auguSta health accredited breast center

Healthmatters
spring 2011 ›› WWW.augustahealth.com
get heart
smart
at our cardiology
center
Why checkups
matter
reduce your
stroke risk
auguSta health
accredited
breast center
learn about thiS Special accreditation
on page 10
we’re a
100 top
hospital
See page 28 ››
A special thank you to all of the members of our Breast Care Accreditation Team.
A
Winning Combination
The Breast Health Program at Augusta Health is the first in the region to receive full
accreditation from the National Accreditation Program for Breast Centers (NAPBC)*.
Our Breast Health Program team — pathology, radiology, surgery, medical oncology and
radiation oncology — works together to review cases and create a customized care plan
for each patient. This accreditation acknowledges our commitment to excellence and
reinforces our claim that you don’t have to travel for the best breast health care. The quality,
compassion and teamwork recognized by the NAPBC are available right here.
Staunton 540-332-4000
Waynesboro 540-932-4000
Toll Free 1-800-932-0262
www.augustahealth.com
* This accreditation is awarded to centers who take a
multidisciplinary, team-oriented approach to breast cancer care,
and is earned after a rigorous evaluation, review of performance
and compliance with 27 evidence-based standards of care.
in this issue . . .
4
augusta HealtH: we‘Re HeRe FOR YOu
5
PReventing cOlOn canceR
A letter from Mary n. Mannix, FACHE
6
The importance of colonoscopies
6
ReDucing stROke Risk witH a liFesaving PROceDuRe
7
Pain-FRee living
8
HeaRt tO HeaRt
10
tOP HOnORs
14
FigHting tHe gOOD FigHt
16
PReventive MeasuRes
17
blOOD DOnatiOn PRiMeR
18
ask tHe PHYsician
21
MODeRn tecHnOlOgY
22
HaPPenings at augusta HealtH
24
baRRett’s esOPHagus
26
new HealtHcaRe PROviDeRs
27
new FacilitY OFFeRs QualitY PRiMaRY caRe
28
augusta HealtH naMeD tOP HOsPital anD HOnOReD witH
Spine surgery can let you do almost anything again
Augusta Health‘s cardiology center—one man‘s story
Breast Center awarded with accreditation
8
How the hospital is helping defeat breast cancer
Why vaccines and screenings are important
Augusta Health physicians answer your questions
Equipment helps with gastroenterologic problems
21
learn more about this serious gErD complication
OtHeR awaRDs
22
www.augustahealth.com
3
augusta Health:
We’re here for you
t H e M a g a z i n e O F a u g u s ta H e a lt H
Serving Staunton, Waynesboro and Augusta counties
and surrounding communities
a u g u s ta H e a lt H b O a R D O F D i R e c t O R s
E. St u a r t Crow, C h a i r man
C h a r l e s “M i c k ” An d e r s e n , M.D.
J o h n B. D av i s
Wi l l i a m Fa u l k e n b e r r y, M.D.
dear friendS,
r o b e r t g . K n ow l e s
goodbye Old Man Winter, hello warmer weather! Burgers are on the grill.
Birds are chirping. Flowers are blooming. But, just because it’s warm out
doesn’t mean you should let your healthcare fall by the wayside.
We’re happy to share that the Augusta Health Cancer Center has
become the first hospital in the region to receive full accreditation from
the national Accreditation Program for Breast Centers (nAPBC). Accreditation is granted only to those centers that undergo a rigorous evaluation
and review of performance and compliance with 27 evidence-based
standards of care. The closest accredited programs are in Winchester and
richmond. read more on page 10.
And more kudos to us! We were recently recognized as one of the
nation’s Top 100 Hospitals® by Thomson reuters, a leading provider of
information and solutions to improve the cost and quality of healthcare.
The 100 hospitals on the list demonstrate quality patient outcomes while
l a u re l l a n d e s
g e o rg e l i n d b e c k , M . D.
M a r y n . M a n n i x , FAC HE
An n D. M c Ph e r s o n
B e ve r l y S . “C h e r i ” M o ran
Wi l l i a m l . P fo s t
J o s e p h r a n z i n i , M . D.
Aro n a E. r i c h a rd
C . r a n d y r o b i n s o n , M . D.
vi c to r M . S a nto s
a u g u s ta H e a lt H F O u n D at i O n b O a R D
r o b e r t g . K n ow l e s, C h a i r man
D e b ra S . Ca l l i s o n
Ed wa rd C l y m o re
D av i d E. Co h ro n
E. St u a r t Crow
r o n a l d W. D e n n e y
Ku r t g o t t s c h a l k
l a u re l l a n d e s
M a r y n . M a n n i x , FAC HE
Wi l l i a m l . P fo s t
Aro n a E. r i c h a rd
C . r a n d y r o b i n s o n , M . D.
Jeanne K. russell
a u g u s ta H e a lt H H O s P i ta l s ta F F
President and ceO Mary n. Mannix, FACHE
chief Medical Officer Fred Castello, M.D.
improving efficiency.
chief Financial Officer John Heider
chief information Officer Bruce Hall
executive Director aMg l. Courtenay Beebe, M.D.
v.P. support services David E. Deering
taking care of yourself
v.P. Planning and Development Kathleen Heatwole
Did you know that 60 percent of colorectal cancer deaths could be
v.P. Medical administration Jan Mangun
v.P. chief nursing Officer lisa Cline
prevented if everyone age 50 and older were screened regularly? get
v.P. Professional services Karen Clark
more colon cancer screening information on the next page.
v.P. aMg administration Ann rubino
And don’t put your health by the wayside this summer—schedule a
checkup. See page 16 to learn why it’s so important to get one.
At Augusta Health, we’re here for you, even when it’s hot and
sticky outside!
Best regards,
MArY n. MAnnIX, FACHE
PrESIDEnT AnD CHIEF EXECUTIvE OFFICEr
AUgUSTA HEAlTH
On tHe cOveR: MeMbeRs OF tHe augusta HealtH bReast caRe accReDitatiOn teaM
4
HealthMatters Spring 2011
v.P. Human Resources Sue Krzastek
cOMMunicatiOns
For more information about services at Augusta Health,
please contact lisa Schwenk, Director of
Communications and Public relations, at
[email protected] or (540) 245-7329.
Health Matters is published three times a year by
Augusta Health, 78 Medical Center Drive,
Fishersville, vA 22939. All rights reserved.
The information contained herein is not a substitute for
professional medical care or advice. If you have medical
concerns, seek the guidance of a healthcare professional.
Health Matters is aimed at connecting the community
with healthcare experts within Augusta Health to learn more
about issues that may be affecting your health.
If you are not receiving Health Matters,
you can view it online or request to be added to the
mailing list at www.augustahealth.com.
eDitOR/ DiRectOR OF MaRketing : vicki Kirby
webMasteR: Brian Mcgill
PROFessiOnal PHOtOgRaPHY bY:
Kevin Blackburn Photography, Waynesboro, vA
Preventing
colon cancer
The importance of colonoscopies
Sixty percent of colorectal cancer deaths could be
prevented if everyone age 50 and older were screened
regularly. That’s a startling statistic from the Centers for
Disease Control and Prevention and a big reason why physicians
diligently educate their patients about tests such as colonoscopy.
“Colorectal cancer screenings are so
important because colorectal cancer is a
common diagnosis,” says Justina Ju, M.D., a
gastroenterologist with Augusta Health. “But
a colonoscopy can catch and remove polyps
before they turn cancerous, or can find cancer
Justina Ju, M.D.
early, when it’s still treatable.”
That brings up another important statistic: Over the past
20 years, the death rate from colorectal cancer has been dropping in both men and women, according to the American Cancer
Society. Experts think screenings are contributing to this decline.
Currently, more than 140,000 Americans are diagnosed with
the disease each year, and more than 50,000 die from it.
Heading off cancer
Colorectal cancer
risk factors
You may have an increased chance of developing
colorectal cancer if you:
» are over age 50
» have had certain types of polyps
» have a close family member who was diagnosed with
colon cancer before age 60
» have had colorectal cancer that was completely
removed
» have long-standing chronic ulcerative colitis
or Crohn’s colitis
» are physically inactive
» eat a high-fat, high-calorie diet
» are overweight
» smoke or drink alcohol heavily
» are Jewish and of Eastern European descent
(Ashkenazi Jewish)
Colonoscopies are the gold standard for colorectal cancer
screening. Using a special scope outfitted with a tiny camera, a
physician looks for polyps, which are abnormal growths that form
in the colon and can potentially develop into cancer. “Factors
such as genetics and aging can increase your likelihood of developing these growths,” Dr. Ju says. If polyps or other abnormal
growths are found, they can be removed or biopsied during the
make an appointment for your
colonoscopy today!
