UVA Health System Blog

After a heart attack or a car accident, you might recall the hospital nurse you saw almost every day, the doctor who spent so much time explaining your surgery or the physical therapist who pushed you to your limit.

But before any of that happened, there were emergency responders who cared for you at the very beginning and got you to the hospital.

May 19-25 is National Emergency Medical Services (EMS) Week, where hospitals, rescue squads and other organizations around the country recognize the hard work of emergency responders. Many are volunteers and give up free time or even sleep to be there when we need them the most.

A “Surrogate Family”: Volunteering for CARS

Every Sunday night, Michael Hanshew works a 13-hour volunteer shift with Charlottesville-Albemarle Rescue Squad (CARS).

Michael Hanshew (top left) is part of Charlottesville-Albemarle Rescue Squad's Sunday night crew.

He’s a duty officer, meaning he supervises the other volunteers, ensures every EMS call gets a response and fills in wherever he’s needed. He can sleep but wakes up every time a 911 call goes out, or he’s needed for a response, or the phone rings with a question. He gets off at 6:30 a.m. Monday. Then he begins his job as a director of quality assurance and compliance in UVA’s radiology department.

Mondays can be rough. But Hanshew, who began volunteering while he was a UVA student 15 years ago, can’t imagine any other life. At one point, he lived in Northern Virginia and drove to Charlottesville every week for his volunteer shift. A lot of his friends are CARS volunteers, and he says the experience helped him get his job at UVA.

You begin volunteering “because you’re interested in medicine and healthcare, and what sustains you through it, I think, are the personal connections with your crew members, and those long nights you’re pulling through together,” he says.

For Sarah Ferrell, who also began volunteering as a UVA student, CARS became her “surrogate family for an undergrad that was away from home.” She now works in emergency services at UVA and has been volunteering for CARS for seven years.

Both Hanshew and Ferrell are intermediate-level EMTs, which is one step below the highest level, paramedic. This level means they can perform a wide scope of interventions and treatments, and it’s a common level at CARS.

Charlottesville-Albemarle Rescue Squad volunteer Sarah Ferrell (left) at a training session

Ferrell, who was the deputy chief of night operations at CARS until December, often volunteered almost forty hours per week in that role. Even though her life now as a UVA employee is far busier, she still runs an average of one shift per week with the agency. The camaraderie with the other volunteers is her favorite part, but the variety of calls and success stories also keep her coming back, such as a cardiac arrest patient in his 30’s.

“We got there, worked with the fire department, resuscitated him, and he walked out a couple of weeks later from the hospital with no deficits,” she says.

EMS at UVA

The Health System’s emergency medical services include:

• Pegasus Air & Ground, UVA’s ambulance and flight helicopter
• NETS, the Newborn Emergency Transport System, which transfers babies and children from other hospitals to UVA
• Medic-5, a team of 36 EMS providers

Medic-5 handles emergencies near the hospital and transports patients from one facility to another. For example, if someone developed chest pains at Northridge Medical Park, four miles from the hospital, the EMTs would take the person to the hospital. EMTs also transport UVA patients to other facilities, such as nursing homes.

EMS employees can perform different skills based on their level of training, but all are capable of lifesaving interventions such as performing CPR, using an AED or giving oxygen. About half of UVA’s team are paramedics, the highest level EMS provider.

UVA also works with local EMS providers to track UVA patients and review their care from the initial 911 call to the time they’re discharged from the hospital. And when there’s a particularly traumatic incident like a child’s death, UVA works with fire department and rescue squad volunteers who were affected.

Interested in EMS?

The Charlottesville-Albemarle Rescue Squad is looking for volunteers and holds EMT-Basic courses several times a year. Learn more about volunteering for CARS.

Glioblastomas. They represent the most common form of brain tumor in adults, and the most deadly. When glioblastomas invade the brain, there isn’t a cure.

Enter UVA researchers, who have just identified an enzyme essential to these brain tumor cancer cells. By targeting this enzyme, the researchers hope to open the door to new and better treatments. They even have identified a drug that inhibits the enzyme, which promises great potential for brain and other cancer treatments in the future.

Read more about this new discovery and what it means for the future of brain cancer treatments.

The folks responsible for the food served at UVA always have their work cut out for them.

