GHS Inside Health Magazine 12.1

3T MRI Gives Tell-all Pictures Breast Health Care: No More Excuses New Ankle Replacement: A STAR Is Born

Saving Lives With Minimally Invasive Procedures

Partners for Health At GHS, our vision is to transform health care for the benefit of the people and communities we serve. It’s a simple statement that keeps this multi-faceted, multifunctional organization on track.

Making Major Repairs Without Major Surgery

One way we go about transforming health care is through new and innovative partnerships with other area organizations. For example …

• GHS and the YMCA of Greenville have formed PATH (Partners Achieving Total Health), which includes low-cost membership to the GHS Life Center® Health & Conditioning Club and the four area Y’s, including the newly named GHS Family YMCA (formerly LivN Nsidout).

Team Effort Solves Medical Puzzle and Saves a Life

• Last year, GHS joined other upstate healthcare providers to offer free medical, dental and vision care to more than 1,200 low-income, uninsured South Carolinians in a two-day event called SC Mission 2010.

New MRI Helps Patients Stay Close to Home

• My personal favorite: GHS has partnered with the Greenville County Recreation District to create the GHS Swamp Rabbit Trail between Travelers Rest and Greenville. Great for biking, jogging and walking, the trail encourages physical activity and healthy lifestyles.

For a fuller picture of GHS’ involvement in the community, see our annual Report to the Community posted at ghs.org/2010annualreport.

Caring for Your Breast Health

At GHS, partnership and collaboration are how we work together every day. The young man pictured on the cover, Drew Rice, is alive and well because GHS physicians, nurses and therapists worked together to repair his heart, limbs and assorted other body parts seriously injured in a car accident. In this issue, you’ll also read about Tina Vile, who enjoyed a successful pregnancy because doctors from various disciplines contributed their expertise to diagnose and treat a tumor on her pituitary gland. And you’ll learn about our Breast Health Center, which brings together the different components necessary for breast health in an accessible and efficient format.

Most of all, we want to partner with you so that you may enjoy the most healthy lifestyle possible. I encourage you to take advantage of resources such as the Swamp Rabbit Trail and to let us know when we may be of service!

New Surgery Is a Star

Departments 15 Q&A A New Kind of Family Doctor 16 Spotlight on Technology Telemedicine Extends Direct Treatment

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Clinical Trials Practice Profiles UMG Directory Around the System

for Stroke Michael C. Riordan President and CEO

If you would like your name added to or removed from the mailing list for this publication, please call (864) 797-7541 or e-mail kcartee@ghs.org.

Making Major Repairs Without Major Surgery When Drew Rice graduated from Clinton High School last May, he celebrated more than receiving a diploma. He celebrated a second chance at life.

One rainy Saturday around suppertime in March 2009, Rice was driving fast on a familiar road when he reached for his fallen cell phone. Just seconds from his driveway, he lost control of his pickup and collided with a tree. He nearly died.

Pictured Above Barry Davis, M.D., (left), and Eugene Langan III, M.D., (right), explain to Drew Rice the minimally invasive procedure that corrected his damaged aorta.

Drew Rice sustained serious injuries in this truck accident.

The truck was mangled almost beyond recognition, and the driver wasn’t in much better shape. The impact shattered Rice’s right elbow; broke his sternum, legs and bones above his eye; and tore ligaments in his knee. More life-threatening were the torn thoracic aorta and a ruptured heart valve.

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“Most people would have died at the scene with either of these potentially catastrophic heart injuries,” said Barry Davis, M.D., the cardiothoracic surgeon who later would perform surgery on Rice. Dr. Davis is division chief of Cardiac Surgery with Greenville Hospital System (GHS) University Medical Group, the system’s multispecialty group practice.

Rice waited more than an hour for rescue workers to free him from the crushed vehicle. He recalls his dad reaching through the windowless truck to cradle his head, sounds of the roof being sawed off and, finally, being pulled out by an EMT. He remembers thinking he was going to die.

Another hour lapsed while Rice traveled by ambulance – heavy fog and rain prevented helicopter transport – to the Emergency Trauma Center at GHS’ Greenville Memorial Hospital (GMH), Greenville’s only Level I trauma center.

Right Place, Right Technology At most centers, Rice would have required major chest surgery to repair the torn aorta. Instead, Eugene Langan III, M.D., GHS professor of Clinical Vascular Surgery, corrected Rice’s damaged aorta by using minimally invasive technology.

Rather than making an incision across the left side of the chest and going through the ribs to reach the aorta, he sent a catheter through the leg artery from groin to chest – and pushed an endoscopic stent through the catheter, placing it in the aorta to repair the injury. This option reduced the chances of unwanted outcomes that may occur with major chest surgery such as heart attack, paralysis, infection and death.

Second Chances, Changed Lives Rice took an up-close and graphic look at the heart valve repair when he turned his near-fatal experience into the focus of a special senior project. Original footage from a pre-surgery 3-D scan shows the valve twisting wildly in the blood flow, almost like a bedsheet flapping in the breeze.

His presentation contains footage of the surgery itself: the chest as it’s cut open, then retractors and six bypass tubes crowding the tiny opening, with instruments cutting away torn valve tissue and repairing it through the incision. The heart is still and pale, chicken cutlet-colored, as the blood is bypassed around it for the surgery.

After three weeks for recovery and more surgery to repair his elbow and legs, Rice went home to continue healing. Four months later, in September, he returned to GMH to fix the injured valve. To perform the minimally invasive tricuspid valve repair, Dr. Davis made a two-inch cut in the right chest – no major incision or breaking of the breastbone, again reducing complications and speeding recovery time.

Dr. Davis noted, “Drew had two major cardiovascular operations through a minimally invasive approach that would typically require two large chest incisions.”

According to Dr. Davis, GHS is the only upstate hospital that could have performed this level of minimally invasive surgery.

Nationwide, only a handful of hospitals conduct minimally invasive valve surgeries, but the number is growing because of intensive training programs such as the one at GHS. GHS does more minimally invasive heart surgeries than any other S.C. hospital – and ranks among the top 25 nationally.

Minimally invasive heart surgeries can be virtually scarless – only a faint two-inch mark remains from Rice’s valve repair. And only faint scars remain on his family. “It’s the most horrific nightmare you can ever imagine happening,” said his mother, Angie. “It just stretched on forever and forever. But we’re a story with a happy ending. We feel like we’ve gotten him back for a second time.”

