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Spring/Summer 2010

the magazine from FirstHealth of the Carolinas


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The Bariatric Center at FirstHealth Moore Regional Hospital is a Bariatric Surgery Center of Excellence with the American Society for Metabolic and Bariatric Surgery and a Blue Cross Blue Shield Blue Distinction Center of Bariatric Surgery ®


firsthealth CEO message

Proud to serve those who serve

T

Charles T. Frock Chief Executive Officer FirstHealth of the Carolinas

hose of us who are fortunate enough to live in the mid-Carolinas are also fortunate to live near two of the finest military facilities in the world. Because both Fort Bragg (home to the XVIII Airborne Corps, the 82nd Airborne Division, the U.S. Army Special Operations Command and the Golden Knights U.S. Army Parachute Team) and Pope Air Base are close by, many of the brave soldiers and airmen stationed there live among us as friends and neighbors. It’s not unusual to encounter young people wearing military fatigues or the green beret of the U.S. Army Special Forces passing by on the street, shopping in a local market or playing with their children in a neighborhood park. We know the drone of the low-flying military transport planes that pass overhead, and only newcomers to the area mistake the rumble of practice shelling for thunder on rainy Sandhills nights. We join the rest of our community in mourning the loss when one of these brave individuals dies on the battlefield of Iraq or Afghanistan. Because of our proximity to Fort Bragg and Pope, the three FirstHealth of the Carolinas hospitals and our various programs and services often see military personnel (both active duty and retired) and members of their families as patients. Many of our physicians, nurses and ancillary employees joined us after being trained by and having served in the military. Some of them are reservists who have been called back into active duty several times since the events of Sept. 11, 2001. In a unique partnership between Fort Bragg’s Womack Army Medical Center and Moore Regional Hospital, an active-duty U.S. Army physician takes leave one day every week to perform a special medical procedure at Moore Regional. His patients are both civilian and military. This special edition of FirstHealth of the Carolinas, which is called “Caring for people in Harm’s Way,” acknowledges the special relationship our organization has with the military. It highlights physicians and staff who serve or have served in the military—including FirstHealth’s oldest employee and vet, 83-year-old Tom Kenney, who encountered three of the most famous men of the 20th century during his 30 months of military service during World War II. It features a number of people with military connections—active duty and retired—who have needed and sought out various FirstHealth services. We hope you enjoy learning more about these people and their stories. We are proud of our various connections with the men and women of the American military, and we are proud to serve them.

www.firsthealth.org

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155 Memorial Drive P.O. Box 3000 Pinehurst, NC 28374 Editor, FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . Brenda Bouser Managing Editor. . . . . . . . . . . . . . . . . . . . . . . . . . . Jason Schneider Creative Director . . . . . . . . . . . . . . . . . . . . . . . . . . . Jan McLean Senior Art Director . . . . . . . . . . . . . . . . . . . . . . . . . . James Davis Production Director. . . . . . . . . . . . . . . . . . . . . . . . . . Traci Marsh

w w w. f i r s t healt h . o rg Contributing Writers

1 . . . . A message from the CEO 4 . . . . Letters

Melissa Biediger, Brenda Bouser, Dick Broom, Erica Stacy

Contributing Photographer Don McKenzie

8 . . . . FHC happenings

Cover Photography

Pfc. Andrya Hill, 4th BCT, 25th ID PAO

Board of Directors FirstHealth of the Carolinas Mr. Alex Bowness, Chair Mr. Julian King, Vice Chair Robert Bahner Jr., M.D. Mr. H. Edward Barnes Jr. David Bruton, M.D. Mr. Jim Bulthuis Mr. David L. Burns David M. Cowherd, M.D. John N. Ellis, M.D. Walter S. Fasolak, D.O. Mr. Charles T. Frock

Mrs. Carolyn Helms Mrs. Anna G. Hollers Mr. John M. May C. Kenneth Mitchell Jr., M.D. Dr. Susan Purser Bruce S. Solomon, D.O. John S. Stevenson, M.D. William L. Stewart, M.D. David C. Thornton, M.D. Mr. Bob Tweed Mr. David Woronoff

Corporate Officers Chief Executive Officer, FirstHealth of the Carolinas

. . . .

Mr. Charles T. Frock

Chief Operating Officer, FirstHealth of the Carolinas President, Moore Regional Hospital. . . . . . . . . . . . . . . . . . . Mr. Stuart G. Voelpel Chief Financial Officer, FirstHealth of the Carolinas . . . . . Mrs. Lynn DeJaco Chief Medical Officer, FirstHealth of the Carolinas . . . . . . George D. Bussey, M.D. Chief Information Officer, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mr. David Dillehunt

10 . . . Calendar 11 . . . New providers

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Intense focus

Vice President, Human Resources, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mr. Daniel F. Biediger Vice President, Finance, FirstHealth of the Carolinas. . . . Mr. Jeffrey A. Casey Vice President, Community Services, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Vivian Harrington Vice President, Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Cindy McNeill-McDonald Vice President, Patient Care Services/CNO, Moore Regional Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Linda Wallace President, Montgomery Memorial Hospital. . . . . . . . . . . . Mrs. Kerry Hensley President, FirstHealth Richmond Memorial Hospital . . . Mr. John J. Jackson President, FirstCarolinaCare Insurance Company. . . . . . . Mr. Kenneth J. Lewis President, Foundation of FirstHealth . . . . . . . . . . . . . . . . . . Mrs. Kathleen Stockham The not-for-profit FirstHealth of the Carolinas is headquartered in Pinehurst, N.C., and is composed of Moore Regional Hospital, Montgomery Memorial Hospital, Richmond Memorial Hospital (a division of Moore Regional Hospital), the Foundation of FirstHealth, FirstCarolinaCare Insurance Company, and Regional Health Services. Comments on FirstHealth of the Carolinas magazine or changes of address should be directed to bbouser@firsthealth.org or to (910) 715-4278.

FirstHealth of the Carolinas is published three times a year by Vitality Communications 407 Norwalk St. Greensboro, NC 27407 (336) 547-8970 President. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William G. Moore Senior Staff Accountant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kelly Carter © Copyright 2010 by Vitality Communications, an operating company of StayWell/MediMedia USA, and FirstHealth of the Carolinas, Inc. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Vitality Communications. Articles in this publication are written by professional journalists who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional adviser. All editorial rights reserved. Opinions expressed herein are not necessarily those of Vitality Communications or FirstHealth of the Carolinas. Models are used for illustrative purposes only.

On the cover This issue of FirstHealth of the Carolinas, “Caring for people in Harm’s Way,” is dedicated to the men and women of the U.S. military—active duty, reservists and retired—and to the physicians, nurses and staff who care for them. Photo: Pfc. Andrya Hill, 4th BCT, 25th ID PAO


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Webcast memory

Features 12

More than weight-loss surgery

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Caring for people in harm’s way

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Cutting edge, close to home

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Life with, and without, afib

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Freedom from pain

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Webcast memory

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From Afghanistan to Moore Regional and recovery

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PTSD: Post Traumatic Stress Disorder

30

Intense focus

20

Life with, and without, afib

www.firsthealth.org

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letters Winter 2010

the magazine th i from f FirstHealth Fii tH lth h off th the C Carolinas li

w w w.fi rst heal t h.o rg

Latest issue Your latest issue (of FirstHealth of the Carolinas) was very informative and well done. Your magazine continues to improve with time and effort. Even though I have moved (from the FirstHealth service area), I enjoy reading and seeing what all is occurring at FirstHealth as I never know when I might be back there for service. A great group of providers is being accumulated, and the new Reid Heart Center will be fantastic for the area. R.S. Cline, M.D. Burlington

Stoneybrook and Foundation make a good team The Foundation of FirstHealth’s partnership with the 59th running of the Stoneybrook Steeplechase was a key driver to making the race day a huge success. Your kind generosity in sponsoring Stoneybrook, developing and managing the 5K and 1K “Run for the Ribbons,” and your overall support were critical components of our strategy to reinvigorate the Stoneybrook Steeplechase. For that, I cannot thank you enough. In partnership with our key sponsors, the Foundation of FirstHealth’s Cancer CARE Fund ensured we were successful in attracting a crowd of approximately 7,500 race-goers, more than double our attendance in 2009. I look forward to a long and rich relationship, and please give all of your team my sincere thanks for their tremendous support. I think we “knocked the ball” out of the Carolina Horse Park this year and will build on this new foundation to make the 60th running of the Stoneybrook Steeplechase in 2011 an even bigger success. Many thanks for your efforts in solidifying the strong partnership between the Foundation of FirstHealth and the Carolina Horse Park. Dr. M. Nixon Ellis Chairman Carolina Horse Park Foundation Hoke County

For more information on these or any of the services provided by FirstHealth of the Carolinas, please call (800) 213-3284. 4

Spring/Summer 2010


Extra mile My wife, Cathy Buono, was a patient in the Waldrip section on the third floor at FirstHealth Moore Regional from Sept. 7 to Sept. 28, 2009. Even though she passed away on Sept. 28, I would like the staff in Waldrip to be commended. They did a lot during the three weeks my wife was there. They went the extra mile. The doctors and nurses were very nice. I really appreciate everything they did. The staff treated me very nicely, too. Ronald Buono Rockingham

Best anyone could ask for...

