Friday, March 30, 2012

Fauquier Health Plans Neonatal Intensive Care Unit

Fauquier Hospital's Family Birthing Center has been making plans to add a Neonatal Intensive Care Unit (NICU) for several years, and the state Certificate of Need process is underway. The unit would include four nursery beds and would be able to care for some premature or ill babies. Right now, if a child is born too early or under a certain weight, he or she is sent to another hospital for special care. The next appropriate NICU is 70 miles away.

Fauquier Hospital hopes to get the go-ahead from the state to add the NICU by August, and the unit could be in place by the end of the year.

Ellen Bejger, director of the Family Birthing Center: “Most exciting to me is the fact that we are going to be able to offer a higher level of care here in Fauquier County; it will allow us to keep families together near their homes, where their support system is strongest. Families should not have to drive an hour or more to have access to this level of care.”

Here's a story about it, which appeared in the Fauquier Times-Democrat on Wednesday, March 28.


The local community has been extremely supportive of the new NICU. In the past 18 months, local philanthropy has provided funding for rapid expansion of our skilled nursing staff and most of the non-pulmonary equipment needed. In December, we received a pledge of $100,000 for a central monitoring system and other equipment. A 2010 local grant allowed Fauquier Hospital to quadruple our staff of Neonatal Nurse Practitioners and provide round-the-clock care.

Within the last week, Fauquier Hospital learned it had been awarded a prestigious Will Rogers Institute grant. The $48,000 awarded will pay for two Hamilton Arabella nasal Constant Positive Airway Pressure machines, or CPAPs ($24,000 each). The system provides safe, effective delivery of NCPAP (Nasal Continuous Positive Airway Pressure) to infants, including those with very low birth weight.

The total dollar amount donated to the NICU in the last 12 months has been $335,000.

-- $200,000 grant to recruit and train neonatal nurse practitioners (NNPs)

-- $100,000 grant for new technology, including central monitoring system

-- $30,000 grant for general NICU support, used to purchase equipment and furnishings, including sleep chairs for nursing mothers

-- $5,000 small individual gifts, including donations from staff and grateful patients, for general NICU support.

Monday, March 12, 2012

Junior Volunteer and Medical Camp Applications Due April 11

Students 13 to 18 years old are invited to apply for volunteering opportunities this summer at Fauquier Health. The same application enables you to request a spot in our incredibly popular medical camps. Deadline to apply for either program is April 11.

Complete information about the programs is available here.

To read a story about a previous camp, click here. Or here.

Sunday, March 11, 2012

Concussion Care Protocol takes Injury Seriously

Dr. Michael Amster will speak on concussions in young athletes at 7 p.m. on Tuesday, March 29 in Fauquier Hospital’s Sycamore Room.

When Liberty High School freshman Emily Fitzwater reported blurry vision after a volleyball hit her hard under the chin, her mom, Becky, experienced a little déjà vu. The nosebleeds, headaches, the fuzzy thinking – she had seen this before.

Almost exactly a year before, Emily had taken a knee under the chin while sliding into home plate during a youth sports softball game. The results were the same: her head snapped back and the blurry vision and headaches followed. The diagnosis: concussion.

But Becky Fitzwater has noticed a world of difference in the way the two events were handled. Fauquier County Public Schools recently put a concussion protocol in place, and local coaches, trainers and physicians are better trained to recognize and treat concussions.

The first time Emily was injured, she returned to play in a softball game just three days later. The volleyball injury was treated much more conservatively. Becky Fitzwater said that Liberty High School’s trainer, Mandy Carter, was very concerned about Emily’s symptoms and directed that Emily undergo a thorough evaluation by her doctor as soon as possible. Emily’s mother said, “Dr. (Joshua) Jakum, Emily’s pediatrician, told us, ‘This is a bruise. You have to let bruises heal, especially if it involves a whole lot of brain cells.’ He told Emily, ‘You are to do nothing: no reading, no video, no cell phone. You can watch TV in 15-minute intervals, but if your vision becomes blurry, stop. You lie on your bed and listen to music.’ She slept the whole first day.”

