Carilion Clinic Living - Fall 2011

Carilion Clinic

New Hope for a Common Women’sDisorder

Inspiring Better Health | CarilionClinic.org | Fall 2011

A Hiker’s Treat inthe New River Valley

Acid RefluxThere Is a Cure

Inspiring better health.™

When you need specialized care, our physicians are committed to one goal: getting you back toliving your life. That’s why we o(er minimally invasive joint replacement surgery, which meanssmaller incisions, shorter rehabilitation and a quicker return to everyday activity. We work togetheras a team to coordinate care tailored to the needs of every patient, every day. That way you can getthe specialized care you need—right here in your community.

To )nd a doctor, visit CarilionClinic.org or call 800-422-8482.

I could be back on the walking trail just a few weeks after hip surgery.

What if healthcare worked the way youwanted?

CarilionClinic.org | Fall 2011 1

Carilion Clinic

7 Teen Health A new health clinic opens.

12 Polycystic Ovary Syndrome This common women’s disorder often goes unrecognized.

14 Acid Reflux New incisionless surgery offers a cure.

16 Specialty Care Close to Home Four patients share their success stories.

22 The Cascade Trail A hiker’s treat in the New River Valley.

24 Kirk Avenue There’s a new vitality in downtown Roanoke.

President’s Message3 Welcome to Carilion Clinic Living.

Healthy Lifestyles5 Tips from our community health educators.

In Your Community8 Making a difference in southwest Virginia.

New Physicians20 New doctors across our region.

Better Living26 Your health calendar.

Healthy Eating27 Tips from our dietitians.

Fitness Tips28 Get your core muscles in shape.

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Fall 2011

FEATURES

DEPARTMENTS

2 Fall 2011 | CarilionClinic.org

CARILION CLINICPRESIDENT AND CEONancy Howell Agee

CARILION CLINIC 1906 BELLEvIEw AvE.P.O. BOx 13367ROANOKE, vA 24033540-981-7000

CARILION CLINIC LIvINg IS PRODUCED BYSTRATEgIC DEvELOPMENT:

vICE PRESIDENT OF STRATEgIC DEvELOPMENT Shirley Holland

DIRECTOR OF MARKETINgMike Dame

EDITOR Maureen Robb

LEAD DESIgNERDavid Porter

DESIgNERSTaryn Anderson, John Cornthwait

CONTRIBUTINg wRITERSRod Belcher, Mary Brewer, Allison Buth, Su Clauson-Wicker, Wendy Maxey, Otesa MiddletonMiles, David Perry, Matthew Sams

PHOTOgRAPHERDarryle Arnold

CONTRIBUTINg PHOTOgRAPHERDavid Hungate

PRINTINgChocklett Press

CARILIONCLINIC.ORg | 800-422-8482

Carilion Clinic is a not-for-profit health care organizationserving nearly one million people in Virginia through amulti-specialty physician group, advanced primary carepractices, hospitals, and outpatient centers. Led by clinicalteams with a shared philosophy that puts the patient first,Carilion is committed to improving outcomes for everypatient while advancing the quality of care through med-ical education and research.

Copyright 2011 by Carilion Clinic. No part of this publication maybe reproduced or transmitted in any form or by any means with-out written permission from Carilion Clinic. Articles in this publica-tion are written by journalists or authors who strive to presentreliable, up-to-date health information. However, personal deci-sions regarding health, finance, exercise and other matters shouldbe made only after consultation with the reader's physician orprofessional advisor. All editorial rights reserved. Opinions ex-pressed herein may or may not reflect the views of Carilion Clinic.

If you would like to be removed from Carilion Clinic mailing lists,please call 800-422-8482, e-mail us at [email protected], orwrite to us at Strategic Development, 711 S. Jefferson St.,Roanoke, VA 24016.

Rod Belcher is aRoanoke writer whosework has appeared inVirginia Living, VirginiaBusiness, and othermagazines. His firstnovel will be publishedby Tor Books next year.

Su Clauson-Wicker is theauthor of two travelbooks and the formereditor of Virginia Techmagazine. Her articleshave also appeared inThe Washington Post andother publications. Shelives in Blacksburg.

David Hungate is anaward-winning photog-rapher who has workedin television news andwhose Roanoke-basedcommercial photographybusiness takes him tophoto shoots around theUnited States.

Wendy Maxey has beenthe managing editor ofLodging.com and a copyeditor and entertain-ment editor for theRoanoke Times. She isnow a freelance writerbased in Roanoke.

Otesa Middleton Mileshas been a medical re-porter for Dow JonesNewswires, a featureswriter for the RichmondTimes-Dispatch, and aKnight-Wallace Journal-ism Fellow. She lives inRichmond.

David Perry is assistantdirector of the WesternVirginia Land Trust and afreelance writer whosearticles have appearedin The Roanoker, BlueRidge Country, and othermagazines. He is a na-tive of Blacksburg.

Our Contributors


President’s MessageWelcome to the first issue of Carilion Clinic Living, a magazine dedicatedto promoting good health and quality of life in our community. In thisand future issues, we’ll explore new developments in health care, andthe resources our region offers for living a healthy and fulfilling life. We’llalso feature articles about those who are making a difference in ourcommunity. We hope you’ll find inspiration—and personal resources—in these pages.

As you’ll see on page 14, a highly effective new treatment is avail-able for those suffering from acid reflux. Some 30 million Americanshave been diagnosed with this condition, which often disrupts sleepand forces a change in eating habits. Our story discusses how manyare finding relief.

In this issue we also address another common disorder, polycysticovary syndrome, which is believed to affect up to 10 percent ofwomen. Left untreated, it can result in infertility or life-threateningcomplications, such as heart disease or stroke. The latest treatmentis described on page 12.

When it comes to living in southwest Virginia, we’re intrigued bythe creativity and talent flourishing around us. Nowhere is this moreevident than in downtown Roanoke, where there’s a new vitality alongKirk Avenue as musicians, filmmakers, and artists create new venues(see page 24). Together, we’re adding vibrancy to our community.

TO YOUR HEALTH,

NANCY HOwELL AgEEPRESIDENT AND CEOCARILION CLINIC

Promoting goodhealth.


Emily would get her treatmentswhere she’s happiest.


At Carilion Clinic Home Care, we understand that familiar surroundings can help children

recover from an illness or injury. Our pediatric programs help make the transition from

high-tech hospital care to home care a little easier, allowing children and their families to

continue healing in a more comfortable environment. That way kids can get back to

being kids.

Learn more at CarilionClinic.org/homecare or call 800-964-9300.



Be Stroke SmartA stroke is an attack on your brain,and just like a heart attack, it needs tobe treated as an emergency.

The sad thing is, when a strokehappens, denial is common. The av-erage American waits 12 to 24hours to get to the hospital—muchtoo long. Every minute of delaymeans that more of your brain cellscan die. Getting treatment within

the first two to three hours could mean the differencebetween walking out of the hospital with little or no dis-ability and being permanently disabled, or worse.

Stroke symptoms—like confusion, trouble speaking,severe headache, dizziness, trouble walking, andnumbness of the face, arm, or leg—also can come onsuddenly.

