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Sentara + RMHBetter Together

healthQuestA PUBLICATION OF SENTARA

RMH MEDICAL CENTER

S U M M E R 2 0 15

May and June mark the four-year anniversary of our merger with Sentara and the five-year anniversary of our move to our new hospital, respectively. Time really does fly when you’re having fun! I thought it only appropriate to mark these milestones by reflecting on a few significant accomplishments we’ve experienced, as there certainly is much of which we can be proud.

Back in 2011 our board of directors decided to affiliate with a larger, integrated delivery system, Sentara, in order to position our local commu-nity hospital for long-term success in a dynamically changing healthcare

environment. As we near the completion of our integration process with Sentara, I am confident we made the right decision. You can read some of the reasons for that confi-dence starting on page 12.

Sentara is now an organization that includes 12 community hospitals—all nonprofit, community-based organizations. All 12 currently are facing similar challenges, and our common Sentara affiliation helps us to more effectively deal with those challenges together. Whether it’s through utilizing the knowledge of others in the system, the high-performance design teams intimately focused on improving care in specific areas across the organization, or the lower cost of strategic capital Sentara brings to the table, there is no doubt in my mind that we are better together, as a network of community hospitals.

In addition, the breadth of services we are able to provide now is significantly different from what it was in 2011, in part due to the resources that have come along with being part of a system. We have introduced minimally invasive heart ser-vices, a wound care center, and a voice and swallowing clinic, and we are seeing continued growth in our orthopedic services. This month we will also break ground on a new clinic in Timberville that will provide primary care, medical imaging and physical therapy. We’re excited to expand our services to meet the healthcare needs of those in the communities we serve.

Even with all the growth and additions, we have not strayed from our number-one focus of keeping our patients safe and providing the highest quality of care possible. We have achieved Magnet® status—the highest recognition a nursing team can receive—and also have been able to reduce the number of serious safety events occurring at the hospital by 83 percent over seven years (see the article beginning on page 17). These two achievements are commendable, and I thank all the members of the Sentara RMH team for helping to make them possible. We simply couldn’t have done so without everyone’s help.

Through all of the changes and enhancements, I have been struck most by the unwavering support of our community. Yes, some things, such as our name, are different these days, but we are still the community hospital you have known and supported. Just like in a marriage, we are finding ourselves better off as a result of that coming together with Sentara.

Over the past five years, we have continued to benefit from the gracious philanthropic support from within our com-munity. For instance, after merging with Sentara we conducted a successful campaign for the new Sentara RMH Funk-houser Women’s Center, with a majority of the funding for the project coming from generous donors in the community, and the remainder of the funds coming from Sentara. That campaign is the perfect example of how working together makes us better, and all RMH Foundation contributions continue to stay here locally for the benefit of our community!

Our recent past has been a time of growth, a time of learning, a time for firsts, and a time to be thankful for how modern medicine allows us to better care for our community. Thank you for your ongoing support and consistent trust in us to meet your healthcare needs. We are honored to take care of you and look forward to what the next five years, and beyond, will bring.Sincerely,

Jim KraussPresident, Sentara RMH Medical Center

Jim KraussPresident,

Sentara RMH Medical Center

Corporate Vice President, Sentara Healthcare

president’s message

There’s Much to Celebrate

contents

3Medical Mission to Haiti

6Back on the TractorKnee Replacement Surgery

12Sentara + RMHBetter Together

17ALWAYS Keep You SafeBuilding a Hospital Culture of Safety

223-D TechnologyA New Option for Annual Mammograms

26Persistence Pays OffOne Man’s Journey to Life-Saving Heart Surgery

f e a t u r e s

S U M M E R 20 1 5

17

34Fighting Cancer Treatment’s EffectsNeurofeedback

40Think It’s a Stroke?Act Fast!

40

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12

d e p a r t m e n t s

2010 Health Campus Drive, Harrisonburg, VA 22801

Sentara.com

A D M I N I S T R A T I O N

President | Jim Krauss

Senior Vice President, Sentara RMH Medical Center; President, Sentara RMH Medical Group | John A. McGowan, MD

Senior Vice President, Clinical Effectiveness | Dale Carroll, MD, MPH

Chief Financial Officer, Sentara Blue Ridge Region | J. Michael Burris

Senior Vice President, Operations | Richard Haushalter

Vice President, Acute Care Services; Chief Nurse Executive | Donna Hahn

Vice President, Business Development, Sentara Blue Ridge Region | Ronald J. Cottrell

Vice President, Human Resources, Sentara Blue Ridge Region | Mark Zimmerman

Vice President, Information Services | Michael J. Rozmus

B O A R D O F D I R E C T O R S

Ann E. C. Homan, Chair | Howard P. Kern, President and COO, Sentara, Vice Chair | Alden L. Hostetter, MD, Secretary |

Devon C. Anders | A. Jerry Benson, PhD | David L. Bernd, CEO, Sentara | Joseph D. Funkhouser II |

Terry M. Gilliland, MD, Senior Vice President and CMO, Sentara | James E. Hartman

Executive Editor | Michael J. Cordell

Managing Editor | Neil Mowbray

Design and Production | Picante Creative

Photographers | Luca E. DiCecco, Allen Litten, Eric Taylor, Tommy Thompson

Contributing Designer | Marc Borzelleca

C O N T R I B U T I N G W R I T E R S

Luanne Austin | Jim Bishop | Karen Doss Bowman | Dale Carroll, MD | Jenn Downs | Christina Kunkle |

Neil Mowbray | Emily Shaber | Kelsey Wakeman

© Copyright 2015 by Sentara RMH Medical Center. No part of this publication may be reproduced or transmitted in any form or by any means without written

permission from Sentara RMH Medical Center. Articles in this publication are written by professional journalists 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 adviser. All editorial rights reserved. Opinions expressed herein are not necessarily those of Sentara RMH Medical Center.

Models are used for illustrative purposes only.

Please email comments or questions to [email protected] or call 540-564-7205.

healthQuestA health lifestyle publication by Sentara RMH Medical Center

30

Calendar of Events

Classes, Support Groups, “Mammo Van”

Schedule and More!

53 20

IFC President’s Letter

4 Physician’s PerspectiveWhere Did the Past 15 Years Go?

20 For Your HealthHave a Healthy Summer!

21 Sobre Su Salud¡Tenga un verano saludable!

30 NutritionMoving Away From Meat

38 Living with SynergyMake Playtime a Priority

44 Medical Staff UpdateWelcome, New Healthcare Professionals!Dr. Susan McDonald, New VP, Medical Affairs

45 RMH FoundationSentara RMH Employees Give Back

47 Friends of the RMH FoundationGifts Received Nov. 24, 2014–March 22, 2015

52 Jim BishopThe Wearing of the Grin

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Medical Mission to HaitiIn late February 2015, emergency physician Eric Kramer, MD, led a team of Sentara RMH Emergency Department (ED) caregiv-ers to Haiti to provide basic medical care at an orphanage in Pignon, a city about 80 miles north of Port-au-Prince, Haiti’s capital. Housed by a local pastor and his wife, who operate the orphanage, the team evaluated patients, provided vaccinations and antibiot-ics, and fitted some with eyeglasses.

“They were all pretty basic services that we tend to take for granted in the United States,” says Anna White, RN, one of the nurses on the medical team. “The trip was truly eye-opening. Patients would walk for miles to receive care and would line up out-side the door before the clinic opened each morning.”

This was the fifth year Dr. Kramer has traveled to Haiti to provide medical care. The annual trip is a concerted effort among ED staff; Sentara RMH Medical Center; and community physicians who donate supplies, medications and their time to the cause.

“It’s a pleasure and a blessing to provide care for these people,” says Dr. Kramer. “Our perennial support has allowed many of them to develop into healthy, mature young men and women who, in turn, are giving back to their communities. We have a few nursing students and a medical student who began life with very little. They can now pay it forward with hope for their community.”

(photo) Posing with some of the children at the orphanage in Pignon are Sentara RMH Emergency Department nurses, from left, Rhian Pulliam, Tiffany Smith, Anna White and Rebecca Foltz. They and Dr. John Lindbergh accompanied Dr. Eric Kramer on the trip. The hand-stitched map of Haiti was presented to them as a token of appreciation.

4 healthQuest | Summer 2015

physician’s perspective

While I was assigned to the Army surgeon gen-eral’s office in the D.C. area in the mid-’90s, I discovered “the Valley.” As I traveled the Shenandoah Valley exploring Civil War sites,

fishing, backpacking and canoeing, I would say, “Oh God, if there is ever a chance after I retire from the Army to get a ‘real job’ in the Valley, please let me know!”

Well, He did, and I did.My wife, Merrily, and I have never regretted choosing

Sentara RMH and Harrisonburg. Having lived all over the world, we now call this place our home. When old Army friends ask me why I like the Valley, I respond: “The people. It feels like we’re all family!” When they ask what I like best about Sentara RMH, I have the same answer: “The people. It feels like we’re all family.”

What will I miss most about Sentara RMH after I retire in June? Again, the people—specifically, my Sentara RMH family. It’s you, the people—the hospital staff, the medical staff and the volunteers who live our culture of safety and quality every day—and your passion for our patients that I will miss most.

The medical staff has always been committed to provid-ing high-quality care for our patients, but I have watched as they have also become passionate advocates for patient safety and for ensuring that patients have the best experi-ence possible.

I marvel at our nurses! A year or so after I arrived at Sentara RMH, Alice Stecker, then director of nursing, chal-lenged me to spend a couple of days shadowing nurses on the units. I was awestruck at how our nurses could juggle so many different responsibilities and yet ensure that their patients received the best of care.

Our nurses perform miracles every day, bringing care and compassion out of the whirlwind of their daily activi-ties. One significant testimony to the high level of patient care our nurses and other clinicians provide is the Magnet® recognition Sentara RMH received last December. Magnet designation is granted to only about 7 percent of hospitals nationwide, and receiving this recognition was the result of incredible teamwork and a sustained focus on providing

patient-centered care. Our Magnet status provides additional assurance to our patients that Sentara RMH nurses, physi-cians and other caregivers have their patients’ best interests and personal safety uppermost in their minds.

Our hospital staff members have many and varied job descriptions, but regardless of the department or service in which they may work, they have only one role: that of being patient advocates—advocates for quality and safety.

Some of my favorite stories are about staff members who have stepped outside of their job descriptions and into

Where Did the Past15 YEARS Go?

Until his retirement in June, Dr. Dale Carroll was senior vice president of clinical effectiveness and chief medical officer for Sentara RMH Medical Center.

By Dale Carroll, MD, MPH

Sentara.com 5

the role of patient advocate. I recall the housekeeper who noticed an elderly patient trying to climb out of bed; she helped the patient back to bed and informed the patient’s nurse. Or take the nutrition care aide who noted one day, while delivering patient meals, that a patient was not as talkative as usual; she took it upon herself to inform the nurse on duty. Or the staff member who proudly told me in the elevator one morning, pending a coming snowstorm, that he had brought his sleeping bag to work with him, so he could be sure he would be “present for duty” the following morning. Or the finance and accounting staff member who each month spends extra time running reports on our observation data because she believes we can improve our observation care.

Nor can I omit our volunteers! They are, in military terms, “force multipliers.” We could not provide the care we do if, for some reason, our volunteers were to disappear suddenly.

We’ve made significant changes since I joined Sentara RMH in July 2000. One major milestone was our move to the new hospital in June 2010. As we began planning for the new hospital, we made a commitment to the goal that no patient would be harmed as a result of the move to the new hospital, and I am pleased to say that we achieved that goal. The planning and move were challenging experi-ences, but the Sentara RMH family rose to the occasion!

Our affiliation with Sentara Healthcare in May 2011 was an-other major milestone. Sentara’s national reputation for quality and safety were major factors in my support of the merger. The depth and breadth of Sentara’s quality and safety team are truly remarkable, and the ability to benchmark against our sister hospitals and share best practices adds significant value to our affiliation.

Another factor that led us to affiliate with Sentara pertains to the changes we saw coming in the healthcare industry. We realized that in the new healthcare environment, the ability of an indepen-dent hospital to compete effectively—while continuing to improve safety and quality—would be difficult, if not impossible. Joining Sentara has enabled us not only to weather these changes, but to proactively prepare for and meet them.

Through all the changes—our move, our affiliation with Sentara and the ever-changing healthcare environment—the most critical factor of our success has been our Sentara RMH family.

The heart of a high-performing organization is its people. Al-though we have new buildings with new signage, we’re still the same Sentara RMH family that has cared for our community for more than 100 years. Our traditions continue—traditions of compassion, community focus, quality and safety, and always striving to exceed patient expectations.

You, the staff and physicians of Sentara RMH, are my heroes! Thank you, and I will miss each of you! n

Dale Carroll, MD, MPH, served in the U.S. Army in the areas of family medicine, preventive medicine and quality improvement.

Dr. Carroll: A Champion for Patient Safety

In 2008, Sentara RMH Senior Vice President of Clinical Effectiveness and Chief Medical Officer Dale Carroll, MD, had a vision to make Sentara RMH one of the safest hospitals in the country. Understanding what it would take to make this a highly reliable organization, Dr. Carroll in August 2008 arranged to have HPI, a leading company in helping organizations achieve high levels of safety, along with the Sentara safety directors, meet with the Sentara RMH board of directors.

“That meeting was the start of the hospital’s ‘safety journey,’” says Rebecca Jessie, director of the Sentara RMH Quality Improvement and Patient Safety Department. By spring 2009, Sentara RMH President Jim Krauss had given Dr. Carroll the directive to move forward by signing a contract with HPI.

“It was Dale’s vision, leadership and tenac-ity that began our journey to become a highly reliable organization,” Jessie continues. “It didn’t stop there, though, because he understood that this journey would be long and needed the sup-port of both our senior leadership and physi-cians. He worked tirelessly to ensure they were well informed, and that we had the support we needed to achieve one of the most important changes this organization could make.”

Rebecca Jessie presents Dr. Carroll with a special “safety champion award” in early March for his leadership in the Sentara RMH safety journey.

A retired construction worker for the state of West Virginia, Terry Sherman enjoys being outdoors, riding his tractor and working on his farm in Mathias, W.Va. For the past several years, however, arthritis and the effects of Lyme disease, contracted decades ago, had begun to cause Sherman significant pain and stiffness in his knees, making everyday activities difficult. Last fall, when he saw in his local newspaper an ad for a joint replacement seminar at Sentara RMH, Sherman decided to attend to gather more information. »

Sentara.com 7

BACK ON THE

TRACTORKnee Replacement Helps West Virginia Man

Get Back to an Active Life on the Farm

BY K A R E N D O S S B OW M A N


“When you can’t walk without expe-riencing pain, it’s obvious you’ve got to do something,” says Sherman, 68. “Sentara RMH is reasonably close to me, and the joint replacement program was explained very well during the seminar. That made me feel comfortable choosing Sentara RMH for my procedure.”

Sherman sought treatment from one of the physicians who had spoken at the semi-nar, orthopedic surgeon Frank Cucé, DO, of Sentara RMH Orthopedics and Sports Medicine.

Becoming a Joint Replacement PatientX-rays showed that a loss of cartilage in Sherman’s knees was resulting in painful bone-on-bone contact, and he also had bone spurs and a loss of normal alignment in the knees. The findings clearly revealed that Sherman was a good candidate for knee replacement, and the procedure on his left knee was scheduled for Tuesday, Jan. 27.

Knee replacement is a resurfacing tech-nique in which the surgeon cuts away all of the damaged bone tissue and covers the re-maining bone with metal, Dr. Cucé explains. A plastic insert is placed between the upper and lower leg bones and the undersurface of the kneecap to provide a cushion. An implant with a rotating platform optimizes the patient’s range of motion.

Sherman’s surgery went smoothly, and he went home just three days after his pro-cedure. About a week after surgery, he put aside his walker and began using a cane. He did his exercises faithfully and kept moving, taking care of himself as his wife, Janice, recovered in a rehabilitation facility follow-ing a hip replacement procedure. When he went for a follow-up visit with Dr. Cucé

When you can’t walk without experiencing pain, it’s obvious

you’ve got to do something.”

(continued on page 12)

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The Joint Replacement Program at Sentara RMH focuses on educating patients before surgery through evening seminars and, once patients are scheduled

for their procedure, a two-hour joint class that provides valuable information about what to expect before, during and after surgery. Patients also must undergo a presurgical medical clearance exam provided by the Sentara RMH Hos-pitalist Service. The presurgical exam helps doctors identify and treat any health conditions that could cause problems during surgery or the recovery period.

Located in a dedicated unit at the hospital, the Sen-tara RMH Joint Replacement Program offers a comfortable environment with spacious, private rooms. Patients are encouraged to wear their own clothes during their stay to help promote a sense of comfort and wellness. The program features physical therapy sessions twice a day in a group set-ting, and the same physical therapist is dedicated to the unit for the entire length of a patient’s stay to provide continuity of care, measuring each patient’s progress on an individual, day-by-day basis.

All joint replacement surgeries are performed on Mon-days, Tuesdays and Wednesdays, and patients are discharged two to three days after surgery. The unit offers a group lun-cheon once a week for patients during their inpatient stay, and patients are invited back for a reunion luncheon about six weeks following surgery.

A SPECIALIZED PROGRAM FOR JOINT REPLACEMENT

Since the launch of the Joint Replacement Program in December 2010, the number of patient complications and readmissions to the hospital has decreased, the average length of a patient’s stay has shortened, and patient rehabilitation results have improved significantly. These improvements are all due to the implementation of nationally recognized, evidence-based best practices for joint replacement surgery, according to Gina Lambert, joint and spine program coordinator for Sentara RMH Orthopedics and Sports Medicine.

“Last year, because of our dramatic improve-ments, our joint replacement team received the Sen-tara CEO Award,” says Lambert. “The award recognizes teams that have achieved dramatic improvements in quality of care, customer service and cost savings.”

Orthopedic surgeon Frank Cucé, DO, attributes much of the program’s success to the team approach he and his colleagues use.

“The team approach means patients are likely to experience fewer problems,” Dr. Cucé says. “Because we have a dedicated hospital unit for joint replace-ment patients, our nurses, physical therapists and other staff members are accustomed to taking care of joint replacement patients. We offer good continuity of care before, during and after surgery.”

Sherman with orthopedic surgeon

Dr. Frank Cucé


about 13 days after surgery, Sherman walked into the office without a walker or cane.

“I’m hardheaded and tenacious, and all kinds of things like that,” Sher-man says with a laugh. “Everything went well for me. I can’t say enough good things about Dr. Cucé, and the other doctors, nurses, therapists and staff were super good. Even the hospital food was excellent. Everything about my experience was great.”

Summing up his patient’s experi-ence, Dr. Cucé notes, “Mr. Sherman went from restricted range of motion and pain in his left knee to a full range of motion and no pain. His outcome has been very good thus far.”

Back for MoreIn fact, Sherman was so pleased with the result of his first knee replacement procedure that he returned to Sentara RMH on March 24 to have his right knee replaced. The second surgery went equally well. Ten days later he was repairing a bulldozer and feeding his cattle, and just 13 days after surgery he returned to Dr. Cucé’s office, again without a walker or cane.

