UVA Health System Blog

Stories about the patients, staff and services of UVA


Podcast Tuesday: Brain Tumor Treatment Research [AUDIO]

On May 26, 2015 | At 10:47 am

A brain tumor diagnosis can be devastating, especially when it’s glioblastoma, one of cancer’s deadliest forms. But researchers at UVA and around the U.S. are developing new brain cancer treatments with promising results.

Get the details from neurologist Benjamin Purow, MD, in this week’s podcast.

Diagnosed with a brain tumor?

Filed under : Cancer,Neurosciences,Podcast Tuesday | By
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Maternity Monday: Breastfeeding Barriers and Benefits

On May 25, 2015 | At 10:21 am

When I meet with Ann Kellams, MD and Lynn McDaniel, MD, in the sunny conference room of the maternity floor, they speak eagerly and passionately about the changes taking place in the world of breastfeeding.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

“When my father was born, my grandmother was knocked out and put to sleep,” McDaniel says. “She woke up and there was a baby. We forget what it was like.”

There have been a lot of changes.

Certainly, the way our culture has treated pregnancy, birth and breastfeeding has significantly altered throughout the last century, and that change is reflected in hospital practices across the country.

“Even if you had kids 5-10 years ago,” McDaniel notes, “The information and the procedures after delivery are different.” For instance, newly instituted at UVA:

  • All babies are put skin-to-skin with their mother immediately after birth
  • Babies sleep in the same room as their mothers at all times
  • All staff have been trained to support breastfeeding mothers, in the NICU
  • Lactation consultants visit new mothers regularly

Kellams, who directs the Breastfeeding Medicine Program that has lead the way in implementing these types of policies and procedures, has achieved great success:

  • UVA is one of only 12 hospitals recognized by the Virginia Department of Health for its support to breastfeeding moms.

    Breastfeeding experts Kellams and McDaniel

    Breastfeeding experts Kellams and McDaniel “want you to love feeding your baby and feel good about it.”

  • In 2014, a federal survey ranked UVA Medical Center in the top 5 percent of hospitals nationally for its support of breastfeeding.
  • Just last week, the Children’s Hospital earned an international award for its support of breastfeeding mothers.

“We have made major changes to ensure that every mother has the best chance of reaching her feeding goal and that mothers and babies have the smoothest transition possible both after birth and when they go home,” says Kellams.

Even better than the awards and recognition? The health improvements visible in their patients.

With the increased rate of breastfeeding mothers, Kellams and her team “see less weight loss, less jaundice, less babies with fast breathing rates after delivery, more stable conditions all around. We’re optimizing the conditions to make this organic process occur naturally. Removing the barriers that 50 years of medicine put in place.”

Breastfeeding Barriers

About 80 percent of women giving birth at UVA choose to breastfeed. So what is happening with the 20 percent who do not?

Cultural and Historical Context

“Before WWII,” Kellams explains, “If a mother died or couldn’t breastfeed, then mom, sister, friend would breastfeed the child. After WWII, we developed formula, and women started working. Science came in and everyone jumped on the formula bandwagon. And it was expensive, so it was a status thing.”

Breastfeeding Benefits

For the Mother:

  • Lower rates of breast/ovarian cancer
  • Lower rates of type 2 diabetes
  • Quicker return to baseline weight
  • Less postpartum bleeding

For the Baby:

  • Lower rate of infections, especially for premature babies
  • Lowers SIDS rates
  • Lessens diabetes risk
  • Fewer ear infections
  • Fewer allergies
  • Better immune function
  • Better digestion

In countries like Mexico and China, she notes, people perceive formula as a status symbol, because of its costs.

Cultural values around modesty and sexuality also play a role in restricting public breastfeeding.

Stress and Lack of Planning

McDaniel wants mothers to think “pre-conceptually. Post birth can be so stressful, I’d prefer that moms think about this before they deliver, when fatigue, pain, stress make thoughtful decision-making difficult. Get as much info as you can beforehand. You need to come in with a commitment and a plan.”