It’s a myth that strokes can’t be prevented or treated.In fact, 80 percent of all strokes could be prevented, ac-cording to the National Stroke Association. What canyou do? Find out if you have high blood pressure, atrialfibrillation, diabetes, or high cholesterol and work withyour doctor to control those stroke risk factors. If youare a smoker, get help to quit. If you drink alcohol, doso in moderation. Exercise daily and lower salt and fatin your diet.

We can all make a difference in preventing stroke bytaking this message to heart. Pass it along to friendsand family.

walk for Health Did you know that regular exercise re-duces the risk of developing almostevery preventable disease?

The benefits of regular exerciseare many, including decreased riskof heart disease, some cancers, highblood pressure, increased bonestrength, and weight control. Regu-lar exercise can even help you sleepbetter and can alleviate your need

for an anti-depressant. But you have to do it! Make acommitment to doing it just about every day.

And, if you’re looking for a fun way to add some ac-tivity to your weekend, join the doctors of CarilionClinic every Saturday morning at 8:30 for Physicianson Foot. Each Saturday a Carilion physician leads a30-minute walk on the Roanoke River Greenway that’sdesigned for all fitness levels, starting at the corner ofHamilton Terrace and Belleview Ave. in front of CarilionRoanoke Memorial Hospital. To learn more, visit Caril-ionClinic.org/walking.

Tips from Our Community Educators

Edie Naughton, R.N.Health Educator

Julie Blanchard, M.S.Health Educator

Healthy Lifestyles

Doctors and nurses aren’t the only health care professionals working to keep youhealthy. At Carilion Clinic, health educators are active in the community, providingfree health screenings and education programs. Here, two of them discuss steps youand your family can take to maintain good health.

* Individual replacement needs may vary. Lyric is not appropriate for allpatients. Only a hearing professional can determine if Lyric is right for you.

Hears the news about aninvisible and comfortablehearing deviceHearing aids can help those with hearingproblems, but their bulky size anduncomfortable ,t can sometimes get inthe way of everyday living. At CarilionClinic, there is a much easier and betterway to improve hearing.

The Lyric hearing device, available inwestern Virginia only from Carilion Clinic,works with your ear’s anatomy to deliver clear, natural sound. It is theworld’s ,rst 100-percent-invisible hearing aid that can be worn 24/7, forup to four months at a time*.

With no batteries to change and no daily insertion or removal, the Lyricis hassle-free, giving you complete freedom to exercise, sleep, shower ortalk on the phone.

To nd out what you may be missing out on or to schedule anappointment, please call 540-581-0232.

CarilionClinic.org

Some Sounds Are Too Important to Miss.

The Lyric �ts deep in the ear canal next tothe ear drum and works with your ear’s

anatomy to produce natural sound qualityin both quiet and noisy environments.


When it comes to health and behavioral problems,teenagers are a high-risk group. Yet across thecountry, many adolescents and young adults lackaccess to health care—and end up in emergencyrooms for problems that could have been pre-vented.

Locally, the Roanoke Adolescent Health Partner-ship (RAHP) has been committed to giving adoles-cents access to health care. The nonprofit group hasserved thousands of teenagers at three clinics inRoanoke since 1994.

Early this fall, however, the clinic now located inthe Hurt Park neighborhood will move to a new, ex-panded location at 902 South Jefferson St. in down-town Roanoke. “We will have expanded hours, moreroom, and more providers,” says Kim Robertson,Carilion Clinic director of ambulatory pediatrics andadolescent health. “We are excited about the futureof this program, and we believe the downtown loca-tion will help provide more services.”

The move also reflects a new financial sponsorshipof the clinics. After years of challenges in acquiringfunding, RAHP approached Carilion Clinic for help,and Carilion has agreed to fund all three clinics, in-cluding those at Patrick Henry and William Fleming

high schools.Accordingly, the new downtown clinic will be

housed in a former Carilion Clinic pediatric office.Located near Carilion Roanoke Community Hospital,it will offer better access to many teenagers, withroom for growth.

All three clinics have physicians, nurses, andnurse practitioners who treat illness and injuriesand provide physical exams, immunizations, wellvisits, STD screening and treatment, health educa-tion, and mental health counseling. The clinics areopen to all Roanoke Valley youth 10 to 26 years ofage. Those with insurance are asked for a co-pay-ment; those without are treated under Medicaid orother eligibility programs, or through charity care.

“Carilion Clinic began supporting RAHP 15 yearsago through grants and volunteers,” says Robertson.“We’ve always recognized what a great communityservice it provides, and we want to see it continue.The goal of the program is to bring awareness to pre-vention and to provide the necessary resources toadolescents to make better life choices and improveoutcomes.”

For more information, call 540-857-7284 or 800-422-8482.

Teen HealthClinic to Openin DowntownRoanoke

By Allison Buth


Local Interest

In Your Community

Carilion Clinic wins Service Awards Three Carilion Clinic hospital units have received tophonors in service from Professional Research Consult-ants, Inc., a nationally known health care researchfirm. The Birthplace at Carilion New River Valley Med-ical Center earned a 5-star award in inpatient obstet-rics and gynecology services, signifying that it is in thetop 10 percent in its field. The 7 South Coronary CareUnit/Medical Cardiology Progressive Care Unit at Caril-ion Roanoke Memorial Hospital also earned a 5-staraward in inpatient cardiac/telemetry services. And theEmergency Department at Carilion Giles CommunityHospital received a 4-star award, indicating that itscored in the top 25 percent in its field. The awards arebased on patient surveys. (Pictured: members of theCoronary Care Unit staff.)

Jacobsen Recognized for Outstand-ing Community workWilliam D. Jacobsen, M.H.A.,F.A.C.H.E., chief executive officer ofCarilion Franklin Memorial Hospi-tal, has received two prestigiousawards: the American Hospital As-sociation’s 2011 Grassroots Cham-pion Award and the AmericanCollege of Healthcare Executives

Senior-Level Healthcare Executive Regent’s Award. Thefirst recognizes him for his exceptional leadership ingenerating grassroots and community support of thehospital’s mission. The second recognizes his signifi-cant contributions to the advancement of health caremanagement excellence and his executive capability,leadership ability, and innovative and creative manage-ment, among other accomplishments.

William D. Jacobsen

Cancer Program Named among Nation’s BestCarilion Clinic’s cancer treatment program inRoanoke has earned the Outstanding Achieve-ment Award from the Commission on Cancerof the American College of Surgeons, placingit among the top 17 percent of accreditedprograms nationwide. The award recog-nizes the quality of care, which features acomprehensive, multi-disciplinary teamapproach, and the latest treatment optionssuch as CyberKnife radiosurgery and tar-geted radiation technologies, as well asaccess to clinical trials.

Medical School welcomes Second ClassForty-two students from 12 states comprise the secondclass of the Virginia Tech Carilion School of Medicine.Chosen from a field of 2,743 applicants, 18 studentsare from Virginia, and nine have graduate-level de-grees. Twenty-five of the students are men; 17 arewomen. The average Medical College Admission Testscore for the class is 33—above the national averagescore of 30. The range of scores was 30 to 40 for theentire class. Of all the applicants, 239 were invited toRoanoke for an interview.


