Just when most people feel energized because it is spring, others want to pull the covers over their heads. Seasonal change can be harder on those with anxiety and depression. Speaking with your primary care physician can be a first step in feeling better.
“Often patients dismiss their earliest suspicions of depression or anxiety,” said Jesse Pace, DO, a family practice physician with Mission Family Medicine Glenwood. “Patients usually come in because they aren’t sleeping or are feeling irritable.”
People often live with untreated depression or anxiety for years due to the stigma of mental health issues. People with clinical depression cannot simply “pull themselves out of it.” It is a legitimate medical condition that must be managed.
It may be surprising that depression causes actual physical symptoms like pain, exhaustion, difficulty concentrating, headaches, recurrent thoughts of suicide and changes in appetite.
“Everyone has anxiety and depression at some point, but when it interferes with daily activities or you’re having intrusive thoughts of bad things, it’s time to get help,” said Dr. Pace.
According to the National Alliance on Mental Illness, while anxiety disorders are highly treatable, over 60 percent of those suffering don’t receive treatment. “Seek help as soon as you think something is amiss,” said Dr. Pace. “We have options from therapy and counseling to medications. The bottom line is to ask for help.”
Tips for Talking with Your Doctor about Anxiety and Depression
Don’t wait. Talk with your doctor as soon as you have concerns about not feeling like yourself. Give your provider ample time and information to help you.
Recognize that while you may feel uncomfortable or embarrassed, you are seeking help for a real medical concern.
Be prepared to talk about changes you’ve noticed in your sleep, eating habits and mood.
Be ready for blood tests. Depression can be linked to other conditions like your thyroid function. Your doctor may want to rule out conditions with a simple blood test.
Be prepared for your doctor to ask about family history and other symptoms.
Keep an open mind.
Jesse Pace, DO, is a family practice physician with Mission Family Medicine Glenwood.
By Michele Pilon
Chief Executive Officer, Transylvania Regional Hospital
Typically, the blossoming of spring is in full effect in western North Carolina during the month of May. This is also the month when we get the chance to recognize the caring professionals who make Transylvania Regional Hospital (TRH) what it is: A facility where patients receive the most advanced care, rooted in evidence-based practice and delivered with a sizeable dose of heart and soul, thanks to our nurses. Their work is pivotal to our being named a Top 20 Critical Access Hospital for four out of the last five years.
The care TRH’s nurses provide shapes our patients’ – and their families’ – experiences every day. When we refer to “positive outcomes,” it’s important to think about what that really means, and how accountable nurses are for creating them. We’re proud that 33 of our nurses hold advanced certifications in a wide range of specialties, including, but not limited to, OR (operating room), ER (emergency room) and critical care certifications. We also encourage and support our nurses as they seek additional training in many areas, from diabetes education to oncology. We want to help our nurses grow their careers in the ways they want, because a more engaged nurse workforce ultimately benefits our patients.
TRH’s most valued and important stakeholders – our patients – have also made their voices heard regarding our nurses. Our most recent inpatient Overall Quality (OQ) and Likelihood to Recommend rating is an impressive 78 percent, while the TRH emergency department earned an 80 percent score for Likelihood of Recommending and Overall Quality. The Likelihood to Recommend score for our outpatient services, which include minor surgery, radiology screenings and lab testing, is 82 percent and the outpatient services area earned an excellent Overall Quality score of 84 percent. Our rate of hospital-acquired infections is currently at the remarkable count of zero, an achievement that is undeniably exceptional, and that we can surely attribute in great part to our nurses.
I also want to highlight our nurses’ contributions to enhancing TRH’s relevance in our community and beyond. They allow our neighbors to get the “close to home” care they deserve and our clinics to be referral mechanisms to the hospital so care remains in our community. We do outreach outside of Transylvania County by providing care to the Highlands-Cashiers community. For example, one day a month one of our surgeons performs colonoscopies for patients at Highlands-Cashiers Hospital, and our nurses are there to assist with the procedure, as well as deliver pre- and post-procedural care. In addition, they represent TRH at community events, and they volunteer at churches, schools and community agencies.