“As weird as it sounds, it was a great experience for my family,” Rice commented. “It made us realize how precious life is. We’ve always been close, but this brought us even closer. I have a great family and a ghs.org • 1-877-GHS-INFO (447-4636) • Inside Health vol.12.1

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great church family at Bellview Baptist Church, and I’ve really learned to appreciate them both.”

Angie added, “We met some of the most amazing people on this journey – paramedics and firefighters, hospital staff and families in the waiting area. We’re Facebook buddies with a lot of the nurses now.”

“We had a great experience at GMH; we built bonds with doctors and nurses,” agreed David, his father.

“When you spend every waking moment for three weeks with those people and see how much care they put into it, it means something – it really does.”

And the senior project? Rice said the judges were astonished when they realized the footage was of his own heart. The project included a written report, take-apart heart models, a surgery video, photographs of Rice in the hospital and photographs of the demolished truck. He scored a 93.

“I like to think of it as being truly heart-felt,” Rice laughed. “Being able to see my own surgery was just awesome.”

For Dr. Davis and his colleagues, the senior project experience has been a wonderful opportunity to work with a patient and his family long after the initial surgeries and recuperation. “We’re used to saving lives,” said Dr. Davis. “We don’t often have the opportunity to see first-hand how those lives are being affected. It’s been great to see how well Drew is doing.”

Rice concluded his report with these words: “When patients leave the hospital, most have a new outlook.

They’ve been give a second chance at living a full life, and usually take nothing for granted. … Patients and their loved ones become closer and love deeper than ever before because they are humbled by the realization of the things they’ve endured together.

They can honestly say that tricuspid valve repair saved and changed their lives.”

With more than 65 surgeons covering virtually every field of surgery, the GHS surgical team provides the most comprehensive care in the state. For more information, visit ghs.org/surgery.

Primary Circulation Primer Pulmonary valve

Aorta

The tricuspid valve sits between two heart

Pulmonary artery Left atrium Aortic valve Mitral valve

Right atrium

Left ventricle

chambers – the right atrium and right ventricle. Its job is to regulate blood flow between these chambers. If this valve malfunctions, it can allow blood to back up into the atrium and thereby slow the entire circulatory process. (The blood goes from the right side of the heart to the lungs,

Tricuspid valve Right ventricle

Ventricular septum

where it trades carbon dioxide for oxygen, then back to the left atrium, through the mitral valve to the left ventricle, then through another valve into the aorta to carry fresh oxygen to the rest of the body.)

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Team Effort Solves Medical Puzzle And Saves a Life Tina Vile was starting a new company and thought the associated stress might be causing her menagerie of symptoms. It was spring of 2009, but there was no spring in her step; she was excessively tired. Her eyebrows were thinning, her fingers swelling so much she couldn’t wear her wedding band. Though she was not pregnant, she had not had a period in six months. And, even though she had not been able to breastfeed daughter Erin (born April 2007) because of a low milk supply, now she was lactating substantially.

Vile saw several doctors, but it was Carrie Ann Twedt, M.D., of Piedmont OB/ GYN – a practice of Greenville Hospital System (GHS) University Medical Group – who noted an elevated level of prolactin, the hormone that stimulates milk production. Dr. Twedt

referred Vile to Bruce Lessey, M.D., Ph.D., medical director of the Fertility Center of the Carolinas of GHS University Medical Group.

“I was going over my symptoms with Dr. Lessey,” recalled Vile, “and the next thing I knew, he was on the phone with Dr. Cory White [a GHS endocrinologist] ordering lab work and scheduling an MRI.” “I was nervous,” continued the 39-year-old resident of Simpsonville, “but I was also reassured. Dr. Lessey was on top of it. He was patient, listened carefully and then got the ball rolling – quickly.”

Collaboration Leads to Diagnosis

Collaborative Circle Widens

According to Dr. Lessey, a diagnosis of hyperprolactinemia (which occurs when an elevated level of prolactin causes the spontaneous flow of breast milk and disrupts the normal menstrual period) didn’t explain the fatigue and other symptoms Vile was describing.

Surgery was scheduled with Charles Kanos, M.D., surgical director of Neurosurgery for GHS University Medical Group.

Lessey

“Tina presented a puzzle,” said Dr. Lessey. “She had a lot of symptoms.”

In addition to the elevated prolactin, blood tests showed that Vile had very low levels of circulating thyroid hormone – and also very low levels of estrogen and the reproductive hormones FSH and LH. Dr. Lessey and Dr. White added central hypothyroidism to the diagnosis.

White

“Her thyroid was not functioning because it wasn’t getting signals from the brain,” Dr. Lessey said.

“Following a collaborative discussion about Tina’s bloodwork analysis, we had a strong hunch about the reason for her symptoms and, after the MRI, it proved correct.”

Kanos

The MRI revealed a large, unusual mass located in the middle of the pituitary gland, a bean-shaped organ located at the base of the brain, behind the bridge of the nose.

The normal job of the pituitary gland, also called the master gland, is to regulate the release of hormones in the body. But when a mass develops in the gland, it can throw off hormone levels, producing too much or too little, which impacts the body’s ability to function normally.

pituitary gland

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The typical therapies for hyperprolactinemia as well as for hypothyroidism are medical ones. And they usually work.

But, in Vile’s case, the root cause was the pressing of the mass on the pituitary gland, disrupting its function and causing the hormonal imbalances.

Inside Health vol.12.1 • 1-877-GHS-INFO (447-4636) • ghs.org

“I was a nervous wreck when I learned I would need surgery,” commented Vile. “But Dr. Lessey already had put me at ease – he had even accompanied my husband and me to the MRI. And Dr. Kanos told me not to worry and that he was 99 percent sure the mass wasn’t cancerous.”

Assisted by GHS otolaryngologist Robert Brown III, M.D., Dr. Kanos performed an endoscopic-assisted transsphenoidal transection: He approached the mass through Vile’s nose and sinuses, without making a single incision on her head or face.

“At Greenville Hospital System University Medical Center, we’re doing the latest minimally invasive endoscopic approaches. That way, we don’t have to make a cut in the skull,” explained Dr. Kanos.

Once he isolated the pituitary mass and was able to see it more closely, Dr. Kanos identified it as a Rathke cleft cyst, a rare type of cyst believed to originate during embryonic development.

Most of these cysts are quite small, cause no symptoms and are discovered only incidentally from imaging studies for other conditions. But in some instances, as with Vile’s, continual accumulation of fluid causes the cyst to grow and compress surrounding structures – the pituitary gland, optic chiasm and/or hypothalamus – resulting in associated symptoms.

