happens if I don’t have an estate plan?
Is a will the only document I need?
n How do I begin to create an estate plan?
The RMH Foundation has prepared a pamphlet that answers commonly asked questions about
estate planning. For your free copy, return the coupon below and the pamphlet will be mailed to you.
n
NAME
ADDRESS
CIT Y STATE ZIP
EMAIL ADDRESS
PHONE
Mail to: Cory Davies, Executive Director, RMH Foundation, 2010 Health Campus Drive, Harrisonburg, VA 22801
friends
of the
RMH Foundation
Gifts received Jan. 1–March 31, 2016
entara RMH Medical Center is grateful to have the support of generous community members.
We express this gratitude and recognize the contributions our donors make through the
President’s Forum, the William Leake Society and the 1910 Cornerstone Club. These exclusive
giving circles are our way to honor our most generous partners who show they care about
having the best medical services available in our community. Thank you for your support!
Totals represent cumulative amounts given in 2016.
President’s Forum
$5,000–$24,999
Diane C. Davis
Mary Doris Joecks and Family
McDonald’s of Harrisonburg and the Boxley
Family
Lynn and Diane Trobaugh
William Leake
Society
$1,000–$4,999
Jerry R. and Kathleen L. Andes
Bill and Terri Aten
Blue Ridge Bank
Cross Keys Mill Creek Ruritan Club
Harrisonburg Emergency Physicians, PLC
Kenneth W. and Lillian B. Hilbert
Charles V. and Lois M. Oster
George and Ann Pace
RMH School of Nursing Alumni Association
Karl D. and Barbara B. Stoltzfus
Paul and Tamela Tait
Texas Roadhouse Restaurant
The Darrin-McHone Charitable Foundation
Tropical Smoothie Cafe
Truck and Equipment Corporation
Nancy Hopkins Voorhees
1910 Cornerstone
Club
$100-$999
Curtis Anderson Jr.
George W. and Mary Anderson
Back Yard BBQ, LLC
Barnes & Noble
Keith and Jan Barton
Drs. A. Jerry Benson and Martha K. Ross
Kenneth G. and Linda R. Berry
Michael T. and Cynthia Bailey Boggs
Joseph W. and Sharon R. Bowman
Chester L. and Nancy B. Bradfield
Briery Branch Church of the Brethren
Women’s Fellowship
Mark G. Burnette
Joseph O. Jr. and Louise B. Butler
Beverly J. Campbell
Eleanor M. Campbell
Jay L. Campbell
Dr. G. Edward Jr. and Elizabeth S. Chappell
Maryjane Chewning
Paul S. and Sherry B. Cline
Daneen A. Coakley
Marla Coggins
Jerry L. and Phyllis Yarrow Coulter
John N. Crist
Dale L. and Sandra S. Cupp
Timothy E. and Jenifer D. Cupp
Irene Morris Davis
Terri Lynn Denton
Raymond C. Diehl
Dr. Christopher D. and Sandra S. DiPasquale
Elizabeth Drewry
Douglas G. and Gayle H. Driver
Kermit and Jean Early
Edward Jones Investments
Elisabeth T. Eggleston
Janet S. Einstein
Ingrid Elliott
Everence
Fidelity Charitable Gift Fund
Audrey G. Fitzwater
Larry A. and Linda J. Fogle
Jay Bee and Sharon Gehman Foley
H. David and Rachel N. Frye
Edwin L. and Esther B. Good
Grand Home Furnishings
Howard N. Jr. and Zanette S. Hahn
Carole Hartman
Charles Jr. and Gladys Hartman
Dr. Charles H. and Mary Henderson
Barbara J. Henry
Cary and George Hevener
Michael L. and Rose Ann Houliston
Geri A. Howdyshell
Russell E. Jr. and Lillian C. Huffman
Robert T. and Margaret E. Jerome
Tedd H. and Lora W. Jett
Richard C. and Mona D. Johnson
Mary R. Johnson
Flora L. Kagey
William R. and Evelyn F. Keller
Daniel B. Keyes
Jim and Vicki Krauss
Steve and Cindy Lamb
Deborah J. Lambert
Eldon F. and Susan B. Layman
Tim and Twila Lehman
Jeffrey G. and Brenda J. Lenhart
John and Linda Light
Litten & Sipe, LLP
Paul R. and Dolores W. Long
Anthony and Jeanne Lubrano
M & K Hoof Care
Beverly T. MacLeod
William R. Madren
Kathleen W. Marshall
Matthew C. McCoy
Noland and James McHone
Rob and Peggy McKearney
Merck Foundation
Craig M. and Lois B. Miller
Janice K. Miller
Margaret (Peggy) M. Miller
Virginia (Ginny) B. Miller
Lawrence F. Jr. and Nancy L. Moran
Jerry and Becky Morris
Jane C. Mundy
James T. Nelson Jr.
