The physicians of Charleston Radiation Therapy Consultants are experts in radiation oncology with decades of clinical experience. Each of the five physicians is board certified in radiation oncology by the American Board of Radiology.

“We treat each patient like part of the family and believe our patients deserve the best treatment, the best care and the best chance at a healthy life,” said Prem Raja, MD.

“During my treatment, Dr. Raja took such good care of me. He was caring and compassionate, and of all the doctors I’ve seen – and I’ve seen a lot – he spent the most time with me,” Simpson said. “And the staff was so kind.”

“I think it’s wonderful they [CAMC Radiation Oncology Services] will be located at the new Cancer Center. I think of all the patients that are going through this very stressful, very difficult time, but they will be sitting in this open, bright, beautiful new building and be comforted by it.”

“Our focus is always on the patient,” said Tamara Fuller, Alliance site manager and CAMC Radiation Oncology Services administrator. “Over the past few months, with this new partnership and our new location, we’ve experienced a lot of changes that have expanded our treatment capabilities. Patients have access to our clinical expertise and advanced radiation technology, all housed in a state-of-the-art facility where patients can receive comprehensive care right here in their community.”

CAMC Today is a publication of CAMC Health System

Inside this issue

Like most patients, when Megan Simpson found herself in the radiation oncology waiting room in the basement of the medical staff office building at CAMC Memorial Hospital, it was at an incredibly stressful time in her life. Simpson was receiving radiation treatments to treat a rare type of tumor, called a desmoid.

“I was nervous,” Simpson said of her first visit to the office. “I looked around me in the cramped, dark waiting area and just wasn’t sure what to expect.”

Simpson was hardly the first patient to note the confined space where the radiation oncology unit formerly resided. But all that has changed.

This October, CAMC Radiation Oncology Services will begin seeing patients in its new location on the first floor of the CAMC Cancer Center. The move unites radiation oncology with the other cancer services provided at the state-of-the-art center, bringing comprehensive outpatient cancer services under one roof.

Six months ago, the CAMC Cancer Center opened its doors to the community and introduced a new level of cancer care to our region. As the largest free-standing cancer center in the region, its services already include medical oncology and hematology, infusion

The CAMC Center for Cancer Research sponsored a celebration of the hundreds of patients who have participated in cancer research studies at CAMC.

The center has been coordinating clinical trials for oncology patients for more than 30 years.

The research center focuses largely on National Cancer Institute trials that are relevant to the needs of our local population. These state-of-the-art research opportunities, coordinated by the research center staff, allow patients in our region to remain in their local communities for treatment of their cancers.

Cancer research trials test new scientific ideas and new treatments, allowing for standards of care for cancer patients to evolve over time.

and chemotherapy, patient navigation and a specialized breast center.

Accredited by the Association of Community Cancer Centers (ACCC) and the American College of Surgeons Commission on Cancer, the CAMC Cancer Center sees more patients than any other cancer center in the state. In 2013 alone, more than 20,000 patients were seen by a multidisciplinary team of cancer specialists that includes medical oncologists, oncological surgeons and radiation oncologists.

CAMC Radiation Oncology Services Created in late 2014, CAMC Radiation Oncology Services is a joint venture that includes Charleston Area Medical Center, Charleston Radiation Therapy Consultants (CRTC) and Alliance Oncology, a division of Alliance HealthCare Services.

The contract between all three organizations was signed in November. “This relationship enables us to expand our oncology services and further improve the health of the communities we serve,” said Dave Ramsey, president and CEO of CAMC. “Alliance brings innovative radiation therapy technologies and national expertise to our community, helping CAMC to deliver high quality care close to home.”

“This partnership elevates the level of care available to patients,” said Lewis Whaley, DO, CRTC radiation oncologist. “Certain advancements in cancer radiation therapy have shortened treatment time and reduced some side effects – it’s all part of the latest technology available at the new cancer center. Together, we’ll be integrating the patient’s care to make treatment seamless and will ensure that CAMC continues to be a leader in oncology care.”

Advanced radiation technology During the planning and construction of the 110,000-square-foot CAMC Cancer Center over the last few years, 15,000 feet was reserved on the first floor for two radiation vaults and office space where CAMC Radiation Oncology Services would eventually be placed. Due to the complicated nature of installing the new

equipment, the space required additional time and planning.

The new technology, provided by the radiation oncology department partnership, includes two new state-of-the-art linear accelerators called TrueBeam® with RapidArc Radiosurgery and Real Time Patient Tracking that delivers radiation therapy and radiosurgery treatment to the brain and body.

