HealthMatters. One Patient s AMC. Amazing Story of Recovery. Your Exclusive Guide to. La Vie Medi-Spa and Cosmetic Center Find it on page 10

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1 AMC HealthMatters spring 2008 Your Exclusive Guide to La Vie Medi-Spa and Cosmetic Center Find it on page 10 One Patient s Amazing Story of Recovery More on page 12 What Every Person Should Know about Vascular Surgery See page 6

2 s p r i n g letter from the ceo Dear Friends, After being on the job as chief executive officer for several months at, I am humbled and honored to work at this wonderful healthcare facility with such talented professionals. My family and I are especially grateful for how warm and welcoming the community has been upon our move to the Shenandoah Valley. While I may still be a new face to some at the hospital, my goals are the same as those who work throughout AMC: to provide the highest quality health care and ensure the hospital meets the community s needs. I am proud to be part of the AMC family, and I look forward to many years of ensuring you and your family receive the very best care. Best Wishes, Mary N. Mannix President and Chief Executive Officer and the ANSWER is 1What is the name of the virus that an estimated 80 percent of 2 women age 50 or older have had or currently have that can cause cervical cancer? Which treatment offered at the La Vie Medi-Spa and Cosmetic Center is injected to treat fine lines and crow s feet for up to four months? If you know the answer to either of the above questions, send your answers to Vicki Kirby, Media and Communications Director, at 78 Medical Center Drive, Fishersville, VA, All correct entries will be entered in a special drawing. A New Leader for the Future On January 1, welcomed Mary N. Mannix, FACHE, as the new president and CEO. She brings a wealth of healthcare experience, including 19 years with Guthrie Healthcare System, which has facilities in New York and Pennsylvania. At Guthrie Health, Mannix was the president and chief operating officer of Robert Packer Hospital a 238-bed, tertiary teaching hospital and senior vice president of the system based in Sayre, Pennsylvania. During her tenure, the system achieved numerous awards, including distinction as a Solucient 100 Top Hospital. LOOKING TO THE FUTURE Now at AMC, Mannix has completed a thorough assessment to learn from the hospital s rich history of excellence as she develops a vision for the future. She shares the organization s belief in putting the patient first while providing safe and quality care that exceeds patients expectations. I began my career as a registered nurse in the intensive care unit, so for me, putting patients at the center of care is essential, says Mannix. I feel very fortunate to join such an outstanding facility with a top-notch staff eager to serve and meet the needs of such a warm and welcoming community. AMC Health Matters is published by. The articles in this publication should not be considered specific medical advice, as each individual circumstance is different. Entire publication Augusta Medical Center All rights reserved. For more information or to be removed from this mailing list, please call (540) ON THE COVER: Harry Coleman is grateful to and Thomas Pereles, MD, orthopedist on staff at AMC, for the care delivered after a tragic bicycle accident threatened to disrupt his normal lifestyle.. two

3 Keeping Up with THE AGES s Crossroads Mental Health Unit has developed a new program to help the young at heart Crossroads Extended Care. The 65-and-older population has become the fastest growing demographic in the Shenandoah Valley. The mental health needs of the aging population are sometimes overlooked, which creates difficulties for their families or care centers, says Taylor Davis, MSW, program director of Crossroads Mental Health Unit at AMC. By specifically designating a distinct unit and tailoring a program that helps meet the needs of our geriatric population, we are responding to a very large and growing community need. We have treated geriatric patients in our adult program at Crossroads Mental Health unit for years, says Davis. Therefore, it was a natural step to create a program that offers people 65 and older specialized treatment, unique to their individualized needs, in a safe and caring environment. The following are some of the issues that may be treated at Crossroads Extended Care: Alzheimer s Anxiety Dementia Depression Acute behavioral changes We will also offer family therapy, as well as individual, group, and adjunctive therapies, Davis says. Patients will be able to learn to how to develop more independence, cope with grief and loss, and will gain increased knowledge of how to manage symptoms and medications. For those patients with more significant problems, we will stabilize Taylor Davis, MSW them so that they can regain a level of functioning that will allow them to return to the community. For more information about Crossroads Mental Health Unit at AMC, visit and search Crossroads Mental Health Unit or call (540) Meet Dr. Christensen is proud to announce the addition of Darin Christensen, MD, psychiatrist, to the medical staff. Dr. Christensen arrived at AMC in February of this year to help open a new inpatient program for adults and geriatrics in need of help and will also be opening a private practice Blue Ridge Behavioral Health. I feel the Shenandoah Valley is underserved, says Dr. Christensen. With the development of a program to meet the inpatient needs of our geriatric population and the opening of Blue Ridge Behavioral Health, more inpatient beds will be opening up, and people who need an outpatient psychiatrist will no longer have to travel for care they deserve or be placed on a waiting list. Coming from Western State Hospital in Staunton, Virginia, Dr. Christensen is eager to help the Shenandoah Valley. People are always asking me how I can sit and listen to people s problems all day, but it is gratifying being able to see people get better over the visits they share with me, says Dr. Christensen. I enjoy watching people get better and helping them reach that goal. To make an appointment with Dr. Christensen, call Blue Ridge Behavioral Health at (540) (Staunton) or (540) (Waynesboro). three