Dan and Gail O’Donnell
Renee A. and Randall S. Ours
Daniel G. Packer
Panera Bread—Blue Ridge Bread Inc.
Edith D. Pence—The Wilson Pence Family
Dr. R. Steven and Stephanie M. Pence
Pendleton Times—The McCoy Family
Heidi D. Rafferty, MD
A. Kenneth and Mildred L. Ranck
U. S. Jr., “Jack” and Billie B. Rinaca
Jesse D. and Wilma K. Robertson
Rockingham Rotary Club Inc.
Beatrice R. Rolon
Thomas J. and Nancy S. Rowell
Saint Michaels UCC Council of
Lay Life & Work
Herbert Salisbury
Joyce M. Schumacher
Bob and Mary Sease and Family
Ralph L. and Ann W. Sebrell
Sentara RMH Wellness Center Zumbathon
William R. and Lucy J. Seymour
Frank B. and Shirley S. Shakespeare
Shes Family and Ronald Will
Richard L. and Shirley M. Shimp
Arvin W. and Shirley D. Shipe
Daina A. Sisk
Marvin T. and Sarah A. Slabaugh
Ilene N. Smith
John L. Smith
Karen A. Sodikoff
Southwest General Health Center
Dr. John M. and Doris S. Stone
William G. and Hope Shank Stoner
Esther J. Strawderman
Leslie Gordon Tait
Stephen C. Tate and Sarah
Oddenino-Tate
Earl F. and Joan B. Taylor
Clayton N. and Jacqueline G. Towers
Gregory S. and Ann B. Trobaugh
Sallye Trobaugh
William D. and Claudette J. Trout
Phillip and Christina Updike
Valley Seeds and Ag Products, LLC
Pamela S. Waggy
Fred F. and Dorris M. Wampler
Jacqueline B. Warren
Henry G. Jr. and Ferne M. Wenger
Denise A. Whitman
Roberta (Robbie) and Robert K. Wilkins
Gladys B. Wonderley
Frederick B. and Brenda Wynn
Dr. Paul R. Jr. and Carol D. Yoder
Ronald and Shirley B. Yoder
Robbie J. Zirkle
Annual Support
$25-$99
Annie R. Adams
Richard F. and Phyllis P. Albers
Garland R., Jr. and Carol D. Anderson
Jean Anne Armstrong
Alexander Banks V
Adam and Christina Blagg
Robert L. and Anna L. Branner
Rodney A. and Patricia D. Branson
Duane D. Brauen
George B. and Edatha V. Brockington
Patricia A. Brunk
Lois C. Burkholder
Ann Cale
Joseph P. and Akiko Carniglia
Donald L. Jr. and Cheryl T. Carr
Donald M. and Elvera L. Casey
Harry W. Cash
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63
friends
of the
RMH Foundation
Brenda D. Cave
Ae Kyung Chong
Carey B. Jr. and Rebecca A. Cole
John D. and Jeane H. Crisman
Dennis A. and Martha C. Cummins
Weldon D. and Shirley B. Dean
Charles J. Sr. and Margaret O. Deane
Conrad F. and Dorothy K. Deeds
John J. and Virginia R. DeForge
John J. Early
B. Earl and Cheryl K. Eshbach
John S. and Patricia O. Evans
Glen O. and Barbara S. Eye
Farm Credit of the Virginias, ACA
Bruce and Barbara Farquhar
J. C. Jr. and Betty B. Foltz
James C. and Beatrice Fulk
Lelia S. Galvin
Michael A. and Deborah W. Good
Glenn R. Griffin
Gregory A. Griffith
Evelyn W. Guyer
Jean S. Hamill
Buck and Ann Harrison
Robert A. and Marlene A. Hazzard
Ralph C. Heishman
Patricia Ann Hensley
Robert P. and Eloise B. Hostetler
Richard A. and Linda J. Humbert
Teresa A. Hunter
Robert N. and Barbara H. Jackson
Ronald P. and Julianne Jilinski
Louise A. Johnson
R. Fleming and Sharon W. Jones
Lt. Colonel Steward S. Jordan,
USAF Ret.