Radiation oncology, also called radiation therapy, uses X-rays, gamma rays and charged particles to fight cancer. Certain levels of radiation work to destroy cancer cells or prevent cells from growing and/or reproducing.

Radiation therapy can be administered through several methods, and can be used in conjunction with other prescribed cancer treatments or on its own. The type of therapy depends on the type and location of the cancer, and care is customized for each patient.

The goal with radiation treatment is maximizing the chances of curing cancer, while at the same time minimizing the radiation dose delivered to surrounding normal tissues and healthy organs. The radiation oncology department’s state-of-the-art technologies help oncologists do just that -- finely targeting radiation beams with precision and accuracy directly to the tumor. These methods of treatment enable patients to maintain their quality of life and preserve normal organ function during treatment.

Experienced team of specialists “Alliance Oncology has been an excellent partner by providing the latest, most advanced technology to our region while allowing us to focus on patient care,” said medical director Lloyd Farinash, MD.

At CAMC Radiation Oncology Services, the radiation therapy team includes radiation oncologists, medical physicists, nursing and radiation therapists who work with patients and often their surgeons to develop customized treatments plans.

October 6, 2015

Radiation oncology joins CAMC Cancer Center

Cancer research patient celebration

Lewis Whaley, DO; Lloyd Farinash, MD; Brian Plants, MD; Prem Raja, MD (not pictured - Michael Harmon, MD)

Program helps families change lifestyles to raise HealthyKids … Page 2

Only at CAMC: Pediatricians offer exclusive support to unique patient populations … Page 2

Neurologists leading the way in providing specialized epilepsy care … Page 3

THE CUTTING EDGE

Unlike a standard knee replacement, one orthopedic surgeon uses a computer-navigated, robotic-assisted procedure that is less invasive and promotes quicker recovery… Page 4

For these high-flying nurses and paramedics, emergency care starts in a garage on Charleston’s west side … Page 4

CAMC is recognized as the only WV hospital ranked among the top 5% in the nation

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Published by CAMC Marketing & Public AffairsElizabeth Pellegrin EditorDale Witte Jessica Duffield Editors/WritersNathan Harris Graphic Designer

Julia Noland Ashley ShowenLindsey LillyScott JarrellWriters

CAMC Women and Children’s Hospital is the only freestanding women and children’s hospital in the state, and offers a wide variety of pediatric specialties. Caring for children requires a different level of skill and expertise, from using smaller equipment to being extra sensitive to their developmental needs.

CAMC is home to three pediatricians who are the only ones in the state board-certified in their sub-specialties, offering valuable resources to pediatric patients in our region.

Child advocacy The Children’s Advocacy Center (CAC) at Women and Children’s Hospital provides professional and compassionate care to children who are possible victims of child abuse. The center provides comprehensive services to pediatric patients and their families, conducting forensic interviews, performing complete medical evaluations and providing case management and advocacy services. In 2014, the center treated more than 500 patients.

Joan Phillips, MD, and Sharon Istfan, MD, are the only pediatricians in West Virginia board-certified in child abuse pediatrics, a sub-specialty that was recognized by the American Academy of Pediatrics beginning in 2009. Phillips’ and Istfan’s specialized training provides them with a solid foundation of the intricacies of caring for a pediatric patient who was potentially the victim of child abuse.

Both Phillips and Istfan started out in general pediatric practices, but as they got deeper into their careers, began to see the need for more specialists focusing on child abuse.

“I would see things that I felt were being missed, such as kids coming into the

emergency room with broken bones, and the stories just didn’t fit,” Istfan said.

While medical students and residents are taught about the signs of child abuse, sometimes the training isn’t comprehensive enough.

Istfan and Phillips attended conferences and completed continuing medical education that made the need for pediatricians specializing in child abuse more evident.

“I realized early on in my career that people were uncomfortable with the subject of child abuse, the medical exams and the legal process,” Phillips said.

“Nobody wants to think about child sexual abuse,” Istfan added.

The benefit of having Istfan and Phillips at the Children’s Advocacy Center is that they can coordinate a multidisciplinary approach to caring for a child who is a suspected victim of abuse.

“It’s a matter of making sure the child’s needs are met so everyone involved in that child’s care knows what’s going on and what the plan of action is, whether it be Child Protective Services, other physicians or law enforcement,” Phillips said.