“He’s been able to get back to his normal activities pretty quickly, and that will only enhance his quality of life,” observes Dr. Cucé.

“I’m really pleased with the results of both of my surgeries,” Sherman says. “I’m glad I chose Sentara RMH, and my progress has been excellent. Dr. Cucé did a great job—I had two surgeries eight weeks apart, and I’m up and going. Either he’s really good, or I’m really lucky. It’s hard to believe how great my results have been.” n

I can’t say enough good things about Dr. Cucé, and the other doctors, nurses, therapists and staff were super good.

Even the hospital food was excellent. Everything about my experience was great.”

Sentara.com 11

Joint replacement surgery is a common treat-ment for arthritis and injuries, with nearly one million procedures performed in the United States in 2011, according to the American Academy of Orthopaedic Surgeons. While the majority of these surgeries were hip and knee replacements, replacement procedures also may be performed on other joints, including ankles and shoulders.

If you’re experiencing chronic pain and limited mobility, it may be time to consider joint replacement surgery, according to orthopedic surgeon William Lennen, MD, of Sentara RMH Orthopedics and Sports Medicine. Here are some factors to consider:

• What are my symptoms? If you’re experiencing chronic pain, loss of motion and stiffness, an X-ray and physical examination will reveal whether those symptoms are coming from rheumatoid arthritis or osteoarthritis.

• Can nonsurgical therapies be effective? If your symptoms are severe, it’s likely that over-the-coun-ter pain relievers are no longer working for you. Your doctor may prescribe anti-inflammatory or non-nar-cotic pain medications. Other nonsurgical therapies include cortisone injections, the use of braces and physical therapy.

• Does my pain affect my quality of life? If you’re not able to do normal, everyday tasks, and you’re giving up activities you love to do, it may be time to talk to a surgeon about the risks and benefits of joint replacement surgery.

“Patients get to the point of wanting to consider surgery when all those conservative measures are not working and their quality of life is severely and adversely affected,” says Dr. Lennen. “I can tell patients if they’re a candidate for joint replacement, but they have to come to the psychological and emotional conclusion that they are ready to go through the process.”

• How long do the implants last? The implants sur-geons use today typically last 15-30 years, depend-

How do I Know if a Joint Replacement

is Right for Me?

ing on factors such as the patient’s activity level and weight. “I use the analogy of driving a car,” explains Dr. Lennen. “The harder you stop, start and rev the engine, the quicker it’s going to wear out. So if the patient is going to do a lot of high-impact activities, the implants will wear out a lot quicker than if they’re just walking around at a slower pace.”

• What are my responsibilities? Rehabilitation is a critical part of the recovery process, and at Sentara RMH, patients begin physical therapy the day of or the day following surgery. Pa-tients must be prepared for and willing to work hard in physical therapy to regain full range of motion and to enjoy the full benefit of a joint replacement. “A joint replacement gets rid of the arthritis,” Dr. Lennen says, “but in order to have a good, successful outcome, the patient has to be dedicated and prepared to do the physical therapy. That will help them get back their range of motion and strengthen the joint. If they don’t do that, they could end up with a knee that is stiff and doesn’t move well, and they’re probably not going to be happy with their results.”

To learn more about joint replacement surgery at Sentara RMH Orthopedics and Sports Medicine, visit Sentara.com or call 540-689-5763.


Sentara + RMH:BETTER TOGETHER

Sentara.com 13

In the summer of 2010, just weeks after RMH moved to its new location, the RMH Board of Directors announced its intention to have RMH merge with Sentara Healthcare, an innovative, not-for-profit healthcare system based in Norfolk, Va.

Hospital staff and community members alike questioned, privately and in conversations with one another, what the proposed merger would mean. In the months following the announcement, the words “We’re better together” were sometimes heard as RMH leaders explained why the board was moving in this direction.

The two organizations merged in May 2011. Four years later, are the board’s objectives being met? What are the benefits of joining a large, integrated health system like Sentara? Is the Sentara RMH of today the same community hospital that RMH always prided itself on being? And, perhaps most important, are we, in fact, better together?

Original Intent“When I joined the board, there were many conversations about hospitals merging nationwide,” recalls Ann Homan, board chair, who joined in 2002. “As we went through our strategic planning over the next few years, we saw that these mergers were becoming a trend, but it was a trend of necessity. The financial impact of healthcare reform alone was going to be monumental. The board determined that it might be better if we picked

On May 26, 2011, Sentara and RMH leaders—from left, Marc Sharp, chair, Sentara Board of Directors; David Bernd, CEO, Sentara; Jim Krauss, president, RMH Healthcare; and Barbara Stoltzfus, immediate past chair, RMH Board of Directors—signed the documents that officially established the partner-ship and merger of the two healthcare organizations.

By Neil Mowbray


our partner instead of being in a position where we had to go to the dance with whomever was left over.”

The board began looking throughout Virginia, and even outside the commonwealth, for partners whose cor-porate culture and dedication to providing quality health care matched those of RMH. All the board members agreed that any decision to join had to be unanimous.

“The understanding when we started looking was that if we didn’t find that match, then we didn’t have to go forward,” Homan says.

Homan notes that Sentara’s proven track record of providing safe, quality health care, and its astute financial management, set the system apart from all others.

“Once we sent some of our doctors to talk with their doctors, before any decisions were actually made, we saw that Sentara had the same culture and philosophy as ours,” she says. “It was a great match.”

Better ClinicallyOne of the most important ways in which RMH and Sentara are better together is the impact the partnership has on the clinical quality of the health care provided. Be-ing a part of Sentara means that RMH has a much larger network in which to explore what works clinically, and what doesn’t work, Homan points out.

“With things constantly changing in the healthcare industry, it helps to have different viewpoints and differ-ent attitudes,” she says.

The 12 hospitals currently within the Sentara system continually share best practices for improved clinical out-comes, notes Sentara RMH President Jim Krauss.

“We can convene a team on a certain issue and study the outcomes achieved by each of the 12 hospitals, to identify which one is getting the best results,” he says. “From that, we can analyze why that one hospital is get-ting the best results, blueprint what that hospital is doing and spread those practices to the rest of the system.”

Partnership benefits don’t flow exclusively from Sen-tara to RMH; there is mutual sharing and learning. One of the best clinical practices in the system, Krauss points out, is the way RMH manages central lines for access to the venous system. A central line is a catheter, or tube, inserted into the vena cava, the largest vein in the body that returns blood to the heart, or into the right atrium (upper cham-ber) of the heart. The insertion of a central line can serve many purposes, from introducing medications directly into the venous system to monitoring blood pressures and the heart’s output.

The problem with inserting any catheter into the body, however, is the risk of infection, according to the

Centers for Disease Control and Prevention. And central line-associated bloodstream infection, or CLABSI, is a serious complication that can prolong a patient’s hospital stay and significantly increase that patient’s risk of dying. But Sentara RMH has one of the lowest CLABSI rates in the entire Sentara system.

“Sentara has therefore blueprinted the RMH process for maintaining central lines and is using that process throughout all 12 of their hospitals,” Krauss says.

Better Management EffectivenessThe partnership between the 12 Sentara hospitals also means that the effectiveness of management has improved, Krauss says, largely due to the wide variety of backgrounds the various hospital presidents bring to the table.

“The presidents of some Sentara hospitals are physi-cians,” Krauss says. “We have a president who is a physical therapist by training, and another who is a pharmacist. So if I, as president of Sentara RMH, have a question about how a physician might perceive something, I can turn to my physician-executive colleagues for input. There are various types of expertise in the management team that I, and the other presidents, can tap into.”

Objectives can also be accomplished more quickly within a system, he adds, because the system’s manage-ment team can work together to set priorities and define organizational goals.

“We’re all on the same management team, so we can jump on something and make significant improvements quickly,” Krauss says. “We’re learning from each other how to become better.”

Homan notes that independent hospitals typically have to work very hard to “recreate the wheel” every time there’s a change in the industry.

“You have to adapt to that change, you have to fine-tune your adaptation,” she says. “With a system, you have a lot more people fixing that wheel, and that’s a tremen-dous asset.”

Better FinanciallySentara RMH is better off financially than it would be as a standalone hospital, says Krauss, in large part due to the reduced costs made possible through economies of scale. Sentara RMH can purchase supplies and equipment at lower cost because, through Sentara, the hospital is buying in larger volumes. And that helps Sentara RMH manage its financial situation better, particularly in light of reduced payments in recent years from Medicare and Medicaid.

“We’re able to lower our costs so we can still keep a margin to reinvest in new services,” he adds.

Once we sent some of our doctors to talk with their doctors, before any decisions were actually made, we saw that Sentara had the same culture and philosophy as ours.” —Ann Homan

Sentara.com 15

Sentara also has a better credit rating than does RMH alone, which allows RMH to get better rates on bonds when the hospital wants to borrow money for major projects. That access to low-cost capital has enabled Sentara RMH to construct the Funkhouser Women’s Center on the main cam-pus—as well as the new orthopedics and imaging center currently under construction—much more quickly than would have been possible had RMH remained independent.

“We put a lot of our financial resources into our new hospital,” Krauss says, “so we didn’t have much borrowing capacity beyond that. But with Sentara we do, and as a result we could do these other building projects that are strategically impor-tant to us.”

Krauss notes also that the bonds taken out to pay for the new hospital have been refinanced at a much lower rate since RMH joined Sentara, result-ing in significant cost savings.

A Better Hospital Today Than We Would Be AloneThe partnership with Sentara has enabled RMH to bring services to the Shenandoah Valley that otherwise likely would not have existed, or would have been a long time arriv-ing. One such example involves structural heart procedures, a new level of heart care that can correct structural and anatomical defects in the heart’s valves and chambers. Sentara RMH interventional cardiologist Nadim Geloo, MD, completed a structural heart fellowship recently at Sentara Heart Hospital in Norfolk, and the program is poised to launch at Sentara RMH in the near future.

“It would have been much more difficult for us to enter into this new realm of cardiac care if we weren’t a part of Sentara,” Krauss says.

Also because of the partnership, Sentara RMH is able to afford to purchase and imple-

We are now a part of a superb healthcare system, but our services are still for this community.” —Jim Krauss

Money Raised Here … Stays HereSince its beginnings in 1975, the RMH Foundation has existed solely to help fund equip-ment, program and educational needs at the local hospital, and that remains true today. Even though RMH and Sentara have merged, the foun-dation’s role has not changed. “All gifts given in our community stay in our community,” says Cory Davies, the foundation’s executive direc-tor. “Those who give to the RMH Foundation can rest assured that their donations go solely to enhance local healthcare needs.”


ment Epic, widely regarded as one of the best information systems in health care. Epic is used for tracking all patient information both within the hospital and in outpatient settings.

“We wouldn’t be able to do that on our own,” Krauss says. “Epic doesn’t go to small, independent hospitals—that’s not their business plan. They work solely with large, integrated healthcare systems.”

Epic is currently in place in eight Sentara hospitals, and its rollout at Sentara RMH is scheduled for April 2016.

Still a Community Hospital?To those who ask if Sentara RMH is still this local community’s hospi-tal, both Krauss and Homan emphatically answer, “Yes!”

Krauss points out that Sentara Healthcare is actually a system of community hospitals that have joined together for mutual benefit. The culture of each hospital is very similar to that of RMH—they’re all not-for-profit institutions, firmly rooted in their respective communi-ties and firmly committed to providing quality health care to the people they serve.

“We are now a part of a superb healthcare system,” he says, “but our services are still for this community.”

Homan adds that she sometimes hears people in the community say, “It’s not RMH anymore. Just look at the signs; they say ‘Sentara.’”

Her answer to them, she says, is, “Just walk through the doors. We’ve got the same people delivering the same services. We’ve got the same physicians, the same clinical commitment, and the same dedication to providing safe, high-quality care.”

On May 26, 2011, Sentara CEO David L. Bernd was at RMH along with other Sentara leaders for the ceremonial signing to finalize the merger of the two healthcare organizations. Bernd addressed the assembled RMH employees and guests as follows: “Our partnership with RMH will help to enable you to do what you do best: care for your friends and neighbors in this community. From bringing new babies into the world in a nurturing environment, to providing compassionate care for hospice patients at the end of life, and everything in between, we stand committed to serve everyone in this community with exceptional health care.”

It’s in the daily pursuit of that commitment, based on their shared vision of what constitutes safe, quality health care, that Sentara and RMH can truthfully claim, “We’re better together.” n

Who is Sentara?Founded in 1888 as the 25-bed Retreat for the Sick in Norfolk, Va., Sentara has grown into an integrated, not-for-profit network of 12 acute care hospitals and more than 100 sites of care throughout Virginia and northeastern North Carolina.

Over the decades, Sentara has been a leader in healthcare innovation. In 1967, Sentara Norfolk General Hospital per-formed the region’s first open-heart sur-gery, and in 1976 the hospital launched Virginia’s first cardiac rehabilitation pro-gram. In 1989, Norfolk General performed one of the nation’s first heart transplants.

During the 1970s, Sentara Health-care was at the forefront of leading-edge surgical technologies and techniques, performing innovative procedures such as Norfolk’s first gender reassign-ment surgery, reconstructive surgery to repair birth defects and reconstruction for breast cancer patients undergoing mastectomies.

In February 1976, Norfolk General opened the Tidewater region’s first radia-tion oncology center, and in the 1990s established the area’s only autologous bone marrow transplant program. Sen-tara was first in the nation to pioneer and develop the eICU®, a remote monitor-ing system that enables intensive care specialists to monitor and treat patients without actually being in the hospital. The eICU system proved its effectiveness by enhancing clinical quality and dra-matically lowering mortality rates.

In 2004, Sentara was recognized nationally for its patient safety efforts by the American Hospital Association and also was honored with the Quest for Qual-ity Award. And in 2014, U.S. News & World Report ranked Sentara Norfolk General the No. 1 hospital in the Commonwealth of Virginia.

Sentara.com 17

his June marks five years since Sentara RMH moved to its current location. What visitors see today— a modern, well-designed building sitting in the middle

of a 254-acre campus—is vastly different from the land-locked hospital of six years ago.

Sentara RMH: Building a Culture of Patient Safety

“We commit to ALWAYS keep you safe.”

By Neil Mowbray

Nurses Kelli Zahn, left, and Katherine Knicely use MobiLab® technology to ensure that a patient’s blood sample is correctly labeled.


Not as evident, however, are the important cultural changes that have taken place at Sentara RMH over roughly the same time—changes that have profoundly affected how health care is delivered in the hospital. In early 2009, the year before the hospital’s move, Sentara RMH began a “safety journey” to create a “culture of safety” to benefit patients and staff alike. The results have been outstanding.

“Since 2009, we’ve been able to reduce our serious safety events by 83 percent,” says Rebecca Jessie, director of the hos-pital’s Patient Safety and Quality Improvement Department. “I want our community to understand that Sentara RMH is one of the safest hospitals in the nation.”

Jessie explains that a serious safety event refers to any incident in which a patient is harmed or dies because of an accident or mistake that occurs in the hospital. Examples of serious safety events include patient falls; adminis-tering the wrong type of blood or the wrong medication; performing surgery on the wrong patient, or on the wrong body part of the right patient; pressure ulcers; and hospital-acquired infections.

Jessie attributes the 83 percent reduction in serious safety events to the vision of Sentara RMH leaders who initially set a goal of creating a safety culture and who allocated the resources to make it happen, and to the hospital staff who have enthusiastically embraced that vision and made it a reality.

“A culture of safety means that everyone in the organiza-tion sees the importance of safety, that they’re actively engaged in improving safety in any way possible—by using the various safety tools we have in place, by learning and applying new safety techniques and practices, and by holding themselves and their co-workers accountable for safety,” says Sentara RMH President Jim Krauss, who decided in late 2008 that the hospital should embark on its safety journey (see sidebar).

Safety Tools, Technologies and BehaviorsCreating a safety culture takes a sustained, organization-wide effort, says Jessie—one in which the leadership must set clear expectations, provide tools to improve safety, and expect cer-tain behaviors of staff.

The new safety journey began with the rollout of two safety tools several months before the hospital relocated. The first, Validate and Verify, encourages staff to take time to double-check and confirm information or orders before proceeding with a task or procedure. The second, Speak Up for Safety, empowers any staff member to voice a safety concern, regardless of his or her place in the “hierarchy” of hospital personnel. All employees were trained in the importance and use of these tools.

To help reinforce this training, the hospital also launched its safety coach program. Safety coaches are staff members who receive ongoing safety training and then help to train other employees, explains Erik Shifflett, Sentara RMH patient safety coordinator. The safety coaches serve as role models and resources for safety.

“We average from 100 to 110 safety coaches throughout the hospital at any one time, and we encourage every department to have at least one safety coach,” Shifflett says.

The Sentara RMH safety coach program has been so successful, he adds, that it has been recognized as a best practice by the Virginia Hospital & Healthcare Association.

In the past five years, additional safety tools, technologies and behaviors have been implemented to move Sentara RMH farther down the path of its safety journey. Patients are now routinely asked multiple times to state their name and birth-date, and patient identification wristbands are checked mul-tiple times before any procedure is begun or any medication is given. To help prevent medication errors, patients’ “meds” are now scanned at the bedside using barcode technology, and the

Scanning a patient’s identification badge … … and the patient’s medication to ensure safe, accurate administration.

MobiLab®

Sentara.com 19

scan is verified against the patient’s electronic medical record on a bedside computer.

MobiLab®, a new wireless technology consisting of a portable, hand-held scanner and printer, allows for positive pa-tient identification, positive specimen identification and label printing right at the patient’s bedside. The implementation of MobiLab at Sentara RMH in 2014 has drastically diminished the chance that one patient’s blood or lab specimen will be confused with that of another patient. Sentara RMH is cur-rently the only hospital in the Sentara system using MobiLab, Jessie says, but other Sentara hospitals are working to imple-ment the technology.

“Timeouts”—referring to the practice of taking the time to double-check that staff have the right patient for the right procedure—are now a routine practice before surgeries and other medical procedures.

Additional safety tools include ARCC (Ask a Question, Make a Request, Express Concern, Use Chain of Command) and STAR (Stop, Think, Act, Review).

“If there’s one thing I encourage our staff to do,” says Jessie, “it’s to slow down, stop and think before they act. Bad things can happen when people are in a hurry.”

These tools, technologies and behaviors are just a few examples of the many ways in which Sentara RMH is improving patient safety by working diligently to drive down the number of serious safety events.

Patient Safety FirstSafety awareness infuses nearly every aspect of the daily work at Sentara RMH. All hospital meetings begin with a “safety moment,” a brief time to focus on a safety success story or review a safety practice or tool. Every weekday morning, department directors and managers meet with senior leaders for a 15-minute “safety huddle,” which provides a daily snap-shot of the hospital and its operations.

“The huddles increase situational awareness,” Jessie says. “We cover what happened in the last 24 hours, what we anticipate in the next 24 hours, and what’s going on right now. It’s focused and concise, and one of the most important safety practices we’ve implemented.”

The hospital’s full integration with Sentara Healthcare also impacts the culture of safety at Sentara RMH. Whenever a safety event occurs at any one of the 11 Sentara hospitals, executive leaders in each hospital review the event at a monthly safety and performance improvement meeting.