Carilion Clinic Announces AppointmentsCarilion Clinic has announced the following promotionsand appointments:

Melina Perdue, Senior Vice Presidentwith responsibility for Carilion’s com-munity hospitals, has been named Ex-ecutive Vice President. She will assumeresponsibility for regional primary carein addition to her existing responsibili-ties.

Carolyn Chrisman, Vice President forQuality and Process Improvement, hasbeen named Senior Vice President. Shewill develop Carilion’s new InnovationCenter, an initiative to further advancequality and process improvements.

Jeanne Armentrout, Vice President,has been named Senior Vice Presidentwith responsibility for Human Re-sources.

Paul Davenport, Senior Director ofCarilion Clinic Patient Transportation,has been named Vice President with re-sponsibility for the Department ofEmergency Services. He will continue tolead Carilion’s patient transportationservices.

Charles “Chuck” Carr has been namedVice President of Administration forCarilion Stonewall Jackson Hospital(CSJH). He has served on the hospital’sboard of directors since 1998 and onthe Carilion Clinic board since 2004. Hecomes to CSJH with over 25 years ofleadership experience at both Reeves

Brothers and Modine Manufacturing Co.

John Piatkowski, M.D. has beennamed Vice President of Administrationfor Carilion New River Valley MedicalCenter. Dr. Piatkowski comes to Carilionfrom HealthEast Care System in SaintPaul, Minnesota, where he served asVice President and Executive MedicalDirector.

Exploration Station Opens at Mill Mountain ZooThe Exploration Station, a new educational site forchildren at Mill Mountain Zoo, has opened to the pub-lic. Sponsored by Carilion Clinic Children’s Hospital,the Exploration Station is a unique indoor space thatoffers presentations involving live animals. In addition,programs that link human health care to animal carein a fun and informative way are available. (Pictured:Sandra Hubbard and her son Aiden, at right, withzookeeper Bambi Godkin on opening day.)

Respiratory Therapy Programs Receive NationalRecognitionThree Carilion Clinic hospitals have earned QualityRespiratory Care Recognition from the American Asso-ciation for RespiratoryCare. They are CarilionRoanoke Memorial Hospi-tal, Carilion New River Val-ley Medical Center, andCarilion Franklin MemorialHospital. Hospitals thatearn this designation agreeto adhere to a strict set ofcriteria governing theirrespiratory care servicesand provide a level of res-piratory care that is con-sistent with nationalstandards and guidelines. About 15 percent of hospi-tals in the United States have applied for and receivedthis designation.


Local Interest

Health Educators Complete Mission to HondurasA team of Jefferson College of Health Sciences studentsand faculty is back from a health education mission toHonduras. The team, including Carilion employees,was led by Dean for Academic Affairs Lisa Allison-Jones and her husband, Bruce. For more than a week,team members provided basic health education to agroup of community health workers from Honduran vil-lages. The students also took a three-credit course,“Transcultural Health Care,” to prepare for the experi-ence.

Carilion Clinic Trains Physicians from Africa Earlier this year Carilion hosted 12 delegates fromAfrica as part of Legacy International’s North AfricanCommunity Health Initiative. The delegates were Egypt-ian and Moroccan community health care profession-als, mostly physicians, who came to the United Statesto exchange ideas and learn new ways to improve pub-lic health in their communities. For two weeks, eachdelegate was assigned a mentor from Carilion Clinic tohelp with training and educational needs. Training em-phasized ways to improve the health of women andchildren.

MyChart Adds 12,000th PatientCarilion Clinic has added its 12,000th patient to My-Chart, an online health care management tool. My-Chart, which is offered in most of Carilion’s primarycare practices, gives patients secure access to portionsof their electronic medical records and convenient waysto communicate with their doctor’s office. Patients canview their medical records, renew prescriptions, get testresults, request or cancel appointments, e-mail ques-tions to their doctor, view their prescribed medications,request referrals, and check for reminders about im-munizations or preventive care that is due.

Research Institute Launches visiting Scholars and Lecture SeriesThe Virginia Tech Carilion Research Institute haslaunched a distinguished visiting scholars and lectureprogram that will bring nationally and internationallyprominent biomedical scientists to Roanoke. Whilehere, scholars will meet with VTC researchers andmedical students and give lectures open to the public.The next speaker in the series will be Nora Volkow,M.D., Ph.D., director of the National Institute on DrugAbuse. She will speak on how the brain becomes ad-dicted on September 29 from 5:30 to 6:30 p.m. at theVirginia Tech Carilion School of Medicine and ResearchInstitute at 2 Riverside Circle in Roanoke.

Free Prostate Screenings Prostate cancer has no symptoms in its early stages,but it can usually be detected with a quick test and ex-amination by a physician. Statistics show that one insix men will be diagnosed with prostate cancer, andAfrican Americans are at even greater risk. Free screen-ings will be offered this fall on a number of dates, in-cluding those on Sept. 22 in Roanoke (5 - 7 p.m.) andSept. 28 in Vinton (5 - 7 p.m.). Those eligible for screen-ing are men who are: age 50 or over; age 45 or over andAfrican American; age 45 or over with a family historyof prostate cancer; and those age 40 or over who meet additional criteria. For more information, call 540-266-6000 or 800-422-8482 or go to CarilionClinic.org/Car-ilion/prostatescreenings. Registration is also requiredby calling the numbers shown.

vice President for Medical AffairsNamedMaxine Lee, M.D., M.B.A. has beennamed Vice President for MedicalAffairs for Carilion Roanoke Memo-rial Hospital. Dr. Lee received hermedical degree from Harvard Med-ical School and completed a resi-dency in anesthesiology at Yale NewHaven Hospital. She is board certi-

fied in anesthesiology. In her new role, she will promotethe effective and efficient use of clinical resourcesthrough patient safety measures, provider quality im-provement, medical staff credentialing, peer review,and the use of evidence-based medicine.

Better Breathers Support group Carilion Clinic’s Better Breathers Club offers patientsand their families the chance to learn ways to bettercope with chronic lung disease—and get support fromothers with the same condition. The group, whichmeets the third Thursday of each month from 3 to 4p.m. at 3 Riverside Circle in Roanoke, offers tools forachieving the best possible quality of life. Members re-ceive guidance in such areas as breathing retraining,exercise, medications, preventing infections, sleep dis-orders, nutrition, airway clearance, oxygen therapy,travel, and emotional and social well-being. For moreinformation and registration, call 540-266-6000 or800-422-8482.

Carilion Clinic Named toTop 100 Most wiredCarilion Clinic has againbeen named as one of the100 Most Wired by theAmerican Hospital Asso-ciation and its publica-tion, Hospitals & HealthNetworks. Carilion hasbeen named to the list anumber of times in thepast 12 years.

Dr. Maxine Lee



Medical News

PCOS often Goes Unrecognized By Mary Brewer

It’s been called a hidden epidemic, and it is believedto affect up to 10 percent of women. Yet this commonhormonal disorder often goes unrecognized by manywho suffer from it.

Polycystic ovary syndrome, or PCOS, is an imbalanceof reproductive hormones that can affect women of anyage—from girls as young as 13 to those enteringmenopause. The disorder is often characterized bysmall cysts on the ovaries and, if left untreated, cancontribute to complications such as infertility, Type 2diabetes, heart disease, or stroke.