Wayne and Kay Frances Kelley
Ronald Kirk
David C. Kleiner
Richard L. and Allison H. Kline
Stashia M. Kline
Geneva Knupp
Dorothy L. Koontz
Boyd and Shirley Landis
Jerry O. and Daisy D. Leake
J. Steve Little
Patricia A. Lobb
John L. and Faye A. Lokey
Robyn R. Ludwig
John R. and Marian S. Martin
Harry F. McDorman
Elizabeth McGirr
Lois C. Miller
Ellen M. Mitchell
Lynne A. Moir
Ernest L. Jr. and Barbara B. Mongold
Michael A. and Julia A. Moretti
Byron R. and Darlene H. Morris
Eileen S. Nelson
Evelyn G. Nice
Martin L. and Nancy L. Nossett
Epifania Nunez
Joseph T. O’Byrne
Joan M. Painter
Ormond S. Painter
Rohit Pandya
Elmo and Ella Massey Pascale
George R. Payne
Donald and Marilyn Pedersen
Martha S. Proctor
Bobby E. Prophet
Ira H. and Ruby C. Propst
Gary Rhinehart
Herbert and Dottie Roy
Bryan W. and Peggy S. Sandridge
Raymond W. and Gladys Shank
Jeffrey K. and Janet S. Sheffer
64 |
SUMMER 2016
Shenandoah Growers Inc.
Alton K. and Helen W. Shipe
James and Shirley Shirron
Harry L. and Shirley M. Shoemaker
John A. and Beverly G. Smith
Shyrl R. and Betty M. Smith
Billy D. and Sharon W. Smitherman
Judith J. Spahr
Randy D. and Gloria G. Stokes
Kathleen V. Stoneberger
Harold R. and Wilma A. Tinsley
Inez Topp
Thomas A. and Susan V. Toth
David K. and Mary M. Tulloch
Glendon W. Sr. and Esther M. Turner
Louemma Turner
William Allen and Rebecca L. Turner
Janette R. Tusing
Raymond W. and Mary V. Tusing
Robert B. and Marilyn P. Tuttle
United Way of South Hampton Roads
Violet R. Via
William R. and Susan M. Walls
Geraldine C. Waterhouse
Louise A. White
Carlyle Whitelow
Dr. Crystl D. and William G. Whitmire
Richard L. and Pamela B. Wilkins
Gloria V. Willets
Garland J. and Shelvy Williams
Evelyn R. Wilson
Anna B. Wimer
Sharon K. Wright
Nancy D. Zirkle
Susan F. Zirkle
Lorriane Diehl
Raymond C. Diehl
Memorial Gifts
M. June Moore
Mark G. Burnette
Jared Alexander
Saint Michaels UCC Council of Lay Life & Work
Glenna Dahmer Anderson
Curtis Anderson Jr.
Charles A. and Mary V. Armentrout
Joseph O. Jr. and Louise B. Butler
Elmer L. and Nancy L. Dahmer and Family
Patricia A. Eirich
Raymond R. and Sharon R. Harr, Genevieve
Ruddle
Mt. Zion United Methodist Church
Marvin and Tammy Smith and Family
The Pendleton Times—The McCoy Family
Reginaldo Antonnicola
Dan and Gail O’Donnell
John Baker
Saint Michaels UCC Council of Lay Life & Work
Reva Bowman
Joseph W. and Sharon R. Bowman
Jennifer Clevinger
Marijo Lecker
Randall S. and Renee A. Ours
Charles D. Coakley
Daneen A. Coakley
Eugene Coakley
Nelson and Linda Simmons
Lee A. Cupp
Dale L. and Sandra S. Cupp
Dr. Garney Darrin
The Darrin-McHone Charitable Foundation
J. William Dellinger
Shirley L. Dellinger
Victor R. Drewry
Elizabeth Drewry
Margaret P. Francisco
Edith D. Pence—The Wilson Pence Family
William C. Gray
Mary S. Gray
James F. Hoak
Betty M. Hedrick
Dr. Charles H. and Mary Henderson
Paul R. and Dolores W. Long
James T. Nelson Jr.
Jane Hoehne, Daughter
Bobbie F. Bradford
Morris and Ruby Homan
Carole Hartman
William “Bill” R. Judd
Percy L. Prickett
Cecil C. Liskey Sr.