TRH’s nurses build trusting bonds with their patients, care for them with an extraordinary blend of competency and emotional intelligence, and serve as bridges between patients and other clinicians who treat them. The numerous critical roles they play in patient care make them simply indispensable throughout the care continuum.
If you can, take a moment this month to think about a nurse who has made a difference in your or your family’s life. Even better, write them a note or tell them what their care has meant.
Michele Pilon, MS, BSN, RN, NE-BC, is Chief Executive Officer and Chief Nursing Officer of Transylvania Regional Hospital. Her diverse professional experience includes service as a bedside nurse and over a decade as a leader at healthcare institutions in Virginia, Florida and North Carolina. Ms. Pilon earned a Bachelor’s in Nursing from Ohio’s University of Akron and a Masters in Health Services Administration from the University of St. Francis in Illinois; she is also a Board-Certified Nursing Executive.
By Carol Wolfenbarger Chief Executive Officer, Mission Hospital McDowell
You may think that there are no fun holidays in May, but think again. There are actually plenty of reasons to celebrate. National Lost Sock Memorial Day is May 9, National Dance Like a Chicken Day is May 14 and National Macaroon Day is May 31! This month is special for Mission Hospital McDowell as well, and offers plenty of reasons to celebrate.
I’m happy to announce to the community that we just received our Acute Stroke Ready Hospital Certification from The Joint Commission and the American Heart Association/American Stroke Association. This designation is something we are honored to receive, but even more importantly, it means that our community has access to the most advanced and rapid stroke treatment available.
Every second counts in identifying and treating stroke. The hospital underwent a review that acknowledges that we employ stroke care-qualified clinicians, have the capability of performing diagnostic testing for stroke at any time of the day or night, can provide timely clot-busting drugs for patients who require this intervention and have telemedicine access to neurology to orchestrate the care of the patient. This also means that care is initiated in the field through collaboration with McDowell County EMS and that we have the support of and access to a Comprehensive Stroke Center, which Mission Hospital is. We are proud to be able to offer this level of care to our patients, as nearly 800,000 people suffer a stroke annually across the US, and stroke is a primary cause of adult disability.
We will also be celebrating cancer survivors this month as we participate in the Relay for Life on May 10. There is hardly a person I meet who has not been touched in some way by cancer – either themselves or a loved one. Relay for Life is about celebrating the courage, strength and resilience of all in our community who have experienced a journey through cancer. You can join the event on Friday, May 10, at 6 pm at Tom Johnson’s Campground. Participants and their supporters can expect an evening of love for cancer survivors and their caregivers with speeches, a moving survivor/caregiver walk and a luminaria ceremony in honor of survivors and in memory of those we have lost, as well as great food, music and other surprises.
Last but never least, we celebrate our care team with National Nurses Week, May 6-12 and National Hospital Week, May 12-18. It needs to be said: Without our incredible nurses and team members, who care for patients and their families with a powerful blend of technical skills and heartfelt compassion, we wouldn’t even exist. Our nurses are second to none when it comes to performing complex medical interventions, mastering the technological tools required to monitor patients, understanding unspoken patient needs and simply holding a patient’s or loved one’s hand, compassionately sharing time and space with them. Likewise, without the complementary efforts of other compassionate and skilled clinical non-nursing team members, such as those in imaging and laboratory, as well as our expert support teams like environmental services, plant operations and patient access, our efforts would flounder.
The Mission Hospital McDowell team proves every day that “Together Is Better!” I am grateful for each of them and celebrate the care they provide to our community.