After about four days, Emily realized her head didn’t hurt anymore but she was still not allowed to return to the volleyball court. It was only until she went a full week without symptoms that she was allowed to slowly resume activity. Becky Fitzwater said, “Because this was Emily’s second concussion, her doctor and the school’s trainer were very cautious, and they monitored her carefully for any return of her symptoms.”

Dr. Jakum is one of three clinicians in the county who have received special training on diagnosing and treating concussions; the other two are Dr. Michael Amster, pediatrician, and Dr. Mary Koralewski, psychiatrist. Dr. Jakum said, “If there is an injury, it’s important that the athlete is pulled off the field immediately and evaluated. Recognizing a concussion requires attention by coaches, athletic trainers and knowledgeable parents.”

Dr. Amster added, “Children with concussions often have difficulty recalling old information and learning new information. A child with a concussion not only needs physical rest, they need mental rest. Strenuous physical or mental activity can make concussion symptoms worse.”

He said, “For those younger than 24, if an athlete suffers a second concussion before fully recovering from an earlier one, it can cause the brain to swell and could result in significant brain damage.” Dr. Amster adds that only 40 percent of children
who have suffered concussions are fully recovered after a week.

Virginia’s concussion law, the Student-Athlete Protection Act (SB 652), was signed into law in April of 2010. The law mandated that schools develop a concussion policy by July 1, 2011 and Fauquier County School District’s health director, Pam Trude, coordinated the development of that new policy.

ImPACT Testing
The school system’s new rules require that all student athletes involved in sports undergo baseline ImPACT testing (Immediate Post-Concussion Assessment and Cognitive Testing). Drs. Jakum, Amster and Koralewski agreed to become ImPACT-certified clinicians.

ImPACT takes approximately 20 minutes to complete. The computer program measures multiple aspects of cognitive functioning in athletes, including:
• Attention span
• Working memory
• Sustained and selective attention time
• Response variability
• Non-verbal problem solving
• Reaction time

The test is given before the season to establish a baseline. If the athlete is injured and a concussion is suspected, school staff can administer the test again and compare results to the baseline to measure the change in cognitive function. This allows the physician to determine whether or not the athlete has suffered a concussion.

Joining the effort to diagnose and effectively treat concussions in young athletes, Fauquier Health has donated $6,550 to the Fauquier County School Division for 2012-2013 ImPACT testing.

Observable signs of a concussion
• Appears dazed or stunned
• Is confused about assignment or
• Forgets an instruction
• Is unsure of game, score or
• Moves clumsily
• Answers questions slowly
• Loses consciousness (even briefly)
• Shows mood, behavior or
personality changes
• Can’t recall events prior to hit or fall
• Can’t recall events after hit or fall
Signs of a Concussion that

Signs that may be reported by an athlete
• Headache or pressure in head
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Sensitivity to light
• Sensitivity to noise
• Feeling sluggish, hazy, foggy
or groggy
• Concentration or memory problems
• Does not “feel right” or is
“feeling down”

Fauquier Hosptial Hosts Discussion on Advance Directives

Fauquier Hospital will host “A Conversation in Ethics: How to Honor Advance Directives,” on Wednesday, March 21, from noon to 1:30 p.m. The event will be held in the hospital’s Sycamore Room.

Topics will include:
• The new Virginia Advance Directive forms and where patients can find them
• How to select a healthcare proxy
• How to make sure the healthcare proxy understands what the Advance Directive means to the patient
• How the healthcare proxy can best honor the Advance Directives

The discussion will feature several speakers:
• Pediatrician Joshua Jakum, M.D., will discuss the ethical issues surrounding Advance Directives and how to honor decisions made by patients.
• Emergency Department physician Michael Jenks, M.D., will address Advance Directives issues that can arise in the Emergency Room.
• A Fauquier Hospital staff physician will speak on issues common in the hospital setting.
• A Fauquier Hospital social worker will talk about the new Advanced Directives in Virginia.

