Carilion Clinic Living - Fall 2012

Carilion Clinic

Inspiring Better Health | CarilionClinic.org | Fall 2012

Magnets in Toys Pose Risks for Kids

Local FoodMovement

The Genetic Link to a Common Women’sCancer

Local FoodMovementTakes Root

Learning you are pregnant is an exciting time. But preparing for a new addition to the family also means making a lot of decisions before the baby arrives.

At the top of the list: Find a doctor you trust. At Carilion Clinic, our providers have been caring for expecting moms and delivering their babies in southwest Virginia for generations of families.

Our maternity services include a comfortable, homelike setting, childbirth and parenting classes, specialized care for high-risk pregnancies, infertility services, and the area’s only neonatal intensive care unit (NICU) at Carilion Roanoke Memorial Hospital (CRMH).

Whether it's at CRMH or at The Birthplace at Carilion New River Valley Medical Center, it's no wondermore moms trust Carilion Clinic as the smart, safe choice to deliver their new bundle of joy.

For more information about our maternity services or an obstetrician, call 800-422-8482 or visit CarilionClinic.org/maternity.

The Smart, Safe ChoiceMaternity care focused on growing families

Join the conversation on Facebook, Real Moms Know.

Inspiring better health.™

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CarilionClinic.org | Fall 2012 1

Carilion Clinic

7 Child Safety Popular magnets pose risk if swallowed.

12 Endometrial Cancer Screening for a genetic link.

14 Neurology New treatment options are available.

16 Community Health Assessing the needs of a community.

18 Healthy Eating Local food movement goes mainstream.

22 Good Ideas Improving the world—and our community.

25 Doctor Q & A An interview with Dr. Paul Yeaton.

26 Quality Care A patient’s story.

31 Sharing Stories Celebrating the 30th anniversary of open-heart surgery.

33 Urgent Care For urgencies that aren’t emergencies.

President’s Message 3 Healthy food choices abound.

Healthy Lifestyles 5 Tips from Carilion Clinic medical professionals.

In Your Community8 Making a difference in western Virginia.

New Providers28 New physicians and advanced care practitioners

across our region.

Better Living32 Your health calendar.

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Fall 2012

FEATURES

DEPARTMENTS

Carilion Clinic

Inspiring Better Health | CarilionClinic.org | Fall 2012

Magnets in Toys Pose Risks for Kids

Local FoodMovement

The Genetic Link to a Common Women’sCancer

Local FoodMovementTakes Root

On Our CoverCarolyn and Ian Reilly ofFour Corners Farm in RockyMount hold eggs from theirfarm and their hen Penny.

2 Fall 2012 | 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

SENIOR DIRECTOR, MARkETINGMike Dame

EDITOR Maureen Robb

LEAD DESIGNERDavid Porter

DESIGNERTaryn Anderson

CONTRIBUTING wRITERSKaren Doss Bowman, Mary Brewer, Allison Buth,Lois Caliri, Su Clauson-Wicker, Jay Conley, Laura Markowski, Otesa Middleton Miles, Erica Stacy, Randolph Walker

PHOTOGRAPHERDarryle Arnold

CONTRIBUTING PHOTOGRAPHERSDavid Hungate, Brett Winter Lemon

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 clini-cal teams with a shared philosophy that puts the patientfirst, Carilion is committed to improving outcomes forevery patient while advancing the quality of care throughmedical education and research.

Copyright 2012 by Carilion Clinic. No part of this publication maybe reproduced or transmitted in any form or by any means withoutwritten permission from Carilion Clinic. Articles in this publicationare written by journalists or authors who strive to present reliable,up-to-date health information. However, personal decisions regard-ing health, finance, exercise and other matters should be madeonly after consultation with the reader's physician or professionaladvisor. All editorial rights reserved. Opinions expressed hereinmay or may not reflect the views of Carilion Clinic.

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

Karen Doss Bowman is awriter who contributesto health care publica-tions, including the University of Virginia’sVim & Vigor. A native ofBassett, Va., she nowlives in Bridgewater.

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.

Jay Conley has been a re-porter for newspapers in-cluding The RoanokeTimes, a staff writer forRandolph College inLynchburg, and a writerfor national publicationssuch as U.S. News & WorldReport.

Brett Winter Lemon is anaward-winning photog-rapher based in Roanokewho has returned to hisnative Virginia after liv-ing abroad. He says he isproud to be part of theregion’s strong creativearts community.

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.

Erica Stacy is a writerwhose articles have ap-peared in regional andnational health publica-tions. She also workswith nonprofit groups inVirginia and the Caroli-nas to promote healthand education. She livesin Pulaski.

Our Contributors

President’s MessageIf you’d like to improve your eating habits, and those of your family, you’re not

alone. Across Virginia, there is growing demand for more natural food. And in-creasingly, that means local food. Luckily, many choices are now available:about 100 farms in the region are devoted to growingorganic fruits and vegetables and naturally raisinglivestock. Maureen Robb’s article about this local foodmovement is a must read! I’m already thinking aboutfresh tomato sauce for dinner tonight.

Have you seen the desktop “toys” for adults madeup of tiny magnetic balls that can be assembled intomany shapes? What you may not know is that chil-dren have been hurt swallowing these balls. The U.S.Consumer Product Safety Commission has issued awarning about the toys, asking parents to keep themaway from kids. Children and accidents—an all-too-common problem. Jay Conley’s article gives us a lotto think about.

For women diagnosed with endometrial cancer,there is a new test that could save the lives of othersin their family. We’ve begun routinely screening endometrial tumors for Lynchsyndrome, a genetic abnormality that dramatically increases the risk for en-dometrial, colon, and other cancers. I’m so proud that we’re offering this impor-tant service. Carilion is the first health care system in the region to provide it. Ihope you’ll find the story, on page 12, to be about courageous women.

This magazine is chock-full of interesting and informative articles. I loved thehelpful hints and new ideas. My favorite, though, is the story on page 11 aboutDr. Keeley! It was a night to remember when we gathered to celebrate Dr. Keeley’s exemplary life of service. Saying thank-you and raising money for theFoundation to honor such an amazing physician was a treasured evening. Hopeto see you at next year’s celebration!

wARM REGARDS,

NANCY HOwELL AGEEPRESIDENT AND CEOCARILION CLINIC


Nancy Howell Agee with Dr. Robert L. A.keeley.

Immunizations Aren’t Just for Babies Adolescence is an important time

to continue to vaccinate your childagainst harmful illnesses and dis-eases. Make sure your child has re-ceived the Tdap, Meningococcal, andHuman Papillomavirus (HPV) vac-cines. These can be administered athis or her 11-year, well-childcheckup. If they are older, it’s not

too late—they can still receive them! Their nextcheckup is a great time to ask your provider aboutthese vaccines. — Erinn Hokanson, R.N., D.N.P., Pediatric Nurse Practitioner,Carilion Clinic Adolescent & Student Health Services, Roanoke

Participate in Your Care When you see your doctor or

health care provider, be sure you tellthem about things that could affectyour care. Often they are workingwith less than all the needed infor-mation, which can affect outcomes.Also know your medicines and why,when, and how you take them—andyour true allergies, not just side ef-

fects or reactions to medications. Patients often don’tuse appropriate medications because they don’t under-stand certain reactions or side effects. And write downany questions you have about a procedure or medica-tion. (Don’t just trust your memory.)— John M. Kerr, M.D.,Bedford Surgery, Bedford

Tips from our Medical Professionals

Healthy Lifestyles


Healthy Lifestyles

Got Milk?Research shows that drinking fat-

free chocolate milk after an intenseworkout or sports may be most ben-eficial in helping to rebuild muscle.Fat-free chocolate milk has a bal-anced ratio of carbohydrates andprotein—and provides double theamount found in most sportsdrinks. It also provides calcium, vi-

tamins, and minerals and has less sodium and sugarthan most sports drinks.— Christina Richardson, Physical TherapistCarilion New River Valley Medical Center

Take Your Medications SafelyIt’s good to remember:

• Safe medication use is your respon-sibility. • Know the names of your medica-tions and why you are taking them.• Take your medications as directedby your health care professional.• Be aware of what side effects mayoccur.