Carol Wolfenbarger, MSN, RN, FACHE, is Chief Executive Officer of Mission Hospital McDowell. She holds both Bachelors and Masters of Science degrees in nursing administration from the University of Tennessee, is board certified in Healthcare Management and is a Fellow of the American College of Healthcare Executives (ACHE). Carol, who has served hospitals and health systems for more than three decades, has worked to add full-time cardiology services, led growth in outpatient services including imaging and surgery, and the expansion of primary care offering in Burke County since assuming her role as President at McDowell Hospital in 2015. She is an active member in Rotary and serves as a Board member for the Rutherford/Polk/McDowell Health District Board of Directors, the Corpening YMCA Board of Directors, and the McDowell County Chamber of Commerce Board of Directors.
By Jackie Medland
Chief Executive Officer/Chief Nursing Officer, Highlands-Cashiers Hospital
I never want to miss a chance to recognize our amazing nurses, whose care has everything to do with creating positive outcomes for our patients and their families. Nurses deftly combine their brilliant scientific minds with the love and trust they build with each patient. Every day, nurses at Highlands-Cashiers Hospital, the Eckerd Living Center and in our clinics expertly merge their love of medicine with their love for patients as they do everything from dress wounds and interpret lab work to comfort souls.
Now is the right time to shine a spotlight on our exceptional team of nursing professionals, because May 6-12 is National Nurses Week. By design, this annual celebration of almost 3 million nurses nationwide occurs around the birthday of Florence Nightingale, the renowned Victorian-era nurse who treated British soldiers during the Crimean War. She treated patients, from 1854-56, in Turkey’s Scutari Hospital, where conditions were horrific. Nightingale is a nursing icon – no doubt she was compassionate, but she was also an astute statistician and scientist who conducted the first care-quality study to improve patient outcomes. She connected the fact that the high mortality rate the British soldiers were suffering was directly linked to the hospital’s filthy and overcrowded conditions. She formulated a plan that increased environmental cleanliness, relieved overcrowding and improved air quality. This resulted in a decrease in patient mortality from 42 percent to an astounding 2 percent, over the course of just a few months.
This nurse-led quest for improvement carries forward to this day, and to this hospital. Just like Nightingale, our own nurse Rosalie Lindecamp noticed that the patient transport process by which we get our sickest patients transported off the mountain could be improved. She worked with other stakeholders, and together they came up with an improved protocol, now in use. The same desire to perfect our work also extends to Trina Rueckerl, who worked alongside our environmental services team to reduce incidental noise in the patient care environment. This has allowed for a more healing and therapeutic milieu.
It’s undeniable that the impact of the care that even one of our patients receives from one of our nurses in the course of a year, a month or a day is profound and long lasting. About 10 years ago, an extensive and carefully executed study by nurse researcher Dr. Linda Aiken proved how much nurses matter – specifically that the right numbers and types of nurses greatly impact the factors that lead to better patient outcomes: improved patient mortality, reduced infection rates, lower readmission rates and fewer medical errors.
The nursing workforce across our campus is about 50 strong, and they hold various roles, including bedside caregivers, educators, quality specialists, case managers, wound care specialists and clinical leaders. Our nurses come from North Carolina, South Carolina and Georgia each day to minister to the needs of our patients, and their dedication spans many years. In fact, one of our nurses has devoted more than 30 years of her career to the Highlands-Cashiers community, and we count eight in our ranks who have served our patients for more than a decade. Their personal and professional investments in our hospital and community are significant.
Every day our nurses bring, in addition to deep compassion, a varied and vital set of skills to work with them that includes cutting-edge clinical knowledge, technical prowess, administrative talents and exemplary team skills. Their care touched more than 4,000 patients last year as they listened intently to patient stories of how their health affects their lives and how their lives affect their health. The talents of our nurses has helped HCH earn the ranking of No. 3 in the state for patient satisfaction, out of 100-plus hospitals.
Critical to the care continuum, invested in innovation and dedicated to peers and profession, our nurses are simply irreplaceable. We thank our nursing professionals across our campus for their extraordinary caregiving. It is through their special gifts and talents that they make our community stronger and healthier.
