UVA Health System Blog

Stories about the patients, staff and services of UVA


Tennis Elbow: To Operate or Not, That is the Question

On July 2, 2014 | At 8:29 am

Angelo Dacus, MD, is upfront with his patient, Lisa Green.

Dr. Dacus works at the UVA Hand Center, as an expert orthopedic surgeon.

Dr. Dacus works at the UVA Hand Center, as an expert orthopedic surgeon.

“Most of the time these can heal with therapy, a splint, rest. “ He nods at her elbow, which she holds, in pain. “But most of the time, people don’t want to take the time.”

Dacus is talking about tennis elbow, or lateral epicondylitis, a condition that affects not just people who play tennis, but anyone who overuses their hand and wrist in repetitively. Having been a rugby player, adventure racer, ultrarunner, and in general a physically active person for most of her life, Green’s elbow damage is not surprising. An MRI shows her ligament is torn and aggravated by a bone spur.

Green is nervous. Before Dacus arrived, she explained that she’s not the kind of person who likes to see doctors. She’s had surgery before, and it wasn’t a great experience – she had a reaction to the anaesthesia; the recovery was painful and long. She’s also afraid that, whatever the solution, she will be without her right arm for a long time. She’s right-handed. She doesn’t like to sit still.

Elbow Surgery vs. Physical Therapy

When Dacus arrived, the two discovered they both hail from Alabama and established a comfortable rapport. Green’s initial anxiety visibly subsides as Dacus addresses her situation.

“I see two main groups of people,” he explains. “Recreational sports and laborers. The sports people don’t want to stop playing, because that’s what they’re energetic about, and for the laborers, it’s a financial consideration—being out of work plus the cost of healthcare. But I’m pretty sure if we put your arm in a splint for six to eight weeks, your elbow will heal on its own. It’s just a question of whether you want to do that or not.”

“What about the bone spur?” Green asks. “Won’t that keep aggravating the joint?”

An MRI of Green's elbow shows the damage to her joint.

An MRI of Green’s elbow shows the damage to her joint.

Bone spurs, Dacus explains, are more common than one might think. He suggests that, “looking at a sampling of patients over 40 would reveal a good 20 percent of them as having some bone spurs.” Dacus explains that wearing a cast to keep her wrist and arm from moving would allow the tissue to reconstruct on its own, bone spur or not. With just medication and physical therapy, it would take months, but could heal.

As Dacus outlines her options – waiting to see if the elbow will heal vs. surgery – Green listens, but shakes her head.

“I had surgery on my other elbow, and I don’t want to wait for this one to get worse like that one did,” she says. Green has already been wearing a wrist brace to help with her elbow and says, “I was immobilized, for weeks, then weeks of physical therapy, it got worse, and then I had to have surgery, more weeks of immobilization and weeks of therapy. So that could happen again, right?”

Dacus nods. “Yes.”

Dacus shows Green where the elbow joint damage needs to be repaired.

Dacus examines Green’s injured tennis elbow.

Green’s other worries: That she drives a stick shift, holds physically demanding jobs, has two school-age children, and there’s yard work and house projects she’s been waiting all winter to get to. Wearing a brace would prevent her from doing all of that—possibly with no recovery at all.

Dacus explains what surgery will entail and the recovery will involve. It’s an outpatient procedure, 45 minutes, followed by 10 days of rest, and six to eight weeks of therapy.

Green nods. “That’s not too bad.”

Dacus describes anesthesia options, and they settle on a nerve block.

The doctor examines her other elbow, and gently shows her where the surgery would occur, what the scar will look like, and he describes the layers of tendon in the elbow. Each layer pulls and moves the hand and wrist in different directions, and during surgery they will have to get to the one that is torn and do any reattaching necessary.  During the procedure, Dacus will also shave away the bone spur.

Elbow Surgery: Scheduled

It’s not a short visit. A nurse checks vitals, another nurse goes over surgery preparation – screens Green for sleep apnea (see sidebar) – and a physician’s assistant (PA) goes over the details of the patient consent form necessary to authorize the operation. Even the scheduler reviews the pre-surgery procedure with Green after scheduling the date and time (which Green set around garden projects and vacation).

