All posts by spsceditor

Richmond: Sneeziest and Wheeziest City in America

Do you suffer from allergies? If you live in the Richmond area, you’re certainly not alone! The Natural Resources Defense Council recently named Richmond the “sneeziest and wheeziest” city in the United States, based on its combination of ragweed pollen and ozone smog. Also named in the top 5 were Memphis, Oklahoma City, Philadelphia and Chattanooga. The report highlights an observation that global warming and carbon pollution increase ragweed and tree pollen production as well as ozone.

This spells double trouble for our patients with asthma, according to Dr. Michael Armstrong of Richmond ENT. “Children and adults who are sensitized to pollen or mold in the air are especially vulnerable to asthma attacks when they are exposed to air pollution. This is particularly serious for our children in the inner city, who are exposed to the highest concentrations of ozone smog and may have limited resources for health care.”

But why do allergies occur? Armstrong explains that people are not born with allergies, but susceptible individuals develop them after repeated exposure. The immune system is designed to protect our bodies from infections such as influenza, chickenpox, and measles. After a natural exposure or vaccination, the body produces antibodies to eliminate the virus or bacteria and prevent future illness.

“Allergic patients develop unnecessary antibodies against harmless particles in the air we breathe or food we eat,” explains Dr. Armstrong. “With repeated exposure, the allergic patient produces inflammation when exposed to pollen, dust, or pet dander. This inflammation causes symptoms such as itchy, watery eyes, nasal and sinus congestion, sneezing, scratchy throat, hives and even shortness of breath. These symptoms are most commonly noticed during the spring tree pollen season and the fall ragweed season.”

Excellent allergy medicines are now available without a prescription, including nonsedating antihistamines and nasal steroid sprays. “Decongestants should be avoided” warns Dr. Armstrong, “as these do not fix the underlying allergic inflammation and they often cause a rebound of symptoms that needs to addiction.”

Anyone suffering from uncontrolled allergies or asthma should make an appointment to see a specialist. During the appointment, a physician will take a comprehensive health history, including your family’s health history and information about your work, hobbies and living environment. A careful history can often suggest the types of allergy exposures that might be causing symptoms. Your doctor will examine your skin, eyes, ears, nose, throat and lungs and may suggest further allergy testing, if appropriate.

If you’ve been suffering from allergies, don’t delay in making an appointment with a specialist. Relief is just around the corner!

A MEDARVAlous Week!

Here at MEDARVA, we’re passionate about giving back to our community and participating in a variety of philanthropic events. Each year, our staff looks forward to what we affectionately refer to as “MEDARVA Week,” a span of five days where we sponsor and support four community events.

Participating in four events over five days is certainly no easy feat, but our staff is up to the challenge because they know that involvement makes a difference in lives as well as the dollars these organizations need. When you combine four events, including the 2015 Annual Awards Breakfast at the Children’s Museum of Richmond, Special Olympics Summer Games, the Boxer Brief 5K, and the Conexus for Health Vision Golf Classic, from Thursday, June 4 through Monday, June 8, you have a “MEDARVAlous” week!

Children’s Museum of Richmond Book Bank Champion Awards Breakfast

The first event to kick off our week will be the Book Bank Champion Annual Awards Breakfast, held at the Children’s Museum of Richmond on Thursday, June 4. Each year, this event highlights an individual who has positively impacted early childhood literacy in Virginia, as well as to recognize the region’s most outstanding preschool and kindergarten teachers. It’s sure to be a wonderful event and we can’t wait to be a part of it!

The Special Olympics Virginia and Healthy Athletes Program

We truly look forward to being a part of the Special Olympics Virginia games again this year. MEDARVA has been a proud sponsor of this event for nine years, providing not only funds to the group, but onsite access to healthcare through The Healthy Athletes Program. The program provides access to healthcare for Special Olympic athletes by offering free health screenings in the areas of vision, hearing, dental, as well as fitness assessments. Because of support from groups like MEDARVA, the Healthy Athletes Program was able to provide free care to every athlete attending the summer games. 

