Carilion Clinic Living - Summer 2015

SUMMER 2015

in this issueHELP FOR NEW MOTHERS 8PRESCRIPTION DRUG ABUSE 10GET FIT—GET ENERGY 14CHECK OUT THE ZOO 22

LivingInspiring better health.

Millions of Americans Don’t Get Enough SleepSleep patient Craig Moore of Christiansburg is back to doing things he loves, including walking with his two cats.

THE SLEEP CRISIS:

ConfidenceAt the new Carilion Clinic Cosmetic Center, we’ve put together an ex-ceptional team of surgeons and clinical staff hand-picked with the high-quality standards you’ve come to expect from Carilion. Combining the latest techniques with a wealth of experience and skill, our team delivers beautiful results and a new confidence that you can see and feel.

2107 Rosalind Ave., Roanoke, VA

Kurtis E. Moyer, M.D. Mark E. Feldmann, M.D. Mark Schoemann, M.D. Gina Hunt, Master Aesthetician

Beauty begins with

CarilionClinic.org/cosmetic

Call for a consultation. 540-853-0510

J1902 Cosmetic Ad CC_Living.indd 1 5/13/15 11:03 AM

President’s Message Did you know that more than 50 million Americans are believed to have a sleep disorder? The effect on their lives can be profound. Losing sleep is linked to many chronic illnesses, including heart disease, diabetes, and obesity. It’s also seen as a factor in car crashes, occupational errors, and industrial accidents. In our cover story, we explore this crisis and discuss how to get the valuable sleep you need.

Another public health problem is the abuse of prescription pain relievers, and how it is leading some to use heroin. Across our region, doctors and police are seeing more of these troubling cases. But what you may not realize is who is abusing prescription drugs.

“They are your neighbors,” says William Rea, M.D., Carilion Clinic’s vice chair of psychiatry. Our story examines this challenging issue.

We also take a look at new initiatives to keep mothers and babies safer. Carilion Roanoke Memorial Hospital has introduced

“kangaroo care,” for instance, which involves placing newborns on their mother’s bare chest immediately after delivery. This has been shown to stabilize the baby’s blood sugar and vital signs, improve sleep, and promote breast-feeding and bonding. Babies also cry less, hearing their mother’s voice and heartbeat.

Speaking of children, have you ever seen kids light up when they encounter animals at the zoo? We invite you to read about new happenings at Roanoke’s Mill Mountain Zoo, home to more than 175 animals, including birds and reptiles. Fun programs like summer camps and Breakfast with the Animals are planned for this summer. We hope you and your family enjoy!

WARM REGARDS,

NANCY HOWELL AGEEPRESIDENT AND CEOCARILION CLINIC

Carilion Clinic President and CEO Nancy Howell Agee meets with employees at Carilion Giles Community Hospital.

Welcoming to Carilion in June PCA Healthcare and Kevin R. Dye, M.D., of Gastrointestinal Associates.

CARILION CLINICPRESIDENT AND CEO Nancy Howell Agee

CARILION CLINIC 1906 BELLEVIEW AVE.P.O. BOX 13367ROANOKE, VA 24033540-981-7000

CARILION CLINIC LIVING IS PRODUCED BY MARKETING, RESEARCH AND COMMUNICATIONS:

VICE PRESIDENT Shirley Holland

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EDITOR Maureen Robb

LEAD DESIGNER David Porter

CONTRIBUTING WRITERS Karen Doss Bowman, Karen A. Chase, Su Clauson-Wicker, Jay Conley, Bruce Ingram, Sarah Beth Jones, Dan Radmacher, Donna Reynolds, Dan Smith, Erica Stacy, Randolph Walker, Alison Weaver

PHOTOGRAPHERS Darryle Arnold, Jared Ladia

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Carilion Clinic is a not-for-profit health care organization based in Roanoke, Va. Through our comprehensive network of hospitals, primary and specialty physician practices, and other complementary services, we work together to provide quality care close to home for nearly 1 million Virginians. With an enduring commitment to the health of our region, we also seek to advance care through medical education and research to help our community stay healthy and inspire our region to grow stronger.

Copyright 2015 by Carilion Clinic. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Carilion Clinic. Articles in this publication are written by journalists or authors who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional advisor. All editorial rights reserved. Opinions expressed herein may or may not reflect the views of Carilion Clinic.

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

Su Clauson-Wicker is the author of two travel books and the former editor of Virginia Tech magazine. Her articles have also appeared in The Washington Post and other publications. She lives in Blacksburg.

Karen A. Chase is an award-winning novelist who has also written for Virginia publications such as The Richmond Times-Dispatch. She is writing a historical novel about the Declaration of Independence. She lives in Richmond.

Sarah Beth Jones blogs about personal devel-opment, was an op-ed columnist for the Greens-boro News & Record, and has written for publi-cations including Valley Business FRONT, Mother Earth News online, and Today’s Woman maga-zine. She lives in Floyd.

Dan Smith is an award-winning journal-ist and photographer, an essayist on public radio, and a member of the Virginia Communi-cations Hall of Fame. He is the author of a novel and several nonfiction books.

Alison Weaver is a freelance writer based in Roanoke. Her work has appeared in Valley Business Front, The Roanoke Times, Good Housekeeping, Woman’s Day, Redbook, and Seventeen.

Randolph Walker is a writer and musician in Roanoke. Formerly a staff writer with The Roanoke Times, his work has appeared in many publications including Virginia Living, Valley Business Front, and The Roanoker.

OUR CONTRIBUTORS

2 SUMMER 2015 | CarilionClinic.org

18

22

8 14features5 PREGNANCY Carilion partners with UNC Fertility.

8 INFANT CARE New programs keep mothers and babies safer.

10 DRUG ABUSE Prescription drug abuse can lead to heroin addiction.

13 TEXTING Bad posture is linked to “text neck.”

14 FITNESS Functional training helps keep you young.

18 SLEEP Losing sleep can affect your health and quality of life.

22 RECREATION What’s new at Mill Mountain Zoo?

27 SERVICES New physician services are available in Lexington.

departments1 PRESIDENT’S MESSAGE Sleep deprivation is linked to many problems.

4 SUPERFOODS What’s all the buzz about quinoa?

6 HEALTH NEWS Research findings that can improve your life.

22 IN YOUR COMMUNITY Making a difference in western Virginia.

25 NEW PROVIDERS New physicians and advanced care providers.

28 RECIPE Enjoy a mango and shrimp summer salad.

CONTENTS

CarilionClinic.org | SUMMER 2015 3

Superfoods: Quinoa SUPERFOODS

You may have seen bags of quinoa (pronounced keen-wah) on the grain or organic food aisles of your grocery store. There are over 100 varieties of this versatile, nutri-ent-rich food, but three are most commonly found on local grocery shelves: white (or golden), red, and black.

While professional palates might be able to discern a greater nuttiness in black quinoa, or a crunchier texture in red, for most of us, which color we choose comes down to aesthetics.

Making the choice in the first place, though, comes down to smarts.Though often eaten as a grain—for example, as the base of a grain salad with kale,

raisins, and a lemon vinaigrette—quinoa is actually the seed of its plant and is botanically related to spinach, beets, and tumbleweed. It’s a little seed that packs a whole lot of nutritional punch.

Quinoa contains all nine of the essential amino acids, making it a complete protein and a great option for vegetarians. It’s also a good source of fiber and a host of minerals, with each cooked cup containing over half of the recom-mended daily allowance of manganese, a mineral that supports bone and skin health.

Also found in one cooked cup are healthy doses of magnesium, zinc, potas-sium, and iron—nutrients that are scarce in most of our diets. Note, though, that quinoa does contain phytic acid, which not only can prevent our bodies from absorbing a food’s nutrients but can even leech calcium from us.