• Do not take medications prescribed for other people. • Carry an up-to-date medication list or bring your med-ication bottles with you each time you visit your doctoror the hospital.— Amy Westmoreland, Pharmacy Manager,Carilion Giles Community Hospital

Be Sure to Get “Me” Time Give yourself permission to take

time for yourself. Our lives are fullwith work and family. We are con-stantly stimulated by TVs, smart-phones, and computers. Don’t loseyourself in all this. Make time torest, enjoy each bite of food, reflecton what brings you joy, and, some-times, simply do nothing. Give as

much to yourself as you give to others. Health startswith you—body, mind, and spirit.— Arlene S. McCain, M.D.Carilion Clinic Family Medicine, Bridgewater

Stay Safe in the Sun Year-roundWe know the sun’s rays can dam-

age skin during the summer, butyou might also be getting more expo-sure than you bargained for duringthe rest of the year. The sun can stillaffect you on a cloudy day, andeveryday exposure adds up over alifetime. To stay safe, use a sun-screen with an SPF of 15 or higher

when you’re outdoors. Also take care of your eyes. Wearsunglasses—they can help reduce your risk of gettingcataracts later on. — Jared Campbell, Certified Physician Assistant,Carilion Clinic Emergency Medicine, Roanoke

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

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

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

website Tailored for YouCheck out these features at CarilionClinic.org:

• Easy-to-use physician finder• Interactive maps to help you find your way to our locations• Health and wellness content, including an A-Z library• A community health education and events calendar

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

Social MediaStay connected through Facebook, Twitter, YouTube, and LinkedIn:

facebook.com/carilionclinictwitter.com/carilionclinicyoutube.com/carilioncliniclinkedin.com/companies/carilion-clinicpinterest.com/carilionclinic

PublicationsPick up a copy of Carilion Clinic Living at magazine racks throughout our facilities,or access the digital edition at CarilionClinic.org/publications, where you can alsoread past issues of our publications. For health tips and news about upcominghealth screenings events, subscribe to Living’smonthly e-newsletter atCarilionClinic.org/living.

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

Children’s Health For the latest news and perspectives on children’s health care, read Close toHome, a blog by Dr. Alice Ackerman, chair of the Department of Pediatrics atCarilion Clinic.


Giving to CarilionClinic Foundation Be part of improving thehealth and vitality ofcommunities in westernVirginia. Make a gift atCarilionClinic.org/giving.

Resources to keep You Healthy


They may seem harmless, but tinymagnetic balls sold as desktop toysfor adults are hurting children whoswallow them.The high-powered BB-sized balls,

which can be fashioned into variousshapes, come in sets of 100 or moreand are sold online and in office andgift stores. But they can clump to-gether in the stomach when swal-lowed and cause obstructions orperforations.Across the country, there have

been reports of serious injury ordeath. The U.S. Consumer ProductSafety Commission has received 22 reports of incidents involvingchildren and teenagers since Juneof 2009. Eleven of these requiredsurgery.

The agency issued a warningabout the magnets last fall and alsonoted that “many more” cases havebeen reported in the media. “Wewant parents to be aware of thedanger associated with these inno-cent looking magnets,” said agencyChairman Inez Tenenbaum.In May, doctors in Louisiana re-

moved most of a one-year-old boy’sintestine after they discovered hehad swallowed eight of the magnets.In January, a Fairfax County, Va.,fifth-grader pretending to have apierced tongue placed the magneticballs on the top and bottom of hertongue to resemble a stud. The mag-nets slid to the back of her throat,and she swallowed them. What ensued was a lengthy hospi-

tal stay during which the girl under-went a battery of X-rays and CTscans. Surgery followed to move themagnets into her appendix, whichwas then removed.In the most serious incident, a 20-

month-old toddler died after ingest-ing several magnets.Parents are advised to keep mag-

nets away from children and tocheck the magnet sets, play areas,and carpets for missing balls. Theyshould also warn teenagers not toput the balls near their faces to pre-tend they have piercings. If they suspect a child has swal-

lowed a magnet, parents are advisedto immediately contact their doctor.

For more information, go tohttp://1.usa.gov/w1ZHKO.

By Jay Conley

Local Interest

Hospitals win Quality AwardsTwo hospital units won 2012 Patient Perception Awardsfrom Professional Research Consultants, Inc., a nation-ally known health care research firm. Carilion RoanokeMemorial Hospital’s 11 West Medical/Surgical Unit wona 5-star award for overall quality of care, signifying thatit is in the top 10 percent in its field. Carilion GilesCommunity Hospital’s Emergency Department earneda 4-star award, indicating it places in the top 25 per-cent. It is also the second year in a row that Giles haswon the 4-star award. All awards are based on confi-dential surveys of patients’ perceptions of their care.(Pictured: The staff of the Emergency Department.)

Respiratory Care Earns Recognition All eight Carilion hospitals earned Quality RespiratoryCare Recognition from the American Association forRespiratory Care. Only 15 percent of U.S. hospitals re-ceive this designation, aimed at helping patients makeinformed decisions about respiratory care. Hospitalsagree to meet strict criteria in their respiratory careservices and provide a level of care consistent with na-tional standards to earn this designation.

Grant to Launch Medication Management ProgramCarilion New River Valley Medical Center (CNRV) andseveral partners received a $4.1 million grant from theCenter for Medicare & Medicaid Innovation. The grantwill fund a new program to help patients in rural Vir-ginia better manage their medications. Pharmacists willreceive in-depth education about advanced care andchronic disease management to help patients. Fewerhospitalizations, emergency room visits, and adversedrug events are expected as a result. CNRV’s partnersin this program are the Virginia Commonwealth Uni-versity School of Pharmacy, Aetna Healthcare, andCVS/Caremark. (Pictured: Pharmacist Mike Czar andRalph Goodson, a recent patient at CNRV.)

MyChart Introduces AppCarilion Clinic has launched a MyChart app foriPhones, iPads, and Android phones and tablets. My-Chart, the first online health care management tool inwestern Virginia, gives patients secure access to por-tions of their electronic medical record. With the mobileapp, patients can see test results, send a message totheir doctor’s office, view upcoming appointments, andreview their medication, allergy, and immunization list-ings. MyChart, which is offered in Carilion primary carepractices, has over 20,000 patients active. To sign up,talk to your provider.


In Your Community

Carilion Clinic Receives Community Benefit Award Carilion Clinic received the Virginia Hospital & Healthcare Association’s 2012 Community BenefitAward. The award recognizes Carilion’s efforts to im-prove the health of the community through its Adolescent and Student Health Services Program atCarilion Clinic Children’s Hospital. This program oper-ates three teen health centers that improve access tohealth care for children aged 10-19 and provide preg-nancy prevention education and confidential servicesfor teens. It is credited with reducing the rate of teenpregnancy in Roanoke.

President Leads Local walkNancy Howell Agee, president and CEO of CarilionClinic, led a two-mile walk for the community as part ofCarilion’s ongoing Physicians on Foot program. Shealso spoke there about how walking promotes goodhealth. “It helps us stay strong and fit,” she said. “It ac-tually lowers the bad cholesterol and raises the good. Ithelps us lose weight. It does all sorts of good things forus, and it’s such an easy thing to do.” Physicians onFoot is a walking group that meets in Roanoke everySaturday morning. A different Carilion physician leadsa walk each week. For more information, go to Carilion-Clinic.org/walking. (Pictured: Nancy Howell Ageespeaks at the event.)

Hospitals Rated among Safest in Nation Three Carilion Clinic hospitals received an A rating forsafety from The Leapfrog Group, a national hospitalrating organization. The group released its first Hospi-tal Safety Score, which grades hospitals with an A, B,C, D, or F to reflect how safe they are. Carilion RoanokeMemorial Hospital, Carilion New River Valley MedicalCenter, and Carilion Franklin Memorial Hospital re-ceived an A, placing them among the 729 hospitalswith this rating out of more than 2,600 U.S. hospitalsgraded. The Leapfrog Group used 26 measures of pub-lic hospital safety data to create its grading system.

Campus Recognized as ‘Bicycle Friendly’ Carilion Clinic’s Riverside campus was recognized as aBicycle Friendly Business by the League of AmericanBicyclists. The campus, which houses specialty physi-cian practices and the Virginia Tech Carilion School ofMedicine and Research Institute, encourages bike com-muting by providing bicycle racks, showers, and lockerrooms. Carilion also sponsors bicycling events for em-ployees and the community. Almost 30 employees tookpart in its Bike to Work Day this year, and other eventswere held at Riverside as part of Carilion’s observanceof national Bike Month. Carilion will also be a goldsponsor of the annual Artie Levin Memorial CenturyRide staged by the Blue Ridge Bicycle Club. The scenicand challenging 105-mile ride originates in Fincastle.(Pictured: Annette Dickerson, Bill Flattery, Jay Hicks,and Clifford Nottingham III, M.D., who rode to work atCarilion Clinic on Bike to Work Day.)


Local Interest

Carilion Clinic Receives Outstanding Corporate Award Carilion Clinic received the Outstanding CorporateAward from the Greater Blue Ridge Chapter of the Juvenile Diabetes Research Foundation. Carilion hasbeen a sponsor of the foundation for 20 years, andmany of its employees have volunteered time and re-sources. One of the many ways Carilion has lent sup-port is by operating Camp Too Sweet for children withdiabetes, and by giving scholarships for area childrento attend the camp. Carilion has also helped sponsorThe Star City Gala and Walk to Cure Diabetes, an an-nual fund-raising event by the foundation. This year’swalk will be held Sept. 23 in downtown Roanoke.