Phillips and Istfan take turns taking call for the ER at Women and Children’s Hospital, and they also see patients once they are admitted to the hospital if child abuse is suspected.

One of the main roles they play in the care of the child is testifying in court. Since Phillips and Istfan work with all members of the child’s care team, they can serve as the clinical liaison to the court to provide an overview of the case.

“That’s the great thing about working at the CAC,” Istfan said. “I have the time to go to court to speak on behalf of these kids.”

A general pediatrics practitioner or other specialist working in the hospital would find it much more difficult to make time for the advocacy component.

Medical residents at Women and Children’s Hospital rotate through the Children’s Advocacy Center, and Phillips and Istfan impress upon them the importance of critical thinking when dealing with a potential child abuse case.

“We get them comfortable with the exams and the process, helping them to learn when to be concerned and how to know when a story isn’t adding up,” Phillips said.

One of the most important decisions a physician makes is where to complete his or her residency upon graduating from medical school. This is a significant transition in a doctor’s career because although residents are qualified medical doctors, most of them will spend three to six years (or even longer depending on the specialty) in a residency or fellowship program receiving more in-depth training in their field.

As the largest teaching hospital in West Virginia, CAMC offers residents the highest level of training in their specialized fields of study. This translates to a higher level of care for patients because teaching hospitals are at the forefront of medical research, innovation and technology.

Kellan Clark, DO, a first-year resident in CAMC’s urological surgery program, graduated from the Edward Via College of Osteopathic Medicine in Virginia. During that time, he attended a CAMC urology conference, and after also completing a four-week rotation at CAMC, knew this was the program for him.

“I was drawn to many aspects of the program,” Clark said. “The residents and attending physicians were probably what drew me the most. They are an extremely supportive and academic group. The nursing staff and OR staff are very enjoyable to work with and are also supportive. Our day-to-day work is challenging but also rewarding.”

Clark was also impressed by the level of training available at CAMC.

“The urology residency is a high-volume program, both surgically and clinically,”

CAMC at the forefront of training new physicians

In fourth grade, Griffin Kuhn was a typical West Virginia boy. Unfortunately, that means he was heavy for his age and he was gaining weight.

This concerned his parents.

“Since kindergarten, he had been gaining weight, which continued even though he was active on a soccer team,” said Tom Kuhn, Griffin’s father. “During games we realized that he wasn’t able to keep pace with his peers, so we knew we had to do something to help him.”

After reading a newspaper article, Griffin’s parents called the HealthyKids Wellness and Weight Management program at CAMC – a family-based, medically-supervised wellness and weight management program for children and teens up to 17 years old.

Children and their families are guided through the program by dietitians, a nurse educator, exercise physiologist and Jamie Jeffrey, MD – a pediatrician and mother of four who is passionate about reversing childhood obesity.

“Dr. Jeffrey and her staff were wonderful, very knowledgeable and compassionate,” Kuhn said. “She explained the program in detail, and did initial blood work and screenings.”

Jeffrey was honest with Griffin and told him it wouldn’t be easy, but fortunately he had a lot of family support and encouragement.

“He had just started gaining weight rapidly due to insulin resistance,” Jeffrey said. “His cholesterol and triglycerides were normal and remained that way.”

Griffin is one of only a handful of HealthyKids participants that didn’t suffer from significant co-morbidities (health problems caused from being overweight) like high blood pressure, abnormal lipids, pre-diabetes or sleep apnea, because his parents sought help early in the insulin resistance process.

During the program participants sign up for “teams” just like in sports. They come to “practice” weekly and remain on their assigned teams until they’ve reached their goals.

The process begins with two office visits: the first with the pediatrician, then with the dietitian. During the initial assessment, Jeffrey goes beyond the medical risks and looks at the family’s behavior, attitudes, nutrition and play environment.

“We ask a lot of questions and go into a lot of detail,” Jeffrey explained. “It’s important that everyone in the household work to change the environment and routines to support a healthier lifestyle.”

The program features weekly classes where patients meet with Jeffrey, the dietitian and nurse educator. They also weigh in, learn about diet and nutrition, and participate in individual and group workouts with an exercise physiologist in the kids’ gym.

“As part of the HealthyKids Team, we do grocery store tours with label reading for picking the healthiest choices, and cooking demos that usually consist of veggie dishes,” Jeffrey said. “The families and patients cook the dishes together and eat them at the end of the class.”