“There was so much relief in knowing what it was – in putting a name on it,” said Vile. “My mind had been going crazy.”

Removal of the cyst required exposure and drainage with care not to disrupt normal tissue.

“I woke up in the neurosurgical ICU to fantastic nurses and good news from Dr. Kanos that everything had gone smoothly,” Vile said. “I had stitches in my nose, and my nose bled some. But that was it. I felt a thousand times better mentally right after the surgery, and after a month I felt like myself again.”

The surgery took place on a Friday, and Vile was home

by Sunday afternoon.

One Life Saved, Another Begins Very soon, Vile’s periods resumed and the breast discharge went away. Four months after surgery, she learned she was pregnant with her second child, a daughter, due September 2010.

“We were thrilled that we were able to have another child,” Vile pronounced. “After this experience, no one could sway me from going to a doctor at GHS. My team went above and beyond. Dr. Lessey would call me at random times to check up on me, and I would start crying. That was just so nice. He was truly excited about my pregnancy!”

According to Dr. Lessey, medical therapies for Vile’s hormonal imbalances would have been timeconsuming and unproductive.

“Without a quick diagnosis, she would have had to go through a lot of treatments,” he said. “It could have been a mess. If the already large mass were allowed to continue to grow, the pressure on the pituitary would cause functions to drop out in order of least importance of survival. The first is reproduction, as with Tina’s loss of periods, then thyroid and then adrenals, which could have threatened her life.”

“Tina’s case is a good example of how a generalist can refer to the specialist,” Dr. Lessey continued. “It’s a picture of the collaborative care, expertise and technology that’s available here at GHS. And it’s proof of just how quickly patients with something this complex can get accurately diagnosed and treated.”

Ellie Maxine joined the Vile family on September 25 following a healthy birth at GHS Women’s Hospital. She weighed 7 lbs., 5 oz., and was just over 20” long. Mom, sister Erin and the baby are doing great. Dad is adjusting to the increased amount of pink.

For more information about GHS’ primary care physicians and specialists at GHS, visit ghs.org.

For information about women’s services, including our exciting new approach to maternity care, visit ghs.org/womens.

New MRI Helps Patients Stay Close to Home Fredrica Douglas knew something was wrong with her 2-year-old. Nigel was dragging his right leg and favoring the left side of his body.

She and Nigel’s grandmother, Dorothy Smith, took him for checkups but didn’t get satisfactory answers until they came to Children’s Hospital of Greenville Hospital System University Medical Center (GHS). Magnetic resonance imaging (MRI) showed that Nigel had a tumor on his brainstem.

“By the time we saw Nigel, he was essentially unable to move the right side of his body, and it was rapidly getting worse,” said Chris Troup, M.D., medical director of Pediatric Neurosurgery at GHS Children’s Hospital. “Once he had the MRI, we saw what was going on.”

Seeing the tumor didn’t mean an automatic solution, however.

“The tumor was deep,” Dr. Troup noted. “It took up about 70 percent of the space where the brainstem should be – there was very little brainstem there.”

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Photo courtesy of Philips Healthcare

Nigel couldn’t use his right arm and leg because the tumor pressed on nerves that sent signals to that side of his body. Fortunately, new technology at GHS allowed Dr. Troup and others to better understand the situation and gave them confidence to perform surgery.

Clear Views With 3-T A few months before Dr. Troup saw Nigel, GHS added a 3-T MRI to its Radiology department. This machine, more commonly found in large academic centers such as Johns Hopkins, gives physicians the best possible look at certain conditions.

“The 3-T has a stronger magnet, which allows us to acquire specialized pictures we couldn’t get before,” explained Naveen Parti, M.D., a neuroradiologist and director of MRI services at GHS. “It helps us further characterize lesions in the brain, so now we can do procedures that we couldn’t do in the past.”

In Nigel’s case, the 3-T MRI helped Drs. Troup and Parti see exactly where the tumor was and how it affected other parts of the brainstem. “Nigel’s tumor was so large we thought it might be invading everything and therefore be inoperable,” Dr. Parti stated.

“We needed to know if the tumor was pressing on normal fibers and pushing them away or if normal fibers were going through the tumor,” explained Dr. Troup. “The brainstem houses parts of the brain that control the things we don’t think about – swallowing,

blinking, our heartbeat. If the fibers went through the tumor, surgery would be devastating to Nigel. But if the fibers went around the tumor, we could take it out.”

“The tumor was displacing the fibers,” he added. “Very few – if any – fibers were going through the tumor itself. The 3-T gave us a virtual roadmap of where the tumor and fibers were going.”

Before having the 3-T MRI, Drs. Troup and Parti could not have pinpointed the fiber locations. They would have referred Nigel to another hospital with more specialized equipment and hoped for the best. Having the 3-T allowed them to see that surgery was possible.

Surgical Success Dr. Troup performed Nigel’s operation less than a week after discovering the tumor’s extent. The physicians considered the procedure a huge success: “We took virtually every drop of the tumor out,” Dr. Troup said.

Nigel spent almost three months in the hospital.

“We were back and forth from ICU to pediatrics and back to ICU,” his mother said. “It was really hard, but everybody was great. Nigel loved all the staff who looked after him.”

Nigel was unable to move the right side of his body when the surgery took place, so he had to relearn how to do everything. He began physical and occupational therapy sessions while in the hospital and continued them for months afterward. He also continued seeing Dr. Troup and Nicole Bryant, M.D., the pediatric neurooncologist, for chemotherapy and other follow-up care.

On a similar note, Dr. Troup wants the community to know that the staff at GHS is prepared to help diagnose and treat virtually any neurosurgical problem without leaving the Upstate:

“GHS has an incredible MRI suite – the best you can get for routine imaging.

The 3-T has some specific uses for stroke or tumor patients or for the vascular system. Adding it is just one more step toward making GHS the premier medical facility of South Carolina. You don’t need to go elsewhere for care.”

Douglas will always be thankful for those medical advances and for GHS having the technology found in large academic centers.

Nigel Douglas has come a long way since his surgery, made possible by GHS’ new technology.

Here, he and his grandmother, Dorothy Smith, take a break from chemotherapy.

“They kept telling me to prepare for the worst, but I wasn’t hoping for the worst,” she emphasized. “And now I’m really not. We got a miracle!”