“We call this agenda item ‘Lessons Learned,’” says Jessie. “We hear stories from all over the system, and we’re expected to look at that information and determine if the same thing could happen at Sentara RMH, what we can do to keep it from happening, and what safety lessons we can learn from the incident.”

The recent designation of Sentara RMH Medical Center as a Magnet® facility by the American Nurses Credentialing Center, as well as the hospital’s certification by Det Norske

Veritas, are “testimonies to the high level of safe, quality care patients receive here,” Shifflett notes.

Everybody on BoardShifflett puts all new Sentara RMH employees through the same safety training the entire staff went through in early 2010, one goal of which is to have all staff looking out for op-portunities to improve safety.

“We want our community to know that 100 percent of our employees are trained to put patients and their safety first,” Jessie says. “We truly have a culture of safety. I want people to understand that the staff working here, managing their care, are all trained to think about safety; they all own it, and they will always speak up if they have a safety concern.” n

Starting the Safety Journey

When Jim Krauss became RMH CEO and president in 2008, one of his responsibilities included serving on the board of directors for the VHA Central Atlantic Division, part of a national network of not-for-profit healthcare organizations seeking to improve efficiency and performance. A primary topic of discussion among VHA board members was how to prevent harm to hospital patients.

“I learned a lot about the level of medical errors that occur in the healthcare industry nationwide,” Krauss says, “and I decided this was something I really needed to focus on.”

In late 2008 and early 2009, a team of RMH staff, led by Rebecca Jessie, director of patient safety and quality improve-ment, and Dale Carroll, MD, MPH, senior vice president for clinical effectiveness and chief medical officer, gathered safety data to examine the hospital’s safety record.

To assist in its efforts, the team engaged the expertise of Healthcare Performance Improvement (HPI), a company with roots in the nuclear power industry that helps other compa-nies become “high-reliability organizations.” HPI’s methods focus on eliminating human error and finding weaknesses and opportunities for failure in systems and processes. The HPI analysis of RMH safety data revealed there was ample opportunity for improvement.

HPI then helped RMH begin its safety journey. Hospital employees were trained in the use of two HPI “safety tools,” Validate and Verify and Speak Up for Safety, which were implemented several months before the hospital moved to its new location.

“We were determined that no patients would be harmed as a result of our move,” says Krauss. “Our staff rose to the challenge, and on June 22, 2010, we moved 95 patients without a single injury or problem. That success revealed to everyone that these safety tools and practices work. Since that day, we’ve continued to work on improving the safety of the health care we provide.”


*• Avoid burnout. Don’t let the longer days and shorter nights of summer deprive you of getting proper sleep and rest. Try to get up and retire at the same time each day, and allow yourself to get at least 7-8 hours of sleep each night.

• Eat fresh. Take advantage of fresh, locally grown fruits and vegetables to provide the essential nutrients your body needs. Try to eat at least a cup of fresh berries—blueberries, raspberries, strawberries and blackberries—daily to boost your immune system.

• Drink plenty of water. Stay hydrated, particularly when working or playing outdoors, or whenever the tem-perature soars above 90 degrees. Choose water instead of alcoholic beverages or sugary drinks that boost your calorie intake.

• Stay active, but avoid heat stroke. Dress in lightweight, light-colored fabrics that allow your skin to “breathe.” In severely hot weather, avoid working outdoors, and consider exercising at the gym.

Have a Healthy Summer!Summertime seems like it’s made for fun. The longer days and warm weather beckon

us outdoors to work and to play. Kids and their parents get a reprieve from the school

year, and many of us take off on vacation excursions, or just relax at home.

No matter what summer means to you, following these tips can help ensure that

your summer is as healthy as can be.

for your health

Additional Summer Safety Tips

* If you enjoy boating, make sure everyone in your boating party is wearing a life preserver.

* Leave the Fourth of July fireworks to the professionals.

* Learn how to swim, but never swim alone. And enroll your children in swim classes.

* Wear a safety helmet when motorcycling, biking, skating or engaging in contact sports.

* Don’t allow passengers on riding mowers or garden tractors

• Wear sunscreen with a sun protection factor (SPF) of at least 15. Sun protection is important year-round, but especially in the sum-mer, when most of us spend more time outdoors. Try to avoid being in direct sunlight for extended periods of time between 10 a.m. and 4 p.m., when the sun’s rays are most intense. When you are outdoors, wear protective cloth-ing and a wide-brimmed hat. Reapply sunscreen peri-odically according to the directions on the container.

• Protect your eyes. Wear sunglasses that block at least 99 percent of the ultraviolet A and B rays from the sun. Following this advice can help you avoid developing cataracts. When you’re mowing or doing other outdoor work, wear goggles or safety glasses to protect your eyes from flying debris.

• Avoid insect bites. If possible, stay away from areas where mosquitoes and ticks are prevalent, but if you have to go into those areas, wear long pants and long sleeves, and apply insect repellent liberally. When coming inside from bushy areas, check yourself for ticks. Check your pets, too!

• Allow yourself some downtime. You don’t always have to be on the go. Take time to travel, engage in a hobby or sport, or just relax around the house or in nature to refresh and reinvigorate your spirit.

Sentara.com 21

*Consejos de seguridad adicionales para el verano

* Si disfruta navegar, asegúrese de que todos los miembros usen un salvavidas.

* Deje los fuegos artificiales del Cuatro de Julio a los profesionales.

* Aprende a nadar, pero nunca nade solo. Inscriba a sus hijos en clases de natación.

* Use un casco de seguridad cuando maneje una motocicleta, una bicicleta, patine o participe en deportes de contacto.

* No permita pasajeros en podadoras o tractores de jardín.

sobre su salud

• Evite el agotamiento. No permita que los días más y más largos y las noches más cortas de verano le impidan de descansar y dormir adecuada. Trate de levantarse y acostarse a la misma hora cada día y permitirse obtener por lo menos de 7 a 8 horas de sueño cada noche.

• Coma alimentos frescos. Aproveche las frutas y verduras frescas, cultivadas local-mente, para proporcionar los nutrientes esenciales que su cuerpo necesita. Trate de comer por lo menos una taza de frutos rojos frescos: arándanos, frambuesas, fresas y moras, diariamente, para estimular su sistema inmunitario.

• Beba mucha agua. Manténgase hidratado, especialmente cuando esté trabajando o jugando al aire libre, o cuando la temperatura se eleve por encima de 90 grados. Elija agua en lugar de bebidas alcohólicas o bebidas con azúcar que aumentan la ingesta de calorías.

• Manténgase activo, pero evite golpes de calor. Vista ropa de tela ligera y colores claros, que permiten que

¡Tenga un verano saludable!El verano parece estar hecho para la diversión. Los días más largos y el clima

cálido nos atraen al aire libre para trabajar y jugar. Los niños y sus padres obtienen

un respiro del año escolar, y muchos de nosotros hacemos excursiones de vacaciones,

o simplemente nos relajamos en el hogar.

Sin importar qué significa el verano para usted, seguir estos consejos puede ayu-

dar a asegurar que su verano sea lo más saludable posible.

su piel “respire”. En un clima muy caliente, evite trabajar al aire libre y considere hacer ejercicio en el gimnasio.

• Use filtro solar con un factor de protección solar (FPS) de por lo menos 15. La protección solar es importante durante todo el año, pero especialmente

en el verano, cuando la mayoría de nosotros pasa más tiempo al aire libre. Trate de evitar la exposición directa a la luz solar por largos períodos de tiempo, entre las 10:00 a.m. y las 4:00 p.m., cuando los rayos del sol son más intensos. Cuando se encuentre al aire libre, use ropa protectora y un sombrero de ala ancha. Vuelva a aplicarse filtro solar periódicamente según las instrucciones del envase.

•Proteja sus ojos. Use lentes de sol que bloqueen por lo menos 99% de los rayos de sol ultravio-letas A y B. Seguir esta recomendación puede ayudarle a evitar el desarrollo de cataratas. Cuando esté cortando el pasto o haciendo otro trabajo al aire libre, use gafas protectoras o anteojos de seguridad para proteger sus ojos de residuos en el aire.

• Evite las picaduras de insectos. Si es posible, manténgase alejado de las áreas donde los mosquitos y las garrapatas son frecuentes, pero si tiene que ir a esas áreas, use pantalones largos y camisas de manga larga, y aplique repelente de insectos de forma abundante. Cuando vuelva de áreas frondosas, revise que no tenga garrapatas. ¡Revise también a sus mascotas!

• Permítase un tiempo de inactividad. No siempre tiene por qué estar sobre la marcha. Tómese tiempo para viajar, realice un pasatiempo o un deporte, o simplemente relájese alrededor de la casa o en la naturaleza para refrescar y para renovar su espíritu.


3-D Technology Gives Doctorsa New View

B Y J E N N D O W N S

Sentara.com 23

espite the fact that yearly screening

mammograms are so essential in

helping physicians detect any early

breast health issues that may be

present, some women still approach

the exams with a certain amount

of trepidation.

Recent technological develop-

ments, however, should help alleviate some

of those worries and make mammograms a

smoother experience in general. A new 3-D

imaging process, known as tomosynthesis,

now enables doctors to examine breast

tissue in three dimensions, with greater

accuracy and in more detail than ever

before, providing impressive benefits

to patients.

A More Complete Picture

The process of acquiring breast images using tomo-synthesis isn’t much different from that of traditional mammography, except that an additional set of imag-es, using a lower dose of radiation, is taken with each view of the breast. According to Emily Ritchie, MD, a Sentara RMH radiologist who is fellowship-trained in women’s imaging, most women will not notice any significant changes between 3-D imaging and what they are accustomed to as part of their regular screen-ing mammograms.

“The breast will be compressed in the same way and for the same duration as with a traditional screening mammogram; however, additional images are quickly ob-tained in an arc around the patient,” says Dr. Ritchie. “The images are then reconstructed by a computer, enabling the physician to better evaluate tissue that normally overlaps.”

The new technology is particularly beneficial to certain groups of women, including those with dense breast tissue, which

Tomosynthesis Provides Additional Option for Annual Mammograms

Sentara.com 23


typically has been more challenging for radiologists to read. The additional images captured in tomosynthesis, however, provide physicians with a more complete and accurate picture, Dr. Ritchie notes. And since dense breast

tissue tends to be more prevalent in younger women, who more frequently receive baseline mammograms, tomosynthesis is well suited for those baseline exams. Women at high risk for breast cancer should also consider 3-D mammography for their annual mammograms.

Fewer Callbacks, Less Anxiety

Apart from the enhanced capabilities of 3-D mammography to detect breast cancer, radiologists believe one of the technology’s greatest benefits is in help-ing to reduce the number of patients who need to come back in for follow-up diagnostic testing.

“One of the largest benefits of breast tomosynthesis is the decreased chance that a patient will be called back in for a finding on her screening mammogram that ultimately turns out to be normal,” says Dr. Ritchie. “While that may not seem significant, the uncertainty of hav-ing an abnormal screening mammogram is extremely stressful for patients and their families—even if the result turns out to be normal.”

Emily Ritchie, MD

Sentara.com 25

Is 3-D Mammography for You?If you are interested in 3-D mammography, talk with your physician about whether the technology is right for you. Your doctor can help you decide the best course of action to take.

If you need a physician, our physician referral service can help. Call 1-800-SENTARA (800-736-8272).

The time and expense associated with follow-up testing also are important benefits to consider with 3-D mammography. “Tomosynthesis can help decrease the impact of an abnormal screening study on the patient’s life, while improving the sensitivity of the exam,” adds Dr. Ritchie.

The Next Chapter in Mammography

Tomosynthesis is becoming a widely accepted—and even expected—technology in mammography de-partments, according to Dr. Ritchie.

“Research has shown over and over again that to-mosynthesis significantly improves our ability to detect early breast cancer, which is my main goal as a radiolo-gist who specializes in women’s imaging,” she says.

Although 3-D mammography may not provide added benefit for some women, Dr. Ritchie notes that there really is no downside to the test. The radiation to the breast during a tomosynthesis exam is very low, and so far studies have found no risk from such a small dose. Even when considering the potential for any such risks, Dr. Ritchie believes the benefits far outweigh any drawbacks.

“Mammography technology is constantly advanc-ing as we strive to improve our ability to detect breast abnormalities at an early and treatable stage,” she says. “One day tomosynthesis may be the accepted standard for screening mammography.” n

PERSISTENCE Pays Off


It was all about what I needed

to do going forward.

I learned that exercise is medicine.

“

“

Jim and Katie McConnel

Sentara.com 27

PERSISTENCEWhile on vacation in Jackson Hole, Wyo., during the summer of 2012, Jim McConnel went on a long bicycle ride. Overcome with exhaustion during an uphill climb, however, he had to dis-mount from the bike to catch his breath.

Pays OffOne Man’s Journey

to Life-Saving Heart Surgery

B Y L U A N N E A U S T I N |

“At the time, I had no other health con-ditions and wasn’t taking any medications,” says McConnel, 60, dean of students and an associate vice president of student affairs at James Madison University. “I had pretty regular checkups and felt fine.”

McConnel’s brother-in-law, Dyer Rodes, an anesthesiologist, was concerned. Rodes, who happened to be on vacation with Mc-Connel, thought the time difference and elevation change could have been factors con-tributing to McConnel’s exhaustion. He also thought, however, McConnel possibly could be dealing with a dangerous condition known as “the widow maker,” caused by blockage in the left anterior descending artery (LAD), which supplies large amounts of blood to the heart. Blockage in the LAD can lead to a massive heart attack.

Ultimately, two years would pass before McConnel learned that Rodes’ frightening suspicion was correct—a long journey that would eventually lead him to Sentara RMH’s Heart Check program and to life-saving heart surgery.

Meeting with Sentara RMH Heart Health

Navigator Maria Hostetter, RN

DIAGNOSIS: UNCERTAINBack home in Mount Crawford, Va., Mc-Connel scheduled an appointment with his primary care physician. An electrocardiogram (ECG) showed an abnormal reading, so the physician recommended an exercise ECG, also called a stress test, which checks for heart abnormalities during exercise.

When McConnel completed the stress test, he then underwent an echocardiogram, an ultrasound test of the heart in which high-energy sound waves are sent through a device that picks up echoes of the sound waves as they bounce off the different parts of the heart.

The results of the three diagnostic tests were somewhat conflicting. The stress test showed the same abnormal reading as the rest-ing ECG, but this result was deemed a “false positive” since the echocardiogram showed no problems. McConnel’s cholesterol and blood pressure were slightly elevated, so his physician prescribed him medications for those conditions.

“Meanwhile, I wasn’t having any light-headedness, unusual fatigue or chest tight-ness—none of the classic signs associated with heart problems,” recalls McConnel. “But I thought, ‘I’ve had two corroborating ECGs,’ so I was uneasy.”

With his blood pressure and cholesterol under control, and no chest tightness, McCon-nel was not considered a candidate for cardiac catheterization, a more involved procedure to check the heart. He continued to feel fine, despite the uncertainty resulting from the initial tests.

“I noticed, though, that after the experi-ence in Wyoming, Jim tended to cut back on strenuous activity and wouldn’t push himself as hard,” says Jim’s wife, Katie.

RUDE AWAKENINGThen, more than a year later in December 2013, McConnel’s younger brother had a seri-ous heart attack. At the time, McConnel was attending a conference in Orlando, Fla., and had planned to visit his brother in Bradenton, about two hours away. To his surprise, his brother called him and said, “Come visit me in the hospital.”

At the hospital, McConnel’s father told the brothers about their maternal grandfa-ther, who had died of a massive heart attack at age 48.

“So now I’m thinking about my abnor-mal ECGs, my brother’s heart attack and my

grandfather’s early death,” McConnel says. “I decided to try another test.”

Katie, who was familiar with the Sentara RMH Heart Check program, suggested that Jim schedule a visit for a coronary calcium scan. McConnel quickly agreed.

“I didn’t want to have heart disease, but I did want to be sure,” says McConnel.

What McConnel didn’t know was that his condition was progressing slowly toward a heart attack.

HEART CHECK“It was very astute of Jim and Katie to in-vestigate further,” says Maria Hostetter, RN, BSN, heart health navigator for the Heart Check program.

Hostetter explains that a coronary calcium scan is a computed tomography (CT) scan that checks for the buildup of calcium, a component of plaque, the sticky substance that adheres to the inner walls of arteries, including the coronary arteries that supply blood to the heart. Normally the coronary arteries don’t contain calcium, and the presence of calcium is a sign of coronary artery disease, a risk factor for heart attack. The calcium scoring scan is a method for screening patients with intermediate risk who show no symptoms, in order for physicians to decide how aggressive they should be with a patient’s preventive medical therapy.

“The test is sometimes used as a tie-break-er,” Hostetter says.

McConnel’s scan, in February 2014, re-vealed a moderate buildup of calcium, prompt-ing him to consult with cardiologist Stewart Pollock, MD.

When Dr. Pollock saw McConnel’s history—a stress test with a false positive, a moderate calcium scan result and two fam-ily members who had suffered massive heart attacks—he scheduled McConnel for a cardiac catheterization on June 19, 2014, at the Sen-tara RMH Heart and Vascular Center.

A cardiac catheterization is an invasive imaging procedure that tests for heart disease by allowing doctors to see how well the heart is functioning. During the test, a long, narrow tube called a catheter is inserted into a blood vessel in the arm or leg and guided to the heart. Contrast dye is injected through the catheter so that X-ray images can be created of the heart’s valves, arteries and chambers. The patient is generally awake but under mild seda-tion throughout the procedure.

“

“

I didn’t want to have heart disease, but I did want to make sure.

Sentara.com 29

Often, if the diagnostic part of the “cath” shows sig-nificant blockage in an artery, the cardiologist can treat the blocked area by inserting a stent, a small, expandable tube that keeps the narrowed artery open.

“Dr. Pollock thought he would go in and, at the most, put in a stent or two, then be done with it,” says McConnel. “But when he and his team saw the X-ray images, the room got quiet.”

EXTENSIVE BLOCKAGEThe McConnels had planned a vacation hiking in the Rockies with their two grown children in July, just a few weeks after the catheterization. Instead, McConnel would be undergoing bypass surgery.

“You have multiple blockages that can best be treated with surgery,” Dr. Pollock told McConnel.

The catheterization revealed six blockages ranging from “minor” to “very blocked,” and the LAD was narrow and twisted. McConnel’s heart output was normal, indicating that no damage had yet occurred, but the heart itself wasn’t getting much oxygen. They had caught the disease just in time.

Dr. Pollock didn’t put in any stents. Instead, he recom-mended that McConnel immediately see Sentara RMH

cardiothoracic surgeon Jerome McDonald, MD, about having bypass surgery.

But Katie had concerns: Shouldn’t her husband get the surgery at a larger hospital? Then the couple spoke with Dr. McDonald.

“We were impressed with his experience,” remembers Katie. “He told us, ‘For you this surgery is a big deal, but for a surgeon this procedure is fairly routine.’ His confi-dence gave us confidence.”

Dr. McDonald notes that in McConnel’s case, he was facing very low risk: “I assured him that his surgery, a quadruple bypass, was straightforward.”

McConnel had the surgery on July 8 and went home just three days later.