Jacqueline Medland, PhD, RN, is Chief Executive Officer and Chief Nursing Officer of Highlands-Cashiers Hospital. Jackie has enjoyed a career as a healthcare leader for over 30 years, including positions in direct patient care, advanced practice nursing, nursing management and hospital administration. Jackie received her MSN from the University of Illinois, College of Nursing, and her PhD in Organization Development from Benedictine University. She is a member of the American Association of Critical Care Nurses, the American Organization of Nurses Executives, the Illinois Organization of Nursing Leaders and Sigma Theta Tau. Jackie’s unique leadership and mentorship was recognized by the University of Illinois, College of Nursing with the Sage Award.
By Becky Carter
Chief Executive Officer/Chief Nursing Officer, Blue Ridge Regional Hospital
On May 14, we will appreciate the mothers in our lives – whether they’re our biological moms or simply women who are like mothers to us. May is also, quite fittingly, National Women’s Health Month, which makes me reflect on the fact that so many women take care of others’ needs before their own. This month I want to talk about how each season of a woman’s life requires that she pay attention to certain health issues and get screened for age-appropriate health conditions.
In her twenties and thirties, a woman must be cognizant of fertility issues, from deciding if and when she wants to have a child, what form of contraception she needs, and when she will get a Pap test, which tests for cervical cell abnormalities. If she plans on becoming pregnant, she should discuss proper nutrition with her physician, especially the role that folic acid supplements play in reducing the risk of neural tube defects in a developing fetus. All women should begin good habits early and continue them throughout their lives. Avoid tobacco, wear sunscreen and wear a seat belt.
The guidelines for how often women should get a Pap test have changed, and now the recommendation is for women to get their first one at age 21 and if test results are normal, they should be retested every three years. However, an annual visit to the OB/GYN is necessary for women to discuss other health concerns, such as getting tested for sexually transmitted diseases and breast and pelvic exams. Additionally, skin exams should start during this phase of life to prevent melanoma. If a patient’s dermatologist can get a baseline picture of the condition of her skin, they can create a preventive strategy together to avoid melanoma, like daily use of sunscreen.
When she reaches her forties, a woman is often in the middle of her career, possibly raising a family, and may increasingly be caring for older parents. Self-care that involves finding some time for herself becomes more important, whether that means 20 minutes of meditation each day, a relaxing bath or coffee with a friend. In terms of health screenings, the most important one is getting her first mammogram. If she has a family history of breast cancer, screening should start even earlier and an appropriate schedule can be determined with one’s physician. Even though our schedules are full, it’s important to reserve this time each year for this important screening. Perimenopause starts in this decade of life as well, so women should discuss any period irregularities, mood changes or other symptoms with their physicians.
As women enter their fifties, menopause is often a prime topic of patient-physician conversations. They may start experiencing hot flashes and night sweats, sleep disturbances, lowered sex drive and more mood changes. There are a range of treatments women can take advantage of to increase their comfort during this life transition. At 50, a woman should schedule her first colonoscopy, the screening that checks for colon cancer. Women should continue to see their gynecologist annually, receive annual mammograms and begin screenings for cardiovascular health. Awareness of blood pressure and cholesterol levels also become more important so patients can know their risks for heart attack and stroke.
Women in their sixties and seventies continue to need annual mammograms and pap tests on a schedule determined by their doctor, as well as a colonoscopy every 10 years. Bone density tests are also necessary to check for osteopenia – a precursor to osteoporosis, a condition in which decreased bone density puts women at risk for bone breaks and fractures, or osteoporosis itself. Immunizations recommended include the shingles and pneumonia vaccines.
In every phase of a woman’s life, she should enjoy a fruit and vegetable-filled diet, regular exercise and adequate rest. These practices support long-term health and lower risk for diseases like cancer and diabetes, as do limiting alcohol and continuing to refrain from tobacco use. Finally, every conversation at her yearly checkup should include screening for depression and other emotional health issues, and an opportunity to discuss whether she’s experiencing any interpersonal violence at home.
Blue Ridge Regional Hospital is here for the women in our community, no matter where they are in their life’s journey. By partnering with their physicians, women can take part in their own care to maintain good health no matter what their age.
