Community Health: Robot Assisted Joint Replacement

total knee replacement

We recorded today’s conversation on location at Warren Memorial Hospital with Mesfin Shibeshi DO, fellowship-trained orthopedic surgeon and Grace Speicher, Program and Operations Manager, Valley Health Orthopaedic Clinics, Southern Region. Click here to have a listen to the conversation.

Dr. Shibeshi shared his knowledge and experience with respect to robot-assisted total knee replacement. Using this technology, Dr. Shibeshi is able to create a 3D model of a patient’s knee before surgery, allowing for precise planning of incisions and implant placement. The robotic surgical technology offers a level of personalization and precision that can limit soft tissue damage, preserve bone and reduce post-surgical pain for some patients.

Dr. Shibeshi is using this technology to aid in same-day total knee reconstruction procedures at Warren Memorial Hospital, the first Valley Health hospital to earn the Gold Seal of Approval® for Total Knee Replacement and Total Hip Replacement Certification from The Joint Commission.

Grace explained why certification is important. Certification keeps everyone focused on providing high quality patient care by providing:

  • Patient Education– patients are prepared for their total joint journey.  This is accomplished by distributing a total joint book to each patient, along with teaching what to expect prior, during, and after surgery.  This is a collaborative effort with the surgeon, nursing, therapy and case management involvement.
  • Early Ambulation and Pain Control– Studies have shown the sooner a patient ambulates the better their recovery. In order to accomplish this, pain must be controlled.  In an effort to keep narcotic use at a minimum, they have what is called a multimodal approach which includes a block placed by the anesthesia team during the surgical process, along with a periarticular injection placed by the surgeon.  This approach allows for a longer pain control with less need for oral pain pills.  This is easier on the patient’s stomach, as well as less of a threat for narcotic dependence.

Practice Office in Front Royal:

Valley Health’s Orthopedics practice in Front Royal is located in the multispecialty clinic on the campus of Warren Memorial Hospital. Dr. Shibeshi sees patients in clinic there, and performs procedures in the OR at Warren Memorial Hospital. Info about the clinic can be found here: Orthopedic Care in Front Royal | Valley Health (

More information about the robotics and certifications can be found here:

Two Valley Health Hospitals Add Robotic Technology for Knee Replacement

Warren Memorial Hospital Earns Gold Seal of Approval for Total Hip and Knee Replacement Program

Community Health: Advance Medical Directives

advance medical directives

We were on the screen today for a conversation with Dr. James VanKirk, Director of Palliative Care for Valley Health, based at Winchester Medical Center about advance medical directives. This is part of an ongoing community health partnership with Valley Health where I talk every month to physicians, administrators, nurses, etc. from Valley Health about a wide range of topics regarding healthcare. Have a listen to the show by clicking here.

Dr. VanKirk explained what palliative care is: a specialized, interdisciplinary approach to improving comfort and quality of life at any stage of serious illness by addressing symptoms, communications, and next steps. We talked about National Healthcare Decision Day that happens on April 16 each year. He told us that it’s actually observed for the entire week but advance medical directives can be done at any time of year.

Dr. VanKirk talked about the different types of advance medical directives, how to start the conversation with loved ones, how to decide who you’d like to be “your person” and the steps you should take to ensure your wishes are on file somewhere like your local hospital. An advance directive is a form you can complete so that you can be in charge of your health care if you become unable to make healthcare decisions for yourself because of injury or illness. “It always seems too early until it’s too late.”

An Advance Directive includes two important parts:

  • Choosing someone to be your voice when you cannot speak for yourself. This person is commonly called a health care agent, or may also be known as a Health Care Proxy, Substitute Decision-Maker, or Medical Power of Attorney.
  • Communicating the kind of medical treatment you want or don’t want. This is called your Living Will.

For more information, visit their website:

To hear more conversations in this series, visit the podcast page:

Community Health: Direct Access to Physical Therapy

Our conversation today was part of our community health partnership with Valley Health. Every month, we chat with physicians, nurses, administrators, and others within the Valley Health system to talk about topics involving the health & wellness of our community.

Today, we talked with Mary Presley, Director of Rehab Services at Warren Memorial Hospital. Mary has been a frequent guest on the show. Joining Mary, was Marsha Cooper, a physical therapist based at Shenandoah Memorial Hospital.