4 Bringing RETINAL SURGERY Into Focus at AMC Thanks to the addition of a new ophthalmologist at, patients from the Shenandoah Valley no longer have to travel out of town to have the state-of-the-art eye surgery they need to preserve their vision. The retina a thin layer of tissue that lines the inside of the eye senses light as it enters the eye. The images we see result when light is translated into electrical signals that are sent to the brain through the optic nerve. The retina is critical for sight, so it s important that any problems that occur, such as diabetic retinopathy or retinal detachments and tears, be diagnosed quickly. When retinal problems are diagnosed in time, the damage to the retina can be stopped or even reversed with retinal surgery, says James Tiedeman, MD, ophthalmologist on staff at AMC. However, if retinal problems remain undiagnosed for too long, we may be unable to stop or reverse the damages. Since Dr. Tiedeman joined the AMC staff in January, patients in the Shenandoah Valley have been able to undergo retinal surgery right here at AMC. Retinal surgery is typically performed on an outpatient basis, using special ophthalmologic surgical tools, including lasers, size scissors, microscopic forceps, and freezing probes to repair the damage. SURGERY FOR DIABETIC RETINOPATHY Diabetic retinopathy, one of the leading causes of blindness for American adults, occurs when changes in the blood vessels cause problems within the retina. In patients with diabetes, the blood vessels in the retina may swell, become blocked, leak blood or fluid, and ultimately develop scar tissue that can cause the retina to detach. These changes may result in visual impairment or even blindness. In the early stages of diabetic retinopathy, there are typically no symptoms and no pain. That s why it s critical for everyone with diabetes to have a dilated eye exam at least once each year. With a dilated eye exam, an ophthalmologist can look for early signs of the disease including leaky blood vessels, retinal swelling (macular edema), damaged nerve tissues, and abnormal blood vessels. As it progresses, diabetic retinopathy can cause a number of different problems, such as bleeding, retinal detachment, scarring, and distortion of the retina, says Dr. Tiedeman, who is also the chair of the American Board of Ophthalmology. All of these issues can be managed with intravitreal surgery, which is called a virectomy. During the surgery, the ophthalmologist makes three small incisions in the eye. Using very small instruments, the ophthalmologist removes the bloody or cloudy vitreous gel (the fluid in the center of the eye). The gel is replaced with a clear liquid, and patients can return home. Patients don t notice a difference between the original vitreous fluid and the replacement solution. SURGERY FOR RETINAL TEARS OR DETACHMENT While it s possible to experience retinal tears or detachments as a result of an injury, the vast majority occur when the vitreous gel separates from the retina and allows the weak retina to tear. Once the vitreous fluid then builds up behind the retina, the retina can separate from the back of the eye, resulting in a partial and sometimes full detachment. four