Sports Clinic Opens for Fall The Saturday Morning Sports Injury Clinic is open forthe fall athletic season. The clinic, which treats sportsinjuries in local athletes, will be open for walk-in pa-tients and those with appointments every Saturdaymorning through November at 4064 Postal Drive inRoanoke. Walk-in patients are asked to register be-tween 8:30 and 9 a.m. For more information, call Carilion Clinic at 540-776-0228.

Most wiredFor the fourth consecutive year, Carilion Clinic hasbeen named as one of the nation’s Most Wired healthcare providers by Hospitals & Health Networks maga-zine. Award recipients are chosen based on their use ofinformation technology in business and administrativemanagement, clinical quality and safety, clinical inte-gration, and infrastructure.

Car-Seat Safety Programs Recognized Carilion Clinic received two awards from the VirginiaDepartment of Health for its car-seat safety programs.The awards recognize that Carilion sponsored the mosteducational events on child safety seats, and inspectedthe most safety seats, in a medium-size Virginia com-munity from 2010 to 2012. Motor vehicle crashes arethe leading cause of death for children, and seven outof 10 car seats put in by parents are installed incor-rectly. To have a child’s safety seat inspected, stop bythe Carilion Clinic and City of Roanoke’s check stationat 1333 Jamison Ave. It is open on the third Thursdayof the month from 4 to 6 p.m. Or call Safe Kids at 540-266-6563.

Children’s HospitalAdopts Mascot Say hello to Ned, a newface at Carilion Clinic

Children’s Hospital. A kid atheart, Ned is a friendly robotwho loves meeting childrenand parents and guiding themaround the hospital. Ned has agreat way of explaining treat-ments so every child can un-

derstand. He is also goodfriends with all the high-tech machines, so hecan explain what theydo. Those clunkingnoises the MRI makes?

Just ask Ned. He can tell youall about it.


Foundation Honors Physician’s Lifetime of Service In honor of Dr. Robert L.A. Keeley’s nearly 60 years as aphysician, the Carilion Clinic Foundation has estab-lished an award in his name. It will be given annually toa health care professional for significant contributions tothe health of the community. Dr. Keeley, 91, is a board-certified thoracic surgeon andone of the founders of Jefferson Surgical Clinic. He hasserved as chief of surgery for Jefferson Hospital and Car-ilion Roanoke Community and Memorial Hospitals, andon the board of directors for Community Hospital andCarilion. He is now medical director for nursing servicesat Roanoke Memorial, a position he has held since 1996.Dr. Keeley received the award at a dinner in his honor.Future recipients of the Dr. Robert L. A. Keeley Awardwill be individuals who best exemplify the standards thatdefine Dr. Keeley, including integrity, moral character,respect, and compassion.The Foundation also announced that it will name a new“healing arts” program after Dr. Keeley. The Dr. Robert L.A. Keeley Healing Arts Program will integrate the creativearts into the healing process and feature literary, per-forming, and visual art experiences.The Work of the FoundationThe Carilion Clinic Foundation establishes and main-tains relationships that generate philanthropic supportto enhance Carilion Clinic’s ability to provide excellencein health care. The focus of the Foundation is to provideresources for Carilion Clinic for equipment, programs,and services that otherwise would not be possible. Earlier this year, Krishan K. Tayal, M.D., of Radfordpledged $100,000 to the foundation to establish an en-dowed fund for staff medical education. Carilion Clinic plans to name the vascular lab at CarilionNew River Valley Medical Center after Dr. Tayal, who iscredited with establishing the lab and making care moreaccessible for patients in the New River Valley and sur-rounding areas.“I hope my gift will raise awareness of the many ways togive to Carilion and that it will inspire others to make agift of any size to something meaningful to them,” hesays.


Dr. keeley and his wife, Nina, at the dinner in his honor.


Medical News

When Deborah Browning learned she had endometrialcancer last year, she began to unravel a generations-oldfamily mystery.Her diagnosis didn’t come as a surprise: Browning’s

mother, grandmother, three aunts, and two sisters hadall had endometrial cancer. But after her hysterectomyat Carilion Clinic, a test on her tumor revealed a poten-tial genetic cause—a possibility Browning hadn’t con-sidered.“I got real excited, because having this knowledge can

save lives in your family,” says Browning, 57, of Prince-ton, W.Va. “Genetic testing is a miracle. Maybe this cansave my grandchildren and great-grandchildren fromhaving to die early.” Last fall, Carilion began routinely screening endome-

trial tumors for genetic abnormalities, since it is nowknown that some endometrial canceris caused by a genetic defect. Carilionis the only health care provider in theregion to provide such screening.After Browning was found to have

abnormalities, she then consultedCarilion’s cancer genetic counselor,Thuy Vu, and opted for furtherscreening. The results were positivefor Lynch syndrome—a hereditarycondition that dramatically increases

the risk for endometrial, colon, and other cancers. Armed with that knowledge, Browning can educate

her relatives about the family’s genetic disorder, andthey can employ early-detection measures, such as an-nual colonoscopies, to prevent future cancers.

“Endometrial cancer is the mostcommon gynecologic cancer we dealwith, and up to 10 percent of our pa-tients might carry a genetic defectthat causes it,” says Carilion gyneco-logic oncologist Janet Osborne, M.D.“So identifying that particular

group of people is really importantfor the impact on their health. They’llundergo intensive screenings for the

other types of cancers that are included in the syn-drome. For the patients and their families to have thisinformation—you could save lives.”

knowledge is PowerAccording to Lynch Syndrome International, the av-

erage person has a 6 percent chance of getting coloncancer in his or her lifetime. With Lynch syndrome—also known as hereditary nonpolyposis colorectal can-cer (HNPCC)—that risk jumps to 60 to 80 percent. Women with the syndrome are at a 40 to 60 percent

risk of developing endometrial cancer in their lifetime,compared to the 2 to 3 percent risk for the averagewoman. Cancers associated with Lynch syndrome tendto develop before age 50.Vu encourages genetic testing for a patient’s children

and siblings, who each have a 50 percent chance ofhaving inherited Lynch syndrome. Browning’s 37-year-old daughter, Christie Wilcox, tested negative for thesyndrome. That means Wilcox’s two daughters couldnot have inherited the genetic mutation. “While it can be frightening to know that a genetic

Carilion Begins Genetic Screening for Lynch SyndromeCondition Increases Cancer Risk By Karen Doss Bowman

Thuy Vu

Janet Osborne, M.D.


condition is lurking in your familyhistory and can be passed down,having the genetic testing makespeople feel empowered,” Vu says. “Ifa patient knows she’s in a high-riskcategory for colon and endometrialcancer, she can become a better ad-vocate for her own health. “But if a patient finds out she

doesn’t have a genetic risk for can-cer and that her children don’t—

that can provide ahuge relief.”

Tailoring Treat-mentsDennis Scrib-

ner, M.D., the gy-necologiconcologist whotreated Browning,is excited about

the rapid advances in genetics.“Someday, we should be able to ge-netically categorize people’s tumorsand individualize treatments basedon that information,” he says. “Thatwill help us to tailor each patient’s

oncological management.”Browning is thankful that she

knows her family’s genetic risk forcancer and encourages others witha strong family history of cancer toconsider genetic testing. “Don’t be timid, and don’t be

backward,” says Browning, who be-lieves her brother’s death fromcolon cancer several years agocould have been prevented if thefamily had known about Lynch syn-drome. “Allow those with the knowledge

of genetics to help you and explainwhat’s going on in your family.There’s nothing scary about it. It’sall good information that you need.It’s not a death sentence—actually,it’s a life sentence. This gives youlife.”

For more information, call 540-266-6000 or 800-422-8482.

Deborah Browning (left), who recently tested positive for Lynch syndrome, andher daughter Christie wilcox.

Endometrial CancerEndometrial cancer is themost common cancer of thefemale reproductive organs.It occurs in the tissue shedeach month as part of awoman’s menstrual period.The most common symptomis abnormal bleeding.Menstrual periods maybecome heavier or longer, orbleeding may occurbetween periods. Aftermenopause, any vaginalbleeding at all, no matterhow slight, is consideredabnormal.Risk factors include earlymenstruation, latemenopause, never havinghad children, obesity, use ofestrogen alone for hormonereplacement, use oftamoxifen, and diabetes.

“I got real excited,because having thisknowledge can savelives in your family.”

— Deborah Browning, Princeton, W.Va.

Dennis Scribner, M.D.


Specialty Care

New Optionsfor TreatingBrain Injuries

Care Is Available Close to Home By Erica Stacy

After suffering a head injury on the set of the movieSyriana, actor George Clooney began experiencing ex-cruciating headaches and memory loss. He describedit as the most unbearable pain he’d ever had. A neurologist identified the problem: Clooney

had torn the dura—a membrane surrounding thebrain and spinal cord. He underwent a series ofoperations, and eventually recovered. Accidents like his happen every

day, turning lives upside down.And while area residents once had

to seek care for such accidents out-side the region, treatments are now

available close to home.“The options for patients with brain

and spinal injuries in our region todayare leaps beyond what was available just a

decade ago,” says Gary Simonds, M.D., sec-tion chief of neurosurgery for Carilion Clinic.“Traditionally, neurosurgeons have opened the

head and skull or spine for treatment. But new,minimally invasive alternatives ensure shorter recov-ery times and reduce risks,” he says.