Recommendation I am writing in regard to Christine LaForge, Mammography supervisor at FirstHealth Moore Regional Hospital. Upon my recent visit to the Imaging department, Ms. LaForge deserves special recognition. She is a very dedicated and caring individual with her patients. She exhibits the highest level of professionalism in every aspect of her job. One actually looks forward to her being in the department from year to year. Her warm smile awaits you upon your arrival each visit. If there is a hospital award or special employee recognition, I recommend Ms. LaForge Thelma E. Rogers Vass

I have worked part time as a patient advocate at FirstHealth Moore Regional Hospital since I moved to Southern Pines almost five years ago. Prior to living in North Carolina, I was a patient advocate at a large hospital in Rockville, Md., for many years. As a patient advocate, I am mainly accustomed to listening to and trying to solve patient complaints by one form or another. I recently found myself to be an unexpected patient at Moore Regional for emergency back surgery and feel the need to tell you, from my perspective, what excellent care I had while I was a patient. I was brought to the ER by my family on Aug. 25 and eventually admitted to 2Neuro later that afternoon. Dr. Darrell Simpkins, from the emergency room, knew immediately that I was in trouble after reviewing my MRI. He and the entire ER staff were wonderful to me, checked on me constantly and made sure I was comfortable and informed at all times. Dr. Simpkins got in touch with an MRH neurosurgeon, Dr. Bruce Jaufmann, who saw me that night, explained my issue to me and scheduled surgery for later the following day. I might add that it did not happen, as the operating room was backed up with emergencies and I was brought back to my room and went down again the following day. The surgery was very successful, and I was brought back to my room and discharged later the following day. What I want you to know is that the care I received, from the moment I came through the ER doors until I left four days later, was the best anyone could ask for. It’s not because I work here, because almost no one knew who I was. From the nurses and staff on 2Neuro, the transporters, the cleaning women, the phlebotomists, the telemetrists, the food service staff, the emergency room, operating room and PACU staff, I couldn’t have asked for better care. I am now and will be forever grateful for this hospital and the people who work here. In today’s climate, this is no easy task and I thank you all for being here. Lyn Doehler Patient Advocate Moore Regional Hospital

www.firsthealth.org

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letters An outstanding medical facility Thank you for all your efforts in providing an outstanding medical facility for the Pinehurst area. I recently had back surgery and, quite honestly, I was scared to death. My fears were never realized as my pre-op testing was done in a caring, efficient manner and my experience in the hospital, though brief, was wonderful. Everyone was kind, friendly and professional. The nurses in outpatient and the neuro nurses—Kelly Holder, Becky Myrick and Carol Lighthall—were outstanding. They made sure I was comfortable and doing well. The surgery was very successful, and I am relieved. I was held in holding for a long time due to necessary emergencies being treated first, but (neurosurgeon) Dr. Bruce Jaufmann, the nurses, techs and anesthesiologist all kept coming by to check on me and keep me updated. My daughter was also updated regarding the delays. I am so grateful for the hospital leadership in providing outstanding professionals who are well trained and caring. It does make a difference having someone wave, smile and say “hi.” Pinehurst Mayor Virginia F. Fallon

Virginia F. Fallon Mayor Village of Pinehurst

Caring staff Thank you so much for being so good to our dad during his stay at FirstHealth Montgomery Memorial Hospital. It’s comforting to know you have such a skilled and caring staff. Thanks for your kindness. Linda Thompson (for The Perry Family) Troy

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For more information on these or any of the services provided by FirstHealth of the Carolinas, please call (800) 213-3284.


“More than a hospital” My wife recently visited the Moore Regional Hospital Emergency Department after spending four hours at a rival hospital attempting to receive medical attention for her severe abdominal pain and swelling. I sat patiently, growing angrier and more frustrated by the minute as I watched my wife attempt to conceal her tears and excruciating pain from our children. Both she and I were consistently dismissed and neglected by insensitive and overworked “medical professionals.” At my wits end, I left that emergency department and was on my way to another hospital in a desperate attempt to obtain care for my wife. A friend recommended that I take her to Moore Regional Hospital, where she was greeted by a caring and professional receptionist who facilitated her quick admittance into the hospital. Seeing the worry on my children’s faces, she handed them crayons and a coloring book to put them at ease. The bedside manner of the nurses was impeccable, and the doctor’s diagnosis and treatments were quick and accurate. Moore Regional is more than a hospital; it is a family hospital reminiscent of the days when doctors made house calls, knew their patients’ names and were genuinely concerned about seeing their patients get better.

Exceptional, professional, quality Many high praises to FirstHealth Moore Regional Hospital for its exceptional, professional quality service during my surgery and stay on March 22, 2010. I had the misfortune during the week to visit my mother in an intensive care unit at another hospital and can seriously say that FirstHealth Moore Regional Hospital is a first-rate hospital. On that note, to my doctor, Andrea T. DiMichele, a sincere, special thank you. To the staff, many thanks for your caring hearts—such a tranquil feeling experience, as if I were at a spa. And let’s not forget the food service. I was very impressed with the food! With great appreciation for all your hard work, thank you, FirstHealth Moore Regional Hospital.

Jeannette Restituyo Raeford (Mrs. Restituyo’s husband is retired from the military.)

Maj. Kali A. McMurray U.S. Army

www.firsthealth.org

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FHC happenings

FirstHealth unveils redesigned Web site “Welcome to FirstHealth … How can I help you?” These friendly words now welcome visitors to the newly designed—and more user-friendly—FirstHealth of the Carolinas Web site. Still located at www.firsthealth.org, the site features a new home page, new landing pages (that are sometimes enhanced by videos), new patient and visitor pages, a new provider search, new utilization of the E-Health Library and a New Movers section (a what-you-need-to-know section for newcomers to the area). Rotating images highlight the redesigned Home Page, which features a variety of navigation enhancements including a drop-down menu that allows easy access to the most frequently visited destinations (such as jobs, physicians, classes and events) as well as “A to Z” navigation. An expanded “Contact Us” function provides contact information for each of the three FirstHealth hospitals, and a new search function uses an internal Google appliance. Landing pages cover most major service lines as well as such areas of interest as “About FirstHealth,” “Newsroom,” “Online Bill Pay,” “Foundation,” “Careers” and others. The previous New Provider search mechanism now includes multiple practice sites for physician satellite offices.

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Spring/Summer 2010


How

FirstHealth recognized for United Way support The United Way of North Carolina recognized FirstHealth of the Carolinas for its support of the 2009 United Way campaign with a Spirit of North Carolina Award for Campaign Excellence. Presented annually, Spirit Awards recognize employees and companies that demonstrate campaign excellence and community commitment. In 2009, FirstHealth employees contributed $95,026, or more than 16 percent of the total goal, to the Moore County United Way. The amount set an all-time record for employee contributions. “Even in these particularly difficult times, when so many people in our community are in need, it is rewarding to see how an organization can come together to raise money for the United Way,” said Linda Pearson, executive director, Moore County United Way. “The United Way is grateful for the generosity shown by FirstHealth employees.”

Former FHC Board chair dies

FirstHealth of the Carolinas has received a $360,000 grant from the Robert Wood Johnson Foundation (RWJF) to improve opportunities for physical activity and access to affordable healthy foods for children and families in Moore and Montgomery counties. The Moore/Montgomery area was among 41 sites selected for the RWJF “Healthy Kids, Healthy Communities” initiative from a rigorous selection process that drew more than 500 proposals from across the country. Like most parts of the South, Moore and Montgomery counties face high rates of childhood obesity. To address that problem, FirstHealth of the Carolinas will use the funds from the “Healthy Kids, Healthy Communities” grant to build on the strengths and assets of local communities to create policies and environments geared toward reducing childhood obesity.