The Boxer Brief 5k

Hitting Cancer Below The Belt’s Boxer Brief 5K is coming up on Saturday, June 6, at Stony Point Fashion Park, and we are thrilled that we’ve had the opportunity to support this wonderful event since its inception three years ago. This fun, annual event raises awareness and much-needed funds for colorectal cancer awareness and prevention. Event proceeds will benefit local efforts in prevention education, early detection and research. MEDARVA volunteers look forward to helping out along the race course, handing out bananas to runners, cheering on the participants and of course, supporting the Richmond community from the front lines.

This year’s event has a new location and will be held at Stony Point Fashion Park, beginning at 8 a.m. It’s a terrific event each year and we can’t wait to see you there!

Conexus For Healthy Vision Golf Classic

MEDARVA is looking forward to sponsoring the 24th Annual Conexus for Healthy Vision’s Golf Classic on Monday, June 8. This event is a Richmond tradition that raises money for Conexus, formerly known as Prevent Blindness Mid-Atlantic. Over 200 golfers are expected to attend this year’s event, hosted at the Hermitage Country Club. The day will begin with a light breakfast reception, before players head out to enjoy a full 18 holes on the golf course. The day will conclude with a delicious dinner and awards banquet.

We are so grateful for our volunteers who take time from work and family schedules to dedicate their time and skills to each wonderful cause. Our favorite yearly tradition, “A MEDARVAlous Weekend” is an absolute gem for the causes it supports, and we hope to see you out and about this weekend!

Raising Awareness of Cancers That Strike Below The Belt

Melinda Conklin is the founder of Hitting Cancer Below the Belt, a Richmond nonprofit dedicated to below the belt cancer prevention, education and awareness.

Each year, Hitting Cancer Below the Belt hosts its signature event, the Boxer Brief 5k, to raise funds that support local efforts for colon cancer early detection and prevention, as well as GI health research.

Colon cancer is the second most common cancer in the United States, and is the second leading cause of cancer death in the US. The disease is not gender specific and affects men and women equally.

Melinda is no stranger to colon cancer, unfortunately. Her husband, Rich Conklin, passed away after being diagnosed with colon cancer in 2011, at the age of 43. There is a 95 percent survival rate if you can catch colon cancer early enough, which inspired Melinda to focus on spreading colon cancer awareness in her community. Melinda formed Hitting Cancer Below The Belt to educate others about colon cancer, spread awareness and to share information about the importance of early detection and prevention.

This year’s Boxer Brief 5k will be held on Saturday, June 6 at 8 a.m. at Stony Point Fashion Park. This fun, annual event raises much-needed funds to support local efforts for early detection and prevention in the Richmond community. MEDARVA Healthcare is proud to sponsor the Boxer Brief 5K and we hope you will join us for this year’s event. You can learn more and register online here.

Online registration for the Boxer Brief 5k ends on Wednesday, June 3, 2015. If you’d like to register in person, you can pick up a registration packet at Lucky Foot Midlothian on Thursday, June 4 from 3 to 7 p.m. or at Lucky Foot Willow Lawn on Friday, June 5 from 3 to 6 p.m.

We’re gearing up for this year’s race and can’t wait to see you there!

Cosmetic Surgery – Special Options For Each Patient

Whether it’s spider veins, scars, sun damage, or another more-detailed or in-depth cosmetic surgery procedure, spring is a popular time to have it done, giving you ample time to recover before summer arrives.

From skin rejuvenation to body enhancement techniques and everything in between, there are many options that will have you well on your way to healing areas of concern. There is a wide range of procedures that offer a short recovery time and will have you out and about to enjoy the warm weather in no time.

Today, surgical options are as unique as each patient. Some of the more popular procedures include breast augmentation, liposuction, an abdominoplasty (known as a tummy tuck), and spider vein treatment. The first steps to determining which option is right for you include having a discussion with your family, followed by a consultation with a plastic surgeon.

Choosing the right plastic surgeon can seem overwhelming. There are many talented surgeons in Richmond that will be happy to meet with you to have in-depth conversations about your individual goals and the best path for achieving them. In addition to helping you meet those goals, you can feel assured that each surgeon’s expertise, experience and patient care initiatives will help you get to where you want to be with terrific results.

If you are considering rejuvenating your appearance, we work with a number of talented, board-certified physicians. Click here to access list.