Happily, there’s an easy solution that requires little more than advanced planning. Soak the uncooked quinoa in a mixture of 1 teaspoon of lemon juice or good apple cider vinegar to every cup of warm water, covered, overnight or for up to 24 hours. When you’re ready to eat, simply drain, rinse, and cook according to package directions.

So how to fill your meal plan with more of a food that the Incans considered sacred? Try substituting it for rice, adding it to pots of chili, or tossing a cooked cup or two into a green salad. Quinoa can act as a nutritious addition to veggie or meat burgers or add texture to baked goods.

Quinoa also makes a great breakfast option. Blend cooked quinoa into a smoothie or reheat it in a few tablespoons of coconut or almond milk before topping with your favorite berries and nuts. Either makes for a filling and delicious start to your day!


MEDICAL NEWS

Carilion Forms IVF Partnership with UNC Fertility Carilion Clinic has formed an in vitro fertil-ization (IVF) partnership with UNC Fertil-ity, a highly regarded embryology lab at the University of North Carolina.

The partnership will allow Carilion to perform IVF procedures for patients using the UNC fertility and embryology labora-tories in Raleigh. It is also an outgrowth of Carilion’s hiring Emily Evans-Hoeker, M.D., who specializes in reproductive

endocrinology and in-fertility and obstetrics and gynecology.

Dr. Evans-Hoeker joined Carilion last year after completing a fellowship in repro-ductive endocrinology and infertility at the University of North

Carolina. She, along with Robert L. Slack-man, M.D., staff Carilion’s Reproductive Medicine and Fertility practice.

A GROWING NEEDMore American women than ever are

seeking medical help to conceive. Infertil-ity is said to affect 6.7 million women, or about 11 percent of the reproductive-age U.S. population. And while IVF is one of the most popular treatment options, its success depends on having access to a state-of-the-art embryology lab.

Dr. Evans-Hoeker, who will perform the IVF procedures, says the new partnership will allow her to do every step of the pro-cess for patients, “instead of sending them to another physician they do not know to perform parts of the IVF cycle.”

“What we do is very personal and can be very emotional,” she says.

Dr. Evans-Hoeker will complete most of the IVF process in Roanoke and then will travel to UNC Fertility with her patients for egg retrieval and embryo transfer.

“Much of the success of IVF has to do with how things are done in the embryology lab,” she says. “UNC Fertility is a nationally recognized lab with high success rates.”

STATE-OF-THE-ART TREATMENTSIn addition to performing IVF, Carilion’s

Reproductive Medicine and Fertility prac-tice treats both men and women at every stage of the reproductive process.

State-of-the art treatments include ovulation stimulation, intrauterine insem-ination (IUI)—a procedure that directly places sperm in the uterus during the time

of ovulation—and donor sperm insemi-nation (TDI). Carilion works with a variety of sperm banks to pro-vide inseminations for couples needing donor sperm.

For women who do not have healthy

eggs, Dr. Evans-Hoeker is able to perform in vitro fertilization using donor eggs. This process involves choosing a donor from a donor bank, combining the donor eggs with sperm in the laboratory, and transfer-ring embryos into the patient’s uterus to achieve pregnancy.

Drs. Slackman and Evans-Hoeker also care for transgender patients, women wish-ing to freeze their eggs for future fertiliza-tion, and patients with excess weight that affects their reproductive health. They also treat a wide variety of conditions affecting reproductive health, including irregular pe-riods and hormonal imbalances.

In addition, they perform surgeries to correct problems with the ovaries, fallopian tubes, vagina, and uterus.For more information or to make an appoint-ment, call 540-985-8078.

Dr. Robert L. Slackman

Dr. Emily Evans-Hoeker


Four Main Types of Breast Cancer Identified

E-Cigarette Use Linked to Other Risks

New Blood Pressure Guidelines Set for Heart Patients

Processed Foods Dominate the Grocery Bag

Processed foods loaded with fat, sugar, and salt make up more than 60 percent of the calories in the typical American’s grocery bag, a new study found. These foods include white bread, chips, cookies, prepared meals, candy, and soda. Researchers are concerned that eating too much of such products can lead to obesity. Go to bit.ly/processed-foods for more information.

Three leading medical groups, including the American Heart Association, have issued new blood pressure guidelines for those with heart disease. They include a blood pressure goal of 130/80 for people who have had a heart attack, stroke or mini-stroke, and others with certain conditions. (Normal blood pressure is having pressure lower than 120/80 most of the time.) Read more at bit.ly/updated-guidelines.

A new study found a striking correlation between students who smoke electronic cigarettes and those who engage in other risky activities, including smoking tobacco or marijuana, and/or binge drinking. With nearly 30 percent of college students surveyed having tried e-cigarettes, health professionals are considering policy decisions for these popular devices. Learn more at bit.ly/e-cig-use.

Breast cancer isn’t a single disease but can occur as one of four major types, according to a new report. Researchers said that classifying the cancers by type of tumor could aid in treatment. The report was issued by the U.S. Centers for Disease Control and Prevention, the American Cancer Society, and other medical groups. For more information, go to bit.ly/cancer-subtypes.

HEALTH NEWS


New Tools Aim to Help Diabetic Kids

Purposeful Seniors Live Healthier Lives

Worried about Body Odor?

Prenatal Yoga for Mind and Spirit

Two new devices may make it easier for parents to keep track of glucose levels in their diabetic children. Both the Apple Watch and a new system called Share transmit blood sugar readings from continuous glucose-monitoring devices to remote locations. For parents, this can mean checking in on their school-aged kids by simply looking at their phones or watches. Find out more at bit.ly/stick-free.

We are all uplifted by feeling as though our time is spent in productive, useful ways. A recent study suggests that for older adults, a sense of purpose may also reduce the risk of brain deterioration. It is thought to influence a part of the brain related to physical and cognitive disabilities characteristic of old age. For more information, visit bit.ly/sense-of-purpose.

Your genes may play a role in whether you have excess body odor, researchers report. New findings are said to significantly advance understanding of the mechanisms of body odor and could lead to new ways to control it. See more study results at bit.ly/body-odor.

Can yoga help ease depression during pregnancy? A recent study published in the journal Women’s Health Issues found a link between easing depression in pregnant women and yoga practices that incorporate a focus on mindfulness and the here and now. Learn more at bit.ly/yoga-pregnancy.


When Amy Cundiff gave birth to her son at Carilion Roanoke Memorial Hos-pital in February, the staff immediately placed him on her chest. Testing and weighing could wait until mother and child bonded.

“It felt like exactly what should be hap-pening—a natural progression,” Cundiff says. “Crosby cried at first, but when they put him on me, he became very peaceful. He had his eyes open wide, just looking at me.”

Within 90 minutes, Cundiff’s son was nursing. The first-time mother was sur-prised at how positive and stress-free the experience was.

“It was amazing to see his instincts in action,” Cundiff, of Roanoke, says.

“Crosby was able to manipulate his body across my chest and begin nursing. He had a lot of head control.”

Last fall Roanoke Memorial adopted the policy of placing newborns on

their mother’s bare chest immediately after delivery. The technique, called

“kangaroo care,” is an evidence-based practice of skin-to-skin contact between mothers and infants that promotes breast-feeding and bonding.

“Kangaroo care stabilizes the baby’s blood sugar and vital signs and makes breast-feeding more successful when implemented immediately after birth,” says Cindy Booth, R.N., director of the hospital’s Mother/Baby Unit. “Babies cry less. Moms are happier because they can help their babies.”