5 Detached retinas are common in older patients, particularly those who have undergone cataract surgery, says Dr. Tiedeman. Surgery has an extremely high success rate for repairing retinal detachment, as long as the patient sees the ophthalmologist quickly to get the condition diagnosed early. There are several common surgical methods for repairing retinal detachments: scleral buckling surgery, pneumatic retinopexy, and virectomy. Scleral buckling surgery. During this procedure, the ophthalmologist sews silicon to the outer layer of the eye. This surgery holds the retina s layers together and relieves traction on the retina to prevent additional or worsening of tears. Pneumatic retinopexy. During this procedure, a gas bubble is injected into the eye, and the bubble then rises to the area that is detached. By placing light pressure against the tear, the bubble is able to close the tear and prevent additional fluid from building up under the retina. A laser beam or freezing probe is then used to seal the retinal tears. Retinal problems aren t anything that should be taken lightly, because they can permanently destroy your vision, Dr. Tiedeman says. Any time you experience vision problems, it s imperative to get them evaluated as quickly as possible. To learn more about retinal surgery at AMC, call Retina Care of Virginia at (866) Patients in the Shenandoah Valley can rely on the excellence of care delivered by professionals like James Tiedeman, MD, ophthalmologist. Meet Dr. Tiedeman James Tiedeman, MD, ophthalmologist, joined the staff of Augusta Medical Center on January 1. Since coming to AMC, he s been the only ophthalmologist at the hospital to perform retinal surgeries. Dr. Tiedeman completed his undergraduate work at Drake University in Des Moines, Iowa, before attending Duke University in Durham, North Carolina, for his dual medical degree and PhD program. Following graduation, Dr. Tiedeman completed an internal medicine/pediatrics internship at the University of North Carolina before completing his ophthalmology residency at Duke University. After completing a fellowship at Bascom Palmer Eye Institute in Miami, Dr. Tiedeman held faculty positions at Duke and the University of Virginia before joining the staff at AMC. Dr. Tiedeman and his wife, Patricia, have two children, Jennifer and John. In his spare time, Dr. Tiedeman enjoys carpentry, gardening, and tinkering with antique cars. To schedule an appointment with Dr. Tiedeman at the Fishersville or Charlottesville offices of his practice, Retina Care of Virginia, call (866) Stephen Keefe, MD, otolaryngologist at Augusta Ear, Nose, and Throat and Facial Plastic Surgery Specialists and on staff at, is an expert in balloon sinuplasty, which ensures patients have quicker recovery times and less pain. fi ve

6 VASCULAR Vital Information about When it comes to maintaining blood flow through your arteries and veins, vascular surgeons at offer cutting-edge procedures to keep you healthy and your recovery time to a minimum. balloon catheter at vessel narrowing plaque catheter with uninflated balloon catheter with inflated balloon The new wave of vascular surgery procedures is easier on patients faster recovery times and lower risks mean that more patients are eligible for the vascular surgery they need. Many of the procedures we offer give our patients definite advantages, says Jacek Paszkowiak, MD, attending vascular surgeon at AMC. Many of these patients could not have been treated 10 years ago. Now, it s possible to treat them and return them to a normal quality of life. While AMC offers a variety of vascular surgery procedures, the three most common are balloon angioplasty, peripheral stenting, and endovascular atherectomy. Read on to learn more about the lifesaving procedures performed every day at AMC. BALLOON ANGIOPLASTY Angioplasties make use of tiny balloons to help clear out clogged arteries. The balloon expands and helps to dilate the blood vessel, which in turn helps increase blood flow. The treatment cannot be used to widen and clean every blood vessel exceptions include vessels in the leg but it can be a viable option in other locations, especially in smaller blood vessels, and for patients with disease involving leg, neck, and kidney vessels. A Surgical Revolution physicians are offering new vascular surgery procedures to improve patient care. We are undergoing a minimally invasive revolution, says Jacek Paszkowiak, MD, attending vascular surgeon at AMC. Many of our procedures are now performed with minimally invasive techniques, and it s making it easier for patients who might not otherwise have been candidates for surgery to receive care. As many as 95 percent of surgeries at AMC are now performed through minimally invasive approaches. The benefits include being able to return home the same day, quicker recovery times, and lower risks of infection. For more information, visit Using a catheter and guiding wire to perform the procedure, a surgeon will navigate to the correct spot in the blood vessel. When he has found the problem area, the surgeon will use the high-pressure balloon to expand the blood vessels. The procedure compresses plaque buildup that clogs the artery and expands the area of blood flow. Balloon angioplasty is a minimally invasive procedure, and patients can typically return home the day the surgery is performed. six