To schedule a screening colonoscopy, contact
the Endoscopy Center at Augusta Health.
Call (540) 332-5526. Hours are weekdays from
6:30 a.m.–5 p.m.
same procedure.
Colonoscopies are recommended for everyone age 50 and
older. If nothing is found at your first screening and you’re not in
options do exist, Dr. Ju says. Fecal occult blood tests (FOBTs) look
the high-risk group for colorectal cancer, you can wait 10 years
for blood in stool—a sign of polyps or cancer—and are repeated
for your next screening, Dr. Ju says. (High-risk individuals include
every year. However, FOBTs don’t always catch cancer because a
those with a personal or family history of the disease; those
growth may not be bleeding at that time. Flexible sigmoidoscopy
with certain inherited conditions, such as familial adenomatous
lets physicians view the rectum and parts of the colon with a
polyposis; and those with inflammatory bowel disease.) Those
scope. This procedure, which is performed every five years, takes
who are considered high risk will likely need to be screened at a
less time than a colonoscopy but can’t display as much of the
younger age and more often.
colon. A disadvantage to both of these tests is that if anything is
While physicians strongly encourage colonoscopies, other
found, you’ll still need a colonoscopy for further evaluation.
www.augustahealth.com
5
Reducing stroke risk
WITH A lIFESAvIng PrOCEDUrE
StrokeS are potentially devaStating. For the more than
blockage that can cut off blood flow to the brain and lead to
700,000 Americans who suffer them each year, they can cause
a stroke. A stroke may also occur when plaque breaks free and
paralysis, speech and emotional problems—even death.
blocks one of the brain’s smaller arteries.
“One-third of strokes are caused by a buildup of plaque
“Carotid endarterectomy is designed to prevent these two
in the carotid arteries,” says Jacek Paszkowiak, M.D., a vascular
things from occurring,” says Charles goff, M.D., a vascular surgeon
surgeon with Augusta Health. For some, this condition, called
with Augusta Health. In this procedure, the surgeon makes a small
cartoid artery disease, can be managed with cholesterol
incision in the neck, exposing the artery, then makes a cut in the
medications and an aspirin regimen to reduce the risk of clot-
artery itself. Special tools remove plaque from the artery walls;
ting. Others will benefit from a surgical intervention called
then the artery and incision are closed. The procedure takes one-
carotid endarterectomy.
and-a-half to two hours, Dr. Paszkowiak says. It’s performed under
While it’s not new, this procedure can literally be a life-
general anesthesia and requires an overnight stay in the intensive
saver. Performed in Augusta Medical Center’s operating room,
care unit for monitoring. Patients are advised to ease back into
it can cut stroke risk by up to half for some patients.
activities for two weeks following the procedure.
Reducing stroke risk
bleeding, nerve injury, heart attack or stroke during the procedure
Plaque is made of cholesterol, fat and other substances. When
and a recurrence of narrowing in the artery. The likelihood of these
it builds up in the carotid arteries, which supply oxygen-rich
complications is low, both physicians note. For example, the odds
blood to the brain, it causes a narrowing of the arteries or a
of an artery narrowing again are less than 1 percent. “The majority
like any surgical procedure, risks are involved, including
of people who experience this are smokers,” Dr. goff says.
is it right for you?
Whether you’re a candidate for carotid endarterectomy
depends on whether you have symptoms and how narrow your arteries are. Possible candidates include those
who have certain symptoms (for example, those who
experience “mini-strokes,” or transient ischemic attacks)
and arteries that are more than 50 percent blocked,
and those who have no symptoms and arteries that
are more than 80 percent blocked, Dr. Paszkowiak says.
The procedure has proven to be the most beneficial for
these patients.
For patients with no symptoms, their stroke risk can
be reduced to 5 percent from 11 percent over five years,
Dr. Paszkowiak says, and those with symptoms may see
their risk reduced to 10 percent from 30 percent.
Jacek PaszkOwiak, M.D. (leFt), anD cHaRles gOFF, M.D.,
Review a Patient‘s cHaRt.
6
HealthMatters Spring 2011
An Internet search led him to Matthew
Pollard, M.D., a spine surgeon at Augusta
Health. In the end, Pruett would be the first
patient at the hospital to undergo one of
the newest spine surgery procedures.
matthew
pollard, M.D.
On the road to recovery
Pruett’s surgery, to remove much of the damaged disk and
replace it with a bone graft, was scheduled for November 2009.
His procedure used NuVasive’s® eXtreme Lateral Interbody
kelvin pruett is
back on duty with
his canine coworker.
Pain-free
living
Spine surgery can let you do
almost anything again
Fusion, or XLIF®. During the XLIF procedure, the spine, which
is traditionally accessed through the front or back of the body,
is instead accessed through a 4-inch incision between the ribs
and hips, also called a direct lateral approach. This minimally
invasive technique offers benefits to many patients.
Compared to going through the front or back to
access the spine, which requires up to a foot-long incision, the
direct lateral approach could be considered the path of least
resistance. “There’s less muscular dissection, you’re not pulling
on nerves and not as much scar tissue is generated,” Dr. Pollard
says. Because of this, patients experience a quicker recovery,
with less blood loss and pain, and many can leave the hospital
in one day, compared to four or five nights in the hospital with
other approaches. Many patients can resume normal activities
in a month, versus three months or more with conventional
surgical methods, he says. Other conditions that might benefit
from the procedure include spondylolisthesis, spinal stenosis
In his 25 years with the Franklin County Sheriff’s Department, K-9 Officer Kelvin Pruett, 47, of Rocky Mount, had
and scoliosis.
Pruett is living proof of a successful recovery. He was
never taken a sick day—until July 2009. It was around that
walking again right after the anesthesia wore off from the
time when pain that had plagued him for almost a decade
operation, and only stayed in the hospital overnight. “The
finally got the best of him. While he was hiking up a steep hill
pain is gone,” he says, estimating that he’s about 80 percent
during a call, his left leg went numb and he fell.
improved. He returned to work on light duty in January 2010,
Pruett had been dealing with nerve pain in that leg,
and returned to full duty that May. He’s also resumed walking
thanks to a tear in a disk in the lower part of his back, or lumbar
three to five miles a day. “I can do almost anything I want; I just
region of his spine, which has nerves that branch off to the
take it easy,” he says.
legs. Pruett chalks up his injury to lifelong wear and tear.
Over the years, Pruett had been referred to neurosurgeons
and pain management experts, but to him, their treatments
were merely temporary measures. He was only 45 years old
when his leg grew too painful for him to work and medication
no longer helped. He figured he had a whole lot of living left to
do. That’s when he began looking into surgery. “At that point, I
eager to feel better?
Schedule an appointment with Augusta Health
Spine Surgery Clinic at (540) 245-7400 in Staunton
and (540) 221-7400 in Waynesboro.
was ready to be operated on, I was in that much pain,” he says.
www.augustahealth.com
7
Heart to heart
Augusta Health’s cardiology center—one man’s story
keith cooper, of StuartS draft, woke up on the morning
Heart disease 101
of nov. 2 with pain in both hiS armS. He chalked it up to
For most people who suffer a heart attack, the main culprit
overusing his arms the day before while moving into the house
is heart disease, which occurs when arteries and small blood
he and his wife had just built. But the pain only worsened, and
vessels that supply blood to the heart narrow—usually
that’s when Cooper’s wife called 911.
because of a buildup on artery walls of fatty substances such
Turns out what he was beginning to experience was a
as cholesterol. Warning signs that heart disease could be
“widow-maker heart attack”; it’s a usually fatal, massive heart
developing include chest pain (angina), shortness of breath
attack stemming from a blockage in one of the heart’s main
and limb pain and discomfort.
arteries. “I used to have borderline high cholesterol and high
“There’s no one pill to help manage heart disease,” says
blood pressure, but I wasn’t having any heart trouble and didn’t
John Yang, M.D., a cardiologist at Augusta Health. “You need
have problems in my family,” 62-year-old Cooper says.
to modify your risk factors,” he notes. genetics play a part in
Cooper, a retired federal government employee, is proof
that heart attacks come in all types of packages. He never ex-
the development of the disease, but so do bad habits.
While you can’t change your heart disease risk factors
perienced any chest pain and showed no other signs of a heart
such as family history or age, you can control your:
attack, so emergency responders were unsure if he was having
• blood pressure
• sedentary lifestyle
one at first. But he went into cardiac arrest and was resuscitated
• cholesterol
• smoking
in the ambulance when they were a few miles from the hospital.