Health outcomes (out of N.C. 100 counties)

Hoke County: Montgomery County: Moore County: Richmond County:

57th 59th 31st 90th

Mortality

Steven J. Smith, an original member of the FirstHealth of the Carolinas Board of Directors, died April 18 at his home in Pinehurst. Mr. Smith, who was also the first duly elected mayor of the Village of Pinehurst, was a member of the Moore Regional Hospital Board of Trustees from 1992 to 1999, serving as board chair in 1997. He was involved with the creation of FirstHealth of the Carolinas and the merger between Moore Regional and Montgomery Memorial hospitals in 1995. As Board chair of FirstHealth of the Carolinas from 1998 through 1999, he played a pivotal role in the acquisition of Richmond Memorial Hospital. He also served terms on the FirstHealth Board from 1995 through 2001 and from 2008 through 2009. “Steve Smith touched many lives and was a tireless advocate for Pinehurst and for FirstHealth of the Carolinas,” said FirstHealth CEO Charles T. Frock. “The FirstHealth family mourns the loss of a wonderful FirstHealth board member, past chairman and gentleman.”

FirstHealth receives grant to combat childhood obesity

From: Robert Wood Johnson Foundation “County Health Rankings,” the first set of reports to rank the overall health of every county in all 50 states. To see the entire report, visit www. countyhealthrankings.org.

(Number of deaths out of N.C. 100 counties)

Hoke County: Montgomery County: Moore County: Richmond County:

67th 68th 50th 87th

Morbidity

(People with illness/disease out of N.C. 100 counties)

Hoke County: Montgomery County: Moore County: Richmond County:

49th 44th 10th 92nd

The FirstHealth program will focus on five communities— Candor, Mt. Gilead, Robbins, Aberdeen and Southern Pines— that were selected according to high free and reduced lunch rates at local schools. Local task forces will conduct assessments, prioritize needs, and create policies and environmental changes that prioritize the health of each community in an effort to reduce childhood obesity. According to data collected by the FirstHealth School Health Centers during the 2007-2008 school year, more than a quarter of Montgomery County children in grades K-12 are obese and another 18 percent are overweight with obesity increasing with each advancing grade.

www.firsthealth.org

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For information on any of these events, call (800) 213-3284.

May

23rd Annual Cancer Survivors Day Sunday, June 6 2 to 4 p.m. The Fair Barn 200 Beulah Hill Road, Pinehurst The event is free and open to cancer survivors, their families and friends.

n First

Blood Drive Wednesday, June 23 10 a.m. to 3 p.m. Conference Center Moore Regional Hospital.

Diabetes Support Groups n Second and fourth Monday of each month Noon to 1 p.m. FirstHealth Family Care Center-Raeford Thursday of each month 9 to 10 a.m. Conference Dining Room Richmond Memorial Hospital

n Third

Friday of each month 10 to 11 a.m. FirstHealth Taylortown Building, West End

All groups are free and open to the public. Diabetes Information Session Thursday, May 20 5:30 to 6:30 p.m. Richmond Memorial Hospital Education Room A free information session about risk factors, signs and symptoms, and the resources available for those with diabetes. Space is limited. Blood Drive Tuesday, May 25 10 a.m. to 2:30 p.m. Center for Health & Fitness–Pinehurst

June

Seventh Annual Blue Jean Ball Saturday, June 5 6:30 to 11 p.m. Fair Barn, Pinehurst Annual benefit for the Cancer CARE Fund. $60 per person.

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July

Treatment Options for Atrial Fibrillation Tuesday, July 20 5:30 p.m. Conference Center Moore Regional Hospital A free, interactive presentation on treatment options for Atrial Fibrillation.

August

Childbirth Preparation Classes Saturday, Aug. 14 9 a.m. to 2 p.m. Third-Floor Auditorium Richmond Memorial Hospital Free one-day session on such topics as breastfeeding information, breathing techniques, pain control, labor positions and postpartum care. Childbirth Preparation Classes Wednesday, August 25 10 a.m. to 3 p.m. Conference Center Moore Regional Hospital


Medical Staff Update Cardiac & Thoracic Surgery

Cardiology

Emergency Medicine

Michael J. Gillespie, M.D.

Andrea R. Ward, P.A.-C FirstHealth Cardiovascular & Thoracic Center (910) 715-4111

Board Certified Sanford Cardiology (919) 777-9005

Stacy L. Nelson, P.A.-C Sandhills Emergency Physicians (910) 715-1111

Hospital Affiliation: Moore Regional Hospital Training: P.A., University of Alabama– Birmingham

Training: M.D., Hahnemann School of Medicine, Pennsylvania Internship/Residency: UNC Hospitals

Hospital Affiliation: Moore Regional Hospital, Richmond Memorial Hospital (a division of Moore Regional Hospital) Training: P.A., Wake Forest University

Family Medicine

Hospitalist

Infectious Diseases

Amy J. Lockett, P.A. C

Brian S. Hough, P.A.-C

FirstHealth Family Care Center–Raeford (910) 904-2350

Moore Regional Hospital Hospitalist Service (910) 715-2164

Hospital Affiliation: Outpatient practice only Training: P.A., D’Youville College, New York

Hospital Affiliation: Moore Regional Hospital Training: P.A., Methodist College, Fayetteville, N.C.

Psychiatry

Radiology

Gretchen Shaughnessy Arnoczy, M.D. Board Certified FirstHealth Infectious Diseases Program (910) 715-5481 Hospital Affiliation: Moore Regional Hospital Training: M.D., University of South Florida Internship/Residency: UNC School of Medicine

Olin M. Fox, M.D. Board Certified Carolina Behavioral Services Pinehurst (910) 295-6007 Hospital Affiliation: Moore Regional Hospital Training: M.D., University of North Carolina at Chapel Hill Internship/Residency: University of Kentucky Medical Center; Milton S. Hershey Medical Center, Pennsylvania

Michael T. Serle, P.A.-C Pinehurst Radiology Associates (910) 295-4400 Hospital Affiliation: Moore Regional Hospital Training: P.A., University of Medicine– Dentistry of New Jersey Hospital

www.firsthealth.org

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More than weight-loss surgery By Dick Broom

Before Mary Williamson had gastric bypass surgery, she weighed 278 pounds and took medication every day for high blood pressure, high cholesterol and diabetes.

Eleven years later, her weight is 112 and the only medication she takes is for a thyroid condition. Williamson is the second patient that Kenneth Mitchell, M.D., operated on after starting the bariatric surgery program at FirstHealth Moore Regional Hospital in March 1999. “It’s the best thing I’ve ever done for myself,” says the 74-yearold Aberdeen resident. “It has made a tremendous difference in my health.” Williamson says that if someone who is morbidly obese (as she was) relies on surgery alone to solve a weight problem, he/she will almost certainly be disappointed. Success at losing weight and keeping it off depends on adopting a radically different lifestyle and forever leaving behind the unhealthy habits that led to obesity in the first place, she says. “Your life has to become totally different,” says Williamson. “I’m not saying that I don’t ever eat anything that I ought not to, but I can’t eat as much as I used to, and I don’t overload my stomach. I have learned with time how to do that.” According to Williamson, a key to taking off more than 160 pounds and maintaining a healthy weight for so many years has 12

Spring/Summer 2010

been the support—in the form of advice, encouragement and sometimes prodding—that she has gotten from Dr. Mitchell. “There has never been a time when he wasn’t there for me,” she says.

Bariatric support

A couple of years after Williamson’s surgery, she and another patient organized the Bariatric Support Group at Moore Regional Hospital. The group continues to meet once a month. “It gives people a place where they can go to be encouraged or ask questions or be reminded of what they ought to be doing,” Williamson says. “You get to hear what other people have accomplished, and that means a lot.” Many times over the years, Dr. Mitchell has taken Williamson up on her offer to talk with people who were about to have bariatric surgery, to tell them what to expect and how determined they would have to be to achieve their goal. “I want people to know that there is success out there,” she says. “You’ve got to want it, but there is success.”


A history of bariatric surgery at Moore Regional

Free information sessions on FirstHealth’s Bariatric Program are offered in Cumberland, Lee, Moore, Randolph, Richmond, Scotland and Wake counties. For the date and time of the next session nearest you, visit our Web site at www.firsthealth.org/bariatric or call (866) 603-9191 toll-free.