To learn more about what GHS Children’s Hospital offers, visit ghschildrens.org.

“Neurologically speaking, he’s gotten a tremendous amount of function back,” Dr. Troup said. “He’s done remarkably well.”

Douglas and Smith found that incentives such as french fries encouraged Nigel to reach with and use his right arm. “He still doesn’t use his right side as much yet, but he’s walking and running,” Douglas said. “He’s not completely normal, but he’s almost there.”

The primary lesson his mother hopes other parents or caregivers will learn from Nigel’s experience is persistence. “Doctors kept telling me that one thing was wrong and then another, but none of it seemed right,” she recalled. “Keep on going to doctors until you know what’s really wrong with your child.” ghs.org • 1-877-GHS-INFO (447-4636) • Inside Health vol. 12.1

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Caring for Your Breast Health You likely know a woman with breast disease. If you are a woman, never too far from your mind is the thought that it could happen to you. And in these hectic times, being caught between taking care of your health and fearing what you may find may lead to procrastination.

Greenville Hospital System University Medical Center (GHS) makes it easy to take care of your breast health – from prevention and screening to treatment for benign breast disease and cancer management. GHS offers convenient, comprehensive breast services with its Breast Health Program.

“We’ve created a center of expertise focused on breast issues,” said Brian McKinley, M.D., medical director of the Breast Health Program. “The emphasis is on bringing care providers together to facilitate quicker action and better outcomes for patients, which result in higher quality care through the cumulative medical knowledge of the providers.”

Prevention In addition to self-exams and clinical breast exams – part of a checkup by a doctor – women should have a screening mammogram yearly starting at age 40 (or earlier as decided by you and your physician). At GHS, mammograms, ultrasounds and magnetic resonance images are read by radiologists at the Breast Imaging Center on GHS’ Patewood Medical Campus. These radiologists examine breast images only, so they are highly skilled at what they do.

Screening mammograms are performed at Greenville Memorial, Greer, North Greenville and Simpsonville medical campuses. Each site has trained technicians, and all digital tests are sent to the Breast Imaging Center and read by the GHS radiologists.

Benign Breast Disease For many, the first thing that comes to mind when hearing “breast health” is cancer. But many complaints, such as breast pain and nipple discharge, are not necessarily related to cancer.

Women with benign breast disease can turn to GHS’ Breast Health Center for help. The center is housed next to the Breast Imaging Center with dedicated breast imaging specialists who facilitate seamless integration in diagnosing and providing care. Practitioners at the center have a wealth of experience in providing breast care to upstate residents.

When the Call Is Cancer For women diagnosed with breast cancer, GHS’ Oncology Multidisciplinary Center (MDC) offers integrated care at its best. Annette Dunphy, B.S.N., R.N., OCN, nurse manager, explained the contrast to traditional care: “Historically, a patient diagnosed with breast cancer had to see numerous specialists in different places, and it often took three or four months before she got to see all of them.

With the MDC approach, we do just the opposite. We bring the patient in to see all of the disciplines in one visit.”

Specialists, including surgeons and medical and radiation oncologists, examine the patient individually.

They, joined by other specialists such as radiologists and pathologists, then meet to determine the best care plan. For Greenvillian Joy Hamilton, diagnosed with breast cancer in fall 2009, it was a blessing to meet with all specialists in one day.

“When you hear the word ‘cancer,’ you don’t want to wait,” Hamilton said. “You want to go ahead and do whatever needs doing.”

Hamilton walked into the MDC expecting to need a lumpectomy. When the doctors recommended a mastectomy, she was taken aback, but knowing they had all looked over the images and discussed the best direction of care gave her the confidence to go ahead with the procedure.

Navigating a Cancer Diagnosis Easing the process was Hamilton’s nurse navigator, Jo Weathers, R.N., OCN, CBCN. GHS’ Nurse Navigator Program provides patients with a trained oncology nurse who guides them through the course of care. The navigator participates with the team of specialists in the initial

conference where the care plan is discussed. Then, when a specialist presents the proposed plan to the patient, the nurse navigator makes sure the patient understands it and knows the next step.

After treatment for breast cancer at the GHS Cancer Multidisciplinary Center, Joy Hamilton welcomed her first granddaughter, Ava Margaret, into the world.

The navigator educates the patient about options and about the treatment plan and encourages her during difficult times. “The patient is always the center of the team,” said Weathers. “We’re here to support her until she crosses the goal line.”

Patients get the direct phone number, e-mail address and pager number for their nurse navigator. “Jo stressed that I could call her anytime,” Hamilton noted. “No question was too small. That was a wonderful comfort.”

Less than a month after her first MDC visit, Hamilton underwent a mastectomy and reconstructive surgery.

Six chemotherapy and 25 radiation sessions followed.

The only trace that remains of her battle is the medication she must take daily for five years. ghs.org • 1-877-GHS-INFO (447-4636) • Inside Health vol. 12.1

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“I hate to use the word ‘great’ because it was cancer and it was miserable, but as far as the care goes, it was great!” emphasized Hamilton.

and the oncology rehab nurse coordinator. Moreover, the program provides access to leading-edge research looking at finding a cure for fatigue.

Dr. McKinley said while it’s easy for the patient to see the convenience from having all specialists in one place, a more important benefit is the higher quality of care that results from medical experts working in tandem.

The Cancer Center is partnering with the University of South Carolina to study the impact of exercise and of a compound called quercetin, found in foods such as red apples, grapes and onions, on cancer-related fatigue. Research on mice indicates that small doses of quercetin increase energy and endurance.

“The MDC really does more than just collect specialists in one center,” he said. “When you bring people together, the practitioners learn more about the patient’s disease. So what we end up doing is standing on each other’s shoulders and advancing our knowledge base, all for the good of the patients.”

Community Outreach A unique component of GHS’ Breast Health Program is the Breast Health Patient Navigation (BHPN) Program, targeted to underinsured and minority women in the community.

Fighting Fatigue The integrated approach at GHS continues through treatment into a groundbreaking oncology rehabilitation program called Moving On. Researchers have learned that exercise plays a significant role in combating the fatigue that patients can face.

“In African-American and Hispanic women, the incidence of breast cancer is actually lower than in Caucasian women; however, the morbidity is much greater,” Dunphy said. “That’s likely in part because minority women are diagnosed at a later stage.”