Rebecca W. Carter, MSN, RN, FACHE, is Chief Executive Officer and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Carter has served in senior hospital management for over 20 years and previously served as Chief Operating Officer and Chief Nursing Officer of Transylvania Regional Hospital in Brevard, also a part of the Mission Health system.
Ms. Carter is board certified in healthcare management and is a Fellow of the American College of Healthcare Executives (FACHE). A native of North Carolina, she holds undergraduate and graduate degrees in nursing from the University of North Carolina at Chapel Hill. Ms. Carter is currently a resident of Burnsville.
By Karen Gorby
Chief Executive Officer/Chief Nursing Officer, Angel Medical Center
I’m devoting this month’s column to the topic of stroke – a serious health issue that strikes many in our community and close to 800,000 Americans annually. It’s a leading cause of adult disability, and its aftereffects profoundly shape quality of life. We at Angel Medical Center (AMC) not only treat stroke patients and offer rehabilitation services to stroke survivors, we want to help the community at large learn what they can do lower their stroke risk.
I’m proud that AMC was certified for the first time as an Acute Stroke Ready Hospital in 2016 by The Joint Commission and the American Stroke Association/American Heart Association. We were the first North Carolina hospital to receive the certification, which lasts for two years. Recertified last year, we continue to strive to do everything the recognition connotes: Our staff includes clinicians specifically trained to treat stroke patients, our technology allows us to perform stroke diagnostic testing, we can link our clinicians to neurologists at Mission Hospital via telemedicine and we can administer the lifesaving clot-busting drug alteplase to patients who need it. If a patient’s emergent needs require that they be flown to Mission Hospital, we’re prepared for that, too.
Cara Smith is AMC’s Acute Stroke Ready Hospital Program Leader and has much to share with the community about stroke – how to spot it, available innovative treatments and how to prevent it. “I’m invested in telling the community how to identify the signs and symptoms of stroke by using this easy-to-remember acronym: BEFAST. It stands for the following:
B – balance problems
E – eyes, or blurred vision or vision loss
F – facial drooping
A – arm or leg strength/movement problems
S – speech difficulty
T – time to call 911
If you can remember BEFAST and notice any of these symptoms, you’ll be able to help the patient as soon as possible, and that’s critical,” declares Smith. She adds that time is brain, meaning that the sooner a person can be treated for stroke, the fewer brains cells that will be damaged.
With that 911 call, stroke treatment starts in our community with our Macon County EMS partners, who work in tandem with us to diagnose stroke while in the field. Their communication allows us to be ready to receive the patient and perform a CAT scan.
“In 2018, AMC treated 146 patients for stroke – 89 patients had ischemic strokes – the most common type where a blood clot forms in the brain, 50 had transient ischemic stroke, otherwise known as a mini-stroke (where the clot creates a temporary blockage) and 7 were treated for hemorrhagic stroke, or a stroke caused by a weak blood vessel that ruptures and bleeds into the surrounding brain tissue,” explains Smith. The good news, she shares, is that ischemic stroke symptoms can be treated with the revolutionary clot-busting drug alteplase up to 4.5 hours after the stroke’s onset. If treated within this time frame, symptoms can be reduced or even eliminated.
Smith notes that the biggest change in stroke treatment came in 2018 with the expansion of the treatment window to 24 hours from time of onset for select cases. Mission, along with AMC, introduced RAPID software, which can study ischemic stroke patient scan data and pinpoint the brain tissue that’s salvageable within this 24-hour window. Patients can then be successfully treated with a clot retrieval intervention. “This discovery has radically changed stroke patients’ lives,” declares Smith. If our patient needs this treatment, we facilitate their transfer to Mission Hospital within 60 minutes, via the MAMA helicopter. Mission was one of the first health systems in the nation to subscribe to the new expanded treatment window.
Smith wants the community to know that AMC has a robust rehabilitation services team of occupational therapists, physical therapists and speech therapists who help stroke patients regain their strength and skills. “AMC also offers a stroke support group the first Wednesday of every month where stroke survivors can get emotional support from each other, share experiences and listen to a wide range of educational speakers,” says Smith.