7 SURGERY Image provided courtesy of Cordis Corporation PERIPHERAL STENTING Stenting can be performed in conjunction with angioplasty, but is not always used with the procedure. Stenting involves reinforcing a blood vessel with a mesh tube, the goal being to keep the artery open and wide, allowing for maximum blood flow. During a procedure that involves an angioplasty, stenting is used following the balloon. Stents can be used all over the body, and many of them are placed in the legs, arms, and pelvis of patients with peripheral artery disease, a condition caused by too little blood getting to the body s extremities. Causes of the disease vary and include everything from blood clots and scar tissue to build-up in the arteries. The most common cause of peripheral vascular disease is arteriosclerosis, a disease caused by high cholesterol, smoking, hypertension, and diabetes. ENDOVASCULAR ATHERECTOMY During an endovascular atherectomy, a common procedure for patients with peripheral artery disease, a surgeon inserts a catheter into the lesion. Special rotating tools are then used to remove plaque from the blood vessels. All the above procedures can be performed on an outpatient basis, meaning it is possible to leave after surgery. For more information, visit Asymptomatic Peripheral Artery Disease: A Quiet Killer Thanks to new screenings available at Augusta Medical Center, patients can be screened for asymptomatic peripheral artery disease, a condition that presents no symptoms but can cause a myriad of health problems. We are educating our primary care physicians and our patients about the importance of screening for asymptomatic peripheral artery disease, says Jacek Paszkowiak, MD, attending vascular surgeon. The condition was not really studied until a recent article out of Vienna, Austria, showed patients suffering from asymptomatic peripheral artery disease had a higher mortality rate over five years than patients suffering from prostate cancer. Tests for the disease are simple and can be done in a primary care office. Physicians will check your pulse at the knee, ankle, and groin to look for signs of weakness. If the doctor believes further testing is necessary, an ankle-brachial index or a magnetic resonance angiogram (MRA) can confirm the diagnosis. Why Worry about Asymptomatic Peripheral Artery Disease? The symptoms of peripheral artery disease include poor balance, wounds that are slow to heal, and cold or numb feet and legs. They can be as severe as gangrene, an infection that causes tissue death. Due to the serious nature of the symptoms, failure to diagnose the disease could be fatal. People don t die from asymptomatic peripheral artery disease itself, says Dr. Paszkowiak. Instead, the disease is an indicator of other life-threatening conditions that if left unchecked could cause people to die due to stroke or heart attack. The Simple Treatment Treatment for asymptomatic peripheral artery disease is a simple regimen of medications. Possible prescriptions range from oldfashioned doses of aspirin to Lipitor, which lowers cholesterol. Many times the condition is also treated with beta-blockers, which impact the heart rate. All these medications can help prevent conditions related to peripheral artery disease. For more information, visit seven

8 Ensuring Quality Health Care throughout the Region remains devoted to supporting a healthy community through the work of the Augusta Health Care (AHC) Community Health Foundation. Since 2001, the AHC Community Health Foundation has awarded over $1 million to community agencies and local health projects. The mission of the Foundation is to support local organizations and collaborative projects that work toward producing a healthier community, says Linda Gail Johnson, RN, executive director of the Foundation. We also provide scholarships to students seeking careers in the medical field and conduct a variety of health-focused programs in the area. PROVIDING MONETARY SUPPORT The AHC Community Health Foundation is a charitable organization of Augusta Health Care, which owns and operates. Using funds set aside by AMC, the Foundation awards gifts and both single-year and multi-year grants to agencies and groups Linda Gail Johnson, RN, dedicated to improving the health of local citizens. executive director of the AHC This year s single-year grant recipients include AMC Hospice of the Shenandoah, American Community Health Foundation Red Cross of the Blue Ridge, Blue Ridge Area Food Bank, The Salvation Army of Staunton and Waynesboro, and Valley Associates of Independent Living. The Augusta Regional Dental Clinic, Healthy Families of the Blue Ridge, and Shenandoah House are current grantees for the multiyear award. The Foundation has also provided scholarship funding to support participants at both the Waynesboro and Staunton YMCAs. Some additional recipients of funding include the Family Resource and Referral Center, Valley Alliance for Education, Shenandoah Valley Grief Services, Valley Community Services Board, Central Shenandoah Office on Youth, Valley Music Academy, and the Waynesboro Services Disability Board. Over 40 organizations received financial assistance in 2007 alone. SUPPORTING THE NEXT GENERATION In addition to supporting various healthcare agencies, the Foundation is committed to supporting quality health care into the future by providing two annual scholarships to high school students pursuing a healthrelated degree. The Foundation also provides a clinical instructor for the licensed practical nurse (LPN) to registered nurse (RN) program at Blue Ridge Community College. This year we are adding another scholarship category for clinical laboratory science students who are pursuing a career in the medical laboratory, says Johnson. Aside from tuition support, some of the non-local students also need help with housing and other expenses, so we are excited to help meet some of their needs as well. It s another way we can encourage the advancement of health careers in our community. To learn more about the Foundation, call (540) or visit Encouraging Healthy Choices Since 2002, the Working on Wellness (WOW) program, sponsored by the Augusta Health Care Community Health Foundation, has encouraged students, adults, and seniors to make healthy choices regarding nutrition and physical activity. Initiated by the Community Health Forum, the ongoing program involves collecting body mass index assessment of area students and adults that has revealed a higher incidence of obesity and inactivity than the national average. As a result of the findings, the Foundation along with other local agencies is developing community health programs to encourage improved nutrition and increased physical activity. With the Foundation as a catalyst and the provider of financial support, the three local school divisions are providing the expert guidance of a shared registered dietitian to assist with the design and promotion of healthy food options at school. eight