• diabetes
• stress levels
• diet
• weight
Waiting for him upon his arrival at Augusta Health was
rajeev Pillai, M.D., an interventional cardiologist, who took
Cooper straight into the hospital’s cardiac catheterization lab.
caring for your heart
In less than 20 minutes, Cooper says, Dr. Pillai was inserting
Cooper has plans. In addition to enjoying retirement, he
a wire mesh device, called a stent, to prop open his clogged
wants to join the hospital’s fitness center to pick up where his
artery. His heart muscle suffered little damage, if any.
cardiac rehabilitation left off. “I couldn’t have asked for better
care,” he says of his time at Augusta Health. He credits the
quick treatment time with helping to save his life.
keitH cOOPeR exeRcises
tO HelP keeP His HeaRt
in sHaPe.
kellY ManOR, P.a.-c,
clinical cOORDinatOR
OF augusta HealtH’s
caRDiac catHeteRizatiOn lab, Meets witH
MaRk MasOnHeiMeR,
b.s.n., aDMinistRative
DiRectOR OF
caRDiOvasculaR
seRvices.
8 HealthMatters Spring 2011
“One of our advantages is that we’re a smaller hospital,
so we can be more responsive,” says Kelly Manor, P.A.-C,
Clinical Coordinator of Augusta Health’s cardiac catheterization lab. She notes that the hospital’s heart attack treatment
times are faster than the national standard. “We’re proud of
what we’ve done here,” she says.
On any given day, you can see this pride in Augusta
Health’s cardiology department, as its medical team is hard at
work for its patients. To meet the community’s needs, “We
offer a variety of services,” says Mark Masonheimer, B.S.n.,
Administrative Director of cardiovascular services.
get your
physician’s ok
Your healthcare provider will likely support your fitness
efforts and may offer specific guidelines based on your
health. Check with him or her to discuss whether any
of the following apply to you:
» chest pain or pain in the neck or arm
» shortness of breath
» a diagnosed heart condition or you take heart or
blood pressure medication
» joint or bone problems
» dizziness
» an inactive lifestyle
You may see patients getting noninvasive services such
as stress tests rooting out heart problems, monitors looking
for irregular heartbeats and ultrasounds detecting blockages in the body. Others may be undergoing more invasive
procedures such as cardiac catheterization for diagnostic and
emergency treatment purposes (including a newer technique
called radial access, which allows for quicker recovery time
for patients), angioplasty, stenting and implantation of
pacemakers. Patients who meet certain criteria, such as those
who’ve had a heart attack, will also be offered cardiac rehab.
“There’s a real feeling of security among patients,” says
Image © istockphoto.com/Kati molin
Debbie Caldwell, rnCCT, AnCC-BC, Clinical Coordinator of
cardiac rehab in the monitored outpatient exercise program.
But medical services and procedures aside, the staff also
plays an important role in the level of quality care offered.
“We have a very dedicated, compassionate team here at
Augusta Health,” Masonheimer says.
tips for getting active
You can find opportunities for physical activity everywhere! Try these tips:
» Organize a family softball game.
» Walk briskly around the mall—and do a little
window-shopping!
» Take the stairs instead of the elevator.
» learn a new dance.
» Take the dog for a walk.
» Park farther away from the store or
your office building.
» Wash the car, garden, vacuum or do any other
chore that gets the heart pumping.
» Train for a charity event, such as a walk-run race.
And they literally take your health to heart.
www.augustahealth.com
9
Top honors
Breast Center awarded
with accreditation for its
quality breast care program
The word is out: Some of the most comprehensive, quality
breast care available can be found right here, in your
own backyard.
While patients and staff at the Augusta Health Cancer
Center have always known that something was special about
the care provided here, this sentiment was recently validated
by a full accreditation from the National Accreditation
Program for Breast Centers (NAPBC).
Of course, the honor won’t be kept under wraps. “We
The best in breast care
don’t want our care to be a secret,” says Meg Shrader, R.N.,
Prior to being certified, Augusta Health submitted an applica-
B.S.N., the hospital’s breast health navigator. “Our patient
tion seeking a review by an NAPBC evaluator. That applica-
outcomes exceed national benchmarks.”
tion, which can take up to 30 days for approval, got the green
Following a rigorous review process, Augusta Health was
light within 48 hours, Shrader says. From there, an all-day,
officially awarded the NAPBC certification on Jan. 21 and is
on-site review was conducted in December and an extensive
the only hospital in the region to hold it. “This was an organi-
list of cases—minus patient names—was provided to the
zational effort,” Shrader says. “Everyone here at the hospital
evaluator, who chose specific ones to analyze.
wanted it. We have a whole team that’s passionate about
breast care.”
“They have their set criteria,” says Julie Plumbley, M.D., a
pathologist at Augusta Health. “They want to see if we’re
performing as well as or better than large institutions. People
assume they have to go to a university center to get quality care, but the surveyor was able to ascertain that we can
give as good care as anybody. And we have the advantage
that our staff sees and talks to each other every day. It’s an
intimate group of caregivers focused on patients.”
Dr. Plumbley says the NAPBC evaluator looked at the
entire program offered at Augusta Health during his visit,
from mammography and biopsy reports, to how well the
surgeon discussed treatment options with the patient, based
on patient charts. He sat in on a breast committee meeting,
where physicians from all disciplines meet bimonthly to
discuss cases, and learned about each person’s role.
Julie Plumbley, M.D., examines a specimen under a microscope.
10
HealthMatters Spring 2011
❝
We wouldn’t have been certified if we
didn’t already have a comprehensive
cancer program in place. You can’t force
this. You have an evaluator here, looking
under every rock and in every closet. ❞
—joseph ranzini, m.d.
before the accreditation process began included using a
multidisciplinary cancer care approach and having radiation
therapy, medical oncology and radiology—including digital
mammography and breast MRI—all under one roof. The only
The Augusta Health breast care accreditation team
missing piece, he says, was someone to fill the role of breast
health navigator, a position that would entail helping breast
cancer patients navigate the increasingly complex world of
cancer treatments. Enter Shrader, who joined Augusta Health
Some areas that impressed the evaluator most were the
highly detailed pathology and radiology reports and strong
in 2009.
A translator of sorts, Shrader is the liaison for patients
support services, which include a licensed social worker,
and physicians. She accompanies patients to appointments,
physical therapy and occupational therapy. These services
takes notes for them during these physician visits, explains
all can help handle issues that arise from treatment, such as
complex medical terms in a patient-friendly way, discusses
lymphedema (swelling in the arms or legs). The evaluator
pros and cons of different treatments, and relays patients’
also praised the excellent teamwork by all players involved
feedback and concerns to their physicians.
in cancer care, from radiologists and surgeons to nurses and
The breast care program will be re-evaluated in 2014,
mammography technicians. He was also struck by how well
and Augusta Health will work hard to ensure it keeps this
Augusta surgeons presented treatment options to patients
honor, including keeping up to date on best practices in
and the effectiveness of the breast health navigator.
breast care and continuing medical education for the staff,
Earning the accreditation didn’t surprise most at Augusta
Health, which has years of exceptional cancer care under its
Dr. Ranzini says.
“This certification doesn’t change what we’re doing, but
belt. “We wouldn’t have been certified if we didn’t already
it does give us an impetus to remain on the leading edge of
have a comprehensive cancer program in place,” says Joseph
breast-cancer care,” Dr. Thompson says.
Ranzini, M.D., an Augusta Health general surgeon. “You can’t
force this. You have an evaluator here, look-
The breast-care team
ing under every rock and in every closet.”
You’ve probably heard the old saying, “It takes a village to
raise a child.” Well, here at Augusta Health, it takes a skilled
william Thompson,
M.D., FACS
More patient resources
team of experts from across all disciplines to provide women
According to William Thompson, M.D.,
the best in breast care—the multidisciplinary approach that
FACS, an Augusta Health general surgeon
impressed the NAPBC evaluator. Some work one-on-one with
who helped head accreditation efforts,
patients, while others are more behind-the-scenes players.
those puzzle pieces already in place
continued on page 12
www.augustahealth.com
11
continued from page 11
All work together to ensure the best patient outcomes. Your
team at Augusta Health includes:
• Skilled surgeons. “We don’t dabble in breast surgery here,”
says Dr. Ranzini, who estimates about half the cases he and
his partners handle are breast surgeries. They work not only
with patients with cancers, but follow those with breast dis-
❝
We offer a comprehensive program.