Sleep Apnea & Surgery

These days, healthcare providers must screen patients for sleep apnea before surgery. Sometimes, people are sent to do a sleep study to rule the disorder out. The reason? People with sleep apnea have more challenges with anesthesia. Know the symptoms of sleep apnea.

While all of this attention to detail not only helps to establish a roadmap of what to expect, the team’s coordination also calms Green’s nerves about surgery.  She takes a deep breath. “I’m nervous,” she admits. “But it looks like I’ll be back in action by mid-June.”

As she is leaving, Green sees Dacus in the hallway. He confirms the date of surgery and jokes with her a little bit. “He’s a cool guy,” Green says. “I like him. You can’t go wrong with an Alabama boy.”

Is she happy with her decision to have surgery?

“Absolutely. I’m glad to get this done and have the pain fixed.”

Do You Have Joint Pain?

Visit the experts at the UVA Hand Center to discuss your options.

Filed under : Orthopedics,Patient Stories | By
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Poetry Friday: Untitled, by Bonnie Carey

On June 13, 2014 | At 10:15 am

Every week we’re publishing the winning poems from April’s medical poetry contest. This week’s poem was a runner-up in Category II: How Sick Did You Get?

By Bonnie Carey
The worst ailment that on me befell
Was an abdominal cyst that did swell
Of alarming surprise
Was its Guinness Book size
But it’s out, thanks to Leigh Anne Cantrell!

Filed under : Patient Stories,Poetry Friday | By
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Vim & Vigor: Bradley Cooper, Pediatric Epilepsy & Lowering Stress

On June 2, 2014 | At 9:06 am

In 2012’s “Silver Linings Playbook,” Bradley Cooper portrayed the role of a mental health patient diagnosed with bipolar disorder.

Image of Jennifer Raymond, who lost her son to H1N1 flu.

Jennifer Raymond’s son died of H1N1 flu complications in 2009. Read Vim & Vigor to find out how she honors his memory.

Read about Cooper’s experiences and his journey from passive bystander to activist for those 5.7 million adult Americans currently suffering from bipolar disorder.

Cooper’s interview along with a Q&A about the disorder are featured in the Summer 2014 issue of UVA’s family health magazine, Vim & Vigor.  Check it out for stories about:

  • Ongoing therapy to reduce peanut allergies
  • Quick and easy stress-busting techniques
  • Common myths about sunscreen
  • Warning signs of concussions

Read the online version here.

Live in Virginia? Sign up to receive Vim & Vigor in the mail for free.


Poetry Contest Winners!

On May 5, 2014 | At 9:20 am

For National Poetry Month, we held a poetry contest focusing on medical themes. We received numerous submissions, from hilarious haikus to heartfelt free verse. We all found it very difficult to choose our favorites!

Daniel Becker, MD, editor of Hospital Drive, worked with our editorial staff to choose the winners.

All winning poems will be published here on this blog. Look for them in our weekly “Poetry Fridays” post!

Grand Prize Winners

The grand prize winners each will receive a $50 Visa gift card.
image of flowers
Meditation on the Sickle Cell, Laura Kolbe
Kolbe’s poem will also be published in UVA Health System literary journal Hospital Drive.

The Maddening Gladness, Jarish Cohen

Honorable Mention

Doctor, Katherine Crowley

Runners-Up by Category

Category I: Bedside Manners

Untitled, Tina Auth

Category II: How Sick Did You Get?

An Embolic Tale, Jamie DeVore

Untitled, Bonnie Carey

Untitled, Jessica Garber

Category III: Grab (the Black) Bag: Miscellaneous Medical Moments

For John, Lisa A. Ryan

Blink, Callie Bateman

Insomnia, Rabita Alamgir

Congratulations to the winners and thanks to everyone who submitted a poem and to Daniel Becker, MD, for his time and efforts. Don’t forget to subscribe to this blog and to Hospital Drive for more poetry and stories about health, wellness, medicine and survival.