The message Smith most urgently wants to convey to the community is that calling 911 is always the right thing to do if one experiences any suspicious symptoms or is with someone who exhibits symptoms. She also emphasizes that there are plenty of healthy lifestyle practices community members can practice to lower their stroke risk, including keeping their blood pressure and weight down via healthy eating, exercise and stress reduction techniques like meditation and yoga.
AMC supports our community in their efforts to prevent stroke and is here to diagnose and treat patients who experience a stroke, as well as help patients with their long-term recovery.
Karen S. Gorby, RN, MSN, MBA, CENP, FACHE, is Chief Executive Officer and Chief Nursing Officer of Angel Medical Center. Gorby is a Fellow of the American College of Healthcare Executives (ACHE). For nearly three decades, she has served hospitals and health systems in Ohio before assuming her role at Angel Medical Center. Gorby received her MSN from Saint Joseph’s College in Standish, Maine, and her MBA from Wright State University in Fairborn, Ohio.
Mission Health’s Angel Seizure Clinic is truly a gift for people who have seizures and live in the more remote areas of western North Carolina. One such resident is Cynthia Clark of Franklin. “Having the clinic closer to where I live is awesome,” said Clark. “It’s easier to make earlier appointments, and we don’t have to drive almost two hours for a doctor’s visit.”
Going to the Patients
Previously, the only place where people with epilepsy and seizures could see a specialist was at Mission Neurology in Asheville. “There are a lot of folks who don’t live within the immediate vicinity of Asheville and need seizure care from a specialist,” said Suzette LaRoche, MD, epilepsy specialist and medical director at Mission Epilepsy Center. “A big issue is that patients who are having seizures are not supposed to drive.”
It’s especially problematic for people who live an hour or more away and don’t have friends or family who can drive them to Asheville. Dr. LaRoche came to Mission Health three years ago from Emory University in Atlanta, where she was an epilepsy specialist. “When I moved here, it was really with the goal to develop an epilepsy and seizure program for all of western North Carolina,” she said.
Dr. LaRoche learned that residents in the farthest points of Mission’s reach weren’t always able to get access to the specialty care provided at Mission Neurology in Asheville. “There are a lot of folks, particularly out in the Franklin area, who have seizures but had been getting their seizure management from their primary care doctor or a lot of times even in the emergency department,” said Dr. LaRoche. “That’s where this came about — the need to go to those patients instead of trying to figure out how they can come to us.”
Finding the Best Location
When choosing a location for the seizure clinic, Dr. LaRoche said they considered where Mission Health already had space, as well as, geographically, a place that was centrally located to some of the farther points from which patients would come. They finally settled on the Angel Medical Center in Franklin, where outpatient space was available and the towns of Highlands, Silva, Murphy and Andrews are nearby.
The clinic opened in August 2018. “We have it one day a month, on a Monday,” said Dr. LaRoche. “It’s myself as the seizure specialist and also our EEG manager, Coleman Cabe.”
Cabe, Dr. LaRoche said, is instrumental to the clinic. “He’s a longtime resident of Silva, and he’s really passionate, too. Before we opened the clinic, there wasn’t a way to get an EEG out there,” she said, adding that Cabe volunteered to go with her to the monthly clinics and perform electroencephalogram (EEG) tests. “The EEG test is a really important part of the workup and evaluation of patients with seizures,” said Dr. LaRoche.
A Model for Specialty Care
The clinic currently sees patients who are age 13 and older and are referred by their primary care physician. Because the visits are so thorough, Dr. LaRoche sees only eight or nine patients in a day.
Clark first visited the clinic in August, after she had a seizure and was referred by her primary care doctor. “I didn’t have any issues or symptoms until I had my seizure at work,” she said.
“It’s really rewarding to be able to be there and see folks,” said Dr. LaRoche. “I’m sensing that it’s really helpful to the primary care physicians out there because they’re the ones who have really been caring for these seizure patients, and doing a really good job.”