More than 1,350 morbidly obese people have had bariatric surgery at FirstHealth Moore Regional Hospital since Kenneth Mitchell, M.D., performed the first gastric bypass procedure at the hospital on March 1, 1999. During the program’s first year, Dr. Mitchell performed 13 procedures. By the following year, the number had grown to 40. Raymond Washington, M.D., joined the program in 2004, and he and Dr. Mitchell now operate on 175 to 250 patients a year. Moore Regional’s bariatric surgery program has grown so much and so fast because of its excellent patient outcomes and low complication rates, and its success is in part the result of being on the leading edge of innovation. Since 2001, most of the Kenneth Mitchell, M.D. bariatric procedures at Moore Regional have been done laparoscopically or through tiny openings instead of a large incision in the abdomen. “This lets the patient have the same results, but with less pain and a quicker recovery,” Dr. Mitchell says. In 2004, FirstHealth received a Center of Excellence designation by BCBS of North Carolina. It was re-certified as a Blue Distinction Center for Bariatric Surgery Raymond Washington, M.D. in 2009. In 2005, the bariatric surgery program, which had been based at Pinehurst Surgical, expanded into the Bariatric Center at Moore Regional. The following year, the program was designated a Bariatric Surgery Center of Excellence by the Surgical Review Corporation, (SRC), a company founded by the American Society for Metabolic and Bariatric Surgery to advance the safety, efficacy and efficiency of bariatric and metabolic surgical care. The Center of Excellence designation was renewed earlier this year. In 2008, Dr. Mitchell became the first surgeon in North Carolina to perform bariatric procedures using a new type of adjustable gastric band to regulate food intake.

www.firsthealth.org

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By Brenda Bouser

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Andrew Doolittle, M.D. / U.S. Army

Military life introduced Andrew Doolittle, M.D., to a host of experiences and a variety of people. The most memorable people he encountered were soldiers from the field. “Taking care of the people who were doing the front-line work, it truly was an honor to do that,” he says. An otolaryngologist (ear, nose and throat specialist) with FirstHealth Richmond Memorial Hospital and Mid-Carolinas Surgical Associates in Rockingham, Dr. Doolittle received his medical training through the military by way of the Health Professions Scholarship Program (HPSP) and graduated in the top 5 percent of his U.S. Army Officer Basic Course in San Antonio, Texas. The HPSP scholarship allowed him to attend the Boston University School of Medicine in Massachusetts, where he received his M.D. He then completed an internship and residency in otolaryngology at Walter Reed Army Medical Center in Washington, D.C. For four years, from 2004 to 2008, Dr. Doolittle was assigned to Fort Bragg and Womack Army Medical Center, where he served as chief of Otolaryngology—Head and Neck Surgery until joining FirstHealth of the Carolinas. He had planned on becoming a primary care physician until a medical school rotation introduced him to ear, nose and throat specialization. “I ended up liking it,” he says. “I found I was drawn more to that.” A brief deployment as a general medical officer in Kuwait and Qatar entailed a return to the primary care that Dr. Doolittle had originally considered, however. The patients he saw in “sick call,” contractors as well as soldiers, had the usual colds, coughs, and blood pressure and diabetes issues of any general medical practice—but were treated in a trailer in a foreign land several thousand miles from home. “I was doing all the things I hadn’t done in five years,” he says. Dr. Doolittle, who left the Army as a major, was at Walter Reed at the beginning of the current war in Iraq when the world-famous medical center was receiving patients with “horrendous injuries” but providing excellent care. He attributes the later and highly publicized allegations of unsatisfactory conditions there more to bureaucratic issues than to standards of medical care. “I’m glad I had the experience,” he says of his time at Walter Reed. “I think I met a lot of great physicians as well as the soldiers.” Story continues on pages 16-18

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David J. Casey, M.D./U.S. Army At first glance, the framed photograph in the office of David Casey, M.D., appears to be a large freefalling flower. A closer look reveals that it is an image of 10 arm-in-arm parachutists and that each member of the Golden Knights U.S. Army Parachute Team has signed it. Dr. Casey, who estimates that 15 to 20 percent of his patients have a military tie, operated on one of those parachutists. A number of his patients are active duty military with the same goal in mind—getting back to their comrades. “They’re some of the best patients in the world who are truly interested in getting better,” he says. An orthopaedic surgeon with FirstHealth Moore Regional Hospital and Pinehurst Surgical, Dr. Casey specializes in adult reconstruction surgery (hip and knee replacement), calling it “my niche.” His own military background helps him identify with the active duty and retired military personnel who need his expertise. Trained by the military through the Health Professions Scholarship Program (HPSP), he earned his M.D. at Boston Univer16

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sity, did his internship at Walter Reed Army Medical Center in Washington, D.C., and his residency at Boston University before completing an orthopaedic fellowship at Cornell University’s Hospital for Special Surgery in New York. As many as 5,000 to 7,000 joint replacements are performed there annually. “It’s a unique place,” says Dr. Casey, who left the Army as a major. “It’s the world’s oldest orthopaedic hospital.” Dr. Casey had the opportunity to use his surgical skills many times over during his own stint in the U.S. Army, which included a 2002 deployment to Afghanistan. In those early days of American involvement in that distant land, many of Dr. Casey’s patients were native Afghans who had suffered traumatic amputations after stepping on old Soviet landmines or who were the victims of high-velocity gunshots. Some were women; many were children. During his 13 years with the military, Dr. Casey experienced the gamut of military medicine—from the M-A-S-H-like efforts of small forward surgical teams to the sophisticated care of Landstuhl Regional Medical Center, where injured military personnel are routinely evacuated from Iraq and Afghanistan. Whatever the location, the goal is the same for the American military physician. “The goal is to preserve the fighting strength,” Dr. Casey says. “That’s one of the main goals of military medicine—with the best interest of the individual soldier as your priority.”


Tom Kenney FirstHealth’s oldest vet

“Taking care of the people who were doing the front-line work, it truly was an honor to do that.“ Andrew Doolittle, M.D.

Polly Flippo, R .N./Navy Nurse Corps When Polly Flippo entered the Navy Nurse Corps as a young nursing diploma graduate out of Columbus, Ohio, her intention was to complete her three-year hitch, see something of the world and figure out what to do with the rest of her life. By the time she left the Navy Nurse Corps, she had earned her bachelor’s and master’s degrees—both on the Navy’s nickel, seen a lot of the world, and gotten more nursing and leadership experience than she ever expected. Twenty years transpired between those personal benchmarks, and Flippo, after spending another 10 years as director of a community college nursing program in Petoskey, Mich., is now clinical director for 4 Medical/3 Medical/Dialysis Services at FirstHealth Moore Regional Hospital. Her military experience has a special place in her heart. “It was a great experience, and I wouldn’t trade it for the world,” she says. Flippo, who retired from the Navy as a commander, began her military career with officer training in Newport, R.I. Her first duty station was Great Lakes, Ill., and subsequent assignments sent her to San (Story continues on page18)

Tom Kenney was just a few months into a 30-month Army career, a green kid from Chicago who had needed his father’s signature to sign up for World War II service, when he looked up from a railroad station platform and into the face of one of the greatest men of the 20th century. Kenney carries the memory of a small and pinkfaced Winston Churchill as if the event had occurred yesterday instead of more than 65 years ago. Churchill was one of three “heroes” Kenney encountered during his military experience. The others were Gen. George C. Marshall—he of the Europe-saving Marshall Plan—and President Harry S. Truman. At 83, Kenney is now FirstHealth of the Carolinas’ oldest full-time employee. He joined the information desk at Moore Regional Hospital’s main lobby as a volunteer 17 years ago and became a paid employee four years later. Although his military service covered only a fraction of a life that has also included a long and successful career with Blue Cross, two happy marriages (he remarried after his first wife’s death) and a family blessed by children and grandchildren, Kenney cherishes those 30 months with the Army. He made good buddies and filled a virtual treasure chest with memories. Kenney trained with replacement troops bound for the European Theater, but never saw a day of combat. Instead, he was selected for a security detail at the Truman White House and to stand guard at the Declaration of Independence. He spent 23 days on a literal slow boat to China, sailing from the American West Coast to Shanghai on the liberty ship Marine Phoenix. He served with a vice squad that hauled soldiers out of Chinese brothels in what is now Beijing, and helped guard Gen. Marshall during the great man’s visit to Nationalist China’s Chiang Kai-shek. He served his country from June 1944 to December 1946, and was proud of every minute. “It was your duty,” he says of his military service. “They asked you to serve, and you were glad to do it.”

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Diego, Calif. (twice); Japan (for three years); Corpus Christi, Texas; and Long Beach, Calif. She was also assigned to the Hospital Ship Comfort during Operation Desert Storm during the first Iraq War in the early 1990s. Flippo’s experiences were as varied as her assignments—from the 150-bed hospital in Yokosuka, Japan, that served ships coming and going throughout the region to the 500-bed teaching hospital in San Diego, where she worked in surgical and pediatrics care. She earned her master’s degree from San Diego State University and met her husband, an Army veteran who joined the Navy to study nursing on the G.I. Bill, in Great Lakes. The Comfort experience, just five months due to the brevity of the war, was especially memorable. The converted oil tanker was equipped with everything that could be found in a modern hospital, and the health care professionals aboard it treated minor combat injuries, accident victims and general surgery patients until called into more serious action after the amphibious assault ship USS Tripoli struck an Iraqi mine in the Persian Gulf. Flippo, who now has a son in the military, calls the Navy “a wonderful career” filled with numerous opportunities for leadership. “You’re serving your country and taking care of the people who serve your country,” she says. “To me, that is the best thing.”