This program encourages 5-2-1-0 goals: eating five servings of fruits/vegetables, no more than two hours of TV/electronic screen time, at least one hour of physical activity and zero sugar-sweetened drinks each day. HealthyKids focuses on eating the recommended servings of vegetables because it is one of the hardest 5-2-1-0 goals to meet.

In between weekly classes, parents and participants keep a log of food and activity for self-monitoring and goal setting.

The success of the program speaks for itself. About 96 percent of HealthyKids participants lose weight and experience other significant health benefits, such as

lowering their cholesterol and triglycerides, and reversing serious problems like diabetes and reflux.

The participants’ weekly visits and the multidisciplinary approach to help the children and families are the keys to success.

“Griffin just started his senior year in high school,” Kuhn said. “He has lost 77 pounds so far, and he has completely changed his whole outlook on life. After graduating, he plans on attending WVU to major in psychology and eventually become a psychiatrist.”

“Griffin knows what he needs to do to keep his weight under control,” Jeffrey said. “We have seen him grow up into a fine, healthy young man.”

“Because of Dr. Jeffrey’s program, I can tell which foods are healthy and foods that aren’t,” Griffin said. “If another kid wants to do what I did, I say go for it! You learn a lot about your body and about different foods, so hang in there – you can do it, too!”

For more information, visit camc.org/HealthyKids or call the CAMC Weight Loss Center at (304) 388-4965.

Program works to turn kids into HealthyKids

Specialists offer much-needed support to unique patients

• EmergencyMedicine

• FamilyMedicine

• InternalMedicine

• InternalMedicine/Pediatrics

• InternalMedicine/Psychiatry

• ObstetricsandGynecology

• OsteopathicInternship

• Pediatrics

• Pharmacy–GeneralPharmacy,Critical Care, Geriatrics, Emergency Medicine

Clark said. “We have a strong academic schedule. This, coupled with the camaraderie and willingness of the senior-level residents to teach, has helped to build a strong knowledge base and early skill-set in urology.”

While CAMC’s residency program attracts many out-of-state physicians, it is equally attractive to those who received their medical training in West Virginia.

“CAMC offers a unique opportunity for medical education because there is a lot of interesting pathology in the state,” said Alison Stalzer, DO, fourth-year resident from the West Virginia School of Osteopathic Medicine. “It has a small-town feel and everyone is extremely friendly. At the same time, there are many outdoor activities and beautiful landscapes to take in around the area.”

Whether it’s the high-quality education and experiences each resident receives or the love that is developed for the area and state, CAMC’s medical residents often find it hard to leave once their training is complete. In fact, 38 percent of CAMC graduates continue to practice and/or train in West Virginia, while close to 50 percent of CAMC’s current medical staff trained here.

CAMC currently has more than 170 medical residents. After completing residencies, doctors can go on to fellowship programs, join a medical staff as an attending physician, open a private practice or pursue other opportunities.

For more information about CAMC’s residency programs, visit camc.wvu.edu.

Continued on page 3

• PsychiatryandBehavioralMedicine

• PsychologyInternship

• GeneralSurgery

• UrologicalSurgery

• VascularSurgery

• HipandKneePreservation/Arthroplasty and Musculoskeletal Trauma Surgery Fellowship

• GeriatricsFellowship

• MaxillofacialSurgeryFellowship

Residency and fellowship training programs:

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camc.org 3

Four convenient mammography locations

Epilepsy is one of the most common neurologic disorders that causes recurrent, unprovoked seizures, affecting nearly 3 million people in the U.S. Epilepsy affects people of all ages, races and ethnic backgrounds.

“People can be awake and even talk to you as they’re experiencing a seizure,” said Appaji Rayi, MD, neurologist with CAMC Physicians Group. “They may appear confused or pause, stare off into space or speak nonsense.”

Seizures can range from slight to severe. People experiencing a seizure may have a variety of symptoms, including staring, jerking movements of the arms and legs, stiffening of the body, loss of consciousness, breathing problems, loss of bowel or bladder control, falling suddenly for no apparent reason, not responding to noise or words for brief periods, and periods of rapid eye blinking.

“Epilepsy is defined as having two unprovoked seizures occurring at least 24 hours apart,” said David Gloss, II, MD, neurologist. “Unprovoked seizures means there is no clear trigger associated with the seizure activity.”

In his years working with patients, Gloss has seen a wide spectrum of seizure activity. “Seizures can look like anything, and it may not be evident that a person is even having one.”