The pair explained a fairly new program offered at all the Valley Health facilities: Direct Access for physical therapy services. This program bypasses the usual primary care/urgent care visit and allows patients to go directly to one of their physical therapists for sprained ankles, aching backs, vertigo, the list goes on as Marsha explained. 

Valley Health direct-access physical therapists have a doctorate degree in physical therapy and significant training in evaluation and diagnosis. These experts use various techniques depending on the patient’s individual needs. They also use an evidence-based tool called FOTO (Focus on Therapeutic Outcomes), which generates real-time data to measure how well the treatment is working. Physical therapists specialize in areas such as orthopedics, sports medicine, pediatrics, wound care, pelvic health, and balance disturbances; they can also help with neurologic issues and frequently work with individuals recovering from stroke.

Mary explained how direct access is often less expensive for patients – along with being more convenient because it reduces the cost of other copays and prior doctor visits before landing at physical therapy. The clinic will contact a patient’s insurance company to obtain authorization, just like when a patient visits their doctor, and verify the copayment determined by the patient’s health plan. Medicare/Medicaid options are also available.

Direct Access is available at all of Valley Health’s outpatient PT clinics. To learn more, visit their website: and read the article about it here.

Community Health: Heart Valves

Community Health: Heart Valves

February is American Heart Month so we pulled up the mics to chat with Dr. Ernesto Jimenez as part of our community health partnership with Valley Health. Dr. Jimenez is a board certified cardiothoracic surgeon specializing in minimally invasive valve surgery, mitral valve repair and coronary artery revascularization with arterial conduits. He’s part of Valley Health Cardiothoracic Surgeons and the advanced valve program team at Winchester Medical Center’s Heart & Vascular Center.

Our conversation centered around healthy valves and what happens when they start to break down. Dr. Jimenez explained how valves work, what happens to them over time and talked about symptoms we might experience when they begin to fail.

He walked us through a few treatment options and talked about the advancements in minimally invasive surgery for valve repair/replacement since the 1950’s.

For more information about Valley Health’s Heart & Vascular Center, visit their website HERE.

Making Healthy Choices With or Without Surgery

Today’s conversation with Georgeann Freimuth, MS, RD, LDN, a registered dietitian with Valley Health’s Metabolic and Bariatric Program was pretty insightful. She gave us some great tips about making healthier eating choices and busted a few myths about how often you should be eating each day to lose weight. Click here to have a listen.

Valley Health’s Metabolic & Bariatric Program offers surgical and non-surgical options. She explained the non-surgical options that include a comprehensive plan with a team approach. We talked about their medication assisted & Optifast programs. She also gave us a rundown of the surgical options available.

We discussed the importance of changing your mindset and your lifestyle for long term success.

To get more details about their various weight loss programs, click here to visit their website.

Setting SMART Goals in 2022

Today’s conversation centered around setting SMART goals for getting in shape in 2022. Joining me for the chat: Lacy Knight – Physical Therapist & Clinical Manager of Warren Memorial Hospital Rehabilitation and Wellness Services; and, Justin Strucyk, and exercise physiologist with Valley Health.

The pair explained what SMART goals are and why they are the ideal way to set and reach any fitness, functional or weight loss goal you may set in 2022. Lacy also explained their “Direct Access” program and why it could be a game changer for many in our community who need physical therapy without a doctor referral.

Direct Access is available at these Valley Health locations:

Valley Health Physical Therapy | Riverton Commons 40-C Riverton Commons Dr., Front Royal, VA 540-636-0480 Warren Memorial Hospital Outpatient Rehabilitation 120 N. Commerce Ave., Front Royal, VA 540-635-0730 Warren Memorial Hospital Physical Therapy & Sports Performance 351 Valley Health Way, Front Royal, VA 540-823-4733

In addition to these topics, we talked about their personal & sports performance training services, fitness assessments, and why gaining functionality in your day-to-day activities is just as important as setting a fitness goal.