Eric Frizzell, M.D./U.S Army Eric Frizzell, M.D., owes his medical career to the military. When family finances clouded the prospect of medical school, Dr. Frizzell turned to the military and the affiliated Uniformed Services University of Health Sciences (USU) in Maryland. “I couldn’t have done it otherwise,” he says. “This was the option.” A health science university operated by the U.S. government, the USU graduated its first class in 1980 with the mission of preparing a medical corps of physicians and nurses for service to the U.S. at home and abroad. It has two mottos: “Learning to Care for Those in Harm’s Way” and “Providing Good Medicine in Bad Places.” Dr. Frizzell observed, first hand, the inspiration for both during a 10-month deployment in Iraq. While attached to the U.S. Army’s 4th Brigade, 2nd Infantry Division out of Fort Lewis, Wash., Dr. Frizzell was assigned to a forward operating base (FOB) during the allied troop surge of 2007. He and five colleagues (four other doctors and a physician assistant) stabilized wounded warriors who were then flown to a support hospital for additional treatment and/or surgery before being evacuated to the U.S. Their patients were often Iraqi—children as well as adults. “We took care of a lot of Iraqis,” Dr. Frizzell recalls. “We also saw a fair amount of pediatric head trauma.” Still on active duty, Dr. Frizzell has been assigned to Womack Army Medical Center at Fort Bragg since 2006. A fellowshiptrained gastroenterologist, he takes leave from the military to travel to FirstHealth Moore Regional Hospital one day a week to 18

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perform diagnostic endoscopic ultrasounds. The agreement between the two hospitals allows him to see patients who are referred by physicians from both Womack and Moore Regional. Currently a U.S. Army major, Dr. Frizzell describes his military career as a “good experience.” “The patients are the best patients in the world,” he says. “Everybody wants to get back to the fight.”

Charles S. Kuzma, M.D./U.S. Navy

Four times a year, Charles Kuzma, M.D., leaves his family and home and his hematology/oncology practice with the FirstHealth Outpatient Cancer Center for reserve duty with the U.S. Navy. It’s a small price to pay to the military that has given him so much—a calling, a career and a tremendous sense of pride in his country. “I hope it makes me a more complete individual,” he says of his military service, “and it allows me to give back to the community.” Inspired by his father, a World War II veteran of the Pacific Theater, Dr. Kuzma chose the Navy because “it seemed to be the right service” for him. He decided to specialize in hematology and oncology because of the inspiration of a professional role model, a physician/mentor who devoted himself to cancer services. Like a number of his FirstHealth colleagues, Dr. Kuzma received his medical training through the Health Professions Scholarship Program (HPSP). Joining the Navy, he says, was “the best thing I ever did.” It is also where he met his wife. Dr. Kuzma, who is a commander in the Navy, spent 14 years on active duty before moving to reserve status almost four years ago. His service has taken him to Navy hospitals in Oakland, Calif.; San Diego, Calif. (twice); Okinawa; and Spain; and on a humanitarian mission to Morocco. The overseas assignments, in particular, have given him a greater appreciation for his native U.S. “It’s given me a tremendous sense of what a great country we live in,” he says. “You take it for granted.” Reserve duty sends Dr. Kuzma back to San Diego and the large Naval Regional Medical Center where he teaches interns and residents, performs medical rounds on the inpatient cancer floor and serves on several Tumor Boards. It’s where he completed his fellowship. “Where I was once a pupil, I am now a teacher,” he says. Most of his patients at the San Diego Naval Medical Center are Department of Defense retirees (either medically retired or retired after 20 years of service). Occasionally, however, a young sailor with cancer will show up on his service. That’s when the business of caring for patients becomes especially difficult. “It’s always hard when you lose a patient,” Dr. Kuzma says. “It’s incredibly hard when it’s someone in his teens or 20s.”


Cutting edge, close to home By Erica Stacy

or Edward Brock, colonel, U.S. Army, serving in the Special Forces is more than a career. It’s a way of life. But 26 years of airborne operations and assignments requiring hauling up to 75 pounds of equipment long distances took a toll. After being diagnosed with bulging lumbar discs more than 10 years ago, Col. Brock took advantage of various treatments including steroid injections and radio-frequency therapy to help manage the pain. They helped, but only temporarily. “Eventually, I couldn’t sit down, lift my leg and put on my shoes because of the pain,” Col. Brock says. It was time for a more permanent solution. Because Col. Brock’s condition involved multiple discs, his options were limited. Doctors could fuse the spine, which would alleviate most of the pain, but would significantly affect his flexibility. Or he could undergo an artificial disc implantation. This cutting-edge neurological procedure would be performed in just a single lumbar area. Yet, unlike fusion, it would mimic the activity of a real spinal disc. Best of all, it could be performed by Larry Van Carson, M.D., at nearby FirstHealth Moore Regional Hospital. Dr. Carson is a neurosurgeon with Carolina Neurosurgical Services, which has offices in both Pinehurst and Fayetteville. On Oct. 28, 2009, Col. Brock underwent the complex procedure to the L3 and L4 section of his spine. “I was up walking around the same day,” he says. “Within four weeks, I had resumed most of my previous activities, except lifting.” Col. Brock’s follow-up care included X-rays, a CT scan and appointments with Dr. Carson. “I have been able to see Dr. Carson here in Fayetteville,” he says. “He is especially personable and willing to spend as much time as needed to answer my questions.” Less than six months after the procedure, Col. Brock is pleased with the results. “About 75 percent of my pain has been relieved,” he says. “I am very thankful that the military outsourced my care and that Tri-Care has been receptive to this new procedure. I am extremely satisfied with every aspect of my treatment. I will probably need to consider fusing L4 and L5 someday; but having had the artificial implant, I will be able to maintain more flexibility longer than any other option.”

Disc replacement surgery Replacing a collapsed spinal disc with an artificial one restores both the cushioning and proper spacing between vertebrae that are needed for normal function and pain relief, according to Larry Van Carson, M.D., the neurosurgeon who operated on Col. Edward Brock. “It’s a load-sharing procedure,” says Dr. Carson. “The disc is a shock absorber. Without it, you get a lot of pressure on the back part of the spine where the joints are located. That can lead to arthritic build-up, and nerves can be irritated, causing pain.” Replacing a diseased disc also helps prevent further back problems. Each artificial disc is a smooth plastic oval that moves within two metal cradles. The cradles attach to the vertebrae above and below the disc. Artificial disc replacement provides the same pain relief as spinal fusion surgery and, for many patients, preserves nearly normal range of motion. “That was particularly important to Col. Brock,” says Dr. Carson, “because he wanted to stay as active as possible. He has done very well.”

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Life with, and without, afib Special Forces vet has Convergent Procedure at Moore Regional By Brenda Bouser

Greg Taylor spent more than 23 years in the U.S. Army, much of that time in Special Forces. He helped train the soldiers of foreign governments, jumped out of airplanes, lived in the climate extremes of Alaska and Sub-Saharan Africa, and deployed to Afghanistan. But none of those experiences prepared him for the news he got after a 1996 electrocardiogram, part of a routine physical to clear him for military free-fall jumps. Taylor learned he had atrial fibrillation (afib). “I didn’t even know about afib,” he says. In June 2009, Taylor had a Convergent Procedure to correct his condition at FirstHealth Moore Regional Hospital. His heart, once described as “out of whack,” now beats normally. “The next day (after the procedure), I got up and was walking around,” he says. A native of rural Southwest Virginia and a lifelong outdoorsman, Taylor doesn’t fit the picture of the typical afib patient. About 5 million Americans suffer from the condition that is characterized by the erratic beating of the upper chambers of the heart, and the risk increases with age. According to the American Heart Association, 3 to 5 percent of people over 65 have atrial fibrillation. Taylor was in his early 30s, 14 years into his military career and for all practical purposes the picture of health. However, his EKG was so chaotic that the physician assistant doing the test at 20

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first thought he had attached one of the wire leads incorrectly. When a second EKG showed the same results, Taylor was told that something was “seriously wrong” and that his heart had a “serious flutter.” It was his first indication of any kind of problem. A cardiologist at Fort Bragg’s Womack Army Medical Center ordered tests and blood work and tried to slow Taylor’s wildly beating heart with medication. When that didn’t work, the cardiologist suggested cardioversion (electric shock). That worked. “I remember going to sleep,” Taylor says. “Then I was fine. I was in rhythm.” With his heart beating normally, Taylor resumed his life and military career. All seemed fine until November 2005. He was feeling tired, but attributed his fatigue to a recent deployment to Afghanistan and a 12-mile march. Another physical revealed that his afib had returned, and the cycle of medication and more began again—this time unsuccessfully. Despite several increasingly strong shocks to his heart, cardio(Story continues on page 22)


