We talk with Sentara Northern Virginia Medical Center’s Dr. Alexandra Modiri, a gastroenterologist with Houshang Makipour MD PC / Northern Virginia Endoscopy Center.

– What does the field of gastroenterology cover?

Gastroenterology is a field of medicine that encompasses diseases of the digestive tract. For example, we prevent colon cancer by performing colonoscopies. We also treat a variety of other conditions such as GERD or gastroesophageal reflux disease, irritable bowel syndrome, hepatitis, etc.

–  GERD Awareness Week is the last week in November – for those who don’t know, what is GERD?

GERD or gastroesophageal reflux disease refers to a disease, which affects the lower esophageal sphincter at the bottom of the esophagus. Transient relaxations of this muscle allow acid from the stomach to spill up to the esophagus resulting in common symptoms of heartburn or regurgitation.

– Who is most likely to have this condition?

This condition affects 10-20% of the population and numerous causes have been identified. Some common causes include acidic foods and beverages, obesity, medications or the presence of a hiatal hernia.

– How is this condition diagnosed?

GERD is often a clinical diagnosis. More severe cases may result in further testing via EGD or upper endoscopy, pH testing, etc.

– What are the symptoms of GERD?

The two most common symptoms of GERD are heartburn and regurgitation. Some patients may also suffer from difficulty swallowing, chronic cough, hoarseness or vomiting.

– What is the treatment?

Treatment options include lifestyle modifications (such as the avoidance of dietary triggers and weight loss) or use of medications such as proton pump inhibitors.

– What do you wish people knew about your specialty that they might not?

Gastroenterology is a huge field, which encompasses hollow organs such as the esophagus, stomach, small intestine, gallbladder and colon or large intestine along with solid organs such as the pancreas and liver. Gastroenterologists have achieved the highest level of training for the performance of colonoscopies and endoscopies.

–  Do patients need an order to see you? What’s the best number to make an appt.?

Some patients require a referral while others may not. We can be contacted at 703-580-7433.

This post is sponsored by Sentara Northern Virginia Medical Center. 

As children, many of us were encouraged to eat certain foods because they would help make our bones strong.

We were also probably cautioned from doing things that would cause them to break.

However, children are not the only ones who need to be reminded of the importance of keeping our bones strong.

Our bones provide support and protect our organs. They also store important minerals, such as calcium and phosphorus, which can be released when needed by the body.

If we don’t eat right and get proper exercise, our bones can become weak. Osteoporosis is a disease in which bone density and quality diminish.

The bones become more porous and fragile, greatly increasing the risk of fractures. People with osteoporosis most often break bones in their wrists, spine, and hip.

There are various factors that put people at greater risk of osteoporosis:

• After 40 years of age, people are not able to replace bone tissue as quickly as it is lost.
• Women, particularly white and Asian women, are more likely to get osteoporosis.
• Family history of osteoporosis is another risk factor.

While those factors cannot be controlled, other factors can be, such as diet, exercise, and other habits. To reduce your risk, follow a bone-healthy diet and exercise regimen, reduce or eliminate alcohol consumption and stop smoking.

Eating a well-balanced diet with foods that are rich in calcium, magnesium and vitamin D can help to keep our bones healthy. Calcium supports the structure of our bones and teeth. Magnesium and vitamin D improve our body’s ability to absorb calcium and aid bone growth. Good sources of calcium include:

• Green leafy vegetables (spinach, kale, okra, broccoli)
• Dairy products (milk, cheese, yogurt)
• Chinese cabbage or bok choy
• Sardines/salmon with edible bones
• Apricots/figs
• Nuts (almonds, sesame seeds)
• Beans/legumes
• Foods fortified with calcium (Check the labels on tofu, soy milk, and orange juice.)
Good sources of magnesium include:
• Nuts (almonds, cashews, peanuts)
• Green leafy vegetables (spinach, kale)
• Soy milk
• Beans/legumes
Good sources of vitamin D include:
• Fatty fish (tuna, salmon)
• Eggs (Vitamin D is in the yolk)
• Cheese
• Foods fortified with calcium (Check the labels on cereal, soymilk and orange juice.)