The causes of epilepsy can vary widely. It can be caused by a chemical imbalance, fever or infection, tumors, strokes, brain damage from illness or injury, or some combination of these factors. However, often there is no detectable cause.

Diagnosis “You can have seizures and not necessarily have epilepsy,” Rayi said of the complicated condition. A number of conditions can cause seizures, such as syncope (temporary loss of consciousness caused by a sudden drop in blood pressure) and certain psychological conditions. Substance abuse or kidney problems can also cause seizures, as well as conditions like meningitis and encephalitis.

“Patients must undergo a number of tests before a diagnosis of epilepsy is made,” said Samip Borad, MD, neurologist. “Only diagnostic tests can determine if a patient does in fact have epilepsy.”

“EEG is the gold standard,” said Sunil Naik, MD, pediatric neurologist. An electroencephalogram (EEG) records brain activity and can detect disruptions in electric signals in the brain that are signs of a seizure.

“It can be done for different durations – 20 minutes, a few hours, 24 hours, and up to three or four days,” Borad said. “Based on a patient’s conditions, we decide if we need to monitor for shorter or longer periods of time. From the results, we can determine if it is epilepsy and what part of the brain the seizures are coming from.”

Additional testing may include computerized tomography (CT) scans, magnetic resonance imaging (MRI), positron emission tomography (PET) scans and neuropsychological tests to assess thinking, memory and speech skills.

“I encourage patients to keep a ‘seizure diary’ where they can keep track of how many seizures they have, how long they last, possible triggers and other details that help us track their condition,” Rayi said.

Treatment for epilepsy depends on the type and severity of the condition, as well as other factors including the patient’s age, overall health and family history. Treatment options range from medications, regular blood work and/or brain monitoring to surgery, in severe cases.

Medications There are two types of medications for treating epilepsy: rescue and prophylactic.

“Rescue is used when the patient has prolonged seizures that we have to stop,” Naik said. “Depending on the type of seizure, patients may be placed on prophylactic (anti-epileptic) medications that can prevent or manage them.”

“All of them are good, but they may have different side effects, so we have to take the patient’s entire situation into account before initiating them,” Borad said. “Often, these are life-long medications so we have to consider long-term what’s best for the patient including long-term side effects.”

CAMC Physicians Group Neurology leads the way in providing specialized care for epilepsy

“One of the most important things patients can do is to take their medication exactly as directed, every day,” Rayi added. He said a common misconception is that patients believe because they haven’t experienced a seizure, they can stop taking their medication, but this is not advisable without doctor supervision.

“Sometimes patients will take their medications like they’re supposed to and are seizure-free for two years, and at that point, we can look at taking them off them,” Gloss said. “But in other cases, long-term medications are required to manage the condition.”

Borad encourages patients to work closely with their medical team in managing their medications. “The important thing is that patients do not change their medications or simply stop taking them unless they’re directed to and their doctor is in agreement.”

Surgery “If patients have tried two medications for a reasonable amount of time that have failed to manage their seizures, it’s important they get a referral to a neurologist who specializes in epilepsy to explore other options,” Gloss said.

When surgery is needed, there are different techniques to either remove or isolate the area of the brain where seizures begin.

Get your mammogram today – it’s quick, easy

and could save your life.

CAMC has four locations

where you can get a mammogram. Appointments encouraged.

Call (304) 388-9677. Walk-ins accepted for

screening mammograms.

• CAMC Breast Center (now located on the third floor of the

CAMC Cancer Center)

• CAMC Imaging Center – Kanawha City

• CAMC Imaging Center – Southridge

• Teays Valley Hospital

Visit camc.org/Mammogram for more information about our locations and the

latest technology in mammography.

Phillips and Istfan also provide community education to other health care providers, particularly in rural areas, and to the community at large.

While dealing with difficult cases on a daily basis is saddening, it’s rewarding as well.

“It’s the sheer need of these children that keeps me coming to work every day,” Phillips said. “They have a unique need, and if I can be one person who makes a difference, that’s what matters. I want to be a part of their healing.”

Developmental-behavioral pediatrics Another specialist that is unique to the state is developmental-behavioral pediatrician Beth Emrick, MD. She works in the WVU Physicians of Charleston – Pediatrics office, located in the medical staff office building at Women and Children’s Hospital.

Developmental-behavioral pediatricians treat children with learning, attention and behavioral disorders as well as other developmental disorders like autism spectrum disorders, feeding disorders and visual and hearing impairments.