SMART goals:

  • Specific
    • Be as clear and specific as possible with your goal setting. It will help you map out HOW to get there.
    • Example: “I want to lose 40lbs.” in comparison to “I want to lose weight.”
  • Measurable
    • Fitness Goals should often times be quantitative, or measured numerically, because they are easier to track. (ie: “I want to squat 100lbs. with proper technique.” OR “I want my body composition to be less than 18% body fat.”)
    • Progress towards a qualitative goal is harder because it is normally measured by “success” or “failure” (ie: “I want to be stronger.” OR “I want to be skinnier.” OR “I want to make the high school soccer team.”)
    • Use Quantitative goals to progress towards qualitative goals. (ie: “I want to make the high school soccer team, but I know I need to get stronger and faster. I will train to increase my squatting ability by 30lbs., and decrease my 20yd. dash sprint by O.5 seconds.”)
  • Achievable
    • Your goal MUST be achievable based on your CURRENT FITNESS LEVEL.
    • Example: It’s not SMART to set a goal to run a marathon next month if have minimal experience with running long distances.
  • Relevant
    • Make sure your goals are RELEVANT to your life, health and fitness needs.
    • EXAMPLE: If you are currently dealing with high blood pressure or pre-diabetes, focusing on a weekly aerobic exercise goal is a lot more relevant than training to increase your vertical jump.
  • Timely
    • The part of goal setting no one likes to talk about… DEADLINES. Give yourself a deadline for your SMART Goal.
    • There is no rule on how much time, but it’s typical to set 1-3 month short-term SMART Goals (ie: “I want to lose 10lbs. in 3 months.”)
    • It is perfectly okay to have long-term goals (ie: “I want to lose 40lbs. in 12 months.”), but long-term goals tend to get “LOST” without short-term goals to keep you on track.

Community Health: Understanding Omicron

As part of our ongoing Community Health series in partnership with Valley Health, today’s conversation with Dr. Jeffrey Feit centered around the Omicron variant of COVID-19.

He explained why this variant is particularly tricky and talked about what is known vs what is not known about it’s spread, virility and the impact vaccines will have in fighting it.

Community Health: A Priority for Valley Health

Our conversation today with Dr. Jeffrey Feit, Valley Health Population & Community Health Officer and Tracy Mitchell, Director, Valley Health Wellness Services centered around how/why Valley Health prioritizes and implements various community health objectives.

Dr. Feit explained the Community Health Needs Assessment that Valley Health conducts every three years. You can take the survey here:

Tracy told us about the various partnerships with local nonprofits, school systems and area agencies to develop community gardens and distribute the goods to those in need in our community. She also told us about health educators and the role they play in keeping our communities healthy.

During our conversation, Dr. Feit mentioned the Community Benefit Report- which I found fascinating. You can get more details about it here:

Community Health: Breast Cancer & Mammograms

October is Breast Cancer Awareness Month, so we chatted for our Community Health episode (in partnership with Valley Health) with Dr. Anita Minghini, breast surgeon & Medical Director, Valley Health Breast Center at Winchester Medical Center.

We talked about the medical and technological advancements in the detection & treatment of breast cancer. We talked about all the options that are now available for specialized care and the importance of early detection through mammograms.

The Valley Health Breast Center includes a surgical practice dedicated exclusively to treating patients with breast disease. Located in the Valley Health Cancer Center, the Breast Center is also conveniently located 100 steps away from the Winchester Medical Center Diagnostic Center.

The Breast Center offers a comprehensive clinic for women who wish to learn more about their individual lifetime risk of developing breast cancer. After consultation with a breast surgeon, patients are advised about the potential need for genetic counseling and testing, the role of advanced breast imaging, and strategies to reduce risk.

For more information about the things we discussed today:

Mammograms: Myth vs. Fact

Screening Mammogram Guidance for Patients Receiving COVID-19 Vaccine

COVID Fatigue: It's Real

Our conversation today with Laura Walls, LPC with the Outpatient Behavioral Health Program at Shenandoah Memorial Hospital centered around COVID fatigue.

Laura explained what many in our community (and the country) are experiencing as the pandemic drags on. She offered advice for managing the uncertainty that included the mindset that it’s okay to not be okay. We discussed real life situations and how to implement these strategies:

  • Don’t fight it-What we resist persists
  • Investing in yourself- Sleep, healthy eating, physical movement, Socialization/connection, Mind your mind-meditation, guided imagery etc
  • Finding healthy comfort items-humor
  • Don’t believe everything you think-Fears and feelings aren’t facts
  • Being mindful-in the moment
  • Owning your own power
  • Finding meaning

As we wrapped up, she suggested that employees reach out to their employer for information about their EAP programs in order to seek some sort of counseling at no cost to them.