Filed under : Healthy Living,Patient Stories | By
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From Cystic Fibrosis to Marathon Ambitions: How a Lung Transplant Changed a Mom’s Life

On April 14, 2014 | At 8:07 am

Tina Tinsley’s dream was to be a mother, and her wish was granted after years of trying. But because of cystic fibrosis, she couldn’t do basic tasks that most moms take for granted. She couldn’t go to the grocery store or give her children baths. When she left the house, she had to take an oxygen tank along with her.

Tina Tinsley with her husband, Phillip and twins Sara and Cole

Lung transplant recipient Tina Tinsley with her husband, Phillip, and twins Sara and Cole

It wasn’t always this way. Tinsley, now 38, was a physically active child, but cystic fibrosis changed all that as she got older.

A hereditary condition that develops during childhood, cystic fibrosis primarily affects the respiratory system, pancreas and sweat glands. The body produces excess mucus that clogs the bronchi, which are the main passageway into the lungs. This leads to breathing difficulties and infections.

Infertility and IVF

Cystic fibrosis also causes infertility. Tinsley, who lives in Staunton, Va., was told she’d never have children, but she wasn’t one to take no for an answer. She and her husband, Phillip, kept trying. After numerous procedures and two in vitro fertilization (IVF) attempts over eight years, they were successful, and twins Cole and Sara were born in 2009.

Her faith in God kept her going through the long and often-disappointing process, she says. The twins were in the NICU for many weeks after their birth. “UVA took excellent care of them and made sure they were coming home,” she says.

After the birth of the babies, her cystic fibrosis symptoms worsened. “My husband says it really took a toll on my body,” she says. “But even if I knew that, if I had been warned, I don’t know if I would’ve listened. I really wanted to have kids.”

Family History of Cystic Fibrosis

Things took a turn for the worse in October 2013, when Tinsley was admitted to UVA with a lung infection and put on a ventilator and feeding tube. “I nearly left here. I almost died,” she says. For Tinsley, that was a very real possibility. Her brother died of cystic fibrosis three years ago at the age of 39. She also has two cousins with the condition, one of whom died from it.

Antibiotics controlled her infection, and eventually she was strong enough to be put on the lung transplant waiting list. Still, she wasn’t ready to admit she needed a transplant. She thought she might still get better and needed the convincing of her doctor, Max Weder, MD. “He said I wasn’t going to live if I didn’t have the transplant,” Tinsley says. “He’s by far the best physician I’ve ever had. We make a good team. The whole transplant team is just phenomenal.”

Tinsley also got support from other members of the transplant team at UVA, including social worker Bill Potts and pre-transplant coordinator Heidi Flanagan, RN.

“Heidi knew how nervous I was, and she was so compassionate. She told me to look ahead a year to what my life was going to be like.”

Potts, she says, asked her what she wanted from the rest of her life. “I told him I just wanted to be a mama to my babies. He said, ‘Transplant can give you that.’”

Lung Transplant and Recovery

While Tinsley was in the hospital, Phillip, Tinsley’s husband of 18 years, would drive 40 miles from Staunton to Charlottesville to be with her and then drive home to be with their children.

Christine Lau, MD, performed Tinsley’s lung transplant, which lasted almost 10 hours. Tinsley was removed from the ventilator the first day after her surgery. “I was up sitting in a chair the next day and walking in the hallways the day after that.”

She stayed in the MICU (medical intensive care unit) for two weeks following the surgery and worked with a respiratory therapist, physical therapist and nutritionist to regain normal function. Tinsley also takes immunosuppressants, drugs that prevent her body from rejecting her new lungs. Transplant recipients take anti-rejection medications for the rest of their lives.

Weder says Tinsley’s case is a special one. It’s not often that patients go from being near death to walking out of the hospital several weeks later. “She is a unique case and serves as a great example of how everyone on our MICU and transplant teams work together in difficult transplant cases.”

Along the way, the Tinsley family received lots of help. People in their Staunton community raised funds to help cover some of their transplant medical expenses. Another group made sure the children had presents under the tree this past Christmas when neither parent had the time or resources to go shopping. The Tinsleys’ church community donated weeks of meals during her hospitalization. The Tinsleys also received a grant from a nonprofit that paid for one round of their IVF procedure.