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An Army wife’s afib experience As you get older, Edris McMillan has learned, “a lot of things happen.” One of the things that happened to her was atrial fibrillation. The wife of a U.S. Army veteran, McMillan had dealt with afib “on and off again” since 1999. “I was very, very short of breath,” she says. “If I would walk any distance, I couldn’t breathe. I had no energy.” In May 2009, McMillan had the Convergent Procedure to correct her afib at FirstHealth Moore Regional Hospital. “There’s been a big difference since I got better,” she says. McMillan has loved her life as an Army wife, but the role has come with its own set of challenges. McMillan’s husband, E8 Charles Nelson McMillan Jr., spent six years in the Marine Corps before converting to the Army and serving as a Special Forces medic and retiring from Civil Affairs last year. In more than 29 years of service, he traveled the world, often landing in such hot spots as Afghanistan, Africa and Haiti. “Those were the ones I had to worry about,” his wife says. Army-induced separations were frequent. During the couple’s first nine years of marriage, their longest stretch together lasted for just four months. “He never left that something didn’t break in the house,” McMillan says. When her afib began, neither McMillan nor her husband knew what it was, but her heart would sometimes race so rapidly that he, even with his background as a medic, couldn’t count the heartbeats. The episodes usually involved a trip to the hospital for medication and later, as the condition became more difficult to control, cardioversion. The on-and-off again afib bouts continued for several years. “A couple of years ago, it went into afib and stayed,” McMillan recalls. McMillan’s cardiologist at Womack Army Medical Center sent her to Mark Landers, M.D., at Pinehurst Cardiology Consultants, who specializes in the electrical impulses of the heart. Dr. Landers also tried medication and cardioversion. When nothing helped, he suggested the Convergent Procedure, a collaborative effort with cardiothoracic surgeon Andy Kiser, M.D., of the FirstHealth Arrhythmia Center. “It’s just been wonderful,” says McMillan. McMillan is now afib-free and full of praise for her doctors and Moore Regional Hospital. “Moore Regional is the best hospital in the country,” she says. “I’ve never been treated any better.” 22

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version didn’t work either. “I think they tried three or four times,” Taylor says. This time, the afib became a career-ender. Taylor retired from the military in 2005 as a sergeant first class. “I definitely couldn’t stay in Special Forces,” he says. “I couldn’t jump out of planes like I like to do.” Looking for a change from the military world of Fort Bragg and the hectic atmosphere of Fayetteville, Taylor bought 11.3 acres of farmland outside Seagrove and started building the comfortable log cabin where he now makes his home. He entered the forestry program at Montgomery Community College and took a parttime job with the U.S. Forest Service, but the afib continued to interfere with his life. He found himself short of breath and unable to keep up with an older co-worker during long walks through forests to mark trees. He worried about the prospect of serious bleeding from even the smallest of cuts—the effect of the blood-thinning Coumadin he was taking to prevent clots and lessen the risk of stroke. “I used to sky-dive on weekends,” he says. “I gave that up. I figured I didn’t need to race my heart anymore.” Afib became a way of life until a visit to the Seagrove Public Library started a chain of events that eventually turned Taylor’s life around. He was thumbing through magazines when an advertisement in an issue of “Our State” caught his eye. It was about cardiothoracic surgeon Andy Kiser, M.D., and his pioneering treatment for atrial fibrillation at Moore Regional. “Pinehurst,” Taylor says he thought. “That’s down the road.” Taylor took down the information and contacted his cardiologist at Womack, who set up an appointment with Dr. Kiser. By that time, May 2009, Dr. Kiser had begun collaborating with invasive cardiologist Mark Landers, M.D., on the Convergent Procedure, a minimally invasive surgery that corrects afib rhythms on both the surface and in the interior of the heart. Taylor’s procedure was scheduled for June 11, 2009. He awakened from the anesthesia to the sound of Dr. Kiser’s physician assistant, Bill Cockfield, an acquaintance from his Army days, saying, “You’re in sinus rhythm.” Two days later, he was home. Life is now very different for Greg Taylor. He walks—a mile, two miles a day with neighbors and his three lively Golden Retrievers. He tinkers with his rebuilt 1965 Chevy pickup, works on his still-under-construction cabin, and hopes for a full-time job in forestry. Thanks to the exercise, his weight, which had ballooned from the low mid-190s to 270, was down to 242 by early this year. “This is great,” he says. n

If you or a loved one suffers

from persistent atrial fibrillation, visit www.firsthealth.org/afib to learn more about the Convergent Procedure.


Understanding the soldier’s pain When Army veteran Jeffrey Farley seeks treatment at the FirstHealth Back & Neck Pain Center at FirstHealth Moore Regional Hospital, he sees a physician who knows about life in the military and the physical wear and tear it can cause to a body. A former U.S. Army physician, Paul Kuzma, M.D., was chief of the Pain Management Center at Walter Reed Army Medical Center in Washington, D.C., before relocating to Pinehurst. Many of his partners at Pinehurst Anesthesia Associates were also physicians in the military. They understand the sacrifices that soldiers and their families make to serve, and they are committed to doing everything they can to help their pain. “Military service can be very physical,” Dr. Kuzma says. “Whether it is jumping from airplanes, or riding in tanks and Humvees, or being in combat, soldiers are subjected to tremendous stress and strain on their bodies that can lead to early degeneration and arthritis. This can lead to significant pain, and this doesn’t even consider the terrible war injuries they may get. Our group is committed to providing compassionate, state-of-the-art care to our service members and their families.”

By Dick Broom

etiring from the Army in 2000 was painful for Sgt. 1st Class Jeffrey Farley. But being in the Army had been painful, too. In fact, nearly everything he did caused him pain because of degenerating discs in his lower back. Even though Farley had been seeing a physical therapist, the pain in his back and legs eventually got so bad that he couldn’t stand up straight. That’s when his local physician referred him to the FirstHealth Back & Neck Pain Center at FirstHealth Moore Regional Hospital. Paul Kuzma, M.D., of Pinehurst Anesthesia Associates examined him and evaluated his problem. “He gave me a steroid injection that helped me tremendously,” Farley says. “Now, I get them every four or five months.”

Farley, who is 48, says that Dr. Kuzma hasn’t recommended surgery because the discs in his back aren’t bulging and, so far, the periodic steroid injections have taken care of his pain. “He said that, at my age, surgery would be the last resort,” says Farley. Farley lives in Fayetteville, and has worked as a civilian employee at Fort Bragg and Pope Air Force Base since he retired from the Army. He is a member of a team that inspects soldiers’ equipment before military deployments to Iraq, Afghanistan or elsewhere in the world. Because of the treatment he has received at the Back & Neck Pain Center at Moore Regional, Farley is able to work and live a normal life. “It has helped me to do whatever I want to do,” he says.

HAVE PAIN that

won’t go away? Call (800) 213-3284 toll-free to learn about treatment options that are available at FirstHealth of the Carolinas.

www.firsthealth.org

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By Brenda Bouser

FirstHealth helped Iraq-deployed dad see twins’ delivery

our-and-a-half-years ago, a young woman gave birth to twins in FirstHealth Moore Regional Hospital as her beaming husband looked on. On the surface, it could have been a scene like one of many others in the hospital’s Labor & Delivery unit. Dig deeper, though, and you learn that April Dyer was having her babies in Pinehurst, North Carolina, and her husband, Army Cpl. Jesse Dyer, was 6,000 miles away in Iraq and watching the happy event by webcast. “It meant everything to us for Jesse to be able to watch the twins’ birth via Internet,” says April. “We appreciated it so very much, because the only other way he would have seen the twins would have been pictures that would have been e-mailed to him or even his calling and asking how they were and what they looked like.” Moore Regional’s Women & Children’s Services staff and FirstHealth’s Information Systems department collaborated on the webcast that allowed Jesse Dyer to be a part of the birth of 24

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Ashlee Faye (at 1:58 p.m.) and Nathaniel Allen (at 1:59 p.m.) on Friday, Nov. 4, 2005. John Byron, M.D., and Walter Fasolak, D.O., both of the Southern Pines Women’s Health Center, delivered the babies by Caesarean section. “We are so grateful that Moore Regional was able to accommodate us with that lifetime experience,” April says. “The staff was so nice and helpful. It’s one memory that will never leave Jesse or me.” Acting on April’s request, the IS department bought a Webcam; configured it with the hospital’s guest network; and engaged Senior Clinical Analyst Kim Kimrey, who is also a registered nurse, to operate it. On the day of the delivery, both April and Jesse logged into Yahoo Messenger and activated the Webcam portion of the application. Two-way video allowed them to see each other, and Jesse could hear April’s voice over FirstHealth’s VOIP (voice over IP) transmission. Because he didn’t have an audio transmitter on his end, he typed his messages to April and they were read to her.