We all work well together—we’re like
a big family.❞
—MAYA GHAEMMAGHAMI, M.D.
ease, cysts and benign growths as well. For women who have
abnormal mammograms or biopsies, follow-up appointments
are made quickly so they don’t have to wait. For a woman
Maya Ghaemmaghami, M.D., a medical oncologist at Augusta
diagnosed with breast cancer, the surgeon is often the first
Health. “And we stay up to date on the latest research and
person she has contact with. Together, they’ll discuss surgical
participate in clinical trials.” Dr. Ghaemmaghami discusses
treatment options such as lumpectomy and mastectomy, and
treatments with patients and can help them make a decision.
the pros and cons of each. When it comes to treatment, “there
• Remarkable radiologists. “Breast imaging is an important
are no black-and-white decisions,” Dr. Thompson says. “There
part of diagnosing breast cancer,” says Patricia Buchanan, M.D.,
are a lot of gray areas.” Women who face a high genetic risk of
a radiologist and director of Augusta Health’s Women’s
breast cancer will also be counseled about their options.
Imaging Center. “It’s skill and practice when you’re searching
• Outstanding oncologists. Two types work at Augusta
for things 1 centimeter or less in size.” Dr. Buchanan says that
Health: medical oncologists and radiation oncologists, both
60 percent of the cancers that the hospital’s breast-cancer
board certified. Medical oncologists oversee the care for a
screening picks up are either in situ (noninvasive) or are less
variety of breast cases, from those taking preventive
than 1 centimeter in size, and are considered minimal cancers.
measures to women whose breast cancer has spread. Radia-
That means Augusta Health radiologists are adept at finding
tion oncologists treat patients who benefit from radiation
cancer early. And, 84.6 percent of the cancers that are found
therapy. “There’s more than one way to treat cancer,” says
on screenings are stage 0 to stage 1 cancers, which are
Meg Shrader, R.N., B.S.N.,
and William Thompson, M.D.,
facs, review a chart.
12
HealthMatters Spring 2011
cancers that haven’t spread to the lymph nodes, exceeding
national standards. Dr. Buchanan credits the technicians
doing the testing with Augusta Health’s success at finding
cancers early. “Our techs are superior at getting patients
through the screenings, comforting them and knowing just
what to do and say,” she says.
• Proficient pathologists. These people behind the microscopes never lose sight of the fact that a person is on the
other side of every specimen. “We understand that the period
between having a biopsy and getting the results is filled with
anxiety,” Dr. Plumbley says. “We try to get the answer out as
quickly as possible without compromising quality.” What they
find will ultimately drive treatment decisions. Pathologists
determine whether a growth is noncancerous, cancerous or
undetermined; specific characteristics of a cancerous tumor;
and if a cancer is invasive or noninvasive. They also have the
privilege of making someone’s day. “It’s a Friday afternoon
and a patient gets good news that her growth is benign.
deana tipler, rt-rm-bd, gives
a patient a mammogram.
There’s no better gift to give someone,” Dr. Plumbley says.
• Nurturing nurses. All Augusta Health Cancer Center nurses
are certified oncology nurses, meaning they’re specially
trained to care for cancer patients. “Oncology nurses are
some of the most compassionate people, with a genuine
desire to help their patients,” Dr. Ghaemmaghami says.
• Specialized support staff. Augusta Health Cancer Center’s
support service staff includes a social worker; a nutritionist;
and massage, physical and occupational therapists dedicated
to handling the needs of cancer patients.
When it comes to breast care, Augusta Health leaves no
stone unturned. “We offer a comprehensive program,”
Dr. Ghaemmaghami says. “We all work well together—we’re
like a big family.”
We treat more than
breast cancer
Augusta Health can also provide you with the most
comprehensive care for breast pain, nipple discharge,
fibroadenomas, atypical ductal hyperplasia and
papillomas, either in the hospital or as an outpatient.
To get more information about our breast care services,
call the Cancer Center at (540) 332-5960 in Staunton or
(540) 932-5960 in Waynesboro.
Comprehensive breast
services available at
Augusta Health
reast MRI
b
cancer-certified dietitian
certified bra and prosthetic fitter for bras, camisoles
and lymphedema garments
chemotherapy
dedicated social worker
digital mammography (Women’s Imaging and
Staunton outpatient locations)
endocrine therapy
genetic counseling
lumpectomy and mastectomy
lymphedema therapy
MRI-guided breast biopsy
massage therapy
medi-port placement
physical therapy
sentinel lymph node biopsy
stereotactic breast biopsy
support groups for patients and caregivers
tai chi for cancer survivors
ultrasound-guided breast biopsy
www.augustahealth.com
13
Fighting the
good fight
How Augusta Health is helping
defeat breast cancer
forty-four-year-old Sandy baZan Sat acroSS from
were dealing with. Her cancer was stage I, grade 3—an
auguSta health Surgeon william thompSon, m.d., facS,
aggressive form of cancer that was caught early on.
waiting for the reSponSe that could change her life.
As she began to come to grips with what she was facing,
“You think I have breast cancer?” she asked the doctor.
she often turned to Shrader. “I can’t begin to describe the
“I’m too young for that,” the mother of two teenage boys
impact that Meg has had,” she says. “It was amazing to have
thought.
That was October 2009, just a few short months after
someone to talk with, someone who’s been where I was
headed. She could relate to everything I was telling her.” The
she first found a lump in her right breast. Though her breast
two women discussed treatment options, as well as physical
tissue had always been a little lumpy, she knew deep down
and emotional issues surrounding breast cancer.
that this time was different.
results from her biopsy confirmed Dr. Thompson’s
Because testing revealed that Bazan was at high risk for
a recurrence of breast cancer, chemotherapy became part of
suspicions, and he called her a few days after their meet-
her treatment plan. After a lumpectomy in november 2009,
ing to give her the news. He also said, “There’s someone I
she began the first of four rounds of chemo in December of
want you to meet. She’s been in your shoes.” That someone
that year. Her first chemotherapy treatment was given in a
was breast health navigator Meg Shrader, r.n., B.S.n. A
private room at the hospital’s infusion center to help her
breast cancer survivor herself, Shrader helps Augusta Health
adjust to the new treatment. Subsequent treatments were
patients work through an overwhelming number of cancer
given in an area alongside other patients. “I met so many
resources and coordinates care among the physicians who
wonderful people there,” she says.
treat the disease.
“It was the beginning of a beautiful relationship on a
not-so-beautiful journey,” Bazan says.
In preparation for the likelihood of losing her hair, she
had her hairdresser cut her long locks into a short style.
“I cried like a baby when she cut my hair off,” she says. In
January 2010, her hair started to fall out. That’s when she
Facing down cancer
shaved her head and covered it with hats.
Bazan would undergo additional testing, including an MrI, a
“It was hard,” admits Bazan. “Society looks at women
second biopsy and a diagnostic mammogram, to confirm her
based on their hair, makeup and breasts. I felt that everything
diagnosis and help physicians determine exactly what they
that made me a woman was being attacked.”
14
HealthMatters Spring 2011
Six weeks of radiation followed the chemotherapy, with
treatment officially wrapping up on April 30, 2010. Bazan was
amazed at how supportive everyone at Augusta Health was.
That included her medical oncologist, Maya ghaemmaghami,
M.D.—“I felt like she never had another patient; she always took
the time with me”—and her surgeon, Dr. Thompson—“so caring
and humble”—and the oncology nurses, who would stop and
pray with her. And, of course, Shrader. “My healthcare provid-
getting genetic testing
If you have a strong family history of breast cancer and
are at high risk for the disease, ask your physician about
getting tested for genetic mutations that increase breast
cancer risk as well as other steps to consider, such as
preventive mastectomy or drug therapy with tamoxifen,
raloxifene or aromatase inhibitors.
ers treated not only the body, but the spirit as well,” Bazan says,
noting that the Augusta Health Cancer Center staff also provided
support to her husband, John, and family.
a new lease on life
now cancer-free, Bazan is currently enrolled in a three-year
clinical trial. It aims to find out if taking bone-building medications
can reduce the risk of cancer spreading to the bones, a common
site of recurrence in breast-cancer patients. She says the study is
helping her do her part to help other women.
Some women might question why breast cancer had to
happen to them, but it’s something that never crossed Bazan’s
mind. “Why not me?” she says. “I’m being led down this path for a
reason.” She says the experience has given her a new lease on life.
She fell in love all over again with her husband, who’s stood by her
throughout this difficult journey. She notices things she may not
have before, such as birds singing during a rainstorm. She’s curbed
the hours she puts in at her job as a supervisor in the health information department at a local psychiatric center.