Dr. LaRoche added that a lot of patients in the area have never seen a specialist for their seizures, and she’s able to see them and develop a treatment plan, with the primary care provider doing follow up.
At the clinic, Clark had an EEG and met with Dr. LaRoche. “Dr. LaRoche has been amazing!” she said. “[She] has helped me find a seizure medicine that I like and helped to regulate it. So far I have not had any more seizures.”
“I really think it’s the model of how we can provide specialty care for the most patients,” said Dr. LaRoche. “The specialist is not going to be able to see every single follow up every time, every visit. If the specialist can see the patient and make a plan, then work with the primary care provider for the follow up, then everyone is getting high-level care.”
Clark is certainly thankful to have a clinic closer to home. “The seizure clinic is very nice to have closer to Franklin,” she said, “because people who can’t drive can be seen.”
Epilepsy by the Numbers
According to the Epilepsy Foundation, epilepsy is the fourth most common neurological problem. Only migraine, stroke and Alzheimer’s disease occur more frequently.
The Centers for Disease Control and Prevention (CDC) reports that, in 2015, 1.2 percent of the US population — about 3.4 million people — had active epilepsy. That number includes 3 million adults and 470,000 children.
North Carolina is estimated to have 111,000 people with active epilepsy.
Suzette LaRoche, MD, is an epilepsy specialist and medical director at Mission Epilepsy Center.
Memes. Texts. Gifs. While teens keep things light with friends, studies show they want to know more about important topics that can affect their overall adult health but are reluctant to talk with parents present. Just when teens are exploring their interests and boundaries, an open relationship with their physician could be a roadmap to health success.
“Teens are developing cognitively, emotionally and socially. They are learning about themselves and how to make decisions,” said Ashley McClary, MD, pediatrician with Mission Pediatrics – McDowell. For some teens, the time is right to take more responsibility for their own health discussions.
A strong network of adults that your teen can talk to could start with your child’s pediatrician. In this familiar setting, teens can be more comfortable learning and talking about their health.
Even some as young as 11 years old can benefit from an option called a “split doctor visit.” Parents are present for part of the visit to discuss such issues as vaccines, general health information and family history. One-on-one visits between the doctor and teen follow where conversations may cover topics such as bullying, sexual health, substance use, healthy eating or mental health screening for depression or anxiety.
“Traditionally, many teens have not received the health information they need,” said Dr. McClary. “This option offers teens reliable health information and guidance from someone who knows your family.”
It’s important to recognize that teen-only doctor visits are completely confidential, and by law the only reason confidentiality can be broken is if the teen is in immediate danger. In North Carolina, teens can consent to their mental health, sexual health and substance abuse treatment.
“It’s really important to build strong relationships between parents, teens and their provider,” said Dr. McClary. “With a little coaching, we can help facilitate tough conversations going forward.”
Topics Teens Discuss with Their Doctors
Avoiding substance use
Mental and sexual health
Promoting healthy sexuality
Safety and bullying
Supporting family connection
Ashley McClary, MD, is a pediatrician with Mission Pediatrics – McDowell.
If you would like to have your teen seen by a pediatrician, call Mission Pediatrics – McDowell at 828-652-6386 or visit missionchildrens.org.
It’s been reported that consuming eggs in some form as a part of our daily breakfast has been part of our morning rituals in America since the end of the Civil War. Ever since, eggs have remained a mainstay in the American diet.
“Eggs are the No. 1 source of dietary cholesterol in the US. Chicken – because we eat so much of it and not because it is higher in cholesterol than other meats – is No. 2,” explains Brian Asbill, MD, of Asheville Cardiology Associates and Mission Heart.
In light of this study, you may consider eliminating eggs from your diet to avoid eggs-acerbating your cholesterol levels. However – are eggs solely the culprit for the high rates of cholesterol, as these studies have suggested? Are there ways to moderate your egg intake without negatively impacting your health?