FOR A VIRTUAL TOUR of the

Women & Children’s Center at FirstHealth Moore Regional Hospital, visit www.firsthealth.org/ tourwomenctr.

The Dyer family today: Ashlee, April, Nathaniel, Jesse and Nickolas.

The event created a lasting memory for everyone involved. “This was the first time that we used this combination of technology and equipment to bring a couple together for such a wonderful event,” says Kimrey. “Every birth is miraculous, but to be able to bring this father and soldier ‘home,’ although briefly, for the birth of his twins makes this miracle one that I will never forget. It was a great way for FirstHealth to demonstrate our mission ‘to care for people.’ ” “It was very rewarding to be able to have a prospective father serving our country in another part of the world be a part of the birth of his twins,” says Maggie Maness-Craft, R.N., director of Women & Children’s Services. “To know that the mother was able to have her husband involved in the delivery experience was worth more than words can express. The departments involved worked hard to assure that it could happen. It was a great example of a team working together toward a common goal and accomplishing the goal, and the end result was an important milestone in a family’s life that they will never forget.”

Today, the Dyers are still a military family with another addition to their brood. After Jesse returned from Iraq in September 2006, they moved to Fort Campbell, Ky., and son Nickolas was born, also by C-section, in nearby Hopkinsville on Dec. 3, 2007. “Jesse was here for this delivery,” says April. In April 2009, the Dyers moved again, this time to Fort Benning, Ga., and Jesse, now Sgt. Dyer, deployed with the 3rd ID 2-69AR to Iraq the following October. Ashlee and Nathaniel are now 4 years old and attend preschool on the Fort Benning post while 2-year-old Nickolas stays home with Mommy. In addition to the demands of her young family, April serves as a co-leader for the Family Readiness Group for her husband’s unit. “Another wife and I make sure that our families of this unit are taken care of (during deployments),” she says. “If they need anything, we assist them in getting it done.” www.firsthealth.org

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From Afghanistan to Moore Regional and recovery By Brenda Bouser

Jonathan Rivera (foreground) with Charles Ofosu, M.D.; Ann Poplin, FNP-C; Willy Chu, M.D.; Paul Jawanda, M.D.; and Darrin Cutrell, P.A.-C

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t took a small village of medical professionals to rid Jonathan Rivera of the painful infection he developed after a 2008 auto accident. But the 26-year-old Raeford resident, a civilian contractor for the U.S. Army, is on the mend thanks to the help of a multidisciplinary team from FirstHealth Moore Regional Hospital.

If all goes as planned, he’ll soon be back in his job in a large postal hub in Bagram, Afghanistan. “As soon as the doctors clear me, I’m definitely going back,” he says. Rivera’s problems began when he fell asleep at the wheel of his vehicle while driving to work at a big-box store near Raeford in the early hours of July 3, 2008. He was transported by ambulance to the emergency department of a nearby hospital where he was observed, X-rayed and sent home. Within days, he was in another area hospital for surgery for a massive infection at the injury site in his left leg. Recovery took several months, but by March 2009, Rivera was much better and ready for the greatest adventure of his young life—the contract job in Afghanistan. All seemed well until January of this year, when things suddenly changed. Rivera had worked his usual 12-hour day in the base’s postal warehouse and was checking out the movies in the PX when a sharp pain in his back knocked him off his feet. “Boom, it hit me like that,” he says. “It hurt so bad it sat me down.” As the pain subsided, Rivera made his way to his hut but began to feel chilled, even though he was fully dressed and wrapped in a blanket. Realizing that something was very wrong, he went to the base hospital where the source of his problem was diagnosed as a staph infection in the site of his 2008 injury. Base physicians opened up Rivera’s leg, cleaned it and prepared him for medical transport to Germany’s Landstuhl Regional Military Center, the largest military hospital outside the continental United States. After 10 days of extensive treatment there, he was evacuated to the U.S. Given his choice of hospitals, he asked for Moore Regional. “I wanted to go to Moore Regional,” he says. During two days of post-evacuation observation and another fourday hospitalization for an abscess at the wound site, Rivera’s caregivers included general surgeon Willy Chu, M.D., and family nurse practitioner Ann Poplin, both of Pinehurst Surgical, as well as Moore Regional’s Hospitalist Services team that included Charles Ofosu, M.D., and Darrin Cutrell, P.A.-C. After his second hospital stay, Rivera went home with a PIC line to accommodate continued IV antibiotics and a referral to FirstHealth’s Infectious Disease Center. Paul Jawanda, M.D., was one of the infectious disease specialists who monitored his IV medications and his continued recovery from a “serious necrotizing infection” that was killing the skin and soft tissue in his leg. After several appointments, Dr. Jawanda released Rivera from any additional care, but with information on what to watch for in case of further complications. He doesn’t expect other problems, though. “He’s well on his way in the healing process,” Dr. Jawanda says. “Most of the improvement now will involve his own body’s healing process—plus the wound care Ann Poplin is giving him to speed that healing process.” As for Rivera, he’s glad to have the ordeal behind him and very happy about the improvement to his leg. “It’s definitely feeling a lot better,” he says, “a lot better.”

WOUNDS THAT WON’T HEAL: If you have a wound that won’t heal, call (800) 213-3284 to learn about the treatment options available at FirstHealth of the Carolinas. www.firsthealth.org

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PTSD

P o s t T r a um a t i c S t r e s s D i s o r d e r By Brenda Bouser

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epending on the war, the debilitating anxiety disorder that can result from the unique trauma of combat might have been called shell shock, battle fatigue or combat stress reaction. It is a problem that has been noted in the annals of the American military at least as long ago as the Civil War. According to a FirstHealth of the Carolinas psychiatrist, the contemporary (and more clinically oriented) terms of acute stress disorder and post traumatic stress disorder (PTSD) identify a true illness that requires medical treatment. When Fernando Cobos, M.D., medical director of FirstHealth Behavioral Health Services, counsels patients with combat-related PTSD, he draws from the personal experience of the combat zone. Dr. Cobos joined the U.S. Army Medical Reserves shortly after the terrorist attacks of Sept. 11, 2001, and has been deployed to Iraq three times since. “I think that having been there myself allows me to relate better to their experiences and to have a better understanding of what they have been through and are going through,” Dr. Cobos says of the way he relates to his PTSD patients. “I also think that knowing I’ve been there helps them feel more comfortable with me and with treatment.” FirstHealth Behavioral Services has a group therapy program that is geared toward men who are suffering from combat-related PTSD. “Because of FirstHealth’s relative proximity to Fort Bragg and Womack Army Medical Center, we are making an effort to collaborate with the mental health professionals there and develop an ongoing Fernando Cobos, M.D. relationship with them,” Dr. Cobos says. Dr. Cobos calls PTSD a serious but “treatable” condition that can and should be addressed. “I am optimistic that the stigma associated with PTSD, as well as with mental illness in general, will continue to decrease,” he says. According to Dr. Cobos, a major part of PTSD treatment means trying to prevent further harm or complications. People suffering from PTSD sometimes turn to alcohol or drugs in an effort to address their symptoms. This causes new problems and sometimes progresses to addiction. The symptoms and behavioral changes of PTSD can also result in failed marriages and relationships, and this can lead to a further sense of loss and personal failure. Depression often complicates PTSD, too. “All of these potential complications should be considered and addressed early on,” says Dr. Cobos, “and the patient’s family should be included in treatment as much as possible.” Although improvement can be slow and challenging, especially if complicated by substance abuse or another mental illness, it is possible and many people recover very well. “Many people bounce back from some pretty terrible experiences,” Dr. Cobos says. “I am always amazed by how resilient people are.”

THE PTSD GROUP FOR MEN at FirstHealth

PTSD symptoms Post Traumatic Stress Disorder is characterized by four basic classes of symptoms: n Memories and intrusive recollections, often involving nightmares or flashbacks, during which the individual relives his traumatic experience or a portion of it n Hyper-vigilance, which causes the person to feel on edge, be unable to relax, startle easily, sometimes at such trivial occurrences as a door closing or a phone ringing n Avoidance and alienation in an effort to decrease cues and reminders of the traumatic event. This can lead to a sense of alienation from friends and family and a restricted, narrowed range of daily activities. n A sense of emotional numbing or remoteness that can be very distressing, not only to the individual but also to his/ her loved ones. In addition, the patient may sometimes worry about friends who are still in harm’s way or experience a sense of loss and bereavement because others have died or been injured.