Likewise, proper exercise can help keep our bones strong. Weight-bearing exercises, such as weight training, walking, climbing stairs, and dance, are best for bone health. Non-weight bearing exercises, such as swimming and bicycling, are good for cardiovascular health, but they do not provide much benefit to your bones.

Talk to your doctor about bone-healthy exercise and foods that are right for you. To learn more about our orthopedic services, visit SentaraOrthopedics.com.

With the days are getting shorter and the temperatures colder, it’s common to feel slightly depressed as you patiently wait for the first blooms of spring – leaving many to wonder if winter depression is a real thing.

The answer is “yes,” winter depression, or fall and winter seasonal affective disorder, is a real ailment that affects many every year. So, what are some of the signs of winter depression?

• Oversleeping
• Loss of interest in activities you once enjoyed
• Difficulty concentrating
• Social withdrawal
• Loss of energy
• Appetite changes – especially a craving for foods high in carbohydrates
• Feelings of hopelessness and anxiety

But, have no fear – treatment is readily available and highly effective.

• For starters, taking walks outside during lunch on sunny days without sunglasses on can be extremely beneficial.
• Your brain craves exposure to sunlight during the winter and, even if it’s cold outside, will respond positively to a little time in the sun.

However, if you feel like more consistent exposure is needed, consider purchasing a sunlight lamp for your home.

• Finally, simple antidepressant therapy can make all the difference in the world.
• So, talk to your doctor about what may work best for you while you brave the winter cold.

This post is sponsored by Sentara Northern Virginia Medical Center. 

Even though we are seeing a decrease in deaths from the disease, it remains the number one cancer killer – more than prostate, breast and colon cancers combined.

• Part of the reason is that unless it’s caught at the early stages when the tumor is in one area, it spreads and is often deadly.

If it is caught at early stages, there’s good news – removal of the tumor can be done more efficiently than ever.

• Using robotic surgical tools, surgeons are able to perform minimally-invasive removal of lung tumors.

While not every lung resection (removal of part of the lung) can be done this way, due to the individual’s health and complexity of the situation, overall robotic surgery can be beneficial to patients.

• In addition to having more efficient surgical options, anyone with a history of smoking should schedule a lung CT scan to catch any tumors at the early stages.
• “I wish people knew more about the advantages of lung cancer screenings. There used to be no good way to screen and now CAT scans with low dose radiation make it much easier to have proof every year that the lungs are tumor-free,” said Dr. Bethany Tan, a general thoracic surgeon.

An annual lung cancer screening is recommended for anyone over 55 who has 30 pack-years (having smoked around a pack a day) or has been a smoker within the last 15 years.

• Of course, people who are currently smoking should be screened, and know that smoking is linked to 80 to 90 percent of lung cancers.
• To make your appointment for a CT Coronary Artery Calcium Scoring exam at the Sentara Heart & Vascular Center call 703-523-1980.

Another sleepless night, another miserable day.

• Your spouse complains about your snoring, but the real problem is that you gasp for air in your sleep several times throughout the night.
• You wonder if it’s nothing, or is it worth looking into?
• The answer: Yes, you should look into it. That’s because sleep apnea is more than just a nuisance — it’s a warning sign.
• “Long-term, undiagnosed sleep apnea can make a lot of other medical issues worse,” says Jennifer May, PhD, RPSGT, Manager of Clinical Neurophysiology at Sentara Sleep Center.

Despite the risks, people still avoid getting diagnosed and treated. In fact, about 10 million Americans have sleep apnea, but don’t know it, estimates the American Association for Respiratory Care.

Reaching A Diagnosis

If you, your spouse or your doctor decide you should be tested for sleep apnea, one of the first steps may include a sleep study.