The food service operations at UVA must please a long list of clients, including:

• Patients
• Staff
• Families and friends

And since it’s in a hospital, the cafeteria also increasingly tries to keep its food and drink as healthy as possible.

Without, importantly, any sacrifice in taste. 

Healthier Comfort Food

“You have to be careful with healthy food, because if that’s all you offer, even though your intentions are good, not everyone is going to respond to it,” says Chris Lee, associate director in the Department of Nutrition Services. “You have to do it in a way that’s creative, flavorful and people feel like they’re still getting that comforting food item that they would at home.”

Grilled vegetable lasagna is part of the new Wellness menu at the UVA cafeteria.

The goal of making a healthier menu is part of the broader goal of  Morrison Healthcare, the contractor that handles UVA’s food service.

In March, Morrison says it became the first healthcare food service company to join The Partnership for Healthier America.

As a result of the partnership, UVA patrons can expect to see more nutrition labeling, a new slate of “wellness meals,” healthier beverages and an emphasis on fresh foods like fruits and vegetables.

For example, cooks making a new lasagna recipe use ground turkey instead of beef and use whole wheat noodles instead of white.

The reformulated lasagna can be served to a variety of different constituencies at the hospital and is appropriate for a patient on a heart healthy diet.

“The nice thing is it’s still good,” Lee says. “And the person who might be sitting next to you doesn’t feel deprived because you got one thing and they got another. “

These sorts of changes have rolled out both for inpatient meals and the food served in the retail locations, Lee said.

A change in beverage offerings — look for more water and fruit juice — means eliminating 5.7 million pounds of sugar from bottled beverages among the hospitals Morrison serves, according to the company.

Small Changes Mean Better Health

Many of the changes are relatively small ones that could easily escape notice. For example:

• Hamburgers are served with a whole wheat bun, although the customer can request a traditional white bun.
• Pans, grills and woks are also now lightly greased with an oil mister.

Although the new program is not strictly the result of customer demand, Lee says Morrison generally sees a more informed, curious clientele these days.

People increasingly want to know what’s in their food, he says.

Other health system-related food and dining related initiatives include:

• Composting of all food waste
• Increasingly purchasing local products ($159,000 so far through the Local Food Hub)
• A new website with breakdowns of the nutritional value of the day’s offerings

There’s an App for That: A diner can also learn about nutritional information by searching for “Morrison” in the MyFitnessPal app.

Mary A. Sullivan coordinates community advocacy, education and outreach efforts for the Teen Health Center. She’s provided health education to local students and parents for over 20 years. Here she shares her thoughts about teens and mental health.

The transition from childhood to adulthood, adolescence, is enormously significant. Physical, cognitive and psychosocial developmental changes render adolescents particularly vulnerable. This inherent vulnerability combined with external stressors and/or a predisposition to mental illness set the stage for the proverbial “perfect storm.”

Let’s look first at common stressors challenging pre-teens, teens and young adults. These include, to name a few:

• Academic pressure
• Social insecurity
• Family discord
• Peer pressure

Teens also experience “trickle-down” stress experienced by their parents or caregivers, including financial instability and divorce or chronic illness experienced by a family member. Since adolescent development varies widely, pre-teens and teens often worry about whether or not they are “normal” compared with their peers.

Depression in Teens

Depressed adolescents may have many of the same symptoms as depressed adults, including:

• Feeling sad, guilty, helpless and hopeless
• Changed appetite and sleep patterns
• Decreased energy and focus
• Loss of interest in activities previously enjoyed
• Suicidal thoughts

But depression in adolescence may also resemble normal adolescent angst: Irritability, apathy and vague complaints. Since depression is potentially lethal, knowing your child’s “normal” is important.

Eating Disorders

Eating disorders often occur during significant life transitional periods, making adolescents susceptible. Anorexia nervosa, bulimia and binge eating are some common eating disorders. While these are more common in women, young men can develop eating disorders. These conditions are most effectively treated with quick diagnosis and intervention.

Anxiety

The stressors challenging adolescents make anxiety a given. While the adolescent brain is not fully developed, the ability to look into the future combined with moodiness and impulsiveness create fertile ground for anxiety.

Teen Alcohol and Drug Use

Experimental use of alcohol and drugs is very common in adolescence. In his most recent book “Clean: Overcoming Addiction and Ending America’s Greatest Tragedy,” David Sheff, journalist and father of an addict in recovery, reports interesting information gleaned from surveys of parents and teens.