At Carilion, five neurosurgeonsprovide treatments that are on thecutting edge. “There is no need toleave the region for neurosurgery,”says Dr. Simonds. “We havebrought state-of-the-art care rightto your backyard.” For example, 80 percent of brain

aneurysms can now be treated hereby threading a catheter through atiny incision in the groin all the wayup to the head. Certain tumors ofthe brain and pituitary may be re-moved using transphenoidal proce-dures, in which a surgeon accessesbrain tissue through the back of thenose. Carilion Clinic is the onlyhealth care system in the region toperform this procedure.Similarly, endoscopic spinal sur-

gery uses cameras and instrumentspassed through small incisions to

reach and repair damaged areas ofthe back. Most of these new procedures re-

quire shorter hospital stays than dotraditional surgeries, and they letpatients resume normal life morequickly.

New options for managing spinalpain—a growing concern for manyAmericans—involve implantingwires in the spinal column that areconnected to a special control de-vice. The device manipulates thenerves, essentially tricking theminto masking pain. This device, apacemaker for the spine, isn’t acure, but it is an effective treatmentfor certain, qualified patients.

Carilion Clinichas also openeda multi-discipli-nary spine cen-ter wherephysicians fromseveral special-ties, includingneurosurgery,collectively helppatients withspinal ailments.

“Targeted radiation for tumorsusing CyberKnife is another ad-vance available at Carilion,” says Si-monds. “We use a computer toposition low-dose beams of radia-tion from various angles. Where thebeams cross, a concentrated dose ofradiation targets a tumor, but doesnot harm other tissue in the area.”

Carilion has expanded its neuro-surgery program rapidly in the lastdecade. In addition to the neurosur-geons, three specialized physicianassistants now serve patients inwestern Virginia.“Many of the health problems we

treat are the results of accidentalinjuries to the head, neck, andback,” says Dr. Simonds. “We carefor patients of all ages, includingchildren, and we have the expertiseto successfully treat a broad spec-trum of problems from injuries andtumors to aneurysms and issueswith the spine.“Because every patient is differ-

ent, our approach involves a teamof medical professionals working to-gether to determine the treatment

that offers each individual the bestpossible outcome.” In 2007, Carilion also launched a

residency program in neurosurgery.“These doctors-in-training enhancethe personal care available for ourpatients,” Dr. Simonds says. “Andin order to teach effectively, ourphysicians are always consideringnew ideas and evaluating new treat-ments. We stay informed about thelatest techniques and technologies.It’s a winning combination for ourpatients.”


Neurosurgeons care forpeople who are experiencingproblems related to thenervous system, which isformed by the brain, spinalcord, and peripheral nerves. The brain serves as commandcentral, controlling the bodyfrom movements andsensations to understandingand speech.The nerves are like electricwires that transferinformation to and from thebrain. Most of them passthrough the spine.

Time can be of the essencewith a head injury, makingquick access to specializedcare invaluable. Trauma is theleading cause of death inchildren older than one in theUnited States, for instance.Head trauma accounts for 80percent or more of thoseinjuries.

Gary Simonds, M.D.

Surgeons can now perform many mini-mally invasive procedures to treatbrain injuries.


How healthy are the residents of the Roanokevalley?With the mission of improving the commu-

nity’s health, Carilion Clinic recently took thelead in conducting a Community HealthNeeds Assessment. Fifty-six community or-ganizations served as partners.“This has been a true community effort

with the involvement of literally thousands ofpeople,” says Shirley Holland, vice presidentof Strategic Development at Carilion Clinicand project director. “Since our goal is to im-prove community health, we had to first un-derstand the issues and needs.”The assessment team developed a 24-ques-

tion survey to learn about the incidence ofchronic illness, access to health care and in-surance, and demographics. Over 4,000 resi-dents completed the survey, which wasdistributed throughout the community. After combining the results with feedback

from focus groups, site surveys, secondarydata, and other assessment tools, a clearerpicture of health needs emerged. The surveyrevealed five areas with unmet needs: accessto adult dentistry, access to primary care, ac-cess to mental health services, coordinationof care, and wellness or health literacy. “The input from focus groups was rich with

useful information,” says Eileen Lepro, exec-utive director of New Horizons Healthcare, aproject partner. “Participants didn’t hesitateto share their honest thoughts about theirown needs and those of the community.“I’m encouraged by what we gleaned. It

suggests real shifts in thinking about priori-ties that focus on wellness and prevention,and not just treatment of illness.”

Access to ResourcesThe survey showed various reasons why

many people did not get adult dentistry orprimary care, or use mental health services.

By Allison Buth

Taking the Pulseof the Roanoke Valley

These included waiting lists formedical care, a lack of reliabletransportation, and a lack of ex-tended hours. The survey alsofound that social stigma, a lack ofhealth literacy, and other factorswere involved.“People who cannot get the appro-

priate care they need often use theEmergency Department, which isn’talways best for the patient and re-sults in very busy, stressed EDs,”says Holland. “This work points tothe need to improve and expand access—especially for the under-served and uninsured populations.”Improving the coordination of

care is expected to help connectmore residents with a primary careprovider, and improve care by help-ing patients navigate through thesystem. To increase wellness in the com-

munity, project managers say thatpromoting a healthy lifestyle, a nu-tritious diet, and an optimal bodyweight can help residents avoid ormanage chronic disease. “We are identifying neighborhoods

where we can influence behaviors toimprove health,” says Pat Young,consultant for CommunityWorksand project manager of the healthassessment. “It is more than justmaking sure you get a flu shot eachyear. We are looking at access to af-fordable healthy foods and ways toengage in physical activity.“To me the health assessment is a

gift to the community. While wespent time looking at what theneeds are and who is impacted themost by disparities, the project al-lowed us to engage the communityin the process and begin to create ahealth improvement plan that willimpact those who live here.”The assessment was largely

funded through an $80,000 federalgrant.

Strategies are now being draftedto improve health care whereneeded; they are expected to be im-plemented over the next few years.Evaluation measures for gaugingwhether goals are met will also bedeveloped.“All of the health care and human

services safety net organizations inthe Roanoke Valley can benefit fromwhat we have learned through this

assessment,” says Lepro. “It pro-vides the basis for us to write bettergrants, formulate strong strategicplans, and answer calls to action—individually and collectively.”It has been 12 years since a

Roanoke Valley community healthsurvey was conducted. “The health assessment is a com-

munity-driven project and its suc-cess is highly dependent on theinvolvement and commitment of thecommunity,” says Holland.

For more information about free com-munity services available in theRoanoke Valley, dial 2-1-1. Atrained professional will listen toyour situation and suggest sourcesof help. To read the assessment,visit carilionclinic.org/chna.

The survey found five areasthat need improvement:• Access to adult dentistry• Access to primary care

services• Access to mental health

services• Coordination of care• Wellness

The health survey found thecommunity has madeimprovements in theseareas:• Children’s health: Medical

care is available for childrenregardless of their insurancestatus

• Prenatal care: Roanoke hasa low rate of late entry intoprenatal care

• Education: Roanoke Cityschool drop-out rates havedeclined from 19 percent in2010 to 12.2 percent in 2011

• Diabetes care: Diabetesdeath rates have declinedfrom 25.6 per 100,000 in2009 to 14.4 in 2012,making Roanoke’s ratelower than the state’s rate of18.7

• Community resources:More programs areavailable throughorganizations such as NewHorizons Healthcare,Carilion Pediatric Dentistry,Project Access, Mission ofMercy, Fralin Clinic, andBradley Free Clinic

• Community involvement:Efforts by residents have ledto an expanded greenwaysystem and morecommunity gardens andmarkets



When it comes to food, local is better.That’s the growing consensus across west-

ern Virginia, where grass-fed meat, pasturedeggs, and organic fruits and vegetables are indemand.The local food movement, which has been

gaining momentum for some time, is goingmainstream. The documentary Food, Inc.,along with books and articles on the poorquality of American diets, have served as awake-up call for many parents who wanttheir kids to grow up healthy. And increas-ingly, that means seeking out meat, seafood,milk, and produce that are fresh and free ofhormones and additives. Parents are also concerned about the obe-

sity epidemic linked to over-processed andfast food.Luckily, consumers in our region enjoy

considerable choice. About 100 farms inwestern Virginia now produce meat from pas-tured animals and organic produce. Theirproducts are sold throughout the region atfarmers markets, individual farms, grocerystores, and food grower co-ops.