“I see kids with any kind of developmental delays young kids with behavior problems, school-aged kids with ADHD, kids with

Specialists Continued from page 2

Resective surgery involves removing part of the brain where the seizures are occurring. With this type of surgery, physicians map brain activity to pinpoint the “epileptic focus” (the location where the seizure is originating) and cut away brain tissue in that area.

“If you can safely remove the part of the brain causing the seizures without causing major deficits, this can be successful for some patients in managing the condition,” Borad said.

Stimulation surgery limits the area of seizure activity. One of the most common stimulation surgeries is vagal nerve stimulation, or VNS, which involves implanting a pacemaker-like device that generates pulses of electricity to stimulate the vagus nerve (a nerve that conducts impulses between different parts of the brain). This technique prevents disrupted electrical patterns commonly seen with epilepsy.

Prognosis Neurologists emphasize that patients with epilepsy can lead healthy and productive lives by managing their seizures and working closely with their health care providers.

feeding disorders, and more,” Emrick said. She also sees children once they are released from the NICU if they are experiencing delays in developmental milestones.

Emrick, who grew up in Charleston, came back to the area because she saw the need for her specialty and wanted to give back to the community where she had lived.

“We didn’t have anybody around here that specialized in developmental-behavioral pediatrics. When I was a resident, we sometimes identified developmental delays or suspected problems like autism, but we didn’t have a specialist in the area to send them to. It was frustrating,” she said. “I wanted to come back here to fulfill that need.”

Emrick completed a three-year fellowship in developmental-behavioral pediatrics at Akron Children’s Hospital and is now board-certified in the specialty.

Emrick coordinates medical care for children with developmental or behavioral disorders, which may include testing, prescribing medications, or making sure parents are in contact with all the additional resources needed.

“Sometimes I’m the first person to make a diagnosis like autism, so I review all the

necessary services with the family to make sure they are getting all the therapies they need,” Emrick said. “There are a lot of parents looking for answers as to why their child is having developmental delays or behavior problems, and if I can be that person who helps them figure it out, that keeps me motivated.”

Having sub-specialists on one campus in addition to dozens of other pediatric specialties offered at CAMC is vital to ensuring the best, most comprehensive care for children served at Women and Children’s Hospital.

The Children’s Advocacy Center sees patients Monday through Friday. To schedule an appointment or for more information, call (304) 388-2391.

Emrick sees patients Monday through Friday at the WVU Physicians of Charleston – Pediatrics office located in Suite 103 of the medical staff office building at Women and Children’s Hospital. Call (304) 388-1552 for more information.

Learn more about other specialties offered at Women and Children’s Hospital at camc.org/Kids.

Until symptoms are under control, patients who are newly-diagnosed with epilepsy should:

• Avoiddrivingforatleastsixmonths.

• Avoidswimming.

• Avoidoperatingheavymachinerythat can be harmful to self or others.

• Takeshowers,notbaths.

• Tellcoworkersandfamilymembersabout your condition.

• Strictly comply with physician’s treatment plan, including taking medications every day.

• Avoidpotentialtriggerslikealcohol,stress and sleep deprivation whenever possible.

• Wearamedicalbracelettoletpeopleknow you have epilepsy.

• Carryrescuemedicationsatalltimes.

What do you do if you are with someone who has a seizure?

• Lettheseizurerunitscourse–95percent of seizures stop on their own.

• Keepthepersonsafe.Makesureheorshe can’t hit his/her head, arms or legs or be hurt by the environment.

• Get theperson ina firm, levelposition, such as on the floor.

• Rollthepersononhis/hersideortipthe chin up.

• Do NOT put anything in the person’s mouth.

• Notewhatpartofthebodyisseizingand how long the seizure lasts.

• Checktheperson’seyestoseeiftheyare open, closed or rolled back in the head.

• Iftheseizurelastslongerthan1.5minutes or they keep occurring back-to-back, call 911.

• Peopleareoftenconfusedaftertheseizure is over so reassure them they are safe.

(L to R): Appaji Rayi, MD; Sunil Naik, MD; Samip Borad, MD; David Gloss II, MD, MPH&TM

“I tell my patients, ‘You have a chronic, but treatable condition, and there are a number of very effective treatments available that can help you manage it,’” Rayi said.

The prognosis for patients depends on a variety of factors.

“In cases where seizures can be managed with medications or surgery, patients can expect to live healthy, relatively normal lives,” Borad said. “For those with intractable epilepsy that does not respond well to medications, the road ahead may be rocky at times.”