There will be time for questions and answers.

Fauquier Health Hosts Unused Medication and Sharps Collection Day March 24

Fauquier Health will sponsor an unused medication and sharps collection day on Saturday, March 24, from 9 a.m. to noon, at the Medical Office Building on Hospital Hill. All contributions will be disposed up properly, keeping the pharmaceuticals out of landfills and waterways.

Just drive up and drop off your unused medicines and used needles.

Sharps must be in hard plastic containers that the needles can't poke through. Only individuals, please. No doctors' offices.

St. Patrick's Day at the Bistro

To celebrate St. Patrick's Day, on Friday, March 16, the Bistro on the Hill at Fauquier Health will serve traditional corned beef, Emerald Isle fish cakes, Dublin colcannon, steamed baby reds, cabbage and carrots, and steamed parsnips. Soups will be Irish chicken and leek and Guiness black bean. Yum.

Fauquier Hospital Thrift Shop Hosts Big Sales

The Fauquier Hospital Auxiliary Thrift Shop on Main Street in Warrenton will hold a half-off sale through Wednesday, March 14. Come in and browse for clothes, small housewares, jewelry and other bargains.

Later in the week, the Thrift Shop will hold a Bag Sale from Thursday March 15 through Satruday, March 17 -- $3 a bag.

Good deals await.


Fauquier Health Rehabilitation & Nursing Center resident James Jeffries turned 100 years young on February 23.

Fauquier Health Physical Therapists Pitch Injury Prevention to Young Baseball Players About Injuries

Spring is in the air. That means, among other things -- baseball season.

Fauquier Health physical therapists Bruce Edwards III, PT, DPT, and Kristen Pierce, PT, DPT, provided a community presentation at Battlefield High School in Haymarket on Thursday, February 23, to the Virginia Generals U8 baseball team, parents, and coaches. The Generals are a travel team in the Old Dominion Baseball League.

The presentation stressed that overuse injuries are the most common type of injury that affect young pitchers. It is estimated that up to 40 percent of young pitchers develop an overuse injury, with shoulder and elbow injuries the most common. An overuse injury is an injury caused by repetitive stress to muscles, tendons, and connective tissue. This is important with the younger population because growing athletes have more compliant connective tissue, open growth plates, and underdeveloped muscles. There are many theories as to why athletes are experiencing more overuse injuries, but the most often mentioned are increased sport specialization and the focus on year-round play.

Bruce and Kristen stressed that the best treatment for overuse injuries is prevention. In a February 2011 publication of the American Journal of Sports Medicine, researchers of a ten-year study reported that participants who pitched more that 100 innings in a year were 3.5 times more likely to be injured. Adhering to pitch count regulations and proper rest periods were stressed as key to preventing injury. Proper pitching mechanics, age appropriate types of pitches, competition during fewer than nine months a year, proper conditioning, stretching, and proper monitoring by coaching staff were also stressed.

If pain arises in the elbow or shoulder area in the youth pitcher, it is recommended that the athlete immediately reduces the amount and intensity of throwing. Ice and rest are recommended, but if pain persists after three days of rest, it is recommended that the player consult with a sports medicine physician. A study by Braum et al 2009, also recommended that physical therapy and rehabilitation, with very few exceptions, should be the primary treatment for throwing athletes.

Youth pitching injuries are rising at an alarming rate. Complaints of elbow and shoulder pain in the throwing athlete should be taken seriously. Proper rest is the most important weapon to combat overuse. However, if problems do arise, it is encouraged to collaborate with a sports medicine team, including physicians and physical therapists with an interest in baseball.

At Fauquier Health Outpatient Physical Medicine and Rehabilitation, several therapists have a special interest in rehabilitation of the young athlete with throwing injuries and all other types of sports-related injuries. The goal is to get the young athlete back to playing pain free.