While only five to 10 percent of breast cancers are hereditary, a Sentara Cancer Network genetic counselor shares that it’s important to identify families with hereditary cancers. These can be breast cancers but also colon, pancreas, prostate or other cancer. By identifying families at higher risk, we are able to help prevent future cancers from occurring in these families with a strong history of cancer.

Here are several questions you can ask yourself to understand if you may be a candidate for genetic testing of the BRCA genes.

• Have you or a family member (mother’s or father’s side) been diagnosed with breast cancer at age 50 or younger?

• Have you or a family member been diagnosed with ovarian cancer at any age?
• Do you have a male family member who has had breast cancer at any age?
• Do you have Ashkenazi Jewish ancestry, and a personal or family history of breast, ovarian, or pancreatic cancer at any age?
• Do you have a previously identified BRCA1 or BRCA2 mutation in your family?

If you answer yes to any of these questions, please call the toll-free Sentara Cancer Network resource line at 888-220-2214 to be connected with a breast expert who can help you with a more thorough discussion of your risk.

“Even though I realize finding out you have a gene that increases your risks of cancer is concerning, helping my patients begin to see that knowledge is power helps them reclaim some control,” says Jessa Blount, MS who is a certified genetic counselor with Sentara Medical Group.

The new information patients learn through genetic testing helps them make better decisions about their health.

Learn more about Sentara Cancer Genetic Services. 

I had been fighting getting a dog for years! I had every excuse you can have not to get a dog!

Kathy Tandy and her dog Roxy.

Last year at the holidays, my daughter came to me and said, “You’re a terrible mother, you didn’t get anything on Shane’s Christmas list…not even the dog!”

Well, that was the day that I took my 20-year-old and 19-year-old to an animal rescue foster home and we came home with Roxy! It was like having another baby. I already have five children and believe me I didn’t need another!

Today, I can say that Roxy has been one of the best things that ever happened to me. Every day she looks at me with those big brown eyes, just begging me to take her for a walk. We walk three times a day, a mile each time. Whether it is raining, snowing or windy…we walk. It forces me to get up and get moving and I feel great when we are done.

I enjoy the exercise, and the therapy I get from Roxy is priceless. I can be mad at my kids or my husband, or have had a really challenging day at work, but Roxy will listen to me. She does not judge me and will just give me that look of “you go girl” or “that’s right, you’ll show them.” It is the best therapy in the world for my heart and body, but also for my soul.

My point here is that working with a partner makes all the difference in the world and it does not have to be a dog. If you are accountable to a friend, family member or health coach, and committed to getting some type of exercise everyday, it sometimes gives you the push you need to follow through. If you don’t feel like getting the exercise on a particular day you are not only letting yourself down, but your partner too!

Having a partner is good for the body, mind and soul.

More than 18 bags of unwanted drugs were retrieved at Sentara CarePlex Hospital and Sentara Port Warwick.

For the safety of the community, Sentara CarePlex Hospital and Sentara Port Warwick recently helped clean up Newport News and Hampton. Teams staffed both locations to accept unwanted prescription drugs during National Drug Take Back Day.

At Sentara locations, more than 18 bags of unwanted drugs were retrieved to keep unwanted drugs out of the reach of children and from being flushed down the drains.  Sentara partnered with Drug Enforcement Agency (DEA) and Hampton and Newport News Police Departments. Nationally, more than 371 tons of drugs were collected during this Take-back event.

Allergy season has arrived, bringing telltale yellow pollen-covered cars and a battle against itchy eyes and runny noses. The 2013 Asthma and Allergy Foundation of American ranks two Virginia cities (Virginia Beach and Richmond) among the top 22 cities in the US in their “Spring 2013 Allergy Capitals” list (allergycapitals.com).

Over-the-counter medications, including saline nasal sprays as well as antihistamines currently available are often sufficient to effectively control the symptoms of hay fever, says Kimberly Smith-Griffin, M.D., a physician with Sentara Internal Medicine Physicians in Chesapeake.

Smith-Griffin also recommends taking a shower and putting on fresh clothes after being outside for any length of time to avoid even more exposure to the yellow stuff. When over-the-counter medications aren’t controlling the symptoms, Smith-Griffin recommends consulting a doctor.