Pediatric epilepsy For babies and children, identifying symptoms and managing epilepsy can be more complicated. Milder symptoms can often be overlooked or misdiagnosed.

Naik recommends that parents closely monitor their children’s feeding patterns, sleeping patterns and growth, and talk to their doctors if they suspect seizure activity.

“I also tell parents to video the seizure event to show the pediatric neurologist to help us compare what we see on the EEG to what they’re experiencing,” Naik said.

Treating epilepsy in children is important because seizures can affect not only quality of life, but also speech, motor function, memory

and overall brain development. Working with teachers, school nurses, day care personnel and others in the child’s life is also very important for children with epilepsy so that seizures can be properly managed.

Neurology experts CAMC Physicians Group has an experienced team of adult and pediatric neurologists that specialize in all neurologic conditions, including epilepsy.

“We have five neurologists, four of whom specialize in epilepsy, and a multidisciplinary team that includes dieticians, geneticists and surgeons,” said Ryan Tierney, practice manager of CAMC Physicians Group Neurology. “We’re well-equipped to help patients with neurologic issues and their loved ones.”

For more information, visit camc.org/Neurology and camc.org/PediatricNeuro.

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JOB surfing? Apply online camc.org

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Surgeon first in WV to perform innovative knee replacement

Simulator allows caregivers to learn before lift off

Being a high school football coach requires an active, high-intensity lifestyle. From rushing up and down the sidelines calling out plays, to constantly standing and kneeling in team huddles, coaching is a physical job.

For Randy Brooks of Lake Jackson, TX, this is a lifestyle to which he has grown accustomed.

“I’ve been a high school football coach for the past 32 years,” Brooks said. “I played football growing up and also was into weightlifting and running. I’ve always maintained a pretty active lifestyle and enjoy spending time outside.”

Brooks was in the middle of a team huddle at a football game when he suddenly couldn’t stand back up. Though there was no initial pain, the past few years had made standing for long periods of time unbearable for him. When pain medication wasn’t helping, he realized something needed to be done.

Brooks researched his options and reached out to James Cox, DO, orthopedic surgeon with CAMC Physicans Group Teays Valley Orthopedics, to whom he was introduced by his brother.

“Dr. Cox and my brother have gone on mission trips to West Africa together for the past 10 years,” Brooks said. “Once I contacted him, I flew to West Virginia for a consultation.”

Cox typically sees patients with aching, unrelenting joint pain.

“The muscles around, above and below the joint get weak, and it starts a self-perpetuating cycle that spirals downward to the point where prescription arthritis medicines don’t really help. They just can’t be as active as they used to be.”

Cox, who specializes in knee replacement, felt that Brooks was an excellent candidate for an

HealthNet Aeromedical Services is training paramedics and nurses on how to care for patients hundreds of feet in the air.

HealthNet recently equipped a retired air ambulance to simulate the sights and sounds of an actual flight. Video screens outside the windows simulate various flying conditions, and speakers are used to create the roar of the helicopter’s powerful engines.

“There’s nothing like it out there,” said Clinton Burley, CEO of HealthNet Aeromedical Services.

Last fall, the helicopter shell was transported from Pittsburgh to Charleston. Students at Carver Career Center cleaned, painted and added decals to the outside. Then the team at HealthNet stripped and rewired the inside, placing cameras in areas so trainees could be observed while in action.

“It’s been a huge team effort,” said Sean McManus, director of education and performance improvement. “We have to make sure everyone functions the same way. Before someone is in the field, they’ve experienced caring for patients in a compact environment. It’s real.”

Training instructors can program the helicopter simulator to present real-life situations to medics and nurses as they care for their patient, including distracting radio traffic, smoke in the helicopter or other in-flight issues that may arise. While those in the simulator are caring for a patient, the rest of

innovative total knee replacement procedure called OMNIplasty™. Unlike a standard knee replacement, OMNIPlasty™ is a computer-navigated, robotic-assisted procedure that is less invasive and promotes quicker recovery for patients.

“With this procedure, a computer navigation system is used in conjunction with a camera that is placed on the patient’s leg to determine the 3D spatial relationships and angles,” Cox said. “The robot places the cutting arm exactly where it needs to be, and then the surgeon makes the cut like he would traditionally with any knee replacement surgery.”

The robotic element of the procedure allows surgeons to achieve more consistent results with greater accuracy and overall improved functionality.