Treatment for Post Traumatic Stress Disorder can involve a range of therapies including behavioral approaches, support family therapy and medications. In addition, the shared experience of a group format can help the patient feel less isolated and alone while also providing a place to learn how others cope and thrive in spite of similar symptoms.

Moore Regional Hospital meets every Monday at 11 a.m. For information on the location or to arrange a private consultation, call (866) 804-7870 toll-free. www.firsthealth.org

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MILITARY MEMBERSHIPS: FirstHealth of the Carolinas participates in the YMCA of the Armed Forces program for military personnel and their families. For information on this program or to learn about other military memberships offered by the FirstHealth Centers for Health & Fitness, call (800) 213-3284.

By Melissa Biediger

Center for Health & Fitness provides training programs for soldiers

ately, Chris Garbark has seen an increase in individuals leading their own workouts with unmistakable power and focus. “When you see someone working out at an intense rate and force, you can guess they’re in the military,” says Garbark, an exercise physiologist at the FirstHealth Center for Health & Fitness–Pinehurst. Like other area businesses, the Pinehurst Center for Health & Fitness has been preparing itself for an influx of military personnel with the implementation of the Department of Defense’s Base Realignment and Closure (BRAC) program. Creating memberships and programs that accommodate active-duty officers and their families is a priority. “We’ve found that the military people who are moving to this area are high-level professionals, and they have a very 30

Spring/Summer 2010

high expectation of quality,” says John Caliri, director of the FirstHealth Centers for Health & Fitness. “Our job is to make sure we accommodate them through space, training expertise and equipment.” In an attempt to accommodate military members, the staff of the Pinehurst Center has tailored more fitness routines to the workout types that active-duty personnel require. Over the last six years, the Center’s trainers have introduced workout programs like TRX, which focuses on total body resistance training. They also offer kettle bells and plyometrics, a program designed to produce fast, powerful movements and heighten nervous system function to improve performance, into these workouts. “Based on what their job requires, their lifestyle demands a higher level of fitness,” says Garbark of his military clients. “We offer the tools they need to obtain that lifestyle.”


A Wounded Warrior Heals

By Brenda Bouser

n October 2009, while on active duty with the U.S. Army, Karl Holt survived a military helicopter crash that killed several comrades. The ordeal left him with a broken back, dislocated left shoulder, shattered jaw and a leg that was broken three places in addition to numerous lesser injuries. He has been in three different hospitals and undergone five surgeries. With three more surgeries to go and recuperation periods of up to six months after each, he has a single goal in mind. “My main job now is to get healthy and operational,” he says. Holt’s plan for returning to his pre-crash status brings him to the FirstHealth Center for Health & Fitness-Pinehurst twice a day, every day—a big difference from December and the beginning of his personally directed post-crash fitness regimen. He was in a wheelchair then. “All I would do is sit in the sauna,” he says. Back then, Holt’s priority was to “maintain some level of health” by getting his heart rate up, increasing his blood flow and sweating. Before long, he had progressed from the wheelchair to a walker and from the sauna to the pool. All he could do was stand in chest-deep water while barely putting weight on his injured leg. Within weeks, however, he had graduated to standing on his toes and then walking a halflength of the pool. By the end of January, he was able to jump in.

“Everything progressed from there,” he says. Stationary bike, rubber bands, strength-training equipment, the elliptical—“I was continually adding things week by week,” he says. Kelley Kibler, a group fitness and water safety instructor and lifeguard at the Center, has observed Holt’s progress from the beginning. “He’s progressed amazingly,” she says. “When I first saw him on the pool deck, he was using a walker, was in lot of pain and had limited range of motion. As the weeks have gone by, he looks a whole lot stronger and a whole lot healthier. Now he gets in and out of the water like the healthy young man he is.” Six months post-crash, Holt thinks he is about halfway where he wants to be. “I’m having more surgery, and that will put me back,” he says. “My goal is to be as healthy and in as good shape as possible going into it to increase my chances for a quick recovery. Small victories are the key—and not being afraid to celebrate the victories.”

The Pinehurst fitness center has also incorporated more functional training workouts, which use exercises that mimic everyday actions. “We don’t ignore strength training, but functional training makes more sense for this group,” Caliri says. “It’s not about how they look or whether they can win a race. It’s about how they can use their bodies as tools in their jobs.” Child- and family-oriented opportunities have also increased at the Center. After-school, evening and weekend exercise programs, parents’ night out programs and swimming lessons allow parents and children to make fitness a family activity. Caliri expects to see a steady increase in the military memberships at the Center as more individuals move to the area.

“Because of the prevalent veteran society where we’re located, there’s a unique opportunity for military families,” he says. “There’s an honest admiration and a deeper understanding for what these people are doing, and I don’t think that would be the same if we were somewhere else.”

www.firsthealth.org

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FirstHealth Mobile Health Services offers three preventive screenings in the comfort and convenience of its mobile unit. Screenings are conducted using painless, non-invasive ultrasound technology. Screenings are for those 18 years and older.

Take charge of your health with three simple screenings. Abdominal Aortic Aneurysm (AAA) Stretching and weakening of the aortic wall can eventually cause the aorta to burst or rupture, leading to life-threatening bleeding. Risk factors: hardening of the arteries, genetics, injury to the abdomen and aging. Men who have smoked more than 100 cigarettes during their lives are also at increased risk.

Stroke Screening / Carotid Artery Carotid artery disease is the number one cause of stroke in the United States. Plaque buildup on the artery walls restricts blood flow to the brain, causing a stroke. Risk factors: family history, age, smoking, high blood pressure, diabetes, obesity and lack of exercise.

Peripheral Vascular Disease (PVD) Plaque buildup in the arteries limits the blood supply to the body’s muscles, organs and tissue, which may lead to the loss of limbs. Risk factors: smoking, diabetes, excess weight, lack of exercise, high blood pressure, high cholesterol and age. Appointments required, call (888) 534-5333. Please plan on spending 30 minutes for all three screenings.

Pricing Information* $85 for all three screenings $60 for two screenings $30 for one screening Financial assistance available for those who qualify. *Please note that insurance, including Medicare, does not cover preventive screenings.

Saturday, May 29 FirstHealth Center for Health & Fitness -Pinehurst 9 a.m. to 12 p.m.

Thursday, June 3 Montgomery County Community College 9 a.m. to 2 p.m.

Saturday, June 5 FirstHealth Center for Health & Fitness -Pinehurst 9 a.m. to 12 p.m.

Thursday, June 10 Aberdeen Parks & Recreation Area 9 a.m. to 2 p.m.

Thursday, June 17 FirstHealth Center for Health & Fitness -Raeford 9 a.m. to 2 p.m.

Saturday, June 19 FirstHealth Center for Health & Fitness -Pinehurst 9 a.m. to 12 p.m.

Thursday, June 24 FirstHealth Center for Health & Fitness -Richmond 9 a.m. to 2 p.m.

w w w. f i r s t h e a l t h . o r g 97-103-10


The ATriAl FibrillATion ConvergenT ProCedure Having served in the military for more than 23 years, I have managed to learn a thing or two about teamwork. FirstHealth believes in teamwork,

ideal Companions

too. By combining two medical specialties,

Andy Kiser, M.d., a cardiothoracic surgeon, and Mark landers, M.d., a

they successfully treated my Atrial Fibrillation.

cardiologist specializing in electrophysiology, have joined forces to develop the new, groundbreaking Convergent Procedure to treat Atrial Fibrillation—a debilitating heart rhythm disorder. by integrating surgical and catheter technology, the Convergent Procedure truly is minimally invasive, helping patients like greg Taylor quickly return to their normal, active lifestyles.

The grand opening of the new, state-of-the-art Reid Heart Center, the FirstHealth Cardiac & Vascular Institute is scheduled for winter 2010-2011.

910-715-1713 • Toll-Free 800-213-3284 www.firsthealth.org/afib

Greg Taylor Retired Army Special Forces Westmoore Community, NC


155 Memorial Drive P.O. Box 3000 Pinehurst, NC 28374

NON-PROFIT U.S. POSTAGE PAID PERMIT NO. 4 LONG PRAIRIE, MN

Because we use a variety of sources for mailing, duplications sometimes occur. Please pass an extra copy along to a friend or neighbor.

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FirstHealth Magazine - Spring/Summer 2010  

FirstHealth Magazine Spring/Summer 2010 - Caring for People In Harm's way

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