• “Our brainwave patterns change as we fall asleep,” explains May. “During a sleep study we can see distinct changes for different sleep stages.”
• “For instance, we have rapid eye movement (REM) sleep. Our bodies are somewhat paralyzed during this stage. Our muscles relax so we don’t move,” May adds. “Sleep apnea can be worse in different stages, like REM sleep, because of the relaxed muscles.”  

During the pause in breathing, your body’s oxygen levels dip slightly–although they could drop more significantly if the sleep apnea is severe.

• One of the tell-tale signs of sleep apnea is snoring.
• “With snoring, you might just have issues with your sinuses,” Dr. May says. “But snoring is also an indication of a blocked airway.”

Treatment Has Come A Long Way

People put off sleep apnea diagnosis and treatment for a number of reasons. But, getting treated comes with one major lifestyle benefit: “It gives you more energy.”

• Treatment for mild sleep apnea can include measures as simple as sleeping with a pillow that forces you into positions that increase airflow or using an oral appliance to open your airway.

CPAP (continuous positive airway pressure)

• A CPAP is considered the gold standard of sleep apnea treatment. It connects a mask to a tube that uses positive pressure to force the airways to stay open. During your sleep study, your sleep technologist will determine the right pressure for your CPAP.
• CPAP technology has come a long way since the days of having to store a clunky machine the size of an industrial vacuum cleaner next to your bed. Today, these machines are small enough to fit on your nightstand. And — perhaps most importantly — they’re quieter.

Surgery

For severe cases, surgery may be the best option. Surgical procedures range from having your tonsils removed to moving your lower jaw forward.

• A new surgical treatment implants a nerve stimulator that stimulates your tongue muscles during sleep to force your tongue forward enough to keep your airway open and reduce sleep apnea.
• Because your sleep isn’t interrupted during the night, you wake up more rested.
• Your spouse will appreciate it, too, especially if he or she is not getting much sleep because of your snoring.

That’s why on Monday, October 14, 2019, Sentara Northern Virginia Medical Center hosted its annual Breast Cancer Awareness event at Potomac Mills.

• Sentara Healthcare teamed with the shopping mall, local providers such as oncologists, gynecologists, and plastic surgeons, along with Matchbox, Harbour Grill, Costco and 7.1 WASH-FM for this fun, educational event.
• As an added bonus, Sentara’s Mobile Mammography unit was onsite to provide 3-D screening mammograms.
• “Mammograms save lives,” explains Deana Henry, Oncology Nurse Navigator for Sentara Northern Virginia Medical Center. “Mammography is the very best tool in the toolkit for early detection of breast cancer, AND early detection is our best defense against breast cancer. Unlike some other cancers, there is not much specific information we can provide to help people prevent it, other than general healthy living habits.”

Breast health doctors were on hand to answer people’s questions and discuss concerns.

• Many women put off having their mammogram, worrying it may be uncomfortable.
• Henry says that small amount of discomfort can mean the difference between life and death.
• “Can a mammogram be uncomfortable? Sure it can, but it is not nearly as uncomfortable as the diagnostic tests and treatments that accompany advanced breast cancer,” says Henry. “Mammography technologists most often only do breast health procedures and they are experts at getting detailed images as comfortably as possible. For those who are anxious about the procedure, I encourage them to speak openly about their concerns with the mammography technologist prior to starting the examination. The technologists anticipate people are anxious and strive to make the experience as comfortable as possible.”

Sentara Comprehensive Breast Center is a highly accredited, award-winning program where our team provides more than just screenings we’re a community resource.

• Whether it’s to answer questions, lend encouragement or supply resources, the newly opened Sentara Cancer Network Resource Center is here to support patients beyond testing. Located in the Century Building on the campus of Sentara Northern Virginia Medical Center, the resource center provides a number of services such as meditation, yoga, art therapy and the American Cancer Society’s monthly Cancer Conversation series.
• To learn more about the Sentara Cancer Network Resource Center, contact Deana Henry at 703-523-1599.