Many parents attributed their teens’ drug use to peer pressure and a “selfish pursuit of pleasure.” But teens reported differently:

• Thirty-two percent reported using drugs to forget troubles
• 24 percent because of troubles at home
• 20 percent to handle school pressure

A mere 7 percent of parents attributed teen drug use as a mode of managing stress!

Sheff also points out that drug addiction usually occurs with other disorders like depression, PTSD, bipolar disorder, OCD and anxiety, illnesses not generally addressed in drug rehab programs.

Teen Suicide

Suicide is the third leading cause of death for 15- to 24-year-olds, according to the Centers for Disease Control and Prevention (CDC), after accidents and homicide. It’s also thought that at least 25 attempts are made for every completed teen suicide. Young people with mental health problems — such as anxiety, depression, bipolar disorder or insomnia — are at higher risk for suicidal thoughts. Teens going through major life changes (parents’ divorce, moving, a parent leaving home due to military service or parental separation, financial changes) and those who are victims of bullying are at greater risk of suicidal thoughts.

Factors that increase the risk of suicide among teens include:

• A psychological disorder, especially depression, bipolar disorder and/or alcohol and drug use (approximately 95% of people who die by suicide have a psychological disorder at the time of death)
• Feelings of distress, irritability or agitation
• Feelings of hopelessness and worthlessness that often accompany depression
• Previous suicide attempt
• Family history of depression or suicide
• Emotional, physical or sexual abuse
• Lack of a support network, poor relationships with parents or peers and feelings of social isolation

Treatment and Final Points

Adolescent stress is real and significant and should not be minimized by those who care for and about young people.

The stress parents experience can be “contagious,” affecting their children. Since adolescents are not always forthcoming with the adults in their lives, these adults must be vigilant, noticing problematic physical, social and emotional changes.

Mental health disorders can be successfully treated, and treatment becomes more effective when combined with other stress management techniques, including:

• Regular physical activity
• Meditation
• Adequate amounts of sleep
• Healthy food

Remember, too, that adolescents in general are a resilient lot, and many surmount the challenges presented during this life transition.

Questions?

Are you a teen who needs help with any of these problems? Or are you a parent who’s worried about your teen?

Contact the Teen Health Center.

Ever wonder what your doctor or health provider does outside the exam room? Our 7 Quick Questions series gives you a personal glimpse into the people of UVA.

You in one sentence:

My name is John Jane Jr. and I am a neurosurgeon at UVA.

Hometown?

I was born at UVA after my family moved to Charlottesville for my father to become the chairman of neurosurgery at the University. In fact, not only was I born at UVA, but so was my wife Robin and my two children, John and Maddie Nell.

Specialty?

I have two main subspecialties in the field of neurosurgery. I specialize in pediatric neurosurgery and in the removal of various tumors along the base of the skull through the nasal passages using an endoscope.

Why medicine?

I chose medicine because it provides the opportunity to positively impact the lives of others. I consider it a profound honor that people put their trust in me to help them during difficult times.  

Best thing about UVA?

The best thing about working at UVA are the people. I feel very at home at UVA. From my colleagues in my department, to my colleagues in other specialties, to the nurses and support staff, everyone is geared toward taking care of patients.

Hobbies?

When I’m not in the hospital, I like to spend time with my family. I’m lucky to have not only my wife and children here, but also my parents and one of my three sisters, my brother-in-law and my nephews. Except when I am out of town teaching or at conferences, the radius of my life extends only 1.2 miles.

What would you do if you weren’t a doctor?

Although I’m often asked this question, I must say I have no good answer. I cannot imagine doing another thing and am grateful for the life that I have.

We celebrate more than just the arrival of warm weather the first couple of weeks in May. National Nurses Week ends on Florence Nightingale’s birthday, May 12, which also marks the beginning of Hospital Week. That means lots of fun activities to celebrate not just our nurses but all the hardworking, talented staff who keep UVA running.

More than 250 nurses joined us at The Paramount Tuesday night for a screening of the documentary “Nurses: If Florence Could See Us Now.” Check out this slideshow of photos from the evening.

Were you there? Leave a comment to share your thoughts about the movie.