9 DOCTORS ANSWER Your QUESTIONS? In this special feature, two doctors on staff at answer your questions about the human papillomavirus and shed light on whether or not energy drinks are safe for your kids. Q: I ve recently heard a lot about the HPV vaccine. What is HPV, and should I get the shot, too? (John Bourgeios, MD, is a board-certified OB/GYN at Augusta Medical Center.) Human papillomavirus (HPV) is a relatively common virus affecting the genital tract in both men and women. If left untreated, the sexually transmitted HPV could develop into cervical cancer, and an estimated 80 percent of women age 50 or older have had an HPV infection or have it currently. The vaccine is a relatively new therapy. At the present time, Gardasil is recommended for girls and women between the ages of 9 and 26. The HPV vaccine is nearly 100 percent effective in preventing four common strains of HPV and is given in a series of three shots over six months. Females are encouraged to receive the vaccine prior to first sexual intercourse. If you are already sexually active but are within the target age range, the vaccine is still a worthwhile investment. Because HPV has a number of subtypes, even if you have already been exposed to one subtype, the vaccine can still protect you against other forms. The vaccine will not protect you against other sexually transmitted diseases, so if you are sexually active, using condoms is recommended. Q: My child is active in sports and always seems to be on the go. When he s had a long day, are energy drinks a safe option? (Robert Gunther, MD, is a board-certified pediatrician with Augusta Pediatrics.) Energy drinks have proven to be a poor way to replenish fluids and boost energy for more than a short period of time. An 8-ounce bottle has been found to contain two to four times more caffeine than a can of Coke. Consuming this high level of caffeine has the potential to do harm in children because caffeine is both a stimulant and a diuretic, so while it tends to speed up the body s systems, it causes dehydration. In addition to causing a jolt-and-crash effect, consuming energy drinks has been shown to cause heart palpitations and numbness and tingling in the hands and feet. Young people should avoid caffeinated drinks as much as possible and try to get energy from their regular dietary sources. Helping your child maintain higher energy is as simple as getting back to basics. Make sure that he or she eats a healthy diet with at least five servings of fruits and vegetables per day. Have the child drink plenty of fluids, such as water or low-fat milk. In addition, make sure he or she gets plenty of rest. nine

10 Considering a Non-Surgical Cosmetic Procedure? s La Vie Medi-Spa and Cosmetic Center now offers cosmetic dermatology services designed with you in mind. For the past year, residents of the Shenandoah Valley have counted on La Vie Medi-Spa and Cosmetic Center for traditional spa treatments, skin consultations, and nail care. Now AMC offers nonsurgical cosmetic procedures including laser and anti-aging services to treat a variety of conditions under the supervision of Kristen Savola, MD, medical director of cosmetic dermatology at La Vie Medi-Spa. Until now, there has not been a physician available to provide these types of treatments and dermatology services, says Dr. Savola. By incorporating the medical aspect into the spa, women need only make one stop when it comes to looking their best. In addition to cosmetic dermatology services at La Vie Medi-Spa and Cosmetic Center, Kristen Savola, MD, medical director of cosmetic dermatology, also offers general and surgical dermatology services, including evaluation and treatment of rashes such as eczema and psoriasis, as well as skin screening exams, mole checks, and treatment for all types of skin cancer. For a listing of services, please visit LASER SERVICES Patients can benefit from a variety of laser procedures for hair removal, sunspots, pigmentation problems, fine lines, wrinkles, rosacea, and acne. These treatments are fairly painless and generally require more than one visit to achieve the desired outcome. The results are longlasting and do not require extensive recovery time. Some patients are hesitant to go through with laser procedures because they are worried about missing work for a few weeks, Dr. Savola says. Patients can actually return to their normal activities immediately following the treatment. THE TECHNOLOGY BEHIND THE RESULTS The laser that is used for the services mentioned earlier uses intense pulsed light (IPL), which restores the appearance of the skin through photorejuvenation. This process reduces redness, evens out pigmentation, and increases collagen in the skin. In the case of hair removal, the laser safely and effectively impedes hair growth in men and women and can be used on most areas of the body. The most common laser procedures are to reduce the appearance of rosacea, sun damage, fine lines, and wrinkles, Dr. Savola says. The technology can be used on the face, neck, and hands. ten