By Maureen Robb


Back to the FarmA number of farms in western

Virginia are using environmentallyconscious practices to grow vegeta-bles and raise livestock. They also have a commitment to

humane and ethical treatment ofanimals and to producing healthyfood. Many are new to farming. Ian and

Carolyn Reilly of Four CornersFarm in Rocky Mount, for instance,moved their family from Gainesville,Fla., two years ago for a more re-warding life. After reading a book byDr. Matthew Sleeth about the joyinherent in a less materialistic,healthier lifestyle and seeing Food,Inc., they resolved to simplify theirlives. They also adopted a newdream: growing “real food” andmaking a difference in their com-munity. “Food really is medicine,” says

Carolyn, a former marketing spe-cialist and graphic designer. “Morepeople are becoming aware of this,and we are seeing a huge demandfor locally produced food.”“Real food may be a little more ex-

pensive up front, but in the longrun, eating cheap food will cost youmore in medical expenses,” says

Ian, who has been an IT systemsadministrator for the University ofFlorida. (He still does some workhere for the university.) “More and more people are look-

ing for local and grass-fed beef,pigs, and chickens,” he says. “It’samazing.” The Reillys, who sell whole pas-

tured chickens and eggs, freshherbs, and produce, say they areselling their eggs “as fast as thechickens can lay them.” They are also happy in their 1907

farmhouse, and have been joined byCarolyn’s parents, who help watchthe kids and maintain the farm.“We have a great pasture, woods,creeks, and a pond,” Carolyn says.“We all love it here.” Others, such as the Tilson family

of Broadview Ranch in Lexington,have long been rooted in Virginiaand are carrying on a family tradi-tion. The Tilsons run a multi-gener-ational farm specializing insustainably raised grass-fed beef,woodland pork, and pastured eggs.“We are focused on producing

good food—good for the body, goodfor the palate, good for the land,good for the animals, and good forour community,” says Lee Atwood, amember of the extended family.Like other farmers who raise

grass-fed cows, he says that beefproduced without grain, antibiotics,hormones, and pesticides tastes

what natural foods can youbuy locally?How about:• Grass-fed beef, pork, lamb,

goat, rabbit, and buffalo• Pastured eggs• Fresh and smoked trout• Organic fruits and vegetables

including bok choy, escarole,baby lettuces, leeks, sorrel,apricots, Asian pears,blackberries, plums, andcurrants

• Hormone-free milk, icecream, and artisan cheeses

• Culinary herbs• Honey

Fresh tomatoes and peppers are for sale at the west End Community Market in Roanoke. Market manager Tee Reynolds(left) buys produce from vendor Betsy Stewartson.


better and is more nutritious thanmass-produced supermarket beef.He also cites its lower fat content,higher Omega 3 fatty acids andbeta-carotene, and greater cancer-fighting CLAs (conjugated linoleicacids).Perhaps the most famous farm in

western Virginia is Polyface, Inc., afamily-owned farm outsideStaunton. It has been featured inthe best-selling book The Omnivore'sDilemma, the movie Food, Inc., anda BBC documentary as a superb ex-ample of sustainable agriculture.Family head Joel Salatin, noted forhis own books on the subject, saysit’s just not natural to eat food thathas traveled 1,500 miles to yourtable.Many other farms in the region

also proclaim their dedication toproducing nutritious and deliciousfoods. They include: ShadowchaseFarm, near Blacksburg; BorderSprings Farm in Patrick Springs;Garden Mountain Farm in Burke’sGarden (near Tazewell); IdleWildFarm in Bedford; Weathertop Farmin Check; Homestead Creamery inWirtz; Sizer Farm in New Castle;Journeys End Farm in Fincastle;and Rolling Meadows Farms inMartinsville. (To locate farms that raise pas-

tured livestock and grow organicproduce, see Resources on page 21.)

Ripple EffectThe effects of the local food move-

ment are being felt far and wide.The state of Virginia, for instance,

is sponsoring a Farm to School Pro-gram that promotes the use of freshproduce. More than 75 schools inwestern Virginia participate, ac-cording to the Virginia Departmentof Agriculture and Consumer Serv-ices.Agri-tourism is also blossoming.

The Black Diamond Ranch in NewCastle says it is developing an agri-tourism business that will feature abed and breakfast, general store,and a cafe. Others have announcedsimilar plans.

kids who Love kaleHow do you get kids to eat their vegetables?By involving them in the cooking process, says Heather Quintana, acertified health coach and director of Happy Healthy Cooks.Quintana ought to know. She’s taught many local children how tochop, shred, and grate veggies, and she regularly gets suchfeedback as:“No fair, he has more cabbage than me!” and “Lentil soup isawesome!”The mission of Happy Healthy Cooks is to teach kids to love healthyand delicious whole foods. Every week, volunteers conduct lessonsin elementary schools. A “no yuck rule” applies: children are asked togive all foods a chance before they jump to conclusions aboutwhether they like it. “They usually do, after they try it,” says Quintana.Children are also taught about dietary fat and exercise, vitamins,knife and kitchen tool safety, and how to wash their hands properly.Lessons incorporate ethnic foods from around the world. Parents rave about the program. “We’ve changed our eating habitsat home,” says Jenny Taylor of Roanoke. Her children now seek outfruits or vegetables at the grocery store, instead of always asking forpizza. And they help out in the kitchen.Susan Mabery of Roanoke says: “Since my son and his classmatesstarted eating kale with Happy Healthy Cooks, they want it fordinner.” The program now teaches children at Grandin Court Elementary,Virginia Heights Elementary, Lincoln Terrace Elementary, and TAPHead Start. It is sponsored by Carilion Clinic, United Way of RoanokeValley, New Horizons Healthcare, and other local organizations,businesses, and individuals.For more information and kid-friendly recipes, go tohappyhealthycooks.com or facebook.com/HappyHealthyCooks.

Director of Happy Healthy Cooks Heather Quintana (center) with studentsAvalon Flowers (left) and Tatum Jepson.

Restaurants across the region,meanwhile, are championing “farmto table” fare. The newest of these,The River and Rail in Roanoke, saysit changes the menu weekly basedon what is available in season fromlocal providers.

Farmers Markets The number of farmers markets

in the region also keeps growing.There are dozens in western Vir-ginia alone, including ones inBlacksburg, Radford, Pulaski,Tazewell, Troutville, Vinton, Mar-tinsville, Lexington, Staunton, West-lake (Smith Mountain Lake), andSalem.Statewide, the value of sales at

farmers markets has more thandoubled over the past five years, ac-cording to the Virginia Departmentof Agriculture and Consumer Serv-ices. In 2011, sales topped $42 mil-lion. Roanoke alone has several farm-

ers markets, including the RoanokeCity Market downtown and those atGrandin Village and the West End. Perhaps the newest market is the

Farmers Table at Carilion RoanokeMemorial Hospital. Open Tuesdayafternoons from May to October, itis one of Carilion Clinic’s programsto promote health in the commu-nity—this time primarily among its

employees. It is operated by GoodFood-Good People of Floyd, a collab-orative of more than 30 farms. Carilion Clinic is also conducting

a community health needs assess-ment for the Roanoke Valley thatwill consider access to healthy food.(See page 16.)

Urban Gardens Community gardens are another

trend, particularly in Roanoke. Three are now flourishing in the

heart of the city: one on 14th St. insoutheast Roanoke; another in theHurt Park neighborhood in south-west Roanoke; and one adjacent toRAM house on Campbell Ave. S.W.All are run by the Roanoke Commu-nity Garden Association.Each is open to the public, and

individuals can pay $15 to $20 an-nually for a plot. Gardeners cangrow whatever they like, providedthey do it organically. The result:fragrant plots carefully tended bylong-time Roanoke residents as wellas by recent immigrants fromBurma, Mexico, Russia, Honduras,the Sudan, and Afghanistan. Mostof the 250 gardeners involved growfood for their families.Roanoke native Mark Powell

launched the garden association in2007 while living in an apartmentwith no land to grow his own food.

His association, which has receivedgrants from local agencies and busi-nesses, is also developing severalnew gardens—and an urban or-chard. “Locations for new gardens and or-

chards are being scouted,” Powellsays. Funding and community par-ticipation are also being explored. “Beyond the gardens, there’s much

more to come,” he adds. “Expandedaccess to community markets, morelocal food in restaurants, communitykitchen programs, greenhouse pro-duction, rooftop gardens, and year-round hydroponic operations are all

Resourcesroanokevalleylocavore.comeatwild.combuylocalvirginia.orgvirginia.org/farmersmarketslocalharvest.orgslowfoodusa.orgvdacs.virginia.gov/vagrownroanokecommunitygarden.orgfoodforthoughtva.orgfranklincountyfreshfoods.org plentylocal.org


Left: Free-range chickens, and theireggs, at Broadview Ranch in Lexing-ton. Center and right: A cow grazesand sheep run to their dinner inFloyd County.