“This experience changes your perspective,” Bazan says.
“Things that I thought were important before I realize aren’t.
“I’m not the person I was before, and I hope I never will be.”
breast cancer symptoms
The following are warning signs of breast cancer.
See your physician if you experience any of these
symptoms, but keep in mind that most breast
lumps are not cancerous.
Most common
a painless lump or mass in or
near the breast
less common
a change in breast size or firmness
breast skin changes such as dimpling,
a sore or a rash
nipple itching, burning, rash, turning inward
or discharge
a warm area in the breast
Rare
pain in the breast
swelling under the armpit or of the arm
bone pain
❝
why not me? i'm being led down this path
for a reason. this experience changes your
perspective. things that i thought were
important before i realize aren’t. i'm not
the person i was before, and i hope i never
will be. ❞
sanDY bazan (leFt) leans On
HeR HusbanD, JOHn.
—sanDY bazan
www.augustahealth.com
15
(pneumonia), herpes zoster vaccine (shingles) or booster shots
for vaccines such as tetanus. Dr. Landauer says she recommends
the zoster vaccine (normally given to those ages 60 and older)
to younger patients if they’ve had multiple shingles recurrences.
She also advocates the flu shot—those 6 months and older need
it annually.
Unsure if you’re up to date on your vaccinations? Ask your
primary care provider.
Screenings
Screenings play a major role in preventing or catching disease
early. Lipid panels can spot problems with cholesterol—a key
contributor to heart disease that doesn’t often have symptoms.
Preventive
measures
Why vaccines, screenings and
physicals are important
“I screen some of my teenage patients for high cholesterol,”
Dr. Landauer says. “You’re ahead of the game if you find this early.”
Colonoscopy, recommended for those ages 50 and older
at average risk of colorectal cancer, is another lifesaver. Not only
can it help physicians spot cancer early, but any precancerous
growths found during the test can be removed during the procedure. (See page 5 for more about colonoscopies.)
Other important screenings include blood pressure, mammograms, Pap tests (for cervical cancer) and diabetes testing.
Physicals
Dr. Landauer advocates getting physicals. “It’s a time when I
can check for high blood pressure and order routine blood
To stay in top shape, think in terms of what you can do
work, which can pick up on things we wouldn’t find other-
now to prevent health problems from developing later.
wise, such as thyroid disease and anemia,” she says.
“People come in when they feel bad, but good health is really
Physicals are recommended for adults at least every three
about prevention—don’t wait until something happens,”
years—more frequently for those who are over age 40 or who
says Diane Landauer, M.D., a family practice physician with
have health issues.
Augusta Health.
Dr. Landauer encourages her patients to get vaccines
(immunizations), screenings and physicals—simple measures to
prevent health problems or catch them early.
Vaccines
Childhood vaccines include hepatitis B,
varicella (chickenpox) and MMR (measles,
mumps, rubella). With preteens, Dr. Landauer
says she promotes vaccination against
the sexually transmitted disease human
Diane
Landauer, M.D.
papillomavirus (HPV), which can cause
cervical cancer and genital warts.
Depending on their age and health history, adults may
need to get immunizations such as pneumococcal vaccine
16
HealthMatters Spring 2011
Talking to teens
The relationship between a primary care provider and
a teenager can be special. While there are no official
guidelines for how often teens should see their physician, Diane Landauer, M.D., says she catches teens when
she can—if they’re in for sports physicals or vaccinations.
She says she assures them that they can talk to her about
anything.
“Sometimes I ask the parent to leave the room,” she
says, allowing the teen to openly discuss issues like sex,
sexually transmitted diseases and drugs. “I want to make
sure they’re not getting their information from their
peers, which may not be so accurate.”
blood donation primer
about one in Seven people entering the hoSpital in the
Testing is performed on all blood donations to ensure safety
united StateS will need blood, according to virginia blood
standards are met before the blood is distributed to hospitals.
ServiceS (vbS), the blood Supplier for auguSta health.
After their blood is processed, all donors will receive information
Yet despite this critical need, less than 10 percent of eligible
identifying their blood type. If a donor’s blood is deemed unus-
donors donate blood annually.
able, he or she will be notified with the reason.
But they might if they knew their one
pint could save as many as three lives. “You
can help a lot of people with just this one gift,
and it doesn’t take a tremendous amount
of effort,” says Christopher novotny, M.D., a
pathologist at Augusta Health.
cHRistOPHeR
nOvOtnY, M.D.
Blood is more than the red blood cells
most people envision. It’s actually made of
several components, including platelets, which promote clotting and can help, among others, cancer patients and accident
victims. Blood also contains plasma, the straw-colored fluid
portion of blood that helps maintain blood pressure and volume.
Substances found in plasma, such as clotting factors and immune system proteins, can be used to treat certain diseases and
deficiencies. Platelets and plasma are separated from red blood
cells following a traditional donation; they can also be specifically
donated through a special process called apheresis, in which
donated blood is spun in a centrifuge, the specific parts collected
and the rest of the blood returned to the donor.
“There’s a tremendous need for platelets,” Dr. novotny says.
That’s because they have a relatively short shelf life of three to
five days. Most red blood cells can be stored for 42 days, and
plasma can be frozen for up to a year.
becoming a donor
Donating blood takes a total of about a half-hour to an hour—
including filling out paperwork to ensure that you qualify. In
faqs about
blood donation
is donating blood safe? Yes, all needles and bags
are used only once, preventing contamination.
can i donate if i’ve been rejected as a donor
before? You may be able to do so, as many donors are
turned away for temporary conditions, such as low
iron levels.
How often can i give blood? Every 56 days.
How can i feel my best on the day i give blood? get
a good night’s sleep, eat a good meal beforehand,
drink plenty of fluids and have some juice and cookies
after you donate. Avoid heavy lifting or strenuous
activity for the rest of the day.
How can i help if i’m ineligible to donate? Organize
a blood drive, recruit donors or volunteer at a drive.
virginia, healthy adults who are at least 16 years old and weigh at
least 110 pounds can donate blood every two months, vBS says.
Some would-be donors may be turned away if they have certain
health issues, such as sexually transmitted diseases, or have
recently traveled to a country where malaria is present.
A single-use needle is inserted into the donor’s arm and
the pint of blood is collected usually within 10 minutes, and the
donor sent on his or her way (those donating plasma or platelets
can expect a longer donation process). “giving blood is no worse
giVe the gift of life
keep your eyes open for blood drives in your area.
augusta health, in conjunction with virginia blood
Services, also offers a collection center in the
acc community care building, which features
traditional blood donation, as well as platelet and
plasma donation. for more information, call
virginia blood Services at (540) 332-4526.
than getting blood drawn,” Dr. novotny says for the needle shy.
www.augustahealth.com
17
Ask the physician
Augusta Health physicians answer
your questions
Q:
How do I know when it’s time for
allergy shots? And do they really
work anyway?
Q:
I’m a mom who has food allergies and my
son is just starting table foods. What’s the
best way to introduce him to foods, making
sure that he doesn’t have the same allergic
reactions I do?
Most people can manage their
allergy symptoms (such as sneezBefore initiating table foods, discuss your
ing, an itchy nose, watery eyes
lia bruner, m.d.
Family practice
in Lexington
or congestion) with avoidance
infant’s feeding schedule with your family
techniques, such as skipping
doctor. A family history of food allergies does
outdoor activity during the peak
increase a child’s risk of having them, too. If
one parent has food allergies, his or her child
pollen times of 5 a.m.–10 a.m., or
by taking over-the-counter or
C. david
sutton, M.d.
has up to a 40 percent chance of having an
prescription medications. But,
Family practice
in Stuarts Draft
allergy, with that risk jumping to 75 percent
not everyone responds to these
if both parents have food allergies. However,
methods. In those hard-to-manage cases, your physi-
most people with food allergies are allergic
cian may recommend seeing an allergist for what’s
to eight specific foods that are responsible
called immunotherapy, or allergy shots. Allergy shots
for 90 percent of food allergies: tree nuts, peanuts, milk, eggs, soy,
work by exposing you to a specific allergen with an
wheat, fish and shellfish—so you shouldn’t be feeding these foods
injection. Doses are gradually increased to help you
to your baby for that very reason (Talk with your pediatrician
build resistance and tolerance to the allergen. Allergy
about when it’s OK to try these eight foods). Most infants start on
shots can be effective for those whose allergies don’t
an iron-fortified, single-grain baby cereal, working their way up to
seem responsive to other treatments. And they can be
pureed meat, vegetables and fruits—aka baby food.
especially effective for children, possibly preventing
the development of asthma in these cases.