Tinsley, whose motto is “Live to fight another day,” says she feels better now than she’s felt since she was a child. She can give her children those baths, she goes to the grocery store and the oxygen tank is gone. She hopes to share her story with local churches and maybe write a book someday. Her new goals also include running a marathon. “I know I can do it,” she says.

More Transplant Information

Find out more about UVA’s lung and other transplant programs.

Meet Dr. Weder

Learn more about his interests and research.


Caring for a Teen with Cerebral Palsy: A Parent’s Story

On March 28, 2014 | At 1:13 am

Helena Frischtak, a third-year medical student working in different clinics and parts of the hospital as part of her training, contributed this post.

In the hospital, people come and go. Rooms take on new patients, and doctors take on different rooms. When you start to know a patient better, he or she is ready to go home, often never to cross paths with you, the medical student, again.

Yet some patients never actually leave you. That is perhaps my favorite thing about medicine: Doctors learn a lot more from patients than patients learn from them.

A Story About a Mom

This article, however, isn’t about patients. It is about those who are right next to the patient’s bed, who aren’t talked about in rounds when doctors discuss diagnoses and treatments, and whose names aren’t in our electronic medical record. But who – in my book – are big heroes, right next to the doctor. I’m talking about the patient’s caregivers.

Here in the pediatric unit, I have met many types of caregivers. They are mothers and fathers, grandparents and aunts, friends, social workers and shelter nurses. They are there every step of the way, living and breathing each patient’s progress and setbacks.

During my first week rotating at the UVA pediatrics unit, I met Mrs. West — a kind, resilient woman who you immediately know can teach you a lot. Her son, Spencer, has cerebral palsy, epilepsy, intellectual disability and severe scoliosis; he cannot speak, understand speech, walk or move his arms in a coordinated fashion.

Image of Spencer and Wanda West. Spencer is a Children's Hospital patient with cerebral palsy.

Spencer and Wanda West

One crisp Saturday afternoon in March, a few days after Spencer had been discharged from the hospital, I drove up the long, winding road to Mrs. West’s home to chat with her about taking care of Spencer. I was curious about it all: The daily hardships and fears, the lessons she had learned along the way and the big, existential questions brought on by life’s challenges (the “why?”). Our interview, transcribed below, showed me how Mrs. West’s love and devotion, as well as her faith, provide her with the strength she needs to face these significant challenges.

Mrs. West, tell me about Spencer.
Spencer is a 14-year-old special needs child; he has cerebral palsy, epilepsy and scoliosis. He’ll easily get sick: The common cold puts Spencer in the hospital, and it can often lead to pneumonia. Winter is a bit hard for us. The heat of the summer time can sometimes induce his seizures.

His favorite thing in life is eating! He has a 17-year-old sister, Jaz, who is very protective of him. She gets upset every time he is hospitalized. She knows the older he gets, the more his health declines, and it concerns her. We all love him. (Life expectancy of children with cerebral palsy is highly dependent on functional ability; only about 50 percent of seriously disabled children with cerebral palsy live past their 20s.)

Do you think he can feel the love?
Oh yes! He feels the love. He will grunt or make little sounds when he hears my mom or my daughter walk into the room and not speak to him. He is so spoiled!

You mentioned the other day that you aren’t only a mother, but a nurse, a lawyer, a doctor…
I am a doctor when it comes to his health, a lawyer when it comes to his rights, a nurse because I take care of him, a cook because I provide for him. Everything I do for myself, I also do for Spencer. I am two people in one; I’m a 52-year-old adult and a 14-year-old male. I don’t have a written degree; I didn’t go to school for all those things; but I live it— I live it every day.

Image of Spencer West, a UVA Children's Hospital patient with cerebral palsy

Spencer West

What has Spencer taught you?
He has especially taught me patience. I have to be on his time. You cannot rush someone who has special needs, not when he is eating and less so when he is recovering from an illness. When I prepare him for a doctor’s appointment or our religious service, I have to prepare 3-4 hours ahead to get us there on time.