Named for its similarity to the way marsupials carry their young, the pro-gram was initially developed to care for pre-term infants in areas with no incu-bators. Now modern medical facilities are adopting the practice for all babies due to its benefits.

“Babies maintain their body tempera-ture well on the mom’s chest,” says Christinne Canela, M.D., a Carilion

Clinic obstetrician/gynecologist who practiced kangaroo care with her own newborn in October. “They cry less when they’re lying on the mom, hear-ing her voice and heartbeat. Kangaroo care has also been shown to improve baby’s sleep, enhance weight gain, and promote successful breast-feeding and bonding. With bonding, parents become more sensitive to their newborn’s cues.”

The first hour or so after birth is a spe-cial time of bonding for mothers and ba-bies at Roanoke Memorial, says Donna Sams, R.N., senior director of OB/GYN Quality Assurance.

“In this ‘golden hour’ after birth, we recommend mothers hold their new-borns skin-to-skin without interrup-tion,” Sams says. “We’re planning to designate quiet times here to allow new moms dedicated, kangaroo-care times to bond with their babies and become more comfortable with breast-feeding.”

By Su Clauson-Wicker

MEDICAL NEWS

KEEPING MOTHERS AND BABIES SAFER


OTHER NEW INITIATIVESRoanoke Memorial has the largest

maternity center in the region, deliver-ing more than 4,000 babies each year. Kangaroo care is one of several initia-tives Carilion has adopted to enhance the health of mothers and infants.

The hospital earlier introduced a pro-gram to reduce early-elective delivery before 39 weeks in favor of waiting for spontaneous labor in women with low-risk pregnancies. According to studies by the National Institutes of Health, critical development of a baby’s brain, lungs, and liver occurs during the 37th through 39th weeks.

Unless there is a compelling medical reason, the hospital is committed to having healthy pregnant women go into labor naturally with fewer medical interventions. Usually this means lower costs and fewer complications.

“Waiting until spontaneous labor or at least 39 weeks truly does reduce the risks for the baby,” Dr. Canela says. “It’s generally better for mothers too. When there are medical complications such as hypertension, diabetes, or possible fetal issues detected in fetal monitoring, the risks of continuing the pregnancy may outweigh the benefits and we would consider an induction.

“When a baby is delivered before 39 weeks and the mom is not in labor, the baby has an increased risk of breathing problems, jaundice, temperature regu-

lation, feeding problems, and possible long-term issues. For the mom, there’s an increased risk of bleeding and infec-tion. If her cervix isn’t ready, there’s a risk of Caesarean delivery.”

Sometimes mothers ask for induc-tions because their military husbands will soon deploy or because they’re concerned they won’t be able to make it to the hospital from distant homes.

“We consider their reasons; however, we want to ensure the risks of inducing don’t outweigh the benefits,” Dr. Canela says.

Roanoke Memo-rial was recently named a top per-

forming Virginia hospital by the March of Dimes and the Virginia Hospital & Healthcare Association for success-fully reducing inductions. In the past three years, only one non-medical early induction was performed. Physician, staff, and patient education programs promoting the benefits of full-term de-livery and vaginal birth are part of the initiative.

In response to guidelines from the American College of Obstetricians and Gynecologists (ACOG), Carilion also has an initiative to eliminate unnecessary Caesarean sections. A C-section is major surgery, increasing the potential for

adverse effects for mothers and babies. In 2012, about one in three American women gave birth by C-section, a 60 percent increase since 1996.

ACOG wants to lower this percentage and has issued guidelines approving longer labor for healthy women. While C-sections can be necessary for high-risk pregnancies, they may pose a greater risk of infection and longer re-covery time for the mother.

“Women undergoing C-sections lose twice as much blood as those with vagi-nal deliveries,” Dr. Canela says. “Ninety percent of women who have C-sections will have them for subsequent births. So we support first-time moms willing to labor a little longer to deliver vaginally.”

Since this initiative has been imple-mented at Roanoke Memorial, the num-ber of C-sections for first-time births has dropped from 30 percent to 23 percent, according to Dr. Canela. This is below the national target of 24 percent.

“Our motive behind all these ini-tiatives is to have safer deliveries for mothers and babies,” she says. “That is happening at Carilion. As we track outcomes, we’re already seeing improve-ments, especially among first-time mothers.” For more information, go to CarilionClinic.org/maternity/services or watch the video at bit.ly/kangaroo-care.

Dr. Christinne Canela

Amy Cundiff of Roanoke holds her son Crosby. Cundiff praises the

“kangaroo care” they received at Carilion Roanoke Memorial Hospital when Crosby was born.


MEDICAL NEWS

Can abusing prescription pain reliev-ers lead to using heroin?

Unfortunately, experts say the answer is yes. And across our region, doctors and law enforcement officials are seeing more of these sad cases.

Roanoke Police Chief Chris Perkins, for instance, has warned publicly of grow-ing heroin use and deaths due to heroin overdoses. If left unchecked, the problem could soon approach epidemic levels, he predicts.

The local trend mirrors a national one. The abuse of such pain medications as Oxycontin, Vicodin, and Demerol has risen steeply in recent years, according to the U.S. National Institute on Drug Abuse. Research suggests that abusing

painkillers may actually pave the way to using heroin.

In surveys of young people who inject heroin, almost half said they abused pre-scription painkillers before switching to heroin, the institute reports. Some said they did so because heroin is actually cheaper to buy than prescription drugs.

Deaths due to overdoses of prescrip-tion painkillers are still a bigger problem than heroin-related deaths, but the latter is a rapidly growing problem. In 2007, the Office of the Chief Medical Examiner reported 100 deaths in Virginia due to heroin overdose. In 2014, there were 238 (a preliminary number pending final toxi-cology test results).

“In recent years, there has been a surge

in heroin use as people who are addicted to opioids turn to heroin,” the Virginia Department of Health stated last year in a report, “Reducing Prescription Drug and Heroin Abuse.” (Opioids are drugs prescribed primarily for pain that have an effect similar to that of opium. Heroin is also an opioid but is not considered to have a legitimate medical use.)

In western Virginia, areas with a heroin problem include Roanoke, Salem, and Bedford, according to the Virginia Depart-ment of Health. In 2013, the city of Roa-noke placed fourth in the top 15 Virginia jurisdictions referring heroin cases to the Virginia Department of Forensic Science. It referred 20 percent of the state’s cases, or 197 out of 963.

PRESCRIPTION DRUG ABUSE AND HEROIN:THE GROWING PROBLEM

By Donna Reynolds


Many people who die of heroin over-dose in the region began by abusing prescription drugs, says Amy Tharp, M.D., the state’s assistant chief medical exam-iner for western Virginia.

Heroin is relatively inexpensive and easy to get regionally, according to au-thorities.

WHO ARE THE ABUSERS? There are two types of prescription

drug abusers, says William Rea, M.D., Carilion Clinic’s vice chair of psychiatry. They are patients who become dependent by overusing legally prescribed pain re-lievers and users seeking a high who get the drugs illegally.

“They are your neighbors,” Dr. Rea says of typical addicts in the region, and they are drawn from all age, social, ethnic, and educational groups. “But we’re seeing expanding problems in two main groups: younger people and pregnant women,” he says.

“There’s a program at Blue Ridge Behavioral Healthcare called Project Link which serves drug-abusing young moth-ers or pregnant women,” Dr. Rea says. “We have a waiting list to treat them.”

According to the Roanoke Area Youth Substance Abuse Coalition, the number of teens using heroin in the region is

growing. Almost 8 percent of 10th- and 12th-graders surveyed in 2013 in the cit-ies of Roanoke and Salem and Botetourt and Craig counties said they had used heroin. This was a 33 percent increase from 2009.