Regional Interest


By Su Clauson-Wicker

Have YouMet TED?Fun and Engaging Talks WinFans, Build Community

Have you ever wondered what we learn before we’re born?Or how Sixth Sense works? And why good design matters? These are just a few of the topics explored in TED talks given

by leaders in their fields, including Steve Jobs and J.K. Rowling,author of the Harry Potter books. The videotaped talks have beenwatched by millions of people online and are the focal point ofTED discussion groups around the world. TED is a nonprofit organization dedicated to what it calls

“Ideas Worth Spreading.” It began as a conference to bring to-gether people from the worlds of technology, entertainment, anddesign, hence the acronym. It has grown into an international phenomenon that now spon-

sors two annual conferences—one in California and one in Edin-burgh, Scotland—along with an annual TED Prize, a Fellowsprogram, a TED talks website, and other projects. The online siteoffers a thousand free talks on science, psychology, art, busi-ness, and other subjects. (Apple also has a TED talks app, Twitter has a feed, YouTube

shows the top ten talks, and Linkedin has a TED discussiongroup.) “We believe passionately in the power of ideas to change atti-

tudes, lives, and ultimately, the world,” says TED’s missionstatement. The group challenges “the world’s most fascinatingthinkers and doers” to give the talk of their lives in 18 minutes orless. Many have.TED discussion groups are coordinated independently by in-

terested communities and are designed to stimulate discussion

Moderator katherine Fralin walker introducesa TED talk.

“People trust TED talksto be interesting, andthey always are.”

— Katherine Fralin Walker


TED TopicsTED talks cover all types ofsubjects, including:

• Enhancing your creative flow

• What’s left to explore?

• Plant fuels that could power ajet

• Don't regret regret

• How games make kidssmarter

• Health and the human mind

• Can astronomers helpdoctors?

• How to make choosing easier

• Building the musical muscle

• The power of cities

• Four lessons from robotsabout being human

• What makes us happy?

• How many lives can you live?

Summer interns from the Taubman Museum of Art were in the frontrows at a recent talk.

and create connections within thecommunity. Locally, a videotaped talk is

shown each Wednesday at noon indowntown Roanoke. Area residentsare invited to watch and discuss thetalk over a brown bag lunch.Until recently, the talks have been

held at the Kirk Avenue Music Hall.*“People trust TED talks to be in-

teresting, and they always are,”says Katherine Fralin Walker, whomoderates the event. “I don’t adver-tise the weekly topics. Once peoplecome, they know TED talks areworthwhile.” Walker and her husband, attor-

ney and developer Ed Walker, ownthe music hall and believe stronglyin the power of individuals withincommunities to create positivechange. Walker is also the foundingdirector of the Batten LeadershipInstitute at Hollins University.“I usually select the talks the day

I show them,” she says. “I want toexpose people to something new—not necessarily something they’realready interested in.”

Sometimes as many as 40 attend,although on a recent sunnyWednesday, only eight were present.This didn’t bother Walker, whonoted that smaller audiences makefor better discussions. In Roanoke, the talks attract a di-

verse group including entrepre-neurs, public officials, designers,artists, and retirees. “Everyone hasa chance to say something, and no-

Transportation planner Mark McCaskillvalues the public policy aspects of TEDdiscussions.

Regional Interest


body can rant,” Walker says. “I askthem to speak their piece in fivesentences or less. People tend toglaze over when someone speaksmuch longer.”“Based on people’s life experi-

ences, reactions to the presenta-tions can be very different,” saysSharlyn Underwood, a Roanoke-based specialist in sustainable design who does green buildingconsulting and commercial furni-ture sales. “The discussions let ussafely express these differences. It’srefreshing to spend an hour eachweek listening, reflecting, formingan opinion, being heard, and beingappreciated for who we are as indi-viduals within this community.”“I go because of the public discus-

sion around ideas,” says Mark McCaskill, a senior transportationplanner for the Roanoke Valley-Alleghany Regional Commission. “Iam a long-range planner and I seeTED talks and the discussion thatfollows as a form of public involve-

ment in public policy concepts andissues. Hopefully, I can bring someideas back to the office.”Artist and commercial painter

John Wiercioch comes to the talksstraight from house painting jobs. “Irelish the opportunity to hear a va-riety of responses to topics,” hesays. “Very often my view is en-larged by insights from someoneelse’s perspective.”Walker also wins praise for her

moderating skills. “Katherine is asuperb facilitator—she believes inbuilding community,” says BobCole, owner of Financial DesignersLLC in Roanoke, who’s been attend-ing since 2010. “You can’t findmany places where everyone canspeak with equal weight the way wecan here.” Before the group adjourns each

week, Walker asks participantswhat struck them as they listenedto each other. “The audiences hereseem really interested in one an-other’s take,” she says. “Discus-

sions rarely get heated.” She smiles.“But that would be okay too.”

* The TED talks are now being heldat 16 West Marketplace at 16 WestChurch Ave. in Roanoke. The newmoderator is Aaron Garland, whohas a background in recreation man-agement and restoring historic prop-erties.

Virginia Tech has also scheduled itsown live TEDx event (a regional con-ference) on Nov. 10, 2012. For infor-mation, go to tedxvirginiatech.com/.

Left: Frequent attendees include financial consultant Bob Cole and sustainable design specialist Sharlyn Underwood. Right:katherine Fralin walker leads a discussion.

Resources• Ted.com• youtube.com/ted• hulu.com/tedtalks• facebook.com/TED • wikipedia.org/wiki/

List_of_TED_speakers


Q & A with Dr. Paul Yeaton,Gastroenterologist

Paul Yeaton, M.D., joined Carilion Clinic Gastroenterology last year. An international leader in advanced endoscopic techniques, Dr. Yeatonalso joined the faculty of the Virginia Tech Carilion School of Medicine.He brought a new expertise to the region using endoscopic ultrasoundto diagnose pancreatic and liver diseases—as well as new options fornon-surgical treatments of these illnesses. Recently, Dr. Yeaton dis-cussed his medical background, his experience at Carilion Clinic, andhis love of fiddling.

Q. Why did you choose to be a gastroenterologist?I had a number of careers before choosing medicine, and I ended up

spending a lot of time learning to play the fiddle from older people whowere sick, and it looked like it was time for me to make a new choice. I feltlike medicine was a good opportunity to impact people’s lives. Q. How does your specialty help patients?Most of my patients are inflicted with yellow jaundice or have conditions

of the pancreas, including cancers. I do unique interventions that eithermake ultimate surgery easier, or they replace the need for surgery.Q. What makes your practice unique in the region?Probably the most unique service we offer now at Carilion would be en-

doscopic ultrasound. So much of what I do is a combination of endo-scopes, which are devices that are passed into the intestine [to examine it,combined with a type] of radiology, in this case, ultrasound.The scope that’s inserted actually has the ultrasound probe on it, and

this allows me to examine organs and structures that are close to the in-testine, but outside the intestine. From there, I can make biopsies, I canput drains, or any number of things to provide a non-invasive form of anintervention [rather than surgery]. Q. What do you enjoy about southwest Virginia?The move to Carilion and the Roanoke area was an easy one for me be-

cause I love the region. We sit in the heart of old-time music and fiddling,and because I’m a fiddler myself, I was attracted just so I could be im-mersed in the culture and region.Q. What else attracted you to Carilion?Another attractive thing for me was the creation of the [Virginia Tech

Carilion] medical school. Carilion Clinic has a strong foundation in patientcare and this represented, for me, the opportunity to build on that founda-tion and to create an environment where we not only offer exceptional carefor our patients, but also we create the new generation of doctors andphysician educators.


To watch a video of the interviewwith Dr. Yeaton, scan this code.

By Matthew Sams

Regional Interest


Carleen Ellis spent her working life teaching futurenurses. So when she had surgery recently at CarilionRoanoke Memorial Hospital, she kept a professionaleye on her caregivers.Ellis, 83, was facing two problems—fingers that went

to sleep, and an unstable hip.The numbness in her fingers was mostly just an irri-

tation, until she had trouble gripping the steeringwheel. “I'd be driving long distances and my handswould go to sleep,” she says.Carpal tunnel syndrome was diagnosed by Deborah

Robinson, a nurse practitioner at Carilion Family Medi-cine, North Roanoke. After consulting with hand sur-gery specialist Cesar Bravo, M.D., Ellis had outpatientsurgery last December. Carpal tunnel release is just one of many orthopaedic

services offered by Carilion, according to Dr. Bravo.“More than 25 orthopaedic physicians are available,and the majority of them are fellowship-trained,” hesays. “We have one of the largest comprehensive prac-tices in the state.”Even as she recovered, Ellis knew she would be fac-

ing another surgery, this one more complicated. For adecade, her right hip had been unstable, combiningwith a back problem to slow down an active woman.“I was at the point of getting someone to help with

buying groceries—grocery shopping would totally ex-haust me,” says Ellis, an independent living resident atFriendship Retirement Community in Roanoke. In February, Ellis had hip replacement surgery by

Phillip Patterson, M.D. Five months post-surgery, thebenefits were apparent. “I was amazed when casual ac-quaintances said to me, ‘You’re taller now, you’restanding better.’ That told me a lot.”Ellis found both surgeries to be positive experiences. “Carilion’s operative experience—the same-day sur-

gery and the inpatient surgery—were highly personal-ized,” says Ellis, who taught at Arizona State and theUniversity of Arizona before retiring and moving toRoanoke. “The nursing care that I observed being givento others, plus what I experienced myself, makes mereally proud to be a nurse.“I can't say enough about the caring staff on 9 West.