Do you ever ask yourself “Why me?”
I don’t ask that because I know if it wasn’t me it would have been someone else, and because of my faith, I understand we live in an imperfect world. I took care of myself during my pregnancy; I never smoked, drank or did drugs. I had genetic testing done on Spencer, and he was one of 4,000 males with this particular epileptic gene. So I don’t ask myself why, I know it’s just a part of life.

When you think back to how much your life has changed since he was born and your husband passed away, would you take any of it back?
No. Even if I knew that my husband would die, that Spencer would be disabled, and I would be left a single parent, I still would repeat that life. Because I had a good husband and my children had a good father. He was a good provider; he was loving and he was kind… but he was short-lived. We almost made it to our 10-year anniversary – he had booked a cruise for us— but he died one month before.

Yet I had nine years and 11 months of true marriage, true love; some people are married 40-50 years and still haven’t experienced that. I would rather take what I got and know it was real, than have more years and not experience that at all.

You stopped working when your husband passed away to take care of Spencer. How do you support yourself?
Yes, Spencer is my full-time job. For the past 14 years, my husband’s social security benefits are all we have, and it is how I’ve supported my family. It’s a very tight budget; I know where every penny is going. If I had more money we would live in a more handicapped-friendly house. Because he’s getting bigger, the wheelchair is getting bigger, but the walls aren’t getting any bigger.

Do you ever think about who will outlive whom?
I do, and I wonder how long Spencer’s lifespan may be, especially with the health issues that will come along. I pray to God to let me live to take care of Spencer and Jaz. I hate to say it, but if he expires first, I’m okay with it because I know he was taken care of by me. But if I die … I do think about it, but I don’t dwell on it.

You told me you always wonder about what Spencer would say if he could talk.
He would say: ‘Mommy, I love you, and thank you for taking care of me.’ He would be a Momma’s boy. He would love our family. We do a lot of bird watching, so maybe he would be an outdoors person.

Do you have any words of advice for other families of children with disabilities?
It’s a big responsibility (taking care of a disabled child), but it’s just my life, and I don’t know it any other way. I’m not going to say I don’t get sad or that I don’t cry. But not enough to get me down that I can’t move, that I can’t live and that I can’t take care of my family. Personally, I find that reading Rev 21:3,4 in the Bible helps me through hard days.

For everyone who has special needs children: appreciate them, because whether you know it or not, they’re teaching you something. They are teaching you love, kindness and patience, even without a word.


Life Saver: Med Student Catches Abdominal Aortic Aneurysm During Training

On January 3, 2014 | At 9:33 am

Jim Malloy was only supposed to be pretending to have an abdominal aortic aneurysm (AAA).

Jim Malloy and Ryan Jones image

During training, medical student Ryan Jones (right) caught an AAA in Jim Malloy.

This condition, where an area in the abdominal section of the aorta swells and can burst, is common in men between 65 and 75. As a School of Medicine “standardized patient,” Malloy’s role was to pretend to have the condition to help students practice diagnosing.

However, medical student Ryan Jones heard and felt the symptoms of an actual AAA. The doctor overseeing the practice session recommended that Malloy, a Crozet resident, see a cardiologist.

It turned out Malloy did have an AAA. He had stent placement surgery at UVA and is now doing well.

“Jim’s life was saved by a UVA medical student, no doubt about it,” says Louise Malloy, his wife.

Read more of Malloy’s story.

Filed under : Patient Stories,The People of UVA | By
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Brain Tumor Surgery and Recovery – One Patient’s Story

On May 1, 2013 | At 8:44 am

It started off as a splitting headache that would not go away. Michelle Green tried a number of therapies: Massage, acupuncture, visiting a chiropractor. Then a neighbor suggested she see a doctor.

“Thank God for pesky neighbors,” Green says.

A brain tumor found through MRI meant neurosurgery and cancer treatment at UVA for patient Michelle Green.The tumor growing in her brain was the size of a golf ball.

The news was “absolutely terrifying.” Green was 33 years old.

Recurring Nightmare: Brain Tumor Symptoms

The surgery was successful. Green moved to Charlottesville and started a massage therapy practice in her home.