These days, more and more women are going into the field of medicine. About half of the medical school applicants in 2005 were women, compared to only 10 percent in 1965.

The result? More and more doctors happen to be mothers. Finding a balance of work and family life can challenge any working parent, but for mothers, especially mothers in the medical field, the stresses are uniquely intense.

Women have been practicing medicine, challenging gender norms, for a long time.

It therefore seemed appropriate to celebrate Mother’s Day this year by sharing some key points about motherhood and work from a talk given by Megan Bray, MD, an OB/GYN here at UVA.

Challenges for Working Mothers Who Are Doctors

A mother herself, Bray’s presentation, delivered at the 2013 Quadruplicity conference here in Charlottesville, VA, discussed the specific disadvantages women with medical careers face:

• When to time pregnancy in regards to career ambition and stress
• Maternity leave guilt and restrictions
• Can’t do the typical 7 a.m. or 7 p.m. meetings
• Difficulty finding reliable childcare for odd schedules

Gender Norms in the Workplace

Bray also pointed out cultural gender norms that can hamper success in any career:

• Definition of success includes “wholeness” and meeting family responsibilities
• Less likely to be effectively mentored or sponsored or tapped for leadership roles
• Need to please, make others comfortable
• Women underestimate their own abilities
• Women are still their family’s primary caregivers

How to Find Balance

Bray’s antidotes to these challenges?

• Maintain a sense of humor
• Build a support network
• Find reliable childcare
• Set boundaries/learn to say no
• Set your own standards (realistic timelines and goals)
• Make time for yourself
• Practice something that centers you like yoga or exercise
• Get organized
• Be flexible
• Simplify your life
• Enjoy quality family time
• Find joy in the journey

These are definitely instructions all of us can take to heart.

This Mother’s Day, we celebrate all the women who are both doctors and mothers, and all the mothers who face the challenges of balancing family and work, whatever their jobs may be.

Happy Mother’s Day!

This month, we met some pretty courageous folks, including:

Michelle, a brain tumor survivor

Alden, a young runner who kept racing after cardiac arrest

Donna, a nurse who became a breast cancer patient

We also explored the “bod pod,” one of the coolest ways that UVA measures your fitness levels so you can plan a personalized workout. Watch how the pod works in this video now.

New research revealed that salt may actually not be as evil as once believed.

In honor of April being STD Awareness Month, we heard from one of our teen health experts about STD testing.

And April also being Child Abuse Prevention Month, we offered tips on how you can be part of the solution to a large but often invisible problem.

Ever wanted to shop with a health-food pro?

Our nutrition expert, Teller Stalfort, took us on a tour of the local Whole Foods to show us how to shop healthy.

Join us by watching this Heart-Smart Shopping Video Series, featuring facts and tips on meat, dairy, label-reading, vegetables, lentils, more.

Now it’s your turn!

You, too, can get a chance to shop healthy by winning a $200 gift certificate to your local Whole Foods. 

Just enter below to win.

We’re trying new heart-healthy recipes every month and will share the results with you. All recipes are from Club Red, UVA’s heart health club for women.

Tuscan Beans with Tomatoes and Oregano

I intended to follow this very easy recipe to the letter, but the ingredients kept conspiring against me. First, the early spring tomatoes at the grocery store looked like … early spring grocery store tomatoes. While tomatoes are obviously turning red and ripe somewhere, the ones that make their way to Virginia in April often leave a lot to be desired. Also, the garbanzo beans I thought I had in the cupboard turned out to be cannellini beans.

This bean salad is a snap to make.

It didn’t matter. I opened and drained the beans and added some thinly sliced radishes, celery and onions instead of the tomatoes.

I then followed the recipe and added the vinaigrette on top of the bean and vegetable mixture. I will confess, though, that I added a bit of salt and paprika instead of the salt-free seasoning blend. If you’re not following a strict no-salt diet, a pinch of salt will really help bring the flavors in this salad together.

Oh, and by all means serve this in a lettuce leaf if you want, like the recipe suggests. Skip it, like I did, and you won’t be compromising flavor or much nutrition.

So, even without following the recipe to the letter, this bean salad tasted great and made a fine side dish. In fact, you could make it with countless combinations of beans, vegetables and herbs all year long.

Stars: 3 out of 5