Last year the Virginia State Police spent 25 percent of its drug investigation budget in rural southwestern communi-ties, which comprise just 1 percent of Virginia’s population. In 2013, the coun-ties of Pulaski, Franklin, Wythe, and Montgomery all ranked in the top 15 jurisdictions referring prescription pain- reliever abuse cases to state authorities.

HOW TO TREAT ADDICTION?There is a range of approaches to treat-

ing addiction with the goal of returning patients to stable, productive lives. One approach is with the drug Suboxone, a maintenance medication that is safer and more effective than methadone, says David Hartman, M.D., Carilion’s chief of adult outpatient psychiatry.

“In 35 years of working with addicts, the success rate with Suboxone is the best I’ve seen,” he says. “Until Subox-one, results were poor.” According to Dr. Hartman, Suboxone produces an effect similar to that of pain relievers but milder, while blocking more potent drugs

Overdose Emergency Room Visits per 100K Population 2012–2013

Alleghany, Augusta, Craig, Pulaski, Rockingham 181-256

28-74Bath, Bland,

Botetourt, Wythe

121-181Bedford, Giles,

Roanoke/Salem, Rockbridge

75-121Floyd, Franklin,

Montgomery, SmythWomen age 15–24 have an exceedingly high overdose

ER visit rate of 200 visits per 100K population.

Data source: Virginia Dept. of Health (2014). Unintentional Drug Overdoses in Virginia: Analysis of Syndromic and Death Data.

WHERE TO FIND HELP

CARILION CLINIC Carilion Clinic is a leader in addiction research, training, and care, offering comprehensive treatment options for adults and adolescents. Options include inpatient detoxification for adults and adolescents; day treatment programs; outpatient intensive treatment of adolescents; and services for high-risk groups like pregnant women and mothers with young children. CarilionClinic.org or 800-422-8482

RESCUE MISSION OF ROANOKE Residential 12-step program. rescuemission.net or 540-777-7665

MOUNT REGIS CENTER, SALEM Inpatient and outpatient treatment. mtregis.com

NARCOTICS ANONYMOUS 12-step program.

Bedford and Lynchburg: car-na.org/appalachian.htm or 1-434-709-4016

Staunton and Waynesboro: brana.org or 800-777-1515

Blacksburg, Christiansburg, Pearisburg, Pulaski, Radford, and Floyd and Giles Counties: newrivervalleyna.org or 800-777-1515

Clifton Forge, Covington, Roanoke, Salem, Rocky Mount, and Vinton: roanokena.com or 800-777-1515


MEDICAL NEWS

like heroin.Unlike methadone, which is dispensed

daily when used to treat addicts, Sub-oxone prescriptions can be written for longer periods. Dr. Hartman prescribes it for a week or more, with refills contin-gent on patients attending therapy ses-sions. “They are critical for recovery,” he says, “because addicts must completely redesign their life.” He also reports success with many patients who have become responsible parents, employees, and students.

“The problem is so enormous, I feel like I’m spitting in the ocean,” Dr. Hartman says. But he is proud of the work Carilion is doing to address the addiction crisis, including having the opportunity to show medical students and residents what can be accomplished.

A 12-STEP PROGRAMAcross town, the Rescue Mission of

Roanoke employs a different treatment model: a year-long residential program based on 12-step recovery principles. It includes intensive mentoring, 12-step meetings, educational evaluation and training, and service assignments.

“Most [participants] have done a lot of damage in their lives to their friends,

their families, their loved ones,” says Helen Ferguson, director of programs for the Rescue Mission. “This is a way to start giving back.”

About 95 percent of those who turn to the Rescue Mission began using drugs in their teenage years, usually between 12 and 14. While in recovery, some learn to read or finish high school. One teen studied C++ programming.

The Rescue Mission’s program centers on building one-on-one relationships, and through those relationships creates accountability and a sense of commu-nity. “We talk about changing behaviors,” says Anders Sylvester-Johnson, chief operating officer. “Intrinsically, we be-lieve that substance abuse is so much more than a substance. The problem began long before an addict picked up that substance.”

What can be done to prevent more lives from being upended? In addition to raising awareness in the community, authorities say prevention is key. Par-ents especially are urged to recognize the warning signs of drug abuse. Early detection can lead to successful inter-vention. For more information on the warning signs of drug abuse, go to bit.ly/signs-of-addiction.

Number of Fatal Heroin OverdosesVirginia: 2007-2014* Data source: Virginia Dept. of Health (2014).

* Fatal heroin overdoses may have one or more drugs/poisons contributing to death. The number of fatal heroin overdoses in 2014 is preliminary and subject to change.

WARNING SIGNS OF DRUG ABUSE

Signs of drug abuse may include:

» Bloodshot eyes or abnormal pupils

» Nosebleeds

» Sudden weight loss or gain

» Unexplained seizures, accidents, or injuries

» Deteriorating personal appearance

» Shakes, tremors

» Slurred or incoherent speech

» Decreased attendance or performance at work or school

» Apathy or social withdrawal

» Sudden personality change

» Mood swings

» Irritability

» Hyperactivity or agitation

» Lethargy, inability to focus

Source: National Council on Alcoholism and Drug Dependence, Inc.

250

200

150

100

50

0 2007 2008 2009 2010 2011 2012 2013 2014*

10089

107

48

100

135

213

238


MEDICAL NEWS

‘Text Neck’:Do you lean over your cell phone as you text or read? If so, you’re part of an epidemic being called “text neck.”

Depending on how far you lean over, poor posture can create up to 60 pounds of pressure on your spine. This degree of leaning is in fact commonly seen in offices and on streets around the world.

Try to look at your phone by casting your eyes down—without moving your head or neck. Keep your head up and your shoulders pulled back!

It Can Damage Your Spine

Your head weighs about 11 pounds. Tilting it forward by only 15 degrees can put 27 pounds of pressure on your spine.

Multiply that by a few hours a day, 365 days a year, and you’re asking for trouble. “Text neck” can lead to pinched nerves, herniated disks, spine degeneration, and even surgery.

60lb

Doctors are seeing more patients with head, neck, or back pain caused by bad posture while using mobile technology.

15˚

45˚

Number of Fatal Heroin OverdosesVirginia: 2007-2014* Data source: Virginia Dept. of Health (2014).


MEDICAL NEWS

FITNESS It Can Change

Your Life

Only one in three adults gets enough exercise every

week, according to the President’s Council on Fitness,

Sports & Nutrition.

The others aren’t just less able to run or react quickly in

an emergency—they may have trouble carrying groceries

in from the car or fully enjoying playtime with their kids.

Being unfit can also make them more susceptible to

heart disease and less able to manage chronic diseases like

diabetes, Parkinson’s, and obesity.

To help people become fit enough to perform their daily

activities without stress, Carilion Clinic introduced func-

tional training at Carilion Wellness-Roanoke (formerly the

Roanoke Athletic Club).

“We took three racquetball courts—2,400 square feet—

and turned the space into our functional training studio,”

says Bud Grey, Carilion’s vice president of wellness. “We

have the tools to focus on the basics like abdominals,

lower back, stability—things that help people get stronger

for their daily lives.”

By Sarah Beth Jones


GETTING YOUR ENERGY BACKMany people are doing functional training through

Carilion’s FIT Rx program, in which doctors prescribe exercise, giving patients 60 days of access to all three Carilion Wellness locations, weekly personal training ses-sions, and an individualized plan to follow for only $60. More than 3,300 people have completed the program since it began in 2011.

Nancy Hurdle, 61, is one of them. “When I was diag-nosed [with fibromyalgia], I had no energy to do anything,” she says. “There was always something that hurt.