“The disease process – as well as treatments – can wipe out a patient to the point that bending over and tying your shoe will become very difficult,” said Larry Gluck, M.D, medical director of the GHS Cancer Center. “But we know that with exercise, there’s something occurring at a cellular level, and that patients enrolled in an exercise program have a much greater chance of fighting that fatigue and regaining some quality of life.”

To remedy that disparity, the BHPN Program gives women who meet the criteria an opportunity to have a mammogram and to meet with a doctor to discuss any findings – at no cost.

In Moving On, a customized physical activity regimen is developed by an exercise conditioning specialist from the GHS Life Center® Health & Conditioning Club

GHS’ comprehensive Breast Health Program means upstate residents can combine high-quality medical science and compassionate care without going far from home. Its efforts have been rewarded: GHS’ Breast Health Program was first in the Upstate to receive full accreditation by the National Accreditation Program for Breast Centers.

The goal of the Breast Health Program is to become the Upstate’s go-to center for any breast problem. “We want to make getting answers easy and straightforward,” said Dr. McKinley, “starting with one central number women can call to see where to go next.” That number is (864) 454-8282.

Take care of your breast health! Call (864) 455-8282 or visit ghs.org/breasthealth.

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New Surgery Is a STAR Older Americans have become accustomed to conversation about the latest knee or hip replacement among their peers. Now, another joint is joining the ranks of those that can be replaced with artificial implants to manage severe arthritis pain.

For years, those who opted for surgery to ease the pain from ankle arthritis had only one option – fusion surgery, in which the worn-out part of the joint is removed and the ankle bones are fused, locking the joint at a 90-degree angle.

New alternatives are appearing on the scene as Americans warm to the idea of ankle replacement surgery. One is the Scandinavian Total Ankle Replacement (STAR) system, a method that has been popular in Europe for more than a decade.

Brian Weatherby, M.D., a surgeon with GHS’ Steadman Hawkins Clinic of the Carolinas (SHCC), recently performed the first STAR surgery in the state. His patient, Chevis Boozer of Mauldin, had been waging an ever-more-painful battle with arthritis in his ankle. The battle began many years ago, although he didn’t realize it.

“I twisted my ankle coaching Little League football more than 30 years ago,” Boozer said. “Of course, I was young then, and it didn’t bother me that much, so I never did anything about it. As I got older, though, it started giving me problems.”

No More Pain The doctor was Dr. Weatherby, and he told Boozer he was a great candidate for the new procedure. After hearing the facts, Boozer agreed and underwent the surgery in January 2010.

Dr. Weatherby explained the specifics of the STAR system as a threepart, mobile-bearing implant consisting of a metal tibial component (the leg bone part), a metal talar component (the ankle bone part) and a piece that slides between those made of polyethylene plastic. This separate, freely mobile piece of polyethylene plastic is one of the design characteristics that makes STAR unique. Most other implants used in ankle replacement surgery have the polyethylene attached or anchored to the metal tibial component.

“Some data say that the three-part implant is more biomechanically sound and shares the forces that are distributed across it in a more manageable fashion,” Dr. Weatherby explained.

When the pain became severe a few years ago, he talked to an orthopaedist at SHCC. At the time, he was told his only option was fusion surgery.

“I didn’t want to do that,” Boozer said. “So I decided to just live with it.”

But by November 2009, Boozer recalled, “It got so bad that I couldn’t stand it. I couldn’t walk either uphill or down. It got to where I’d have to walk sideways. I couldn’t bend my ankle at all.”

He resigned himself to having the fusion surgery. But this time when he visited SHCC, he was told a doctor on staff might be able to present him with an alternative. ghs.org • 1-877-GHS-INFO (447-4636) • Inside Health vol. 12.1

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Chevis Boozer enjoys a family vacation to Alaska with his wife, children and grandchildren.

The surgery and a regimen of physical therapy have allowed Boozer to get back on his feet without the crippling pain he once endured. It enabled him to enjoy a special trip to Alaska last summer with his wife and their children and grandchildren to celebrate the couple’s 50th wedding anniversary.

“I wanted to be able to walk the glaciers and do fun things,” Boozer said. “It’s been a real blessing to have had the surgery done.”’

STAR Leads the Way While Dr. Weatherby echoes the benefits of the STAR system, when it comes to pain reduction and preservation of motion, he points out that it’s not a procedure that will necessarily guarantee an improvement in joint motion.

“Joint replacement surgery is a great thing,” Dr. Weatherby said. “It’s mainly a pain operation. You want to take patients’ pain away, first and foremost, with the secondary goal being maintenance of their motion. But it’s not a surgery to improve somebody’s ankle motion.”

He continued, “Patients are not supposed to do any high-impact activity with an ankle replacement. So they shouldn’t be playing tennis or running or anything like that. But they can still do lower-demand, lower-impact type activities.”

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While Boozer heartily recommends the STAR surgery to people in similar situations as his, and Dr. Weatherby is quick to suggest it to appropriate candidates, the surgery is not yet mainstream. The STAR system was approved by the Federal Food and Drug Administration in May 2009, making it the only ankle replacement system with that designation. Success stories such as Boozer’s are raising awareness and acceptance of the STAR procedure.

“When something new comes out in orthopaedics, you don’t want to be the first to jump on the bandwagon, and you don’t want to be the last,” Dr. Weatherby said. “But this procedure has gained a lot of believers and a lot of supporters in the medical community, and I’m definitely one of them. It has the evidenced-based medicine to back it up.”

Dr. Weatherby was trained in the new system in the summer of 2009 during a Foot and Ankle fellowship at the Foundation for Orthopaedic, Athletic and Reconstructive Research at the University of Texas– Houston. There, he assisted his mentor, Thomas Clanton, M.D., in a series of STAR surgeries.

“I would recommend it in a heartbeat for anyone with the kind of pain I had,” Boozer said. “When you get to the point where you can’t walk, you’ve got to do something. I was even willing to fuse it but was fortunate to have an alternative.”

For more information about this or other orthopaedic services, visit ghs.org/STAR. To schedule a consultation with Dr. Weatherby or another SHCC orthopaedic specialist, call (864) 454-SHCC (7422).

Q&A A New Kind of Family Doctor Jeremy Byrd, M.D., is with Heritage Pediatrics & Internal Medicine, a part of Greenville Hospital System (GHS) University Medical Group, GHS’ multispecialty physician group practice.

He answers questions about the field of internal medicine-pediatrics.

Q. What are the benefits of seeing an internal medicine-pediatrics physician?

A. We are uniquely adept at treating adults with the diseases of childhood such as sickle cell disease, autism, congenital heart disease, cystic fibrosis, childhood malignancies and genetic disorders (such as Down syndrome).