That’s why the first step in the breastfeeding program begins with prenatal consultations. “We want to give you all the information, so you can make the best choice for you and your baby,” Kellams notes. “As a new mom, you need all the knowledge you can get.”

In fact, Kellams and McDaniel have found that successful breastfeeding can improve a mother’s ability to manage post-partum depression. “Breastfeeding is a protective factor for depression. Instilling mom’s confidence in her body’s is a way to protect moms against PPD.”

Hospital Practices That Miss the Golden Hour

A huge culprit when it comes to factors that hinder breastfeeding: Hospital practices that remove the baby from mom.

The sooner you feed your baby, the better. Professionals call it the golden hour or power hour, the time right after birth when the largest amount of colostrum releases (the most protein and nutrient-rich part of breast milk) and the highest prolactin level exists in the mother.

If you do the first feeding in the first hour, and keep the baby with the mother, the benefits include:

  • The baby eats more later
  • The baby receives a boost to the immune system
  • The baby’s vital signs are more stable
  • The unit is quieter, due to fewer babies crying

Keeping the baby with the mother, eliminating the need for a nursery, reflects a big shift in best practices. “We used to say you should do this for various reasons, give the mom rest, etc.,” McDaniel says. “But now we know that separating them sets them up for failure.”

Medical or Other Hindrances

According to Kellams and McDonald, not many medical issues exist that completely prevent a woman from breastfeeding. Even procedures like C-sections do not render breastfeeding impossible.

Certainly, being HIV-positive, a drug user, a prison inmate or having some emotional barriers due to abuse could interfere with a breastfeeding plan.

Breast Pumps: Lack of Access

One barrier to sustained breastfeeding occurs if the mother needs a breast pump, either due to a medical condition or to return to work, and can’t afford to buy one.

At UVA, “We are now starting a program where we will have the insurance-approved pumps for mom. If they need to go back to work, we will provide that and it will get billed to insurance. We give prescriptions. WIC comes to the hospital, and they provide pumps. We provide hand pumps. We test pumps if they aren’t working well. Help mothers find a pump to rent before they leave the hospital.”

How UVA Helps

At UVA, we help you manage these barriers to breastfeeding.

Post-Hospital Support

The UVA program also sees mothers after they have returned home. They can help a mother manage:

  • Dealing with medications
  • A dwindling milk supply
  • A baby refusing a bottle
  • Mastitis
  • Soreness
  • Oversupply
  • Nursing when the baby is hospitalized

Supporting Your Choice

“Everyone that starts thinking about breastfeeding worries the doctors will pressure you into it,” notes McDaniel. But that’s not the approach the doctors at UVA take.

Certainly, the benefits to both mother and child clearly make the case for breastfeeding as opposed to formula feeding. But, McDaniel says, “In the end after all the info we give you, your choice is what we’re going to support. The thing we want most is we want you to love feeding your baby and feel good about it.”

Get Breastfeeding Support

Preparing to Breastfeed?

Problems Breastfeeding?

We can help: Call or visit the Breastfeeding Medicine Clinic



Podcast Tuesday: Concussions in Children [AUDIO]

On May 19, 2015 | At 9:07 am

We hear a lot about sports and concussions. But kids can get concussions as a result of car accidents, playground mishaps and even horseplay. And concussions in children can be hard to diagnose or notice.

Listen to this week’s podcast to learn:

  • Symptoms
  • Prevention tips
  • Treatment information
  • When it’s OK for kids to use computers and tablets again


Maternity Monday: The Partner’s Role in Pregnancy

On May 18, 2015 | At 10:18 am

Forty weeks of pregnancy is a long time and can put a toll on a woman’s body. She’ll experience every emotionfrom stress to excitement to feeling out of control. Pregnancy can put a strain on a relationship as well, and without the emotional and physical support of a partner, a woman may feel completely overwhelmed with everything going on. The partner’s role is quite simple: to be there.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

Meanwhile, partners are trying to navigate through their own emotions. There’s an old saying that goes, “a mom becomes a mom when she finds out she is pregnant. A dad becomes a dad when he sees the baby.” Partners play their own special role in the journey of pregnancy. Julie Ruffing is a labor and delivery nurse at UVA and a new mom. Here’s her perspective on the role her husband played in her pregnancy.