“When it snowed, I had to just let the snow sit in front of the house,” Hurdle says. “Now I shovel all of my walk, my neighbor’s walk, the driveway. I still get tired but I can do all those things and get them done without quitting. That sense of accomplishment makes you want to work even harder to do more things.”

Though she’s graduated from FIT Rx, Hurdle has contin-ued with the functional training program for motivation, accountability, and to ensure that she continues to do the

prescribed exercises correctly. “With fibro fog [concentra-tion challenges experienced by many with fibromyalgia], I sometimes can’t remember how to do things from week to week,” she says.

According to Christin Vernick, functional training man-ager at Carilion Wellness, a person’s motivation is the key to success. “The biggest thing is people have to want it for themselves,” she says.

“For example, a person who is told he is pre-diabetic and thinks, ‘I don’t want to give myself insulin, I don’t want to have to worry about that. I just want to be able to keep up with my family.’ Those are the people who experience the best outcomes.”

That describes Diane Smith. The 55-year-old law firm office manager began functional training in the hopes of losing weight, reducing her need for prescription medi-cines, and to “just feel better.”

“Truthfully, I did not really look forward to it,” says Smith, “but the trainers made it fun.”

Smith is now 40 pounds lighter, on track to getting off

L to R: Michael Tumulak swings kettlebells to improve his core and leg strength while Diane Smith and Shirley Jones do bicep curls to help them lift and hold everyday objects. They all work out at Carilion Wellness-Roanoke (formerly the Roanoke Athletic Club).


her blood pressure medications, and is noticing significant changes in her daily life. “Carrying six or seven bags of grocer-ies up the stairs isn’t a big deal anymore. Neither is putting a five-gallon bottle of water on the cooler.”

Because her training included exercises that require no special equipment, Smith is continuing on her own but with the comfort of knowing, “Support is there if I need it.”

A FOCUS ON BALANCE AND STRENGTHShirley Jones, 64, has noticed similar

benefits from functional training; her progress has been a welcome success in a two-year stretch that included diagnoses of both rheumatoid arthritis and Parkin-son’s disease, as well as the loss of her husband and mother.

To counteract the deterioration caused by both diseases, Jones’s trainer has fo-

cused on balance, whole-body strength training, and special attention to her posture to avoid the stooped carriage so often caused by Parkinson’s.

Though there is no cure for either dis-ease, Jones is steadier on her feet and able to do work she couldn’t have imag-ined just last year, including tending her garden. “I have four flower beds and last year I laid some sod,” she said.

“A person doesn’t have to be in the FIT Rx program, though,” says Grey. “Anyone can walk in and do functional training.”

Michael Tumulak, 46, has been using the functional training room since it first opened, often spending time there five or six days a week despite also juggling jobs at UPS and as a landscaper. As a person with a passion for obstacle course races, he has found that the diverse strength train-ing available in the functional studio has helped him finish races at a faster pace.

“I do lots of the classes,” says Tumulak. “I’m hooked on the GRIT classes because they’re only about 30 minutes long and incorporate strength, plyo [plyometrics, also known as jump training], and cardio. The instructors are great at pointing out things to work on and the right form to avoid injury.”

On the weekends, Tumulak’s wife joins him while their kids, ages 10 and 13, spend time in the youth center.

“Whether it’s in this program or any other program—the biggest thing I want to get across to people is not to be intimi-dated by movement,” says Vernick. “Your body craves it. Your body needs move-ment as much as it needs nutrition. Any way you can get moving, it’s going to do wonders for you.”

For more information, go to CarilionWellness.com or call 540-853-0000.

MEDICAL NEWS

Clockwise: Michael Tumulak gets guidance on proper weight-lifting technique from Leonard Jones, a trainer at Carilion Wellness-Roanoke; Leonard Jones works out with battle ropes, which conditions the upper body and stabilizes the core. Shirley Jones uses a stretching bar.


CARILION DIRECT Our physician referral and health information service is here to help. Call us at 540-266-6000 or 800-422-8482, email us at [email protected], or chat with us online @carilionclinic.org.

RESOURCES TO KEEP YOU HEALTHY

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 to Home, a blog by Alice Ackerman, M.D., chair of the Department of Pediatrics at Carilion Clinic. Visit CarilionClinic.org/blogs/ackerman.

NEWS BLOGKeep up with the latest news, photos, videos, and more at Carilion Clinic’s newsroom. CarilionClinic.org/blogs/newsblog.

MOBILE RESOURCESStay connected with our mobile apps, available for iPhone and Android:

Carilion Clinic Mobile Health Resource – Use our interactive symptom checker to access the most relevant information in our digital health library, then connect with Carilion services by using the search feature to find Carilion health care providers, hospitals, and urgent care locations near you.

MyChart – Access your medical record, request an appointment or prescription refill, and stay in touch with your doctor, all while on the go. If you are interested in MyChart, speak with your doctor.

GIVING TO CARILION CLINIC FOUNDATION Be part of improving the health and vitality of communities in western Virginia. Make a gift at CarilionFoundation.org.

“WELL SAID” SPEAKER’S BUREAUIf you’d like a speaker on a health topic for your community group or workplace, call 540-266-6561 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/provider finder » Interactive maps to help you find your way to

our locations » Health and wellness content, including an A-Z

library and symptom checker » A community health education and events

calendar

SOCIAL MEDIAStay connected to Carilion Clinic through social media:

facebook.com/carilionclinictwitter.com/carilionclinicyoutube.com/carilionclinic google.com/+CarilionClinicVApinterest.com/carilionclinic

PUBLICATIONSPick up a copy of Carilion Clinic Living at magazine racks throughout our facilities, or access the digital edition at CarilionClinic.org/living, where you can also read past issues. For health tips and news about upcoming health screenings events, subscribe to Living’s monthly e-newsletter at CarilionClinic.org/living.

RESOURCES


COVER STORY

THE SLEEP CRISIS:

By Randolph Walker

Craig Moore is happy in his work as an engineer with the Virginia Department of Transportation. But years ago, his life nearly took an opposite turn.

As a freshman engineering student at Virginia Tech, he was struggling.

“I was feeling tired, worn out,” recalls Moore, now 43. “I had headaches, but I thought that was a natural way of life.” Coping with a demanding curriculum, while chronically exhausted, was more than he could handle. He withdrew in the spring of his freshman year.

Moore, of Christiansburg, went to work in his father’s grading and exca-vating business. Alarmingly, he caught himself nearly falling asleep while driv-ing heavy machines. He never had an accident, but he worried to the point of seeking medical advice.

His family physician sent him to see William Elias, M.D., a Carilion Clinic sleep medicine specialist. Noting Moore’s headaches and exhaustion, Dr. Elias suspected that Moore had a sleep disorder. He rec-ommended a sleep study.

During a sleep study, a patient spends the night in a bedroom-like facility, while brain activity, breathing, heart rate, and other functions are mon-itored.

In Moore’s case, the results confirmed Dr. Elias’s sus-picions. Moore had sleep apnea, a con-dition in which the patient repeatedly

experiences interruptions in breathing. “They realized I had around 15 apneas

an hour,” Moore says. “My oxygen level dropped considerably, and they decided to put me on a CPAP machine.”

At bedtime, Moore began donning a breathing mask that exerts contin-uous positive airway pressure (CPAP) and keeps his airway open. He started feeling better, and his headaches disap-peared. Returning to his dream of an engineering career, he went to Virginia Western Community College, then back to Virginia Tech where he completed his engineering studies.

Today he’s an assistant district location and design engineer at VDOT’s Salem office, working on road projects and su-pervising a team of other engineers.