The new school year is in full swing.

• Besides those initial back to school physicals and vaccinations at the doctor’s office, local providers say it’s important to keep the lines of communication open throughout the year.

Manisha Kunwar is a Family Nurse Practitioner at Sentara Family Medicine Physicians in Dumfries. She joined the team earlier this year, “I love taking care of our patients and bringing a smile back to their face,” says Ms. Kunwar. “Getting a chance to be involved in their healing process is priceless.”

Many families may not realize their primary care provider is there for more than sick visits.

• These high-skilled, trained professionals can help parents navigate the sometimes tumultuous school year, dealing with everything from bullies to anxiety.

“It’s important parents listen to their children and provide an environment where they can share with you,” says Kunwar. “Ask your child to tell you about their problems, listen to them without interruption and avoid judgment so that your child can express their feelings to you. If you see any changes in your kids’ behavior, take it seriously. If you think your kid is suffering from bullying or anxiety, call your PCP. As a provider, we can help. We will screen for risk factors during a routine health visit and anytime you feel that your kids need to be seen. We’re here for you and your family.”

Looking for a new provider?

• Sentara Family Medicine Physicians at 3600 Pointe Center Court in Dumfries is accepting new patients.
• Visit Sentara.com/Kunwar or call 703-523-1750 to schedule your appointment today.

For more than 30 years, Yolanda Elliott was the woman you came to when you wanted to look your best.

The irony that a woman who “did hair” lost her hair doesn’t escape the longtime cosmetologist, but Elliott knows there’s more to life than good hair. 

For the last year and a half, Elliott has been battling breast cancer.

She discovered a lump in her right breast through self-examination nearly two years ago. At the time, she was in the middle of a transition, preparing to move. 

“I think, sometimes as women, we take on so much and set ourselves on the backburner. Even at 60, I’m still learning how to make myself a priority,” explains Elliott. 

It wasn’t until several months after she had settled into her new home in Woodbridge, she was able to make a doctor’s appointment. At that point, her breast was red and inflamed.

The then 58-year-old mom of three was diagnosed with stage 3/HER2+ breast cancer in Summer 2018. She was referred to Sentara Surgery Specialist Dr. Steven Nakao. Dr. Nakao introduced her to Deana Henry, Sentara Northern Virginia Medical Center’s Cancer Nurse Navigator. 

Deana helped her work through the sometimes overwhelming business of a cancer diagnosis. 

“Deana was really instrumental for me, not stressing. She was just so full of information, and she’d always tell me, ‘Well, that’s my job!'” said Elliott. “She went that extra mile and cleared the path for me to go through this.”

Soon after her diagnosis, Elliott started chemotherapy with hematologist/oncologist Dr. Farn Chan. The chemo shrunk her tumor and allowed Dr. Nakao to perform her mastectomy and remove several lymph nodes where cancer had spread. 

After surgery, radiation with Dr. Susan Boylan was prescribed in addition to more chemotherapy. 

Finally, on August 22nd, Elliott had her last treatment. 

“A part of me was relieved to be through with the treatment, but another side of me was anxious- am I really through? Is this really it?” she asked. 

Many cancer patients have mixed emotions at the end of their treatment. 

Elliott is now at a crossroads. 

While chemo is over, she’s not sure how much of her old life will fit into her new circumstances. She’s dealing with neuropathy in her arm, which is keeping her from using it as quickly as she once did. 

Though Elliott is dealing with a lot, she’s resilient. 

Her faith and the support team she’s discovered at the Sentara Cancer Network Resource Center are keeping her going. 

“I have such a faith that no matter what I walkthrough, I don’t walk through it alone,” she said. “My tribe has changed. I’ve done the support group under Deana and yoga, and I visit the resource center. I’m trying to take full advantage of all these great resources.” 