She learned that her seemingly mundane symptoms had been “big red flags. Waking up at night with a splitting headache. It’s not uncommon for a tumor growing in your brain to start showing signs of distress.”

And she knew about the other brain tumor symptoms, too — seizure, hemorrhage, stroke.

So last year when she had a seizure after being cancer-free for 10 years, she didn’t wait. She went straight to the doctor.

“One afternoon I just seized right in my kitchen. Somehow I made it over to my couch in my living room. I woke up dazed and called a good friend who came to get me. I went to my primary care physician, who announced I needed another MRI.” Within a week doctors discovered a new tumor, “a bit smaller, like an acorn.”

“World-Renowned” Neurosurgery Treatment at UVA

Green felt lucky to be in Charlottesville, with UVA and its “world-renowned neuro department just a mile away. It’s a town where a lot of people come from out of nowhere to get good healthcare.  I met people who came from Tennessee, Kentucky, Roanoke, two hours away to get radiation. It’s the best in the mid-Atlantic.”

Green met neurosurgeon Dr. Jeff Elias, who “explained to me what the possibilities were. “

Green had to undergo surgery. This time, it was trickier. “The risk involved was that the tumor was very close to the speech area in the brain, so I had to do an extensive amount of MRI screening so they could find the area.”

The risk to her speech also required “awake craniotomy.” They gave Green what she calls “twilight drugs, because you wake up in a twilight zone during the operation. You have to respond to the questions to see if they are too close to ruining your speech capacity.”

Green says you have to “mentally prepare for it, with the most courage you can. As they were attempting to bring me to consciousness, I started to have a seizure. They had to wait until I could gain control of my speech. You can’t remember anything and then you wake up. You wake up in a whole other land, with people frantically around you, 50 people all around you, busy busy. It’s a journey I don’t wish upon anyone.”

Recovery in the ICU

After surgery, Green was in the intensive care unit.

“The ICU nurses were fantastic. Not only were they confident and professional, they were very sweet to my parents who, as elderly people, were stunned, shell-shocked that they had to go through this again. Anyone who has to experience a hospital setting knows it’s so disorienting; you just want a coffee, or to know where to park in the middle of January. I worried more about them. That was the hard part, trying not to get wrapped up in caring for the people around you. Which is very common for patients.”

Green says one nurse in particular made a deep impression she’ll never forget. “She was rushing around when I was in danger of having a stroke because I was hemorrhaging a little bit. She was very intent to make sure I was getting scans; it was a sleepless night for her watching me.

Somewhere between 3 and 4 in the morning, she woke me with a little light to make sure I was lucid and dilating. Like an angelic figure hovering around me. I said, ‘Susan, you’re so pretty. Do you like chocolate?’ She said, ‘I love it.’ So as soon as I could, I got her some Gearharts Chocolates.”

Like an “Airwalk”: A Caring Team

After her surgery, Green had to have extensive and very specific brain tumor therapy to make sure the cancer was gone and didn’t recur. Dr. Elias told her, “Dr. David Schiff will be the quarterback of your team now.”

According to Green, it was “really an outstanding team. I was carefully and lovingly carried along. Like a mosh pit when you do the airwalk — everyone carries you along.”

But it wasn’t just the medical care that impressed Green. “What is so good about UVA is they assign you a nurse coordinator and a social worker. The nurse coordinator was very helpful, and the nurse from neuro-oncology. They were very helpful, doing things like reminding me to come in every week to get blood work.”

Green also felt confidence because “I know I’m in the system. They know my patient number, my blood type. They know me. They’ll have my history. Nowadays with MRI scans in real time, I can get my answers quickly, and that is the most important thing.”

Brain Tumor Therapy and Recovery

Green started chemotherapy and radiation at the Emily Couric Clinical Cancer Center on Valentine’s Day 2012.

“Emily Couric — love it,” she says. But it was hard. She had six weeks of radiation, every day, Monday through Friday.

“I was so exhausted. I had to stay on top of my meds. Keep myself fed. Try to keep it together. In the evening, take my chemo meds. And then six more cycles. It’s been a long year, taking medication on regimented cycles.”