Moore is willing to take time out of

MILLIONS OF AMERICANS DON’T GET ENOUGH SLEEP

Frank H. Biscardi, M.D., medical director of the Carilion sleep centers.


his day to talk about his experience, be-cause he knows how devastating sleep disorders can be—and how the correct diagnosis and treatment can change someone’s life.

A NATIONAL SLEEP DEFICITAccording to the Centers for Disease

Control and Prevention (CDC), an esti-mated 50 to 70 million Americans have a sleep or wakefulness disorder. The consequences are more than just red eyes in the morning. Insufficient sleep is asso-ciated with a number of chronic illnesses, including diabetes, cardiovascular dis-ease, obesity, and depression.

In what it calls a public health epidemic, the CDC says insufficient sleep is linked to motor vehicle crashes, occupational errors, and industrial accidents. It says that nodding off while driving, uninten-tionally falling asleep, and having trouble doing daily tasks due to sleepiness may

all contribute to these problems.The most common sleep disorders in-

clude:» Sleep apnea, which affects some

18 million Americans, according to the National Sleep Foundation. The vast ma-jority are thought to be undiagnosed

and untreated.» Insomnia: Difficulty going to sleep

or staying asleep. Many sufferers wake up too early and can’t get back to sleep.

» Narcolepsy: Attacks of excessive daytime sleepiness combined with sud-den muscle weakness.

» Restless Legs Syndrome: Unpleas-ant sensations or aches in the legs, often relieved by moving or kicking the legs.

Dr. Elias has seen all of these at the Carilion Clinic Sleep Center in Roanoke, where he advises on testing and inter-prets results. The main complaints? Trouble getting to sleep or staying asleep, or being excessively sleepy during the day in spite of sleeping at night.

“It ranges all the way from something serious, like someone falls asleep and has an automobile accident, to just chron-ically feeling nonrefreshed,” Dr. Elias says. “Also, complaints of snoring and interrupted breathing at night. That

DO YOU GET ENOUGH SLEEP?The Centers for Disease Control and Prevention recommends these daily sleep amounts:

Newborns: 16-18 hours

Preschool children: 11-12 hours

School-aged children: At least 10 hours

Teens: 9-10 hours

Adults: (including the elderly): 7-8 hours

Craig Moore likes walking outdoors with his cats Chickpea (with white markings) and Gremlin, whom he and his wife Paula rescued eight years ago when the cats were only two-weeks-old and abandoned by the side of the road. The Moores also like to travel with the cats and have taken them to such spots as Norfolk and Nags Head. Craig Moore says he has been able to enjoy more outdoor activities as a result of managing his sleep apnea.


requires the observation of a bed partner. A lot of times, people are surprised that the bed partner reports that they are ex-tremely restless in their sleep.”

TREATMENT OPTIONS Not every sleep

patient requires overnight testing. After referral by a primary care physi-cian, many patients are diagnosed and treated at Carilion Pulmonary and Sleep Medicine in Roanoke. Its medical team, led by Edmundo Rubio, M.D., includes physicians certified in sleep medicine. Home testing for sleep apnea may be available based on initial clinical evalua-tion for some patients.

Other patients are referred for more comprehensive overnight sleep studies

“so we can see your stages of sleep,” says Teresa Carroll, manager of the Carilion sleep centers. This network of sleep

centers, the largest in western Virginia, includes four overnight sleep labs.

The lab in Roanoke has eight patient bedrooms, including one pediatric room, says Carroll. There are also two beds at Carilion’s Westlake Center, two at Caril-ion Stonewall Jackson Hospital, and four at Carilion New River Valley Medical Center. All are staffed by registered sleep technologists, and patients typically check in at 8:30 p.m. and check out at 7 a.m.

Yet another option is behavioral sleep medicine. Carilion’s new sleep specialist, clinical psychologist Barbara Hutchin-son, Psy.D., practices cognitive behav-ioral therapy, a relatively new approach to treating sleep disorders. “I’m more like a sleep coach,” Dr. Hutchinson says.

“I help retrain people to get a good night’s sleep.”

Retraining involves changing coun-terproductive behaviors. “For insomnia, the behavioral approach is considered the most effective treatment and has just as good short-term results as medi-

Teresa Carroll

SLEEP WELL The National Sleep Foundation of-fers these tips for how to sleep well:

» Avoid naps. Exercise daily.

» Practice a relaxing bedtime rou-tine, away from bright lights and free of anything that causes stress or anxiety.

» Your bedroom should be cool (60 to 67 degrees), quiet, and dark. Consider using blackout curtains, eye shades, ear plugs, and “white noise” machines.

» Sleep on a comfortable and supportive mattress. Most good quality mattresses have a life ex-pectancy of nine or 10 years.

» Avoid bright light in the evening, and get sunlight in the morning. This will keep your circadian rhythms in balance.

» Avoid alcohol, cigarettes, and heavy meals in the evening. Finish eating at least two or three hours before bedtime.

» Avoid electronics before bed or in the middle of the night. The light from these screens activates the brain.

» If you can’t sleep, go into another room and do something relaxing until you feel tired.

» Take work materials, computers, and televisions out of the sleeping environment.

COVER STORY

FACTS ABOUT SLEEP

Altitude at which sleep disturbance becomes greater.

13,200 FEET

36%Percentage of Americans who drive drowsy or fall asleep while driving.

SHIFT WORKERSare at increased risk for a variety of chronic illnesses such as cardiovascular and gastrointestinal diseases.

SELF-IMPOSEDSLEEP DEPRIVATION One of the primary causes of sleepiness among Americans.


cation, and long-term better impact,” Dr. Hutchinson says.

“Rather than sedating people, we’re working to correct whatever is causing their trouble sleeping,” she notes. For example, some people force themselves to go to bed at the same time every night, whether they’re sleepy or not. Dr. Hutchinson advises waiting until you are sleepy.

“A lot of people have this misconcep-tion that they should fall asleep the second their head hits the pillow, and they should sleep soundly throughout the entire night without waking up,” she says. “Ten to 30 min-utes is a more realistic time to expect to fall asleep. And most people, especially adults as we age, wake up one to three times a night. As long as you’re getting back to sleep in 30 minutes or less, that’s fine.”

For people who can’t unwind at night, Dr. Hutchinson provides relaxation training. “A lot of times people don’t allow enough time to relax before bed,” she says.

Whether it is through traditional sleep testing or cognitive behavioral therapy, sleep treatment is helping many people lead more productive and fulfilling lives. Nobody knows that better than Craig Moore. Even after all these years, he becomes visibly emotional when talking about the Carilion team who helped him, including Dr. Elias.

“If it hadn’t been for him saying, ‘You’re a candidate for a sleep study,’ my life would have turned out a whole lot differ-ently,” Moore says. “I wouldn’t have gone back to college.

“It’s had a tremendous impact,” he says. “It’s an emotional thing because the differ-ence it made in my life is phenomenal.” For more information, go to CarilionClinic.org/pulmonary/sleep-medicine or call 800-422-8482.

Dr. Barbara Hutchinson

FACTS ABOUT SLEEP

CAFFEINE has been called the most popular drug

in the world.

SLEEP is just as important as diet and exercise.

SNORINGis the primary cause of

sleep disruption for 90 million American adults.

People who don’t get enough sleep have

BIGGER APPETITES due to low leptin levels.

TEENS AND SLEEP

Does your teenager seem chron-ically tired? He or she may not be getting enough sleep.

The average teen should sleep about nine hours a night, but most get closer to seven and a half, according to the National Sleep Foundation.

“There is plenty of data to suggest that, especially for teenagers, schools need to start later,” says sleep expert and author Michael Breus, Ph.D. “The data shows that everything from grades, to emotions, to driving skills are affected by not enough sleep for teens.”