Why wait to make an appointment for a consultation? Advances in surgical procedures have made it faster, easier and safer than ever to make the changes you’ve been thinking about.

Colorectal Cancer Awareness Month

CRSOnlineAdRMWorriedGuy300x250When you think of March, you might think of St. Patrick’s Day or warmer weather, but did you know that it’s also Colorectal Cancer Awareness Month? Colorectal cancer is one of the most commonly diagnosed cancers in the United States, but the good news is that with regular screenings, this type of cancer is often preventable.

“Colorectal cancer is simply a term for cancer that starts in the colon or rectum” said Dr. Andrew Vorenberg of Colon & Rectal Specialists. “This type of cancer often starts out as a growth called a polyp. Most polyps are not cancer and regular screenings can help determine that polyp removal is necessary. The early detection and removal of a polyp may prevent it from progressing into cancer.”

Risk for developing colorectal center grows with age, so it is recommended that those 50 and older receive regular screenings. In addition to finding polyps, regular screenings can help detect cancer early, when treatment is most effective.

If you are under 50 years of age, there are things you can do to lower your risk. Regular exercise, maintaining a healthy weight and limiting alcohol intake can all help lower your risk. Be sure to talk with your family to determine whether there is a family history of colorectal cancer or other risk factors.

Colorectal Cancer Awareness Month provides a valuable reminder of how important it is to talk with loved ones about family history and prevention. If you or a family member has been putting off making an appointment for an exam, don’t delay! Prevention and early detection are key. There are many doctors to choose from; if you’re not sure how to find a specialist, our website is a terrific place to start.

The Art of Facial Restoration and Aesthetics Around the Eye

With summer in full swing and the sunrays at its strongest, we are constantly reminded of the importance of protecting our eyes. Not only is it important to protect your physical eye, but you don’t want to neglect the area around your eye as well.

Many factors can damage your eyes. From excessive sun exposure to trauma and disease, our eyes are vulnerable and when damaged can be extremely difficult to mend.

Dr. Jeffrey Zuravleff

At Stony Point Surgery Center, we are proud to have Dr. Jeffery Zuravleff in our network, Dr. Zuravleff strictly focuses on the needs of individuals for cosmetic, corrective and reconstructive surgery of the eye.

A Delicate Approach

As a specialist in oculoplastic and reconstructive surgery, Dr. Zuravleff treats both functional and aesthetic problems of the upper face and eye region. Facial disfigurement and scarring from trauma, facial paralysis, tearing, thyroid eye disease and excision and reconstruction of cancerous lesions are among the many medical problems treated by Dr. Zuravleff. He is accustomed to working around the eye and face and understands the delicate anatomy and function of the eyelids and their surrounding structures.

How Is His Work Different From Ophthalmology?

Oculoplastic surgeons, like Dr. Zuravleff are ophthalmologists or “eye surgeons” who are board certified and have completed several years of additional, highly specialized fellowship training following their ophthalmology residency. Oculoplastic surgeons understand how eyelid surgery can affect the comfort of the eye and the clarity of vision.

Oculoplastic surgery manages and repairs problems primarily related to the tissues or structures surrounding the eye, rather than the eyeball itself. These structures include the eyelids, the tear ducts, and the orbit “bony socket surrounding the eye”.

What Can He Do For You?

Dr. Zuravleff can address abnormal eyelid position and contour, reconstruction of the lids following skin cancer removal, burns, or trauma. In addition he performs facial rejuvenation cosmetic procedures such as eyelid lifts, eyebrow lifts, cheek lifts, as well as non-surgical procedures like injectable fillers, and Botox.

If you are interested in learning more about how Dr. Zuravleff can help you please contact him at 804-934-9344 or visit his website at:


Dr. Zuravleff received his Doctorate of Medicine from the University of Pittsburgh’s School of Medicine and Master of Science from the University of Pittsburgh’s School of Public Health. He received residency training in ophthalmology and a fellowship in oculoplastics at Duke University Medical Center.

He has lectured locally, nationally and internationally and practiced as an oculoplastic and orbital surgeon since 1990, managing the care of over ten thousand patients with functional and aesthetic issues of the face.