Q. What is an internal medicine-pediatrics doctor?

A. Internal medicine-pediatrics physicians treat adults and children. We complete four years of medical school, then four more years of specialized training: two in internal medicine and two in pediatrics.

On the other hand, we are trained to treat children who have developed “adult” diseases such as diabetes, hypertension, obesity, sleep apnea and high cholesterol.

Q. How are they board certified?

A. We can become board certified both in internal medicine and in pediatrics – as are all the physicians in our practice.

Q. How are internal medicine-pediatrics physicians different from family medicine doctors?

A. Some overlap exists, but the training is different.

The typical family practitioner receives four to six months of formal training in pediatrics vs. two years for the internal medicine-pediatrics physician.

While we are especially suited to treat people with these conditions, at Heritage Pediatrics & Internal Medicine, we see all patients.

Q. Is there an advantage to family members seeing the same doctor?

A. Yes. Caring for multiple generations of the same family lends the physician a better comprehension of family dynamics, disease state and the impact of acute or chronic illness at all ages. Patients and families may form long-term relationships with their health provider over several decades.

Q. Why did you choose to become an internal medicine-pediatrics physician?

A. I enjoy the challenge of combining the skills, wisdom and dedication of a pediatrician and an internist in one physician. And I enjoy taking care of “kids” of all ages (parents and grandparents included)!

Heritage Pediatrics & Internal Medicine, the Upstate’s only internal medicine-pediatrics practice, is located at 727 S.E. Main St., Suite 320, Simpsonville (864) 454-6440. For more information, visit heritagemedpeds.com.

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SPOTLIGHT

on Technology

Telemedicine Extends Direct Treatment for Stroke In early 2010, Greenville Hospital System University Medical Center (GHS) initiated the NeuroDirect telemedicine system. Using web-based technology, neurologists at GHS’ Greenville Memorial Hospital (GMH) provide acute stroke consults via telemedicine to emergency departments at the system’s Greer and Hillcrest hospitals as well as to Baptist Easley Hospital in Pickens County. NeuroDirect allows neurologists at GMH to collaborate remotely with ER physicians and nurses to rapidly assess and treat patients with symptom duration under 4.5 hours – the critical window for receiving tPA, a powerful clot-dissolving medication that can minimize, even reverse, effects of stroke.

Gardziola

Hughes

A secure, private, Internet-based program, NeuroDirect employs a two-way camera system. The neurologist can see and speak with the patient, family and staff, and vice versa, as if present in the room.

“When there is no neurologist in-house, NeuroDirect enables us to be in two places at once,” stated Gregory Gardziola, D.O., director of GHS’ Stroke Program.

Fellowship-trained in vascular neurology and neurocritical care, Dr. Gardziola teaches stroke protocols to NeuroDirect partner hospitals such

Data from a patient’s test are sent from an outlying facility via web-based technology to a specialist at another hospital, who reviews the test results and then advises the patient’s physician.

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as Baptist Easley, which has had approximately 10 emergency stroke cases since its first consult in April.

“Forty percent of those patients were able to receive tPA because they were within the benchmark,” said Scott Parker, M.D., medical director of Baptist Easley Hospital. “That’s directly attributable to the consults with GHS, frequent communication with GHS physicians, standardized protocols, backup technology in place and ongoing training.”

Mary Hughes, M.D., chair, GHS Division of Neurology, helped establish NeuroDirect at GHS and anticipates that its success will expand telemedicine to other uses.

The Duke Endowment already is funding a psychiatry model to help rural hospitals evaluate and triage patients with psychoses.

“I see a potential for greater applications, for example, the assessment of hemorrhage in the ER by a neurosurgeon,” said Dr. Hughes. “I think new uses for telemedicine will develop.”

In the meantime, extending neurologic expertise through technology to other area hospitals is the next step in improving patient care for GHS’ certified Primary Stroke Center.

CLINICAL

Trials

Hundreds of clinical trials are conducted throughout Greenville Hospital System University Medical Center on a variety of drug therapies, surgical devices and other treatments in all areas of medicine. The following participants are needed for trials: Women Interested in Contraception This study tests the safety and effectiveness of a birth control pill for the prevention of pregnancy. The cycle length for this study is 91 days instead of the usual 28-day cycle. To qualify, you must be 18 to 40 years of age, sexually active and have regular menstrual cycles. Qualified participants will receive study-related exams, lab tests and study drug at no charge, and may receive up to $450 for time and travel. Call Chrystal at (864) 455-4872.

Pregnant Women With Preterm Birth Concerns You may qualify for this research study if you have had a previous single-baby preterm delivery, are currently pregnant and expecting only one baby, are currently less that 20 weeks pregnant and are at least 18 years old. Call Allison at (864) 455-6203 (devotedtobabies.com).

participants will receive the study drug and studyrelated medical care at no cost and may also receive compensation for time and travel. Call Jane at (864) 454-2818 or visit www.veinstudy.com.

Persons With Fibromuscular Dysplasia (FMD) In conjunction with the Fibromuscular Dysplasia Society of America, the GHS Vascular Health Alliance is enrolling patients in an international registry to learn more about this rare condition. Since FMD is not commonly recognized and often misdiagnosed, the only way to gather enough information to learn how to better diagnose and treat patients is to form a data registry that allows collection of many cases from multiple institutions. With large numbers of cases, physicians can create statistical models that can accurately predict which tests/procedures/ medications result in the best outcomes. If you have been diagnosed with FMD and are interested in hearing more about the FMD Registry, call Catriona at (864) 455-9833.

People With Obstructive Superficial Femoral Artery Disease

Persons With Varicose Veins If you are between the ages of 18 and 75 and have varicose veins that are enlarged, swollen or bulging, and rise above the surface of your skin, you may qualify for this study. This study will evaluate an investigational drug for varicose veins, and it will involve a non-surgical outpatient procedure. Qualified

This study evaluates the safety and efficacy of using a stent to open up an artery in the leg. To qualify, you must be 30 or older, have significant pain due to a narrowing (stenosis) of one of the main arteries in your leg, the superficial femoral artery (SFA). You must not have any ulcers or other open wounds on the leg. Participants will be expected to follow up at regular intervals and may be compensated for travel expenses incurred throughout the study. Call Catriona at (864) 455-9833.

For information on other clinical trials at GHS, visit ghs.org/research.