There is no cure at this time, but PCOS (pronouncedpea-kose) can be managed to reduce the risk of moresevere medical problems, and to help women who havetrouble becoming pregnant.

Recognizing the SymptomsDoctors don’t know the exact cause of the condition,but several factors are thought to play a role. Excessinsulin is one. Heredity is another; if your mother orsister has PCOS, you may have it, too. Low-grade in-flammation may also be a culprit.

Symptoms of PCOS include irregular or absent men-strual periods; excess hair on the face or body; andacne. In addition, more than half of women with PCOSare, or go on to become, obese—with the resultingthreats of heart disease and Type 2 diabetes.

If you have PCOS, you may also be predisposed todeveloping high blood pressure; cholesterol abnormali-ties such as high triglycerides; metabolic syndrome;sleep apnea; and nonalcoholic steatohepatitis, a severeliver inflammation caused by fat deposits in the liver.

Dr. Robert Slackman with a sonogram showing an earlypregnancy within the uterus.

New Hope for a Common women’sDisorder

Finding TreatmentAt Carilion Clinic, reproductive en-docrinologist Robert Slackman,M.D. often sees women with PCOS.“The first thing I determine is, arethey trying to get pregnant?” hesays. “If so, I will induce ovulationwith a medication like Clomid. Weare usually very successful at get-ting women to become pregnant.

“If they’re not trying to becomepregnant, then I might put them onbirth control pills or progesterone10 days a month to bring on a regu-lar menses.”

Patients may also be prescribedmetformin, an oral diabetes medica-tion that lowers insulin levels. Thisimproves ovulation and often leadsto regular menstrual cycles.

The general focus of treatment isto manage a woman’s obesity, highblood pressure, and high blood cho-

lesterol. Healthy eating habits andregular exercise are key, becauseobesity makes insulin resistanceworse.

A Medical SpecialtyDr. Slackman, who is the region’sonly full-time reproductive endocri-nologist, also treats and managesother women’s disorders. These in-clude endometriosis, a condition inwhich cells from within the uterusgrow outside the uterine wall, whichcan lead to pain and infertility. Healso treats uterine fibroids—benigntumors found in the uterus—thatcan lead to painful menstrual peri-ods, painful intercourse, and infer-tility.

His success rate is approximately80 percent when treating womenwith infertility due to PCOS. “Webegin with a thorough evaluation,starting with the partner’s semen,”he says. “We next evaluate ovula-tion, the shape of the uterine wall,and so on. Then we know what di-rection to go in.”

But PCOS is expected to remainone of the main conditions that heand other specialists across thecountry must address. Keeping thehormones in balance is critical tomaintaining good health.


Symptoms of PCOS include: • Infertility• Irregular or infrequent menstrual

periods • Excess hair on the face or body• Acne that gets worse

“The first thing I determine is, arethey trying to get pregnant?” — Dr. Robert Slackman



Medical News

But a new treatment can greatly improve quality of life forthose suffering from this condition. The procedure, which re-quires no incision, is a leap forward in minimally invasivesurgery. It leaves no outside scarring, minimizes post-opera-tive pain, and reduces recovery time.

At Carilion Clinic, gastroenterologist Paul Yeaton, M.D., andgeneral surgeon Mark O. Smith, M.D., are working together tobring this treatment to patients in western Virginia.

Acid RefluxThere Is a CureAnyone who suffers from chronicheartburn—also known as acid reflux—can tell you how hard it can be to find relief.

By Matthew Sams

A Common ProblemThe clinical term for heartburn isgastroesophageal reflux disease(GERD), and nearly 30 millionAmericans have been diagnosedwith it. Various treatment optionsare available, including daily med-ications that suppress acid produc-tion. However, studies show thatsome of these interact poorly withother prescription drugs, and canlead to inadequate absorption ofminerals such as calcium.

In severe GERD cases, traditionalsurgery is also an option. But manypatients would prefer to avoid thescarring often associated with inva-sive surgeries and the post-opera-tive limitations on foods andbeverages.

“We are very excited to be able tooffer our patients the same benefitsas more invasive procedures withonly minimal risk,” Dr. Smith says.

“It can be a real life-changer for ourpatients.”

How the Procedure worksThere is a natural valve between theesophagus and the stomach thatforms a physical barrier, preventingstomach acids from backwashing,or “refluxing,” up into the esopha-gus. Patients who suffer from GERDhave a faulty valve that lets refluxoccur.

With the new procedure, a sur-geon inserts an endoscope (a tubu-lar device) through the mouth andinto the stomach. Using a tiny, fiberoptic camera embedded within thesurgical tools to view the surgicalsite, he or she then reconstructs thevalve. The procedure is known asTIF (transoral incisionless fundopli-cation).

Patients usually stay overnight inthe hospital and are discharged thenext day. They typically return totheir normal activities within a fewdays.

Clinical studies also show thattwo years after the TIF procedure,nearly 80 percent of patients canstop using daily reflux medications.And they can eat and drink foodsand beverages they had avoided foryears.

“The TIF procedure can signifi-cantly improve quality of life for ourpatients,” Dr. Smith says. “Becausepatients return to their daily livesso quickly, we’re typically able to

see results in the management ofthe disease soon after the proce-dure.”

“Bringing the TIF procedure tothis area demonstrates CarilionClinic’s dedication to offering cut-ting-edge surgical procedures,”

adds Christopher Baker, M.D.,chair of the Department of Surgeryat Carilion. “Dr. Yeaton and Dr.Smith have years of experience inmanaging chronic acid reflux, andthey should be commended for theirefforts in finding new ways to helppatients.”


The new procedure is said tobe ideal for acid reflux pa-tients who:

• Have moderate to severesymptoms

• Are dissatisfied with prescrip-tion drug treatment

• Have trouble adjusting toeating restrictions or changesin sleeping habits they mustmake

• Suffer from non-acid symp-toms of reflux such as asthma,persistent cough, or sore throat

with the new procedure, a surgeon in-serts an endoscope (a tubular device)through the mouth and into the stom-ach. Using a tiny, fiber optic cameraembedded within the surgical tools toview the surgical site, he or she thenreconstructs the valve.

“We are very excited tobe able to offer ourpatients the samebenefits as moreinvasive procedureswith only minimal risk.” — Dr. Mark O. Smith



Specialty Care

Replacing a Heart valve A New Lease on Life

On May 7, less than two weeks afterheart surgery, Michael Logan and hisbass fishing team won sixth place outof 178 participants in the Angler'sChoice Tournament at Smith Moun-tain Lake.

“Before, when I would go on fish-ing expeditions, it would take methree or four days to fully recover,”says Logan, 43, who used to havesevere mitral valve leakage. Todayhe recovers at a normal pace.

Logan’s condition used to causehalf the blood being pumped by hisheart to flow backward. It made hisheart work twice as hard and lefthim constantly drained and short ofbreath. A further complication wasthe fact that he’d been diagnosedwith a heart murmur at a youngage.

It was when he could barely keephis head up, literally, that he de-cided to go to the doctor. An abnor-mal echocardiogram spurred hisphysician to refer him to a cardiolo-gist. “It didn't sound like a regularheartbeat at all,” says Logan. “Itsounded squishy.”