With his wife, Lynn, Dr. Zuravleff has spent the past eight years restoring the home and grounds of Grasberger’s Spoon Factory on their 160-acre farm/estate.  Dr. Zuravleff is also an amateur potter and enjoys outdoor sportsman activities.

Perception is Everything: A Kids-Eye look at the 5 Senses

Did you ever wonder why your 7-year-old trips over his shoes, without picking them up? Or why your teenager doesn’t hear you when you ask him to make his bed? Or why your toddler spits out the carrots she loved just yesterday?

Despite the evidence of your own eyes and ears, there’s probably nothing wrong with your child’s senses. The sensory faculties of touch, sight, taste, smell, and hearing, allow us to perceive the environment are fine. It’s just that different stages of growth and development allow the child to use them in ways none of us would imagine – or at least not since we were kids ourselves.

1. Touch

The delicate, soft skin of an infant is loaded with sensory nerves, programmed to respond to touch. Think about how a baby just knows how to find the nipple when the side of his face is gently stroked, and how tiny babies respond to that inaugural bath, when for the first time they are wet and cooler than usual.

For a newborn these encounters with touch aren’t just comforting, they can help him thrive. A report out of the Touch Research Institute from the University of Miami School of Medicine revealed that premature babies, who were much less cuddled and touched than their full-term counterparts, weren’t gaining weight at comparable rates. When infant massage and therapeutic touch programs were introduced, these little ones gained more weight and improved their development.

2. Sight 

Anyone who had poor vision as a young child can remember the first time he donned those prescription glasses. Who knew that tree bark had actually had texture!

Vision problems are commonly noticed when a child starts school, but there are a number of things that can be done to evaluate vision beforehand. Natario Couser, MD, is the medical director of Where Healthy Eyes and Ears Lead to Success (WHEELS), an initiative from Prevent Blindness Mid-Atlantic and MEDARVA Healthcare that conducts pre-school screening to help identify children at risk. He says ophthalmologists, clinics, and programs like WHEELS are a valuable tool in diagnosing and treating problems before they can affect learning.

The sense of sight is critical to learning success. “Approximately 80% of the information children process during the school day is from visual stimuli,” says Dr. Couser,. “If a child has problems seeing clearly, learning can be affected. Fortunately, most problems can be easily treated with noninvasive techniques and eyeglasses.”

3. Taste

It’s amazing how your toddler will love squash one day and spit it out the next right?!

The sense of taste is more complex than you would think. It’s closely aligned with the sense of smell, says otolaryngologist Evan Reiter, MD, with VCU Health System’s department of otolaryngology. The taste buds, specialized nerve endings on the tongue, can distinguish several kinds of flavors, notably sweet, salty, bitter, and sour.

All taste buds are not alike. There is research indicating that tweens may be more sensitive to sweet flavors than younger or older children. Also, the overall sensitivity of the taste buds seems to increase and refine by the teenage years.

An unexpected link between taste preference and society was described in a Stanford University study. When kids were given unidentified foods, they preferred the flavors of a highly advertised food chain to similar foods from other sources. Food preference is an important area of scientific study, especially with the new emphasis on combating childhood obesity.

4. Smell

It is estimated that humans have about five million smell receptors, and that the peak sensitivity is at around eight years of age. It will gradually drop off with age, with women generally maintaining the sense of smell better than men.

We use the smells to help taste our food, and we form emotional links and memories from the smells. “We’ve all had the experience of recalling an event when a particular odor wafts by,” says Richard Costanzo, PhD, professor of physiology and biophysics at VCU’s School of Medicine and a pioneer in the study of smell and taste disorders.

“It may be a special perfume, chocolate chip cookies in the oven, or the smell of a gas leak. These are powerful emotional triggers that generate feelings and, in the case of a warning odor, prompt action. In that way, the sense of smell can truly be a life-saver.”

5. Hearing

Are you deaf? Am I talking to myself? These are common questions exasperated parents ask teenagers, says Travis Shaw, MD, ear, nose, throat, and sinus specialist. “Rest assured – this selective hearing loss is not a permanent condition and will go away without treatment, if not without a lot of parental frustration!”

Like the other senses, the sense of hearing has a great impact on learning and development. We learn to associate sounds with emotions. Soft music is relaxing; very loud sounds can sometimes be painful – and may actually damage the fragile receptor cells in the ear.