Families struggling with the spring allergy season have a new high-tech tool in the battle. The telehealth service, called Sentara MDLIVE, offers patients easy and immediate access to a team of board-certified physicians licensed in the state of Virginia, via Webcam, phone or email. These doctors can diagnose allergies and prescribe necessary medications during the “virtual visits” – saving patients a trip to the doctor’s office.

“The good news is that there are effective allergy treatments available for adults and children. Sentara MDLIVE allows you to receive the care you need whenever it’s most convenient,” says Smith-Griffin, who also takes call for Sentara MDLIVE.

The service is available to all Virginia residents (and nationwide) and the visits are often covered by insurance providers. If not, the cost of a visit is $45 –  significantly less than an ER or Urgent Care visit.

Sentara MDLIVE is not limited to seasonal allergy ailments; patients can use the service for any non-emergency condition including a cold or flu, sinus infection or mild respiratory problems.

How does it work?

Sentara MDLIVE visits are covered for Sentara employees covered by Optima Health insurance – learn more by logging onto your optimahealth.com account.

Or you can log on to www.mdlive.com/sentara or call 1-800-335-4836 to get started. You’ll consult with a board-certified doctor using your computer and a webcam or the telephone. Virtual appointments are usually scheduled within minutes of registration and are available 24 hours a day, 7 days a week.

Written by Angie Laing, RN, CEN, SANE-A, Program Coordinator of the Sentara Norfolk General Hospital Forensic Nurse Examiner Program, Charge Nurse in the Emergency Department, and Magnet Co-Chair.   Angie has worked at Sentara Norfolk General Hospital for 8 years.

Angie Laing

In recognition of National Sexual Assault Awareness Month, Forensic Nurses, advocacy groups, agencies and organizations are raising awareness and educating communities and individuals in identifying and preventing sexual violence.

So, join the conversation, and start talking about identification and prevention of adult and child sexual abuse.

Here’s how you can help. Be informed.

Sexual and domestic/intimate partner violence poses a significant public health problem linked to increased mortality and morbidity.

• These crimes can result in severe physical and psychological problems, both immediate and long-term and create a considerable health burden for survivors.
• Access to care and available resources creates an additional community burden for this population.
• Forensic nurses, law enforcement officers and victim advocates are often the first to come in contact with survivors of sexual violence.

Understand what a forensic nurse examiner does?

Forensic Nurse Examiners (FNEs) or Sexual Assault Nurse Examiners (SANEs) are registered nurses who specialize in the care and management of survivors of sexual and domestic/intimate partner violence.  Their specialized knowledge goes beyond the medical field and extends into the legal arena of identification and collection of evidence and familiarity of the judicial system.

FNEs provide survivors of sexual assault a comprehensive medical-forensic examination, testing and treatment of sexually transmitted infections, emergency contraception, evidence collection and chain of custody procedures, give testimony in a court of law, and promote a continuum of care by managing follow-up services and referrals to valuable community resources.

Find out how forensic nurses respond to survivors. 

We also work in conjunction with a multidisciplinary team of professionals from law enforcement agencies, victim advocates, victim services, and the legal system that make up the Sexual Assault Response Team (SART).

This specialized team provides a coordinated community response to survivors of sexual violence by offering immediate access and improvement of victim services, outreach, follow-up, primary prevention education, and identifying and bringing the responsible person(s) to justice.

Learn more about Sentara Healthcare’s Forensic Programs

 Sentara Healthcare has a Forensic Nurse Examiners Program at the following hospitals including: Sentara CarePlex Hospital, Sentara Norfolk General Hospital, Sentara Northern Virginia Medical Center, Sentara Williamsburg Regional Medical Center and RMH Healthcare.

The programs provide immediate care and services for survivors of sexual and domestic/intimate partner violence.

Sentara’s first forensic nurse examiner program was established in April 2006 at Sentara Norfolk General Hospital. The program, which is staffed with 7 part-time forensic nurses, serves victims of sexual and domestic/intimate partner violence and is an extension of the hospital’s Emergency Department.