“Over time, Michael’s murmurhad worsened to the point that hisvalve was leaking so badly that hewas short of breath,” says CarilionClinic cardiothoracic surgeon W.Scott Arnold, M.D., who performedLogan's surgery.

Dr. Arnold also couldn’t be surewhether he could repair Logan’s mi-tral valve—or would have to replaceit—until surgery was under way.

“There was an 80 percent chance Icould repair it successfully,” Dr.Arnold told Logan.

In fact Dr. Arnold was able to re-pair the valve by removing a leakingsegment and placing a small ringaround the valve to reshape it. Fol-lowing a three-day stay in the hos-pital, Logan was home on a Fridayand in church on Sunday.

“When it comes to the mitralvalve, far and away, repair is a bet-ter option than replacement,” Dr.Arnold says. For one thing, replace-ment requires patients to take bloodthinners for the rest of their lives—which presents its own risks andcomplications. “For someone younglike Michael, we really wanted tostrive for a repair,” Dr. Arnold says.

Logan is thankful he avoided a re-placement, and his one-a-day babyaspirin is the sole reminder of hispast heart condition. He is also ableto exercise without problems.

“I was extremely impressed withDr. Arnold,” says Logan, whoseCatawba-based machine-shop busi-ness keeps him on the go. “This isvery personal to him and thatmeans a lot. I felt very comfortable.”

“I feel better than I have in a longtime.”

By Wendy Maxey

Specialty Care—Close to Home

Michael Logan says he feels betterthan he has in a long time.


Fighting Lung CancerAn Interdisciplinary Team Improves Care

Dreama Poore’s comforting mannerinvites you to confide your secrets toher. Recently, though, she was theone sharing secrets—by revealingher battle with lung cancer.

“This is the first time I’ve reallyshared my story,” says Poore, 58, ofElliston, who has been cancer-freefor a year and a half.

When she was diagnosed, Poore’stumor was relatively small. Becauseof its size, and the fact that she wasotherwise healthy, Carilion Cliniccardiothoracic surgeon DavidWyatt, M.D. was able to perform alobectomy, removing a lobe ofPoore’s right lung. Dr. Wyatt alsoremoved Poore’s surrounding lymphnodes.

Twenty years ago, this surgerywould have required removing a riband cutting through the muscles ofthe chest, greatly adding to recoverytime. But Dr. Wyatt was able to per-form the surgery after making onlya small incision between Poore’sribs. “Thoracic surgery today takesadvantage of lesser invasive tech-niques,” Dr. Wyatt says.

Poore also had the advantage ofhaving her case reviewed by a tho-racic oncology team that meetsweekly at Carilion Clinic to evaluatepatient cases from an interdiscipli-nary point of view. The team in-cludes both Carilion andnon-Carilion physicians who aresub-specialists in pulmonology,medical oncology, cardiothoracicsurgery, radiation oncology, pathol-ogy, radiology, and interventionalradiology.

All the physicians focus on lungcancer and share the goal of givingpatients the most advanced and ef-fective treatments.

“I couldn't believe it was me thatthis [cancer] was happening to,”Poore says of her first reaction toher diagnosis. “But as soon as I re-alized I had no control, I just let it

go and treated it like it was a badcold.”

Apparently that attitude con-tributed to her recovery. “Dreamawas a good patient and did herpart,” Dr. Wyatt says. “She was ac-tive and interested, and chose notto be a victim of her own problem.”

Following her surgery, Poore un-derwent four months of chemother-

apy, and six months after her diag-nosis, she was back at work full-time at Roanoke College. This pastMay, she attended her 40th highschool reunion in Wythe County.She doesn't have her next CT scanuntil December. She is loving life.

“Life has more meaning than itever has,” says Poore. “I have a zestnow, more than ever.”

Dreama Poore says her life now has more meaning than ever.

getting a Hip ReplacedA New Approach

Dr. Joseph Duckwall, 74, has hadcause to celebrate lately.

He and his wife commemoratedtheir 50th wedding anniversary thissummer at Smith Mountain Lake.His three children and seven grand-children were also there. And—hecan now walk without a limp.

Dr. Duckwall, who had his hip re-placed in April, is walking withease, and doesn’t even need a cane.“I feel like I did 10 years ago,” hesays. “I feel like I could run if I hadto, without any pain.”

The retired physician is one ofabout 400 patients at CarilionClinic who have received a hip re-placement via a new surgicalmethod. Called the anterior ap-proach, it is minimally invasive sur-gery that involves computer-assisted techniques for increasedaccuracy and precision.

Joseph Moskal, M.D., chief of or-thopaedics, brought this new ap-proach to Carilion Clinic. He is oneof four Carilion Clinic orthopaedicsurgeons who perform the proce-dure, which involves making an in-cision at the front (anterior) of thehip that is much less invasive thanthe incision required at the back orside for a traditional hip replace-ment.

“The big difference with this ap-proach and all the others is that nomuscles or tendons are cut or de-tached from the bone,” says Dr.Moskal. This reduces healing timeimmensely because the musclesand tendons are kept intact.

Dr. Duckwall, who had his otherhip replaced the traditional waythree years ago, thinks the new ap-proach is better. “I may not havehad problems, but I have heard sto-ries, specifically from my daughterwho also had that procedure not toolong ago, that post-op recovery canbe difficult,” he says.

“I felt good after the first hip re-placement,” he adds, “but I feltgreat after the second. Getting the

second one done has really takenme back a few years physically.”

One thing he appreciates aboutDr. Moskal is his exceptional proto-col. “Dr. Moskal’s program antici-pates any problems ahead of time,”says Dr. Duckwall. “His staff is welltrained. I took a class before thesurgery that prepared me for anyproblems that might arise. Havingthat education is essential.”

The pre-surgery class is part ofCarilion’s Points on Joints free edu-cational seminar series, which is

held throughout the region on aregular basis.

Dr. Duckwall returned home twodays after his surgery, and he neverneeded pain medication. He used acrutch only here and there, and wasreleased to drive again after onlytwo weeks (the typical waiting timeis six weeks).

“The way I feel now is so muchbetter than how I felt for years,” hesays. “Walking without a limp,that’s the biggie for me.”

Dr. Joseph Duckwall walks with ease after having his hip replaced in April.


Specialty Care

Pre-Surgery Testing It Saves Lives

Russell Meador has worked at CEI, for-merly Elizabeth Arden, for 41 years.He works the third shift and is nostranger to 10- to 12-hour days,sometimes seven days a week if nec-essary. Meador knows what beingtired feels like, so when he startedfeeling more tired than usual, he de-cided it was time to get a checkup.

His physician diagnosed him withanemia, and gave him iron pills. Healso scheduled a colonoscopy, dur-ing which a malignant tumor wasfound that was too large to removewithout surgery.

But before proceeding, Meadorwas given tests to gauge whetherany problems might arise duringsurgery. As it turned out, he wasflagged for an abnormal EKG, indi-cating a potential heart condition.Abnormal EKGs are consideredhigh risk because the stress of sur-gery can compromise the heart andcause complications, possibly lead-ing to death.

A subsequent cardiac stress testand heart catheterization found ex-tensive blockage, and the next day,Meador underwent a quintuple by-pass operation. Had it not been forhis testing, Meador might not behere today.