Russell E. Jr. and Lillian C. Huffman
Herman Luttrell
Daniel L. and Patricia L. Thomale
Judith Long Messick
Roger L. and Sharon L. Huffman
Charles Misner
Beatrice R. Rolon
Lester S. Mongold
Mildred F. Branner
Fred L. Neininger
Bill and Terri Aten
Beverly J. Campbell
Thomas J. and Nancy S. Rowell
Southwest General Health Center
Leslie Gordon Tait
Paul and Tamela Tait
Mary K. Shipe
Jacqueline B. Warren
Denise A. Whitman
Judith R. Smith
John L. Smith
William Steeber
Kenneth L. and Virginia J. Steeber
Wayne A. Strawderman
Esther J. Strawderman
Willie and Sue Swadley
Pamela S. Waggy
Valery and Gene Trout
William D. and Claudette J. Trout
Robbie M. “Robbie” Warlitner
Maureen Deane
Mary Wilson Ritchie Whetzel
William H. and Naomi Lantz Good
Shes Family and Ronald Will
Ernest B. Whitelaw
Ruby Hartman Whitelaw
Katie Whitfield
H. L. Jr. and Mildred R. Maiden
Lois McCoy Williams
Kenneth W. and Beverly M. Keyser
John “Yogi” Wolfe
Jay L. Campbell
Ginger L. Wright
Belinda Arey
Sue D. Young
Ltc. Charles D. Young
Lena Zirk
Earl F. and Joan B. Taylor
Honor Gifts
Dr. Aklilu M. Degene
U. S. Jr., “Jack” and Billie B. Rinaca
Donna Baylor Olbert, RMH Class of 1968
Kenneth W. and Lillian B. Hilbert
Dr. Punkaj Dua
Karen Wood Grizzard
Robert L. Rankin
Barbara L. Tutt
Steve Johnson
Lattisa M. Evelsizer
Donald K. Sharpes
Michael T. and Cynthia Bailey Boggs
Bradly Lam
Allen C. Lam
Hollis “Billy” Dewitt Sheffer
Ronald L. and Rebecca C. Shaver
W. R. (Ray) Waddell
Phil Maxwell
John D. and Toni H. Stone
Mary Lou Shifflett
H. L. Jr. and Mildred R. Maiden
James R. Sipe Jr.
Sharon S. Balint
Keith and Jan Barton
Joan S. Byrd
Family of Brownie Cummins
Terri Lynn Denton
Clinton M. Devier
Dr. Christopher D. and Sandra S. DiPasquale
Jay Bee and Sharon Gehman Foley
Dr. Charles H. and Mary Henderson
Doug and Kathy Hulvey
Litten & Sipe, LLP
Paul R. and Dolores W. Long
John and Betsy Mauzy
Noland and James McHone
Jennifer Rader
Sentara RMH Medical Group Administration
Dr. David P. McLaughlin
Roberta (Robbie) and Robert K. Wilkins
Sue N. Menefee, RN
Ann and Neal Menefee
The Services that Provide for the Low Income
Nsaif Jasim Mohamme Al Karawi
Dr. Brian E. Robinson
Curtis Anderson Jr.
Dr. Duane S. White
Mary J. Purdie
Dr. Mary Helen Witt
U. S. Jr., “Jack” and Billie B. Rinaca
Jerry “Pete” Wright
George W. Land
Game Time!
Sports season is coming soon, and with sports comes the risk of
an injury. If your student athlete is sidelined, the Sentara RMH
Orthopedic & Sports Medicine Specialists can help. We offer:
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School and sport physicals
Onsite team physician for Valley football games
Concussion clinic
Same-day appointments for emergencies,
such as a broken bone
Fracture care
Hand, shoulder, knee, foot and ankle care
Specialized and minimally invasive surgery
Physical therapy
Our team will get your child back to the game they love.
540-689-5500
sentara.com
Chad Muxlow, DO
Benjamin Mwanika, DO
Thomas Weber, MD
Your community not-for-profit health partner
NON-PROFIT
U.S. POSTAGE
PAID
PERMIT NO. 19
BURLINGTON, VT
Sentara RMH Medical Center
2010 Health Campus Drive
Harrisonburg, Virginia 22801
Sentara.com
Change service requested
Ad
We’re Better Together.
CELEBRATING FIVE YEARS AS SENTARA
Sometimes when two good
things come together, the end
result is even better.
In May 2011, RMH Healthcare partnered with the awardwinning health system Sentara Healthcare to become
Sentara RMH Medical Center. In those five years, Sentara
RMH has evolved into an even stronger, more forwardthinking, superior healthcare facility than we were before.
Though our name has changed, our primary focus is still
the same: the health and well-being of our community.
sentara.com
Here are just a few examples of what we’ve accomplished thanks to our partnership
with Sentara Healthcare:
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Sharing best practices across the system resulting in improved quality and outcomes
Construction of the Sentara RMH Funkhouser Women’s Center
Construction of the Sentara RMH Orthopedic Center
Construction of Sentara RMH Timber Way Health Center
Conversion to Epic, the patient clinical documentation system
Recognized as a Magnet® Designated hospital for sustained excellence in nursing care
Implementation of an RN Residency Program for new graduates
Launch of the new Sentara.com
Learn more about Sentara and Sentara RMH Medical Center at Sentara.com.
Your community not-for-profit health partner