Question: What role did you husband take in your pregnancy?

Julie Ruffing: During pregnancy my husband was incredibly supportive. I think for a man, expecting a child can be a difficult time that is often underrepresented. For me, physical and emotional changes were obviously apparent, but for him, his life was changing slowly without his full comprehension. Early in my pregnancy I went through normal morning sickness and I just wasn’t myself. My husband struggled to understand why I was not excited to eat the meals he cooked and he often tried to get me motivated to be active when all I wanted to do was take a nap. As the pregnancy progressed, he was great! He massaged my aching feet after a 12 hour shift, made food that I was craving, and didn’t care that I needed 10 pillows to get a good night sleep. He did everything he could to support me in the changes that were taking place.

Q:Did you take labor classes? Did your husband attend?

Julie, her husband Ross, and their daughter, Josephine.

Julie, her husband Ross, and their daughter, Josephine.

JR: Since I am a labor and delivery nurse, I attempted to teach him about the labor process myself. We spent many long car rides discussing his role at the bedside during labor and all of the crazy events that may take place. We also talked about what would happen once the baby was born. Although I tried to cover everything I don’t think I prepared him fully for what to expect.  I’m sure he believed what I had taught him, but there is very little you can do to help someone understand what they’re in for when being a part of labor for the first time.

Q: Did your partner attend doctor’s appointments?

JR: My husband was present for the first appointment as well as the most important appointments throughout, including both of our ultrasounds. I find the ultrasounds important for the partner because it helps them to conceptualize that there is a living person growing inside the pregnant mother. During the process my husband was very excited and wanted to be a part of each step.  He is also the kind of person who seeks understanding and was quick to ask questions along way. At first I found this slightly frustrating because many of his questions I felt like I could answer.  However, as the process went along this trait proved to be very helpful and encouraging.

Q: Do you think there was a difference in how you felt toward the pregnancy and how your partner felt toward the pregnancy? Why or why not?

JR: Absolutely. I don’t think any man can fully understand pregnancy because they can’t go through it. It’s a crazy feeling to have a baby moving around inside your belly. During the pregnancy, I was constantly reminded that there was a living being inside me. She was always so active, rolling around and kicking me — 24/7. For the man, or a supportive partner, this simply is not the case. You may see the belly moving and continuing to grow but in many ways the reality of that does not sink in until that baby is born. Pregnancy can be a difficult time for any woman. A support system can be quite helpful.  For me that support came from my husband and has continued into raising our child together.

Filed under : Maternity Monday,Women's Health | By
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#MyHospital: Sharing How UVA Gives Back [VIDEO]

On May 15, 2015 | At 9:51 am

“What does my hospital bring to the community?” Last week, the American Hospital Association encouraged hospitals to answer this question through videos and photos and share on social media.

We talked to four Health System employees with vastly different jobs. Watch what they had to say.

Filed under : Nursing,The People of UVA | By
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Podcast Tuesday: Cancer Genetic Testing

On May 12, 2015 | At 9:39 am

Just like you have your mom’s hair color and your dad’s athletic ability, you can inherit a predisposition for cancer. Cancer genetic testing can determine if you’re likely to get cancer, especially:

  • Breast cancer
  • Colon cancer
  • Ovarian cancer
  • Pancreatic cancer

Listen to a Cancer Center genetic counselor explain the testing.

Filed under : Cancer,Podcast Tuesday | By
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Maternity Monday: UVA’s Free Prenatal Classes

On May 11, 2015 | At 11:11 am

Are you a new parent or a parent-to-be and looking for some free advice? Oh Baby! is a free night of advice from UVA doctors.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

Diane Sampson, education director for UVA Obstetrics and Gynecology, explains the event: “The talks are based on what our obstetricians and pediatricians wish they had known as first time parents themselves, and what our physicians want our patients to know before baby comes.”

What You’ll Learn:

  • Typical newborn behavior
  • Tips for calming a fussy baby
  • The top 10 things to know about breastfeeding before your baby is born
  • Postpartum: the good, the bad and the ugly

All participants receive door prizes, refreshments and helpful take-home materials.