11 Kristen Savola, MD is excited to welcome Kristen Savola, MD, to La Vie Medi-Spa and Cosmetic Center. Dr. Savola is board certified in dermatology, internal medicine, and infectious diseases. She is a member of the American Academy of Dermatology and the Women s Dermatologic Society. After earning her degree in medicine from Columbia University s College of Physicians and Surgeons, she completed her residency in internal medicine at the University of California, San Francisco. She completed a fellowship in infectious diseases at Stanford University in 2001 and finished her residency program in dermatology at the Medical College of Virginia in 2005, where she served as chief resident. At La Vie Medi-Spa and Cosmetic Center, Dr. Savola will provide general dermatology services as well as skin and laser treatments. To schedule an appointment, please call (540) INJECTION TREATMENTS In addition to laser services, AMC s La Vie Medi-Spa and Cosmetic Center will administer injections to treat fine lines, wrinkles, and spider veins. These treatments also do not require recovery time, though there is a potential for mild bruising and swelling. Here are some of the available offerings: Botox. This purified protein is injected to treat fine lines and crow s feet for up to six months. Restylane. This dermal filler contains hyaluronic acid, which is found naturally in the skin. It is injected to provide support and reduces the appearance of wrinkles for up to 12 months. Juvéderm. This hyaluronic acid-based gel restores skin volume and is effective in smoothing moderate to severe wrinkles for up to 12 months. Radiesse. This calcium hydroxy apatite gel is injected in the skin and stimulates the production of new collagen. Results often last more than two years. Sclerotherapy. This procedure removes spider veins through an injected solution called sclerosant, which causes the veins to collapse. It treats only the veins that are visible and will not prevent the formation of new veins. Botox and fillers are generally safe for anyone wishing to achieve a rejuvenated appearance, Dr. Savola says. However, laser treatments may require initial test spots on some skin types to ensure the procedure will yield the desired results. A NEW YOU The cosmetic dermatology services at La Vie Medi-Spa and Cosmetic Center are designed with the patient in mind, and all provide safe, non-surgical methods of improving the appearance of the skin without plastic surgery. Our goal is to make patients feel better about themselves, Dr. Savola says. These procedures safely improve overall skin health and help to boost patient confidence. For more information about the cosmetic dermatology services offered at AMC s La Vie Medi-Spa and Cosmetic Center or to schedule a consultation with Dr. Savola, call (540) Take a Spa Day In addition to laser surgery and cosmetic dermatology services, La Vie Medi-Spa and Cosmetic Center offers a variety of options to leave you feeling rejuvenated, relaxed, and ready for the world. Call today and let our professionals help create the perfect spa package that s individually tailored for you. Make your skin feel new with one of the following facial treatments: problem-solver facial program classic European facial luxury facial gentlemen s facial treatment neck facial anti-aging yoga facial Look your best by participating in one of our make-up services, including: makeup consultation/custom blend makeup application makeup lesson Indulge in one of our many massage offerings, including: classic massage therapeutic massage natural stone therapy reflexology anti-stress massage treatment prenatal and postpartum massage Add an extra glow with one of the following body treatments: neroli body polish cryogenic slimming mask gly-body smoothing peel seaweed cellulite treatment relaxing steam therapy eleven