DOING WELLMcConnel took six weeks off from work for his sur-gery and recovery. He then began six weeks of cardiac rehabilitation at the Heart and Vascular Center, which consisted of light workouts on a treadmill, bicycle and step machine. The therapists also talked to him about lifestyle improvements he could make in terms of diet, mental health, spirituality, work and handling stress.

“It was all about what I needed to do going forward,” McConnel says. “I learned that exercise is medicine.”

Once he started working out, McConnel quickly felt the results of the surgery—he had much more energy. When the rehab program ended, he joined the Sentara RMH Wellness Center, where he participated in Pro-Ex, a medically based progressive exercise program designed specifically to help people recovering from prolonged ill-ness or surgery.

“I had a red card, which showed I was a cardiac pa-tient,” McConnel says. “They took good care of me.”

Katie had been exercising at the Wellness Center for years, she says, but Jim was never interested in going. These days they go together, but the problem is that when she’s ready to leave, her husband is still exercising.

“Now,” she says, “I can’t get him off the treadmill.”Today, nearly a year after the surgery, Jim and Katie

say they’re thankful that at every stage of his heart care journey—from his initial Heart Check appointment, through diagnostic catheterization, to life-saving heart sur-gery and beyond—Jim was able to receive the high-quality, safe care he needed within several miles of their home.

“Having friends and neighbors involved in every-thing from critical care nursing to rehab to working out independently at the Wellness Center made a huge differ-ence for my recovery,” says McConnel. “And I know now how important it is to listen to yourself when it comes to your own health and to work with the medical commu-nity to pursue answers. Now, the surgery has given me a new lease on life and a healthy heart, and I plan on doing everything I can to keep it that way.” n


nutrition

Moving Away From Meat

Easing Into a Vegetarian Diet Can Make for a Smoother Transition

BY EMILY SHABER, RD

Multiple studies show that a meatless diet can help reduce the risk of cardiovascular disease, lower blood pressure and cholesterol levels, and support weight-loss efforts. A vegetarian diet may even help keep cancer cell production at bay.

Getting your family to go completely vegetarian may be a hard sell, at least at first, but start slowly. Inching in that direction at a leisurely pace could be an excellent game plan for achieving better health for you and your family.

Vegan or Vegetarian? The Importance of Protein“Going vegetarian” can refer to a shift toward different types of diet plans. One type, the vegan diet, involves eating no animal products at all—no eggs, cheese, honey, meat, seafood or dairy products. Other types of vegetarian diets might include dairy products and eggs, but no fish, poultry, beef, pork, lamb, veal or game.

If you do decide to forgo most or all animal protein by moving toward a vegetarian lifestyle, you still need to make sure each meal provides a balance of protein, starch, and vegetables or fruit.

Sentara.com 31

Getting StartedHere are a few tips that can help you alter your diet. It all starts by simply eating fewer animal proteins than is typical for your diet.

BREAKFAST

Tip: Have eggs and breakfast meats such as bacon and sausage less frequently.Step 1: Have them just on the weekends. Step 2: Replace with soy bacon or sausage.Menu Ideas:

Whole-grain cereal with soy milk or almond milk and seasonal fruitPeanut butter and banana slices on whole-grain toastVeggie sausage patty on a toasted English muffin and half a grapefruit

LUNCH

Tip: Begin to alternate meat-filled sandwiches with vegetarian fillings such as nut butters, hummus or veggie burgers. Add layers of raw vegetables such as spinach or lettuce leaves, tomato slices, mushrooms, and roasted bell pepper strips.

Tip: Replace meat in hearty soups, stews and salads with kidney and white beans, chick peas, nuts, and low-fat or soy-milk cheeses.Menu Ideas:

Hummus and chopped raw veggies in a tortilla wrapNavy bean soup and a side saladLarge veggie salad with pecans, chick peas and dressingGrilled cheese sandwich on whole-grain bread and a cup of vegetable soup (try soy cheese, if you’re following a vegan diet)

DINNER Tip: Begin by having one vegetarian meal per week, then increase the frequency. Tip: Reduce the amount of animal protein in stews, chili, spaghetti sauce and stir-frys, but add more beans and vegetables.Menu Ideas:

Multigrain pasta with marinara sauce and soy veggie crumbles, and a side salad

Vegetarian Protein Shopping List Dried beans and peas: black, cannellini,

chick, Great Northern, kidney, lentil, navy, pinto and white beansDairy products (preferably low-fat): milk (1% or fat-free), cheese, regular or Greek yogurt, cottage cheese Soy products: cheeses, milk, yogurt, tempeh and tofu

Veggie or soy bacon, burgers, sausage and “ground beef” crumblesNuts and nut butters: almonds, cashews, peanuts, pecans, pistachios, soy, sunflower and walnutsGreen edamame soybeansQuinoaOlive oil


nutrition

3 tablespoons vegetable or olive oil

1 cup yellow onion, chopped

½ cup carrot, chopped

½ cup celery, chopped

½ teaspoon salt, divided (optional)

2 garlic cloves, minced

4 cups salt-free vegetable broth, divided

7 cups kale, stemmed and chopped (about 1 bunch)

2 (15-ounce) cans no-salt-added cannellini beans, rinsed, drained and divided

1 (15-ounce) can no-salt-added black beans, rinsed and drained

½ teaspoon freshly ground black pepper

1 tablespoon red wine vinegar

1 teaspoon fresh rosemary, chopped

Heat a large Dutch oven over medium-high heat. Add oil to pan; swirl to coat. Add onion, carrot and celery and sauté 6 minutes or until tender. Stir in ¼ teaspoon salt and garlic; cook 1 minute. Stir in 3 cups vegetable broth and kale. Bring to a boil; cover, reduce heat, and simmer 3 minutes or until kale is crisp-tender.

Place half of cannellini beans and remaining 1 cup vegetable broth in a blender or food proces-sor; process until smooth.

Add puréed bean mixture, remaining cannellini beans, black beans and pepper to soup. Bring to a boil; reduce heat and simmer 5 minutes. Stir in remaining ¼ tea-spoon salt, vinegar and rosemary.

Two-Bean Soup With Kale

If you do decide to forgo

most or all animal

protein by moving toward

a vegetarian lifestyle, you

still need to make sure each

meal provides a balance

of protein, starch, and

vegetables or fruit.

Marinated, stir-fried tofu cubes with assorted vegetables over wild riceStuffed baked potato with broccoli and grated low-fat cheese (or soy cheese)Vegetarian meatloaf made with cooked lentilsVeggie burger on a whole-grain bun with seasonal vegetablesBurritos filled with brown rice, black beans, corn, cheese (or soy cheese), and salsa

If you go vegetarian, remember to monitor the other types of foods you eat to make sure you’re getting a healthy balance of protein, fats and carbohydrates. And watch your calorie intake! Meat is a primary source of calories, but giving up meat, entirely or partially, should not become an excuse for eating a lot of sugar and other refined carbohydrates.

Sentara.com 33

Vegetarian Chili 2 (12-ounce) bags frozen tofu crumbles

2 medium onions, chopped

1 green pepper, chopped

3-4 garlic cloves, minced

3 (14.5-ounce) cans diced tomatoes

4 (8-ounce) cans tomato sauce

1 (6-ounce) can tomato paste

¼ cup chili powder

2 tablespoons cumin

1 tablespoon sugar

1 teaspoon salt

1 teaspoon pepper

1 can light kidney beans, drained and rinsed

1 can black beans, drained and rinsed

Cook ground vegetarian crumbles in batches in a large pot or skillet over medium heat until soft. You may add a little water to help speed cooking time and to prevent burning. Stir in onions and peppers, and add remaining ingredients. Cook, covered, for 2 hours. Recipe makes about 15-18 cups.

To reduce sodium, use half no-salt-added diced tomatoes and tomato sauce, and reduced-sodium beans. You may also omit the sugar and salt, if desired.

1 (15-ounce) can black beans, drained and rinsed

1 (15-ounce) can kidney beans, drained and rinsed

1 (15-ounce) can cannellini beans, drained and rinsed

1 green bell pepper, chopped fine

1 red bell pepper, chopped fine

1 (10-ounce) package frozen corn kernels, thawed

½ cup olive oil

½ cup red wine vinegar

1 tablespoon fresh lemon juice

2 tablespoons fresh lime juice

1 tablespoon salt

2 tablespoons sugar

1 clove garlic, minced

¼ cup fresh cilantro, chopped

½ tablespoon ground black pepper

½ tablespoon ground cumin

½ teaspoon chili powder

1 dash hot pepper sauce

In a large bowl, combine beans, bell peppers, corn and red onion.

In a small bowl, whisk together the olive oil, red wine vinegar, lime juice, lemon juice, sugar, salt, garlic, cilantro, cumin and black pepper. Add hot sauce and chili powder to taste.

Pour the olive oil dressing over the vegetables and mix well. Chill and serve cold.

Tex-Mex Bean Salad

Sentara.com 33

Fighting CANCER Treatment’s

EFFECTS ON THE BRAIN


When Krista Hogan, 59, was diagnosed with breast cancer in February 2013, it wasn’t the thought of unpleasant side effects—nausea, vomiting, hair loss—from chemotherapy treatments that worried her most. Hogan was concerned about the potentially debilitating toll that “chemo brain,” a common side effect of chemotherapy that causes forgetfulness and an inability to concentrate, would take on her professional life.

Neurofeedback involves attaching sen-sors to the patient’s scalp that read

brain activity. During each session, the patient watches a kaleidoscope of images on a computer screen. When the computer senses that the patient’s brain is drifting out of focus or working inefficiently, a crackling sound is emitted that snaps the brain back to attention.

Oncology counselor Elaine Dunaway compares the auditory component of neu-rofeedback to rumble strips on the shoulder of an interstate.

“If you get a little sleepy and veer too close to the edge of the road, you’ll hit the rumble strips,” she says, “The vibration and noise jerk you back to the present and get you back on track. In a similar way, neuro-feedback detects when the brain begins to lose focus—to drift out of concentration. When that happens, the computer sends a sound signal to the brain to bring it back to the present.”

This continual refocusing can help the brain reorganize or “reset” itself to have im-proved focus and concentration, Dunaway explains. Over time, the brain adjusts to the training and patients experience a shift in their ability to cope. Neurofeedback also helps repair the damage that can result from chemotherapy and improves the brain’s relaxation response.

“People report that they feel less stressed and anxious and have improved sleep and word recall,” says Dunaway. “It’s a cognitive-behavioral approach to life’s problems.”

B y K a r e n D o s s B o w m a n

Sentara.com 35

>> How Neurofeedback Works

Oncology Counsellor Elaine Dunaway

instructs patients in the use of

neurofeedback.


t the time, Hogan was a special education adminis-trator for Harrisonburg City Schools. Her colleagues depended on her to interpret state and federal regula-tions regarding special education to ensure the school system’s compliance. They looked to her to as a men-tor, problem-solver and decision-maker.

During months of chemotherapy, Hogan struggled at times to remember basic words during conversations. She had difficulty concen-trating and multitasking, and she became easily confused if too much information came at her at once. She was easily overwhelmed and fatigued.

“Losing my hair was no fun, but losing my mind was devastating,” says Hogan, who moved to Nashville last summer and holds

a similar position with a school system there. “The people who looked to me needed to feel confident the information they were getting from me was accurate. I thought this was a real threat to my professional life, and I was feeling helpless to address it.”

A Workout for the BrainIn her distress, Hogan reached out to Elaine Dunaway, MSW, LCSW, an oncology counselor at the Sentara RMH Hahn Cancer Center. Dunaway introduced Hogan to neurofeedback, a technique used to “retrain” the brain to focus and function more efficiently. Re-search conducted by the Cleveland Clinic has shown that neurofeedback can reduce, and possibly reverse, the effects of chemo brain.

“It’s like a gym workout for the brain,” Dunaway says. “The brain is very malleable, and neurofeedback can help a person’s brain rebound from the trauma and

>> Neurofeedback or Biofeedback?

Both neurofeedback and biofeedback measure physiological responses in the

body, and they’re two of the most utilized mind-body services at the Sentara RMH Hahn Cancer Center—but for different purposes, according to oncology counselor Elaine Dunaway.

“Neurofeedback is very helpful in dealing with chemo brain,” says Dunaway. “Biofeedback is help-ful with teaching about the breath and anxiety management, helping patients improve the qual-ity and quantity of their heart rate variability—the time that elapses between individual heartbeats. A good heart rate variability is an indicator of health, fitness and adaptability.”

Using computer software, patients employ biofeedback to deal with anxiety, depression and changes in their diagnosis status. The technique also helps patients prepare for cancer treatment.

stress of cancer treatment. It can help relieve anxiety, help people sleep better and improve memory.”

According to Hogan, the neurofeedback treat-ment she received was “like magic.”

“I was really ex-cited about my results,” says Hogan. “Before I did neurofeedback, my ability to function was at two on a scale of 10. I couldn’t handle a lot of new things, and I had to take breaks to get my thoughts together. But now my word-recall ability is 100 percent better. I was able to handle end-of-the-year meetings with families to develop educational plans for the next school year. No one seemed to detect that I had been through chemo.

“I also went through a high-stress job interview, where I was able to come up with examples of things I’d done professionally, speak without stumbling over words and remember the names of everyone sitting around the table,” she continues. “After finishing neurofeedback, I notice a difference in how my brain functions. The quality of my thinking is much sharper.”

Caring for the Whole PersonMany cancer patients and their families feel trauma-tized by a cancer diagnosis, Dunaway says. They may have a wide range of emotional and spiritual needs as they face not only the usual worry and depression the disease can cause, but also feelings of isolation,

Krista Hogan

Monitoring biofeedback

Sentara.com 37

financial worries and job-related concerns. Like Hogan, many patients who undergo chemotherapy experience the effects of chemo brain, and many cancer survivors struggle with fear that their cancer will return.

Although the physicians and nurses at the Hahn Cancer Center strive to address patient concerns with a great deal of compassion, managing the complexities of medical treatment often leaves these caregivers little time to dedicate to patients’ psychological concerns.

“Having a dedicated counselor on-site helps us treat the whole person,” says Janet Macarthur, direc-tor of oncology and palliative care services at Sentara RMH Medical Center. “Elaine offers an integrated ap-proach to treating both patients and their families. She plays a key role in the care we provide, and the Hahn Cancer Center is fortunate to have her.”

Dunaway can be brought into a patient’s journey at any stage. “I’m available for patients and their fami-lies throughout the duration of their cancer experi-ence,” she says.

Dunaway learns much from sharing her patients’ experiences.

“I’m amazed by the resiliency of the human spirit,” she says. “It’s very rewarding to help people rebound from this kind of trauma.”

Thanks to Dunaway’s help, Hogan has become an enthusiastic advocate of neurofeedback and readily recommends it to other chemotherapy patients.

“When you have cancer, you feel like you lose control of everything—you’re getting poked and prod-ded all the time,” Hogan says. “But neurofeedback is different. It’s very user friendly; you can even stay in your street clothes—no hospital gown! You don’t have to fear chemo brain. Neurofeedback really works.” n

>> Mind-Body Services for Cancer Patients and Families

Neurofeedback is one of a range of services that Elaine Dunaway, oncology counselor, offers to patients and

their family members and caregivers at the Sentara RMH Hahn Cancer Center. Other services include:

• Individual or family counseling for patients, family members or caregivers.

• Biofeedback/heart rate variability—to help patients recognize and control the effects of stress on their bodies.

• “Prepare for Treatment, Heal Faster”—a one-hour class to help patients prepare mentally for surgery, chemo-therapy or radiation, and to help them recover faster.

• “Facing Forward”—a class for cancer survivors who have completed treatments; covers fear of recurrence, anxiety, nutrition and future cancer surveillance.

• Integrative Health Coaching—uses evidence-based techniques to help participants make healthy lifestyle changes, improve relationships, learn mindfulness and combat depression.

• Yoga—free classes for cancer patients and caregivers at all fitness levels; open to men and women. Those undergoing treatment should get their doctor’s permis-sion to participate.

• Support Groups

For more information about these mind-body services, contact Elaine Dunaway at 540-689-7065 or [email protected].


living with synergy

7 Easy Ways to Make Playtime

a Priority

The speed of life is faster now than when we were kids, and for most purpose-driven professionals, the dog days of summer don’t automatically have precious downtime

built in anymore. In fact, many of us are busier than ever keeping the bases covered at work and at home, and active kids happily occupied.

How sad is it that the average preschooler laughs or smiles 400 times a day, but then the number drops to only 15 times a day by the time people reach age 35! Seems like once we’re grown-ups, with adult roles to play, tasks to juggle and hats to wear, we forget about making playtime a priority.

One thing we cannot create more of is time.Each of us gets only 525,600 minutes per year, and as new tragedies unfold daily, we’re not always guaranteed all of them. It’s been five years since my biggest defining moment, where a brush with death reminded me that life is short and meant to be played all out.

That’s why I’ve NEVER been more serious about having fun, or more passionate about helping others live a restorative lifestyle for balanced success—one that creates a clear mind, healthy body and loving spirit through small steps and daily deposits of intention, playfulness and rest.

While constant hard work and focus are great assets for high achievers, at times you must stop pushing and take a break to maintain a healthy, well-balanced you. Snippets of time for fun and games aren’t just a luxury; they’re one of the main ways we prevent burnout. The joy of let-ting your inner child lollygag should never be underestimated.

Right now, check your calendar. When is your next vacation? Are blocks of playtime

Remember how you felt as a kid on the last day of school—the excitement of being “out for the summer”? This meant no studying, fewer respon-sibilities, beach vacations and relaxed time to do a whole lot of nothing. By the time fall rolled around, we were rested and ready to begin a new school year.

Are You Serious Enough About Having Fun?

Sentara.com 39

n Christina Kunkle, RN, is a CTA-certified life and wellness coach. To learn more, visit her website at www.synergylifeandwellnesscoaching.com or call 540-746-5206.

scheduled into your calendar each week, like other im-portant appointments? You’d be surprised at the various answers I get when I ask my clients that question. Do any of these sound familiar to you?• “The price I have to pay for taking time off is just

not worth it. That’s why I haven’t had a vacation for the last three years.”

• “No one runs my business the way I do, and things only pile up or fall apart if I’m gone.”

• “When I take time off I feel guilty because every-one else’s needs aren’t met.”

• “Fun? Playtime? I’ve forgotten what that is!”• “I can’t afford it.” (How much would a nervous

breakdown cost you?) • “I can’t relax long enough to unwind.” • “I haven’t earned it yet. My to-do list is still

too long.” • “I’m a primary caregiver 24/7 and have no one to

cover for me.”• “I don’t have anyone to do things with.”

If you can relate to one or more of these state-ments, it could mean you’re letting worry, stress and the daily grind rob your life of pleasure. As entrepreneur Seth Godin recently blogged, “Instead of wondering when your next vacation is, maybe you should set up a life you don’t need to escape from.”

Ready to crank up the fun and replenish your reserves? Here are seven easy ways to make playtime a priority: 1 Goof off—it’s good medicine! Smiling and laugh-

ing boost the immune system and reduce levels of stress hormones like cortisol and adrenaline. In a recent study, American psychologists discovered that positive thinkers live 7.5 years longer than pessimists on average. As George Bernard Shaw wisely stated, “We don’t stop playing because we grow old; we grow old because we stop playing.”