However, keep a few things in mind. Allergy shots
Introduce new foods one at a time, and wait a few days to see
if your baby has a reaction, such as diarrhea, a rash or vomiting. If
a reaction does occur, discuss it with your child’s physician, or seek
require a big time investment; for the first several
emergency help for severe reactions. Some allergies, such as those
months, you may need to visit the allergist up to twice
to milk, eggs, soybean products and wheat, may be outgrown,
a week—and it may take you awhile to feel better.
while others, such as allergic reactions to peanuts or shellfish,
You also need to make sure your insurance covers the
will likely not be. On a side note, as many as a quarter of people
treatment. Allergy shots can be riskier in people with
think they’re allergic to certain foods but really only 2 percent of
underlying health conditions or who are on certain
adults and 6 percent of children actually have a true food allergy.
medications, so talk with your physician before
Most people have what’s called a “food intolerance,” which causes
making a decision.
some unpleasant symptoms such as gas, nausea and vomiting but
doesn’t involve the body’s immune system.
18
HealthMatters Spring 2011
Q:
My son plays baseball and my daughter
plays tennis. What type of equipment
should they wear to protect their eyes?
injuries could have been prevented with the proper protective eyewear. Possible eye injuries include blunt trauma,
when something hits you in the eye (which can lead to such
serious injuries as a detached retina or broken bones around
the eye); penetrating injuries, when something cuts your eye;
and radiation injuries, when the eye is exposed to the sun’s
When you talk about protection for
sports, you may automatically think of
ultraviolet light.
Because baseball and tennis are two of the leading
helmets, padding and other gear. But
sports with eye injuries, you need to ensure that your chil-
don’t overlook the importance of shield-
dren are protected. Contact lenses, sunglasses and helmets
ing the eyes from harm. An estimated
don’t offer enough protection from blunt or penetrating
marc
shields, m.d.
40,000 eye injuries happen during
injuries. Instead, look for protective sports eyewear with
Ophthalmology
practice
in Fishersville
sports every year—in fact, eye injuries
3-mm polycarbonate lenses—these impact-resistant lenses
are the leading cause of blindness in
are available in regular and prescription forms. They’re slim
American children, and most injuries
and light, so your children won’t have to compromise com-
that occur in school-age children
fort for safety. If you’re having trouble finding eyewear, ask
are sports-related. Sadly, more than 90 percent of these
your child’s pediatrician for recommendations.
Image © istockphoto.com/Steve Cole
continued on page 20
www.augustahealth.com
19
continued from page 19
Q:
My teenage daughter said she plans to
bake in the sun all summer. What are the
negative effects of tanning? I‘d like to
teach her that this isn’t a wise idea.
Q:
I know that prostate cancer is often
called a “silent” disease, with few or no
symptoms early on. But are there signs
I should be looking for?
School will soon be out for summer,
Prostate cancer is the most common-
and that means lots of teenagers will
ly diagnosed cancer in men, second only
be headed outdoors to soak up the
to lung cancer in the number of cancer
sun—often without proper sun protec-
deaths. In its early stages, prostate
tion. Skin cancer, of course, is one of the
kristen L. savola,
M.d., M.Ed.
Laser and
cosmetic
dermatology
practice
in Fishersville
biggest consequences of unprotected
sunbathing. Research has shown that
childhood sunburns lay the founda-
cancer often doesn’t have symptoms.
william r.
jones, m.d.
Urology practice
in Fishersville
As it advances, it may cause urination
problems, such as a frequent or urgent
need to pass urine, including at night;
tion for the development of future
difficulties starting or stopping the urine
melanoma (the deadliest form of skin
stream; an inability to urinate; weak
cancer). Exposure to the sun’s ultraviolet
urine flow; painful or burning urination; blood in the urine
(UV) rays can also lead to other types of skin cancer, including
or in semen; pain in the lower back, hips or upper thighs;
basal cell and squamous cell carcinomas.
erection difficulties; and painful ejaculation. However, these
Tanning beds have been associated with a 75 percent
symptoms can also indicate conditions other than cancer,
increased risk of melanoma when used before age 35 and
which is why it’s important to see your physician if you’re
have been linked to eye cancer, squamous cell and basal cell
experiencing any of them. He or she can perform testing to
carcinomas, immune system depression and allergic reac-
reach a definitive diagnosis.
tions. But if that still doesn’t prove convincing to your teen,
Debate surrounds screening for the disease, as potential
benefits of screening may not outweigh the potential risks,
can lead to age spots, spider veins on the face, leathery skin,
including false-positives and side effects associated with
wrinkles, loose skin and a blotchy complexion. Dermatolo-
prostate cancer treatment. Talk with your physician about the
gists refer to this as “photoaging.” To prevent it, follow some
benefits and risks of screening (testing includes the digital
basic sun-protection practices: Don’t deliberately tan; stay out
rectal exam and the prostate specific antigen, or PSA, test)
of the sun between the peak sun hours of 10 a.m. and 4 p.m.;
to determine if it’s right for you. Your physician may suggest
protect yourself with a wide-brimmed hat and a long-sleeved
beginning at age 50, or earlier if you fall into a high-risk cat-
shirt; and use broad-spectrum sunscreen with an SPF of 30 or
egory, such as if you have a family history of prostate cancer
higher year-round.
or are African-American.
Image © istockphoto.com/fatihhoca
speak in terms of premature aging: Unprotected UV exposure
20
HealthMatters Spring 2011
get help from a
gastroenterologist
(L to R) vanessa lee, m.d., is at the
computer with wendy wyant, R.n.,
and melissa stokes, R.N.
Think you may benefit
from esophageal testing?
Speak with your primary care
physician, who may suggest that
you see a gastroenterologist. He
or she can determine if you’re
a candidate for ManoScan 360.
To find a gastroenterologist,
please call Augusta Health
Gastroenterology at (540)
245-7350 in Staunton or (540)
221-7350 in Waynesboro.
Modern technology
New equipment helps with gastroenterologic problems
Having trouble swallowing? Plagued by heartburn?
impedance testing with the ManoScan 360,
Augusta Health can help you get to the root of the
Dr. Lee notes. In both tests, a very thin tube
problem with its modern diagnostic technology.
with 36 sensors is placed through the nose
Since December, the hospital has been using the ManoScan
360™ to perform two tests that evaluate noncardiac chest pain
and down the esophagus.
During esophageal manometry, you’re
and diagnose esophageal disorders such as gastroesophageal
asked to swallow, and the tube measures
reflux disease (GERD) and dysphagia (difficulty swallowing), says
your esophagus’ response. Full-color
Missy Stokes, R.N., who tests patients using the new system. With
images and pressure measurements are then displayed on a
precise pressure measurements, the ManoScan 360 can measure
computer screen. Esophageal manometry is performed as an
how well your esophagus muscles can squeeze and if the muscles
outpatient procedure, and with a local anesthetic takes about
are squeezing in the correct sequence—a test called esophageal
45 minutes—with only about 15 minutes of that spent with
manometry. The ManoScan 360 also can evaluate reflux and
the tube in the throat for the procedure. The only special prep
determine if you’re experiencing the acidic or nonacidic variety
is not drinking or eating for several hours before the test, says
through a procedure called a pH impedance test. This distinction
Wendy Wyant, R.N., of Augusta Health.
is important since medications used to treat acid reflux don’t work
Vanessa Lee, M.D.
During pH impedance testing, you’re sent home with
on nonacid reflux, says Vanessa Lee, M.D., a gastroenterologist
the tube taped in the right place and attached to a recording
with Augusta Health Gastroenterology. Like acid reflux, nonacid
device for 24 hours. As you go about your day, the system
reflux is also uncomfortable and damages the esophagus. Be-
evaluates every episode of reflux and measures its pH,
cause previous diagnostic tools weren’t as sensitive, nonacid reflux
says Vicki Taylor, R.N., B.S.N., director of surgical services at
was more difficult to diagnose, making it harder to treat.
Augusta Health. The tube won’t affect eating, drinking or
breathing. After 24 hours, you return to your physician’s office
How it works
to have the tube removed. He or she will read the results and
Many patients get both esophageal manometry and pH
make a diagnosis.
www.augustahealth.com
21
Happenings
at Augusta Health
Calendar of classes and groups
Nonmembers may purchase a 10-class
pass for $100. Classes run on an ongoing basis. Other classes not listed here
can be found on our website at www.
augustahealth.com/lifetime-fitness.
For more information, call Sharon Stiteler
of Lifetime Fitness at (540) 332-5571.