Safety and comfort were their obvious priorities, andthey are good at what they do.”Ellis also gives high marks to her surgeons, their of-

fice assistants, the pre-op staff, and the recovery roomnurses.

“The entire experience, beginning with the excellentvalet service at the Riverside complex and on throughthe follow-up, earns my highest praise.”

Correcting CarpalTunnel — and anUnstable Hip: A Patient’s StoryBy Randolph Walker


da vinci Surgical SystemArrives in the New River Valley

A robotic surgical system that lets surgeonsperform complex operations with a few tiny in-cisions is now available at Carilion New RiverValley Medical Center (CNRV) for gynecologicprocedures.The state-of-the-art da Vinci Surgical Sys-

tem will give New River Valley patients accessto the latest advancements in minimally in-vasive surgery.“We are proud to offer a new level of surgi-

cal service to New River Valley residents,”says John Piatkowski, M.D., vice presidentand hospital administrator at CNRV. “This isyet another step in our development as thepremier center for medical care in the area.” “Patients and their families continue to re-

alize world-class care is no longer an hourplus commute from Blacksburg, Wytheville,etc. It is available right here at Carilion NewRiver Valley Medical Center.” The da Vinci system allows surgeons to

perform difficult surgeries with increased ac-curacy by controlling the tiny, precise handsof the robot to execute movements about fivetimes smaller than they could achieve withtheir own hands. Patients in turn have shorter hospital

stays, less pain, less risk of infection, lessblood loss, fewer transfusions, less scarring,and quicker recoveries.Using the da Vinci system, a surgeon sits

at a console showing a 3-D image of the sur-gical field. He or she then uses instrumentcontrols below the display to precisely ma-neuver the surgical instruments. From a clinical perspective, surgeons bene-

fit from greater surgical precision, increasedrange of motion, improved dexterity, en-hanced visualization, and improved access.The da Vinci system, which has been

praised as an effective alternative to bothtraditional open and laparoscopic surgery, isalso available at Carilion Roanoke MemorialHospital.

For more information, go toCarilionClinic.org/davinci.

Top (L to R): Cecilia Irvin, R.N., Tam-era Howell, M.D., and Alice Huff,R.N. with the da vinci Surgical Sys-tem at Carilion New River valleyMedical Center. Left and below: Dr.Howell at the instrument panel.

By Allison Buth


New Providers Leading Trauma Surgeon Joins Carilion Clinic

Bryan Richard Collier, D.O., a surgeon who specializesin trauma, critical care, and nutrition, has joined CarilionClinic. He is board certified in general surgery and surgi-

cal critical care and is a certifiednutrition specialist-physician.

Dr. Collier comes to Carilionfrom Vanderbilt University MedicalCenter in Nashville, where heserved in several capacities, includ-ing as associate director for surgi-cal critical care education. AtVanderbilt University School ofMedicine, he served as assistant

professor of surgery and internal medicine. Since 2008,he has also been a clinical adjunct faculty member atLincoln Memorial University’s DeBusk College of Osteo-pathic Medicine.

He has been active in research, acting as lead investi-gator on two sepsis studies and as sub-investigator on

11 other trials. He has served as a manuscript reviewerfor several peer-reviewed medical journals, includingThe New England Journal of Medicine, Hospital Practice,and the Journal of Emergencies, Trauma, and Shock.

While in Tennessee and Pennsylvania, Dr. Collier vol-unteered in several community organizations includingthe Vanderbilt University Medical Center’s Shade TreeFamily Clinic in Nashville, which provides free medicalcare to those without health insurance. He also volun-teered at the Johnstown Free Medical Clinic in John-stown, Pa.

He received his D.O. degree from the PhiladelphiaCollege of Osteopathic Medicine and completed his in-ternship and residency at Memorial Medical Center inJohnstown, Pa. He did his fellowship in surgical criticalcare and trauma at Vanderbilt University Medical Cen-ter.

He practices at 3 Riverside Circle in Roanoke and canbe reached at 540-224-5170.

Bryan Richard Collier, D.O.

Heart Specialist Joins Carilion Clinic Jason R. Foerst, M.D., whose specialties are interven-

tional cardiology and structural heart disease, bringsexpertise in a new advanced heart procedure to Caril-ion Clinic.

Dr. Foerst has just completed afellowship at the University of Dus-seldorf in Germany and training ina minimally invasive procedurecalled Transcatheter Aortic ValveImplantation, or TAVI. It is a life-ex-tending option for patients whoare too high-risk for open-heartsurgery.

Called one of the most revolu-tionary developments in cardiology in the pastdecade, TAVI can help those with a severely narrowedaortic valve. During the procedure, a special heartvalve made of cow tissue and stainless steel is passedthrough an artery in the leg up to the heart using atube, or catheter. Special imaging equipment helps

guide the valve into place. Dr. Foerst most recently served concurrently as staff

physician at the Dartmouth-Hitchcock Medical Centerin Lebanon, N.H., and the V.A. Medical Center in WhiteRiver Junction, Vt. He won the Excellence in TeachingAward nine times while at Dartmouth-Hitchcock. Healso taught at Dartmouth Medical School.

He has published numerous articles about the natu-ral history of coronary stents and recently completedbook chapters on coronary thrombectomy and thepathology of drug eluting stents.

Dr. Foerst received his M.D. degree from the Univer-sity of Missouri at Columbia School of Medicine. Hecompleted his residency in internal medicine, andpostdoctoral training in cardiovascular disease and in-terventional cardiology, at Dartmouth-Hitchcock Med-ical Center.

He practices at 127 McClanahan St. and 2001 CrystalSpring Ave. in Roanoke and can be reached at 540-982-8204 and 540-266-6505, respectively.

Jason R. Foerst, M.D.


Saira Arif, M.D.PsychiatryEducation: Government Science College, Karachi, PakistanMedical Degree: Dow Medical College Residency: UVa Roanoke-Salem Psychiatry ProgramFellowship: Carilion Clinic2017 South Jefferson St., Roanoke, VA 24014 540-981-8025

Karol L. Gordon, D.O.Family Medicine and Urgent CareEducation: Bluefield CollegeMedical Degree: West Virginia School of Osteopathic MedicineResidency: Carilion ClinicFellowship: Carilion Clinic434 Peppers Ferry Road, Christiansburg, VA 24073 540-382-6000

Anthony L. Loschner, M.D.Pulmonary and Sleep MedicineMedical Degree: Charles University First Faculty of Medicine,PragueResidency: University of North Carolina School of MedicineFellowship: West Virginia University2001 Crystal Spring Ave., Suite 205, Roanoke, VA 24014540-985-8505

Lisa Alleyne, M.D.Family MedicineEducation: Liberty University Medical Degree: Eastern Virginia Medical SchoolResidency: Lancaster General Hospital1371 Lee Highway, Verona, VA 24482540-248-3413

Jason R. Foerst, M.D. Interventional CardiologyEducation: University of Missouri - ColumbiaMedical Degree: University of Missouri - Columbia School ofMedicineResidency: Dartmouth-Hitchcock Medical CenterFellowship: Dartmouth-Hitchcock Medical Center; University ofDusseldorf, Dusseldorf, Germany127 McClanahan St., Roanoke, VA 24014540-982-8204

David Edward Johnsen, M.D.Radiology Education: University of ChicagoMedical Degree: Medical College of Virginia Residency: Geisinger Medical Center2900 Lamb Circle, Christiansburg, VA 24073540-731-2000

Amy K. Barnhart, M.D.PediatricsEducation: University of VirginiaMedical Degree: American University of the Caribbean Schoolof MedicineResidency: Medical College of Virginia Hospitals4040 Postal Drive, Roanoke, VA 24018540-772-4453

Joseph Ferrara, M.D.Neurology Education: Bates CollegeMedical Degree: SUNY Upstate Medical CenterResidency: Duke University Medical CenterFellowship: Baylor College of Medicine3 Riverside Circle, Roanoke, VA 24016540-224-5170

Bryan R. Collier, D.O.Trauma and Surgical Critical Care Education: Wake Forest UniversityMedical Degree: Philadelphia College of Osteopathic MedicineResidency: Memorial Medical CenterFellowship: Vanderbilt University Medical Center 3 Riverside Circle, Roanoke, VA 24016540-224-5170

Brandon Coates, M.D. Family Medicine and Urgent Care Education: Hampden-Sydney CollegeMedical Degree: Virginia Commonwealth University School ofMedicineResidency: Carilion Clinic46 Wesley Road, Daleville, VA 24083540-591-9440