2 Whistle while you work. Fun and work don’t have to be an “either/or” proposition. Studies show employees experience increased productivity, job satisfaction, innovation, creativity and morale when lighthearted collaboration and playfulness are present in the workplace. And when play is not valued, the result is increased absenteeism, turnover, stress and illness.

3 Reward productivity with pleasure. Provide yourself with a fun motivation for meeting dead-lines and accomplishing tasks. Since it’s not always possible to take weeks off at a time, treat yourself

regularly to a ”free day” to unplug from work, technology and responsibilities—to simply do what brings a smile to your face and joy to your heart. It could do wonders.

4 Reframe fun. Do you file exercise under the category of “work”? If so, I invite you to reconsider. Perhaps you haven’t found the right fit yet, so ex-periment until you find an activity you love. If you’re up for a challenge, make a list of 10 new things you’d like to do for fun, play or adventure. Remember: what you consider fun is as unique to you as your fingerprints.

5 Bring it on! Don’t wait for someone else to bring the fun; be a leader! Create a group of like-minded others who share your zest for life. There’s a ripple effect when someone has a playful presence—friends, family and co-workers are all impacted positively. Think of people you find uplifting and fun to be around. What’s the common denomina-tor? They know how to laugh and have fun.

6 Get sneaky. Everyone needs a little sunshine now and then, so anonymously make someone’s day with a random act of generosity: Leave an unexpectedly large tip for a tired waitress, hold the door open for the person behind you or give someone your undi-vided attention. Promoting a playful spirit will create an environment of having fun wherever you are.

7 Cultivate an attitude of gratitude. Make an effort to recognize even the smallest blessings, like the sunrise, a friend’s email, or the giggle of a child catching fireflies. It’s the little moments that create big, beautiful memories. When you give gratitude more space in your life, you’ll be delighted at how it spills over into your working life, parenting, decision-making and more.

Whether you’re a parent, manager, business owner or teacher, remember that play brings out the best in all of us. Some say if you’re not having fun, you must not be working hard enough.

So what do you say we get serious about stay-ing amused? n

Celebration StartersHost a game night.Be a barrel of laughs.Engage in a great book.Go fly-fishing.Spoil someone silly.Get a massage.Go wine tasting at local vineyards.Watch a funny movie.Play a harmless prank.Plan an office party.Picnic with friends.Catch an outdoor concert.Try zip lining.Hike in nature.Have a happy-hour pool party.


“All the normal symptoms of stroke that you hear about on TV ads—I had none of them,” says Kane, 48, of Mount Crawford.

He underwent several tests at a medical facility near his workplace, including a computed tomography (CT) scan, a special imaging process that renders cross-sectional images of the body. The CT revealed no abnormalities in his brain and no sign of a bleeding stroke, but Kane’s blood pressure was very high, so doctors treated that problem and sent him home within a few hours.

Getting the DiagnosisThe next day, Kane still didn’t feel well, so he went to the Sentara RMH Emergency Department. He was quickly admitted to the intensive care unit for dangerously elevated blood pressure.

“An extremely high blood pressure puts excessive strain on the heart and other organs,” says neu-rologist Daniel Chehebar, DO, of the Sentara RMH Medical Group. As the first neurohospitalist at Sentara RMH, Dr. Chehebar provides care for hospitalized patients who have suffered stroke.

Dr. Chehebar gave Kane a thorough physical examination and ordered a magnetic resonance imaging (MRI) test. The MRI showed that Kane had, in fact, experienced a stroke.

“Mr. Kane went to the first medical facility with a ‘weird feeling’ and sensory problems—not typi-cal stroke symptoms—and that made it harder for doctors to recognize what was going on, especially in light of his relatively young age,” says Dr. Chehebar. “But an acute stroke can’t be diagnosed with a CT scan alone; most strokes don’t show up on CT for 24-72 hours. An MRI, however, will show an acute stroke, so even if a patient has a normal CT scan, you have to dig deeper.”

Though the clot-busting drug known as tissue plasminogen activator, or tPA, is the gold standard of treatment for most strokes, Kane had missed the three-hour window of opportunity to receive this

In May 2014, while working as a veterinary technician at an animal hospital in a neighboring county, David Kane began feeling that “something wasn’t right.” He was experiencing problems with his visual acuity, balance issues and weakness on his right side. It didn’t occur to him that he could be having a stroke.

Think It’s A STROKE? Act Fast!

Sentara.com 41

treatment. Instead, Dr. Chehebar and the Sentara RMH team worked to identify and control his risk factors, which included high blood pressure and diabetes.

In June, Kane suffered a second stroke, again with atypical symptoms. Dr. Chehebar suspects that the cause of this second stroke may have been abnormally narrowed blood vessels, includ-ing one completely blocked vessel, which were discovered on further brain scans.

“Unfortunately, because this second stroke occurred so soon after the first stroke, Mr. Kane was not eligible to receive tPA, since he was at increased risk for bleeding,” Dr. Chehebar explains. “But we were able to treat him by other means.”

In spite of the challenges Kane has faced since suffering the two strokes, he says he’s pleased with the care he has received.

Is it a Stroke? Know the Signs and Act Fast!

Know the Signs of Stroke

• Sudden NUMBNESS or weakness of the face, arm or leg—especially on one side of the body

• Sudden CONFUSION, or trouble speaking or understanding speech

• Sudden TROUBLE SEEING in one or both eyes

• Sudden TROUBLE WALKING, dizziness, or loss of balance or coordination

• Sudden SEVERE HEADACHE with no known cause

Act FastIf you or someone you know experiences any of these signs, call 911 immediately—even if the signs go away. Note and record the time when the signs began or when you first noticed them. Knowing this time will help healthcare providers determine whether tPA can be administered to the patient.

David Kane plays “Wii Bowling” as occupational therapist Oscar

Larson watches. Kane uses his interest in video games

to increase his awareness of his visual field.


“My care at Sentara RMH has been outstanding, and I’m so glad they were able to determine what happened to me,” Kane says. “I had a team of good people who took care of me, paid attention to me and listened to me.”

Living With DisabilityAs a result of the first stroke, Kane has suffered permanent brain damage and now is unable to work or drive. The right side of his visual field in both eyes has been affected, as has his ability to com-prehend written language. But his speech, balance and mobility have not been impaired.

He is currently working with Sentara RMH speech therapist Denis Finnigan, PhD, to improve his visual-verbal comprehension, and an optometrist who specializes in care for low-vision patients has assessed Kane for side-vision glasses. Occupational therapist Oscar Larson, OTR/L, MA, of Sentara RMH Rehabilitation Services, is working with Kane to help him adapt to his limitations, strengthen his muscles and develop new skills.

“Therapy cannot repair the brain cells that die during a stroke,” Larson says. “But therapy can help build new connections between healthy cells, allowing David to regain some movement, sensation, and cognitive and communication skills.”

Larson points out that 100 percent recovery after a stroke is rare, so the focus of therapy typically becomes helping stroke pa-tients develop skills that are within their ability.

“Our objective with David’s therapy is to find other tasks that can help him continue to develop his skills, and provide the meaning and structure he enjoyed during his professional career,” says Larson.

Taking Stroke SeriouslySentara RMH is dedicated to educating the community about stroke symptoms and emphasizing the importance of seeking medi-

Without his side-vision glasses, Kane doesn’t notice objects until they are directly in front of him.

Understanding Stroke: Why It’s Important to Seek Prompt Medical Attention

There are two main types of stroke. Hemorrhagic stroke occurs when a weakened blood vessel in the brain ruptures. The most common type, however, and the type David Kane experienced, is ischemic stroke, which occurs when a blood clot lodges in an artery and blocks blood flow to the brain. Anyone can have a stroke, regardless of age, race or gender.

Regardless of the type, a stroke, also known as a “brain attack,” is an urgent medical emergency, says Daniel Chehebar, DO, Sentara RMH neurohospitalist. When brain cells are deprived of oxygen-rich blood during a stroke, they die. The result is permanent damage that may leave a patient disabled or result in death. In fact, according to the American Stroke Association, stroke is the fifth-leading cause of death in the United States and a leading cause of disability.

When a stroke occurs, every second counts, Dr. Chehebar empha-sizes. The countdown begins at the onset of the first symptoms, which typically include sudden weakness or numbness on one side of the face or body, slurred speech, dizziness, vision problems, or headache. The first three to four-and-a-half hours are the critical time period during which a patient suffering an ischemic stroke may receive tPA, a drug that dissolves the blood clot and restores blood flow to the brain. The drug cannot be used with hemorrhagic strokes, but Sentara RMH provides other proven treatments for those patients.

As an advanced primary stroke center, Sentara RMH must meet a number of quality measures, includ-ing delivery of personalized treat-ment for stroke and coordination of care among providers. The majority of Sentara RMH stroke patients who qualify for tPA receive the drug within 60 minutes of the time they come into the Emergency Department.

Sentara.com 43

cal help quickly to allow for the best chance of recovery, offering stroke education throughout the community and partnering with local rescue squads to provide quality care for stroke patients. If a local emergency medical services (EMS) team suspects that a patient is having a stroke, they will call ahead to activate the hospital’s stroke team, alerting caregivers so they can be on standby to treat stroke patients as soon as they arrive in the Emergency Department.

“When the rescue squad calls ahead, the neurologist can get to the emergency room before the patient arrives, allowing the evaluation process to go very quickly,” says Dr. Chehebar. “That collaboration between EMS and our Emergency Department has shortened the time it takes for us to give a patient tPA by about 15-20 minutes, which can make a big difference in terms of recovery. And if a patient isn’t able to receive tPA, we can quickly take other measures to care for them.”

Kane, who had none of the traditional symptoms of stroke, advises people to call 911 immediately if they think there’s even a slight chance they or someone else may be having a stroke.

“The sooner the treatment starts, the better,” Kane says. “If you think something is wrong, it probably is. I’d strongly advise getting checked as soon as possible.” n

Expanding the Frontiers of Stroke Care

Currently, Sentara RMH neurohospitalist Daniel Chehebar, DO, and members of the Sentara Healthcare Neurosciences high-performance design team are work-ing to design protocols that could allow patients experiencing large strokes to receive endovascular stroke treatment at specialized medical centers.

The term “endovascular” refers to the insertion of catheters (thin, flexible tubes) into arteries within the body to perform certain medical procedures, Dr. Chehebar explains. These new stroke protocols involve using mechanical catheter-based devices capable of physi-cally removing or extracting a blood clot from a blocked artery to restore blood flow to the brain.

“These methods could double a patient’s chances of a good recovery from a serious stroke, and could significantly re-duce stroke mortality,” Dr. Chehebar says.

Kane practices using letters

to form words, to increase his

recognition of letters and

words.

Playing card games, a task he can perform at home, helps reinforce skills he is learning in the clinic.


medical staff update

Carol A. Lee-Collins, MDGastroenterologyHarrisonburg Medical AssociatesMedical School: University of Illinois–Chicago College of MedicineResidency: Los Angeles County/University of Southern California Medical CenterFellowship: King-Drew Medical Center, Los Angeles, Calif. (gastroenterology)Clinical Interests: GERD, inflammatory bowel disease, liver disease

Jessica P. Liskey, PA-CAllied HealthHarrisonburg Emergency PhysiciansGraduate School: James Madison University, HarrisonburgClinical Interests: Pediatrics, geriatrics

Monvasi Pachinburavan, MDPulmonology, Critical CareSentara RMH Pulmonary AssociatesMedical School: Chulalongkorn University, Bangkok, ThailandResidency: Albert Einstein Medical Center, Philadelphia, Pa. Fellowship: Thomas Jefferson University Hospital, Philadelphia, Pa. (pulmonary and critical care medicine); Stanford University (lung and heart-lung transplantation)Clinical Interests: Advanced lung disease, interstitial lung disease

Julie L. Patterson, PA-CAllied HealthSentara RMH Orthopedics and Sports MedicineGraduate School: University of Texas Medical Branch, GalvestonClinical Interests: Knee and hip pain

Edward T. Pomicter, MDAnesthesiologyHarrisonburg Physicians for AnesthesiologyMedical School: University of Vermont College of Medicine, Burlington, Vt.Residency: Fletcher Allen Health Care/University of VermontClinical Interests: Pediatric anesthesia, regional anesthesia, ambulatory anesthesia

The following professionals have recently joined the Sentara RMH medical staff. We welcome them to Sentara RMH and the community.

Do you need a physician referral or need to contact a physician? Call our free contact center, Sentara RMH Healthsource, at 1-800-SENTARA.

Mark T. Zreliak, PA-CAllied HealthSentara RMH Cardiothoracic SurgeryGraduate School: Gannon University, Erie, Pa. Clinical Interests: Critical care medicine, cardiac surgery


Allows Sentara RMH Employees to Give Back to the Jobs They Love

Susan McDonald, MD, has been selected as the new vice president of medical affairs (VPMA) for Sentara RMH Medical Center, effective June 26.

Since January 2014, Dr. McDonald has served as director of Sentara RMH Organizational Excellence, the hospital department that works to improve workplace safety, promote quality care, and enhance patient and employee satisfaction using Lean Six Sigma principles.

“I am very excited that Dr. McDonald will be joining the senior leadership team at Sentara RMH,” says Jim Krauss, president, Sentara RMH Medical Center. “She has experi-ence, skill sets and a persona that make her an excellent match for the leadership role. Her efforts in organizational excellence have made a very positive impact on the quality of care here in our community medical center.”

Before coming to Sentara RMH, Dr. McDonald served as vice president of medical affairs for St. Joseph’s Medical Center in Stockton, Calif. Her involvement with process improvement projects goes back to her time as a faculty anesthesiologist at Virginia Mason Medical Center in Seattle, Wash.

“I am thrilled to have this opportunity to join the out-standing group of leaders at Sentara RMH as we continue our efforts to provide the highest-quality care and safest environment for our patients,” Dr. McDonald says.

After graduating from the University of Pennsylvania School of Medicine in Philadelphia, Pa., Dr. McDonald completed an internship and anesthesiology residency at Virginia Mason Medical Center in Seattle, as well as a fellowship in cardiothoracic anesthesiology at Washington University School of Medicine in St. Louis, Mo.

She is married to Sentara RMH cardiothoracic surgeon Jerome (Jerry) McDonald, MD.

Dr. Susan McDonald Selected as New Vice President, Medical Affairs

Sentara.com 45

hasity Wilson, RN, who serves as a unit coordinator and teaches birthing classes in the Sentara

RMH Family Birthplace, loves being a nurse. She says she particularly enjoys

the educational aspects of her job.“For me, it doesn’t get much better than taking

care of newborns and their moms,” she says. Actively engaged with her career, Wilson is always

looking for ways to improve the patient care she pro-vides. Currently she is working toward her bachelor of science in nursing degree at James Madison University, fully aware of the importance of expanding her nursing skills in today’s complex healthcare environment.

Another way Wilson demonstrates her dedication to her nursing career is through her generous support of the Employee Gifts Campaign conducted by the RMH Foundation from late May through late June each year. The campaign appeals to Sentara RMH employees to give back to their workplace by supporting various equipment and program needs at the hospital through monetary donations.

“We ask our employees to go above and beyond their day-to-day service at Sentara RMH, and many of them are happy to give back,” says Cory Davies, execu-tive director of the RMH Foundation.

According to Davies, last year employees donated $100,000 through the Employee Gifts Campaign, and employees have contributed more than $500,000 since the hospital moved to its new health campus in 2010. Those who give to the campaign may elect to have their donations go to support specific departments or programs, or to fund general equipment needs for the hospital.

Since Wilson began working at Sentara RMH in 2004, she has donated the equivalent of one week’s pay annually through the Employee Gifts Campaign,

By Kelsey Wakeman, Sentara RMH Marketing and Communications intern

Gifts Campaign Allows Sentara RMH Employees to Give Back to the Jobs They Love

C

RMH foundation

each year requesting that her gift support the Family Birthplace.

“I give because it helps my patients,” Wilson says. “When I give back to my unit, I know that my money is somehow going to benefit the people who are in my care on a daily basis.”

In past years, Davies notes, the Employee Gifts Campaign has enabled the RMH Foundation to provide funds to help the Family Birthplace purchase lifesaving equipment such as dopplers for listening to infant heartbeats, monitoring equipment for the newborn nursery and other fetal monitors.

“If we have top-of-the-line equipment, that helps

A Gift That Pays Income for Life?

my patients get the best care possible,” Wilson adds. “I get to see every day how my gifts, and those of the other employees who give to the campaign, really benefit patients.”

Wilson says she appreciates how hard the RMH Founda-tion staff works each year to make the Employee Gifts Cam-paign a fun, celebratory event for hospital employees, with an upbeat theme centered on music and dance. Last year’s theme was “Giving Makes You Happy,” and the theme song was Pharrell Williams’ “Happy.” The 2015 campaign theme is “Be the Spark,” based on the Katy Perry song “Firework.”

“We want to ‘light up the night’ and ‘ignite the light,’ and want everyone to ‘be the spark’ for our campaign,” says Janet Wendelken, senior development consultant for the RMH Foundation. “I love it when we celebrate raising these funds by dancing together at our annual celebration on the patio outside the hospital. We teach the dance moves to everyone who attends, and our team here is very willing to get up and dance together. Even those who can’t dance get involved. We have a lot of fun together with this campaign each year—but more important, it’s a way we can all make a real difference for our patients.”

Wilson believes the significance of the annual campaign goes beyond helping to fund equipment and program needs at the hospital, also serving to instill a real sense of commu-nity among staff members throughout the organization. And, she says, that cohesion, that sense of belonging and together-ness among staff members, helps to reinforce the commit-ment of all Sentara RMH employees to providing the best care they possibly can.

“I truly, passionately love the job I do, helping moms have babies,” says Wilson. “It provides me with a paycheck, and that’s helpful, of course—but I also feel like it’s impor-tant to support the Employee Gifts Campaign because it helps my patients. It’s my way of giving back to the job I love so much.” n

A charitable gift annuity, in addition to helping improve and enhance the care our patients receive, can also provide income back to you. For example, a 78-year-old individual would receive the following benefits for a $10,000 gift annuity:

• A6.4percent*return($640annually)fortherestof his or her life, partly tax free

• Anincometaxdeduction• Aneffectiverateofreturnupto9.2percent*after

tax benefits• Advancingourmissiontoimprovehealthand

promote well-being*Rates depend on age and whether the annuity is for one or two lives

Many of our friends have found this option to be one of the more satisfying ways to make a gift. To receive the “Giving Through Gift Annuities” pamphlet without cost or obligation, please complete and return the form below:

Name: __________________________________________________

________________________________________________________

Address: ________________________________________________

________________________________________________________

City: ____________________________________________________

State: ______________________________Zip: _________________

Mail to: Cory Davies, Executive Director, RMH Foundation 2010 Health Campus Drive, Harrisonburg, VA 22801 540-564-7225

Sentara.com 47

OF THE RMH FOUNDATIONGifts received Nov. 24, 2014-March 22, 2015

Sentara RMH Medical Center is grateful to have the support of generous community mem-

bers. We express this gratitude and recognize the contributions our donors make through the

President’s Forum, the William Leake Society and the 1910 Cornerstone Club. These exclusive

giving circles are our way to honor our most generous partners who show they care about

having the best medical services available in our community. Thank you for your support!