The American Academy of Pediatrics (AAP) last year issued a new recom-mendation that middle and high schools start no earlier than 8:30 a.m.

“Studies show that adolescents who don’t get enough sleep often suffer physical and mental health problems, an increased risk of au-tomobile accidents, and a decline in academic performance,” the AAP said in a statement. “But getting enough sleep each night can be hard for teens whose natural sleep cycles make it difficult for them to fall asleep before 11 p.m.—and who face a first-period class at 7:30 a.m. or earlier the next day.”

Source: The National Sleep Foundation.

SELF-IMPOSEDSLEEP DEPRIVATION One of the primary causes of sleepiness among Americans.


REGIONAL INTEREST

By Alison Weaver

Lucy Cook has had little time to catch her breath since becoming executive director of Mill Mountain Zoo in Jan-uary. Coming from Buffalo, N.Y., she arrived just in time for one of Roa-noke’s coldest and snowiest winters on record. “Everyone joked that I brought the bad weather with me,” she says.

With more than 30 years of nonprofit management experience, Cook is jump-ing in to develop new exhibits and pro-grams. “But first and foremost, our focus is on the stewardship of the animals,” she says. “Their care and well-being is our primary goal.”

The zoo is home to more than 175 ani-mals, including mammals, birds, reptiles, and invertebrates—including 21 vulner-able species. Among them are the cou-gar, snow leopard, wolverine, Japanese

macaque, fishing cat, blue-bellied roller, dwarf zebu, and eastern screech owl.

Nestled atop Roanoke’s Mill Mountain, the zoo was founded in 1952 and is fully accredited by the Association of Zoos and Aquariums. It offers year-round edu-cational and recreational opportunities.

One of them is Breakfast with the Animals. Every third Saturday from May to October, zoo guests can enjoy a light breakfast buffet, meet one of the zoo’s animals, and learn about its diet, behav-ior, and personality. A chat with the zoo-keepers follows.

On Saturday, June 20, the zoo will hold Relish with Rodents. Visitors will have breakfast and learn about some of the zoo’s intriguing resident rodents. Children will get to design an easy foam-block print of their favorite.

The zoo continues to offer summer

camps for children. Each is designed to engage kids in the natural world through fun, hands-on activities. These include animal encounters, talks with zookeep-ers, games, arts and crafts, scavenger hunts, and scientific explorations.

Field trips to the zoo by school, church, and civic groups are also welcome. But if you can’t visit, the zoo may be able to visit you. Zoo staff members go into schools and homes to introduce four or five “animal ambassadors” during a 45-to-60-minute interactive, educational program. A three-week series of classes is also designed for home school groups.

ENDANGERED SPECIESRed pandas are one of the zoo’s most

remarkable success stories. An endan-gered Asian species, red pandas have a

WHAT’S NEW AT THE ZOO?


low rate of survival when born in captiv-ity. “Fifty percent do not survive the first month,” says zoo curator Robin Lentz.

“During the weaning period, another 25 percent don’t make it.”

When two cubs were born at the zoo last year, the mother rejected the male cub. Lentz and zookeeper Jessica Fizer dedicated themselves to raising him—feeding the cub every three hours, day and night, for months. Archibald, his sister, Beatrix, and an orphaned cub who joined the zoo last year are now thriving.

“To have one cub survive beats more than 4-to-1 odds, so to have three make it through the first year is astounding,” Cook says. “We are extremely fortunate to have Robin.”

The zoo also hopes to announce the ar-rival of Pallas kittens after this breeding season or next year’s. The Pallas cats are

part of the zoo’s Species Survival Plan breeding program.

Joe Francis, a 10-year-old Roanoker, has been coming to the zoo for longer than he can remember. “He was in an infant stroller when we first visited,” says his mother, Jeanie Francis.

For the Francis family, the zoo is a package deal. “The city of Roanoke has a great playground and picnic area beside it, there’s the [Mill Mountain] Star, a beautiful wildflower garden, and walking trails,” Jeanie says. “The natural beauty of this site is spectacular. I love the se-renity.”

Joe, who wants to be an actor, a come-dian, and the lead singer for a band when he grows up, seems to know everything about Mill Mountain Zoo. He knows the names of most of the animals, except for the ones in the Reptile House, where he

is somewhat reluctant to venture.“A skink? I don’t think I know what that

is,” he said, peering in at the large lizard one day this past spring. He studied the skink’s prehensile tail—used for gripping branches—and listened in wonder as he heard that this species is different than most reptiles because the mother raises the babies for six months and the father guards and protects them. “Cool! Very cool,” Joe exclaimed.

Expanding the somewhat cramped marmoset exhibit is on the zoo’s wish list. By early summer, zoo officials hope to confirm funding for a new facility thanks to a benefactor.

“The community support for this zoo is overwhelming,” Cook says.

WHAT’S NEW AT THE ZOO?

Far left: Mill Mountain Zoo’s sign welcomes visitors. Top L to R: Zoo residents include Archibald, a red panda; China, a snow leopard; and Count Dooku, a red-billed blue magpie. Bottom L to R: Jayden, a Eurasian lynx, looks out over the zoo; Joe Francis, 10, is a frequent zoo visitor; Lucy Cook is the zoo’s new executive director.


Carilion Clinic Children’s Hospital Playground is now open in Elmwood Park in Roanoke. A partnership between Carilion and the city of Roanoke, the park provides a fun place for children to be active and stay healthy. The park is an outgrowth of the community health needs assessments that Carilion has been conducting in the region. To fill a need for more exercise venues for children, and to encourage them to form a life-long habit of exercise, Carilion teamed with the city to create its first themed playground—built around the story of Peter Pan.

CHILDREN’S HOSPITAL PLAYGROUND OPENS IN ELMWOOD PARK

Jefferson College of Health Sciences’ Master of Healthcare Administration and Bachelor of Science in Healthcare Management degree programs have been ranked among the top 20 programs in the nation by the website Healthcare Management Degree Guide. The two programs were paired and ranked 17th among those of all other U.S. colleges and universities that offer similar degrees.

JEFFERSON DEGREE PROGRAMS NATIONALLY RECOGNIZED

Have a question about your health or diet? Why not ask a Carilion dietitian? Just submit your question, and you’ll receive a response online on Carilion’s home page. Go to CarilionClinic.org/blogs/dining-nutrition.

ASK THE DIETITIAN

Art by 97 Carilion employees, volunteers, and immediate family members was on display at Carilion’s second annual Employee Art Show this spring. The show is an initiative of the Dr. Robert L.A. Keeley Healing Arts Program, conducted in partnership with The National Arts Program. The art was shown in the lobby of Carilion Roanoke Memorial Hospital and judged by professional artists for cash prizes. To view the paintings, works on paper, photography, sculpture, and craft works that were entered, go to CarilionClinic.org/art-show.

HEALING ARTS PROGRAM

SPONSORS ART SHOW

IN YOUR COMMUNITY


Carilion will open two new VelocityCare urgent care centers this summer in Salem beside Walmart and in Roanoke across from Keagy Village. They will bring the number of VelocityCare locations

to seven. VelocityCare provides treatment of common illnesses and injuries and on-site lab and X-ray services. All locations are open seven days a week, with no appointments necessary.

Carilion has launched a new online feature, Fact Check, that addresses common myths and misconceptions about health topics. Fact Check postings so far have included recommendations on how to keep kids safe, along with advice on supplements, vitamins, and cold remedies. Watch for future Fact Checks by Karen McNew on CarilionClinic.org.