YOGA CLASSES
Basic: Mondays, 5:30 p.m., and
Tuesdays, 9 a.m.
Intermediate: Thursdays, 8:45 a.m.
Fitness Yoga: Wednesdays, 6:30 p.m.
TAI CHI
Cancer Recovery: Tuesdays, 6:45 p.m.
Free to cancer recovery patients; sponsored by Augusta Health Cancer Center
Arthritis and Diabetes: Tuesdays,
11:15 a.m.
Beginner: Wednesdays, 11:15 a.m.
Intermediate: Thursdays, 11:15 a.m.
Advanced: Tuesdays, 7:30 p.m.
CHI KUNG
Intermediate: Tuesdays, 10:15 a.m.
Advanced: Thursdays, 10:15 a.m.
LES MILLS BODY COMBAT
Mondays, 5:30 p.m.; Tuesdays, 4:30 p.m.;
Wednesdays, noon; Fridays, 5:15 a.m.
MARTIAL ARTS
Extra fee, class passes excluded
Beginner: Mondays and Wednesdays,
7–8 p.m.
Intermediate: Mondays and
Wednesdays, 8–9 p.m.
Cost: $55 a month for members,
$90 for nonmembers
22
HealthMatters Spring 2011
AQUATIC CLASSES
Aqua Power: Mondays, Tuesdays and
Fridays, 7:45 a.m.; Tuesdays and Fridays,
9 a.m.; Mondays, 4:45 p.m. (Fitness Pool)
Aqua Express: Thursdays, 4:45–5:30 p.m.
Aqua Jogging: Mondays and
Thursdays, 9 a.m. (Fitness Pool)
THERAPEUTIC/REHABILITATIVE
AQUATIC CLASSES
Aqua Lite: Mondays–Fridays, 9 a.m. and
10 a.m.; Tuesdays and Thursdays,
9 a.m. and 10 a.m.; Wednesdays, 4:45 p.m.
(Therapy Pool)
Range of Motion (ROM): Mondays and
Fridays, 11 a.m. (Therapy Pool)
ZUMBA DANCE
Mondays, 9:15 a.m.; Tuesdays, 3:45 p.m.;
Wednesdays, 5:30 p.m.; Thursdays,
12:15 p.m.; Fridays, 5:30 p.m.
Oncology Support Groups
For more information about any cancer
group, call Leigh Anderson at
(540) 245-7105.
FRIENDS LISTENING
TO FRIENDS GROUP
For newly diagnosed cancer patients
who have fears, questions or concerns.
This group also addresses life after cancer
treatments, dealing with recurrence of the
disease and chronic symptoms related to
living with cancer.
When: Mondays, 4:30–5:30 p.m.
Where: Augusta Health Cancer Center
Conference Room
caregiver support GROUP
While you‘re taking care of your loved
one, don’t forget to take care of yourself.
When: Mondays, 4–5 p.m.
Where: Augusta Health Cancer Center
Conference Room
Stroke Support
SHENANDOAH VALLEY
STROKE CLUB
Sponsored by the Recreation Therapy
department at Augusta Health, the Stroke
Club is a support group for those who
have suffered a stroke and their family
members, care partners and friends.
When: At noon the first Friday of every
month (May 6, June 3, July 1, Aug. 5 )
Call: Shelley Payne at (540) 332-4047 or
(540) 932-4047
STROKE SYMPOSIUM 2011
Who: People in the Augusta Health
service area interested in learning more
about stroke prevention
What: 2011 Augusta Health Annual
Stroke Symposium
When: May 12, 4–6 p.m.
Where: Augusta Health Community Care
Building, Rooms 2 and 3
Sponsor: Augusta Health
Educational opportunities: Stroke
information presented by Augusta Health
Stroke Program Medical Director Robert
McMahon Jr., M.D. Dietary information
presented by Kara McGill Meeks, R.D.
Sleep apnea and stroke information
presented by Evan Wenger, M.D.
Screenings:
Carotid ultrasound as well as cholesterol
and glucose screenings: Call
(540) 332-5647 to schedule a time slot.
Blood pressure screening.
Stroke risk assessment.
Information about: High cholesterol, diabetes, carotid narrowing, heart disease,
Image © istockphoto.com/Sondra Paulson
Augusta Health Lifetime
Fitness Group Classes
high blood pressure, quitting smoking,
atrial fibrillation and a healthy diet.
Community Wellness
GAIN INDEPENDENCE FROM
TOBACCO
This proven six-session smoking and
smokeless tobacco cessation program
will help you examine how and why you
use tobacco and create an individual quit
plan. Nicotine replacement therapy and
pharmacological aids for cessation are
examined so that each person can choose
if he or she needs this help. One-on-one
assistance is available upon request.
When: Fall classes begin Thursday,
Sept. 15, 6–7:30 p.m.
Call: (540) 332-4988 for more information
You can! live well, Augusta!
This series of workshops helps people
who suffer with chronic illnesses, such as
asthma and heart disease, learn ways to
self-manage their condition.
When: Fall classes begin Tuesday, Sept. 6 at
1 p.m. and 6 p.m.
Call: (540) 332-4192 or (540) 332-4988
for more information
live well, with diabetes!
Classes focus on healthy eating, practical
exercise, problem solving, goal setting,
pain and fatigue management, appropriate use of medications and working more
effectively with healthcare providers as
related to diabetes. This program doesn’t
conflict with or take the place of your
current self-management education or
treatment. We encourage continued contact with your current certified diabetes
educator and healthcare provider.
When: Fall classes begin Tuesday, Oct. 18
at 1 p.m. and 6 p.m.
Call: (540) 332-4192 or (540) 332-4988
for more information
Smart-Sitters
This babysitting class for adolescents
ages 12 and older includes infant and child
care: feeding, bathing and age-appropriate
activities. First Aid and Family and Friends
CPR are also covered.
When: Thursday, June 16, 8 a.m.–4:30 p.m.
Call: (540) 332-4190
Ostomy Support Group
AUGUSTA HEALTH DIVERSIONS—
ASSISTING YOU FOLLOWING
OSTOMY SURGERY
In this group meeting, you’ll share ideas
and improve your quality of life after
ostomy surgery.
Where: Augusta Health Community
Care Building
Call: (540) 332-4346 for details
Augusta Health Lifetime
Fitness Tennis Program
Schedule
ADULT 1*2*3 TENNIS
Tennis is as easy as 1*2*3! Learn to play,
improve skills and how to practice in
this group clinic. Ages 18 and older
When: Thursdays, 6–7:30 p.m.
Cost: $76.50
Sessions: May 26–June 16, June 30–
July 21, Aug. 11–Sept. 1
LADIES' NIGHT TENNIS
Enjoy round robin ladies' singles, doubles,
and alternative format play with new and
old friends.
When: Wednesdays, 6–8 p.m.
Cost: $72
Session: June 8–Aug. 31
MEN'S NIGHT TENNIS
Enjoy round robin men’s singles, doubles,
and alternative format play with new and
old friends.
When: Wednesdays, 6–8 p.m.
Cost: $72
Session: June 8–Aug. 31
ADULT CARDIO TENNIS
Feel the beat and move your feet! This
“workout” tennis program is sure to leave
you energized.
Ages 18 and older
When: Mondays, 6:15–7:15 p.m.;
Wednesdays, 9–10 a.m.
Cost: $60
Monday Sessions: June 6–July 11,
July 25–Aug. 29
Wednesday Sessions: June 8–July 13,
July 27–Aug. 31
MUNCHKIN TENNIS
Age 10 and under tennis format: Smaller
court, smaller equipment, BIG FUN!
Beginner, ages 4–6
When: Mondays, Tuesdays and Thursdays,
9:15–10 a.m.
Cost: $57.50
Sessions: June 13–23, June 27–July 7,
July 18–28, Aug. 8–18
FUTURE STARS
10 and under tennis format: Smaller court,
smaller equipment, BIG FUN!
Beginner and intermediate, ages 7–10
When: Mondays and Wednesdays,
10 a.m.–12 p.m.
Cost: $102
Sessions: June 13–23, June 27–July 7,
July 18–28, Aug. 8–18
RISING STARS
Learn to play the right way through
competitive drills and games.
Beginner and intermediate, ages 11–17
When: Tuesdays and Thursdays,
10 a.m-12 p.m.
Cost: $102
Sessions: June 13–23, June 27–July 7,
July 18–28, Aug. 8–18
ACES
Take your game to new levels with
advanced training and competition.
Advanced and competitive, ages 12–17
When: Tuesdays, Wednesdays and
Thursdays, 12:30–2:30 p.m.
