Outpatient Clinics

Outpatient Clinics

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Overview of Anemia

What is anemia?

Anemia is a common blood disorder that occurs when there are fewer red blood cells than normal, or there is a low concentration of hemoglobin in the blood.

  • Hemoglobin. The iron-containing protein inside the red blood cell that carries oxygen from the lungs to tissues in the body.

  • Hematocrit. The percentage of a volume of blood that is made up by the red blood cells.

Anemia is often a symptom of a disease rather than a disease itself. Anemia usually develops due to the presence of one of the following:

  • Excessive blood loss or hemorrhaging

  • Deficient production of red cells

  • Excessive red cell destruction

  • Both decreased production and excessive destruction of red blood cells

What are the symptoms of anemia?

Most symptoms of anemia are a result of the decreased amount of oxygen getting to the cells and tissues of the body, or hypoxia. Because the hemoglobin in red blood cells carries oxygen, a decreased production or number of these cells result in hypoxia. Many of the symptoms will not be present with mild anemia, as the body can often compensate for gradual changes in hemoglobin.

The following are the most common symptoms of anemia. However, each individual may experience symptoms differently. The symptoms may include, but are not limited to, the following:

  • Abnormal paleness or lack of color of the skin

  • Increased heart rate (tachycardia)

  • Breathlessness, or difficulty catching a breath (dyspnea)

  • Lack of energy, or tiring easily (fatigue)

  • Dizziness or faintness, especially when standing

  • Headache

  • Irritability

  • Irregular menstruation cycles

  • Absent or delayed menstruation (amenorrhea)

  • Sore or swollen tongue (glossitis)

  • Jaundice, or yellowing of skin, eyes, and mouth

  • Enlarged spleen or liver (splenomegaly, hepatomegaly)

  • Impaired wound and tissue healing

The symptoms of anemia may resemble other blood disorders or medical problems. Because anemia is often a symptom associated with another disease, it is important for your doctor to be aware of symptoms you may be experiencing. Always consult your doctor for a diagnosis.

What causes anemia?

Generally, anemia may be caused by several problems, including the following:

  • Certain infections

  • Certain diseases

  • Certain medications

  • Poor nutrition

  • Blood loss

What are the different types of anemia?

There are several different types of anemia, each with a specific cause and treatment, including the following:

  • Iron-deficiency anemia

  • Megaloblastic (pernicious or vitamin B12 deficiency) anemia

  • Anemia of folate deficiency

  • Hemolytic anemia

  • Sickle cell anemia

  • Cooley's anemia (beta thalassemia)

  • Aplastic anemia

  • Chronic anemia

  • Kidney failure associated anemia 

How is anemia diagnosed?

Anemia may be suspected from general findings on a complete medical history and physical examination, such as complaints of tiring easily, pale skin and lips, or a fast heartbeat (tachycardia). Anemia is usually discovered during a medical examination through blood tests that measure the concentration of hemoglobin and the number of red blood cells.

In addition to a complete medical history and physical examination, diagnostic procedures for anemia may include:

  • Additional blood tests

  • Bone marrow aspiration and/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

Treatment for anemia

Specific treatment for anemia will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Treatment of the causative disease

  • Vitamin and mineral supplements

  • Change in diet

  • Medication

  • Blood transfusion

  • Bone marrow transplant

  • Surgery (to remove the spleen, if related to hemolytic anemia)

  • Antibiotics (if an infection is the causative agent)

Anticoagulation Clinic
Valley Health’s Anticoagulation Clinic exists to meet the needs of patients who take the common “blood thinner” known as warfarin (brand name Coumadin®).

Physicians may prescribe an anticoagulant to treat a variety of conditions, including:
  • Abnormal heart rhythm
  • Heart valve replacement
  • Clot in the deep veins of the leg
  • Recovery after heart procedure
  • Recovery after heart attack
  • Clot in the lungs
An anticoagulant decreases the blood’s ability to clot and therefore requires careful monitoring of the blood. The Anticoagulation Clinic offers a convenient setting to help patients maintain their target range for the blood’s clotting ability, and learn about the drug and its effects.

Physician referral is required for a clinic appointment. For more information or to make an appointment, call:

540-536-5262 in Winchester
540-636-0636 in Front Royal
540-459-1140 in Woodstock

EPO Clinic
Valley Health offers hematocrit monitoring and erythropoietin (EPO) injections for outpatients at risk for anemia. Anemia can become a serious problem in the absence of normal kidney function and also as a result of bone marrow suppression.

During a clinic visit, patients have their blood pressure checked, receive a finger stick to check their hematocrit count, and, if the count is low, receive an EPO injection.

Appointments are required. For more information or to make an appointment, call:

540-536-5262 in Winchester
540-636-0636 in Front Royal
540-459-1163 in Woodstock

CHF Clinic
Congestive heart failure (CHF) can be managed successfully with medication, diet and activity. Valley Health’s CHF Clinic educates patients with a diagnosis of heart failure about the disease process, the purpose of medications, the limitation of certain foods and beverages that aggravate symptoms, and the importance of activity. The clinic’s team of specialized nurses, pharmacists, dietitians and other healthcare professionals, together with the patient’s own doctor, can assist in managing heart failure and controlling symptoms, allowing the patient a more normal lifestyle.

A physician referral is required for the clinic, which has locations in Winchester and Front Royal. For more information, click here or call 540 536-0518 or 866-264-1595.

EECP® Therapy
Winchester Medical Center offers enhanced external counterpulsation (EECP®) therapy, an outpatient treatment for angina and congestive heart failure. You may be a candidate for EECP if your heart medications no longer relieve your symptoms, you have had an invasive heart procedure and your symptoms have returned, or if you cannot or have chosen not to have further invasive procedures. Your doctor will determine if EECP therapy is an appropriate treatment for you.

During treatment, the patient lies on a table with large blood pressure-like cuffs wrapped around the legs and buttocks. The cuffs inflate and deflate at specific times between heart beats. Treatments are usually given for an hour each day, five days a week, for seven weeks.

The EECP® Therapy Program is located at 1840 Amherst Street in Winchester. For more information, call 540-536-5264 or toll-free 866-264-1595.
Infusion Center 
Winchester Medical Center provides outpatient infusions for independently ambulatory patients, that is, individuals who can walk on their own. 

Infusions include: 
  • Remicade® for rheumatoid arthritis and Crohn’s disease 
  • Intravenous (IV) iron infusions 
  • IgG IV (IV immunoglobulin) 
  • Blood and blood product transfusions 
  • Solu-medrol® infusions 
  • Mediport flushes 
  • Methotrexate injections 
  • Antibiotics 
  • Boniva® and Reclast® 
  • Xolair® 
  • Large volume phlebotomy 
  • Follow-up rabies injections 
Due to the nature of the services provided, it is important that all patients arrive in a timely manner according to scheduled appointment times. Infusions may take several hours; some infusions require a shorter time period. For patient comfort, recliner chairs are available for use during infusions. 

The Infusion Center is located next to the conference center on the Winchester Medical Center campus. Hours of operation: 
Monday, Tuesday, Thursday – 8 a.m.-5 p.m. 
Wednesday, Friday – 8 a.m.-8 p.m. 
Saturday, Sunday – 8 a.m.-4 p.m. 

 For more information, click here or call 540-536-2050 or toll-free 866-264-1595.