Where: Quayle Learning Center, Battle Building. Park for free in the 11th Street Garage.

When: Wed., May 20th 6-8 p.m.

UVA also offers a variety of prenatal classes for family members of all ages. From breastfeeding and newborn care basics to grandparents and siblings classes, you can learn all aspects of welcoming a new addition to the family. They’re free, and new sessions start all the time.

Learn more about our available class options and sign up for Oh Baby!


Filed under : Events,Maternity Monday,Women's Health | By
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7 Quick Questions: Meet Dr. Winston Gwathmey

On May 7, 2015 | At 10:14 am

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.

Winston Gwathmey, MD, specializes in sports medicine and hip arthroscopy. He is a team physician for UVA and James Madison athletics as well as several high school teams.

Dr. Winston Gwathmey

Orthopedic surgeon, Winston Gwathmey, MD.

1. Why did you become a doctor?

I became a doctor because medicine combined my interest in science with a desire to provide a service to people. I was always drawn to science as a young student and found biology and physics to be fascinating. Becoming a doctor has allowed me to apply that fascination throughout my career and utilize what I have learned to help other people as well as advance our collective understanding of medicine.

2. Why did you choose your specialty?

Orthopedic surgery appealed to me because it offered the ability to fix broken people. There is nothing more gratifying than helping someone walk again after an injury has taken away that simple ability. The profound understanding of anatomy and the biomechanics that orthopedics requires allows me to recognize and appreciate the miracle of the human body.

3. What’s your favorite thing about Charlottesville?

Charlottesville has all of the sophistication, culture, and activity of a much larger city in a small town in a beautiful setting. It has the best of everything in my mind and is a wonderful place to raise a family. It helps that I am a big Cavaliers fan.

4. Where did you grow up?

I grew up in a red brick house on a muddy creek just off the Lafayette River in Norfolk, Virginia.

5. What’s the most exciting thing/research happening in your field right now?

Sports medicine is a field that is constantly evolving and the progress that we make on a daily basis is astounding. Hip arthroscopy in particular has been very exciting in that we are now able to recognize and treat hip injuries in younger patients and find ways to prevent the development of arthritis.

6. Who is your inspiration/hero?

My heroes are my grandfather, the late Dr. Harry Muller, and my father, Dr. Frank Gwathmey. Both men were fantastic surgeons and giants in their respective fields but were also outstanding fathers and husbands at the same time. While I love my work, these men remind me how important it is to remember the family for whom I work.

7. What’s your favorite thing about working at UVA?

UVA understands how to be an integral part of the community here in Charlottesville while at the same time attaining national and international recognition for the outstanding medical care, research, and education that is provided here. It is fun to be a part of the team and helping to generate the momentum that will undoubtedly advance UVA’s position as a leader in orthopedic surgery and health care as a whole.

Hear more from Dr. Gwathmey in his profile video.

Filed under : Orthopedics,The People of UVA | By
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Summer Vim & Vigor: Mental Illnesses & Your Overall Well-Being

On May 6, 2015 | At 9:44 am

The summer issue of our family health magazine, Vim & Vigor, focuses on the commonality of mental illness.

Frances and Charlie Berry were diagnosed with lung cancer just months apart.

Frances and Charlie Berry were diagnosed with lung cancer just months apart.

Read about:

  • Soccer star David Beckham opens up about dealing with obsessive-compulsive disorder (OCD).
  • A list of celebrities who struggle with other forms of mental illness including anxiety and depression.
  • A Culpeper couple, Frances and Charlie Berry, were diagnosed with lung cancer just months apart. Now, nearly six years later, the Berrys are cancer free and celebrating their 50th wedding anniversary.

Plus, learn more about concussions in children, as well as tips to stop a headache before it ruins your day.

Read the online version of the magazine.


Podcast Tuesday: Advances in Vascular Surgery [AUDIO]

On May 5, 2015 | At 10:33 am

Filed under : Heart,Podcast Tuesday | By
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