Cost: $153
Sessions: June 13–23, June 27–July 7,
July 18–28, Aug. 8–18
JUNIOR SOFT COURT CHAMPIOnSHIPS
Girls and boys ages 12 and under, 14 and
under, 16 and under; and 18 and under
singles and doubles tournament
When: Monday–Friday, 8 a.m.–5 p.m.,
July 11-15
Cost: $22 first event, $12 second event
All programs held at the Lifetime
Fitness/Tennis facility on the Augusta
Health campus. Times and fees are subject
to change. For more information about
tennis programming, call Chad Reed,
Tennis Coordinator/Pro, at (540) 332-5280
or e-mail [email protected].
www.augustahealth.com
23
Augusta Health gastroenterology. “People most at risk include
those with gErD, those over the age of 50, those who are
obese, those who have a hiatal hernia and those who are
male.” Of people with Barrett’s esophagus, 1 in 200 develop
esophageal cancer each year, Dr. guarino says. That’s because
constant exposure to stomach acid damages the esophagus’
lining, which can trigger precancerous cell changes.
Do i have barrett’s esophagus?
"Aside from acid reflux, Barrett’s esophagus has no symptoms," Dr. guarino says. It can only be diagnosed with an
upper endoscopy, a procedure which examines the esophagus. If needed, during the endoscopy, a tissue sample
can also be taken to be analyzed for abnormalities; small
cancers may also be removed.
Treatment for Barrett’s esophagus includes acidsuppressing medications such as proton pump inhibitors
(PPIs) and monitoring of the condition. To keep an eye on
any changes, an upper endoscopy is recommended every
barrett’s
esophagus
learn more about this serious
gerd complication
many people have heard of gerd (gaStroeSophageal
reflux diSeaSe) and know that frequent heartburn iS itS
moSt common Symptom. gErD can be chalked up to weak-
ened muscles in the digestive tract that allow stomach acid to
leak back into the esophagus.
But what you may not know is that over time, gErD can
cause serious complications—including Barrett’s esophagus.
one to three years for people who have been diagnosed
with the condition, Dr. guarino says. Many experts also
recommend that everyone over age 40 who suffers from
chronic acid reflux get an upper endoscopy to check for
any abnormal changes.
tips to reduce
acid reflux
Avoid trigger foods, including chocolate, fatty foods,
caffeine, tomatoes, citrus fruits, spicy foods, mint
and alcohol.
Maintain a normal weight.
Avoid big meals and meals
eaten later at night.
Eat slowly.
Don’t use tobacco.
Wear looser-fitting clothes.
According to the American Cancer Society,
people with this condition have 30 to
125 times the risk of developing esophageal
cancer than those who don’t.
“Barrett’s esophagus affects 1 percent
of adults in the United States,” says Paul
Paul guaRinO, M.D.
24
guarino, M.D., a gastroenterologist at
HealthMatters Spring 2011
stop heartburn in its tracks!
make an appointment with paul guarino, m.d.,
by calling (540) 245-7350 in Staunton or
(540) 221-7350 in waynesboro.
New heathcare providers
A
t Augusta Health, recruiting experienced, dedicated providers for your healthcare is one of our
top priorities. These generalists and specialists can help keep you and your family healthy. We’d
like to introduce you to our new medical staff members.
allison baroco, M.d.
Infectious disease physician
Medical School: University of
South Alabama
Residency: Eastern Virginia
Medical School
Fellowship: Eastern Virginia
Medical School
Practice: Augusta Medical Group
Hospitalist
Medical School: University of
South Alabama
Residency: Eastern Virginia
Medical School
Practice: Augusta Health Hospitalists
Certified physician assistant
Education: Hampden-Sydney
College, B.S., math/economics
Kings College, B.S., Physician
Assistant
Practice: Augusta Health Cardiology
Kelly Jensen, M.D.
Alan Cohen, M.D.
Internal medicine physician
Medical School: Washington
University School of Medicine
Residency: Jewish Hospital,
Washington University School
of Medicine
Practice: Augusta Health
Internal Medicine, Waynesboro
}
Our highly trained physicians
and staff use state-of-the-art
technology to provide the best
care with warmth and
compassion.
26 HealthMatters Spring 2011
Family nurse practitioner
Education: Eastern Mennonite
University, BSN
University of Virginia, MSN
Practice: Augusta Health Family
Practice, Lexington
John “Jack“ Garber, P.A.-c
Patrick Baroco, M.D.
}
Mary “Ashley” Cook,
F.N.P.
Obstetrician and gynecologist
Medical School: University of
Mississippi
Residency: Eastern Virginia Medical
School
Practice: Augusta Health Care for
Women
find the physician you need!
If you or a family member needs a primary
care or specialty physician, visit www.augusta
health.com and click on “Find a Physician.”
new facility offers quality
primary care, right in your
own community
auguSta health iS helping meet the growing need for
overseeing the development of the new
primary care providerS with the opening of itS auguSta
practice. “And if you need more special-
health family practice in churchville.
ized care, he or she will know exactly
Slated to open June 13, the practice will be headed up
by Diane landauer, M.D. Dr. landauer specializes in family
where to send you to get that.”
The practice is located at 3881
medicine and sees everyone from children to adults. The
Churchville Ave. in Churchville. Hours will
practice will offer a variety of services, from physicals and flu
be Mondays and Fridays, 8 a.m.–4:30 p.m.;
shots, to disease management and specialist referrals.
Tuesdays, 8 a.m.–noon; and Wednesdays,
“A primary care physician is the gatekeeper for your
Diane
lanDaueR, M.D.
10 a.m.–8 p.m. The office will be closed on Thursdays and
medical records and knows everything that ails you, which
weekends. To schedule an appointment at this new facility,
is why it’s so important to have one,” says Phillip Worrell,
call (540) 248-4417. To make an appointment after June 13,
who, as project manager for Augusta Health, has been
call (540) 213-9260.
www.augustahealth.com
27
Augusta Health
78 medical center drive
P.O. Box 1000
Fishersville, VA 22939
Non-Profit Organization
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PAID
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Augusta Health named
Top Hospital and honored
with other awards
Providing quality patient care and having a strong
Award denotes a hospital’s low rates of avoidable complications,
commitment to the well-being of its community—those
such as bedsores and severe infections, says Lisa Schwenk, Direc-
have always been the cornerstone of augusta health’s
tor of Communications and Public Relations at the hospital.
mission. Now these efforts have garnered national
recognition.
In March, Augusta Health was the only hospital in Virginia
The hospital also netted nine HealthGrades Top 10 Awards
in areas such as coronary intervention, stroke, orthopedic
surgery and critical care.
to be named one of the Thompson Reuters 100 Top Hospitals®.
Just as the name implies, Augusta Health was recognized as
Caring for the community
one of the best hospitals in the country for excellence in clini-
“The Foster G. McGaw Prize is the premier community service
cal care, patient perception of care, operational efficiency and
honor given by the American Hospital Association,” Schwenk says.
financial stability. Among the 100 Top, Augusta Health was
one of six Everest Award winners for the highest rate of im-
its community-based initiatives, including:
provement and performance. Augusta Health was also
• Community Health Forum Initiative
recently awarded the Distinguished Hospital Award for
• ORCAS (Outreach, Resources, Care and Prevention,
Clinical Excellence and the Patient Safety Excellence Award
As a finalist, Augusta Health was recognized for several of
Assessment and Sealants)
from HealthGrades, an independent healthcare ratings
• Fit for Life
organization. The hospital was also named one of four national
• WOW (Working on Wellness)
finalists for the American Hospital Association’s 2010 Foster
• Mentoring the Next Generation
G. McGaw Prize, an award that recognizes a hospital’s service
While the 100 Top, Everest Award, HealthGrades and Foster
and commitment to improving the health of its community
G. McGaw recognitions are feathers in the Augusta Health
through various initiatives.
cap, they say a lot more about what you can expect from your
For the second year in a row, Augusta Health has been the
community hospital. “Our community has some of the best care
only hospital in Virginia honored with both the Clinical Excellence
available in the nation, right in their own backyards,” Schwenk
and Patient Safety Awards from HealthGrades. Using patient
says. “These awards let everyone know, ‘You don’t need to travel
outcomes to rank hospitals, the Distinguished Hospital Award is
for your healthcare. Quality care is given right here by your
given to hospitals performing in the top 5 percent nationwide in
friends, family and neighbors.’ It’s a real community connection
26 medical procedures and diagnoses. The Patient Safety Excellence
that makes a difference.”