Totals represent cumulative amounts given in 2014 and 2015.

Cary and George HevenerGlenn M. and Sandra K. HodgeRobert L. and Martha L. HoldenGeorge W. II and Ann E. C. HomanIDM Trucking Inc.Lantz Construction CompanyTravis F. and Kara A. MarshallChad and Jill McGlaughlinDr. and Mrs. John A. McGowanT. Carter Jr. and Connie G. MeltonAnn and Neal MenefeeDr. Marcus N. and Jodi G. MorraEdward A. MorrisNielsen Builders Inc.Panera Bread—Blue Ridge Bread Inc.Carolyn B. PenceJanice L. PenceDr. R. Steven and Stephanie M. PenceDrs. Zack T. and Judith S. PerdueHeidi D. Rafferty, MDReba S. RawleyRobert and Sarah ReesRockingham GroupJanice F. and Rick ScaglioneSchwab Charitable FundJohn H. and Faye T. SellersGary and Rebecca W. ShickelShickel CorporationMarvin T. and Sarah A. SlabaughAudrey L. SmithDoris S. TrumboUnion First Market BankWharton, Aldhizer & Weaver, PLCWayne and Joyce WrightDwight and Sheryl Wyse

William G. and Hope Shank StonerJudith S. StricklerThe Merck FoundationN. Paige and Ann C. Will

2015Harrisonburg Emergency Physicians,

PLCJohn H. and Faye T. Sellers

William Leake Society$1,000–$4,9992014Dr. Santhosh AmbikaDevon C. and Teresa B. AndersGerald W. and Carolyn L. BeamBlue Ridge BankAuburn and Ruth BoyersBridgewater Village AssociationDr. and Mrs. Douglas T. BrownRuby J. CallahanEleanor F. CanterDr. Henry H. ChangClassic Kitchen & BathMike, Mary, Cana and Peyton DavisEddie Edwards Signs Inc.Dr. C. Wayne and Donna GatesDr. Terry GillilandDr. Joseph M. Jr. and Sandra GreeneJosh P. and Chassidy S. HaleDr. David C. and Amelia M. HallDr. Eugene J. HarperMartin F. and Elizabeth L. HaydukOllie Heatwole Trust

President’s Forum$100,000 and above2014 Harrisonburg Emergency Physicians,

PLCCarolyn Henry Joseph Charitable Trust

2015 RMH Volunteer Auxiliary

$25,000–$99,9992014 EverenceSelect Aerospace Industries Inc.Karl D. and Barbara B. Stoltzfus

$5,000–$24,9992014Donna AmentaJohn T. and Gina BauerMary Ann ClarkRalph W. ClineCline Energy IncorporatedDiane C. DavisDynamic Aviation Group Inc.Kermit and Jean EarlyJoseph K. II and Sallie FunkhouserElizabeth Harnsberger TrustHarrisonburg Electric CommissionJim and Vicki KraussDr. William I. and Lynda D. LeeMillerCoors Shenandoah BreweryKathy Moran and Marcie HarrisTami Hibarger Stein

2015Jerry R. and Kathleen L. AndesBeam Bros. Trucking Inc.Cross Keys Mill Creek Ruritan ClubDr. Christopher D. and Sandra S.

DiPasqualeRobert T. and Margaret E. JeromeFrances Plecker and Plecker Family

Fund of The Community Foundation of Harrisonburg and Rockingham County

RMH School of Nursing Alumni Association

N. Paige and Ann C. Will

1910 Cornerstone Club$100–$9992014Mazin Baker Adil Al AlawiDonald V. AllenMarguerite AllenEddy R. AndersonGeorge W. and Mary AndersonAnonymous Fund of The Community

Foundation of Harrisonburg and Rockingham County

Keith S. and Denise R. AtkinsJames H. BarnhartCharles and Janet BattenRussell M. and Lydia M. BaylorBeck CompanyGeorge W. BellCharles H. Boggs Jr.

friends


James E. and Carolyn K. HartmanRobert A. and Marlene A. HazzardKathryn S. HeatwoleJudith N. HennebergerRobert E. and Gail L. HessJudge Marvin C. Jr. and Grace W.

HillsmanRonald Lee and Della Irene HinkleShelvy K. HinkleWilliam R. and Barbara H. HiteJames F. and Delores H. HoakAnn Ewing HomanLinda S. Hoover, CFPDr. Jerome J. Hotchkiss Jr. and Kimberly

HainesDavid M. HughesBilly M. Hulvey IIDelores D. HulveyMarian C. JamesonTedd H. and Lora W. JettHorace E. Jr. and Sara G. JonesWilliam R. and Evelyn F. KellerDr. Charles E. and Dawn F. KernCarson L. and Sharon L. KiracofeLeroy and Juanita KiserRick V. and Elizabeth Ann KiserDavid J. and Olivia P. KistlerCurtis and Margery KiteAlan L. and Patricia W. KnicelyBetty M. KnissPaul G. and Mary N. KnissJohn E. and Madeline KoehlerH. Nelson KoinerRon and Mary P. KolbJoseph C. and Carol A. KudlessAnna S. LabrousseC. Stephen and Cynthia H. LambMaurice E. and Delores R. Le PeraNettie S. LeeEdwin M. and Dianna R. LehmanRobert J. and Carolyn J. LeistonCarl G. and Arnesa F. LindJean G. LinkC. W. Sr. and Frances M. LongTerry D. and Linda M. LooneyDavid M. and E. Grace LynchWilliam R. MadrenH. L. Jr. and Mildred R. MaidenPeter A. and Susan D. MassaroPhilip H. MaxwellPaul A. McEnderferJohn J. Jr. and Marcia Blay McGrathDwight E. MillerMabel V. MillerMargaret (Peggy) M. MillerPauline G. MillerSara G. MillerVirginia (Ginny) B. MillerSean and Jessica M. MilliganIvy A. MitchellSheila A. Moorman and Helen B.

MooreAnn M. MorabitoRichard R. J. Morin

OF THE RMH FOUNDATION

Dr. Ben F. and Janice W. WadeJacqueline L. WallineWylie E. and Diane WaltonKenneth C. and Dale B. WatersGordon D. and Barbara WeirichStephen D. and Joyce A. WelpottHenry G. Jr. and Ferne M. WengerHerbert C. WengerStephen WhiteTracy Wickham—Wickham and

Huntley FamilyDavid and Karen WiggintonRichard L. and Pamela B. WilkinsUna Lee WilkinsLinda T. WiltThomas E. Wimer Jr.Lewis D. and Kathleen L. WissingerDr. Mary H. & D. Graham Witt IILaurie and Peter YatesRichard L. and Jeanelle G. Yoder

2015Gary A. ArehartKimberly A. BarbLinda Heatwole BlandChester L. and Nancy B. BradfieldBrooks Bell Interactive Inc.J. Michael and Dianne H. BurrisWilliam B. Sr. and Phyllis W. CarperCharitable Flex FundPaul S. and Sherry B. ClineThomas F. Constable Jr.Christopher R. and Ronda R. CookLoretta M. Covert FamilyDiane C. DavisLynn and Dave DiveleyBrian P. and Ruth A. DoranIngrid ElliottDaniel F. and Debra W. FraserTammy FulkOrden L. and Reba R. HarmanDr. Charles H. and Mary HendersonDr. Alden L. and Louise Otto HostetterRichard C. and Mona D. JohnsonAlice M. JuliasMarie W. KauffmanCal and Gail A. KneeJim and Vicki KraussL D & B Insurance AgencyOscar and Linda LarsonMilton and Mary S. LaughlandMary Louise LeakeTim and Twila LehmanRichard H. and Nancy B. LundgrenLaura S. MappDavid A. and Karin E. MarsT. Carter Jr. and Connie G. MeltonAnn and Neal MenefeeCraig M. and Lois B. MillerEdgar and Carmen Strite MillerGarry and Nancy NicholsCharles V. and Lois M. OsterGeorge and Ann PaceDr. R. Steven and Stephanie M. Pence

friendsClifford L. BowmanChester L. and Nancy B. BradfieldSteve and Chris BradshawAddison D. BrainardMatthew Page and Marianne C.

BraniganLanny L. and Phyllis B. BrannerJohn J. and Mary T. BroaddusRobert E., Sr. and Susan R. BrownPatricia A. BrunkRichard C. and Kathryn C. BumpMary E. BunchMartin J. and Elizabeth J. BundrickBruce B. and Jean S. BurkholderOwen and Judy BurkholderLouise R. BurtnerCharles C. and Frances Ann ByersFranklin R. and Shirley D. CampbellA. Fontaine and Martha J. CanadaLarry A. and Angela M. CaplingerPaul R. and Becky A. ChristophelBarbara Fielding ColsonThomas F. Constable Jr.Dr. Diane Cowger and Dr. Marc A.

HudsonJ. E. G. Craig Jr.Albert L. and Nevia T. CrowChildren of Pauline R. Day—Perry Jr.,

Sandra, Larry and JaniceJ. Brisco and Janet DellingerRaymond C. DiehlLynn and Dave DiveleyNorman R. Downey Jr.Elisabeth T. EgglestonJames F. and Elissa Gail EnterlineJoseph J. and Rose Marie EstockLeighton D. and Kathryn R. EvansL. Kathryn EvansDaniel and Cyndi EverardAnne G. FarmerAnna Lee FegaEarl S. and Sharon M. FinkFirst Clearing, LLCMaryjean Baker FlemingDr. William P. and Nancy R. FletcherLarry A. and Linda J. FogleFoilz Hair Studio, LLCMarie K. FreyCharles J. FryeCathy FulkDr. Linford K. and Rebecca L. GehmanTommy and Betsy Heatwole GlendyeSteve Gordon Charitable Fund of The

Community Foundation of Har-risonburg and Rockingham County

Bob and Marsha GordonGrand Home FurnishingsPeter M. and Mary M. GreenMae B. GuthrieHerman W. and Rosemary G. HaleJean S. HamillRobert H. HammondEston B. HarmonCarole and Heidi Hartman

Michael L. and Patricia A. MorrisPricilla D MowbrayDavid D. and Joanne E. Moyer DienerDarryl W. and Diane NashG. Keith Nash and Darryl and Diane

NashRobert E. and Delores M. NashJohn N. and Linda E. Neff Charitable

Fund of The Community Foundation of Harrisonburg and Rockingham County

Joseph T. O’ByrneLoretta G. OrebaughCharles V. and Lois M. OsterAustin F. Pacher Sr.Page County High SchoolSentara RMH Patient SchedulingBonnie L. PaulRobert O. PeerClarence E. and Rhoda W. PeiferOwen C. PencePorter Wellons & Pierce Hospitality

Management LLC.Mary E. ReitzPhilip F. and Sheila F. RileyMaurice F. and Frances E. RitchieRockingham Rotary FoundationHarold W. and Carolyn M. RollerAmy L. RushDorothy W. SaumJoyce M. SchumacherCarolyn ScottFrank B. and Shirley S. ShakespeareDr. Christopher N. and Norma M.

SheapJeffrey K. and Janet S. ShefferEdward L. and Marsha M. Shenk Jonathan D. and Sheryl L. ShenkCharles C. Shiflet Jr.Aaron J. and Jennifer E. ShirkeyGoldie T. ShowalterJames and Amanda SimmonsRandall L. and Mariann A. SimpsonDoris L. SipeDelbert SlaterLawrence E. and Carolyn D. SmootCathy StawarskiKenneth L. and Virginia J. SteeberKarl D. Jr. and Laura K. StoltzfusJean F. StoverWilliam L. and Louise K. StoverRichard P. StricklerRobert Hopkins and Lorraine Warren

StricklerDennis R. and Cathy J. StuterMarian SuterDavid O. and Elizabeth A. SwingleElizabeth M. TavennerJuanita M. TaylorHobert G. TexiereClayton N. and Jacqueline D. TowersGregory S. and Ann B. TrobaughDonald, Florence and Todd TurnerPhillip and Christina Updike

Sentara.com 49

Randall L. CraigStephen R. and Deborah F. CreechDaughters of the American RevolutionJohn E. and Elaine A. De JongRonald and Sandra J. DickinsonDale M. and Lula Belle DodrillPhillip B. DuboseMary E. DudayAnn H. DuffieldBetty H. EarmanHobert and Jackie EdwardsWalter E. and Fonda M. ErdmanJudith B. EspinozaJohn S. and Patricia O. EvansEsther R. EyeArnold A. and Halcie FishbackRoger F. & Linda L. FordPaul B. and Janet E. FosterArthur C. and Corrine W. FrazierMary S. FullerBetelehem GebremedhinLawrence A. Sr. and Laura I. GettMichael A. and Deborah W. GoodRichard P. and Frances M. GoodJohn M. and Christie L. GreerLarry P. and Jannie M. GreimanAlma C. Hale-CooperRobert L. HaltermanRichard W. HatchRonald W. and Cheryl M. HawesMelvyn C. Sr. and Betty A. HeishmanRalph C. HeishmanCharlotte L. HigginsMarvin and Diane HolsoppleRobert P. and Eloise B. HostetlerBaxter E. and Pamela M. HottingerCharles D. and Nancy E. HuffRobert Zigler HuffmanM. Ruth HunterWilliam J. Jr. and Catherine G. HunterJeanette L. JamisonKalpana R. JhaveriWilliam R. and Joan E. JuddKenneth W. and Karen L. KandillDon T. KellerWayne and Kay Frances KelleyRobert O. and Carol J. KempGlenda J. KesnerKarl J. and Margaret R. KwolekDavid J. LawrenceLouise A. LaymanJohn W. and Bev M. LeonardJunior L. LineweaverCharles H. and Mary A. LinggJanet H. LiskeyDorothy D. LoganKevin G. MallowJack and Sondra MayJo Ann N. MilanderJanice K. MillerMartha B. MillerCharles B. and Dorothy L. MisnerJ. Robert and Marjorie B. Moore

Susan Moore AreyH. Nelson KoinerDouglas and Martha T. Rexrode

Forrest L. ArmentroutJune A. Wise

Dr. Warren BannisterDr. Charles E. and Dawn F. Kern

Lawrence Florence Miller BarbKimberly A. BarbGary W. and Ellen V. Dellinger

Kyle W. BareDr. Bary and Ruth BergerJerry W. and Linda K. SweckerLeonard C. and Donna M.

Wojciechowski

Nancy B. BareNancy R. Crawford and

Angelique C. Spitzer

Audrey BarnhartJames H. Barnhart

Brenda S. Morin BazinetRichard R. J. Morin

Judith H. BellGeorge W. Bell

Dorothy Ann BergquistRon and Mary P. KolbDavid S. and Carmel McMahon

Martha BlizzardBetty T. Armentrout

Ira B. and Ethel G. BoyersPamela B. Arbogast

Margaret BrainardAddison D. Brainard

Anna H. BrannerJames B. Branner

Verda BrownRobert E. Sr. and Susan R. Brown

Don W. BrunkPatricia A. Brunk

Roscoe E. Burgess Sr.Richard B. Schneider

Faye BurkartRay and Betty C. Burkart

Dr. Donald M. CallahanRuby J. Callahan

Dr. Noland Mackenzie Canter Jr.Neale Nickels

Emory Wayne CarrCharles C. Shiflet Jr.

Weldon W. ClickBetty D. Click

Anne J. ClineDiane C. Davis

Elwood Walton and Carroll ComerWylie E. and Diane Walton

Arlene D. Conger and Ida T. PetersCharles J. and Linda W. Peters

Robert E. and Delores M. NashEpifania NunezLewis E. and Nancy C. OmpsLt. Col. Frank G. Padilla USAF (Ret.)Arthur E. ParenteElmo and Ella Massey PascaleRobbie D. and Beryl Jean PayneMile and Ljubica PesevicThomas A. and Daille G. PettitLeroy W. and Nora P. PlaugherJohn E. Jr. and Jo Ann PoolMark J. and L. Carmella PsujekMarrietta QuarforthJoan QuassCalvin Wall RedekopKatie S. RenaldsCharles E. and Marie E. RhodesPaul C. RobertsonGalen L. and Frances I. RohrerJohn K. RoudabushRobert S. and Johanna R. RunionMaryann RuttJudith A. SeeJeffrey K. and Janet S. ShefferJames L. SheffieldAlton K. and Helen W. ShipeGary D. and Judy A. ShipeHarry R. Shirley Jr.Harry L. ShoemakerMark C. Jr. and Dorothy S. ShowalterThomas G. and Nancy K. SimmonsIra C. and Janice SpitzerNancy P. StehmanKathleen V. StonebergerAlbert H. and Patricia E. StudtDr. Fred W. and Nancy C. SwartzBarbara R. ThompsonR. Jan and Roma J. ThompsonDavid K. and Mary M. TullochPeggy B. TurnerWayne A. and Betty H. TurnerRaymond W. and Mary V. TusingUnited Way of South Hampton RoadsThomas R. and Helene M. Van DerveerEdward S. and Carolyn S. Van DyckMary Sue VanHussFay R. VoigtStephen D. and Joyce A. WelpottThomas E. Wimer Jr.Richard S. and Margaret M. WurstMatilda M. Yoder

Memorial GiftsGary S. AlbritePhyllis Albrite

Leonard O. AlbritePlyllis Albrite

Marion AllenDonald V. Allen

James E. and Janet M. PetersonIrene Puleo Book Club FriendsHeidi D. Rafferty, MDE. John III and Carol H. RosenbergerG. Michael and Peggy J. ScabooJanice F. and Rick ScaglioneBob and Mary Sease & FamilyJames and Margaret ShaefferShenandoah County Public Schools

Instructional Services DepartmentCarolyn and Terry ShirkeyBetty J. SittigJohn and Sandra SittigDolores, Paul, Faye, Charles and Julie

Sittig, Pam & Charles LiepitzKarl D. and Barbara B. StoltzfusThe Merck FoundationLynn and Diane TrobaughTruck and Equipment CorporationMax and Becky UnruhNancy Hopkins VoorheesFred F. and Dorris M. WamplerTheresa A. WardValerie S. WeaverMerv and Marlene WebbAllen J. WilsonRay M. and Ann H. WineRon YoderRobbie J. Zirkle

Annual Support$25–$99Mary G. AllenRobert E. and Linda L. AlleyGarland R. Jr. and Carol D. AndersonKaren ArnoldAlexander Banks VDale C. and Evelyn W. BasingerSamuel C. and Kathryn J. BeckMary S. BerbesByron Bland Jr.Kenton Clemmer BossermanNorma C. BowmanDick L. and Judy A. BoydMarcia T. BrownfieldGay N. BrownleeGeorge R. Brunk III and Ruthann

Miller BrunkLouise R. BurtnerDr. H. Byrd and Vera TeterBrenda D. CaveMargaret A. ChandlerCarolyn F. ChapmanMike and Dawn ClaypooleDallas N. and Peggy H. ClaytorJames R. and Margaret E. ClineRichard A. and Carolyn G. ClineJanice K. CobbEmanuel B. Conley Jr.