The program provides services and referrals to approximately 80-100 forensic patients a year. It is funded by the Virginia Department of Criminal Justice (DCJS) bi-annual grant, the Virginia Sexual and Domestic Violence Victim Fund, which is designed to improve services for victims of sexual and domestic/intimate partner violence, an underserved population in the community.

Angie’s dedication to raising awareness and educating communities and individuals in identifying and preventing sexual violence earned her an Inside Business Healthcare Hero award.

Read Forensic Nurse is a champion for prevention. 

Ambulances and firetrucks lined up on Colley Avenue.

The surrounding Colley Avenue community as well as those on the medical center campus saw and heard the activities, sirens and lights of first responders during the drill, which took place on Children’s Lane.

There was no cause for alarm during the drill.

Important facts about the drill:

• The emergency activities on Children’s Lane on April 25, from 9 to 11 am, were part of a drill.
• All EVMS, CHKD and Sentara Norfolk General Hospital services were fully operational during the exercise.
• All city roadways were open during the exercise, with the exception of Children’s Lane, which runs parallel to Colley Avenue between Olney Road and Raleigh Avenue.
• Travelers used Raleigh Avenue to reach the CHKD Emergency Room.

Take an inside look at the drill. 

• 

  Local responders off load “patients” from the active shooter drill.

• 

  “Patients” are triaged and assigned in the Emergency Department.

  

  Local responders and Sentara Norfolk General Hospital Emergency staff participate in the drill.

  

  Emergency Department teams assess “patients” during the drill.

  

  Teams from EVMS, CHKD, Sentara and local responders participate in a debriefing after the drill.

LifeNet Health is our region’s federally designated Organ Procurement Organization and through the work of LifeNet, many thousands of lives are saved.

Here are some national and regional facts that might make becoming a donor more meaningful:

•  One donor can save 9 lives through organ donation (heart, split liver, pancreas, 2 kidneys, 2 lungs and small intestine), enhance more than 50 lives through tissue donation and restore sight to two people through eye donation.

•  • Over 117,000 people are currently awaiting an organ transplant in the U.S.; more than 3,000 of them in Virginia.

•  • On average, 18 men, women and children die each day waiting for a life-saving organ transplant in the U.S. On average, three die each week in Virginia.

•  • To be an organ, eye and tissue donor, document your wish at a DMV office or on-line at DonateLifeVirginia.org.

•  • Your designation at DonateLifeVirginia.org or on your driver’s license is a legal document and your wish will be honored.

For more than 40 years, the Sentara Transplant Center at Sentara Norfolk General Hospital, has been saving lives through organ transplantation.  Over that time, more than 2,200 transplants have been performed.

The Unique Boutique is a free wig, hat and scarf shop that’s located at Sentara Williamsburg Regional Medical Center, on the first floor of the Geddy Outpatient Center.

(L-R) Margaret Cullivan, Director of Volunteer Services/Guest Services, Sentara Williamsburg Regional Medical Center is pictured at the Unique Boutique opening with hospital volunteers and auxiliary members Jane Anderson, Marie Bond, “CC” Collins and Suzi Williamson.

Volunteers, under the direction of Margaret Cullivan, Sentara Williamsburg Regional Medical Center volunteer services/guest services, help patients with medical hair loss select a wig or other head cover. Volunteers meet with patients one-on-one for about an hour to give them privacy and time to select the looks they like. 

“The Sentara Williamsburg Regional Medical Center Auxiliary has strongly supported the breast cancer program in Williamsburg. The Auxiliary introduced a free mammography program and continues to donate chemo caps and lap blankets to patients. The ongoing support allows Sentara to enhance its offerings to cancer patients in order to make a difficult situation much better,” says Margaret Cullivan.

“Two of the women met me before the official opening of the Unique Boutique. They showed me wigs, hats and scarves,” says Pat Parrott. “My hair is almost gone from the chemo; I have just a few sprigs left.”

A unique experience. 

(L-R) Suzi Williamson and Bob Graves, President, Sentara Williamsburg Regional Medical Center, are pictured at the ribbon cutting ceremony for the Unique Boutique. Suzi donated 700 wigs and 1,400 hats to the Unique Boutique.