It is clear that the senses are truly our window into the world. Throughout our children’s lives, the information gathered using these faculties will help them mature into balanced and productive members of society. Science and medicine have developed insights, technology, and procedures that help us keep these windows wide open from the very beginning.

Why Colonoscopies Creep Us Out!

Being chased in a dark forest by a man with chainsaw. A demonic clown with green nubs for teeth. Or that eerie scene from Ghostbusters when the gentle librarian’s spirit hovers in the stacks and transmogrifies into an evil zombie.

Thanks to the media and the abundance of horror movies these days, a lot of creepy concepts are top-of-mind no matter your age. But to some folks approaching fifty, nothing is as scary as the thought of a colonoscopy. Your primary physician is strongly suggesting, urging, almost insisting that you have a colonoscopy. The very thought of it sends chills down your spine. You remember the story your uncle shared – at the dinner table no less – about his experience with the procedure.

It’s an important test performed in doctors’ offices and ambulatory surgery centers worldwide to screen for colon cancer, which is the second leading cause of cancer death in the United States.

Does that stat surprise you? You’re not alone.

Paul Charron, MD, with Colon and Rectal Specialists of Richmond, says many people are misinformed when it comes to the relevancy of colon
cancer. “They think colon cancer isn’t common, or that because it doesn’t run in their family, they won’t get it,” says Dr. Charron. “But people have a one in seventeen lifetime risk of getting colon cancer.” What’s more, the doctor says, the most common form of colon cancer is sporadic, or the kind that it is not inherited, with no changes in bowels, and no symptoms at all. This makes following the American Cancer Society’s (ACS) recommendations for regular screening – colonoscopy every ten years starting at fifty – even more important.

Research has shown that nearly every case of colon cancer can be diagnosed early and quickly treated by following ACS guidelines. The very nature of the disease, in fact, means opportunity for detection is abundant. Colon cancer usually takes years to develop. Early detection, as in most kinds of cancer, is vital to survival.

So where’s the disconnect? People put off plans to have this life-saving test performed for a number of reasons. Primary among them is the colonoscopy’s reputation. Dr. Charron, who performs the procedure at his Stony Point office, says in the past colonoscopies were a lot more frightening and uncomfortable than they are today. Fortunately, the science has evolved: the equipment is smaller, streamlined, and more effective. The preparation is easier, and sedation is much more gentle.

The American Cancer Society currently recommends colonoscopy for men and women, no matter their family history, every ten years, starting at age

After a colonoscopy, Dr. Charron says, “I hear patients say if they had known it was this easy, they would have done it five years ago. It’s certainly okay to be afraid of horror movies and even apprehensive about doctors and hospitals, but when it comes to having a colonoscopy, we like to tell people that they shouldn’t be scared to death of a test that can save your life.”

Now Hear This!

Charlotte Steele put in a call to a repairman recently when she heard an odd clicking sound coming from her electric stove. She had purchased the stove three years ago and had never heard that noise before. When the repairman came out, he told her the noise was completely normal; it happened every time the stove was warming up. Steele, 62, laughs as she recalls the incident. For most of her life, she has lived with conductive hearing loss. In October of last year, she received a bone-anchored hearing device that crystallized her hearing. “I’m hearing better now than I have ever heard,” she says.

Steele lives with her husband in Prince Edward County and has had trouble with her ears ever since she was a youngster growing up in Amelia. “As long as I can remember,” she says, noting that she suffered with agonizing earaches that played havoc with her hearing. “It would be so bad that I would have to sit right next to the teacher to hear.”

Her mother would take her to the doctor for a shot of penicillin or eardrops and she would be okay until the next ear infection. “It got worse as I got older,” she says. “When I was seventeen, my older brother brought me into Richmond for my first ear operation.”

Later, Steele was a patient of Fred Shaia, MD, who performed several operations to remove infections. “I had one ear infection where I was in the hospital for 21 days,” says Steele, who was in her thirties at the time. “Each time I had an infection my hearing got worse.”

Fortunately, Steele never had any nerve damage from the infections. But they affected the quality of her hearing. If someone stood near her and spoke loud enough, she could hear them. “If you were in the other room, I couldn’t understand you,” she says. “I needed to see people’s faces and watch their lips.”