Leroy LineweaverCarson L. and Sharon L. Kiracofe

Violet LineweaverCarson L. and Sharon L. Kiracofe

Violet M. LoomisWilliam C. III and Beverly M Loomis

Juanita LoudFranklin R. and Shirley D. Campbell

Raymond W. and Lillian F. MartinJames E. and Janet M. Peterson

Christopher MastPaul R. and Becky A. Christophel

Laura Leone McLaughlinTheresa BuckinghamRobert F. Covert and Mary L. RoyLoretta M. Covert FamilyBrian P. and Ruth A. DoranJohn W. and Patricia F. FrankRichard H. and Nancy B. LundgrenDr. and Mrs. John A. McGowanBetty J. SittigJohn and Sandra SittigDolores, Paul, Faye, Charles and Julie

Sittig, Pam & Charles LiepitzJeanne TysingerIrene Puleo Book Club Friends: Patricia

Frank, Julie Fitzpatrick, Pat Tierney, Pat Jeremiah, Liz O’Brien, Kathy Courtney and Nancy Lundgren

Elizabeth Raines MichonDr. David C. and Amelia M. Hall

Lowell W. and Steven Lee MillerPauline G. Miller

Earl L. MitchellIvy A. Mitchell

Garnet B. MongoldVernon A. and Lucy M. Good

Phyllis J. MorinRichard R. J. Morin

Victoria “Tori” Morris, RNEdward A. Morris

Raymond F. MowbrayPricilla D. Mowbray

Christine MyersEarl S. and Sharon M. Fink

Shirley Ann MyersRussell M. and Lydia M. Baylor

Irvin F. and Paige F. NashG. Keith Nash and Darryl and

Diane Nash

Marion E. NewkirkJames F. and Elissa Gail Enterline

Clarissa NewmanJohn and Mary Strickler

John NortonNancy N. McCord

Rita OrebaughRobert E. Sr. and Susan R. Brown

OF THE RMH FOUNDATION

Warren S. GarrettLee and Sharon Caplinger

Lynn W. GeorgeKeith S. and Denise R. AtkinsThane K. and Evelyn R. Wilkins

Stephen GillKenneth L. and Virginia J. Steeber

James R. GlanzerBeam Bros. Trucking Inc.Linda Heatwole BlandChester L. and Nancy B. BradfieldJ. Michael and Dianne H. BurrisEleanor M. CampbellWilliam B. Sr. and Phyllis W. CarperPaul S. and Sherry B. ClineThomas F. Constable Jr.Cory Davies, Mary Sherman, Sandy

Tusing and Janet WendelkenDiane C. DavisLynn and Dave DiveleyRonald G. and Regina M. DunhamDr. William P. and Nancy R. FletcherDr. Charles H. and Mary HendersonBarbara J. HenryCary and George HevenerDr. Alden L. and Louise Otto HostetterRichard C. and Mona D. JohnsonSherry JoynerAlice M. JuliasJim and Vicki KraussMary Louise LeakeRonald T. and Louise M. McCoyT. Carter Jr. and Connie G. MeltonAnn and Neal MenefeeEdgar and Carmen Strite MillerVirginia (Ginny) B. MillerKathy Moran and Marcie HarrisGarry and Nancy NicholsGeorge and Ann PaceDr. R. Steven and Stephanie M. PenceE. John III and Carol H. RosenbergerJanice F. and Rick ScaglioneBob and Mary SeaseRodney L. and Karen S. ShifletAudrey L. SmithIlene N. SmithKarl D. and Barbara B. StoltzfusDr. John M. and Doris S. StoneLynn and Diane TrobaughMax and Becky UnruhPhillip and Christina UpdikeNancy Hopkins VoorheesValerie S. WeaverMerv and Marlene WebbGordon D. and Barbara WeirichDenise A. WhitmanN. Paige and Ann C. WillRon Yoder

Janet GlendyeTommy and Betsy Heatwole Glendye

Elanor F. Glick, RNCharles D. and Virginia S. Jones

Kenneth H. GoadSybil LoweMarilyn J. Spooner

Janice H. CzyzewskiBrooks Bell Interactive Inc.Gary D. Griffis and Leslie E. PearlmanCal and Gail A. KneeMarcia S. SchollAllen J. Wilson

Robert D’AnjeloMartin J. and Elizabeth J. Bundrick

Owen S. DavisH. L. Jr. and Mildred R. Maiden

Richard D. DavisDiane C. DavisMike, Mary, Cana and Peyton Davis

Sara Alyce DeanAlice Talbert

Great Grandparents, George and Vivian Delawder and Richard Moore

Ashlyn Delawder and Reilly Olinger

Jerry DellinigerGary A. Arehart

Virginia R. Dellinger, Peggy A. Dellinger and Karen S. Dellinger

Shirley L. Dellinger

Elizabeth Ann DiehlJean Anne Armstrong

Margaret DoveJoan D. Minnick

Chad L. DowneyNorman R. Downey Jr.

Karen DuvalKatherine K. Byers

Dennis Lee EdwardsBeck CompanyEdwin R. Jr. and Edith GroppAnnie K. Bradley and Mary E.

HendersonMolly P. LovePorter Wellons & Pierce Hospitality

Management LLC.

Clarence and Jane EwingAnn Ewing Homan

Ray FarmerAnne G. Farmer

Concetta FazzoneLeslie C. Schory

LeRoy Henry FegaAnna Lee Fega

Alice B. FisherKenneth E. Fisher

Betty Anne FordneyRichard A. and Cathy D. Baugh

My Sister, Janet FreezeCarroll L. and Dianna L. Cubbage

Elizabeth A. FryeCharles J. Frye

Boyd and Ada GarberAnne G. Farmer

Derwood and Ruby GarberAnne G. Farmer

friendsFrances E. GreenRobert F. Green

Marie Shank HarperDr. Eugene J. Harper

Mildred S. HarperTammy Fulk

Ulvey S. HarrisMary C. Harris

Dewitt HeatwoleKathryn S. Heatwole

Elwood Lee HensleyRoger L. and Mary Frances Lam

Alice V. HerringFirst Baptist Church of Elkton

Shirley A. and Robert W. HilbargerTami Hibarger Stein

Faye HilbertRexford J. Schroyer

John and Mary Ann Hilbert, Our ParentsKathy L. Hilbert and J. Steve Hilbert

Harold Hinegardner and Jack HinegardnerWilliam R. and Barbara H. Hite

Donald W. HinkleShelvy K. HinkleMr. and Mrs. Ray H. HolsingerMargaret A. AlexanderEllwood and Ernestine HooverAnne G. FarmerHarold HooverAnne G. Farmer

Donald and Robert HorneGloria Horne

My Husband of 57 YearsMadeline Clark

Peggy K. HyltonH. Nelson Koiner

Dr. Harold S. JenkinsKarl D. and Barbara B. Stoltzfus

Lois J. KephartDarl K. and Sondra E. MayCarl L. and Vickie S. Stultz

Henry KiracofeCarson L. and Sharon L. Kiracofe

Catherine Ann Liskey KoinerH. Nelson Koiner

Frederic P. LabrousseAnna S. Labrousse

Kathryn E. LandGeorge W. Land

Judy Ennis LarsonJenkins Insurance & Financial

Services Inc.Lynn L. and Stephen M. Rhoads

Irvin C. LeeNettie S. Lee

Darla Faye Craft LePeraAllen G. and Kaethe J. Schick

Sentara.com 51

Sandy PackerDaniel G. Packer

Dr. William PatzigEdith JohnsonTracy Wickham—Wickham and

Huntley Family

Kerry Roadcap PeeryRobert E. Sr. and Susan R. Brown

Hallie Bowman PenceCarolyn B. Pence

Bertie PerduePeggy S. Wessner

Marina Massaro PleckerPeter A. and Susan D. Massaro

Karen PuckettRobert and Deborah A. Ryder

Phoebe Reamer ReedKeith S. and Denise R. Atkins

Herman R. ReitzMary E. Reitz

Patricia M. ReynoldsRobert O. and Carol J. Kemp

Charles L. RhodesJanet D. Rhodes

Raymond P. RhodesWanda D. BakerClifford M. and Stephanie A. BeauneChristopher R. and Ronda R. CookOrden L. and Reba R. HarmanDavid A. and Lisa D. HinegardnerJames R., II and Harriet Z. HinerDonald L. and Sylvia A. HollenWilliam H. and Virginia G. KingParnassus United Methodist Church A.

C. Knott Sunday School ClassShenandoah County Public Schools

Instructional Services DeptCharles C. Shiflet Jr.Krista L. SuterSheldon L. and Evelyn H. Wenger

Arvilla RoadcapRobert E. Sr. and Susan R. Brown

Tuck RoadcapRobert E. Sr. and Susan R. Brown

Phyllis R. Roberts and Gary L. HiggsMaurice F. and Frances E. Ritchie

Robert S. RollerRichard W. and Evah L. Roller

Diane W. RymanDeborah M. BarrickKenneth S. and Kitty J. Hines

Dr. Robert H. Sease Sr.Joyce A. Randolph

Rosemary SeeseHobert G. Texiere

Derwood ShafferMary E. FoleyJohn D. Rossheim

Bonnie MillerTerry D. and Linda M. Looney

Janice MillerBennie R. and Ethel D. Lough

Sandy MillerMartha Floyd

Vada Miller, SisterLeona K. Judy

Lowell and Paula MoyersOwen and Judy Burkholder

Jack Nicholson, RNDr. Marcus N. and Jodi G. Morra

Dr. and Mrs. Thomas McFee OatesRobert Hopkins and Lorraine Warren

Strickler

Dr. and Mrs. Terry E. OverbyCharles H. Boggs Jr.

Jim and Mavis PleckerEllen T. Wilhite

Eunie and Bill PowellMarian Rabeno

The Radiant Angels of Sentara RMH Hahn Cancer Center

Lawrence E. and Carolyn D. Smoot

Sentara RMH MAGNET NursesSusan Winslow

Michael Ruckman Jr.William L. and Louise K. Stover

Peter Sabau Jr.Peter G. Jr. and Margaret A. Sabau

Dr. Sease and Urology StaffRobert T. and Margaret E. Jerome

Carolyn Shifflett and Linda SimmonsRussell M. and Lydia M. Baylor

Martha N. ShulerCharles F. Shuler

Lisa Spruhan, RN, BSN—Surgical Services

John D. and Toni H. Stone

Margaret StrateRobert and Sarah Rees

Ken and Faye Hoover ThomasJoseph D. and Elinor H. BotkinJohn E. HanlyLoretta A. HarrisBruce and Barbara HooverSandra K. Lacks

Ken and Faye Hoover Thomas and Jeanne Veney

James W. and Faye P. Hiner

Dr. John D. WengerHerbert C. Wenger

The Witt Family—Mary Helen, Graham, Savannah and Brady

N. Paige and Ann C. Will

Susan Zucconi, RNDr. Marcus N. and Jodi G. Morra

Arlene R. ShermanOwen L. and Margaret B. Phillips

Alfred Clyde ShifflettH. L. Jr. and Mildred R. Maiden

James E. ShifflettAlice B. Shifflett

David Howard ShullTommy and Betsy Heatwole Glendye

James “Jim” SimmonsJames and Amanda Simmons

Wilda SipeRobert E. Sr. and Susan R. Brown

Reba D. SlaterDelbert Slater

Irene B. SmithMarian C. Jameson

Dr. Richard SmithTommy and Betsy Heatwole Glendye

James E. “Sonny” StoverJean F. Stover

Jane L. StroupeAllen Wayne Stroupe

Lucille SwankCarol S. Burkholder

Evelyn TexiereMr. Hobert G. Texiere

Ruth Robertson TurnerChildren of Pauline R. Day—Perry Jr.,

Sandra, Larry and JaniceDarryl W. and Diane NashMr. and Mrs. James B. Nipe

Lillain WaggyCarolyn and Terry Shirkey

Edward WardTheresa A. Ward

Jean WhetzelTommy and Betsy Heatwole Glendye

Earnest B. WhitelawRuby Hartman Whitelaw

Mildred Francis WhitmoreH. L. Jr. and Mildred R. Maiden

Mr. and Mrs. Everette E. Wilfong and Mr. and Mrs. Russel S. Rhodes

Dr. Richard T. and Carolyn F. Wilfong

Emerson H. WilmertonG. Michael and Peggy J. Scaboo

May WimerAlan L. and Patricia W. Knicely

Loretta G. YankeyH. L. Jr. and Mildred R. Maiden

Lois ZehringTyrus C. and Lita Z. Lytton

Dr. Walter M. “Moff ” Zirkle Jr.Richard C. and Kathryn C. Bump

Honor GiftsBeth Curry and Penny from KS,

Dr. Burl Norris Judy von Seldeneck

Dr. James W. BradshawSteve and Chris Bradshaw

Michele BrannerLanny L. and Phyllis B. Branner

Tina Custer, Toni Custer, Melissa Alger and Anna Whitmore

Robert E. Sr. and Susan R. Brown

Dr. James and Nancy DeaconBob and Marsha Gordon

Mary DoveJ. Brisco and Janet Dellinger

John and Sherri DurhamBennie R. and Ethel D. Lough

Sallie and Joseph Funkhouser II and FamilyDavid J. and Olivia P. Kistler

Charlie GardnerWalter P. Randolph Sr.

Sherrill GlanzerWilliam G. and Hope Shank StonerDr. William P. and Nancy R. Fletcher

Leslie HarlackerSean and Jessica M. Milligan

Wayne HarrisonCathy Fulk

Woodrow and Alice HartmanCarole and Heidi Hartman

Edna Mae HensleyRoger L. and Mary Frances Lam

James F. HoakJames F. and Delores H. Hoak

Hospice VolunteersHorace E. Jr. and Sara G. Jones

Judy JenkinsJulie JonesDr. R. Steven and Stephanie M. Pence

Judy Jenkins and in memory of Father, Arnold Jenkins

Oscar and Linda Larson

Vallie KiracofeCarson L. and Sharon L. Kiracofe

John G. Leake Jr.Audrey L. Smith

Linda LightKenneth R. and Sandra C. Arey

Dr. Robert S. McCormickMargaret Oncken

Carol and Domenic MeglieriBennie R. and Ethel D. Lough

Sue N. MenefeeAnn and Neal Menefee


Jim Bishop

How easy it is to complain, to criticize and cast aspersions, to wallow in self-pity and, in the process, help make life miserable for those around us.

Why is it so “natural” to accentuate the negative in moving from what seems like one rut to another? Life is so unfair, I mutter. Why can’t I be among that 1 percent that has it all? After all, I deserve it.

As I grow older, I’m finding that if I don’t recognize and consciously deal with these recurring emotions, I can quickly become the very type of person I don’t enjoy being around—a critical, caustic, self-righteous, crusty curmudgeon.

So what steps can we take to avoid falling down the slippery stairs of melancholy and despair? Glad you asked. Here are some energizing activities that are proving helpful to me, and I commend these modest injunctions to you, even if retirement is but a hazy image on the horizon:• Resolve to give up one bad habit—smoking, gossip-

ing, overeating, texting while driving, watching reality

TV, brushing your teeth (good) with the water running (bad). You get the idea.

•Don’t make promises you can’t keep; meet deadlines; go to bed a half-hour earlier and get up at least 10 minutes earlier to better cope with the morning rush.

•Engage in physical exercise for 30 minutes at least three times a week (I swim four days a week at Virginia Mennonite Retirement Community’s indoor pool); take brisk walks (go with a spouse or neighbor); take dance lessons (a great way to unclog those neural pathways).

•Cut out a half-hour of TV watching in favor of a book or news magazine. Gradually increase the time allot-ment, and soon dust might collect on the flat-screen while you get on a first-name basis with your librarian.

•Volunteer with a local community service program. Donate blood regularly if you’re physically able. Take advantage of speakers, seminars and other public affairs programs at our area schools and universities.

•Live within your means, even if that means doing with-out some things you’d like to have or postponing certain purchases. Ask yourself: “What credit cards (the sweet buy and buy) can I do without?”

•Offer words of encouragement or affirmation to a family member, a colleague at work or someone in your larger social sphere. Regular deposits in the neighborhood bank of friendship will pay sizable dividends.

•Attend the church or synagogue of your choice regular-ly; offer your talents, great or small, for the enrichment of congregational life.

•Perhaps most important, cultivate a regimen of daily inspirational reading and prayer.

Attitude is everything, so remember to be grateful. To this end, upon awakening each morning, I give thanks for the opportunities each new dawn affords.

Psalm 92:2 (TLB) echoes this senti-ment: “Every morning tell him, ‘Thank you for your kindness,’ and every evening rejoice in all his faithfulness.” nl Jim Bishop is retired after 40 years as public information officer at Eastern Mennonite University. He can be contacted at [email protected].

THE WEARING OF the Grin

C a l l S e n t a r a R M H H e a l t h s o u r c e a t 1 - 8 0 0 - S E N T A R A

events for women

Mammography Van Schedule

Call the Sentara RMH Funkhouser Women’s Center at 540-689-6800 or 800-277-1021 to schedule your mammogram at the following locations:

To register, call Sentara RMH Healthsource at 1-800-SENTARA unless otherwise noted. Sentara RMH Funkhouser Women’s Center is located at 2275 Health Campus Drive, Harrisonburg.

AR = advance registration required.

July 1, Oct. 20 • New Market Community Center

July 2 • Perdue

July 6, Aug. 27 • Sentara RMH Springbrook Family Medicine

July 10, Sept. 18 • Carilion Family Medicine

July 16, Oct. 7 • Elkton Area Community Center

July 17 • Luray Walmart

July 21, Sept. 30 • Plains District Community Center

July 24, Aug. 28, Sept. 25, Oct. 23 • Sentara RMH East Rockingham Health Center

July 27, Aug. 3, Aug. 14, Sept. 11, Oct. 12, Oct. 27 • Sentara RMH Timberville Imaging Services

July 30, Aug. 25 • Pilgrim’s Pride

Aug. 4, Oct. 6 • Bridgewater Retirement

Aug. 8 • Briery Branch Church of the Brethren

Aug. 13, Oct. 8 • Grottoes Food Lion

Aug. 18, Oct. 14 • Shenandoah Grocery

Aug. 19, Oct. 13 • Virginia Mennonite Retirement Center

Aug. 20 • Sentara RMH Mt. Jackson Health Center

Aug. 26 • Waynesboro City Employees

Aug. 31 • RR Donnelley

Sept. 10 • Page County Administration

Sept. 24 • Highland Medical Center

Sept. 29 • Whitewave

Oct. 1 • Rockingham County Administration

Oct. 9 • Perdue

Oct. 15 • Ed Good Memorial Park

Oct. 16, Oct. 30 • EMCO

Oct. 21 • Turner Ashby High School

Oct. 22, Oct. 29 • Miller Coors

Oct. 26 • Dick Myers Chrysler Dodge Jeep & Ram

Oct. 28 • Merck

events

SUMMER 2015

Breast Cancer Support Group. For women dealing with diagnosis and treatment, and for women who have completed treatments and desire ongoing support and education. Meets the second and fourth Thursdays of each month, 4-5:30 p.m., Funkhouser Women’s Center. AR FREE

Healthy Me: Women’s Seminar. Meets 6:30-7:30 p.m. on the dates indicated, Funkhouser Women’s Center. AR FREE

• “Endocrinology for Women: It’s All About Hormones.” Endocrinologist Nabeel Babar, MD, discusses how hormones—and particularly thyroid hormone—impact women’s health. Tuesday, Sept. 15.