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PRACTICE

Profiles

These leading primary care practices of Greenville Hospital System University Medical Group are at the West Georgia Road area in Simpsonville.

Christie Pediatrics, the area’s oldest pediatric practice, has opened its first office in Simpsonville. Nine doctors enjoy a range of special medical interests – but all share a special interest in your child. Its board certified physicians are E. Vernon Anderson Jr., Pamela Chivers, Stephen Lookadoo Jr., James Nichols Jr., Joseph Pool, Kevin Springle, Jeffrey Stoeber and William Wylie Jr.; Andrea Nesbit is board eligible. 1409 W. Georgia Road, Suite A • (864) 454-5062

Anderson

Chivers

Lookadoo

Nesbit

Nichols

Pool

Springle

Stoeber

Wylie

For Cypress Internal Medicine–Simpsonville, it’s a new address but the same great staff. Cypress’ physicians are as committed to keeping you healthy through prevention as they are to healing you when you’re ill. Its board certified doctors are Banks Cates III, Patricia Cheek and Nanette Dendy. 1409 W. Georgia Road, Suite D • (864) 454-6540

Cates

Cheek

Dendy

With a new name (formerly West Butler Family Medicine), new address and two new doctors, Keystone Family Medicine provides personalized, expert care – the keystone of your family’s health. Its board certified physicians are J. Duncan Burnette, Long Hoang, Thomas Moore Jr. and Rebecca Smith. 1409 W. Georgia Road, Suite B • (864) 454-5000

Burnette

Hoang

Moore

Smith

For a complete listing of our primary and specialty care physicians, please visit ghs.org/umg or call 1-877-GHS-INFO (447-4636).

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UMG

Directory

Greenville Hospital System University Medical Group Directory (keep for reference)

Primary Care Practices Finding a primary care physician … it may be something you’ve been meaning to do. And the best time to establish a medical home is before you get sick – and no referral is needed.

If you’re looking for a doctor, try University Medical Group (UMG), the multi-specialty medical group practice of Greenville Hospital System University Medical Center (GHS). UMG is one of the nation’s 20 largest multi-specialty group practices and the state’s largest multi-specialty group, with more than 550 physicians providing medical and consultative services. UMG primary care practices are located throughout upstate South Carolina, offering convenient access to primary care services on a daily basis.

Our healthcare professionals strive to provide excellence in medical practice, making use of the best that evidenced-based medicine, innovative technologies and clinical research have to offer. As part of Greenville Hospital System, they have access to the most sophisticated healthcare services in the Upstate. Together, they provide the most advanced care, keeping patients close to home for even the most serious of conditions.

FAMILY MEDICINE Center for Family Medicine 877 W. Faris Rd., 29605 455-7800 Family Medicine–Pelham Pointe 81 Pointe Circle, 29615 232-0321 Family Medicine–Powdersville 207 Three Bridges Rd., 29611 269-5567 Greenville Family Practice 2-A Cleveland Ct., 29607 271-7761 Greer Family Medicine 1107 W. Poinsett St., Greer, 29651 879-8886 Keystone Family Medicine (formerly West Butler Family Medicine) 1409 W. Georgia Rd., Ste. B Simpsonville, 29680 454-5000 Laurens Family Practice 106 Parkview Dr., Laurens, 29360 984-0571 9100 Hwy. 14, Gray Court, 29645 876-4888

Mountain View Family Practice– Memorial Drive 406 Memorial Dr. Ext., Greer, 29651 877-9066 Palmetto Medical Associates 210 Freeman Farm Rd., Duncan, 29334 968-5123 Riverside Family Practice–Eastside 215 Halton Rd., 29607 454-2700 Riverside Family Practice–Maxwell Pointe 3909 S. Hwy. 14, 29615 627-8878 Travelers Rest Family Practice 9 McElhaney Rd., Travelers Rest, 29690 834-3192 INTERNAL MEDICINE Cross Creek Internal Medicine 109 Doctors Dr., 29605 797-7035 Cypress Internal Medicine–Greer 315 Medical Pkwy., Ste. 200, Greer, 29650 797-9550

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Cypress Internal Medicine–Maxwell Pointe 3907 S. Hwy. 14, 29615 675-1491 Cypress Internal Medicine–Patewood 200 Patewood Dr., Ste. B460, 29615 454-2226 Cypress Internal Medicine–Simpsonville (formerly Cypress Internal Medicine–Hillcrest) 1409 W. Georgia Rd., Ste. D Simpsonville, 29680 454-6540 Internal Medicine Associates of Greenville 1025 Verdae Blvd., Ste. A, 29607 242-4683 3308 Brushy Creek Rd., Greer, 29651 752-2000 OB/GYN Greenville Ob Gyn Associates 2 Memorial Medical Dr., 29605 295-4210 1025 Verdae Blvd., Ste. F, 29607 286-7500 727 S.E. Main St., Ste. 120, Simpsonville, 29681 454-6500 Greer OB/GYN 325 Medical Pkwy., Ste. 100, Greer, 29650 797-9200 Gynecology Specialists 890 W. Faris Rd., Ste. 510, 29605 455-1600 101 Halton Village Circle, 29607 455-1600 Piedmont OB/GYN 890 W. Faris Rd., Ste. 330, 29605 455-1270 3917 S. Hwy. 14, 29615 234-0226 Premier Women’s Care 209 Three Bridges Rd., 29611 220-4209

PEDIATRICS AND INTERNAL MEDICINE Heritage Pediatrics & Internal Medicine 727 S.E. Main St., Ste. 320 Simpsonville, 29681 454-6440 PEDIATRICS Carolina Pediatrics of Greenville 200 Patewood Dr., Ste. A120, 29615 454-2670 The Children’s Clinic 1350 Cleveland St., 29607 271-1450 727 S.E. Main St., Ste. 100, Simpsonville, 29681 454-6520 325 Medical Pkwy., Ste. 150, Greer, 29650 797-9300 Christie Pediatric Group 9 Mills Ave., 29605 242-4840 3911 S. Hwy. 14, 29615 297-8890 1409 W. Georgia Rd., Ste. A, Simpsonville, 29680 454-5062 Pediatric Associates–Easley 800 N. A St., Easley, 29640 855-0001 Pediatric Associates–Greer 554-C Memorial Dr. Ext., Greer, 29651 879-3883 Pediatric Associates–Spartanburg 1686 Skylyn Dr., Ste. 201, Spartanburg, 29307 582-8135 Pediatric Rapid Access 57 Cross Park Ct., 29605 220-8909 MD360® URGENT CARE 300 Scuffletown Rd., Simpsonville, 29681 329-0029

For a complete listing of our primary and specialty care physicians, please visit ghs.org/umg or call 1-877-GHS-INFO (447-4636). The practices listed here are part of GHS Partners In Health Inc. and affiliated with GHS University Medical Group.