Jaunt, a regional transportation system, also turned out to be a life-saver, since Green was officially disabled and couldn’t drive herself to the hospital. “The folks at Jaunt were really sweet. It was an incredible service; people don’t realize it’s so critical to this community.”

Green’s therapy also included physical and speech therapists.

She explains, “The physical therapists were concerned about me going in and out of the bathtub. So much of the deficit from surgery, chemo and radiation is a real loss of short-term memory and balance.” A year later, Green still experiences some cognitive deficiency. “It happens casually now. I may get so excited about a topic and forget what I was talking about. It’s like word recall and memory recall.“

After Cancer: Moving Forward

Green still gets screened every three months, but it’s become routine for her. And she’s grateful to have been given a clean bill of health and for the care she received.

“You’re not going to get any better in this region than UVA. Stunningly smooth system for patient care. I’m going to stay in Cville for a while, because I feel so confident in this system.”


Mindfulness and Antioxidants: The 10 Most Popular Blog Posts of 2012

On December 27, 2012 | At 10:00 am

Mindfulness and Antioxidants: The 10 Most Popular Blog Posts of 2012

This year’s most popular blog posts are a wide-ranging group, including everything from myths and facts about multivitamins to how to avoid Lyme disease and other tick-borne illnesses.

We hope you enjoy this look back at the 10 most popular blog posts of 2012.

  1. Medical TV Shows: Do Doogie Howser and Dr. House Work Here? This light-hearted look at scripted hospital work reminded us just how many shows about hospitals there are!
  2. Are Multivitamins Necessary? And Other Frequently Asked Questions. This post discussed what exactly multivitamins are and whether most of us actually need them.
  3. Protect Infants (And Yourself) from Whooping Cough. This post introduced readers to 7-week old Jack Jordan, a spirited young boy who has struggled with the illness. Since this post ran, Jack has been doing very well!
  4. Not Just Lyme Disease: Tick-Borne Illnesses in Virginia. Nobody likes to find a tick crawling on his or her skin, and with good reason! A bite from these insects can cause a host of dangerous diseases.
  5. Antioxidants and Vegan Diets: The Role of a Cancer Center Dietitian. Can a vegan diet help fight breast cancer? This post introduces us to a woman who thinks it may help.
  6. Want to Lose Weight? Neuroscience and EBT Can Help.  Can “emotional brain training” play a role in weight loss? A UVA counselor believes it can.
  7. Prenatal Vitamins: When, Why and How. It turns out prenatal vitamins are very important for most expecting mothers.
  8. Pay Attention: The Medicine of Mindfulness. Learning that you are living with cancer is understandably difficult for most people. There are way to manage the stress while managing the disease, however.
  9. Flu Vaccine Facts: Who Should Get It, Who Shouldn’t and Why. This winter’s flu season looks like it may be a rough one. Get the facts on protecting yourself.
  10. Save Your Knees: Pay Attention to the Pain. Our knees can be among the first joints to start feeling the years. Learn how to protect them.

Breaking the Language Barrier: Interpreters Play Key Role in Patient Care

On October 10, 2012 | At 8:38 am

Fifteen percent of Charlottesville residents speak a language other than English at home, according to the U.S. Census Bureau. For them, understanding diagnoses and following care instructions would be nearly impossible without the help of interpreters.

Liz Cook (left) interprets American Sign Language for patient Wanda Biser (center) and LPN Cynthia Napier during a dermatology appointment.

Liz Cook (left) interprets American Sign Language for patient Wanda Biser (center) and LPN Cynthia Napier during a dermatology appointment.

UVA has eight full-time employees who can interpret Spanish and hires local experts for other languages as needed. Some of the most common are:

  • American Sign Language (ASL)
  • Russian
  • Chinese
  • Arabic
  • Nepali

UVA, like other federally funded organizations, must provide interpreters at no charge for patients who aren’t proficient in English. But this service is about more than fulfilling a requirement. Interpreters are necessary for “the safety of everyone involved. We’re dealing with medicine and the patient’s health, and it’s crucial to get everything right,” says Jerry Brooks, one of UVA’s Spanish interpreters.