The pre-surgery testing Meadorreceived is provided by the CarilionAssessment Registration Educationfor Surgery (CARES) program,which specifically targets high-riskpatients like Meador to improve pa-tient outcomes. CARES expands onthe traditional pre-surgery teststhat surgery patients around thecountry typically undergo. And hisis but one example of how the pro-gram is flagging high-risk patients.

“If a patient is found to be highrisk, the primary care physician iscontacted for further evaluation,”says Michele Berry, R.N., an operat-ing room nurse and one of the facil-itators of this new program.“Additional testing is completedwhen needed with the possibility ofpostponing surgery.”

Before the new high-risk programwas instituted at Carilion, the re-sults of patient tests were going tothe surgeons, not the primary carephysicians. “We’ve changed this sothat the surgeon is not trying todeal with heart conditions, etc. butis only dealing with the surgery,”says Berry. “The patient's primarycare physician is the best resourcein these situations, since they knowthe patient.”

“If all surgery patients at RoanokeMemorial Hospital went throughCARES, we calculate that about400 people per year would bespared unnecessary and preventa-ble deaths, based on the total num-ber of procedures done at thehospital and our improved survivalrates so far,” says surgeon Sandy L.Fogel, M.D.. Dr. Fogel has been aleader in starting the CARES pro-

gram. “That’s 400 mothers or fa-thers, spouses, siblings, and chil-dren who leave the hospital alivewho in previous times might nothave,” he says. “That's progress.”

In Meador’s case, he recoveredswiftly from his bypass surgery andwent on to receive colon surgery.Today he has fully recovered, andhe is back to working long hours atCEI and helping his wife, JoAnne,raise their 4-year-old grandson,Conner. He also feels fine.

“I know all this is very life-threat-ening and serious stuff, but I justtook it as it happened,” saysMeador. “I did what the doctors toldme. The Lord’s been good to me,and life is too short to get upset orangry.”

For more information on all thesespecialty services, call 540-266-6000 or 800-422-8482.

Russell Meador is here today thanks to pre-surgery testing.



Physicians

New Physicians

Leading Urogynecologist Joins Carilion ClinicJames A. Daucher, M.D., an obste-trician and gynecologist with par-ticular expertise in female pelvicreconstruction surgery, has joinedCarilion Clinic.

Dr. Daucher comes to Carilionfrom Howard University, wherehe was director of clinical and

translational research in the Department of Obstet-rics and Gynecology at the College of Medicine. Hehas taught at several institutions, including VirginiaTech, Ross University’s School of Medicine, EastCarolina University Brody School of Medicine,Magee-Womens Hospital in Pittsburgh, and HowardUniversity College of Medicine.

He has published many papers on a range of top-

ics, including urinary function after weight loss sur-gery, and co-authored papers with Anthony Fauci,M.D., head of the National Institute of Allergy andInfectious Disease at the National Institutes ofHealth.

Dr. Daucher received his M.D. degree from RossUniversity School of Medicine in Dominica, West In-dies. He completed his residency in obstetrics andgynecology at the East Carolina University BrodySchool of Medicine, and his fellowship in femalepelvic medicine and reconstructive surgery at theMagee-Womens Hospital at the University of Pitts-burgh School of Medicine.

He practices at Carilion Clinic Urogynecology at101 Elm Ave. in Roanoke and can be reached at540-985-4099.

James A. Daucher, M.D.

Neurosurgeon and Spine Specialist to Practice at Carilion ClinicNicholas Qandah, D.O., a neuro-surgeon who specializes in com-plex spinal conditions, hasjoined Carilion Clinic. He has ex-tensive training in spinal trauma,spine oncology, deformity, andminimally invasive spine surgery.

Dr. Qandah completed hisneurosurgical residency in 2010 at Carilion, wherehe was chief neurosurgery resident. He was honoredin 2010 by the American College of OsteopathicNeurosurgeons for his academic achievements

throughout his residency, and he went on to com-plete a spine fellowship at the world-famous Univer-sity of Washington-Harborview Medical Center.

He has conducted research, authored scientificpapers and book chapters, and has been a guestspeaker at local and national conferences on a widerange of neurosurgical and spinal topics.

Dr. Qandah received his doctorate of osteopathicmedicine from Midwestern University’s Arizona Col-lege of Osteopathic Medicine and his bachelor de-gree from the University of Michigan.

He practices at 3 Riverside Center in Roanoke andcan be reached at 540-224-5170.

Nicholas Qandah, D.O.


Ahmet Burakgazi, M.D.NeurologyEducation: Hacettepe University, Ankara, TurkeyMedical Degree: Hacettepe University School of Medicine,Ankara, TurkeyResidency: Neurology, George Washington University Schoolof MedicineFellowship: Clinical Neurophysiology, George WashingtonUniversity School of Medicine3 Riverside Circle, Roanoke, VA 24016540-224-5170

Gerald W. Beltran, D.O.Emergency MedicineEducation: University of MassachusettsMedical Degree: University of New England College ofOsteopathic MedicineResidency: Emergency Medicine, Medical College of GeorgiaFellowship: EMS, Emory University 1906 Belleview Ave., Roanoke, VA 24014540-981-7000

Janet Young, M.D.Emergency MedicineEducation: University of North Carolina at Chapel HillMedical Degree: East Carolina University Brody School ofMedicineResidency: Emergency Medicine, Boston Medical Center1906 Belleview Ave., Roanoke, VA 24014540-981-7000

Thomas R. Milam, M.D., M.Div.PsychiatryUndergraduate Education: West Virginia UniversityGraduate Education: Yale UniversityMedical Degree: University of Virginia School of MedicineResidency: Duke University Medical Center and University ofVirginia Department of Behavioral Medicine2017 South Jefferson St., Roanoke, VA 24014540-981-8025

Joseph J. Baum, M.D.Family MedicineEducation: University of IowaMedical Degree: University of Iowa Carver College of MedicineInternship: USAF Hospital Carswell 911 E. Main St., Floyd, VA 24091540-745-2031

Jeremy A. Llavore, M.D. Family MedicineEducation: University of Santo Tomas Medical Degree: University of Santo Tomas Faculty of Medicineand SurgeryResidency: Carilion Clinic Family Medicine 22890 Virgil Goode Highway, Boones Mill, VA 24065 540-334-5511

Chheany W.C. Ung, M.D.Interventional Pain Management Education: University of PennsylvaniaMedical Degree: Penn State College of MedicineResidency: Milton S. Hershey Medical CenterFellowship: Chronic Pain Management, Milton S. HersheyMedical Center 3 Riverside Center, Roanoke, VA 24016540-224-5170

Julia Bulkeley, M.D.Pediatric OrthopaedicsEducation: High Point UniversityMedical Degree: Brody School of Medicine at East CarolinaUniversityResidency: Orthopaedic Surgery, University of LouisvilleFellowship: Pediatric Orthopaedics, Baylor College of Medicine 3 Riverside Center, Roanoke, VA 24016540-224-5170

Colleen E. James, D.O. Family Medicine Education: Roanoke College Medical Degree: Edward Via Virginia College of OsteopathicMedicineResidency: Wake Forest University Baptist Medical Center 415 S. Pollard St., Vinton, VA 24179 540-983-6700

Franco Coniglione, D.O.Orthopaedic Trauma Education: New York UniversityMedical Degree: New York College of Osteopathic MedicineResidency: Michigan State University, Botsford HospitalFellowship: Orthopedic Trauma, Florida Orthopedic Institute,Tampa General Hospital 1906 Belleview Ave., Roanoke, VA 24014540-224-5170

You hear the Cascade Falls before yousee them. Two miles deep within the Jefferson

National Forest, you approach them via a boulder-

strewn path, until the drumbeat of water becomes

a roar. Then, when you round a final boulder, a

steel-blue waterfall towers above you—sheets of

water plummeting over a vertical cliff into an inky

pool—69 feet of liquid majesty.