VELOCITYCARE TO OPEN AT TWO NEW LOCATIONS

FACT CHECK CAN HELP

Physicians to Women, the Roanoke practice providing obstetric and gynecological care, celebrates its 75th anniver-sary this year. Founded in 1940 by Julien H. Meyer, M.D., and his wife, Dorothy, who was also his nurse, the practice has grown steadily over the years. When Dr. Meyer retired in 1993, he had delivered more than 6,000 babies. The prac-tice has since expanded to include 10 physi-cians, who participate in Carilion’s OB/GYN training program, as well as physician assistants and nurse practitioners. Physicians to Women also sponsors or supports many wom-en’s health events in the community.

What does it take to transform a grocery store into a state-of-the-art medical center? See for yourself [at right]. Work is continuing on the renovation of the former Ukrop’s market in Roanoke. When it is complete, Carilion Clinic will open an outpatient center specializing in neuroscience and orthopaedics. It is tentatively scheduled to open in early 2016.

PHYSICIANS TO WOMEN CELEBRATES 75TH ANNIVERSARY

NEW ORTHO-NEURO INSTITUTE TAKES SHAPE

Nelson studs welded to beams

tons of structural steel

cubic yards of concrete poured

77030125+ tractor-trailer loads 6,316


NEW PROVIDERS

Mohamed Elgabaly, M.D. Neuro-Interventional Radiology1906 Belleview Ave., Roanoke, VA 24014 540-981-7122

Ernest Moore, D.D.S. Dentistry2017 S. Jefferson St., Roanoke, VA 24014 540-981-7128

Michael B. Priest, M.D. Family Medicine282 Westlake Road, Hardy, VA 24101 540-721-2689

Ido Heletz, M.D. Cardiology2001 Crystal Spring Ave., Roanoke, VA 24014 540-982-8204

Ashley Houk, N.P. Family Medicine199 Hospital Drive, Galax, VA 24333 276-236-5181

Katy Meinbresse, F.N.P. Family Medicine428 S. Magnolia Ave., Waynesboro, VA 22980 540-949-8241

Jill Bloom, P.A.-C. Urology120 Akers Farm Road, Christiansburg, VA 24073 540-382-3440

Parrisa Rupe, P.A.-C. Family Medicine1375 W. Ridge Road, Wytheville, VA 24382 276-228-8686

Sherry Tompkins, N.P. Psychiatry2900 Lamb Circle, Christiansburg, VA 23074 540-731-7311

Joni Sessor, W.H.N.P. OB/GYN902 S. Jefferson St., Roanoke, VA 24016 540-985-9862

Emily Turner, N.P. Family Medicine911 E. Main St., Floyd, VA 24091 540-745-2031

Sarah Shepherd, N.P. Pediatrics1030 S. Jefferson St., Roanoke, VA 24016 540-224-4520

PHYSICIANS ADVANCED CARE PROVIDERS

PCA HEALTHCARE TO JOIN CARILION CLINICPCA Healthcare, whose 17 physicians see patients in Salem, Floyd, and Daleville, will be joining Carilion Clinic in June.

The physicians will join Carilion family and community medicine practices, and their patients will have greater access to Carilion’s network of health care providers and its MyChart online patient portal. MyChart gives patients access to their medical records and lets them exchange secure messages with their doctors and other providers.

GASTROINTESTINAL ASSOCIATES JOINS CARILION CLINICKevin R. Dye, M.D., and his practice, Gastrointestinal Associates of Roanoke, have joined Carilion Clinic.

Dr. Dye, with more than 25 years of experience, will continue to see patients at 1201 Franklin Road S.W. For an appointment, call 540-985-0244.


LEXINGTON HOSPITAL EXPANDS SERVICESBy Dan Smith

Carilion Stonewall Jackson Hospital in Lexington is adding family medicine physicians and specialists to serve patients in Rockbridge County.

The new specialists include a gynecologist, oncologists, and orthopaedists from nearby independent practices or other Carilion Clinic locations.

“Adding the family physicians will allow them to create a close relationship with the specialists,” says hospital President and CEO Charles Carr. “This is important to the patient.”

The new physician specialty services will be provided part-time to meet demand.

Stonewall Jackson has also introduced specialized equip-ment unusual for hospitals of its size (25 beds). In the past two years, the hospital invested $4.5 million in state-of-the-art technology, which included:

» A new low-dose digital mammography system, Mammomat Inspiration Prime, which reduces radiation exposure by up to 30% over conventional mammogram systems.

» A wireless, minimally invasive surgical system for arthroscopy and laparoscopy procedures.

» A medication-dispensing system that offers added safety for patient care.

Over the coming year, the hospital will also spend $500,000 for a nuclear heart scan camera.

New developments at the hospital have not gone unnoticed. Professional Research Consultants gave it a 5-Star Award for physician communication with patients. Hospitalist Rob Marsh, M.D., was also named the nation’s Country Doctor of the Year by AMN Healthcare, a consultant to the industry.

REGIONAL NEWS

Clockwise: The entrance to Carilion Stonewall Jackson Hospital in Lexington; a statue of Stonewall Jackson at the Virginia Military Institute; a historic street in downtown Lexington.

THE NEW DOCTORS

Family medicine physicians serving the hospital are:• Thomas S. Peck, M.D., formerly of Fairfield Medical

Associates; Thomas F. Hamilton, M.D., formerly of Buena Vista Family Medicine; and Robert Pickral, M.D., and Laura Lanier, M.D., formerly of Lexington Family Medicine. Their three practices have joined Carilion Clinic.

• Ralph Caldroney, M.D., who joined Carilion last fall. • Ayesha J. Kelly, M.D., and John D. Sedovy, M.D., of Carilion

Clinic General Surgery. They also see patients at Stonewall Jackson.

The new specialists will be:• Ido Heletz, M.D., who will join Jeffrey Todd, M.D., in his

cardiology practice in Lexington.• Robert L. Slackman, M.D., whose specialties are

gynecology and infertility and reproductive medicine. Dr. Slackman practices at Carilion Clinic Reproductive Medicine and Fertility in Roanoke.

• Oncologists Padmaja V. Mallidi, M.D., and William A. Fintel, M.D., of Blue Ridge Cancer Care in Roanoke. They will rotate weekly visits to the hospital.

In addition, three Carilion orthopaedic specialists are available:• J. Randolph Clements, D.P.M. (podiatry); Hugh J. Hagan,

III, M.D. (hand surgery); and certified physician’s assistant Jason Peery (orthopaedic spine).

The three will complement the general ortho and sports medicine services that Edward S. Hemphill, M.D., of Carilion Clinic Orthopaedics has been providing to local schools and the Lexington and Rockbridge areas.


The evenings are warm, and the sun is setting late. Why not have a relaxed dinner outdoors and enjoy a grilled shrimp and mango salad?

Mangoes are not only a sweet complement to the shrimp, they are packed with antioxidants, fiber, potassium, and vitamins A and C.

ENJOY A TROPICAL SUMMER SALAD

PREPARATION1. Slice mangoes into long thin strips. Place

mangoes, avocado, onion, olive oil, and lime zest in a bowl. Do not toss or stir yet.

2. Set grill to highest setting. Grill the shrimp 3-4 minutes until pink.

3. Place the shrimp in the bowl with the other ingredients. Season with salt and pepper. Toss gently.

4. Top with cilantro before serving.

• 1 lime, zest and squeezed• 2 tablespoons olive oil• 2 large mangoes, peeled and pitted• 2 avocados, pitted and diced• 1/3 cup green onion, sliced thin• 1/3 cup cilantro, chopped• 1lb. large raw peeled and deveined

shrimp• Salt and fresh ground pepper• 3/4 cup blueberries, fresh or frozen

GRILLED SHRIMP AND MANGO SALAD

INGREDIENTS

RECIPE


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Carilion Clinic Living - Summer 2015

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