How Medical Interpretation Works

The interpreters are available for any patient who isn’t fluent in English, and they’re trained in medical terminology. Non-English-speaking patients make appointments at UVA in a few different ways:

  • Patients call the clinic and an over-the-phone interpreter facilitates the conversation.
  • An English-speaking family member or a friend contacts UVA for them.
  • The International Rescue Committee’s Charlottesville office refers people to UVA and helps them set up appointments.
  • Patients who speak some English make the appointment themselves, and they or a staff member request an interpreter for the appointment.

Once patients make the first appointment, employees put notes in their registration information and electronic medical record so they’ll know to request an interpreter for future appointments.

When an interpreter goes to a doctor’s appointment, the conversation is still between the healthcare provider and the patient, explains Liz Cook, an ASL interpreter. Her job is to interpret the languages, not add to the conversation.

The interpreters also work with patients staying in the hospital. If one isn’t available in person, the healthcare provider accesses one through a video chat or phone system.

Feeling Safer: One Patient’s Story

Cook recently worked with Stuarts Draft, Va., resident Wanda E. Biser, who had a basal cell carcinoma (a form of skin cancer) removed at UVA. Biser and her husband are deaf and communicate in ASL.

When Biser was interviewed for this story, she signed as Cook interpreted her words into English. Biser said UVA’s use of nationally certified interpreters made her “feel safer.”

During a recent dermatology appointment, Biser also had a chance to try out UVA’s new Video Remote Interpreting (VRI) service, which connects patients with interpreters through an online video chat system.

Wanda Biser (right) tries out a new American Sign Language video interpreting system as she talks with dermatologist Mark Russell, MD.

Wanda Biser (right) tries out a new American Sign Language video interpreting system as she talks with dermatologist Mark Russell, MD.

She said that was a “good experience, but you have to get so used to it. … Especially for last-minute appointments, I think it’s good.”

She’s been in emergency rooms before where there was no interpreter at all.

“I’d rather have the VRI than a nurse trying to work out finger spellings,” she says.

Vickie Marsh, interim manager of Language Assistance Services, says having a live interpreter is ideal, but the video and phone services fill a much-needed gap when patients need an interpreter quickly or there is no local interpreter who speaks the patient’s language.

Help for Refugees: A UVA-IRC Partnership

Each year, the Charlottesville IRC office helps about 200 refugees start a new life in central Virginia. That includes helping them find a primary care doctor.

“What we don’t want is for our clients to have to use the emergency room as their primary care provider,” says Terri DiCintio, IRC’s community relations coordinator.

Refugees sometimes have medical problems such as malaria that U.S. doctors don’t usually see, DiCintio explains. So the IRC often refers refugees to UVA’s International Family Medicine Clinic. Fern Hauck, MD, started the clinic in 2002 to serve refugees in Charlottesville.

In turn, UVA relies on the IRC’s 50 interpreters, some of whom know less-common languages such as Nepali and Kirundi, to ensure all patients can communicate with their health care providers.

Otherwise, patients may try to rely on a family member or a friend, and “there are all kinds of problems that can result from that,” DiCintio says. “Let’s say a pregnant woman has to go to an OB/GYN appointment, and the only person she has to bring with her is her 12-year-old child. It’s not appropriate. It’s uncomfortable. Is the patient going to be open and honest?”

Need an Interpreter? Want to Work as an Interpreter?

If you or your family member need an interpreter for your next doctor’s appointment, let our staff know when you schedule the appointment.

  • To reach our over-the-phone Spanish interpreter, call 877.297.2366 and enter the access code 4044.1905.7434. An interpreter will help you make your appointment.
  • For any language-related concerns, please contact Language Assistance Services at 434.982.1794.

We’re looking for nationally certified Spanish and ASL interpreters with medical training to work as contractors on an as-needed basis. If you’re interested, contact Language Assistance Services.

Also, Charlottesville’s IRC office is looking for people fluent in:

  • Arabic
  • Burmese
  • Karen
  • Karenni
  • Swahili

If you’re interested in working or volunteering as a community interpreter and are willing to take a language test, send your resume to Eugeniya Haas.

Learn more about UVA’s initiative to make culture and language resources easily available for staff.

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