Pat left the appointment with two wigs and a few knit hats. She has especially appreciated the hats because her head gets cold in brisk weather. No money was needed for Pat to feel more comfortable and confident: The consultation and head cover-ups were free, thanks to the Auxiliary volunteers and the generosity of Suzi Williamson, a former Williamsburg resident.

“I offered the service on my own in my home after I survived breast cancer,” explains Suzi, who called herself The Hat Trader. “I’ve been meeting with patients since 1999. I was so happy that the hospital accepted my donation and created The Unique Boutique because I’m moving to Colorado to be with family.”

Her stock included 700 wigs and 1,400 hats, all accumulated through donations. Suzi estimates she helped about 85 patients a year, and she anticipates that the hospital volunteers will serve more people.

“My community had gated security, so that could be a barrier. I also didn’t have wheelchair accessibility,” Suzi notes. “I sometimes met patients on my front steps because they couldn’t get up the stairs. I think the hospital will be much more convenient for people, so I’m thrilled.”

The volunteers are thrilled, too.

Jane Andersen, a breast cancer survivor, has been working with fellow Auxiliary member Carolyn Collins to organize the Unique Boutique and recruit volunteers. They opened in January 2013 and see patients by appointment. Andersen loves the Unique Boutique’s warm, homey room that has been painted a soft yellow and includes lots of cabinets and a dressing table with a mirror.

“It really looks like a boutique,” she says. “It’s a safe, cozy place. That’s what we want: we want it to be a wonderful place for women and men, anyone who is experiencing medical hair loss.”

Pat, the lymphoma patient, could be going back to the Unique Boutique in the near future. She describes her head as small, and she’d like to select another wig or two to get a perfect fit.

“I might take another look,” she says. “They told me they keep getting new stock.”

Suzi, the Hat Trader, confirmed that new donations are rarely a problem.

“Customers would always ask me ‘what do I owe you?,’ ‘what can I do to re-pay you?,’” says Suzi. “I would tell them ‘get better,’ and ‘then, if you like, make a donation to help someone else.’ So many of them did just that.”

The Unique Boutique’s free wig, hat and scarf shop, is located at Sentara Williamsburg Regional Medical Center, on the first floor of The Geddy Outpatient Center, 100 Sentara Circle. Auxiliary volunteers will help patients with medical hair loss select a wig or other head cover. Volunteers meet with patients one-on-one for about an hour to give them privacy and time to select the looks they like. Patients can call 757-345-4439 for an appointment.

Dr. Kimberly Croteau-Sparks

Ever wonder what the difference is between an ear, nose & throat (ENT) doctor and an audiologist?  You’re not alone!  Understanding the difference between an ear, nose, and throat (ENT) doctor and an audiologist can help patients determine where to go to address problems concerning their hearing and balance.

What is an Audiologist?

An audiologist is a healthcare professional that specializes in identifying, diagnosing, managing, and treating disorders of the auditory (hearing) and vestibular (balance) portions of the ear.  Their unique education and training provides them with the skills to assess and diagnose dysfunction in hearing, balance, and related systems of the ear.

Common reasons patients come to an Audiologist include:

• hearing loss
• ear infections
• wax in the ear
• sudden loss of hearing
• balance problems
• dizziness/vertigo
• ringing/noises in the ear(s)
• pressure of the ear(s)
• chronic itching of the ear(s)

In addition, audiologists conduct hearing screenings, recommend and sell hearing aids and assist with rehabilitation options for vertigo/imbalance.

What kind of training does an audiologist have?

Audiology is the branch of science that studies hearing, balance, and other related disorders.  As of 2007, the entry-level degree for the profession is now a Doctorate of Audiology (Au.D. or equivalent).  This degree is the clinical equivalent to a Ph.D. and requires 3 years of academic study, 1 year of working full time in the field, and a research component (at many universities).  Every audiologist has to be licensed by the Board of Audiology, Board of Hearing Aid Dispensers (if working with hearing aids), and will have certification through the American Speech-Language-Hearing Association, American Academy Audiology, or American Board of Audiology.

When would you see an ENT doctor?