The Sentara Cancer Network Resource Center is located in the Century Building at 2280 Opitz Boulevard, Suite 225, Woodbridge, VA 22191. You can contact the nurse navigator, Deana Henry, at 703-523-1599.

To schedule your mammogram, call 703-523-1560 today.  

By Sentara Northern Virginia Medical Center

Many older adults suddenly find themselves struggling to survive in situations of isolation and loneliness, often for the first time in their lives.

Such isolation can result from factors such as illness, the loss of a spouse or partner, mobility issues, lifestyle choices, and a decline in energy, among others, all of which can contribute to the shrinking of one’s social ties. And while living the life of a recluse may have its benefits for a select few, it’s not always a good approach to healthy living for the rest of us.

Experts agree that a sense of belonging is integral to human wellness, especially among seniors. In every way—biologically, cognitively, physically and spiritually—we are meant to belong, to be needed, to function as members of a tribe.

Seniors who aren’t able to engage in social settings may face serious health and behavioral problems, including an increased risk of

• High blood pressure
• Stroke
• Diabetes
• Colon cancer
• Cardiovascular disease
• Depression

Staying connected and sharing similar interests with others is important at any age—but it’s all the more crucial for seniors, who may have more limited opportunities for social interactions.

Fortunately, life for seniors doesn’t have to be that way. The one immediate step older adults can take to improve their lives is to exercise.

While the exercise itself isn’t necessarily a remedy for isolation it can help reduce some of the many health problems associated with loneliness. Improved physical and mental health, is a good first step toward extending oneself and remaining active in a social environment.

• Before beginning an exercise program, older adults should check with their physician, especially if they have health problems like heart disease, diabetes or arthritis.

However, exercise alone probably isn’t enough. Seniors also should make a point to maintain existing social relationships or generate new ones.

There’s a wide range of ways in which older adults can initiate and maintain social engagement.

• Churches provide many outlets for volunteering and helping others.
• Parks and recreation departments offer numerous low-cost classes in such diverse areas as arts and crafts, meditation, gardening, scrapbooking, music, and computer use.

In the process of learning and keeping the mind supple, older adults also may find opportunities to make new friends. To become a Sentara Northern Virginia Medical Center volunteer and join the Auxiliary call 703-523-1345 or visit us online.

It may not be a topic you want to discuss, but it should be.

Colorectal health is something which both men and women should be aware of, oftentimes women think of colon and rectal cancers as men’s diseases, something doctors say is absolutely not true.

“Colon cancer affects both men and women,” explains Caroline Sanchez, MD, FACS, FASCRS, a colon and rectal board-certified surgeon with Sentara Northern Virginia Medical Center. “The lifetime risk of developing colon cancer is 1 in 24 (4.15%) in women compared to 1 in 22 (4.49%) for men.”

The American Cancer Society recommends that people at average risk of colorectal cancer start regular screening at age 45. Dr. Sanchez says colon issues in both men and women are very similar.
“I take care of colon and rectal diseases. These conditions can range in severity. These diseases can be mildly irritating to life-threatening. They can be benign or cancerous,” explains Dr. Sanchez.

“Early colon cancer rarely causes any obvious symptoms. Warning signs include a change in bowel habits, rectal bleeding, abdominal pain, cramping, bloating, unexpected weight loss, or anemia.”
Dr. Sanchez says many women will dismiss their symptoms and attribute them to their menstrual cycle, that’s why she says it’s so important to discuss colorectal diseases.

“Issues of the colon and rectum are often difficult to discuss, but you should not be afraid to talk about new symptoms you may be able experiencing.  Often times there is a simple explanation which can easily be treated and you don’t have to suffer in silence. If there is something more serious, it is best to find out earlier.”

To find a gastroenterologist or colorectal surgeon, call 1-800-Sentara or visit sentara.com/digestive.