• “Integrative Health Coaching.” Learn how to set and achieve your goals for health and well-being. Tuesday, Sept. 29.

Women’s Well-Being. Includes one-on-one health education sessions with four healthcare professionals, a nutrition seminar and a healthy lunch. Friday, Oct. 9, 8:30 a.m.-1 p.m., Funkhouser Women’s Center. $100. Register by Sept. 30.


Call 540-236-6638 for more information. Childcare and dinner provided. AR FREE

La Leche League of Harrisonburg. Breast-feeding education support group. Nursing babies are welcome. First Wednesday of each month, 10 a.m., Blessed Sacrament Catholic Church, corner of Main and Wolfe Streets, Harrisonburg. NR FREE

Mothers of Multiples Support Group. Second Wednesday of each month, 7-8:30 p.m., March of Dimes Office, 1356 South Main St., Harrisonburg. For more information, call 540-434-7789. NR FREE

New Moms Ask a Nurse. Meets every Wednesday, 1:30-3 p.m., Sentara RMH Atrium. For more information, call 540-689-3390. NR FREE

Parenting Education and Support (PEAS). Childcare and dinner are provided for all classes. Tuesdays, 6-8:30 p.m., Lucy F. Simms Continuing Education Center, 620 Simms Ave., Harrisonburg. Class series starts Sept. 8.

• All About Baby. For parents expecting their first child or with a child under age 2. Topics include Baby and Mommy, Baby and Daddy, Using Signs to Talk to Your Baby, Happiest Baby on the Block. Nursery provided. Call Sentara RMH Healthsource for more infor-mation. AR FREE

• Milestones Programming for Kids. Early literacy class for ages 3-5. AR FREE

• Nursery. Available for children under age 2. AR FREE

• SMART Moves Programming for Kids. Skills, mastery and resistance training for children ages 6-11 while their parents are in one of the classes listed here. AR FREE

• Staying Connected With Your Teen. For parents of children 12-17 years old. Children attend with parents. AR FREE

• The Incredible Years. Education and sup-port for parents of children ages 3-11. AR FREE

• The Incredible Years (in Spanish). Education and support for parents of children ages 3-11. Call 540-236-6601 to register. AR FREE

Pregnant and Parenting Teen Support Group. Share with peers and receive education on pregnancy and parenting. Fourth Monday of each month (except July and December), 6:30-8 p.m., Sentara RMH Atrium. NR FREE

l DiabetesCaring for Your Diabetes Class Series. Topics include introduction to diabetes, medica-tions, monitoring, reducing risks, staying active, problem solving, healthy coping and healthy eat-ing. Medicare and most insurance plans cover a

To register, call Sentara RMH Healthsource at 1-800-SENTARA unless otherwise noted. Upcoming classes are also listed on Sentara.com. For your convenience, we have coded our classes and activities as follows:

AR Advance registration requiredNR No advance registration requiredFREE No fee

The following locations are in Harrisonburg:

Sentara RMH2010 Health Campus Drive

Sentara RMH Atrium2000 Beery Road

Sentara RMH Behavioral Health644 University Boulevard

Sentara RMH Funkhouser Women’s Center2275 Health Campus Drive

Sentara RMH Hahn Cancer Center2008 Health Campus Drive

Sentara RMH Hahn Medical Building (HB)2006 Health Campus Drive

Sentara RMH Rehab Services and Sentara RMH Wellness Center2500 Wellness Drive

l Behavioral HealthTo participate in a Sentara RMH Behavioral Health group, call 540-564-5960 or 877-294-5731 to schedule an assessment to determine the best service for your needs. Major insurance plans often cover these services.

Adolescent Substance Abuse Group. Ages 13-18. For those whose drug or alcohol use is interfering with personal safety, achievement and communication.

Adult Doing Better Today. Ages 18 and older. Learn how to replace problem behaviors with more adaptive ways of coping with distress. Meets once a week.

Phase Two. Ages 18 and older. For those who self-identify as dependent on substances, are committed to abstinence and wish to work on their recovery. Meets mornings and evenings.

Square One. Adults explore how to make changes that support health and reduce concerns about their alcohol or drug use. All levels of change are supported; quitting is not required to join.

l Cancer CenterBreast Cancer Support Group. Meets the second and fourth Thursdays of each month, 4-5:30 p.m., Funkhouser Women’s Center. AR FREE

Caregivers Group. For those caring for a loved one dealing with cancer. Meets the third Friday of each month, 2-3 p.m., Hahn Cancer Center educational room. NR FREE

Chair Yoga. Meets Wednesdays, 11:45 a.m.-12:30 p.m., HB conference rooms. AR FREE

Facing Forward: Life After Cancer Treat-ment. Topics covered: What’s Normal After Treatment, Nutrition, Managing Symptoms, Emotional Wellness. Meets the second Wednesday of each month, 9-11 a.m., HB conference room (park in Lot B). For more information and to register, call 540-689-7065.

Leukemia and Lymphoma Support Group. For persons with blood-related cancers and their families. Thursday, Sept. 3, 4-5 p.m., HB conference rooms (park in Lot B). AR FREE

Prepare for Surgery or Treatment: Heal Faster. A one-hour class to help persons pre-pare mentally for surgery or cancer treatment. Calm pretreatment anxiety. Includes a book and CD. $35. Call 540-689-7065 to schedule.

Yoga for Cancer Survivors and Caregiv-ers. Tuesdays, 6-7 p.m., HB conference rooms (park in Lot B). Call 540-689-7065 for infor-mation. NR FREE

l Caring for Children/ParentingFamily Birthplace Classes. The following are offered regularly: Birth Preparation Class, Family Care Class, Spanish Birth and Family Care Class, Refresher Birth Class, Cesarean Birth Class, Breastfeeding Class, Sibling Class, and Infant/Child CPR. For more information or to register, call 540-689-3390 or visit Sentara.com. AR

Family Birthplace Tours. For prospective parents. Tour labor and delivery, postpartum rooms and the newborn nursery. First Sunday of each month, 1 p.m. Call Healthsource to register. AR FREE

Grandparenting Education and Support (GrandPEAS). Grandparents and other rela-tives in the role of primary parent face many legal, financial and emotional difficulties. Ongo-ing groups meet at two locations during the school year:

• Lacey Springs Elementary School—First Tuesday of each month, 6-7:30 p.m.

• South River Elementary School, Grot-toes—Second Wednesday of each month, 6-7:30 p.m.

calendar of events

Sentara.com 55

JOIN the Sentara RMH Wellness Center This Summer!

We offer something for everyone.For more information about Wellness Center membership, parties and programs, go to www.rmhwellnesscenter.com. Program and party information is also available in the calendar of events in this magazine.

Stop in for a visit and check us out. To join the Wellness Center, stop by the membership office or call 540-564-5685.

Present this coupon when making payment and receive 80% off your enrollment fee.

Cannot be combined with any other offer.

This coupon expires Aug. 1, 2015.

portion of the cost. Series starts on July 18. For more information, including cost, or to register, call Sentara RMH Healthsource. AR

Diabetes Support Group (Adult). For per-sons with diabetes and their families and friends. Second Monday of each month, 7-8:30 p.m., Hahn Building. NR FREE

Diabetes Support Group (Pediatric). For children with Type 1 diabetes and their fami-lies. Second Sunday of each month, 2:30-4:30 p.m., Sentara RMH, lower level conference rooms. Call 540-383-3432 for more informa-tion. NR FREE

l Grief and Loss Grief: 1 to 1. Grief can follow death, mar-riage breakup, chronic illness, job change or retirement. Talk with someone trained to help you understand how your grief can affect you. For an appointment, call Sentara Bereavement Services, 540-433-4427 or 877-294-5731, ext. 4427. No charge for the first two sessions.

Grieving Friends—Spousal Loss Support Group. For adults who have lost a spouse or partner. Share stories and experience support, care and strength. Meets the third Thursday of each month, 6-7:30 p.m., Sentara RMH, HB conference room A. Call Sentara RMH Healthsource for more information. NR FREE

Hospice Peer Support Groups. For hospice participants who have experienced the death of a loved one and would like to share and work on their grief with others. Meets at the Sentara RMH Atrium. For meeting dates and times, and to register, call 540-433-4430. AR FREE

• Grief Works: Loss of a Spouse—for widows and widowers

• Grief Works: Loss of a Parent—for adults who have lost a parent

Life Seekers. For those who have worked through initial grief experiences and wish to connect socially with others who have experi-enced a loss. Meets the first Thursday of each month for dinner at Thomas House Restaurant, Dayton, 6 p.m. Cost of meal. NR

l Ongoing GroupsADHD Advocacy Group. For relatives and caregivers of children with ADHD/ADD. Sec-ond Tuesday of each month, 6:30-8 p.m., Blue Ridge Hall at JMU, room 326 (location may vary due to special events). Call Sentara RMH Healthsource for more information. NR FREE

A.W.A.K.E. Sleep Disorders Support Group. Thursday, July 17, 7-8 p.m., Sentara RMH Medical Center, lower level conference room 1. To register, call Sentara RMH Health-source. AR FREE

Bariatric Support Group. For those who have had or are interested in having bariatric surgery. Mondays, Aug. 3 or Nov. 2, 6-7 p.m., HB conference room A/B. For more informa-tion, call 540-689-5646. NR FREE

“The Beat Goes On.” See “Cardiac Device Support Group: The Beat Goes On.”

Branching Out on a New Limb. For those who have had an amputation. Families are wel-come. Call 540-689-4296 for more information. NR FREE

Cardiac Device Support Group: The Beat Goes On. Receive education, ask questions and share concerns and experiences. Saturday, Aug. 22, Sentara RMH Medical Center, lower level conference rooms. Call Sentara RMH Health-source to register. AR FREE

Caregiver Chat. Discuss the joys and chal-lenges of caregiving. Education provided. First Wednesday of each month, 9-10 a.m., Genera-tions Crossing Adult Day Care Center, 3765 Taylor Spring Lane, Harrisonburg. NR FREE

CMT Disease Support Group. For people with Charcot-Marie-Tooth disease and their families. Meets every other month September-May, on the second Saturday of the month, 1-3 p.m., Sunnyside Room, Sunnyside Retirement Community, Harrisonburg. For more informa-tion, call 540-568-8328.

Greater Shenandoah Valley Brain Injury Support Group. For survivors of brain injury and their families and caregivers. Third Wednes-day of each month, 6:30 p.m., Harrisonburg Rescue Squad, 1700 Reservoir St. Call 540-421-5610 or 800-336-6012 for more information. NR FREE

Mended Hearts. Support for heart patients and their families. Meets the third Wednesday of each month, 6-7 p.m., Sentara RMH. For more information, call 540-689-1839.

Parkinson’s Support Group. All are wel-come. Third Saturday of each month, 1 p.m., Sentara RMH, lower level conference room 2. For more information, call 540-810-5210. NR FREE

Shenandoah Valley Chapter of the United Ostomy Associations of America. For people with ostomies and their support persons. Call 540-689-1183 for more information. NR FREE

l Personal Health and WellnessHeart Check. A heart disease screening for women and men. Includes lab work, one-on-one consultation, education and goal setting. Call 540-689-6000 for more information and to schedule an appointment. $50. AR

Sentara RMH Volunteer Services. Contact us to learn more about volunteer opportunities. Email [email protected] or call 540-689-6400.

Vascular Screenings. Detect artery blockages that can lead to debilitating leg pain with walk-ing, stroke or death. For ages 50 and older with risk factors for, or a history of, heart and vascular disease. Sentara RMH Medical Center. Call Sentara RMH Healthsource for more informa-tion. $50. AR

l SeniorsSentara RMH Senior Advantage. Offers members health education, social events, free health screenings and more! Call the hotline at 540-437-7970 or visit Sentara.com to learn more about our upcoming events and how to become a member.

In the Loop. Walk the loop around the hospital with others for your health. Join anytime. Meets Thursdays from May through October, 9 a.m., Sentara RMH Medical Center (meet in Lot B). Call Sentara RMH Senior Advantage Hotline at 540-437-7970 for more information. NR FREE

Sentara RMH Wellness Center

The Sentara RMH Wellness Center offers state-of-the-art fitness equipment, 70 land and water group fitness classes each week, fitness and warm-water pools, whirlpool and sauna, nutrition classes, Pilates, and child care programs. From infants to seniors, we offer something for everyone. Call 540-564-5685 for more details.

GroupX Pass. Community members who want to participate only in land or water group fitness classes can purchase a GroupX Pass, in eight-class or 12-class packages. $64 for eight-class pass, $90 for 12-class pass. Call 540-564-5685 for more information.

Metabolic Meltdown. FREE weekly workouts for all fitness levels. Progress safely over 8-12 weeks. Work out on your own or join the instructor-led group sessions Mondays-Thursdays, 5:30 a.m., noon and 5:30 p.m., and Fridays, 5:30 a.m. and noon.

ACTIVE ADULT PROGRAMS

CPR, AED and First Aid. BLS for Healthcare Providers and Recertifications; Heart Saver CPR for adult, child and infant; and HeartSaver First Aid classes are available. For schedule, cost and registration, call 540-564-7200.

Metacheck Metabolic Analysis. A 10-minute breath test gives you your resting metabolic rate (the number of calories you burn at rest). Learn exactly how many calories you can eat and still lose weight. $48 members, $58 nonmembers. To learn more and to register, call 540-564-5682.

Progressive Exercise Plus (ProEx Plus). Customized exercise program to help hip and knee replacement patients prepare for and recover after surgery. Includes a floating 90-day Wellness Center membership, physical therapy assessment, two 30-minute group sessions weekly with a fitness specialist, and postfitness assessment. $119. Call 540-564-5694 for more information.

Progressive Exercise Program (ProEx). Twice-weekly 30-minute group meetings with a fitness specialist for eight weeks. Includes customized exercise to meet your medical needs and fitness goals and your doctor’s recom-mendations. Enjoy full use of the Wellness Center during the program. $60 for a 60-day membership. Ask your healthcare provider if

you’re a ProEx candidate; if so, call 540-564-5694 for more information.

Right Weigh Challenge. Compete to win prizes, including a $500 top prize! Information session: Saturday, June 28, 9:30-10:30 a.m.; challenge dates: June 30-Sept. 19; award ceremony: Saturday, Sept. 20, 9:30-10:30 a.m. $50 members, $199 nonmembers (includes the registration fee and a temporary Wellness Center membership during the program dates). Call 540-564-5682 for more information.

ACTIVE KIDS’ PROGRAMS

Fall Soccer League. Ages 4-6. Soccer basics with no score/no win records. Parents, coach your child’s team and receive one FREE child’s registration. Saturdays for one hour, 9 a.m.-noon. Aug. 29-Oct. 17. For more information, call 540-564-7200.

Kids’ Parties. No age limit. Themes include creative arts party, pool party, sports and activities party, and pampering spa party. Other themes are considered—not limited to birthday parties. Offered Fridays, 3-8:30 p.m., and Saturdays and Sundays, 1-6:30 p.m. Reserve at least two weeks in advance. For pricing and information, call 540-564-5684.

Summer Camp. Keep your child active this summer with sports, recreation, arts, crafts, swimming for older kids and lots of fun! Monday-Friday, June 15-Aug. 21. (No camp held June 29-July 3.) Call 540-564-7200 for more information and to register.

AQUATIC PROGRAMS

Unless otherwise noted, call Sentara RMH Healthsource at 1-800-SENTARA for dates and times and to register. All group swim lessons are $80.

Baby & Me. Ages 6 months-18 months, with a parent. Orient yourself and your child to the water. Follows American Red Cross guidelines.

Toddler & Me. Ages 18 months-3 years, with a parent. Introduce basic water skills to your child. Follows American Red Cross guidelines.

Preschool Swim Lessons. Ages 3-5 years, with instructor. Basic water safety and skills for beginners; improves water comfort and agility.

School-Age Swim Lessons. Ages 6-12 years. Water safety and skills. Learn the crawl, breast-stroke, backstroke, sidestroke and butterfly.

Private Swim Lessons. Ages 3 years and older, all skill levels. Half-hour lessons: $20 members, $30 nonmembers. Package of five half-hour lessons: $85 members, $130 nonmembers. To register, call 540-433-4347.

Semiprivate Swim Lessons. Ages 3 years and older, all skill levels. Half-hour lessons for two people: $25 members, $40 nonmembers. Package of five half-hour lessons: $110 members, $150 nonmembers. To register, call 540-433-4347.

Wellness Center Masters. Ages 18 and older. No competitive swimming experience neces-sary. Gain speed, develop technique. Come when you can; cards will be punched only when you participate. Practices are held Mondays, Wednesdays and Fridays, 5:30-7 a.m., and every other Saturday, 7-9 a.m. 15-session punch cards: $75 members, $110 nonmembers. Try your first session for FREE! To register, call 540-564-5682.

Lifeguard Certification. A 25.5-hour American Red Cross lifeguarding course. Participants must be 15 years old by the end of the course. All classes and eligibility swim held at the Sentara RMH Wellness Center. All eligibility swims are mandatory. $175. Oct. 16-18; eligibility swim: Thursday, Oct. 8, 5 p.m. Call 1-800-SENTARA to register.

Lifeguard Recertification Course. A six- to eight-hour recertification course offered through the American Red Cross. This two-year certification teaches rescue and surveillance skills, first aid, CPR/AED and other skills needed to work as a professional lifeguard. Emergency oxygen certification is available upon request. Wednesday, Sept. 20. $85. Call 1-800-SENTARA to register.

C a l l S e n t a r a R M H H e a l t h s o u r c e a t 1 - 8 0 0 - S E N T A R A

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What if there was a technology that allowed for the increased ability to detect breast cancer? What if that technology was as simple as the traditional mammogram, but meant fewer callbacks for patients, and fewer follow-up diagnostic tests? At Sentara RMH Funkhouser Women’s Center, the future is here. Tomosynthesis, or 3-D mammography, is the latest and most advanced mammographic breast imaging technology. To schedule either a 2-D or 3-D mammogram, call the Women’s Center at 540-689-6800. There may be an additional $75 charge if your insurance does not cover the cost of a 3-D mammogram. 540-689-6800

N E W T E C H N O L O G Y S P O T L I G H T

3-D Mammography: A more complete picture

Sentara RMH Medical Center2010 Health Campus DriveHarrisonburg, Virginia 22801

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BURLINGTON, VT

Joint Replacement Surgery: When is the right time? An Orthopedics 101 seminar presented by orthopedic surgeon William Lennen, MD

Are you suffering with knee, hip or shoulder joint pain?Is pain keeping you from the activities you love?At Sentara RMH Orthopedics and Sports Medicine, our comprehensive joint replacement surgery program is designed to get our patients back to the life they love as quickly and efficiently as possible. Join Dr. Lennen as he explores joint pain, how to know when it’s time to consider surgery, and the technology available at Sentara RMH.

Thursday, July 16 at 7 p.m.Sentara RMH Medical Center, conference rooms 2-3

Registration is required by calling 1-800-SENTARA. This event is free.

William Lennen, MDOrthopedic Surgeon

Medical School: Georgetown University Medical SchoolInternship and Residency: Georgetown University Medical CenterFellowship: Total Joint and Adult Reconstruction, Johns Hopkins University

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