An ear, nose and throat (ENT) doctor is a medical doctor (MD) also referred to as an otolaryngologist who specializes in diagnosing and medically or surgically treating ear, nose and throat issues.  ENT doctors do NOT perform any comprehensive hearing or balance testing in their offices.  That’s where an audiologist comes in!  ENT doctors often work very closely with audiologists as a compliment to the care they provide.  By collaborating to diagnose and treat medical issues causing hearing and/or balance problems, patients can be sure to get the care they need.

What should you do if you have issues with your hearing or balance?

First, schedule an appointment with an audiologist for hearing and balance testing to get you a step closer to a diagnosis and recommended course of treatment.  If the audiologist finds there is a medical reason complicating or causing your hearing or balance issue, here again is where a close connection between an audiologist and ENT doctors comes into play.  As needed, the audiologist will refer you directly to an ENT doctor to make sure you get the appropriate treatment.

Sentara Medical Group financial counselor Bobbi Lee Rivas thought the worst was behind her when she was robbed at gunpoint on Feb. 4, 2011, at a shopping center she frequented often.

Bobbi Lee Rivas.

Rattled but safe, Bobbi returned home, only to feel like she was having a heart attack 30 minutes later.

“I was having an extremely difficult time breathing,” says the now 47-year-old “I yelled for my husband to call an ambulance.”

Although Bobbi remembers her health quickly deteriorating, she says the staff at Sentara Leigh Hospital was able to stabilize her and transfer her to Sentara Heart Hospital.

She hadn’t suffered from any heart-related problems before that day, but she was familiar with the symptoms of a heart attack and the treatment protocol from her job.

Bobbi Lee Rivas recovering in the hospital.

For seven days she was sedated in a coma, with doctors believing she may have suffered from a severe heart attack.

She was identified as a candidate for a possible heart transplant — before cardiologist Dr. John  M. Herre determined that she had not suffered a heart attack at all: She had Takotsubo cardiomyopathy, a rare condition she and many others have never heard of.

It was first recognized in Japan in 1990. The name is often simplified to “stress cardiomyopathy” or “broken heart syndrome.”

“The way it was explained to me is that the condition occurs when there is a sudden temporary weakening of the heart muscle, usually due to emotional stress,” Bobbi shares.

With a database of 6,229 Takotsubo cardiomyopathy patients, researchers in 2007 studied 5,558 women and 671 men. They found:

• Women are 7.5 times more likely to develop broken heart syndrome than men.
• Women older than 55 are at 2.9 times higher risk of developing the syndrome compared to women younger than 55.
• Among those younger than 55, women were 9.5 times more likely to develop the syndrome compared to men.

The next step for researchers is to determine if and how hormonal influence might affect Takotsubo cardiomyopathy. Its symptoms include:

* Chest pain
* Shortness of breath
* An irregular heartbeat
* A generalized weakness

The symptoms often begin minutes to hours after the person has experienced severe stress.

The stress could be physical — such as high body temperature, dehydration, or low blood sugar — or emotional. The body can produce large amounts of adrenaline to help the person escape a real or perceived danger. With stress cardiomyopathy, researchers believe that the heart is overwhelmed by adrenaline. More research is needed to know exactly how this affects the heart.

The good news is that the condition is treatable when caught in time. It is believed that a person who experiences it once does not necessarily have the same reaction the next time he or she faces an extreme stressor.

After some ups and downs with her recovery, Bobbi is back to work.

“I am so pleased to be a Sentara employee,” she says. “I could not be prouder to be a ‘piece’ of The Sentara Commitments for patients, staff and others I come in contact with… I had many doctors and staff members take care of me, as well as my family, while I was in the hospital. Every hospital staff member, from those in housekeeping to administration, treated me and my family with dignity and grace. They were truly angels walking among us.”

Bobbi has embraced her love of life and expressed her appreciation for everyone in it with something she had never considered before: A tattoo. It’s a small one of Tigger, the loveable bouncing tiger from Winnie the Pooh, on her ankle.

“Mine is crouching and has a butterfly on his nose,” says Bobbi. “My three stepchildren, who helped me so much too, have similar ones to celebrate me getting out of the hospital and getting better.”