Brooks had the procedure in June, which was the first of its kind performed in West Virginia. The benefits were immediately evident, and the quicker recovery time has been ideal for Brooks’ fast-paced lifestyle.

the class is watching and listening in the next room.

“It’s intimidating to think everyone is sitting in the other room critiquing you,” said Kim Morgan, RN. “The best thing about learning in a setting like this is that you can learn from mistakes and no one gets hurt.”

“People get a feel for the type of stress they’ll experience in flight,” McManus said. “It’s all practiced before there is a real situation.”

Some of those undergoing training are used to having help from other paramedics or nurses on a unit.

Those going through training learn how to make difficult decisions and think critically, because in the air, they are on their own while caring for the patient.

Newly-hired paramedics and nurses undergo an intense 10-week training program. They spend one week in an academy-style class that includes the simulator and classroom learning. They are assigned to a flight training officer to mentor them at their assigned base. And one day a week, they come back to the Charleston facility to train in the simulator.

Even experienced crew members come to Charleston annually for refresher courses.

“Patient care on an aircraft requires nurses and paramedics to think differently,” McManus said.

“This helicopter simulator keeps HealthNet Aeromedical Services at the top of the patient transport industry,” Burley said.

“I do physical therapy three times a week along with water aerobics and other exercises,” Brooks said. “Other people have noticed that I’m able to walk better and stand for longer periods of time. There’s no way I would be able to keep doing what I’m doing had I not had the surgery.”

Cox said this type of procedure helps dispel some common misconceptions about joint replacement.

“Many times a patient will have this idea that they’re going to lose a lot of bone and there’s going to be a cut above and below the knee. With this robotic technique, the reality is they truly are just skin cuts, and those cuts match exactly the inside surface of the implant. The implant is just an end cap that gets bonded onto the end of the bone.”

OMNIPlasty™ is an option for most patients who are candidates for total knee replacement, and it offers some key advantages over traditional surgery.

“The benefits include less blood loss, less swelling and less post-operative pain,” Cox said. “We certainly expect there to be a quicker recovery time for patients as well, and the handful of surgeons that are using this technology across the country are definitely seeing that.”

Cox said studies have shown that alignment of the knee prosthesis is significantly better with robotic guidance than with other techniques, which is expected to translate into longevity – one of the keys for implant development and innovation.

“It’s great for our area to have access to technology like this,” Cox said. “It shows that CAMC is going to stay abreast of current concepts in medicine across all fields.”

For more information, visit camc.org/TVortho.

CAMC is home to one of the top heart centers in the nation, performing thousands of diagnostic exams, open-heart surgeries, cardiac catheterizations and electrophysiology (EP) and interventional cardiology procedures each year. A 2014 consumer survey showed that CAMC was named by over two-thirds of respondents as the preferred hospital in the region for serious heart problems or heart disease.

“Patients travel from all over the region to receive the highest levels of cardiac care at CAMC,” said Don Lilly, MD, associate chief medical officer at CAMC Memorial Hospital. “We take that seriously, and we are committed to staying at the forefront of cardiac care.”

In 2014, CAMC performed approximately 5,000 heart catheterizations, 1,100 open heart operations and 2,100 cardiac interventions. Roughly 650 electrophysiology cases were performed in the EP lab, which included pacemakers, implantable cardioverter defibrillators (ICDs), electrophysiology studies and complex ablations.

Many of these procedures involve an inpatient stay at the hospital, and most require extensive follow-up care.

“Due to the complex nature of heart-related conditions and procedures, patients need to have regular appointments with cardiologists to make sure everything is functioning properly and that no other complications arise,” Lilly said. “Patients who don’t live in Charleston often have to return here to see their physician for every appointment, which can be inconvenient and expensive.”

CAMC Physicians Group, which is the physician practice group within CAMC Health System, is responding to the growing need for more accessible cardiac care by expanding services around the state, from Summersville and Chapmanville, to its newest location in Princeton.

“With satellite offices in these communities, more patients have access to the same high level of cardiac care and expertise just like they would receive in Charleston, which also makes it easier on them to continue their care,” Lilly said. “And because these practices are part of CAMC, it means better coordination of care, more convenient scheduling, and improved efficiency through sharing of patient medical information between providers.”

To learn more about CAMC Physicians Group’s cardiac services, visit camc.org/CPGcardiology.

Physicians Group brings advanced cardiac care closer to more homes

Dr. Cox showing the sawbones knee model, which helps patients understand the bone cuts and how the implant will fit into the knee.

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