Wayne T. Shaia M.D.
Wayne T. Shaia M.D.

A few years ago, Steele began seeing the son of Dr. Fred Shaia, Wayne Shaia, MD. Like his father, he’s an otologist and neurotologist at the Balance & Ear Center in Richmond, one of Virginia’s leading practices in developing and advancing techniques in hearing. When the younger Shaia mentioned a different approach to improving her hearing, the bone-anchored hearing system, Steele had some concerns about the procedure. When her ear problems continued to worsen, however, she reconsidered. “I built up trust in Dr. Wayne Shaia,” she says. “He is a great doctor, and he told me I was a great candidate for the procedure.”

Steele’s worries were alleviated when she realized the device wasn’t uncomfortable at all. “It didn’t even feel like I had anything foreign in my head and was completely invisible. Nobody knows I have it because it’s hidden in my hair.”

A leader in hearing technology, Dr. Shaia plans to perform this procedure to implant the hearing system at Stony Point Surgery Center

Over the years, Dr. Shaia has helped develop more efficient ways to reduce surgery time and costs. The surgical procedure for this implant takes less than a half-hour. He says the difference between a typical hearing aid and this system is measurable and immediate.

According to Dr. Shaia, the procedure is used for people with single-sided deafness as well as people who have congenital hearing loss or chronic ear infections, like Steele. In order to have the life-changing procedure, “at least one hearing nerve in the ear has to work,” says Dr. Shaia.

The device gives patients two-sided hearing. “It helps their hearing become more normal,” Dr. Shaia says, adding that the day the device is turned on can be a magical one for patients. “Some people that haven’t heard for years get quite emotional. They can hear speech at a normal tone.”

Steele remembers the day the device was turned on. She was so overwhelmed she almost cried. Now every time she hears a noise like that stove clicking, she wonders if it’s a new noise or something she just couldn’t hear over the years. She often asks family and friends, is that the way it’s supposed to sound?

Thank goodness I said ‘yes’ to this.” The father and son medical team of Fred Shaia and Wayne Shaia, who still collaborate at the Balance and Ear Center, are glad she said yes, too. “Helping patients like Charlotte Steele achieve better hearing, and in some cases having the opportunity to give hearing back to patients, gives us absolute joy,” says Dr. Wayne Shaia.

Can My Nose Make Me Run Faster?

Richmond is rapidly becoming one of the most active sports and recreation areas in the nation. We have more and more amateur running races every year, expansions of the biking trails, the Nissan Xterra series, and the 2015 World Cycling Championships on the horizon. Richmond was recently voted “Best Town Ever” by Outside magazine. It is a really exciting time in RVA!

I am seeing more and more athletes in my practice who are suffering from breathing issues while exercising. Many people feel like their nose is blocked or stuffy, or that they have excessive drainage which hinders their performance. As a competitive cyclist, I understand how it feels to not be able to perform at your best.

The most common reason for not breathing well during exercise is a deviated septum. The septum is the cartilage in the middle of your nose that divides each nostril. If this cartilage is not straight, it can severely impact the amount of air that comes through. Think of a deviated septum like an accident on I-64: If you take 3 lanes of traffic and squeeze it down to 1, not many cars can get through. Similarly in the nose, if you take one side and deviate the septum, not much air gets through. Some people may need a simple 1 hour surgical procedure to correct the problem, while many others improve after using medicated nasal spray.

In the office, I try to spend more than the average amount of time with my patients. With active people, I try to find out just how the issue is impacting their life, and what their goals are with treatment. I do a very thorough physical exam including watching how the nose is working during your breathing, and often using a small video camera to look inside of the nose or throat to really get an understanding of each patient’s unique anatomy. I then try to explain my thoughts in a really easy to understand manner. I never appreciate someone who tries to impress people using strange terminology – whether it is at the Apple Store or at my local mechanic. My thought is, just give it to me straight and in terms I can grasp. I apply the same philosophy to my patients. We will come to a mutual decision about the best way to proceed whether it is medication, surgery, or lifestyle modification.

If you have difficulty breathing through your nose or feel like your performance is not what you would like, come in for a visit. You can find me online at or call 804-775-4559.