Hiking the

CascadeTrail By Su Clauson-Wicker

Regional Interest


Until the mid-20th century, few people had wit-nessed this spectacle. The Cascade gorge and

surrounding forests in Giles County were privatelyowned and heavily logged. Hikers can still see therusting remains of a portable boiler used to power asawmill. But in 1965, the U.S. Forest Service acquiredthe area surrounding the gorge, and hardwood treesand hemlocks were allowed to flourish once again.And the government opened the four-mile CascadeTrail to the public.

Hikers arriving at the Jefferson National Forestparking area can choose between two paths: the wind-ing, creekside Lower Trail or the more aerobicallychallenging Upper Trail.

The Lower Trail meanders through colonies of moss-covered boulders and skirts the edges of gushingflumes. The gurgle and splash are often loud enoughto block out the calls of nearby vireos, phoebes, andscarlet tanagers. Cool air drifts down the gorge fromthe high plateau, keeping the temperatures lower thanthat of the outside world. Hiking here can feel likepassing through the interior of a cave.

But there’s no taking the Lower Trail on automaticpilot. Hikers need to be alert to slick rocks and pro-truding roots—or the flash of a rainbow trout in shal-low water. (Little Stony Creek, whose waters create thewaterfall, is also a native trout stream, and those whofish here must use single-barbed hooks and artificiallures only.)

The Upper Trail, a steady 740-foot climb, offerswide-angle, aerial views of Little Stony Creek. Thehigher the trail goes, the rougher the terrain. Stonewalkways are rammed into the side of the gorge withsteel spikes and mortar. Frothy water rips betweenboulders.

Either way, when you arrive at the falls, you’ll be re-warded with one of Mother Nature’s most amazingsights.

About 150,000 visitors come to the Cascade Trailevery year, lured by the prospect of viewing one of themost spectacular waterfalls on the entire East Coast.

For more information, call the Blacksburg Ranger Dis-trict at 540-552-4641.

DIRECTIONS: FROM INTERSTATE 81, TAKE ExIT 118C AND FOLLOw US 460 wEST ABOUT 25MILES TO PEMBROKE. TURN RIgHT ON vA 623 AND gO 4 MILES TO THE CASCADE PARKINg LOT.

DIFFICULTY: MILD TO MODERATE.

DISTANCE: AROUND 4 MILES TO THE TOP AND BACK, APPROxIMATELY 2 MILES EACH wAY.

FACILITIES: 15 PICNIC TABLES wITH gRILLS; BATHROOMS.

FEES: $3 PER vEHICLE. DROP YOUR MONEY IN AN ENvELOPE IN THE COLLECTION BOx ANDPICK UP A HANg TAg FOR YOUR CAR.

OPEN YEAR-ROUND.

CASCADESWATERFALL

WOODLANDTRAIL

PARKING LOT& PICNIC AREA

Little

Ston

y Cre

ek

Sawmill Boiler

CREEKSIDE TRAIL

Bridge 2Halfway point

Bridge 1



Kirk Avenuegets Hip

On one end is a parking lot for CityHall. On the other, a tire store. Its fourone-way blocks change direction mid-way at Jefferson Street, making it hardto drive. And Kirk Avenue doesn’t evenappear in Google Street View. But tothose attuned to new trends, it’s themost happening place in town.

What turned these four blocks into oneof the most culturally vibrant streets insouthwest Virginia?

The metamorphosis began about fouryears ago, when the Kirk Avenue MusicHall opened on the block between Jeffer-son and First Street. Music promoterGary Jackson had just stopped doingshows at 202 Market when he was ap-proached by Roanoke developer EdWalker. Walker and his wife Katherinemissed the music and wanted Jackson toset up shop in a space that Walkerowned on Kirk.

“Ed said, ‘What you did at 202 Marketmade such a difference in our lives,’ ”says Jackson. And so the Music Hall’sfourth season will begin this fall and isexpected to feature about 100 shows.

The mission of the Music Hall is to“bring in as high-quality talent as possi-ble to Roanoke,” Jackson says. Past actshave run across the entire live musicspectrum and featured both national andlocal talent. The Music Hall was alsoonce home to the Downtown Music Lab,an after-school music program (now atthe Jefferson Center), and today it sharesits space with the Shadowbox, a cinema

What’s so special aboutRoanoke’s Kirk Avenue,anyway?

By David Perry

Regional Interest


that shows independent and experi-mental films.

“We’re trying to encourage localfilmmaking,” says Shadowboxowner Jason Garnett. “We give localfilmmakers a venue to show theirwork.” The Shadowbox’s projectorfirst rolled in March of 2010. LikeJackson, Garnett was approachedby Walker, who suggested an openprojector night when the Music Hallwasn’t booked for a show.

“It’s like an open mic night forfilmmakers,” says Garnett. “We callthe Shadowbox Roanoke’s commu-nity micro-cinema. It’s like a big liv-ing room where you get to watchfilms with other strangers,” hejokes.

Nearby in another space ownedby Walker is Lucky Restaurant, abistro where the menu is all-local,all the time. “As much as possible,we try to go from farm to table,”says Lucky co-owner John “J.P.”Powell. “We pay very close attentionto where we buy our food and thequality of the source.” (Fans of theoysters, the cassoulet, and the wa-tercress salad will attest to that.)

Lucky opened in October of 2010.Powell describes its fare as “Ameri-can comfort meets country French.”Everything at Lucky is homemade,says Powell. Even the ketchup ismade in-house.

Another new eatery on the blockis Freckles (formerly GET), whichcombines a café with a vintageclothing shop. Owner StephanieSowder rents the space from Walkerand serves up a menu that featurescoffee, tea, and ramen. “Businesshas been great,” she says, addingthat each month “more and morepeople are discovering us.”

That theme is true up and downKirk Avenue, which also featuresvenues like the Uttara Yoga Studioand the POParazzi portrait studioand gallery, along with recently ren-ovated live/work space.

“I feel like it’s a great time to beon this street,” says Sowder. “It’sturning into part of that vibrantdowntown scene that exists over to-

ward the market square.”Says Garnett of the Shadowbox:

“Kirk has changed so much in thepast few years. Five years ago it wasthis alley that no one ever wentdown. It’s very eclectic. People havebeen calling it ‘Quirk Avenue.’ ”

“I think it’s going to continue toevolve,” says Lucky’s Powell of thelatest additions to Kirk Avenue. “Weall have similar things in common.”

“I give all the credit to Ed Walker,”says the Music Hall’s Jackson.