12 On the Road Again When a bicycling accident left Harry Colman, then 56, with a badly fractured hip, he was thankful for the care he received at. With the help of Thomas Pereles, MD, orthopedist on staff at AMC, Harry is back on his bike and feeling better than ever. Harry has been an active person all his life. An avid cyclist, he also was once an active runner and even qualified for and ran the Boston Marathon. It was this event, however, that made Harry think about getting more serious about cycling. The Boston Marathon was somewhat anticlimactic for me, and I gradually lost interest in running, says Harry. That s when I became passionate about cycling. You can cover a lot more ground on a bike than you can when you re running, and, unlike being in a car, you re out experiencing the great outdoors. The beautiful countryside and the wildlife that s what I love about cycling. THE ACCIDENT Back at home in Waynesboro, Virginia, Harry and his wife, Ann, soon began riding regularly and decided to organize a century ride, which started and ended at their own home. A great success, the ride became an annual event and even spurred the creation of a local bicycle club. It was on a regular, everyday ride on April 12, 2003, however, that Harry had an accident that changed his life forever. I was riding with a friend I d ridden thousands of miles with when he suddenly slowed down and I didn t notice, says Harry. My front tire got hung up on his rear wheel and I fell down hard, shattering my hand, hip, and helmet. My helmet saved my life. Initially, Harry was treated at the University of Virginia Medical Center where doctors told him he needed a hip replacement. They couldn t do the procedure at that time, however, because his hip was too badly shattered and there was nothing to attach the prosthesis to. Instead, the physicians patched it up with plates and screws and told him he d have to wait for it to heal before they could perform further surgery. PAIN AND RELIEF Over the next two years, Harry continued to be as active as possible with his marginal right hip, but a rapid decline of clearance in the joint made his hip very stiff and painful. In January 2006, Harry decided he couldn t take the pain anymore and scheduled an appointment with Dr. Pereles, who practices at Orthopedic Associates, LTD. His timing couldn t have been better. twelve

13 When a bicycle accident threatened to disrupt his normal lifestyle, Harry Coleman turned to Thomas Pereles, MD, orthopedist on staff at, for help. When I first saw Harry, his hip joint had essentially collapsed and was rubbing bone on bone, says Dr. Pereles. Although his previous surgery had worked well temporarily, it was definitely time for a hip replacement. The surgery was scheduled for February, and from the very morning after the procedure, Harry felt better than he had in two and a half years. I was walking by the day after surgery, and I no longer needed pain medications on a day-to-day basis, says Harry. It made me wish I d done it earlier! MODERN JOINT REPLACEMENTS As technology has improved over the years, so have the prostheses used in joint replacements. Today, the prostheses used at AMC are often cementless, made out of metal, plastic, or ceramic, and last longer than ever. One of the most common misconceptions about joint replacements is that they ll have to be replaced every 10 or 15 years, says Dr. Pereles. The new prostheses are so good, however, it s unlikely they ll ever wear out. They also won t come loose because, without cement, the bone grows directly into the prosthesis and makes it part of your regular skeletal structure. A successful joint replacement like Harry s could last for as long as 50 years. ON THE ROAD AGAIN Within six weeks of his hip replacement, Harry was back on his bike. Since then, he s ridden in five century events and rode more than 2,500 miles in 2007 alone. Now, he can t stop singing the praises of AMC and its staff. I am so fortunate to have had the help of such an accomplished surgeon at AMC when I needed it most, says Harry. The Shenandoah Valley is very lucky to have such a wonderful facility and skilled physicians like Dr. Pereles. I am so grateful for the care I received at AMC they gave me my life back. For more information on the orthopedic services at AMC, visit thirteen

14 HealthCare Decisions to Come: Are You Prepared? By Rev. Mark Westebbe, AAPC Fellow, AHC Chaplaincy Coordinator and Ethics Consultant As long as you are alert and able to communicate, you will be the one making healthcare decisions. The problem arises when you are no longer able to make decisions. Who should decide in your place? Advance directives provide guidance and direction for people having to make medical decisions on behalf of another. Virginia has enacted the Health Care Decisions Act with a suggested form for a written advance directive. This form allows you to express your treatment choices and preferences in writing in case you cannot make informed treatment decisions for yourself or make your wishes known. Here are some common questions about advance directives. What happens if I do not have an advance directive? Virginia law directs your physician to talk with someone when you are unable to make an informed decision about your medical care. What is in the Virginia Advance Directive? The Virginia form contains several sections: a Living Will; a Durable Power of Attorney for Health Care; and an Appointment of Agent to Make Anatomical Gift. You may fill out any or all of these sections. You may change your mind and even revoke this form at any time. How do I create a valid advance directive? The form should be signed by you in the presence of two witnesses. You do not need a notary or an attorney. Who Should Be Your Power of Attorney for Health Care? Appointing this person is the single most useful thing you can do to preserve your rights and protect your loved ones. This person makes decision on your behalf by applying your values and standards, not their own. Any adult over 18 years old can serve in this role. We strongly recommend that you select only one person and identify an alternate in case that person cannot serve. What does the Living Will do? This section offers guidance to your decision maker and physician when you suffer from a terminal condition. It allows you to specify your choices concerning life prolonging procedures and comfort measures. Be aware of some practical limitations of a Living Will. It is not always clear whether or not you may be suffering from a terminal illness. People differ about what is treatment and not treatment. It is probably impossible to foresee every treatment decision that may arise. You can resolve these uncertainties by appointing a Power of Attorney for Health Care. What about an Anatomical Gift (organ donation)? Anatomical gifts can be complicated; not all are accepted. You should consult with your physician and family to work out your choices in advance. Is a Power of Attorney for Health Care the same as a General or Financial Power of Attorney? You should carefully check your particular documents. A Power of Attorney for property or personal matters is not usually the same as a Power of Attorney for Health Care, though you can name the same person. Make sure you have a Power of Attorney for Health Care. When does a Power of Attorney for Health Care take effect? Whenever you are unable to make informed medical decisions for yourself, as determined by two physicians. If you regain decisionmaking capacity, the Power of Attorney stops. You are not giving anything away with this form it can only be used when you cannot make decisions for yourself. The advance directive form allows you to limit the scope of the Power of Attorney. What is a DNR or Do Not Resuscitate Order? A DNR and an advance directive are very different things. A DNR is a physician s order to medical personnel to not perform certain procedures if your heart stops or you stop breathing. A DNR is usually discussed and agreed to by you (or your decision maker) and your physician. If you think you may need a DNR, you need to talk with your physician. fourteen