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Health I N S I D E

V o l . 12 . 1 W i n t e r 2 0 11

AROUND THE SYSTEM GHS was tapped as the January 2011 Studer Group® Health Care Organization of the Month in recognition of the hard work and dedication by the system’s staff and physicians in achieving clinical, service and operational excellence.

Greenville Memorial Medical Campus 701 Grove Road • Greenville New Accreditation A collaboration between GHS Cancer Center and Cancer Centers of the Carolinas, the Blood and Marrow Transplant Program has been awarded the Upstate’s only continuing accreditation by the Foundation for the Accreditation of Cellular Therapy for autologous stem cell transplantation and collection. (864) 370-1393

Community Blood Drive • The Blood Connection Fourth Monday monthly • Feb. 28, March 28, April 25, May 23 • 1:30-6:30 p.m. • North Greenville Hospital, Mobile

Patewood Medical Campus 200 Patewood Drive • Greenville Patewood Memorial Hospital received the Studer Excellence in Patient Care Award for quietness on the nursing unit.

Community Blood Drive • The Blood Connection Wed.-Thurs., May 18-19 • 9 a.m.-5 p.m. • GMH Conference Center

Community Blood Drive • The Blood Connection Wed., April 20 • 9:30 a.m.-2:30 p.m., Conf. Rm. A 11:30 a.m.-4:30 p.m., Bloodmobile, Building C

Greer Medical Campus

Simpsonville Medical Campus

313 Memorial Drive • Greer

729 S.E. Main Street • Simpsonville

Children’s Hospital–Greer offers pediatric inpatient services for conditions requiring a short medical stay.

Hillcrest Memorial Hospital garnered the Premier QUEST Top Performer Award for a second straight year, and its Emergency Trauma Center earned the Studer Excellence in Patient Care Award.

Community Blood Drive • The Blood Connection First Monday monthly • March 7, April 4, May 2 1-6 p.m. • Greer Campus, Mobile

Community Blood Drive • The Blood Connection Second Monday monthly • March 14, April 11, May 9 • 1-6 p.m. • Hillcrest Hospital Conference Room

North Greenville Medical Campus Highway 276 (N. Main Street) • Travelers Rest

Special Events Minority Health Summit Sat., April 16 • 9 a.m.-2 p.m. • Carolina First Center Donna Richardson Joyner will get the crowd moving with an interactive exercise demonstration.

This event, including lunch and breakout sessions, is free, but registration is required. Visit ghs.org or call toll-free 1-877-GHS-INFO (447-4636).

Dragon Boat Upstate Festival Sat., April 16 • 8 a.m.-5 p.m. • Lake Hartwell Join a team and paddle to cure cancer! This fundraiser includes great music, food and fun. Visit www.dragonboatupstatesc.org or e-mail gtrellue@ghs.org.

Inside Health is published by Greenville Hospital System University Medical Center as a community service. This information is for educational purposes solely – it should not take the place of medical advice or diagnoses made by healthcare professionals.

Greenville Hospital System is known for its comprehensive services and world-class physicians, in addition to being a university medical center and conducting leading-edge research.

However, our compassion and strength come from our people – 10,000 dedicated professionals, your neighbors, who work together to care for you and your family.

Editor-in-chief: Jerry R. Youkey, M.D. VP, Medical and Academic Services, Greenville Hospital System Art Direction: GHS Creative Services Contributing Writers: Claire Cross Leigh DeLozier Lark Reynolds For more information, contact Nancy Parker, Editor, Marketing Communications Greenville Hospital System 701 Grove Road Greenville, SC 29605-5601 (864) 797-7541

Every Woman Thurs., May 12 • 6:30 p.m. • Centre Stage Join us for Ungirdled Truths, the popular oneact play that presents an unvarnished look at women’s health issues, and for discussion with a physician panel. Refreshments served.

Opening This Year!

MD360 provides convenient, comprehensive care without an appointment. New location at 1025 Verdae Blvd., Ste. C, joins the one at 300 Scuffletown Road with early morning, late evening and weekend hours. Verdae (864) 286-7550 • Scuffletown (864) 329-0029

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© 2011 Greenville Hospital System 100133

NONPROFIT ORG. U.S. POSTAGE PAID GREENVILLE SC PERMIT NO. 842 701 Grove Road • Greenville, SC 29605-5601

GHS Vision Transform health care for the benefit of the people and communities we serve.

GHS Mission Heal compassionately. Teach Innovatively.

Improve constantly.

Are YOU at Risk for Type 2 Diabetes?

Thousands of children and adults in Greenville County are at risk for type 2 diabetes – a disease linked to heart disease and stroke. However, it often can be prevented! Take these small steps to for a healthy change: • Exercise 30 minutes every day – walking or cycling will make a difference in your overall health • Eat HEALTHY foods – fruits, vegetables and whole grains • Lose excess pounds – if you are overweight, losing just 5% of your body weight can make a difference

To learn more, visit ghs.org/preventdiabetes.

Physicians and clinical staff alike agree that Baptist Easley is a great place for patients to receive care, employees to work and physicians to practice medicine.

Kudos to GHS Affiliate Baptist Easley Hospital!

Baptist Easley was named one of the Best Places to Work in Health Care 2010 by Modern Healthcare (#40 of the top 100 hospitals in the country). Also, for the second year in a row, Baptist Easley received the Press Ganey Partner of Choice Award for ranking in the top 10 percent in the country for Patient, Employee and Physician satisfaction.

Finally, Baptist Easley recently received the S.C. Governor’s Gold Achiever Award for 2009, based on Malcolm Baldrige Quality Award criteria.

The Future of Cancer Care Is Now ITOR (Institute for Translational Oncology Research) of Greenville Hospital System University Medical Center is fighting cancer with innovative research, groundbreaking drugs developed on the fast track and clinical care that delivers life-sustaining hope. ITOR-ghs.org • (864) 455-3600

Visit our Web site: ghs.org

Greenville Hospital System

To see GHS’ 2010 Report to the Community, visit ghs.org/2010annualreport.

@ghs_org