The Study by Victor Zhong
In the study, Victor Zhong, postdoctoral researcher in the Department of Preventative Medicine at Northwestern University Fienberg School of Medicine, claimed that “eggs, specifically the yolk, are a major source of dietary cholesterol.”
Zhong measured data from six US study groups. These study groups included over 29,000 people observed for an average of 17.5 years. Over the follow-up period, roughly 5,400 cardiovascular events occurred. These included 1,302 fatal and nonfatal strokes, 1,897 episodes of fatal and nonfatal heart failure, and 113 other deaths caused by heart disease. In addition to these numbers, 6,132 other individuals died from other miscellaneous causes.
Dr. Asbill’s Takeaways
“There are many factors that we try and ‘correct’ for when we look at studies like this,” said Dr. Asbill. “I think that one of the reasons we seem to be perpetually confused by these studies – are eggs good or bad? – is that we continue to look at individual nutrients or dietary components instead of looking at the larger picture. People eat a variety of foods, and it is the pattern that ultimately affects our health.”
There is some consensus that an occasional egg as part of a healthy eating pattern is not a major issue, but eggs are certainly not essential. “We would rather you eat eggs than Lucky Charms, but oats with berries would be a better choice,” said Dr. Asbill.
If you’re concerned about cholesterol levels, turn to plants such as fruits, vegetables, grains and beans. “Cholesterol is only found in animal products, so the more animal products you eat – meats, dairy, eggs – the more dietary cholesterol you consume,” said Dr. Asbill. “We have made eating way too complicated. Seventy-five years ago we ate way less processed junk, way less meat and dairy, though we did eat it, and were better off.”
Brian Asbill, MD, is cardiologist and board-certified lipidologist at Asheville Cardiology Associates, an affiliate of Mission Health.
Brian Barrow, MD, an obstetrician-gynecologist at Transylvania Women’s Care in Brevard, grew up in the Florida panhandle, which would shape his love for community and concern for others. We sat down with Dr. Barrow and discussed his passion for medicine and helping others, as well as his thoughts on serving the Brevard community.
What drew you to practice medicine in a more rural setting?
“I grew up in a very small, rural town in the Florida panhandle. There was only one school and no traffic lights. Everyone knew everyone, and it was a tight-knit community. I lived in a large city for college and my medical training. I missed the small town, so I was thrilled when I found out there was a job opening here in Brevard. I really enjoy taking care of people in my community who I can know for many years.”
How important is it to the population of Transylvania County to not have to drive a long distance to receive the care you provide?
“I think it is critical for our community to have the care that we provide available locally. Having our services available near home is convenient, and when someone can get their care easier it helps them stay healthier. This includes having our office in the community as well as our ability to provide surgeries locally.”
Have you seen the demand for services increase over the years as population figures tick up in the area?
“We have seen major growth in all aspects of our practice over the last several years. We stay very busy at the office and have a record number of pregnant patients we are taking care of. We also stay very busy doing women’s surgery at Transylvania Regional Hospital. I feel certain some of this is due to an increase in population, and the other is due to us being local, making it easier for patients to get all of their care near home.”
What are some of the developments in women’s healthcare you all are most excited about?
“I think the advances in minimally invasive surgical care continue to make surgery safer and helps patients get better outcomes and heal quicker. I also think the cancer screening tools that are becoming available continue to get better, which helps us catch anything earlier.”
What is one piece of advice you tend to give your patients?
“I tell patients it is important to continue to see your gynecologist even if you are past having children or needing Paps. I also try and remind everyone that just because you may experience physical changes with age that are frustrating, that doesn’t mean you just have to live with it — like urine leakage or vaginal bulges. Just ask us about whatever is bothering you, because we have really good ways to fix these problems and make you feel better.”
Brian Barrow, MD, and Jamie L. Ramsey, MD, FAACOG, practice obstetrics and gynecology at Transylvania Women’s Care in Brevard, North Carolina.
Both providers are accepting new patients. For an appointment, call 828-884-8860.