P H y S I C I A N S

Providers


Randall A. Ruppel, M.D.Pediatric Critical CareEducation: Kalamazoo CollegeMedical Degree: University of Michigan Medical SchoolResidency: Children's National Medical Center Fellowship: Children's Hospital of Pittsburgh1906 Belleview Ave., Roanoke, VA 24014540-981-7000

Heather Norden, M.S.N., F.N.P.-B.C.Nurse Practitioner, Family MedicineUndergraduate Degree: Hope CollegeGraduate Degree: University of North Carolina, Chapel Hill205 Roanoke St., Christiansburg, VA 24073540-381-6000

Randal Luke Swatzyna, P.A.-C.Physician Assistant, Family MedicineUndergraduate Degree: Roanoke CollegeGraduate Degree: Jefferson College of Health Sciences1314 Peters Creek Road, Roanoke, VA 24017540-562-5700

Jose Rivero, M.D.CardiologyEducation: University of MiamiMedical Degree: American University of the CaribbeanResidency: Brooklyn Hospital CenterFellowship: Brooklyn Hospital Center1201 Elm St., Christiansburg, VA 24073540-382-6711

Jessica D. Hall, M.S.N., F.N.P.-B.C. Nurse Practitioner, Family MedicineUndergraduate Degree: Bluefield State CollegeGraduate Degree: Marshall University141 Ben Bolt Ave., Tazewell, VA 24651276-988-8850

Edward McDowell, P.A.-C.Physician Assistant, Orthopaedics Undergraduate Degree: Winston-Salem State UniversityGraduate Degree: Wake Forest University, Physician AssistantProgram2900 Lamb Circle, Suite 380, Christiansburg, VA 24073276-773-8145

John Sedovy, M.D.General SurgeryEducation: Temple UniversityMedical Degree: Temple UniversityResidency: Carilion Roanoke Memorial Hospital100 Spottswood Drive, Lexington, VA 24450540-463-7108

Pheston G. Shelton IV, M.D.Child Psychiatry and BehavioralMedicine Education: East Carolina UniversityMedical Degree: Brody School of MedicineResidency: Brody School of MedicineFellowship: Brody School of Medicine2017 S. Jefferson St., Roanoke, VA 24014540-981-8025

Richard Weiss, M.D., M.B.A.Physical Medicine and Rehabilitation Education: Duke UniversityMedical Degree: St. George’s University School of MedicineResidency: Pitt County Memorial Hospital Fellowship: Orthopaedic Specialists of the Carolinas3 Riverside Circle, Roanoke, VA 24016540-224-5170

A D VA N C E D C A R E P R O V I D E R S

Vydia Permashwar, M.D.PediatricsEducation: The University of the West Indies School of MedicineMedical Degree: The University of the West Indies School ofMedicineResidency: Children’s Hospital of Michigan1030 South Jefferson St., Roanoke, VA 24016 540-985-8230


Sharing Stories By Laura Markowski

All are eloquent reminders of patients who’ve hadopen-heart surgery at Carilion Roanoke MemorialHospital.Now, on the 30th anniversary of open-heart sur-

gery in the region, 74 quilts line four floors ofRoanoke Memorial. And their squares were all cre-ated by patients or their families.What began in 1992 as an idea to celebrate the

10th anniversary of open-heart surgery here has be-come an ongoing symbol of cardiac care at CarilionClinic. When heart patients were first asked to decorate

a quilt square, hospital staffers only expected to geta few dozen squares back. “But we received about1,600,” says Cathy Jennings, R.N., D.N.P., a clinicalnurse specialist and leader of the quilt project.“It was meant to be a one-time thing, but after the

initial quilts were completed, we kept getting re-quests to create more. So we did!”The only requirements were that the squares had

to include the patient’s name and surgery date.Anything else was up to the patient. “It’s amazinghow much thought patients and families have putinto their squares,” Jennings says. “Each time I think I’ve seen every possible design,

another totally unique square comes in. It’s won-derful to see such creativity — and the pride ourpatients take in their squares.”People also view the quilts as a memorial to their

loved ones. “Recently a mother was waiting whileher son had surgery and actually found her hus-band’s square on a quilt in the waiting room,” Jen-nings says. “Her husband had since passed away,

but seeing his square was special to her.”Carilion Clinic’s entire cardiac team takes pride in

the impact their care has had on so many patientsand their families.

Setting the StandardAs leaders in cardiac care, Carilion Clinicperforms advanced heart proceduresevery day. Carilion Roanoke MemorialHospital, for instance, is the only hospitalin the region to offer transcatheter aorticvalve implantation (TAVI) for patientswith advanced valve disease, who are toosick to undergo open-heart surgery.Last year 1,839 cardiac patients weretransferred to the hospital for advancedcare from 36 other hospitals, includingthree in West Virginia.

Quilts Commemorate 30 Years of Open-heart SurgeryEvery quilt square tells a story. Many bear images of hearts. Some contain thank you notes to doctors and nurses.


Better Living

Your Calendar for Better HealthFall 2012wELL BABY CARE

A registered nurse coversthe basics of caring for anewborn7 – 9 p.m.Carilion New River ValleyMedical Center FiresideRoom B$10Please call 540-266-6000to register.

STROkE SCREENING8 a.m.Carilion Franklin Memo-rial HospitalFreePlease call 800-422-8482to register.

POSITIvELY PINk PARADE AND PARTY11 a.m. – 12:30 p.m.Begins at Panera Bread atValley View MallFor more information,please call 800-422-8482.

wOMEN’S HEALTH UNIvERSITYWomen Take Charge ofHealth: Leading the Way inHealth Care11:30 a.m. – 1 p.m.Jefferson Center, Roanoke$15 (includes lunch)Please call 540-266-6000to register.

ROANOkE HEART wALkHeart-healthy three-milewalk, benefiting the Ameri-can Heart Association9 a.m.Green Hill Park

PHYSICIANS ON FOOT8:30 a.m.Meet at the corner of Hamil-ton Terrace and BelleviewAvenue (in front of CarilionRoanoke Memorial Hospital)through October.Rain location: TanglewoodMallBeginning in November,meet inside TanglewoodMall. For more information, pleasecall 800-422-8482 or visitCarilionClinic.org/walking.

4TH FRIDAY DANCEEvery 4th Friday of themonth starting Sept. 28All levels are welcome for aone-hour dance lesson.Stay and continue dancinguntil 10:30 p.m. Latin andswing music. No partnerrequired!7:30 – 10:30 p.m.Roanoke Athletic Club$10/non-members;$8/membersFor more information,please call 540-772-2238.

Oct

13

Oct

13

Nov

1

Nov

3

EverySaturday

EveryFourthFriday

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

Oct

11


velocityCare Opensacross Region

velocityCare, a new urgent care service by CarilionClinic, has opened in Roanoke, Christiansburg,Daleville, and westlake (Smith Mountain Lake).Designed to bridge the gap between primary care

and the emergency room, VelocityCare provideswalk-in medical services for non-life-threatening ill-nesses and injuries. These include allergic reactions, back injuries, bee

stings, upper respiratory illnesses, coughs, colds,sore throats, earaches, eye infections/irritations,minor burns, minor cuts and wounds, rashes,sprains, and sports-related injuries.Many medical services are also available, includ-

ing:• Sports physicals• Occupational health services • Common prescriptions • Lab and X-ray services • Routine and seasonal vaccinations (call 48 hours

in advance) VelocityCare is open seven days a week with ex-

tended hours. No appointments are necessary.

For more information, go to velocitycarebycarilion.com.

Roanoke4035 Electric Road,Suite ARoanoke, VA 24018 540-772-8670

Christiansburg434 Peppers FerryRoadChristiansburg, VA24073 540-382-6000

Daleville46 Wesley RoadDaleville, VA 24083 540-591-9440

Westlake13205 Booker T.Washington HighwayHardy, VA 24101 540-719-1815

Opening day celebrations were held in (top to bottom)Roanoke, Daleville, and Christiansburg.

After learning she was at risk of ovarian cancer because of her genetics,

Diane decided to take a proactive step and sought the care of Carilion

Clinic’s gynecologic oncology practice. Diagnosed with ovarian cancer

in 2006, Diane has been treated by a coordinated care team, led by

Dennis Scribner, M.D., and Janet Osborne, M.D., both board-certified

gynecologic oncologists.

To learn more about Diane’s story or Carilion Clinic’s gynecologic

oncology services, please call 800-422-8482 or visit CarilionClinic.org.

Pictured L-R: Dennis Scribner, M.D.; Janet Osborne, M.D.; Thuy Vu, genetic counselor; Nicole Bush, L.N.P.; Lisa Manning, R.N.

Inspiring better health.™

CarilionClinic.org | 800-422-8482

Coordinated care for gynecologic cancers here in our community

M E E T T E A M D I A N E

“I’ve had five surgeries, fourrounds of chemotherapy,

I’m in remission, and I feelgreat! It’s all thanks to

Dr. Scribner and his team.”— Diane williams

ovarian cancer survivor

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 2012

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