15 Complete the crossword puzzle. When a Decision Can t Wait 1 2 All of us expect to receive medical care during our lives. We have an ache, pain; we fall, get in a car accident; something changes color or shape, a bump appears. We go to a physician to diagnose the problem and recommend treatment. We are especially concerned to provide care when someone we love develops problems. Physicians today are equipped to respond as never before their knowledge and understanding of how our bodies and minds work has exponentially exploded. Treatments and procedures unimaginable just a generation ago are now commonplace. Today, your physician may well have to educate you about your choices, for there are risks and trade-offs in every treatment or procedure. It may seem strange that you can be asked to decide about something a physician may have spent years trying to understand. On the other hand, who else but you can make choices that affect you, your body, and your life? The Federal Patient Self-Determination Act was enacted to promote the use of Advance Directives to provide guidance and direction for people having to make medical decisions on behalf of another What if I am unsure or need help about what to say? The form is pretty much self-explanatory. Consult with your physician about medical conditions. Where can I get this form? Advance directives are free and available in many places. can supply copies. There are many Web sites that address this topic, including the Virginia State Bar (www.vsb.org; search Health Care Decisions Day and look at the list of resources, including Spanish language). Members of s Ethics Committee will be available to speak with your organization about advance directives (forms and other materials are provided). Please call (540) Play Smarter Try your hand at the AMC Health Matters crossword puzzle and have fun while you add to your health knowledge. Help with the clues can be found throughout the issue. ACROSS 3 Energy drinks are not recommended for teens because they often contain too much of this stimulant. 5 Small, mesh tubes that reinforce blood vessels to allow for maximum blood flow. 6 Small insulin pumps for diabetes management are half the size of this fruit. 10 Vaccine recommended for women ages 9 to 26 to protect against the human papillomavirus (HPV). 11 One of the issues that may be treated at Blue Ridge Behavioral Health specialized program for people ages 65 and older. 13 Kind of surgery that repairs damaged retinas and stops the progress of retinal disease. DOWN 1 A leading cause of blindness in adults with diabetes. 2 Asymptomatic peripheral artery disease can cause symptoms as severe as this infection that causes tissue death. 4 With durable power of attorney, one of the two most common types of advance directives. 7 Procedure that removes spider veins through an injected solution called sclerosing. 8 One of the massage offerings at LaVie Medi-Spa and Cosmetic Center. 9 Grants awared by our Foundation have exceeded $1. 12 City in Pennsylvania from which our new CEO hails. ANSWERS: Please visit for this puzzle s solution. fi fteen

16 You deserve the latest... in medical technology and equipment, specialists who actually specialize, and physicians and staff working right here at home everyday... is here to take care of you... taking care of our friends and neighbors with the focus always on quality healthcare. The kind of care youʼve come to expect...with a personal touch. Your health. Your home. Your hospital. 78 Medical Center Drive Fishersville, VA (932) Augusta Health Care, Inc. 78 Medical Center Drive PO Box 1000 Fishersville, VA Nonprofit Organization US Postage PAID Lynchburg, VA Permit No. 830

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