And what does Walker say aboutthe Renaissance on Kirk? “Kirk Av-enue is just another example, or ex-

periment, exploring the inter-rela-tionship between commerce andplace-making in a positive way,”says Roanoke’s revitalization king,whose other downtown projects in-clude the Patrick Henry Hotel andThe Cotton Mill lofts.

Walker also hopes that others inthe region will take the Kirk Avenueexample and run with it. “Whatwould be nice in five to 10 yearswould be for other parts of the cityand for other community-mindedbusiness people to be pursuing sim-ilar ideas that make Roanoke moreinteresting and dynamic,” he says.

Above: A shopper checks out vin-tage clothing at Freckles. Left: Acouple enjoys sidewalk dining atLucky. Below: A street sign for newlypopular Kirk Avenue.


Better Living

Your Calendar for Better HealthFall 2011BLOOD PRESSURE & BLOOD SUgAR CHECK

9 – 10:30 a.m.Christiansburg RecreationCenter FreePlease call 800-422-8482for more information.

HEALTHY U SEMINAR: POINTS ON JOINTS 10:30 – 11:30 a.m.Carilion Stonewall Jack-son Hospital, Lexington FreePlease call 540-458-3568for more information.

CHOLESTEROL SCREENINg/HEALTH FAIR8 – 10 a.m.Tanglewood Mall, Roanoke$15Please call 540-266-6000to register.

FIRED UP FOR THE CURE9 a.m. – 2 p.m.Roanoke Civic CenterPlease call 540-853-5785for more information.

PEARLS OF HOPE: wOMEN'S HEALTH TEAFacts about breast healthand living with breast cancer1 - 2:30 p.m.Bedford Central LibraryCommunity RoomFreeRegistration required bycalling Carilion Direct at540-266-6000.

INFANT CPR & SAFETY6:30 – 9 p.m.Carilion Roanoke Memo-rial Hospital $20 per couple Please call 800-422-8482for more information.

CAR SEAT CHECK 4 – 6 p.m.Fire Station # 61333 Jamison Ave.,Roanoke FreePlease call 800-422-8482for more information.

PHYSICIANS ON FOOT8:30 a.m.Roanoke River GreenwayFor more information, call 540-266-6000 or visit CarilionClinic.org/walking.

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

Sept.

14

Sept.

19

Sept.

29

Oct.

13

Oct.

20

Sept.

20

Sept.

24

EverySaturda

y


Healthy Eating

get the Nutrition You NeedIn June, the USDA replaced its foodguide pyramid with the new“Choose My Plate.” The most obvi-ous change is that the pyramid hasbecome a circle—and that half of itconsists of fruits and vegetables.The other half is divided into wholegrain starches and a leanprotein choice. In ad-dition, a low-fatserving ofdairy(skim or 1percentmilk) is in-cluded. Ifyour platedoesn’t yet re-semble theUSDA’s, go towww.ChooseMy-Plate.gov and checkout “10 Tips to a GreatPlate.”

Tips from Our Dietitians

Make the Most of Your FoodBudgetEven with food costs on the rise, itisn’t as hard as you may think toeat healthy and not blow yourbudget. Sit down, make a list, andstick to it. Try to shop once aweek, and cut outcoupons fromthe paper. Don’tgo shopping onan empty stom-ach. Shop theperimeter of thestore first for thehealthiest foods,and choose fruitsand vegetables thatare on sale. Those are usually inseason and taste the best. Also con-sider buying generic products—theycan provide great savings. Finally,buy some healthy snacks and bag-gies and make your own 100-calorieportions!

A Little Planning goes a Long wayA crucial part of healthy eating isthe often overlooked “meal plan.”This means thinking ahead aboutwhat’s needed for all your family’smeals and snacks and shopping ac-

cordingly so ingredients are avail-able during the busy work week.It also helps stave off the other-wise inevitable fast food run—and its often unhealthy choices.So, as the kids head back toschool and schedules get evenmore hectic, take some time tothink about the week’s sched-ule. Consider cooking extra ata particular meal so you’ll

have leftovers to quickly reheat forlunch or dinner another day. Notonly will meal planning save youtime and stress during the week, itwill save money too!

Cheryl Tutwiler, R.D., M.S.Registered Dietitian, Carilion Stonewall Jackson Hospital

Kate Jones, R.D., C.D.E.Registered Dietitian andCertified Diabetes Educator,Carilion Diabetes Management

Jill Traegde-Halstead,R.D., C.L.C.Registered Dietitian, Carilion New River ValleyMedical Center

Blueberries

Strawberrie

s

Bananas

Spinach

Quinoa

Avocado

Carilion Clinic’s registered dietitians provide individual nutrition counseling and group nutri-tion programs for churches, schools, and civic groups. They offer community support throughsupermarket teaching tours, health fairs, weight management programs for adults and chil-dren, and Camp Too Sweet for children with diabetes. They also assist individuals with celiacdisease and those who are in cardiac rehab or who have had bariatric surgery. To contact aregistered dietitian in your community, call 540-266-6000 or 800-422-8482.


Fitness Tips

Core fitness is all the rage in exerciseprograms right now. But what is corefitness, you ask?

Our core is a complex layer ofmuscles around our midsectionthat includes our upper/lower ab-dominals and obliques. To get a bet-ter sense of their function, lie flatwith one hand over your belly but-ton. Take a deep breath. As you ex-hale, contract your abdominalmuscles. It may help to visualizepulling your belly button closer toyour spine during the contraction.You should feel these core musclestightening under your fingers.

Practice contracting your core inthis way for 10-second intervalsthroughout the day. A strong core isan essential foundation for a fitbody. It can prevent injury and im-prove your quality of life.

And remember, no fitness routineis complete without proper nutri-tion.

Allison Brelyn-PorterRoanoke and Botetourt Athletic Clubs

Strengthening Your Core

Isometric exercises like planks and side planks can help you tighten your abdomi-nal and oblique muscles, improving your overall core strength. Roanoke andBotetourt Athletic Club fitness instructors Brooke Carlin (left) and Tiffany McCor-mack demonstrate side planks (above).

Using bands can also help you to activate your core stabilizing muscles andincrease your core function.



Imagine undergoing surgery with barely a scar to show for it. Or bouncing back from hip

replacement surgery in weeks instead of months. Or having cancer treatments that don’t

interfere with your plans for the day. All are possible today at Carilion Clinic, where our

specialists work as a team to meet the unique needs of every patient, every day. Because when

you need specialized care, we are committed to one goal: getting you back to living your life.

To *nd a doctor, visit CarilionClinic.org or call 800-422-8482.

I could get the specialty care I need — right here in my community.


��

When someone you love dies, how do you deal with the memories? You may experiencedepression and lose the will to carry on normal activities. Or you try to lose yourself bystaying busy, not having to face your grief. To help you savor the great memories, we pro-vide bereavement counseling and our Journey of Hope support group. We even o$erCamp Treehouse, a special haven for children who’ve lost someone they love.

CarilionClinic.org/hospice | 800-964-9300

Hospice Is...

CARILION CLINICP.O. BOx 13727ROANOKE, vA 24036-3727

NON-PROFIT ORg.U.S. POSTAgE

PAIDROANOKE, vA

PERMIT NO. 247

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Carilion Clinic Living - Fall 2011

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